A model for predicting air quality along highways.

DOT National Transportation Integrated Search

1973-01-01

The subject of this report is an air quality prediction model for highways, AIRPOL Version 2, July 1973. AIRPOL has been developed by modifying the basic Gaussian approach to gaseous dispersion. The resultant model is smooth and continuous throughout...

Model documentation for relations between continuous real-time and discrete water-quality constituents in Cheney Reservoir near Cheney, Kansas, 2001--2009

USGS Publications Warehouse

Stone, Mandy L.; Graham, Jennifer L.; Gatotho, Jackline W.

2013-01-01

Cheney Reservoir, located in south-central Kansas, is one of the primary water supplies for the city of Wichita, Kansas. The U.S. Geological Survey has operated a continuous real-time water-quality monitoring station in Cheney Reservoir since 2001; continuously measured physicochemical properties include specific conductance, pH, water temperature, dissolved oxygen, turbidity, fluorescence (wavelength range 650 to 700 nanometers; estimate of total chlorophyll), and reservoir elevation. Discrete water-quality samples were collected during 2001 through 2009 and analyzed for sediment, nutrients, taste-and-odor compounds, cyanotoxins, phytoplankton community composition, actinomycetes bacteria, and other water-quality measures. Regression models were developed to establish relations between discretely sampled constituent concentrations and continuously measured physicochemical properties to compute concentrations of constituents that are not easily measured in real time. The water-quality information in this report is important to the city of Wichita because it allows quantification and characterization of potential constituents of concern in Cheney Reservoir. This report updates linear regression models published in 2006 that were based on data collected during 2001 through 2003. The update uses discrete and continuous data collected during May 2001 through December 2009. Updated models to compute dissolved solids, sodium, chloride, and suspended solids were similar to previously published models. However, several other updated models changed substantially from previously published models. In addition to updating relations that were previously developed, models also were developed for four new constituents, including magnesium, dissolved phosphorus, actinomycetes bacteria, and the cyanotoxin microcystin. In addition, a conversion factor of 0.74 was established to convert the Yellow Springs Instruments (YSI) model 6026 turbidity sensor measurements to the newer YSI model 6136 sensor at the Cheney Reservoir site. Because a high percentage of geosmin and microcystin data were below analytical detection thresholds (censored data), multiple logistic regression was used to develop models that best explained the probability of geosmin and microcystin concentrations exceeding relevant thresholds. The geosmin and microcystin models are particularly important because geosmin is a taste-and-odor compound and microcystin is a cyanotoxin.

42 CFR § 512.413 - Quality measures and reporting for SHFFT model.

Code of Federal Regulations, 2010 CFR

2017-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL... 42 Public Health 5 2017-10-01 2017-10-01 false Quality measures and reporting for SHFFT model. Â... reporting for SHFFT model. (a) Required measures. (1) Hospital-Level Risk-Standardized Complication Rate...

Developmental trajectories of marital happiness in continuously married individuals: a group-based modeling approach.

PubMed

Anderson, Jared R; Van Ryzin, Mark J; Doherty, William J

2010-10-01

Most contemporary studies of change in marital quality over time have used growth curve modeling to describe continuously declining mean curves. However, there is some evidence that different trajectories of marital quality exist for different subpopulations. Group-based trajectory modeling provides the opportunity to conduct an empirical investigation of the variance in marital quality trajectories. We applied this method to analyze data from continuously married individuals from the Marital Instability over the Life Course Study (N = 706). Instead of a single continuously declining trajectory of marital happiness, we found 5 distinct trajectories. Nearly two thirds of participants reported high and stable levels of happiness over time, and the other one third showed either a pattern of continuous low happiness, low happiness that subsequently declined, or a curvilinear pattern of high happiness, decline, and recovery. Marital problems, time spent in shared activities, and (to a lesser degree) economic hardship were able to distinguish trajectory group membership. Our results suggest that marital happiness may have multiple distinct trajectories across reasonably diverse populations. Implications for theory, research, and practice are discussed.

Water quality and relation to taste-and-odor compounds in North Fork Ninnescah River and Cheney Reservoir, south-central Kansas, 1997-2003

USGS Publications Warehouse

Christensen, Victoria G.; Graham, Jennifer L.; Milligan, Chad R.; Pope, Larry M.; Ziegler, Andrew C.

2006-01-01

Regression models were developed between geosmin and the physical property measurements continuously recorded by water-quality monitors at each site. The geosmin regression model was applied to water-quality monitor measurements, providing a continuous estimate of geosmin for 2003. The city of Wichita will be able to use this type of analysis to determine the probability of when concentrations of geosmin are likely to be at or above the human detection level of 0.01 microgram per liter.

42 CFR § 512.400 - Quality measures and reporting-general.

Code of Federal Regulations, 2010 CFR

2017-10-01

... SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Quality Measures... EPM participant is eligible for reconciliation payments under § 512.305(d)(1)(iii), and for assigning...

Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

ERIC Educational Resources Information Center

Pietz, Victoria Lynn

2014-01-01

Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

Applying a Continuous Quality Improvement Model To Assess Institutional Effectiveness.

ERIC Educational Resources Information Center

Roberts, Keith

This handbook outlines techniques and processes for improving institutional effectiveness and ensuring continuous quality improvement, based on strategic planning activities at Wisconsin's Milwaukee Area Technical College (MATC). First, institutional effectiveness is defined and 17 core indicators of effectiveness developed by the Wisconsin…

42 CFR § 512.411 - Quality measures and reporting for AMI model.

Code of Federal Regulations, 2010 CFR

2017-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL... 42 Public Health 5 2017-10-01 2017-10-01 false Quality measures and reporting for AMI model. Â... reporting for AMI model. (a) Required measures. (1) Hospital 30-Day, All-Cause, Risk-Standardized Mortality...

42 CFR § 512.412 - Quality measures and reporting for CABG model.

Code of Federal Regulations, 2010 CFR

2017-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL... 42 Public Health 5 2017-10-01 2017-10-01 false Quality measures and reporting for CABG model. Â... reporting for CABG model. (a) Required measures. (1) Hospital 30-Day, All-Cause, Risk-Standardized Mortality...

Accreditation and Continuous Quality Improvement in Athletic Training Education.

ERIC Educational Resources Information Center

Peer, Kimberly S.; Rakich, Jonathon S.

2000-01-01

Describes the application of the continuous quality improvement model, commonly associated with the business sector, to entry-level athletic training education programs accredited by the Commission on the Accreditation of Allied Health Education Programs. After discussing historical perspectives on athletic training education programs, the paper…

42 CFR § 414.1330 - Quality performance category.

Code of Federal Regulations, 2010 CFR

2017-10-01

... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1330 Quality... comprise: (1) 60 percent of a MIPS eligible clinician's final score for MIPS payment year 2019. (2) 50...

40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Guideline on Air Quality Models W Appendix W to Part 51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS REQUIREMENTS FOR PREPARATION, ADOPTION, AND SUBMITTAL OF IMPLEMENTATION PLANS Pt. 51, App. W Appendix W to Part 51—Guideline on Air Quality Models...

Midwife-led continuity models versus other models of care for childbearing women.

PubMed

Sandall, Jane; Soltani, Hora; Gates, Simon; Shennan, Andrew; Devane, Declan

2016-04-28

Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led continuity models and other models of care. To compare midwife-led continuity models of care with other models of care for childbearing women and their infants. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (25 January 2016) and reference lists of retrieved studies. All published and unpublished trials in which pregnant women are randomly allocated to midwife-led continuity models of care or other models of care during pregnancy and birth. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach. We included 15 trials involving 17,674 women. We assessed the quality of the trial evidence for all primary outcomes (i.e. regional analgesia (epidural/spinal), caesarean birth, instrumental vaginal birth (forceps/vacuum), spontaneous vaginal birth, intact perineum, preterm birth (less than 37 weeks) and all fetal loss before and after 24 weeks plus neonatal death using the GRADE methodology: all primary outcomes were graded as of high quality.For the primary outcomes, women who had midwife-led continuity models of care were less likely to experience regional analgesia (average risk ratio (RR) 0.85, 95% confidence interval (CI) 0.78 to 0.92; participants = 17,674; studies = 14; high quality), instrumental vaginal birth (average RR 0.90, 95% CI 0.83 to 0.97; participants = 17,501; studies = 13; high quality), preterm birth less than 37 weeks (average RR 0.76, 95% CI 0.64 to 0.91; participants = 13,238; studies = eight; high quality) and less all fetal loss before and after 24 weeks plus neonatal death (average RR 0.84, 95% CI 0.71 to 0.99; participants = 17,561; studies = 13; high quality evidence). Women who had midwife-led continuity models of care were more likely to experience spontaneous vaginal birth (average RR 1.05, 95% CI 1.03 to 1.07; participants = 16,687; studies = 12; high quality). There were no differences between groups for caesarean births or intact perineum.For the secondary outcomes, women who had midwife-led continuity models of care were less likely to experience amniotomy (average RR 0.80, 95% CI 0.66 to 0.98; participants = 3253; studies = four), episiotomy (average RR 0.84, 95% CI 0.77 to 0.92; participants = 17,674; studies = 14) and fetal loss less than 24 weeks and neonatal death (average RR 0.81, 95% CI 0.67 to 0.98; participants = 15,645; studies = 11). Women who had midwife-led continuity models of care were more likely to experience no intrapartum analgesia/anaesthesia (average RR 1.21, 95% CI 1.06 to 1.37; participants = 10,499; studies = seven), have a longer mean length of labour (hours) (mean difference (MD) 0.50, 95% CI 0.27 to 0.74; participants = 3328; studies = three) and more likely to be attended at birth by a known midwife (average RR 7.04, 95% CI 4.48 to 11.08; participants = 6917; studies = seven). There were no differences between groups for fetal loss equal to/after 24 weeks and neonatal death, induction of labour, antenatal hospitalisation, antepartum haemorrhage, augmentation/artificial oxytocin during labour, opiate analgesia, perineal laceration requiring suturing, postpartum haemorrhage, breastfeeding initiation, low birthweight infant, five-minute Apgar score less than or equal to seven, neonatal convulsions, admission of infant to special care or neonatal intensive care unit(s) or in mean length of neonatal hospital stay (days).Due to a lack of consistency in measuring women's satisfaction and assessing the cost of various maternity models, these outcomes were reported narratively. The majority of included studies reported a higher rate of maternal satisfaction in midwife-led continuity models of care. Similarly, there was a trend towards a cost-saving effect for midwife-led continuity care compared to other care models. This review suggests that women who received midwife-led continuity models of care were less likely to experience intervention and more likely to be satisfied with their care with at least comparable adverse outcomes for women or their infants than women who received other models of care.Further research is needed to explore findings of fewer preterm births and fewer fetal deaths less than 24 weeks, and all fetal loss/neonatal death associated with midwife-led continuity models of care.

Model documentation for relations between continuous real-time and discrete water-quality constituents in Indian Creek, Johnson County, Kansas, June 2004 through May 2013

USGS Publications Warehouse

Stone, Mandy L.; Graham, Jennifer L.

2014-01-01

Johnson County is the fastest growing county in Kansas, with a population of about 560,000 people in 2012. Urban growth and development can have substantial effects on water quality, and streams in Johnson County are affected by nonpoint-source pollutants from stormwater runoff and point-source discharges such as municipal wastewater effluent. Understanding of current (2014) water-quality conditions and the effects of urbanization is critical for the protection and remediation of aquatic resources in Johnson County, Kansas and downstream reaches located elsewhere. The Indian Creek Basin is 194 square kilometers and includes parts of Johnson County, Kansas and Jackson County, Missouri. Approximately 86 percent of the Indian Creek Basin is located in Johnson County, Kansas. The U.S. Geological Survey, in cooperation with Johnson County Wastewater, operated a series of six continuous real-time water-quality monitoring stations in the Indian Creek Basin during June 2011 through May 2013; one of these sites has been operating since February 2004. Five monitoring sites were located on Indian Creek and one site was located on Tomahawk Creek. The purpose of this report is to document regression models that establish relations between continuously measured water-quality properties and discretely collected water-quality constituents. Continuously measured water-quality properties include streamflow, specific conductance, pH, water temperature, dissolved oxygen, turbidity, and nitrate. Discrete water-quality samples were collected during June 2011 through May 2013 at five new sites and June 2004 through May 2013 at a long-term site and analyzed for sediment, nutrients, bacteria, and other water-quality constituents. Regression models were developed to establish relations between discretely sampled constituent concentrations and continuously measured physical properties to estimate concentrations of those constituents of interest that are not easily measured in real time because of limitations in sensor technology and fiscal constraints. Regression models for 28 water-quality constituents were developed and documented. The water-quality information in this report is important to Johnson County Wastewater because it allows the concentrations of many potential pollutants of interest, including nutrients and sediment, to be estimated in real time and characterized during conditions and time scales that would not be possible otherwise.

Enforcement of continuous compliance with air quality regulations

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

Harrington, C.W.

1985-01-01

The compliance of stationary air-pollution sources with air quality regulations is examined. Contrary to the predictions of economic models of enforcement, sources are generally in continuous compliance with the regulations. An alternative voluntary compliance model of enforcement is proposed, in which regulated sources are penalized not for violations, but for failing to return to compliance when a violation is discovered. It is argued that continuous compliance is a bargain struck between the source and the regulatory agency, in which the agency agrees to avoid use of penalties in return for the source's good faith attempts to maintain compliance.

Real-time, continuous water-quality monitoring in Indiana and Kentucky

USGS Publications Warehouse

Shoda, Megan E.; Lathrop, Timothy R.; Risch, Martin R.

2015-01-01

Water-quality “super” gages (also known as “sentry” gages) provide real-time, continuous measurements of the physical and chemical characteristics of stream water at or near selected U.S. Geological Survey (USGS) streamgages in Indiana and Kentucky. A super gage includes streamflow and water-quality instrumentation and representative stream sample collection for laboratory analysis. USGS scientists can use statistical surrogate models to relate instrument values to analyzed chemical concentrations at a super gage. Real-time, continuous and laboratory-analyzed concentration and load data are publicly accessible on USGS Web pages.

APPLICATION OF THE MODELS-3 COMMUNITY MULTI-SCALE AIR QUALITY (CMAQ) MODEL SYSTEM TO SOS/NASHVILLE 1999

EPA Science Inventory

The Models-3 Community Multi-scale Air Quality (CMAQ) model, first released by the USEPA in 1999 (Byun and Ching. 1999), continues to be developed and evaluated. The principal components of the CMAQ system include a comprehensive emission processor known as the Sparse Matrix O...

Continuous quality improvement: a shared governance model that maximizes agent-specific knowledge.

PubMed

Burkoski, Vanessa; Yoon, Jennifer

2013-01-01

Motivate, Innovate, Celebrate: an innovative shared governance model through the establishment of continuous quality improvement (CQI) councils was implemented across the London Health Sciences Centre (LHSC). The model leverages agent-specific knowledge at the point of care and provides a structure aimed at building human resources capacity and sustaining enhancements to quality and safe care delivery. Interprofessional and cross-functional teams work through the CQI councils to identify, formulate, execute and evaluate CQI initiatives. In addition to a structure that facilitates collaboration, accountability and ownership, a corporate CQI Steering Committee provides the forum for scaling up and spreading this model. Point-of-care staff, clinical management and educators were trained in LEAN methodology and patient experience-based design to ensure sufficient knowledge and resources to support the implementation.

A Hybrid Approach for Estimating Total Deposition in the ...

EPA Pesticide Factsheets

Atmospheric deposition of nitrogen and sulfur causes many deleterious effects on ecosystems including acidification and excess eutrophication. Assessments to support development of strategies to mitigate these effects require spatially and temporally continuous values of nitrogen and sulfur deposition. In the U.S., national monitoring networks exist that provide values of wet and dry deposition at discrete locations. While wet deposition can be interpolated between the monitoring locations, dry deposition cannot. Additionally, monitoring networks do not measure the complete suite of chemicals that contribute to total sulfur and nitrogen deposition. Regional air quality models provide spatially continuous values of deposition of monitored species as well as important unmeasured species. However, air quality modeling values are not generally available for an extended continuous time period. Air quality modeling results may also be biased for some chemical species. We developed a novel approach for estimating dry deposition using data from monitoring networks such as the Clean Air Status and Trends Network (CASTNET), the National Atmospheric Deposition Program (NADP) Ammonia Monitoring Network (AMoN), and the Southeastern Aerosol Research and Characterization (SEARCH) network and modeled data from the Community Multiscale Air Quality (CMAQ) model. These dry deposition values estimates are then combined with wet deposition values from the NADP National Trends Networ

A Novel Hybrid Approach for Estimating Total Deposition in ...

EPA Pesticide Factsheets

Atmospheric deposition of nitrogen and sulfur causes many deleterious effects on ecosystems including acidification and excess eutrophication. Assessments to support development of strategies to mitigate these effects require spatially and temporally continuous values of nitrogen and sulfur deposition. In the U.S., national monitoring networks exist that provide values of wet and dry deposition at discrete locations. While wet deposition can be interpolated between the monitoring locations, dry deposition cannot. Additionally, monitoring networks do not measure the complete suite of chemicals that contribute to total sulfur and nitrogen deposition. Regional air quality models provide spatially continuous values of deposition of monitored species as well as important unmeasured species. However, air quality modeling values are not generally available for an extended continuous time period. Air quality modeling results may also be biased for some chemical species. We developed a novel approach for estimating dry deposition using data from monitoring networks such as the Clean Air Status and Trends Network (CASTNET), the National Atmospheric Deposition Program (NADP) Ammonia Monitoring Network (AMoN), and the Southeastern Aerosol Research and Characterization (SEARCH) network and modeled data from the Community Multiscale Air Quality (CMAQ) model. These dry deposition values estimates are then combined with wet deposition values from the NADP National Trends Networ

40 CFR 52.1824 - Review of new sources and modifications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) North Dakota § 52.1824... the language contained in the North Dakota Administrative Code on the use of the EPA “Guideline on Air Quality Models” as supplemented by the “North Dakota Guideline for Air Quality Modeling Analysis”.In a...

40 CFR 52.1824 - Review of new sources and modifications.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) North Dakota § 52.1824... the language contained in the North Dakota Administrative Code on the use of the EPA “Guideline on Air Quality Models” as supplemented by the “North Dakota Guideline for Air Quality Modeling Analysis”.In a...

40 CFR 52.1824 - Review of new sources and modifications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) North Dakota § 52.1824... the language contained in the North Dakota Administrative Code on the use of the EPA “Guideline on Air Quality Models” as supplemented by the “North Dakota Guideline for Air Quality Modeling Analysis”.In a...

Is Bigger Better? Customer Base Expansion through Word-of-Mouth Reputation

ERIC Educational Resources Information Center

Rob, Rafael; Fishman, Arthur

2005-01-01

A model of gradual reputation formation through a process of continuous investment in product quality is developed. We assume that the ability to produce high-quality products requires continuous investment and that as a consequence of informational frictions, such as search costs, information about firms' past performance diffuses only gradually…

Incorporating principal component analysis into air quality model evaluation

EPA Science Inventory

The efficacy of standard air quality model evaluation techniques is becoming compromised as the simulation periods continue to lengthen in response to ever increasing computing capacity. Accordingly, the purpose of this paper is to demonstrate a statistical approach called Princi...

Development Design Model of Academic Quality Assurance at Private Islamic University Jakarta Indonesia

ERIC Educational Resources Information Center

Suprihatin, Krebet; Bin Mohamad Yusof, Hj. Abdul Raheem

2015-01-01

This study aims to evaluate the practice of academic quality assurance in design model based on seven aspects of quality are: curriculum design, teaching and learning, student assessment, student selection, support services, learning resources, and continuous improvement. The design study was conducted in two stages. The first stage is to obtain…

Users' Continuance Intention of Virtual Learning Community Services: The Moderating Role of Usage Experience

ERIC Educational Resources Information Center

Zhang, Min; Liu, Yupei; Yan, Weiwei; Zhang, Yan

2017-01-01

Users' continuance intention plays a significant role in the process of information system (IS) service, especially virtual learning community (VLC) services. Following the IS success model and IS post-acceptance model, this study explores the determinants of users' intention to continue using VLCs' service from the perspective of quality,…

Midwife-led continuity models versus other models of care for childbearing women.

PubMed

Sandall, Jane; Soltani, Hora; Gates, Simon; Shennan, Andrew; Devane, Declan

2015-09-15

Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led continuity models and other models of care. To compare midwife-led continuity models of care with other models of care for childbearing women and their infants. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2015) and reference lists of retrieved studies. All published and unpublished trials in which pregnant women are randomly allocated to midwife-led continuity models of care or other models of care during pregnancy and birth. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We included 15 trials involving 17,674 women. We assessed the quality of the trial evidence for all primary outcomes (i.e., regional analgesia (epidural/spinal), caesarean birth, instrumental vaginal birth (forceps/vacuum), spontaneous vaginal birth, intact perineum, preterm birth (less than 37 weeks) and overall fetal loss and neonatal death (fetal loss was assessed by gestation using 24 weeks as the cut-off for viability in many countries) using the GRADE methodology: All primary outcomes were graded as of high quality.For the primary outcomes, women who had midwife-led continuity models of care were less likely to experience regional analgesia (average risk ratio (RR) 0.85, 95% confidence interval (CI) 0.78 to 0.92; participants = 17,674; studies = 14; high quality), instrumental vaginal birth (average RR 0.90, 95% CI 0.83 to 0.97; participants = 17,501; studies = 13; high quality), preterm birth less than 37 weeks (average RR 0.76, 95% CI 0.64 to 0.91; participants = 13,238; studies = 8; high quality) and less overall fetal/neonatal death (average RR 0.84, 95% CI 0.71 to 0.99; participants = 17,561; studies = 13; high quality evidence). Women who had midwife-led continuity models of care were more likely to experience spontaneous vaginal birth (average RR 1.05, 95% CI 1.03 to 1.07; participants = 16,687; studies = 12; high quality). There were no differences between groups for caesarean births or intact perineum.For the secondary outcomes, women who had midwife-led continuity models of care were less likely to experience amniotomy (average RR 0.80, 95% CI 0.66 to 0.98; participants = 3253; studies = 4), episiotomy (average RR 0.84, 95% CI 0.77 to 0.92; participants = 17,674; studies = 14) and fetal loss/neonatal death before 24 weeks (average RR 0.81, 95% CI 0.67 to 0.98; participants = 15,645; studies = 11). Women who had midwife-led continuity models of care were more likely to experience no intrapartum analgesia/anaesthesia (average RR 1.21, 95% CI 1.06 to 1.37; participants = 10,499; studies = 7), have a longer mean length of labour (hours) (mean difference (MD) 0.50, 95% CI 0.27 to 0.74; participants = 3328; studies = 3) and more likely to be attended at birth by a known midwife (average RR 7.04, 95% CI 4.48 to 11.08; participants = 6917; studies = 7). There were no differences between groups for fetal loss or neonatal death more than or equal to 24 weeks, induction of labour, antenatal hospitalisation, antepartum haemorrhage, augmentation/artificial oxytocin during labour, opiate analgesia, perineal laceration requiring suturing, postpartum haemorrhage, breastfeeding initiation, low birthweight infant, five-minute Apgar score less than or equal to seven, neonatal convulsions, admission of infant to special care or neonatal intensive care unit(s) or in mean length of neonatal hospital stay (days).Due to a lack of consistency in measuring women's satisfaction and assessing the cost of various maternity models, these outcomes were reported narratively. The majority of included studies reported a higher rate of maternal satisfaction in midwife-led continuity models of care. Similarly, there was a trend towards a cost-saving effect for midwife-led continuity care compared to other care models. This review suggests that women who received midwife-led continuity models of care were less likely to experience intervention and more likely to be satisfied with their care with at least comparable adverse outcomes for women or their infants than women who received other models of care.Further research is needed to explore findings of fewer preterm births and fewer fetal deaths less than 24 weeks, and overall fetal loss/neonatal death associated with midwife-led continuity models of care.

Impact of length of calibration period on the APEX model water quantity and quality simulation performance

USDA-ARS?s Scientific Manuscript database

Availability of continuous long-term measured data for model calibration and validation is limited due to time and resources constraints. As a result, hydrologic and water quality models are calibrated and, if possible, validated when measured data is available. Past work reported on the impact of t...

MODELING CONSISTENCY, MODEL QUALITY, AND FOSTERING CONTINUED IMPROVEMENT

EPA Science Inventory

We believe that most contributors to and participants of the International Conference, Marine Waste Water Discharges 2000, "MWWD 2000," could agree that the overarching dream of the conference might be to chart a path the will lead to the best, long-term, applicable water quality...

CHOOSING A CHEMICAL MECHANISM FOR REGULATORY AND RESEARCH AIR QUALITY MODELING APPLICATIONS

EPA Science Inventory

There are numerous, different chemical mechanisms currently available for use in air quality models, and new mechanisms and versions of mechanisms are continually being developed. The development of Morphecule-type mechanisms will add a near-infinite number of additional mecha...

Promoting Continuous Quality Improvement in Online Teaching: The META Model

ERIC Educational Resources Information Center

Dittmar, Eileen; McCracken, Holly

2012-01-01

Experienced e-learning faculty members share strategies for implementing a comprehensive postsecondary faculty development program essential to continuous improvement of instructional skills. The high-impact META Model (centered around Mentoring, Engagement, Technology, and Assessment) promotes information sharing and content creation, and fosters…

Storm Water Management Model Reference Manual Volume III – Water Quality

EPA Science Inventory

SWMM is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. The runoff component of SWMM operates on a collection of subcatchment areas that receive precipitation and gene...

A novel hybrid approach for estimating total deposition in the United States

NASA Astrophysics Data System (ADS)

Schwede, Donna B.; Lear, Gary G.

2014-08-01

Atmospheric deposition of nitrogen and sulfur causes many deleterious effects on ecosystems including acidification and excess eutrophication. Assessments to support development of strategies to mitigate these effects require spatially and temporally continuous values of nitrogen and sulfur deposition. In the U.S., national monitoring networks exist that provide values of wet and dry deposition at discrete locations. While wet deposition can be interpolated between the monitoring locations, dry deposition cannot. Additionally, monitoring networks do not measure the complete suite of chemicals that contribute to total sulfur and nitrogen deposition. Regional air quality models provide spatially continuous values of deposition of monitored species as well as important unmeasured species. However, air quality modeling values are not generally available for an extended continuous time period. Air quality modeling results may also be biased for some chemical species. We developed a novel approach for estimating dry deposition using data from monitoring networks such as the Clean Air Status and Trends Network (CASTNET), the National Atmospheric Deposition Program (NADP) Ammonia Monitoring Network (AMoN), and the Southeastern Aerosol Research and Characterization (SEARCH) network and modeled data from the Community Multiscale Air Quality (CMAQ) model. These dry deposition values estimates are then combined with wet deposition values from the NADP National Trends Network (NTN) to develop values of total deposition of sulfur and nitrogen. Data developed using this method are made available via the CASTNET website.

Comparisons of Historical versus Synthetic Weather Inputs to Watershed Models and their Effect on Pollutant Loads

USDA-ARS?s Scientific Manuscript database

Synthetic weather generators are important for continuous-simulation of agricultural watersheds for risk analyses of downstream water quality. Many watersheds are sparsely or totally ungauged and daily weather must either be transposed or augmented. Since water quality models must recognize runoff...

USE OF REMOTE SENSING AIR QUALITY INFORMATION IN REGIONAL SCALE AIR POLLUTION MODELING: CURRENT USE AND REQUIREMENTS

EPA Science Inventory

In recent years the applications of regional air quality models are continuously being extended to address atmospheric pollution phenomenon from local to hemispheric spatial scales over time scales ranging from episodic to annual. The need to represent interactions between physic...

From Access to Excess: Changing Roles and Relationships for Distance Education, Continuing Education, and Academic Departments in American Universities

ERIC Educational Resources Information Center

Ashcroft, Judy Copeland

2013-01-01

In American universities, early distance education needed both continuing education and academic departments for establishing institutional cooperation, developing quality standards, adapting to change, and finding a funding model. Today, the Internet and the need for additional revenue are driving new distance education models.

Objective assessment of MPEG-2 video quality

NASA Astrophysics Data System (ADS)

Gastaldo, Paolo; Zunino, Rodolfo; Rovetta, Stefano

2002-07-01

The increasing use of video compression standards in broadcasting television systems has required, in recent years, the development of video quality measurements that take into account artifacts specifically caused by digital compression techniques. In this paper we present a methodology for the objective quality assessment of MPEG video streams by using circular back-propagation feedforward neural networks. Mapping neural networks can render nonlinear relationships between objective features and subjective judgments, thus avoiding any simplifying assumption on the complexity of the model. The neural network processes an instantaneous set of input values, and yields an associated estimate of perceived quality. Therefore, the neural-network approach turns objective quality assessment into adaptive modeling of subjective perception. The objective features used for the estimate are chosen according to the assessed relevance to perceived quality and are continuously extracted in real time from compressed video streams. The overall system mimics perception but does not require any analytical model of the underlying physical phenomenon. The capability to process compressed video streams represents an important advantage over existing approaches, like avoiding the stream-decoding process greatly enhances real-time performance. Experimental results confirm that the system provides satisfactory, continuous-time approximations for actual scoring curves concerning real test videos.

Health-related quality of life trajectories of methamphetamine-dependent individuals as a function of treatment completion and continued care over a 1-year period.

PubMed

Gonzales, Rachel; Ang, Alfonso; Marinelli-Casey, Patricia; Glik, Deborah C; Iguchi, Martin Y; Rawson, Richard A

2009-12-01

This study applies a chronic illness framework to evaluate treatment outcomes among individuals dependent on methamphetamine (MA). Using growth curve modeling, health-related quality of life (HRQOL) trajectories of MA-dependent individuals (N = 723) were examined over a 1-year period. Results show greater improvements in mental HRQOL trajectories as a function of treatment completion and continued care, although fairly static trajectories in physical health status. Other factors affecting HRQOL trajectories included gender, psychosocial functioning, drug use severity, and health impairment. Results extend research on treatment evaluations for MA dependence, highlighting the importance of continued service utilization for improved quality of life outcomes.

Visions, Strategic Planning, and Quality--More than Hype.

ERIC Educational Resources Information Center

Kaufman, Roger

1996-01-01

Discusses the need to shift from the old models for organizational development to the new methods of quality management and continuous improvement, visions and visioning, and strategic planning, despite inappropriate criticisms they receive. (AEF)

42 CFR § 414.1335 - Data submission criteria for the quality performance category.

Code of Federal Regulations, 2010 CFR

2017-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive...

Relations of water-quality constituent concentrations to surrogate measurements in the lower Platte River corridor, Nebraska, 2007 through 2011

USGS Publications Warehouse

Schaepe, Nathaniel J.; Soenksen, Philip J.; Rus, David L.

2014-01-01

The lower Platte River, Nebraska, provides drinking water, irrigation water, and in-stream flows for recreation, wildlife habitat, and vital habitats for several threatened and endangered species. The U.S. Geological Survey (USGS), in cooperation with the Lower Platte River Corridor Alliance (LPRCA) developed site-specific regression models for water-quality constituents at four sites (Shell Creek near Columbus, Nebraska [USGS site 06795500]; Elkhorn River at Waterloo, Nebr. [USGS site 06800500]; Salt Creek near Ashland, Nebr. [USGS site 06805000]; and Platte River at Louisville, Nebr. [USGS site 06805500]) in the lower Platte River corridor. The models were developed by relating continuously monitored water-quality properties (surrogate measurements) to discrete water-quality samples. These models enable existing web-based software to provide near-real-time estimates of stream-specific constituent concentrations to support natural resources management decisions. Since 2007, USGS, in cooperation with the LPRCA, has continuously monitored four water-quality properties seasonally within the lower Platte River corridor: specific conductance, water temperature, dissolved oxygen, and turbidity. During 2007 through 2011, the USGS and the Nebraska Department of Environmental Quality collected and analyzed discrete water-quality samples for nutrients, major ions, pesticides, suspended sediment, and bacteria. These datasets were used to develop the regression models. This report documents the collection of these various water-quality datasets and the development of the site-specific regression models. Regression models were developed for all four monitored sites. Constituent models for Shell Creek included nitrate plus nitrite, total phosphorus, orthophosphate, atrazine, acetochlor, suspended sediment, and Escherichia coli (E. coli) bacteria. Regression models that were developed for the Elkhorn River included nitrate plus nitrite, total Kjeldahl nitrogen, total phosphorus, orthophosphate, chloride, atrazine, acetochlor, suspended sediment, and E. coli. Models developed for Salt Creek included nitrate plus nitrite, total Kjeldahl nitrogen, suspended sediment, and E. coli. Lastly, models developed for the Platte River site included total Kjeldahl nitrogen, total phosphorus, sodium, metolachlor, atrazine, acetochlor, suspended sediment, and E. coli.

Measuring, managing and maximizing refinery performance

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

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

1996-01-01

Implementing continuous quality improvement is a confluence of total quality management, people empowerment, performance indicators and information engineering. Supporting information technologies allow a refiner to narrow the gap between management objectives and the process control level. Dynamic performance monitoring benefits come from production cost savings, improved communications and enhanced decision making. A refinery workgroup information flow model helps automate continuous improvement of processes, performance and the organization. The paper discusses the rethinking of refinery operations, dynamic performance monitoring, continuous process improvement, the knowledge coordinator and repository manager, an integrated plant operations workflow, and successful implementation.

A Comparative Case Study Analysis of Administrators Perceptions on the Adaptation of Quality and Continuous Improvement Tools to Community Colleges in the State of Michigan

ERIC Educational Resources Information Center

Mattis, Ted B.

2011-01-01

The purpose of this study was to determine whether community college administrators in the state of Michigan believe that commonly known quality and continuous improvement tools, prevalent in a manufacturing environment, can be adapted to a community college model. The tools, specifically Six Sigma, benchmarking and process mapping have played a…

National Models for Continuing Professional Development: The Challenges of Twenty-First-Century Knowledge Management

ERIC Educational Resources Information Center

Leask, Marilyn; Younie, Sarah

2013-01-01

If teacher quality is the most critical factor in improving educational outcomes, then why is so little attention drawn to the knowledge and evidence base available to support teachers in improving the quality of their professional knowledge? This paper draws together findings from a range of sources to propose national models for continuing…

EDMS Multi-year Validation Plan

DOT National Transportation Integrated Search

2001-06-01

The Emissions and Dispersion Modeling System (EDMS) is the air quality model required for use on airport projects by the Federal Aviation Administration (FAA). This model has continued to be improved and recently has included several important enhanc...

Refinement, Validation and Benchmarking of a Model for E-Government Service Quality

NASA Astrophysics Data System (ADS)

Magoutas, Babis; Mentzas, Gregoris

This paper presents the refinement and validation of a model for Quality of e-Government Services (QeGS). We built upon our previous work where a conceptualized model was identified and put focus on the confirmatory phase of the model development process, in order to come up with a valid and reliable QeGS model. The validated model, which was benchmarked with very positive results with similar models found in the literature, can be used for measuring the QeGS in a reliable and valid manner. This will form the basis for a continuous quality improvement process, unleashing the full potential of e-government services for both citizens and public administrations.

Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial.

PubMed

Desai, Sanjay V; Feldman, Leonard; Brown, Lorrel; Dezube, Rebecca; Yeh, Hsin-Chieh; Punjabi, Naresh; Afshar, Kia; Grunwald, Michael R; Harrington, Colleen; Naik, Rakhi; Cofrancesco, Joseph

2013-04-22

On July 1, 2011, the Accreditation Council for Graduate Medical Education implemented further restrictions of its 2003 regulations on duty hours and supervision. It remains unclear if the 2003 regulations improved trainee well-being or patient safety. To determine the effects of the 2011 Accreditation Council for Graduate Medical Education duty hour regulations compared with the 2003 regulations concerning sleep duration, trainee education, continuity of patient care, and perceived quality of care among internal medicine trainees. Crossover study design in an academic research setting. Medical house staff. General medical teams were randomly assigned using a sealed-envelope draw to an experimental model or a control model. We randomly assigned 4 medical house staff teams (43 interns) using a 3-month crossover design to a 2003-compliant model of every fourth night overnight call (control) with 30-hour duty limits or to one of two 2011-compliant models of every fifth night overnight call (Q5) or a night float schedule (NF), both with 16-hour duty limits. We measured sleep duration using actigraphy and used admission volumes, educational opportunities, the number of handoffs, and satisfaction surveys to assess trainee education, continuity of patient care, and perceived quality of care. RESULTS The study included 560 control, 420 Q5, and 140 NF days that interns worked and 834 hospital admissions. Compared with controls, interns on NF slept longer during the on call period (mean, 5.1 vs 8.3 hours; P = .003), and interns on Q5 slept longer during the postcall period (mean, 7.5 vs 10.2 hours; P = .05). However, both the Q5 and NF models increased handoffs, decreased availability for teaching conferences, and reduced intern presence during daytime work hours. Residents and nurses in both experimental models perceived reduced quality of care, so much so with NF that it was terminated early. Compared with a 2003-compliant model, two 2011 duty hour regulation-compliant models were associated with increased sleep duration during the on-call period and with deteriorations in educational opportunities, continuity of patient care, and perceived quality of care.

Application of automated measurement stations for continuous water quality monitoring of the Dender river in Flanders, Belgium.

PubMed

Vandenberghe, V; Goethals, P L M; Van Griensven, A; Meirlaen, J; De Pauw, N; Vanrolleghem, P; Bauwens, W

2005-09-01

During the summer of 1999, two automated water quality measurement stations were installed along the Dender river in Belgium. The variables dissolved oxygen, temperature, conductivity, pH, rain-intensity, flow and solar radiation were measured continuously. In this paper these on-line measurement series are presented and interpreted using also additional measurements and ecological expert-knowledge. The purpose was to demonstrate the variability in time and space of the aquatic processes and the consequences of conducting and interpreting discrete measurements for river quality assessment and management. The large fluctuations of the data illustrated the importance of continuous measurements for the complete description and modelling of the biological processes in the river.

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

PubMed

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

2016-06-01

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

Rough case-based reasoning system for continues casting

NASA Astrophysics Data System (ADS)

Su, Wenbin; Lei, Zhufeng

2018-04-01

The continuous casting occupies a pivotal position in the iron and steel industry. The rough set theory and the CBR (case based reasoning, CBR) were combined in the research and implementation for the quality assurance of continuous casting billet to improve the efficiency and accuracy in determining the processing parameters. According to the continuous casting case, the object-oriented method was applied to express the continuous casting cases. The weights of the attributes were calculated by the algorithm which was based on the rough set theory and the retrieval mechanism for the continuous casting cases was designed. Some cases were adopted to test the retrieval mechanism, by analyzing the results, the law of the influence of the retrieval attributes on determining the processing parameters was revealed. A comprehensive evaluation model was established by using the attribute recognition theory. According to the features of the defects, different methods were adopted to describe the quality condition of the continuous casting billet. By using the system, the knowledge was not only inherited but also applied to adjust the processing parameters through the case based reasoning method as to assure the quality of the continuous casting and improve the intelligent level of the continuous casting.

Identifying Continuous Quality Improvement Priorities in Maternal, Infant, and Early Childhood Home Visiting.

PubMed

Preskitt, Julie; Fifolt, Matthew; Ginter, Peter M; Rucks, Andrew; Wingate, Martha S

2016-01-01

The purpose of this article was to describe a methodology to identify continuous quality improvement (CQI) priorities for one state's Maternal, Infant, and Early Childhood Home Visiting program from among the 40 required constructs associated with 6 program benchmarks. The authors discuss how the methodology provided consensus on system CQI quality measure priorities and describe variation among the 3 service delivery models used within the state. Q-sort methodology was used by home visiting (HV) service delivery providers (home visitors) to prioritize HV quality measures for the overall state HV system as well as their service delivery model. There was general consensus overall and among the service delivery models on CQI quality measure priorities, although some variation was observed. Measures associated with Maternal, Infant, and Early Childhood Home Visiting benchmark 1, Improved Maternal and Newborn Health, and benchmark 3, Improvement in School Readiness and Achievement, were the highest ranked. The Q-sort exercise allowed home visitors an opportunity to examine priorities within their service delivery model as well as for the overall First Teacher HV system. Participants engaged in meaningful discussions regarding how and why they selected specific quality measures and developed a greater awareness and understanding of a systems approach to HV within the state. The Q-sort methodology presented in this article can easily be replicated by other states to identify CQI priorities at the local and state levels and can be used effectively in states that use a single HV service delivery model or those that implement multiple evidence-based models for HV service delivery.

A Quality Framework for Continuous Improvement of e-Learning: The e-Learning Maturity Model

ERIC Educational Resources Information Center

Marshall, Stephen

2010-01-01

The E-Learning Maturity Model (eMM) is a quality improvement framework designed to help institutional leaders assess their institution's e-learning maturity. This paper reviews the eMM, drawing on examples of assessments conducted in New Zealand, Australia, the UK and the USA to show how it helps institutional leaders assess and compare their…

The Mediating Effect of Kaizen between Total Quality Management (TQM) and Business Performance

NASA Astrophysics Data System (ADS)

Shan, Ang Wei; Fauzi Ahmad, Mohd; Hisyamudin Muhd Nor, Nik

2016-11-01

Every customer preference is different but yet important. The global market is shifting rapidly, organizations are needed to continuously identify new opportunity to obtain competitive advantages. Literature suggested that manufacturing companies are needed to differentiate themselves through emphasize on quality and continuous improvement in product and services as a crucial part to secure and success in the future. The Total Quality Management (TQM) practices has developed a strong bearing on growth and competitiveness in market. Therefore, a proper continuous improvement (Kaizen) practice is needed to eliminate waste and value added in production to remain competitiveness and retained the potential customer. However, based on the previous study it had indicated an inconsistent result between TQM and BP. Besides that, researcher also less emphasized on mediator in previous work. Therefore, the purpose of this paper is to recommend the relationship between TQM and business performance with a mediator's effect of Kaizen. This proposed model attempt to create knowledge to both academician and company players to acquire a better understanding among the TQM and Kaizen practices. Consequently, the Structural Equation Modelling (SEM) techniques is applying to identify and evaluate the relationship among TQM, Kaizen, and business performance in developing a new TQM model.

Continual improvement: A bibliography with indexes, 1992-1993

NASA Technical Reports Server (NTRS)

1994-01-01

This bibliography lists 606 references to reports and journal articles entered into the NASA Scientific and Technical Information Database during 1992 to 1993. Topics cover the philosophy and history of Continual Improvement (CI), basic approaches and strategies for implementation, and lessons learned from public and private sector models. Entries are arranged according to the following categories: Leadership for Quality, Information and Analysis, Strategic Planning for CI, Human Resources Utilization, Management of Process Quality, Supplier Quality, Assessing Results, Customer Focus and Satisfaction, TQM Tools and Philosophies, and Applications. Indexes include subject, personal author, corporate source, contract number, report number, and accession number.

Quality competition in local hospital markets: some econometric evidence from the period 1982-1988.

PubMed

Chirikos, T N

1992-05-01

This study examines whether American hospitals continued to engage in non-price or quality competition over the recent past as health care markets underwent fundamental structural changes and the economic incentives facing hospital managers were correspondingly altered. It also investigates the degree to which such rivalrous behavior contributes to losses in economic welfare. An econometric model of quality competition is specified that tests, among other things, for the effect of spending by the hospital to enhance the quality of output on annual changes in its share of the local (inpatient) market as well as the effects of competitive conditions in the local market on the annual sum spent on quality enhancement. The model is estimated with panel data on 195 acute care hospitals in the State of Florida for the years 1982-1988. The results suggest that quality competitive behavior continued unabated over this period and that it was stimulated as much by the growth in physician supply and alternative delivery mechanisms as it was by other competing hospitals in the local market. Furthermore, the results show that quality competition yields some inefficiency or waste, but much of it also meets the test of the market.

Multidisciplinary Prerounding Meeting as a Continuous Quality Improvement Tool: Leveraging to Reduce Continuous Benzodiazepine Use at an Academic Medical Center.

PubMed

Flannery, Alexander H; Thompson Bastin, Melissa L; Montgomery-Yates, Ashley; Hook, Corrine; Cassity, Evan; Eaton, Phillip M; Morris, Peter E

2018-01-01

Evidence-based medicine often has many barriers to overcome prior to implementation in practice, hence the importance of continuous quality improvement. We report on a brief (≤10 minutes) multidisciplinary meeting prior to rounds to establish a dashboard for continuous quality improvement and studied the success of this meeting on a particular area of focus: continuous infusion benzodiazepine minimization. This was a prospective observational study of patients admitted to the medical intensive care unit (MICU) of a large academic medical center over a 4-month period. A morning multidisciplinary prerounding meeting was implemented to report on metrics required to establish a dashboard for MICU care for the previous 24 hours. Fellows and nurse practitioners on respective teams reported on key quality metrics and other important data related to patient census. Continuous benzodiazepines were tracked daily as the number of patients per team who had orders for a continuous benzodiazepine infusion. The aim of this report is to describe the development of the morning multidisciplinary prerounding meeting and its impact on continuous benzodiazepine use, along with associated clinical outcomes. The median number of patients prescribed a continuous benzodiazepine daily decreased over this time period and demonstrated a sustained reduction at 1 year. Furthermore, sedation scores improved, corresponding to a reduction in median duration of mechanical ventilation. The effectiveness of this intervention was mapped post hoc to conceptual models used in implementation science. A brief multidisciplinary meeting to review select data points prior to morning rounds establishes mechanisms for continuous quality improvement and may serve as a mediating factor for successful implementation when initiating and monitoring practice change in the ICU.

The importance of continuing education for transplant coordination staff.

PubMed

Tokalak, Ibrahim; Emiroğlu, Remzi; Karakayali, Hamdi; Bilgin, Nevzat; Haberal, Mehmet

2005-06-01

Continuous quality improvement activities are necessary to achieve excellence at any institution. The Başkent University Hospitals have implemented continuous in-service training programs to improve all health services provided. Also, continuing medical education programs are being instituted in organ procurement and transplantation centers. In addition to receiving basic orientation and training upon hiring, transplant coordination staff complete forms that detail their current training status, further job training needed, and other courses of interest. The information is used to monitor skill levels, to determine the success of educational programs, and to identify further education that is needed. Our aim is to improve the quality of transplant coordination activities and increase organ donation at the hospitals in our network through effective monitoring and evaluation of continuous in-service training. These training programs enhance staff members' understanding of and participation in procedures related to transplantation and improves the total quality of the transplantation process. In the near future, this training model may be used to improve the donor hospital education program in Turkey.

An analytical probabilistic model of the quality efficiency of a sewer tank

NASA Astrophysics Data System (ADS)

Balistrocchi, Matteo; Grossi, Giovanna; Bacchi, Baldassare

2009-12-01

The assessment of the efficiency of a storm water storage facility devoted to the sewer overflow control in urban areas strictly depends on the ability to model the main features of the rainfall-runoff routing process and the related wet weather pollution delivery. In this paper the possibility of applying the analytical probabilistic approach for developing a tank design method, whose potentials are similar to the continuous simulations, is proved. In the model derivation the quality issues of such devices were implemented. The formulation is based on a Weibull probabilistic model of the main characteristics of the rainfall process and on a power law describing the relationship between the dimensionless storm water cumulative runoff volume and the dimensionless cumulative pollutograph. Following this approach, efficiency indexes were established. The proposed model was verified by comparing its results to those obtained by continuous simulations; satisfactory agreement is shown for the proposed efficiency indexes.

Quality Risk Management. Modernising the Architecture of Quality Assurance

ERIC Educational Resources Information Center

Raban, Colin; Turner, Liz

2006-01-01

Although the world is changing, quality management remains an area of relative calm. Many institutions continue to use elaborated versions of a model that is developed by the Council of Academic Awards and conceived at a time when higher education was not so exposed to market forces, when the policy and regulatory environment was relatively…

NEW DEVELOPMENTS IN THE COMMUNITY MULTISCALE AIR QUALITY (CMAQ) MODEL

EPA Science Inventory

CMAQ model research and development is currently following two tracks at the Atmospheric Modeling Division of the USEPA. Public releases of the community model system for research and policy analysis is continuing on an annual interval with the latest release scheduled for Augus...

The Total Quality Classroom.

ERIC Educational Resources Information Center

Bonstingl, John Jay

1992-01-01

Deming's quality-focused principles contradict Taylor's top-down, authoritarian industrial model. Deming advises educators to fix the system instead of blaming individual teachers for student apathy and low achievement. In the new paradigm, education will be a process that encourages continual progress through improving one's abilities, expanding…

Accelerating quality improvement within your organization: Applying the Model for Improvement.

PubMed

Crowl, Ashley; Sharma, Anita; Sorge, Lindsay; Sorensen, Todd

2015-01-01

To discuss the fundamentals of the Model for Improvement and how the model can be applied to quality improvement activities associated with medication use, including understanding the three essential questions that guide quality improvement, applying a process for actively testing change within an organization, and measuring the success of these changes on care delivery. PubMed from 1990 through April 2014 using the search terms quality improvement, process improvement, hospitals, and primary care. At the authors' discretion, studies were selected based on their relevance in demonstrating the quality improvement process and tests of change within an organization. Organizations are continuously seeking to enhance quality in patient care services, and much of this work focuses on improving care delivery processes. Yet change in these systems is often slow, which can lead to frustration or apathy among frontline practitioners. Adopting and applying the Model for Improvement as a core strategy for quality improvement efforts can accelerate the process. While the model is frequently well known in hospitals and primary care settings, it is not always familiar to pharmacists. In addition, while some organizations may be familiar with the "plan, do, study, act" (PDSA) cycles-one element of the Model for Improvement-many do not apply it effectively. The goal of the model is to combine a continuous process of small tests of change (PDSA cycles) within an overarching aim with a longitudinal measurement process. This process differs from other forms of improvement work that plan and implement large-scale change over an extended period, followed by months of data collection. In this scenario it may take months or years to determine whether an intervention will have a positive impact. By following the Model for Improvement, frontline practitioners and their organizational leaders quickly identify strategies that make a positive difference and result in a greater degree of success.

[The effectiveness of continuing care models in patients with chronic diseases: a systematic review].

PubMed

Chen, Hsiao-Mei; Han, Tung-Chen; Chen, Ching-Min

2014-04-01

Population aging has caused significant rises in the prevalence of chronic diseases and the utilization of healthcare services in Taiwan. The current healthcare delivery system is fragmented. Integrating medical services may increase the quality of healthcare, enhance patient and patient family satisfaction with healthcare services, and better contain healthcare costs. This article introduces two continuing care models: discharge planning and case management. Further, the effectiveness and essential components of these two models are analyzed using a systematic review method. Articles included in this systematic review were all original articles on discharge-planning or case-management interventions published between February 1999 and March 2013 in any of 6 electronic databases (Medline, PubMed, Cinahl Plus with full Text, ProQuest, Cochrane Library, CEPS and Center for Chinese Studies electronic databases). Of the 70 articles retrieved, only 7 were randomized controlled trial studies. Three types of continuity-of-care models were identified: discharge planning, case management, and a hybrid of these two. All three models used logical and systematic processes to conduct assessment, planning, implementation, coordination, follow-up, and evaluation activities. Both the discharge planning model and the case management model were positively associated with improved self-care knowledge, reduced length of stay, decreased medical costs, and better quality of life. This study cross-referenced all reviewed articles in terms of target clients, content, intervention schedules, measurements, and outcome indicators. Study results may be referenced in future implementations of continuity-care models and may provide a reference for future research.

Bacteria transport simulation using apex model in the toenepi watershed, New Zealand

USDA-ARS?s Scientific Manuscript database

The Agricultural Policy/Environmental eXtender (APEX) model is a distributed, continuous, daily-timestep small watershed-scale hydrologic and water quality model. In this study, the newly developed fecal-derived bacteria fate and transport subroutine was applied and validated using APEX model. The ...

THE STORM WATER MANAGEMENT MODEL (SWMM) AND RELATED WATERSHED TOOLS DEVELOPMENT

EPA Science Inventory

The Storm Water Management Model (SWMM) is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. It is the only publicly available model capable of performing a comprehensiv...

Getting Started with TQM.

ERIC Educational Resources Information Center

Freeston, Kenneth R.

1992-01-01

Tired of disjointed programs and projects, the staff of Newtown (Connecticut) Public Schools developed their own Success-Oriented School Model, blending elements of Deming's 14 points with William Glasser's approach to quality. To obtain quality outcomes means stressing continuous improvement and staying close to the customer. (six references)…

Leadership versus management: translating pharmacists' abilities into quality performance.

PubMed

Reeder, C E

2005-03-01

To describe the quality gap in health care as it was referred to in the Institute of Medicine's reports, to try to harness pharmacy's potential to improve the quality of drug therapy, and to provide insight into the elusive leadership, management, and dynamics of change. Current health care is nowhere near ideal. Successful quality initiatives have included establishing a "culture of quality" (promoting a learning organization), having good leadership, and developing strong management. Ideally, all of these concepts must be applied concurrently for the best results because using only one will not spirit medicine across the gap. To close the gap, pharmacists need to understand various types of change and select a change mechanism that will continuously improve care. Optimizing drug therapy is both a great challenge and a great opportunity for pharmacy. AMCP's Framework for Quality Drug Therapy is a continuous quality improvement model that gives us the tools to plan, implement, and evaluate strategies to improve the quality of patient care and cross the "quality chasm."

A hybrid health service accreditation program model incorporating mandated standards and continuous improvement: interview study of multiple stakeholders in Australian health care.

PubMed

Greenfield, David; Hinchcliff, Reece; Hogden, Anne; Mumford, Virginia; Debono, Deborah; Pawsey, Marjorie; Westbrook, Johanna; Braithwaite, Jeffrey

2016-07-01

The study aim was to investigate the understandings and concerns of stakeholders regarding the evolution of health service accreditation programs in Australia. Stakeholder representatives from programs in the primary, acute and aged care sectors participated in semi-structured interviews. Across 2011-12 there were 47 group and individual interviews involving 258 participants. Interviews lasted, on average, 1 h, and were digitally recorded and transcribed. Transcriptions were analysed using textual referencing software. Four significant issues were considered to have directed the evolution of accreditation programs: altering underlying program philosophies; shifting of program content focus and details; different surveying expectations and experiences and the influence of external contextual factors upon accreditation programs. Three accreditation program models were noted by participants: regulatory compliance; continuous quality improvement and a hybrid model, incorporating elements of these two. Respondents noted the compatibility or incommensurability of the first two models. Participation in a program was reportedly experienced as ranging on a survey continuum from "malicious compliance" to "performance audits" to "quality improvement journeys". Wider contextual factors, in particular, political and community expectations, and associated media reporting, were considered significant influences on the operation and evolution of programs. A hybrid accreditation model was noted to have evolved. The hybrid model promotes minimum standards and continuous quality improvement, through examining the structure and processes of organisations and the outcomes of care. The hybrid model appears to be directing organisational and professional attention to enhance their safety cultures. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

A Quality Model to Select Patients in Cupping Therapy Clinics: A New Tool for Ensuring Safety in Clinical Practice.

PubMed

Aboushanab, Tamer; AlSanad, Saud

2018-06-08

Cupping therapy is a popular treatment in various countries and regions, including Saudi Arabia. Cupping therapy is regulated in Saudi Arabia by the National Center for Complementary and Alternative Medicine (NCCAM), Ministry of Health. The authors recommend that this quality model for selecting patients in cupping clinics - first version (QMSPCC-1) - be used routinely as part of clinical practice and quality management in cupping clinics. The aim of the quality model is to ensure the safety of patients and to introduce and facilitate quality and auditing processes in cupping therapy clinics. Clinical evaluation of this tool is recommended. Continued development, re-evaluation and reassessment of this tool are important. Copyright © 2018. Published by Elsevier B.V.

Lean management systems: creating a culture of continuous quality improvement.

PubMed

Clark, David M; Silvester, Kate; Knowles, Simon

2013-08-01

This is the first in a series of articles describing the application of Lean management systems to Laboratory Medicine. Lean is the term used to describe a principle-based continuous quality improvement (CQI) management system based on the Toyota production system (TPS) that has been evolving for over 70 years. Its origins go back much further and are heavily influenced by the work of W Edwards Deming and the scientific method that forms the basis of most quality management systems. Lean has two fundamental elements--a systematic approach to process improvement by removing waste in order to maximise value for the end-user of the service and a commitment to respect, challenge and develop the people who work within the service to create a culture of continuous improvement. Lean principles have been applied to a growing number of Healthcare systems throughout the world to improve the quality and cost-effectiveness of services for patients and a number of laboratories from all the pathology disciplines have used Lean to shorten turnaround times, improve quality (reduce errors) and improve productivity. Increasingly, models used to plan and implement large scale change in healthcare systems, including the National Health Service (NHS) change model, have evidence-based improvement methodologies (such as Lean CQI) as a core component. Consequently, a working knowledge of improvement methodology will be a core skill for Pathologists involved in leadership and management.

A participatory sensing approach to characterize ride quality

NASA Astrophysics Data System (ADS)

Bridgelall, Raj

2014-03-01

Rough roads increase vehicle operation and road maintenance costs. Consequently, transportation agencies spend a significant portion of their budgets on ride-quality characterization to forecast maintenance needs. The ubiquity of smartphones and social media, and the emergence of a connected vehicle environment present lucrative opportunities for cost-reduction and continuous, network-wide, ride-quality characterization. However, there is a lack of models to transform inertial and position information from voluminous data flows into indices that transportation agencies currently use. This work expands on theories of the Road Impact Factor introduced in previous research. The index characterizes road roughness by aggregating connected vehicle data and reporting roughness in direct proportion to the International Roughness Index. Their theoretical relationships are developed, and a case study is presented to compare the relative data quality from an inertial profiler and a regular passenger vehicle. Results demonstrate that the approach is a viable alternative to existing models that require substantially more resources and provide less network coverage. One significant benefit of the participatory sensing approach is that transportation agencies can monitor all network facilities continuously to locate distress symptoms, such as frost heaves, that appear and disappear between ride assessment cycles. Another benefit of the approach is continuous monitoring of all high-risk intersections such as rail grade crossings to better understand the relationship between ride-quality and traffic safety.

Storm Water Management Model Reference Manual Volume II ...

EPA Pesticide Factsheets

SWMM is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. The runoff component of SWMM operates on a collection of subcatchment areas that receive precipitation and generate runoff and pollutant loads. The routing portion of SWMM transports this runoff through a system of pipes, channels, storage/treatment devices, pumps, and regulators. SWMM tracks the quantity and quality of runoff generated within each subcatchment, and the flow rate, flow depth, and quality of water in each pipe and channel during a simulation period comprised of multiple time steps. The reference manual for this edition of SWMM is comprised of three volumes. Volume I describes SWMM’s hydrologic models, Volume II its hydraulic models, and Volume III its water quality and low impact development models. This document provides the underlying mathematics for the hydraulic calculations of the Storm Water Management Model (SWMM)

Bacteria transport simulation using APEX model in the Toenepi watershed, New Zealand

USDA-ARS?s Scientific Manuscript database

The Agricultural Policy/Environmental eXtender (APEX) model is a distributed, continuous, daily-time step small watershed-scale hydrologic and water quality model. In this study, the newly developed fecal-derived bacteria fate and transport subroutine was applied and evalated using APEX model. The e...

42 CFR § 512.725 - Data sharing for FFS-CR participants.

Code of Federal Regulations, 2010 CFR

2017-10-01

... SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL CR Incentive Payment Model for EPM and Medicare Fee-for-Service Participants Provisions for Ffs-Cr Participants § 512... quality. (3) Enhance efficiencies in the delivery of care. (4) Otherwise achieve the goals of the model...

Model for integrated management of quality, labor risks prevention, environment and ethical aspects, applied to R&D&I and production processes in an organization

NASA Astrophysics Data System (ADS)

González, M. R.; Torres, F.; Yoldi, V.; Arcega, F.; Plaza, I.

2012-04-01

It is proposed an integrated management model for an organization. This model is based on the continuous improvement Plan-Do-Check-Act cycle and it intends to integrate the environmental, risk prevention and ethical aspects as well as research, development and innovation projects management in the general quality management structure proposed by ISO 9001:2008. It aims to fulfill the standards ISO 9001, ISO 14001, OSHAS 18001, SGE 21 y 166002.

SENSITIVITY OF OZONE AND AEROSOL PREDICTIONS TO THE TRANSPORT ALGORITHMS IN THE MODELS-3 COMMUNITY MULTI-SCALE AIR QUALITY (CMAQ) MODELING SYSTEM

EPA Science Inventory

EPA's Models-3 CMAQ system is intended to provide a community modeling paradigm that allows continuous improvement of the one-atmosphere modeling capability in a unified fashion. CMAQ's modular design promotes incorporation of several sets of science process modules representing ...

STORM WATER MANAGEMENT MODEL USER'S MANUAL VERSION 5.0

EPA Science Inventory

The EPA Storm Water Management Model (SWMM) is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. SWMM was first developed in 1971 and has undergone several major upgrade...

Continuous Certification Within Residency: An Educational Model.

PubMed

Rachlin, Susan; Schonberger, Alison; Nocera, Nicole; Acharya, Jay; Shah, Nidhi; Henkel, Jacqueline

2015-10-01

Given that maintaining compliance with Maintenance of Certification is necessary for maintaining licensure to practice as a radiologist and provide quality patient care, it is important for radiology residents to practice fulfilling each part of the program during their training not only to prepare for success after graduation but also to adequately learn best practices from the beginning of their professional careers. This article discusses ways to implement continuous certification (called Continuous Residency Certification) as an educational model within the residency training program. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Learning a Continuous-Time Streaming Video QoE Model.

PubMed

Ghadiyaram, Deepti; Pan, Janice; Bovik, Alan C

2018-05-01

Over-the-top adaptive video streaming services are frequently impacted by fluctuating network conditions that can lead to rebuffering events (stalling events) and sudden bitrate changes. These events visually impact video consumers' quality of experience (QoE) and can lead to consumer churn. The development of models that can accurately predict viewers' instantaneous subjective QoE under such volatile network conditions could potentially enable the more efficient design of quality-control protocols for media-driven services, such as YouTube, Amazon, Netflix, and so on. However, most existing models only predict a single overall QoE score on a given video and are based on simple global video features, without accounting for relevant aspects of human perception and behavior. We have created a QoE evaluator, called the time-varying QoE Indexer, that accounts for interactions between stalling events, analyzes the spatial and temporal content of a video, predicts the perceptual video quality, models the state of the client-side data buffer, and consequently predicts continuous-time quality scores that agree quite well with human opinion scores. The new QoE predictor also embeds the impact of relevant human cognitive factors, such as memory and recency, and their complex interactions with the video content being viewed. We evaluated the proposed model on three different video databases and attained standout QoE prediction performance.

Development and testing of a fast conceptual river water quality model.

PubMed

Keupers, Ingrid; Willems, Patrick

2017-04-15

Modern, model based river quality management strongly relies on river water quality models to simulate the temporal and spatial evolution of pollutant concentrations in the water body. Such models are typically constructed by extending detailed hydrodynamic models with a component describing the advection-diffusion and water quality transformation processes in a detailed, physically based way. This approach is too computational time demanding, especially when simulating long time periods that are needed for statistical analysis of the results or when model sensitivity analysis, calibration and validation require a large number of model runs. To overcome this problem, a structure identification method to set up a conceptual river water quality model has been developed. Instead of calculating the water quality concentrations at each water level and discharge node, the river branch is divided into conceptual reservoirs based on user information such as location of interest and boundary inputs. These reservoirs are modelled as Plug Flow Reactor (PFR) and Continuously Stirred Tank Reactor (CSTR) to describe advection and diffusion processes. The same water quality transformation processes as in the detailed models are considered but with adjusted residence times based on the hydrodynamic simulation results and calibrated to the detailed water quality simulation results. The developed approach allows for a much faster calculation time (factor 10 5 ) without significant loss of accuracy, making it feasible to perform time demanding scenario runs. Copyright © 2017 Elsevier Ltd. All rights reserved.

School Development Applications in Turkey

ERIC Educational Resources Information Center

Hosgörür, Vural

2014-01-01

This study aims to define and explain the establishment, functioning and problems of school development management teams (SDMTs), similar to quality circles used in total quality management practices, for the purposes of continuous development and improvement of schools on the basis of the planned school development model. This is a qualitative…

“Changes in US Regional Air Quality at 2030 Simulated Using RCP 6.0”

EPA Science Inventory

Session: Global/Regional Modeling Applications Recent improvements in air quality in the United States have been due to significant reductions in emissions of ozone and particulate matter (PM) precursors, and these downward emissions trends are expected to continue in the next...

Power and Resistance: Leading Change in Medical Education

ERIC Educational Resources Information Center

Sundberg, Kristina; Josephson, Anna; Reeves, Scott; Nordquist, Jonas

2017-01-01

A key role for educational leaders within undergraduate medical education is to continually improve the quality of education; global quality health care is the goal. This paper reports the findings from a study employing a power model to highlight how educational leaders influence the development of undergraduate medical curricula and the…

USING BAYESIAN SPATIAL MODELS TO FACILITATE WATER QUALITY MONITORING

EPA Science Inventory

The Clean Water Act of 1972 requires states to monitor the quality of their surface water. The number of sites sampled on streams and rivers varies widely by state. A few states are now using probability survey designs to select sites, while most continue to rely on other proce...

42 CFR § 414.1370 - APM scoring standard under MIPS.

Code of Federal Regulations, 2010 CFR

2017-10-01

... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1370 APM scoring... Participation List; (3) The APM bases payment on cost/utilization and quality measures; and (4) The APM is not...

42 CFR § 414.1340 - Data completeness criteria for the quality performance category.

Code of Federal Regulations, 2010 CFR

2017-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive... that meet the measure's denominator criteria, regardless of payer for MIPS payment year 2019. (2) At...

Improving quality and patient satisfaction in a pediatric resident continuity clinic through advanced access scheduling.

PubMed

Tuli, Sanjeev Y; Thompson, Lindsay A; Ryan, Kathleen A; Srinivas, Ganga L; Fillipps, Donald J; Young, Christopher M; Tuli, Sonal S

2010-06-01

To evaluate the impact of advanced access scheduling in a pediatric residency clinic on resident and patient satisfaction, medical education, practice quality, and efficiency. Residents were assigned to either the advanced access template (10 appointments available to patients and 2 physician overbooks) or the prior template (5 available and 8 overbooks). Outcomes included resident and patient satisfaction, appointment availability, and continuity of care and clinic costs. Patient satisfaction improved in 7 areas (P < .001). Residents in either template did not report an impact on medical education experiences. Significant increases were realized with appointment availability and the number of patients seen. Continuity also increased as the overflow/acute visits decreased (P < .001). Overall costs per visit decreased 22%. Because of the significant improvements in access, continuity, and efficiency, all residents were switched to the advanced access template after completion of the study. Improvement in access to the primary physician has a significant impact on patient satisfaction with health care delivery. This model optimizes the limited time that residents have in continuity clinic, and it has implications for health care delivery quality improvement.

MODELS-3 COMMUNITY MULTISCALE AIR QUALITY (CMAQ) MODEL AEROSOL COMPONENT 2. MODEL EVALUATION

EPA Science Inventory

Ambient air concentrations of particulate matter (atmospheric suspensions of solid of liquid materials, i.e., aerosols) continue to be a major concern for the U.S. Environmental Protection Agency (EPA). High particulate matter (PM) concentrations are associated not only with adv...

42 CFR § 512.315 - Composite quality scores for determining reconciliation payment eligibility and effective and...

Code of Federal Regulations, 2010 CFR

2017-10-01

... (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Pricing and Payment § 512.315... and suppresses the measure value. (5) Establishing SHFFT model reconciliation payment eligibility and... factor for reconciliation payments. (A) A 3.0 percentage point effective discount factor for SHFFT model...

Modeling of Particulate Emissions

DTIC Science & Technology

2011-12-01

Concern Local Air Quality - A Continuing Concern Ground Level Troposphere Ozone Layer Depletion • H2O Ozone Depletion (ice formation) 5 Modeling... Ozone & Smog Formation Health Effects Local Air Quality 33,000-58,000 ft• NOx •Traffic Growth • CO2* • NOx O3* • NOx Reduces CH4 • H2O Vapor...Particulates • SOx Cloud Formation Global Warming * - Greenhouse Gases Ozone Layer Depletion - Not an Immediate Concern Global Warming - An Emerging

Development and integration of sub-hourly rainfall-runoff modeling capability within a watershed model

USDA-ARS?s Scientific Manuscript database

Increasing urbanization changes runoff patterns to be flashy and instantaneous with decreased base flow. A model with the ability to simulate sub-daily rainfall–runoff processes and continuous simulation capability is required to realistically capture the long-term flow and water quality trends in w...

Evidence synthesis for medical decision making and the appropriate use of quality scores.

PubMed

Doi, Suhail A R

2014-09-01

Meta-analyses today continue to be run using conventional random-effects models that ignore tangible information from studies such as the quality of the studies involved, despite the expectation that results of better quality studies reflect more valid results. Previous research has suggested that quality scores derived from such quality appraisals are unlikely to be useful in meta-analysis, because they would produce biased estimates of effects that are unlikely to be offset by a variance reduction within the studied models. However, previous discussions took place in the context of such scores viewed in terms of their ability to maximize their association with both the magnitude and direction of bias. In this review, another look is taken at this concept, this time asserting that probabilistic bias quantification is not possible or even required of quality scores when used in meta-analysis for redistribution of weights. The use of such a model is contrasted with the conventional random effects model of meta-analysis to demonstrate why the latter is inadequate in the face of a properly specified quality score weighting method. © 2014 Marshfield Clinic.

Building A High Quality Oncology Nursing Workforce Through Lifelong Learning: The De Souza Model.

PubMed

Esplen, Mary Jane; Wong, Jiahui; Green, Esther; Richards, Joy; Li, Jane

2018-01-05

AbstractCancer is one of the leading causes of death in the world. Along with increased new cases, cancer care has become increasingly complex due to advances in diagnostics and treatments, greater survival, and new models of palliative care. Nurses are a critical resource for cancer patients and their families. Their roles and responsibilities are expanding across the cancer care continuum, calling for specialized training and support. Formal education prepares nurses for entry level of practice, however, it does not provide the specialized competencies required for quality care of cancer patients. There is urgent need to align the educational system to the demands of the health care system, ease transition from formal academic systems to care settings, and to instill a philosophy of lifelong learning. We describe a model of education developed by de Souza Institute in Canada, based on the Novice to Expert specialty training framework, and its success in offering structured oncology continuing education training to nurses, from undergraduate levels to continued career development in the clinical setting. This model may have global relevance, given the challenge in managing the demand for high quality care in all disease areas and in keeping pace with the emerging advances in technologies.

Can didactic continuing education improve clinical decision making and reduce cost of quality? Evidence from a case study.

PubMed

Vuković, Mira; Gvozdenović, Branislav S; Ranković, Milena; McCormick, Bryan P; Vuković, Danica D; Gvozdenović, Biljana D; Kastratović, Dragana A; Marković, Srdjan Z; Ilić, Miodrag; Jakovljević, Mihajlo B

2015-01-01

Administration of human serum albumin (HSA) solutions for the resuscitation of critically ill patients remains controversial. The objective of this study was to assess the effect of continuing medical education (CME) on health care professionals' clinical decision making with regard to HSA administration and the costs of quality (COQ). A quasi-experimental study of time series association of CME intervention with COQ and use of HSA solution was conducted at the Surgery Department of the Hospital Valjevo, Serbia. The CME contained evidence-based criteria for HSA solution administration in surgical patients. The preintervention period was defined as January 2009 to May 2011. CME was provided in June 2011, with the postintervention period June 2011 to May 2012. Total mortality rate, the rate of nonsurgical mortality, the rate of surgical mortality, the rate of sepsis patient mortality, index of irrational use of HSA solutions, and number of hospital days per hospitalized patient were collected for each month as quality indicators. Statistical analysis was performed by multivariate autoregressive integrated moving average (MARIMA) modeling. The specification of the COQ was performed according to a traditional COQ model. The CME intervention resulted in an average monthly reduction of the hospital days per hospitalized patient, the rate of sepsis patient mortality, index of irrational use of HSA solutions, and COQ for $593,890.77 per year. Didactic CME presenting evidence-based criteria for HSA administration was associated with improvements in clinical decisions and COQ. In addition, this study demonstrates that models combining MARIMA and traditional COQ models can be useful in the evaluation of CME interventions aimed at reducing COQ. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

A Quantitative Quality Control Model for Parallel and Distributed Crowdsourcing Tasks

ERIC Educational Resources Information Center

Zhu, Shaojian

2014-01-01

Crowdsourcing is an emerging research area that has experienced rapid growth in the past few years. Although crowdsourcing has demonstrated its potential in numerous domains, several key challenges continue to hinder its application. One of the major challenges is quality control. How can crowdsourcing requesters effectively control the quality…

Quality tracing in meat supply chains

PubMed Central

Mack, Miriam; Dittmer, Patrick; Veigt, Marius; Kus, Mehmet; Nehmiz, Ulfert; Kreyenschmidt, Judith

2014-01-01

The aim of this study was the development of a quality tracing model for vacuum-packed lamb that is applicable in different meat supply chains. Based on the development of relevant sensory parameters, the predictive model was developed by combining a linear primary model and the Arrhenius model as the secondary model. Then a process analysis was conducted to define general requirements for the implementation of the temperature-based model into a meat supply chain. The required hardware and software for continuous temperature monitoring were developed in order to use the model under practical conditions. Further on a decision support tool was elaborated in order to use the model as an effective tool in combination with the temperature monitoring equipment for the improvement of quality and storage management within the meat logistics network. Over the long term, this overall procedure will support the reduction of food waste and will improve the resources efficiency of food production. PMID:24797136

Quality tracing in meat supply chains.

PubMed

Mack, Miriam; Dittmer, Patrick; Veigt, Marius; Kus, Mehmet; Nehmiz, Ulfert; Kreyenschmidt, Judith

2014-06-13

The aim of this study was the development of a quality tracing model for vacuum-packed lamb that is applicable in different meat supply chains. Based on the development of relevant sensory parameters, the predictive model was developed by combining a linear primary model and the Arrhenius model as the secondary model. Then a process analysis was conducted to define general requirements for the implementation of the temperature-based model into a meat supply chain. The required hardware and software for continuous temperature monitoring were developed in order to use the model under practical conditions. Further on a decision support tool was elaborated in order to use the model as an effective tool in combination with the temperature monitoring equipment for the improvement of quality and storage management within the meat logistics network. Over the long term, this overall procedure will support the reduction of food waste and will improve the resources efficiency of food production.

Framework for industry engagement and quality principles for industry-provided medical education in Europe.

PubMed

Allen, Tamara; Donde, Nina; Hofstädter-Thalmann, Eva; Keijser, Sandra; Moy, Veronique; Murama, Jean-Jacques; Kellner, Thomas

2017-01-01

Lifelong learning through continuing professional development (CPD) and medical education is critical for healthcare professionals to stay abreast of knowledge and skills and provide an optimal standard of care to patients. In Europe, CPD and medical education are fragmented as there are numerous models, providers and national regulations and a lack of harmonisation of qualitative criteria. There is continued debate on the appropriate role of pharmaceutical companies in the context of medical education. Accrediting bodies such as European Accreditation Council for Continuing Medical Education do not permit active involvement of the pharmaceutical industry due to concerns around conflicts of interest and potential for bias. However, many examples of active collaboration between pharmaceutical companies and medical societies and scientific experts exist, demonstrating high integrity, clear roles and responsibilities, and fair and balanced content. Medical education experts from 16 pharmaceutical companies met to develop a set of quality principles similar to standards that have been established for clinical trials and in alignment with existing principles of accrediting bodies. This paper outlines their proposal for a framework to improve and harmonise medical education quality standards in Europe, and is also an invitation for all stakeholders to join a discussion on this integrative model.

Cardiac surgery report cards: comprehensive review and statistical critique.

PubMed

Shahian, D M; Normand, S L; Torchiana, D F; Lewis, S M; Pastore, J O; Kuntz, R E; Dreyer, P I

2001-12-01

Public report cards and confidential, collaborative peer education represent distinctly different approaches to cardiac surgery quality assessment and improvement. This review discusses the controversies regarding their methodology and relative effectiveness. Report cards have been the more commonly used approach, typically as a result of state legislation. They are based on the presumption that publication of outcomes effectively motivates providers, and that market forces will reward higher quality. Numerous studies have challenged the validity of these hypotheses. Furthermore, although states with report cards have reported significant decreases in risk-adjusted mortality, it is unclear whether this improvement resulted from public disclosure or, rather, from the development of internal quality programs by hospitals. An additional confounding factor is the nationwide decline in heart surgery mortality, including states without quality monitoring. Finally, report cards may engender negative behaviors such as high-risk case avoidance and "gaming" of the reporting system, especially if individual surgeon results are published. The alternative approach, continuous quality improvement, may provide an opportunity to enhance performance and reduce interprovider variability while avoiding the unintended negative consequences of report cards. This collaborative method, which uses exchange visits between programs and determination of best practice, has been highly effective in northern New England and in the Veterans Affairs Administration. However, despite their potential advantages, quality programs based solely on confidential continuous quality improvement do not address the issue of public accountability. For this reason, some states may continue to mandate report cards. In such instances, it is imperative that appropriate statistical techniques and report formats are used, and that professional organizations simultaneously implement continuous quality improvement programs. The statistical methodology underlying current report cards is flawed, and does not justify the degree of accuracy presented to the public. All existing risk-adjustment methods have substantial inherent imprecision, and this is compounded when the results of such patient-level models are aggregated and used inappropriately to assess provider performance. Specific problems include sample size differences, clustering of observations, multiple comparisons, and failure to account for the random component of interprovider variability. We advocate the use of hierarchical or multilevel statistical models to address these concerns, as well as report formats that emphasize the statistical uncertainty of the results.

Environmental Flow for Sungai Johor Estuary

NASA Astrophysics Data System (ADS)

Adilah, A. Kadir; Zulkifli, Yusop; Zainura, Z. Noor; Bakhiah, Baharim N.

2018-03-01

Sungai Johor estuary is a vital water body in the south of Johor and greatly affects the water quality in the Johor Straits. In the development of the hydrodynamic and water quality models for Sungai Johor estuary, the Environmental Fluid Dynamics Code (EFDC) model was selected. In this application, the EFDC hydrodynamic model was configured to simulate time varying surface elevation, velocity, salinity, and water temperature. The EFDC water quality model was configured to simulate dissolved oxygen (DO), dissolved organic carbon (DOC), chemical oxygen demand (COD), ammoniacal nitrogen (NH3-N), nitrate nitrogen (NO3-N), phosphate (PO4), and Chlorophyll a. The hydrodynamic and water quality model calibration was performed utilizing a set of site specific data acquired in January 2008. The simulated water temperature, salinity and DO showed good and fairly good agreement with observations. The calculated correlation coefficients between computed and observed temperature and salinity were lower compared with the water level. Sensitivity analysis was performed on hydrodynamic and water quality models input parameters to quantify their impact on modeling results such as water surface elevation, salinity and dissolved oxygen concentration. It is anticipated and recommended that the development of this model be continued to synthesize additional field data into the modeling process.

New technique for oil backstreaming contamination measurements

NASA Technical Reports Server (NTRS)

Alterovitz, S. A.; Speier, H. J.; Sieg, R. M.; Drotos, M. N.; Dunning, J. E.

1992-01-01

The backstreaming contamination in the Space Power Facility, Ohio, was measured using small size clean silicon wafers as contamination sensors placed at all measurement sites. Two ellipsometric models were developed to measure the oil film with the contamination film refractive index of DC 705: a continuous, homogeneous film and islands of oil with the islands varying in coverage fraction and height. The island model improved the ellipsometric analysis quality parameter by up to two orders of magnitude. The continuous film model overestimated the oil volume by about 50 percent.

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda

PubMed Central

2014-01-01

Background Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. Methods In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. Discussion EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. Trial registration PACTR201311000681314 PMID:24690284

Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda.

PubMed

Hanson, Claudia; Waiswa, Peter; Marchant, Tanya; Marx, Michael; Manzi, Fatuma; Mbaruku, Godfrey; Rowe, Alex; Tomson, Göran; Schellenberg, Joanna; Peterson, Stefan

2014-04-02

Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. PACTR201311000681314.

42 CFR § 512.460 - Compliance enforcement.

Code of Federal Regulations, 2010 CFR

2017-10-01

... (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Quality Measures, Beneficiary... regulations under this part must not be construed to affect the applicable payment, coverage, program..., commonly referred to as a CAP. (iii) Reducing or eliminating the EPM participant's reconciliation payment...

Continuity Clinic Model and Diabetic Outcomes in Internal Medicine Residencies: Findings of the Educational Innovations Project Ambulatory Collaborative

PubMed Central

Francis, Maureen D.; Julian, Katherine A.; Wininger, David A.; Drake, Sean; Bollman, KeriLyn; Nabors, Christopher; Pereira, Anne; Rosenblum, Michael; Zelenski, Amy B.; Sweet, David; Thomas, Kris; Varney, Andrew; Warm, Eric; Francis, Mark L.

2016-01-01

Background Efforts to improve diabetes care in residency programs are ongoing and in the midst of continuity clinic redesign at many institutions. While there appears to be a link between resident continuity and improvement in glycemic control for diabetic patients, it is uncertain whether clinic structure affects quality measures and patient outcomes. Methods This multi-institutional, cross-sectional study included 12 internal medicine programs. Three outcomes (glycemic control, blood pressure control, and achievement of target low-density lipoprotein [LDL]) and 2 process measures (A1C and LDL measurement) were reported for diabetic patients. Traditional, block, and combination clinic models were compared using analysis of covariance (ANCOVA). Analysis was adjusted for continuity, utilization, workload, and panel size. Results No significant differences were found in glycemic control across clinic models (P = .06). The percentage of diabetic patients with LDL < 100 mg/dL was 60% in block, compared to 54.9% and 55% in traditional and combination models (P = .006). The percentage of diabetic patients with blood pressure < 130/80 mmHg was 48.4% in block, compared to 36.7% and 36.9% in other models (P < .001). The percentage of diabetic patients with HbA1C measured was 92.1% in block compared to 75.2% and 82.1% in other models (P < .001). Also, the percentage of diabetic patients with LDL measured was significantly different across all groups, with 91.2% in traditional, 70.4% in combination, and 83.3% in block model programs (P < .001). Conclusions While high scores on diabetic quality measures are achievable in any clinic model, the block model design was associated with better performance. PMID:26913099

Patient-Centered Specialty Practice: Defining the Role of Specialists in Value-Based Health Care.

PubMed

Ward, Lawrence; Powell, Rhea E; Scharf, Michael L; Chapman, Andrew; Kavuru, Mani

2017-04-01

Health care is at a crossroads and under pressure to add value by improving patient experience and health outcomes and reducing costs to the system. Efforts to improve the care model in primary care, such as the patient-centered medical home, have enjoyed some success. However, primary care accounts for only a small portion of total health-care spending, and there is a need for policies and frameworks to support high-quality, cost-efficient care in specialty practices of the medical neighborhood. The Patient-Centered Specialty Practice (PCSP) model offers ambulatory-based specialty practices one such framework, supported by a formal recognition program through the National Committee for Quality Assurance. The key elements of the PCSP model include processes to support timely access to referral requests, improved communication and coordination with patients and referring clinicians, reduced unnecessary and duplicative testing, and an emphasis on continuous measurement of quality, safety, and performance improvement for a population of patients. Evidence to support the model remains limited, and estimates of net costs and value to practices are not fully understood. The PCSP model holds promise for promoting value-based health care in specialty practices. The continued development of appropriate incentives is required to ensure widespread adoption. Copyright © 2017. Published by Elsevier Inc.

Quantitative structure-activity relationship models that stand the test of time.

PubMed

Davis, Andrew M; Wood, David J

2013-04-01

The pharmaceutical industry is in a period of intense change. While this has many drivers, attrition through the development process continues to be an important pressure. The emerging definitions of "compound quality" that are based on retrospective analyses of developmental attrition have highlighted a new direction for medicinal chemistry and the paradigm of "quality at the point of design". The time has come for retrospective analyses to catalyze prospective action. Quality at the point of design places pressure on the quality of our predictive models. Empirical QSAR models when built with care provide true predictive control, but their accuracy and precision can be improved. Here we describe AstraZeneca's experience of automation in QSAR model building and validation, and how an informatics system can provide a step-change in predictive power to project design teams, if they choose to use it.

Does glycemic variability impact mood and quality of life?

PubMed

Penckofer, Sue; Quinn, Lauretta; Byrn, Mary; Ferrans, Carol; Miller, Michael; Strange, Poul

2012-04-01

Diabetes is a chronic condition that significantly impacts quality of life. Poor glycemic control is associated with more diabetes complications, depression, and worse quality of life. The impact of glycemic variability on mood and quality of life has not been studied. A descriptive exploratory design was used. Twenty-three women with type 2 diabetes wore a continuous glucose monitoring system for 72 h and completed a series of questionnaires. Measurements included (1) glycemic control shown by glycated hemoglobin and 24-h mean glucose, (2) glycemic variability shown by 24-h SD of the glucose readings, continuous overall net glycemic action (CONGA), and Fourier statistical models to generate smoothed curves to assess rate of change defined as "energy," and (3) mood (depression, anxiety, anger) and quality of life by questionnaires. Women with diabetes and co-morbid depression had higher anxiety, more anger, and lower quality of life than those without depression. Certain glycemic variability measures were associated with mood and quality of life. The 24-h SD of the glucose readings and the CONGA measures were significantly associated with health-related quality of life after adjusting for age and weight. Fourier models indicated that certain energy components were significantly associated with depression, trait anxiety, and overall quality of life. Finally, subjects with higher trait anxiety tended to have steeper glucose excursions. Data suggest that greater glycemic variability may be associated with lower quality of life and negative moods. Implications include replication of the study in a larger sample for the assessment of blood glucose fluctuations as they impact mood and quality of life.

Real-time assessments of water quality: expanding nowcasting throughout the Great Lakes

USGS Publications Warehouse

,

2013-01-01

Nowcasts are systems that inform the public of current bacterial water-quality conditions at beaches on the basis of predictive models. During 2010–12, the U.S. Geological Survey (USGS) worked with 23 local and State agencies to improve existing operational beach nowcast systems at 4 beaches and expand the use of predictive models in nowcasts at an additional 45 beaches throughout the Great Lakes. The predictive models were specific to each beach, and the best model for each beach was based on a unique combination of environmental and water-quality explanatory variables. The variables used most often in models to predict Escherichia coli (E. coli) concentrations or the probability of exceeding a State recreational water-quality standard included turbidity, day of the year, wave height, wind direction and speed, antecedent rainfall for various time periods, and change in lake level over 24 hours. During validation of 42 beach models during 2012, the models performed better than the current method to assess recreational water quality (previous day's E. coli concentration). The USGS will continue to work with local agencies to improve nowcast predictions, enable technology transfer of predictive model development procedures, and implement more operational systems during 2013 and beyond.

The experience factory: Can it make you a 5? or what is its relationship to other quality and improvement concepts?

NASA Technical Reports Server (NTRS)

Basili, Victor R.

1992-01-01

The concepts of quality improvements have permeated many businesses. It is clear that the nineties will be the quality era for software and there is a growing need to develop or adapt quality improvement approaches to the software business. Thus we must understand software as an artifact and software as a business. Since the business we are dealing with is software, we must understand the nature of software and software development. The software discipline is evolutionary and experimental; it is a laboratory science. Software is development not production. The technologies of the discipline are human based. There is a lack of models that allow us to reason about the process and the product. All software is not the same; process is a variable, goals are variable, etc. Packaged, reusable, experiences require additional resources in the form of organization, processes, people, etc. There have been a variety of organizational frameworks proposed to improve quality for various businesses. The ones discussed in this presentation include: Plan-Do-Check-Act, a quality improvement process based upon a feedback cycle for optimizing a single process model/production line; the Experience Factory/Quality Improvement Paradigm, continuous improvements through the experimentation, packaging, and reuse of experiences based upon a business's needs; Total Quality Management, a management approach to long term success through customer satisfaction based on the participation of all members of an organization; the SEI capability maturity model, a staged process improvement based upon assessment with regard to a set of key process areas until you reach a level 5 which represents a continuous process improvement; and Lean (software) Development, a principle supporting the concentration of the production on 'value added' activities and the elimination of reduction of 'not value added' activities.

Pathogen Transport and Fate Modeling in the Upper Salem River Watershed using SWAT Model

EPA Science Inventory

SWAT (Soil and Water Assessment Tool) is a dynamic watershed model that is applied to simulate the impact of land management practices on water quality over a continuous period. The Upper Salem River, located in Salem County New Jersey, is listed by the New Jersey Department of ...

Evaluation of impact of length of calibration time period on the APEX model streamflow simulation

USDA-ARS?s Scientific Manuscript database

Due to resource constraints, continuous long-term measured data for model calibration and validation (C/V) are rare. As a result, most hydrologic and water quality models are calibrated and, if possible, validated using limited available measured data. However, little research has been carried out t...

Pathogen Transport and Fate Modeling in the Upper Salem River Watershed Using SWAT Model

EPA Science Inventory

SWAT (Soil and Water Assessment Tool) is a dynamic watershed model that is applied to simulate the impact of land management practices on water quality over a continuous period. The Upper Salem River, located in Salem County New Jersey, is listed by the New Jersey Department of ...

[Water environmental capacity calculation model for the rivers in drinking water source conservation area].

PubMed

Chen, Ding-jiang; Lü, Jun; Shen, Ye-na; Jin, Shu-quan; Shi, Yi-ming

2008-09-01

Based on the one-dimension model for water environmental capacity (WEC) in river, a new model for the WEC estimation in river-reservoir system was developed in drinking water source conservation area (DWSCA). In the new model, the concept was introduced that the water quality target of the rivers in DWSCA was determined by the water quality demand of reservoir for drinking water source. It implied that the WEC of the reservoir could be used as the water quality control target at the reach-end of the upstream rivers in DWSCA so that the problems for WEC estimation might be avoided that the differences of the standards for a water quality control target between in river and in reservoir, such as the criterions differences for total phosphorus (TP)/total nitrogen (TN) between in reservoir and in river according to the National Surface Water Quality Standard of China (GB 3838-2002), and the difference of designed hydrology conditions for WEC estimation between in reservoir and in river. The new model described the quantitative relationship between the WEC of drinking water source and of the river, and it factually expressed the continuity and interplay of these low water areas. As a case study, WEC for the rivers in DWSCA of Laohutan reservoir located in southeast China was estimated using the new model. Results indicated that the WEC for TN and TP was 65.05 t x a(-1) and 5.05 t x a(-1) in the rivers of the DWSCA, respectively. According to the WEC of Laohutan reservoir and current TN and TP quantity that entered into the rivers, about 33.86 t x a(-1) of current TN quantity should be reduced in the DWSCA, while there was 2.23 t x a(-1) of residual WEC of TP in the rivers. The modeling method was also widely applicable for the continuous water bodies with different water quality targets, especially for the situation of higher water quality control target in downstream water body than that in upstream.

Storm Water Management Model Reference Manual Volume I, Hydrology

EPA Science Inventory

SWMM is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. The runoff component of SWMM operates on a collection of subcatchment areas that receive precipitation and gene...

Storm Water Management Model Reference Manual Volume II – Hydraulics

EPA Science Inventory

SWMM is a dynamic rainfall-runoff simulation model used for single event or long-term (continuous) simulation of runoff quantity and quality from primarily urban areas. The runoff component of SWMM operates on a collection of subcatchment areas that receive precipitation and gene...

Web quality control for lectures: Supercourse and Amazon.com.

PubMed

Linkov, Faina; LaPorte, Ronald; Lovalekar, Mita; Dodani, Sunita

2005-12-01

Peer review has been at the corner stone of quality control of the biomedical journals in the past 300 years. With the emergency of the Internet, new models of quality control and peer review are emerging. However, such models are poorly investigated. We would argue that the popular system of quality control used in Amazon.com offers a way to ensure continuous quality improvement in the area of research communications on the Internet. Such system is providing an interesting alternative to the traditional peer review approaches used in the biomedical journals and challenges the traditional paradigms of scientific publishing. This idea is being explored in the context of Supercourse, a library of 2,350 prevention lectures, shared for free by faculty members from over 150 countries. Supercourse is successfully utilizing quality control approaches that are similar to Amazon.com model. Clearly, the existing approaches and emerging alternatives for quality control in scientific communications needs to be assessed scientifically. Rapid explosion of internet technologies could be leveraged to produce better, more cost effective systems for quality control in the biomedical publications and across all sciences.

Water-quality data and Escherichia coli predictions for selected karst catchments of the upper Duck River watershed in central Tennessee, 2007–10

USGS Publications Warehouse

Murphy, Jennifer C.; Farmer, James; Layton, Alice

2016-06-13

The U.S. Geological Survey, in cooperation with the Tennessee Duck River Development Agency, monitored water quality at several locations in the upper Duck River watershed between October 2007 and September 2010. Discrete water samples collected at 24 sites in the watershed were analyzed for water quality, and Escherichia coli (E. coli) and enterococci concentrations. Additional analyses, including the determination of anthropogenic-organic compounds, bacterial concentration of resuspended sediment, and bacterial-source tracking, were performed at a subset of sites. Continuous monitoring of streamflow, turbidity, and specific conductance was conducted at seven sites; a subset of sites also was monitored for water temperature and dissolved oxygen concentration. Multiple-regression models were developed to predict instantaneous E. coli concentrations and loads at sites with continuous monitoring. This data collection effort, along with the E. coli models and predictions, support analyses of the relations among land use, bacteria source and transport, and basin hydrology in the upper Duck River watershed.

An Analysis of Contraceptive Discontinuation among Female, Reversible Method Users in Urban Honduras

PubMed Central

Barden-O’Fallon, Janine; Speizer, Ilene S.; Cálix, Javier; Rodriguez, Francisco

2013-01-01

A panel study examining the effects of individual characteristics, side effects experienced, and service quality on contraceptive discontinuation was undertaken in four urban areas of Honduras. Data were collected from October 2006 to December 2007. The baseline population included 800 women aged 15–44 who were new or continuing users of the injectable, IUD, or oral contraceptive pill. A total of 671 women (84%) were re-interviewed after one year. Life tables and Cox proportional hazards models are used to present discontinuation rates and factors associated with contraceptive discontinuation. Among new users, discontinuation of the baseline method at 12 months was high (45%); especially for users of the injectable (50%). In the hazards model, service quality had little effect on discontinuation, while individual characteristics and the experience of specific side effects showed significant effects. The results suggest that programs should emphasize continuous contraceptive coverage rather than continuous use of a particular method. PMID:21500697

Influence of raw material properties upon critical quality attributes of continuously produced granules and tablets.

PubMed

Fonteyne, Margot; Wickström, Henrika; Peeters, Elisabeth; Vercruysse, Jurgen; Ehlers, Henrik; Peters, Björn-Hendrik; Remon, Jean Paul; Vervaet, Chris; Ketolainen, Jarkko; Sandler, Niklas; Rantanen, Jukka; Naelapää, Kaisa; De Beer, Thomas

2014-07-01

Continuous manufacturing gains more and more interest within the pharmaceutical industry. The International Conference of Harmonisation (ICH) states in its Q8 'Pharmaceutical Development' guideline that the manufacturer of pharmaceuticals should have an enhanced knowledge of the product performance over a range of raw material attributes, manufacturing process options and process parameters. This fits further into the Process Analytical Technology (PAT) and Quality by Design (QbD) framework. The present study evaluates the effect of variation in critical raw material properties on the critical quality attributes of granules and tablets, produced by a continuous from-powder-to-tablet wet granulation line. The granulation process parameters were kept constant to examine the differences in the end product quality caused by the variability of the raw materials properties only. Theophylline-Lactose-PVP (30-67.5-2.5%) was used as model formulation. Seven different grades of theophylline were granulated. Afterward, the obtained granules were tableted. Both the characteristics of granules and tablets were determined. The results show that differences in raw material properties both affect their processability and several critical quality attributes of the resulting granules and tablets. Copyright © 2014 Elsevier B.V. All rights reserved.

Faculty Opinions Regarding the Philosophical Principles of Total Quality Management (TQM).

ERIC Educational Resources Information Center

Aliff, John Vincent

The 14 points of the Total Quality Management (TQM) model can be distilled into the following 5 main guiding principles: establish a moral purpose for the institution, use cooperative efforts instead of individual efforts, stop the use of inspection (testing) to improve students and teachers, continuously improve the system and its products, and…

Putting Student Evaluations into Perspective: The Course Experience Quality and Satisfaction Model (CEQS)

ERIC Educational Resources Information Center

Grace, Debra; Weaven, Scott; Bodey, Kelli; Ross, Mitchell; Weaven, Keith

2012-01-01

Although not specifically designed for this purpose, the Course Experience Questionnaire (CEQ) continues to be used as a proxy for student satisfaction. This may be due to a lack of appropriate alternative measures, or a clear understanding of the relationship between quality and satisfaction. This study, therefore, examines the CEQ dimensions…

INTEGRATION OF SATELLITE, MODELED, AND GROUND BASED AEROSOL DATA FOR USE IN AIR QUALITY AND PUBLIC HEALTH APPLICATIONS ( AGU-BALTIMORE )

EPA Science Inventory

Within the next several years NOAA and EPA will begin to issue PM_2.5 air quality forecasts over the entire domain of the eastern United States, eventually extending to national coverage. These forecasts will provide continuous estimated values of particulate matter on ...

Measuring maternal satisfaction with maternity care: A systematic integrative review: What is the most appropriate, reliable and valid tool that can be used to measure maternal satisfaction with continuity of maternity care?

PubMed

Perriman, Noelyn; Davis, Deborah

2016-06-01

The objective of this systematic integrative review is to identify, summarise and communicate the findings of research relating to tools that measure maternal satisfaction with continuity of maternity care models. In so doing the most appropriate, reliable and valid tool that can be used to measure maternal satisfaction with continuity of maternity care will be determined. A systematic integrative review of published and unpublished literature was undertaken using selected databases. Research papers were included if they measured maternal satisfaction in a continuity model of maternity care, were published in English after 1999 and if they included (or made available) the instrument used to measure satisfaction. Six hundred and thirty two unique papers were identified and after applying the selection criteria, four papers were included in the review. Three of these originated in Australia and one in Canada. The primary focus of all papers was not on the development of a tool to measure maternal satisfaction but on the comparison of outcomes in different models of care. The instruments developed varied in terms of the degree to which they were tested for validity and reliability. Women's satisfaction with maternity services is an important measure of quality. Most satisfaction surveys in maternity appear to reflect fragmented models of care though continuity of care models are increasing in line with the evidence demonstrating their effectiveness. It is important that robust tools are developed for this context and that there is some consistency in the way this is measured and reported for the purposes of benchmarking and quality improvement. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Integrity Model Application: A Quality Support System for Decision-makers on Water Quality Assessment and Improvement

NASA Astrophysics Data System (ADS)

Mirauda, D.; Ostoich, M.; Di Maria, F.; Benacchio, S.; Saccardo, I.

2018-03-01

In this paper, a mathematical model has been applied to a river in North-East Italy to describe vulnerability scenarios due to environmental pollution phenomena. Such model, based on the influence diagrams theory, allowed identifying the extremely critical factors, such as wastewater discharges, drainage of diffuse pollution from agriculture and climate changes, which might affect the water quality of the river. The obtained results underlined how the water quality conditions have improved thanks to the continuous controls on the territory, following the application of Water Framework Directive 2000/60/EC. Nevertheless, some fluvial stretches did not reach the “good ecological status” by 2015, because of the increasing population in urban areas recorded in the last years and the high presence of tourists during the summer months, not balanced by a treatment plants upgrade.

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

PubMed

McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2014-10-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

PubMed

McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2015-01-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Prediction of wastewater quality indicators at the inflow to the wastewater treatment plant using data mining methods

NASA Astrophysics Data System (ADS)

Szeląg, Bartosz; Barbusiński, Krzysztof; Studziński, Jan; Bartkiewicz, Lidia

2017-11-01

In the study, models developed using data mining methods are proposed for predicting wastewater quality indicators: biochemical and chemical oxygen demand, total suspended solids, total nitrogen and total phosphorus at the inflow to wastewater treatment plant (WWTP). The models are based on values measured in previous time steps and daily wastewater inflows. Also, independent prediction systems that can be used in case of monitoring devices malfunction are provided. Models of wastewater quality indicators were developed using MARS (multivariate adaptive regression spline) method, artificial neural networks (ANN) of the multilayer perceptron type combined with the classification model (SOM) and cascade neural networks (CNN). The lowest values of absolute and relative errors were obtained using ANN+SOM, whereas the MARS method produced the highest error values. It was shown that for the analysed WWTP it is possible to obtain continuous prediction of selected wastewater quality indicators using the two developed independent prediction systems. Such models can ensure reliable WWTP work when wastewater quality monitoring systems become inoperable, or are under maintenance.

Perseverative Cognition as an Explanatory Mechanism in the Relation Between Job Demands and Sleep Quality.

PubMed

Van Laethem, Michelle; Beckers, Debby G J; Geurts, Sabine A E; Garefelt, Johanna; Magnusson Hanson, Linda L; Leineweber, Constanze

2018-04-01

The aim of this longitudinal three-wave study was to examine (i) reciprocal associations among job demands, work-related perseverative cognition (PC), and sleep quality; (ii) PC as a mediator in-between job demands and sleep quality; and (iii) continuous high job demands in relation to sleep quality and work-related PC over time. A representative sample of the Swedish working population was approached in 2010, 2012, and 2014, and 2316 respondents were included in this longitudinal full-panel survey study. Structural equation modelling was performed to analyse the temporal relations between job demands, work-related PC, and sleep quality. Additionally, a subsample (N = 1149) consisting of individuals who reported the same level of exposure to job demands during all three waves (i.e. stable high, stable moderate, or stable low job demands) was examined in relation to PC and sleep quality over time. Analyses showed that job demands, PC, and poor sleep quality were positively and reciprocally related. Work-related PC mediated the normal and reversed, direct across-wave relations between job demands and sleep quality. Individuals with continuous high job demands reported significantly lower sleep quality and higher work-related PC, compared to individuals with continuous moderate/low job demands. This study substantiated reciprocal relations between job demands, work-related PC, and sleep quality and supported work-related PC as an underlying mechanism of the reciprocal job demands-sleep relationship. Moreover, this study showed that chronically high job demands are a risk factor for low sleep quality.

42 CFR § 512.310 - Appeals process.

Code of Federal Regulations, 2010 CFR

2017-10-01

... (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Pricing and Payment § 512.310... related to payment, a CR incentive payment, reconciliation amounts, repayment amounts, the use of quality..., CMS deems final the reconciliation report and CR incentive payment report 45 calendar days after the...

Relations between continuous real-time turbidity data and discrete suspended-sediment concentration samples in the Neosho and Cottonwood Rivers, east-central Kansas, 2009-2012

USGS Publications Warehouse

Foster, Guy M.

2014-01-01

The Neosho River and its primary tributary, the Cottonwood River, are the primary sources of inflow to the John Redmond Reservoir in east-central Kansas. Sedimentation rate in the John Redmond Reservoir was estimated as 743 acre-feet per year for 1964–2006. This estimated sedimentation rate is more than 80 percent larger than the projected design sedimentation rate of 404 acre-feet per year, and resulted in a loss of 40 percent of the conservation pool since its construction in 1964. To reduce sediment input into the reservoir, the Kansas Water Office implemented stream bank stabilization techniques along an 8.3 mile reach of the Neosho River during 2010 through 2011. The U.S. Geological Survey, in cooperation with the Kansas Water Office and funded in part through the Kansas State Water Plan Fund, operated continuous real-time water-quality monitors upstream and downstream from stream bank stabilization efforts before, during, and after construction. Continuously measured water-quality properties include streamflow, specific conductance, water temperature, and turbidity. Discrete sediment samples were collected from June 2009 through September 2012 and analyzed for suspended-sediment concentration (SSC), percentage of sediments less than 63 micrometers (sand-fine break), and loss of material on ignition (analogous to amount of organic matter). Regression models were developed to establish relations between discretely measured SSC samples, and turbidity or streamflow to estimate continuously SSC. Continuous water-quality monitors represented between 96 and 99 percent of the cross-sectional variability for turbidity, and had slopes between 0.91 and 0.98. Because consistent bias was not observed, values from continuous water-quality monitors were considered representative of stream conditions. On average, turbidity-based SSC models explained 96 percent of the variance in SSC. Streamflow-based regressions explained 53 to 60 percent of the variance. Mean squared prediction error for turbidity-based regression relations ranged from -32 to 48 percent, whereas mean square prediction error for streamflow-based regressions ranged from -69 to 218 percent. These models are useful for evaluating the variability of SSC during rapidly changing conditions, computing loads and yields to assess SSC transport through the watershed, and for providing more accurate load estimates compared to streamflow-only based estimation methods used in the past. These models can be used to evaluate the efficacy of streambank stabilization efforts.

Long-Term Cost-Effectiveness of Transanal Irrigation in Patients with Neurogenic Bowel Dysfunction.

PubMed

Emmanuel, Anton; Kumar, Gayathri; Christensen, Peter; Mealing, Stuart; Størling, Zenia M; Andersen, Frederikke; Kirshblum, Steven

2016-01-01

People suffering from neurogenic bowel dysfunction (NBD) and an ineffective bowel regimen often suffer from fecal incontinence (FI) and related symptoms, which have a huge impact on their quality of life. In these situations, transanal irrigation (TAI) has been shown to reduce these symptoms and improve quality of life. To investigate the long-term cost-effectiveness of initiating TAI in patients with NBD who have failed standard bowel care (SBC). A deterministic Markov decision model was developed to project the lifetime health economic outcomes, including quality-adjusted life years (QALYs), episodes of FI, urinary tract infections (UTIs), and stoma surgery when initiating TAI relative to continuing SBC. A data set consisting of 227 patients with NBD due to spinal cord injury (SCI), multiple sclerosis, spina bifida and cauda equina syndrome was used in the analysis. In the model a 30-year old individual with SCI was used as a base-case. A probabilistic sensitivity analysis was applied to evaluate the robustness of the model. The model predicts that a 30-year old SCI patient with a life expectancy of 37 years initiating TAI will experience a 36% reduction in FI episodes, a 29% reduction in UTIs, a 35% reduction in likelihood of stoma surgery and a 0.4 improvement in QALYs, compared with patients continuing SBC. A lifetime cost-saving of £21,768 per patient was estimated for TAI versus continuing SBC alone. TAI is a cost-saving treatment strategy reducing risk of stoma surgery, UTIs, episodes of FI and improving QALYs for NBD patients who have failed SBC.

Space Shuttle flying qualities and flight control system assessment study, phase 2

NASA Technical Reports Server (NTRS)

Myers, T. T.; Johnston, D. E.; Mcruer, D. T.

1983-01-01

A program of flying qualities experiments as part of the Orbiter Experiments Program (OEX) is defined. Phase 1, published as CR-170391, reviewed flying qualities criteria and shuttle data. The review of applicable experimental and shuttle data to further define the OEX plan is continued. An unconventional feature of this approach is the use of pilot strategy model identification to relate flight and simulator results. Instrumentation, software, and data analysis techniques for pilot model measurements are examined. The relationship between shuttle characteristics and superaugmented aircraft is established. STS flights 1 through 4 are reviewed from the point of view of flying qualities. A preliminary plan for a coordinated program of inflight and simulator research is presented.

Process performance and product quality in an integrated continuous antibody production process.

PubMed

Karst, Daniel J; Steinebach, Fabian; Soos, Miroslav; Morbidelli, Massimo

2017-02-01

Continuous manufacturing is currently being seriously considered in the biopharmaceutical industry as the possible new paradigm for producing therapeutic proteins, due to production cost and product quality related benefits. In this study, a monoclonal antibody producing CHO cell line was cultured in perfusion mode and connected to a continuous affinity capture step. The reliable and stable integration of the two systems was enabled by suitable control loops, regulating the continuous volumetric flow and adapting the operating conditions of the capture process. For the latter, an at-line HPLC measurement of the harvest concentration subsequent to the bioreactor was combined with a mechanistic model of the capture chromatographic unit. Thereby, optimal buffer consumption and productivity throughout the process was realized while always maintaining a yield above the target value of 99%. Stable operation was achieved at three consecutive viable cell density set points (20, 60, and 40 × 10 6 cells/mL), together with consistent product quality in terms of aggregates, fragments, charge isoforms, and N-linked glycosylation. In addition, different values for these product quality attributes such as N-linked glycosylation, charge variants, and aggregate content were measured at the different steady states. As expected, the amount of released DNA and HCP was significantly reduced by the capture step for all considered upstream operating conditions. This study is exemplary for the potential of enhancing product quality control and modulation by integrated continuous manufacturing. Biotechnol. Bioeng. 2017;114: 298-307. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Does Glycemic Variability Impact Mood and Quality of Life?

PubMed Central

Quinn, Lauretta; Byrn, Mary; Ferrans, Carol; Miller, Michael; Strange, Poul

2012-01-01

Abstract Background Diabetes is a chronic condition that significantly impacts quality of life. Poor glycemic control is associated with more diabetes complications, depression, and worse quality of life. The impact of glycemic variability on mood and quality of life has not been studied. Methods A descriptive exploratory design was used. Twenty-three women with type 2 diabetes wore a continuous glucose monitoring system for 72 h and completed a series of questionnaires. Measurements included (1) glycemic control shown by glycated hemoglobin and 24-h mean glucose, (2) glycemic variability shown by 24-h SD of the glucose readings, continuous overall net glycemic action (CONGA), and Fourier statistical models to generate smoothed curves to assess rate of change defined as “energy,” and (3) mood (depression, anxiety, anger) and quality of life by questionnaires. Results Women with diabetes and co-morbid depression had higher anxiety, more anger, and lower quality of life than those without depression. Certain glycemic variability measures were associated with mood and quality of life. The 24-h SD of the glucose readings and the CONGA measures were significantly associated with health-related quality of life after adjusting for age and weight. Fourier models indicated that certain energy components were significantly associated with depression, trait anxiety, and overall quality of life. Finally, subjects with higher trait anxiety tended to have steeper glucose excursions. Conclusions Data suggest that greater glycemic variability may be associated with lower quality of life and negative moods. Implications include replication of the study in a larger sample for the assessment of blood glucose fluctuations as they impact mood and quality of life. PMID:22324383

40 CFR 51.1007 - Attainment demonstration and modeling requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... requirements. 51.1007 Section 51.1007 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Implementation of PM2.5 National Ambient Air Quality Standards § 51.1007 Attainment demonstration and modeling requirements. (a) For any area designated as nonattainment for the PM2.5 NAAQS, the State must submit an...

40 CFR 51.1007 - Attainment demonstration and modeling requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... requirements. 51.1007 Section 51.1007 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Implementation of PM2.5 National Ambient Air Quality Standards § 51.1007 Attainment demonstration and modeling requirements. (a) For any area designated as nonattainment for the PM2.5 NAAQS, the State must submit an...

40 CFR 51.1007 - Attainment demonstration and modeling requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... requirements. 51.1007 Section 51.1007 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Implementation of PM2.5 National Ambient Air Quality Standards § 51.1007 Attainment demonstration and modeling requirements. (a) For any area designated as nonattainment for the PM2.5 NAAQS, the State must submit an...

40 CFR 51.1007 - Attainment demonstration and modeling requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requirements. 51.1007 Section 51.1007 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Implementation of PM2.5 National Ambient Air Quality Standards § 51.1007 Attainment demonstration and modeling requirements. (a) For any area designated as nonattainment for the PM2.5 NAAQS, the State must submit an...

Effects of urbanization on the water quality of lakes in Eagan, Minnesota

USGS Publications Warehouse

Ayers, M.A.; Payne, G.A.; Have, Mark A.

1980-01-01

Three phosphorus-prediction models developed during the study are applicable to shallow (less than about 12 feet), nonstratifying lakes and ponds. The data base was not sufficient to select an appropriate model to predict the effects of future loading from continuing urbanization on the deeper lakes.

An Interactive Model for Studying Student Retention. AIR 1990 Annual Forum Paper.

ERIC Educational Resources Information Center

Glover, Robert H.; Wilcox, Jerry

A design for improving the quality of information available for continuous operational study of student retention at the University of Hartford in Connecticut was examined involving a microcomputer based decision support system for student retention research. The system, an interactive modeling approach to conduct longitudinal and comparative…

Mesh quality oriented 3D geometric vascular modeling based on parallel transport frame.

PubMed

Guo, Jixiang; Li, Shun; Chui, Yim Pan; Qin, Jing; Heng, Pheng Ann

2013-08-01

While a number of methods have been proposed to reconstruct geometrically and topologically accurate 3D vascular models from medical images, little attention has been paid to constantly maintain high mesh quality of these models during the reconstruction procedure, which is essential for many subsequent applications such as simulation-based surgical training and planning. We propose a set of methods to bridge this gap based on parallel transport frame. An improved bifurcation modeling method and two novel trifurcation modeling methods are developed based on 3D Bézier curve segments in order to ensure the continuous surface transition at furcations. In addition, a frame blending scheme is implemented to solve the twisting problem caused by frame mismatch of two successive furcations. A curvature based adaptive sampling scheme combined with a mesh quality guided frame tilting algorithm is developed to construct an evenly distributed, non-concave and self-intersection free surface mesh for vessels with distinct radius and high curvature. Extensive experiments demonstrate that our methodology can generate vascular models with better mesh quality than previous methods in terms of surface mesh quality criteria. Copyright © 2013 Elsevier Ltd. All rights reserved.

Patients' experience of Chinese Medicine Primary Care Services: Implications on Improving Coordination and Continuity of Care.

PubMed

Chung, Vincent Ch; Yip, Benjamin Hk; Griffiths, Sian M; Yu, Ellen Lm; Liu, Siya; Ho, Robin St; Wu, Xinyin; Leung, Albert Wn; Sit, Regina Ws; Wu, Justin Cy; Wong, Samuel Ys

2015-12-21

Chinese medicine (CM) is major form of traditional and complementary medicine used by Chinese populations. Evaluation on patients' experience on CM service is essential for improving service quality. This cross sectional study aims (i) to assess how CM clinics with different administrative model differ in terms of quality from patients' perspective; and (ii) to investigate how quality varies with patients' demographic and health characteristics. Five hundred and sixteen patients were sampled from charity and semi-public CM clinics in Hong Kong, and were invited to assess their experience using the Primary Care Assessment Tool (PCAT). Results indicated that overall mean PCAT scoring is satisfactory, achieving 70.7% (91.26/129) of total score. Ratings were lower in areas of "coordination of patient information", "continuity of care", and "range of service provided". Impact of administrative models, including involvement of tax-funded healthcare system and outreach delivery, were minimal after adjusting for patient characteristics. Demographic and health characteristics of patients did not contribute to substantial variations in scoring. To improve patient experience, policy makers should consider strengthening care coordination, continuity and comprehensiveness in CM primary care services. Sharing of electronic records and establishing referral system are potential solutions for linking CM and conventional healthcare services.

Framework for industry engagement and quality principles for industry-provided medical education in Europe

PubMed Central

Allen, Tamara; Donde, Nina; Hofstädter-Thalmann, Eva; Keijser, Sandra; Moy, Veronique; Murama, Jean-Jacques; Kellner, Thomas

2017-01-01

ABSTRACT Lifelong learning through continuing professional development (CPD) and medical education is critical for healthcare professionals to stay abreast of knowledge and skills and provide an optimal standard of care to patients. In Europe, CPD and medical education are fragmented as there are numerous models, providers and national regulations and a lack of harmonisation of qualitative criteria. There is continued debate on the appropriate role of pharmaceutical companies in the context of medical education. Accrediting bodies such as European Accreditation Council for Continuing Medical Education do not permit active involvement of the pharmaceutical industry due to concerns around conflicts of interest and potential for bias. However, many examples of active collaboration between pharmaceutical companies and medical societies and scientific experts exist, demonstrating high integrity, clear roles and responsibilities, and fair and balanced content. Medical education experts from 16 pharmaceutical companies met to develop a set of quality principles similar to standards that have been established for clinical trials and in alignment with existing principles of accrediting bodies. This paper outlines their proposal for a framework to improve and harmonise medical education quality standards in Europe, and is also an invitation for all stakeholders to join a discussion on this integrative model. PMID:29644135

Urban Quality Development and Management: Capacity Development and Continued Education for the Sustainable City

ERIC Educational Resources Information Center

Lehmann, Martin; Fryd, Ole

2008-01-01

Purpose: The purpose of this paper is to describe and discuss the development and the structure of a new international master on the subject of urban quality development and management (UQDM), and explore the potential of the process and the outcome in serving as models adoptable by faculty at other universities. Design/methodology/approach: The…

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

PubMed

Jansson, Inger; Ene, Kerstin W

2016-09-01

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

Using a tracer technique to identify the extent of non-ideal flows in the continuous mixing of non-Newtonian fluids

NASA Astrophysics Data System (ADS)

Patel, D.; Ein-Mozaffari, F.; Mehrvar, M.

2013-05-01

The identification of non-ideal flows in a continuous-flow mixing of non-Newtonian fluids is a challenging task for various chemical industries: plastic manufacturing, water and wastewater treatment, and pulp and paper manufacturing. Non-ideal flows such as channelling, recirculation, and dead zones significantly affect the performance of continuous-flow mixing systems. Therefore, the main objective of this paper was to develop an identification protocol to measure non-ideal flows in the continuous-flow mixing system. The extent of non-ideal flows was quantified using a dynamic model that incorporated channelling, recirculation, and dead volume in the mixing vessel. To estimate the dynamic model parameters, the system was excited using a frequency-modulated random binary input by injecting the saline solution (as a tracer) into the fresh feed stream prior to being pumped into the mixing vessel. The injection of the tracer was controlled by a computer-controlled on-off solenoid valve. Using the trace technique, the extent of channelling and the effective mixed volume were successfully determined and used as mixing quality criteria. Such identification procedures can be applied at various areas of chemical engineering in order to improve the mixing quality.

Principles of continuous quality improvement applied to intravenous therapy.

PubMed

Dunavin, M K; Lane, C; Parker, P E

1994-01-01

Documentation of the application of the principles of continuous quality improvement (CQI) to the health care setting is crucial for understanding the transition from traditional management models to CQI models. A CQI project was designed and implemented by the IV Therapy Department at Lawrence Memorial Hospital to test the application of these principles to intravenous therapy and as a learning tool for the entire organization. Through a prototype inventory project, significant savings in cost and time were demonstrated using check sheets, flow diagrams, control charts, and other statistical tools, as well as using the Plan-Do-Check-Act cycle. As a result, a primary goal, increased time for direct patient care, was achieved. Eight hours per week in nursing time was saved, relationships between two work areas were improved, and $6,000 in personnel costs, storage space, and inventory were saved.

Strategies for optimizing BioNano and Dovetail explored through a second reference quality assembly for the legume model, Medicago truncatula.

PubMed

Moll, Karen M; Zhou, Peng; Ramaraj, Thiruvarangan; Fajardo, Diego; Devitt, Nicholas P; Sadowsky, Michael J; Stupar, Robert M; Tiffin, Peter; Miller, Jason R; Young, Nevin D; Silverstein, Kevin A T; Mudge, Joann

2017-08-04

Third generation sequencing technologies, with sequencing reads in the tens- of kilo-bases, facilitate genome assembly by spanning ambiguous regions and improving continuity. This has been critical for plant genomes, which are difficult to assemble due to high repeat content, gene family expansions, segmental and tandem duplications, and polyploidy. Recently, high-throughput mapping and scaffolding strategies have further improved continuity. Together, these long-range technologies enable quality draft assemblies of complex genomes in a cost-effective and timely manner. Here, we present high quality genome assemblies of the model legume plant, Medicago truncatula (R108) using PacBio, Dovetail Chicago (hereafter, Dovetail) and BioNano technologies. To test these technologies for plant genome assembly, we generated five assemblies using all possible combinations and ordering of these three technologies in the R108 assembly. While the BioNano and Dovetail joins overlapped, they also showed complementary gains in continuity and join numbers. Both technologies spanned repetitive regions that PacBio alone was unable to bridge. Combining technologies, particularly Dovetail followed by BioNano, resulted in notable improvements compared to Dovetail or BioNano alone. A combination of PacBio, Dovetail, and BioNano was used to generate a high quality draft assembly of R108, a M. truncatula accession widely used in studies of functional genomics. As a test for the usefulness of the resulting genome sequence, the new R108 assembly was used to pinpoint breakpoints and characterize flanking sequence of a previously identified translocation between chromosomes 4 and 8, identifying more than 22.7 Mb of novel sequence not present in the earlier A17 reference assembly. Adding Dovetail followed by BioNano data yielded complementary improvements in continuity over the original PacBio assembly. This strategy proved efficient and cost-effective for developing a quality draft assembly compared to traditional reference assemblies.

Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement.

PubMed

Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne

2015-01-01

This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.

A statistical model for water quality predictions from a river discharge using coastal observations

NASA Astrophysics Data System (ADS)

Kim, S.; Terrill, E. J.

2007-12-01

Understanding and predicting coastal ocean water quality has benefits for reducing human health risks, protecting the environment, and improving local economies which depend on clean beaches. Continuous observations of coastal physical oceanography increase the understanding of the processes which control the fate and transport of a riverine plume which potentially contains high levels of contaminants from the upstream watershed. A data-driven model of the fate and transport of river plume water from the Tijuana River has been developed using surface current observations provided by a network of HF radar operated as part of a local coastal observatory that has been in place since 2002. The model outputs are compared with water quality sampling of shoreline indicator bacteria, and the skill of an alarm for low water quality is evaluated using the receiver operating characteristic (ROC) curve. In addition, statistical analysis of beach closures in comparison with environmental variables is also discussed.

New deconvolution method for microscopic images based on the continuous Gaussian radial basis function interpolation model.

PubMed

Chen, Zhaoxue; Chen, Hao

2014-01-01

A deconvolution method based on the Gaussian radial basis function (GRBF) interpolation is proposed. Both the original image and Gaussian point spread function are expressed as the same continuous GRBF model, thus image degradation is simplified as convolution of two continuous Gaussian functions, and image deconvolution is converted to calculate the weighted coefficients of two-dimensional control points. Compared with Wiener filter and Lucy-Richardson algorithm, the GRBF method has an obvious advantage in the quality of restored images. In order to overcome such a defect of long-time computing, the method of graphic processing unit multithreading or increasing space interval of control points is adopted, respectively, to speed up the implementation of GRBF method. The experiments show that based on the continuous GRBF model, the image deconvolution can be efficiently implemented by the method, which also has a considerable reference value for the study of three-dimensional microscopic image deconvolution.

A review of AirQ Models and their applications for forecasting the air pollution health outcomes.

PubMed

Oliveri Conti, Gea; Heibati, Behzad; Kloog, Itai; Fiore, Maria; Ferrante, Margherita

2017-03-01

Even though clean air is considered as a basic requirement for the maintenance of human health, air pollution continues to pose a significant health threat in developed and developing countries alike. Monitoring and modeling of classic and emerging pollutants is vital to our knowledge of health outcomes in exposed subjects and to our ability to predict them. The ability to anticipate and manage changes in atmospheric pollutant concentrations relies on an accurate representation of the chemical state of the atmosphere. The task of providing the best possible analysis of air pollution thus requires efficient computational tools enabling efficient integration of observational data into models. A number of air quality models have been developed and play an important role in air quality management. Even though a large number of air quality models have been discussed or applied, their heterogeneity makes it difficult to select one approach above the others. This paper provides a brief review on air quality models with respect to several aspects such as prediction of health effects.

Moving from Control to Culture in Higher Education Quality

NASA Astrophysics Data System (ADS)

Ehlers, Ulf-Daniel

In this article, it is argued that quality development in higher education needs to go beyond the implementation of rules and processes for quality management purposes to improve the educational quality. Quality development has to rather focus on promoting a quality culture, which enables individual actors to continuously improve their profession. While this understanding of quality as part of the organizational culture gains more importance, there is still a lack of fundamental research and conceptual understanding of the phenomenon in itself. This article aims to lay the foundations for a comprehensive understanding of quality culture in organizations focusing on higher education. For this purpose, the state of the art in research on organizational culture is discussed and a model of quality culture is presented.

MO-F-CAMPUS-T-03: Continuous Dose Delivery with Gamma Knife Perfexion

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

Ghobadi,; Li, W; Chung, C

2015-06-15

Purpose: We propose continuous dose delivery techniques for stereotactic treatments delivered by Gamma Knife Perfexion using inverse treatment planning system that can be applied to various tumour sites in the brain. We test the accuracy of the plans on Perfexion’s planning system (GammaPlan) to ensure the obtained plans are viable. This approach introduces continuous dose delivery for Perefxion, as opposed to the currently employed step-and-shoot approaches, for different tumour sites. Additionally, this is the first realization of automated inverse planning on GammaPlan. Methods: The inverse planning approach is divided into two steps of identifying a quality path inside the target,more » and finding the best collimator composition for the path. To find a path, we select strategic regions inside the target volume and find a path that visits each region exactly once. This path is then passed to a mathematical model which finds the best combination of collimators and their durations. The mathematical model minimizes the dose spillage to the surrounding tissues while ensuring the prescribed dose is delivered to the target(s). Organs-at-risk and their corresponding allowable doses can also be added to the model to protect adjacent organs. Results: We test this approach on various tumour sizes and sites. The quality of the obtained treatment plans are comparable or better than forward plans and inverse plans that use step- and-shoot technique. The conformity indices in the obtained continuous dose delivery plans are similar to those of forward plans while the beam-on time is improved on average (see Table 1 in supporting document). Conclusion: We employ inverse planning for continuous dose delivery in Perfexion for brain tumours. The quality of the obtained plans is similar to forward and inverse plans that use conventional step-and-shoot technique. We tested the inverse plans on GammaPlan to verify clinical relevance. This research was partially supported by Elekta, Sweden (vendor of Gamma Knife Perfexion)« less

Process Improvements in Training Device Acceptance Testing: A Study in Total Quality Management

DTIC Science & Technology

1990-12-12

Quality Management , a small group of Government and industry specialists examined the existing training device acceptance test process for potential improvements. The agreed-to mission of the Air Force/Industry partnership was to continuously identify and promote implementable approaches to minimize the cost and time required for acceptance testing while ensuring that validated performance supports the user training requirements. Application of a Total Quality process improvement model focused on the customers and their requirements, analyzed how work was accomplished, and

40 CFR 75.21 - Quality assurance and quality control requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Quality assurance and quality control... PROGRAMS (CONTINUED) CONTINUOUS EMISSION MONITORING Operation and Maintenance Requirements § 75.21 Quality assurance and quality control requirements. (a) Continuous emission monitoring systems. The owner or...

Model of care transformation: a health care system CNE's journey.

PubMed

Swick, Maureen; Doulaveris, Phyllis; Christensen, Patricia

2012-01-01

In 2001, the Institute of Medicine released the report "Crossing the Quality Chasm: A New Health System for the 21st Century." The report criticizes our health care system and argues that we are failing to provide Americans with the high-quality and affordable health care they deserve and need. While incremental progress has been made, we continue to strive for improved care quality, and our rising costs are potentially catastrophic. Consistent with the Institute of Medicine report, and its reputation for innovation, Inova Health System identified care model transformation as a system priority. Given that the organization is replacing its electronic health record and introducing advanced analytic capabilities, the opportunity to transform the model of care in tandem with core clinical platform enhancement was a compelling reason to move forward.

Influences of water and sediment quality and hydrologic processes on mussels in the Clinch River

USGS Publications Warehouse

Johnson, Gregory C.; Krstolic, Jennifer L.; Ostby, Brett J.K.

2014-01-01

Segments of the Clinch River in Virginia have experienced declining freshwater mussel populations during the past 40 years, while other segments of the river continue to support some of the richest mussel communities in the country. The close proximity of these contrasting reaches provides a study area where differences in climate, hydrology, and historic mussel distribution are minimal. The USGS conducted a study between 2009 and 2011 to evaluate possible causes of the mussel declines. Evaluation of mussel habitat showed no differences in physical habitat quality, leaving water and sediment quality as possible causes for declines. Three years of continuous water-quality data showed higher turbidity and specific conductance in the reaches with low-quality mussel assemblages compared to reaches with high-quality mussel assemblages. Discrete water-quality samples showed higher major ions and metals concentrations in the low-quality reach. Base-flow samples contained high major ion and metal concentrations coincident to low-quality mussel populations. These results support a conceptual model of dilution and augmentation where increased concentrations of major ions and other dissolved constituents from mined tributaries result in reaches with declining mussel populations. Tributaries from unmined basins provide water with low concentrations of dissolved constituents, diluting reaches of the Clinch River where high-quality mussel populations occur.

Continuous cultivation of photosynthetic microorganisms: Approaches, applications and future trends.

PubMed

Fernandes, Bruno D; Mota, Andre; Teixeira, Jose A; Vicente, Antonio A

2015-11-01

The possibility of using photosynthetic microorganisms, such as cyanobacteria and microalgae, for converting light and carbon dioxide into valuable biochemical products has raised the need for new cost-efficient processes ensuring a constant product quality. Food, feed, biofuels, cosmetics and pharmaceutics are among the sectors that can profit from the application of photosynthetic microorganisms. Biomass growth in a photobioreactor is a complex process influenced by multiple parameters, such as photosynthetic light capture and attenuation, nutrient uptake, photobioreactor hydrodynamics and gas-liquid mass transfer. In order to optimize productivity while keeping a standard product quality, a permanent control of the main cultivation parameters is necessary, where the continuous cultivation has shown to be the best option. However it is of utmost importance to recognize the singularity of continuous cultivation of cyanobacteria and microalgae due to their dependence on light availability and intensity. In this sense, this review provides comprehensive information on recent breakthroughs and possible future trends regarding technological and process improvements in continuous cultivation systems of microalgae and cyanobacteria, that will directly affect cost-effectiveness and product quality standardization. An overview of the various applications, techniques and equipment (with special emphasis on photobioreactors) in continuous cultivation of microalgae and cyanobacteria are presented. Additionally, mathematical modeling, feasibility, economics as well as the applicability of continuous cultivation into large-scale operation, are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

Distributed software framework and continuous integration in hydroinformatics systems

NASA Astrophysics Data System (ADS)

Zhou, Jianzhong; Zhang, Wei; Xie, Mengfei; Lu, Chengwei; Chen, Xiao

2017-08-01

When encountering multiple and complicated models, multisource structured and unstructured data, complex requirements analysis, the platform design and integration of hydroinformatics systems become a challenge. To properly solve these problems, we describe a distributed software framework and it’s continuous integration process in hydroinformatics systems. This distributed framework mainly consists of server cluster for models, distributed database, GIS (Geographic Information System) servers, master node and clients. Based on it, a GIS - based decision support system for joint regulating of water quantity and water quality of group lakes in Wuhan China is established.

Control Systems Engineering in Continuous Pharmaceutical Manufacturing May 20-21, 2014 Continuous Manufacturing Symposium.

PubMed

Myerson, Allan S; Krumme, Markus; Nasr, Moheb; Thomas, Hayden; Braatz, Richard D

2015-03-01

This white paper provides a perspective of the challenges, research needs, and future directions for control systems engineering in continuous pharmaceutical processing. The main motivation for writing this paper is to facilitate the development and deployment of control systems technologies so as to ensure quality of the drug product. Although the main focus is on small-molecule pharmaceutical products, most of the same statements apply to biological drug products. An introduction to continuous manufacturing and control systems is followed by a discussion of the current status and technical needs in process monitoring and control, systems integration, and risk analysis. Some key points are that: (1) the desired objective in continuous manufacturing should be the satisfaction of all critical quality attributes (CQAs), not for all variables to operate at steady-state values; (2) the design of start-up and shutdown procedures can significantly affect the economic operation of a continuous manufacturing process; (3) the traceability of material as it moves through the manufacturing facility is an important consideration that can at least in part be addressed using residence time distributions; and (4) the control systems technologies must assure quality in the presence of disturbances, dynamics, uncertainties, nonlinearities, and constraints. Direct measurement, first-principles and empirical model-based predictions, and design space approaches are described for ensuring that CQA specifications are met. Ways are discussed for universities, regulatory bodies, and industry to facilitate working around or through barriers to the development of control systems engineering technologies for continuous drug manufacturing. Industry and regulatory bodies should work with federal agencies to create federal funding mechanisms to attract faculty to this area. Universities should hire faculty interested in developing first-principles models and control systems technologies for drug manufacturing that are easily transportable to industry. Industry can facilitate the move to continuous manufacturing by working with universities on the conception of new continuous pharmaceutical manufacturing process unit operations that have the potential to make major improvements in product quality, controllability, or reduced capital and/or operating costs. Regulatory bodies should ensure that: (1) regulations and regulatory practices promote, and do not derail, the development and implementation of continuous manufacturing and control systems engineering approaches; (2) the individuals who approve specific regulatory filings are sufficiently trained to make good decisions regarding control systems approaches; (3) provide regulatory clarity and eliminate/reduce regulatory risks; (4) financially support the development of high-quality training materials for use of undergraduate students, graduate students, industrial employees, and regulatory staff; (5) enhance the training of their own technical staff by financially supporting joint research projects with universities in the development of continuous pharmaceutical manufacturing processes and the associated control systems engineering theory, numerical algorithms, and software; and (6) strongly encourage the federal agencies that support research to fund these research areas. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Control systems engineering in continuous pharmaceutical manufacturing. May 20-21, 2014 Continuous Manufacturing Symposium.

PubMed

Myerson, Allan S; Krumme, Markus; Nasr, Moheb; Thomas, Hayden; Braatz, Richard D

2015-03-01

This white paper provides a perspective of the challenges, research needs, and future directions for control systems engineering in continuous pharmaceutical processing. The main motivation for writing this paper is to facilitate the development and deployment of control systems technologies so as to ensure quality of the drug product. Although the main focus is on small-molecule pharmaceutical products, most of the same statements apply to biological drug products. An introduction to continuous manufacturing and control systems is followed by a discussion of the current status and technical needs in process monitoring and control, systems integration, and risk analysis. Some key points are that: (1) the desired objective in continuous manufacturing should be the satisfaction of all critical quality attributes (CQAs), not for all variables to operate at steady-state values; (2) the design of start-up and shutdown procedures can significantly affect the economic operation of a continuous manufacturing process; (3) the traceability of material as it moves through the manufacturing facility is an important consideration that can at least in part be addressed using residence time distributions; and (4) the control systems technologies must assure quality in the presence of disturbances, dynamics, uncertainties, nonlinearities, and constraints. Direct measurement, first-principles and empirical model-based predictions, and design space approaches are described for ensuring that CQA specifications are met. Ways are discussed for universities, regulatory bodies, and industry to facilitate working around or through barriers to the development of control systems engineering technologies for continuous drug manufacturing. Industry and regulatory bodies should work with federal agencies to create federal funding mechanisms to attract faculty to this area. Universities should hire faculty interested in developing first-principles models and control systems technologies for drug manufacturing that are easily transportable to industry. Industry can facilitate the move to continuous manufacturing by working with universities on the conception of new continuous pharmaceutical manufacturing process unit operations that have the potential to make major improvements in product quality, controllability, or reduced capital and/or operating costs. Regulatory bodies should ensure that: (1) regulations and regulatory practices promote, and do not derail, the development and implementation of continuous manufacturing and control systems engineering approaches; (2) the individuals who approve specific regulatory filings are sufficiently trained to make good decisions regarding control systems approaches; (3) provide regulatory clarity and eliminate/reduce regulatory risks; (4) financially support the development of high-quality training materials for use of undergraduate students, graduate students, industrial employees, and regulatory staff; (5) enhance the training of their own technical staff by financially supporting joint research projects with universities in the development of continuous pharmaceutical manufacturing processes and the associated control systems engineering theory, numerical algorithms, and software; and (6) strongly encourage the federal agencies that support research to fund these research areas. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Image aesthetic quality evaluation using convolution neural network embedded learning

NASA Astrophysics Data System (ADS)

Li, Yu-xin; Pu, Yuan-yuan; Xu, Dan; Qian, Wen-hua; Wang, Li-peng

2017-11-01

A way of embedded learning convolution neural network (ELCNN) based on the image content is proposed to evaluate the image aesthetic quality in this paper. Our approach can not only solve the problem of small-scale data but also score the image aesthetic quality. First, we chose Alexnet and VGG_S to compare for confirming which is more suitable for this image aesthetic quality evaluation task. Second, to further boost the image aesthetic quality classification performance, we employ the image content to train aesthetic quality classification models. But the training samples become smaller and only using once fine-tuning cannot make full use of the small-scale data set. Third, to solve the problem in second step, a way of using twice fine-tuning continually based on the aesthetic quality label and content label respective is proposed, the classification probability of the trained CNN models is used to evaluate the image aesthetic quality. The experiments are carried on the small-scale data set of Photo Quality. The experiment results show that the classification accuracy rates of our approach are higher than the existing image aesthetic quality evaluation approaches.

77 FR 18709 - Quality Assurance Requirements for Continuous Opacity Monitoring Systems at Stationary Sources

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... Quality Assurance Requirements for Continuous Opacity Monitoring Systems at Stationary Sources AGENCY... direct final rule titled ``Quality Assurance Requirements for Continuous Opacity Monitoring Systems at...--Quality Assurance Requirements for Continuous Opacity Monitoring Systems at Stationary Sources Docket, EPA...

[Delegation of GP Work to Qualified Medical Staff in Germany - An Overview].

PubMed

Mergenthal, K; Leifermann, M; Beyer, M; Gerlach, F M; Güthlin, C

2016-09-01

To assure nationwide provision of family medical care, a greater involvement of non-physician healthcare professionals has been discussed in Germany for some time. Currently, there are various delegation models. The aim of this study is to provide an overview of existing delegation models in a German family practice setting and to investigate to what extent they are implemented in practice. Internet search was made for delegation models for non-physician healthcare staff, and various experts were contacted in April 2014. Models that explicitly addressed family practice, involved continuing education of more than 80 h, and for which health insurance funds bore the costs, were taken into consideration. The models were judged in accordance with the PDCA implementation cycle (Plan-Do-Check-Act). 6 delegation models used in family practice were identified for which only 4 qualifications were still available in 2014. The duration, content and aims of the training courses differed markedly. Since 2015, training to become a NäPA non-physician practice assistant (or a VERAH healthcare assistant in the family practice if the necessary supplementary qualification is achieved) is the basic qualification for which costs are reimbursed. However, one important quality criterion for its broad implementation, namely evaluation, is missing in NäPA training. Only the VERAH qualification fulfills all quality criteria. In order to fully implement the delegation models and to strengthen and promote the healthcare assistant profession, the delegation models for which training costs are generally reimbursable should satisfy all quality criteria and also be subject to continual evaluation. © Georg Thieme Verlag KG Stuttgart · New York.

Study on the continuing education innovative talents training mode of civil engineering major

NASA Astrophysics Data System (ADS)

Sun, Shengnan; Su, Zhibin; Cui, Shicai

2017-12-01

According to the characteristics of civil engineering professional continuing education, continuing education of innovative talents training mode suitable for the characteristics of our school is put forward in this paper. The characteristics of the model include: the education of professional basic courses and specialized courses should be paid attention to; engineering training should be strengthened and engineering quality should be trained; the concept of large civil engineering should be highlighted, the specialized areas should be broadened, and the curriculum system should be reconstructed; the mechanism of personnel training program should be constructed by the employers, the domestic highlevel institutions and our university. It is hoped that the new training model will promote the development of continuing education of civil engineering specialty in our university.

[Prediction of regional soil quality based on mutual information theory integrated with decision tree algorithm].

PubMed

Lin, Fen-Fang; Wang, Ke; Yang, Ning; Yan, Shi-Guang; Zheng, Xin-Yu

2012-02-01

In this paper, some main factors such as soil type, land use pattern, lithology type, topography, road, and industry type that affect soil quality were used to precisely obtain the spatial distribution characteristics of regional soil quality, mutual information theory was adopted to select the main environmental factors, and decision tree algorithm See 5.0 was applied to predict the grade of regional soil quality. The main factors affecting regional soil quality were soil type, land use, lithology type, distance to town, distance to water area, altitude, distance to road, and distance to industrial land. The prediction accuracy of the decision tree model with the variables selected by mutual information was obviously higher than that of the model with all variables, and, for the former model, whether of decision tree or of decision rule, its prediction accuracy was all higher than 80%. Based on the continuous and categorical data, the method of mutual information theory integrated with decision tree could not only reduce the number of input parameters for decision tree algorithm, but also predict and assess regional soil quality effectively.

Evaluating a nursing care delivery model using a quality improvement design.

PubMed

Nardone, P L; Markie, J W; Tolle, S

1995-10-01

The goal to develop and implement a new model of nursing care delivery grew out of administrative and shared governance initiatives to improve the quality of nursing care. This evaluative study used both quantitative and qualitative methods. Seven principles related to quality were identified and became the driving force behind the changes. Aspects of these changes in care delivery were piloted on a neurological unit and included implementation of collaborative rounds, a modular structure, role changes, and work redesign. Frequency distribution, questionnaire, focus group, and financial data indicated that there had been improvement in the delivery of care in addition to financial benefits. A considerable amount of the data provided evidence that supported continuing the changes.

Evaluating Rater Accuracy in Rater-Mediated Assessments Using an Unfolding Model

ERIC Educational Resources Information Center

Wang, Jue; Engelhard, George, Jr.; Wolfe, Edward W.

2016-01-01

The number of performance assessments continues to increase around the world, and it is important to explore new methods for evaluating the quality of ratings obtained from raters. This study describes an unfolding model for examining rater accuracy. Accuracy is defined as the difference between observed and expert ratings. Dichotomous accuracy…

A high and low noise model for strong motion accelerometers

NASA Astrophysics Data System (ADS)

Clinton, J. F.; Cauzzi, C.; Olivieri, M.

2010-12-01

We present reference noise models for high-quality strong motion accelerometer installations. We use continuous accelerometer data acquired by the Swiss Seismological Service (SED) since 2006 and other international high-quality accelerometer network data to derive very broadband (50Hz-100s) high and low noise models. The proposed noise models are compared to the Peterson (1993) low and high noise models designed for broadband seismometers; the datalogger self-noise; background noise levels at existing Swiss strong motion stations; and typical earthquake signals recorded in Switzerland and worldwide. The standard strong motion station operated by the SED consists of a Kinemetrics Episensor (2g clip level; flat acceleration response from 200 Hz to DC; <155dB dynamic range) coupled with a 24-bit Nanometrics Taurus datalogger. The proposed noise models are based on power spectral density (PSD) noise levels for each strong motion station computed via PQLX (McNamara and Buland, 2004) from several years of continuous recording. The 'Accelerometer Low Noise Model', ALNM, is dominated by instrument noise from the sensor and datalogger. The 'Accelerometer High Noise Model', AHNM, reflects 1) at high frequencies the acceptable site noise in urban areas, 2) at mid-periods the peak microseismal energy, as determined by the Peterson High Noise Model and 3) at long periods the maximum noise observed from well insulated sensor / datalogger systems placed in vault quality sites. At all frequencies, there is at least one order of magnitude between the ALNM and the AHNM; at high frequencies (> 1Hz) this extends to 2 orders of magnitude. This study provides remarkable confirmation of the capability of modern strong motion accelerometers to record low-amplitude ground motions with seismic observation quality. In particular, an accelerometric station operating at the ALNM is capable of recording the full spectrum of near source earthquakes, out to 100 km, down to M2. Of particular interest for the SED, this study provides acceptable noise limits for candidate sites for the on-going Strong Motion Network modernisation.

Provider connectedness and communication patterns: extending continuity of care in the context of the circle of care

PubMed Central

2013-01-01

Background Continuity is an important aspect of quality of care, especially for complex patients in the community. We explored provider perceptions of continuity through a system’s lens. The circle of care was used as the system. Methods Soft systems methodology was used to understand and improve continuity for end of life patients in two communities. Participants: Physicians, nurses, pharmacists in two communities in British Columbia, involved in end of life care. Two debates/discussion groups were completed after the interviews and initial analysis to confirm findings. Interview recordings were qualitatively analyzed to extract components and enablers of continuity. Results 32 provider interviews were completed. Findings from this study support the three types of continuity described by Haggerty and Reid (information, management, and relationship continuity). This work extends their model by adding features of the circle of care that influence and enable continuity: Provider Connectedness the sense of knowing and trust between providers who share care of a patient; a set of ten communication patterns that are used to support continuity across the circle of care; and environmental factors outside the circle that can indirectly influence continuity. Conclusions We present an extended model of continuity of care. The components in the model can support health planners consider how health care is organized to promote continuity and by researchers when considering future continuity research. PMID:23941179

Laparoscopic fundoplication compared with medical management for gastro-oesophageal reflux disease: cost effectiveness study.

PubMed

Epstein, David; Bojke, Laura; Sculpher, Mark J

2009-07-14

To describe the long term costs, health benefits, and cost effectiveness of laparoscopic surgery compared with those of continued medical management for patients with gastro-oesophageal reflux disease (GORD). We estimated resource use and costs for the first year on the basis of data from the REFLUX trial. A Markov model was used to extrapolate cost and health benefit over a lifetime using data collected in the REFLUX trial and other sources. The model compared laparoscopic surgery and continued proton pump inhibitors in male patients aged 45 and stable on GORD medication. Laparoscopic surgery versus continued medical management. We estimated quality adjusted life years and GORD related costs to the health service over a lifetime. Sensitivity analyses considered other plausible scenarios, in particular size and duration of treatment effect and the GORD symptoms of patients in whom surgery is unsuccessful. Main results The base case model indicated that surgery is likely to be considered cost effective on average with an incremental cost effectiveness ratio of pound2648 (euro3110; US$4385) per quality adjusted life year and that the probability that surgery is cost effective is 0.94 at a threshold incremental cost effectiveness ratio of pound20 000. The results were sensitive to some assumptions within the extrapolation modelling. Surgery seems to be more cost effective on average than medical management in many of the scenarios examined in this study. Surgery might not be cost effective if the treatment effect does not persist over the long term, if patients who return to medical management have poor health related quality of life, or if proton pump inhibitors were cheaper. Further follow-up of patients from the REFLUX trial may be valuable. ISRCTN15517081.

An evaluation of freshwater mussel toxicity data in the derivation of water quality guidance and standards for copper

USGS Publications Warehouse

March, F.A.; Dwyer, F.J.; Augspurger, T.; Ingersoll, C.G.; Wang, N.; Mebane, C.A.

2007-01-01

The state of Oklahoma has designated several areas as freshwater mussel sanctuaries in an attempt to provide freshwater mussel species a degree of protection and to facilitate their reproduction. We evaluated the protection afforded freshwater mussels by the U.S. Environmental Protection Agency (U.S. EPA) hardness-based 1996 ambient copper water quality criteria, the 2007 U.S. EPA water quality criteria based on the biotic ligand model and the 2005 state of Oklahoma copper water quality standards. Both the criterion maximum concentration and criterion continuous concentration were evaluated. Published acute and chronic copper toxicity data that met American Society for Testing and Materials guidance for test acceptability were obtained for exposures conducted with glochidia or juvenile freshwater mussels. We tabulated toxicity data for glochidia and juveniles to calculate 20 species mean acute values for freshwater mussels. Generally, freshwater mussel species mean acute values were similar to those of the more sensitive species included in the U.S. EPA water quality derivation database. When added to the database of genus mean acute values used in deriving 1996 copper water quality criteria, 14 freshwater mussel genus mean acute values included 10 of the lowest 15 genus mean acute values, with three mussel species having the lowest values. Chronic exposure and sublethal effects freshwater mussel data available for four species and acute to chronic ratios were used to evaluate the criterion continuous concentration. On the basis of the freshwater mussel toxicity data used in this assessment, the hardness-based 1996 U.S. EPA water quality criteria, the 2005 Oklahoma water quality standards, and the 2007 U.S. EPA water quality criteria based on the biotic ligand model might need to be revised to afford protection to freshwater mussels. ?? 2007 SETAC.

Nurse managers' experiences in continuous quality improvement in resource-poor healthcare settings.

PubMed

Kakyo, Tracy Alexis; Xiao, Lily Dongxia

2017-06-01

Ensuring safe and quality care for patients in hospitals is an important part of a nurse manager's role. Continuous quality improvement has been identified as one approach that leads to the delivery of quality care services to patients and is widely used by nurse managers to improve patient care. Nurse managers' experiences in initiating continuous quality improvement activities in resource-poor healthcare settings remain largely unknown. Research evidence is highly demanded in these settings to address disease burden and evidence-based practice. This interpretive qualitative study was conducted to gain an understanding of nurse managers' Continuous Quality Improvement experiences in rural hospitals in Uganda. Nurse managers in rural healthcare settings used their role to prioritize quality improvement activities, monitor the Continuous Quality Improvement process, and utilize in-service education to support continuous quality improvement. The nurse managers in our sample encountered a number of barriers during the implementation of Continuous Quality Improvement, including: limited patient participation, lack of materials, and limited human resources. Efforts to address the challenges faced through good governance and leadership development require more attention. © 2017 John Wiley & Sons Australia, Ltd.

[Review on HSPF model for simulation of hydrology and water quality processes].

PubMed

Li, Zhao-fu; Liu, Hong-Yu; Li, Yan

2012-07-01

Hydrological Simulation Program-FORTRAN (HSPF), written in FORTRAN, is one ol the best semi-distributed hydrology and water quality models, which was first developed based on the Stanford Watershed Model. Many studies on HSPF model application were conducted. It can represent the contributions of sediment, nutrients, pesticides, conservatives and fecal coliforms from agricultural areas, continuously simulate water quantity and quality processes, as well as the effects of climate change and land use change on water quantity and quality. HSPF consists of three basic application components: PERLND (Pervious Land Segment) IMPLND (Impervious Land Segment), and RCHRES (free-flowing reach or mixed reservoirs). In general, HSPF has extensive application in the modeling of hydrology or water quality processes and the analysis of climate change and land use change. However, it has limited use in China. The main problems with HSPF include: (1) some algorithms and procedures still need to revise, (2) due to the high standard for input data, the accuracy of the model is limited by spatial and attribute data, (3) the model is only applicable for the simulation of well-mixed rivers, reservoirs and one-dimensional water bodies, it must be integrated with other models to solve more complex problems. At present, studies on HSPF model development are still undergoing, such as revision of model platform, extension of model function, method development for model calibration, and analysis of parameter sensitivity. With the accumulation of basic data and imorovement of data sharing, the HSPF model will be applied more extensively in China.

Using quality indicators in anaesthesia: feeding back data to improve care.

PubMed

Benn, J; Arnold, G; Wei, I; Riley, C; Aleva, F

2012-07-01

After recent UK policy developments, considerable attention has been focused upon how clinical specialties measure and report on the quality of care delivered to patients. Defining the right indicators alone is insufficient to close the feedback loop. This narrative review aims to describe and synthesize a diverse body of research relevant to the question of how information from quality indicators can be fed back and used effectively to improve care. Anaesthesia poses certain challenges in the identification of valid outcome indicators sensitive to variations in anaesthetic care. Metrics collected during the immediate post-anaesthetic recovery period, such as patient temperature, patient-reported quality of recovery, and pain and nausea, provide potentially useful information for the anaesthetist, yet this information is not routinely fed back. Reviews of the effects of feeding back performance data to healthcare providers suggest that this may result in small to moderate positive effects upon outcomes and professional practice, with stronger effects where feedback is integrated within a broader quality improvement strategy. The dominant model for use of data within quality improvement is based upon the industrial process control approach, in which care processes are monitored continuously for process changes which are rapidly detectable for corrective action. From this review and experience of implementing these principles in practice, effective feedback from quality indicators is timely, credible, confidential, tailored to the recipient, and continuous. Considerable further work is needed to understand how information from quality indicators can be fed back in an effective way to clinicians and clinical units, in order to support revalidation and continuous improvement.

CyberArc: a non-coplanar-arc optimization algorithm for CyberKnife

NASA Astrophysics Data System (ADS)

Kearney, Vasant; Cheung, Joey P.; McGuinness, Christopher; Solberg, Timothy D.

2017-07-01

The goal of this study is to demonstrate the feasibility of a novel non-coplanar-arc optimization algorithm (CyberArc). This method aims to reduce the delivery time of conventional CyberKnife treatments by allowing for continuous beam delivery. CyberArc uses a 4 step optimization strategy, in which nodes, beams, and collimator sizes are determined, source trajectories are calculated, intermediate radiation models are generated, and final monitor units are calculated, for the continuous radiation source model. The dosimetric results as well as the time reduction factors for CyberArc are presented for 7 prostate and 2 brain cases. The dosimetric quality of the CyberArc plans are evaluated using conformity index, heterogeneity index, local confined normalized-mutual-information, and various clinically relevant dosimetric parameters. The results indicate that the CyberArc algorithm dramatically reduces the treatment time of CyberKnife plans while simultaneously preserving the dosimetric quality of the original plans.

CyberArc: a non-coplanar-arc optimization algorithm for CyberKnife.

PubMed

Kearney, Vasant; Cheung, Joey P; McGuinness, Christopher; Solberg, Timothy D

2017-06-26

The goal of this study is to demonstrate the feasibility of a novel non-coplanar-arc optimization algorithm (CyberArc). This method aims to reduce the delivery time of conventional CyberKnife treatments by allowing for continuous beam delivery. CyberArc uses a 4 step optimization strategy, in which nodes, beams, and collimator sizes are determined, source trajectories are calculated, intermediate radiation models are generated, and final monitor units are calculated, for the continuous radiation source model. The dosimetric results as well as the time reduction factors for CyberArc are presented for 7 prostate and 2 brain cases. The dosimetric quality of the CyberArc plans are evaluated using conformity index, heterogeneity index, local confined normalized-mutual-information, and various clinically relevant dosimetric parameters. The results indicate that the CyberArc algorithm dramatically reduces the treatment time of CyberKnife plans while simultaneously preserving the dosimetric quality of the original plans.

Environment quality monitoring using ARM processor

NASA Astrophysics Data System (ADS)

Vinaya, C. H.; Krishna Thanikanti, Vamsi; Ramasamy, Sudha

2017-11-01

This paper of air quality monitoring system describes a model of sensors network to continuously monitoring the environment with low cost developed model. At present time all over the world turned into a great revolution in industrial domain and on the other hand environment get polluting in a dangerous value. There are so many technologies present to reduce the polluting contents but still there is no completely reduction of that pollution. Even there are different methods to monitor the pollution content; these are much costly that not everyone can adapt those methods or devices. Now we are proposing a sensors connected network to monitor the environment continuously and displaying the pollutant gases percentage in air surroundings and can transmit the results to our mobiles by message. The advantage of this system is easy to design, establish at area to monitor, maintenance and most cost effective as well.

Transforming the Primary Care Training Clinic: New York State's Hospital Medical Home Demonstration Pilot.

PubMed

Angelotti, Marietta; Bliss, Kathryn; Schiffman, Dana; Weaver, Erin; Graham, Laura; Lemme, Thomas; Pryor, Veronica; Gesten, Foster C

2015-06-01

Training in patient-centered medical home (PCMH) settings may prepare new physicians to measure quality of care, manage the health of populations, work in teams, and include cost information in decision making. Transforming resident clinics to PCMHs requires funding for additional staff, electronic health records, training, and other resources not typically available to residency programs. Describe how a 1115 Medicaid waiver was used to transform the majority of primary care training sites in New York State to the PCMH model and improve the quality of care provided. The 2013-2014 Hospital Medical Home Program provided awards to 60 hospitals and 118 affiliated residency programs (training more than 5000 residents) to transform outpatient sites into PCMHs and provide high-quality, coordinated care. Site visits, coaching calls, resident surveys, data reporting, and feedback were used to promote and monitor change in resident continuity and quality of care. Descriptive analyses measured improvements in these areas. A total of 156 participating outpatient sites (100%) received PCMH recognition. All sites enhanced resident education using PCMH principles through patient empanelment, development of quality dashboards, and transforming resident scheduling and training. Clinical quality outcomes showed improvement across the demonstration, including better performance on colorectal and breast cancer screening rates (rate increases of 13%, P≤.001, and 11%, P=.011, respectively). A 1115 Medicaid waiver is a viable mechanism for states to transform residency clinics to reflect new primary care models. The PCMH transformation of 156 sites led to improvements in resident continuity and clinical outcomes.

Continuous improvement, burnout and job engagement: a study in a Dutch nursing department.

PubMed

Benders, Jos; Bleijerveld, Hans; Schouteten, Roel

2017-10-01

Continuous improvement (CI) programs are potentially powerful means to improve the quality of care. The more positive nurses perceive these programs' effects, the better they may be expected to cooperate. Crucial to this perception is how nurses' quality of working life is affected. We studied this in a nursing department, using the job demands-resources model. We found that two job demands improved, and none of the job resources. Job engagement did not change significantly, while the burnout risk decreased slightly. Overall, the nurses felt the impact to be small yet the changes were in a positive direction. CI can thus be used to improve nurses' working lives and, by restructuring the work processes, the quality of care. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Introducing quality assurance and medical audit into the UCSF medical center curriculum.

PubMed

Barbaccia, J C

1976-05-01

The experience gained by a medical school faculty in developing and piloting a course for undergraduate medical students in medical care evaluation led to a similar effort for house staff. It is recognized that if the profession is to fulfill the demand by society for social accountability in the use of resources for health care, medical care assessment and quality assurance mechanisms must become an intimate part of the clinical experience of medical students and house officers. Teaching these subjects requires a theoretical framework; introduction of content and skills appropriate to the level of the student and continuation of progressively more advanced training throughout medical education; use of assessment and quality assurance techniques by clinician-teachers themselves to provide models for the student; and continued evolution of pedagogic approach and course content based on developments in the area.

The Continuous Quality Improvement Book Club: Developing a Book Club to Promote Praxis

ERIC Educational Resources Information Center

Lyons, Becky; Ray, Chris

2014-01-01

This article poses a model for developing a book club to promote praxis. This model is built upon a basic four step framework for developing book clubs and includes specific recommendations to focus the book club on reflection of theory and how to incorporate it into practice. This model will be used to start a book club examining Continuous…

A novel approach to support formulation design on twin screw wet granulation technology: Understanding the impact of overarching excipient properties on drug product quality attributes.

PubMed

Willecke, N; Szepes, A; Wunderlich, M; Remon, J P; Vervaet, C; De Beer, T

2018-04-21

The overall objective of this work is to understand how excipient characteristics influence the drug product quality attributes and process performance of a continuous twin screw wet granulation process. The knowledge gained in this study is intended to be used for Quality by Design (QbD)-based formulation design and formulation optimization. Three principal components which represent the overarching properties of 8 selected pharmaceutical fillers were used as factors, whereas factors 4 and 5 represented binder type and binder concentration in a design of experiments (DoE). The majority of process parameters were kept constant to minimize their influence on the granule and drug product quality. 27 DoE batches consisting of binary filler/binder mixtures were processed via continuous twin screw wet granulation followed by tablet compression. Multiple linear regression models were built providing understanding of the impact of filler and binder properties on granule and tablet quality attributes (i.e. 16 DoE responses). The impact of fillers on the granule and tablet responses was more dominant compared to the impact of binder type and concentration. The filler properties had a relevant effect on granule characteristics, such as particle size, friability and specific surface area. Binder type and concentration revealed a relevant influence on granule flowability and friability as well as on the compactability (required compression force during tableting to obtain target hardness). In order to evaluate the DoE models' validity, a verification of the DoE models was performed with new formulations (i.e. a new combination of filler, binder type and binder concentration) which were initially not included in the dataset used to build the DoE models. The combined PCA (principle component analysis)/DoE approach allowed to link the excipient properties with the drug product quality attributes. Copyright © 2018 Elsevier B.V. All rights reserved.

Continuous real-time water-quality monitoring and regression analysis to compute constituent concentrations and loads in the North Fork Ninnescah River upstream from Cheney Reservoir, south-central Kansas, 1999–2012

USGS Publications Warehouse

Stone, Mandy L.; Graham, Jennifer L.; Gatotho, Jackline W.

2013-01-01

Cheney Reservoir, located in south-central Kansas, is the primary water supply for the city of Wichita. The U.S. Geological Survey has operated a continuous real-time water-quality monitoring station since 1998 on the North Fork Ninnescah River, the main source of inflow to Cheney Reservoir. Continuously measured water-quality physical properties include streamflow, specific conductance, pH, water temperature, dissolved oxygen, and turbidity. Discrete water-quality samples were collected during 1999 through 2009 and analyzed for sediment, nutrients, bacteria, and other water-quality constituents. Regression models were developed to establish relations between discretely sampled constituent concentrations and continuously measured physical properties to compute concentrations of those constituents of interest that are not easily measured in real time because of limitations in sensor technology and fiscal constraints. Regression models were published in 2006 that were based on data collected during 1997 through 2003. This report updates those models using discrete and continuous data collected during January 1999 through December 2009. Models also were developed for four new constituents, including additional nutrient species and indicator bacteria. In addition, a conversion factor of 0.68 was established to convert the Yellow Springs Instruments (YSI) model 6026 turbidity sensor measurements to the newer YSI model 6136 sensor at the North Ninnescah River upstream from Cheney Reservoir site. Newly developed models and 14 years of hourly continuously measured data were used to calculate selected constituent concentrations and loads during January 1999 through December 2012. The water-quality information in this report is important to the city of Wichita because it allows the concentrations of many potential pollutants of interest to Cheney Reservoir, including nutrients and sediment, to be estimated in real time and characterized over conditions and time scales that would not be possible otherwise. In general, model forms and the amount of variance explained by the models was similar between the original and updated models. The amount of variance explained by the updated models changed by 10 percent or less relative to the original models. Total nitrogen, nitrate, organic nitrogen, E. coli bacteria, and total organic carbon models were newly developed for this report. Additional data collection over a wider range of hydrological conditions facilitated the development of these models. The nitrate model is particularly important because it allows for comparison to Cheney Reservoir Task Force goals. Mean hourly computed total suspended solids concentration during 1999 through 2012 was 54 milligrams per liter (mg/L). The total suspended solids load during 1999 through 2012 was 174,031 tons. On an average annual basis, the Cheney Reservoir Task Force runoff (550 mg/L) and long-term (100 mg/L) total suspended solids goals were never exceeded, but the base flow goal was exceeded every year during 1999 through 2012. Mean hourly computed nitrate concentration was 1.08 mg/L during 1999 through 2012. The total nitrate load during 1999 through 2012 was 1,361 tons. On an annual average basis, the Cheney Reservoir Task Force runoff (6.60 mg/L) nitrate goal was never exceeded, the long-term goal (1.20 mg/L) was exceeded only in 2012, and the base flow goal of 0.25 mg/L was exceeded every year. Mean nitrate concentrations that were higher during base flow, rather than during runoff conditions, suggest that groundwater sources are the main contributors of nitrate to the North Fork Ninnescah River above Cheney Reservoir. Mean hourly computed phosphorus concentration was 0.14 mg/L during 1999 through 2012. The total phosphorus load during 1999 through 2012 was 328 tons. On an average annual basis, the Cheney Reservoir Task Force runoff goal of 0.40 mg/L for total phosphorus was exceeded in 2002, the year with the largest yearly mean turbidity, and the long-term goal (0.10 mg/L) was exceeded in every year except 2011 and 2012, the years with the smallest mean streamflows. The total phosphorus base flow goal of 0.05 mg/L was exceeded every year. Given that base flow goals for total suspended solids, nitrate, and total phosphorus were exceeded every year despite hydrologic conditions, the established base flow goals are either unattainable or substantially more best management practices will need to be implemented to attain them. On an annual average basis, no discernible patterns were evident in total suspended sediment, nitrate, and total phosphorus concentrations or loads over time, in large part because of hydrologic variability. However, more rigorous statistical analyses are required to evaluate temporal trends. A more rigorous analysis of temporal trends will allow evaluation of watershed investments in best management practices.

U.S. Geological Survey quality-assurance plan for continuous water-quality monitoring in Kansas, 2014

USGS Publications Warehouse

Bennett, Trudy J.; Graham, Jennifer L.; Foster, Guy M.; Stone, Mandy L.; Juracek, Kyle E.; Rasmussen, Teresa J.; Putnam, James E.

2014-01-01

A quality-assurance plan for use in conducting continuous water-quality monitoring activities has been developed for the Kansas Water Science Center in accordance with guidelines set forth by the U.S. Geological Survey. This quality-assurance plan documents the standards, policies, and procedures used by the U.S. Geological Survey in Kansas for activities related to the collection, processing, storage, analysis, and release of continuous water-quality monitoring data. The policies and procedures that are documented in this quality-assurance plan for continuous water-quality monitoring activities complement quality-assurance plans for surface-water and groundwater activities in Kansas.

DockQ: A Quality Measure for Protein-Protein Docking Models

PubMed Central

Basu, Sankar

2016-01-01

The state-of-the-art to assess the structural quality of docking models is currently based on three related yet independent quality measures: Fnat, LRMS, and iRMS as proposed and standardized by CAPRI. These quality measures quantify different aspects of the quality of a particular docking model and need to be viewed together to reveal the true quality, e.g. a model with relatively poor LRMS (>10Å) might still qualify as 'acceptable' with a descent Fnat (>0.50) and iRMS (<3.0Å). This is also the reason why the so called CAPRI criteria for assessing the quality of docking models is defined by applying various ad-hoc cutoffs on these measures to classify a docking model into the four classes: Incorrect, Acceptable, Medium, or High quality. This classification has been useful in CAPRI, but since models are grouped in only four bins it is also rather limiting, making it difficult to rank models, correlate with scoring functions or use it as target function in machine learning algorithms. Here, we present DockQ, a continuous protein-protein docking model quality measure derived by combining Fnat, LRMS, and iRMS to a single score in the range [0, 1] that can be used to assess the quality of protein docking models. By using DockQ on CAPRI models it is possible to almost completely reproduce the original CAPRI classification into Incorrect, Acceptable, Medium and High quality. An average PPV of 94% at 90% Recall demonstrating that there is no need to apply predefined ad-hoc cutoffs to classify docking models. Since DockQ recapitulates the CAPRI classification almost perfectly, it can be viewed as a higher resolution version of the CAPRI classification, making it possible to estimate model quality in a more quantitative way using Z-scores or sum of top ranked models, which has been so valuable for the CASP community. The possibility to directly correlate a quality measure to a scoring function has been crucial for the development of scoring functions for protein structure prediction, and DockQ should be useful in a similar development in the protein docking field. DockQ is available at http://github.com/bjornwallner/DockQ/ PMID:27560519

Summary and interpretation of discrete and continuous water-quality monitoring data, Mattawoman Creek, Charles County, Maryland, 2000-11

USGS Publications Warehouse

Chanat, Jeffrey G.; Miller, Cherie V.; Bell, Joseph M.; Majedi, Brenda Feit; Brower, David P.

2013-01-01

Discrete samples and continuous (15-minute interval) water-quality data were collected at Mattawoman Creek (U.S. Geological Survey station number 01658000) from October 2000 through January 2011, in cooperation with the Charles County (Maryland) Department of Planning and Growth Management, the Maryland Department of the Environment, and the Maryland Geological Survey. Mattawoman Creek is a fourth-order Maryland tributary to the tidal freshwater Potomac River; the creek’s watershed is experiencing development pressure due to its proximity to Washington, D.C. Data were analyzed for the purpose of describing ambient water quality, identifying potential contaminant sources, and quantifying nutrient and sediment loads to the tidal freshwater Mattawoman estuary. Continuous data, collected at 15-minute intervals, included discharge, derived from stage measurements made using a pressure transducer, as well as water temperature, pH, specific conductance, dissolved oxygen, and turbidity, all measured using a water-quality sonde. In addition to the continuous data, a total of 360 discrete water-quality samples, representative of monthly low-flow and targeted storm conditions, were analyzed for suspended sediment and nutrients. Continuous observations gathered by a second water-quality sonde, which was temporarily deployed in 2011 for quality-control purposes, indicated substantial lateral water-quality gradients due to inflow from a nearby tributary, representing about 10 percent of the total gaged area upstream of the sampling location. These lateral gradients introduced a time-varying bias into both the continuous and discrete data, resulting in observations that were at some times representative of water-quality conditions in the main channel and at other times biased towards conditions in the tributary. Despite this limitation, both the continuous and discrete data provided insight into the watershed-scale factors that influence water quality in Mattawoman Creek. Annual precipitation over the study period was representative of the long-term record for southern Maryland. The median value of continuously measured discharge was 25 cubic feet per second (ft3/s), and the maximum observed value was 3,210 ft3/s; there were 498 days, or about 15 percent of the study period, when flow was zero or too low to measure. Continuously measured water temperature followed a seasonal trend characteristic of the geographic setting; the trend in dissolved oxygen was inverted relative to temperature, and reflected nearly saturated conditions year round. Relations between discharge and both pH and specific conductance indicate that stream water can be conceptualized as a mixture of acidic, dilute precipitation with pH-neutral groundwater of higher conductance. Specific conductance data showed a pronounced winter peak in both median and extreme measurements, indicating the influence of road salt. However, this influence is minor relative to that observed in the Northeast Branch Anacostia River (U.S. Geological Survey station number 01649500), a nearby, more heavily urbanized comparison basin. The median suspended-sediment concentration in discrete samples was 24 milligrams per liter (mg/L), with minimum and maximum concentrations of 1 mg/L and 2,890 mg/L, respectively. Total nitrogen ranged from 0.21 mg/L to 4.09 mg/L, with a median of 0.69 mg/L; total phosphorus ranged from less than 0.01 mg/L to 0.98 mg/L, with a median of 0.07 mg/L. Total nitrogen was dominated by the dissolved organic fraction (49 percent based on median species concentrations); total phosphorus was predominantly particulate (70 percent). Seasonal trends in suspended-sediment concentration indicate a supply subsidy in late winter and spring; this could be linked to flood-plain interaction, mobilization of sediment from the channel or banks, or anthropogenic input. Seasonal trends for both total phosphorus and total nitrogen generally corresponded to seasonal trends for suspended sediment, indicating a common underlying physical control, likely acting in synchrony with seasonal biological controls on total nutrient concentrations. Speciation of phosphorus, including proportional concentration of the biologically available dissolved inorganic fraction, did not vary seasonally. The speciation of nitrogen reflected demand for inorganic nitrogen and associated transformation into organic nitrogen during the growing season. Stepwise regression models were developed, using continuous data corresponding to collection times for discrete samples as candidate surrogates for suspended sediment, total phosphorus, and total nitrogen. Turbidity and discharge were both included in the model for suspended sediment (R2 = 0.76, n = 185); only turbidity was selected as a robust predictor of total phosphorus and nitrogen (R2 = 0.68 and 0.61, respectively, n = 186 for both). Loads of sediment and nutrients to the downstream Mattawoman estuary were computed using the U.S. Geological Survey computer program LOADEST. Load estimation included comparison of a routinely applied seven-parameter regression model based on time, season, and discharge, with an eight-parameter model that also includes turbidity. Adding turbidity decreased total load estimates, based on hourly data for a fixed 2-month period, by 21, 8, and 3 percent for suspended sediment, total phosphorus, and total nitrogen, respectively, in addition to decreasing the standard error of prediction for all three constituents. The seasonal pattern in specific conductance, reflecting road salt application, is the strongest evidence of the effect of upstream development on water quality at Mattawoman Creek. Accordingly, ongoing continuous monitoring for trends in specific conductance would be the most reliable means of detecting further degradation associated with increased development.

Epidemiology of Cystic Fibrosis.

PubMed

Spoonhower, Kimberly A; Davis, Pamela B

2016-03-01

Improved quality of care and rapidly emerging therapeutic strategies to restore chloride transport profoundly impact the epidemiology and pathobiology of cystic fibrosis (CF) in the twenty-first century. CF now serves as a model for chronic illness management, continuous quality improvement via registry data, and a seamless link between basic science research, translational studies, clinical trials, and outcomes research to enable rapid expansion of treatment options. Copyright © 2016 Elsevier Inc. All rights reserved.

78 FR 11122 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Motor Vehicle...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-15

... of the most recent version of the Motor Vehicle Emission Simulator model (MOVES). Those counties are... Area's ability to continue to attain the 1997 PM 2.5 NAAQS. This action is being taken under section... version of the MOVES model. On January 29, 2013, Pennsylvania DEP submitted its formal, final SIP revision...

75 FR 49215 - Medicare Program; End-Stage Renal Disease Quality Incentive Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

... new feature on http://www.medicare.gov that was modeled after Nursing Home Compare and continues to be... for the three finalized measures. We believe that this is the performance period that best balances...

Performance of ANFIS versus MLP-NN dissolved oxygen prediction models in water quality monitoring.

PubMed

Najah, A; El-Shafie, A; Karim, O A; El-Shafie, Amr H

2014-02-01

We discuss the accuracy and performance of the adaptive neuro-fuzzy inference system (ANFIS) in training and prediction of dissolved oxygen (DO) concentrations. The model was used to analyze historical data generated through continuous monitoring of water quality parameters at several stations on the Johor River to predict DO concentrations. Four water quality parameters were selected for ANFIS modeling, including temperature, pH, nitrate (NO3) concentration, and ammoniacal nitrogen concentration (NH3-NL). Sensitivity analysis was performed to evaluate the effects of the input parameters. The inputs with the greatest effect were those related to oxygen content (NO3) or oxygen demand (NH3-NL). Temperature was the parameter with the least effect, whereas pH provided the lowest contribution to the proposed model. To evaluate the performance of the model, three statistical indices were used: the coefficient of determination (R (2)), the mean absolute prediction error, and the correlation coefficient. The performance of the ANFIS model was compared with an artificial neural network model. The ANFIS model was capable of providing greater accuracy, particularly in the case of extreme events.

Nursing issues in renal replacement therapy: organization, manpower assessment, competency evaluation and quality improvement processes.

PubMed

Graham, Patricia; Lischer, Eileen

2011-01-01

For the patient with acute kidney injury, continuous renal replacement therapy (CRRT) is a treatment option that has application for the hemodynamically unstable critically ill patient. The decision to initiate a continuous renal replacement modality depends not only on the physician, either the nephrologist or intensivist, but also on the availability of specially trained nursing resources. This article will explore the nursing collaborative model of care at a large university-based research and teaching Medical Center in Southern California. The focus will be on nursing issues in CRRT including organization of educational programs, manpower assessment, competency evaluation, and quality improvement processes. © 2011 Wiley Periodicals, Inc.

[E-Learning--an important contribution to general medical training and continuing education?].

PubMed

Ruf, D; Berner, M M; Kriston, L; Härter, M

2008-09-01

There is increasing activity in the development of e-learning modules for general medical training and continuing education. One of the central advantages of e-learning is flexibility regarding time and place of its use. The quality of the available e-learning opportunities varies quite considerably. For users it is often not easy to assess the quality of e-learning modules or to find offers of high quality. This could be a reason for the fact that despite the huge number of e-learning modules still only few students and physicians are using them. This is although e-learning has proven to be as effective as and even more efficient than learning in the classroom or with paper-based materials. This article summarizes the different models of e-learning, how and where to find offers of high quality, advantages of using e-learning, and the effectiveness and efficiency of such offers. In addition problems of e-learning and possibilities to overcome these problems are shown.

Quality Improvement on the Acute Inpatient Psychiatry Unit Using the Model for Improvement

PubMed Central

Singh, Kuldeep; Sanderson, Joshua; Galarneau, David; Keister, Thomas; Hickman, Dean

2013-01-01

Background A need exists for constant evaluation and modification of processes within healthcare systems to achieve quality improvement. One common approach is the Model for Improvement that can be used to clearly define aims, measures, and changes that are then implemented through a plan-do-study-act (PDSA) cycle. This approach is a commonly used method for improving quality in a wide range of fields. The Model for Improvement allows for a systematic process that can be revised at set time intervals to achieve a desired result. Methods We used the Model for Improvement in an acute psychiatry unit (APU) to improve the screening incidence of abnormal involuntary movements in eligible patients—those starting or continuing on standing neuroleptics—with the Abnormal Involuntary Movement Scale (AIMS). Results After 8 weeks of using the Model for Improvement, both of the participating inpatient services in the APU showed substantial overall improvement in screening for abnormal involuntary movements using the AIMS. Conclusion Crucial aspects of a successful quality improvement initiative based on the Model for Improvement are well-defined goals, process measures, and structured PDSA cycles. Success also requires communication, organization, and participation of the entire team. PMID:24052768

Quality improvement on the acute inpatient psychiatry unit using the model for improvement.

PubMed

Singh, Kuldeep; Sanderson, Joshua; Galarneau, David; Keister, Thomas; Hickman, Dean

2013-01-01

A need exists for constant evaluation and modification of processes within healthcare systems to achieve quality improvement. One common approach is the Model for Improvement that can be used to clearly define aims, measures, and changes that are then implemented through a plan-do-study-act (PDSA) cycle. This approach is a commonly used method for improving quality in a wide range of fields. The Model for Improvement allows for a systematic process that can be revised at set time intervals to achieve a desired result. We used the Model for Improvement in an acute psychiatry unit (APU) to improve the screening incidence of abnormal involuntary movements in eligible patients-those starting or continuing on standing neuroleptics-with the Abnormal Involuntary Movement Scale (AIMS). After 8 weeks of using the Model for Improvement, both of the participating inpatient services in the APU showed substantial overall improvement in screening for abnormal involuntary movements using the AIMS. Crucial aspects of a successful quality improvement initiative based on the Model for Improvement are well-defined goals, process measures, and structured PDSA cycles. Success also requires communication, organization, and participation of the entire team.

Model for selecting quality standards for a salad bar through identifying elements of customer satisfaction.

PubMed

Ouellet, D; Norback, J P

1993-11-01

Continuous quality improvement is the new requirement of the Joint Commission on Accreditation of Healthcare Organizations. This means that meeting quality standards will not be enough. Dietitians will need to improve those standards and the way they are selected. Because quality is defined in terms of the customers, all quality improvement projects must start by defining what customers want. Using a salad bar as an example, this article presents and illustrates a technique developed in Japan to identify which elements in a product or service will satisfy or dissatisfy consumers. Using a model and a questionnaire format developed by Kano and coworkers, 273 students were surveyed to classify six quality elements of a salad bar. Four elements showed a dominant "must-be" characteristic: food freshness, labeling of the dressings, no spills in the food, and no spills on the salad bar. The two other elements (food easy to reach and food variety) showed a dominant one-dimensional characteristic. By better understanding consumer perceptions of quality elements, foodservice managers can select quality standards that focus on what really matters to their consumers.

Identifying effective pathways in a successful continuous quality improvement programme: the GEDAPS study.

PubMed

Bodicoat, Danielle H; Mundet, Xavier; Gray, Laura J; Cos, Xavier; Davies, Melanie J; Khunti, Kamlesh; Cano, Juan-Franciso

2014-12-01

Continuous quality improvement programmes often target several aspects of care, some of which may be more effective meaning that resources could be focussed on these. The objective was to identify the effective and ineffective aspects of a successful continuous quality improvement programme for individuals with type 2 diabetes in primary care. Data were from a series of cross-sectional studies (GEDAPS) in primary care, Catalonia, Spain, in 55 centres (2239 participants) in 1993, and 92 centres (5819 participants) in 2002. A structural equation modelling approach was used. The intervention was associated with improved microvascular outcomes through microalbuminuria and funduscopy screening, which had a direct effect on microvascular outcomes, and through attending 2-4 nurse visits and having ≥1 blood pressure measurement, which acted through reducing systolic blood pressure. The intervention was associated with improved macrovascular outcomes through blood pressure measurement and attending 2-4 nurse visits (through systolic blood pressure) and having ≥3 education topics, ≥1 HbA1c measurement and adequate medication (through HbA1c). Cholesterol measurement, weight measurement and foot examination did not contribute towards the effectiveness of the intervention. The pathways through which a continuous quality improvement programme appeared to act to reduce microvascular and macrovascular complications were driven by reductions in systolic blood pressure and HbA1c, which were attained through changes in nurse and education visits, measurement and medication. This suggests that these factors are potential areas on which future quality improvement programmes should focus. © 2014 John Wiley & Sons, Ltd.

How to achieve optimal organization of primary care service delivery at system level: lessons from Europe.

PubMed

Pelone, Ferruccio; Kringos, Dionne S; Spreeuwenberg, Peter; De Belvis, Antonio G; Groenewegen, Peter P

2013-09-01

To measure the relative efficiency of primary care (PC) in turning their structures into services delivery and turning their services delivery into quality outcomes. Cross-sectional study based on the dataset of the Primary Healthcare Activity Monitor for Europe project. Two Data Envelopment models were run to compare the relative technical efficiency. A sensitivity analysis of the resulting efficiency scores was performed. PC systems in 22 European countries in 2009/2010. Model 1 included data on PC governance, workforce development and economic conditions as inputs and access, coordination, continuity and comprehensiveness of care as outputs. Model 2 included the previous process dimensions as inputs and quality indicators as outputs. There is relatively reasonable efficiency in all countries at delivering as many as possible PC processes at a given level of PC structure. It is particularly important to invest in economic conditions to achieve an efficient structure-process balance. Only five countries have fully efficient PC systems in turning their services delivery into high quality outcomes, using a similar combination of access, continuity and comprehensiveness, although they differ on the adoption of coordination of services. There is a large variation in efficiency levels obtained by countries with inefficient PC in turning their services delivery into quality outcomes. Maximizing the individual functions of PC without taking into account the coherence within the health-care system is not sufficient from a policymaker's point of view when aiming to achieve efficiency.

The development of an integrated Indonesian health care model using Kano's model, quality function deployment and balanced scorecard

NASA Astrophysics Data System (ADS)

Jonny, Zagloed, Teuku Yuri M.

2017-11-01

This paper aims to present an integrated health care model for Indonesian health care industry. Based on previous researches, there are two health care models in the industry such as decease- and patient-centered care models. In their developments, the patient-centered care model is widely applied due to its capability in reducing cost and improving quality simultaneously. However, there is still no comprehensive model resulting in cost reduction, quality improvement, patient satisfaction and hospital profitability simultaneously. Therefore, this research is intended to develop that model. In doing so, first, a conceptual model using Kano's Model, Quality Function Deployment (QFD) and Balanced Scorecard (BSC) is developed to generate several important elements of the model as required by stakeholders. Then, a case study of an Indonesian hospital is presented to evaluate the validity of the model using correlation analysis. As a result, it can be concluded that the model is validated implying several managerial insights among its elements such as l) leadership (r=0.85) and context of the organization (r=0.77) improve operations; 2) planning (r=0.96), support process (r=0.87) and continual improvement (r=0.95) also improve operations; 3) operations improve customer satisfaction (r=0.89) and financial performance (r=0.93) and 4) customer satisfaction improves the financial performance (0.98).

International quality improvement initiatives.

PubMed

Hickey, Patricia A; Connor, Jean A; Cherian, Kotturathu M; Jenkins, Kathy; Doherty, Kaitlin; Zhang, Haibo; Gaies, Michael; Pasquali, Sara; Tabbutt, Sarah; St Louis, James D; Sarris, George E; Kurosawa, Hiromi; Jonas, Richard A; Sandoval, Nestor; Tchervenkov, Christo I; Jacobs, Jeffery P; Stellin, Giovanni; Kirklin, James K; Garg, Rajnish; Vener, David F

2017-12-01

Across the globe, the implementation of quality improvement science and collaborative learning has positively affected the care and outcomes for children born with CHD. These efforts have advanced the collective expertise and performance of inter-professional healthcare teams. In this review, we highlight selected quality improvement initiatives and strategies impacting the field of cardiovascular care and describe implications for future practice and research. The continued leveraging of technology, commitment to data transparency, focus on team-based practice, and recognition of cultural norms and preferences ensure the success of sustainable models of global collaboration.

The objective impact of clinical peer review on hospital quality and safety.

PubMed

Edwards, Marc T

2011-01-01

Despite its importance, the objective impact of clinical peer review on the quality and safety of care has not been studied. Data from 296 acute care hospitals show that peer review program and related organizational factors can explain up to 18% of the variation in standardized measures of quality and patient safety. The majority of programs rely on an outmoded and dysfunctional process model. Adoption of best practices informed by the continuing study of peer review program effectiveness has the potential to significantly improve patient outcomes.

A business case for quality improvement in addiction treatment: evidence from the NIATx collaborative.

PubMed

Quanbeck, Andrew R; Madden, Lynn; Edmundson, Eldon; Ford, James H; McConnell, K John; McCarty, Dennis; Gustafson, David H

2012-01-01

The Network for the Improvement of Addiction Treatment (NIATx) promotes treatment access and retention through a customer-focused quality improvement model. This paper explores the issue of the "business case" for quality improvement in addiction treatment from the provider's perspective. The business case model developed in this paper is based on case examples of early NIATx participants coupled with a review of the literature. Process inefficiencies indicated by long waiting times, high no-show rates, and low continuation rates cause underutilization of capacity and prevent optimal financial performance. By adopting customer-focused practices aimed at removing barriers to treatment access and retention, providers may be able to improve financial performance, increase staff retention, and gain long-term strategic advantage.

Mechanisms of deterioration of nutrients. [freeze drying methods for space flight food

NASA Technical Reports Server (NTRS)

Karel, M.; Flink, J. M.

1974-01-01

Methods are reported by which freeze dried foods of improved quality will be produced. The applicability of theories of flavor retention has been demonstrated for a number of food polymers, both proteins and polysacchardies. Studies on the formation of structures during freeze drying have been continued for emulsified systems. Deterioration of organoleptic quality of freeze dried foods due to high temperature heating has been evaluated and improved procedures developed. The influence of water activity and high temperature on retention of model flavor materials and browning deterioration has been evaluated for model systems and food materials.

Enhancing quality improvements in cancer care through CME activities at a nationally recognized cancer center.

PubMed

Uemura, Marc; Morgan, Robert; Mendelsohn, Mary; Kagan, Jean; Saavedra, Crystal; Leong, Lucille

2013-06-01

Changing healthcare policy will undoubtedly affect the healthcare environment in which providers function. The current Fee for Service reimbursement model will be replaced by Value-Based Purchasing, where higher quality and more efficient care will be emphasized. Because of this, large healthcare organizations and individual providers must adapt to incorporate performance outcomes into patient care. Here, we present a Continuing Medical Education (CME)-based initiative at the City of Hope National Cancer Center that we believe can serve as a model for using CME as a value added component to achieving such a goal.

Network modeling of PM10 concentration in Malaysia

NASA Astrophysics Data System (ADS)

Supian, Muhammad Nazirul Aiman Abu; Bakar, Sakhinah Abu; Razak, Fatimah Abdul

2017-08-01

Air pollution is not a new phenomenon in Malaysia. The Department of Environment (DOE) monitors the country's ambient air quality through a network of 51 stations. The air quality is measured using the Air Pollution Index (API) which is mainly recorded based on the concentration of particulate matter, PM10 readings. The Continuous Air Quality Monitoring (CAQM) stations are located in various places across the country. In this study, a network model of air quality based on PM10 concen tration for selected CAQM stations in Malaysia has been developed. The model is built using a graph formulation, G = (V, E) where vertex, V is a set of CAQM stations and edges, E is a set of correlation values for each pair of vertices. The network measurements such as degree distributions, closeness centrality, and betweenness centrality are computed to analyse the behaviour of the network. As a result, a rank of CAQM stations has been produced based on their centrality characteristics.

Maximum-entropy description of animal movement.

PubMed

Fleming, Chris H; Subaşı, Yiğit; Calabrese, Justin M

2015-03-01

We introduce a class of maximum-entropy states that naturally includes within it all of the major continuous-time stochastic processes that have been applied to animal movement, including Brownian motion, Ornstein-Uhlenbeck motion, integrated Ornstein-Uhlenbeck motion, a recently discovered hybrid of the previous models, and a new model that describes central-place foraging. We are also able to predict a further hierarchy of new models that will emerge as data quality improves to better resolve the underlying continuity of animal movement. Finally, we also show that Langevin equations must obey a fluctuation-dissipation theorem to generate processes that fall from this class of maximum-entropy distributions when the constraints are purely kinematic.

Mechanism for multiplicity of steady states with distinct cell concentration in continuous culture of mammalian cells.

PubMed

Yongky, Andrew; Lee, Jongchan; Le, Tung; Mulukutla, Bhanu Chandra; Daoutidis, Prodromos; Hu, Wei-Shou

2015-07-01

Continuous culture for the production of biopharmaceutical proteins offers the possibility of steady state operations and thus more consistent product quality and increased productivity. Under some conditions, multiplicity of steady states has been observed in continuous cultures of mammalian cells, wherein with the same dilution rate and feed nutrient composition, steady states with very different cell and product concentrations may be reached. At those different steady states, cells may exhibit a high glycolysis flux with high lactate production and low cell concentration, or a low glycolysis flux with low lactate and high cell concentration. These different steady states, with different cell concentration, also have different productivity. Developing a mechanistic understanding of the occurrence of steady state multiplicity and devising a strategy to steer the culture toward the desired steady state is critical. We establish a multi-scale kinetic model that integrates a mechanistic intracellular metabolic model and cell growth model in a continuous bioreactor. We show that steady state multiplicity exists in a range of dilution rate in continuous culture as a result of the bistable behavior in glycolysis. The insights from the model were used to devise strategies to guide the culture to the desired steady state in the multiple steady state region. The model provides a guideline principle in the design of continuous culture processes of mammalian cells. © 2015 Wiley Periodicals, Inc.

Innovations in projecting emissions for air quality modeling ...

EPA Pesticide Factsheets

Air quality modeling is used in setting air quality standards and in evaluating their costs and benefits. Historically, modeling applications have projected emissions and the resulting air quality only 5 to 10 years into the future. Recognition that the choice of air quality management strategy has climate change implications is encouraging longer modeling time horizons. However, for multi-decadal time horizons, many questions about future conditions arise. For example, will current population, economic, and land use trends continue, or will we see shifts that may alter the spatial and temporal pattern of emissions? Similarly, will technologies such as building-integrated solar photovoltaics, battery storage, electric vehicles, and CO2 capture emerge as disruptive technologies - shifting how we produce and use energy - or will these technologies achieve only niche markets and have little impact? These are some of the questions that are being evaluated by researchers within the U.S. EPA’s Office of Research and Development. In this presentation, Dr. Loughlin will describe a range of analytical approaches that are being explored. These include: (i) the development of alternative scenarios of the future that can be used to evaluate candidate management strategies over wide-ranging conditions, (ii) the application of energy system models to project emissions decades into the future and to assess the environmental implications of new technologies, (iii) and methodo

Dynamic extreme values modeling and monitoring by means of sea shores water quality biomarkers and valvometry.

PubMed

Durrieu, Gilles; Pham, Quang-Khoai; Foltête, Anne-Sophie; Maxime, Valérie; Grama, Ion; Tilly, Véronique Le; Duval, Hélène; Tricot, Jean-Marie; Naceur, Chiraz Ben; Sire, Olivier

2016-07-01

Water quality can be evaluated using biomarkers such as tissular enzymatic activities of endemic species. Measurement of molluscs bivalves activity at high frequency (e.g., valvometry) during a long time period is another way to record the animal behavior and to evaluate perturbations of the water quality in real time. As the pollution affects the activity of oysters, we consider the valves opening and closing velocities to monitor the water quality assessment. We propose to model the huge volume of velocity data collected in the framework of valvometry using a new nonparametric extreme values statistical model. The objective is to estimate the tail probabilities and the extreme quantiles of the distribution of valve closing velocity. The tail of the distribution function of valve closing velocity is modeled by a Pareto distribution with parameter t,τ , beyond a threshold τ according to the time t of the experiment. Our modeling approach reveals the dependence between the specific activity of two enzymatic biomarkers (Glutathione-S-transferase and acetylcholinesterase) and the continuous recording of oyster valve velocity, proving the suitability of this tool for water quality assessment. Thus, valvometry allows in real-time in situ analysis of the bivalves behavior and appears as an effective early warning tool in ecological risk assessment and marine environment monitoring.

Relationships between women and their parents: implications for midlife well-being.

PubMed

Welsh, W M; Stewart, A J

1995-06-01

The rapid changes in women's roles during the 1970s gave the graduates of the Radcliffe College class of 1964 opportunities for life experiences markedly different from those of either their mothers or their fathers. This longitudinal study of 89 Radcliffe graduates examined the ways in which women in midlife find continuity with their parents and the implications of experiences of continuity for women's relationships with parents and for women's self-esteem and well-being. Support was found for a model linking women's educational and occupational similarity to their parents to later perceptions of parental influence, perceived parental influence to parent-daughter relationship quality, and parent-daughter relationship quality to self-esteem and subsequent well-being. The quality of women's relationships with their fathers did not predict subsequent well-being, perhaps because of fathers' decreased involvement in their adult daughters' lives.

SEER*Educate: Use of Abstracting Quality Index Scores to Monitor Improvement of All Employees.

PubMed

Potts, Mary S; Scott, Tim; Hafterson, Jennifer L

2016-01-01

Integral parts of the Seattle-Puget Sound's Cancer Surveillance System registry's continuous improvement model include the incorporation of SEER*Educate into its training program for all staff and analyzing assessment results using the Abstracting Quality Index (AQI). The AQI offers a comprehensive measure of overall performance in SEER*Educate, which is a Web-based application used to personalize learning and diagnostically pinpoint each staff member's place on the AQI continuum. The assessment results are tallied from 6 abstracting standards within 2 domains: incidence reporting and coding accuracy. More than 100 data items are aligned to 1 or more of the 6 standards to build an aggregated score that is placed on a continuum for continuous improvement. The AQI score accurately identifies those individuals who have a good understanding of how to apply the 6 abstracting standards to reliably generate high quality abstracts.

Quality assurance and stability reference (QUASAR) monitoring concept for calibration/validation

NASA Astrophysics Data System (ADS)

Teillet, Philippe M.; Horler, D. N.; O'Neill, Norman T.

1997-12-01

The paper introduces the concept that calibration/validation (cal/val) can play an essential role in bringing remote sensing to mainstream consumers in an information-based society, provided that cal/val is an integral part of a quality-assurance strategy. A market model for remote sensing is introduced and used to demonstrate that quality assurance is the key to bridging the gap between early adopters of technology and mainstream markets. The paper goes on to propose the semi-continuous monitoring of quality assurance and stability reference (QUASAR) sites as an important first step towards a cal/val infrastructure beneficial to mainstream users. Prospective QUASAR test sites are described.

TQM: the essential concepts.

PubMed

Chambers, D W

1998-01-01

This is an introduction to the major concepts in total quality management, a loose collection of management approaches that focus on continuous improvement of processes, guided by routine data collection and adjustment of the processes. Customer focus and involvement of all members of an organization are also characteristics commonly found in TQM. The seventy-five-year history of the movement is sketched from its beginning in statistical work on quality assurance through the many improvements and redefinitions added by American and Japanese thinkers. Essential concepts covered include: control cycles, focus on the process rather than the defects, the GEAR model, importance of the customer, upstream quality, just-in-time, kaizen, and service quality.

Modeling the effects of pulsed versus chronic sand inputs on salmonid spawning habitat in a low-gradient gravel-bed river

Treesearch

Oscar Maturana; Daniele Tonina; James A. McKean; John M. Buffington; Charles H. Luce; Diego Caamano

2013-01-01

It is widely recognized that high supplies of fine sediment, largely sand, can negatively impact the aquatic habitat quality of gravel-bed rivers, but effects of the style of input (chronic vs. pulsed) have not been examined quantitatively. We hypothesize that a continuous (i.e. chronic) supply of sand will be more detrimental to the quality of aquatic habitat than an...

Recent Enhancements to the National Transonic Facility

NASA Technical Reports Server (NTRS)

Kilgore, W. A.; Balakrishna, S.; Bobbitt, C. W.; Underwood, P.

2003-01-01

The National Transonic Facility continues to make enhancements to provide quality data in a safe, efficient and cost effective method for aerodynamic ground testing. Recent enhancements discussed in this paper include the restoration of reliability and improved performance of the heat exchanger systems resulting in the expansion of the NTF air operations envelope. Additionally, results are presented from a continued effort to reduce model dynamics through the use of a new stiffer balance and sting

Template for success: using a resident-designed sign-out template in the handover of patient care.

PubMed

Clark, Clancy J; Sindell, Sarah L; Koehler, Richard P

2011-01-01

Report our implementation of a standardized handover process in a general surgery residency program. The standardized handover process, sign-out template, method of implementation, and continuous quality improvement process were designed by general surgery residents with support of faculty and senior hospital administration using standard work principles and business models of the Virginia Mason Production System and the Toyota Production System. Nonprofit, tertiary referral teaching hospital. General surgery residents, residency faculty, patient care providers, and hospital administration. After instruction in quality improvement initiatives, a team of general surgery residents designed a sign-out process using an electronic template and standard procedures. The initial implementation phase resulted in 73% compliance. Using resident-driven continuous quality improvement processes, real-time feedback enabled residents to modify and improve this process, eventually attaining 100% compliance and acceptance by residents. The creation of a standardized template and protocol for patient handovers might eliminate communication failures. Encouraging residents to participate in this process can establish the groundwork for successful implementation of a standardized handover process. Integrating a continuous quality-improvement process into such an initiative can promote active participation of busy general surgery residents and lead to successful implementation of standard procedures. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Fully vectorial laser resonator modeling of continuous-wave solid-state lasers including rate equations, thermal lensing and stress-induced birefringence.

PubMed

Asoubar, Daniel; Wyrowski, Frank

2015-07-27

The computer-aided design of high quality mono-mode, continuous-wave solid-state lasers requires fast, flexible and accurate simulation algorithms. Therefore in this work a model for the calculation of the transversal dominant mode structure is introduced. It is based on the generalization of the scalar Fox and Li algorithm to a fully-vectorial light representation. To provide a flexible modeling concept of different resonator geometries containing various optical elements, rigorous and approximative solutions of Maxwell's equations are combined in different subdomains of the resonator. This approach allows the simulation of plenty of different passive intracavity components as well as active media. For the numerically efficient simulation of nonlinear gain, thermal lensing and stress-induced birefringence effects in solid-state active crystals a semi-analytical vectorial beam propagation method is discussed in detail. As a numerical example the beam quality and output power of a flash-lamp-pumped Nd:YAG laser are improved. To that end we compensate the influence of stress-induced birefringence and thermal lensing by an aspherical mirror and a 90° quartz polarization rotator.

SWAT Model Application to Assess the Impact of Intensive Corn‐farming on Runoff, Sediments and Phosphorous loss from an Agricultural Watershed in Wisconsin

EPA Science Inventory

The potential future increase in corn-based biofuel may be expected to have a negative impact on water quality in streams and lakes of the Midwestern US due to increased agricultural chemicals usage. This study used the SWAT model to assess the impact of continuous-corn farming o...

Implementation Differences of Two Staffing Models in the German Home Visiting Program "Pro Kind"

ERIC Educational Resources Information Center

Brand, Tilman; Jungmann, Tanja

2012-01-01

As different competencies or professional backgrounds may affect the quality of program implementation, staffing is a critical issue in home visiting. In this study, N = 430 women received home visits delivered either by a tandem of a midwife and a social worker or by only one home visitor (primarily midwives, continuous model). The groups were…

Systems approach to managing educational quality in the engineering classroom

NASA Astrophysics Data System (ADS)

Grygoryev, Kostyantyn

Today's competitive environment in post-secondary education requires universities to demonstrate the quality of their programs in order to attract financing, and student and academic talent. Despite significant efforts devoted to improving the quality of higher education, systematic, continuous performance measurement and management still have not reached the level where educational outputs and outcomes are actually produced---the classroom. An engineering classroom is a complex environment in which educational inputs are transformed by educational processes into educational outputs and outcomes. By treating a classroom as a system, one can apply tools such as Structural Equation Modeling, Statistical Process Control, and System Dynamics in order to discover cause-and-effect relationships among the classroom variables, control the classroom processes, and evaluate the effect of changes to the course organization, content, and delivery, on educational processes and outcomes. Quality improvement is best achieved through the continuous, systematic application of efforts and resources. Improving classroom processes and outcomes is an iterative process that starts with identifying opportunities for improvement, designing the action plan, implementing the changes, and evaluating their effects. Once the desired objectives are achieved, the quality improvement cycle may start again. The goal of this research was to improve the educational processes and outcomes in an undergraduate engineering management course taught at the University of Alberta. The author was involved with the course, first, as a teaching assistant, and, then, as a primary instructor. The data collected from the course over four years were used to create, first, a static and, then, a dynamic model of a classroom system. By using model output and qualitative feedback from students, changes to the course organization and content were introduced. These changes led to a lower perceived course workload and increased the students' satisfaction with the instructor, but the students' overall satisfaction with the course did not change significantly, and their attitude toward the course subject actually became more negative. This research brought performance measurement to the level of a classroom, created a dynamic model of the classroom system based on the cause-and-effect relationships discovered by using statistical analysis, and used a systematic, continuous improvement approach to modify the course in order to improve selected educational processes and outcomes.

Assessing the relationship between technology readiness and continuance intention in an E-appointment system: relationship quality as a mediator.

PubMed

Chen, Shih-Chih; Jong, Din; Lai, Min-Tsai

2014-09-01

Numerous types of self-service technologies have prevailed due to innovations in network and information technology. To hospitals, patient intentions to continue to use the e-appointment system are crucial. Previous investigations discussed only the relationships between the technology readiness of users and their continuance intentions, and ignored the most important mediator, relationship quality. This study explored the relationships among technology readiness, relationship quality, and continuance intention. The research results demonstrated that both optimism and innovativeness significantly and positively influenced continuance intention through the mediating effect of relationship quality. However, discomfort and insecurity hid not significantly influence relationship quality or continuance intention. Finally, theoretical contributions, managerial implications and future research directions were discussed.

Implications of Modeling Uncertainty for Water Quality Decision Making

NASA Astrophysics Data System (ADS)

Shabman, L.

2002-05-01

The report, National Academy of Sciences report, "Assessing the TMDL Approach to Water Quality Management" endorsed the "watershed" and "ambient water quality focused" approach" to water quality management called for in the TMDL program. The committee felt that available data and models were adequate to move such a program forward, if the EPA and all stakeholders better understood the nature of the scientific enterprise and its application to the TMDL program. Specifically, the report called for a greater acknowledgement of model prediction uncertinaity in making and implementing TMDL plans. To assure that such uncertinaity was addressed in water quality decision making the committee called for a commitment to "adaptive implementation" of water quality management plans. The committee found that the number and complexity of the interactions of multiple stressors, combined with model prediction uncertinaity means that we need to avoid the temptation to make assurances that specific actions will result in attainment of particular water quality standards. Until the work on solving a water quality problem begins, analysts and decision makers cannot be sure what the correct solutions are, or even what water quality goals a community should be seeking. In complex systems we need to act in order to learn; adaptive implementation is a concurrent process of action and learning. Learning requires (1) continued monitoring of the waterbody to determine how it responds to the actions taken and (2) carefully designed experiments in the watershed. If we do not design learning into what we attempt we are not doing adaptive implementation. Therefore, there needs to be an increased commitment to monitoring and experiments in watersheds that will lead to learning. This presentation will 1) explain the logic for adaptive implementation; 2) discuss the ways that water quality modelers could characterize and explain model uncertinaity to decision makers; 3) speculate on the implications of the adaptive implementation for setting of water quality standards, for design of watershed monitoring programs and for the regulatory rules governing the TMDL program implementation.

Decomposition of heterogeneous organic matterand its long-term stabilization in soils

USGS Publications Warehouse

Sierra, Carlos A.; Harmon, Mark E.; Perakis, Steven S.

2011-01-01

Soil organic matter is a complex mixture of material with heterogeneous biological, physical, and chemical properties. Decomposition models represent this heterogeneity either as a set of discrete pools with different residence times or as a continuum of qualities. It is unclear though, whether these two different approaches yield comparable predictions of organic matter dynamics. Here, we compare predictions from these two different approaches and propose an intermediate approach to study organic matter decomposition based on concepts from continuous models implemented numerically. We found that the disagreement between discrete and continuous approaches can be considerable depending on the degree of nonlinearity of the model and simulation time. The two approaches can diverge substantially for predicting long-term processes in soils. Based on our alternative approach, which is a modification of the continuous quality theory, we explored the temporal patterns that emerge by treating substrate heterogeneity explicitly. The analysis suggests that the pattern of carbon mineralization over time is highly dependent on the degree and form of nonlinearity in the model, mostly expressed as differences in microbial growth and efficiency for different substrates. Moreover, short-term stabilization and destabilization mechanisms operating simultaneously result in long-term accumulation of carbon characterized by low decomposition rates, independent of the characteristics of the incoming litter. We show that representation of heterogeneity in the decomposition process can lead to substantial improvements in our understanding of carbon mineralization and its long-term stability in soils.

Precision of working memory for speech sounds.

PubMed

Joseph, Sabine; Iverson, Paul; Manohar, Sanjay; Fox, Zoe; Scott, Sophie K; Husain, Masud

2015-01-01

Memory for speech sounds is a key component of models of verbal working memory (WM). But how good is verbal WM? Most investigations assess this using binary report measures to derive a fixed number of items that can be stored. However, recent findings in visual WM have challenged such "quantized" views by employing measures of recall precision with an analogue response scale. WM for speech sounds might rely on both continuous and categorical storage mechanisms. Using a novel speech matching paradigm, we measured WM recall precision for phonemes. Vowel qualities were sampled from a formant space continuum. A probe vowel had to be adjusted to match the vowel quality of a target on a continuous, analogue response scale. Crucially, this provided an index of the variability of a memory representation around its true value and thus allowed us to estimate how memories were distorted from the original sounds. Memory load affected the quality of speech sound recall in two ways. First, there was a gradual decline in recall precision with increasing number of items, consistent with the view that WM representations of speech sounds become noisier with an increase in the number of items held in memory, just as for vision. Based on multidimensional scaling (MDS), the level of noise appeared to be reflected in distortions of the formant space. Second, as memory load increased, there was evidence of greater clustering of participants' responses around particular vowels. A mixture model captured both continuous and categorical responses, demonstrating a shift from continuous to categorical memory with increasing WM load. This suggests that direct acoustic storage can be used for single items, but when more items must be stored, categorical representations must be used.

Colour Measurements and Modeling

NASA Astrophysics Data System (ADS)

Jha, Shyam N.

The most common property to measure quality of any material is its appearance. Appearance includes colour, shape, size and surface conditions. The analysis of colour is especially an important consideration when determining the efficacy of variety of postharvest treatments. Consumers can easily be influenced by preconceived ideas of how a particular fruit or vegetable or a processed food should appear, and marketers often attempt to improve upon what nature has painted. Recently colour measurements have also been used as quality parameters and indicator of some inner constituents of the material. In spite of the significance of colour in food industries, many continue to analyze it inadequately. This chapter deals with theory of colour, colour scales and its measurement, sampling techniques, and modeling of colour values for correlating them with some internal quality parameters of selected fruits.

The statistical evaluation and comparison of ADMS-Urban model for the prediction of nitrogen dioxide with air quality monitoring network.

PubMed

Dėdelė, Audrius; Miškinytė, Auksė

2015-09-01

In many countries, road traffic is one of the main sources of air pollution associated with adverse effects on human health and environment. Nitrogen dioxide (NO2) is considered to be a measure of traffic-related air pollution, with concentrations tending to be higher near highways, along busy roads, and in the city centers, and the exceedances are mainly observed at measurement stations located close to traffic. In order to assess the air quality in the city and the air pollution impact on public health, air quality models are used. However, firstly, before the model can be used for these purposes, it is important to evaluate the accuracy of the dispersion modelling as one of the most widely used method. The monitoring and dispersion modelling are two components of air quality monitoring system (AQMS), in which statistical comparison was made in this research. The evaluation of the Atmospheric Dispersion Modelling System (ADMS-Urban) was made by comparing monthly modelled NO2 concentrations with the data of continuous air quality monitoring stations in Kaunas city. The statistical measures of model performance were calculated for annual and monthly concentrations of NO2 for each monitoring station site. The spatial analysis was made using geographic information systems (GIS). The calculation of statistical parameters indicated a good ADMS-Urban model performance for the prediction of NO2. The results of this study showed that the agreement of modelled values and observations was better for traffic monitoring stations compared to the background and residential stations.

[Guided and computer-assisted implant surgery and prosthetic: The continuous digital workflow].

PubMed

Pascual, D; Vaysse, J

2016-02-01

New continuous digital workflow protocols of guided and computer-assisted implant surgery improve accuracy of implant positioning. The design of the future prosthesis is based on the available prosthetic space, gingival height and occlusal relationship with the opposing and adjacent teeth. The implant position and length depend on volume, density and bone quality, gingival height, tooth-implant and implant-implant distances, implant parallelism, axis and type of the future prosthesis. The crown modeled on the software will therefore serve as a guide to the future implant axis and not the reverse. The guide is made by 3D printing. The software determines surgical protocol with the drilling sequences. The unitary or plural prosthesis, modeled on the software and built before surgery, is loaded directly after implant placing, if needed. These protocols allow for a full continuity of the digital workflow. The software provides the surgeon and the dental technician a total freedom for the prosthetic-surgery guide design and the position of the implants. The prosthetic project, occlusal and aesthetic, taking the bony and surgical constraints into account, is optimized. The implant surgery is simplified and becomes less "stressful" for the patient and the surgeon. Guided and computer-assisted surgery with continuous digital workflow is becoming the technique of choice to improve the accuracy and quality of implant rehabilitation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Accounting for electric vehicles in air quality conformity \\0x2012 final report.

DOT National Transportation Integrated Search

2014-12-01

Electric vehicles (EVs) obtain at least a part of the energy required for their propulsion from electricity. The : market for EVs, including hybrid, plug-in hybrid, and battery electric vehicles continues to grow, as many : new and affordable models ...

Air Quality Modeling Needs for Exposure Assessment form the Source-To-Outcome Perspective

EPA Science Inventory

Humans are exposed continuously to mixtures of air pollutants. The compositions of these mixtures vary with time and location and their components originate from many types of sources, both local and distant, including industrial facilities, vehicles, consumer products, and more....

Cuff-less blood pressure measurement using pulse arrival time and a Kalman filter

NASA Astrophysics Data System (ADS)

Zhang, Qiang; Chen, Xianxiang; Fang, Zhen; Xue, Yongjiao; Zhan, Qingyuan; Yang, Ting; Xia, Shanhong

2017-02-01

The present study designs an algorithm to increase the accuracy of continuous blood pressure (BP) estimation. Pulse arrival time (PAT) has been widely used for continuous BP estimation. However, because of motion artifact and physiological activities, PAT-based methods are often troubled with low BP estimation accuracy. This paper used a signal quality modified Kalman filter to track blood pressure changes. A Kalman filter guarantees that BP estimation value is optimal in the sense of minimizing the mean square error. We propose a joint signal quality indice to adjust the measurement noise covariance, pushing the Kalman filter to weigh more heavily on measurements from cleaner data. Twenty 2 h physiological data segments selected from the MIMIC II database were used to evaluate the performance. Compared with straightforward use of the PAT-based linear regression model, the proposed model achieved higher measurement accuracy. Due to low computation complexity, the proposed algorithm can be easily transplanted into wearable sensor devices.

Integral projection models for finite populations in a stochastic environment.

PubMed

Vindenes, Yngvild; Engen, Steinar; Saether, Bernt-Erik

2011-05-01

Continuous types of population structure occur when continuous variables such as body size or habitat quality affect the vital parameters of individuals. These structures can give rise to complex population dynamics and interact with environmental conditions. Here we present a model for continuously structured populations with finite size, including both demographic and environmental stochasticity in the dynamics. Using recent methods developed for discrete age-structured models we derive the demographic and environmental variance of the population growth as functions of a continuous state variable. These two parameters, together with the expected population growth rate, are used to define a one-dimensional diffusion approximation of the population dynamics. Thus, a substantial reduction in complexity is achieved as the dynamics of the complex structured model can be described by only three population parameters. We provide methods for numerical calculation of the model parameters and demonstrate the accuracy of the diffusion approximation by computer simulation of specific examples. The general modeling framework makes it possible to analyze and predict future dynamics and extinction risk of populations with various types of structure, and to explore consequences of changes in demography caused by, e.g., climate change or different management decisions. Our results are especially relevant for small populations that are often of conservation concern.

Development of a cloud-based application for the Fracture Liaison Service model of care.

PubMed

Holzmueller, C G; Karp, S; Zeldow, D; Lee, D B; Thompson, D A

2016-02-01

The aims of this study are to develop a cloud-based application of the Fracture Liaison Service for practitioners to coordinate the care of osteoporotic patients after suffering primary fractures and provide a performance feedback portal for practitioners to determine quality of care. The application provides continuity of care, improved patient outcomes, and reduced medical costs. The purpose of this study is to describe the content development and functionality of a cloud-based application to broadly deploy the Fracture Liaison Service (FLS) to coordinate post-fracture care for osteoporotic patients. The Bone Health Collaborative developed the FLS application in 2013 to support practitioners' access to information and management of patients and provide a feedback portal for practitioners to track their performance in providing quality care. A five-step protocol (identify, inform, initiate, investigate, and iterate) organized osteoporotic post-fracture care-related tasks and timelines for the application. A range of descriptive data about the patient, their medical condition, therapies and care, and current providers can be collected. Seven quality of care measures from the National Quality Forum, The Joint Commission, and the Centers for Medicare and Medicaid Services can be tracked through the application. There are five functional areas including home, tasks, measures, improvement, and data. The home, tasks, and data pages are used to enter patient information and coordinate care using the five-step protocol. Measures and improvement pages are used to enter quality measures and provide practitioners with continuous performance feedback. The application resides within a portal, running on a multitenant, private cloud-based Avedis enterprise registry platform. All data are encrypted in transit and users access the application using a password from any common web browser. The application could spread the FLS model of care across the US health care system, provide continuity of care, effectively manage osteoporotic patients, improve outcomes, and reduce medical costs.

Honing process optimization algorithms

NASA Astrophysics Data System (ADS)

Kadyrov, Ramil R.; Charikov, Pavel N.; Pryanichnikova, Valeria V.

2018-03-01

This article considers the relevance of honing processes for creating high-quality mechanical engineering products. The features of the honing process are revealed and such important concepts as the task for optimization of honing operations, the optimal structure of the honing working cycles, stepped and stepless honing cycles, simulation of processing and its purpose are emphasized. It is noted that the reliability of the mathematical model determines the quality parameters of the honing process control. An algorithm for continuous control of the honing process is proposed. The process model reliably describes the machining of a workpiece in a sufficiently wide area and can be used to operate the CNC machine CC743.

Quality management, a directive approach to patient safety.

PubMed

Ayuso-Murillo, Diego; de Andrés-Gimeno, Begoña; Noriega-Matanza, Concha; López-Suárez, Rafael Jesús; Herrera-Peco, Ivan

Nowadays the implementation of effective quality management systems and external evaluation in healthcare is a necessity to ensure not only transparency in activities related to health but also access to health and patient safety. The key to correctly implementing a quality management system is support from the managers of health facilities, since it is managers who design and communicate to health professionals the strategies of action involved in quality management systems. This article focuses on nursing managers' approach to quality management through the implementation of cycles of continuous improvement, participation of improvement groups, monitoring systems and external evaluation quality models (EFQM, ISO). The implementation of a quality management system will enable preventable adverse effects to be minimized or eliminated, and promote patient safety and safe practice by health professionals. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Continuity of care in mental health: understanding and measuring a complex phenomenon.

PubMed

Burns, T; Catty, J; White, S; Clement, S; Ellis, G; Jones, I R; Lissouba, P; McLaren, S; Rose, D; Wykes, T

2009-02-01

Continuity of care is considered by patients and clinicians an essential feature of good quality care in long-term disorders, yet there is general agreement that it is a complex concept. Most policies emphasize it and encourage systems to promote it. Despite this, there is no accepted definition or measure against which to test policies or interventions designed to improve continuity. We aimed to operationalize a multi-axial model of continuity of care and to use factor analysis to determine its validity for severe mental illness. A multi-axial model of continuity of care comprising eight facets was operationalized for quantitative data collection from mental health service users using 32 variables. Of these variables, 22 were subsequently entered into a factor analysis as independent components, using data from a clinical population considered to require long-term consistent care. Factor analysis produced seven independent continuity factors accounting for 62.5% of the total variance. These factors, Experience and Relationship, Regularity, Meeting Needs, Consolidation, Managed Transitions, Care Coordination and Supported Living, were close but not identical to the original theoretical model. We confirmed that continuity of care is multi-factorial. Our seven factors are intuitively meaningful and appear to work in mental health. These factors should be used as a starting-point in research into the determinants and outcomes of continuity of care in long-term disorders.

Air Quality and Health Benefits of China's Recent Stringent Environmental Policy

NASA Astrophysics Data System (ADS)

Zheng, Y.; Xue, T.; Zhang, Q.; Geng, G.; He, K.

2016-12-01

Aggressive emission control measures were taken by China's central and local governments after the promulgation of the "Air Pollution Prevention and Control Action Plan" in 2013. We evaluated the air quality and health benefits of this ever most stringent air pollution control policy during 2013-2015 by utilizing a two-stage data fusion model and newly-developed cause-specific integrated exposure-response functions (IER) developed for the Global Burden of Disease (GBD). The two-stage data fusion model predicts spatiotemporal continuous PM2.5 (particulate matter with aerodynamic diameter less than 2.5 µm) concentrations by integrating satellite-derived aerosol optical depth (AOD) measurements, PM2.5 concentrations from measurement and air quality model, and other ancillary information. During the years of analysis, PM2.5 concentration dropped significantly on national average and over heavily polluted regions as identified by Mann-Kendall analysis. The national PM2.5-attributable mortality decreased by 72.8 (95% CI: 59.4, 85.2) thousand (6%) from 1.23 (95% CI: 1.06, 1.39) million in 2013 to 1.15 (95% CI: 0.98, 1.31) million in 2015 due to considerable reduction (i.e. 18%) of population-weighted PM2.5 from 61.4 to 50.5 µg/m3. Meteorological variations between 2013 and 2015 were estimated to raise the PM2.5 levels by 0.24 µg/m3 and national mortality by 2.1 (95% CI: 1.6, 2.6) thousand through sensitivity tests, which implies the dominant role of anthropogenic impacts on PM2.5 abatement and attributable mortality reduction. Our study affirms the effectiveness of China's recent air quality policy, however, due to the possible supralinear shape of C-R functions, health benefits induced by air quality improvement in these years are limited. We therefore appeal for continuous implementation of current policies and further stringent measures from both air quality improvement and public health protection perspectives.

A random optimization approach for inherent optic properties of nearshore waters

NASA Astrophysics Data System (ADS)

Zhou, Aijun; Hao, Yongshuai; Xu, Kuo; Zhou, Heng

2016-10-01

Traditional method of water quality sampling is time-consuming and highly cost. It can not meet the needs of social development. Hyperspectral remote sensing technology has well time resolution, spatial coverage and more general segment information on spectrum. It has a good potential in water quality supervision. Via the method of semi-analytical, remote sensing information can be related with the water quality. The inherent optical properties are used to quantify the water quality, and an optical model inside the water is established to analysis the features of water. By stochastic optimization algorithm Threshold Acceptance, a global optimization of the unknown model parameters can be determined to obtain the distribution of chlorophyll, organic solution and suspended particles in water. Via the improvement of the optimization algorithm in the search step, the processing time will be obviously reduced, and it will create more opportunity for the increasing the number of parameter. For the innovation definition of the optimization steps and standard, the whole inversion process become more targeted, thus improving the accuracy of inversion. According to the application result for simulated data given by IOCCG and field date provided by NASA, the approach model get continuous improvement and enhancement. Finally, a low-cost, effective retrieval model of water quality from hyper-spectral remote sensing can be achieved.

Quantitative image quality evaluation of MR images using perceptual difference models

PubMed Central

Miao, Jun; Huo, Donglai; Wilson, David L.

2008-01-01

The authors are using a perceptual difference model (Case-PDM) to quantitatively evaluate image quality of the thousands of test images which can be created when optimizing fast magnetic resonance (MR) imaging strategies and reconstruction techniques. In this validation study, they compared human evaluation of MR images from multiple organs and from multiple image reconstruction algorithms to Case-PDM and similar models. The authors found that Case-PDM compared very favorably to human observers in double-stimulus continuous-quality scale and functional measurement theory studies over a large range of image quality. The Case-PDM threshold for nonperceptible differences in a 2-alternative forced choice study varied with the type of image under study, but was ≈1.1 for diffuse image effects, providing a rule of thumb. Ordering the image quality evaluation models, we found in overall Case-PDM ≈ IDM (Sarnoff Corporation) ≈ SSIM [Wang et al. IEEE Trans. Image Process. 13, 600–612 (2004)] > mean squared error ≈ NR [Wang et al. (2004) (unpublished)] > DCTune (NASA) > IQM (MITRE Corporation). The authors conclude that Case-PDM is very useful in MR image evaluation but that one should probably restrict studies to similar images and similar processing, normally not a limitation in image reconstruction studies. PMID:18649487

Visual Working Memory Cannot Trade Quantity for Quality.

PubMed

Ramaty, Ayelet; Luria, Roy

2018-01-01

Two main models have been proposed to describe how visual working memory (WM) allocates its capacity: the slot-model and the continuous resource-model. The purpose of the current study was to test a direct prediction of the resource model suggesting that WM can trade-off between the quantity and quality of the encoded information. Previous research reported equivocal results, with studies that failed to find such a trade-off and other studies that reported a trade-off. Following the design of previous studies, in Experiment 1 we replicated this trade-off, by presenting the memory array for 1200 ms. Experiment 2 failed to observe a trade-off between quantity and quality using a memory array interval of 300 ms (a standard interval for visual WM). Experiment 3 again failed to find this trade-off, when reinstating the 1200 ms memory array interval but adding an articulatory suppression manipulation. We argue that while participants can trade quantity for quality, this pattern depends on verbal encoding and transfer to long-term memory processes that were possible to perform only during the long retention interval. When these processes were eliminated, the trade-off disappeared. Thus, we didn't find any evidence that the trade-off between quantity for quality can occur within visual WM.

Trial-dependent psychometric functions accounting for perceptual learning in 2-AFC discrimination tasks.

PubMed

Kattner, Florian; Cochrane, Aaron; Green, C Shawn

2017-09-01

The majority of theoretical models of learning consider learning to be a continuous function of experience. However, most perceptual learning studies use thresholds estimated by fitting psychometric functions to independent blocks, sometimes then fitting a parametric function to these block-wise estimated thresholds. Critically, such approaches tend to violate the basic principle that learning is continuous through time (e.g., by aggregating trials into large "blocks" for analysis that each assume stationarity, then fitting learning functions to these aggregated blocks). To address this discrepancy between base theory and analysis practice, here we instead propose fitting a parametric function to thresholds from each individual trial. In particular, we implemented a dynamic psychometric function whose parameters were allowed to change continuously with each trial, thus parameterizing nonstationarity. We fit the resulting continuous time parametric model to data from two different perceptual learning tasks. In nearly every case, the quality of the fits derived from the continuous time parametric model outperformed the fits derived from a nonparametric approach wherein separate psychometric functions were fit to blocks of trials. Because such a continuous trial-dependent model of perceptual learning also offers a number of additional advantages (e.g., the ability to extrapolate beyond the observed data; the ability to estimate performance on individual critical trials), we suggest that this technique would be a useful addition to each psychophysicist's analysis toolkit.

Manufacturing Bms/Iso System Review

NASA Technical Reports Server (NTRS)

Gomez, Yazmin

2004-01-01

The Quality Management System (QMS) is one that recognizes the need to continuously change and improve an organization s products and services as determined by system feedback, and corresponding management decisions. The purpose of a Quality Management System is to minimize quality variability of an organization's products and services. The optimal Quality Management System balances the need for an organization to maintain flexibility in the products and services it provides with the need for providing the appropriate level of discipline and control over the processes used to provide them. The goal of a Quality Management System is to ensure the quality of the products and services while consistently (through minimizing quality variability) meeting or exceeding customer expectations. The GRC Business Management System (BMS) is the foundation of the Center's ISO 9001:2000 registered quality system. ISO 9001 is a quality system model developed by the International Organization for Standardization. BMS supports and promote the Glenn Research Center Quality Policy and wants to ensure the customer satisfaction while also meeting quality standards. My assignment during this summer is to examine the manufacturing processes used to develop research hardware, which in most cases are one of a kind hardware, made with non conventional equipment and materials. During this process of observation I will make a determination, based on my observations of the hardware development processes the best way to meet customer requirements and at the same time achieve the GRC quality standards. The purpose of my task is to review the manufacturing processes identifying opportunities in which to optimize the efficiency of the processes and establish a plan for implementation and continuous improvement.

Modeling in the quality by design environment: Regulatory requirements and recommendations for design space and control strategy appointment.

PubMed

Djuris, Jelena; Djuric, Zorica

2017-11-30

Mathematical models can be used as an integral part of the quality by design (QbD) concept throughout the product lifecycle for variety of purposes, including appointment of the design space and control strategy, continual improvement and risk assessment. Examples of different mathematical modeling techniques (mechanistic, empirical and hybrid) in the pharmaceutical development and process monitoring or control are provided in the presented review. In the QbD context, mathematical models are predominantly used to support design space and/or control strategies. Considering their impact to the final product quality, models can be divided into the following categories: high, medium and low impact models. Although there are regulatory guidelines on the topic of modeling applications, review of QbD-based submission containing modeling elements revealed concerns regarding the scale-dependency of design spaces and verification of models predictions at commercial scale of manufacturing, especially regarding real-time release (RTR) models. Authors provide critical overview on the good modeling practices and introduce concepts of multiple-unit, adaptive and dynamic design space, multivariate specifications and methods for process uncertainty analysis. RTR specification with mathematical model and different approaches to multivariate statistical process control supporting process analytical technologies are also presented. Copyright © 2017 Elsevier B.V. All rights reserved.

GP Practices as a One-Stop Shop: How Do Patients Perceive the Quality of Care? A Cross-Sectional Study in Thirty-Four Countries.

PubMed

Schäfer, Willemijn L A; Boerma, Wienke G W; Schellevis, François G; Groenewegen, Peter P

2017-12-29

To contribute to the current knowledge on how a broad range of services offered by general practitioners (GPs) may contribute to the patient perceived quality and, hence, the potential benefits of primary care. Between 2011 and 2013, primary care data were collected among GPs and their patients in 31 European countries, plus Australia, Canada, and New Zealand. In these countries, GPs are the main providers of primary care, mostly specialized in family medicine and working in the ambulatory setting. In this cross-sectional study, questionnaires were completed by 7,183 GPs and 61,931 visiting patients. Moreover, 7,270 patients answered questions about what they find important (their values). In the analyses of patient experiences, we adjusted for patients' values in each country to measure patient perceived quality. Perceived quality was measured regarding five areas: accessibility and continuity of care, doctor-patient communication, patient involvement in decision making, and comprehensiveness of care. The range of GP services was measured in relation to four areas: (1) to what extent they are the first contact to the health care system for patients in need of care, (2) their involvement in treatment and follow-up of acute and chronic conditions, in other words treatment of diseases, (3) their involvement in minor technical procedures, and (4) their involvement in preventive treatments. Data of the patients were linked to the data of the GPs. Multilevel modeling was used to construct scale scores for the experiences of patients in the five areas of quality and the range of services of GPs. In these four-level models, items were nested within patients, nested in GP practices, nested in countries. The relationship between the range of services and the experiences of patients was analyzed in three-level multilevel models, also taking into account the values of patients. In countries where GPs offer a broader range of services patients perceive better accessibility, continuity, and comprehensiveness of care, and more involvement in decision making. No associations were found between the range of services and the patient perceived communication with their GP. The range of GP services mostly explained the variation between countries in the areas of patient perceived accessibility and continuity of care. This study showed that in countries where GP practices serve as a "one-stop shop," patients perceive better quality of care, especially in the areas of accessibility and continuity of care. Therefore, primary care in a country is expected to benefit from investments in a broader range of services of GPs or other primary care physicians. © Health Research and Educational Trust.

A story of success: continuous quality improvement in cystic fibrosis care in the USA.

PubMed

Quon, Bradley S; Goss, Christopher H

2011-12-01

Continuous quality improvement (CQI) in healthcare can be described as a reiterative approach to improving processes to reduce unexpected variation in health outcomes. CQI represents one model to achieve quality improvement (QI) and has long been recognized as a key to success in the manufacturing industry with companies like Toyota leading the way. Healthcare, and specifically pulmonary, critical care and sleep medicine represent ideal settings for the application of CQI. This opinion piece will describe QI and CQI initiatives in the US Cystic fibrosis (CF) population. QI in CF care in the United States has been ongoing since inception of the US CF Foundation (CFF) in 1955. This effort has included work to improve the quality of clinical care provided at CF centers and work to improve clinical outcomes in CF. More recently, QI methods have been applied to the conduct of clinical research. The CF community has become a leader in the area of QI and has pointed out the opportunities for others to follow in the area of lung diseases.

The administrative and clinical rationale for the total organization approach to continuous quality improvement.

PubMed

Jones, D J; Ziegenfuss, J T

1993-01-01

In our view TQM and CQI represent important innovations in the continuing effort to develop higher performance organizations. Never before has the need been so great to improve quality while at the same time constraining, or reducing, costs. An increasing number of health care organizations can document their experiences that as quality goes up, costs can come down. The contribution of these new approaches is in some sense the wedding of many long established methodologies--the scientific method, statistical quality control, planning, joint problem solving, participative management, and empowerment of the work force. While this recognition could lend support to those who label this new model a fad, that perception denies the linkage of TQM/CQI to the greater stream of innovations pushing us toward ever-greater organizational excellence. Can we not take the philosophy and methods that are potentially useful and try them experimentally? Let our empirical tests tell us of their contribution. We believe the concepts and procedures of TQM/CQI will help us to be better in years to come, even though we highly respect our starting point.

Minding the gap: Interprofessional communication during inpatient and post discharge chasm care.

PubMed

Scotten, Mitzi; Manos, Eva LaVerne; Malicoat, Allison; Paolo, Anthony M

2015-07-01

Poor communication is cited as a main cause of poor patient outcomes and errors in healthcare, and clear communication can be especially critical during transitions such as discharge. In this project, communication was standardized for clarity, and techniques were implemented to continue care from inpatient, to discharge, across the post-discharge chasm, to hand-off with the primary care provider (PCP). The interprofessional (IP) quality improvement initiative included: (1) evidence-based teamwork system; (2) in situ simulation; (3) creation of an IP model of care; and (4) innovations in use of telehealth technology to continue care post-discharge. Measures inpatient/parent satisfaction and the attitudes of the care team have improved. Traditional methods of communication and transition do not meet patient or healthcare provider needs. Communication must be standardized to be understandable and be used by the IP team. Care must continue post-discharge by utilizing technology to increase quality and continuity of care. Improving and practicing communication skills may lead to reductions in healthcare errors and readmissions, and may decrease the length of stay and improve satisfaction of care teams. Published by Elsevier Ireland Ltd.

[Quality management and consumer orientation: survey of referring pediatricians of a Berlin pediatric clinic].

PubMed

Lüthy, A; Lotze, I; Leiske, M; Rossi, R

2000-01-01

Quality management in hospitals not only includes performance according to international medical standards but also the optimization of processes regarding internal staff as well as external customers. Total Quality Management (TQM) and the Business Excellence Model of the European Foundation of Quality Management (EFQM) require continuous evaluation of customer satisfaction. Specialists and family physician as external customers influence the patient's choice of a hospital. The aim of the present study is to evaluate the satisfaction of admitting physicians of a children's hospital with the help of a questionnaire. The results describe their needs and their level of satisfaction regarding service, information, cooperation and communication within the hospital.

Future Supply Chains Enabled by Continuous Processing-Opportunities Challenges May 20-21 2014 Continuous Manufacturing Symposium.

PubMed

Srai, Jagjit Singh; Badman, Clive; Krumme, Markus; Futran, Mauricio; Johnston, Craig

2015-03-01

This paper examines the opportunities and challenges facing the pharmaceutical industry in moving to a primarily "continuous processing"-based supply chain. The current predominantly "large batch" and centralized manufacturing system designed for the "blockbuster" drug has driven a slow-paced, inventory heavy operating model that is increasingly regarded as inflexible and unsustainable. Indeed, new markets and the rapidly evolving technology landscape will drive more product variety, shorter product life-cycles, and smaller drug volumes, which will exacerbate an already unsustainable economic model. Future supply chains will be required to enhance affordability and availability for patients and healthcare providers alike despite the increased product complexity. In this more challenging supply scenario, we examine the potential for a more pull driven, near real-time demand-based supply chain, utilizing continuous processing where appropriate as a key element of a more "flow-through" operating model. In this discussion paper on future supply chain models underpinned by developments in the continuous manufacture of pharmaceuticals, we have set out; The paper recognizes that although current batch operational performance in pharma is far from optimal and not necessarily an appropriate end-state benchmark for batch technology, the adoption of continuous supply chain operating models underpinned by continuous production processing, as full or hybrid solutions in selected product supply chains, can support industry transformations to deliver right-first-time quality at substantially lower inventory profiles. © 2015 The Authors. Journal of Pharmaceutical Sciences published by Wiley Periodicals, Inc. and the American Pharmacists Association. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Exploration of funding models to support hybridisation of Australian primary health care organisations.

PubMed

Reddy, Sandeep

2017-09-01

Primary Health Care (PHC) funding in Australia is complex and fragmented. The focus of PHC funding in Australia has been on volume rather than comprehensive primary care and continuous quality improvement. As PHC in Australia is increasingly delivered by hybrid style organisations, an appropriate funding model that matches this set-up while addressing current issues with PHC funding is required. This article discusses and proposes an appropriate funding model for hybrid PHC organisations.

Expert decision-making strategies

NASA Technical Reports Server (NTRS)

Mosier, Kathleen L.

1991-01-01

A recognition-primed decisions (RPD) model is employed as a framework to investigate crew decision-making processes. The quality of information transfer, a critical component of the team RPD model and an indicator of the team's 'collective consciouness', is measured and analyzed with repect to crew performance. As indicated by the RPD model, timing and patterns of information search transfer were expected to reflect extensive and continual situation assessment, and serial evaluation of alternative states of the world or decision response options.

TOLNet - A Tropospheric Ozone Lidar Profiling Network for Satellite Continuity and Process Studies

NASA Technical Reports Server (NTRS)

Newchurch, Michael J.; Kuang, Shi; Wang, Lihua; LeBlanc, Thierry; Alvarez II, Raul J.; Langford, Andrew O.; Senff, Christoph J.; Brown, Steve; Johnson, Bryan; Burris, John F.;

New Developments in Wildfire Pollution Forecasting at the Canadian Meteorological Centre

NASA Astrophysics Data System (ADS)

Pavlovic, Radenko; Chen, Jack; Munoz-Alpizar, Rodrigo; Davignon, Didier; Beaulieu, Paul-Andre; Landry, Hugo; Menard, Sylvain; Gravel, Sylvie; Moran, Michael

2017-04-01

Environment and Climate Change Canada's air quality forecast system with near-real-time wildfire emissions, named FireWork, was developed in 2012 and has been run by the Canadian Meteorological Centre Operations division (CMCO) since 2013. In June 2016 this system was upgraded to operational status and wildfire smoke forecasts for North America are now available to the general public. FireWork's ability to model the transport and diffusion of wildfire smoke plumes has proved to be valuable to regional air quality forecasters and emergency first responders. Some of the most challenging issues with wildfire pollution modelling concern the production of wildfire emission estimates and near-source dispersion within the air quality model. As a consequence, FireWork is undergoing constant development. During the massive Fort McMurray wildfire event in western Canada in May 2016, for example, different wildfire emissions processing approaches and wildfire emissions injection and dispersion schemes were tested within the air quality model. Work on various FireWork components will continue in order to deliver a new operational version of the forecasting system for the 2017 wildfire season. Some of the proposed improvements will be shown in this presentation along with current and planned FireWork post-processing products.

The business process management software for successful quality management and organization: A case study from the University of Split School of Medicine.

PubMed

Sapunar, Damir; Grković, Ivica; Lukšić, Davor; Marušić, Matko

2016-05-01

Our aim was to describe a comprehensive model of internal quality management (QM) at a medical school founded on the business process analysis (BPA) software tool. BPA software tool was used as the core element for description of all working processes in our medical school, and subsequently the system served as the comprehensive model of internal QM. The quality management system at the University of Split School of Medicine included the documentation and analysis of all business processes within the School. The analysis revealed 80 weak points related to one or several business processes. A precise analysis of medical school business processes allows identification of unfinished, unclear and inadequate points in these processes, and subsequently the respective improvements and increase of the QM level and ultimately a rationalization of the institution's work. Our approach offers a potential reference model for development of common QM framework allowing a continuous quality control, i.e. the adjustments and adaptation to contemporary educational needs of medical students. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Influence of rainfall and catchment characteristics on urban stormwater quality.

PubMed

Liu, An; Egodawatta, Prasanna; Guan, Yuntao; Goonetilleke, Ashantha

2013-02-01

The accuracy and reliability of urban stormwater quality modelling outcomes are important for stormwater management decision making. The commonly adopted approach where only a limited number of factors are used to predict urban stormwater quality may not adequately represent the complexity of the quality response to a rainfall event or site-to-site differences to support efficient treatment design. This paper discusses an investigation into the influence of rainfall and catchment characteristics on urban stormwater quality in order to investigate the potential areas for errors in current stormwater quality modelling practices. It was found that the influence of rainfall characteristics on pollutant wash-off is step-wise based on specific thresholds. This means that a modelling approach where the wash-off process is predicted as a continuous function of rainfall intensity and duration is not appropriate. Additionally, other than conventional catchment characteristics, namely, land use and impervious surface fraction, other catchment characteristics such as impervious area layout, urban form and site specific characteristics have an important influence on both, pollutant build-up and wash-off processes. Finally, the use of solids as a surrogate to estimate other pollutant species was found to be inappropriate. Individually considering build-up and wash-off processes for each pollutant species should be the preferred option. Copyright © 2012 Elsevier B.V. All rights reserved.

Assessment of surgical discharge summaries and evaluation of a new quality improvement model.

PubMed

Stein, Ran; Neufeld, David; Shwartz, Ivan; Erez, Ilan; Haas, Ilana; Magen, Ada; Glassberg, Elon; Shmulevsky, Pavel; Paran, Haim

2014-11-01

Discharge summaries after hospitalization provide the most reliable description and implications of the hospitalization. A concise discharge summary is crucial for maintaining continuity of care through the transition from inpatient to ambulatory care. Discharge summaries often lack information and are imprecise. Errors and insufficient recommendations regarding changes in the medical regimen may harm the patient's health and may result in readmission. To evaluate a quality improvement model and training program for writing postoperative discharge summaries for three surgical procedures. Medical records and surgical discharge summaries were reviewed and scored. Essential points for communication between surgeons and family physicians were included in automated forms. Staff was briefed twice regarding required summary contents with an interim evaluation. Changes in quality were evaluated. Summaries from 61 cholecystectomies, 42 hernioplasties and 45 colectomies were reviewed. The average quality score of all discharge summaries increased from 72.1 to 78.3 after the first intervention (P < 0.0005) to 81.0 following the second intervention. As the discharge summary's quality improved, its length decreased significantly. Discharge summaries lack important information and are too long. Developing a model for discharge summaries and instructing surgical staff regarding their contents resulted in measurable improvement. Frequent interventions and supervision are needed to maintain the quality of the surgical discharge summary.

Factors affecting continued use of ceramic water purifiers distributed to tsunami-affected communities in Sri Lanka.

PubMed

Casanova, Lisa M; Walters, Adam; Naghawatte, Ajith; Sobsey, Mark D

2012-11-01

There is little information about continued use of point-of-use technologies after disaster relief efforts. After the 2004 tsunami, the Red Cross distributed ceramic water filters in Sri Lanka. This study determined factors associated with filter disuse and evaluate the quality of household drinking water. A cross-sectional survey of water sources and treatment, filter use and household characteristics was administered by in-person oral interview, and household water quality was tested. Multivariable logistic regression was used to model probability of filter non-use. At the time of survey, 24% of households (107/452) did not use filters; the most common reason given was breakage (42%). The most common household water sources were taps and wells. Wells were used by 45% of filter users and 28% of non-users. Of households with taps, 75% had source water Escherichia coli in the lowest World Health Organisation risk category (<1/100 ml), vs. only 30% of households reporting wells did. Tap households were approximately four times more likely to discontinue filter use than well households. After 2 years, 24% of households were non-users. The main factors were breakage and household water source; households with taps were more likely to stop use than households with wells. Tap water users also had higher-quality source water, suggesting that disuse is not necessarily negative and monitoring of water quality can aid decision-making about continued use. To promote continued use, disaster recovery filter distribution efforts must be joined with capacity building for long-term water monitoring, supply chains and local production. © 2012 Blackwell Publishing Ltd.

Refinement of regression models to estimate real-time concentrations of contaminants in the Menomonee River drainage basin, southeast Wisconsin, 2008-11

USGS Publications Warehouse

Baldwin, Austin K.; Robertson, Dale M.; Saad, David A.; Magruder, Christopher

2013-01-01

In 2008, the U.S. Geological Survey and the Milwaukee Metropolitan Sewerage District initiated a study to develop regression models to estimate real-time concentrations and loads of chloride, suspended solids, phosphorus, and bacteria in streams near Milwaukee, Wisconsin. To collect monitoring data for calibration of models, water-quality sensors and automated samplers were installed at six sites in the Menomonee River drainage basin. The sensors continuously measured four potential explanatory variables: water temperature, specific conductance, dissolved oxygen, and turbidity. Discrete water-quality samples were collected and analyzed for five response variables: chloride, total suspended solids, total phosphorus, Escherichia coli bacteria, and fecal coliform bacteria. Using the first year of data, regression models were developed to continuously estimate the response variables on the basis of the continuously measured explanatory variables. Those models were published in a previous report. In this report, those models are refined using 2 years of additional data, and the relative improvement in model predictability is discussed. In addition, a set of regression models is presented for a new site in the Menomonee River Basin, Underwood Creek at Wauwatosa. The refined models use the same explanatory variables as the original models. The chloride models all used specific conductance as the explanatory variable, except for the model for the Little Menomonee River near Freistadt, which used both specific conductance and turbidity. Total suspended solids and total phosphorus models used turbidity as the only explanatory variable, and bacteria models used water temperature and turbidity as explanatory variables. An analysis of covariance (ANCOVA), used to compare the coefficients in the original models to those in the refined models calibrated using all of the data, showed that only 3 of the 25 original models changed significantly. Root-mean-squared errors (RMSEs) calculated for both the original and refined models using the entire dataset showed a median improvement in RMSE of 2.1 percent, with a range of 0.0–13.9 percent. Therefore most of the original models did almost as well at estimating concentrations during the validation period (October 2009–September 2011) as the refined models, which were calibrated using those data. Application of these refined models can produce continuously estimated concentrations of chloride, total suspended solids, total phosphorus, E. coli bacteria, and fecal coliform bacteria that may assist managers in quantifying the effects of land-use changes and improvement projects, establish total maximum daily loads, and enable better informed decision making in the future.

Quality of maternity care and its determinants along the continuum in Kenya: A structural equation modeling analysis

PubMed Central

Mendez, Bomar Rojas

2017-01-01

Background Improving access to delivery services does not guarantee access to quality obstetric care and better survival, and therefore, concerns for quality of maternal and newborn care in low- and middle-income countries have been raised. Our study explored characteristics associated with the quality of initial assessment, intrapartum, and immediate postpartum and newborn care, and further assessed the relationships along the continuum of care. Methods The 2010 Service Provision Assessment data of Kenya for 627 routine deliveries of women aged 15–49 were used. Quality of care measures were assessed using recently validated quality of care measures during initial assessment, intrapartum, and postpartum periods. Data were analyzed with negative binomial regression and structural equation modeling technique. Results The negative binomial regression results identified a number of determinants of quality, such as the level of health facilities, managing authority, presence of delivery fee, central electricity supply and clinical guideline for maternal and neonatal care. Our structural equation modeling (SEM) further demonstrated that facility characteristics were important determinants of quality for initial assessment and postpartum care, while characteristics at the provider level became more important in shaping the quality of intrapartum care. Furthermore we also noted that quality of initial assessment had a positive association with quality of intrapartum care (β = 0.71, p < 0.001), which in turn was positively associated with the quality of newborn and immediate postpartum care (β = 1.29, p = 0.004). Conclusions A continued focus on quality of care along the continuum of maternity care is important not only to mothers but also their newborns. Policymakers should therefore ensure that required resources, as well as adequate supervision and emphasis on the quality of obstetric care, are available. PMID:28520771

A Study to Determine the Optimal Feasible Model for the Quality Assurance/Risk Management Program at Naval Hospital, Bethesda

DTIC Science & Technology

1984-05-04

Assurance. Within the last half of this century and especially since the advent of Medicare and Medicaid, a number of forces and trends have been...force in the quality assurance movement. They have been especially concerned about costs, allegations of excessive utilization of services and...ell as teintra- S;L.%.4ce accivities. At least a portion of continuing educacion of irsezvice tra~nn :)u~ e the result of probleI ident ificati on

Evaluating confidence in the impact of regulatory nutrient reduction and assessing the competing impact of climate change

NASA Astrophysics Data System (ADS)

Irby, I.; Friedrichs, M. A. M.

2017-12-01

Human impacts on the Chesapeake Bay through increased nutrient run-off as a result of land-use change, urbanization, and industrialization, have resulted in a degradation of water quality over the last half-century. These direct impacts, compounded with human-induced climate changes such as warming, rising sea level, and changes in precipitation, have elevated the conversation surrounding the future of the Bay's water quality. As a result, in 2010, a Total Maximum Daily Load (TMDL) was established for the Chesapeake Bay that limited nutrient and sediment input in an effort to increase dissolved oxygen. This research utilizes a multiple model approach to evaluate confidence in the estuarine water quality modeling portion of the TMDL. One of the models is then used to assess the potential impact climate change may have on the success of currently mandated nutrient reduction levels in 2050. Results demonstrate that although the models examined differ structurally and in biogeochemical complexity, they project a similar attainment of regulatory water quality standards after nutrient reduction, while also establishing that meeting water quality standards is relatively independent of hydrologic conditions. By developing a Confidence Index, this research identifies the locations and causes of greatest uncertainty in modeled projections of water quality. Although there are specific locations and times where the models disagree, this research lends an increased degree of confidence in the appropriateness of the TMDL levels and in the general impact nutrient reductions will have on Chesapeake Bay water quality under current environmental conditions. However, when examining the potential impacts of climate change, this research shows that the combined impacts of increasing temperature, sea level, and river flow negatively affect dissolved oxygen throughout the Chesapeake Bay and impact progress towards meeting the water quality standards associated with the TMDL with increased temperature as the primary culprit. These results, having been continually shared with the regulatory TMDL modelers, will aid in the decision making for the 2017 TMDL Mid-Point Assessment.

Research on Holographic Evaluation of Service Quality in Power Data Network

NASA Astrophysics Data System (ADS)

Wei, Chen; Jing, Tao; Ji, Yutong

2018-01-01

With the rapid development of power data network, the continuous development of the Power data application service system, more and more service systems are being put into operation. Following this, the higher requirements for network quality and service quality are raised, in the actual process for the network operation and maintenance. This paper describes the electricity network and data network services status. A holographic assessment model was presented to achieve a comprehensive intelligence assessment on the power data network and quality of service in the operation and maintenance on the power data network. This evaluation method avoids the problems caused by traditional means which performs a single assessment of network performance quality. This intelligent Evaluation method can improve the efficiency of network operation and maintenance guarantee the quality of real-time service in the power data network..

Implementation of a WRF-CMAQ Air Quality Modeling System in Bogotá, Colombia

NASA Astrophysics Data System (ADS)

Nedbor-Gross, R.; Henderson, B. H.; Pachon, J. E.; Davis, J. R.; Baublitz, C. B.; Rincón, A.

2014-12-01

Due to a continuous economic growth Bogotá, Colombia has experienced air pollution issues in recent years. The local environmental authority has implemented several strategies to curb air pollution that have resulted in the decrease of PM10 concentrations since 2010. However, more activities are necessary in order to meet international air quality standards in the city. The University of Florida Air Quality and Climate group is collaborating with the Universidad de La Salle to prioritize regulatory strategies for Bogotá using air pollution simulations. To simulate pollution, we developed a modeling platform that combines the Weather Research and Forecasting Model (WRF), local emissions, and the Community Multi-scale Air Quality model (CMAQ). This platform is the first of its kind to be implemented in the megacity of Bogota, Colombia. The presentation will discuss development and evaluation of the air quality modeling system, highlight initial results characterizing photochemical conditions in Bogotá, and characterize air pollution under proposed regulatory strategies. The WRF model has been configured and applied to Bogotá, which resides in a tropical climate with complex mountainous topography. Developing the configuration included incorporation of local topography and land-use data, a physics sensitivity analysis, review, and systematic evaluation. The threshold, however, was set based on synthesis of model performance under less mountainous conditions. We will evaluate the impact that differences in autocorrelation contribute to the non-ideal performance. Air pollution predictions are currently under way. CMAQ has been configured with WRF meteorology, global boundary conditions from GEOS-Chem, and a locally produced emission inventory. Preliminary results from simulations show promising performance of CMAQ in Bogota. Anticipated results include a systematic performance evaluation of ozone and PM10, characterization of photochemical sensitivity, and air quality predictions under proposed regulatory scenarios.

42 CFR 422.152 - Quality improvement program.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2014-10-01 2014-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...

42 CFR 422.152 - Quality improvement program.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2012-10-01 2012-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...

42 CFR 422.152 - Quality improvement program.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., quality of life indicators, depression scales, or chronic disease outcomes). (iii) Staff implementation of... 42 Public Health 3 2013-10-01 2013-10-01 false Quality improvement program. 422.152 Section 422... (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM Quality Improvement § 422.152 Quality...

40 CFR 81.16 - Metropolitan Denver Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.16 Metropolitan Denver Intrastate Air Quality Control Region. The Metropolitan Denver Intrastate Air Quality Control Region (Colorado) consists of the territorial area...

40 CFR 81.62 - Northeast Mississippi Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.62 Northeast Mississippi Intrastate Air Quality Control Region. The Alabama-Mississippi-Tennessee Interstate Air Quality Control Region has been renamed the Northeast...

40 CFR 81.16 - Metropolitan Denver Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.16 Metropolitan Denver Intrastate Air Quality Control Region. The Metropolitan Denver Intrastate Air Quality Control Region (Colorado) consists of the territorial area...

40 CFR 81.31 - Metropolitan Providence Interstate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.31 Metropolitan Providence Interstate Air Quality Control Region. The Metropolitan Providence Interstate Air Quality Control Region (Rhode Island-Massachusetts) consists of the...

40 CFR 81.16 - Metropolitan Denver Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.16 Metropolitan Denver Intrastate Air Quality Control Region. The Metropolitan Denver Intrastate Air Quality Control Region (Colorado) consists of the territorial area...

40 CFR 81.30 - Southeastern Wisconsin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.30 Southeastern Wisconsin Intrastate Air Quality Control Region. The Metropolitan Milwaukee Intrastate Air Quality Control Region (Wisconsin) has been renamed the Southeastern...

40 CFR 81.31 - Metropolitan Providence Interstate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.31 Metropolitan Providence Interstate Air Quality Control Region. The Metropolitan Providence Interstate Air Quality Control Region (Rhode Island-Massachusetts) consists of the...

40 CFR 81.62 - Northeast Mississippi Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.62 Northeast Mississippi Intrastate Air Quality Control Region. The Alabama-Mississippi-Tennessee Interstate Air Quality Control Region has been renamed the Northeast...

40 CFR 81.28 - Metropolitan Baltimore Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.28 Metropolitan Baltimore Intrastate Air Quality Control Region. The Metropolitan Baltimore Intrastate Air Quality Control Region (Maryland) consists of the territorial area...

40 CFR 81.78 - Metropolitan Portland Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.78 Metropolitan Portland Intrastate Air Quality Control Region. The Metropolitan Portland Intrastate Air Quality Control Region (Maine) consists of the territorial area...

40 CFR 81.78 - Metropolitan Portland Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.78 Metropolitan Portland Intrastate Air Quality Control Region. The Metropolitan Portland Intrastate Air Quality Control Region (Maine) consists of the territorial area...

40 CFR 81.28 - Metropolitan Baltimore Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.28 Metropolitan Baltimore Intrastate Air Quality Control Region. The Metropolitan Baltimore Intrastate Air Quality Control Region (Maryland) consists of the territorial area...

40 CFR 81.62 - Northeast Mississippi Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.62 Northeast Mississippi Intrastate Air Quality Control Region. The Alabama-Mississippi-Tennessee Interstate Air Quality Control Region has been renamed the Northeast...

40 CFR 81.28 - Metropolitan Baltimore Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.28 Metropolitan Baltimore Intrastate Air Quality Control Region. The Metropolitan Baltimore Intrastate Air Quality Control Region (Maryland) consists of the territorial area...

40 CFR 81.30 - Southeastern Wisconsin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.30 Southeastern Wisconsin Intrastate Air Quality Control Region. The Metropolitan Milwaukee Intrastate Air Quality Control Region (Wisconsin) has been renamed the Southeastern...

40 CFR 81.29 - Metropolitan Indianapolis Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Air Quality Control Region. 81.29 Section 81.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.29 Metropolitan Indianapolis Intrastate Air Quality Control...

40 CFR 81.31 - Metropolitan Providence Interstate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.31 Metropolitan Providence Interstate Air Quality Control Region. The Metropolitan Providence Interstate Air Quality Control Region (Rhode Island-Massachusetts) consists of the...

40 CFR 81.29 - Metropolitan Indianapolis Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Air Quality Control Region. 81.29 Section 81.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.29 Metropolitan Indianapolis Intrastate Air Quality Control...

40 CFR 81.44 - Metropolitan Memphis Interstate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.44 Metropolitan Memphis Interstate Air Quality Control Region. The Metropolitan Memphis Interstate Air Quality Control Region (Arkansas-Mississippi-Tennessee) consists of the...

40 CFR 81.30 - Southeastern Wisconsin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.30 Southeastern Wisconsin Intrastate Air Quality Control Region. The Metropolitan Milwaukee Intrastate Air Quality Control Region (Wisconsin) has been renamed the Southeastern...

40 CFR 81.30 - Southeastern Wisconsin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.30 Southeastern Wisconsin Intrastate Air Quality Control Region. The Metropolitan Milwaukee Intrastate Air Quality Control Region (Wisconsin) has been renamed the Southeastern...

40 CFR 81.28 - Metropolitan Baltimore Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.28 Metropolitan Baltimore Intrastate Air Quality Control Region. The Metropolitan Baltimore Intrastate Air Quality Control Region (Maryland) consists of the territorial area...

40 CFR 81.29 - Metropolitan Indianapolis Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Air Quality Control Region. 81.29 Section 81.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.29 Metropolitan Indianapolis Intrastate Air Quality Control...

40 CFR 81.19 - Metropolitan Boston Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.19 Metropolitan Boston Intrastate Air Quality Control Region. The Metropolitan Boston Intrastate Air Quality Control Region (Massachusetts) consists of the territorial area...

40 CFR 81.19 - Metropolitan Boston Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.19 Metropolitan Boston Intrastate Air Quality Control Region. The Metropolitan Boston Intrastate Air Quality Control Region (Massachusetts) consists of the territorial area...

40 CFR 81.44 - Metropolitan Memphis Interstate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.44 Metropolitan Memphis Interstate Air Quality Control Region. The Metropolitan Memphis Interstate Air Quality Control Region (Arkansas-Mississippi-Tennessee) consists of the...

40 CFR 81.16 - Metropolitan Denver Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.16 Metropolitan Denver Intrastate Air Quality Control Region. The Metropolitan Denver Intrastate Air Quality Control Region (Colorado) consists of the territorial area...

40 CFR 81.19 - Metropolitan Boston Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.19 Metropolitan Boston Intrastate Air Quality Control Region. The Metropolitan Boston Intrastate Air Quality Control Region (Massachusetts) consists of the territorial area...

40 CFR 81.19 - Metropolitan Boston Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.19 Metropolitan Boston Intrastate Air Quality Control Region. The Metropolitan Boston Intrastate Air Quality Control Region (Massachusetts) consists of the territorial area...

40 CFR 81.29 - Metropolitan Indianapolis Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Air Quality Control Region. 81.29 Section 81.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.29 Metropolitan Indianapolis Intrastate Air Quality Control...

40 CFR 81.44 - Metropolitan Memphis Interstate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.44 Metropolitan Memphis Interstate Air Quality Control Region. The Metropolitan Memphis Interstate Air Quality Control Region (Arkansas-Mississippi-Tennessee) consists of the...

40 CFR 81.31 - Metropolitan Providence Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.31 Metropolitan Providence Interstate Air Quality Control Region. The Metropolitan Providence Interstate Air Quality Control Region (Rhode Island-Massachusetts) consists of the...

40 CFR 81.44 - Metropolitan Memphis Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.44 Metropolitan Memphis Interstate Air Quality Control Region. The Metropolitan Memphis Interstate Air Quality Control Region (Arkansas-Mississippi-Tennessee) consists of the...

40 CFR 81.44 - Metropolitan Memphis Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.44 Metropolitan Memphis Interstate Air Quality Control Region. The Metropolitan Memphis Interstate Air Quality Control Region (Arkansas-Mississippi-Tennessee) consists of the...

40 CFR 81.16 - Metropolitan Denver Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.16 Metropolitan Denver Intrastate Air Quality Control Region. The Metropolitan Denver Intrastate Air Quality Control Region (Colorado) consists of the territorial area...

40 CFR 81.28 - Metropolitan Baltimore Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.28 Metropolitan Baltimore Intrastate Air Quality Control Region. The Metropolitan Baltimore Intrastate Air Quality Control Region (Maryland) consists of the territorial area...

40 CFR 81.30 - Southeastern Wisconsin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.30 Southeastern Wisconsin Intrastate Air Quality Control Region. The Metropolitan Milwaukee Intrastate Air Quality Control Region (Wisconsin) has been renamed the Southeastern...

40 CFR 81.19 - Metropolitan Boston Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.19 Metropolitan Boston Intrastate Air Quality Control Region. The Metropolitan Boston Intrastate Air Quality Control Region (Massachusetts) consists of the territorial area...

40 CFR 81.29 - Metropolitan Indianapolis Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Air Quality Control Region. 81.29 Section 81.29 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.29 Metropolitan Indianapolis Intrastate Air Quality Control...

40 CFR 81.78 - Metropolitan Portland Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.78 Metropolitan Portland Intrastate Air Quality Control Region. The Metropolitan Portland Intrastate Air Quality Control Region (Maine) consists of the territorial area...

40 CFR 81.62 - Northeast Mississippi Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.62 Northeast Mississippi Intrastate Air Quality Control Region. The Alabama-Mississippi-Tennessee Interstate Air Quality Control Region has been renamed the Northeast...

40 CFR 81.31 - Metropolitan Providence Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.31 Metropolitan Providence Interstate Air Quality Control Region. The Metropolitan Providence Interstate Air Quality Control Region (Rhode Island-Massachusetts) consists of the...

Emerging Media in Engineering Technology: A Case Study in Higher Education

ERIC Educational Resources Information Center

Ostler, Karl B.

2013-01-01

Technical illustration, 3D modeling, and design drafting under the discipline of engineering technology face rapid change and advancements in technologies such that educational leaders must continually anticipate change and make intelligent choices in providing a quality educational experience to adult students. However, how successful program…

Advisors, Faculty, and Librarians: Collaborating for Student Success

ERIC Educational Resources Information Center

Guy, Ashley; Eimer, Lisa

2016-01-01

Librarians have continuously struggled with developing quality relationships with faculty and advisors to support students online. In 2014, Rasmussen College introduced a one-stop student support model of service that makes a student's advisor their primary point of contact for library resources, academic support, financial aid, course scheduling,…

Survey Design Recommendations.

ERIC Educational Resources Information Center

Fisher, William P., Jr.

2000-01-01

Presents 17 rules of thumb to create surveys that are likely to provide data of high enough quality to meet the requirements for measurement specified in a probabilistic conjoint measurement model. Use of these steps should allow the survey to be joined with others measuring the same variable to ensure continued equating with a single reference…

Information system end-user satisfaction and continuance intention: A unified modeling approach.

PubMed

Hadji, Brahim; Degoulet, Patrice

2016-06-01

Permanent evaluation of end-user satisfaction and continuance intention is a critical issue at each phase of a clinical information system (CIS) project, but most validation studies are concerned with the pre- or early post-adoption phases. The purpose of this study was twofold: to validate at the Pompidou University Hospital (HEGP) an information technology late post-adoption model built from four validated models and to propose a unified metamodel of evaluation that could be adapted to each context or deployment phase of a CIS project. Five dimensions, i.e., CIS quality (CISQ), perceived usefulness (PU), confirmation of expectations (CE), user satisfaction (SAT), and continuance intention (CI) were selected to constitute the CI evaluation model. The validity of the model was tested using the combined answers to four surveys performed between 2011 and 2015, i.e., more than ten years after the opening of HEGP in July 2000. Structural equation modeling was used to test the eight model-associated hypotheses. The multi-professional study group of 571 responders consisted of 158 doctors, 282 nurses, and 131 secretaries. The evaluation model accounted for 84% of variance of satisfaction and 53% of CI variance for the period 2011-2015 and for 92% and 69% for the period 2014-2015. In very late post adoption, CISQ appears to be the major determinant of satisfaction and CI. Combining the results obtained at various phases of CIS deployment, a Unified Model of Information System Continuance (UMISC) is proposed. In a meaningful CIS use situation at HEGP, this study confirms the importance of CISQ in explaining satisfaction and CI. The proposed UMISC model that can be adapted to each phase of CIS deployment could facilitate the necessary efforts of permanent CIS acceptance and continuance evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

A case study comparison of landfire fuel loading and emissions generation on a mixed conifer forest in northern Idaho, USA

Treesearch

Josh Hyde; Eva K. Strand; Andrew T. Hudak; Dale Hamilton

2015-01-01

The use of fire as a land management tool is well recognized for its ecological benefits in many natural systems. To continue to use fire while complying with air quality regulations, land managers are often tasked with modeling emissions from fire during the planning process. To populate such models, the Landscape Fire and Resource Management Planning Tools (...

Designing and implementing a trust-wide quality assurance programme.

PubMed

Coope, Sally-Ann

2018-04-02

Derbyshire Community Health Services (DCHS) NHS Foundation Trust provides a wide range of community-based health services. After the Care Quality Commission (CQC) found gaps in the trust's assurance process, its board decided to develop a method of continuous quality improvements that could be used as a basis for the trust's quality assurance system. The trust adapted and built on an acute model so it was suitable for community services. The final assurance system, Quality Always, has four elements: the clinical assessment and accreditation scheme; leadership development; 'champions' within clinical teams to support and promote the scheme; and dashboards to record and monitor progress. A system to recognise and reward achievement was essential for success. Quality Always has resulted in better care quality, an improved CQC rating, a sense of achievement among staff, the development of support networks, learning (especially among support staff) and good practice being shared.

Decentralised training for medical students: Towards a South African consensus.

PubMed

De Villiers, Marietjie R; Blitz, Julia; Couper, Ian; Kent, Athol; Moodley, Kalavani; Talib, Zohray; Van Schalkwyk, Susan; Young, Taryn

2017-09-28

Health professions training institutions are challenged to produce greater numbers of graduates who are more relevantly trained to provide quality healthcare. Decentralised training offers opportunities to address these quantity, quality and relevance factors. We wanted to draw together existing expertise in decentralised training for the benefit of all health professionals to develop a model for decentralised training for health professions students. An expert panel workshop was held in October 2015 initiating a process to develop a model for decentralised training in South Africa. Presentations on the status quo in decentralised training at all nine medical schools in South Africa were made and 33 delegates engaged in discussing potential models for decentralised training. Five factors were found to be crucial for the success of decentralised training, namely the availability of information and communication technology, longitudinal continuous rotations, a focus on primary care, the alignment of medical schools' mission with decentralised training and responsiveness to student needs. The workshop concluded that training institutions should continue to work together towards formulating decentralised training models and that the involvement of all health professions should be ensured. A tripartite approach between the universities, the Department of Health and the relevant local communities is important in decentralised training. Lastly, curricula should place more emphasis on how students learn rather than how they are taught.

The effectiveness of substitution of hospital ward care from medical doctors to physician assistants: a study protocol.

PubMed

Timmermans, Marijke J C; van Vught, Anneke J A H; Wensing, Michel; Laurant, Miranda G H

2014-01-28

Because of an expected shrinking supply of medical doctors for hospitalist posts, an increased emphasis on efficiency and continuity of care, and the standardization of many medical procedures, the role of hospitalist is increasingly allocated to physician assistants (PAs). PAs are nonphysician clinicians with medical tasks. This study aims to evaluate the effects of substitution of hospital ward care to PAs. In a multicenter matched controlled study, the traditional model in which the role of hospitalist is taken solely by medical doctors (MD model) is compared with a mixed model in which a PA functions as a hospitalist, contingent with MDs (PA/MD model). Twenty intervention and twenty control wards are included across The Netherlands, from a range of medical specialisms. Primary outcome measure is patients' length of hospital stay. Secondary outcomes include indicators for quality of hospital ward care, patients experiences with medical ward care, patients health-related quality of life, and healthcare providers' experiences. An economic evaluation is conducted to assess the cost implications and potential efficiency of the PA/MD model. For most measures, data is collected from medical records or questionnaires in samples of 115 patients per hospital ward. Semi-structured interviews with healthcare professionals are conducted to identify determinants of efficiency, quality and continuity of care and barriers and facilitators for the implementation of PAs in the role of hospitalist. Findings from this study will help to further define the role of nonphysician clinicians and provides possible key components for the implementation of PAs in hospital ward care. Like in many studies of organizational change, random allocation to study arms is not feasible, which implies an increased risk for confounding. A major challenge is to deal with the heterogeneity of patients and hospital departments.

HD Hydrological modelling at catchment scale using rainfall radar observations

NASA Astrophysics Data System (ADS)

Ciampalini Rossano. Ciampalini@Gmail. Com), Rossano; Follain, Stéphane; Raclot, Damien; Crabit, Armand; Pastor, Amandine; Augas, Julien; Moussa, Roger; Colin, François; Le Bissonnais, Yves

2017-04-01

Hydrological simulations at catchment scale repose on the quality and data availability both for soil and rainfall data. Soil data are quite easy to be collected, although their quality depends on the resources devoted to this task, rainfall data observations, instead, need further effort because of their spatiotemporal variability. Rainfalls are normally recorded with rain gauges located in the catchment, they can provide detailed temporal data, but, the representativeness is limited to the point where the data are collected. Combining different gauges in space can provide a better representation of the rainfall event but the spatialization is often the main obstacle to obtain data close to the reality. Since several years, radar observations overcome this gap providing continuous data registration, that, when properly calibrated, can offer an adequate, continuous, cover in space and time for medium-wide catchments. Here, we use radar records for the south of the France on the La Peyne catchment with the protocol there adopted by the national meteo agency, with resolution of 1 km space and 5' time scale observations. We present here the realisation of a model able to perform from rainfall radar observations, continuous hydrological and soil erosion simulations. The model is semi-theoretically based, once it simulates water fluxes (infiltration-excess overland flow, saturation overland flow, infiltration and channel routing) with a cinematic wave using the St. Venant equation on a simplified "bucket" conceptual model for ground water, and, an empirical representation of sediment load as adopted in models such as STREAM-LANDSOIL (Cerdan et al., 2002, Ciampalini et al., 2012). The advantage of this approach is to furnish a dynamic representation - simulation of the rainfall-runoff events more easily than using spatialized rainfalls from meteo stations and to offer a new look on the spatial component of the events.

Tracking and forecasting the Nation’s water quality - Priorities and strategies for 2013-2023

USGS Publications Warehouse

Rowe, Gary L.; Gilliom, Robert J.; Woodside, Michael D.

2013-01-01

Water-quality issues facing the Nation are growing in number and complexity, and solutions are becoming more challenging and costly. Key factors that affect the quality of our drinking water supplies and ecosystem health include contaminants of human and natural origin in streams and groundwater; excess nutrients and sediment; alteration of natural streamflow; eutrophication of lakes, reservoirs, and coastal estuaries; and changes in surface and groundwater quality associated with changes in climate, land and water use, and management practices. Tracking and forecasting the Nation's water quality in the face of these and other pressing water-quality issues are important goals for 2013-2023, the third decade of the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) program. In consultation with stakeholders and the National Research Council, a new strategic Science Plan has been developed that describes a strategy for building upon and enhancing assessment of the Nation's freshwater quality and aquatic ecosystems. The plan continues strategies that have been central to the NAWQA program's long-term success, but it also makes adjustments to the monitoring and modeling approaches NAWQA will use to address critical data and science information needs identified by stakeholders. This fact sheet describes surface-water and groundwater monitoring and modeling activities that will start in fiscal year 2013. It also provides examples of the types of data and information products planned for the next decade, including (1) restored monitoring for reliable and timely status and trend assessments, (2) maps and models that show the distribution of selected contaminants (such as atrazine, nitrate, and arsenic) in streams and aquifers, and (3) Web-based modeling tools that allow managers to evaluate how water quality may change in response to different scenarios of population growth, climate change, or land-use management.

40 CFR 81.90 - Androscoggin Valley Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Quality Control Region. 81.90 Section 81.90 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.90 Androscoggin Valley Interstate Air Quality Control Region. The...

40 CFR 81.90 - Androscoggin Valley Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Quality Control Region. 81.90 Section 81.90 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.90 Androscoggin Valley Interstate Air Quality Control Region. The...

40 CFR 81.75 - Metropolitan Charlotte Interstate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.75 Metropolitan Charlotte Interstate Air Quality Control Region. The Metropolitan Charlotte Interstate Air Quality Control Region (North Carolina-South Carolina) has been revised...

40 CFR 81.45 - Metropolitan Atlanta Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.45 Metropolitan Atlanta Intrastate Air Quality Control Region. The Metropolitan Atlanta Intrastate Air Quality Control Region (Georgia) has been revised to consist of the...

40 CFR 81.34 - Metropolitan Dayton Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.34 Metropolitan Dayton Intrastate Air Quality Control Region. The Metropolitan Dayton Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

40 CFR 81.24 - Niagara Frontier Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.24 Niagara Frontier Intrastate Air Quality Control Region. The Niagara Frontier Intrastate Air Quality Control Region (New York) consists of the territorial area...

40 CFR 81.43 - Metropolitan Toledo Interstate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.43 Metropolitan Toledo Interstate Air Quality Control Region. The Metropolitan Toledo Interstate Air Quality Control Region (Ohio-Michigan) consists of the territorial area...

40 CFR 81.45 - Metropolitan Atlanta Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.45 Metropolitan Atlanta Intrastate Air Quality Control Region. The Metropolitan Atlanta Intrastate Air Quality Control Region (Georgia) has been revised to consist of the...

40 CFR 81.47 - Central Oklahoma Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.47 Central Oklahoma Intrastate Air Quality Control Region. The Metropolitan Oklahoma Intrastate Air Quality Control Region has been renamed the Central Oklahoma Intrastate...

40 CFR 81.41 - Metropolitan Birmingham Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.41 Metropolitan Birmingham Intrastate Air Quality Control Region. The Metropolitan Birmingham Intrastate Air Quality Control Region (Alabama) has been revised to consist of the...

40 CFR 81.34 - Metropolitan Dayton Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.34 Metropolitan Dayton Intrastate Air Quality Control Region. The Metropolitan Dayton Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

40 CFR 81.41 - Metropolitan Birmingham Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.41 Metropolitan Birmingham Intrastate Air Quality Control Region. The Metropolitan Birmingham Intrastate Air Quality Control Region (Alabama) has been revised to consist of the...

40 CFR 81.20 - Metropolitan Cincinnati Interstate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.20 Metropolitan Cincinnati Interstate Air Quality Control Region. The Metropolitan Cincinnati Interstate Air Quality Control Region (Ohio-Kentucky-Indiana) is revised to consist of...

40 CFR 81.23 - Southwest Pennsylvania Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.23 Southwest Pennsylvania Intrastate Air Quality Control Region. The Southwest Pennsylvania Intrastate Air Quality Control Region is redesignated to consist of the territorial...

40 CFR 81.34 - Metropolitan Dayton Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.34 Metropolitan Dayton Intrastate Air Quality Control Region. The Metropolitan Dayton Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

40 CFR 81.79 - Northeastern Oklahoma Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.79 Northeastern Oklahoma Intrastate Air Quality Control Region. The Metropolitan Tulsa Intrastate Air Quality Control Region has been renamed the Northeastern Oklahoma Intrastate...

40 CFR 81.59 - Cumberland-Keyser Interstate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.59 Cumberland-Keyser Interstate Air Quality Control Region. The Cumberland-Keyser Interstate Air Quality Control Region (Maryland-West Virginia) has been revised to consist...

40 CFR 81.49 - Southeast Florida Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.49 Southeast Florida Intrastate Air Quality Control Region. The Southeast Florida Intrastate Air Quality Control Region is redesignated to consist of the territorial area...

40 CFR 81.49 - Southeast Florida Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.49 Southeast Florida Intrastate Air Quality Control Region. The Southeast Florida Intrastate Air Quality Control Region is redesignated to consist of the territorial area...

40 CFR 81.41 - Metropolitan Birmingham Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.41 Metropolitan Birmingham Intrastate Air Quality Control Region. The Metropolitan Birmingham Intrastate Air Quality Control Region (Alabama) has been revised to consist of the...

40 CFR 81.41 - Metropolitan Birmingham Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.41 Metropolitan Birmingham Intrastate Air Quality Control Region. The Metropolitan Birmingham Intrastate Air Quality Control Region (Alabama) has been revised to consist of the...

40 CFR 81.34 - Metropolitan Dayton Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.34 Metropolitan Dayton Intrastate Air Quality Control Region. The Metropolitan Dayton Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

40 CFR 81.43 - Metropolitan Toledo Interstate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.43 Metropolitan Toledo Interstate Air Quality Control Region. The Metropolitan Toledo Interstate Air Quality Control Region (Ohio-Michigan) consists of the territorial area...

40 CFR 81.24 - Niagara Frontier Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.24 Niagara Frontier Intrastate Air Quality Control Region. The Niagara Frontier Intrastate Air Quality Control Region (New York) consists of the territorial area...

40 CFR 81.47 - Central Oklahoma Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.47 Central Oklahoma Intrastate Air Quality Control Region. The Metropolitan Oklahoma Intrastate Air Quality Control Region has been renamed the Central Oklahoma Intrastate...

40 CFR 81.23 - Southwest Pennsylvania Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.23 Southwest Pennsylvania Intrastate Air Quality Control Region. The Southwest Pennsylvania Intrastate Air Quality Control Region is redesignated to consist of the territorial...

40 CFR 81.49 - Southeast Florida Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.49 Southeast Florida Intrastate Air Quality Control Region. The Southeast Florida Intrastate Air Quality Control Region is redesignated to consist of the territorial area...

40 CFR 81.45 - Metropolitan Atlanta Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.45 Metropolitan Atlanta Intrastate Air Quality Control Region. The Metropolitan Atlanta Intrastate Air Quality Control Region (Georgia) has been revised to consist of the...

40 CFR 81.47 - Central Oklahoma Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.47 Central Oklahoma Intrastate Air Quality Control Region. The Metropolitan Oklahoma Intrastate Air Quality Control Region has been renamed the Central Oklahoma Intrastate...

40 CFR 81.23 - Southwest Pennsylvania Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.23 Southwest Pennsylvania Intrastate Air Quality Control Region. The Southwest Pennsylvania Intrastate Air Quality Control Region is redesignated to consist of the territorial...

40 CFR 81.59 - Cumberland-Keyser Interstate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.59 Cumberland-Keyser Interstate Air Quality Control Region. The Cumberland-Keyser Interstate Air Quality Control Region (Maryland-West Virginia) has been revised to consist...

40 CFR 81.20 - Metropolitan Cincinnati Interstate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.20 Metropolitan Cincinnati Interstate Air Quality Control Region. The Metropolitan Cincinnati Interstate Air Quality Control Region (Ohio-Kentucky-Indiana) is revised to consist of...

40 CFR 81.43 - Metropolitan Toledo Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.43 Metropolitan Toledo Interstate Air Quality Control Region. The Metropolitan Toledo Interstate Air Quality Control Region (Ohio-Michigan) consists of the territorial area...

40 CFR 81.24 - Niagara Frontier Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.24 Niagara Frontier Intrastate Air Quality Control Region. The Niagara Frontier Intrastate Air Quality Control Region (New York) consists of the territorial area...

40 CFR 81.20 - Metropolitan Cincinnati Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.20 Metropolitan Cincinnati Interstate Air Quality Control Region. The Metropolitan Cincinnati Interstate Air Quality Control Region (Ohio-Kentucky-Indiana) is revised to consist of...

40 CFR 81.43 - Metropolitan Toledo Interstate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.43 Metropolitan Toledo Interstate Air Quality Control Region. The Metropolitan Toledo Interstate Air Quality Control Region (Ohio-Michigan) consists of the territorial area...

40 CFR 81.75 - Metropolitan Charlotte Interstate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.75 Metropolitan Charlotte Interstate Air Quality Control Region. The Metropolitan Charlotte Interstate Air Quality Control Region (North Carolina-South Carolina) has been revised...

40 CFR 81.14 - Metropolitan Chicago Interstate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.14 Metropolitan Chicago Interstate Air Quality Control Region. The Metropolitan Chicago Interstate Air Quality Control Region (Illinois-Indiana) is revised to consist of the...

40 CFR 81.14 - Metropolitan Chicago Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.14 Metropolitan Chicago Interstate Air Quality Control Region. The Metropolitan Chicago Interstate Air Quality Control Region (Illinois-Indiana) is revised to consist of the...

40 CFR 81.24 - Niagara Frontier Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.24 Niagara Frontier Intrastate Air Quality Control Region. The Niagara Frontier Intrastate Air Quality Control Region (New York) consists of the territorial area...

40 CFR 81.49 - Southeast Florida Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.49 Southeast Florida Intrastate Air Quality Control Region. The Southeast Florida Intrastate Air Quality Control Region is redesignated to consist of the territorial area...

40 CFR 81.23 - Southwest Pennsylvania Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.23 Southwest Pennsylvania Intrastate Air Quality Control Region. The Southwest Pennsylvania Intrastate Air Quality Control Region is redesignated to consist of the territorial...

40 CFR 81.14 - Metropolitan Chicago Interstate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.14 Metropolitan Chicago Interstate Air Quality Control Region. The Metropolitan Chicago Interstate Air Quality Control Region (Illinois-Indiana) is revised to consist of the...

40 CFR 81.20 - Metropolitan Cincinnati Interstate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.20 Metropolitan Cincinnati Interstate Air Quality Control Region. The Metropolitan Cincinnati Interstate Air Quality Control Region (Ohio-Kentucky-Indiana) is revised to consist of...

40 CFR 81.59 - Cumberland-Keyser Interstate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.59 Cumberland-Keyser Interstate Air Quality Control Region. The Cumberland-Keyser Interstate Air Quality Control Region (Maryland-West Virginia) has been revised to consist...

40 CFR 81.14 - Metropolitan Chicago Interstate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.14 Metropolitan Chicago Interstate Air Quality Control Region. The Metropolitan Chicago Interstate Air Quality Control Region (Illinois-Indiana) is revised to consist of the...

40 CFR 81.45 - Metropolitan Atlanta Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.45 Metropolitan Atlanta Intrastate Air Quality Control Region. The Metropolitan Atlanta Intrastate Air Quality Control Region (Georgia) has been revised to consist of the...

40 CFR 81.59 - Cumberland-Keyser Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.59 Cumberland-Keyser Interstate Air Quality Control Region. The Cumberland-Keyser Interstate Air Quality Control Region (Maryland-West Virginia) has been revised to consist...

40 CFR 81.87 - Metropolitan Boise Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.87 Metropolitan Boise Intrastate Air Quality Control Region. The Metropolitan Boise Intrastate Air Quality Control Region (Idaho) consists of the territorial area encompassed...

40 CFR 81.47 - Central Oklahoma Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.47 Central Oklahoma Intrastate Air Quality Control Region. The Metropolitan Oklahoma Intrastate Air Quality Control Region has been renamed the Central Oklahoma Intrastate...

40 CFR 81.75 - Metropolitan Charlotte Interstate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.75 Metropolitan Charlotte Interstate Air Quality Control Region. The Metropolitan Charlotte Interstate Air Quality Control Region (North Carolina-South Carolina) has been revised...

40 CFR 81.79 - Northeastern Oklahoma Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.79 Northeastern Oklahoma Intrastate Air Quality Control Region. The Metropolitan Tulsa Intrastate Air Quality Control Region has been renamed the Northeastern Oklahoma Intrastate...

40 CFR 81.43 - Metropolitan Toledo Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.43 Metropolitan Toledo Interstate Air Quality Control Region. The Metropolitan Toledo Interstate Air Quality Control Region (Ohio-Michigan) consists of the territorial area...

40 CFR 81.49 - Southeast Florida Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.49 Southeast Florida Intrastate Air Quality Control Region. The Southeast Florida Intrastate Air Quality Control Region is redesignated to consist of the territorial area...

40 CFR 81.20 - Metropolitan Cincinnati Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.20 Metropolitan Cincinnati Interstate Air Quality Control Region. The Metropolitan Cincinnati Interstate Air Quality Control Region (Ohio-Kentucky-Indiana) is revised to consist of...

40 CFR 81.75 - Metropolitan Charlotte Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.75 Metropolitan Charlotte Interstate Air Quality Control Region. The Metropolitan Charlotte Interstate Air Quality Control Region (North Carolina-South Carolina) has been revised...

40 CFR 81.47 - Central Oklahoma Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.47 Central Oklahoma Intrastate Air Quality Control Region. The Metropolitan Oklahoma Intrastate Air Quality Control Region has been renamed the Central Oklahoma Intrastate...

40 CFR 81.24 - Niagara Frontier Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.24 Niagara Frontier Intrastate Air Quality Control Region. The Niagara Frontier Intrastate Air Quality Control Region (New York) consists of the territorial area...

40 CFR 81.23 - Southwest Pennsylvania Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.23 Southwest Pennsylvania Intrastate Air Quality Control Region. The Southwest Pennsylvania Intrastate Air Quality Control Region is redesignated to consist of the territorial...

40 CFR 81.59 - Cumberland-Keyser Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.59 Cumberland-Keyser Interstate Air Quality Control Region. The Cumberland-Keyser Interstate Air Quality Control Region (Maryland-West Virginia) has been revised to consist...

40 CFR 81.14 - Metropolitan Chicago Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.14 Metropolitan Chicago Interstate Air Quality Control Region. The Metropolitan Chicago Interstate Air Quality Control Region (Illinois-Indiana) is revised to consist of the...

40 CFR 81.45 - Metropolitan Atlanta Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.45 Metropolitan Atlanta Intrastate Air Quality Control Region. The Metropolitan Atlanta Intrastate Air Quality Control Region (Georgia) has been revised to consist of the...

40 CFR 81.41 - Metropolitan Birmingham Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.41 Metropolitan Birmingham Intrastate Air Quality Control Region. The Metropolitan Birmingham Intrastate Air Quality Control Region (Alabama) has been revised to consist of the...

40 CFR 81.34 - Metropolitan Dayton Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.34 Metropolitan Dayton Intrastate Air Quality Control Region. The Metropolitan Dayton Intrastate Air Quality Control Region consists of the territorial area encompassed by the...

A dynamic water-quality modeling framework for the Neuse River estuary, North Carolina

USGS Publications Warehouse

Bales, Jerad D.; Robbins, Jeanne C.

1999-01-01

As a result of fish kills in the Neuse River estuary in 1995, nutrient reduction strategies were developed for point and nonpoint sources in the basin. However, because of the interannual variability in the natural system and the resulting complex hydrologic-nutrient inter- actions, it is difficult to detect through a short-term observational program the effects of management activities on Neuse River estuary water quality and aquatic health. A properly constructed water-quality model can be used to evaluate some of the potential effects of manage- ment actions on estuarine water quality. Such a model can be used to predict estuarine response to present and proposed nutrient strategies under the same set of meteorological and hydrologic conditions, thus removing the vagaries of weather and streamflow from the analysis. A two-dimensional, laterally averaged hydrodynamic and water-quality modeling framework was developed for the Neuse River estuary by using previously collected data. Development of the modeling framework consisted of (1) computational grid development, (2) assembly of data for model boundary conditions and model testing, (3) selection of initial values of model parameters, and (4) limited model testing. The model domain extends from Streets Ferry to Oriental, N.C., includes seven lateral embayments that have continual exchange with the main- stem of the estuary, three point-source discharges, and three tributary streams. Thirty-five computational segments represent the mainstem of the estuary, and the entire framework contains a total of 60 computa- tional segments. Each computational cell is 0.5 meter thick; segment lengths range from 500 meters to 7,125 meters. Data that were used to develop the modeling framework were collected during March through October 1991 and represent the most comprehensive data set available prior to 1997. Most of the data were collected by the North Carolina Division of Water Quality, the University of North Carolina Institute of Marine Sciences, and the U.S. Geological Survey. Limitations in the modeling framework were clearly identified. These limitations formed the basis for a set of suggestions to refine the Neuse River estuary water-quality model.

Advanced Computational Methods for High-accuracy Refinement of Protein Low-quality Models

NASA Astrophysics Data System (ADS)

Zang, Tianwu

Predicting the 3-dimentional structure of protein has been a major interest in the modern computational biology. While lots of successful methods can generate models with 3˜5A root-mean-square deviation (RMSD) from the solution, the progress of refining these models is quite slow. It is therefore urgently needed to develop effective methods to bring low-quality models to higher-accuracy ranges (e.g., less than 2 A RMSD). In this thesis, I present several novel computational methods to address the high-accuracy refinement problem. First, an enhanced sampling method, named parallel continuous simulated tempering (PCST), is developed to accelerate the molecular dynamics (MD) simulation. Second, two energy biasing methods, Structure-Based Model (SBM) and Ensemble-Based Model (EBM), are introduced to perform targeted sampling around important conformations. Third, a three-step method is developed to blindly select high-quality models along the MD simulation. These methods work together to make significant refinement of low-quality models without any knowledge of the solution. The effectiveness of these methods is examined in different applications. Using the PCST-SBM method, models with higher global distance test scores (GDT_TS) are generated and selected in the MD simulation of 18 targets from the refinement category of the 10th Critical Assessment of Structure Prediction (CASP10). In addition, in the refinement test of two CASP10 targets using the PCST-EBM method, it is indicated that EBM may bring the initial model to even higher-quality levels. Furthermore, a multi-round refinement protocol of PCST-SBM improves the model quality of a protein to the level that is sufficient high for the molecular replacement in X-ray crystallography. Our results justify the crucial position of enhanced sampling in the protein structure prediction and demonstrate that a considerable improvement of low-accuracy structures is still achievable with current force fields.

Evaluating Aquatic Life Benefits of Reducing Nutrient Loading ...

EPA Pesticide Factsheets

Theoretical linkages between excess nutrient loading, nutrient-enhanced community metabolism (i.e., production and respiration), and hypoxia in estuaries are well-understood. In seasonally-stratified estuaries and coastal systems (e.g., Chesapeake Bay, northern Gulf of Mexico), hypoxia is predominantly seasonal, such that the spatial extent indicates potential aquatic life impacts. However, in relatively small and shallow Gulf of Mexico bays and bayous, hypoxia frequently occurs episodically or on a diel basis. This study utilized continuous DO monitoring and 3-D hydrodynamic (Environmental Fluid Dynamics Code) and water quality (Water Quality Analysis Simulation Program) models to examine physical and biological controls on DO dynamics and ecosystem metabolism in Weeks Bay, AL. Observed vertical DO gradients varied on a diel basis, with larger amplitude variations at depth relative to the surface, underscoring the importance of benthic production and respiration as a driver of ecosystem metabolism in shallow estuaries. Hydrodynamic and water quality models simulated seasonal and event-driven dynamics, but struggled to resolve the amplitude of daily DO fluctuations, particularly in bottom waters. Using these data in conjunction with the 10-year continuous O2 record from Weeks Bay, we applied empirical relationships and simple scaling relations to predict how reducing nutrient loading may affect the frequency, severity and duration of hypoxia. We further applied

Quality assessment concept of the World Data Center for Climate and its application to CMIP5 data

NASA Astrophysics Data System (ADS)

Stockhause, M.; Höck, H.; Toussaint, F.; Lautenschlager, M.

2012-08-01

The preservation of data in a high state of quality which is suitable for interdisciplinary use is one of the most pressing and challenging current issues in long-term archiving. For high volume data such as climate model data, the data and data replica are no longer stored centrally but distributed over several local data repositories, e.g. the data of the Climate Model Intercomparison Project Phase 5 (CMIP5). The most important part of the data is to be archived, assigned a DOI, and published according to the World Data Center for Climate's (WDCC) application of the DataCite regulations. The integrated part of WDCC's data publication process, the data quality assessment, was adapted to the requirements of a federated data infrastructure. A concept of a distributed and federated quality assessment procedure was developed, in which the workload and responsibility for quality control is shared between the three primary CMIP5 data centers: Program for Climate Model Diagnosis and Intercomparison (PCMDI), British Atmospheric Data Centre (BADC), and WDCC. This distributed quality control concept, its pilot implementation for CMIP5, and first experiences are presented. The distributed quality control approach is capable of identifying data inconsistencies and to make quality results immediately available for data creators, data users and data infrastructure managers. Continuous publication of new data versions and slow data replication prevents the quality control from check completion. This together with ongoing developments of the data and metadata infrastructure requires adaptations in code and concept of the distributed quality control approach.

Using long-term ground-based HSRL and geostationary observations in combination with model re-analysis to help disentangle local and long-range transported aerosols in Seoul, South Korea

NASA Astrophysics Data System (ADS)

Phillips, C.; Holz, R.; Eloranta, E. W.; Reid, J. S.; Kim, S. W.; Kuehn, R.; Marais, W.

2017-12-01

The University of Wisconsin High Spectral Resolution Lidar (HSRL) has been continuously operating at Seoul National University as part of the Korea-United States Air Quality Study (KORUS-AQ). The instrument was installed in March of 2016 and continues to operate as of August 2017, providing a truly unique data set to monitor aerosol and cloud properties. With its capability to separate the molecular and particulate scattering, the HSRL is able to detect extremely thin aerosol layers with sub-molecular scattering sensitivity. The system deployed in Seoul has depolarization measurements at 532 nm as well as a near IR channel at 1064 nm providing discrimination between dust, smoke, pollution, water clouds, and ice clouds. As will be presented, these capabilities can be used to produce three channel combined RGB images that provide visualization of small changes in the aerosol properties. A primary motivation of KORUS-AQ was to determine the relative effects of transported pollution and local pollution on air quality in Seoul. We hypothesize that HSRL-based image analysis algorithms combined with satellite and model re-analysis has the potential to identify cases when remote sources of aerosols and pollution are advected into the boundary layer with impacts to the surface air quality. To facilitate this research we have developed the capability to combine ten-minute geostationary imagery from Himawari-8, nearby radiosondes, model output, surface PM measurements, and AERONET data over the HSRL site. On a case-by-case basis, it is possible to separate layers of aerosols with different scattering properties using these tools. Additionally, a preliminary year-long aerosol climatology with integrated geo-stationary retrievals and modeling data will be presented. The focus is on investigating correlations between the HSRL aerosol measurements (depolarization, color ratio, extinction, and lidar ratio) with the model output and aerosol sources. This analysis will use recently developed algorithms that automate the HSRL cloud and aerosol masking, providing the capability to characterize the seasonal changes in aerosol radiative properties and supplement the month-long field campaign with almost two years of continuous HSRL observations.

Water quality modelling of an impacted semi-arid catchment using flow data from the WEAP model

NASA Astrophysics Data System (ADS)

Slaughter, Andrew R.; Mantel, Sukhmani K.

2018-04-01

The continuous decline in water quality in many regions is forcing a shift from quantity-based water resources management to a greater emphasis on water quality management. Water quality models can act as invaluable tools as they facilitate a conceptual understanding of processes affecting water quality and can be used to investigate the water quality consequences of management scenarios. In South Africa, the Water Quality Systems Assessment Model (WQSAM) was developed as a management-focussed water quality model that is relatively simple to be able to utilise the small amount of available observed data. Importantly, WQSAM explicitly links to systems (yield) models routinely used in water resources management in South Africa by using their flow output to drive water quality simulations. Although WQSAM has been shown to be able to represent the variability of water quality in South African rivers, its focus on management from a South African perspective limits its use to within southern African regions for which specific systems model setups exist. Facilitating the use of WQSAM within catchments outside of southern Africa and within catchments for which these systems model setups to not exist would require WQSAM to be able to link to a simple-to-use and internationally-applied systems model. One such systems model is the Water Evaluation and Planning (WEAP) model, which incorporates a rainfall-runoff component (natural hydrology), and reservoir storage, return flows and abstractions (systems modelling), but within which water quality modelling facilities are rudimentary. The aims of the current study were therefore to: (1) adapt the WQSAM model to be able to use as input the flow outputs of the WEAP model and; (2) provide an initial assessment of how successful this linkage was by application of the WEAP and WQSAM models to the Buffalo River for historical conditions; a small, semi-arid and impacted catchment in the Eastern Cape of South Africa. The simulations of the two models were compared to the available observed data, with the initial focus within WQSAM on a simulation of instream total dissolved solids (TDS) and nutrient concentrations. The WEAP model was able to adequately simulate flow in the Buffalo River catchment, with consideration of human inputs and outputs. WQSAM was adapted to successfully take as input the flow output of the WEAP model, and the simulations of nutrients by WQSAM provided a good representation of the variability of observed nutrient concentrations in the catchment. This study showed that the WQSAM model is able to accept flow inputs from the WEAP model, and that this approach is able to provide satisfactory estimates of both flow and water quality for a small, semi-arid and impacted catchment. It is hoped that this research will encourage the application of WQSAM to an increased number of catchments within southern Africa and beyond.

Primary care quality and safety systems in the English National Health Service: a case study of a new type of primary care provider.

PubMed

Baker, Richard; Willars, Janet; McNicol, Sarah; Dixon-Woods, Mary; McKee, Lorna

2014-01-01

Although the predominant model of general practice in the UK National Health Service (NHS) remains the small partnership owned and run by general practitioners (GPs), new types of provider are emerging. We sought to characterize the quality and safety systems and processes used in one large, privately owned company providing primary care through a chain of over 50 general practices in England. Senior staff with responsibility for policy on quality and safety were interviewed. We also undertook ethnographic observation in non-clinical areas and interviews with staff in three practices. A small senior executive team set policy and strategy on quality and safety, including a systematic incident reporting and investigation system and processes for disseminating learning with a strong emphasis on customer focus. Standardization of systems was possible because of the large number of practices. Policies appeared generally well implemented at practice level. However, there was some evidence of high staff turnover, particularly of GPs. This caused problems for continuity of care and challenges in inducting new GPs in the company's systems and procedures. A model of primary care delivery based on a corporate chain may be useful in standardizing policies and procedures, facilitating implementation of systems, and relieving clinical staff of administrative duties. However, the model also poses some risks, including those relating to stability. Provider forms that retain the long term, personal commitment of staff to their practices, such as federations or networks, should also be investigated; they may offer the benefits of a corporate chain combined with the greater continuity and stability of the more traditional general practice.

40 CFR 81.48 - Champlain Valley Interstate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.48 Champlain Valley Interstate Air Quality Control Region. The Champlain Valley Interstate Air Quality Control Region (Vermont-New York) has been revised to consist of the...

40 CFR 81.48 - Champlain Valley Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.48 Champlain Valley Interstate Air Quality Control Region. The Champlain Valley Interstate Air Quality Control Region (Vermont-New York) has been revised to consist of the...

40 CFR 81.48 - Champlain Valley Interstate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.48 Champlain Valley Interstate Air Quality Control Region. The Champlain Valley Interstate Air Quality Control Region (Vermont-New York) has been revised to consist of the...

40 CFR 81.48 - Champlain Valley Interstate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.48 Champlain Valley Interstate Air Quality Control Region. The Champlain Valley Interstate Air Quality Control Region (Vermont-New York) has been revised to consist of the...

40 CFR 81.48 - Champlain Valley Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.48 Champlain Valley Interstate Air Quality Control Region. The Champlain Valley Interstate Air Quality Control Region (Vermont-New York) has been revised to consist of the...

Toward a Unified Integration Approach: Uniting Diverse Primary Care Strategies Under the Primary Care Behavioral Health (PCBH) Model.

PubMed

Sandoval, Brian E; Bell, Jennifer; Khatri, Parinda; Robinson, Patricia J

2018-06-01

Primary care continues to be at the center of health care transformation. The Primary Care Behavioral Health (PCBH) model of service delivery includes patient-centered care delivery strategies that can improve clinical outcomes, cost, and patient and primary care provider satisfaction with services. This article reviews the link between the PCBH model of service delivery and health care services quality improvement, and provides guidance for initiating PCBH model clinical pathways for patients facing depression, chronic pain, alcohol misuse, obesity, insomnia, and social barriers to health.

Microscale Obstacle Resolving Air Quality Model Evaluation with the Michelstadt Case

PubMed Central

Rakai, Anikó; Kristóf, Gergely

2013-01-01

Modelling pollutant dispersion in cities is challenging for air quality models as the urban obstacles have an important effect on the flow field and thus the dispersion. Computational Fluid Dynamics (CFD) models with an additional scalar dispersion transport equation are a possible way to resolve the flowfield in the urban canopy and model dispersion taking into consideration the effect of the buildings explicitly. These models need detailed evaluation with the method of verification and validation to gain confidence in their reliability and use them as a regulatory purpose tool in complex urban geometries. This paper shows the performance of an open source general purpose CFD code, OpenFOAM for a complex urban geometry, Michelstadt, which has both flow field and dispersion measurement data. Continuous release dispersion results are discussed to show the strengths and weaknesses of the modelling approach, focusing on the value of the turbulent Schmidt number, which was found to give best statistical metric results with a value of 0.7. PMID:24027450

Microscale obstacle resolving air quality model evaluation with the Michelstadt case.

PubMed

Rakai, Anikó; Kristóf, Gergely

2013-01-01

Modelling pollutant dispersion in cities is challenging for air quality models as the urban obstacles have an important effect on the flow field and thus the dispersion. Computational Fluid Dynamics (CFD) models with an additional scalar dispersion transport equation are a possible way to resolve the flowfield in the urban canopy and model dispersion taking into consideration the effect of the buildings explicitly. These models need detailed evaluation with the method of verification and validation to gain confidence in their reliability and use them as a regulatory purpose tool in complex urban geometries. This paper shows the performance of an open source general purpose CFD code, OpenFOAM for a complex urban geometry, Michelstadt, which has both flow field and dispersion measurement data. Continuous release dispersion results are discussed to show the strengths and weaknesses of the modelling approach, focusing on the value of the turbulent Schmidt number, which was found to give best statistical metric results with a value of 0.7.

Research on Soft Reduction Amount Distribution to Eliminate Typical Inter-dendritic Crack in Continuous Casting Slab of X70 Pipeline Steel by Numerical Model

NASA Astrophysics Data System (ADS)

Liu, Ke; Wang, Chang; Liu, Guo-liang; Ding, Ning; Sun, Qi-song; Tian, Zhi-hong

2017-04-01

To investigate the formation of one kind of typical inter-dendritic crack around triple point region in continuous casting(CC) slab during the operation of soft reduction, fully coupled 3D thermo-mechanical finite element models was developed, also plant trials were carried out in a domestic continuous casting machine. Three possible types of soft reduction amount distribution (SRAD) in the soft reduction region were analyzed. The relationship between the typical inter-dendritic cracks and soft reduction conditions is presented and demonstrated in production practice. Considering the critical strain of internal crack formation, a critical tolerance for the soft reduction amount distribution and related casing parameters have been proposed for better contribution of soft reduction to the internal quality of slabs. The typical inter-dendritic crack around the triple point region had been eliminated effectively through the application of proposed suggestions for continuous casting of X70 pipeline steel in industrial practice.

Geophysical insights on the GIA process provided by high-quality constraints from peripheral regions: An outlook on perspectives from North America and from the Mediterranean basin

NASA Astrophysics Data System (ADS)

Roy, K.; Peltier, W. R.

2017-12-01

Our understanding of the Earth-Ice-Ocean interactions that have accompanied the large glaciation-deglaciation process characteristic of the last half of the Pleistocene has benefited significantly from the development of high-quality models of the Glacial Isostatic Adjustment (GIA) process. These models provide fundamental insight on the large changes in sea level and land ice cover over this time period, as well as key constraints on the viscosity structure of the Earth's interior. Their development has benefited from the recent availability of high-quality constraints from regions of forebulge collapse. In particular, over North America, the joint use of high-quality sea level data from the U.S. East coast, together with the vast network of precise space-geodetic observations of crustal motion existing over most of the interior of the continent, has led to the latest ICE-7G_NA (VM7) model (Roy & Peltier, GJI, 2017). In this paper, exciting opportunities provided by such high-quality observations related to the GIA process will be discussed, not only in the context of the continuing effort to refine global models of this phenomenon, but also in terms of the fundamental insight they may provide on outstanding issues in high-pressure geophysics, paleoclimatology or hydrogeology. Specific examples where such high-quality observations can be used (either separately, or using a combination of independent sources) will be presented, focusing particularly on constraints from the North American continent and from the Mediterranean basin. This work will demonstrate that, given the high-quality of currently available constraints on the GIA process, considerable further geophysical insight can be obtained based upon the use of spherically-symmetric models of the viscosity structure of the planet.

Double the dates and go for Bayes - Impacts of model choice, dating density and quality on chronologies

NASA Astrophysics Data System (ADS)

Blaauw, Maarten; Christen, J. Andrés; Bennett, K. D.; Reimer, Paula J.

2018-05-01

Reliable chronologies are essential for most Quaternary studies, but little is known about how age-depth model choice, as well as dating density and quality, affect the precision and accuracy of chronologies. A meta-analysis suggests that most existing late-Quaternary studies contain fewer than one date per millennium, and provide millennial-scale precision at best. We use existing and simulated sediment cores to estimate what dating density and quality are required to obtain accurate chronologies at a desired precision. For many sites, a doubling in dating density would significantly improve chronologies and thus their value for reconstructing and interpreting past environmental changes. Commonly used classical age-depth models stop becoming more precise after a minimum dating density is reached, but the precision of Bayesian age-depth models which take advantage of chronological ordering continues to improve with more dates. Our simulations show that classical age-depth models severely underestimate uncertainty and are inaccurate at low dating densities, and also perform poorly at high dating densities. On the other hand, Bayesian age-depth models provide more realistic precision estimates, including at low to average dating densities, and are much more robust against dating scatter and outliers. Indeed, Bayesian age-depth models outperform classical ones at all tested dating densities, qualities and time-scales. We recommend that chronologies should be produced using Bayesian age-depth models taking into account chronological ordering and based on a minimum of 2 dates per millennium.

Is there a trade-off between longevity and quality of life in Grossman's pure investment model?

PubMed

Eisenring, C

2000-12-01

The question is posed whether an individual maximizes lifetime or trades off longevity for quality of life in Grossman's pure investment (PI)-model. It is shown that the answer critically hinges on the assumed production function for healthy time. If the production function for healthy time produces a trade-off between life-span and quality of life, one has to solve a sequence of fixed time problems. The one offering maximal intertemporal utility determines optimal longevity. Comparative static results of optimal longevity for a simplified version of the PI-model are derived. The obtained results predict that higher initial endowments of wealth and health, a rise in the wage rate, or improvements in the technology of producing healthy time, all increase the optimal length of life. On the other hand, optimal longevity is decreasing in the depreciation and interest rate. From a technical point of view, the paper illustrates that a discrete time equivalent to the transversality condition for optimal longevity employed in continuous optimal control models does not exist. Copyright 2000 John Wiley & Sons, Ltd.

42 CFR 476.82 - Continuation of functions not assumed by QIOs.

Code of Federal Regulations, 2010 CFR

2010-10-01

....82 Section 476.82 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

Quality-based financial incentives in health care: can we improve quality by paying for it?

PubMed

Conrad, Douglas A; Perry, Lisa

2009-01-01

This article asks whether financial incentives can improve the quality of health care. A conceptual framework drawn from microeconomics, agency theory, behavioral economics, and cognitive psychology motivates a set of propositions about incentive effects on clinical quality. These propositions are evaluated through a synthesis of extant peer-reviewed empirical evidence. Comprehensive financial incentives--balancing rewards and penalties; blending structure, process, and outcome measures; emphasizing continuous, absolute performance standards; tailoring the size of incremental rewards to increasing marginal costs of quality improvement; and assuring certainty, frequency, and sustainability of incentive payoffs--offer the prospect of significantly enhancing quality beyond the modest impacts of prevailing pay-for-performance (P4P) programs. Such organizational innovations as the primary care medical home and accountable health care organizations are expected to catalyze more powerful quality incentive models: risk- and quality-adjusted capitation, episode of care payments, and enhanced fee-for-service payments for quality dimensions (e.g., prevention) most amenable to piece-rate delivery.

Increasing the Use of Earth Science Data and Models in Air Quality Management.

PubMed

Milford, Jana B; Knight, Daniel

2017-04-01

In 2010, the U.S. National Aeronautics and Space Administration (NASA) initiated the Air Quality Applied Science Team (AQAST) as a 5-year, $17.5-million award with 19 principal investigators. AQAST aims to increase the use of Earth science products in air quality-related research and to help meet air quality managers' information needs. We conducted a Web-based survey and a limited number of follow-up interviews to investigate federal, state, tribal, and local air quality managers' perspectives on usefulness of Earth science data and models, and on the impact AQAST has had. The air quality managers we surveyed identified meeting the National Ambient Air Quality Standards for ozone and particulate matter, emissions from mobile sources, and interstate air pollution transport as top challenges in need of improved information. Most survey respondents viewed inadequate coverage or frequency of satellite observations, data uncertainty, and lack of staff time or resources as barriers to increased use of satellite data by their organizations. Managers who have been involved with AQAST indicated that the program has helped build awareness of NASA Earth science products, and assisted their organizations with retrieval and interpretation of satellite data and with application of global chemistry and climate models. AQAST has also helped build a network between researchers and air quality managers with potential for further collaborations. NASA's Air Quality Applied Science Team (AQAST) aims to increase the use of satellite data and global chemistry and climate models for air quality management purposes, by supporting research and tool development projects of interest to both groups. Our survey and interviews of air quality managers indicate they found value in many AQAST projects and particularly appreciated the connections to the research community that the program facilitated. Managers expressed interest in receiving continued support for their organizations' use of satellite data, including assistance in retrieving and interpreting data from future geostationary platforms meant to provide more frequent coverage for air quality and other applications.

Quality management in home care: models for today's practice.

PubMed

Verhey, M P

1996-01-01

In less than a decade, home care providers have been a part of two major transitions in health care delivery. First, because of the advent of managed care and a shift from inpatient to community-based services, home care service delivery systems have experienced tremendous growth. Second, the principles and practices of total quality management and continuous quality improvement have permeated the organization, administration, and practice of home health care. Based on the work of Deming, Juran, and Crosby, the basic tenets of the new quality management philosophy involve a focus on the following five key areas: (1) systems and processes rather than individual performance; (2) involvement, collaboration, and empowerment; (3) internal and external "customers"; (4) data and measurement; and (5) standards, guidelines, and outcomes of care. Home care providers are among those in the forefront who are developing and implementing programs that integrate these foci into the delivery of quality home care services. This article provides a summary of current home care programs that address these five key areas of quality management philosophy and provide models for innovative quality management practice in home care. For further information about each program, readers are referred to the original reports in the home care and quality management journal literature, as cited herein.

The challenge of documenting water quality benefits of conservation practices: a review of USDA-ARS's conservation effects assessment project watershed studies.

PubMed

Tomer, M D; Locke, M A

2011-01-01

The Conservation Effects Assessment Project was established to quantify water quality benefits of conservation practices supported by the U.S. Department of Agriculture (USDA). In 2004, watershed assessment studies were begun in fourteen agricultural watersheds with varying cropping systems, landscapes, climate, and water quality concerns. This paper reviews USDA Agricultural Research Service 'Benchmark' watershed studies and the challenge of identifying water quality benefits in watersheds. Study goals included modeling and field research to assess practices, and evaluation of practice placement in watersheds. Not all goals were met within five years but important lessons were learned. While practices improved water quality, problems persisted in larger watersheds. This dissociation between practice-focused and watershed-scale assessments occurred because: (1) Conservation practices were not targeted at critical sources/pathways of contaminants; (2) Sediment in streams originated more from channel and bank erosion than from soil erosion; (3) Timing lags, historical legacies, and shifting climate combined to mask effects of practice implementation; and (4) Water quality management strategies addressed single contaminants with little regard for trade-offs among contaminants. These lessons could help improve conservation strategies and set water quality goals with realistic timelines. Continued research on agricultural water quality could better integrate modeling and monitoring capabilities, and address ecosystem services.

Air quality modeling for the urban Jackson, Mississippi Region using a high resolution WRF/Chem model.

PubMed

Yerramilli, Anjaneyulu; Dodla, Venkata B; Desamsetti, Srinivas; Challa, Srinivas V; Young, John H; Patrick, Chuck; Baham, Julius M; Hughes, Robert L; Yerramilli, Sudha; Tuluri, Francis; Hardy, Mark G; Swanier, Shelton J

2011-06-01

In this study, an attempt was made to simulate the air quality with reference to ozone over the Jackson (Mississippi) region using an online WRF/Chem (Weather Research and Forecasting-Chemistry) model. The WRF/Chem model has the advantages of the integration of the meteorological and chemistry modules with the same computational grid and same physical parameterizations and includes the feedback between the atmospheric chemistry and physical processes. The model was designed to have three nested domains with the inner-most domain covering the study region with a resolution of 1 km. The model was integrated for 48 hours continuously starting from 0000 UTC of 6 June 2006 and the evolution of surface ozone and other precursor pollutants were analyzed. The model simulated atmospheric flow fields and distributions of NO2 and O3 were evaluated for each of the three different time periods. The GIS based spatial distribution maps for ozone, its precursors NO, NO2, CO and HONO and the back trajectories indicate that all the mobile sources in Jackson, Ridgeland and Madison contributing significantly for their formation. The present study demonstrates the applicability of WRF/Chem model to generate quantitative information at high spatial and temporal resolution for the development of decision support systems for air quality regulatory agencies and health administrators.

Statistical Methods for Quality Control of Steel Coils Manufacturing Process using Generalized Linear Models

NASA Astrophysics Data System (ADS)

García-Díaz, J. Carlos

2009-11-01

Fault detection and diagnosis is an important problem in process engineering. Process equipments are subject to malfunctions during operation. Galvanized steel is a value added product, furnishing effective performance by combining the corrosion resistance of zinc with the strength and formability of steel. Fault detection and diagnosis is an important problem in continuous hot dip galvanizing and the increasingly stringent quality requirements in automotive industry has also demanded ongoing efforts in process control to make the process more robust. When faults occur, they change the relationship among these observed variables. This work compares different statistical regression models proposed in the literature for estimating the quality of galvanized steel coils on the basis of short time histories. Data for 26 batches were available. Five variables were selected for monitoring the process: the steel strip velocity, four bath temperatures and bath level. The entire data consisting of 48 galvanized steel coils was divided into sets. The first training data set was 25 conforming coils and the second data set was 23 nonconforming coils. Logistic regression is a modeling tool in which the dependent variable is categorical. In most applications, the dependent variable is binary. The results show that the logistic generalized linear models do provide good estimates of quality coils and can be useful for quality control in manufacturing process.

Centers for medicare and medicaid services: using an episode-based payment model to improve oncology care.

PubMed

Kline, Ronald M; Bazell, Carol; Smith, Erin; Schumacher, Heidi; Rajkumar, Rahul; Conway, Patrick H

2015-03-01

Cancer is a medically complex and expensive disease with costs projected to rise further as new treatment options increase and the United States population ages. Studies showing significant regional variation in oncology quality and costs and model tests demonstrating cost savings without adverse outcomes suggest there are opportunities to create a system of oncology care in the US that delivers higher quality care at lower cost. The Centers for Medicare and Medicaid Services (CMS) have designed an episode-based payment model centered around 6 month periods of chemotherapy treatment. Monthly per-patient care management payments will be made to practices to support practice transformation, including additional patient services and specific infrastructure enhancements. Quarterly reporting of quality metrics will drive continuous quality improvement and the adoption of best practices among participants. Practices achieving cost savings will also be eligible for performance-based payments. Savings are expected through improved care coordination and appropriately aligned payment incentives, resulting in decreased avoidable emergency department visits and hospitalizations and more efficient and evidence-based use of imaging, laboratory tests, and therapeutic agents, as well as improved end of life care. New therapies and better supportive care have significantly improved cancer survival in recent decades. This has come at a high cost, with cancer therapy consuming $124 billion in 2010. CMS has designed an episode-based model of oncology care that incorporates elements from several successful model tests. By providing care management and performance based payments in conjunction with quality metrics and a rapid learning environment, it is hoped that this model will demonstrate how oncology care in the US can transform into a high value, high quality system. Copyright © 2015 by American Society of Clinical Oncology.

Air Quality Improvements of Increased Integration of Renewables: Solar Photovoltaics Penetration Scenarios

NASA Astrophysics Data System (ADS)

Duran, P.; Holloway, T.; Brinkman, G.; Denholm, P.; Littlefield, C. M.

2011-12-01

Solar photovoltaics (PV) are an attractive technology because they can be locally deployed and tend to yield high production during periods of peak electric demand. These characteristics can reduce the need for conventional large-scale electricity generation, thereby reducing emissions of criteria air pollutants (CAPs) and improving ambient air quality with regard to such pollutants as nitrogen oxides, sulfur oxides and fine particulates. Such effects depend on the local climate, time-of-day emissions, available solar resources, the structure of the electric grid, and existing electricity production among other factors. This study examines the air quality impacts of distributed PV across the United States Eastern Interconnection. In order to accurately model the air quality impact of distributed PV in space and time, we used the National Renewable Energy Lab's (NREL) Regional Energy Deployment System (ReEDS) model to form three unique PV penetration scenarios in which new PV construction is distributed spatially based upon economic drivers and natural solar resources. Those scenarios are 2006 Eastern Interconnection business as usual, 10% PV penetration, and 20% PV penetration. With the GridView (ABB, Inc) dispatch model, we used historical load data from 2006 to model electricity production and distribution for each of the three scenarios. Solar PV electric output was estimated using historical weather data from 2006. To bridge the gap between dispatch and air quality modeling, we will create emission profiles for electricity generating units (EGUs) in the Eastern Interconnection from historical Continuous Emissions Monitoring System (CEMS) data. Via those emissions profiles, we will create hourly emission data for EGUs in the Eastern Interconnect for each scenario during 2006. Those data will be incorporated in the Community Multi-scale Air Quality (CMAQ) model using the Sparse Matrix Operator Kernel Emissions (SMOKE) model. Initial results indicate that PV penetration significantly reduces conventional peak electricity production and that, due to reduced emissions during periods of extremely active photochemistry, air quality could see benefits.

Low Socioeconomic Status Negatively Affects Sleep in Pregnant Women

PubMed Central

Okun, Michele L.; Tolge, Madeline; Hall, Martica

2014-01-01

Objective To evaluate the effect of socioeconomic status on measures of sleep quality, continuity, and quantity in a large cohort of pregnant women. Design Prospective, longitudinal study. Participants One hundred seventy (170) pregnant women at 10-20 weeks gestation. Methods Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Sleep duration and continuity (sleep fragmentation index [SFI]) were assessed with actigraphy at 10-12, 14-16, and 18-20 weeks gestation. Since sleep did not significantly differ across time, averages across all three time points were used in analyses. Socioeconomic status (SES) was defined by self-reported annual household income. Linear regression analyses were used to model the independent associations of SES on sleep after adjusting for age, race, parity, marital status, body mass index (BMI), perceived stress, depressive symptoms, and financial strain. Results On average, women reported modestly poor sleep quality (M = 5.4, SD= 2.7), short sleep duration (391 (55.6) min) and fragmented sleep (SFI M = 33.9, SD= 10.4. A household income < $50,000/year was associated with poorer sleep quality (β = -.18, p < .05) and greater sleep fragmentation (β= -.18, p < .05) following covariate adjustment. Conclusions Low SES was associated with poorer sleep quality and fragmented sleep, even after statistical adjustments. Perceived stress and financial strain attenuated SES-sleep associations indicating that psychosocial situations preceding pregnancy are also important to consider. PMID:24617761

The Center For Medicare And Medicaid Innovation's blueprint for rapid-cycle evaluation of new care and payment models.

PubMed

Shrank, William

2013-04-01

The Affordable Care Act established the Center for Medicare and Medicaid Innovation to test innovative payment and service delivery models. The goal is to reduce program expenditures while preserving or improving the quality of care provided to beneficiaries of Medicare, Medicaid, and the Children's Health Insurance Program. Central to the success of the Innovation Center is a new, rapid-cycle approach to evaluation. This article describes that approach--setting forth how the Rapid Cycle Evaluation Group aims to deliver frequent feedback to providers in support of continuous quality improvement, while rigorously evaluating the outcomes of each model tested. This article also describes the relationship between the group's work and that of the Office of the Actuary at the Centers for Medicare and Medicaid Services, which plays a central role in the assessment of new models.

Predictive time-series modeling using artificial neural networks for Linac beam symmetry: an empirical study.

PubMed

Li, Qiongge; Chan, Maria F

2017-01-01

Over half of cancer patients receive radiotherapy (RT) as partial or full cancer treatment. Daily quality assurance (QA) of RT in cancer treatment closely monitors the performance of the medical linear accelerator (Linac) and is critical for continuous improvement of patient safety and quality of care. Cumulative longitudinal QA measurements are valuable for understanding the behavior of the Linac and allow physicists to identify trends in the output and take preventive actions. In this study, artificial neural networks (ANNs) and autoregressive moving average (ARMA) time-series prediction modeling techniques were both applied to 5-year daily Linac QA data. Verification tests and other evaluations were then performed for all models. Preliminary results showed that ANN time-series predictive modeling has more advantages over ARMA techniques for accurate and effective applicability in the dosimetry and QA field. © 2016 New York Academy of Sciences.

The NASA Lightning Nitrogen Oxides Model (LNOM): Application to Air Quality Modeling

NASA Technical Reports Server (NTRS)

Koshak, William; Peterson, Harold; Khan, Maudood; Biazar, Arastoo; Wang, Lihua

2011-01-01

Recent improvements to the NASA Marshall Space Flight Center Lightning Nitrogen Oxides Model (LNOM) and its application to the Community Multiscale Air Quality (CMAQ) modeling system are discussed. The LNOM analyzes Lightning Mapping Array (LMA) and National Lightning Detection Network(TradeMark)(NLDN) data to estimate the raw (i.e., unmixed and otherwise environmentally unmodified) vertical profile of lightning NO(x) (= NO + NO2). The latest LNOM estimates of lightning channel length distributions, lightning 1-m segment altitude distributions, and the vertical profile of lightning NO(x) are presented. The primary improvement to the LNOM is the inclusion of non-return stroke lightning NOx production due to: (1) hot core stepped and dart leaders, (2) stepped leader corona sheath, K-changes, continuing currents, and M-components. The impact of including LNOM-estimates of lightning NO(x) for an August 2006 run of CMAQ is discussed.

Lidocaine/monoethylglycinexylidide test, galactose elimination test, and sorbitol elimination test for metabolic assessment of liver cell bioreactors.

PubMed

Gerlach, Jörg C; Brayfield, Candace; Puhl, Gero; Borneman, Reiner; Müller, Christian; Schmelzer, Eva; Zeilinger, Katrin

2010-06-01

Various metabolic tests were compared for the performance characterization of a liver cell bioreactor as a routine function assessment of cultures in a standby for patient application in clinical studies. Everyday quality assessment (QA) is essential to ensure a continuous level of cellular functional capacity in the development of hepatic progenitor cell expansion systems providing cells for regenerative medicine research; it is also of interest to meet safety requirements in bioartificial extracorporeal liver support systems under clinical evaluation. Quality criteria for the description of bioreactor cultures were developed using primary porcine liver cells as a model. Porcine liver cells isolated by collagenase perfusion with an average of 3 x 10(9) primary cells were used in 39 bioreactors for culture periods up to 33 days. Measurements of monoethylglycinexylidide synthesis and elimination of lidocaine, galactose elimination, and sorbitol elimination proved to be useful for routine QA of primary liver cell cultures. We demonstrate two methods for dispensing test substances, bolus administration and continuous, steady-state administration. Bolus test data were grouped in Standard, Therapy, Infection/Contamination, and Cell-free control groups. Statistical analyses show significant differences among all groups for every test substance. Post hoc comparisons indicated significant differences between Standard and Cell-free groups for all elimination parameters. For continuous tests, results were categorized according to number of culture days and time-dependent changes were analyzed. Continuous administration enables a better view of culture health and the time dependency of cellular function, whereas bolus administration is more flexible. Both procedures can be used to define cell function. Assessment of cellular function and bioreactor quality can contribute significantly to the quality of experimental or clinical studies in the field of hepatic bioreactor development.

Simulation to coating weight control for galvanizing

NASA Astrophysics Data System (ADS)

Wang, Junsheng; Yan, Zhang; Wu, Kunkui; Song, Lei

2013-05-01

Zinc coating weight control is one of the most critical issues for continuous galvanizing line. The process has the characteristic of variable-time large time delay, nonlinear, multivariable. It can result in seriously coating weight error and non-uniform coating. We develop a control system, which can automatically control the air knives pressure and its position to give a constant and uniform zinc coating, in accordance with customer-order specification through an auto-adaptive empirical model-based feed forward adaptive controller, and two model-free adaptive feedback controllers . The proposed models with controller were applied to continuous galvanizing line (CGL) at Angang Steel Works. By the production results, the precise and stability of the control model reduces over-coating weight and improves coating uniform. The product for this hot dip galvanizing line does not only satisfy the customers' quality requirement but also save the zinc consumption.

DETERMINING PARTICLE EMISSION SOURCE STRENGTHS FOR COMMON RESIDENTIAL INDOOR SOURCES USING REAL-TIME MEASUREMENTS AND PIECEWISE-CONTINUOUS SOLUTIONS TO THE MASS BALANCE EQUATION

EPA Science Inventory

A variety of common activities in the home, such as smoking and cooking, generate indoor particle concentrations. Mathematical indoor air quality models permit predictions of indoor pollutant concentrations in homes, provided that parameter values such as source strengths and ...

Integrating Planning, Assessment, and Improvement in Higher Education

ERIC Educational Resources Information Center

Sherlock, Barbara J.

2009-01-01

Based on Penn State's popular "Innovation Insights" series, this book brings together in one handy reference nearly a decade of tried and true insights into continuous quality improvements in higher education. Their five-step model for integrating planning, assessment, and improvement moves plans off the shelf and into the weekly and daily…

Improvements to the WRF-CMAQ modeling system for fine-scale air quality simulations

EPA Science Inventory

Despite significant reductions in atmospheric pollutants such as ozone (O₃) and fine particulate matter (PM_2.5) over the past several decades, air pollution continues to pose a threat to the health of humans and sensitive ecosystems. A number of areas across...

From Quick Start Teams to Home Teams: The Duke TQM Experience.

ERIC Educational Resources Information Center

Lubans, John; Gordon, Heather

This paper describes the Duke University Libraries' transition in early 1994 from its traditional hierarchical model to an organization emphasizing Total Quality Management (TQM) concepts such as self-managing teams and continuous improvement. Existing conditions at the libraries that played a role in the decision to switch included: (1) rising…

Using Tropospheric Ozone Profiles and Surface Data (2004 - 2012) to Determine Background Ozone Levels in Houston, Texas

NASA Astrophysics Data System (ADS)

Spychala, M. D.; Morris, G. A.; Lefer, B. L.; Rappenglueck, B.; Cohan, D. S.; zhou, W.

2012-12-01

The Tropospheric Ozone Pollution Project (TOPP) at Rice University (2004 - 2006) and the University of Houston (2006 - present) has gathered > 400 profiles of ozone, temperature, pressure, and relative humidity, and > 250 of those also have wind speed and wind direction near the core of the City of Houston, Texas. Houston continues to be plagued with difficulty in coming into compliance with EPA National Ambient Air Quality Standards (NAAQS) due to a combination of its geographic location, large commuter population, significant petrochemical and energy production, and favorable weather patterns. An outstanding question remains the relative partitioning of ozone between local and remote, anthropogenic and natural sources. In this presentation, we use TOPP ozone profiles to determine a "background" ozone concentration and compare this measure with surface monitor "background" ozone as determined from upwind and downwind Continuous Air Monitoring Stations (CAMS) in an effort to further our understanding of this partitioning. For periods studied with the Community Multiscale Air Quality (CMAQ) Model, we also compare the sonde and surface "background" ozone with that suggested by the model.

Effective Interpolation of Incomplete Satellite-Derived Leaf-Area Index Time Series for the Continental United States

NASA Technical Reports Server (NTRS)

Jasinski, Michael F.; Borak, Jordan S.

2008-01-01

Many earth science modeling applications employ continuous input data fields derived from satellite data. Environmental factors, sensor limitations and algorithmic constraints lead to data products of inherently variable quality. This necessitates interpolation of one form or another in order to produce high quality input fields free of missing data. The present research tests several interpolation techniques as applied to satellite-derived leaf area index, an important quantity in many global climate and ecological models. The study evaluates and applies a variety of interpolation techniques for the Moderate Resolution Imaging Spectroradiometer (MODIS) Leaf-Area Index Product over the time period 2001-2006 for a region containing the conterminous United States. Results indicate that the accuracy of an individual interpolation technique depends upon the underlying land cover. Spatial interpolation provides better results in forested areas, while temporal interpolation performs more effectively over non-forest cover types. Combination of spatial and temporal approaches offers superior interpolative capabilities to any single method, and in fact, generation of continuous data fields requires a hybrid approach such as this.

Monitoring scale scores over time via quality control charts, model-based approaches, and time series techniques.

PubMed

Lee, Yi-Hsuan; von Davier, Alina A

2013-07-01

Maintaining a stable score scale over time is critical for all standardized educational assessments. Traditional quality control tools and approaches for assessing scale drift either require special equating designs, or may be too time-consuming to be considered on a regular basis with an operational test that has a short time window between an administration and its score reporting. Thus, the traditional methods are not sufficient to catch unusual testing outcomes in a timely manner. This paper presents a new approach for score monitoring and assessment of scale drift. It involves quality control charts, model-based approaches, and time series techniques to accommodate the following needs of monitoring scale scores: continuous monitoring, adjustment of customary variations, identification of abrupt shifts, and assessment of autocorrelation. Performance of the methodologies is evaluated using manipulated data based on real responses from 71 administrations of a large-scale high-stakes language assessment.

Achieving continuous improvement in laboratory organization through performance measurements: a seven-year experience.

PubMed

Salinas, Maria; López-Garrigós, Maite; Gutiérrez, Mercedes; Lugo, Javier; Sirvent, Jose Vicente; Uris, Joaquin

2010-01-01

Laboratory performance can be measured using a set of model key performance indicators (KPIs). The design and implementation of KPIs are important issues. KPI results from 7 years are reported and their implementation, monitoring, objectives, interventions, result reporting and delivery are analyzed. The KPIs of the entire laboratory process were obtained using Laboratory Information System (LIS) registers. These were collected automatically using a data warehouse application, spreadsheets and external quality program reports. Customer satisfaction was assessed using surveys. Nine model laboratory KPIs were proposed and measured. The results of some examples of KPIs used in our laboratory are reported. Their corrective measurements or the implementation of objectives led to improvement in the associated KPIs results. Measurement of laboratory performance using KPIs and a data warehouse application that continuously collects registers and calculates KPIs confirmed the reliability of indicators, indicator acceptability and usability for users, and continuous process improvement.

[Recommendations for the evaluation and follow-up of the continuous quality improvement].

PubMed

Maurellet-Evrard, S; Daunizeau, A

2013-06-01

Continual improvement of the quality in a medical laboratory is based on the implementation of tools for systematically evaluate the quality management system and its ability to meet the objectives defined. Monitoring through audit and management review, addressing complaints and nonconformities and performing client satisfaction survey are the key for the continual improvement.

Positioning Continuing Education: Boundaries and Intersections between the Domains Continuing Education, Knowledge Translation, Patient Safety and Quality Improvement

ERIC Educational Resources Information Center

Kitto, Simon; Bell, Mary; Peller, Jennifer; Sargeant, Joan; Etchells, Edward; Reeves, Scott; Silver, Ivan

2013-01-01

Public and professional concern about health care quality, safety and efficiency is growing. Continuing education, knowledge translation, patient safety and quality improvement have made concerted efforts to address these issues. However, a coordinated and integrated effort across these domains is lacking. This article explores and discusses the…

40 CFR 81.240 - Northeastern Plains Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Northeastern Plains Intrastate Air Quality Control Region (New Mexico) consists of the territorial area... Quality Control Region. 81.240 Section 81.240 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of...

40 CFR 81.240 - Northeastern Plains Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Northeastern Plains Intrastate Air Quality Control Region (New Mexico) consists of the territorial area... Quality Control Region. 81.240 Section 81.240 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of...

40 CFR 52.2682 - Air quality surveillance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 5 2012-07-01 2012-07-01 false Air quality surveillance. 52.2682... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Guam § 52.2682 Air quality... Pollution Control Standards and Regulations” (buffer zones—air quality sampling) are not in conformance with...

40 CFR 52.2682 - Air quality surveillance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 5 2013-07-01 2013-07-01 false Air quality surveillance. 52.2682... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Guam § 52.2682 Air quality... Pollution Control Standards and Regulations” (buffer zones—air quality sampling) are not in conformance with...

40 CFR 52.2682 - Air quality surveillance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 5 2014-07-01 2014-07-01 false Air quality surveillance. 52.2682... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Guam § 52.2682 Air quality... Pollution Control Standards and Regulations” (buffer zones—air quality sampling) are not in conformance with...

40 CFR 52.2682 - Air quality surveillance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Air quality surveillance. 52.2682... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Guam § 52.2682 Air quality... Pollution Control Standards and Regulations” (buffer zones—air quality sampling) are not in conformance with...

40 CFR 81.51 - Portland Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Control Region. 81.51 Section 81.51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.51 Portland Interstate Air Quality Control Region. The Portland Interstate...

40 CFR 81.51 - Portland Interstate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Control Region. 81.51 Section 81.51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.51 Portland Interstate Air Quality Control Region. The Portland Interstate...

40 CFR 81.51 - Portland Interstate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Control Region. 81.51 Section 81.51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of Air Quality Control Regions § 81.51 Portland Interstate Air Quality Control Region. The Portland Interstate...

40 CFR 52.2682 - Air quality surveillance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Air quality surveillance. 52.2682... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Guam § 52.2682 Air quality... Pollution Control Standards and Regulations” (buffer zones—air quality sampling) are not in conformance with...

Improve processes on healthcare: current issues and future trends.

PubMed

Chen, Jason C H; Dolan, Matt; Lin, Binshan

2004-01-01

Information Technology (IT) is a critical resource for improving today's business competitiveness. However, many healthcare providers do not proactively manage or improve the efficiency and effectiveness of their services with IT. Survival in a competitive business environment demands continuous improvements in quality and service, while rigorously maintaining core values. Electronic commerce continues its development, gaining ground as the preferred means of business transactions. Embracing e-healthcare and treating IT as a strategic tool to improve patient safety and the quality of care enables healthcare professionals to benefit from technology formerly used only for management purposes. Numerous improvement initiatives, introduced by both the federal government and the private sector, seek to better the status quo in IT. This paper examines the current IT climate using an enhanced "Built to Last" model, and comments on future IT strategies within the healthcare industry.

Management systems, patient quality improvement, resource availability, and substance abuse treatment quality.

PubMed

Fields, Dail; Roman, Paul M; Blum, Terry C

2012-06-01

To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007-2008. Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. © Health Research and Educational Trust.

Management Systems, Patient Quality Improvement, Resource Availability, and Substance Abuse Treatment Quality

PubMed Central

Fields, Dail; Roman, Paul M; Blum, Terry C

2012-01-01

Objective To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data Sources/Study Setting Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). Study Design The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Data Collection Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007–2008. Principal Findings Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Conclusions Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. PMID:22098342

Conceptualizing clinical nurse leader practice: an interpretive synthesis.

PubMed

Bender, Miriam

2016-01-01

The Institute of Medicine's Future of Nursing report identifies the clinical nurse leader as an innovative new role for meeting higher health-care quality standards. However, specific clinical nurse leader practices influencing documented quality outcomes remain unclear. Lack of practice clarity limits the ability to articulate, implement and measure clinical nurse leader-specific practice and quality outcomes. Interpretive synthesis design and grounded theory analysis were used to develop a theoretical understanding of clinical nurse leader practice that can facilitate systematic and replicable implementation across health-care settings. The core phenomenon of clinical nurse leader practice is continuous clinical leadership, which involves four fundamental activities: facilitating effective ongoing communication; strengthening intra and interprofessional relationships; building and sustaining teams; and supporting staff engagement. Clinical nurse leaders continuously communicate and develop relationships within and across professions to promote and sustain information exchange, engagement, teamwork and effective care processes at the microsystem level. Clinical nurse leader-integrated care delivery systems highlight the benefits of nurse-led models of care for transforming health-care quality. Managers can use this study's findings to frame an implementation strategy that addresses theoretical domains of clinical nurse leader practice to help ensure practice success. © 2015 John Wiley & Sons Ltd.

Advanced dendritic web growth development and development of single-crystal silicon dendritic ribbon and high-efficiency solar cell program

NASA Technical Reports Server (NTRS)

Duncan, C. S.; Seidensticker, R. G.; Mchugh, J. P.; Hopkins, R. H.

1986-01-01

Efforts to demonstrate that the dendritic web technology is ready for commercial use by the end of 1986 continues. A commercial readiness goal involves improvements to crystal growth furnace throughput to demonstrate an area growth rate of greater than 15 sq cm/min while simultaneously growing 10 meters or more of ribbon under conditions of continuous melt replenishment. Continuous means that the silicon melt is being replenished at the same rate that it is being consumed by ribbon growth so that the melt level remains constant. Efforts continue on computer thermal modeling required to define high speed, low stress, continuous growth configurations; the study of convective effects in the molten silicon and growth furnace cover gas; on furnace component modifications; on web quality assessments; and on experimental growth activities.

Impact of rain gauge quality control and interpolation on streamflow simulation: an application to the Warwick catchment, Australia

NASA Astrophysics Data System (ADS)

Liu, Shulun; Li, Yuan; Pauwels, Valentijn R. N.; Walker, Jeffrey P.

2017-12-01

Rain gauges are widely used to obtain temporally continuous point rainfall records, which are then interpolated into spatially continuous data to force hydrological models. However, rainfall measurements and interpolation procedure are subject to various uncertainties, which can be reduced by applying quality control and selecting appropriate spatial interpolation approaches. Consequently, the integrated impact of rainfall quality control and interpolation on streamflow simulation has attracted increased attention but not been fully addressed. This study applies a quality control procedure to the hourly rainfall measurements obtained in the Warwick catchment in eastern Australia. The grid-based daily precipitation from the Australian Water Availability Project was used as a reference. The Pearson correlation coefficient between the daily accumulation of gauged rainfall and the reference data was used to eliminate gauges with significant quality issues. The unrealistic outliers were censored based on a comparison between gauged rainfall and the reference. Four interpolation methods, including the inverse distance weighting (IDW), nearest neighbors (NN), linear spline (LN), and ordinary Kriging (OK), were implemented. The four methods were firstly assessed through a cross-validation using the quality-controlled rainfall data. The impacts of the quality control and interpolation on streamflow simulation were then evaluated through a semi-distributed hydrological model. The results showed that the Nash–Sutcliffe model efficiency coefficient (NSE) and Bias of the streamflow simulations were significantly improved after quality control. In the cross-validation, the IDW and OK methods resulted in good interpolation rainfall, while the NN led to the worst result. In term of the impact on hydrological prediction, the IDW led to the most consistent streamflow predictions with the observations, according to the validation at five streamflow-gauged locations. The OK method performed second best according to streamflow predictions at the five gauges in the calibration period (01/01/2007–31/12/2011) and four gauges during the validation period (01/01/2012–30/06/2014). However, NN produced the worst prediction at the outlet of the catchment in the validation period, indicating a low robustness. While the IDW exhibited the best performance in the study catchment in terms of accuracy, robustness and efficiency, more general recommendations on the selection of rainfall interpolation methods need to be further explored.

Impact of rain gauge quality control and interpolation on streamflow simulation: an application to the Warwick catchment, Australia

NASA Astrophysics Data System (ADS)

Liu, Shulun; Li, Yuan; Pauwels, Valentijn R. N.; Walker, Jeffrey P.

2018-01-01

Rain gauges are widely used to obtain temporally continuous point rainfall records, which are then interpolated into spatially continuous data to force hydrological models. However, rainfall measurements and interpolation procedure are subject to various uncertainties, which can be reduced by applying quality control and selecting appropriate spatial interpolation approaches. Consequently, the integrated impact of rainfall quality control and interpolation on streamflow simulation has attracted increased attention but not been fully addressed. This study applies a quality control procedure to the hourly rainfall measurements obtained in the Warwick catchment in eastern Australia. The grid-based daily precipitation from the Australian Water Availability Project was used as a reference. The Pearson correlation coefficient between the daily accumulation of gauged rainfall and the reference data was used to eliminate gauges with significant quality issues. The unrealistic outliers were censored based on a comparison between gauged rainfall and the reference. Four interpolation methods, including the inverse distance weighting (IDW), nearest neighbors (NN), linear spline (LN), and ordinary Kriging (OK), were implemented. The four methods were firstly assessed through a cross-validation using the quality-controlled rainfall data. The impacts of the quality control and interpolation on streamflow simulation were then evaluated through a semi-distributed hydrological model. The results showed that the Nash–Sutcliffe model efficiency coefficient (NSE) and Bias of the streamflow simulations were significantly improved after quality control. In the cross-validation, the IDW and OK methods resulted in good interpolation rainfall, while the NN led to the worst result. In term of the impact on hydrological prediction, the IDW led to the most consistent streamflow predictions with the observations, according to the validation at five streamflow-gauged locations. The OK method performed second best according to streamflow predictions at the five gauges in the calibration period (01/01/2007–31/12/2011) and four gauges during the validation period (01/01/2012–30/06/2014). However, NN produced the worst prediction at the outlet of the catchment in the validation period, indicating a low robustness. While the IDW exhibited the best performance in the study catchment in terms of accuracy, robustness and efficiency, more general recommendations on the selection of rainfall interpolation methods need to be further explored.

GPCRM: a homology modeling web service with triple membrane-fitted quality assessment of GPCR models.

PubMed

Miszta, Przemyslaw; Pasznik, Pawel; Jakowiecki, Jakub; Sztyler, Agnieszka; Latek, Dorota; Filipek, Slawomir

2018-05-21

Due to the involvement of G protein-coupled receptors (GPCRs) in most of the physiological and pathological processes in humans they have been attracting a lot of attention from pharmaceutical industry as well as from scientific community. Therefore, the need for new, high quality structures of GPCRs is enormous. The updated homology modeling service GPCRM (http://gpcrm.biomodellab.eu/) meets those expectations by greatly reducing the execution time of submissions (from days to hours/minutes) with nearly the same average quality of obtained models. Additionally, due to three different scoring functions (Rosetta, Rosetta-MP, BCL::Score) it is possible to select accurate models for the required purposes: the structure of the binding site, the transmembrane domain or the overall shape of the receptor. Currently, no other web service for GPCR modeling provides this possibility. GPCRM is continually upgraded in a semi-automatic way and the number of template structures has increased from 20 in 2013 to over 90 including structures the same receptor with different ligands which can influence the structure not only in the on/off manner. Two types of protein viewers can be used for visual inspection of obtained models. The extended sortable tables with available templates provide links to external databases and display ligand-receptor interactions in visual form.

Selected hydrologic data from the Cedar Rapids area, Linn County, Iowa, April 1996 through March 1999

USGS Publications Warehouse

Boyd, R.A.; Kuzniar, R.L.; Schulmeyer, P.M.

1999-01-01

The City of Cedar Rapids, Iowa obtains its municipal water supply from four well fields along the Cedar River. The wells are completed at depths of about 60 to 80 feet in a shallow alluvial aquifer adjacent to the Cedar River. The City of Cedar Rapids and the U.S. Geological Survey have conducted a cooperative study of the groundwater flow system and water quality near the well fields since 1992. The purpose of this report is to document selected hydrologic data collected from April 1996 through March 1999. Data include the results of water-quality analyses, ground-waterlevels continuously measured with pressure transducers and data recorders, and physical properties continuously monitored using multiprobe instruments. Water-quality samples were collected from selected wells and the Cedar River to conduct periodic monitoring, to evaluate ground-water geochemistry, to assess the occurrence of pesticides and herbicide degradates in the alluvial aquifer, and to characterize water quality in shallow ground water near a wetland area in the Seminole Well Field. Types of water-quality analyses included common ions (calcium, chloride, iron, magnesium, manganese, potassium, silica, sodium, and sulfate), trace elements (boron, bromide, and fluoride), nutrients (ammonia as nitrogen, nitrite as nitrogen, nitrite plus nitrate as nitrogen, and orthophosphate as phosphorus), dissolved organic carbon, and selected pesticides and herbicide degradates. Ground-water levels in selected observation wells were continuously measured to assess temporal trends in groundwater levels in the alluvial aquifer and bedrock aquifer, to help calibrate a ground-water flow model being constructed to simulate local groundwater flow under transient conditions near the well fields, and to assess hydrologic conditions near a wetland area in the Seminole Well Field. Physical properties (specific conductance, pH, dissolved oxygen, and water temperature) were continuously monitored to assess temporal variation and to help evaluate the interaction between the Cedar River and ground water in the alluvial aquifer.

The NCC project: A quality management perspective

NASA Technical Reports Server (NTRS)

Lee, Raymond H.

1993-01-01

The Network Control Center (NCC) Project introduced the concept of total quality management (TQM) in mid-1990. The CSC project team established a program which focused on continuous process improvement in software development methodology and consistent deliveries of high quality software products for the NCC. The vision of the TQM program was to produce error free software. Specific goals were established to allow continuing assessment of the progress toward meeting the overall quality objectives. The total quality environment, now a part of the NCC Project culture, has become the foundation for continuous process improvement and has resulted in the consistent delivery of quality software products over the last three years.

False alarm reduction in BSN-based cardiac monitoring using signal quality and activity type information.

PubMed

Tanantong, Tanatorn; Nantajeewarawat, Ekawit; Thiemjarus, Surapa

2015-02-09

False alarms in cardiac monitoring affect the quality of medical care, impacting on both patients and healthcare providers. In continuous cardiac monitoring using wireless Body Sensor Networks (BSNs), the quality of ECG signals can be deteriorated owing to several factors, e.g., noises, low battery power, and network transmission problems, often resulting in high false alarm rates. In addition, body movements occurring from activities of daily living (ADLs) can also create false alarms. This paper presents a two-phase framework for false arrhythmia alarm reduction in continuous cardiac monitoring, using signals from an ECG sensor and a 3D accelerometer. In the first phase, classification models constructed using machine learning algorithms are used for labeling input signals. ECG signals are labeled with heartbeat types and signal quality levels, while 3D acceleration signals are labeled with ADL types. In the second phase, a rule-based expert system is used for combining classification results in order to determine whether arrhythmia alarms should be accepted or suppressed. The proposed framework was validated on datasets acquired using BSNs and the MIT-BIH arrhythmia database. For the BSN dataset, acceleration and ECG signals were collected from 10 young and 10 elderly subjects while they were performing ADLs. The framework reduced the false alarm rate from 9.58% to 1.43% in our experimental study, showing that it can potentially assist physicians in diagnosing a vast amount of data acquired from wireless sensors and enhance the performance of continuous cardiac monitoring.

Associated and mediating variables related to quality of life among service users with mental disorders.

PubMed

Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

2018-02-01

This study aimed to identify variables associated with quality of life (QoL) and mediating variables among 338 service users with mental disorders in Quebec (Canada). Data were collected using nine standardized questionnaires and participant medical records. Quality of life was assessed with the Satisfaction with Life Domains Scale. Independent variables were organized into a six-block conceptual framework. Using structural equation modeling, associated and mediating variables related to QoL were identified. Lower seriousness of needs was the strongest variable associated with QoL, followed by recovery, greater service continuity, gender (male), adequacy of help received, not living alone, absence of substance use or mood disorders, and higher functional status, in that order. Recovery was the single mediating variable linking lower seriousness of needs, higher service continuity, and reduced alcohol use with QoL. Findings suggest that greater service continuity creates favorable conditions for recovery, reducing seriousness of needs and increasing QoL among service users. Lack of recovery-oriented services may affect QoL among alcohol users, as substance use disorders were associated directly and negatively with QoL. Decision makers and mental health professionals should promote service continuity, and closer collaboration between primary care and specialized services, while supporting recovery-oriented services that encourage service user involvement in their treatment and follow-up. Community-based organizations should aim to reduce the seriousness of needs particularly for female service users and those living alone.

How Implementation of TQM and the Development of a Process Improvement Model, Within a Forward Support Battalion, Can Improve Preparation of the Material Condition Status Report (DA Form 2406)

DTIC Science & Technology

1990-12-01

studies for the continuing education of managers new to the TQM approach , for informing vendors of their responsibilities under a changed process, and...Department of Defense (DoD) is adopting a management approach known as Total Quality Management (TQM) in an effort to improve quality and productivity...individuals selected be highly knowledgeable about the operations in their shop or unit. The main function of PATs is to collect and summarize process data for

Fused Deposition Technique for Continuous Fiber Reinforced Thermoplastic

NASA Astrophysics Data System (ADS)

Bettini, Paolo; Alitta, Gianluca; Sala, Giuseppe; Di Landro, Luca

2017-02-01

A simple technique for the production of continuous fiber reinforced thermoplastic by fused deposition modeling, which involves a common 3D printer with quite limited modifications, is presented. An adequate setting of processing parameters and deposition path allows to obtain components with well-enhanced mechanical characteristics compared to conventional 3D printed items. The most relevant problems related to the simultaneous feeding of fibers and polymer are discussed. The properties of obtained aramid fiber reinforced polylactic acid (PLA) in terms of impregnation quality and of mechanical response are measured.

Quality assurance programs for pressure ulcers.

PubMed

Xakellis, G C

1997-08-01

Traditional medical quality assurance programs are beginning to incorporate the principles of continuous quality improvement pioneered by Juran and Deming. Strategies for incorporating these principles into a long-term care facility are described, and two examples of successful implementation of continuous quality improvement programs for pressure ulcers are presented.

40 CFR 81.242 - Pecos-Permian Basin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Pecos-Permian Basin Intrastate Air Quality Control Region (New Mexico) consists of the territorial area... Quality Control Region. 81.242 Section 81.242 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of...

40 CFR 81.242 - Pecos-Permian Basin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Pecos-Permian Basin Intrastate Air Quality Control Region (New Mexico) consists of the territorial area... Quality Control Region. 81.242 Section 81.242 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of...

Quality Assurance in Continuing Professional Education. An Analysis.

ERIC Educational Resources Information Center

Tovey, Philip

Based on research conducted in and around universities in the United Kingdom, this book analyzes quality assurance in continuing professional education (CPE). An introduction provides a close look at the terms "quality,""quality assurance," and "CPE." Part I deals with context. Chapter 1 looks at theoretical…

The NASA Space Radiobiology Risk Assessment Project

NASA Astrophysics Data System (ADS)

Cucinotta, Francis A.; Huff, Janice; Ponomarev, Artem; Patel, Zarana; Kim, Myung-Hee

The current first phase (2006-2011) has the three major goals of: 1) optimizing the conventional cancer risk models currently used based on the double-detriment life-table and radiation quality functions; 2) the integration of biophysical models of acute radiation syndromes; and 3) the development of new systems radiation biology models of cancer processes. The first-phase also includes continued uncertainty assessment of space radiation environmental models and transport codes, and relative biological effectiveness factors (RBE) based on flight data and NSRL results, respectively. The second phase of the (2012-2016) will: 1) develop biophysical models of central nervous system risks (CNS); 2) achieve comphrensive systems biology models of cancer processes using data from proton and heavy ion studies performed at NSRL; and 3) begin to identify computational models of biological countermeasures. Goals for the third phase (2017-2021) include: 1) the development of a systems biology model of cancer risks for operational use at NASA; 2) development of models of degenerative risks, 2) quantitative models of counter-measure impacts on cancer risks; and 3) indiviudal based risk assessments. Finally, we will support a decision point to continue NSRL research in support of NASA's exploration goals beyond 2021, and create an archival of NSRL research results for continued analysis. Details on near term goals, plans for a WEB based data resource of NSRL results, and a space radiation Wikepedia are described.

Evidence-based characteristics of nurse-managed health centers for quality and outcomes.

PubMed

Holt, Jeana; Zabler, Bev; Baisch, Mary Jo

2014-01-01

There are approximately 250 nurse-managed health centers (NMHC) in the United States, but there are few consistent descriptions of their functions and even fewer reports of their outcomes. Because NMHCs have been identified as a unique and effectual health care delivery care model (Patient Protection and Affordable Care Act), a description of their characteristics and a framework for outcome evaluation are required for their continued evolution and expansion. This study identifies the principal characteristics of U.S. NMHCs described in the professional literature through an integrative review and classifies these characteristics through a multistage qualitative analysis in relation to Donabedian's structure-process-outcomes model, a well-established model for evaluating quality in health care. This study yielded an evidence-based definition of NMHCs that is more reflective of current NMHC practice across settings and recognizes the full scope of nursing practice that is considered one solution to the health care crisis in the country. Using the results from this study, NMHCs will be able to structure self-evaluations of quality care and compare their quality related to structure, processes, and outcomes with other primary health care delivery systems. Copyright © 2014 Elsevier Inc. All rights reserved.

Cost Models for MMC Manufacturing Processes

NASA Technical Reports Server (NTRS)

Elzey, Dana M.; Wadley, Haydn N. G.

1996-01-01

The quality cost modeling (QCM) tool is intended to be a relatively simple-to-use device for obtaining a first-order assessment of the quality-cost relationship for a given process-material combination. The QCM curve is a plot of cost versus quality (an index indicating microstructural quality), which is unique for a given process-material combination. The QCM curve indicates the tradeoff between cost and performance, thus enabling one to evaluate affordability. Additionally, the effect of changes in process design, raw materials, and process conditions on the cost-quality relationship can be evaluated. Such results might indicate the most efficient means to obtain improved quality at reduced cost by process design refinements, the implementation of sensors and models for closed loop process control, or improvement in the properties of raw materials being fed into the process. QCM also allows alternative processes for producing the same or similar material to be compared in terms of their potential for producing competitively priced, high quality material. Aside from demonstrating the usefulness of the QCM concept, this is one of the main foci of the present research program, namely to compare processes for making continuous fiber reinforced, metal matrix composites (MMC's). Two processes, low pressure plasma spray deposition and tape casting are considered for QCM development. This document consists of a detailed look at the design of the QCM approach, followed by discussion of the application of QCM to each of the selected MMC manufacturing processes along with results, comparison of processes, and finally, a summary of findings and recommendations.

Simulation of effects of wastewater discharges on Sand Creek and lower Caddo Creek near Ardmore, Oklahoma

USGS Publications Warehouse

Wesolowski, Edwin A.

1999-01-01

A streamflow and water-quality model was developed for reaches of Sand and Caddo Creeks in south-central Oklahoma to simulate the effects of wastewater discharge from a refinery and a municipal treatment plant.The purpose of the model was to simulate conditions during low streamflow when the conditions controlling dissolved-oxygen concentrations are most severe. Data collected to calibrate and verify the streamflow and water-quality model include continuously monitored streamflow and water-quality data at two gaging stations and three temporary monitoring stations; wastewater discharge from two wastewater plants; two sets each of five water-quality samples at nine sites during a 24-hour period; dye and propane samples; periphyton samples; and sediment oxygen demand measurements. The water-quality sampling, at a 6-hour frequency, was based on a Lagrangian reference frame in which the same volume of water was sampled at each site. To represent the unsteady streamflows and the dynamic water-quality conditions, a transport modeling system was used that included both a model to route streamflow and a model to transport dissolved conservative constituents with linkage to reaction kinetics similar to the U.S. Environmental Protection Agency QUAL2E model to simulate nonconservative constituents. These model codes are the Diffusion Analogy Streamflow Routing Model (DAFLOW) and the branched Lagrangian transport model (BLTM) and BLTM/QUAL2E that, collectively, as calibrated models, are referred to as the Ardmore Water-Quality Model.The Ardmore DAFLOW model was calibrated with three sets of streamflows that collectively ranged from 16 to 3,456 cubic feet per second. The model uses only one set of calibrated coefficients and exponents to simulate streamflow over this range. The Ardmore BLTM was calibrated for transport by simulating dye concentrations collected during a tracer study when streamflows ranged from 16 to 23 cubic feet per second. Therefore, the model is expected to be most useful for low streamflow simulations. The Ardmore BLTM/QUAL2E model was calibrated and verified with water-quality data from nine sites where two sets of five samples were collected. The streamflow during the water-quality sampling in Caddo Creek at site 7 ranged from 8.4 to 20 cubic feet per second, of which about 5.0 to 9.7 cubic feet per second was contributed by Sand Creek. The model simulates the fate and transport of 10 water-quality constituents. The model was verified by running it using data that were not used in calibration; only phytoplankton were not verified.Measured and simulated concentrations of dissolved oxygen exhibited a marked daily pattern that was attributable to waste loading and algal activity. Dissolved-oxygen measurements during this study and simulated dissolved-oxygen concentrations using the Ardmore Water-Quality Model, for the conditions of this study, illustrate that the dissolved-oxygen sag curve caused by the upstream wastewater discharges is confined to Sand Creek.

Self-assessment procedure using fuzzy sets

NASA Astrophysics Data System (ADS)

Mimi, Fotini

2000-10-01

Self-Assessment processes, initiated by a company itself and carried out by its own people, are considered to be the starting point for a regular strategic or operative planning process to ensure a continuous quality improvement. Their importance has increased by the growing relevance and acceptance of international quality awards such as the Malcolm Baldrige National Quality Award, the European Quality Award and the Deming Prize. Especially award winners use the instrument of a systematic and regular Self-Assessment and not only because they have to verify their quality and business results for at least three years. The Total Quality Model of the European Foundation for Quality Management (EFQM), used for the European Quality Award, is the basis for Self-Assessment in Europe. This paper presents a self-assessment supporting method based on a methodology of fuzzy control systems providing an effective means of converting the linguistic approximation into an automatic control strategy. In particular, the elements of the Quality Model mentioned above are interpreted as linguistic variables. The LR-type of a fuzzy interval is used for their representation. The input data has a qualitative character based on empirical investigation and expert knowledge and therefore the base- variables are ordinal scaled. The aggregation process takes place on the basis of a hierarchical structure. Finally, in order to render the use of the method more practical a software system on PC basis is developed and implemented.

Comparing microbial water quality in an intermittent and continuous piped water supply.

PubMed

Kumpel, Emily; Nelson, Kara L

2013-09-15

Supplying piped water intermittently is a common practice throughout the world that increases the risk of microbial contamination through multiple mechanisms. Converting an intermittent supply to a continuous supply has the potential to improve the quality of water delivered to consumers. To understand the effects of this upgrade on water quality, we tested samples from reservoirs, consumer taps, and drinking water provided by households (e.g. from storage containers) from an intermittent and continuous supply in Hubli-Dharwad, India, over one year. Water samples were tested for total coliform, Escherichia coli, turbidity, free chlorine, and combined chlorine. While water quality was similar at service reservoirs supplying the continuous and intermittent sections of the network, indicator bacteria were detected more frequently and at higher concentrations in samples from taps supplied intermittently compared to those supplied continuously (p < 0.01). Detection of E. coli was rare in continuous supply, with 0.7% of tap samples positive compared to 31.7% of intermittent water supply tap samples positive for E. coli. In samples from both continuously and intermittently supplied taps, higher concentrations of total coliform were measured after rainfall events. While source water quality declined slightly during the rainy season, only tap water from intermittent supply had significantly more indicator bacteria throughout the rainy season compared to the dry season. Drinking water samples provided by households in both continuous and intermittent supplies had higher concentrations of indicator bacteria than samples collected directly from taps. Most households with continuous supply continued to store water for drinking, resulting in re-contamination, which may reduce the benefits to water quality of converting to continuous supply. Copyright © 2013 Elsevier Ltd. All rights reserved.

Developing Staffing Models to Support Population Health Management And Quality Oucomes in Ambulatory Care Settings.

PubMed

Haas, Sheila A; Vlasses, Frances; Havey, Julia

2016-01-01

There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory, and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.

Modified SPC for short run test and measurement process in multi-stations

NASA Astrophysics Data System (ADS)

Koh, C. K.; Chin, J. F.; Kamaruddin, S.

2018-03-01

Due to short production runs and measurement error inherent in electronic test and measurement (T&M) processes, continuous quality monitoring through real-time statistical process control (SPC) is challenging. Industry practice allows the installation of guard band using measurement uncertainty to reduce the width of acceptance limit, as an indirect way to compensate the measurement errors. This paper presents a new SPC model combining modified guard band and control charts (\\bar{\\text{Z}} chart and W chart) for short runs in T&M process in multi-stations. The proposed model standardizes the observed value with measurement target (T) and rationed measurement uncertainty (U). S-factor (S f) is introduced to the control limits to improve the sensitivity in detecting small shifts. The model was embedded in automated quality control system and verified with a case study in real industry.

The Big Sky Model: A Regional Collaboration for Participatory Research on Environmental Health in the Rural West

PubMed Central

Ward, Tony J.; Vanek, Diana; Marra, Nancy; Holian, Andrij; Adams, Earle; Jones, David; Knuth, Randy

2010-01-01

The case for inquiry-based, hands-on, meaningful science education continues to gain credence as an effective and appropriate pedagogical approach (Karukstis 2005; NSF 2000). An innovative community-based framework for science learning, hereinafter referred to as the Big Sky Model, successfully addresses these educational aims, guiding high school and tribal college students from rural areas of Montana and Idaho in their understanding of chemical, physical, and environmental health concepts. Students participate in classroom lessons and continue with systematic inquiry through actual field research to investigate a pressing, real-world issue: understanding the complex links between poor air quality and respiratory health outcomes. This article provides background information, outlines the procedure for implementing the model, and discusses its effectiveness as demonstrated through various evaluation tools. PMID:20428505

Inventory of environmental impact models related to energy technologies

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

Owen, P.T.; Dailey, N.S.; Johnson, C.A.

The purpose of this inventory is to identify and collect data on computer simulations and computational models related to the environmental effects of energy source development, energy conversion, or energy utilization. Information for 33 data fields was sought for each model reported. All of the information which could be obtained within the time alloted for completion of the project is presented for each model listed. Efforts will be continued toward acquiring the needed information. Readers who are interested in these particular models are invited to contact ESIC for assistance in locating them. In addition to the standard bibliographic information, othermore » data fields of interest to modelers, such as computer hardware and software requirements, algorithms, applications, and existing model validation information, are included. Indexes are provided for contact person, acronym, keyword, and title. The models are grouped into the following categories: atmospheric transport, air quality, aquatic transport, terrestrial food chains, soil transport, aquatic food chains, water quality, dosimetry, and human effects, animal effects, plant effects, and generalized environmental transport. Within these categories, the models are arranged alphabetically by last name of the contact person.« less

RTD-based Material Tracking in a Fully-Continuous Dry Granulation Tableting Line.

PubMed

Martinetz, M C; Karttunen, A-P; Sacher, S; Wahl, P; Ketolainen, J; Khinast, J G; Korhonen, O

2018-06-06

Continuous manufacturing (CM) offers quality and cost-effectiveness benefits over currently dominating batch processing. One challenge that needs to be addressed when implementing CM is traceability of materials through the process, which is needed for the batch/lot definition and control strategy. In this work the residence time distributions (RTD) of single unit operations (blender, roller compactor and tablet press) of a continuous dry granulation tableting line were captured with NIR based methods at selected mass flow rates to create training data. RTD models for continuous operated unit operations and the entire line were developed based on transfer functions. For semi-continuously operated bucket conveyor and pneumatic transport an assumption based the operation frequency was used. For validation of the parametrized process model, a pre-defined API step change and its propagation through the manufacturing line was computed and compared to multi-scale experimental runs conducted with the fully assembled continuous operated manufacturing line. This novel approach showed a very good prediction power at the selected mass flow rates for a complete continuous dry granulation line. Furthermore, it shows and proves the capabilities of process simulation as a tool to support development and control of pharmaceutical manufacturing processes. Copyright © 2018. Published by Elsevier B.V.

Water-quality variability and constituent transport and processes in streams of Johnson County, Kansas, using continuous monitoring and regression models, 2003-11

USGS Publications Warehouse

Rasmussen, Teresa; Gatotho, Jackline

2014-01-01

The population of Johnson County, Kansas increased by about 24 percent between 2000 and 2012, making it one of the most rapidly developing areas of Kansas. The U.S. Geological Survey, in cooperation with the Johnson County Stormwater Management Program, began a comprehensive study of Johnson County streams in 2002 to evaluate and monitor changes in stream quality. The purpose of this report is to describe water-quality variability and constituent transport for streams representing the five largest watersheds in Johnson County, Kansas during 2003 through 2011. The watersheds ranged in urban development from 98.3 percent urban (Indian Creek) to 16.7 percent urban (Kill Creek). Water-quality conditions are quantified among the watersheds of similar size (50.1 square miles to 65.7 square miles) using continuous, in-stream measurements, and using regression models developed from continuous and discrete data. These data are used to quantify variability in concentrations and loads during changing streamflow and seasonal conditions, describe differences among sites, and assess water quality relative to water-quality standards and stream management goals. Water quality varied relative to streamflow conditions, urbanization in the upstream watershed, and contributions from wastewater treatment facilities and storm runoff. Generally, as percent impervious surface (a measure of urbanization) increased, streamflow yield increased. Water temperature of Indian Creek, the most urban site which is also downstream from wastewater facility discharges, was higher than the other sites about 50 percent of the time, particularly during winter months. Dissolved oxygen concentrations were less than the Kansas Department of Health and Environment minimum criterion of 5 milligrams per liter about 15 percent of the time at the Indian Creek site. Dissolved oxygen concentrations were less than the criterion about 10 percent of the time at the rural Blue River and Kill Creek sites, and less than 5 percent of the time at the other sites. Low dissolved oxygen at all sites generally coincided with lowest streamflow and warmer water temperatures. Hourly dissolved oxygen concentrations less than 5 milligrams per liter were measured at all sites every year, indicating that even under normal climate conditions in non-urban watersheds such as Kill Creek, dissolved oxygen concentrations may not meet State aquatic-life criterion. Specific conductance was nearly always highest in Indian and Mill Creeks, which were the most urban streams with the largest upstream discharges from wastewater treatment facilities. The largest chloride concentrations and variability were recorded at urban sites and during winter. Each winter during the study period, chloride concentrations in the most urban site, Indian Creek, exceeded the U.S. Environmental Protection Agency-recommended criterion of 230 milligrams per liter for at least 10 consecutive days. The U.S. Environmental Protection Agency-recommended ecoregion criterion for turbidity was exceeded 30 (Indian Creek) to 50 (Blue River) percent of the time. The highest average annual streamflow-weighted suspendedsediment concentration during the study period was in Mill Creek, which has undergone rapid development that likely contributed to higher sediment concentrations. One of the largest suspended-sediment load events in Indian Creek was recorded in early May 2007 when about 25 percent of the total annual sediment load was transported during a period of about 2.25 days. A simultaneous load event was recorded in Kill Creek, when about 75 percent of the total annual sediment load was transported. Sediment yields generally increased as percent impervious surface increased. Computed hourly total nitrogen and total phosphorus concentrations and yields and streamflow-weighted concentrations generally were largest in Indian and Mill Creeks. Annual percent contribution of total nitrogen in the Blue River from wastewater treatment facility discharges ranged from 19 percent in 2010 to 60 percent in 2006. Annual percent contribution of total nitrogen in Indian Creek from wastewater treatment facility discharges ranged from 35 percent in 2010 to 93 percent in 2006. The largest percent nutrient contributions from wastewater discharges coincided with the smallest annual precipitation and streamflow volume, resulting in less contribution originating from runoff. Fecal indicator bacteria Escherichia coli density at the urban Indian Creek site was usually the largest of the five monitoring sites, with an annual median density that consistently exceeded the State primary contact criterion value but was less than the secondary contact criterion. Less than 1 percent of the total annual bacteria load in the Blue River and Indian Creek originated from wastewater discharges, except during 2006 when about 6 percent of the Indian Creek load originated from wastewater. Continuous water-quality monitoring provides a foundation for comprehensive evaluation and understanding of variability and loading characteristics in streams in Johnson County. Because several directly measured parameters are strongly correlated with particular constituents of interest, regression models provide a valuable tool for evaluating variability and loading on the basis of computed continuous data. Continuous data are particularly useful for characterizing nonpoint-source contributions from stormwater runoff. Transmission of continuous data in real-time makes it possible to rapidly detect and respond to potential environmental concerns. As monitoring technologies continue to improve, so does the ability to monitor additional constituents of interest, with smaller measurement error, and at lower operational cost. Continuous water-quality data including model information and computed concentrations and loads during the study period are available at http://nrtwq.usgs.gov/ks/.

Integrating microbial physiology and enzyme traits in the quality model

NASA Astrophysics Data System (ADS)

Sainte-Marie, Julien; Barrandon, Matthieu; Martin, Francis; Saint-André, Laurent; Derrien, Delphine

2017-04-01

Microbe activity plays an undisputable role in soil carbon storage and there have been many calls to integrate microbial ecology in soil carbon (C) models. With regard to this challenge, a few trait-based microbial models of C dynamics have emerged during the past decade. They parameterize specific traits related to decomposer physiology (substrate use efficiency, growth and mortality rates...) and enzyme properties (enzyme production rate, catalytic properties of enzymes…). But these models are built on the premise that organic matter (OM) can be represented as one single entity or are divided into a few pools, while organic matter exists as a continuum of many different compounds spanning from intact plant molecules to highly oxidised microbial metabolites. In addition, a given molecule may also exist in different forms, depending on its stage of polymerization or on its interactions with other organic compounds or mineral phases of the soil. Here we develop a general theoretical model relating the evolution of soil organic matter, as a continuum of progressively decomposing compounds, with decomposer activity and enzyme traits. The model is based on the notion of quality developed by Agren and Bosatta (1998), which is a measure of molecule accessibility to degradation. The model integrates three major processes: OM depolymerisation by enzyme action, OM assimilation and OM biotransformation. For any enzyme, the model reports the quality range where this enzyme selectively operates and how the initial quality distribution of the OM subset evolves into another distribution of qualities under the enzyme action. The model also defines the quality range where the OM can be uptaken and assimilated by microbes. It finally describes how the quality of the assimilated molecules is transformed into another quality distribution, corresponding to the decomposer metabolites signature. Upon decomposer death, these metabolites return to the substrate. We explore here the how microbial physiology and enzyme traits can be incorporated in a model based on a continuous representation of the organic matter and evaluate how it can improve our ability to predict soil C cycling. To do so, we analyse the properties of the model by implementing different scenarii and test the sensitivity of its parameters. Agren, G. I., & Bosatta, E. (1998). Theoretical ecosystem ecology: understanding element cycles. Cambridge University Press.

42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Qualified Health Maintenance Organizations: Services § 417.106 Quality assurance program; Availability, accessibility, and continuity of basic and supplemental health services. (a) Quality assurance program. Each HMO or CMP must have an ongoing quality assurance program for its health services that meets the...

40 CFR 81.241 - Southwestern Mountains-Augustine Plains Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Quality Control Region (New Mexico) consists of the territorial area encompassed by the boundaries of the... Plains Intrastate Air Quality Control Region. 81.241 Section 81.241 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY...

40 CFR 81.239 - Upper Rio Grande Valley Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... The Upper Rio Grande Valley Intrastate Air Quality Control Region (New Mexico) consists of the... Quality Control Region. 81.239 Section 81.239 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of...

40 CFR 81.82 - El Paso-Las Cruces-Alamogordo Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Control Region. The El Paso-Las Cruces-Alamogordo Interstate Air Quality Control Region (New Mexico-Texas... Interstate Air Quality Control Region. 81.82 Section 81.82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES...

40 CFR 81.241 - Southwestern Mountains-Augustine Plains Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Quality Control Region (New Mexico) consists of the territorial area encompassed by the boundaries of the... Plains Intrastate Air Quality Control Region. 81.241 Section 81.241 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY...

40 CFR 81.239 - Upper Rio Grande Valley Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... The Upper Rio Grande Valley Intrastate Air Quality Control Region (New Mexico) consists of the... Quality Control Region. 81.239 Section 81.239 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES Designation of...

40 CFR 81.83 - Albuquerque-Mid Rio Grande Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Region. The Albuquerque-Mid Rio Grande Intrastate Air Quality Control Region (New Mexico) is revised to... Air Quality Control Region. 81.83 Section 81.83 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES...

40 CFR 81.83 - Albuquerque-Mid Rio Grande Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Region. The Albuquerque-Mid Rio Grande Intrastate Air Quality Control Region (New Mexico) is revised to... Air Quality Control Region. 81.83 Section 81.83 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES...

40 CFR 81.82 - El Paso-Las Cruces-Alamogordo Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Control Region. The El Paso-Las Cruces-Alamogordo Interstate Air Quality Control Region (New Mexico-Texas... Interstate Air Quality Control Region. 81.82 Section 81.82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) DESIGNATION OF AREAS FOR AIR QUALITY PLANNING PURPOSES...

Ninth Annual NASA/Contractors Conference on Quality and Productivity. World Class Excellence: The Journey Continues. Keynote presentations

NASA Technical Reports Server (NTRS)

Templeton, Geoffrey B. (Editor)

1992-01-01

This coference provided an excellent forum for the members of the NASA community to share their experience and expertise in an effort to continuously improve the quality of the US space program. The topics covered include the following: NASA's approach to continual improvement; commitment to total quality; total quality at AlliedSignal Aerospace; organizational TQM; recognition of the 1992 Low Trophy Finalists; announcement of the 1992 Low Trophy Recipients; and the changing face of aerospace contracting.