Child characteristics, caregiver characteristics, and environmental factors affecting the quality of life of caregivers of children with cerebral palsy.

PubMed

Tseng, Mei-Hui; Chen, Kuan-Lin; Shieh, Jeng-Yi; Lu, Lu; Huang, Chien-Yu; Simeonsson, Rune J

2016-12-01

The study aimed to investigate comprehensively the determinants of the quality of life (QOL) of caregivers of children with cerebral palsy (CP) based on the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). A total of 167 children with CP (mean age 9.06 years, SD 2.61 years) and their caregivers (mean age 40.24 years, SD 5.43 years) participated in this study. The QOL of caregivers was measured with the World Health Organization Quality of Life-BREF-Taiwan version (WHOQOL-BREF-TW). The potential determinants of QOL were collected, including child characteristics, caregiver characteristics, and environmental factors from all dimensions of the ICF-CY and analysed using multiple regression models. Four multiple regression models revealed that determinants of the QOL of caregivers of children with CP was multidimensional, encompassing child characteristics (age, type of CP, fine motor impairment, other diseases, behaviour and emotions, visual impairment, hearing impairment), caregiver characteristics (general mental health, parenting stress, marital status, family coping patterns, and socio-economic status), and environmental factors (child's medication, school setting, and current rehabilitation service, caregiver's spouse's age, family life impacts, and domestic helper). Knowledge of the determinants of QOL could serve as a guide in a holistic approach to evaluation and intervention and help plan interventions targeted at these determinants to improve the QOL of caregivers of children with CP. Implications for Rehabilitation Caregivers of children with CP had lower QOL, except the environment QOL. The QOL determinants of caregivers of children with CP are multidimensional, including child characteristics, caregiver characteristics, and environmental factors. In addition to child characteristics of severity of fine motor impairments and emotional and behavioural problems, caregiver characteristics of general mental health, parenting stress, and coping patterns, and environmental factors of family life impacts, and school setting demonstrated important relationships with caregiver QOL.

LANDING QUALITY IN ARTISTIC GYMNASTICS IS RELATED TO LANDING SYMMETRY

PubMed Central

Marinšek, M.

2013-01-01

In gymnastics every exercise finishes with a landing. The quality of landing depends on subjective (e.g. biomechanical) and objective (e.g. mechanical characteristics of landing area) factors. The aim of our research was to determine which biomechanical (temporal, kinematic and dynamic) characteristics of landing best predict the quality of landing. Twelve male gymnasts performed a stretched forward and backward salto; also with 1/2, 1/1 and 3/2 turns. Stepwise multiple regression extracted five predictors which explained 51.5% of landing quality variance. All predictors were defining asymmetries between legs (velocities, angles). To avoid asymmetric landings, gymnasts need to develop enough height; they need higher angular momentum around the transverse and longitudinal axis and they need to better control angular velocity in the longitudinal axis. PMID:24744462

Financial burden is associated with worse health-related quality of life in adults with multiple endocrine neoplasia type 1.

PubMed

Peipert, Benjamin J; Goswami, Sneha; Helenowski, Irene; Yount, Susan E; Sturgeon, Cord

2017-12-01

Health-related quality of life and financial burden among patients with multiple endocrine neoplasia type 1 is poorly described. It is not known how financial burden influences health-related quality of life in this population. We hypothesized that the financial burden attributable to multiple endocrine neoplasia type 1 is associated with worse health-related quality of life. United States adults (≥18 years) with multiple endocrine neoplasia type 1 were recruited from the AMENSupport MEN online support group. Patient demographics, clinical characteristics, and financial burden were assessed via an online survey. The instrument Patient-Reported Outcomes Measurement Information System 29-item profile measure was used to assess health-related quality of life. Multivariable linear regression was used to identify significant variables in each Patient-Reported Outcomes Measurement Information System domain. Out of 1,378 members in AMENSupport, our survey link was accessed 449 times (33%). Of 153 US respondents who completed our survey, 84% reported financial burden attributable to multiple endocrine neoplasia type 1. The degree of financial burden had a linear relationship with worse health-related quality of life across all Patient-Reported Outcomes Measurement Information System domains (r = 0.36-0.55, P < .001); 63% reported experiencing ≥1 negative financial event(s). Borrowing money from friends/family (30%), unemployment (13%), and spending >$100/month out-of-pocket on prescription medications (46%) were associated consistently with impaired health-related quality of life (ß = 3.75-6.77, P < .05). Respondents were 3- and 34-times more likely to be unemployed and declare bankruptcy than the US population, respectively. This study characterizes the financial burden in patients with multiple endocrine neoplasia type 1. Individuals with multiple endocrine neoplasia type 1 report a high degree of financial burden, negative financial events, and unemployment. Each of these factors was associated with worse health-related quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

Epidemiology, quality, and reporting characteristics of systematic reviews and meta-analyses of nursing interventions published in Chinese journals.

PubMed

Zhang, Juxia; Wang, Jiancheng; Han, Lin; Zhang, Fengwa; Cao, Jianxun; Ma, Yuxia

2015-01-01

Systematic reviews (SRs) and meta-analyses (MAs) of nursing interventions have become increasingly popular in China. This review provides the first examination of epidemiological characteristics of these SRs as well as compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses and Assessment of Multiple Systematic Reviews guidelines. The purpose of this study was to examine epidemiologic and reporting characteristics as well as the methodologic quality of SRs and MAs of nursing interventions published in Chinese journals. Four Chinese databases were searched (the Chinese Biomedicine Literature Database, Chinese Scientific Journal Full-text Database, Chinese Journal Full-text Database, and Wanfang Database) for SRs and MAs of nursing intervention from inception through June 2013. Data were extracted into Excel (Microsoft, Redmond, WA). The Assessment of Multiple Systematic Reviews and Preferred Reporting Items for Systematic Reviews and Meta-analyses checklists were used to assess methodologic quality and reporting characteristics, respectively. A total of 144 SRs were identified, most (97.2%) of which used "systematic review" or "meta-analyses" in the titles. None of the reviews had been updated. Nearly half (41%) were written by nurses, and more than half (61%) were reported in specialist journals. The most common conditions studied were endocrine, nutritional and metabolic diseases, and neoplasms. Most (70.8%) reported information about quality assessment, whereas less than half (25%) reported assessing for publication bias. None of the reviews reported a conflict of interest. Although many SRs of nursing interventions have been published in Chinese journals, the quality of these reviews is of concern. As a potential key source of information for nurses and nursing administrators, not only were many of these reviews incomplete in the information they provided, but also some results were misleading. Improving the quality of SRs of nursing interventions conducted and published by nurses in China is urgently needed in order to increase the value of these studies. Copyright © 2015 Elsevier Inc. All rights reserved.

Rural-urban analyses of health-related quality of life among people with multiple sclerosis.

PubMed

Buchanan, Robert J; Zhu, Li; Schiffer, Randolph; Radin, Dagmar; James, Wesley

2008-01-01

Health-related quality of life (HRQOL) is a multi-dimensional construct including aspects of life quality or function that are affected by physical health and symptoms, psychosocial factors, and psychiatric conditions. HRQOL gives a broader measure of the burden of disease than physical impairment or disability levels. To identify factors associated with HRQOL among people with multiple sclerosis (MS) utilizing the SF-8 Health Survey. Data presented in this study were collected in a survey of 1,518 people with MS living in all 50 states. The survey sample was randomly selected from the database of the National Multiple Sclerosis Society, using ZIP codes to recruit the survey sample. A multiple linear regression model was employed to analyze the survey data, with the Physical Component Summary and the Mental Component Summary of the SF-8 the dependent variables. Independent variables were demographic characteristics, MS-disease characteristics, and health services utilized. People with MS in rural areas tended to report lower physically related HRQOL. Worsening MS symptoms were associated with reduced physical and mental dimensions of HRQOL. In addition, people with MS who received a diagnosis of depression tended to have reduced physical and mental dimensions of HRQOL. Receiving MS care at an MS clinic was associated with better physically related HRQOL, while having a neurologist as principal care physician was associated with better mental-related HRQOL. The challenge is to increase the access that people living with MS in rural areas have to MS-focused specialty care.

Fundamentals in the management of multiple myeloma.

PubMed

Fadilah, S A W

2010-09-01

Progress in our understanding of multiple myeloma and its treatment has resulted in a more tailored approach to patient management, with different therapeutics regimens for different patient populations. The decision to initiate therapy depends primarily on the presence of symptoms which has to balance the chance of tumor clearance and against the risks of treatment related mortality. Selection of appropriate initial treatment should be based primarily on patient's characteristics (biologic age, co-morbidities), the disease characteristics (tumor burden and genetic risk profile) and the expected toxicity profile of the different regimens. When treatment begins, in younger transplant eligible patients the goal is to achieve high quality responses with intensive therapies as the quality of response appears to be important surrogates for long-term outcome. In the majority of myeloma patients in whom intensive treatment is not an option due to advanced age and co-morbidities, treatment should emphasize on optimal disease control to obtain symptomatic relief and to maintain a satisfactory quality of life. The introduction of novel agents has substantially changed the treatment paradigm of this otherwise incurable disease. The utilization of these drugs has moved from relapse setting to the front line setting and has benefited all patient groups. Because of these rapid developments and many treatment options we need good quality clinical studies to guide clinical practice in the management of patients with multiple myeloma. This review presents an update on current concepts of diagnosis and treatment of patients with multiple myeloma and provides recommendations on tailored therapies with particular reference to the local practice. The information presented herein may be used by the health care providers caring for myeloma patients as a guideline to counsel patients to understand their disease and the treatment better.

The quality of drinking water in North Carolina farmworker camps.

PubMed

Bischoff, Werner E; Weir, Maria; Summers, Phillip; Chen, Haiying; Quandt, Sara A; Liebman, Amy K; Arcury, Thomas A

2012-10-01

The purpose of this study was to assess water quality in migrant farmworker camps in North Carolina and determine associations of water quality with migrant farmworker housing characteristics. We collected data from 181 farmworker camps in eastern North Carolina during the 2010 agricultural season. Water samples were tested using the Total Coliform Rule (TCR) and housing characteristics were assessed using North Carolina Department of Labor standards. A total of 61 (34%) of 181 camps failed the TCR. Total coliform bacteria were found in all 61 camps, with Escherichia coli also being detected in 2. Water quality was not associated with farmworker housing characteristics or with access to registered public water supplies. Multiple official violations of water quality standards had been reported for the registered public water supplies. Water supplied to farmworker camps often does not comply with current standards and poses a great risk to the physical health of farmworkers and surrounding communities. Expansion of water monitoring to more camps and changes to the regulations such as testing during occupancy and stronger enforcement are needed to secure water safety.

The Quality of Drinking Water in North Carolina Farmworker Camps

PubMed Central

Weir, Maria; Summers, Phillip; Chen, Haiying; Quandt, Sara A.; Liebman, Amy K.; Arcury, Thomas A.

2012-01-01

Objectives. The purpose of this study was to assess water quality in migrant farmworker camps in North Carolina and determine associations of water quality with migrant farmworker housing characteristics. Methods. We collected data from 181 farmworker camps in eastern North Carolina during the 2010 agricultural season. Water samples were tested using the Total Coliform Rule (TCR) and housing characteristics were assessed using North Carolina Department of Labor standards. Results. A total of 61 (34%) of 181 camps failed the TCR. Total coliform bacteria were found in all 61 camps, with Escherichia coli also being detected in 2. Water quality was not associated with farmworker housing characteristics or with access to registered public water supplies. Multiple official violations of water quality standards had been reported for the registered public water supplies. Conclusions. Water supplied to farmworker camps often does not comply with current standards and poses a great risk to the physical health of farmworkers and surrounding communities. Expansion of water monitoring to more camps and changes to the regulations such as testing during occupancy and stronger enforcement are needed to secure water safety. PMID:22897558

Modeling the relationship between landscape characteristics and water quality in a typical highly intensive agricultural small watershed, Dongting lake basin, south central China.

PubMed

Li, Hongqing; Liu, Liming; Ji, Xiang

2015-03-01

Understanding the relationship between landscape characteristics and water quality is critically important for estimating pollution potential and reducing pollution risk. Therefore, this study examines the relationship between landscape characteristics and water quality at both spatial and temporal scales. The study took place in the Jinjing River watershed in 2010; seven landscape types and four water quality pollutions were chosen as analysis parameters. Three different buffer areas along the river were drawn to analyze the relationship as a function of spatial scale. The results of a Pearson's correlation coefficient analysis suggest that "source" landscape, namely, tea gardens, residential areas, and paddy lands, have positive effects on water quality parameters, while forests exhibit a negative influence on water quality parameters because they represent a "sink" landscape and the sub-watershed level is identified as a suitable scale. Using the principal component analysis, tea gardens, residential areas, paddy lands, and forests were identified as the main landscape index. A stepwise multiple regression analysis was employed to model the relationship between landscape characteristics and water quality for each season. The results demonstrate that both landscape composition and configuration affect water quality. In summer and winter, the landscape metrics explained approximately 80.7 % of the variance in the water quality variables, which was higher than that for spring and fall (60.3 %). This study can help environmental managers to understand the relationships between landscapes and water quality and provide landscape ecological approaches for water quality control and land use management.

Examining the relationship between work-family spillover and sleep quality.

PubMed

Williams, Alysha; Franche, Renée-Louise; Ibrahim, Selahadin; Mustard, Cameron A; Layton, Francine Roussy

2006-01-01

The present study examined the relationship between work-family spillover, job characteristics, and sleep quality in a sample of health care workers (N = 168) recruited from 3 Canadian hospitals. A multiple regression analysis revealed that positive family-to-work spillover is associated with better sleep quality, after controlling for age, physical health, depressive symptomatology, work situation, and number of children. These findings are discussed within a theoretical framework drawing on the concepts of effort and recovery. Copyright 2006 APA.

Community Characteristics and Mortality: The Relative Strength of Association of Different Community Characteristics

PubMed Central

Roberts, Eric; McCleary, Rachael; Buttorff, Christine; Gaskin, Darrell J.

2014-01-01

Objectives. We compared the strength of association between average 5-year county-level mortality rates and area-level measures, including air quality, sociodemographic characteristics, violence, and economic distress. Methods. We obtained mortality data from the National Vital Statistics System and linked it to socioeconomic and demographic data from the Census Bureau, air quality data, violent crime statistics, and loan delinquency data. We modeled 5-year average mortality rates (1998–2002) for all-cause, cancer, heart disease, stroke, and respiratory diseases as a function of county-level characteristics using ordinary least squares regression models. We limited analyses to counties with population of 100 000 or greater (n = 458). Results. Demographic and socioeconomic characteristics, particularly the percentage older than 65 years and near poor, were top predictors of all-cause and condition-specific mortality, as were a high concentration of construction and service workers. We found weaker associations for air quality, mortgage delinquencies, and violent crimes. Protective characteristics included the percentage of Hispanics, Asians, and married residents. Conclusions. Multiple factors influence county-level mortality. Although county demographic and socioeconomic characteristics are important, there are independent, although weaker, associations of other environmental characteristics. Future studies should investigate these factors to better understand community mortality risk. PMID:25033152

An Approach to Economic Dispatch with Multiple Fuels Based on Particle Swarm Optimization

NASA Astrophysics Data System (ADS)

Sriyanyong, Pichet

2011-06-01

Particle Swarm Optimization (PSO), a stochastic optimization technique, shows superiority to other evolutionary computation techniques in terms of less computation time, easy implementation with high quality solution, stable convergence characteristic and independent from initialization. For this reason, this paper proposes the application of PSO to the Economic Dispatch (ED) problem, which occurs in the operational planning of power systems. In this study, ED problem can be categorized according to the different characteristics of its cost function that are ED problem with smooth cost function and ED problem with multiple fuels. Taking the multiple fuels into account will make the problem more realistic. The experimental results show that the proposed PSO algorithm is more efficient than previous approaches under consideration as well as highly promising in real world applications.

EVALUATION OF MULTIPLE AQUATIC BIOMONITORS FOR SOURCE WATER PROTECTION

EPA Science Inventory

A variety of probes for use in continuous monitoring of water quality exist. They range from single parameter chemical/physical probes to comprehensive screening systems based on whole organism responses. Originally developed for monitoring specific characteristics of water qua...

Pain Quality Descriptors in Community-Dwelling Older Adults with Nonmalignant Pain

PubMed Central

Thakral, Manu; Shi, Ling; Foust, Janice B.; Patel, Kushang V.; Shmerling, Robert H.; Bean, Jonathan F.; Leveille, Suzanne G.

2016-01-01

This study aimed to characterize the prevalence of various pain qualities in older adults with chronic non-malignant pain and determine the association of pain quality to other pain characteristics namely: severity, interference distribution, and pain-associated conditions. In the population-based MOBILIZE Boston Study, 560 participants aged≥70 years reported chronic pain in the baseline assessment, which included a home interview and clinic exam. Pain quality was assessed using a modified version of the McGill Pain Questionnaire (MPQ) consisting of 20 descriptors, from which 3 categories were derived: cognitive/affective, sensory and neuropathic. Presence of ≥2 pain-associated conditions was significantly associated with 18 of the 20 pain quality descriptors. Sensory descriptors were endorsed by nearly all older adults with chronic pain (93%), followed by cognitive/affective (83.4%) and neuropathic descriptors (68.6%). Neuropathic descriptors were associated with the greatest number of pain-associated conditions including osteoarthritis of the hand and knee. More than half of participants (59%) endorsed descriptors in all 3 categories and had more severe pain and interference, and multi-site or widespread pain than those endorsing 1 or 2 categories. Strong associations were observed between pain quality and measures of pain severity, interference, and distribution (p<.0001). Findings from this study indicate that older adults have multiple pain-associated conditions which likely reflect multiple physiological mechanisms for pain. Linking pain qualities with other associated pain characteristics serves to develop a multidimensional approach to geriatric pain assessment. Future research is needed to investigate the physiological mechanisms responsible for the variability in pain qualities endorsed by older adults. PMID:27842050

Pain quality descriptors in community-dwelling older adults with nonmalignant pain.

PubMed

Thakral, Manu; Shi, Ling; Foust, Janice B; Patel, Kushang V; Shmerling, Robert H; Bean, Jonathan F; Leveille, Suzanne G

2016-12-01

This study aimed to characterize the prevalence of various pain qualities in older adults with chronic nonmalignant pain and determine the association of pain quality to other pain characteristics namely: severity, interference, distribution, and pain-associated conditions. In the population-based MOBILIZE Boston Study, 560 participants aged ≥70 years reported chronic pain in the baseline assessment, which included a home interview and clinic exam. Pain quality was assessed using a modified version of the McGill Pain Questionnaire (MPQ) consisting of 20 descriptors from which 3 categories were derived: cognitive/affective, sensory, and neuropathic. Presence of ≥2 pain-associated conditions was significantly associated with 18 of the 20 pain quality descriptors. Sensory descriptors were endorsed by nearly all older adults with chronic pain (93%), followed by cognitive/affective (83.4%) and neuropathic descriptors (68.6%). Neuropathic descriptors were associated with the greatest number of pain-associated conditions including osteoarthritis of the hand and knee. More than half of participants (59%) endorsed descriptors in all 3 categories and had more severe pain and interference, and multisite or widespread pain than those endorsing 1 or 2 categories. Strong associations were observed between pain quality and measures of pain severity, interference, and distribution (P < 0.0001). Findings from this study indicate that older adults have multiple pain-associated conditions that likely reflect multiple physiological mechanisms for pain. Linking pain qualities with other associated pain characteristics serve to develop a multidimensional approach to geriatric pain assessment. Future research is needed to investigate the physiological mechanisms responsible for the variability in pain qualities endorsed by older adults.

A cross-sectional cluster analysis of the combined association of physical activity and sleep with sociodemographic and health characteristics in mid-aged and older adults.

PubMed

Rayward, Anna T; Duncan, Mitch J; Brown, Wendy J; Plotnikoff, Ronald C; Burton, Nicola W

2017-08-01

This study aimed to identify how different patterns of physical activity, sleep duration and sleep quality cluster together, and to examine how the identified clusters differ in terms of socio-demographic and health characteristics. Participants were adults from Brisbane, Australia, aged 42-72 years who reported their physical activity, sleep duration, sleep quality, socio-demographic and health characteristics in 2011 (n=5854). Two-step Cluster Analyses were used to identify clusters. Cluster differences in socio-demographic and health characteristics were examined using chi square tests (p<0.05). Four clusters were identified: 'Poor Sleepers' (31.2%), 'Moderate Sleepers' (30.7%), 'Mixed Sleepers/Highly Active' (20.5%), and 'Excellent Sleepers/Mixed Activity' (17.6%). The 'Poor Sleepers' cluster had the highest proportion of participants with less-than-recommended sleep duration and poor sleep quality, had the poorest health characteristics and a high proportion of participants with low physical activity. Physical activity, sleep duration and sleep quality cluster together in distinct patterns and clusters of poor behaviours are associated with poor health status. Multiple health behaviour change interventions which target both physical activity and sleep should be prioritised to improve health outcomes in mid-aged adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Patient characteristics associated with multiple pharmacy use in the U.S. population: Findings from the Medical Expenditure Panel Survey.

PubMed

Look, Kevin A

2015-01-01

Multiple pharmacy use (MPU) is an important safety and quality issue, as it results in fragmented patient care. However, few studies have examined patient characteristics predicting the use of multiple pharmacies, and the findings have been inconsistent. To identify patient characteristics associated with MPU using national data. Data were obtained from the 2011 U.S. Medical Expenditure Panel Survey. The dependent variable was MPU, or the use of more than one pharmacy. The Andersen Behavioral Model of Health Service Use was used to guide the selection of independent variables, which were categorized as predisposing, enabling, and medical need related characteristics. Multivariable logistic regression analysis was conducted to identify the relationships between predisposing, enabling, and need variables and MPU in a hierarchical fashion. Point estimates were weighted to the U.S. non-institutionalized population, and to adjust standard errors to account for the complex survey design. MPU was common, with a national prevalence of 41.3%. Individuals aged 40-64 and adults 65 and older were significantly less likely to use multiple pharmacies as patients aged 18-39 years (40-64 years OR: 0.67, CI: 0.58-0.77; ≥65 years OR: 0.49, CI: 0.41-0.58). Females were significantly more likely to use multiple pharmacies than males (OR: 1.16, CI: 1.05-1.29). Individuals lacking health insurance were more likely to use multiple pharmacies as individuals with private health insurance (OR: 1.42, CI: 1.16-1.73); in contrast, individuals having drug insurance were more likely to use multiple pharmacies (OR: 1.25, CI: 1.06-1.47) relative to those without drug insurance. Any mail order use was the strongest predictor of MPU (OR: 6.94, CI: 5.90-8.18). Pharmacists and other health care providers need to be aware that their patients may be using multiple pharmacies, especially younger patients, those lacking access to health insurance, or those using mail order pharmacies. The findings from this study can be used to identify patients that may need additional monitoring to ensure safe and appropriate drug therapy, and has important implications as health care continues to shift toward performance-based reimbursement and quality ratings. Copyright © 2015 Elsevier Inc. All rights reserved.

A multiple objective optimization approach to quality control

NASA Technical Reports Server (NTRS)

Seaman, Christopher Michael

1991-01-01

The use of product quality as the performance criteria for manufacturing system control is explored. The goal in manufacturing, for economic reasons, is to optimize product quality. The problem is that since quality is a rather nebulous product characteristic, there is seldom an analytic function that can be used as a measure. Therefore standard control approaches, such as optimal control, cannot readily be applied. A second problem with optimizing product quality is that it is typically measured along many dimensions: there are many apsects of quality which must be optimized simultaneously. Very often these different aspects are incommensurate and competing. The concept of optimality must now include accepting tradeoffs among the different quality characteristics. These problems are addressed using multiple objective optimization. It is shown that the quality control problem can be defined as a multiple objective optimization problem. A controller structure is defined using this as the basis. Then, an algorithm is presented which can be used by an operator to interactively find the best operating point. Essentially, the algorithm uses process data to provide the operator with two pieces of information: (1) if it is possible to simultaneously improve all quality criteria, then determine what changes to the process input or controller parameters should be made to do this; and (2) if it is not possible to improve all criteria, and the current operating point is not a desirable one, select a criteria in which a tradeoff should be made, and make input changes to improve all other criteria. The process is not operating at an optimal point in any sense if no tradeoff has to be made to move to a new operating point. This algorithm ensures that operating points are optimal in some sense and provides the operator with information about tradeoffs when seeking the best operating point. The multiobjective algorithm was implemented in two different injection molding scenarios: tuning of process controllers to meet specified performance objectives and tuning of process inputs to meet specified quality objectives. Five case studies are presented.

Optimization of multiple quality characteristics in bone drilling using grey relational analysis

PubMed Central

Pandey, Rupesh Kumar; Panda, Sudhansu Sekhar

2014-01-01

Purpose Drilling of bone is common during bone fracture treatment to fix the fractured parts with screws wires or plates. Minimally invasive drilling of the bone has a great demand as it helps in better fixation and quick healing of the broken bones. The purpose of the present investigation is to determine the optimum cutting condition for the minimization of the temperature, force and surface roughness simultaneously during bone drilling. Method In this study, drilling experiments have been performed on bovine bone with different conditions of feed rate and drill rotational speed using full factorial design. Optimal level of the drilling parameters is determined by the grey relational grade (GRG) obtained from the GRA as the performance index of multiple quality characteristics. The effect of each drilling parameter on GRG is determined using analysis of variance (ANOVA) and the results obtained are validated by confirmation experiment. Results Grey relational analysis showed that the investigation with feed rate of 40 mm/min and spindle speed of 500 rpm has the highest grey relational grade and is recommended setting for minimum temperature, force and surface roughness simultaneously during bone drilling. Feed rate has the highest contribution (59.49%) on the multiple performance characteristics followed by the spindle speed (37.69%) as obtained from ANOVA analysis. Conclusions The use of grey relational analysis will simplify the complex process of optimization of the multi response characteristics in bone drilling by converting them into a single grey relational grade. The use of the above suggested methodology can greatly minimize the bone tissue injury during drilling. PMID:25829751

Optimization of multiple quality characteristics in bone drilling using grey relational analysis.

PubMed

Pandey, Rupesh Kumar; Panda, Sudhansu Sekhar

2015-03-01

Drilling of bone is common during bone fracture treatment to fix the fractured parts with screws wires or plates. Minimally invasive drilling of the bone has a great demand as it helps in better fixation and quick healing of the broken bones. The purpose of the present investigation is to determine the optimum cutting condition for the minimization of the temperature, force and surface roughness simultaneously during bone drilling. In this study, drilling experiments have been performed on bovine bone with different conditions of feed rate and drill rotational speed using full factorial design. Optimal level of the drilling parameters is determined by the grey relational grade (GRG) obtained from the GRA as the performance index of multiple quality characteristics. The effect of each drilling parameter on GRG is determined using analysis of variance (ANOVA) and the results obtained are validated by confirmation experiment. Grey relational analysis showed that the investigation with feed rate of 40 mm/min and spindle speed of 500 rpm has the highest grey relational grade and is recommended setting for minimum temperature, force and surface roughness simultaneously during bone drilling. Feed rate has the highest contribution (59.49%) on the multiple performance characteristics followed by the spindle speed (37.69%) as obtained from ANOVA analysis. The use of grey relational analysis will simplify the complex process of optimization of the multi response characteristics in bone drilling by converting them into a single grey relational grade. The use of the above suggested methodology can greatly minimize the bone tissue injury during drilling.

Predictors of Parenting Stress Trajectories in Premature Infant–Mother Dyads

PubMed Central

Spinelli, Maria; Poehlmann, Julie; Bolt, Daniel

2014-01-01

This prospective longitudinal study examined predictors of parenting stress trajectories over time in a sample of 125 mothers and their preterm infants. Infant (multiple birth, gestational age, days hospitalized, and neonatal health risks) and maternal (socioeconomic, education, depressive symptoms, social support, and quality of interaction during infant feeding) characteristics were collected just prior to infant hospital discharge. Parenting stress and maternal interaction quality during play were measured at 4, 24, and 36 months corrected age. Hierarchical linear modeling was used to analyze infant and maternal characteristics as predictors of parenting stress scores and change over time. Results indicated significant variability across individuals in parenting stress at 4 months and in change trajectories. Mothers of multiples and infants with more medical risks and shorter hospitalization, and mothers with lower education and more depressive symptoms, reported more parenting stress at 4 months of age. Parenting stress decreased over time for mothers of multiples and for mothers with lower education more than for mothers of singletons or for mothers with higher educational levels. Changes in parenting stress scores over time were negatively associated with maternal behaviors during mother–infant interactions. Results are interpreted for their implications for preventive interventions. PMID:24188086

Optimization of Selective Laser Melting by Evaluation Method of Multiple Quality Characteristics

NASA Astrophysics Data System (ADS)

Khaimovich, A. I.; Stepanenko, I. S.; Smelov, V. G.

2018-01-01

Article describes the adoption of the Taguchi method in selective laser melting process of sector of combustion chamber by numerical and natural experiments for achieving minimum temperature deformation. The aim was to produce a quality part with minimum amount of numeric experiments. For the study, the following optimization parameters (independent factors) were chosen: the laser beam power and velocity; two factors for compensating the effect of the residual thermal stresses: the scale factor of the preliminary correction of the part geometry and the number of additional reinforcing elements. We used an orthogonal plan of 9 experiments with a factor variation at three levels (L9). As quality criterias, the values of distortions for 9 zones of the combustion chamber and the maximum strength of the material of the chamber were chosen. Since the quality parameters are multidirectional, a grey relational analysis was used to solve the optimization problem for multiple quality parameters. As a result, according to the parameters obtained, the combustion chamber segments of the gas turbine engine were manufactured.

Improving Factor Score Estimation Through the Use of Observed Background Characteristics

PubMed Central

Curran, Patrick J.; Cole, Veronica; Bauer, Daniel J.; Hussong, Andrea M.; Gottfredson, Nisha

2016-01-01

A challenge facing nearly all studies in the psychological sciences is how to best combine multiple items into a valid and reliable score to be used in subsequent modelling. The most ubiquitous method is to compute a mean of items, but more contemporary approaches use various forms of latent score estimation. Regardless of approach, outside of large-scale testing applications, scoring models rarely include background characteristics to improve score quality. The current paper used a Monte Carlo simulation design to study score quality for different psychometric models that did and did not include covariates across levels of sample size, number of items, and degree of measurement invariance. The inclusion of covariates improved score quality for nearly all design factors, and in no case did the covariates degrade score quality relative to not considering the influences at all. Results suggest that the inclusion of observed covariates can improve factor score estimation. PMID:28757790

Methodological quality and descriptive characteristics of prosthodontic-related systematic reviews.

PubMed

Aziz, T; Compton, S; Nassar, U; Matthews, D; Ansari, K; Flores-Mir, C

2013-04-01

Ideally, healthcare systematic reviews (SRs) should be beneficial to practicing professionals in making evidence-based clinical decisions. However, the conclusions drawn from SRs are directly related to the quality of the SR and of the included studies. The aim was to investigate the methodological quality and key descriptive characteristics of SRs published in prosthodontics. Methodological quality was analysed using the Assessment of Multiple Reviews (AMSTAR) tool. Several electronic resources (MEDLINE, EMBASE, Web of Science and American Dental Association's Evidence-based Dentistry website) were searched. In total 106 SRs were located. Key descriptive characteristics and methodological quality features were gathered and assessed, and descriptive and inferential statistical testing performed. Most SRs in this sample originated from the European continent followed by North America. Two to five authors conducted most SRs; the majority was affiliated with academic institutions and had prior experience publishing SRs. The majority of SRs were published in specialty dentistry journals, with implant or implant-related topics, the primary topics of interest for most. According to AMSTAR, most quality aspects were adequately fulfilled by less than half of the reviews. Publication bias and grey literature searches were the most poorly adhered components. Overall, the methodological quality of the prosthodontic-related systematic was deemed limited. Future recommendations would include authors to have prior training in conducting SRs and for journals to include a universal checklist that should be adhered to address all key characteristics of an unbiased SR process. © 2013 Blackwell Publishing Ltd.

Morningness-eveningness and daytime functioning in university students: the mediating role of sleep characteristics.

PubMed

Bakotic, Marija; Radosevic-Vidacek, Biserka; Koscec Bjelajac, Adrijana

2017-04-01

The aim of this study was to explore the mediating role of sleep characteristics in the relationship between morningness-eveningness and three different aspects of daytime functioning: daytime sleepiness, depressive mood and substance use in university students. A multiple mediator model was proposed with sleep debt, poor sleep quality and bedtime delay at weekends as parallel mediators in these relationships. We analysed the data of 1052 university students aged 18-25 years who completed a modified version of the School Sleep Habits Survey, which included questions on sleep and the Composite Scale of Morningness, Sleepiness Scale, Depressive Mood Scale and Substance Use Scale. Students with more pronounced eveningness reported greater daytime sleepiness, greater depressive mood and more frequent substance use, as well as greater sleep debt, poorer sleep quality and greater bedtime delay at weekends. Mediation analyses indicated that morningness-eveningness affected daytime sleepiness and substance use both directly and indirectly through all proposed sleep-related mediators. However, the effect of morningness-eveningness on depressive mood was entirely indirect and was accounted for more by poor sleep than by sleep debt or bedtime irregularity. In conclusion, there are multiple possible mechanisms through which morningness-eveningness affects daytime functioning in university students, and sleep characteristics are a significant mechanism. Sleep debt, poor sleep quality and bedtime irregularity can, to a significant extent, explain the feeling of daytime sleepiness and greater substance use in students with eveningness preferences. However, more depressed mood in the evening-orientated students is primarily a consequence of their poor sleep quality. © 2016 European Sleep Research Society.

Variation in Trajectories of Women's Marital Quality

PubMed Central

James, Spencer L.

2014-01-01

I examine variation in trajectories of women's marital quality across the life course. The analysis improves upon earlier research in three ways: (1) the analysis uses a sequential cohort design and data from the first 35 years of marriage; (2) I analyze rich data from a national sample; (3) I examine multiple dimensions of marital quality. Latent class growth analyses estimated on data from women in the National Longitudinal Survey of Youth-1979 (N = 2604) suggest multiple trajectories for each of three dimensions of marital quality, including two trajectories of marital happiness, two trajectories of marital communication, and three trajectories of marital conflict. Socioeconomic and demographic covariates are then used to illustrate how factors such as income, cohabitation, and race-ethnicity set individuals at risk of poor marital quality throughout the life course by differentiating between high and low trajectories of marital quality. Women on low marital quality trajectories are, as expected, at much greater risk of divorce. Taken together, these findings show how fundamental socioeconomic and demographic characteristics contribute to subsequent marital outcomes via their influence on trajectories of marital quality as well as providing a better picture of the complexity in contemporary patterns of marital quality. PMID:25432600

Angry Responses to Infant Challenges: Parent, Marital, and Child Genetic Factors Associated with Harsh Parenting

PubMed Central

Hajal, Nastassia J.; Neiderhiser, Jenae M.; Moore, Ginger A.; Leve, Leslie D.; Shaw, Daniel S.; Harold, Gordon T.; Scaramella, Laura V.; Ganiban, Jody M.; Reiss, David

2014-01-01

This study examined genetic and environmental influences on harsh parenting of 9-month-olds. We examined whether positive child-, parent-, and family-level characteristics were associated with harsh parenting in addition to negative characteristics. We were particularly interested in examining evocative gene-environment correlation (rGE) by testing the effect of birth parent temperament on adoptive parents’ harsh parenting. Additionally, we examined associations among adoptive parents’ own temperaments, their marital relationship quality, and harsh parenting. Adoptive fathers’ (but not adoptive mothers’) harsh parenting was inversely related to an index of birth mother positive temperament (reward dependence), indicating evocative rGE. Higher marital quality was associated with less harsh parenting, but only for adoptive fathers. Adoptive parents’ negative temperamental characteristics (harm avoidance) were related to hostile parenting. Findings suggest the importance of enhancing positive family characteristics in addition to mitigating negative characteristics, as well as engaging multiple levels of the family system to prevent harsh parenting. PMID:25641632

College Tuition and Perceptions of Private University Quality

ERIC Educational Resources Information Center

Tang, Thomas Li-Ping; Tang, David Shin-Hsiung; Tang, Cindy Shin-Yi

2004-01-01

This research employs institutional characteristics and market-related factors to predict undergraduate students' tuition at 190 private colleges and universities in the USA. Results showed that the strongest correlations among variables for college tuition were reputation ranking and SAT scores. Results of a hierarchical multiple regression…

Investigation of the extended use of Ground Penetrating Radar (GPR) for measuring in-situ material quality characteristics : final report.

DOT National Transportation Integrated Search

2008-09-01

This report tests the application of Ground Penetrating Radar (GPR) as a non-destructive tool for highway infrastructure assessment. Multiple antennas with different frequency ranges were used on a variety infrastructure projects. This report highlig...

How common is multiple general practice attendance in Australia?

PubMed

Wright, Michael; Hall, Jane; van Gool, Kees; Haas, Marion

2018-05-01

Australians can seek general practice care from multiple general practitioners (GPs) in multiple locations. This provides high levels of patient choice but may reduce continuity of care. The aim of this study was to estimate the prevalence of attendance at multiple general practices in Australia, and identify patient characteristics associated with multiple practice attendances. A cross-sectional survey of 2477 Australian adults was conducted online in July 2013. Respondents reported whether they had attended more than one general practice in the past year, and whether they had a usual general practice and GP. Demographic information, health service use and practice characteristics were also obtained from the survey. Over one-quarter of the sample reported attending more than one practice in the previous year. Multiple practice attendance is less common with increasing age, and less likely for survey respondents from regional Australia, compared with respondents from metropolitan areas. Multiple practice attenders are just as likely as single practice attenders to have a usual GP. A significant proportion of general practice care is delivered away from usual practices. This may have implications for health policy, in terms of continuity and quality of primary care.

Features of Coping with Disease in Iranian Multiple Sclerosis Patients: a Qualitative Study.

PubMed

Dehghani, Ali; Dehghan Nayeri, Nahid; Ebadi, Abbas

2018-03-01

Introduction: Coping with disease is of the main components improving the quality of life in multiple sclerosis patients. Identifying the characteristics of this concept is based on the experiences of patients. Using qualitative research is essential to improve the quality of life. This study was conducted to explore the features of coping with the disease in patients with multiple sclerosis. Method: In this conventional content analysis study, eleven multiple sclerosis patients from Iran MS Society in Tehran (Iran) participated. Purposive sampling was used to select participants. Data were gathered using semi structured interviews. To analyze data, a conventional content analysis approach was used to identify meaning units and to make codes and categories. Results: Results showed that features of coping with disease in multiple sclerosis patients consists of (a) accepting the current situation, (b) maintenance and development of human interactions, (c) self-regulation and (d) self-efficacy. Each of these categories is composed of sub-categories and codes that showed the perception and experience of patients about the coping with disease. Conclusion: Accordingly, a unique set of features regarding features of coping with the disease were identified among the patients with multiple sclerosis. Therefore, working to ensure the emergence of, and subsequent reinforcement of these features in MS patients can be an important step in improving the adjustment and quality of their lives.

Epidemiology, methodological and reporting characteristics of systematic reviews of nursing interventions published in China.

PubMed

Shi, Chunhu; Zhu, Lin; Wang, Xue; Qin, Chunxia; Xu, Qi; Tian, Jinhui

2014-12-01

The importance of systematic reviews (SRs) of nursing interventions' impact on practice makes their methodological quality and reporting characteristics especially important as it directly influence their utility for clinicians, patients and policy makers.The study aims to assess the methodological quality and reporting characteristics of SRs of nursing interventions in Chinese nursing journals. Three Chinese databases were searched for SRs of nursing interventions from inception to October 2011. The assessment of multiple systematic reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statements were used to assess methodological quality and reporting characteristics. Seventy-four SRs were included. The proportion of SRs complying with AMSTAR checklist items ranged from 0% to 82.4%. No SRs reported an 'a priori' design or conflict of interest. Only four items were found to be reported in more than 50% of the SRs: a list of included and excluded studies, the scientific quality of included studies, the appropriate use of methods to combine findings, and formulating conclusions appropriately. The majority of SRs of nursing interventions in China had major methodological and reporting flaws that limited their value to guide decisions. Chinese authors and journals should adopt and keep up with the AMSTAR and PRISMA statements to improve the quality of SRs in this field. © 2014 Wiley Publishing Asia Pty Ltd.

Solute-specific patterns and drivers of urban stream chemistry revealed by long-term monitoring in Baltimore, Maryland

NASA Astrophysics Data System (ADS)

Reisinger, A. J.; Woytowitz, E.; Majcher, E.; Rosi, E. J.; Groffman, P.

2017-12-01

Urban streams receive a myriad of chemical inputs from the surrounding landscape due to altered lithology (asphalt, concrete), leaky sewage infrastructure, and other human activities (road salt, fertilizer, industrial wastes, wastewater effluent), potentially leading to multiple chemical stressors occurring simultaneously. To evaluate potential drivers of water chemistry change, we used approximately 20 years of weekly water chemistry monitoring data from streams in the Baltimore Ecosystem Study (BES) to quantify trends of annual loads and flow-weighted concentrations for multiple solutes of interest, including nitrate (NO3-), phosphate (PO43-), total nitrogen (TN), total phosphorus (TP), chloride (Cl-), and sulfate (SO42-) and subsequently examined various gray and green infrastructure characteristics at the watershed scale. For example, we quantified annual volume and duration of reported sanitary sewer overflows (SSO) and cumulative storage volume and area of various best management practices (BMPs). Site- and solute-specific trends differed, but across our monitoring network we found evidence for decreasing annual export for multiple solutes. Additionally, we found that changes in gray- and green-infrastructure characteristics were related to changes in water quality at our most downstream (most urban) monitoring site. For example, annual NO3- loads increased with longer cumulative SSO duration, whereas annual PO43- and TP loads decreased with a cumulative BMP area in the watershed. Further, we used same long-term water chemistry data and multivariate analyses to investigate whether urban streams have unique water chemistry fingerprints representing the multiple chemical stressors at a given site, which could provide insight into sources and impacts of water-quality impairment. These analyses and results illustrate the major role gray and green infrastructure play in influencing water quality in urban environments, and illustrate that focusing on a variety of chemical stressors is necessary to gain a broader understanding of the issues affecting urban water quality.

Multidrug-resistant bacteria infection and nursing quality management application in the department of physical examination.

PubMed

Xu, Li; Luo, Qiang; Chen, Liangzhen; Jiao, Lingmei

2017-09-01

The main problem of clinical prevention and control of multi drug resistant bacteria infection is to strengthen the monitoring of pathogenic bacteria spectrum, this study research on the multi drug-resistant bacteria infection and nursing quality management application in the department of physical examination. The results of this study showed that the number of patients with multiple drug resistant infections showed an increasing trend. Therefore, once the patients with multiple drug-resistant bacteria infection are found, the prevention and control of the patients with multiple drug-resistant bacteria should be strictly followed, and the patient's medication care should be highly valued. Also, the nurses need to be classified based on the knowledge and skill characteristics of the nurses in the department of physical examination, and compare the nursing effect before and after classification and grouping. The physicians and individuals receiving physical examinations in the department of physical examination had a higher degree of satisfaction for nursing effect after classification compared with those before classification. Classification and grouping management helps improve the nursing quality and overall quality of the nurses in the department of physical examination.

Discrepancy in reports of support exchanges between parents and adult offspring: within- and between-family differences.

PubMed

Kim, Kyungmin; Zarit, Steven H; Birditt, Kira S; Fingerman, Karen L

2014-04-01

Using data from 929 parent-child dyads nested in 458 three-generation families (aged 76 for the oldest generation, 50 for the middle generation, and 24 for the youngest generation), this study investigated how discrepancies in reports of support that parents and their adult offspring exchanged with one another vary both within and between families, and what factors explain variations in dyadic discrepancies. We found substantial within- and between-family differences in dyadic discrepancies in reports of support exchanges. For downward exchanges (from parents to offspring), both dyad-specific characteristics within a family (e.g., gender composition, relative levels of relationship quality, and family obligation) and shared family characteristics (e.g., average levels of relationship quality) showed significant effects on dyadic discrepancies. For upward exchanges (from offspring to parents), however, only dyad-specific characteristics (e.g., gender composition, coresidence, relative levels of positive relationship quality, and family obligation) were significantly associated with discrepancies. Discrepancies in support exchanges were mainly associated with dyad-specific characteristics, but they also appeared to be influenced by family emotional environments. The use of multiple informants revealed that families differ in discrepancies in reports of exchanges, which has implications for quality of family life as well as future exchanges. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Discrepancy in Reports of Support Exchanges between Parents and Adult Offspring: Within- and Between-Family Differences

PubMed Central

Kim, Kyungmin; Zarit, Steven H.; Birditt, Kira S.; Fingerman, Karen L.

2014-01-01

Using data from 929 parent-child dyads nested in 458 three-generation families (aged 76 for the oldest generation, 50 for the middle generation, and 24 for the youngest generation), this study investigated how discrepancies in reports of support that parents and their adult offspring exchanged with one another vary both within and between families, and what factors explain variations in dyadic discrepancies. We found substantial within- and between-family differences in dyadic discrepancies in reports of support exchanges. For downward exchanges (from parents to offspring), both dyad-specific characteristics within a family (e.g., gender composition, relative levels of relationship quality, and family obligation) and shared family characteristics (e.g., average levels of relationship quality) showed significant effects on dyadic discrepancies. For upward exchanges (from offspring to parents), however, only dyad-specific characteristics (e.g., gender composition, coresidence, relative levels of positive relationship quality, and family obligation) were significantly associated with discrepancies. Discrepancies in support exchanges were mainly associated with dyad-specific characteristics, but they also appeared to be influenced by family emotional environments. The use of multiple informants revealed that families differ in discrepancies in reports of exchanges, which has implications for quality of family life as well as future exchanges. PMID:24548009

Quality of outpatient clinical notes: a stakeholder definition derived through qualitative research.

PubMed

Hanson, Janice L; Stephens, Mark B; Pangaro, Louis N; Gimbel, Ronald W

2012-11-19

There are no empirically-grounded criteria or tools to define or benchmark the quality of outpatient clinical documentation. Outpatient clinical notes document care, communicate treatment plans and support patient safety, medical education, medico-legal investigations and reimbursement. Accurately describing and assessing quality of clinical documentation is a necessary improvement in an increasingly team-based healthcare delivery system. In this paper we describe the quality of outpatient clinical notes from the perspective of multiple stakeholders. Using purposeful sampling for maximum diversity, we conducted focus groups and individual interviews with clinicians, nursing and ancillary staff, patients, and healthcare administrators at six federal health care facilities between 2009 and 2011. All sessions were audio-recorded, transcribed and qualitatively analyzed using open, axial and selective coding. The 163 participants included 61 clinicians, 52 nurse/ancillary staff, 31 patients and 19 administrative staff. Three organizing themes emerged: 1) characteristics of quality in clinical notes, 2) desired elements within the clinical notes and 3) system supports to improve the quality of clinical notes. We identified 11 codes to describe characteristics of clinical notes, 20 codes to describe desired elements in quality clinical notes and 11 codes to describe clinical system elements that support quality when writing clinical notes. While there was substantial overlap between the aspects of quality described by the four stakeholder groups, only clinicians and administrators identified ease of translation into billing codes as an important characteristic of a quality note. Only patients rated prioritization of their medical problems as an aspect of quality. Nurses included care and education delivered to the patient, information added by the patient, interdisciplinary information, and infection alerts as important content. Perspectives of these four stakeholder groups provide a comprehensive description of quality in outpatient clinical documentation. The resulting description of characteristics and content necessary for quality notes provides a research-based foundation for assessing the quality of clinical documentation in outpatient health care settings.

Scenario Problem Solving: A Measure of the Quality of Gifted Students' Thinking

ERIC Educational Resources Information Center

Munro, John K.

2015-01-01

Teachers continue to face the challenge of identifying efficaciously gifted students' learning capacity in its multiple forms. While most educators acknowledge its multidimensional characteristics, the protocols used to identify it are frequently evaluated as unnecessarily restrictive. This study investigates an assessment tool that could…

Multiple Generations on Video Tape Recorders.

ERIC Educational Resources Information Center

Wiens, Jacob H.

Helical scan video tape recorders were tested for their dubbing characteristics in order to make selection data available to media personnel. The equipment, two recorders of each type tested, was submitted by the manufacturers. The test was designed to produce quality evaluations for three generations of a single tape, thereby encompassing all…

Inclusion of Riparian Wetland Module (RWM) into the SWAT model for assessment of wetland hydrological benefit

USDA-ARS?s Scientific Manuscript database

Wetlands are an integral part of many agricultural watersheds. They provide multiple ecosystem functions, such as improving water quality, mitigating flooding, and serving as natural habitats. Those functions are highly depended on wetland hydrological characteristics and their connectivity to the d...

Child anthropometry data quality from Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and National Nutrition Surveys in the West Central Africa region: are we comparing apples and oranges?

PubMed Central

Corsi, Daniel J.; Perkins, Jessica M.; Subramanian, S. V.

2017-01-01

ABSTRACT Background: There has been limited work comparing survey characteristics and assessing the quality of child anthropometric data from population-based surveys. Objective: To investigate survey characteristics and indicators of quality of anthropometric data in children aged 0–59 months from 23 countries in the West Central Africa region. Methods: Using established methodologies and criteria to examine child age, sex, height, and weight, we conducted a comprehensive assessment and scoring of the quality of anthropometric data collected in 100 national surveys. Results: The Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS) collected data from a greater number of younger children than older children while the opposite was found for the National Nutrition Surveys (NNS). Missing or implausible height/weight data proportions were 12% and 8% in MICS and DHS compared to 3% in NNS. Average data quality scores were 14 in NNS, 33 in DHS, and 41 in MICS. Conclusions: Although our metric of data quality suggests that data from the NNS appear more consistent and robust, it is equally important to consider its disadvantages related to access and lack of broader socioeconomic information. In comparison, the DHS and MICS are publicly-accessable for research and provide socioeconomic context essential for assessing and addressing the burden of undernutrition within and between countries. The strengths and weaknesses of data from these three sources should be carefully considered when seeking to determine the burden of child undernutrition and its variation within countries. PMID:28641057

Child anthropometry data quality from Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and National Nutrition Surveys in the West Central Africa region: are we comparing apples and oranges?

PubMed

Corsi, Daniel J; Perkins, Jessica M; Subramanian, S V

2017-01-01

There has been limited work comparing survey characteristics and assessing the quality of child anthropometric data from population-based surveys. To investigate survey characteristics and indicators of quality of anthropometric data in children aged 0-59 months from 23 countries in the West Central Africa region. Using established methodologies and criteria to examine child age, sex, height, and weight, we conducted a comprehensive assessment and scoring of the quality of anthropometric data collected in 100 national surveys. The Multiple Indicator Cluster Surveys (MICS) and Demographic and Health Surveys (DHS) collected data from a greater number of younger children than older children while the opposite was found for the National Nutrition Surveys (NNS). Missing or implausible height/weight data proportions were 12% and 8% in MICS and DHS compared to 3% in NNS. Average data quality scores were 14 in NNS, 33 in DHS, and 41 in MICS. Although our metric of data quality suggests that data from the NNS appear more consistent and robust, it is equally important to consider its disadvantages related to access and lack of broader socioeconomic information. In comparison, the DHS and MICS are publicly-accessable for research and provide socioeconomic context essential for assessing and addressing the burden of undernutrition within and between countries. The strengths and weaknesses of data from these three sources should be carefully considered when seeking to determine the burden of child undernutrition and its variation within countries.

Statistical characteristics of excess fiber length in loose tubes of optical cable

NASA Astrophysics Data System (ADS)

Andreev, Vladimir A.; Gavryushin, Sergey A.; Popov, Boris V.; Popov, Victor B.; Vazhdaev, Michael A.

2017-04-01

This paper presents an analysis of the data measurements of excess fiber length in the loose tubes of optical cable during the post-process quality control of ready-made products. At determining estimates of numerical characteristics of excess fiber length method of results processing of direct multiple equally accurate measurements has been used. The results of experimental research of the excess length value at the manufacturing technology of loose tube remains constant.

Reviewing the quality, health benefit and value for money of chemotherapy and targeted therapy for metastatic breast cancer.

PubMed

Pouwels, Xavier Ghislain Léon Victor; Ramaekers, Bram L T; Joore, Manuela A

2017-10-01

To provide an overview of model characteristics and outcomes of model-based economic evaluations concerning chemotherapy and targeted therapy (TT) for metastatic breast cancer (MBC); to assess the quality of the studies; to analyse the association between model characteristics and study quality and outcomes. PubMED and NHS EED were systematically searched. Inclusion criteria were as follows: English or Dutch language, model-based economic evaluation, chemotherapy or TT as intervention, population diagnosed with MBC, published between 2000 and 2014, reporting life years (LY) or quality-adjusted life-year (QALY) and an incremental cost-effectiveness ratio. General characteristics, model characteristics and outcomes of the studies were extracted. Quality of the studies was assessed through a checklist. 24 studies were included, considering 50 comparisons (20 concerning chemotherapy and 30 TT). Seven comparisons were represented in multiple studies. A health state-transition model including the following health states: stable/progression-free disease, progression and death was used in 18 studies. Studies fulfilled on average 14 out of the 26 items of the quality checklist, mostly due to a lack of transparency in reporting. Thirty-one per cent of the incremental net monetary benefit was positive. TT led to higher iQALY gained, and industry-sponsored studies reported more favourable cost-effectiveness outcomes. The development of a disease-specific reference model would improve the transparency and quality of model-based cost-effectiveness assessments for MBC treatments. Incremental health benefits increased over time, but were outweighed by the increased treatment costs. Consequently, increased health benefits led to lower value for money.

The organization of multidisciplinary care teams: modeling internal and external influences on cancer care quality.

PubMed

Fennell, Mary L; Das, Irene Prabhu; Clauser, Steven; Petrelli, Nicholas; Salner, Andrew

2010-01-01

Quality cancer treatment depends upon careful coordination between multiple treatments and treatment providers, the exchange of technical information, and regular communication between all providers and physician disciplines involved in treatment. This article will examine a particular type of organizational structure purported to regularize and streamline the communication between multiple specialists and support services involved in cancer treatment: the multidisciplinary treatment care (MDC) team. We present a targeted review of what is known about various types of MDC team structures and their impact on the quality of treatment care, and we outline a conceptual model of the connections between team context, structure, process, and performance and their subsequent effects on cancer treatment care processes and patient outcomes. Finally, we will discuss future research directions to understand how MDC teams improve patient outcomes and how characteristics of team structure, culture, leadership, and context (organizational setting and local environment) contribute to optimal multidisciplinary cancer care.

Quality of life of patients who undergo breast reconstruction after mastectomy: effects of personality characteristics.

PubMed

Bellino, Silvio; Fenocchio, Marina; Zizza, Monica; Rocca, Giuseppe; Bogetti, Paolo; Bogetto, Filippo

2011-01-01

Reconstruction after mastectomy has become an integral part of breast cancer treatment. The effects of psychological factors on quality of life after reconstruction have been poorly investigated. The authors examined clinical and personality characteristics related to quality of life in patients receiving reconstructive surgery. All patients received immediate reconstruction and were evaluated in the week before tissue expander implantation (T0) with a semistructured interview for demographic and clinical characteristics, the Temperament and Character Inventory, the Inventory of Interpersonal Problems, the Short Form Health Survey, the Severity Item of the Clinical Global Impression, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. Assessment with the Short Form was repeated 3 months after expander placement (T1). Statistics were calculated with univariate regression and analysis of variance. Significant variables were included in a multiple regression analysis to identify factors related to the change T1-T0 of the mean of the Short Form-transformed scores. Results were significant when p was less than or equal to 0.05. Fifty-seven women were enrolled. Results of multiple regression analysis showed that the Temperament and Character Inventory personality dimension harm avoidance and the Inventory of Interpersonal Problems domain vindictive/self-centered were significantly and independently related to the change in Short Form mean score. Personality dimensions and patterns of interpersonal functioning produce significant effects on patients' quality of life during breast reconstruction. Patients with high harm avoidance are apprehensive and doubtful. Restoration of body image could help them to reduce social anxiety and insecurity. Vindictive/self-centered patients are resentful and aggressive. Breast reconstruction could symbolize the conclusion of a reparative process and fulfill the desire of revenge on cancer.

[Experimental research of turbidity influence on water quality monitoring of COD in UV-visible spectroscopy].

PubMed

Tang, Bin; Wei, Biao; Wu, De-Cao; Mi, De-Ling; Zhao, Jing-Xiao; Feng, Peng; Jiang, Shang-Hai; Mao, Ben-Jiang

2014-11-01

Eliminating turbidity is a direct effect spectroscopy detection of COD key technical problems. This stems from the UV-visible spectroscopy detected key quality parameters depend on an accurate and effective analysis of water quality parameters analytical model, and turbidity is an important parameter that affects the modeling. In this paper, we selected formazine turbidity solution and standard solution of potassium hydrogen phthalate to study the turbidity affect of UV--visible absorption spectroscopy detection of COD, at the characteristics wavelength of 245, 300, 360 and 560 nm wavelength point several characteristics with the turbidity change in absorbance method of least squares curve fitting, thus analyzes the variation of absorbance with turbidity. The results show, In the ultraviolet range of 240 to 380 nm, as the turbidity caused by particle produces compounds to the organics, it is relatively complicated to test the turbidity affections on the water Ultraviolet spectra; in the visible region of 380 to 780 nm, the turbidity of the spectrum weakens with wavelength increases. Based on this, this paper we study the multiplicative scatter correction method affected by the turbidity of the water sample spectra calibration test, this method can correct water samples spectral affected by turbidity. After treatment, by comparing the spectra before, the results showed that the turbidity caused by wavelength baseline shift points have been effectively corrected, and features in the ultraviolet region has not diminished. Then we make multiplicative scatter correction for the three selected UV liquid-visible absorption spectroscopy, experimental results shows that on the premise of saving the characteristic of the Ultraviolet-Visible absorption spectrum of water samples, which not only improve the quality of COD spectroscopy detection SNR, but also for providing an efficient data conditioning regimen for establishing an accurate of the chemical measurement methods.

Peru and its new challenge in higher education: Towards a research university.

PubMed

Lavalle, Carlos; de Nicolas, Victor Luis

2017-01-01

The paradigm of research universities linked to the emergence of university rankings has unified and universalized the criteria relating to the quality of higher education. This situation has led to multiple responses across global society, which has started rating the quality of higher education systems through these rankings, supported by a series of indicators aligned to the characteristics of research universities. Given that the quality of a country's higher education is one of the fundamental pillars of its development, many countries have started to take government action in this respect. In the case of Peru this has not taken long, with the approval of Law 30220 in 2014. This aims to regulate the quality of higher education through a series of specific conditions governed by a newly created body known as SUNEDU. This article uses a Delphi panel to analyze the existing relationship between the conditions imposed by SUNEDU and the research universities' intrinsic characteristics. During the Delphi panel a consensus was reached through an acceptable and stable level of responses, resulting in confirmation that there is alignment between the conditions imposed by SUNEDU and the intrinsic characteristics of research universities.

Peru and its new challenge in higher education: Towards a research university

PubMed Central

2017-01-01

The paradigm of research universities linked to the emergence of university rankings has unified and universalized the criteria relating to the quality of higher education. This situation has led to multiple responses across global society, which has started rating the quality of higher education systems through these rankings, supported by a series of indicators aligned to the characteristics of research universities. Given that the quality of a country’s higher education is one of the fundamental pillars of its development, many countries have started to take government action in this respect. In the case of Peru this has not taken long, with the approval of Law 30220 in 2014. This aims to regulate the quality of higher education through a series of specific conditions governed by a newly created body known as SUNEDU. This article uses a Delphi panel to analyze the existing relationship between the conditions imposed by SUNEDU and the research universities’ intrinsic characteristics. During the Delphi panel a consensus was reached through an acceptable and stable level of responses, resulting in confirmation that there is alignment between the conditions imposed by SUNEDU and the intrinsic characteristics of research universities. PMID:28787463

Developing effective feedback on quality of anaesthetic care: what are its most valuable characteristics from a clinical perspective?

PubMed

D'Lima, Danielle M; Moore, Joanna; Bottle, Alex; Brett, Stephen J; Arnold, Glenn M; Benn, Jonathan

2015-01-01

Research suggests that better feedback from quality and safety indicators leads to enhanced capability of clinicians and departments to improve care and change behaviour. The aim of the current study was to investigate the characteristics of feedback perceived by clinicians to be of most value. Data were collected using a survey designed as part of a wider evaluation of a data feedback initiative in anaesthesia. Eighty-nine consultant anaesthetists from two English NHS acute Trusts completed the survey. Multiple linear regression with hierarchical variable entry was used to investigate which characteristics of feedback predict its perceived usefulness for monitoring variation and improving care. The final model demonstrated that the relevance of the quality indicators to the specific service area (β=0.64, p=0.01) and the credibility of the data as coming from a trustworthy, unbiased source (β=0.55, p=0.01) were the significant predictors, having controlled for all other covariates. For clinicians to engage with effective quality monitoring and feedback, the perceived local relevance of indicators and trust in the credibility of the resulting data are paramount. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Lightning-Related Indicators for National Climate Assessment (NCA) Studies

NASA Technical Reports Server (NTRS)

Koshak, W.

2017-01-01

Changes in climate can affect the characteristics of lightning (e.g., number of flashes that occur in a region, return stroke current and multiplicity, polarity of charge deposited to ground, and the lightning cloud-top optical energy emission). The NASA/MSFC Lightning Analysis Tool (LAT) monitors these and other quantities in support of the National Climate Assessment (NCA) program. Changes in lightning characteristics lead to changes in lightning-caused impacts to humans (e.g., fatalities, injuries, crop/property damage, wildfires, airport delays, changes in air quality).

Bioavailability of atrazine, pyrene and benzo[a]pyrene in European river waters

USGS Publications Warehouse

Akkanen, J.; Penttinen, S.; Haitzer, M.; Kukkonen, J.V.K.

2001-01-01

Thirteen river waters and one humic lake water were characterized. The effects of dissolved organic matter (DOM) on the bioavailability of atrazine, pyrene and benzo[a]pyrene (B[a]P) was evaluated. Binding of the chemicals by DOM was analyzed with the equilibrium dialysis technique. For each of the water samples, 24 h bioconcentration factors (BCFs) of the chemicals were measured in Daphnia magna. The relationship between DOM and other water characteristics (including conductivity, water hardness and pH), and bioavailability of the chemicals was studied by performing several statistical analyses, including multiple regression analyses, to determine how much of the variation of BCF values could be explained by the quantity and quality of DOM. The bioavailability of atrazine was not affected by DOM or any other water characteristics. Although equilibrium dialysis showed binding of pyrene to DOM, the bioavailability of pyrene was not significantly affected by DOM. The bioavailability of B[a]P was significantly affected by both the quality and quantity of DOM. Multiple regression analyses, using the quality (ABS270 and HbA%) and quantity of DOM as variables, explainedup to 70% of the variation in BCF of B[a]P in the waters studied. ?? 2001 Elsevier Science Ltd. All rights reserved.

Environmental Education Research in Southern Africa: Dilemmas of Interpretation

ERIC Educational Resources Information Center

Gough, Annette; Gough, Noel

2004-01-01

These multiple framings of our reflections on environmental education research in southern Africa are written as dilemmas of interpretation that aim to disrupt any temptation to generalise or essentialise its qualities and characteristics. Recognising that research is a textual practice, we use J. M. Coetzee's portrayal of the dilemmas faced by…

Analysis of the Quality of Parabolic Flight

NASA Technical Reports Server (NTRS)

Lambot, Thomas; Ord, Stephan F.

2016-01-01

Parabolic flight allows researchers to conduct several micro-gravity experiments, each with up to 20 seconds of micro-gravity, in the course of a single day. However, the quality of the flight environment can vary greatly over the course of a single parabola, thus affecting the experimental results. Researchers therefore require knowledge of the actual flight environment as a function of time. The NASA Flight Opportunities program (FO) has reviewed the acceleration data for over 400 parabolas and investigated the level of micro-gravity quality. It was discovered that a typical parabola can be segmented into multiple phases with different qualities and durations. The knowledge of the microgravity characteristics within the parabola will prove useful when planning an experiment.

PERSONALITY TRAITS, ANGER AND PSYCHIATRIC SYMPTOMS RELATED TO QUALITY OF LIFE IN PATIENTS WITH NEWLY DIAGNOSED DIGESTIVE SYSTEM CANCER.

PubMed

Honorato, Noemi Peres; Abumusse, Luciene Vaccaro de Morais; Coqueiro, Daniel Pereira; Citero, Vanessa de Albuquerque

2017-01-01

The presence of psychiatric symptoms, anger, and personality characteristics are factors that affect the quality of life of newly diagnosed digestive system cancer patients. This study aims to identify which stable characteristics of the individual's personality interfere with quality of life, even when reactive emotional characteristics of falling ill are controlled. A cross-sectional study was performed at the Oncology Clinic ( Hospital das Clínicas ), Marília/SP, Brazil, in which 50 adult patients with digestive system cancer and diagnosed less than 6 months answered the State-Trait Anger Expression Inventory, Temperament and Character Inventory, Hospital Anxiety and Depression Scale and WHOQOL-BREF. Multiple regression was performed to verify if quality of life was related to stable characteristics of the subject's personality (anger trait, temperament and character) after controlling to the transient emotional aspects (anger state, psychiatric symptoms). The quality of life psychological health score was higher in presence of self-directedness character and reward dependence temperament and quality of life environment score was higher in presence of self-directedness character and lower in presence of harm avoidance temperament. The psychological well-being and the adaptive needs to the environment that favoring a better quality of life were reinforced mainly by the self-directedness character; which means that patients more autonomous cope better with the disease. On the other hand, the harm avoidance temperament (meaning the patient has fear of aversive situations) impaired the adaptive capacity to deal with the changes of the day-to-day imposed by the disease. Understanding these personality traits is important to the health professionals drive the patient to more successful treatment.

Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES).

PubMed

Karasek, R A; Theorell, T; Schwartz, J E; Schnall, P L; Pieper, C F; Michela, J L

1988-08-01

Associations between psychosocial job characteristics and past myocardial infarction (MI) prevalence for employed males were tested with the Health Examination Survey (HES) 1960-61, N = 2,409, and the Health and Nutrition Examination Survey (HANES) 1971-75, N = 2,424. A new estimation method is used which imputes to census occupation codes, job characteristic information from national surveys of job characteristics (US Department of Labor, Quality of Employment Surveys). Controlling for age, we find that employed males with jobs which are simultaneously low in decision latitude and high in psychological work load (a multiplicative product term isolating 20 per cent of the population) have a higher prevalence of myocardial infarction in both data bases. In a logistic regression analysis, using job measures adjusted for demographic factors and controlling for age, race, education, systolic blood pressure, serum cholesterol, smoking (HANES only), and physical exertion, we find a low decision latitude/high psychological demand multiplicative product term associated with MI in both data bases. Additional multiple logistic regressions show that low decision latitude is associated with increased prevalence of MI in both the HES and the HANES. Psychological workload and physical exertion are significant only in the HANES.

Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES).

PubMed Central

Karasek, R A; Theorell, T; Schwartz, J E; Schnall, P L; Pieper, C F; Michela, J L

1988-01-01

Associations between psychosocial job characteristics and past myocardial infarction (MI) prevalence for employed males were tested with the Health Examination Survey (HES) 1960-61, N = 2,409, and the Health and Nutrition Examination Survey (HANES) 1971-75, N = 2,424. A new estimation method is used which imputes to census occupation codes, job characteristic information from national surveys of job characteristics (US Department of Labor, Quality of Employment Surveys). Controlling for age, we find that employed males with jobs which are simultaneously low in decision latitude and high in psychological work load (a multiplicative product term isolating 20 per cent of the population) have a higher prevalence of myocardial infarction in both data bases. In a logistic regression analysis, using job measures adjusted for demographic factors and controlling for age, race, education, systolic blood pressure, serum cholesterol, smoking (HANES only), and physical exertion, we find a low decision latitude/high psychological demand multiplicative product term associated with MI in both data bases. Additional multiple logistic regressions show that low decision latitude is associated with increased prevalence of MI in both the HES and the HANES. Psychological workload and physical exertion are significant only in the HANES. PMID:3389427

Quality of working life: perceptions of professional nurses at Phramongkutklao Hospital.

PubMed

Boonrod, Wallapa

2009-02-01

The 10th National Economic and Social Developmental Plan considered quality of human. Quality of human life was affected by quality of working life (QWL). Professional nurses had responsibility for patients' quality of life. Thus, professional nurses should have a quality of working life more effectively before they could help patients. Personal factors have relationships with the quality of working life. Thus, the present study was to describe the level of the QWL, to examine the relationships between job characteristics, organizational climate, organizational commitment, and job satisfaction with the QWL and to predict the QWL among professional nurses at Phramongkutklao Hospital. Two hundred and thirty-one professional nurses, who had worked for at least 3 years, were selected by stratified random sampling from 12 departments at Phramongkutklao Hospital. The questionnaires were developed, consisting of personal factors, job characteristics, organizational climate and commitment, job satisfaction and QWL. Content validity was examined by 9 experts. Reliability was obtained at 0.97 by means of Cronbach's alpha coefficient. The over all mean score of the level of quality of working life among professional nurses was at a moderate level (mean = 3.412, SD = 0.459). Personal factors were age, status, education, position, experience, salary and wards were no relationships with the QWL. Job satisfaction was positive and related at a high level, while organizational commitment, organizational climate, and job characteristics were positive and related at a moderate level to the QWL significantly at 0.001 level (r = 0.724, 0.694, 0.640, and 0.334). Multiple regression analysis factors affecting QWL indicated that professional nurses associated negative factors with job characteristics and positive factors with job satisfaction, organizational commitment, and organizational climate at 62.10 percent (R2 = 0.621). QWL = 0.762 + 0.336 Job satisfaction + 0.265 Organizational climate + 0.250 Organizational commitment - 0.118 Job characteristics. In order to develop the QWL among professional nurses at Phramongkutklao hospital, nursing administrators should promote their job satisfaction, organizational commitment, organizational climate, and job characteristics. Professional nurses who have better QWL, are more likely to stay in their positions and provide better nursing care.

Image sharpness assessment based on wavelet energy of edge area

NASA Astrophysics Data System (ADS)

Li, Jin; Zhang, Hong; Zhang, Lei; Yang, Yifan; He, Lei; Sun, Mingui

2018-04-01

Image quality assessment is needed in multiple image processing areas and blur is one of the key reasons of image deterioration. Although great full-reference image quality assessment metrics have been proposed in the past few years, no-reference method is still an area of current research. Facing this problem, this paper proposes a no-reference sharpness assessment method based on wavelet transformation which focuses on the edge area of image. Based on two simple characteristics of human vision system, weights are introduced to calculate weighted log-energy of each wavelet sub band. The final score is given by the ratio of high-frequency energy to the total energy. The algorithm is tested on multiple databases. Comparing with several state-of-the-art metrics, proposed algorithm has better performance and less runtime consumption.

Do Flexible Goal Adjustment and Acceptance Help Preserve Quality of Life in Patients with Multiple Sclerosis?

PubMed

Van Damme, Stefaan; De Waegeneer, Annelies; Debruyne, Jan

2016-06-01

Goal regulation strategies such as flexible goal adjustment and acceptance are believed to be protective factors in persons with chronic illness, but research on their relative contributions to quality of life in multiple sclerosis (MS) is lacking. We aimed to test the idea that acceptance and flexible goal adjustment (in contrast to tenacious goal pursuit) may help preserve the quality of life in persons with MS. A sample of 117 patients with MS was recruited. They completed questionnaires measuring quality of life (physical functioning, psychological distress), acceptance, flexible goal adjustment, and tenacious goal pursuit. Acceptance significantly accounted for variance in all three indexes of quality of life, beyond the effects of demographic and illness characteristics. The role of goal regulation style was less clear. Flexible goal adjustment significantly accounted for psychological well-being only. Surprisingly, tenacious goal pursuit predicted better psychological functioning and less psychological distress. No support was found for the hypothesis that acceptance and flexible goal adjustment would moderate the relation between illness severity and quality of life. The findings suggest the potential importance of acceptance in understanding MS patients' quality of life, although its hypothesized protective function could not be confirmed. Further conceptual work on acceptance and goal regulation style is needed, as well as prospective work investigating their causal status.

Test-Wiseness Cues in the Options of Mathematics Items.

ERIC Educational Resources Information Center

Kuntz, Patricia

The quality of mathematics multiple choice items and their susceptibility to test wiseness were examined. Test wiseness was defined as "a subject's capacity to utilize the characteristics and formats of the test and/or test taking situation to receive a high score." The study used results of the Graduate Record Examinations Aptitude Test (GRE) and…

An A+ Teaching Model for Serving K-12 Gifted Students in a Technologically Rich Environment

ERIC Educational Resources Information Center

Maynard, Brandi

2012-01-01

Experts in the field have had a difficult time finding a conclusive set of attributes of high-quality gifted teachers using collaborative technology. The purpose of this multiple, exploratory case study was to examine the views of selected educators regarding the teacher characteristics and technology most relevant to the development of shared…

Multiple-scale roost habitat comparisons of female Merriam's wild turkeys in the southern Black Hills, South Dakota

Treesearch

Daniel J. Thompson; Mark A. Rumble; Lester D. Flake; Chad P. Lehman

2009-01-01

Because quantity and quality of roosting habitat can affect Merriam's Wild Turkey (Meleagris gallopavo merriami) distribution, we described habitat characteristics of Merriam's turkey roost sites in the southern Black Hills of South Dakota. Varying proportions of Merriam's turkeys in the southern Black Hills depended on supplemental feed from livestock...

Phonation Interval Modification and Speech Performance Quality during Fluency-Inducing Conditions by Adults Who Stutter

ERIC Educational Resources Information Center

Ingham, Roger J.; Bothe, Anne K.; Wang, Yuedong; Purkhiser, Krystal; New, Anneliese

2012-01-01

Purpose: To relate changes in four variables previously defined as characteristic of normally fluent speech to changes in phonatory behavior during oral reading by persons who stutter (PWS) and normally fluent controls under multiple fluency-inducing (FI) conditions. Method: Twelve PWS and 12 controls each completed 4 ABA experiments. During A…

Methodological quality of systematic reviews on influenza vaccination.

PubMed

Remschmidt, Cornelius; Wichmann, Ole; Harder, Thomas

2014-03-26

There is a growing body of evidence on the risks and benefits of influenza vaccination in various target groups. Systematic reviews are of particular importance for policy decisions. However, their methodological quality can vary considerably. To investigate the methodological quality of systematic reviews on influenza vaccination (efficacy, effectiveness, safety) and to identify influencing factors. A systematic literature search on systematic reviews on influenza vaccination was performed, using MEDLINE, EMBASE and three additional databases (1990-2013). Review characteristics were extracted and the methodological quality of the reviews was evaluated using the assessment of multiple systematic reviews (AMSTAR) tool. U-test, Kruskal-Wallis test, chi-square test, and multivariable linear regression analysis were used to assess the influence of review characteristics on AMSTAR-score. Fourty-six systematic reviews fulfilled the inclusion criteria. Average methodological quality was high (median AMSTAR-score: 8), but variability was large (AMSTAR range: 0-11). Quality did not differ significantly according to vaccination target group. Cochrane reviews had higher methodological quality than non-Cochrane reviews (p=0.001). Detailed analysis showed that this was due to better study selection and data extraction, inclusion of unpublished studies, and better reporting of study characteristics (all p<0.05). In the adjusted analysis, no other factor, including industry sponsorship or journal impact factor had an influence on AMSTAR score. Systematic reviews on influenza vaccination showed large differences regarding their methodological quality. Reviews conducted by the Cochrane collaboration were of higher quality than others. When using systematic reviews to guide the development of vaccination recommendations, the methodological quality of a review in addition to its content should be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

Exploration of Patient Characteristics and Quality of Life in Patients with Lipoedema Using a Survey.

PubMed

Romeijn, Jeroen R M; de Rooij, Michette J M; Janssen, Loes; Martens, Herm

2018-05-10

Lipoedema is a chronic disorder in which excessive fat distribution occurs predominantly from the waist down, resulting in a disproportion between the lower extremities and upper torso. Lipoedema is often not recognized, while patients experience pain and easy bruising. As a long-term condition, lipoedema has a massive effect on patients' lives and mental health. The aim of this study is to explore patient characteristics, quality of life, physical complaints and comorbidities in patients with lipoedema. A survey was conducted by email amongst lipoedema patients, consisting of informed consent and multiple questionnaires. The questionnaires included general patient characteristics, physical complaints, comorbidities, RAND-36 and EQ-5D-3L. Participants who responded to a message on the Dutch Lipoedema Association website were recruited. All lipoedema patients experience physical complaints, with pain (88.3 %) and easy bruising (85.9 %) as primary complaints. The diagnosis was mostly made by a dermatologist after visiting a mean of 2.8 doctors. Furthermore, mean time from onset until diagnosis was 18 years. Quality of life (59.3) was significantly lower than the Dutch female average (74.9; p < 0.001). Additionally, patients with comorbidities had significant lower quality of life (RAND 54.7, p < 0.001). Lipoedema patients often have severe complaints and experience lower quality of life regarding physical, emotional and social functioning. Additionally, comorbidities have a large impact on quality of life.

A unified framework of unsupervised subjective optimized bit allocation for multiple video object coding

NASA Astrophysics Data System (ADS)

Chen, Zhenzhong; Han, Junwei; Ngan, King Ngi

2005-10-01

MPEG-4 treats a scene as a composition of several objects or so-called video object planes (VOPs) that are separately encoded and decoded. Such a flexible video coding framework makes it possible to code different video object with different distortion scale. It is necessary to analyze the priority of the video objects according to its semantic importance, intrinsic properties and psycho-visual characteristics such that the bit budget can be distributed properly to video objects to improve the perceptual quality of the compressed video. This paper aims to provide an automatic video object priority definition method based on object-level visual attention model and further propose an optimization framework for video object bit allocation. One significant contribution of this work is that the human visual system characteristics are incorporated into the video coding optimization process. Another advantage is that the priority of the video object can be obtained automatically instead of fixing weighting factors before encoding or relying on the user interactivity. To evaluate the performance of the proposed approach, we compare it with traditional verification model bit allocation and the optimal multiple video object bit allocation algorithms. Comparing with traditional bit allocation algorithms, the objective quality of the object with higher priority is significantly improved under this framework. These results demonstrate the usefulness of this unsupervised subjective quality lifting framework.

Characteristic Chromatogram: A Method of Discriminate and Quantitative Analysis for Quality Evaluation of Uncaria Stem with Hooks.

PubMed

Hou, Jinjun; Feng, Ruihong; Zhang, Yibei; Pan, Huiqin; Yao, Shuai; Han, Sumei; Feng, Zijin; Cai, Luying; Wu, Wanying; Guo, De-An

2018-04-01

It remains a challenge to establish new monographs for herbal drugs derived from multiple botanical sources. Specifically, the difficulty involves discriminating and quantifying these herbs with components whose levels vary markedly among different samples. Using Uncaria stem with hooks as an example, a characteristic chromatogram was proposed to discriminate its five botanical origins and to quantify its characteristic components in the chromatogram. The characteristic chromatogram with respect to the components of Uncaria stem with hooks with the five botanical origins was established using 0.02% diethylamine and acetonitrile as the mobile phase. The total analysis time was 50 min and the detection wavelength was 245 nm. Using the same chromatogram parameters, the single standard to determine multicomponents method was validated to simultaneously quantify nine indole alkaloids, including vincosamide, 3 α -dihydrocadambine, isocorynoxeine, corynoxeine, isorhynchophylline, rhynchophylline, hirsuteine, hirsutine, and geissoschizine methyl ether. The results showed that only the Uncaria stem with hooks from Uncaria rhynchophylla , the most widely used in the herbal market, showed the presence of these nine alkaloids. The conversion factors were 1.27, 2.32, 0.98, 1.04, 1.00, 1.02, 1.26, 1.33, and 1.25, respectively. The limits of quantitation were lower than 700 ng/mL. The total contents of 31 batches of Uncaria stem with hooks were in the range of 0.1 - 0.6%, except for Uncaria hirsuta Havil and Uncaria sinensis (Oliv.) Havil. The results also showed that the total content of indole alkaloids tended to decrease with an increase in the hook diameter. This showed that the characteristic chromatogram is practical for controlling the quality of traditional Chinese medicines with multiple botanical origins. Georg Thieme Verlag KG Stuttgart · New York.

Effect of Novel Starter Culture on Reduction of Biogenic Amines, Quality Improvement, and Sensory Properties of Doenjang, a Traditional Korean Soybean Fermented Sauce Variety.

PubMed

Shukla, Shruti; Lee, Jong Suk; Park, Hae-Kyong; Yoo, Jung-Ah; Hong, Sung-Yong; Kim, Jong-Kyu; Kim, Myunghee

2015-08-01

To select appropriate microorganisms as starter cultures for the reliable and reproducible fermentation of soybean fermented products of Korean Doenjang, various ratios of fungi (Aspergillus oryzae J, Mucor racemosus 15, M. racemosus 42) combined with Bacillus subtilis TKSP 24 were selected as either single, double, or multiple Meju strains for commercial mass production of Doenjang, followed by analysis of sensory characteristics. In the sensory evaluation, Doenjang BAM15-1 and BAM42-1, which were fermented with multiple strains (1:1:1), showed the highest sensory scores as compared to control. Based on sensory characteristics, 6 Doenjang samples were subjected to quantitative determination of amino acids, free sugars, and organic acids (volatile and nonvolatile) contents, followed by determination of biogenic amines. Total sweet taste amino acid contents were highest in BAM15-1 and BAM42-1 samples (333.7 and 295.8 mg/100 g, respectively) and similar that of control (391.1 mg/100 g). Samples BAM15-1 and BAM42-1 showed the relatively high volatile and nonvolatile organic acid contents (154.24, 192.26, and 71.31, 82.42 mg/100 g, respectively). In addition, BAM15-1 and BAM42-1 showed negligible biogenic amine formation, ranging from 0.00 to 1.02 and 0.00 to 3.92 mg/100 g, respectively. These findings indicate that determination of food components along with sensory and quality attributes using multiple microbial Meju strains as a starter culture may provide substantial results on improved quality fermented Doenjang products. © 2015 Institute of Food Technologists®

Are Young Children's Utterances Affected by Characteristics of Their Learning Environments? A Multiple Case Study

ERIC Educational Resources Information Center

Richardson, Tanya; Murray, Jane

2017-01-01

Within English early childhood education, there is emphasis on improving speech and language development as well as a drive for outdoor learning. This paper synthesises both aspects to consider whether or not links exist between the environment and the quality of young children's utterances as part of their speech and language development and if…

Determinants of community pharmacists' quality of care: a population-based cohort study using pharmacy administrative claims data.

PubMed

Winslade, Nancy; Tamblyn, Robyn

2017-09-21

To determine if a prototype pharmacists' services evaluation programme that uses linked community pharmacy claims and health administrative data to measure pharmacists' performance can be used to identify characteristics of pharmacies providing higher quality of care. Population-based cohort study using community pharmacy claims from 1 November 2009 to 30 June 2010. All community pharmacies in Quebec, Canada. 1742 pharmacies dispensing 8 655 348 antihypertensive prescriptions to 760 700 patients. Patient adherence to antihypertensive medications. Pharmacy level: dispensing workload, volume of pharmacist-provided professional services (eg, refusals to dispense, pharmacotherapy recommendations), pharmacy location, banner/chain, pharmacist overlap and within-pharmacy continuity of care. Patient level: sex, age, income, patient prescription cost, new/chronic therapy, single/multiple antihypertensive medications, single/multiple prescribers and single/multiple dispensing pharmacies. Dispensing level: prescription duration, time of day dispensed and antihypertensive class. Multivariate alternating logistic regression estimated predictors of the primary outcome, accounting for patient and pharmacy clustering. 9.2% of dispensings of antihypertensive medications were provided to non-adherent patients. Male sex, decreasing age, new treatment, multiple prescribers and multiple dispensing pharmacies were risk factors for increased non-adherence. Pharmacies that provided more professional services were less likely to dispense to non-adherent hypertensive patients (OR: 0.60; 95% CI: 0.57 to 0.62) as were those with better scores on the Within-Pharmacy Continuity of Care Index. Neither increased pharmacists' services for improving antihypertensive adherence per se nor increased pharmacist overlap impacted the odds of non-adherence. However, pharmacist overlap was strongly correlated with dispensing workload. There was significant unexplained variability among pharmacies belonging to different banners and chains. Pharmacy administrative claims data can be used to calculate pharmacy-level characteristics associated with improved quality of care. This study supports the importance of pharmacist's professional services and continuity of pharmacist's care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Transfer of residents to hospital prior to cardiac death: the influence of nursing home quality and ownership type.

PubMed

Anic, Gabriella M; Pathak, Elizabeth Barnett; Tanner, Jean Paul; Casper, Michele L; Branch, Laurence G

2014-01-01

We hypothesised that among nursing home decedents, nursing home for-profit status and poor quality-of-care ratings, as well as patient characteristics, would lower the likelihood of transfer to hospital prior to heart disease death. Using death certificates from a large metropolitan area (Tampa Florida Metropolitan Statistical Area) for 1998-2002, we geocoded residential street addresses of heart disease decedents to identify 2172 persons who resided in nursing homes (n=131) at the time of death. We analysed decedent place of death as an indicator of transfer prior to death. Multilevel logistic regression modelling was used for analysis. Cause of death and decedent characteristics were obtained from death certificates. Nursing home characteristics, including state inspector ratings for multiple time points, were obtained from Florida's Agency for Healthcare Administration. Nursing home for-profit status, level of nursing care and quality-of-care ratings were not associated with the likelihood of transfer to hospital prior to heart disease death. Nursing homes >5 miles from a hospital were more likely to transfer decedents, compared with facilities located close to a hospital. Significant predictors of no transfer for nursing home residents were being white, female, older, less educated and widowed/unmarried. In this study population, contrary to our hypotheses, sociodemographic characteristics of nursing home decedents were more important predictors of no transfer prior to cardiac death than quality rankings or for-profit status of nursing homes.

Physiotherapy practice in the private sector: organizational characteristics and models.

PubMed

Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

2014-08-29

Even if a large proportion of physiotherapists work in the private sector worldwide, very little is known of the organizations within which they practice. Such knowledge is important to help understand contexts of practice and how they influence the quality of services and patient outcomes. The purpose of this study was to: 1) describe characteristics of organizations where physiotherapists practice in the private sector, and 2) explore the existence of a taxonomy of organizational models. This was a cross-sectional quantitative survey of 236 randomly-selected physiotherapists. Participants completed a purpose-designed questionnaire online or by telephone, covering organizational vision, resources, structures and practices. Organizational characteristics were analyzed descriptively, while organizational models were identified by multiple correspondence analyses. Most organizations were for-profit (93.2%), located in urban areas (91.5%), and within buildings containing multiple businesses/organizations (76.7%). The majority included multiple providers (89.8%) from diverse professions, mainly physiotherapy assistants (68.7%), massage therapists (67.3%) and osteopaths (50.2%). Four organizational models were identified: 1) solo practice, 2) middle-scale multiprovider, 3) large-scale multiprovider and 4) mixed. The results of this study provide a detailed description of the organizations where physiotherapists practice, and highlight the importance of human resources in differentiating organizational models. Further research examining the influences of these organizational characteristics and models on outcomes such as physiotherapists' professional practices and patient outcomes are needed.

Field Crickets Compensate for Unattractive Static Long-Distance Call Components by Increasing Dynamic Signalling Effort.

PubMed

McAuley, Emily M; Bertram, Susan M

2016-01-01

The evolution of multiple sexual signals presents a dilemma since individuals selecting a mate should pay attention to the most honest signal and ignore the rest; however, multiple signals may evolve if, together, they provide more information to the receiver than either one would alone. Static and dynamic signals, for instance, can act as multiple messages, providing information on different aspects of signaller quality that reflect condition at different time scales. While the nature of static signals makes them difficult or impossible for individuals to augment, dynamic signals are much more susceptible to temporary fluctuations in effort. We investigated whether male Texas field crickets, Gryllus texensis, that produce unattractive static signals compensate by dynamically increasing their calling effort. Our findings lend partial support to the compensation hypothesis, as males that called at unattractive carrier frequencies (a static trait) spent more time calling each night (a dynamic trait). Interestingly, this finding was most pronounced in males that called with attractive pulse characteristics (static traits) but did not occur in males that called with unattractive pulse characteristics. Males that signalled with unattractive pulse characteristics (duration and pause) spent less time calling through the night. Our correlative findings on wild caught males suggest that only males that signal with attractive pulse characteristics may be able to afford to pay the costs of both trait exaggeration and increased calling effort to compensate for poor carrier frequencies.

Relations between Housing Characteristics and the Well-Being of Low-Income Children and Adolescents

PubMed Central

Coley, Rebekah Levine; Leventhal, Tama; Lynch, Alicia Doyle; Kull, Melissa

2013-01-01

Extant research has highlighted the importance of multiple characteristics of housing, but has not comprehensively assessed a broad range of housing characteristics and their relative contributions to children's well-being. Using a representative, longitudinal sample of low-income children and adolescents from low-income urban neighborhoods (N = 2,437, ages 2 through 21 years) from the Three-City Study, this study assessed housing quality, stability, type (i.e., ownership status and subsidy status), and cost simultaneously to delineate their unique associations with children's development. Hierarchical linear models found that poor housing quality was most consistently associated with children's and adolescents’ development, including worse emotional and behavioral functioning and lower cognitive skills. These associations operated in part through mothers’ psychological functioning. Residential instability showed mixed links with functioning, whereas housing cost and type were not consistently predictive. Results suggest that housing contexts are associated with functioning across the developmental span from early childhood through late adolescence, with some differences in patterns by child age. PMID:23244408

Program and Teacher Characteristics Predicting the Implementation of Banking Time with Preschoolers Who Display Disruptive Behaviors.

PubMed

Williford, Amanda P; Wolcott, Catherine Sanger; Whittaker, Jessica Vick; Locasale-Crouch, Jennifer

2015-11-01

This study examined the relationship among baseline program and teacher characteristics and subsequent implementation of Banking Time. Banking Time is a dyadic intervention intended to improve a teacher's interaction quality with a specific child. Banking Time implementation was examined in the current study using a sample of 59 teachers and preschool children displaying disruptive behaviors in the classroom (~three children per classroom). Predictors included preschool program type, teacher demographic characteristics (personal and professional), and teacher beliefs (self-efficacy, authoritarian beliefs, and negative attributions about child disruptive behavior). Multiple measures and methods (i.e., teacher report, consultant report, independent observations) were used to assess implementation. We created three implementation composite measures (dosage, quality, and generalized practice) that had high internal consistencies within each composite but were only modestly associated with one another, suggesting unique constructs of implementation. We found that type of preschool program was associated with dosage and quality. Aspects of teacher demographics related to all three implementation composites. Teacher beliefs predicted dosage and generalized practice. Results suggest that the factors that predict the implementation of Banking Time vary as a function of the type of implementation being assessed.

Designing a multiple dependent state sampling plan based on the coefficient of variation.

PubMed

Yan, Aijun; Liu, Sanyang; Dong, Xiaojuan

2016-01-01

A multiple dependent state (MDS) sampling plan is developed based on the coefficient of variation of the quality characteristic which follows a normal distribution with unknown mean and variance. The optimal plan parameters of the proposed plan are solved by a nonlinear optimization model, which satisfies the given producer's risk and consumer's risk at the same time and minimizes the sample size required for inspection. The advantages of the proposed MDS sampling plan over the existing single sampling plan are discussed. Finally an example is given to illustrate the proposed plan.

Quality of life, symptom distress, and social support among renal transplant recipients in Southern Taiwan: a correlational study.

PubMed

Chen, Wan-Chi; Chen, Ching-Huey; Lee, Po-Chang; Wang, Wen-Ling

2007-12-01

Quality of life is an important indicator for evaluating therapeutic outcomes and mortality in patients with end-stage renal disease. Few studies have explored the impact of symptom distress and social support on quality of life in this population. A correlational study was designed to examine the influence of symptom distress, social support and demographic characteristics on quality of life in renal transplant recipients. A convenience sample of 113 renal transplant recipients was recruited from a medical center in Southern Taiwan. A structured questionnaire was used to collect data. This four-part tool included: Quality of Life Index--Kidney Transplant Version III, Physical Symptom Distress Scale, Social Support Scale, and demographic characteristics. Data were analyzed by descriptive and inferential statistics (SPSS 10.1 statistical package). Percentage, rank, mean and standard deviation, t-tests, chi-square, ANOVA, Pearson's correlation and multiple regression were computed. Results showed that renal transplant recipients had a moderate quality of life. Social support and symptom distress, age, employment status, and household income significantly explained 28.8% of the variance in quality of life. Findings suggest implications for interventional programming and research aimed toward improving quality of life, including individual and family-based approaches designed to enhance recipients' social support and address effective management of symptoms. Recruiting a transplant clinical nurse specialist to design and implement an intervention program also is recommended.

The risk assessment of sudden water pollution for river network system under multi-source random emission

NASA Astrophysics Data System (ADS)

Li, D.

2016-12-01

Sudden water pollution accidents are unavoidable risk events that we must learn to co-exist with. In China's Taihu River Basin, the river flow conditions are complicated with frequently artificial interference. Sudden water pollution accident occurs mainly in the form of a large number of abnormal discharge of wastewater, and has the characteristics with the sudden occurrence, the uncontrollable scope, the uncertainty object and the concentrated distribution of many risk sources. Effective prevention of pollution accidents that may occur is of great significance for the water quality safety management. Bayesian networks can be applied to represent the relationship between pollution sources and river water quality intuitively. Using the time sequential Monte Carlo algorithm, the pollution sources state switching model, water quality model for river network and Bayesian reasoning is integrated together, and the sudden water pollution risk assessment model for river network is developed to quantify the water quality risk under the collective influence of multiple pollution sources. Based on the isotope water transport mechanism, a dynamic tracing model of multiple pollution sources is established, which can describe the relationship between the excessive risk of the system and the multiple risk sources. Finally, the diagnostic reasoning algorithm based on Bayesian network is coupled with the multi-source tracing model, which can identify the contribution of each risk source to the system risk under the complex flow conditions. Taking Taihu Lake water system as the research object, the model is applied to obtain the reasonable results under the three typical years. Studies have shown that the water quality risk at critical sections are influenced by the pollution risk source, the boundary water quality, the hydrological conditions and self -purification capacity, and the multiple pollution sources have obvious effect on water quality risk of the receiving water body. The water quality risk assessment approach developed in this study offers a effective tool for systematically quantifying the random uncertainty in plain river network system, and it also provides the technical support for the decision-making of controlling the sudden water pollution through identification of critical pollution sources.

Do Individual and Neighborhood Characteristics Influence Perceived Air Quality?

PubMed Central

Deguen, Séverine; Padilla, Manon; Kihal-Talantikite, Wahida

2017-01-01

Background: Despite improvements, air pollution still remains a major public health issue. Numerous epidemiological studies have demonstrated the adverse health effects of air pollution exposure based on modeled measures, but only a few have considered the health impact of perceived air quality. Improving our knowledge of individual perceptions is crucial to defining targeted actions and promoting appropriate intervention measures. Our objective is to investigate the relationship between subjective and objective measures of air pollution and to focus on how individual characteristics combined with the neighborhood socioeconomic deprivation index, measured at a fine spatial scale, may or may not alter this relationship. Materials and Methods: The subjective measures of air quality reported by a sample of Lyon residents were collected via an individual questionnaire. The objective measures of air pollution were modeled by the local air quality monitoring network of the Rhône-Alpes region at census block level. We used a socioeconomic deprivation index to capture the different socioeconomic dimensions at census block level. The statistical analysis was structured in two steps: (1) identification of individual determinants of the subjective measures of air quality using multiple correspondence analysis followed by hierarchical clustering; (2) identification of individual and contextual characteristics that may alter the relationship between the objective and subjective measures of air pollution. Results: Among the youngest and the middle aged population (ages 30 to 59), consistent results between level of satisfaction, perceived air quality and objective measures of air pollution were found whatever the individual characteristics of the population. It is less clear among the oldest population: globally no significant difference between the NO2 concentrations and the level of satisfaction was observed. Conclusions: We found a significant relationship between the subjective and objective measures of air pollution in many population sub-groups with different combinations of individual characteristics. The relationship is less clear among the oldest population, which confirms previous findings. Our finding highlights that age combined with low level of education and unemployment, or women or health problems as well as the neighborhood deprivation index influence the level of air quality satisfaction. PMID:29231899

Do Individual and Neighborhood Characteristics Influence Perceived Air Quality?

PubMed

Deguen, Séverine; Padilla, Manon; Padilla, Cindy; Kihal-Talantikite, Wahida

2017-12-12

Background : Despite improvements, air pollution still remains a major public health issue. Numerous epidemiological studies have demonstrated the adverse health effects of air pollution exposure based on modeled measures, but only a few have considered the health impact of perceived air quality. Improving our knowledge of individual perceptions is crucial to defining targeted actions and promoting appropriate intervention measures. Our objective is to investigate the relationship between subjective and objective measures of air pollution and to focus on how individual characteristics combined with the neighborhood socioeconomic deprivation index, measured at a fine spatial scale, may or may not alter this relationship. Materials and Methods : The subjective measures of air quality reported by a sample of Lyon residents were collected via an individual questionnaire. The objective measures of air pollution were modeled by the local air quality monitoring network of the Rhône-Alpes region at census block level. We used a socioeconomic deprivation index to capture the different socioeconomic dimensions at census block level. The statistical analysis was structured in two steps: (1) identification of individual determinants of the subjective measures of air quality using multiple correspondence analysis followed by hierarchical clustering; (2) identification of individual and contextual characteristics that may alter the relationship between the objective and subjective measures of air pollution. Results : Among the youngest and the middle aged population (ages 30 to 59), consistent results between level of satisfaction, perceived air quality and objective measures of air pollution were found whatever the individual characteristics of the population. It is less clear among the oldest population: globally no significant difference between the NO₂ concentrations and the level of satisfaction was observed. Conclusion s : We found a significant relationship between the subjective and objective measures of air pollution in many population sub-groups with different combinations of individual characteristics. The relationship is less clear among the oldest population, which confirms previous findings. Our finding highlights that age combined with low level of education and unemployment, or women or health problems as well as the neighborhood deprivation index influence the level of air quality satisfaction.

Automatic Multi-sensor Data Quality Checking and Event Detection for Environmental Sensing

NASA Astrophysics Data System (ADS)

LIU, Q.; Zhang, Y.; Zhao, Y.; Gao, D.; Gallaher, D. W.; Lv, Q.; Shang, L.

2017-12-01

With the advances in sensing technologies, large-scale environmental sensing infrastructures are pervasively deployed to continuously collect data for various research and application fields, such as air quality study and weather condition monitoring. In such infrastructures, many sensor nodes are distributed in a specific area and each individual sensor node is capable of measuring several parameters (e.g., humidity, temperature, and pressure), providing massive data for natural event detection and analysis. However, due to the dynamics of the ambient environment, sensor data can be contaminated by errors or noise. Thus, data quality is still a primary concern for scientists before drawing any reliable scientific conclusions. To help researchers identify potential data quality issues and detect meaningful natural events, this work proposes a novel algorithm to automatically identify and rank anomalous time windows from multiple sensor data streams. More specifically, (1) the algorithm adaptively learns the characteristics of normal evolving time series and (2) models the spatial-temporal relationship among multiple sensor nodes to infer the anomaly likelihood of a time series window for a particular parameter in a sensor node. Case studies using different data sets are presented and the experimental results demonstrate that the proposed algorithm can effectively identify anomalous time windows, which may resulted from data quality issues and natural events.

Urban air quality forecasting based on multi-dimensional collaborative Support Vector Regression (SVR): A case study of Beijing-Tianjin-Shijiazhuang

PubMed Central

Liu, Bing-Chun; Binaykia, Arihant; Chang, Pei-Chann; Tiwari, Manoj Kumar; Tsao, Cheng-Chin

2017-01-01

Today, China is facing a very serious issue of Air Pollution due to its dreadful impact on the human health as well as the environment. The urban cities in China are the most affected due to their rapid industrial and economic growth. Therefore, it is of extreme importance to come up with new, better and more reliable forecasting models to accurately predict the air quality. This paper selected Beijing, Tianjin and Shijiazhuang as three cities from the Jingjinji Region for the study to come up with a new model of collaborative forecasting using Support Vector Regression (SVR) for Urban Air Quality Index (AQI) prediction in China. The present study is aimed to improve the forecasting results by minimizing the prediction error of present machine learning algorithms by taking into account multiple city multi-dimensional air quality information and weather conditions as input. The results show that there is a decrease in MAPE in case of multiple city multi-dimensional regression when there is a strong interaction and correlation of the air quality characteristic attributes with AQI. Also, the geographical location is found to play a significant role in Beijing, Tianjin and Shijiazhuang AQI prediction. PMID:28708836

A framework for evaluating student perceptions of health policy training in medical school.

PubMed

Patel, Mitesh S; Lypson, Monica L; Miller, D Douglas; Davis, Matthew M

2014-10-01

Nearly half of graduating medical students in the United States report that medical school provides inadequate instruction in topics related to health policy. Although most medical schools report some form of policy education, there lacks a standard for teaching core concepts and evaluating student satisfaction. Responses to the Association of American Medical College's Medical School Graduation Questionnaire were obtained for the years 2007-2008 and 2011-2012 and mapped to domains of training in health policy curricula for four domains: systems and principles; value and equity; quality and safety; and politics and law. Chi-square tests were used to test differences among unadjusted temporal trends. Multiple logistic regression models were fit to the outcome variables and adjusted for student characteristics, student preferences, and medical school characteristics. Compared with 2007-2008, students' perceptions of training in 2011-2012 increased on a relative basis by 11.7% for components within systems and principles, 2.8% for quality and safety, and 6.8% for value and equity. Components within politics and law had a composite decline of 4.8%. Multiple logistic regression models found higher odds of reporting satisfaction with training over time for all components within the domains of systems and principles, quality and safety, and value and equity (P < .01), with the exception of medical economics. Medical student perceptions of training in health policy improved over time. Causal factors for these trends require further study. Despite improvement, nearly 40% of graduating medical students still report inadequate instruction in health policy.

Genetic dissection of sorghum grain quality traits using diverse and segregating populations.

PubMed

Boyles, Richard E; Pfeiffer, Brian K; Cooper, Elizabeth A; Rauh, Bradley L; Zielinski, Kelsey J; Myers, Matthew T; Brenton, Zachary; Rooney, William L; Kresovich, Stephen

2017-04-01

Coordinated association and linkage mapping identified 25 grain quality QTLs in multiple environments, and fine mapping of the Wx locus supports the use of high-density genetic markers in linkage mapping. There is a wide range of end-use products made from cereal grains, and these products often demand different grain characteristics. Fortunately, cereal crop species including sorghum [Sorghum bicolor (L.) Moench] contain high phenotypic variation for traits influencing grain quality. Identifying genetic variants underlying this phenotypic variation allows plant breeders to develop genotypes with grain attributes optimized for their intended usage. Multiple sorghum mapping populations were rigorously phenotyped across two environments (SC Coastal Plain and Central TX) in 2 years for five major grain quality traits: amylose, starch, crude protein, crude fat, and gross energy. Coordinated association and linkage mapping revealed several robust QTLs that make prime targets to improve grain quality for food, feed, and fuel products. Although the amylose QTL interval spanned many megabases, the marker with greatest significance was located just 12 kb from waxy (Wx), the primary gene regulating amylose production in cereal grains. This suggests higher resolution mapping in recombinant inbred line (RIL) populations can be obtained when genotyped at a high marker density. The major QTL for crude fat content, identified in both a RIL population and grain sorghum diversity panel, encompassed the DGAT1 locus, a critical gene involved in maize lipid biosynthesis. Another QTL on chromosome 1 was consistently mapped in both RIL populations for multiple grain quality traits including starch, crude protein, and gross energy. Collectively, these genetic regions offer excellent opportunities to manipulate grain composition and set up future studies for gene validation.

Identification of milling and baking quality QTL in multiple soft wheat mapping populations.

PubMed

Cabrera, Antonio; Guttieri, Mary; Smith, Nathan; Souza, Edward; Sturbaum, Anne; Hua, Duc; Griffey, Carl; Barnett, Marla; Murphy, Paul; Ohm, Herb; Uphaus, Jim; Sorrells, Mark; Heffner, Elliot; Brown-Guedira, Gina; Van Sanford, David; Sneller, Clay

2015-11-01

Two mapping approaches were use to identify and validate milling and baking quality QTL in soft wheat. Two LG were consistently found important for multiple traits and we recommend the use marker-assisted selection on specific markers reported here. Wheat-derived food products require a range of characteristics. Identification and understanding of the genetic components controlling end-use quality of wheat is important for crop improvement. We assessed the underlying genetics controlling specific milling and baking quality parameters of soft wheat including flour yield, softness equivalent, flour protein, sucrose, sodium carbonate, water absorption and lactic acid, solvent retention capacities in a diversity panel and five bi-parental mapping populations. The populations were genotyped with SSR and DArT markers, with markers specific for the 1BL.1RS translocation and sucrose synthase gene. Association analysis and composite interval mapping were performed to identify quantitative trait loci (QTL). High heritability was observed for each of the traits evaluated, trait correlations were consistent over populations, and transgressive segregants were common in all bi-parental populations. A total of 26 regions were identified as potential QTL in the diversity panel and 74 QTL were identified across all five bi-parental mapping populations. Collinearity of QTL from chromosomes 1B and 2B was observed across mapping populations and was consistent with results from the association analysis in the diversity panel. Multiple regression analysis showed the importance of the two 1B and 2B regions and marker-assisted selection for the favorable alleles at these regions should improve quality.

Understanding Existing Salmonid Habitat Availability and Connectivity to Improve River Management

NASA Astrophysics Data System (ADS)

Duffin, J.; Yager, E.; Tonina, D.; Benjankar, R. M.

2017-12-01

In the Pacific Northwest river restoration is common for salmon conservation. Mangers need methods to help target restoration to problem areas in rivers to create habitat that meets a species' needs. Hydraulic models and habitat suitability curves provide basic information on habitat availability and overall quality, but these analyses need to be expanded to address habitat quality based on the accessibility of habitats required for multiple life stages. Scientists are starting to use connectivity measurements to understand the longitudinal proximity of habitat patches, which can be used to address the habitat variability of a reach. By evaluating the availability and quality of habitat and calculating the connectivity between complementary habitats, such as spawning and rearing habitats, we aim to identify areas that should be targeted for restoration. To meet these goals, we assessed Chinook salmon habitat on the Lemhi River in Idaho. The depth and velocity outputs from a 2D hydraulic model are used in conjunction with locally created habitat suitability curves to evaluate the availability and quality of habitat for multiple Chinook salmon life stages. To assess the variability of the habitat, connectivity between habitat patches necessary for different life stages is calculated with a proximity index. A spatial representation of existing habitat quality and connectivity between complimentary habitats can be linked to river morphology by the evaluation of local geomorphic characteristics, including sinuosity and channel units. The understanding of the current habitat availability for multiple life stage needs, the connectivity between these habitat patches, and their relationship with channel morphology can help managers better identify restoration needs and direct their limited resources.

The Relationship Between Reported Sleep Quality and Sleep Hygiene in Italian and American Adolescents

PubMed Central

LeBourgeois, Monique K.; Giannotti, Flavia; Cortesi, Flavia; Wolfson, Amy R.; Harsh, John

2014-01-01

Objective The purpose of the study was to examine the relationship between self-reported sleep quality and sleep hygiene in Italian and American adolescents and to assess whether sleep-hygiene practices mediate the relationship between culture and sleep quality. Methods Two nonprobability samples were collected from public schools in Rome, Italy, and Hattiesburg, Mississippi. Students completed the following self-report measures: Adolescent Sleep-Wake Scale, Adolescent Sleep Hygiene Scale, Pubertal Developmental Scale, and Morningness/Eveningness Scale. Results The final sample included 776 Italian and 572 American adolescents 12 to 17 years old. Italian adolescents reported much better sleep hygiene and substantially better sleep quality than American adolescents. A moderate-to-strong linear relationship was found between sleep hygiene and sleep quality in both samples. Separate hierarchical multiple regression analyses were performed on both samples. Demographic and individual characteristics explained a significant proportion of the variance in sleep quality (Italians: 18%; Americans: 25%), and the addition of sleep-hygiene domains explained significantly more variance in sleep quality (Italians: 17%; Americans: 16%). A final hierarchical multiple regression analysis with both samples combined showed that culture (Italy versus United States) only explained 0.8% of the variance in sleep quality after controlling for sleep hygiene and all other variables. Conclusions Cross-cultural differences in sleep quality, for the most part, were due to differences in sleep-hygiene practices. Sleep hygiene is an important predictor of sleep quality in Italian and American adolescents, thus supporting the implementation and evaluation of educational programs on good sleep-hygiene practices. PMID:15866860

Field Crickets Compensate for Unattractive Static Long-Distance Call Components by Increasing Dynamic Signalling Effort

PubMed Central

McAuley, Emily M.

2016-01-01

The evolution of multiple sexual signals presents a dilemma since individuals selecting a mate should pay attention to the most honest signal and ignore the rest; however, multiple signals may evolve if, together, they provide more information to the receiver than either one would alone. Static and dynamic signals, for instance, can act as multiple messages, providing information on different aspects of signaller quality that reflect condition at different time scales. While the nature of static signals makes them difficult or impossible for individuals to augment, dynamic signals are much more susceptible to temporary fluctuations in effort. We investigated whether male Texas field crickets, Gryllus texensis, that produce unattractive static signals compensate by dynamically increasing their calling effort. Our findings lend partial support to the compensation hypothesis, as males that called at unattractive carrier frequencies (a static trait) spent more time calling each night (a dynamic trait). Interestingly, this finding was most pronounced in males that called with attractive pulse characteristics (static traits) but did not occur in males that called with unattractive pulse characteristics. Males that signalled with unattractive pulse characteristics (duration and pause) spent less time calling through the night. Our correlative findings on wild caught males suggest that only males that signal with attractive pulse characteristics may be able to afford to pay the costs of both trait exaggeration and increased calling effort to compensate for poor carrier frequencies. PMID:27936045

Comprehensive care programs for patients with multiple chronic conditions: a systematic literature review.

PubMed

de Bruin, Simone R; Versnel, Nathalie; Lemmens, Lidwien C; Molema, Claudia C M; Schellevis, François G; Nijpels, Giel; Baan, Caroline A

2012-10-01

To provide insight into the characteristics of comprehensive care programs for patients with multiple chronic conditions and their impact on patients, informal caregivers, and professional caregivers. Systematic literature search in multiple electronic databases for English language papers published between January 1995 and January 2011, supplemented by reference tracking and a manual search on the internet. Wagner's chronic care model (CCM) was used to define comprehensive care. After inclusion, the methodological quality of each study was assessed. A best-evidence synthesis was applied to draw conclusions. Forty-two publications were selected describing thirty-three studies evaluating twenty-eight comprehensive care programs for multimorbid patients. Programs varied in the target patient groups, implementation settings, number of included interventions, and number of CCM components to which these interventions related. Moderate evidence was found for a beneficial effect of comprehensive care on inpatient healthcare utilization and healthcare costs, health behavior of patients, perceived quality of care, and satisfaction of patients and caregivers. Insufficient evidence was found for a beneficial effect of comprehensive care on health-related quality of life in terms of mental functioning, medication use, and outpatient healthcare utilization and healthcare costs. No evidence was found for a beneficial effect of comprehensive care on cognitive functioning, depressive symptoms, functional status, mortality, quality of life in terms of physical functioning, and caregiver burden. Because of the heterogeneity of comprehensive care programs, it is as yet too early to draw firm conclusions regarding their effectiveness. More rigorous evaluation studies are necessary to determine what constitutes best care for the increasing number of people with multiple chronic conditions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Doctors on the move: a European case study on the key characteristics of national recertification systems

PubMed Central

Govaerts, Marjan J; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

2018-01-01

Objectives With increased cross-border movement, ensuring safe and high-quality healthcare has gained primacy. The purpose of recertification is to ensure quality of care through periodically attesting doctors’ professional proficiency in their field. Professional migration and facilitated cross-border recognition of qualifications, however, make us question the fitness of national policies for safeguarding patient care and the international accountability of doctors. Design and setting We performed document analyses and conducted 19 semistructured interviews to identify and describe key characteristics and effective components of 10 different European recertification systems, each representing one case (collective case study). We subsequently compared these systems to explore similarities and differences in terms of assessment criteria used to determine process quality. Results Great variety existed between countries in terms and assessment formats used, targeting cognition, competence and performance (Miller’s assessment pyramid). Recertification procedures and requirements also varied significantly, ranging from voluntary participation in professional development modules to the mandatory collection of multiple performance data in a competency-based portfolio. Knowledge assessment was fundamental to recertification in most countries. Another difference concerned the stakeholders involved in the recertification process: while some systems exclusively relied on doctors’ self-assessment, others involved multiple stakeholders but rarely included patients in assessment of doctors’ professional competence. Differences between systems partly reflected different goals and primary purposes of recertification. Conclusion Recertification systems differ substantially internationally with regard to the criteria they apply to assess doctors’ competence, their aims, requirements, assessment formats and patient involvement. In the light of professional mobility and associated demands for accountability, we recommend that competence assessment includes patients’ perspectives, and recertification practices be shared internationally to enhance transparency. This can help facilitate cross-border movement, while guaranteeing high-quality patient care. PMID:29666131

Quality of life instruments used in mental health research: properties and utilization.

PubMed

Prigent, Amélie; Simon, Sandrine; Durand-Zaleski, Isabelle; Leboyer, Marion; Chevreul, Karine

2014-01-30

Quality of life (QoL) assessment is increasingly used in mental health. Multiple instruments exist, but the conditions for choosing one instrument over another for purposes of a specific study are not clear. We performed a systematic review to identify the QoL instruments used in mental health. The instruments were systematically described regarding their intrinsic properties (e.g., generic v. disease-specific) and their characteristics of utilization in studies (e.g., study objectives). Using cluster analyses, we investigated the existence of similar instruments with respect to each of these sets of characteristics and studied potential links between instruments' intrinsic properties and their characteristics of utilization. We included 149 studies in which 56 distinct instruments were used. Similarities were found among instruments in terms of their intrinsic properties as well as their characteristics of utilization, leading to the construction of four clusters of instruments in each case. However, no relevant links were identified between instruments' intrinsic properties and their characteristics of utilization, suggesting that the choice of QoL instruments did not depend on their properties. A consensus about common QoL instruments must be reached to facilitate the choice of instruments, the comparison of results and thus to have an impact on clinical and policy decision-making. © 2013 Published by Elsevier Ireland Ltd.

Crime prediction modeling

NASA Technical Reports Server (NTRS)

1971-01-01

A study of techniques for the prediction of crime in the City of Los Angeles was conducted. Alternative approaches to crime prediction (causal, quasicausal, associative, extrapolative, and pattern-recognition models) are discussed, as is the environment within which predictions were desired for the immediate application. The decision was made to use time series (extrapolative) models to produce the desired predictions. The characteristics of the data and the procedure used to choose equations for the extrapolations are discussed. The usefulness of different functional forms (constant, quadratic, and exponential forms) and of different parameter estimation techniques (multiple regression and multiple exponential smoothing) are compared, and the quality of the resultant predictions is assessed.

Growth and Photosynthesis Characteristics of an Artificially Regenerated Mixed Hardwood Stand in the Southern USA

Treesearch

Shi-Jean S. Sung; Paul P. Kormanik; Stanley J. Zarnoch; Charles Possee

2002-01-01

The hardwood forests of the southern U.S. are not naturally composed of singe predominant species. The diversity of tree species within these stands is one of the qualities that make them so valuable for multiple use stand management. While many of the best hardwood sites have been planted to pines since the 1950's, some proportion of these pine stands now being...

Simplified multiple scattering model for radiative transfer in turbid water

NASA Technical Reports Server (NTRS)

Ghovanlou, A. H.; Gupta, G. N.

1978-01-01

Quantitative analytical procedures for relating selected water quality parameters to the characteristics of the backscattered signals, measured by remote sensors, require the solution of the radiative transport equation in turbid media. Presented is an approximate closed form solution of this equation and based on this solution, the remote sensing of sediments is discussed. The results are compared with other standard closed form solutions such as quasi-single scattering approximations.

Feasibility investigations on multi-cutter milling process: A novel fabrication method for microreactors with multiple microchannels

NASA Astrophysics Data System (ADS)

Pan, Minqiang; Zeng, Dehuai; Tang, Yong

A novel multi-cutter milling process for multiple parallel microchannels with manifolds is proposed to address the challenge of mass manufacture as required for cost-effective commercial applications. Several slotting cutters are stacked together to form a composite tool for machining microchannels simultaneously. The feasibility of this new fabrication process is experimentally investigated under different machining conditions and reaction characteristics of methanol steam reforming for hydrogen production. The influences of cutting parameters and the composite tool on the microchannel qualities and burr formation are analyzed. Experimental results indicate that larger cutting speed, smaller feed rate and cutting depth are in favor of obtaining relatively good microchannel qualities and small burrs. Of all the cutting parameters considered in these experiments, 94.2 m min -1 cutting speed, 23.5 mm min -1 feed rate and 0.5 mm cutting depth are found to be the optimum value. According to the comparisons of experimental results of multi-cutter milling process and estimated one of other alternative methods, it is found that multi-cutter milling process shows much shorter machining time and higher work removal rate than that of other alternative methods. Reaction characteristics of methanol steam reforming in microchannels also indicate that multi-cutter milling process is probably suitable for a commercial application.

Tools for beach health data management, data processing, and predictive model implementation

USGS Publications Warehouse

,

2013-01-01

This fact sheet describes utilities created for management of recreational waters to provide efficient data management, data aggregation, and predictive modeling as well as a prototype geographic information system (GIS)-based tool for data visualization and summary. All of these utilities were developed to assist beach managers in making decisions to protect public health. The Environmental Data Discovery and Transformation (EnDDaT) Web service identifies, compiles, and sorts environmental data from a variety of sources that help to define climatic, hydrologic, and hydrodynamic characteristics including multiple data sources within the U.S. Geological Survey and the National Oceanic and Atmospheric Administration. The Great Lakes Beach Health Database (GLBH-DB) and Web application was designed to provide a flexible input, export, and storage platform for beach water quality and sanitary survey monitoring data to compliment beach monitoring programs within the Great Lakes. A real-time predictive modeling strategy was implemented by combining the capabilities of EnDDaT and the GLBH-DB for timely, automated prediction of beach water quality. The GIS-based tool was developed to map beaches based on their physical and biological characteristics, which was shared with multiple partners to provide concepts and information for future Web-accessible beach data outlets.

Clinical characteristics and objective living conditions in relation to quality of life among community-based individuals of schizophrenia in Hong Kong.

PubMed

Yeung, Frederick Ka Ching; Chan, Sunny Ho Wan

2006-11-01

Quality of life (QOL) has gained importance as an outcome measure for people with schizophrenia living in the community following deinstitutionalization. This study aims at exploring the effects of clinical characteristics and objective living conditions on QOL. In this study, 201 community-based individuals with schizophrenia were recruited from five different types of objective living conditions comprising long stay care home, halfway house, supported hostel/housing, living with family, and living alone. Clinical characteristics including cognitive abilities, symptom levels, and community/social functioning were assessed by the Allen Cognitive Level Screen, the Scales for the Assessment of Negative Symptoms and Positive Symptoms, and the Chinese version of the Multnomah Community Ability Scale respectively. The outcome measure of QOL was measured by the Chinese version of the WHO Quality of Life Measure. Analysis of covariance showed significant differences in community/social functioning, cognitive abilities, and negative symptoms; but not in QOL under different objective living conditions. Further simultaneous multiple regressions found out that community/social functioning was the robust significant predictor of QOL. Yet caution should be noted in making the conclusion with the objective living condition of long stay care home, as it provides a protective element for the perseverance of QOL.

Angry responses to infant challenges: parent, marital, and child genetic factors associated with harsh parenting.

PubMed

Hajal, Nastassia; Neiderhiser, Jenae; Moore, Ginger; Leve, Leslie; Shaw, Daniel; Harold, Gordon; Scaramella, Laura; Ganiban, Jody; Reiss, David

2015-01-01

This study examined genetic and environmental influences on harsh parenting of adopted 9-month-olds (N = 503), with an emphasis on positive child-, parent-, and family-level characteristics. Evocative gene-environment correlation (rGE) was examined by testing the effect of both positive and negative indices of birth parent temperament on adoptive parents' harsh parenting. Adoptive fathers' harsh parenting was inversely related to birth mother positive temperament, indicating evocative rGE, as well as to marital quality. Adoptive parents' negative temperamental characteristics were related to hostile parenting for both fathers and mothers. Findings support the importance of enhancing positive family characteristics in addition to mitigating negative characteristics, as well as engaging multiple levels of the family system to prevent harsh parenting. © 2015 The Authors. Child Development © 2015 Society for Research in Child Development, Inc.

Evaluation of multiple water quality indices for drinking and irrigation purposes for the Karoon river, Iran.

PubMed

Aminiyan, Milad Mirzaei; Aitkenhead-Peterson, Jacqueline; Aminiyan, Farzad Mirzaei

2018-06-16

The main purpose of this study was to evaluate the water quality of the Karoon river, which is a main river in Iran country. For this purpose, hydrochemical analyses of a database that maintained by the Water Resources Authority of Khuzestan Province, Iran's Ministry of Energy, were carried out. These data were compared with the maximum permissible limit values recommended by World Health Organization and Food and Agriculture Organization water standards for drinking and agricultural purposes, respectively. Also in this regard, multiple indices of water quality were utilized. However, not all indices gave similar rankings for water quality. According to the USSL diagram and Kelly ratio, Karoon's water quality is not suitable for irrigation purposes due to high salinity and moderate alkalinity. However, the results of the magnesium hazard analysis suggested that water quality for irrigation is acceptable. A Piper diagram illustrated that the most dominant water types during the 15 years of the study were Na-Cl and Na-SO 4 . The mineral saturation index also indicated that Na-Cl is the dominant water type. The water quality for drinking purpose was evaluated using a Schoeller diagram and water quality index (WQI). According to the computed WQI ranging from 111.9 to 194.0, the Karoon's water in the Khuzestan plain can be categorized as "poor water" for drinking purposes. Based on hydrochemical characteristics, years 2000-2007 and 2008-2014 were categorized into two clusters illustrating a decline in water quality between the two time periods.

Nursing unit teams matter: Impact of unit-level nurse practice environment, nurse work characteristics, and burnout on nurse reported job outcomes, and quality of care, and patient adverse events--a cross-sectional survey.

PubMed

Van Bogaert, Peter; Timmermans, Olaf; Weeks, Susan Mace; van Heusden, Danny; Wouters, Kristien; Franck, Erik

2014-08-01

To investigate the impact of nurse practice environment factors, nurse work characteristics, and burnout on nurse reported job outcomes, quality of care, and patient adverse events variables at the nursing unit level. Nurse practice environment studies show growing insights and knowledge about determining factors for nurse workforce stability, quality of care, and patient safety. Until now, international studies have primarily focused on variability at the hospital level; however, insights at the nursing unit level can reveal key factors in the nurse practice environment. A cross-sectional design with a survey. In a cross-sectional survey, a sample of 1108 nurses assigned to 96 nursing units completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality of care, and patient adverse events. Associations between the variables were examined using multilevel modelling techniques. Various unit-level associations (simple models) were identified between nurse practice environment factors, nurse work characteristics, burnout dimensions, and nurse reported outcome variables. Multiple multilevel models showed various independent variables such as nursing management at the unit level, social capital, emotional exhaustion, and depersonalization as important predictors of nurse reported outcome variables such job satisfaction, turnover intentions, quality of care (at the unit, the last shift, and in the hospital within the last year), patient and family complaints, patient and family verbal abuse, patient falls, nosocomial infections, and medications errors. Results suggested a stable nurse work force, with the capability to achieve superior quality and patient safety outcomes, is associated with unit-level favourable perceptions of nurse work environment factors, workload, decision latitude, and social capital, as well low levels of burnout. Nurses, physicians, nursing leaders, and executives share responsibility to create an environment supportive of interdisciplinary team development. Copyright © 2013 Elsevier Ltd. All rights reserved.

Factors affecting quality of life in adults with epilepsy in Taiwan: A cross-sectional, correlational study.

PubMed

Chen, Hsiu-Fang; Tsai, Yun-Fang; Hsi, Mo-Song; Chen, Jui-Chen

2016-05-01

The purpose of this study was to assess eight factors considered important for quality of life in persons with epilepsy in order to determine which of these components affect quality of life in adults with epilepsy in Taiwan. A cross-sectional, correlational study using structured questionnaires assessed 260 patients with epilepsy purposively sampled from a medical center in Northern Taiwan. Health-related quality of life (HRQoL) was evaluated with the Quality of Life in Epilepsy-31 (QOLIE-31) questionnaire. Data also included personal and health-related characteristics, knowledge of epilepsy, efficacy in the self-management of epilepsy, and social support. Scores for the QOLIE-31 were correlated with the following factors: (1) demographic characteristics of age, gender, and income; (2) sleep quality; (3) symptoms of anxiety and depression; (4) epilepsy-specific variables: seizure frequency; types, number, and frequency of antiepileptic drugs (AEDs); and adverse events of AEDs; and (5) social support. Stepwise regression analysis showed that seven factors were predictive for quality of life: anxiety, depression, adverse events of AEDs, social support, seizure frequency of at least once in three months, household income of NT$ 40,001-100,000, and male gender. These factors accounted for 58.2% of the variance of quality of life. Our study assessed multiple factors in an examination of relationships and predictive factors for quality of life in adults with epilepsy in Taiwan. Knowledge of these contributing factors can assist health-care providers when evaluating patients with epilepsy to help target interventions for improving quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

Health-related quality of life and satisfaction with case management in cancer survivors.

PubMed

Hsu, Ya-Hui; Chai, Hsiu-Ying; Lin, Yu-Fen; Wang, Chao-Hui; Chen, Shu-Ching

2017-12-01

To (i) investigate the characteristics of health-related quality of life and satisfaction with case management and (ii) to identify factors associated with health-related quality of life in cancer survivors. The level of health-related quality of life can reflect treatment efficacy and satisfaction with cancer care. A cross-sectional study design was adopted. Subjects from the outpatient setting of a cancer centre in northern Taiwan were recruited by consecutive sampling. A set of questionnaires were employed, including a background information form, case management service satisfaction survey (CMSS) and The European Quality of Life Scale (EQ-5D). Descriptive statistics were used to examine levels of health-related quality of life and satisfaction with case management. Pearson's correlation was used to identify relationships between treatment characteristics, satisfaction with case management and health-related quality of life. Multiple stepwise regression was used to identify factors associated with health-related quality of life. A total of 252 cancer patients were recruited. The three lowest scores for items of health-related quality of life were mobility, self-care and usual activities. Cancer survivors with higher mobility, less pain and discomfort, and lower anxiety and depression were more likely to have better health-related quality of life. Mobility, pain and discomfort, and anxiety and depression are important predictive factors of high health-related quality of life in cancer survivors. In clinical care, patients' physical mobility, pain and discomfort, and anxiety and depression are important indicators of health-related quality of life. Case managers should include self-care and symptom management into survivorship care plans to improve health-related quality of life during survival after treatment concludes. © 2017 John Wiley & Sons Ltd.

Applicability of market-based instruments for safeguarding water quality in coastal waterways: Case study for Darwin Harbour, Australia

NASA Astrophysics Data System (ADS)

Greiner, Romy

2014-02-01

Water pollution of coastal waterways is a complex problem due to the cocktail of pollutants and multiplicity of polluters involved and pollution characteristics. Pollution control therefore requires a combination of policy instruments. This paper examines the applicability of market-based instruments to achieve effective and efficient water quality management in Darwin Harbour, Northern Territory, Australia. Potential applicability of instruments is examined in the context of biophysical and economic pollution characteristics, and experience with instruments elsewhere. The paper concludes that there is potential for inclusion of market-based instruments as part of an instrument mix to safeguard water quality in Darwin Harbour. It recommends, in particular, expanding the existing licencing system to include quantitative pollution limits for all significant point polluters; comprehensive and independent pollution monitoring across Darwin Harbour; public disclosure of water quality and emissions data; positive incentives for landholders in the Darwin Harbour catchment to improve land management practices; a stormwater offset program for greenfield urban developments; adoption of performance bonds for developments and operations which pose a substantial risk to water quality, including port expansion and dredging; and detailed consideration of a bubble licensing scheme for nutrient pollution. The paper offers an analytical framework for policy makers and resource managers tasked with water quality management in coastal waterways elsewhere in Australia and globally, and helps to scan for MBIs suitable in any given environmental management situation.

Image degradation characteristics and restoration based on regularization for diffractive imaging

NASA Astrophysics Data System (ADS)

Zhi, Xiyang; Jiang, Shikai; Zhang, Wei; Wang, Dawei; Li, Yun

2017-11-01

The diffractive membrane optical imaging system is an important development trend of ultra large aperture and lightweight space camera. However, related investigations on physics-based diffractive imaging degradation characteristics and corresponding image restoration methods are less studied. In this paper, the model of image quality degradation for the diffraction imaging system is first deduced mathematically based on diffraction theory and then the degradation characteristics are analyzed. On this basis, a novel regularization model of image restoration that contains multiple prior constraints is established. After that, the solving approach of the equation with the multi-norm coexistence and multi-regularization parameters (prior's parameters) is presented. Subsequently, the space-variant PSF image restoration method for large aperture diffractive imaging system is proposed combined with block idea of isoplanatic region. Experimentally, the proposed algorithm demonstrates its capacity to achieve multi-objective improvement including MTF enhancing, dispersion correcting, noise and artifact suppressing as well as image's detail preserving, and produce satisfactory visual quality. This can provide scientific basis for applications and possesses potential application prospects on future space applications of diffractive membrane imaging technology.

Evaluation of the effect of salts on chemical, structural, textural, sensory and heating properties of cheese: Contribution of conventional methods and spectral ones.

PubMed

Loudiyi, M; Aït-Kaddour, A

2018-03-21

Chemical composition, sensory characteristics, textural and functional properties are among the most important characteristics, which directly relates to the global quality of cheese and to consumer acceptability. A number of factors including milk composition, processing conditions and salt content, influences these properties. The past decades many investigations were performed on the possibilities to reduce salt content of cheese due to its adverse health effects, the current lifestyle and the awareness of the consumers for nutrition quality products. Due to the multiple potential effects of reducing NaCl (simple reduction or substitution) on cheese attributes, it is of utmost importance to identify and understand those effects in order to control the global quality and safety of the final product. In the present review a collection of the different results and conclusions drawn after studying the effect of salts by conventional (e.g. wet chemistry) and instrumental (e.g. spectral) methods on chemical, structural, textural, sensory and heating properties of cheese are presented.

Epidemiology, quality and reporting characteristics of meta-analyses of observational studies published in Chinese journals.

PubMed

Zhang, Zhe-wen; Cheng, Juan; Liu, Zhuan; Ma, Ji-chun; Li, Jin-long; Wang, Jing; Yang, Ke-hu

2015-12-07

The aim of this study was to examine the epidemiological and reporting characteristics as well as the methodological quality of meta-analyses (MAs) of observational studies published in Chinese journals. 5 Chinese databases were searched for MAs of observational studies published from January 1978 to May 2014. Data were extracted into Excel spreadsheets, and Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Assessment of Multiple Systematic Reviews (AMSTAR) checklists were used to assess reporting characteristics and methodological quality, respectively. A total of 607 MAs were included. Only 52.2% of the MAs assessed the quality of the included primary studies, and the retrieval information was not comprehensive in more than half (85.8%) of the MAs. In addition, 50 (8.2%) MAs did not search any Chinese databases, while 126 (20.8%) studies did not search any English databases. Approximately 41.2% of the MAs did not describe the statistical methods in sufficient details, and most (95.5%) MAs did not report on conflicts of interest. However, compared with the before publication of the MOOSE Checklist, the quality of reporting improved significantly for 20 subitems after publication of the MOOSE Checklist, and 7 items of the included MAs demonstrated significant improvement after publication of the AMSTAR Checklist (p<0.05). Although many MAs of observational studies have been published in Chinese journals, the reporting quality is questionable. Thus, there is an urgent need to increase the use of reporting guidelines and methodological tools in China; we recommend that Chinese journals adopt the MOOSE and AMSTAR criteria. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

PubMed Central

Xu, Shiguo; Wang, Tianxiang; Hu, Suduan

2015-01-01

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

Tailoring recombinant protein quality by rational media design.

PubMed

Brühlmann, David; Jordan, Martin; Hemberger, Jürgen; Sauer, Markus; Stettler, Matthieu; Broly, Hervé

2015-01-01

Clinical efficacy and safety of recombinant proteins are closely associated with their structural characteristics. The major quality attributes comprise glycosylation, charge variants (oxidation, deamidation, and C- & N-terminal modifications), aggregates, low-molecular-weight species (LMW), and misincorporation of amino acids in the protein backbone. Cell culture media design has a great potential to modulate these quality attributes due to the vital role of medium in mammalian cell culture. The purpose of this review is to provide an overview of the way both classical cell culture medium components and novel supplements affect the quality attributes of recombinant therapeutic proteins expressed in mammalian hosts, allowing rational and high-throughput optimization of mammalian cell culture media. A selection of specific and/or potent inhibitors and activators of oligosaccharide processing as well as components affecting multiple quality attributes are presented. Extensive research efforts in this field show the feasibility of quality engineering through media design, allowing to significantly modulate the protein function. © 2015 American Institute of Chemical Engineers.

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

PubMed

Xu, Shiguo; Wang, Tianxiang; Hu, Suduan

2015-02-16

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

Quality of life profile and correlated factors in chronic leg ulcer patients in the mid-west of São Paulo State, Brazil*

PubMed Central

Wachholz, Patrick Alexander; Masuda, Paula Yoshiko; Nascimento, Dejair Caitano; Taira, Cecilia Midori Higashi; Cleto, Norma Gondim

2014-01-01

BACKGROUND Chronic leg ulcer may have an impact on patients' quality of life. OBJECTIVES This study aimed to identify the impact of leg ulcers on patient's quality of life using the Dermatology Life Quality Index and to define the main factors correlated with this perception. METHOD Cross-sectional, non-probabilistic sampling study. We included patients with chronic leg ulcers being treated for at least 3 months. A sociodemographic and clinical survey was conducted to assess the profile of the ulcers. We administered a screening for depressive symptoms and the Dermatology Life Quality Index. We performed a descriptive statistical analysis, chi-square test and Mann-Whitney test for categorical data, Pearson for numeric variables, and multiple regression for categorical data. RESULTS Forty-one patients were assessed. Their mean age was 61.78 years. Venous ulcers (48.8%) were the most prevalent. Seventy-three percent of the sample perceived no impact/low impact on quality of life in the past week, and 26.8% perceived moderate/high impact. A multiple regression analysis identified the causes of lesion, pain related to the ulcers, time of onset, and severity of the depressive symptoms as the variables that had an influence on quality of life. CONCLUSIONS The majority of the sample perceived low or no impact of the condition on the quality of the life. The variables etiology of the lesion (p<0.001), pain related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the depressive symptoms (p<0.001) had an influence on the quality of life, suggesting the need for further studies with more robust designs to confirm the causal relationship between these characteristics and quality of life. PMID:24626651

Review on antibacterial biocomposites of structural laminated veneer lumber

PubMed Central

Chen, Zi-xiang; Lei, Qiong; He, Rui-lin; Zhang, Zhong-feng; Chowdhury, Ahmed Jalal Khan

2015-01-01

In this review, the characteristics and applications of structural laminated veneer lumber made from planted forest wood is introduced, and its preparation is explained, including various tree species and slab qualities, treatments for multiple effects and reinforced composites. The relevant factors in the bonding technology and pressing processes as well as the mechanical properties, research direction and application prospects of structural laminated veneer lumber made from planted forest wood are discussed. PMID:26858559

Attenuation characteristics in eastern Himalaya and southern Tibetan Plateau: An understanding of the physical state of the medium

NASA Astrophysics Data System (ADS)

Singh, Sagar; Singh, Chandrani; Biswas, Rahul; Mukhopadhyay, Sagarika; Sahu, Himanshu

2016-08-01

Attenuation characteristics of the crust in the eastern Himalaya and the southern Tibetan Plateau are investigated using high quality data recorded by Himalayan Nepal Tibet Seismic Experiment (HIMNT) during 2001-2003. The present study aims to provide an attenuation model that can address the physical mechanism governing the attenuation characteristics in the underlying medium. We have studied the Coda wave attenuation (Qc) in the single isotropic scattering model hypothesis, S wave attenuation (Qs) by using the coda normalization method and intrinsic (Qi-1) and scattering (Qsc-1) quality factors by the multiple Lapse Time Window Analysis (MLTWA) method under the assumption of multiple isotropic scattering in a 3-D half space within the frequency range 2-12 Hz. All the values of Q exhibit frequency dependent nature for a seismically active area. At all the frequencies intrinsic absorption is predominant compared to scattering attenuation and seismic albedo (B0) are found to be lower than 0.5. The observed discrepancies between the observed and theoretical models can be corroborated by the depth-dependent velocity and attenuation structure as well as the assumption of a uniform distribution of scatterers. Our results correlate well with the existing geo-tectonic model of the area, which may suggest the possible existence of trapped fluids in the crust or its thermal nature. Surprisingly the underlying cause of high attenuation in the crust of eastern Himalaya and southern Tibet makes this region distinct from its adjacent western Himalayan segment. The results are comparable with the other regions reported globally.

Managing imperfect competition by pay for performance and reference pricing.

PubMed

Mak, Henry Y

2018-01-01

I study a managed health service market where differentiated providers compete for consumers by choosing multiple service qualities, and where copayments that consumers pay and payments that providers receive for services are set by a payer. The optimal regulation scheme is two-sided. On the demand side, it justifies and clarifies value-based reference pricing. On the supply side, it prescribes pay for performance when consumers misperceive service benefits or providers have intrinsic quality incentives. The optimal bonuses are expressed in terms of demand elasticities, service technology, and provider characteristics. However, pay for performance may not outperform prospective payment when consumers are rational and providers are profit maximizing, or when one of the service qualities is not contractible. Copyright © 2017 Elsevier B.V. All rights reserved.

Developing Interoperable Air Quality Community Portals

NASA Astrophysics Data System (ADS)

Falke, S. R.; Husar, R. B.; Yang, C. P.; Robinson, E. M.; Fialkowski, W. E.

2009-04-01

Web portals are intended to provide consolidated discovery, filtering and aggregation of content from multiple, distributed web sources targeted at particular user communities. This paper presents a standards-based information architectural approach to developing portals aimed at air quality community collaboration in data access and analysis. An important characteristic of the approach is to advance beyond the present stand-alone design of most portals to achieve interoperability with other portals and information sources. We show how using metadata standards, web services, RSS feeds and other Web 2.0 technologies, such as Yahoo! Pipes and del.icio.us, helps increase interoperability among portals. The approach is illustrated within the context of the GEOSS Architecture Implementation Pilot where an air quality community portal is being developed to provide a user interface between the portals and clearinghouse of the GEOSS Common Infrastructure and the air quality community catalog of metadata and data services.

Job satisfaction and quality of life among home care workers: a comparison of home care workers who are and who are not informal carers.

PubMed

Chou, Yueh-Ching; Fu, Li-Yeh; Kröger, Teppo; Ru-Yan, Chiu

2011-06-01

Job satisfaction and quality of life among home care workers who serve simultaneously as informal carers for their own family members have seldom been explored. This study examined how this dual role influences job satisfaction and quality of life by comparing these dual carers with home care workers who do not provide informal care. The study also explored whether the factors related to job satisfaction and quality of life between these two groups were different. Standardized self-administered questionnaires (Job Satisfaction Survey, the World Health Organization Quality of Life (WHOQOL) scales and various social demographic questions) were administered to the two groups of home care workers in Taiwan from March to April 2009. A total of 1,641 home care workers working in 119 non-government organizations sponsored by 23 local authorities completed and returned the questionnaires. The two groups did not differ in individual characteristics, work characteristics or job satisfaction. Analysis results indicate that the lowest mean scores for all home care workers were the domains of promotion and pay within their job satisfaction and the domain of environment within their quality of life. Multiple regression analysis revealed a significant effect of unpaid caregiving in terms of quality of life but not in terms of job satisfaction. Moreover, job satisfaction and quality of life among home care workers were significantly determined by both their work conditions (e.g. travelling time, salary and length of work experience) and personal variables (e.g. age, family income and family support).

Comparison of imaging characteristics of multiple-beam equalization and storage phosphor direct digitizer radiographic systems

NASA Astrophysics Data System (ADS)

Sankaran, A.; Chuang, Keh-Shih; Yonekawa, Hisashi; Huang, H. K.

1992-06-01

The imaging characteristics of two chest radiographic equipment, Advanced Multiple Beam Equalization Radiography (AMBER) and Konica Direct Digitizer [using a storage phosphor (SP) plate] systems have been compared. The variables affecting image quality and the computer display/reading systems used are detailed. Utilizing specially designed wedge, geometric, and anthropomorphic phantoms, studies were conducted on: exposure and energy response of detectors; nodule detectability; different exposure techniques; various look- up tables (LUTs), gray scale displays and laser printers. Methods for scatter estimation and reduction were investigated. It is concluded that AMBER with screen-film and equalization techniques provides better nodule detectability than SP plates. However, SP plates have other advantages such as flexibility in the selection of exposure techniques, image processing features, and excellent sensitivity when combined with optimum reader operating modes. The equalization feature of AMBER provides better nodule detectability under the denser regions of the chest. Results of diagnostic accuracy are demonstrated with nodule detectability plots and analysis of images obtained with phantoms.

Accountable Care Organizations in the United States: market and demographic factors associated with formation.

PubMed

Lewis, Valerie A; Colla, Carrie H; Carluzzo, Kathleen L; Kler, Sarah E; Fisher, Elliott S

2013-12-01

The Accountable Care Organization (ACO) model is rapidly being implemented by Medicare, private payers, and states, but little is known about the scope of ACO implementation. To determine the number of accountable care organizations in the United States, where they are located, and characteristics associated with ACO formation. Cross-sectional study of all ACOs in the United States as of August 2012. We identified ACOs from multiple sources; documented service locations (practices, clinics, hospitals); and linked service locations to local areas, defined as Dartmouth Atlas hospital service areas. We used multivariate analysis to assess what characteristics were associated with local ACO presence. We examined demographic characteristics (2010 American Community Survey) and health care system characteristics (2010 Medicare fee-for-service claims data). We identified 227 ACOs located in 27 percent of local areas. Fifty-five percent of the US population resides in these areas. HSA-level characteristics associated with ACO presence include higher performance on quality, higher Medicare per capita spending, fewer primary care physician groups, greater managed care penetration, lower poverty rates, and urban location. Much of the US population resides in areas where ACOs have been established. ACO formation has taken place where it may be easier to meet quality and cost targets. Wider adoption of the ACO model may require tailoring to local context. © Health Research and Educational Trust.

Identification of Biomarkers Associated with the Rearing Practices, Carcass Characteristics, and Beef Quality: An Integrative Approach.

PubMed

Gagaoua, Mohammed; Monteils, Valérie; Couvreur, Sébastien; Picard, Brigitte

2017-09-20

Data from birth to slaughter of cull cows allowed using a PCA-based approach coupled with the iterative K-means algorithm the identification of three rearing practices classes. The classes were different in their carcass characteristics. Old cows raised mainly on pasture have better carcass characteristics, while having an equivalent tenderness, juiciness, flavor, intramuscular fat content, and pHu to those fattened with hay or haylage. The Longissimus thoracis muscle of the cows raised on pasture (with high physical activity) showed greater proportions of IIA fibers at the expense of the fast IIX ones. Accordingly, the meat of these animals have better color characteristics. Superoxide dismutase (SOD1) and αB-crystallin quantified by Dot-Blot were the only other biomarkers to be more abundant in "Grass" class compared to "Hay" and "Haylage" classes. The relationships between the biomarkers and the 6 carcass and 11 meat quality traits were investigated using multiple regression analyses per rearing practices. The associations were rearing practice class and phenotype trait-dependent. ICDH and TP53 were common for the three classes, but the direction of their entrance was different. In addition, rearing practices and carcass traits were not related with Hsp70-Grp75 and μ-calpain abundances. The other relationships were specific for two or one rearing practices class. The rearing practices dependency of the relationships was also found with meat quality traits. Certain proteins were for the first time related with some beef quality traits. MyHC-IIx, PGM1, Hsp40, ICDH, and Hsp70-Grp75 were common for the three rearing practices classes and retained to explain at list one beef quality trait. A positive relationship was found between PGM1 and hue angle irrespective of rearing practices class. This study confirms once again that production-related traits in livestock are the result of sophisticated biological processes finely orchestrated during the life of the animal and soon after slaughter.

Differences in health-related quality of life between European and Asian patients with hepatocellular carcinoma.

PubMed

Chie, Wei-Chu; Blazeby, Jane M; Hsiao, Chin-Fu; Chiu, Herng-Chia; Poon, Ronnie T; Mikoshiba, Naoko; Al-Kadhim, Gillian; Heaton, Nigel; Calara, Jozer; Collins, Peter; Caddick, Katharine; Costantini, Anna; Vilgrain, Valerie

2017-10-01

The aim of this study is to explore the possible effects of clinical and cultural characteristics of hepatocellular carcinoma on patients' health-related quality of life (HRQoL). Patients with hepatocellular carcinoma from Asian and European countries completed the EORTC QLQ-C30 and the EORTC QLQ-HCC18. Comparisons were made using Student's t-test and Wilcoxon rank-sum test with method of false discovery to correct multiple comparisons. Multiway analysis of variance and model selection were used to assess the effects of clinical characteristics and geographic areas. Two hundred and twenty-seven patients with hepatocellular carcinoma completed questionnaires. After adjusting for demographic and clinical characteristics, Asian patients still had significantly better HRQoL scores in emotional functioning, insomnia, (QLQ-C30) and in sexual interest (QLQ-HCC18). We also found an interaction in physical functioning (QLQ-C30) and fatigue (QLQ-HCC18) between geographic region and marital status, married European had worse HRQoL scores than Asian singles. Both clinical characteristics and geographic areas affected the HRQoL in with hepatocellular carcinoma. Cultural differences and clinical differences in the pattern of disease due to active surveillance of Asian countries may explain the results. © 2016 John Wiley & Sons Australia, Ltd.

What you should know about land-cover data

USGS Publications Warehouse

Gallant, Alisa L.

2009-01-01

Wildlife biologists are using land-characteristics data sets for a variety of applications. Many kinds of landscape variables have been characterized and the resultant data sets or maps are readily accessible. Often, too little consideration is given to the accuracy or traits of these data sets, most likely because biologists do not know how such data are compiled and rendered, or the potential pitfalls that can be encountered when applying these data. To increase understanding of the nature of land-characteristics data sets, I introduce aspects of source information and data-handling methodology that include the following: ambiguity of land characteristics; temporal considerations and the dynamic nature of the landscape; type of source data versus landscape features of interest; data resolution, scale, and geographic extent; data entry and positional problems; rare landscape features; and interpreter variation. I also include guidance for determining the quality of land-characteristics data sets through metadata or published documentation, visual clues, and independent information. The quality or suitability of the data sets for wildlife applications may be improved with thematic or spatial generalization, avoidance of transitional areas on maps, and merging of multiple data sources. Knowledge of the underlying challenges in compiling such data sets will help wildlife biologists to better assess the strengths and limitations and determine how best to use these data.

Understanding apple consumers' expectations in terms of likes and dislikes. Use of comment analysis in a cross-cultural study.

PubMed

Galmarini, M V; Symoneaux, R; Chollet, S; Zamora, M C

2013-03-01

Apple consumers' expectations in Argentina and France were studied by comment analysis of open-ended questions. In an on-line survey consumers stated: attributes which defined quality in an apple; visual, flavor and texture characteristics they liked/did not like to find in an apple. Influence of country, consumption frequency and cultivar knowledge were analyzed by contingency tables, Chi-square per cell tests and Multiple Factor Analysis. Consumers' quality expectations were not the same in both countries. Argentineans and French consumers agreed that quality apples should be juicy (most used term in both countries), tasty, firm and fresh. However, for Argentineans quality was more related to visual characteristics, whereas for French it was driven by flavor. Argentineans used more words but French were more specific, particularly for flavour description. Moreover, frequency of consumption, varieties knowledge and the number of terms given were highly related. Frequent consumers knew more varieties and were more prolific in relation to flavour. Less frequent consumers knew fewer apple varieties and gave more words in the visual category. The use of comment analysis allowed identifying the terms that consumers used in their day to day life to describe apples, finding separately likes and dislikes, in spite of the different languages. Copyright © 2012 Elsevier Ltd. All rights reserved.

Tunneling and Origin of Large Access Resistance in Layered-Crystal Organic Transistors

NASA Astrophysics Data System (ADS)

Hamai, Takamasa; Arai, Shunto; Minemawari, Hiromi; Inoue, Satoru; Kumai, Reiji; Hasegawa, Tatsuo

2017-11-01

Layered crystallinity of organic semiconductors is crucial to obtaining high-performance organic thin-film transistors (OTFTs), as it allows both smooth-channel-gate-insulator interface formation and efficient two-dimensional carrier transport along the interface. However, the role of vertical transport across the crystalline molecular layers in device operations has not been a crucial subject so far. Here, we show that the interlayer carrier transport causes unusual nonlinear current-voltage characteristics and enormous access resistance in extremely high-quality single-crystal OTFTs based on 2-decyl-7-phenyl[1]-benzothieno[3 ,2 -b ][1]benzothiophene (Ph -BTBT -C10 ) that involve inherent multiple semiconducting π -conjugated layers interposed, respectively, by electrically inert alkyl-chain layers. The output characteristics present layer-number (n )-dependent nonlinearity that becomes more evident at larger n (1 ≤n ≤15 ), demonstrating tunneling across multiple alkyl-chain layers. The n -dependent device mobility and four-probe measurements reveal that the alkyl-chain layers generate a large access resistance that suppresses the device mobility from the intrinsic value of about 20 cm2 V-1 s-1 . Our findings clarify the reason why device characteristics are distributed in single-crystal OTFTs.

The Influence of Parental Control and Parent-Child Relational Qualities on Adolescent Internet Addiction: A 3-Year Longitudinal Study in Hong Kong

PubMed Central

Shek, Daniel T. L.; Zhu, Xiaoqin; Ma, Cecilia M. S.

2018-01-01

This study investigated how parental behavioral control, parental psychological control, and parent-child relational qualities predicted the initial level and rate of change in adolescent internet addiction (IA) across the junior high school years. The study also investigated the concurrent and longitudinal effects of different parenting factors on adolescent IA. Starting from the 2009/2010 academic year, 3,328 Grade 7 students (Mage = 12.59 ± 0.74 years) from 28 randomly selected secondary schools in Hong Kong responded on a yearly basis to a questionnaire measuring multiple constructs including socio-demographic characteristics, perceived parenting characteristics, and IA. Individual growth curve (IGC) analyses showed that adolescent IA slightly decreased during junior high school years. While behavioral control of both parents was negatively related to the initial level of adolescent IA, only paternal behavioral control showed a significant positive relationship with the rate of linear change in IA, suggesting that higher paternal behavioral control predicted a slower decrease in IA. In addition, fathers' and mothers' psychological control was positively associated with the initial level of adolescent IA, but increase in maternal psychological control predicted a faster drop in IA. Finally, parent-child relational qualities negatively and positively predicted the initial level and the rate of change in IA, respectively. When all parenting factors were considered simultaneously, multiple regression analyses revealed that paternal behavioral control and psychological control as well as maternal psychological control and mother-child relational quality were significant concurrent predictors of adolescent IA at Wave 2 and Wave 3. Regarding the longitudinal predicting effects, paternal psychological control and mother-child relational quality at Wave 1 were the two most robust predictors of later adolescent IA at Wave 2 and Wave 3. The above findings underscore the importance of the parent-child subsystem qualities in influencing adolescent IA in the junior high school years. In particular, these findings shed light on the different impacts of fathering and mothering which are neglected in the scientific literature. While the findings based on the levels of IA are consistent with the existing theoretical models, findings on the rate of change are novel. PMID:29765349

The Influence of Parental Control and Parent-Child Relational Qualities on Adolescent Internet Addiction: A 3-Year Longitudinal Study in Hong Kong.

PubMed

Shek, Daniel T L; Zhu, Xiaoqin; Ma, Cecilia M S

2018-01-01

This study investigated how parental behavioral control, parental psychological control, and parent-child relational qualities predicted the initial level and rate of change in adolescent internet addiction (IA) across the junior high school years. The study also investigated the concurrent and longitudinal effects of different parenting factors on adolescent IA. Starting from the 2009/2010 academic year, 3,328 Grade 7 students ( M age = 12.59 ± 0.74 years) from 28 randomly selected secondary schools in Hong Kong responded on a yearly basis to a questionnaire measuring multiple constructs including socio-demographic characteristics, perceived parenting characteristics, and IA. Individual growth curve (IGC) analyses showed that adolescent IA slightly decreased during junior high school years. While behavioral control of both parents was negatively related to the initial level of adolescent IA, only paternal behavioral control showed a significant positive relationship with the rate of linear change in IA, suggesting that higher paternal behavioral control predicted a slower decrease in IA. In addition, fathers' and mothers' psychological control was positively associated with the initial level of adolescent IA, but increase in maternal psychological control predicted a faster drop in IA. Finally, parent-child relational qualities negatively and positively predicted the initial level and the rate of change in IA, respectively. When all parenting factors were considered simultaneously, multiple regression analyses revealed that paternal behavioral control and psychological control as well as maternal psychological control and mother-child relational quality were significant concurrent predictors of adolescent IA at Wave 2 and Wave 3. Regarding the longitudinal predicting effects, paternal psychological control and mother-child relational quality at Wave 1 were the two most robust predictors of later adolescent IA at Wave 2 and Wave 3. The above findings underscore the importance of the parent-child subsystem qualities in influencing adolescent IA in the junior high school years. In particular, these findings shed light on the different impacts of fathering and mothering which are neglected in the scientific literature. While the findings based on the levels of IA are consistent with the existing theoretical models, findings on the rate of change are novel.

The modifying role of caregiver burden on predictors of quality of life of caregivers of hospitalized chronic stroke patients.

PubMed

Jeong, Yeon-Gyu; Myong, Jun-Pyo; Koo, Jung-Wan

2015-10-01

Caregiver burden is an important predictor of quality of life (QoL) among caregivers of stroke patients. While caregiver burden and QoL might be closely related, caregiver burden seems also to be a potential modifier of the associations between patients' and caregivers' characteristics and caregivers' QoL. The purpose of this study was to investigate the effect of caregiver burden in caregivers of hospitalized chronic stroke patients and the predictors of caregivers' QoL by level of caregiver burden. A total of 238 patients and their caregivers were interviewed using questionnaires consisting of the Zarit Burden Interview and the Korean-version of the World Health Organization Quality of Life-BREF. Multiple hierarchical regression analyses were performed to determine the predictors of caregivers' QoL among caregivers stratified by median caregiver burden score (high/low). Caregiver burden had a modifying effect on caregivers' QoL. In caregivers with high burden, the patient characteristics of being unemployed and the caregiver characteristics of poor health status, lower income, and being a spouse were negative predictors of caregivers' QoL. In caregivers with low burden, the patient characteristics of being hospitalized for a longer duration and the caregiver characteristics of poor health status were negative predictors of caregivers' QoL (all ps < 0.05). This study found that in South Korea, more attention should be paid to spouses who are caring for hospitalized chronic stroke patients, particularly with regard to their health status and financial problems. Further studies are needed to examine the impact of factors not examined in the Korean cultural context. Copyright © 2015 Elsevier Inc. All rights reserved.

Effective International Medical Disaster Relief: A Qualitative Descriptive Study.

PubMed

Broby, Nicolette; Lassetter, Jane H; Williams, Mary; Winters, Blaine A

2018-04-01

Purpose The aim of this study was to assist organizations seeking to develop or improve their medical disaster relief effort by identifying fundamental elements and processes that permeate high-quality, international, medical disaster relief organizations and the teams they deploy. A qualitative descriptive design was used. Data were gathered from interviews with key personnel at five international medical response organizations, as well as during field observations conducted at multiple sites in Jordan and Greece, including three refugee camps. Data were then reviewed by the research team and coded to identify patterns, categories, and themes. The results from this qualitative, descriptive design identified three themes which were key characteristics of success found in effective, well-established, international medical disaster relief organizations. These characteristics were first, ensuring an official invitation had been extended and the need for assistance had been identified. Second, the response to that need was done in an effective and sustainable manner. Third, effective organizations strived to obtain high-quality volunteers. By following the three key characteristics outlined in this research, organizations are more likely to improve the efficiency and quality of their work. In addition, they will be less likely to impede the overall recovery process. Broby N , Lassetter JH , Williams M , Winters BA . Effective international medical disaster relief: a qualitative descriptive study. Prehosp Disaster Med. 2018;33(2):119-126.

Delivery system characteristics and their association with quality and costs of care: implications for accountable care organizations.

PubMed

Chukmaitov, Askar; Harless, David W; Bazzoli, Gloria J; Carretta, Henry J; Siangphoe, Umaporn

2015-01-01

Implementation of accountable care organizations (ACOs) is currently underway, but there is limited empirical evidence on the merits of the ACO model. The aim was to study the associations between delivery system characteristics and ACO competencies, including centralization strategies to manage organizations, hospital integration with physicians and outpatient facilities, health information technology, infrastructure to monitor community health and report quality, and risk-adjusted 30-day all-cause mortality and case-mixed-adjusted inpatient costs for the Medicare population. Panel data (2006-2009) were assembled from Florida and multiple sources: inpatient hospital discharge, vital statistics, the American Hospital Association, the Healthcare Information and Management Systems Society, and other databases. We applied a panel study design, controlling for hospital and market characteristics. Hospitals that were in centralized health systems or became more centralized over the study period had significantly larger reductions in mortality compared with hospitals that remained freestanding. Surprisingly, tightly integrated hospital-physician arrangements were associated with increased mortality; as such, hospitals may wish to proceed cautiously when developing specific types of alignment with local physician organizations. We observed no statistically significant differences in the growth rate of costs across hospitals in any of the health systems studied relative to freestanding hospitals. Although we observed quality improvement in some organizational types, these outcome improvements were not coupled with the additional desired objective of lower cost growth. This implies that additional changes not present during our study period, potentially changes in provider payment approaches, are essential for achieving the ACO objectives of higher quality of care at lower costs. Provider organizations implementing ACOs should consider centralizing service delivery as a viable strategy to improve quality of care, although the strategy did not result in lower cost growth.

The integrated quality assessment of Chinese commercial dry red wine based on a method of online HPLC-DAD-CL combined with HPLC-ESI-MS.

PubMed

Yu, Hai-Xiang; Sun, Li-Qiong; Qi, Jin

2014-07-01

To apply an integrated quality assessment strategy to investigate the quality of multiple Chinese commercial dry red wine samples. A comprehensive method was developed by combining a high performance liquid chromatography-diode array detector-chemiluminescence (HPLC-DAD-CL) online hyphenated system with an HPLC-ESI-MS technique. Chromatographic and H2O2-scavenging active fingerprints of thirteen batches of different, commercially available Chinese dry red wine samples were obtained and analyzed. Twenty-five compounds, including eighteen antioxidants were identified and evaluated. The dominant and characteristic antioxidants in the samples were identified. The relationships between antioxidant potency and the cultivated variety of grape, producing area, cellaring period, and trade mark are also discussed. The results provide the feasibility for an integrated quality assessment strategy to be efficiently and objectively used in quality (especially antioxidant activity) assessment and identification of dry red wine. Copyright © 2014 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.

Physical neighborhood and social environment, beliefs about sleep, sleep hygiene behaviors, and sleep quality among African Americans.

PubMed

Nam, Soohyun; Whittemore, Robin; Jung, Sunyoung; Latkin, Carl; Kershaw, Trace; Redeker, Nancy S

2018-06-01

African Americans (AAs) have a higher prevalence of sleep disorders than other racial/ethnic groups. However, little is known about the relationships among individual and neighborhood factors related to sleep quality in AAs. The purposes of this study were to (1) describe beliefs about sleep, sleep hygiene behaviors, and sleep quality among AAs; and (2) examine the relationships among sociodemographic characteristics, neighborhood environment, beliefs about sleep, sleep hygiene behaviors, and sleep quality. We conducted a cross-sectional study of 252 AA men and women in the Greater New Haven, CT, USA community. We assessed their sociodemographic characteristics, neighborhood environment, beliefs about sleep, sleep hygiene, and sleep quality with the following measures, respectively: the Neighborhood Environment Scale, the brief version of Dysfunctional Beliefs and Attitudes about Sleep, the Sleep Hygiene Practice Scale, the Pittsburgh Sleep Quality Index. We performed descriptive statistics, correlations and multiple hierarchical regression. About 72% of the participants (mean age: 53.88 ± 14.17 years, 77.8% women) reported experiencing sleep disturbance. People with poor sleep quality were more likely to report poorer neighborhood social environment (social cohesion), poorer overall neighborhood environment, more dysfunctional beliefs toward sleep, and poorer sleep hygiene than those who had good sleep quality. In the final multivariate model that controlled for a number of chronic comorbid conditions, neighborhood environment, beliefs about sleep, and sleep hygiene behaviors were significantly associated with sleep quality. Future efforts are needed to improve sleep among AAs by considering both the individual's belief about sleep, sleep hygiene behaviors and neighborhood factors. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Integrated and global pseudotargeted metabolomics strategy applied to screening for quality control markers of Citrus TCMs.

PubMed

Shu, Yisong; Liu, Zhenli; Zhao, Siyu; Song, Zhiqian; He, Dan; Wang, Menglei; Zeng, Honglian; Lu, Cheng; Lu, Aiping; Liu, Yuanyan

2017-08-01

Traditional Chinese medicine (TCM) exerts its therapeutic effect in a holistic fashion with the synergistic function of multiple characteristic constituents. The holism philosophy of TCM is coincident with global and systematic theories of metabolomics. The proposed pseudotargeted metabolomics methodologies were employed for the establishment of reliable quality control markers for use in the screening strategy of TCMs. Pseudotargeted metabolomics integrates the advantages of both targeted and untargeted methods. In the present study, targeted metabolomics equipped with the gold standard RRLC-QqQ-MS method was employed for in vivo quantitative plasma pharmacochemistry study of characteristic prototypic constituents. Meanwhile, untargeted metabolomics using UHPLC-QE Orbitrap HRMS with better specificity and selectivity was employed for identification of untargeted metabolites in the complex plasma matrix. In all, 32 prototypic metabolites were quantitatively determined, and 66 biotransformed metabolites were convincingly identified after being orally administered with standard extracts of four labeled Citrus TCMs. The global absorption and metabolism process of complex TCMs was depicted in a systematic manner.

Health-related quality of life in multiple sclerosis: role of cognitive appraisals of self, illness and treatment.

PubMed

Wilski, Maciej; Tasiemski, Tomasz

2016-07-01

Health-related quality of life (HRQoL) is considered an important measure of treatment and rehabilitation outcomes in multiple sclerosis (MS) patients. In this study, we used multivariate regression analysis to examine the role of cognitive appraisals, adjusted for clinical, socioeconomic and demographic variables, as correlates of HRQoL in MS. The cross-sectional study included 257 MS patients, who completed Multiple Sclerosis Impact Scale, Generalized Self-Efficacy Scale, Rosenberg Self-Esteem Scale, Brief Illness Perception Questionnaire, Treatment Beliefs Scale, Actually Received Support Scale (a part of Berlin Social Support Scale) and Socioeconomic Resources Scale. Demographic and clinical characteristics of the participants were collected with a self-report survey. Correlation and regression analyses were conducted to determine associations between the variables. Five variables, illness identity (β = 0.29, p ≤ 0.001), self-esteem (β = -0.22, p ≤ 0.001), general self-efficacy (β = -0.21, p ≤ 0.001), disability subgroup "EDSS" (β = 0.14, p = 0.006) and age (β = 0.12, p = 0.012), were significant correlates of HRQoL in MS. These variables explained 46 % of variance in the dependent variable. Moreover, we identified correlates of physical and psychological dimensions of HRQoL. Cognitive appraisals, such as general self-efficacy, self-esteem and illness perception, are more salient correlates of HRQoL than social support, socioeconomic resources and clinical characteristics, such as type and duration of MS. Therefore, interventions aimed at cognitive appraisals may also improve HRQoL of MS patients.

Spatial heterogeneity regulates plant-pollinator networks across multiple landscape scales.

PubMed

Moreira, Eduardo Freitas; Boscolo, Danilo; Viana, Blandina Felipe

2015-01-01

Mutualistic plant-pollinator interactions play a key role in biodiversity conservation and ecosystem functioning. In a community, the combination of these interactions can generate emergent properties, e.g., robustness and resilience to disturbances such as fluctuations in populations and extinctions. Given that these systems are hierarchical and complex, environmental changes must have multiple levels of influence. In addition, changes in habitat quality and in the landscape structure are important threats to plants, pollinators and their interactions. However, despite the importance of these phenomena for the understanding of biological systems, as well as for conservation and management strategies, few studies have empirically evaluated these effects at the network level. Therefore, the objective of this study was to investigate the influence of local conditions and landscape structure at multiple scales on the characteristics of plant-pollinator networks. This study was conducted in agri-natural lands in Chapada Diamantina, Bahia, Brazil. Pollinators were collected in 27 sampling units distributed orthogonally along a gradient of proportion of agriculture and landscape diversity. The Akaike information criterion was used to select models that best fit the metrics for network characteristics, comparing four hypotheses represented by a set of a priori candidate models with specific combinations of the proportion of agriculture, the average shape of the landscape elements, the diversity of the landscape and the structure of local vegetation. The results indicate that a reduction of habitat quality and landscape heterogeneity can cause species loss and decrease of networks nestedness. These structural changes can reduce robustness and resilience of plant-pollinator networks what compromises the reproductive success of plants, the maintenance of biodiversity and the pollination service stability. We also discuss the possible explanations for these relationships and the implications for landscape planning in agricultural areas.

Spatial Heterogeneity Regulates Plant-Pollinator Networks across Multiple Landscape Scales

PubMed Central

Moreira, Eduardo Freitas; Boscolo, Danilo; Viana, Blandina Felipe

2015-01-01

Mutualistic plant-pollinator interactions play a key role in biodiversity conservation and ecosystem functioning. In a community, the combination of these interactions can generate emergent properties, e.g., robustness and resilience to disturbances such as fluctuations in populations and extinctions. Given that these systems are hierarchical and complex, environmental changes must have multiple levels of influence. In addition, changes in habitat quality and in the landscape structure are important threats to plants, pollinators and their interactions. However, despite the importance of these phenomena for the understanding of biological systems, as well as for conservation and management strategies, few studies have empirically evaluated these effects at the network level. Therefore, the objective of this study was to investigate the influence of local conditions and landscape structure at multiple scales on the characteristics of plant-pollinator networks. This study was conducted in agri-natural lands in Chapada Diamantina, Bahia, Brazil. Pollinators were collected in 27 sampling units distributed orthogonally along a gradient of proportion of agriculture and landscape diversity. The Akaike information criterion was used to select models that best fit the metrics for network characteristics, comparing four hypotheses represented by a set of a priori candidate models with specific combinations of the proportion of agriculture, the average shape of the landscape elements, the diversity of the landscape and the structure of local vegetation. The results indicate that a reduction of habitat quality and landscape heterogeneity can cause species loss and decrease of networks nestedness. These structural changes can reduce robustness and resilience of plant-pollinator networks what compromises the reproductive success of plants, the maintenance of biodiversity and the pollination service stability. We also discuss the possible explanations for these relationships and the implications for landscape planning in agricultural areas. PMID:25856293

The Effects of Quality of Care on Costs: A Conceptual Framework

PubMed Central

Nuckols, Teryl K; Escarce, José J; Asch, Steven M

2013-01-01

Context The quality of health care and the financial costs affected by receiving care represent two fundamental dimensions for judging health care performance. No existing conceptual framework appears to have described how quality influences costs. Methods We developed the Quality-Cost Framework, drawing from the work of Donabedian, the RAND/UCLA Appropriateness Method, reports by the Institute of Medicine, and other sources. Findings The Quality-Cost Framework describes how health-related quality of care (aspects of quality that influence health status) affects health care and other costs. Structure influences process, which, in turn, affects proximate and ultimate outcomes. Within structure, subdomains include general structural characteristics, circumstance-specific (e.g., disease-specific) structural characteristics, and quality-improvement systems. Process subdomains include appropriateness of care and medical errors. Proximate outcomes consist of disease progression, disease complications, and care complications. Each of the preceding subdomains influences health care costs. For example, quality improvement systems often create costs associated with monitoring and feedback. Providing appropriate care frequently requires additional physician visits and medications. Care complications may result in costly hospitalizations or procedures. Ultimate outcomes include functional status as well as length and quality of life; the economic value of these outcomes can be measured in terms of health utility or health-status-related costs. We illustrate our framework using examples related to glycemic control for type 2 diabetes mellitus or the appropriateness of care for low back pain. Conclusions The Quality-Cost Framework describes the mechanisms by which health-related quality of care affects health care and health status–related costs. Additional work will need to validate the framework by applying it to multiple clinical conditions. Applicability could be assessed by using the framework to classify the measures of quality and cost reported in published studies. Usefulness could be demonstrated by employing the framework to identify design flaws in published cost analyses, such as omitting the costs attributable to a relevant subdomain of quality. PMID:23758513

A Prospective, Longitudinal Examination of the Influence of Childhood Home and School Contexts on Psychopathic Characteristics in Adolescence.

PubMed

Fisher, Jacqueline Horan; Brown, Joshua L

2018-05-28

Much of the existing research examining etiological contributors to psychopathic characteristics considers only biological and physiological deficits, with little consideration given to contextual factors that may play a role in their development. This prospective, longitudinal study examined the influence of childhood home and school environments on adolescent psychopathic characteristics among 390 youth (50.5% female; 46.2% Black/African American, 44.9% Hispanic/Latino, 6.9% Asian or Native American/Alaska Native, and 2.1% Non-Hispanic White). Specifically, this study examined (1) the effect of home chaos and poor parental monitoring on adolescent primary and secondary psychopathy and callous-unemotional traits through the lens of multiple reporters, and (2) whether classroom climate quality across three years of childhood moderated these relationships. The results indicated that delinquency and home chaos in childhood were related to primary psychopathy in adolescence and that exposure to higher quality classroom climates across childhood acted as a buffer by mitigating the negative relationship between parental monitoring in childhood and secondary psychopathy in adolescence. These findings have implications for designing interventions to mitigate the manifestation of youth psychopathy.

Improving the home health acute-care hospitalization quality measure.

PubMed

Schade, Charles P; Brehm, John G

2010-06-01

(1) To demonstrate average length of service (ALOS) bias in the currently used acute-care hospitalization (ACH) home health quality measure, limiting comparability across agencies, and (2) to propose alternative ACH measures. Secondary analysis of Medicare home health service data 2004-2007; convenience sample of Medicare fee-for-service hospital discharges. Cross-sectional analysis and patient-level simulation. We aggregated outcome and ALOS data from 2,347 larger Medicare-certified home health agencies (HHAs) in the United States between 2004 and 2007, and calculated risk-adjusted monthly ACH rates. We used multiple regression to identify agency characteristics associated with ACH. We simulated ACH during and immediately after home health care using patient and agency characteristics similar to those in the actual data, comparing the existing measure with alternative fixed-interval measures. Of agency characteristics studied, ALOS had by far the highest partial correlation with the current ACH measure (r(2)=0.218, p<.0001). We replicated the correlation between ACH and ALOS in the patient-level simulation. We found no correlation between ALOS and the alternative measures. Alternative measures do not exhibit ALOS bias and would be appropriate for comparing HHA ACH rates with one another or over time.

Methodologic quality of meta-analyses and systematic reviews on the Mediterranean diet and cardiovascular disease outcomes: a review.

PubMed

Huedo-Medina, Tania B; Garcia, Marissa; Bihuniak, Jessica D; Kenny, Anne; Kerstetter, Jane

2016-03-01

Several systematic reviews/meta-analyses published within the past 10 y have examined the associations of Mediterranean-style diets (MedSDs) on cardiovascular disease (CVD) risk. However, these reviews have not been evaluated for satisfying contemporary methodologic quality standards. This study evaluated the quality of recent systematic reviews/meta-analyses on MedSD and CVD risk outcomes by using an established methodologic quality scale. The relation between review quality and impact per publication value of the journal in which the article had been published was also evaluated. To assess compliance with current standards, we applied a modified version of the Assessment of Multiple Systematic Reviews (AMSTARMedSD) quality scale to systematic reviews/meta-analyses retrieved from electronic databases that had met our selection criteria: 1) used systematic or meta-analytic procedures to review the literature, 2) examined MedSD trials, and 3) had MedSD interventions independently or combined with other interventions. Reviews completely satisfied from 8% to 75% of the AMSTARMedSD items (mean ± SD: 31.2% ± 19.4%), with those published in higher-impact journals having greater quality scores. At a minimum, 60% of the 24 reviews did not disclose full search details or apply appropriate statistical methods to combine study findings. Only 5 of the reviews included participant or study characteristics in their analyses, and none evaluated MedSD diet characteristics. These data suggest that current meta-analyses/systematic reviews evaluating the effect of MedSD on CVD risk do not fully comply with contemporary methodologic quality standards. As a result, there are more research questions to answer to enhance our understanding of how MedSD affects CVD risk or how these effects may be modified by the participant or MedSD characteristics. To clarify the associations between MedSD and CVD risk, future meta-analyses and systematic reviews should not only follow methodologic quality standards but also include more statistical modeling results when data allow. © 2016 American Society for Nutrition.

Assessing the effects of multiple stressors on the functioning of Mediterranean rivers using poplar wood breakdown.

PubMed

Aristi, Ibon; Díez, Jose Ramon; Larrañaga, Aitor; Navarro-Ortega, Alícia; Barceló, Damià; Elosegi, Arturo

2012-12-01

Mediterranean rivers in the Iberian Peninsula are being increasingly affected by human activities, which threaten their ecological status. A clear picture of how do these multiple stressors affect river ecosystem functioning is still lacking. We addressed this question by measuring a key ecosystem process, namely breakdown of organic matter, at 66 sites distributed across Mediterranean Spain. We performed breakdown experiments by measuring the mass lost by wood sticks for 54 to 106 days. Additionally, we gathered data on physico-chemical, biological and geomorphological characteristics of study sites. Study sites spanned a broad range of environmental characteristics and breakdown rates varied fiftyfold across sites. No clear geographic patterns were found between or within basins. 90th quantile regressions performed to link breakdown rates with environmental characteristics included the following 7 variables in the model, in decreasing order of importance: altitude, water content in phosphorus, catchment area, toxicity, invertebrate-based biotic index, riparian buffer width, and diatom-based quality index. Breakdown rate was systematically low in high-altitude rivers with few human impacts, but showed a high variability in areas affected by human activity. This increase in variability is the result of the influence of multiple stressors acting simultaneously, as some of these can promote whereas others slow down the breakdown of organic matter. Therefore, stick breakdown gives information on the intensity of a key ecosystem process, which would otherwise be very difficult to predict based on environmental variables. Copyright © 2012 Elsevier B.V. All rights reserved.

Cost-Effectiveness and Cost-Utility of Internet-Based Computer Tailoring for Smoking Cessation

PubMed Central

Evers, Silvia MAA; de Vries, Hein; Hoving, Ciska

2013-01-01

Background Although effective smoking cessation interventions exist, information is limited about their cost-effectiveness and cost-utility. Objective To assess the cost-effectiveness and cost-utility of an Internet-based multiple computer-tailored smoking cessation program and tailored counseling by practice nurses working in Dutch general practices compared with an Internet-based multiple computer-tailored program only and care as usual. Methods The economic evaluation was embedded in a randomized controlled trial, for which 91 practice nurses recruited 414 eligible smokers. Smokers were randomized to receive multiple tailoring and counseling (n=163), multiple tailoring only (n=132), or usual care (n=119). Self-reported cost and quality of life were assessed during a 12-month follow-up period. Prolonged abstinence and 24-hour and 7-day point prevalence abstinence were assessed at 12-month follow-up. The trial-based economic evaluation was conducted from a societal perspective. Uncertainty was accounted for by bootstrapping (1000 times) and sensitivity analyses. Results No significant differences were found between the intervention arms with regard to baseline characteristics or effects on abstinence, quality of life, and addiction level. However, participants in the multiple tailoring and counseling group reported significantly more annual health care–related costs than participants in the usual care group. Cost-effectiveness analysis, using prolonged abstinence as the outcome measure, showed that the mere multiple computer-tailored program had the highest probability of being cost-effective. Compared with usual care, in this group €5100 had to be paid for each additional abstinent participant. With regard to cost-utility analyses, using quality of life as the outcome measure, usual care was probably most efficient. Conclusions To our knowledge, this was the first study to determine the cost-effectiveness and cost-utility of an Internet-based smoking cessation program with and without counseling by a practice nurse. Although the Internet-based multiple computer-tailored program seemed to be the most cost-effective treatment, the cost-utility was probably highest for care as usual. However, to ease the interpretation of cost-effectiveness results, future research should aim at identifying an acceptable cutoff point for the willingness to pay per abstinent participant. PMID:23491820

Design Method of Digital Optimal Control Scheme and Multiple Paralleled Bridge Type Current Amplifier for Generating Gradient Magnetic Fields in MRI Systems

NASA Astrophysics Data System (ADS)

Watanabe, Shuji; Takano, Hiroshi; Fukuda, Hiroya; Hiraki, Eiji; Nakaoka, Mutsuo

This paper deals with a digital control scheme of multiple paralleled high frequency switching current amplifier with four-quadrant chopper for generating gradient magnetic fields in MRI (Magnetic Resonance Imaging) systems. In order to track high precise current pattern in Gradient Coils (GC), the proposal current amplifier cancels the switching current ripples in GC with each other and designed optimum switching gate pulse patterns without influences of the large filter current ripple amplitude. The optimal control implementation and the linear control theory in GC current amplifiers have affinity to each other with excellent characteristics. The digital control system can be realized easily through the digital control implementation, DSPs or microprocessors. Multiple-parallel operational microprocessors realize two or higher paralleled GC current pattern tracking amplifier with optimal control design and excellent results are given for improving the image quality of MRI systems.

A space-frequency multiplicative regularization for force reconstruction problems

NASA Astrophysics Data System (ADS)

Aucejo, M.; De Smet, O.

2018-05-01

Dynamic forces reconstruction from vibration data is an ill-posed inverse problem. A standard approach to stabilize the reconstruction consists in using some prior information on the quantities to identify. This is generally done by including in the formulation of the inverse problem a regularization term as an additive or a multiplicative constraint. In the present article, a space-frequency multiplicative regularization is developed to identify mechanical forces acting on a structure. The proposed regularization strategy takes advantage of one's prior knowledge of the nature and the location of excitation sources, as well as that of their spectral contents. Furthermore, it has the merit to be free from the preliminary definition of any regularization parameter. The validity of the proposed regularization procedure is assessed numerically and experimentally. It is more particularly pointed out that properly exploiting the space-frequency characteristics of the excitation field to identify can improve the quality of the force reconstruction.

High-quality uniaxial In(x)Ga(1-x)N/GaN multiple quantum well (MQW) nanowires (NWs) on Si(111) grown by metal-organic chemical vapor deposition (MOCVD) and light-emitting diode (LED) fabrication.

PubMed

Ra, Yong-Ho; Navamathavan, R; Park, Ji-Hyeon; Lee, Cheul-Ro

2013-03-01

This article describes the growth and device characteristics of vertically aligned high-quality uniaxial p-GaN/InxGa1-xN/GaN multiple quantum wells (MQW)/n-GaN nanowires (NWs) on Si(111) substrates grown by metal-organic chemical vapor deposition (MOCVD) technique. The resultant nanowires (NWs), with a diameter of 200-250 nm, have an average length of 2 μm. The feasibility of growing high-quality NWs with well-controlled indium composition MQW structure is demonstrated. These resultant NWs grown on Si(111) substrates were utilized for fabricating vertical-type light-emitting diodes (LEDs). The steep and intense photoluminescence (PL) and cathodoluminescence (CL) spectra are observed, based on the strain-free NWs on Si(111) substrates. High-resolution transmission electron microscopy (HR-TEM) analysis revealed that the MQW NWs are grown along the c-plane with uniform thickness. The current-voltage (I-V) characteristics of these NWs exhibited typical p-n junction LEDs and showed a sharp onset voltage at 2.75 V in the forward bias. The output power is linearly increased with increasing current. The result indicates that the pulsed MOCVD technique is an effective method to grow uniaxial p-GaN/InxGa1-xN/GaN MQW/n-GaN NWs on Si(111), which is more advantageous than other growth techniques, such as molecular beam epitaxy. These results suggest the uniaxial NWs are promising to allow flat-band quantum structures, which can enhance the efficiency of LEDs.

Estimation of selected flow and water-quality characteristics of Alaskan streams

USGS Publications Warehouse

Parks, Bruce; Madison, R.J.

1985-01-01

Although hydrologic data are either sparse or nonexistent for large areas of Alaska, the drainage area, area of lakes, glacier and forest cover, and average precipitation in a hydrologic basin of interest can be measured or estimated from existing maps. Application of multiple linear regression techniques indicates that statistically significant correlations exist between properties of basins determined from maps and measured streamflow characteristics. This suggests that corresponding characteristics of ungaged basins can be estimated. Streamflow frequency characteristics can be estimated from regional equations developed for southeast, south-central and Yukon regions. Statewide or modified regional equations must be used, however, for the southwest, northwest, and Arctic Slope regions where there is a paucity of data. Equations developed from basin characteristics are given to estimate suspended-sediment values for glacial streams and, with less reliability, for nonglacial streams. Equations developed from available specific conductance data are given to estimate concentrations of major dissolved inorganic constituents. Suggestions are made for expanding the existing data base and thus improving the ability to estimate hydrologic characteristics for Alaskan streams. (USGS)

Neighborhood socioeconomic circumstances and the co-occurrence of unhealthy lifestyles: evidence from 206,457 Australians in the 45 and up study.

PubMed

Feng, Xiaoqi; Astell-Burt, Thomas

2013-01-01

Research on the co-occurrence of unhealthy lifestyles has tended to focus mainly upon the demographic and socioeconomic characteristics of individuals. This study investigated the relevance of neighborhood socioeconomic circumstance for multiple unhealthy lifestyles. An unhealthy lifestyle index was constructed for 206,457 participants in the 45 and Up Study (2006-2009) by summing binary responses on smoking, alcohol, physical activity and five diet-related variables. Higher scores indicated the co-occurrence of unhealthy lifestyles. Association with self-rated health, quality of life; and risk of psychological distress was investigated using multilevel logistic regression. Association between the unhealthy lifestyle index with neighborhood characteristics (local affluence and geographic remoteness) were assessed using multilevel linear regression, adjusting for individual-level characteristics. Nearly 50% of the sample reported 3 or 4 unhealthy lifestyles. Only 1.5% reported zero unhealthy lifestyles and 0.2% had all eight. Compared to people who scored zero, those who scored 8 (the 'unhealthiest' group) were 7 times more likely to rate their health as poor (95%CI 3.6, 13.7), 5 times more likely to report poor quality of life (95%CI 2.6, 10.1), and had a 2.6 times greater risk of psychological distress (95%CI 1.8, 3.7). Higher scores among men decreased with age, whereas a parabolic distribution was observed among women. Neighborhood affluence was independently associated with lower scores on the unhealthy lifestyle index. People on high incomes scored higher on the unhealthy lifestyle index if they were in poorer neighborhoods, while those on low incomes had fewer unhealthy lifestyles if living in more affluent areas. Residents of deprived neighborhoods tend to report more unhealthy lifestyles than their peers in affluent areas, regardless of their individual demographic and socioeconomic characteristics. Future research should investigate the trade-offs of population-level versus geographically targeted multiple lifestyle interventions.

Neighborhood Socioeconomic Circumstances and the Co-Occurrence of Unhealthy Lifestyles: Evidence from 206,457 Australians in the 45 and Up Study

PubMed Central

Feng, Xiaoqi; Astell-Burt, Thomas

2013-01-01

Background Research on the co-occurrence of unhealthy lifestyles has tended to focus mainly upon the demographic and socioeconomic characteristics of individuals. This study investigated the relevance of neighborhood socioeconomic circumstance for multiple unhealthy lifestyles. Method An unhealthy lifestyle index was constructed for 206,457 participants in the 45 and Up Study (2006–2009) by summing binary responses on smoking, alcohol, physical activity and five diet-related variables. Higher scores indicated the co-occurrence of unhealthy lifestyles. Association with self-rated health, quality of life; and risk of psychological distress was investigated using multilevel logistic regression. Association between the unhealthy lifestyle index with neighborhood characteristics (local affluence and geographic remoteness) were assessed using multilevel linear regression, adjusting for individual-level characteristics. Results Nearly 50% of the sample reported 3 or 4 unhealthy lifestyles. Only 1.5% reported zero unhealthy lifestyles and 0.2% had all eight. Compared to people who scored zero, those who scored 8 (the ‘unhealthiest’ group) were 7 times more likely to rate their health as poor (95%CI 3.6, 13.7), 5 times more likely to report poor quality of life (95%CI 2.6, 10.1), and had a 2.6 times greater risk of psychological distress (95%CI 1.8, 3.7). Higher scores among men decreased with age, whereas a parabolic distribution was observed among women. Neighborhood affluence was independently associated with lower scores on the unhealthy lifestyle index. People on high incomes scored higher on the unhealthy lifestyle index if they were in poorer neighborhoods, while those on low incomes had fewer unhealthy lifestyles if living in more affluent areas. Interpretation Residents of deprived neighborhoods tend to report more unhealthy lifestyles than their peers in affluent areas, regardless of their individual demographic and socioeconomic characteristics. Future research should investigate the trade-offs of population-level versus geographically targeted multiple lifestyle interventions. PMID:23977335

Effects of multi-scale environmental characteristics on agricultural stream biota in eastern Wisconsin

USGS Publications Warehouse

Fitzpatrick, F.A.; Scudder, B.C.; Lenz, B.N.; Sullivan, D.J.

2001-01-01

The U.S. Geological Survey examined 25 agricultural streams in eastern Wisconsin to determine relations between fish, invertebrate, and algal metrics and multiple spatial scales of land cover, geologic setting, hydrologic, aquatic habitat, and water chemistry data. Spearman correlation and redundancy analyses were used to examine relations among biotic metrics and environmental characteristics. Riparian vegetation, geologic, and hydrologic conditions affected the response of biotic metrics to watershed agricultural land cover but the relations were aquatic assemblage dependent. It was difficult to separate the interrelated effects of geologic setting, watershed and buffer land cover, and base flow. Watershed and buffer land cover, geologic setting, reach riparian vegetation width, and stream size affected the fish IBI, invertebrate diversity, diatom IBI, and number of algal taxa; however, the invertebrate FBI, percentage of EPT, and the diatom pollution index were more influenced by nutrient concentrations and flow variability. Fish IBI scores seemed most sensitive to land cover in the entire stream network buffer, more so than watershed-scale land cover and segment or reach riparian vegetation width. All but one stream with more than approximately 10 percent buffer agriculture had fish IBI scores of fair or poor. In general, the invertebrate and algal metrics used in this study were not as sensitive to land cover effects as fish metrics. Some of the reach-scale characteristics, such as width/depth ratios, velocity, and bank stability, could be related to watershed influences of both land cover and geologic setting. The Wisconsin habitat index was related to watershed geologic setting, watershed and buffer land cover, riparian vegetation width, and base flow, and appeared to be a good indicator of stream quality. Results from this study emphasize the value of using more than one or two biotic metrics to assess water quality and the importance of environmental characteristics at multiple scales.

[Quality of life after multiple trauma].

PubMed

Mörsdorf, P; Becker, S C; Holstein, J H; Burkhardt, M; Pohlemann, T

2014-03-01

Multiple trauma is an independent injury pattern which, because of its complexity, is responsible for 25 % of the costs for the treatment of all injured patients. Because of the often long-lasting physical impairment and the high incidence of residual permanent handicaps, it is apparent that multiple trauma can lead to a reduction in patient quality of life. The aim of this study was to give an overview of the known data concerning the change in quality of life for multiple trauma patients. Furthermore, predictors for the reduction of quality of life after multiple trauma will be identified. A MedLine search was performed to identify studies dealing with the outcome after multiple trauma. In addition to functional outcome parameters, the term quality of life has become more important in recent years when it comes to evaluating the outcome following injury. While the mortality after multiple trauma could be significantly reduced over the years, there is no comparable effect on the quality of life. Predictors for a worse quality of life after multiple trauma are female gender, high age, low social status, concomitant head injuries and injury to the lower extremities. The fact that mortality after multiple trauma has decreased but not impairment of the quality of life makes it clear that in addition to the acute medical treatment, a follow-up treatment including not only physiotherapy but also psychotherapy is crucial for multiple trauma patients.

Doctors on the move: a European case study on the key characteristics of national recertification systems.

PubMed

Sehlbach, Carolin; Govaerts, Marjan J; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

2018-04-17

With increased cross-border movement, ensuring safe and high-quality healthcare has gained primacy. The purpose of recertification is to ensure quality of care through periodically attesting doctors' professional proficiency in their field. Professional migration and facilitated cross-border recognition of qualifications, however, make us question the fitness of national policies for safeguarding patient care and the international accountability of doctors. We performed document analyses and conducted 19 semistructured interviews to identify and describe key characteristics and effective components of 10 different European recertification systems, each representing one case (collective case study). We subsequently compared these systems to explore similarities and differences in terms of assessment criteria used to determine process quality. Great variety existed between countries in terms and assessment formats used, targeting cognition, competence and performance (Miller's assessment pyramid). Recertification procedures and requirements also varied significantly, ranging from voluntary participation in professional development modules to the mandatory collection of multiple performance data in a competency-based portfolio. Knowledge assessment was fundamental to recertification in most countries. Another difference concerned the stakeholders involved in the recertification process: while some systems exclusively relied on doctors' self-assessment, others involved multiple stakeholders but rarely included patients in assessment of doctors' professional competence. Differences between systems partly reflected different goals and primary purposes of recertification. Recertification systems differ substantially internationally with regard to the criteria they apply to assess doctors' competence, their aims, requirements, assessment formats and patient involvement. In the light of professional mobility and associated demands for accountability, we recommend that competence assessment includes patients' perspectives, and recertification practices be shared internationally to enhance transparency. This can help facilitate cross-border movement, while guaranteeing high-quality patient care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

PubMed

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

2015-03-01

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

Positive and Negative Aspects of Relationship Quality and Unprotected Sex among Young Women.

PubMed

Brady, Sonya S; Gruber, Sandra K; Wolfson, Julian A

2016-01-01

The aim of this study was to examine both positive and negative aspects of relationship quality in relation to condom use. Sexually active young women aged 14-18 years (n=111; 34% non-white) were recruited from community clinics and schools in the Midwest USA and provided data via an online survey. The number of unprotected sex acts in the past month with the most recent male partner was regressed on relationship quality with that partner, adjusting for demographics and other characteristics. Negative relationship quality was associated with a greater number of unprotected sex acts among women reporting a low level of positive relationship quality and among women taking hormonal/IUD contraception. Positive relationship quality was associated with unprotected sex among women who reported multiple partners in the past month. Both positive and negative aspects of relationship quality may confer risk for unprotected sex. This risk appears modified by patterns of contraceptive use and other sexual behaviours. Health professionals may be more effective in promoting condom use if they ask questions about both positive and negative aspects of young people's relationship quality and tailor their conversations based on the responses received.

The impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of addicted persons.

PubMed

Marques, Tais Cristina Nascimento; Sarracini, Karin Luciana Migliato; Cortellazzi, Karine Laura; Mialhe, Fábio Luiz; de Castro Meneghim, Marcelo; Pereira, Antonio Carlos; Ambrosano, Glaucia Maria Bovi

2015-03-20

The aim of this cross-sectional study was to evaluate the impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of alcohol and drug addicted persons, receiving care at outpatient treatment facilities in Brazil. A random sample of 262 participants, mean age 37 years, from Psychosocial Care Centers for Alcohol and Drugs (CAPS AD) located in three cities in the state of São Paulo, Brazil, were clinically examined for caries experience (DMFT index) by a calibrated examiner. They were asked to complete a series of questionnaires, including the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), socioeconomic characteristics, and the World Health Organization Quality of Life assessment (WHOQOL), which were considered the outcome variables of the study. Associations between oral health status, socioeconomic characteristics, substance involvement with WHOQOL were investigated by means of the chi-square test and multiple logistic regression analysis with a level of significance α < 0.05. The mean DMF index of the group was 13.0. Subjects with DMFT >14 (OR = 2.25; CI 95% = 1.30-3.89); low-income (OR = 2.41; CI 95% = 1.22-4.77) and users of cocaine/crack (OR = 2.02; CI 95% = 1.15-3.59) were more likely to have poor general quality of life. This study demonstrated that the general quality of life of addicted persons was associated with caries experience, low income and cocaine/crack use.

Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework.

PubMed

Kontopantelis, Evangelos; Buchan, Iain; Reeves, David; Checkland, Kath; Doran, Tim

2013-08-02

To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system. Retrospective longitudinal study. Data for 2007-2008 to 2010-2011, extracted from the clinical computer systems of general practices in England. All English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice. Levels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement. Seven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels). Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system.

Linking water quality guidelines to the natural characteristics of catchments in order to support distinct aquatic ecosystems: Water quality guidelines for suspended particulate matter

NASA Astrophysics Data System (ADS)

Bilotta, G. S.; Grove, M. K.; Harrison, C.; Joyce, C. B.; Peacock, C.

2012-12-01

The natural characteristics of a catchment provide a template that controls the background rates of geomorphological processes operating within that catchment, which in-turn determines the background physico-chemical and hydro-morphological characteristics of the catchment's surface waters. Large differences in the natural characteristics of catchments (e.g. geology, topography, climate), lead to unique physico-chemical and hydro-morphological conditions that support unique freshwater communities. However, this uniqueness is not always recognised in international water quality guidelines, which often attempt to apply blanket water-quality guidelines to 'protect' a wide range of ecosystems. In this paper we investigate the natural characteristics that control background concentrations of suspended particulate matter (SPM - including nano-scale particles to sand-sized sediments), which is a well-known cause of ecological degradation. At present, the management of SPM is hampered by a lack of understanding of the SPM conditions that water quality managers should aim to achieve in contrasting environments in order to support good ecological status. To address this, in this paper we examine the SPM preferences of contrasting biological communities that are in reference condition (minimal anthropogenic disturbance and high ecological status). We analyse historical SPM data collected on a monthly basis from a wide range of reference-condition temperate environments (638 stream/river sites comprising 42 different biological community-types). This analysis reveals that there are statistically significant differences (One-way ANOVA p < 0.001) between the background SPM concentrations observed in contrasting communities that are in reference condition. Mean background SPM concentrations for contrasting communities ranged from 1.7 to 26.2 mg L-1 (i.e. more than a 15-fold difference). We propose a model for predicting environment-specific water quality guidelines for SPM. In order to develop this model, the 638 reference-condition sites were first classified into one of five mean background SPM ranges (0.00-5.99, 6.00-11.99, 12.00-17.99, 18.00-23.99 and >24.00 mg L-1). Stepwise Multiple Discriminant Analysis (MDA) of these ranges showed that a site's SPM range can be predicted as a function of: mean annual air temperature, mean annual precipitation, mean altitude of upstream catchment, distance from source, slope to source, channel width and depth, the percentage of catchment area comprised of clay, chalk, and hard rock solid geology, and the percentage of the catchment area comprised of blown sand/landslide material as the surface (drift) material. Although the model is still being improved and developed, this research highlights the need to link water quality guidelines to the natural characteristics of catchments and the physico-chemical preferences of the biological communities that would naturally inhabit them.

Gallium phosphide high temperature diodes

NASA Technical Reports Server (NTRS)

Chaffin, R. J.; Dawson, L. R.

1981-01-01

High temperature (300 C) diodes for geothermal and other energy applications were developed. A comparison of reverse leakage currents of Si, GaAs, and GaP was made. Diodes made from GaP should be usable to 500 C. A Liquid Phase Epitaxy (LPE) process for producing high quality, grown junction GaP diodes is described. This process uses low vapor pressure Mg as a dopant which allows multiple boat growth in the same LPE run. These LPE wafers were cut into die and metallized to make the diodes. These diodes produce leakage currents below ten to the -9th power A/sq cm at 400 C while exhibiting good high temperature rectification characteristics. High temperature life test data is presented which shows exceptional stability of the V-I characteristics.

Objective Understanding of Front-of-Package Nutrition Labels among Nutritionally At-Risk Individuals

PubMed Central

Ducrot, Pauline; Méjean, Caroline; Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Fezeu, Léopold K.; Hercberg, Serge; Péneau, Sandrine

2015-01-01

In the ongoing debate about front-of-package (FOP) nutrition labels, little data exist regarding nutritionally at-risk populations, although they are critical targets of prevention programs. This study aimed to compare the impact of FOP labels on the ability to rank products according to their nutritional quality among French adults potentially at risk of poor dietary quality (N = 14,230). Four labels were evaluated: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), along with a reference without label. Mixed models were used to assess how individual characteristics and FOP labels were associated with the ability to rank products. Older participants and those with a lower educational level, income, nutritional knowledge, and likelihood of reading nutrition facts were less skilled at ranking food products according to nutritional quality. Compared with individual characteristics, nutrition labels had an increased impact on food product ranking ability. Overall, 5-CNL corresponded to the highest rate of correct responses, followed by MTL, GDA, and Tick (p < 0.0001). The strongest impact of 5-CNL was observed among individuals with no nutritional knowledge (odds ratio (OR): 20.24; 95% confidence interval (CI): 13.19–31.06). Therefore, 5-CNL appeared to be effective at informing consumers, including those who are nutritionally at-risk, about the nutritional quality of food products. PMID:26305255

Objective Understanding of Front-of-Package Nutrition Labels among Nutritionally At-Risk Individuals.

PubMed

Ducrot, Pauline; Méjean, Caroline; Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Fezeu, Léopold K; Hercberg, Serge; Péneau, Sandrine

2015-08-24

In the ongoing debate about front-of-package (FOP) nutrition labels, little data exist regarding nutritionally at-risk populations, although they are critical targets of prevention programs. This study aimed to compare the impact of FOP labels on the ability to rank products according to their nutritional quality among French adults potentially at risk of poor dietary quality (N = 14,230). Four labels were evaluated: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), along with a reference without label. Mixed models were used to assess how individual characteristics and FOP labels were associated with the ability to rank products. Older participants and those with a lower educational level, income, nutritional knowledge, and likelihood of reading nutrition facts were less skilled at ranking food products according to nutritional quality. Compared with individual characteristics, nutrition labels had an increased impact on food product ranking ability. Overall, 5-CNL corresponded to the highest rate of correct responses, followed by MTL, GDA, and Tick (p < 0.0001). The strongest impact of 5-CNL was observed among individuals with no nutritional knowledge (odds ratio (OR): 20.24; 95% confidence interval (CI): 13.19-31.06). Therefore, 5-CNL appeared to be effective at informing consumers, including those who are nutritionally at-risk, about the nutritional quality of food products.

A pragmatic randomized comparative effectiveness trial of transitional care for a socioeconomically diverse population: Design, rationale and baseline characteristics.

PubMed

Schaeffer, Christine; Teter, Caroline; Finch, Emily A; Hurt, Courtney; Keeter, Mary Kate; Liss, David T; Rogers, Angela; Sheth, Avani; Ackermann, Ronald

2018-02-01

Transitional care programs have been widely used to reduce readmissions and improve the quality and safety of the handoff process between hospital and outpatient providers. Very little is known about effective transitional care interventions among patients who are uninsured or with Medicaid. This paper describes the design and baseline characteristics of a pragmatic randomized comparative effectiveness trial of transitional care. Northwestern Medical Group- Transitional Care (NMG-TC) care model was developed to address the needs of patients with multiple medical problems that required lifestyle changes and were amenable to office-based management. We present the design, evaluation methods and baseline characteristics of NMG-TC trial patients. Baseline demographic characteristics indicate that our patient population is predominantly male, Medicaid insured and non-white. This study will evaluate two methods for implementing an effective transitional care model in a medically complex and socioeconomically diverse population. Copyright © 2017 Elsevier Inc. All rights reserved.

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study.

PubMed

Teles, Mariza Alves Barbosa; Barbosa, Mirna Rossi; Vargas, Andréa Maria Duarte; Gomes, Viviane Elizângela; Ferreira, Efigênia Ferreira e; Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição

2014-05-15

Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression. Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions. There is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers.

Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

PubMed Central

2014-01-01

Background Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. Methods This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health workers. Data were collected by interviews. Quality of life was assessed using the WHOQOL-BREF; general quality of life, as well as the physical, psychological, social and environmental domains were considered, with scores from 0 to 100. Higher scores indicate a better quality of life. Poor quality of life was defined by the lowest quartiles of the WHOQOL score distributions for each of the domains. Adverse psychosocial work conditions were investigated by the Effort-Reward Imbalance model. Associations were verified using multiple logistic regression. Results Poor quality of life was observed in 117 (15.4%) workers. Workers with imbalanced effort-reward (high effort/low reward) had an increased probability of general poor quality of life (OR = 1.91; 1.07–3.42), and in the physical (OR = 1.62; 1.02–2.66), and environmental (OR = 2.39; 1.37–4.16) domains; those with low effort/low reward demonstrated a greater probability of poor quality of life in the social domain (OR = 1.82; 1.00–3.30). Workers with overcommitment at work had an increased likelihood of poor quality of life in the physical (OR = 1.55, 1.06–2.26) and environmental (OR = 1.69; 1.08–2.65) domains. These associations were independent of individual characteristics, job characteristics, lifestyle, perception of general health, or psychological and biological functions. Conclusions There is an association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. PMID:24884707

The effect of work on people with severe mental illness in Taiwan using a stress-social support model: an exploratory study.

PubMed

Wu, Hui-Ching

2006-06-01

Satisfaction with quality of life is one aspect of a positive and successful life, and this remains true in the rehabilitation of people with severe mental illness. This study explores the meaning and impact of work on people with severe mental illness in Taiwan and, specifically, the value of encouraging people with severe mental illness to work to enhance their quality of life. We apply stress-social support theory (a Western model) to examine daily life and work stressors in an Eastern cultural environment (Taiwan). We use multiple regression models to analyze predictive factors for their effect on life quality. There are five categories: socio-demographic characteristics, mental illness history, current work status variables (as controls), stress variable and social support variable. Unlike Western studies, current work status, in itself, did not lead to better satisfaction with quality of life, but the stress-social support model did. The implications for rehabilitation success are discussed.

Quantitative analysis of aircraft multispectral-scanner data and mapping of water-quality parameters in the James River in Virginia

NASA Technical Reports Server (NTRS)

Johnson, R. W.; Bahn, G. S.

1977-01-01

Statistical analysis techniques were applied to develop quantitative relationships between in situ river measurements and the remotely sensed data that were obtained over the James River in Virginia on 28 May 1974. The remotely sensed data were collected with a multispectral scanner and with photographs taken from an aircraft platform. Concentration differences among water quality parameters such as suspended sediment, chlorophyll a, and nutrients indicated significant spectral variations. Calibrated equations from the multiple regression analysis were used to develop maps that indicated the quantitative distributions of water quality parameters and the dispersion characteristics of a pollutant plume entering the turbid river system. Results from further analyses that use only three preselected multispectral scanner bands of data indicated that regression coefficients and standard errors of estimate were not appreciably degraded compared with results from the 10-band analysis.

Perceived service quality and its influence on behavioral intention in South Korean public dental hospitals.

PubMed

Kim, Yukyoung; Kim, Soungmin; Myoung, Hoon; Lee, Hyung Ryong

2012-03-01

South Korean national university dental hospitals (NUDHs) face unprecedented challenges in maintaining primary function as public hospitals and surviving in intensified competition. The aim of the study was to evaluate the perceived service quality of NUDH patients and its influences on behavior and to gain managerial implications. Perceived service quality, value, satisfaction, and behavioral intention were measured in 438 NUDH patients from 3 NUDHs. With demographic analyses, the authors used structural equation models to test the validity to prove the relationship between dimensions. showed that the dimension of dentist concern directly influenced satisfaction and behavior, and tangibles was the only significant antecedent factor of value that had a significant positive effect on satisfaction. Based on demographic characteristics, highly educated, self-motivated patients who underwent multiple treatments had lower perceptions of value and satisfaction. NUDHs need to maintain their public image and to improve the dimensions of communication and tangibles to gain competitiveness.

Study of Laser Drilled Hole Quality of Yttria Stabilized Zirconia

NASA Astrophysics Data System (ADS)

Saini, Surendra K.; Dubey, Avanish K.; Pant, Piyush; Upadhyay, B. N.; Choubey, A.

2017-09-01

The Yttria Stabilized Zirconia ceramic is extensively used in aerospace, automotives, medical and microelectronics industries. These applications demand manufacturing of different macro and micro features with close tolerances in this material. To make miniature holes with accurate dimensions in advanced ceramics such as Yttria Stabilized Zirconia is very difficult due to its tailored attributes such as high toughness, hardness, strength, resistance to wear, corrosion and temperature. Due to inherent characteristics of laser drilling, researchers are working to fulfill the requirement of creation of micro holes in advanced ceramics. The present research investigates the laser drilling of 2 mm thick Yttria Stabilized Zirconia with the aim to achieve good micro holes with reduced geometrical inaccuracies and improved hole quality. The results show that multiple quality response comprising hole circularity, hole taper and recast layer thickness has been improved at optimally selected process parameters.

Quantitative and fingerprint analyses of Chinese sweet tea plant (Rubus Suavissimus S. Lee)

PubMed Central

Chou, Guixin; Xu, Shun-Jun; Liu, Dong; Koh, Gar Yee; Zhang, Jian; Liu, Zhijun

2009-01-01

Quality of botanical food is increasingly assessed by the content of multiple bioactive compounds. In this study we report, for the first time, an HPLC fingerprinting method for the quality evaluation of Rubus suavissimus leaves possessing multiple bioactivities. Five constituents, gallic acid, rutin, ellagic acid, rubusoside, and steviol monoside were quantified and used in developing qualitative chromatographic fingerprints. The limits of detection and quantification ranged from 0.29 μg/mL to 37.86 μg/mL. The relative standard deviations (RSDs) of intra- and inter-day precisions were no more than 3.14% and 3.01%, respectively. The average recoveries were between 93.1% and 97.5%. The developed method was validated in analyzing fourteen leaf samples with satisfactory results. The contents of the five marker compounds accounted for an average of about 6% w/w with a variability of 16% among the fourteen samples collected from a single site and year. Gallic acid was the least whereas steviol monoside the most variable compounds among the fourteen leaf samples. The characteristic compound rubusoside that is responsible for the sweet taste accounted for 5% of leaf weight. The validated method can now be used to quantitatively and qualitatively assess the quality of Rubus suavissimus leaves as traditional beverage or potential medicines. PMID:19138116

Biogeochemical and hydrological constraints on concentration-discharge curves

NASA Astrophysics Data System (ADS)

Moatar, Florentina; Abbott, Ben; Minaudo, Camille; Curie, Florence; Pinay, Gilles

2017-04-01

The relationship between concentration and discharge (C-Q) can give insight into the location, abundance, rate of production or consumption, and transport dynamics of elements in coupled terrestrial-aquatic ecosystems. Consequently, the investigation of C-Q relationships for multiple elements at multiple spatial and temporal scales can be a powerful tool to address three of ecohydrology's fundamental questions: where does water comes from, how long does it stay, and what happens to the solutes and particulates it carries along the way. We analyzed long-term water quality data from 300 monitoring stations covering nearly half of France to investigate how elemental properties, catchment characteristics, and hydrological parameters influence C-Q. Based on previous work, we segmented the hydrograph, calculating independent C-Q slopes for flows above and below the median discharge. We found that most elements only expressed two of the nine possible C-Q modalities, indicating strong elemental control of C-Q shape. Catchment characteristics including land use and human population had a strong impact on concentration but typically did not influence the C-Q slopes, also suggesting inherent constraints on elemental production and transport. Biological processes appeared to regulate C-Q slope at low flows for biologically-reactive elements, but at high flows, these processes became unimportant, and most parameters expressed chemostatic behavior. This study provides a robust description of possible C-Q shapes for a wide variety of catchments and elements and demonstrates the value of low-frequency, long-term data collected by water quality agencies.

Modeling companion diagnostics in economic evaluations of targeted oncology therapies: systematic review and methodological checklist.

PubMed

Doble, Brett; Tan, Marcus; Harris, Anthony; Lorgelly, Paula

2015-02-01

The successful use of a targeted therapy is intrinsically linked to the ability of a companion diagnostic to correctly identify patients most likely to benefit from treatment. The aim of this study was to review the characteristics of companion diagnostics that are of importance for inclusion in an economic evaluation. Approaches for including these characteristics in model-based economic evaluations are compared with the intent to describe best practice methods. Five databases and government agency websites were searched to identify model-based economic evaluations comparing a companion diagnostic and subsequent treatment strategy to another alternative treatment strategy with model parameters for the sensitivity and specificity of the companion diagnostic (primary synthesis). Economic evaluations that limited model parameters for the companion diagnostic to only its cost were also identified (secondary synthesis). Quality was assessed using the Quality of Health Economic Studies instrument. 30 studies were included in the review (primary synthesis n = 12; secondary synthesis n = 18). Incremental cost-effectiveness ratios may be lower when the only parameter for the companion diagnostic included in a model is the cost of testing. Incorporating the test's accuracy in addition to its cost may be a more appropriate methodological approach. Altering the prevalence of the genetic biomarker, specific population tested, type of test, test accuracy and timing/sequence of multiple tests can all impact overall model results. The impact of altering a test's threshold for positivity is unknown as it was not addressed in any of the included studies. Additional quality criteria as outlined in our methodological checklist should be considered due to the shortcomings of standard quality assessment tools in differentiating studies that incorporate important test-related characteristics and those that do not. There is a need to refine methods for incorporating the characteristics of companion diagnostics into model-based economic evaluations to ensure consistent and transparent reimbursement decisions are made.

Key factors affecting urban runoff pollution under cold climatic conditions

NASA Astrophysics Data System (ADS)

Valtanen, Marjo; Sillanpää, Nora; Setälä, Heikki

2015-10-01

Urban runoff contains various pollutants and has the potential of deteriorating the quality of aquatic ecosystems. In this study our objective is to shed light on the factors that control the runoff water quality in urbanized catchments. The effects of runoff event characteristics, land use type and catchment imperviousness on event mass loads (EML) and event mean concentrations (EMC) were studied during warm and cold periods in three study catchments (6.1, 6.5 and 12.6 ha in size) in the city of Lahti, Finland. Runoff and rainfall were measured continuously for two years at each catchment. Runoff samples were taken for total nutrients (tot-P and tot-N), total suspended solids (TSS), heavy metals (Zn, Cr, Al, Co, Ni, Cu, Pb, Mn) and total organic carbon (TOC). Stepwise multiple linear regression analysis (SMLR) was used to identify general relationships between the following variables: event water quality, runoff event characteristics and catchment characteristics. In general, the studied variables explained 50-90% of the EMLs but only 30-60% of the EMCs, with runoff duration having an important role in most of the SMLR models. Mean runoff intensity or peak flow was also often included in the runoff quality models. Yet, the importance (being the first, second or third best) and role (negative or positive impact) of the explanatory variables varied between the cold and warm period. Land use type often explained cold period concentrations, but imperviousness alone explained EMCs weakly. As for EMLs, the influence of imperviousness and/or land use was season and pollutant dependent. The study suggests that pollutant loads can be - throughout the year - adequately predicted by runoff characteristics given that seasonal differences are taken into account. Although pollutant concentrations were sensitive to variation in seasonal and catchment conditions as well, the accurate estimation of EMCs would require a more complete set of explanatory factors than used in this study.

What affects the subjective sleep quality of hospitalized elderly patients?

PubMed

Park, Mi Jeong; Kim, Kon Hee

2017-03-01

The present study aimed to identify the factors affecting the subjective sleep quality in elderly inpatients. The participants were 290 older adults admitted in three general hospitals. Data were collected using a structured questionnaire consisting of scales for general characteristics, sleep quality, activities of daily living, instrumental activities of daily living and depression. Collected data were analyzed by descriptive statistics, t-test, one-way anova, Scheffé post-hoc, Pearson's correlation coefficient and stepwise multiple regression. There were statistically significant differences in sleep quality according to age, education level, marital status, monthly income and number of cohabitants. The most powerful predictor of sleep quality was depression (P < 0.01, R 2  = 0.30). Five variables, depression, perceived health status, diagnosis, number of cohabitants and duration of hospitalization; explained 43.0% of the total variance in sleep quality. Elderly inpatients suffered from low sleep quality, and depression affected their sleep. We should develop and apply hospital-tailored sleep interventions considering older adults' depression, and then hospitalized older adults' sleep could improve. Furthermore, it is useful to identify other sleep-related factors. Geriatr Gerontol Int 2017; 17: 471-479. © 2016 Japan Geriatrics Society.

Intelligent composting assisted by a wireless sensing network.

PubMed

López, Marga; Martinez-Farre, Xavier; Casas, Oscar; Quilez, Marcos; Polo, Jose; Lopez, Oscar; Hornero, Gemma; Pinilla, Mirta R; Rovira, Carlos; Ramos, Pedro M; Borges, Beatriz; Marques, Hugo; Girão, Pedro Silva

2014-04-01

Monitoring of the moisture and temperature of composting process is a key factor to obtain a quality product beyond the quality of raw materials. Current methodologies for monitoring these two parameters are time consuming for workers, sometimes not sufficiently reliable to help decision-making and thus are ignored in some cases. This article describes an advance on monitoring of composting process through a Wireless Sensor Network (WSN) that allows measurement of temperature and moisture in real time in multiple points of the composting material, the Compo-ball system. To implement such measurement capabilities on-line, a WSN composed of multiple sensor nodes was designed and implemented to provide the staff with an efficient monitoring composting management tool. After framing the problem, the objectives and characteristics of the WSN are briefly discussed and a short description of the hardware and software of the network's components are presented. Presentation and discussion of practical issues and results obtained with the WSN during a demonstration stage that took place in several composting sites concludes the paper. Copyright © 2014 Elsevier Ltd. All rights reserved.

Quality of survey reporting in nephrology journals: a methodologic review.

PubMed

Li, Alvin Ho-Ting; Thomas, Sonia M; Farag, Alexandra; Duffett, Mark; Garg, Amit X; Naylor, Kyla L

2014-12-05

Survey research is an important research method used to determine individuals' attitudes, knowledge, and behaviors; however, as with other research methods, inadequate reporting threatens the validity of results. This study aimed to describe the quality of reporting of surveys published between 2001 and 2011 in the field of nephrology. The top nephrology journals were systematically reviewed (2001-2011: American Journal of Kidney Diseases, Nephrology Dialysis Transplantation, and Kidney International; 2006-2011: Clinical Journal of the American Society of Nephrology) for studies whose primary objective was to collect and report survey results. Included were nephrology journals with a heavy focus on clinical research and high impact factors. All titles and abstracts were screened in duplicate. Surveys were excluded if they were part of a multimethod study, evaluated only psychometric characteristics, or used semi-structured interviews. Information was collected on survey and respondent characteristics, questionnaire development (e.g., pilot testing), psychometric characteristics (e.g., validity and reliability), survey methods used to optimize response rate (e.g., system of multiple contacts), and response rate. After a screening of 19,970 citations, 216 full-text articles were reviewed and 102 surveys were included. Approximately 85% of studies reported a response rate. Almost half of studies (46%) discussed how they developed their questionnaire and only a quarter of studies (28%) mentioned the validity or reliability of the questionnaire. The only characteristic that improved over the years was the proportion of articles reporting missing data (2001-2004: 46.4%; 2005-2008: 61.9%; and 2009-2011: 84.8%; respectively) (P<0.01). The quality of survey reporting in nephrology journals remains suboptimal. In particular, reporting of the validity and reliability of the questionnaire must be improved. Guidelines to improve survey reporting and increase transparency are clearly needed. Copyright © 2014 by the American Society of Nephrology.

Clinical Characteristics of Mixed Arteriovenous Leg Ulcers: A Descriptive Study.

PubMed

Marin, Joseph A; Woo, Kevin Y

The purpose of this study was to identify the clinical characteristics of mixed arteriovenous leg ulcers (MLU) that differentiated them from venous leg ulcers (VLU). Secondary analysis of data from larger electronic database. The sample comprised 1007 persons with lower extremity ulcers. Two hundred sixty three individuals with MLU were compared to 744 individuals with VLU; their ankle brachial indices were 0.51-0.90 and 0.91-.30 respectively. Subjects were drawn from community care settings from across Canada. Data concerning baseline demographic and pertinent clinical characteristics including ulcer history were collected using multiple validated instruments. The Leg Ulcer Assessment Tool was used to collect demographic and pertinent medical history, The Short Form Health Survey 12 and the Euro Wuol 5D (EQ-5D) were used to measure health related quality of life, the numeric pain scales was used to measure character and intensity of pain. Groups were compared using χ or Mann-Whitney U. Individuals with MLU were significantly older, has lower body mass index, a history of smoking, and more comorbid conditions than subjects with VLU. In many cases, clinical presentation was indicative of significant arterial insufficiency including cool extremities, shiny, cracked and inelastic skin, impaired capillary refill, and weak pedal pulses. Ulcer pain was highly prevalent, but overall pain rating was similar between groups. Mixed arteriovenous leg ulcers were associated with lower health related quality of life, greater mobility impairments, and more deficits in self-care and usual activities. Greater knowledge and understanding of the distinct characteristics of MLU is critical for appropriate screening, prevention, assessment and management of persons with this form of leg ulcer. Pain and health related quality of life factors are important considerations when evaluating and managing these patients.

A Quality Assurance Initiative for Commercial-Scale Production in High-Throughput Cryopreservation of Blue Catfish Sperm

PubMed Central

Hu, E; Liao, T. W.; Tiersch, T. R.

2013-01-01

Cryopreservation of fish sperm has been studied for decades at a laboratory (research) scale. However, high-throughput cryopreservation of fish sperm has recently been developed to enable industrial-scale production. This study treated blue catfish (Ictalurus furcatus) sperm high-throughput cryopreservation as a manufacturing production line and initiated quality assurance plan development. The main objectives were to identify: 1) the main production quality characteristics; 2) the process features for quality assurance; 3) the internal quality characteristics and their specification designs; 4) the quality control and process capability evaluation methods, and 5) the directions for further improvements and applications. The essential product quality characteristics were identified as fertility-related characteristics. Specification design which established the tolerance levels according to demand and process constraints was performed based on these quality characteristics. Meanwhile, to ensure integrity throughout the process, internal quality characteristics (characteristics at each quality control point within process) that could affect fertility-related quality characteristics were defined with specifications. Due to the process feature of 100% inspection (quality inspection of every fish), a specific calculation method, use of cumulative sum (CUSUM) control charts, was applied to monitor each quality characteristic. An index of overall process evaluation, process capacity, was analyzed based on in-control process and the designed specifications, which further integrates the quality assurance plan. With the established quality assurance plan, the process could operate stably and quality of products would be reliable. PMID:23872356

Local and Long-Distance Effects of Land Use Change on Nutrient Levels in Streams and Rivers of the Conterminous United States

NASA Astrophysics Data System (ADS)

Smith, R. A.; Alexander, R. B.; Schwarz, G. E.

2003-12-01

Determining the effects of land use change (e.g. urbanization, deforestation) on water quality at large spatial scales has been difficult because water quality measurements in large rivers with heterogeneous basins show the integrated effects of multiple factors. Moreover, the observed effects of land use changes on water quality in small homogeneous stream basins may not be indicative of downstream effects (including effects on such ecologically relevant characteristics as nutrient levels and elemental ratios) because of loss processes occurring during downstream transport in river channels. In this study we used the USGS SPARROW (Spatially-Referenced Regression on Watersheds) models of total nitrogen (TN) and total phosphorus (TP) in streams and rivers of the conterminous US to examine the effects of various aspects of land use change on nutrient concentrations and flux from the pre-development era to the present. The models were calibrated with data from 370 long-term monitoring stations representing a wide range of basin sizes, land use/cover classes, climates, and physiographies. The non-linear formulation for each model includes 20+ statistically estimated parameters relating to land use/cover characteristics and other environmental variables such as temperature, soil conditions, hill slope, and the hydraulic characteristics of 2200 large lakes and reservoirs. Model predictions are available for 62,000 river/stream channel nodes. Model predictions of pre-development water quality compare favorably with nutrient data from 63 undeveloped (reference) sites. Error statistics are available for predictions at all nodes. Model simulations were chosen to compare the effects of selected aspects of land use change on nutrient levels at large and small basin scales, lacustrine and coastal receiving waters, and among the major US geographic regions.

Spatial-Temporal Variations of Water Quality and Its Relationship to Land Use and Land Cover in Beijing, China

PubMed Central

Chen, Xiang; Zhou, Weiqi; Pickett, Steward T. A.; Li, Weifeng; Han, Lijian

2016-01-01

Rapid urbanization with intense land use and land cover (LULC) change and explosive population growth has a great impact on water quality. The relationship between LULC characteristics and water quality provides important information for non-point sources (NPS) pollution management. In this study, we first quantified the spatial-temporal patterns of five water quality variables in four watersheds with different levels of urbanization in Beijing, China. We then examined the effects of LULC on water quality across different scales, using Pearson correlation analysis, redundancy analysis, and multiple regressions. The results showed that water quality was improved over the sampled years but with no significant difference (p > 0.05). However, water quality was significantly different among nonurban and both exurban and urban sites (p < 0.05). Forest land was positively correlated with water quality and affected water quality significantly (p < 0.05) within a 200 m buffer zone. Impervious surfaces, water, and crop land were negatively correlated with water quality. Crop land and impervious surfaces, however, affected water quality significantly (p < 0.05) for buffer sizes greater than 800 m. Grass land had different effects on water quality with the scales. The results provide important insights into the relationship between LULC and water quality, and thus for controlling NPS pollution in urban areas. PMID:27128934

High precision gas hydrate imaging of small-scale and high-resolution marine sparker multichannel seismic data

NASA Astrophysics Data System (ADS)

Luo, D.; Cai, F.

2017-12-01

Small-scale and high-resolution marine sparker multi-channel seismic surveys using large energy sparkers are characterized by a high dominant frequency of the seismic source, wide bandwidth, and a high resolution. The technology with a high-resolution and high-detection precision was designed to improve the imaging quality of shallow sedimentary. In the study, a 20KJ sparker and 24-channel streamer cable with a 6.25m group interval were used as a seismic source and receiver system, respectively. Key factors for seismic imaging of gas hydrate are enhancement of S/N ratio, amplitude compensation and detailed velocity analysis. However, the data in this study has some characteristics below: 1. Small maximum offsets are adverse to velocity analysis and multiple attenuation. 2. Lack of low frequency information, that is, information less than 100Hz are invisible. 3. Low S/N ratio since less coverage times (only 12 times). These characteristics make it difficult to reach the targets of seismic imaging. In the study, the target processing methods are used to improve the seismic imaging quality of gas hydrate. First, some technologies of noise suppression are combined used in pre-stack seismic data to suppression of seismic noise and improve the S/N ratio. These technologies including a spectrum sharing noise elimination method, median filtering and exogenous interference suppression method. Second, the combined method of three technologies including SRME, τ-p deconvolution and high precision Radon transformation is used to remove multiples. Third, accurate velocity field are used in amplitude energy compensation to highlight the Bottom Simulating Reflector (short for BSR, the indicator of gas hydrates) and gas migration pathways (such as gas chimneys, hot spots et al.). Fourth, fine velocity analysis technology are used to improve accuracy of velocity analysis. Fifth, pre-stack deconvolution processing technology is used to compensate for low frequency energy and suppress of ghost, thus formation reflection characteristics are highlighted. The result shows that the small-scale and high resolution marine sparker multi-channel seismic surveys are very effective in improving the resolution and quality of gas hydrate imaging than the conventional seismic acquisition technology.

Interventions to improve physical activity among socioeconomically disadvantaged groups: an umbrella review.

PubMed

Craike, Melinda; Wiesner, Glen; Hilland, Toni A; Bengoechea, Enrique Garcia

2018-05-15

People from socioeconomically disadvantaged population groups are less likely to be physically active and more likely to experience adverse health outcomes than those who are less disadvantaged. In this umbrella review we examined across all age groups, (1) the effectiveness of interventions to improve physical activity among socioeconomically disadvantaged groups, (2) the characteristics of effective interventions, and (3) directions for future research. PubMed/MEDLINE and Scopus were searched up to May 2017 to identify systematic reviews reporting physical activity interventions in socioeconomically disadvantaged populations or sub-groups. Two authors independently conducted study screening and selection, data extraction (one author, with data checked by two others) and assessment of methodological quality using the 'Assessment of Multiple Systematic Reviews' scale. Results were synthesized narratively. Seventeen reviews met our inclusion criteria, with only 5 (30%) reviews being assessed as high quality. Seven (41%) reviews focused on obesity prevention and an additional four focused on multiple behavioural outcomes. For pre school children, parent-focused, group-based interventions were effective in improving physical activity. For children, school-based interventions and policies were effective; few studies focused on adolescents and those that did were generally not effective; for adults, there was mixed evidence of effectiveness but characteristics such as group-based interventions and those that focused on physical activity only were associated with effectiveness. Few studies focused on older adults. Across all ages, interventions that were more intensive tended to be more effective. Most studies reported short-term, rather than longer-term, outcomes and common methodological limitations included high probability of selection bias, low response rates, and high attrition. Interventions can be successful at improving physical activity among children from socioeconomically disadvantaged groups, with evidence for other age groups weak or inconclusive. More high-quality studies in this population group are needed, which adopt strategies to increase recruitment rates and reduce attrition, report longer term outcomes, and provide adequate intervention details, to allow determination of the characteristics of effective interventions. We recommend that the benefits of physical activity be recognised more broadly than obesity prevention in future studies, as this may have implications for the design and appeal of interventions.

Is high–dose rate RapidArc-based radiosurgery dosimetrically advantageous for the treatment of intracranial tumors?

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

Zhao, Bo; Yang, Yong, E-mail: yangy2@upmc.edu; Li, Xiang

In linac-based stereotactic radiosurgery (SRS) and radiotherapy (SRT), circular cone(s) or conformal arc(s) are conventionally used to treat intracranial lesions. However, when the target is in close proximity to critical structures, it is frequently quite challenging to generate a quality plan using these techniques. In this study, we investigated the dosimetric characteristics of using high–dose rate RapidArc (RA) technique for radiosurgical treatment of intracranial lesions. A total of 10 intracranial SRS/SRT cases previously planned using dynamic conformal arc (DCA) or cone-based techniques have been included in this study. For each case, 3 treatment plans were generated: (1) a DCA planmore » with multiple noncoplanar arcs, (2) a high–dose rate RA plan with arcs oriented the same as DCA (multiple-arc RA), and 3) a high–dose rate RA plan with a single coplanar arc (single-arc RA). All treatment plans were generated under the same prescription and similar critical structure dose limits. Plan quality for different plans was evaluated by comparing various dosimetric parameters such as target coverage, conformity index (CI), homogeneity index (HI), critical structures, and normal brain tissue doses as well as beam delivery time. With similar critical structure sparing, high–dose rate RA plans can achieve much better target coverage, dose conformity, and dose homogeneity than the DCA plans can. Plan quality indices CI and HI, for the DCA, multiple-arc RA, and single-arc RA techniques, were measured as 1.67 ± 0.39, 1.32 ± 0.28, and 1.38 ± 0.30 and 1.24 ± 0.11, 1.10 ± 0.04, and 1.12 ± 0.07, respectively. Normal brain tissue dose (V{sub 12} {sub Gy}) was found to be similar for DCA and multiple-arc RA plans but much larger for the single-arc RA plans. Beam delivery was similar for DCA and multiple-arc RA plans but shorter with single-arc RA plans. Multiple-arc RA SRS/SRT can provide better treatment plans than conventional DCA plans, especially for complex cases.« less

Paediatric x-ray radiation dose reduction and image quality analysis.

PubMed

Martin, L; Ruddlesden, R; Makepeace, C; Robinson, L; Mistry, T; Starritt, H

2013-09-01

Collaboration of multiple staff groups has resulted in significant reduction in the risk of radiation-induced cancer from radiographic x-ray exposure during childhood. In this study at an acute NHS hospital trust, a preliminary audit identified initial exposure factors. These were compared with European and UK guidance, leading to the introduction of new factors that were in compliance with European guidance on x-ray tube potentials. Image quality was assessed using standard anatomical criteria scoring, and visual grading characteristics analysis assessed the impact on image quality of changes in exposure factors. This analysis determined the acceptability of gradual radiation dose reduction below the European and UK guidance levels. Chest and pelvis exposures were optimised, achieving dose reduction for each age group, with 7%-55% decrease in critical organ dose. Clinicians confirmed diagnostic image quality throughout the iterative process. Analysis of images acquired with preliminary and final exposure factors indicated an average visual grading analysis result of 0.5, demonstrating equivalent image quality. The optimisation process and final radiation doses are reported for Carestream computed radiography to aid other hospitals in minimising radiation risks to children.

Socio-Demographic Factors, Social Support, Quality of Life, and HIV/AIDS in Ghana.

PubMed

Abrefa-Gyan, Tina; Cornelius, Llewellyn J; Okundaye, Joshua

2016-01-01

The increase in the access to biomedical interventions for people living with HIV/AIDS in the developing world has not been adequately matched with the requisite psychosocial treatments to help improve the effectiveness of biomedical interventions. Therefore, in this study the author seeks to determine whether socio-demographic characteristics and social support are associated with quality of life in individuals diagnosed with HIV/AIDS in Ghana. A convenience sample of 300 HIV/AIDS support group members was obtained via cross-sectional design survey. The Medical Outcome Studies (MOS) HIV Health Survey, the MOS Social Support Survey (MOS-SSS), and demographic questionnaire instruments were used to assess quality of life, social support, and demographic information respectively. Multiple regression analysis showed that there was a positive association between overall social support and overall quality of life (r = .51). It also showed that being younger, male, attending support group meetings for over a year, and having ≥ 13 years of schooling related to higher quality of life. Implications of the findings for practice, policy, and research in Ghana and the rest of the developing world are discussed.

Parent Diet Quality and Energy Intake Are Related to Child Diet Quality and Energy Intake

PubMed Central

Robson, Shannon M.; Couch, Sarah C.; Peugh, James L.; Glanz, Karen; Zhou, Chuan; Sallis, James F.; Saelens, Brian E.

2016-01-01

Background Parents' diets are believed to influence their children's diets. Previous studies have not adequately and simultaneously assessed the relation of parent and child total diet quality and energy intake. Objective To investigate if parent and child diet quality and energy intakes are related. Design A cross-sectional analysis using baseline dietary intake data from the Neighborhood Impact on Kids (NIK) study collected in 2007-2009. Participants/setting Parents and 6-12 year old children from households in King County (Seattle area), WA and San Diego County, CA, targeted by NIK were recruited. Eligible parent-child dyads (n=698) with two or three 24-hour dietary recalls were included in this secondary analysis. Main Outcome Measures Child diet quality (Healthy Eating Index-2010 [HEI-2010], Dietary Approaches to Stop Hypertension [DASH] score, and energy density (for food-only) and energy intake were derived from the dietary recalls using Nutrition Data Systems for Research. Statistical Analyses Performed Multiple linear regression models examined the relationship between parent diet quality and child diet quality, and the relationship between parent energy intake and child energy intake. In both analyses, we controlled for parent characteristics, child characteristics, household education and neighborhood type. Results Parent diet quality measures were significantly related to corresponding child diet quality measures: HEI-2010 (standardized beta [β] = 0.39, p<0.001); DASH score (β = 0.33, p<0.001); energy density (β = 0.32, p<0.001). Parent daily average energy intake (1763 ± 524 kilocalories) also was significantly related (β = 0.30, p<0.001) to child daily average energy intake (1751 ± 431 kilocalories). Conclusion Parent and child intakes were closely related across various metrics of diet quality and for energy intake. Mechanisms of influence are likely to be shared food environments, shared meals, and parent modeling. PMID:27050725

Clinical Considerations of Adapted Drilling Protocol by Bone Quality Perception.

PubMed

Toia, Marco; Stocchero, Michele; Cecchinato, Francesca; Corrà, Enrico; Jimbo, Ryo; Cecchinato, Denis

To evaluate insertion torque value (ITV) and marginal bone loss (MBL) of an implant system after a clinically perceived bone quality-adapted drilling. This multicenter retrospective study included patients treated with implants, conventionally loaded, in completely healed sites. Operators customized the osteotomy preparation according to radiographic assessment and their perception of bone quality. Drilling sequence, bone quality, and ITV were recorded at the time of surgery. Radiographs were taken at the time of implant placement and permanent restoration. MBL between implant placement and permanent restoration was calculated. The implant was used as the statistical unit. Demographic and implant characteristics were shown by means of descriptive statistics. Outcome values were compared using analysis of variance (ANOVA) and Kruskal-Wallis tests. Multiple regression models were used to test the effect of independent variables on ITV and MBL. One hundred eighty-eight implants placed in 87 patients were included in the analysis. The mean observation period was 144 ± 59 days. The mean ITV was 30.8 ± 15.1 Ncm. ITV differed significantly based on arches (mandible/maxilla) (P = .001), bone quality (P < .001), implant diameter (P = .032), and drilling protocol (P = .019). Median MBL was 0.05 mm (0.00; 0.24). A significant difference was found between the mandible and maxilla (P = .008) and between drilling protocols (P = .011). In particular, significantly higher MBL was found in the undersized drilling protocol. Multiple regression analysis showed that ITV was influenced by bone quality and implant diameter. MBL was influenced by bone quality, implant diameter, ITV, and the interaction between bone quality and ITV. It was estimated that MBL was greater with increased bone density and ITV. Excessive ITV in dense bone can cause negative marginal bone responses. A presurgical radiographic assessment and the perception of bone quality are necessary to select an optimal drilling protocol and to minimize surgical trauma.

DL-sQUAL: A Multiple-Item Scale for Measuring Service Quality of Online Distance Learning Programs

ERIC Educational Resources Information Center

Shaik, Naj; Lowe, Sue; Pinegar, Kem

2006-01-01

Education is a service with multiplicity of student interactions over time and across multiple touch points. Quality teaching needs to be supplemented by consistent quality supporting services for programs to succeed under the competitive distance learning landscape. ServQual and e-SQ scales have been proposed for measuring quality of traditional…

Should "Multiple Imputations" Be Treated as "Multiple Indicators"?

ERIC Educational Resources Information Center

Mislevy, Robert J.

1993-01-01

Multiple imputations for latent variables are constructed so that analyses treating them as true variables have the correct expectations for population characteristics. Analyzing multiple imputations in accordance with their construction yields correct estimates of population characteristics, whereas analyzing them as multiple indicators generally…

Effect of threading defects on InGaN /GaN multiple quantum well light emitting diodes

NASA Astrophysics Data System (ADS)

Ferdous, M. S.; Wang, X.; Fairchild, M. N.; Hersee, S. D.

2007-12-01

Photoelectrochemical etching was used to measure the threading defect (TD) density in InGaN multiple quantum well light-emitting diodes (LEDs) fabricated from commercial quality epitaxial wafers. The TD density was measured in the LED active region and then correlated with the previously measured characteristics of these LEDs. It was found that the reverse leakage current increased exponentially with TD density. The temperature dependence of this dislocation-related leakage current was consistent with a hopping mechanism at low reverse-bias voltage and Poole-Frenkel emission at higher reverse-bias voltage. The peak intensity and spectral width of the LED electroluminescence were found to be only weakly dependent on TD density for the measured TD range of 1×107-2×108cm-2.

Sustainable Management of Springs and Associated Wetlands in Aridland Regions: A Water Quality Perspective for Cibola National Forest, NM

NASA Astrophysics Data System (ADS)

Paffett, K.; Crossey, L. J.; Crowley, L.; Karlstrom, K. E.

2010-12-01

In the arid southwestern U.S., springs and their associated wetlands provide an opportunity for diverse ecosystems to flourish. With increasing encroachment, multiple-use requirements and increasing groundwater depletion, a better understanding of how the springs function is needed in order to properly manage the springs as a resource. Critical data on spring status (discharge patterns across seasons and water quality) are lacking for most springs. New strategies and environmental sensors can be employed to provide baseline information, as well as continuous data. We report here on systematic evaluation of a suite of springs of the Cibola National Forest in central New Mexico, including characteristics of discharge and water quality. The work is prompted by concerns on preservation of vital habitat for the Zuni Bluehead Sucker in portions of the Cibola National Forest. Spring occurrence includes a range of elevation (2000-2500m), vegetation type (arid grasslands to alpine wilderness), impact (livestock use, increased groundwater withdrawal, species of concern, and increased recreational use), and water quality (potable to saline). Many of the springs occur along fault structures, and are fed by groundwater from confined aquifer systems. Two levels of protocols are described: Level One for developing a baseline survey for water quality in managed lands (geospatial data, geologic map, systematic photography, discharge estimate and field-determined water quality parameters); and Level Two Impact Evaluation Monitoring (includes high-resolution geologic mapping, major ion chemistry, multiple sampling dates, and real-time autonomous logging of several parameters including temperature, pH, conductance and dissolved oxygen). Data collected from the surveys are stored in a geospatial repository to serve as background for future monitoring of the water resources in the area.

How well are journal and clinical article characteristics associated with the journal impact factor? a retrospective cohort study

PubMed Central

Lokker, Cynthia; Haynes, R. Brian; Chu, Rong; McKibbon, K. Ann; Wilczynski, Nancy L; Walter, Stephen D

2012-01-01

Objective: Journal impact factor (JIF) is often used as a measure of journal quality. A retrospective cohort study determined the ability of clinical article and journal characteristics, including appraisal measures collected at the time of publication, to predict subsequent JIFs. Methods: Clinical research articles that passed methods quality criteria were included. Each article was rated for relevance and newsworthiness by 3 to 24 physicians from a panel of more than 4,000 practicing clinicians. The 1,267 articles (from 103 journals) were divided 60∶40 into derivation (760 articles) and validation sets (507 articles), representing 99 and 88 journals, respectively. A multiple regression model was produced determining the association of 10 journal and article measures with the 2007 JIF. Results: Four of the 10 measures were significant in the regression model: number of authors, number of databases indexing the journal, proportion of articles passing methods criteria, and mean clinical newsworthiness scores. With the number of disciplines rating the article, the 5 variables accounted for 61% of the variation in JIF (R2 = 0.607, 95% CI 0.444 to 0.706, P<0.001). Conclusion: For the clinical literature, measures of scientific quality and clinical newsworthiness available at the time of publication can predict JIFs with 60% accuracy. PMID:22272156

Grey Relational Analysis Coupled with Principal Component Analysis for Optimization of Stereolithography Process to Enhance Part Quality

NASA Astrophysics Data System (ADS)

Raju, B. S.; Sekhar, U. Chandra; Drakshayani, D. N.

2017-08-01

The paper investigates optimization of stereolithography process for SL5530 epoxy resin material to enhance part quality. The major characteristics indexed for performance selected to evaluate the processes are tensile strength, Flexural strength, Impact strength and Density analysis and corresponding process parameters are Layer thickness, Orientation and Hatch spacing. In this study, the process is intrinsically with multiple parameters tuning so that grey relational analysis which uses grey relational grade as performance index is specially adopted to determine the optimal combination of process parameters. Moreover, the principal component analysis is applied to evaluate the weighting values corresponding to various performance characteristics so that their relative importance can be properly and objectively desired. The results of confirmation experiments reveal that grey relational analysis coupled with principal component analysis can effectively acquire the optimal combination of process parameters. Hence, this confirm that the proposed approach in this study can be an useful tool to improve the process parameters in stereolithography process, which is very useful information for machine designers as well as RP machine users.

Rainbow trout movement behavior and habitat occupancy are influenced by sex and Pacific salmon presence in an Alaska river system

USGS Publications Warehouse

Fraley, Kevin M.; Falke, Jeffrey A.; McPhee, Megan V.; Prakash, Anupma

2018-01-01

We used spatially continuous field-measured and remotely-sensed aquatic habitat characteristics paired with weekly ground-based telemetry tracking and snorkel surveys to describe movements and habitat occupancy of adult rainbow trout (N = 82) in a runoff-fed, salmon-influenced southcentral Alaska river system. We found that during the ice-free feeding season (June through September) rainbow trout occurrence was associated more with fine-scale (channel unit) characteristics relative to coarse-scale (stream reach) variables. The presence of Pacific salmon (which provide an important seasonal food subsidy), and habitat size were particularly useful predictors. Weekly movement distance differed between pre- and post- spawning salmon arrival, but did not vary by sex. Habitat quality, season, and the arrival of spawning salmon influenced the likelihood of rainbow trout movement, and fish moved farther to seek out higher quality habitats. Because rainbow trout respond to habitat factors at multiple scales and seek out salmon-derived subsidies, it will be important to take a multiscale approach in protecting trout and salmon populations and managing the associated fisheries.

Potential Subjective Effectiveness of Active Interior Noise Control in Propeller Airplanes

NASA Technical Reports Server (NTRS)

Powell, Clemans A.; Sullivan, Brenda M.

2000-01-01

Active noise control technology offers the potential for weight-efficient aircraft interior noise reduction, particularly for propeller aircraft. However, there is little information on how passengers respond to this type of interior noise control. This paper presents results of two experiments that use sound quality engineering practices to determine the subjective effectiveness of hypothetical active noise control (ANC) systems in a range of propeller aircraft. The two experiments differed by the type of judgments made by the subjects: pair comparisons based on preference in the first and numerical category scaling of noisiness in the second. Although the results of the two experiments were in general agreement that the hypothetical active control measures improved the interior noise environments, the pair comparison method appears to be more sensitive to subtle changes in the characteristics of the sounds which are related to passenger preference. The reductions in subjective response due to the ANC conditions were predicted with reasonable accuracy by reductions in measured loudness level. Inclusion of corrections for the sound quality characteristics of tonality and fluctuation strength in multiple regression models improved the prediction of the ANC effects.

A quantitative study of factors influencing quality of life in rural Mexican women diagnosed with HIV.

PubMed

Holtz, Carol; Sowell, Richard; VanBrackle, Lewis; Velasquez, Gabriela; Hernandez-Alonso, Virginia

2014-01-01

This quantitative study explored the level of Quality of Life (QoL) in indigenous Mexican women and identified psychosocial factors that significantly influenced their QoL, using face-to-face interviews with 101 women accessing care in an HIV clinic in Oaxaca, Mexico. Variables included demographic characteristics, levels of depression, coping style, family functioning, HIV-related beliefs, and QoL. Descriptive statistics were used to analyze participant characteristics, and women's scores on data collection instruments. Pearson's R correlational statistics were used to determine the level of significance between study variables. Multiple regression analysis examined all variables that were significantly related to QoL. Pearson's correlational analysis of relationships between Spirituality, Educating Self about HIV, Family Functioning, Emotional Support, Physical Care, and Staying Positive demonstrated positive correlation to QoL. Stigma, depression, and avoidance coping were significantly and negatively associated with QoL. The final regression model indicated that depression and avoidance coping were the best predictor variables for QoL. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Linking Nurse Leadership and Work Characteristics to Nurse Burnout and Engagement.

PubMed

Lewis, Heather Smith; Cunningham, Christopher J L

2016-01-01

Burnout and engagement are critical conditions affecting patient safety and the functioning of healthcare organizations; the areas of worklife model suggest that work environment characteristics may impact employee burnout and general worklife quality. The purpose was to present and test a conditional process model linking perceived transformational nurse leadership to nurse staff burnout and engagement via important work environment characteristics. Working nurses (N = 120) provided perceptions of the core study variables via Internet- or paper-based survey. The hypothesized model was tested using the PROCESS analysis tool, which enables simultaneous testing of multiple, parallel, indirect effects within the SPSS statistical package. Findings support the areas of worklife model and suggest that transformational leadership is strongly associated with work environment characteristics that are further linked to nurse burnout and engagement. Interestingly, different work characteristics appear to be critical channels through which transformational leadership impacts nurse burnout and engagement. There are several methodological and practical implications of this work for researchers and practitioners interested in preventing burnout and promoting occupational health within healthcare organizations. These implications are tied to the connections observed between transformational leadership, specific work environment characteristics, and burnout and engagement outcomes.

Framework for regional synthesis of water-quality data for the glacial aquifer system in the United States

USGS Publications Warehouse

Warner, Kelly L.; Arnold, Terri L.

2005-01-01

The glacial aquifer system is the largest principal aquifer in aerial extent and ground-water use for public supply in the United States. A principal aquifer is defined as a regionally extensive aquifer or aquifer system that has the potential to be used as a source of potable water (U.S. Geological Survey, 2003). Multiple aquifers often are grouped into large, extensive aquifer systems such as the glacial aquifer system. The glacial aquifer system is considered here to include all unconsolidated aquifers above bedrock north of the line of continental glaciation throughout the country (fig. 1). Total withdrawals from the glacial aquifer system were 3,560 million gallons per day in 2000, which constitutes almost 5 percent of total withdrawals from all aquifers in the United States (Maupin and Barber, 2005). Approximately 41 million people relied on the glacial aquifer for public supply and domestic use in 2000. The U.S. Geological Survey National Water-Quality Assessment (NAWQA) Program began assessing the glacial aquifer system in 1991. The assessment of water-quality data on a regional scale, such as the glacial aquifer system, is coincident with the regional framework established by the Regional Aquifer-System Analysis Program (RASA) (Sun and others, 1997). From 1978 to 1995, the RASA Program systematically evaluated 25 of the Nation's most important groundwater systems including studies in the glacial aquifer system in the northeast, Midwest, and northern Midwest United States. The NAWQA Program is building on the work of the RASA Program to study the water quality of 16 of the most important ground-water systems (Lapham and others, 2005). Over 1,700 water-quality samples have been collected by the NAWQA Program from 1991 to 2004 to assess the glacial aquifer system. This large data set is unique in that the samples have been collected using a consistent sampling protocol, and multiple nested samples. The nested samples address the recently recharged shallow ground water, deeper water from principal aquifers often used for domestic supply, and source water used for public supplies within the glacial aquifer system. Information concerning the NAWQA Program including study unit boundaries is shown in figure 1 (Lapham and others, 2005). A framework for comparison of water quality across the glacial aquifer system has been developed based on two primary characteristics: intrinsic susceptibility and vulnerability. Intrinsic susceptibility, which is a measure of the ease at which water enters and moves through aquifer material, is a characteristic of the aquifer and overlying material and of the hydrologic conditions. Intrinsic susceptibility is independent of the chemical characteristics of the contaminant and its sources. In this way, intrinsic susceptibility assessments do not target specific natural or anthropogenic sources of contamination but instead consider only the physical factors affecting the flow of water to, and through the ground-water resource (Focazio and others, 2002). On a regional scale, intrinsic susceptibility is represented by the spatial distribution of fine- or coarse-grained material at the land surface, and the physical setting of the aquifer system. Vulnerability, which is a function of both intrinsic susceptibility and the proximity and characteristics of contaminant sources, includes consideration of features related to anthropogenic sources of contaminants, such as the character of the upgradient land use (for example, urban, agricultural, undeveloped, and others); as well as features related to natural sources of contaminants, such as the mineralogy of the aquifer material or the geochemical conditions within the aquifer system. The framework helps categorize this large region into areas of similar hydrogeologic characteristics for which water quality can be compared. The purpose of this report is to describe this framework and how it will be used for regional synthesis of water-quality da

Quality of Disease Management and Risk of Mortality in English Primary Care Practices.

PubMed

Dusheiko, Mark; Gravelle, Hugh; Martin, Stephen; Smith, Peter C

2015-10-01

To investigate whether better management of chronic conditions by family practices reduces mortality risk. Two random samples of 5 million patients registered with over 8,000 English family practices followed up for 4 years (2004/5-2007/8). Measures of the quality of disease management for 10 conditions were constructed for each family practice for each year. The outcome measure was an indicator taking the value 1 if the patient died during a specified year, 0 otherwise. Cross-section and multilevel panel data multiple logistic regressions were estimated. Covariates included age, gender, morbidity, hospitalizations, attributed socio-economic characteristics, and local health care supply measures. Although a composite measure of the quality of disease management for all 10 conditions was significantly associated with lower mortality, only the quality of stroke care was significant when all 10 quality measures were entered in the regression. The panel data results suggest that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 [95 percent CI: 423, 1140]. A longer study period may be necessary to detect any mortality impact of better management of other conditions. © Health Research and Educational Trust.

[Degree of dry mouth and factors influencing oral health-related quality of life for community-dwelling elders].

PubMed

Park, Myung Sook; Ryu, Se Ang

2010-10-01

This study was conducted to investigate the degree of dry mouth and oral health-related quality of life and to identify factors contributing to oral health-related quality of life for community-dwelling elders. A descriptive correlational study design was used. Participants were 156 older adults from two senior welfare centers. Data were collected on February 21, 22 and 29, 30, 2009 using structured questionnaires. Enter type multiple regression analysis was used to identify factors influencing oral health-related quality of life according to general and oral health characteristics. There were significant differences in oral health-related quality of life according to living arrangement, insurance, smoking, number of natural teeth, and denture type. The oral health-related quality of life had significant correlations with the number of chronic disease, number of medications, and dry mouth. Factors influencing oral health-related quality of life for community-dwelling older adults were dry mouth, number of chronic disease, and medical aid, which explained about 47.9% of total variance. These results indicate that in order to promote oral health-related quality of life for older adults, prevention or management of chronic diseases as well as oral health and dry mouth are needed for this population, and especially economically poor elders.

Understanding the characteristics of friendship quality, activity participation, and emotional well-being in Taiwanese adolescents with autism spectrum disorder.

PubMed

Chang, Yu-Chien; Chen, Chih-Hsuan; Huang, Pai-Chuan; Lin, Ling-Yi

2018-03-13

Autism spectrum disorder (ASD) is a lifelong developmental disability characterized by deficits in social communication and social interaction across multiple contexts. Existing literature on social relationships and well-being among adolescents with ASD in Asian countries is scant. This study compared the perceptions of adolescents with ASD with those of their neurotypical peers toward their friendship quality, activity participation, and emotional well-being, and examined the relationships between friendship quality, activity participation, and emotional well-being. The study participants-101 adolescents with ASD and 101 neurotypical peers, aged 10-19 years-completed the following self-administered questionnaires: the Friendship Quality Questionnaire, the Child and Adolescent Scale of Participation, the Beck Anxiety Inventory, and the short-form UCLA loneliness scale. Adolescents with ASD reported lower friendship quality, lower school participation, and higher levels of anxiety and loneliness compared to their neurotypical peers. Loneliness correlated negatively with friendship quality and school participation and positively with anxiety. Adolescents with ASD experienced increased levels of anxiety when low friendship quality was accompanied by greater loneliness. These findings reveal that friendship quality, school participation, and loneliness have a considerable effect on the emotional well-being of adolescents with ASD, thus indicating the need for therapeutic interventions that address interpersonal relationships and emotional well-being.

TU-A-201-01: Introduction to In-Room Imaging System Characteristics

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

Chang, J.

2016-06-15

Recent years have seen a widespread proliferation of available in-room image guidance systems for radiation therapy target localization with many centers having multiple in-room options. In this session, available imaging systems for in-room IGRT will be reviewed highlighting the main differences in workflow efficiency, targeting accuracy and image quality as it relates to target visualization. Decision-making strategies for integrating these tools into clinical image guidance protocols that are tailored to specific disease sites like H&N, lung, pelvis, and spine SBRT will be discussed. Learning Objectives: Major system characteristics of a wide range of available in-room imaging systems for IGRT. Advantagesmore » / disadvantages of different systems for site-specific IGRT considerations. Concepts of targeting accuracy and time efficiency in designing clinical imaging protocols.« less

Quality specifications for articles of botanical origin from the United States Pharmacopeia.

PubMed

Ma, Cuiying; Oketch-Rabah, Hellen; Kim, Nam-Cheol; Monagas, Maria; Bzhelyansky, Anton; Sarma, Nandakumara; Giancaspro, Gabriel

2018-06-01

In order to define appropriate quality of botanical dietary supplements, botanical drugs, and herbal medicines, the United States Pharmacopeia (USP) and the Herbal Medicines Compendium (HMC) contain science-based quality standards that include multiple interrelated tests to provide a full quality characterization for each article in terms of its identity, purity, and content. To provide a comprehensive description of the pharmacopeial tests and requirements for articles of botanical origin in the aforementioned compendia. Selective chromatographic procedures, such as high-performance liquid chromatography (HPLC) and high-performance thin-layer chromatography (HPTLC), are used as Identification tests in pharmacopeial monographs to detect species substitution or other confounders. HPLC quantitative tests are typically used to determine the content of key constituents, i.e., the total or individual amount of plant secondary metabolites that are considered bioactive constituents or analytical marker compounds. Purity specifications are typically set to limit the content of contaminants such as toxic elements, pesticides, and fungal toxins. Additional requirements highlight the importance of naming, definition, use of reference materials, and packaging/storage conditions. Technical requirements for each section of the monographs were illustrated with specific examples. Tests were performed on authentic samples using pharmacopeial reference standards. The chromatographic analytical procedures were validated to provide characteristic profiles for the identity and/or accurate determination of the content of quality markers. The multiple tests included in each monograph complement each other to provide an appropriate pharmacopeial quality characterization for the botanicals used as herbal medicines and dietary supplements. The monographs provide detailed specifications for identity, content of bioactive constituents or quality markers, and limits of contaminants, adulterants, and potentially toxic substances. Additional requirements such as labeling and packaging further contribute to preserve the quality of these products. Compliance with pharmacopeial specifications should be required to ensure the reliability of botanical articles used for health care purposes. Copyright © 2018. Published by Elsevier GmbH.

Variation in stream diatom communities in relation to water quality and catchment variables in a boreal, urbanized region.

PubMed

Teittinen, Anette; Taka, Maija; Ruth, Olli; Soininen, Janne

2015-10-15

Intensive anthropogenic land use such as urbanization alters the hydrological cycle, water chemistry and physical habitat characteristics, thus impairing stream physicochemical and biological quality. Diatoms are widely used to assess stream water quality as they integrate water chemistry temporally and reflect the joint influence of multiple stressors on stream biota. However, knowledge of the major community patterns of diatoms in urban streams remains limited especially in boreal regions. The aim of this study was to examine the effects of water chemistry and catchment characteristics on stream diatom communities, and to test the performance of the Index of Pollution Sensitivity (IPS) as a stream water quality indicator across an urban-to-rural gradient in southern Finland. Diatom community structure and species richness were related to local-scale variables such as water temperature, aluminium concentration, and electrical conductivity, which were in turn influenced by patterns in catchment land use and land cover. Diatoms reflected the intensity of human activities as more intensive land use increased the occurrence of pollution-tolerant species. The change in community structure along the land use intensity gradient was accompanied by a distinct decline in species richness. On the contrary, the IPS index failed to indicate differences in water quality along the urban-to-rural gradient as no consistent differences in the IPS values were found. Our results highlight the joint influence of multifaceted factors that underlie diatom patterns, and show that diatom biodiversity can be used as cost-effective metric indicating urban stream conditions. However, the IPS index turned out to be an unsuitable tool for assessing water quality among these streams. Copyright © 2015 Elsevier B.V. All rights reserved.

Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework

PubMed Central

Kontopantelis, Evangelos; Buchan, Iain; Reeves, David; Checkland, Kath; Doran, Tim

2013-01-01

Objectives To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system. Design Retrospective longitudinal study. Setting Data for 2007–2008 to 2010–2011, extracted from the clinical computer systems of general practices in England. Participants All English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice. Main outcome measures Levels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement. Results Seven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels). Conclusions Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system. PMID:23913774

Development of a cross-cultural item bank for measuring quality of life related to mental health in multiple sclerosis patients.

PubMed

Michel, Pierre; Auquier, Pascal; Baumstarck, Karine; Pelletier, Jean; Loundou, Anderson; Ghattas, Badih; Boyer, Laurent

2015-09-01

Quality of life (QoL) measurements are considered important outcome measures both for research on multiple sclerosis (MS) and in clinical practice. Computerized adaptive testing (CAT) can improve the precision of measurements made using QoL instruments while reducing the burden of testing on patients. Moreover, a cross-cultural approach is also necessary to guarantee the wide applicability of CAT. The aim of this preliminary study was to develop a calibrated item bank that is available in multiple languages and measures QoL related to mental health by combining one generic (SF-36) and one disease-specific questionnaire (MusiQoL). Patients with MS were enrolled in this international, multicenter, cross-sectional study. The psychometric properties of the item bank were based on classical test and item response theories and approaches, including the evaluation of unidimensionality, item response theory model fitting, and analyses of differential item functioning (DIF). Convergent and discriminant validities of the item bank were examined according to socio-demographic, clinical, and QoL features. A total of 1992 patients with MS and from 15 countries were enrolled in this study to calibrate the 22-item bank developed in this study. The strict monotonicity of the Cronbach's alpha curve, the high eigenvalue ratio estimator (5.50), and the adequate CFA model fit (RMSEA = 0.07 and CFI = 0.95) indicated that a strong assumption of unidimensionality was warranted. The infit mean square statistic ranged from 0.76 to 1.27, indicating a satisfactory item fit. DIF analyses revealed no item biases across geographical areas, confirming the cross-cultural equivalence of the item bank. External validity testing revealed that the item bank scores correlated significantly with QoL scores but also showed discriminant validity for socio-demographic and clinical characteristics. This work demonstrated satisfactory psychometric characteristics for a QoL item bank for MS in multiple languages. This work may offer a common measure for the assessment of QoL in different cultural contexts and for international studies conducted on MS.

The impact of relative intensity noise on the signal in multiple reference optical coherence tomography

NASA Astrophysics Data System (ADS)

Neuhaus, Kai; Subhash, Hrebesh; Alexandrov, Sergey; Dsouza, Roshan; Hogan, Josh; Wilson, Carol; Leahy, Martin; Slepneva, Svetlana; Huyet, Guillaume

2016-03-01

Multiple reference optical coherence tomography (MR-OCT) applies a unique low-cost solution to enhance the scanning depth of standard time domain OCT by inserting an partial mirror into the reference arm of the interferometric system. This novel approach achieves multiple reflections for different layers and depths of an sample with minimal effort of engineering and provides an excellent platform for low-cost OCT systems based on well understood production methods for micro-mechanical systems such as CD/DVD pick-up systems. The direct integration of a superluminescent light-emitting diode (SLED) is a preferable solution to reduce the form- factor of an MR-OCT system. Such direct integration exposes the light source to environmental conditions that can increase fluctuations in heat dissipation and vibrations and affect the noise characteristics of the output spectrum. This work describes the impact of relative intensity noise (RIN) on the quality of the interference signal of MR-OCT related to a variety of environmental conditions, such as temperature.

Evaluation of the Multiple Sclerosis Walking Scale-12 (MSWS-12) in a Dutch sample: Application of item response theory.

PubMed

Mokkink, Lidwine Brigitta; Galindo-Garre, Francisca; Uitdehaag, Bernard Mj

2016-12-01

The Multiple Sclerosis Walking Scale-12 (MSWS-12) measures walking ability from the patients' perspective. We examined the quality of the MSWS-12 using an item response theory model, the graded response model (GRM). A total of 625 unique Dutch multiple sclerosis (MS) patients were included. After testing for unidimensionality, monotonicity, and absence of local dependence, a GRM was fit and item characteristics were assessed. Differential item functioning (DIF) for the variables gender, age, duration of MS, type of MS and severity of MS, reliability, total test information, and standard error of the trait level (θ) were investigated. Confirmatory factor analysis showed a unidimensional structure of the 12 items of the scale, explaining 88% of the variance. Item 2 did not fit into the GRM model. Reliability was 0.93. Items 8 and 9 (of the 11 and 12 item version respectively) showed DIF on the variable severity, based on the Expanded Disability Status Scale (EDSS). However, the EDSS is strongly related to the content of both items. Our results confirm the good quality of the MSWS-12. The trait level (θ) scores and item parameters of both the 12- and 11-item versions were highly comparable, although we do not suggest to change the content of the MSWS-12. © The Author(s), 2016.

Characterizing the spatial distribution of multiple pollutants and populations at risk in Atlanta, Georgia.

PubMed

Pearce, John L; Waller, Lance A; Sarnat, Stefanie E; Chang, Howard H; Klein, Mitch; Mulholland, James A; Tolbert, Paige E

2016-08-01

Exposure metrics that identify spatial contrasts in multipollutant air quality are needed to better understand multipollutant geographies and health effects from air pollution. Our aim is to improve understanding of: (1) long-term spatial distributions of multiple pollutants; and (2) demographic characteristics of populations residing within areas of differing air quality. We obtained average concentrations for ten air pollutants (p=10) across a 12 km grid (n=253) covering Atlanta, Georgia for 2002-2008. We apply a self-organizing map (SOM) to our data to derive multipollutant patterns observed across our grid and classify locations under their most similar pattern (i.e, multipollutant spatial type (MST)). Finally, we geographically map classifications to delineate regions of similar multipollutant characteristics and characterize associated demographics. We found six MSTs well describe our data, with profiles highlighting a range of combinations, from locations experiencing generally clean air to locations experiencing conditions that were relatively dirty. Mapping MSTs highlighted that downtown areas were dominated by primary pollution and that suburban areas experienced relatively higher levels of secondary pollution. Demographics show the largest proportion of the overall population resided in downtown locations experiencing higher levels of primary pollution. Moreover, higher proportions of nonwhites and children in poverty reside in these areas when compared to suburban populations that resided in areas exhibiting relatively lower pollution. Our approach reveals the nature and spatial distribution of differential pollutant combinations across urban environments and provides helpful insights for identifying spatial exposure and demographic contrasts for future health studies. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Intervention characteristics that facilitate return to work after sickness absence: a systematic literature review.

PubMed

Hoefsmit, Nicole; Houkes, Inge; Nijhuis, Frans J N

2012-12-01

In many Western countries, a vast amount of interventions exist that aim to facilitate return to work (RTW) after sickness absence. These interventions are usually focused on specific target populations such as employees with low back pain, stress-related complaints or adjustment disorders. The aim of the present study is to detect and identify characteristics of RTW interventions that generally facilitate return to work (i.e. in multiple target populations and across interventions). This type of knowledge is highly relevant to policy makers and health practitioners who want to deliver evidence based care that supports the employee's health and participation in labour. We performed a keyword search (systematic literature review) in seven databases (period: 1994-2010). In total, 23 articles were included and assessed for their methodological quality. The characteristics of the interventions were evaluated as well. Early interventions, initiated in the first 6 weeks of the RTW process were scarce. These were effective to support RTW though. Multidisciplinary interventions appeared effective to support RTW in multiple target groups (e.g. back pain and adjustment disorders). Time contingent interventions in which activities followed a pre-defined schedule were effective in all physical complaints studied in this review. Activating interventions such as gradual RTW were effective in physical complaints. They have not been studied for people with psychological complaints. Early- and multidisciplinary intervention and time-contingent-, activating interventions appear most effective to support RTW.

Sleep disorders in patients with multiple sclerosis.

PubMed

Čarnická, Zuzana; Kollár, Branislav; Šiarnik, Pavel; Krížová, Lucia; Klobučníková, Katarína; Turčáni, Peter

2015-04-15

Poor sleep is a frequent symptom in patients with multiple sclerosis (MS). The objective of the study was to assess the relationship between nocturnal polysomnographic (PSG) findings and quality of sleep, fatigue, and increased daytime sleepiness among patients with MS. Clinical characteristics were collected. Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), and International Restless Legs Syndrome Rating Scale were used to assess quality of sleep, fatigue, excessive daytime sleepiness, and the presence of restless legs syndrome (RLS). All patients underwent nocturnal diagnostic PSG examination. Fifty patients with MS were enrolled into the study. Age was the only independent variable significantly determining apnea-hypopnea index and desaturation index (DI) (beta = 0.369, p = 0.010, beta 0.301, p = 0.040). PSQI and ESS score were significantly higher in a population with RLS (p = 0.004, p = 0.011). FSS significantly correlated with DI (r = 0.400, p = 0.048). Presence of RLS was the only independent variable significantly determining PSQI and ESS (p = 0.005, p = 0.025). DI and presence of RLS were independent variables determining FSS (p = 0.015, p = 0.024). Presence of RLS seems to be the main factor determining poor sleep, fatigue, and daytime somnolence. Sleep disordered breathing and its severity influences only fatigue in patients with MS. © 2015 American Academy of Sleep Medicine.

Influence of multiple brain metastases’ size and number on the quality of SRS - VMAT dose delivery

NASA Astrophysics Data System (ADS)

Prentou, G.; Koutsouveli, E.; Pantelis, E.; Papagiannis, P.; Georgiou, E.; Karaiskos, P.

2017-11-01

Stereotactic radiosurgery with volumetric modulated arc therapy (SRS-VMAT) has recently been introduced for treatment of multiple brain metastases with a single isocenter. The technique’s high efficiency is nevertheless dependent of metastatic tumors’ characteristics such as size and number. In this work the impact of the metastases’ size and number on the plan quality indices clinically used for plan evaluation and acceptance is investigated. Fifteen targets with a diameter of 1 cm and average volume of 0.7 cm3 and ten targets with a diameter of 2 cm and average volume of 6.5 cm3 were contoured on an anonymized patient CT dataset, in Monaco (Elekta) treatment planning system. VMAT plans for different target volumes (1 and 2 cm in diameter) and various target numbers (1-15) were generated using four non-coplanar arcs and the Agility (Elekta) linear accelerator (5 mm MLC width) using a Monte Carlo dose calculation algorithm and 1mm dose calculation grid resolution. Conformity index (CI), gradient index (GI) and heterogeneity index (HI) were determined for each target. High quality plans were created for both 1 cm and 2 cm in diameter targets for limited (<6) number of targets per plan. For increased number of irradiated targets (>6) both CI and GI, clinically used for plan evaluation and acceptance, were found to deteriorate.

A comparative study of multi-focus image fusion validation metrics

NASA Astrophysics Data System (ADS)

Giansiracusa, Michael; Lutz, Adam; Messer, Neal; Ezekiel, Soundararajan; Alford, Mark; Blasch, Erik; Bubalo, Adnan; Manno, Michael

2016-05-01

Fusion of visual information from multiple sources is relevant for applications security, transportation, and safety applications. One way that image fusion can be particularly useful is when fusing imagery data from multiple levels of focus. Different focus levels can create different visual qualities for different regions in the imagery, which can provide much more visual information to analysts when fused. Multi-focus image fusion would benefit a user through automation, which requires the evaluation of the fused images to determine whether they have properly fused the focused regions of each image. Many no-reference metrics, such as information theory based, image feature based and structural similarity-based have been developed to accomplish comparisons. However, it is hard to scale an accurate assessment of visual quality which requires the validation of these metrics for different types of applications. In order to do this, human perception based validation methods have been developed, particularly dealing with the use of receiver operating characteristics (ROC) curves and the area under them (AUC). Our study uses these to analyze the effectiveness of no-reference image fusion metrics applied to multi-resolution fusion methods in order to determine which should be used when dealing with multi-focus data. Preliminary results show that the Tsallis, SF, and spatial frequency metrics are consistent with the image quality and peak signal to noise ratio (PSNR).

Factors Affecting Employment Among Informal Caregivers Assisting People with Multiple Sclerosis

PubMed Central

Huang, Chunfeng; Zheng, Zhida

2013-01-01

The objective of this study was to identify characteristics of informal caregivers, caregiving, and the people with multiple sclerosis (MS) receiving assistance that are associated with reduced caregiver employment. Data were collected during telephone interviews with 530 MS caregivers, including 215 employed caregivers, with these survey data analyzed using logistic regression. Poorer cognitive ability by the care recipient to make decisions about daily tasks and more caregiving hours per week predicted reduced caregiver employment. Better physical health domains of caregiver quality of life were associated with significantly lower odds of reduced employment. Health professionals treating informal caregivers, as well as those treating people with MS, need to be aware of respite, support, and intervention programs available to MS caregivers and refer them to these programs, which could reduce the negative impact of caregiving on employment. PMID:24453784

Critical appraisal of clinical trials in multiple system atrophy: Toward better quality.

PubMed

Castro Caldas, Ana; Levin, Johannes; Djaldetti, Ruth; Rascol, Olivier; Wenning, Gregor; Ferreira, Joaquim J

2017-10-01

Multiple system atrophy (MSA) is a rare neurodegenerative disease of undetermined cause. Although many clinical trials have been conducted, there is still no treatment that cures the disease or slows its progression. We sought to assess the clinical trials, methodology, and quality of reporting of clinical trails conducted in MSA patients. We conducted a systematic review of all trials with at least 1 MSA patient subject to any pharmacological/nonpharmacological interventions. Two independent reviewers evaluated the methodological characteristics and quality of reporting of trials. A total of 60 clinical trials were identified, including 1375 MSA patients. Of the trials, 51% (n = 31) were single-arm studies. A total of 28% (n = 17) had a parallel design, half of which (n = 13) were placebo controlled. Of the studies, 8 (13.3%) were conducted in a multicenter setting, 3 of which were responsible for 49.3% (n = 678) of the total included MSA patients. The description of primary outcomes was unclear in 60% (n = 40) of trials. Only 10 (16.7%) clinical trials clearly described the randomization process. Blinding of the participants, personnel, and outcome assessments were at high risk of bias in the majority of studies. The number of dropouts/withdrawals was high (n = 326, 23.4% among the included patients). Overall, the design and quality of reporting of the reviewed studies is unsatisfactory. The most frequent clinical trials were small and single centered. Inadequate reporting was related to the information on the randomization process, sequence generation, allocation concealment, blinding of participants, and sample size calculations. Although improved during the recent years, methodological quality and trial design need to be optimized to generate more informative results. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

Random Forest Application for NEXRAD Radar Data Quality Control

NASA Astrophysics Data System (ADS)

Keem, M.; Seo, B. C.; Krajewski, W. F.

2017-12-01

Identification and elimination of non-meteorological radar echoes (e.g., returns from ground, wind turbines, and biological targets) are the basic data quality control steps before radar data use in quantitative applications (e.g., precipitation estimation). Although WSR-88Ds' recent upgrade to dual-polarization has enhanced this quality control and echo classification, there are still challenges to detect some non-meteorological echoes that show precipitation-like characteristics (e.g., wind turbine or anomalous propagation clutter embedded in rain). With this in mind, a new quality control method using Random Forest is proposed in this study. This classification algorithm is known to produce reliable results with less uncertainty. The method introduces randomness into sampling and feature selections and integrates consequent multiple decision trees. The multidimensional structure of the trees can characterize the statistical interactions of involved multiple features in complex situations. The authors explore the performance of Random Forest method for NEXRAD radar data quality control. Training datasets are selected using several clear cases of precipitation and non-precipitation (but with some non-meteorological echoes). The model is structured using available candidate features (from the NEXRAD data) such as horizontal reflectivity, differential reflectivity, differential phase shift, copolar correlation coefficient, and their horizontal textures (e.g., local standard deviation). The influence of each feature on classification results are quantified by variable importance measures that are automatically estimated by the Random Forest algorithm. Therefore, the number and types of features in the final forest can be examined based on the classification accuracy. The authors demonstrate the capability of the proposed approach using several cases ranging from distinct to complex rain/no-rain events and compare the performance with the existing algorithms (e.g., MRMS). They also discuss operational feasibility based on the observed strength and weakness of the method.

Quality of Life in Chinese Persons Living With an Ostomy: A Multisite Cross-sectional Study.

PubMed

Geng, Zhaohui; Howell, Doris; Xu, Honglian; Yuan, Changrong

The aim of the study was to describe health-related quality of life (HRQOL) in persons with ostomies and to explore influencing factors. Secondary analysis of data from a cross-sectional survey. Eight hundred twenty-seven persons living with an ostomy were enrolled from 5 provinces and cities in China from October 2010 to November 2012; the final sample comprises 729 individuals who completed data collection. Their mean ± SD age was 62.59 ± 12.40 years (range 26-93 years). Health-related quality of life was assessed using the Chinese language version of the City of Hope-Quality of Life-Ostomy Questionnaire-Chinese Version. Sociodemographic data, clinical characteristics, self-efficacy, adjustment to an ostomy, social support, and psychological state of patients were measured by a general information questionnaire. We also administered the Stoma Self-Efficacy Scale, Ostomy Adjustment Inventory-Chinese Version, the Social Support Revalued Scale, and Hospital Anxiety Depression Scale. Of the 729 ostomy patients, the overall HRQOL in ostomy patients was in the moderate range (mean score 5.19 ± 1.29); scores of physical domain, psychological domain, social domain, and spiritual domains also in the moderate range (5.00 ± 1.73, 5.97 ± 1.59, 4.86 ± 2.31, and 4.93 ± 2.08 respectively). Multivariate analysis found that multiple factors influenced HRQOL in persons with an ostomy; they were gender, religious belief, and marital status, psychological factors depression and anxiety, and specific components related to social support, self-efficacy in ostomy care, and adjustment to an ostomy. Health-related quality of life among Chinese patients with fecal ostomies was less than optimal and influenced by multiple demographic and psychosocial factors. Additional research is needed to design strategies to improve HRQOL in this population.

A mixed-methods evaluation of health-related quality of life for male veterans with and without intestinal stomas.

PubMed

Krouse, Robert S; Grant, Marcia; Wendel, Christopher S; Mohler, M Jane; Rawl, Susan M; Baldwin, Carol M; Coons, Stephen Joel; McCorkle, Ruth; Ko, Clifford Y; Schmidt, C Max

2007-12-01

Intestinal stomas have a major impact on Cases' lives. It is essential to better understand the areas in which interventions may help to minimize the negative consequences. This was a case-control survey study using validated instruments (City of Hope Quality of Life-Ostomy and Short Form 36 for Veterans). Cases were accrued from Veterans Affairs Medical Centers in Tucson, Indianapolis, and Los Angeles. Eligibility included a major intra-abdominal surgical procedure that led to an ostomy (cases), or a similar procedure that did not mandate a stoma (controls). Analysis included quantitative and qualitative responses. The response rate was 48 percent (511/1,063). Cases and controls had relatively similar demographic characteristics. Because of low numbers of female respondents (13 cases and 11 controls), only results for males are reported. Based on both the City of Hope Quality of Life-Ostomy and Short Form 36 for Veterans, cases reported significantly poorer scores on scales/domains reflecting psychologic and social functioning and well being. Additionally, cases reported poorer scores on Short Form 36 for Veterans scales reflecting physical functioning and significantly lower scores on multiple items in the social domain of the City of Hope Quality of Life-Ostomy compared with controls. Two-thirds of cases replied to an open-ended question on their "greatest challenge" related to their ostomy, which led to further clarification of major issues. Multiple health-related quality of life problems were reported by male veterans with intestinal stomas. The greatest differences between cases and controls were observed in the social and psychologic domains/scales. Findings from this study provide a greater understanding of the challenges faced by ostomates and will inform the development and evaluation of urgently needed intervention strategies.

Seasonal functional relevance of sperm characteristics in equine spermatozoa.

PubMed

Gamboa, S; Rodrigues, A S; Henriques, L; Batista, C; Ramalho-Santos, J

2010-04-15

A group of stallions with different reproductive indexes were used to study seasonal variations in sperm quality (Equus caballus). Semen samples were collected from late September to July and analyzed according to four seasonal periods: late September-December, January-March, late March-May, and June-July. Parameters monitored included sperm concentration, sperm motility, sperm morphology, sperm viability, acrosomal status, plasma membrane stability, and sperm mitochondrial membrane potential. Overall, seminal parameters monitored are affected mostly by time period, followed by animal and lastly by fertility, stressing the importance of individual variations in out-bred animal models. The analysis of multiple ejaculates from the same animals showed clear seasonal-based differences (P<0.05) with poor semen quality in winter and a noticeable improvement in sperm quality with increasing photoperiod. Better semen quality was observed between late March and May. Interactions between month period, animal, and fertility were evident (P<0.05) for sperm concentration, head and tail sperm anomalies, and acrosomal integrity. Thus, it may be advisable to adjust the use of stallion semen according to seasonal variations. Copyright 2010 Elsevier Inc. All rights reserved.

NASA Educational Product Development and Post-Secondary Program Assessment Planning

NASA Technical Reports Server (NTRS)

Salmons, Phyllis A.

1999-01-01

Producing "value-added students" involves proactively addressing how successfully students develop their skills, knowledge, and personal, social, and ethical growth due to their association with a program. NASA programs for higher education can certainly be responsive in aiding the academic community strive for quality in terms of "valueadded" students. By identifying essential characteristics of exemplary assessment practices, the standards developed by accrediting agencies serve as guides for developing quality practices and policies. Such a process is an effective tool for communicating the expectations of the educational components of a program to all concerned with the program and its expected results. When standards are connected to student performance, they provide a very compelling argument for refocusing the definition of quality in higher education. By linking standards and performance, student learning and development becomes the starting point for examining program quality. If the multiple stakeholders - faculty, peers, the professional community, addressed assessment issues, then accreditation can be a link among various constituencies, the parties can better understand the needs of each other and develop the necessary trust needed for understanding and support.

Multivariate trajectories across multiple domains of health-related quality of life in children with new-onset epilepsy.

PubMed

Sajobi, Tolulope T; Wang, Meng; Ferro, Mark A; Brobbey, Anita; Goodwin, Shane; Speechley, Kathy N; Wiebe, Samuel

2017-10-01

The diagnosis of epilepsy in children is known to impact the trajectory of their health-related quality of life (HRQOL) over time. However, there is limited knowledge about variations in longitudinal trajectories across multiple domains of HRQOL. This study aims to characterize the heterogeneity in HRQOL trajectories across multiple HRQOL domains and to evaluate predictors of differences among the identified trajectory groups in children with new-onset epilepsy. Data were obtained from the Health Related Quality of Life in Children with Epilepsy Study (HERQULES), a prospective multi-center study of 373 children newly diagnosed with new-onset epilepsy who were followed up over 2years. Child HRQOL and family factors were reported by parents, and clinical characteristics were reported by neurologists. Group-based multi-trajectory modeling was adopted to characterize longitudinal trajectories of HRQOL as measured by the individual domains of cognitive, emotional, physical, and social functioning in the 55-item Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55). Multinomial logistic regression was used to assess potential factors that explain differences among the identified latent trajectory groups. Three distinct HRQOL trajectory subgroups were identified in children with new-onset epilepsy based on HRQOL scores: "High" (44.7%), "Intermediate" (37.0%), and "Low" (18.3%). While most trajectory groups exhibited increasing scores over time on physical and social domains, both flat and declining trajectories were noted on emotional and cognitive domains. Less severe epilepsy, an absence of cognitive and behavioral problems, lower parental depression scores, better family functioning, and fewer family demands were associated with a "Higher" or "Intermediate" HRQOL trajectory. The course of HRQOL over time in children with new-onset epilepsy appears to follow one of three different trajectories. Addressing the clinical and psychosocial determinants identified for each pattern can help clinicians provide more targeted care to these children and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

Current paediatric orthopaedic practice in hereditary multiple osteochondromas of the forearm: a systematic review

PubMed Central

EL-Sobky, Tamer A.; Samir, Shady; Atiyya, Ahmed Naeem; Mahmoud, Shady; Aly, Ahmad S.; Soliman, Ramy

2018-01-01

Introduction: This systematic review aims to answer three research questions concerning the management of hereditary multiple osteochondromas of forearm in children: What is the best available evidence for the currently employed surgical procedures? What patient characteristics are associated with better prognosis? What disease characteristics are associated with better prognosis? Methods: We searched the literature using three major databases with no publication date restrictions. To enhance search sensitivity and maintain precision we used keywords/subject terms correlating with patient population, problem and interventions. We used strict inclusion/exclusion criteria to improve validity evidence. Results: The search process yielded 34 eligible studies with a total of 282 patients (315 forearms). We comprehensively analysed study and patient demographics and interventions and outcomes. Eleven studies (32%) had a long-term follow-up and 31 studies (91%) were retrospective. Of the total number of forearms, ulnar lengthening +/− associated procedures was used in 210 forearms (66.7%), isolated osteochondroma excision in 65 forearms (20.6%) and isolated distal radius hemiepiphysiodesis in 15 forearms (4.7%) among others. Discussion: Ulnar lengthening can restore radiologic anatomy, improve appearance and to a lesser extent objective clinical parameters like joint range of motion on the short/intermediate term. Isolated osteochondroma excision can relief pain and satisfy cosmetic concerns occasionally. There is poor evidence to suggest that surgery improves quality of life or function. Predictors of surgical success in regard to patient and disease characteristics remain elusive. Natural history and prospective randomized control studies where the control group receives no treatment should be rethought. They have the potential for bias control and identification of the ideal surgical candidate. The complex interplay between the confounding variables has undermined the capability of most studies to provide well-grounded evidence to support and generalize their conclusions. Valid quality of life scales should supplement objective outcome measures. PMID:29565244

Quality of life among people living with hypertension in a rural Vietnam community.

PubMed

Ha, Ninh Thi; Duy, Hoa Thi; Le, Ninh Hoang; Khanal, Vishnu; Moorin, Rachael

2014-08-11

To respond to growing prevalence of hypertension in Vietnam, it is critical to have an in-depth understanding about quality of life (QOL) among people living with hypertension and related factors. This study aimed to measure QOL among hypertensive people in a rural community in Vietnam, and its association with socio-demographic characteristics and factors related to treatment. This study was conducted in a rural community located 60 km from Ho Chi Minh City. Face-to-face interviews were conducted among 275 hypertensive people aged 50 years and above using WHOQOL-BREF questionnaire. Descriptive statistics were used to examine mean scores of quality of life. Cronbach's alpha coefficient and Pearson's correlation coefficient were applied to estimate the internal consistency, and the level of agreement between different domains of WHOQOL-BREF, respectively. Independent T-test and ANOVA test followed by multiple linear regression analyses were used to measure the association between QOL domains and independent variables. Both overall WHOQOL-BREF and each domain had a good internal consistency, ranging from 0.65 to 0.88. The QOL among hypertensive patients was found moderate in all domains, except for psychological domain that was fairly low (mean = 49.4). Backward multiple linear regressions revealed that being men, married, attainment of higher education, having physical activities at moderate level, and adherence to treatment were positively associated with QOL. However, older age and presence of co-morbidity were negatively associated with QOL. WHOQOL-BREF is a reliable instrument to measure QOL among hypertensive patients. The results revealed low QOL in psychological domain and inequality in QOL across socio-demographic characteristics. Given the results, encouraging physical activities and strengthening treatment adherence should be considered to improve QOL of hypertensive people, especially for psychological aspect. Actions to improve QOL among hypertensive patients targeted towards women, lower educated and unmarried patients are needed in the setting.

The ability of clinical balance measures to identify falls risk in multiple sclerosis: a systematic review and meta-analysis.

PubMed

Quinn, Gillian; Comber, Laura; Galvin, Rose; Coote, Susan

2018-05-01

To determine the ability of clinical measures of balance to distinguish fallers from non-fallers and to determine their predictive validity in identifying those at risk of falls. AMED, CINAHL, Medline, Scopus, PubMed Central and Google Scholar. First search: July 2015. Final search: October 2017. Inclusion criteria were studies of adults with a definite multiple sclerosis diagnosis, a clinical balance assessment and method of falls recording. Data were extracted independently by two reviewers. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 scale and the modified Newcastle-Ottawa Quality Assessment Scale. Statistical analysis was conducted for the cross-sectional studies using Review Manager 5. The mean difference with 95% confidence interval in balance outcomes between fallers and non-fallers was used as the mode of analysis. We included 33 studies (19 cross-sectional, 5 randomised controlled trials, 9 prospective) with a total of 3901 participants, of which 1917 (49%) were classified as fallers. The balance measures most commonly reported were the Berg Balance Scale, Timed Up and Go and Falls Efficacy Scale International. Meta-analysis demonstrated fallers perform significantly worse than non-fallers on all measures analysed except the Timed Up and Go Cognitive ( p < 0.05), but discriminative ability of the measures is commonly not reported. Of those reported, the Activities-specific Balance Confidence Scale had the highest area under the receiver operating characteristic curve value (0.92), but without reporting corresponding measures of clinical utility. Clinical measures of balance differ significantly between fallers and non-fallers but have poor predictive ability for falls risk in people with multiple sclerosis.

A near-optimal low complexity sensor fusion technique for accurate indoor localization based on ultrasound time of arrival measurements from low-quality sensors

NASA Astrophysics Data System (ADS)

Mitilineos, Stelios A.; Argyreas, Nick D.; Thomopoulos, Stelios C. A.

2009-05-01

A fusion-based localization technique for location-based services in indoor environments is introduced herein, based on ultrasound time-of-arrival measurements from multiple off-the-shelf range estimating sensors which are used in a market-available localization system. In-situ field measurements results indicated that the respective off-the-shelf system was unable to estimate position in most of the cases, while the underlying sensors are of low-quality and yield highly inaccurate range and position estimates. An extensive analysis is performed and a model of the sensor-performance characteristics is established. A low-complexity but accurate sensor fusion and localization technique is then developed, which consists inof evaluating multiple sensor measurements and selecting the one that is considered most-accurate based on the underlying sensor model. Optimality, in the sense of a genie selecting the optimum sensor, is subsequently evaluated and compared to the proposed technique. The experimental results indicate that the proposed fusion method exhibits near-optimal performance and, albeit being theoretically suboptimal, it largely overcomes most flaws of the underlying single-sensor system resulting in a localization system of increased accuracy, robustness and availability.

Linking optical properties of dissolved organic matter to multiple processes at the coastal plume zone in the East China Sea.

PubMed

Jiang, Yulin; Zhao, Jianfu; Li, Penghui; Huang, Qinghui

2016-10-12

Because of the significance in photosynthesis, nutrient dynamics, trophodynamics and biological activity, dissolved organic matter (DOM) is important to the microbial community in the coastal plume zone. In this study, we investigated the hydrodynamic processes, photodegradation and biodegradation of DOM at the Yangtze River plume in the East China Sea through analyzing water quality and optical properties of DOM. Surface water samples were collected to examine water quality and fluorescence properties of fluorescent dissolved organic matter (FDOM). The results indicated that dilution was the key factor in the multiple processes, and the mixing process gradually increased from nearshore to offshore in coastal water. Four components of FDOM representing humic-like substances (C1 & C4) and protein-like substances (C2 & C3) were identified, and all components showed nearly conservative behaviors. Protein-like substances were more mutable compared to humic-like substances. The photodegradation of humic-like substances caused brown algae blooms to some extent. The molecular weight of humic substances gradually decreased along the mixing process. FDOM in the plume zone was both of terrigenous and autochthonous origins, and the characteristic of terrigenous origin was obvious compared to that of autochthonous origin.

QUALITY OF LIFE AND HEALTH SELF-PERCEPTION IN CHILDREN WITH POOR SCHOOL PERFORMANCE.

PubMed

Rezende, Bárbara Antunes; Lemos, Stela Maris Aguiar; Medeiros, Adriane Mesquita de

2017-01-01

To examine the association between quality of life and health self-perception of children with poor school performance, considering sociodemographic factors. An analytical, observational, cross-sectional study was conducted with 99 children aged 7 to 12 years receiving specialized educational assistance. Parents and legal guardians answered questions concerning the sociodemographic profile. For an assessment of the quality of life and proposed domains (autonomy, functioning, leisure, and family), the children completed the Autoquestionnarie Qualité de Vie Enfant Imagé (AUQEI) and answered a question concerning their self-perceived health. Data were analyzed using multiple linear regression, considering a 5% significance level. Among the evaluated children, 69 (69.7%) male participants with mean age of 8.7±1.5, 27% self-assessed their health status as poor/very poor, and 36.4% of the children reported having impaired quality of life. As for the domains assessed by AUQEI, there was statistical significance in the associations between family with age, autonomy with economic classification, and leisure and functioning with self-perceived health. The quality of life of children with academic underachievement is associated with their health self-perception and sociodemographic characteristics.

Effectiveness of applying progressive muscle relaxation technique on quality of life of patients with multiple sclerosis.

PubMed

Ghafari, Somayeh; Ahmadi, Fazlolah; Nabavi, Masoud; Anoshirvan, Kazemnejad; Memarian, Robabe; Rafatbakhsh, Mohamad

2009-08-01

To identify the effects of applying Progressive Muscle Relaxation Technique on Quality of Life of patients with multiple Sclerosis. In view of the growing caring options in Multiple Sclerosis, improvement of quality of life has become increasingly relevant as a caring intervention. Complementary therapies are widely used by multiple sclerosis patients and Progressive Muscle Relaxation Technique is a form of complementary therapies. Quasi-experimental study. Multiple Sclerosis patients (n = 66) were selected with no probability sampling then assigned to experimental and control groups (33 patients in each group). Means of data collection included: Individual Information Questionnaire, SF-8 Health Survey, Self-reported checklist. PMRT performed for 63 sessions by experimental group during two months but no intervention was done for control group. Statistical analysis was done by SPSS software. Student t-test showed that there was no significant difference between two groups in mean scores of health-related quality of life before the study but this test showed a significant difference between two groups, one and two months after intervention (p < 0.05). anova test with repeated measurements showed that there is a significant difference in mean score of whole and dimensions of health-related quality of life between two groups in three times (p < 0.05). Although this study provides modest support for the effectiveness of Progressive Muscle Relaxation Technique on quality of life of multiple sclerosis patients, further research is required to determine better methods to promote quality of life of patients suffer multiple sclerosis and other chronic disease. Progressive Muscle Relaxation Technique is practically feasible and is associated with increase of life quality of multiple sclerosis patients; so that health professionals need to update their knowledge about complementary therapies.

Multi-frame super-resolution with quality self-assessment for retinal fundus videos.

PubMed

Köhler, Thomas; Brost, Alexander; Mogalle, Katja; Zhang, Qianyi; Köhler, Christiane; Michelson, Georg; Hornegger, Joachim; Tornow, Ralf P

2014-01-01

This paper proposes a novel super-resolution framework to reconstruct high-resolution fundus images from multiple low-resolution video frames in retinal fundus imaging. Natural eye movements during an examination are used as a cue for super-resolution in a robust maximum a-posteriori scheme. In order to compensate heterogeneous illumination on the fundus, we integrate retrospective illumination correction for photometric registration to the underlying imaging model. Our method utilizes quality self-assessment to provide objective quality scores for reconstructed images as well as to select regularization parameters automatically. In our evaluation on real data acquired from six human subjects with a low-cost video camera, the proposed method achieved considerable enhancements of low-resolution frames and improved noise and sharpness characteristics by 74%. In terms of image analysis, we demonstrate the importance of our method for the improvement of automatic blood vessel segmentation as an example application, where the sensitivity was increased by 13% using super-resolution reconstruction.

Statistical Methods and Sampling Design for Estimating Step Trends in Surface-Water Quality

USGS Publications Warehouse

Hirsch, Robert M.

1988-01-01

This paper addresses two components of the problem of estimating the magnitude of step trends in surface water quality. The first is finding a robust estimator appropriate to the data characteristics expected in water-quality time series. The J. L. Hodges-E. L. Lehmann class of estimators is found to be robust in comparison to other nonparametric and moment-based estimators. A seasonal Hodges-Lehmann estimator is developed and shown to have desirable properties. Second, the effectiveness of various sampling strategies is examined using Monte Carlo simulation coupled with application of this estimator. The simulation is based on a large set of total phosphorus data from the Potomac River. To assure that the simulated records have realistic properties, the data are modeled in a multiplicative fashion incorporating flow, hysteresis, seasonal, and noise components. The results demonstrate the importance of balancing the length of the two sampling periods and balancing the number of data values between the two periods.

Assessing the impacts of sediments from dredging on corals.

PubMed

Jones, Ross; Bessell-Browne, Pia; Fisher, Rebecca; Klonowski, Wojciech; Slivkoff, Matthew

2016-01-15

There is a need to develop water quality thresholds for dredging near coral reefs that can relate physical pressures to biological responses and define exposure conditions above which effects could occur. Water quality characteristics during dredging have, however, not been well described. Using information from several major dredging projects, we describe sediment particle sizes in the water column/seabed, suspended sediment concentrations at different temporal scales during natural and dredging-related turbidity events, and changes in light quantity/quality underneath plumes. These conditions differ considerably from those used in past laboratory studies of the effects of sediments on corals. The review also discusses other problems associated with using information from past studies for developing thresholds such as the existence of multiple different and inter-connected cause-effect pathways (which can confuse/confound interpretations), the use of sediment proxies, and the reliance on information from sediment traps to justify exposure regimes in sedimentation experiments. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Detection of human enteric viruses in stream water with RT-PCR and cell culture.

USGS Publications Warehouse

Denis-Mize, K.; Fout, G.S.; Dahling, D.R.; Francy, D.S.

2004-01-01

A multiplex RT-PCR method was used to measure virus occurrence at five stream water sites that span a range of hydroclimatic, water-quality, and land-use characteristics. The performance of the molecular method was evaluated in comparison with traditional cell culture and Escherichia coli membrane filtration assays. The study incorporated multiple quality controls and included a control for virus recovery during the sampling procedure as well as controls to detect potentially false-negative and false-positive data. Poliovirus recovery ranged from 16 to 65% and was variable, even in samples collected within the same stream. All five sites were positive for viruses by both molecular and cell culture-based virus assays. Enteroviruses, reoviruses, rotaviruses, and hepatitis A viruses were detected, but the use of the quality controls proved critical for interpretation of the molecular data. All sites showed evidence of faecal contamination, and culturable viruses were detected in four samples that would have met the US Environmental Protection Agency's recommended E. coli guideline for safe recreational water.

Classification of air quality using fuzzy synthetic multiplication.

PubMed

Abdullah, Lazim; Khalid, Noor Dalina

2012-11-01

Proper identification of environment's air quality based on limited observations is an essential task to meet the goals of environmental management. Various classification methods have been used to estimate the change of air quality status and health. However, discrepancies frequently arise from the lack of clear distinction between each air quality, the uncertainty in the quality criteria employed and the vagueness or fuzziness embedded in the decision-making output values. Owing to inherent imprecision, difficulties always exist in some conventional methodologies when describing integrated air quality conditions with respect to various pollutants. Therefore, this paper presents two fuzzy multiplication synthetic techniques to establish classification of air quality. The fuzzy multiplication technique empowers the max-min operations in "or" and "and" in executing the fuzzy arithmetic operations. Based on a set of air pollutants data carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone, and particulate matter (PM(10)) collected from a network of 51 stations in Klang Valley, East Malaysia, Sabah, and Sarawak were utilized in this evaluation. The two fuzzy multiplication techniques consistently classified Malaysia's air quality as "good." The findings indicated that the techniques may have successfully harmonized inherent discrepancies and interpret complex conditions. It was demonstrated that fuzzy synthetic multiplication techniques are quite appropriate techniques for air quality management.

Multimodal sexual signals in male ocellated lizards Lacerta lepida: vitamin E in scent and green coloration may signal male quality in different sensory channels

NASA Astrophysics Data System (ADS)

Martín, José; López, Pilar

2010-06-01

The mechanisms that confer honesty to multiple sexual signals of vertebrates remain less known. We suggest that vitamin E in the scent (femoral secretions) and carotenoids in coloration of Lacerta lepida lizards might advertise quality because they are relevant in metabolism as major antioxidants and have a dietary origin. Results showed that there may be similar trade-offs between immunity and both chemical and visual signaling, as males with more vitamin E in secretions and those with more greenish, darker, and saturated carotenoid-dependent colorations had a higher immune response. This suggests that only high-quality males can divert from metabolism and allocate enough vitamin E to secretions and enough carotenoids to coloration. Therefore, information provided by visual and chemical signals is congruent. The use of multiple sensory channels may allow signaling a male quality under different circumstances or reinforce the reliability of the signal when both signals are perceived simultaneously. However, we also found that characteristics of carotenoid-dependent coloration mirror the amounts of vitamin E in secretions. This might support that carotenoids, which are not true antioxidants in the organism, would just reflect and “inform” on the actual contents of metabolic antioxidant vitamin E, which is part of the true system that prevent oxidation. We suggest that the metabolic roles of vitamins might be the actual basis of honesty of many sexual displays, and that carotenoid-based signals might be just the visible part of the whole system.

Height and Cognition at Work: Labor market productivity in a low income setting

PubMed Central

LaFave, Daniel; Thomas, Duncan

2016-01-01

Taller workers earn more, particularly in lower income settings. It has been argued that adult height is a marker of strength which is rewarded in the labor market; a proxy for cognitive performance or other dimensions of human capital such as school quality; a proxy for health status; and a proxy for family background and genetic characteristics. As a result, the argument goes, height is rewarded in the labor market because it is an informative signal of worker quality to an employer. It has also been argued that the height premium is driven by occupational and sectoral choice. This paper evaluates the relative importance of these potential mechanisms underlying the link between adult stature and labor market productivity in a specific low income setting, rural Central Java, Indonesia. Drawing on twelve waves of longitudinal survey data, we establish that height predicts hourly earnings after controlling education, multiple indicators of cognitive performance and physical health status, measures of family background, sectoral and occupational choice, as well as local area market characteristics. The height premium is large and significant in both the wage and self-employed sectors indicating height is not only a signal of worker quality to employers. Since adult stature is largely determined in the first few years of life, we conclude that exposures during this critical period have an enduring impact on labor market productivity. PMID:27843117

Craniodentofacial characteristics, dental esthetics-related quality of life, and self-esteem.

PubMed

Gavric, Anja; Mirceta, Dubravka; Jakobovic, Mario; Pavlic, Andrej; Zrinski, Magda Trinajstic; Spalj, Stjepan

2015-06-01

Self-esteem is a psychological trait that may develop in interaction with craniodentofacial esthetics. The aim of this study was to explore the relationship among craniodentofacial characteristics, dental esthetics-related quality of life, and self-esteem in adolescents and young adults. The study was cross-sectional; the sample included 200 pupils and university students (58% female) aged 13 to 33 years. The Rosenberg Self-Esteem Scale and the Psychosocial Impact of Dental Aesthetics Questionnaire were used. Craniodentofacial features were estimated by the method of Martin and Saller, the Index of Orthodontic Treatment Need, and the Index of Complexity, Outcome and Need. When malocclusion severity increases, dental esthetics-related quality of life decreases. The multiple linear regression showed that with the control of all other predictors in the model, the social impact of dental esthetics, borderline dental self-confidence, and facial type contribute the most to explain the variability of self-esteem, accounting for 3.2%, 1.3%, and 1.4%, respectively, of the variability values. The whole model accounts for 24.2% of the variability of self-esteem. In adolescents and young adults, self-esteem appears to be more influenced by the self-perceived psychosocial impacts of dental esthetics than the normative level of malocclusion, craniofacial typology, sex, or age. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Effects of high-intensity interval training on fatigue and quality of life in testicular cancer survivors.

PubMed

Adams, Scott C; DeLorey, Darren S; Davenport, Margie H; Fairey, Adrian S; North, Scott; Courneya, Kerry S

2018-05-08

Testicular cancer survivors (TCS) are at increased risk of cancer-related fatigue (CRF), psychosocial impairment, and poor mental health-related quality of life (HRQoL). Here, we examine the effects of high-intensity interval training (HIIT) on patient-reported outcomes (PROs) in TCS. Secondarily, we explore cardiorespiratory fitness as a mediator of intervention effects and select baseline characteristics as moderators of intervention effects. TCS (n = 63) were randomly assigned to 12 weeks of supervised HIIT or usual care (UC). PROs included CRF, depression, anxiety, stress, self-esteem, sleep quality, and HRQoL assessed at baseline, post-intervention, and 3-month follow-up. TCS (median 7 years postdiagnosis) completed 99% of training sessions and achieved 98% of target training intensity. ANCOVA revealed that, compared to UC, HIIT significantly improved post-intervention CRF (p = 0.003), self-esteem (p = 0.029), and multiple HRQoL domains (ps ≤ 0.05). Effects on CRF (p = 0.031) and vitality (p = 0.015) persisted at 3-month follow-up. Cardiorespiratory fitness changes mediated CRF and HRQoL improvements. CRF effects were larger for TCS with an inactive lifestyle, lower fitness, higher testosterone, and clinical fatigue at baseline. HIIT significantly improves CRF and HRQoL in TCS. Mediation by cardiorespiratory fitness and moderation by clinical characteristics suggests opportunities for targeted exercise interventions to optimise PROs in TCS.

A Review of International Space Station Habitable Element Equipment Offgassing Characteristics

NASA Technical Reports Server (NTRS)

Perry, Jay L.

2010-01-01

Crewed spacecraft trace contaminant control employs both passive and active methods to achieve acceptable cabin atmospheric quality. Passive methods include carefully selecting materials of construction, employing clean manufacturing practices, and minimizing systems and payload operational impacts to the cabin environment. Materials selection and manufacturing processes constitute the first level of equipment offgassing control. An element-level equipment offgassing test provides preflight verification that passive controls have been successful. Offgassing test results from multiple International Space Station (ISS) habitable elements and cargo vehicles are summarized and implications for active contamination control equipment design are discussed

Temporal characteristics of gustatory responses in rat parabrachial neurons vary by stimulus and chemosensitive neuron type.

PubMed

Geran, Laura; Travers, Susan

2013-01-01

It has been demonstrated that temporal features of spike trains can increase the amount of information available for gustatory processing. However, the nature of these temporal characteristics and their relationship to different taste qualities and neuron types are not well-defined. The present study analyzed the time course of taste responses from parabrachial (PBN) neurons elicited by multiple applications of "sweet" (sucrose), "salty" (NaCl), "sour" (citric acid), and "bitter" (quinine and cycloheximide) stimuli in an acute preparation. Time course varied significantly by taste stimulus and best-stimulus classification. Across neurons, the ensemble code for the three electrolytes was similar initially but quinine diverged from NaCl and acid during the second 500 ms of stimulation and all four qualities became distinct just after 1s. This temporal evolution was reflected in significantly broader tuning during the initial response. Metric space analyses of quality discrimination by individual neurons showed that increases in information (H) afforded by temporal factors was usually explained by differences in rate envelope, which had a greater impact during the initial 2s (22.5% increase in H) compared to the later response (9.5%). Moreover, timing had a differential impact according to cell type, with between-quality discrimination in neurons activated maximally by NaCl or citric acid most affected. Timing was also found to dramatically improve within-quality discrimination (80% increase in H) in neurons that responded optimally to bitter stimuli (B-best). Spikes from B-best neurons were also more likely to occur in bursts. These findings suggest that among PBN taste neurons, time-dependent increases in mutual information can arise from stimulus- and neuron-specific differences in response envelope during the initial dynamic period. A stable rate code predominates in later epochs.

[EARLY IN-HOSPITAL MORTALITY IN INTERNAL MEDICINE WARDS (WITHIN 24 HOURS): A POTENTIAL QUALITY INDICATOR OR A VARIABLE AFFECTED BY MULTIPLE FACTORS?

PubMed

Niv, Yaron; Berkov, Evgeny; Kanter, Pazit; Abrahmson, Evgeny; Gabbay, Uri

2017-04-01

To evaluate in-hospital mortality rate within 24 hours in internal medicine wards and to evaluate if it may be used as quality indicator. In-hospital mortality rate is an outcome measure which apparently reflects quality of care. There are debates on whether it may be considered a quality indicator since it is difficult to compare different case-mixes between hospitals. Research on mortality within 24 hours had not been published. An historical prospective study was conducted including the entire internal wards admissions to the Rabin Medical Center between 1/7/14 and 30/6/15. We evaluated inhospital deaths and 7 days post discharge deaths. We focused on deaths within 24 hours, patients' characteristics, the primary diagnosis (which we assumed is the cause of death) and co-morbidity. The analysis includes descriptive statistics and mortality rates performed with SPSS version 22. Overall, 25,414 patients were admitted to internal wards during the study period. There were 1,620 in-hospitals deaths (6.37%) among which 164 deaths occurred within 24 hours (0.65%), which is 10.1% of in-hospital deaths. These patients were very old (median 82), many were residents of nursing homes and nearly all were brought to the hospital by ambulance. The most frequent primary diagnoses were sepsis (24%), pneumonia (22%), metastatic cancer (10%) and acute neurologic event (5%). The results exclude excessive inhospital mortality within 24 hours. The patients' characteristics enable researchers to assume that these deaths were expected and not preventable. There is no excessive mortality within 24 hours, the deaths were expected and a seasonal modifying effect was evident. All this and the different case mix in between hospitals suggest that early in-hospital mortality seems inadequate as a quality measure.

Diet quality in young adults and its association with food-related behaviours.

PubMed

Thorpe, Maree G; Kestin, Mark; Riddell, Lynn J; Keast, Russell Sj; McNaughton, Sarah A

2014-08-01

To determine the diet quality of a group of young adults and explore its associations with two food-related behaviours (involvement in meal preparation and consumption of commercially prepared meals). Cross-sectional study of young adults. Sample characteristics, food-related behaviours and dietary intake were assessed using a self-administered questionnaire including an FFQ. Diet quality was measured using the fifteen-item Dietary Guideline Index (DGI) designed to assess adherence to Australian dietary guidelines. One-way ANOVA, t tests and multiple linear regression analyses were used to explore the relationships between DGI scores, sample characteristics and food-related behaviours. University students enrolled in an undergraduate nutrition class, Melbourne, Australia. Students (n 309) aged 18-36 years. The DGI score was normally distributed, with a mean score of 93·4 (sd 17·1) points (range 51·9-127·4 points), out of a possible score of 150 points. In multivariate analyses adjusted for age, sex, nationality, BMI and maternal education, cooking meals for oneself was positively associated with DGI score (β = 0·15; 95 % CI 1·15, 10·03; P = 0·01); frequency of takeaway and frequency of convenience meal consumption were inversely associated with DGI score (β = -0·21; 95 % CI -9·96, -2·32; P = 0·002 and β = -0·16; 95 % CI -7·40, -0·97; P < 0·01, respectively). Cooking meals for oneself was linked to higher diet quality among young adults, while consumption of commercially prepared meals was associated with poorer diet quality. Maintaining education programmes that promote cooking skills within young adults has the potential to improve DGI scores.

Temporal Characteristics of Gustatory Responses in Rat Parabrachial Neurons Vary by Stimulus and Chemosensitive Neuron Type

PubMed Central

Geran, Laura; Travers, Susan

2013-01-01

It has been demonstrated that temporal features of spike trains can increase the amount of information available for gustatory processing. However, the nature of these temporal characteristics and their relationship to different taste qualities and neuron types are not well-defined. The present study analyzed the time course of taste responses from parabrachial (PBN) neurons elicited by multiple applications of “sweet” (sucrose), “salty” (NaCl), “sour” (citric acid), and “bitter” (quinine and cycloheximide) stimuli in an acute preparation. Time course varied significantly by taste stimulus and best-stimulus classification. Across neurons, the ensemble code for the three electrolytes was similar initially but quinine diverged from NaCl and acid during the second 500ms of stimulation and all four qualities became distinct just after 1s. This temporal evolution was reflected in significantly broader tuning during the initial response. Metric space analyses of quality discrimination by individual neurons showed that increases in information (H) afforded by temporal factors was usually explained by differences in rate envelope, which had a greater impact during the initial 2s (22.5% increase in H) compared to the later response (9.5%). Moreover, timing had a differential impact according to cell type, with between-quality discrimination in neurons activated maximally by NaCl or citric acid most affected. Timing was also found to dramatically improve within-quality discrimination (80% increase in H) in neurons that responded optimally to bitter stimuli (B-best). Spikes from B-best neurons were also more likely to occur in bursts. These findings suggest that among PBN taste neurons, time-dependent increases in mutual information can arise from stimulus- and neuron-specific differences in response envelope during the initial dynamic period. A stable rate code predominates in later epochs. PMID:24124597

Air pollution characteristics and health risks in Henan Province, China.

PubMed

Shen, Fuzhen; Ge, Xinlei; Hu, Jianlin; Nie, Dongyang; Tian, Li; Chen, Mindong

2017-07-01

Events of severe air pollution occurred frequently in China recently, thus understanding of the air pollution characteristics and its health risks is very important. In this work, we analyzed a two-year dataset (March 2014 - February 2016) including daily concentrations of six criteria pollutants (PM 2.5 , PM 10 , CO, SO 2 , NO 2 , and O 3 ) from 18 cities in Henan province. Results reveal the serious air pollution status in Henan province, especially the northern part, and Zhengzhou is the city with the worst air quality. Annual average PM 2.5 concentrations exceed the second grade of Chinese Ambient Air Quality Standard (75μg/m 3 ) at both 2014 and 2015. PM 2.5 is typically the major pollutant, but ozone pollution can be significant during summer. Furthermore, as the commonly used air quality index (AQI) neglects the mutual health effects from multiple pollutants, we introduced the aggregate air quality index (AAQI) and health-risk based air quality index (HAQI) to evaluate the health risks. Results show that based on HAQI, the current AQI system likely significantly underestimate the health risks of air pollution, highlighting that the general public may need stricter health protection measures. The population-weighted two-year average HAQI data further demonstrates that all population in the studied cities in Henan province live with polluted air - 72% of the population is exposed to air that is unhealthy for sensitive people, while 28% of people is exposed to air that can be harmful to healthy people; and the health risks are much greater during winter than during other seasons. Future works should further improve the HAQI algorithm, and validate the links between the clinical/epidemiologic data and the HAQI values. Copyright © 2017 Elsevier Inc. All rights reserved.

Removal of bacteria, protozoa and viruses through a multiple-barrier household water disinfection system.

PubMed

Espinosa-García, A C; Díaz-Ávalos, C; Solano-Ortiz, R; Tapia-Palacios, M A; Vázquez-Salvador, N; Espinosa-García, S; Sarmiento-Silva, R E; Mazari-Hiriart, M

2014-03-01

Municipal water disinfection systems in some areas are not always able to meet water consumer needs, such as ensuring distributed water quality, because household water management can be a contributing factor in water re-contamination. This fact is related to the storage options that are common in places where water is scarce or is distributed over limited time periods. The aim of this study is to assess the removal capacity of a multiple-barrier water disinfection device for protozoa, bacteria, and viruses. Water samples were taken from households in Mexico City and spiked with a known amount of protozoa (Giardia cyst, Cryptosporidium oocyst), bacteria (Escherichia coli), and viruses (rotavirus, adenovirus, F-specific ribonucleic acid (FRNA) coliphage). Each inoculated sample was processed through a multiple-barrier device. The efficiency of the multiple-barrier device to remove E. coli was close to 100%, and more than 87% of Cryptosporidium oocysts and more than 98% of Giardia cysts were removed. Close to 100% of coliphages were removed, 99.6% of the adenovirus was removed, and the rotavirus was almost totally removed. An effect of site by zone was detected; this observation is important because the water characteristics could indicate the efficiency of the multiple-barrier disinfection device.

Designing for movement quality in exergames: lessons learned from observing senior citizens playing stepping games.

PubMed

Skjæret, Nina; Nawaz, Ather; Ystmark, Kristine; Dahl, Yngve; Helbostad, Jorunn L; Svanæs, Dag; Vereijken, Beatrix

2015-01-01

Exergames are increasingly used as an exercise intervention to reduce fall risk in elderly. However, few exergames have been designed specifically for elderly, and we lack knowledge about the characteristics of the movements elicited by exergames and thereby about their potential to train functions important for fall risk reduction. This study investigates game elements and older players' movement characteristics during stepping exergames in order to inform exergame design for movement quality in the context of fall preventive exercise. Fourteen senior citizens (mean age 73 years ± 5.7, range 65 - 85) played 3 stepping exergames in a laboratory. Each of the exergames was described with respect to 7 game elements (physical space, sensing hardware technology, game graphics and sound, model of user, avatar/mapping of movements, game mechanism and game narrative). Five movement characteristics (weight shift; variation in step length, speed, and movement direction; visual independency) were scored on a 5-point Likert scale based on video observations of each player and each game. Disagreement between raters was resolved by agreement. Differences in scores for the 3 exergames were analyzed with a multivariate one-way ANOVA. The Mole received the highest sum score and the best score on each of the 5 movement characteristics (all p values <0.0005). LightRace scored the lowest of the 3 exergames on weight shift and variation in movement direction (both p values <0.0005), while DanceDanceRevolution scored lowest on step length variation and visual independency (p < 0.03 and p < 0.0005, respectively), and lower than The Mole on speed variation (p < 0.05). The physical space players used when exergaming and the on-screen representation of the player, affected movement quality positively as indexed by multiple weight shifts and variation in stepping size, direction, and speed. Furthermore, players' movements improved when playing speed-affected game progression and when the game narrative was related to a natural context. Comparing differences in game elements with associated differences in game movement requirements provides valuable insights about how to design for movement quality in exergames. This provided important lessons for the design of exergames for fall-preventive exercise in senior citizens and illustrates the value of including analyses of movement characteristics when designing such exergames. © 2014 S. Karger AG, Basel.

Racial/Ethnic Disparities in Primary Care Quality Among Type 2 Diabetes Patients, Medical Expenditure Panel Survey, 2012.

PubMed

Hu, Ruwei; Shi, Leiyu; Liang, Hailun; Haile, Geraldine Pierre; Lee, De-Chih

2016-08-04

Racial and ethnic disparities exist in diabetes prevalence, access to diabetes care, diabetes-related complications and mortality rates, and the quality of diabetes care among Americans. We explored racial and ethnic disparities in primary care quality among Americans with type 2 diabetes. We analyzed data on adults with type 2 diabetes derived from the household component of the 2012 Medical Expenditure Panel Survey. Multiple regression and multivariate logistic regressions were used to examine the association between race/ethnicity and primary care attributes related to first contact, longitudinality, comprehensiveness, and coordination, and clusters of confounding factors were added sequentially. Preliminary findings indicated differences in primary care quality between racial/ethnic minorities and whites across measures of first contact, longitudinality, comprehensiveness, and coordination. After controlling for confounding factors, these differences were no longer apparent; all racial/ethnic categories showed similar rates of primary care quality according to the 4 primary care domains of interest in the study. Results indicate equitable primary care quality for type 2 diabetes patients across 4 key domains of primary care after controlling for socioeconomic characteristics. Additional research is necessary to support these findings, particularly when considering smaller racial/ethnic groups and investigating outcomes related to diabetes.

Sleep in lonely heroin-dependent patients receiving methadone maintenance treatment: longer sleep latency, shorter sleep duration, lower sleep efficiency, and poorer sleep quality.

PubMed

Li, Hong-Jie; Zhong, Bao-Liang; Xu, Yan-Min; Zhu, Jun-Hong; Lu, Jin

2017-10-24

Given the socially isolated status of Chinese heroin-dependent patients (HDPs) and the significant association between loneliness and sleep problem in the general population, the impact of loneliness on sleep of HDPs is potentially substantial. The study aimed to test whether loneliness is associated with poor sleep in terms of quantity and quality in a consecutive sample of Chinese HDPs receiving methadone maintenance treatment (MMT). The study participants were 603 HDPs of three MMT clinics in Wuhan, China. Data on socio-demographic and clinical characteristics were collected by a standardized self-administered questionnaire. Sleep outcomes included sleep latency, sleep duration, sleep efficiency, and sleep quality. We measured depressive symptoms, loneliness, and sleep quality by using Zung's Self-rating Depression Scale, the single-item self-report of loneliness, and the Pittsburgh Sleep Quality Index, respectively. Multiple linear regression was used to examine whether loneliness is independently associated with sleep measures. After controlling for the confounding effects of potential socio-demographic and clinical variables, loneliness was significantly associated with longer sleep latency, shorter sleep duration, lower sleep efficiency, and poorer sleep quality. Loneliness may exacerbate sleep disturbance in Chinese HDPs of MMT clinics. Psychosocial interventions aimed at reducing loneliness in MMT clinics would improve the sleep of HDPs.

Movement quality of conventional prostheses and the DEKA Arm during everyday tasks

PubMed Central

Cowley, Jeffrey; Resnik, Linda; Wilken, Jason; Walters, Lisa Smurr; Gates, Deanna

2017-01-01

Background Conventional prosthetic devices fail to restore the function and characteristic movement quality of the upper limb. The DEKA Arm is a new, advanced prosthesis featuring a compound, powered wrist and multiple grip configurations. Objectives The purpose of this study was to determine if the DEKA Arm improved the movement quality of upper limb prosthesis users compared to conventional prostheses. Study design Case series. Methods Three people with transradial amputation completed tasks of daily life with their conventional prosthesis and with the DEKA Arm. A total of 10 healthy controls completed the same tasks. The trajectory of the wrist joint center was analyzed to determine how different prostheses affected movement duration, speed, smoothness, and curvature compared to patients’ own intact limbs and controls. Results Movement quality decreased with the DEKA Arm for two participants, and increased for the third. Prosthesis users made slower, less smooth, more curved movements with the prosthetic limb compared to the intact limb and controls, particularly when grasping and manipulating objects. Conclusion The effects of one month of training with the DEKA Arm on movement quality varied with participants’ skill and experience with conventional prostheses. Future studies should examine changes in movement quality after long-term use of advanced prostheses. PMID:26932980

Quality of Disease Management and Risk of Mortality in English Primary Care Practices

PubMed Central

Dusheiko, Mark; Gravelle, Hugh; Martin, Stephen; Smith, Peter C

2015-01-01

Objective To investigate whether better management of chronic conditions by family practices reduces mortality risk. Data Two random samples of 5 million patients registered with over 8,000 English family practices followed up for 4 years (2004/5–2007/8). Measures of the quality of disease management for 10 conditions were constructed for each family practice for each year. The outcome measure was an indicator taking the value 1 if the patient died during a specified year, 0 otherwise. Study Design Cross-section and multilevel panel data multiple logistic regressions were estimated. Covariates included age, gender, morbidity, hospitalizations, attributed socio-economic characteristics, and local health care supply measures. Principal Findings Although a composite measure of the quality of disease management for all 10 conditions was significantly associated with lower mortality, only the quality of stroke care was significant when all 10 quality measures were entered in the regression. Conclusions The panel data results suggest that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 [95 percent CI: 423, 1140]. A longer study period may be necessary to detect any mortality impact of better management of other conditions. PMID:25597263

The Effects of HMO Penetration on Preventable Hospitalizations

PubMed Central

Zhan, Chunliu; Miller, Marlene R; Wong, Herbert; Meyer, Gregg S

2004-01-01

Objective To examine the effects of health maintenance organization (HMO) penetration on preventable hospitalizations. Data Source Hospital inpatient discharge abstracts for 932 urban counties in 22 states from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID), hospital data from American Hospital Association (AHA) annual survey, and population characteristics and health care capacity data from Health Resources and Services Administration (HRSA) Area Resource File (ARF) for 1998. Methods Preventable hospitalizations due to 14 ambulatory care sensitive conditions were identified using the Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators. Multiple regressions were used to determine the association between preventable hospitalizations and HMO penetration while controlling for demographic and socioeconomic characteristics and health care capacity of the counties. Principal Findings A 10 percent increase in HMO penetration was associated with a 3.8 percent decrease in preventable hospitalizations (95 percent confidence interval, 2.0 percent–5.6 percent). Advanced age, female gender, poor health, poverty, more hospital beds, and fewer primary care physicians per capita were significantly associated with more preventable hospitalizations. Conclusions Our study suggests that HMO penetration has significant effects in reducing preventable hospitalizations due to some ambulatory care sensitive conditions. PMID:15032958

Improvements in cognition, quality of life, and physical performance with clinical Pilates in multiple sclerosis: a randomized controlled trial

PubMed Central

Küçük, Fadime; Kara, Bilge; Poyraz, Esra Çoşkuner; İdiman, Egemen

2016-01-01

[Purpose] The aim of this study was to determine the effects of clinical Pilates in multiple sclerosis patients. [Subjects and Methods] Twenty multiple sclerosis patients were enrolled in this study. The participants were divided into two groups as the clinical Pilates and control groups. Cognition (Multiple Sclerosis Functional Composite), balance (Berg Balance Scale), physical performance (timed performance tests, Timed up and go test), tiredness (Modified Fatigue Impact scale), depression (Beck Depression Inventory), and quality of life (Multiple Sclerosis International Quality of Life Questionnaire) were measured before and after treatment in all participants. [Results] There were statistically significant differences in balance, timed performance, tiredness and Multiple Sclerosis Functional Composite tests between before and after treatment in the clinical Pilates group. We also found significant differences in timed performance tests, the Timed up and go test and the Multiple Sclerosis Functional Composite between before and after treatment in the control group. According to the difference analyses, there were significant differences in Multiple Sclerosis Functional Composite and Multiple Sclerosis International Quality of Life Questionnaire scores between the two groups in favor of the clinical Pilates group. There were statistically significant clinical differences in favor of the clinical Pilates group in comparison of measurements between the groups. Clinical Pilates improved cognitive functions and quality of life compared with traditional exercise. [Conclusion] In Multiple Sclerosis treatment, clinical Pilates should be used as a holistic approach by physical therapists. PMID:27134355

Improvements in cognition, quality of life, and physical performance with clinical Pilates in multiple sclerosis: a randomized controlled trial.

PubMed

Küçük, Fadime; Kara, Bilge; Poyraz, Esra Çoşkuner; İdiman, Egemen

2016-03-01

[Purpose] The aim of this study was to determine the effects of clinical Pilates in multiple sclerosis patients. [Subjects and Methods] Twenty multiple sclerosis patients were enrolled in this study. The participants were divided into two groups as the clinical Pilates and control groups. Cognition (Multiple Sclerosis Functional Composite), balance (Berg Balance Scale), physical performance (timed performance tests, Timed up and go test), tiredness (Modified Fatigue Impact scale), depression (Beck Depression Inventory), and quality of life (Multiple Sclerosis International Quality of Life Questionnaire) were measured before and after treatment in all participants. [Results] There were statistically significant differences in balance, timed performance, tiredness and Multiple Sclerosis Functional Composite tests between before and after treatment in the clinical Pilates group. We also found significant differences in timed performance tests, the Timed up and go test and the Multiple Sclerosis Functional Composite between before and after treatment in the control group. According to the difference analyses, there were significant differences in Multiple Sclerosis Functional Composite and Multiple Sclerosis International Quality of Life Questionnaire scores between the two groups in favor of the clinical Pilates group. There were statistically significant clinical differences in favor of the clinical Pilates group in comparison of measurements between the groups. Clinical Pilates improved cognitive functions and quality of life compared with traditional exercise. [Conclusion] In Multiple Sclerosis treatment, clinical Pilates should be used as a holistic approach by physical therapists.

Reducing racial/ethnic disparities in diabetes: the Coached Care (R2D2C2) project.

PubMed

Kaplan, Sherrie H; Billimek, John; Sorkin, Dara H; Ngo-Metzger, Quyen; Greenfield, Sheldon

2013-10-01

Despite numerous efforts to change healthcare delivery, the profile of disparities in diabetes care and outcomes has not changed substantially over the past decade. To understand potential contributors to disparities in diabetes care and glycemic control. Cross sectional analysis. Seven outpatient clinics affiliated with an academic medical center. Adult patients with type 2 diabetes who were Mexican American, Vietnamese American or non-Hispanic white (n = 1,484). Glycemic control was measured as hemoglobin A1c (HbA1c) level. Patient, provider and system characteristics included demographic characteristics; access to care; quality of process of care including clinical inertia; quality of interpersonal care; illness burden; mastery (diabetes management confidence, passivity); and adherence to treatment. Unadjusted HbA1c values were significantly higher for Mexican American patients (n = 782) (mean = 8.3 % [SD:2.1]) compared with non-Hispanic whites (n = 389) (mean = 7.1 % [SD:1.4]). There were no significant differences in HbA1c values between Vietnamese American and non-Hispanic white patients. There were no statistically significant group differences in glycemic control after adjustment for multiple measures of access, and quality of process and interpersonal care. Disease management mastery and adherence to treatment were related to glycemic control for all patients, independent of race/ethnicity. Generalizability to other minorities or to patients with poorer access to care may be limited. The complex interplay among patient, physician and system characteristics contributed to disparities in HbA1c between Mexican American and non-Hispanic white patients. In contrast, Vietnamese American patients achieved HbA1c levels comparable to non-Hispanic whites and adjustment for numerous characteristics failed to identify confounders that could have masked disparities in this subgroup. Disease management mastery appeared to be an important contributor to glycemic control for all patient subgroups.

The Role of Quality Health Services and Discussion about Birth Spacing in Postpartum Contraceptive Use in Sindh, Pakistan: A Multilevel Analysis

PubMed Central

Tappis, Hannah; Dahar, Zaib; Ali, Anayat; Agha, Sohail

2015-01-01

Introduction Rapid population growth, stagnant contraceptive prevalence, and high unmet need for family planning present significant challenges for meeting Pakistan’s national and international development goals. Although health behaviors are shaped by multiple social and environmental factors, research on contraceptive uptake in Pakistan has focused on individual and household determinants, and little attention has been given to community characteristics that may affect access to services and reproductive behavior. Methods Individual and community determinants of contraceptive use were identified using multivariable multilevel logistic regression to analyze data from a 2014 cross-sectional survey of 6,200 mothers in 503 communities in Sindh, Pakistan. Results Only 27% of women who had given birth in the two years before the study reported using contraceptives. After adjusting for individual and community characteristics, there was no difference in the odds of contraceptive use between urban and rural women. Women who had delivered at a health facility had 1.4 times higher odds of contraceptive use than women who delivered at home. Those who received information about birth spacing from a doctor or relatives/friends had 1.81 and 1.38 times higher odds of contraceptive use, respectively, than those who did not. Living in a community where a higher proportion of women received quality antenatal care and where discussion of birth spacing was more common was significantly associated with contraceptive use. Community-wide poverty lowered contraceptive use. Conclusions Quality of care at the community level has strong effects on contraceptive use, independent of the characteristics of individual households or women. These findings suggest that powerful gains in contraceptive use may be realized by improving the quality of antenatal care in Pakistan. Community health workers should focus on generating discussion of birth spacing in the community. Outreach efforts should target communities where the demand for contraception appears to be depressed due to high levels of poverty. PMID:26485524

The Role of Quality Health Services and Discussion about Birth Spacing in Postpartum Contraceptive Use in Sindh, Pakistan: A Multilevel Analysis.

PubMed

Tappis, Hannah; Kazi, Anis; Hameed, Waqas; Dahar, Zaib; Ali, Anayat; Agha, Sohail

2015-01-01

Rapid population growth, stagnant contraceptive prevalence, and high unmet need for family planning present significant challenges for meeting Pakistan's national and international development goals. Although health behaviors are shaped by multiple social and environmental factors, research on contraceptive uptake in Pakistan has focused on individual and household determinants, and little attention has been given to community characteristics that may affect access to services and reproductive behavior. Individual and community determinants of contraceptive use were identified using multivariable multilevel logistic regression to analyze data from a 2014 cross-sectional survey of 6,200 mothers in 503 communities in Sindh, Pakistan. Only 27% of women who had given birth in the two years before the study reported using contraceptives. After adjusting for individual and community characteristics, there was no difference in the odds of contraceptive use between urban and rural women. Women who had delivered at a health facility had 1.4 times higher odds of contraceptive use than women who delivered at home. Those who received information about birth spacing from a doctor or relatives/friends had 1.81 and 1.38 times higher odds of contraceptive use, respectively, than those who did not. Living in a community where a higher proportion of women received quality antenatal care and where discussion of birth spacing was more common was significantly associated with contraceptive use. Community-wide poverty lowered contraceptive use. Quality of care at the community level has strong effects on contraceptive use, independent of the characteristics of individual households or women. These findings suggest that powerful gains in contraceptive use may be realized by improving the quality of antenatal care in Pakistan. Community health workers should focus on generating discussion of birth spacing in the community. Outreach efforts should target communities where the demand for contraception appears to be depressed due to high levels of poverty.

Using High Resolution Commercial Satellite Imagery to Quantify Spatial Features of Urban Areas and their Relationship to Quality of Life Indicators in Accra, Ghana

NASA Astrophysics Data System (ADS)

Sandborn, A.; Engstrom, R.; Yu, Q.

2014-12-01

Mapping urban areas via satellite imagery is an important task for detecting and anticipating land cover and land use change at multiple scales. As developing countries experience substantial urban growth and expansion, remotely sensed based estimates of population and quality of life indicators can provide timely and spatially explicit information to researchers and planners working to determine how cities are changing. In this study, we use commercial high spatial resolution satellite imagery in combination with fine resolution census data to determine the ability of using remotely sensed data to reveal the spatial patterns of quality of life in Accra, Ghana. Traditionally, spectral characteristics are used on a per-pixel basis to determine land cover; however, in this study, we test a new methodology that quantifies spatial characteristics using a variety of spatial features observed in the imagery to determine the properties of an urban area. The spatial characteristics used in this study include histograms of oriented gradients, PanTex, Fourier transform, and line support regions. These spatial features focus on extracting structural and textural patterns of built-up areas, such as homogeneous building orientations and straight line indices. Information derived from aggregating the descriptive statistics of the spatial features at both the fine-resolution census unit and the larger neighborhood level are then compared to census derived quality of life indicators including information about housing, education, and population estimates. Preliminary results indicate that there are correlations between straight line indices and census data including available electricity and literacy rates. Results from this study will be used to determine if this methodology provides a new and improved way to measure a city structure in developing cities and differentiate between residential and commercial land use zones, as well as formal versus informal housing areas.

A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review.

PubMed

Domínguez-Mayo, F J; Escalona, M J; Mejías, M; Aragón, G; García-García, J A; Torres, J; Enríquez, J G

2015-01-01

e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems.

A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review

PubMed Central

Escalona, M. J.; Mejías, M.; Aragón, G.; García-García, J. A.; Torres, J.; Enríquez, J. G.

2015-01-01

e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems. PMID:26146656

Review of reviews on exposures to synthetic organic chemicals and children's neurodevelopment: Methodological and interpretation challenges.

PubMed

LaKind, Judy S; Anthony, Laura G; Goodman, Michael

2017-01-01

Environmental epidemiology data are becoming increasingly important in public health decision making, which commonly incorporates a systematic review of multiple studies. This review addresses two fundamental questions: What is the quality of available reviews on associations between exposure to synthetic organic chemicals and neurodevelopmental outcomes? What is the value (e.g., quality and consistency) of the underlying literature? Published reviews on associations between synthetic organic environmental chemical exposures and neurodevelopmental outcomes in children were systematically evaluated. Seventy-four relevant reviews were identified, and these were evaluated with respect to four methodological characteristics: (1) systematic inclusion/exclusion criteria and reproducible methods for search and retrieval of studies; (2) structured evaluation of underlying data quality; (3) systematic assessment of consistency across specific exposure-outcome associations; and (4) evaluation of reporting/publication bias. None of the 74 reviews fully met the criteria for all four methodological characteristics. Only four reviews met two criteria, and six reviews fulfilled only one criterion. Perhaps more importantly, the higher quality reviews were not able to meet all of the criteria owing to the shortcomings of underlying studies, which lacked comparability in terms of specific research question of interest, overall design, exposure assessment, outcome ascertainment, and analytic methods. Thus, even the most thoughtful and rigorous review may be of limited value if the underlying literature includes investigations that address different hypotheses and are beset by methodological inconsistencies and limitations. Issues identified in this review of reviews illustrate considerable challenges that are facing assessments of epidemiological evidence.

SU-E-T-617: Plan Quality Estimation of Intensity-Modulated Radiotherapy Cases for Lung Cancer

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

Koo, J; Yoon, M; Chung, W

Purpose: To estimate the planning quality of intensity-modulated radiotherapy in lung cancer cases and to provide preliminary data for the development of a planning quality assurance algorithm. Methods: 42 IMRT plans previously used in cases of solitary lung cancers were collected. Organs in or near the thoracic cavity, such as lung (ipsilateral, contralateral), heart, liver, esophagus, cord and bronchus were considered as organs at risk (OARs) in this study. The coverage index (CVI), conformity index (CI), homogeneity index (HI), volume, irregularity (standard deviation of center-surface distance) were used to compare PTV dose characteristics. The effective uniform dose (EUD), V10Gy, andmore » V20Gy of the OARs were used to compare OAR dose characteristics. Results: Average CVI, CI, HI values were 0.9, 0.8, 0.1, respectively. CVI and CI had narrow Gaussian distribution curves without a singular value, but one case had a relatively high (0.25) HI because of location and irregular shape (Irregularity of 18.5 when average was 12.5) of PTV. EUDs tended to decrease as OAR-PTV distance increased and OAR-PTV overlap volume decreased. Conclusion: This work indicates the potential for significant plan quality deviation of similar lung cancer cases. Considering that this study were from a single department, differences in the treatment results for a given patient would be much more pronounced if multiple departments (and therefore more planners) were involved. Therefore, further examination of QA protocols is needed to reduce deviations in radiation treatment planning.« less

StreamThermal: A software package for calculating thermal metrics from stream temperature data

USGS Publications Warehouse

Tsang, Yin-Phan; Infante, Dana M.; Stewart, Jana S.; Wang, Lizhu; Tingly, Ralph; Thornbrugh, Darren; Cooper, Arthur; Wesley, Daniel

2016-01-01

Improving quality and better availability of continuous stream temperature data allows natural resource managers, particularly in fisheries, to understand associations between different characteristics of stream thermal regimes and stream fishes. However, there is no convenient tool to efficiently characterize multiple metrics reflecting stream thermal regimes with the increasing amount of data. This article describes a software program packaged as a library in R to facilitate this process. With this freely-available package, users will be able to quickly summarize metrics that describe five categories of stream thermal regimes: magnitude, variability, frequency, timing, and rate of change. The installation and usage instruction of this package, the definition of calculated thermal metrics, as well as the output format from the package are described, along with an application showing the utility for multiple metrics. We believe this package can be widely utilized by interested stakeholders and greatly assist more studies in fisheries.

High Dynamic Range Imaging Using Multiple Exposures

NASA Astrophysics Data System (ADS)

Hou, Xinglin; Luo, Haibo; Zhou, Peipei; Zhou, Wei

2017-06-01

It is challenging to capture a high-dynamic range (HDR) scene using a low-dynamic range (LDR) camera. This paper presents an approach for improving the dynamic range of cameras by using multiple exposure images of same scene taken under different exposure times. First, the camera response function (CRF) is recovered by solving a high-order polynomial in which only the ratios of the exposures are used. Then, the HDR radiance image is reconstructed by weighted summation of the each radiance maps. After that, a novel local tone mapping (TM) operator is proposed for the display of the HDR radiance image. By solving the high-order polynomial, the CRF can be recovered quickly and easily. Taken the local image feature and characteristic of histogram statics into consideration, the proposed TM operator could preserve the local details efficiently. Experimental result demonstrates the effectiveness of our method. By comparison, the method outperforms other methods in terms of imaging quality.

Multiple Criteria Evaluation of Quality and Optimisation of e-Learning System Components

ERIC Educational Resources Information Center

Kurilovas, Eugenijus; Dagiene, Valentina

2010-01-01

The main research object of the paper is investigation and proposal of the comprehensive Learning Object Repositories (LORs) quality evaluation tool suitable for their multiple criteria decision analysis, evaluation and optimisation. Both LORs "internal quality" and "quality in use" evaluation (decision making) criteria are analysed in the paper.…

Clinical Characteristics of Pediatric-Onset and Adult-Onset Multiple Sclerosis in Hispanic Americans.

PubMed

Langille, Megan M; Islam, Talat; Burnett, Margaret; Amezcua, Lilyana

2016-07-01

Multiple sclerosis can affect pediatric patients. Our aim was to compare characteristics between pediatric-onset multiple sclerosis and adult-onset multiple sclerosis in Hispanic Americans. This was a cross-sectional analysis of 363 Hispanic American multiple scleroses cases; demographic and clinical characteristics were analyzed. A total of 110 Hispanic patients presented with multiple sclerosis before age 18 and 253 as adult multiple sclerosis. The most common presenting symptoms for both was optic neuritis. Polyfocal symptoms, seizures, and cognitive symptoms at presentation were more prevalent in pediatric-onset multiple sclerosis (P ≤ .001). Transverse myelitis was more frequent in adult-onset multiple sclerosis (P ≤ .001). Using multivariable analysis, pediatric-onset multiple sclerosis (adjusted odds ratio, 0.3OR 95% confidence interval 0.16-0.71, P = .004) and being US born (adjusted odds ratio, 0.553, 95% confidence interval 0.3-1.03, P = .006) were less likely to have severe ambulatory disability. Results suggest that pediatric-onset multiple sclerosis and adult-onset multiple sclerosis in Hispanics have differences that could be important for treatment and prognosis. © The Author(s) 2016.

Multiple category-lot quality assurance sampling: a new classification system with application to schistosomiasis control.

PubMed

Olives, Casey; Valadez, Joseph J; Brooker, Simon J; Pagano, Marcello

2012-01-01

Originally a binary classifier, Lot Quality Assurance Sampling (LQAS) has proven to be a useful tool for classification of the prevalence of Schistosoma mansoni into multiple categories (≤10%, >10 and <50%, ≥50%), and semi-curtailed sampling has been shown to effectively reduce the number of observations needed to reach a decision. To date the statistical underpinnings for Multiple Category-LQAS (MC-LQAS) have not received full treatment. We explore the analytical properties of MC-LQAS, and validate its use for the classification of S. mansoni prevalence in multiple settings in East Africa. We outline MC-LQAS design principles and formulae for operating characteristic curves. In addition, we derive the average sample number for MC-LQAS when utilizing semi-curtailed sampling and introduce curtailed sampling in this setting. We also assess the performance of MC-LQAS designs with maximum sample sizes of n=15 and n=25 via a weighted kappa-statistic using S. mansoni data collected in 388 schools from four studies in East Africa. Overall performance of MC-LQAS classification was high (kappa-statistic of 0.87). In three of the studies, the kappa-statistic for a design with n=15 was greater than 0.75. In the fourth study, where these designs performed poorly (kappa-statistic less than 0.50), the majority of observations fell in regions where potential error is known to be high. Employment of semi-curtailed and curtailed sampling further reduced the sample size by as many as 0.5 and 3.5 observations per school, respectively, without increasing classification error. This work provides the needed analytics to understand the properties of MC-LQAS for assessing the prevalance of S. mansoni and shows that in most settings a sample size of 15 children provides a reliable classification of schools.

The Validity and Test-Retest Reliability of the Leeds Multiple Sclerosis Quality of Life Scale in Turkish Patients

ERIC Educational Resources Information Center

Akbiyik, Derya Iren; Sumbuloglu, Vildan; Guney, Zafer; Armutlu, Kadriye; Korkmaz, Nilufer; Keser, Ilke; Yuksel, Muazzez Merve; Karabudak, Rana

2009-01-01

The aim of the study was to translate and test the reliability and validity of the Leeds Multiple Sclerosis Quality of Life Scale (LMSQoL) in Turkish patients with multiple sclerosis (MS). Demographic data of MS patients who had a registration in and followed up by a university hospital were recorded. The LMSQoL and Turkish Quality of Life…

Methodological quality of meta-analyses of single-case experimental studies.

PubMed

Jamshidi, Laleh; Heyvaert, Mieke; Declercq, Lies; Fernández-Castilla, Belén; Ferron, John M; Moeyaert, Mariola; Beretvas, S Natasha; Onghena, Patrick; Van den Noortgate, Wim

2017-12-28

Methodological rigor is a fundamental factor in the validity and credibility of the results of a meta-analysis. Following an increasing interest in single-case experimental design (SCED) meta-analyses, the current study investigates the methodological quality of SCED meta-analyses. We assessed the methodological quality of 178 SCED meta-analyses published between 1985 and 2015 through the modified Revised-Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. The main finding of the current review is that the methodological quality of the SCED meta-analyses has increased over time, but is still low according to the R-AMSTAR checklist. A remarkable percentage of the studies (93.80% of the included SCED meta-analyses) did not even reach the midpoint score (22, on a scale of 0-44). The mean and median methodological quality scores were 15.57 and 16, respectively. Relatively high scores were observed for "providing the characteristics of the included studies" and "doing comprehensive literature search". The key areas of deficiency were "reporting an assessment of the likelihood of publication bias" and "using the methods appropriately to combine the findings of studies". Although the results of the current review reveal that the methodological quality of the SCED meta-analyses has increased over time, still more efforts are needed to improve their methodological quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

A study of satisfaction of medical students on their mentoring programs at one medical school in Korea

PubMed Central

2017-01-01

Purpose The purpose of this study was to investigate the awareness levels of medical students regarding the characteristics of each function within a mentoring program conducted within Kyung Hee University and to ultimately suggest points for reformation. Medical students’ awareness levels were determined using a 29-item questionnaire. Methods The questionnaire was conducted on 347 medical students, excluding 25 students who either marked multiple answers or did not reply. The assessment of the program was based on a questionnaire with the use of a 5-point Likert scale using SPSS version 22.0. Multiple regression was conducted to examine the relationship between the satisfaction level, regarding functions of mentoring programs, and characteristics of mentoring programs. Interviews were conducted to supplement additional information that was hard to gain from the questionnaire. Results The results on demographic and functional characteristics revealed that there was no statistically significant differences in satisfaction levels across gender, whereas there were significant differences across grade levels. In addition, there were significant differences in the frequency of meetings and topics of conversation while the length of meetings and meeting place were not significantly different. Conclusion For the improved mentoring programs for medical students, the program should focus on the frequency of meetings and the topics of conversation. Furthermore, mentoring programs of high quality can be expected if professors take interview results into consideration. Also, students want to be provided with psychosocial advice from mentors in various ways such as role model function. PMID:29207456

A Review of the Literature on the Multiple Dimensions of Chronic Pain in Adults with Sickle Cell Disease

PubMed Central

Taylor, Lou Ella V.; Stotts, Nancy A.; Humphreys, Janice; Treadwell, Marsha J.; Miaskowski, Christine

2010-01-01

Sickle cell disease (SCD) is a major healthcare and societal problem that affects millions of people worldwide. In Nigeria, 45,000 to 90,000 babies are born each year with SCD. In the United States, SCD is the most common genetic disorder, affecting more than 80,000 people, the majority of whom are African American. Sickle cell pain is the hallmark feature of SCD. Most of the research on pain from SCD has focused on children with acute pain associated with sickle cell crisis. Consequently, very little is known about the occurrence and characteristics of chronic pain, especially in adults with SCD. Individuals with SCD who experience chronic pain are often underserved and their pain is under-treated. This under-treatment may result in millions of dollars per year spent on emergency room visits, hospitalizations, and lost work productivity. The primary purpose of this literature review was to summarize the findings from studies that evaluated the characteristics of chronic pain in adults with SCD. Each of the studies included in this review was evaluated to determine if it provided data on the following multidimensional characteristics of chronic pain: occurrence, number of pain episodes, duration, pattern, quality, location, intensity, aggravating factors, relieving factors, and impact of pain on function. A secondary purpose was to identify gaps in knowledge and directions for future research on the multiple dimensions of chronic pain in adults with SCD. PMID:20656451

Multivariate classification of small order watersheds in the Quabbin Reservoir Basin, Massachusetts

USGS Publications Warehouse

Lent, R.M.; Waldron, M.C.; Rader, J.C.

1998-01-01

A multivariate approach was used to analyze hydrologic, geologic, geographic, and water-chemistry data from small order watersheds in the Quabbin Reservoir Basin in central Massachusetts. Eighty three small order watersheds were delineated and landscape attributes defining hydrologic, geologic, and geographic features of the watersheds were compiled from geographic information system data layers. Principal components analysis was used to evaluate 11 chemical constituents collected bi-weekly for 1 year at 15 surface-water stations in order to subdivide the basin into subbasins comprised of watersheds with similar water quality characteristics. Three principal components accounted for about 90 percent of the variance in water chemistry data. The principal components were defined as a biogeochemical variable related to wetland density, an acid-neutralization variable, and a road-salt variable related to density of primary roads. Three subbasins were identified. Analysis of variance and multiple comparisons of means were used to identify significant differences in stream water chemistry and landscape attributes among subbasins. All stream water constituents were significantly different among subbasins. Multiple regression techniques were used to relate stream water chemistry to landscape attributes. Important differences in landscape attributes were related to wetlands, slope, and soil type.A multivariate approach was used to analyze hydrologic, geologic, geographic, and water-chemistry data from small order watersheds in the Quabbin Reservoir Basin in central Massachusetts. Eighty three small order watersheds were delineated and landscape attributes defining hydrologic, geologic, and geographic features of the watersheds were compiled from geographic information system data layers. Principal components analysis was used to evaluate 11 chemical constituents collected bi-weekly for 1 year at 15 surface-water stations in order to subdivide the basin into subbasins comprised of watersheds with similar water quality characteristics. Three principal components accounted for about 90 percent of the variance in water chemistry data. The principal components were defined as a biogeochemical variable related to wetland density, an acid-neutralization variable, and a road-salt variable related to density of primary roads. Three subbasins were identified. Analysis of variance and multiple comparisons of means were used to identify significant differences in stream water chemistry and landscape attributes among subbasins. All stream water constituents were significantly different among subbasins. Multiple regression techniques were used to relate stream water chemistry to landscape attributes. Important differences in landscape attributes were related to wetlands, slope, and soil type.

GraDit: graph-based data repair algorithm for multiple data edits rule violations

NASA Astrophysics Data System (ADS)

Ode Zuhayeni Madjida, Wa; Gusti Bagus Baskara Nugraha, I.

2018-03-01

Constraint-based data cleaning captures data violation to a set of rule called data quality rules. The rules consist of integrity constraint and data edits. Structurally, they are similar, where the rule contain left hand side and right hand side. Previous research proposed a data repair algorithm for integrity constraint violation. The algorithm uses undirected hypergraph as rule violation representation. Nevertheless, this algorithm can not be applied for data edits because of different rule characteristics. This study proposed GraDit, a repair algorithm for data edits rule. First, we use bipartite-directed hypergraph as model representation of overall defined rules. These representation is used for getting interaction between violation rules and clean rules. On the other hand, we proposed undirected graph as violation representation. Our experimental study showed that algorithm with undirected graph as violation representation model gave better data quality than algorithm with undirected hypergraph as representation model.

Analytical Models of Cross-Layer Protocol Optimization in Real-Time Wireless Sensor Ad Hoc Networks

NASA Astrophysics Data System (ADS)

Hortos, William S.

The real-time interactions among the nodes of a wireless sensor network (WSN) to cooperatively process data from multiple sensors are modeled. Quality-of-service (QoS) metrics are associated with the quality of fused information: throughput, delay, packet error rate, etc. Multivariate point process (MVPP) models of discrete random events in WSNs establish stochastic characteristics of optimal cross-layer protocols. Discrete-event, cross-layer interactions in mobile ad hoc network (MANET) protocols have been modeled using a set of concatenated design parameters and associated resource levels by the MVPPs. Characterization of the "best" cross-layer designs for a MANET is formulated by applying the general theory of martingale representations to controlled MVPPs. Performance is described in terms of concatenated protocol parameters and controlled through conditional rates of the MVPPs. Modeling limitations to determination of closed-form solutions versus explicit iterative solutions for ad hoc WSN controls are examined.

New insight into the comparative power of quality-control rules that use control observations within a single analytical run.

PubMed

Parvin, C A

1993-03-01

The error detection characteristics of quality-control (QC) rules that use control observations within a single analytical run are investigated. Unlike the evaluation of QC rules that span multiple analytical runs, most of the fundamental results regarding the performance of QC rules applied within a single analytical run can be obtained from statistical theory, without the need for simulation studies. The case of two control observations per run is investigated for ease of graphical display, but the conclusions can be extended to more than two control observations per run. Results are summarized in a graphical format that offers many interesting insights into the relations among the various QC rules. The graphs provide heuristic support to the theoretical conclusions that no QC rule is best under all error conditions, but the multirule that combines the mean rule and a within-run standard deviation rule offers an attractive compromise.

A Two-Dimensional Ruddlesden-Popper Perovskite Nanowire Laser Array based on Ultrafast Light-Harvesting Quantum Wells.

PubMed

Zhang, Haihua; Wu, Yishi; Liao, Qing; Zhang, Zhaoyi; Liu, Yanping; Gao, Qinggang; Liu, Peng; Li, Meili; Yao, Jiannian; Fu, Hongbing

2018-06-25

Miniaturized nanowire nanolasers of 3D perovskites feature a high gain coefficient; however, room-temperature optical gain and nanowire lasers from 2D layered perovskites have not been reported to date. A biomimetic approach is presented to construct an artificial ligh-harvesting system in mixed multiple quantum wells (QWs) of 2D-RPPs of (BA) 2 (FA) n-1 Pb n Br 3n+1 , achieving room-temperature ASE and nanowire (NW) lasing. Owing to the improvement of flexible and deformable characteristics provided by organic BA cation layers, high-density large-area NW laser arrays were fabricated with high photostability. Well-controlled dimensions and uniform geometries enabled 2D-RPPs NWs functioning as high-quality Fabry-Perot (FP) lasers with almost identical optical modes, high quality (Q) factor (ca. 1800), and similarly low lasing thresholds. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Urban ecosystem services for resilience planning and management in New York City.

PubMed

McPhearson, Timon; Hamstead, Zoé A; Kremer, Peleg

2014-05-01

We review the current state of knowledge about urban ecosystem services in New York City (NYC) and how these services are regulated, planned for, and managed. Focusing on ecosystem services that have presented challenges in NYC-including stormwater quality enhancement and flood control, drinking water quality, food provisioning and recreation-we find that mismatches between the scale of production and scale of management occur where service provision is insufficient. Adequate production of locally produced services and services which are more accessible when produced locally is challenging in the context of dense urban development that is characteristic of NYC. Management approaches are needed to address scale mismatches in the production and consumption of ecosystem services. By coordinating along multiple scales of management and promoting best management practices, urban leaders have an opportunity to ensure that nature and ecosystem processes are protected in cities to support the delivery of fundamental urban ecosystem services.

Hospital ownership and performance: evidence from stroke and cardiac treatment in Taiwan.

PubMed

Lien, Hsien-Ming; Chou, Shin-Yi; Liu, Jin-Tan

2008-09-01

This paper compares program expenditure and treatment quality of stroke and cardiac patients between 1997 and 2000 across hospitals of various ownership types in Taiwan. Because Taiwan implemented national health insurance in 1995, the analysis is immune from problems arising from the complex setting of the U.S. health care market, such as segmentation of insurance status or multiple payers. Because patients may select admitted hospitals based on their observed and unobserved characteristics, we employ instrument variable (IV) estimation to account for the endogeneity of ownership status. Results of IV estimation find that patients admitted to non-profit hospitals receive better quality care, either measured by 1- or 12-month mortality rates. In terms of treatment expenditure, our results indicate no difference between non-profits and for-profits index admission expenditures, and at most 10% higher long-term expenditure for patients admitted to non-profits than to for-profits.

Housing Satisfaction of Older (55+) Single-Person Householders in U.S. Rural Communities.

PubMed

Ahn, Mira; Lee, Sung-Jin

2016-08-01

This study aims to understand the housing satisfaction of older (55+) single-person householders in U.S. rural communities using the available variables from a secondary data set, the 2011 American Housing Survey (AHS). In this study, housing satisfaction was considered to be an indicator of quality of life. Based on previous studies, we developed a model to test a hypothesized relationship between older (55+) single-person householders' (N = 1,017) housing satisfaction and their personal, physical, financial, and environmental characteristics. Multiple regression results showed that the model was supported, indicating that significant variables in housing satisfaction include age, gender, health status, age of house, structure type, and unit location. Among the significant variables, health status was revealed to be the strongest factor in housing satisfaction. Housing satisfaction was discussed as potential indicators of quality of life. © The Author(s) 2015.

The effects of pranayama, hatha and raja yoga on physical pain and the quality of life of women with multiple sclerosis.

PubMed

Doulatabad, Shahla Najafi; Nooreyan, Khirollah; Doulatabad, Ardavan Najafi; Noubandegani, Zinat Mohebbi

2012-01-01

In a clinical trial carried out on 60 women with multiple sclerosis, the researchers obtained data using survey questionnaires. In addition to demographic data, the Multiple Sclerosis Quality of Life-54 (MSQoL-54) instrument was used to determine how multiple sclerosis influences the quality of life of the studied women. Within the frame of this randomized controlled trial, the participants were divided into two equally sized groups (the case and the control group) in which the level of pain and the quality of life were evaluated. The case group exercised pain-managing Yoga methods for three months, keeping the pace of eight 90-minute sessions per month. The control participants were subjected to no intervention. One month after the Yoga therapy, the level of pain and the quality of life were evaluated in both groups and compared to the baseline data. Data were analyzed using SPSS software and paired t-tests. After the Yoga therapy, the case group showed a significant improvement in physical pain management (P=0.007) and the quality of life (P=0.001) as compared to the control group. The results showed that Yoga techniques can alleviate physical pain and improve the quality of life of multiple sclerosis patients.

Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment.

PubMed

Gross, Anita; Langevin, Pierre; Burnie, Stephen J; Bédard-Brochu, Marie-Sophie; Empey, Brian; Dugas, Estelle; Faber-Dobrescu, Michael; Andres, Cristy; Graham, Nadine; Goldsmith, Charles H; Brønfort, Gert; Hoving, Jan L; LeBlanc, Francis

2015-09-23

Manipulation and mobilisation are commonly used to treat neck pain. This is an update of a Cochrane review first published in 2003, and previously updated in 2010. To assess the effects of manipulation or mobilisation alone compared wiith those of an inactive control or another active treatment on pain, function, disability, patient satisfaction, quality of life and global perceived effect in adults experiencing neck pain with or without radicular symptoms and cervicogenic headache (CGH) at immediate- to long-term follow-up. When appropriate, to assess the influence of treatment characteristics (i.e. technique, dosage), methodological quality, symptom duration and subtypes of neck disorder on treatment outcomes. Review authors searched the following computerised databases to November 2014 to identify additional studies: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). We also searched ClinicalTrials.gov, checked references, searched citations and contacted study authors to find relevant studies. We updated this search in June 2015, but these results have not yet been incorporated. Randomised controlled trials (RCTs) undertaken to assess whether manipulation or mobilisation improves clinical outcomes for adults with acute/subacute/chronic neck pain. Two review authors independently selected studies, abstracted data, assessed risk of bias and applied Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methods (very low, low, moderate, high quality). We calculated pooled risk ratios (RRs) and standardised mean differences (SMDs). We included 51 trials (2920 participants, 18 trials of manipulation/mobilisation versus control; 34 trials of manipulation/mobilisation versus another treatment, 1 trial had two comparisons). Cervical manipulation versus inactive control: For subacute and chronic neck pain, a single manipulation (three trials, no meta-analysis, 154 participants, ranged from very low to low quality) relieved pain at immediate- but not short-term follow-up. Cervical manipulation versus another active treatment: For acute and chronic neck pain, multiple sessions of cervical manipulation (two trials, 446 participants, ranged from moderate to high quality) produced similar changes in pain, function, quality of life (QoL), global perceived effect (GPE) and patient satisfaction when compared with multiple sessions of cervical mobilisation at immediate-, short- and intermediate-term follow-up. For acute and subacute neck pain, multiple sessions of cervical manipulation were more effective than certain medications in improving pain and function at immediate- (one trial, 182 participants, moderate quality) and long-term follow-up (one trial, 181 participants, moderate quality). These findings are consistent for function at intermediate-term follow-up (one trial, 182 participants, moderate quality). For chronic CGH, multiple sessions of cervical manipulation (two trials, 125 participants, low quality) may be more effective than massage in improving pain and function at short/intermediate-term follow-up. Multiple sessions of cervical manipulation (one trial, 65 participants, very low quality) may be favoured over transcutaneous electrical nerve stimulation (TENS) for pain reduction at short-term follow-up. For acute neck pain, multiple sessions of cervical manipulation (one trial, 20 participants, very low quality) may be more effective than thoracic manipulation in improving pain and function at short/intermediate-term follow-up. Thoracic manipulation versus inactive control: Three trials (150 participants) using a single session were assessed at immediate-, short- and intermediate-term follow-up. At short-term follow-up, manipulation improved pain in participants with acute and subacute neck pain (five trials, 346 participants, moderate quality, pooled SMD -1.26, 95% confidence interval (CI) -1.86 to -0.66) and improved function (four trials, 258 participants, moderate quality, pooled SMD -1.40, 95% CI -2.24 to -0.55) in participants with acute and chronic neck pain. A funnel plot of these data suggests publication bias. These findings were consistent at intermediate follow-up for pain/function/quality of life (one trial, 111 participants, low quality). Thoracic manipulation versus another active treatment: No studies provided sufficient data for statistical analyses. A single session of thoracic manipulation (one trial, 100 participants, moderate quality) was comparable with thoracic mobilisation for pain relief at immediate-term follow-up for chronic neck pain. Mobilisation versus inactive control: Mobilisation as a stand-alone intervention (two trials, 57 participants, ranged from very low to low quality) may not reduce pain more than an inactive control. Mobilisation versus another active treatment: For acute and subacute neck pain, anterior-posterior mobilisation (one trial, 95 participants, very low quality) may favour pain reduction over rotatory or transverse mobilisations at immediate-term follow-up. For chronic CGH with temporomandibular joint (TMJ) dysfunction, multiple sessions of TMJ manual therapy (one trial, 38 participants, very low quality) may be more effective than cervical mobilisation in improving pain/function at immediate- and intermediate-term follow-up. For subacute and chronic neck pain, cervical mobilisation alone (four trials, 165 participants, ranged from low to very low quality) may not be different from ultrasound, TENS, acupuncture and massage in improving pain, function, QoL and participant satisfaction at immediate- and intermediate-term follow-up. Additionally, combining laser with manipulation may be superior to using manipulation or laser alone (one trial, 56 participants, very low quality). Although support can be found for use of thoracic manipulation versus control for neck pain, function and QoL, results for cervical manipulation and mobilisation versus control are few and diverse. Publication bias cannot be ruled out. Research designed to protect against various biases is needed. Findings suggest that manipulation and mobilisation present similar results for every outcome at immediate/short/intermediate-term follow-up. Multiple cervical manipulation sessions may provide better pain relief and functional improvement than certain medications at immediate/intermediate/long-term follow-up. Since the risk of rare but serious adverse events for manipulation exists, further high-quality research focusing on mobilisation and comparing mobilisation or manipulation versus other treatment options is needed to guide clinicians in their optimal treatment choices.

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.

Beyond memory problems: multiple obstacles to health and quality of life in older people seeking help for subjective memory complaints.

PubMed

Rotenberg Shpigelman, Shlomit; Sternberg, Shelley; Maeir, Adina

2017-08-29

Preliminary evidence suggests that older people who seek medical help for subjective memory complaints (SMC) may be at risk for depression, poor quality of life (QoL), and functional limitations. This study aims to: (1) further investigate bio-psycho-social characteristics, participation in personally meaningful activities and QoL of help-seekers; and (2) examine the relationship of these characteristics to QoL, and explore the unique contribution of participation to QoL. Cognitive, meta-cognitive, emotional, social, participation, and QoL measures were used to compare 51 help-seekers referred from geriatric clinics to 40 age-matched controls who did not seek help for memory problems. Help-seekers exhibited lower participation and QoL, had lower mean cognitive scores, reported more memory mistakes and negative memory-beliefs, more depression, worse self-efficacy, and less positive social interaction than non-help-seekers. Quality of life in help-seekers was significantly correlated with most variables. Participation contributed to the explained variance of QoL in help-seekers, beyond that accounted for by cognition and emotional status. Help-seekers with SMC exhibited a complex health condition that includes not only SMC, but also objective memory impairment, depression, functional restrictions, negative memory beliefs, low perception of memory abilities, reduced self-efficacy and insufficient social interactions, all associated with lower QoL. This multi-faceted condition should be considered in the treatment of help-seekers. Implications for Rehabilitation Older people who seek help for subjective memory complaints may be facing a larger problem involving bio-psycho-social factors, affecting participation in meaningful activities and quality of life. Quality of life may be improved via treatment of depression, functional restrictions, memory beliefs, self-efficacy, and positive social interactions. Participation in meaningful activities is an especially important target for improving health and quality of life in this population. Interventions for older adults seeking help for subjective memory complaints will benefit from adopting a bio-psycho-social rehabilitation perspective.

Change in quality of life and predictors of change among patients with multiple sclerosis: a prospective cohort study.

PubMed

Tepavcevic, Darija Kisic; Pekmezovic, Tatjana; Stojsavljevic, Nebojsa; Kostic, Jelena; Basuroski, Irena Dujmovic; Mesaros, Sarlota; Drulovic, Jelena

2014-04-01

The aim of this study was to determine the changes in the health-related quality of life (HRQoL) and predictors of change among patients with multiple sclerosis (MS) at 3 and 6 years during the follow-up period. A group of 109 consecutive MS patients (McDonald's criteria) referred to the Clinic of Neurology, Belgrade, were enrolled in the study. At three time points during the study (baseline, and at 3 and 6 years during the follow-up period), the HRQoL (measured by MSQoL-54), Expanded Disability Status Scale, and Hamilton Rating Scale for Depression and Fatigue Severity Scale were assessed. During the study period, 93 patients provided both follow-up assessments. Statistically significant deterioration in the HRQoL at each subsequent time point was detected for all scales of the MSQoL-54 except for the pain and change in health scales. A higher level of education was a significant prognostic factor for a better HRQoL on the cognitive function scale throughout the entire period of observation, while marital status (single, including divorced and widowed) and increased age at the onset of MS had significant predictive values of poorer quality-of-life scores on the overall quality-of-life scale at 6-year follow-up. Higher levels of physical disability and depression at baseline were statistically significant prognostic markers for deterioration in HRQoL for the majority of MSQoL-54 scales during the entire follow-up period. Our study suggests that baseline demographic and clinical characteristics could be applied as prognostic markers of the HRQOL for patients diagnosed with MS.

Advances in exercise, fitness, and performance genomics in 2010.

PubMed

Hagberg, James M; Rankinen, Tuomo; Loos, Ruth J F; Pérusse, Louis; Roth, Stephen M; Wolfarth, Bernd; Bouchard, Claude

2011-05-01

This review of the exercise genomics literature emphasizes the strongest articles published in 2010 as defined by sample size, quality of phenotype measurements, quality of the exercise program or physical activity exposure, study design, adjustment for multiple testing, quality of genotyping, and other related study characteristics. One study on voluntary running wheel behavior was performed in 448 mice from 41 inbred strains. Several quantitative trait loci for running distance, speed, and duration were identified. Several studies on the alpha-3 actinin (ACTN3) R577X nonsense polymorphism and the angiotensin-converting enzyme (ACE) I/D polymorphism were reported with no clear evidence for a joint effect, but the studies were generally underpowered. Skeletal muscle RNA abundance at baseline for 29 transcripts and 11 single nucleotide polymorphisms (SNPs) were both found to be predictive of the V˙O2max response to exercise training in one report from multiple laboratories. None of the 50 loci associated with adiposity traits are known to influence physical activity behavior. However, physical activity seems to reduce the obesity-promoting effects of at least 12 of these loci. Evidence continues to be strong for a role of gene-exercise interaction effects on the improvement in insulin sensitivity after exposure to regular exercise. SNPs in the cAMP-responsive element binding position 1 (CREB1) gene were associated with training-induced HR response, in the C-reactive protein (CRP) gene with training-induced changes in left ventricular mass, and in the methylenetetrahydrofolate reductase (MTHFR) gene with carotid stiffness in low-fit individuals. We conclude that progress is being made but that high-quality research designs and replication studies with large sample sizes are urgently needed. © 2011 by the American College of Sports Medicine

Advances in Exercise, Fitness, and Performance Genomics in 2010 (Medicine and Science in Sports and Exercise)

PubMed Central

Hagberg, James M.; Rankinen, Tuomo; Loos, Ruth J. F.; Pérusse, Louis; Roth, Stephen M.; Wolfarth, Bernd; Bouchard, Claude

2014-01-01

This review of the exercise genomics literature emphasizes the strongest papers published in 2010 as defined by sample size, quality of phenotype measurements, quality of the exercise program or physical activity exposure, study design, adjustment for multiple testing, quality of genotyping, and other related study characteristics. One study on voluntary running wheel behavior was performed in 448 mice from 41 inbred strains. Several quantitative trait loci for running distance, speed, and duration were identified. Several studies on the alpha-3 actinin (ACTN3) R577X nonsense polymorphism and the angiotensin converting enzyme (ACE) I/D polymorphism were reported with no clear evidence for a joint effect, but the studies were generally underpowered. Skeletal muscle RNA abundance at baseline for 29 transcripts and 11 single nucleotide polymorphisms (SNPs) were both found to be predictive of the VO2max response to exercise training in one report from multiple laboratories. None of the 50 loci associated with adiposity traits is known to influence physical activity behavior. However, physical activity appears to reduce the obesity-promoting effects of at least 12 of these loci. Evidence continues to be strong for a role of gene-exercise interaction effects on the improvement in insulin sensitivity following exposure to regular exercise. SNPs in the cAMP responsive element binding position 1 (CREB1) gene were associated with training-induced heart rate response, in the C-reactive protein (CRP) gene with training-induced changes in left ventricular mass, and in the methylenetetrahydrofolate reductase (MTHFR) gene with carotid stiffness in low-fit individuals. We conclude that progress is being made but that high-quality research designs and replication studies with large sample sizes are urgently needed. PMID:21499051

Comparison of CIGS solar cells made with different structures and fabrication techniques

DOE PAGES

Mansfield, Lorelle M.; Garris, Rebekah L.; Counts, Kahl D.; ...

2016-11-03

Cu(In, Ga)Se2 (CIGS)-based solar cells from six fabricators were characterized and compared. The devices had differing substrates, absorber deposition processes, buffer materials, and contact materials. The effective bandgaps of devices varied from 1.05 to 1.22 eV, with the lowest optical bandgaps occurring in those with metal-precursor absorber processes. Devices with Zn(O, S) or thin CdS buffers had quantum efficiencies above 90% down to 400 nm. Most voltages were 250-300 mV below the Shockley-Queisser limit for their bandgap. Electroluminescence intensity tracked well with the respective voltage deficits. Fill factor (FF) was as high as 95% of the maximum for each device'smore » respective current and voltage, with higher FF corresponding to lower diode quality factors (~1.3). An in-depth analysis of FF losses determined that diode quality reflected in the quality factor, voltage-dependent photocurrent, and, to a lesser extent, the parasitic resistances are the limiting factors. As a result, different absorber processes and device structures led to a range of electrical and physical characteristics, yet this investigation showed that multiple fabrication pathways could lead to high-quality and high-efficiency solar cells.« less

Health-related quality of life and related factors of military police officers

PubMed Central

2014-01-01

Purpose The present study aimed to determine the effect of demographic characteristics, occupation, anthropometric indices, and leisure-time physical activity levels on coronary risk and health-related quality of life among military police officers from the State of Santa Catarina, Brazil. Methods The sample included 165 military police officers who fulfilled the study’s inclusion criteria. The International Physical Activity Questionnaire and the Short Form Health Survey were used, in addition to a spreadsheet of socio-demographic, occupational and anthropometric data. Statistical analyses were performed using descriptive analysis followed by Spearman Correlation and multiple linear regression analysis using the backward method. Results The waist-to-height ratio was identified as a risk factor low health-related quality of life. In addition, the conicity index, fat percentage, years of service in the military police, minutes of work per day and leisure-time physical activity levels were identified as risk factors for coronary disease among police officers. Conclusions These findings suggest that the Military Police Department should adopt an institutional policy that allows police officers to practice regular physical activity in order to maintain and improve their physical fitness, health, job performance, and quality of life. PMID:24766910

Automatic relative RPC image model bias compensation through hierarchical image matching for improving DEM quality

NASA Astrophysics Data System (ADS)

Noh, Myoung-Jong; Howat, Ian M.

2018-02-01

The quality and efficiency of automated Digital Elevation Model (DEM) extraction from stereoscopic satellite imagery is critically dependent on the accuracy of the sensor model used for co-locating pixels between stereo-pair images. In the absence of ground control or manual tie point selection, errors in the sensor models must be compensated with increased matching search-spaces, increasing both the computation time and the likelihood of spurious matches. Here we present an algorithm for automatically determining and compensating the relative bias in Rational Polynomial Coefficients (RPCs) between stereo-pairs utilizing hierarchical, sub-pixel image matching in object space. We demonstrate the algorithm using a suite of image stereo-pairs from multiple satellites over a range stereo-photogrammetrically challenging polar terrains. Besides providing a validation of the effectiveness of the algorithm for improving DEM quality, experiments with prescribed sensor model errors yield insight into the dependence of DEM characteristics and quality on relative sensor model bias. This algorithm is included in the Surface Extraction through TIN-based Search-space Minimization (SETSM) DEM extraction software package, which is the primary software used for the U.S. National Science Foundation ArcticDEM and Reference Elevation Model of Antarctica (REMA) products.

Affective symptoms and determinants of health-related quality of life in Mexican people with epilepsy.

PubMed

Camara-Lemarroy, Carlos R; Hoyos, Mariana; Ibarra-Yruegas, Beatriz E; Díaz-Torres, Marco A; De León, Rolando

2017-10-01

Epilepsy is known to be associated with multiple psychiatric comorbidities, such as depression, sleep-disorders, and anxiety. The objective of this study was to determine the prevalence and impact of affective symptoms over health-related quality of life (QOL) in Mexican people with epilepsy (PWE). We performed a cross-sectional observational study on 73 consecutive PWE and corresponding age- and sex-matched controls. HrQOL was assessed using the QOLIE-10 (QOL in Epilepsy-10) instrument. Clinical and demographic characteristics were recorded, and instruments evaluating depressive/anxiety symptoms, sleep quality, and insomnia were completed. PWE had more depressive/anxiety symptoms when compared with controls. QOLIE-10 scores were significantly inversely correlated with poor sleep quality, insomnia symptoms, depressive/anxiety symptoms, and number of anti-epileptic drugs used, but not with seizure type or number of seizures per month. A poor QOL was independently associated only with anti-epileptic drug polytherapy. PWE are burdened with depressive/anxiety symptoms at alarming rates. The presence of depressive symptoms along with sleep disturbances and more significantly, anti-epileptic drug polytherapy, appears to negatively impact QOL, to a greater degree than short-term seizure control.

Comparison of CIGS solar cells made with different structures and fabrication techniques

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

Mansfield, Lorelle M.; Garris, Rebekah L.; Counts, Kahl D.

Cu(In, Ga)Se2 (CIGS)-based solar cells from six fabricators were characterized and compared. The devices had differing substrates, absorber deposition processes, buffer materials, and contact materials. The effective bandgaps of devices varied from 1.05 to 1.22 eV, with the lowest optical bandgaps occurring in those with metal-precursor absorber processes. Devices with Zn(O, S) or thin CdS buffers had quantum efficiencies above 90% down to 400 nm. Most voltages were 250-300 mV below the Shockley-Queisser limit for their bandgap. Electroluminescence intensity tracked well with the respective voltage deficits. Fill factor (FF) was as high as 95% of the maximum for each device'smore » respective current and voltage, with higher FF corresponding to lower diode quality factors (~1.3). An in-depth analysis of FF losses determined that diode quality reflected in the quality factor, voltage-dependent photocurrent, and, to a lesser extent, the parasitic resistances are the limiting factors. As a result, different absorber processes and device structures led to a range of electrical and physical characteristics, yet this investigation showed that multiple fabrication pathways could lead to high-quality and high-efficiency solar cells.« less

Chronic Stress and Fatigue-Related Quality of Life after Mild-to-Moderate Traumatic Brain Injury (TBI)

PubMed Central

Bay, Esther; de-Leon, Marita B.

2010-01-01

Objective To determine relationships between chronic stress, fatigue-related quality of life (QOL-F) and related covariates after mild-to-moderate traumatic brain injury (TBI). Design Observational and cross-sectional Participants A total of 84 community-dwelling individuals with mild-to-moderate TBI recruited from multiple out-patient rehabilitation clinics assessed on average 15 months after injury. Method Data were collected with self-report surveys and chart abstraction. Measures Neurofunctional Behavioral Inventory, Perceived Stress Scale-14, Impact of Events Scale, McGill Pain Short-form Scale, and modified version of the Fatigue Impact Scale. Results Fatigue-related quality of life was associated with somatic symptoms, perceived situational stress, but not with event-related stress (PTSD symptoms) related to index TBI, pre-injury demographic, or post-injury characteristics. Somatic symptoms and chronic situational stress accounted for 42% of the variance in QOL (F). Conclusions QOL (F) in community-dwelling individuals with mild-to- moderate TBI is associated with chronic situational stress and somatic symptoms. Symptom management strategies may need to include general stress management to reduce fatigue burden and improve quality of life. PMID:21169862

Health-related quality of life and related factors of military police officers.

PubMed

da Silva, Franciele Cascaes; Hernandez, Salma Stéphany Soleman; Arancibia, Beatriz Angélica Valdivia; Castro, Thiago Luis da Silva; Filho, Paulo José Barbosa Gutierres; da Silva, Rudney

2014-04-27

The present study aimed to determine the effect of demographic characteristics, occupation, anthropometric indices, and leisure-time physical activity levels on coronary risk and health-related quality of life among military police officers from the State of Santa Catarina, Brazil. The sample included 165 military police officers who fulfilled the study’s inclusion criteria. The International Physical Activity Questionnaire and the Short Form Health Survey were used, in addition to a spreadsheet of socio-demographic, occupational and anthropometric data. Statistical analyses were performed using descriptive analysis followed by Spearman Correlation and multiple linear regression analysis using the backward method. The waist-to-height ratio was identified as a risk factor low health-related quality of life. In addition, the conicity index, fat percentage, years of service in the military police, minutes of work per day and leisure-time physical activity levels were identified as risk factors for coronary disease among police officers. These findings suggest that the Military Police Department should adopt an institutional policy that allows police officers to practice regular physical activity in order to maintain and improve their physical fitness, health, job performance, and quality of life.

Psychosocial work characteristics and sleep quality: a systematic review of longitudinal and intervention research.

PubMed

Van Laethem, Michelle; Beckers, Debby G J; Kompier, Michiel A J; Dijksterhuis, Ap; Geurts, Sabine A E

2013-11-01

The objective of this study was to review longitudinal and intervention studies examining the association between psychosocial work characteristics (eg, job demands, job control, and social support) and sleep quality. Our main research aims were to examine whether (i) psychosocial work characteristics are a predictor of sleep quality, and (ii) sleep quality, in turn, is a predictor of psychosocial work characteristics. A systematic literature search resulted in 20 relevant papers, of which 16 were longitudinal studies and 3 were intervention studies (1 study was discussed in separate papers). To quantify results, we assessed the strength of evidence of all examined associations and subsequently evaluated the studies' research quality based on predefined quality criteria. One intervention and three longitudinal studies studies were categorized as being of high-quality. In longitudinal studies, we found consistent and strong evidence for a negative relation between job demands and sleep quality as well as evidence for a positive relation between job control and sleep quality. Other psychosocial work characteristics were examined in an insufficient number of (high-quality) studies. Moreover, both intervention studies as well as studies investigating reversed and reciprocal relations are rare, which further limits the possibility of drawing conclusions on causality. Based on the current literature, it can be concluded that high job demands and low job control are predictors of poor sleep quality. More high-quality research is needed to examine the possible causal relationship between these and other psychosocial work characteristics with sleep quality, in addition to research focusing on reversed and reciprocal relations.

The More the Merrier? Multiple Parent-Adult Child Relations

ERIC Educational Resources Information Center

Ward, Russell A.; Spitze, Glenna; Deane, Glenn

2009-01-01

Although parent-adult child ties are generally positive, most parents have multiple children whose relations may yield collective ambivalence combining higher and lower quality. Little research has investigated these multiple relations. NSFH respondents aged 50+ with adult children (N = 2,270) are used to assess patterns of quality and contact…

Handling Qualities Optimization for Rotorcraft Conceptual Design

NASA Technical Reports Server (NTRS)

Lawrence, Ben; Theodore, Colin R.; Berger, Tom

2016-01-01

Over the past decade, NASA, under a succession of rotary-wing programs has been moving towards coupling multiple discipline analyses in a rigorous consistent manner to evaluate rotorcraft conceptual designs. Handling qualities is one of the component analyses to be included in a future NASA Multidisciplinary Analysis and Optimization framework for conceptual design of VTOL aircraft. Similarly, the future vision for the capability of the Concept Design and Assessment Technology Area (CD&A-TA) of the U.S Army Aviation Development Directorate also includes a handling qualities component. SIMPLI-FLYD is a tool jointly developed by NASA and the U.S. Army to perform modeling and analysis for the assessment of flight dynamics and control aspects of the handling qualities of rotorcraft conceptual designs. An exploration of handling qualities analysis has been carried out using SIMPLI-FLYD in illustrative scenarios of a tiltrotor in forward flight and single-main rotor helicopter at hover. Using SIMPLI-FLYD and the conceptual design tool NDARC integrated into a single process, the effects of variations of design parameters such as tail or rotor size were evaluated in the form of margins to fixed- and rotary-wing handling qualities metrics as well as the vehicle empty weight. The handling qualities design margins are shown to vary across the flight envelope due to both changing flight dynamic and control characteristics and changing handling qualities specification requirements. The current SIMPLI-FLYD capability and future developments are discussed in the context of an overall rotorcraft conceptual design process.

Health-Related Quality of Life of the Roma in Greece: The Role of Socio-Economic Characteristics and Housing Conditions.

PubMed

Pappa, Evelina; Chatzikonstantinidou, Simela; Chalkiopoulos, George; Papadopoulos, Angelos; Niakas, Dimitris

2015-06-12

The aim was to assess the health-related quality of life (HRQL) of the Roma and further to detect the significant determinants that are associated with their HRQL. The cross-sectional study involved 1068 Roma adults living in settlements (mean age 36). HRQL was measured by the Greek version of SF-36 Health Survey and further socio-demographic characteristics (sex, age, marital status, education, permanent occupation etc.) and housing conditions (stable housing, access to basic amenities such as drinkable water, drainage, electricity which compose material deprivation) were involved. Non parametric tests and multiple linear regression models were applied to identify the factors that have significant association with HRQL. After controlling for socio-demographic characteristics, health status and housing conditions, sex, age, education, chronic diseases, stable housing and material deprivation were found to be significant determinants of the Roma's HRQL. Men reported significantly better health than women as well as those who attended school compared to the illiterate. Chronic diseases were remarkably associated with poor HRQL from 10 units in MH (Mental Health) to 34 units in RP (Role Physical). Material deprivation was related to lower GH (General Health), and VT (Vitality) scores and higher RP (Role Physical) and RE (Role Emotional) scores. Chronic conditions and illiteracy are two key areas that contribute significantly to worse HRQL. Policies should be part of a comprehensive and holistic strategy for the Roma through intervention to education, housing and public health.

Family Socioeconomic Status, Cortisol, and Physical Health in Early Childhood: The Role of Advantageous Neighborhood Characteristics.

PubMed

Roubinov, Danielle S; Hagan, Melissa J; Boyce, W Thomas; Adler, Nancy E; Bush, Nicole R

2018-06-01

Children from families with lower socioeconomic status (SES) evidence greater physiological dysregulation and poorer health. Despite recognition of environmental contributors, little is known about the influence of neighborhood characteristics. The present study examined the moderating role of community-level risks and resources on the relation of family SES to children's daily cortisol output and physical health during the kindergarten year. In fall and spring of kindergarten, children's (N = 338) daily total cortisol was measured and parents and teachers rated children's global physical health. Parents reported family SES. Neighborhood characteristics were assessed using the Child Opportunity Index, a population-level tool that evaluates the quality of multiple domains of neighborhood attributes. In fall, children reared in lower SES family environments had higher cortisol when residing in lower quality (lower opportunity) neighborhoods (b = -.097, p < .001), but there was no relation between family SES and children's cortisol in more advantaged (higher opportunity) neighborhoods (b = -.023, p = .36). Lower family SES was prospectively associated with poorer physical health in spring (controlling for fall health) only among children living in lower opportunity neighborhoods (b = -.250, p = .018) and was unrelated to physical health among children residing in higher opportunity neighborhoods (b = .042, p = .70). Higher opportunity neighborhoods may protect against the negative consequences of low family SES on children's stress physiology and physical health. Public health interventions that bolster neighborhood opportunities may benefit young children reared in socioeconomically disadvantaged family environments.

Analysis of Clinicians' Perceptual Cough Evaluation.

PubMed

Laciuga, Helena; Brandimore, Alexandra E; Troche, Michelle S; Hegland, Karen W

2016-08-01

This study examined the relationships between subjective descriptors and objective airflow measures of cough. We hypothesized that coughs with specific airflow characteristics would share common subjective perceptual descriptions. Thirty clinicians (speech-language pathologists, otolaryngologists, and neurologists) perceptually evaluated ten cough audio samples with specific airflow characteristics determined by peak expiratory flow rate, cough expired volume, cough duration, and number of coughs in the cough epoch. Participants rated coughs by strength, duration, quality, quantity, and overall potential effectiveness for airway protection. Perception of cough strength and effectiveness was determined by the combination of presence of pre-expulsive compression phase, short peak expiratory airflow rate rise time, high peak expiratory flow rates, and high cough volume acceleration. Perception of cough abnormality was defined predominantly by descriptors of breathiness and strain. Breathiness was characteristic for coughs with either absent compression phases and relatively high expiratory airflow rates or coughs with significantly low expired volumes and reduced peak flow rates. In contrast, excessive strain was associated with prolonged compression phases and low expiratory airflow rates or the absence of compression phase with high peak expiratory rates. The study participants reached greatest agreement in distinguishing between single and multiple coughs. Their assessment of cough strength and effectiveness was less consistent. Finally, the least agreement was shown in determining the quality categories. Modifications of cough airflow can influence perceptual cough evaluation outcomes. However, the inconsistency of cough ratings among our participants suggests that a uniform cough rating system is required.

Application-Driven No-Reference Quality Assessment for Dermoscopy Images With Multiple Distortions.

PubMed

Xie, Fengying; Lu, Yanan; Bovik, Alan C; Jiang, Zhiguo; Meng, Rusong

2016-06-01

Dermoscopy images often suffer from blur and uneven illumination distortions that occur during acquisition, which can adversely influence consequent automatic image analysis results on potential lesion objects. The purpose of this paper is to deploy an algorithm that can automatically assess the quality of dermoscopy images. Such an algorithm could be used to direct image recapture or correction. We describe an application-driven no-reference image quality assessment (IQA) model for dermoscopy images affected by possibly multiple distortions. For this purpose, we created a multiple distortion dataset of dermoscopy images impaired by varying degrees of blur and uneven illumination. The basis of this model is two single distortion IQA metrics that are sensitive to blur and uneven illumination, respectively. The outputs of these two metrics are combined to predict the quality of multiply distorted dermoscopy images using a fuzzy neural network. Unlike traditional IQA algorithms, which use human subjective score as ground truth, here ground truth is driven by the application, and generated according to the degree of influence of the distortions on lesion analysis. The experimental results reveal that the proposed model delivers accurate and stable quality prediction results for dermoscopy images impaired by multiple distortions. The proposed model is effective for quality assessment of multiple distorted dermoscopy images. An application-driven concept for IQA is introduced, and at the same time, a solution framework for the IQA of multiple distortions is proposed.

Measurement accuracy of a stressed contact lens during its relaxation period

NASA Astrophysics Data System (ADS)

Compertore, David C.; Ignatovich, Filipp V.

2018-02-01

We examine the dioptric power and transmitted wavefront of a contact lens as it releases its handling stresses. Handling stresses are introduced as part of the contact lens loading process and are common across all contact lens measurement procedures and systems. The latest advances in vision correction require tighter quality control during the manufacturing of the contact lenses. The optical power of contact lenses is one of the critical characteristics for users. Power measurements are conducted in the hydrated state, where the lens is resting inside a solution-filled glass cuvette. In a typical approach, the contact lens must be subject to long settling times prior to any measurements. Alternatively, multiple measurements must be averaged. Apart from potential operator dependency of such approach, it is extremely time-consuming, and therefore it precludes higher rates of testing. Comprehensive knowledge about the settling process can be obtained by monitoring multiple parameters of the lens simultaneously. We have developed a system that combines co-aligned a Shack-Hartmann transmitted wavefront sensor and a time-domain low coherence interferometer to measure several optical and physical parameters (power, cylinder power, aberrations, center thickness, sagittal depth, and diameter) simultaneously. We monitor these parameters during the stress relaxation period and show correlations that can be used by manufacturers to devise methods for improved quality control procedures.

Improving multiple sclerosis management and collecting safety information in the real world: the MSDS3D software approach.

PubMed

Haase, Rocco; Wunderlich, Maria; Dillenseger, Anja; Kern, Raimar; Akgün, Katja; Ziemssen, Tjalf

2018-04-01

For safety evaluation, randomized controlled trials (RCTs) are not fully able to identify rare adverse events. The richest source of safety data lies in the post-marketing phase. Real-world evidence (RWE) and observational studies are becoming increasingly popular because they reflect usefulness of drugs in real life and have the ability to discover uncommon or rare adverse drug reactions. Areas covered: Adding the documentation of psychological symptoms and other medical disciplines, the necessity for a complex documentation becomes apparent. The collection of high-quality data sets in clinical practice requires the use of special documentation software as the quality of data in RWE studies can be an issue in contrast to the data obtained from RCTs. The MSDS3D software combines documentation of patient data with patient management of patients with multiple sclerosis. Following a continuous development over several treatment-specific modules, we improved and expanded the realization of safety management in MSDS3D with regard to the characteristics of different treatments and populations. Expert opinion: eHealth-enhanced post-authorisation safety study may complete the fundamental quest of RWE for individually improved treatment decisions and balanced therapeutic risk assessment. MSDS3D is carefully designed to contribute to every single objective in this process.

The quality of life, mental health, and perceived stigma of leprosy patients in Bangladesh.

PubMed

Tsutsumi, Atsuro; Izutsu, Takashi; Islam, Akramul Md; Maksuda, A N; Kato, Hiroshi; Wakai, Susumu

2007-06-01

The present study aims to determine the quality of life (QOL) and general mental health of leprosy patients compared with the general population, and evaluate contributing factors such as socio-economic characteristics and perceived stigma. A total of 189 patients (160 outpatients, 29 inpatients) and 200 controls without leprosy or other chronic diseases were selected from Dhaka district, Bangladesh, using stratified random sampling. A Bangladeshi version of a structured questionnaire including socio-demographic characteristics-the Bangla version of the World Health Organization Quality of Life Assessment BREF (WHOQOL-BREF)-was used to assess QOL; a Self-Reporting Questionnaire (SRQ) was used to evaluate general mental health; the Barthel Index to control activities of daily living (ADL); and the authors' Perceived Stigma Questionnaire was used to assess perceived stigma of patients with leprosy. Medical records were examined to evaluate disability grades and impairment. QOL and general mental health scores of leprosy patients were worse than those of the general population. Multiple regression analysis revealed that factors potentially contributing to the deteriorated QOL of leprosy patients were the presence of perceived stigma, fewer years of education, the presence of deformities, and a lower annual income. Perceived stigma showed the greatest association with adverse QOL. We conclude that there is an urgent need for interventions sensitive to the effects of perceived stigma, gender, and medical conditions to improve the QOL and mental health of Bangladeshi leprosy patients.

Home range and habitat use of juvenile green turtles (Chelonia mydas) in the northern Gulf of Mexico

USGS Publications Warehouse

Lamont, Margaret M.; Fujisaki, Ikuko; Stephens, Brail S.; Hackett, Caitlin

2015-01-01

Conclusions: Green turtles in St. Joseph Bay have relatively small home ranges and many contain multiple activity centers. The frequent use of channels by turtles suggests bathymetry plays a major role in habitat selection of juvenile green turtles, particularly as temperatures drop in winter. The quality and density of seagrass habitat in St. Joseph Bay and its proximity to deep channels appears to provide ideal conditions for juvenile greens. The results of this study help define characteristics of foraging habitat utilized by juvenile greens in the northern Gulf of Mexico that managers can use in creating protected areas such as aquatic preserves.

Poultry Meat Quality in Relation to Muscle Growth and Muscle Fiber Characteristics

PubMed Central

Ismail, Ishamri; Joo, Seon-Tea

2017-01-01

Variations in the definition of poultry meat quality exist because the quality traits are not solely based on intrinsic and extrinsic factors but also consumers’ preference. Appearance quality traits (AQT), eating quality traits (EQT), and reliance quality traits (RQT) are the major factors focused by the consumer before buying good quality of poultry meat. AQT and EQT of poultry meat are controlled by physical and biochemical characteristics of muscle fibers which can be categorized into a total number of fibers (TNF), cross-sectional area of fibers (CSAF), and fiber type composition (FTC). In poultry meat, it has been shown that muscle fiber properties play a key role in meat quality because numerous studies have reported the relationships between quality traits and fiber characteristics. Despite intensive research has been carried out to manipulate the muscle fiber to improve poultry meat quality, demand in a rapid growth of poultry muscle has correlated to the deterioration in the meat quality. The present paper reviews the definition of poultry meat quality, meat quality traits, and variations of meat quality. Also, this review presents recent knowledge underlying the relationship between poultry meat quality traits and muscle fiber characteristics. PMID:29725209

The impact of software quality characteristics on healthcare outcome: a literature review.

PubMed

Aghazadeh, Sakineh; Pirnejad, Habibollah; Moradkhani, Alireza; Aliev, Alvosat

2014-01-01

The aim of this study was to discover the effect of software quality characteristics on healthcare quality and efficiency indicators. Through a systematic literature review, we selected and analyzed 37 original research papers to investigate the impact of the software indicators (coming from the standard ISO 9126 quality characteristics and sub-characteristics) on some of healthcare important outcome indicators and finally ranked these software indicators. The results showed that the software characteristics usability, reliability and efficiency were mostly favored in the studies, indicating their importance. On the other hand, user satisfaction, quality of patient care, clinical workflow efficiency, providers' communication and information exchange, patient satisfaction and care costs were among the healthcare outcome indicators frequently evaluated in relation to the mentioned software characteristics. Regression Logistic Method was the most common assessment methodology, and Confirmatory Factor Analysis and Structural Equation Modeling were performed to test the structural model's fit. The software characteristics were considered to impact the healthcare outcome indicators through other intermediate factors (variables).

Responsive parenting is associated with improved type 1 diabetes-related quality of life

PubMed Central

Botello-Harbaum, Maria; Nansel, Tonja; Haynie, Denise; Iannotti, Ronald J.; Simons-Morton, Bruce

2008-01-01

Background Improved quality of life is an important treatment goal for children and adolescents with type 1 diabetes. While previous research supports a relationship between family environment and quality of life, little research has addressed the relationship of parenting style constructs to quality of life in children with chronic disease. The present investigation assesses the relationship of parent responsiveness and demandingness with diabetes-related quality of life among children and adolescents with type 1 diabetes. Methods Baseline and 12-month follow-up self-report assessments were collected on a sample of 81 children with type 1 diabetes participating in an efficacy trial of a behavioral intervention to enhance adherence. The sample had a mean age of 13.3 years (SD = 1.7) and duration of diabetes of 7.7 years (SD = 3.7). Multiple regression analyses were conducted to determine the relationship of parent responsiveness and demandingness to diabetes-related quality of life at each time point. Results After adjusting for demographic and diabetes characteristics, as well as diabetes-specific parent-child behaviors, parent responsiveness was significantly associated with baseline diabetes-related quality of life (B=.23; p=.04). This relationship was sustained at 12-month follow-up (B=.22; p=.04) after adjusting for baseline quality of life and treatment group assignment, suggesting that parent responsiveness is associated with improved quality of life. Conclusions Findings indicate the importance of a supportive and emotionally warm parenting style in promoting improved quality of life for children with type 1 diabetes. Appropriate parenting skills should be an element of diabetes family management health care. PMID:18796059

Evaluation of outpatient service quality in Eastern Saudi Arabia

PubMed Central

Fraihi, Khalid J. Al; FAMCO, Dip; FAMCO, Fellow; Latif, Shahid A.

2016-01-01

Objectives: To investigate perceptions and expectations of patients regarding hospital outpatient services by using a service quality gap model and factors influencing such gaps. Methods: In this cross-sectional descriptive study conducted between October and November 2014 in the outpatient waiting areas of a hospital in the Eastern Province of Saudi Arabia, a sample of 306 patients was selected by convenience sampling technique. The data was collected through an Arabic version of the service quality (SERVQUAL) questionnaire consisting of 2 parts: patients’ demographic characteristics, and 22 items scales of patients’ expectations and perceptions of SERVQUAL. The data was analyzed by confirmatory factor analysis, independent, and paired t samples tests and one way analysis of variance test. Results: The results showed that the proposed model for service quality dimensions had a good fit by satisfying the recommended values. The patients’ expectations exceeded perceptions in all service quality dimensions indicating statistically significant service quality gaps (t=26.3, p<0.000). Findings revealed that the empathy dimension contributed most patients’ expectations (4.7 ± 0.5) and perceptions (3.7 ± 0.8) scores, and responsiveness contributed least to expectations (4.5 ± 0.6) and perceptions (3.2 ± 0.8) scores. Prompt services showed highest service quality gap, while observation of privacy showed the smallest service quality gap in the statements. The study showed a significant association between gender, age, education, multiple visits, and service quality dimensions. Conclusion: The proposed model is valid and reliable and significant service quality gaps of all 5 dimensions need to be prioritized and addressed by focused improvement efforts of hospital management. PMID:27052285

Evaluation of outpatient service quality in Eastern Saudi Arabia. Patient's expectations and perceptions.

PubMed

Al Fraihi, Khalid J; Latif, Shahid A

2016-04-01

To investigate perceptions and expectations of patients regarding hospital outpatient services by using a service quality gap model and factors influencing such gaps. In this cross-sectional descriptive study conducted between October and November 2014 in the outpatient waiting areas of a hospital in the Eastern Province of Saudi Arabia, a sample of 306 patients was selected by convenience sampling technique. The data was collected through an Arabic version of the service quality (SERVQUAL) questionnaire consisting of 2 parts: patients' demographic characteristics, and 22 items scales of patients' expectations and perceptions of SERVQUAL. The data was analyzed by confirmatory factor analysis, independent, and paired t samples tests and one way analysis of variance test The results showed that the proposed model for service quality dimensions had a good fit by satisfying the recommended values. The patients' expectations exceeded perceptions in all service quality dimensions indicating statistically significant service quality gaps (t=26.3, p less than 0.000). Findings revealed that the empathy dimension contributed most patients' expectations (4.7 ± 0.5) and perceptions (3.7 ± 0.8) scores, and responsiveness contributed least to expectations (4.5 ± 0.6) and perceptions (3.2 ± 0.8) scores. Prompt services showed highest service quality gap, while observation of privacy showed the smallest service quality gap in the statements. The study showed a significant association between gender, age, education, multiple visits, and service quality dimensions. The proposed model is valid and reliable and significant service quality gaps of all 5 dimensions need to be prioritized and addressed by focused improvement efforts of hospital management.

Application of flowmeter and depth-dependent water quality data for improved production well construction.

PubMed

Gossell, M A; Nishikawa, T; Hanson, R T; Izbicki, J A; Tabidian, M A; Bertine, K

1999-01-01

Ground water production wells commonly are designed to maximize well yield and, therefore, may be screened over several water-bearing zones. These water-bearing zones usually are identified, and their hydrogeologic characteristics and water quality are inferred, on the basis of indirect data such as geologic and geophysical logs. Production well designs based on these data may result in wells that are drilled deeper than necessary and are screened through zones having low permeability or poor-quality ground water. In this study, we examined the application of flowmeter logging and depth-dependent water quality samples for the improved design of production wells in a complex hydrogeologic setting. As a demonstration of these techniques, a flowmeter log and depth-dependent water quality data were collected from a long-screened production well within a multilayered coastal aquifer system in the Santa Clara-Calleguas Basin, Ventura County, California. Results showed that the well yields most of its water from four zones that constitute 58% of the screened interval. The importance of these zones to well yield was not readily discernible from indirect geologic or geophysical data. The flowmeter logs and downhole water quality data also show that small quantities of poor-quality water could degrade the overall quality of water from the well. The data obtained from one well can be applied to other proposed wells in the same hydrologic basin. The application of flowmeter and depth-dependent water quality data to well design can reduce installation costs and improve the quantity and quality of water produced from wells in complex multiple-aquifer systems.

Application of flowmeter and depth-dependent water quality data for improved production well construction

USGS Publications Warehouse

Gossell, M.A.; Nishikawa, Tracy; Hanson, Randall T.; Izbicki, John A.; Tabidian, M.A.; Bertine, K.

1999-01-01

Ground water production wells commonly are designed to maximize well yield and, therefore, may be screened over several water-bearing zones. These water-bearing zones usually are identified, and their hydrogeologic characteristics and water quality are inferred, on the basis of indirect data such as geologic and geophysical logs. Production well designs based on these data may result in wells that are drilled deeper than necessary and are screened through zones having low permeability or poor-quality ground water. In this study, we examined the application of flowmeter logging and depth-dependent water quality samples for the improved design of production wells in a complex hydrogeologic setting. As a demonstration of these techniques, a flowmeter log and depth-dependent water quality data were collected from a long-screened production well within a multilayered coastal aquifer system in the Santa Clara-Calleguas Basin, Ventura County, California. Results showed that the well yields most of its water from four zones that constitute 58% of the screened interval. The importance of these zones to well yield was not readily discernible from indirect geologic or geophysical data. The flowmeter logs and downhole water quality data also show that small quantities of poor-quality water could degrade the overall quality of water from the well. The data obtained from one well can be applied to other proposed wells in the same hydrologic basin. The application of flowmeter and depth-dependent water quality data to well design can reduce installation costs and improve the quantity and quality of water produced from wells in complex multiple-aquifer systems.

Vulnerable patients' perceptions of health care quality and quality data.

PubMed

Raven, Maria Catherine; Gillespie, Colleen C; DiBennardo, Rebecca; Van Busum, Kristin; Elbel, Brian

2012-01-01

Little is known about how patients served by safety-net hospitals utilize and respond to hospital quality data. To understand how vulnerable, lower income patients make health care decisions and define quality of care and whether hospital quality data factor into such decisions and definitions. Mixed quantitative and qualitative methods were used to gather primary data from patients at an urban, tertiary-care safety-net hospital. The study hospital is a member of the first public hospital system to voluntarily post hospital quality data online for public access. Patients were recruited from outpatient and inpatient clinics. Surveys were used to collect data on participants' sociodemographic characteristics, health literacy, health care experiences, and satisfaction variables. Focus groups were used to explore a representative sample of 24 patients' health care decision making and views of quality. Data from focus group transcripts were iteratively coded and analyzed by the authors. Focus group participants were similar to the broader diverse, low-income clinic. Participants reported exercising choice in making decisions about where to seek health care. Multiple sources influenced decision-making processes including participants' own beliefs and values, social influences, and prior experiences. Hospital quality data were notably absent as a source of influence in health care decision making for this population largely because participants were unaware of its existence. Participants' views of hospital quality were influenced by the quality and efficiency of services provided (with an emphasis on the doctor-patient relationship) and patient centeredness. When presented with it, patients appreciated the hospital quality data and, with guidance, were interested in incorporating it into health care decision making. Results suggest directions for optimizing the presentation, content, and availability of hospital quality data. Future research will explore how similar populations form and make choices based on presentation of hospital quality data.

The Impact of Exercise Training on Living Quality in Multiple Sclerosis Individuals

ClinicalTrials.gov

2017-08-27

Multiple Sclerosis; Fatigue; Mental Status Change; Physical Disability; Physical Activity; Mental Impairment; Quality of Life; Disabilities Psychological; Disability Physical; Pain; Energy Supply; Deficiency; Motivation

Characteristics of a global classification system for perinatal deaths: a Delphi consensus study.

PubMed

Wojcieszek, Aleena M; Reinebrant, Hanna E; Leisher, Susannah Hopkins; Allanson, Emma; Coory, Michael; Erwich, Jan Jaap; Frøen, J Frederik; Gardosi, Jason; Gordijn, Sanne; Gulmezoglu, Metin; Heazell, Alexander E P; Korteweg, Fleurisca J; McClure, Elizabeth; Pattinson, Robert; Silver, Robert M; Smith, Gordon; Teoh, Zheyi; Tunçalp, Özge; Flenady, Vicki

2016-08-15

Despite the global burden of perinatal deaths, there is currently no single, globally-acceptable classification system for perinatal deaths. Instead, multiple, disparate systems are in use world-wide. This inconsistency hinders accurate estimates of causes of death and impedes effective prevention strategies. The World Health Organisation (WHO) is developing a globally-acceptable classification approach for perinatal deaths. To inform this work, we sought to establish a consensus on the important characteristics of such a system. A group of international experts in the classification of perinatal deaths were identified and invited to join an expert panel to develop a list of important characteristics of a quality global classification system for perinatal death. A Delphi consensus methodology was used to reach agreement. Three rounds of consultation were undertaken using a purpose built on-line survey. Round one sought suggested characteristics for subsequent scoring and selection in rounds two and three. The panel of experts agreed on a total of 17 important characteristics for a globally-acceptable perinatal death classification system. Of these, 10 relate to the structural design of the system and 7 relate to the functional aspects and use of the system. This study serves as formative work towards the development of a globally-acceptable approach for the classification of the causes of perinatal deaths. The list of functional and structural characteristics identified should be taken into consideration when designing and developing such a system.

Psychosocial job characteristics and psychological distress / well-being: the mediating role of personal goal facilitation.

PubMed

Pisanti, Renato; van der Doef, Margot; Maes, Stan; Violani, Cristiano; Lazzari, David

2016-01-01

This study examined the mediating role of personal goal facilitation through work (PGFW), defined as perceptions of the extent to which one's job facilitates the attainment of one's personal goals, in the association between psychosocial job characteristics and psychological distress and job-related well-being. Questionnaire data from 217 nurses (84% female, with a mean age of 42.7 years, SD=7.2) were analyzed. Participants completed the following measures: the Leiden Quality of Work Questionnaire for Nurses, Workplace Goal Facilitation Inventory, Maslach Burnout Inventory-Human Services Survey, and Utrecht Work Engagement Scale (short version). A cross-sectional study design was applied. Hierarchical multiple regression analyses were conducted. The results indicated that unfavorable psychosocial job characteristics (high demands, low control, and low social support) were associated with lower PGFW. Furthermore, personal goal facilitation through work explained significant additional variance (from 2 to 11%) in psychological distress (somatic complaints and emotional exhaustion) and job-related well-being (personal accomplishment, job satisfaction, and work engagement), controlling for demographic indicators and psychosocial job characteristics. Finally, the results provided support for the mediating effects of PGFW between all psychosocial job characteristics and all outcomes, except in the case of depersonalization. This study suggests that hindered personal goal facilitation may be a mechanism through which psychosocial job characteristics have a negative impact on employees' well-being.

The effect of family characteristics on the recovery of burn injuries in children.

PubMed

Sheridan, Robert L; Lee, Austin F; Kazis, Lewis E; Liang, Matthew H; Li, Nien-Chen; Hinson, Michelle I; Bauk, Helena; Meyer, Walter J; Stubbs, Teresa K; Palmieri, Tina L; Tompkins, Ronald G

2012-09-01

Interactions between family members and characteristics of family life and function may affect a child's recovery from burn injury. We prospectively examined the relationship between family characteristics and physical and psychosocial recovery from burns. The families of 399 burned children aged 5 years to 18 years admitted to one of four Shriners Hospitals for Children for management of acute burns completed the Family Environment Scale within 7 days of admission and then the American Burn Association/Shriners Hospitals for Children Burn Outcome Questionnaire (BOQ) at baseline, 3, 6, 12, 18, 24, 36, and 48 months. Generalized estimating equations with random effects for the time since burn were used to track recovery of the BOQ patient-centered domains associated with baseline family characteristics during the course of the study. The children had a mean age of 11 years and burn size of 32% total body surface area burned. Higher Family Environment Scale scores in cohesion, independence, organization, and active recreational orientation were associated with significantly better rates of recovery in multiple BOQ domains of health-related quality of life. Higher scores in conflict and achievement orientation predicted statistically significant impaired recovery. Higher expressiveness predicted greater difficulty with school reentry. Family characteristics affect the recovery of children after serious burns. Some of these may be amenable to focused anticipatory family interventions to help optimize outcomes. In particular, those characteristics that impair school reentry should be targeted.

Association analysis and marker development for grain quality traits using USDA diverse rice germplasm collections

USDA-ARS?s Scientific Manuscript database

New molecular markers are being designed and validated for grain quality improvement based on computationally assisted analysis of genome wide association study (GWAS) findings across multiple panels and multiple grain quality traits. The traits include grain dimensions, apparent amylose content (A...

Substrate Temperature effect on the transition characteristics of Vanadium (IV) oxide

NASA Astrophysics Data System (ADS)

Yang, Tsung-Han; Wei, Wei; Jin, Chunming; Narayan, Jay

2008-10-01

One of the semiconductor to metal transition material (SMT) is Vanadium Oxide (VO2) which has a very sharp transition temperature close to 340 K as the crystal structure changes from monoclinic phase (semiconductor) into tetragonal phase (metal phase). We have grown high-quality epitaxial vanadium oxide (VO2) films on sapphire (0001) substrates by pulsed laser deposition for oxygen pressure 10-2torr and obtained interesting results without further annealing treatments. The epitaxial growth via domain matching epitaxy, where integral multiples of planes matched across the film-substrate interface. We were able to control the transition characteristics such as the sharpness (T), amplitude (A) of SMT transition and the width of thermal hysteresis (H) by altering the substrate temperature from 300 ^oC, 400 ^oC, 500 ^oC, and 600 ^oC. We use the XRD to identify the microstructure of film and measure the optical properties of film. Finally the transition characteristics is observed by the resistance with the increase of temperature by Van Der Pauw method from 25 to 100 ^oC to measure the electrical resistivity hystersis loop during the transition temperature.

Selected family characteristics are associated with adolescents' subjective health complaints.

PubMed

Petanidou, Dimitra; Mihas, Constantinos; Dimitrakaki, Christine; Kolaitis, Gerasimos; Tountas, Yannis

2014-02-01

This national study of schoolchildren in Greece investigated the association between adolescents' subjective health complaints (SHC) and a number of family characteristics. Questionnaires were completed by a random, school-based sample of children from 12 to 18 years of age, and one of their parents (76.6% mothers), in 2003. Data from 1041 adolescent-parent pairs were analysed. Multiple linear regression analysis was used to assess the associations between the adolescent's SHC and the following characteristics: parent's marital status, parent's physical and mental health status, parent's worries about their child's SHC, the parent-child relationship, family cohesion, family socio-economic status and the adolescent's sex and age. The analysis showed that the adolescents' SHC were independently and significantly correlated with poor parental subjective mental health status, poor quality parent-child relationships and parental worry. There were also associations between levels of SHC and female and older adolescents. Certain family features can be seen as potential contributing factors to SHC in adolescence and should therefore constitute complementary targets for prevention and treatment planning. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Hospital Value-Based Purchasing Performance: Do Organizational and Market Characteristics Matter?

PubMed

Spaulding, Aaron; Edwardson, Nick; Zhao, Mei

The hospital value-based purchasing (HVBP) program of the Centers for Medicare & Medicaid Services challenges hospitals to deliver high-quality care or face a reduction in Medicare payments. How do different organizational structures and market characteristics enable or inhibit successful transition to this new model of value-based care? To address that question, this study employs an institutional theory lens to test whether certain organizational structures and market characteristics mediate hospitals' ability to perform across HVBP domains.Data from the 2014 American Hospital Association Annual Survey Database, Area Health Resource File, the Medicare Hospital Compare Database, and the association between external environment and hospital performance are assessed through multiple regression analysis. Results indicate that hospitals that belong to a system are more likely than independent hospitals to score highly on the domains associated with the HVBP incentive arrangement. However, varying and sometimes counterintuitive market influences bring different dimensions to the HVBP program. A hospital's ability to score well in this new value arrangement may be heavily based on the organization's ability to learn from others, implement change, and apply the appropriate amount of control in various markets.

Improved statistical signal detection in pharmacovigilance by combining multiple strength-of-evidence aspects in vigiRank.

PubMed

Caster, Ola; Juhlin, Kristina; Watson, Sarah; Norén, G Niklas

2014-08-01

Detection of unknown risks with marketed medicines is key to securing the optimal care of individual patients and to reducing the societal burden from adverse drug reactions. Large collections of individual case reports remain the primary source of information and require effective analytics to guide clinical assessors towards likely drug safety signals. Disproportionality analysis is based solely on aggregate numbers of reports and naively disregards report quality and content. However, these latter features are the very fundament of the ensuing clinical assessment. Our objective was to develop and evaluate a data-driven screening algorithm for emerging drug safety signals that accounts for report quality and content. vigiRank is a predictive model for emerging safety signals, here implemented with shrinkage logistic regression to identify predictive variables and estimate their respective contributions. The variables considered for inclusion capture different aspects of strength of evidence, including quality and clinical content of individual reports, as well as trends in time and geographic spread. A reference set of 264 positive controls (historical safety signals from 2003 to 2007) and 5,280 negative controls (pairs of drugs and adverse events not listed in the Summary of Product Characteristics of that drug in 2012) was used for model fitting and evaluation; the latter used fivefold cross-validation to protect against over-fitting. All analyses were performed on a reconstructed version of VigiBase(®) as of 31 December 2004, at around which time most safety signals in our reference set were emerging. The following aspects of strength of evidence were selected for inclusion into vigiRank: the numbers of informative and recent reports, respectively; disproportional reporting; the number of reports with free-text descriptions of the case; and the geographic spread of reporting. vigiRank offered a statistically significant improvement in area under the receiver operating characteristics curve (AUC) over screening based on the Information Component (IC) and raw numbers of reports, respectively (0.775 vs. 0.736 and 0.707, cross-validated). Accounting for multiple aspects of strength of evidence has clear conceptual and empirical advantages over disproportionality analysis. vigiRank is a first-of-its-kind predictive model to factor in report quality and content in first-pass screening to better meet tomorrow's post-marketing drug safety surveillance needs.

Double jeopardy: assessing the association between internal displacement, housing quality and chronic illness in a low-income neighborhood.

PubMed

Habib, Rima R; Yassin, Nasser; Ghanawi, Joly; Haddad, Pascale; Mahfoud, Ziyad

2011-04-01

PURPOSE: This study analyzed associations between war-related internal displacement, housing quality and the prevalence of chronic illness in Nabaa, a low-income neighborhood on the outskirts of Beirut, Lebanon. METHODS: A cross-sectional survey of sociodemographics, household characteristics and health conditions of the study population was carried out in 2002. Using a structured questionnaire, the research team surveyed 1,151 households representing 4,987 residents of all ages. The survey was administered to a proxy respondent from each household in face-to-face interviews. A multiple logistic regression model using the generalized estimation equation method was constructed to assess the simultaneous effect of displacement and housing quality on reported ill health, while adjusting for potential confounders. RESULTS: Housing quality and internal displacement were strongly associated with occurrences of chronic illness. The most vulnerable respondents were older residents, females and internally displaced people, who reported high rates of chronic illnesses. Residents with high levels of education were less likely to report a chronic illness than those that had elementary education or less. CONCLUSION: Nabaa residents' experience of poor health was associated with inadequate housing quality. Moreover, residents who have been displaced experience worse living conditions and were more likely to experience poor health than those who were not displaced. These results reveal a need for policies to improve housing quality and alleviate war-related consequences in low-income neighborhoods.

How does employment quality relate to health and job satisfaction in Europe? A typological approach.

PubMed

Van Aerden, Karen; Puig-Barrachina, Vanessa; Bosmans, Kim; Vanroelen, Christophe

2016-06-01

The changing nature of employment in recent decades, due to an increased emphasis on flexibility and competitiveness in European labour markets, compels the need to assess the consequences of contemporary employment situations for workers. This article aims to study the relation between the quality of employment and the health and well-being of European workers, using data from the 2010 European Working Conditions Survey. A typology of employment arrangements, mapping out employment quality in the European labour force, is constructed by means of a Latent Class Cluster Analysis. This innovative approach shows that it is possible to condense multiple factors characterising the employment situation into five job types: Standard Employment Relationship-like (SER-like), instrumental, precarious unsustainable, precarious intensive and portfolio jobs. Binary logistic regression analyses show that, controlling for other work quality characteristics, this employment quality typology is related to self-perceived job satisfaction, general health and mental health. Precarious intensive jobs are associated with the worst and SER-like jobs with the best health and well-being situation. The findings presented in this study indicate that, among European wage workers, flexible and de-standardised employment tends to be related to lower job satisfaction, general health and mental health. The quality of employment is thus identified as an important social determinant of health (inequalities) in Europe. Copyright © 2016 Elsevier Ltd. All rights reserved.

What Predicts Online Health Information-Seeking Behavior Among Egyptian Adults? A Cross-Sectional Study.

PubMed

Ghweeba, Mayada; Lindenmeyer, Antje; Shishi, Sobhi; Abbas, Mostafa; Waheed, Amani; Amer, Shaymaa

2017-06-22

Over the last decade, the Internet has become an important source of health-related information for a wide range of users worldwide. Yet, little is known about the personal characteristics of Egyptian Internet users who search for online health information (OHI). The aim of the study was to identify the personal characteristics of Egyptian OHI seekers and to determine any associations between their personal characteristics and their health information-seeking behavior.  This cross-sectional questionnaire study was conducted from June to October 2015. A Web-based questionnaire was sent to Egyptian users aged 18 years and older (N=1400) of a popular Arabic-language health information website. The questionnaire included (1) demographic characteristics; (2) self-reported general health status; and (3) OHI-seeking behavior that included frequency of use, different topics sought, and self-reported impact of obtained OHI on health behaviors. Data were analyzed using descriptive statistics and multiple regression analysis. A total of 490 participants completed the electronic questionnaire with a response rate equivalent to 35.0% (490/1400). Regarding personal characteristics, 57.1% (280/490) of participants were females, 63.4% (311/490) had a university level qualification, and 37.1% (182/490) had a chronic health problem. The most commonly sought OHI by the participants was nutrition-related. Results of the multiple regression analysis showed that 31.0% of the variance in frequency of seeking OHI among Egyptian adults can be predicted by personal characteristics. Participants who sought OHI more frequently were likely to be female, of younger age, had higher education levels, and good self-reported general health. Our results provide insights into personal characteristics and OHI-seeking behaviors of Egyptian OHI users. This will contribute to better recognize their needs, highlight ways to increase the availability of appropriate OHI, and may lead to the provision of tools allowing Egyptian OHI users to navigate to the highest-quality health information. ©Mayada Ghweeba, Antje Lindenmeyer, Sobhi Shishi, Mostafa Abbas, Amani Waheed, Shaymaa Amer. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.06.2017.

Social-emotional characteristics of gifted accelerated and non-accelerated students in the Netherlands.

PubMed

Hoogeveen, Lianne; van Hell, Janet G; Verhoeven, Ludo

2012-12-01

In the studies of acceleration conducted so far a multidimensional perspective has largely been neglected. No attempt has been made to relate social-emotional characteristics of accelerated versus non-accelerated students in perspective of environmental factors. In this study, social-emotional characteristics of accelerated gifted students in the Netherlands were examined in relation to personal and environmental factors. Self-concept and social contacts of accelerated (n = 148) and non-accelerated (n = 55) gifted students, aged 4 to 27 (M = 11.22, SD = 4.27) were measured. Self-concept and social contacts of accelerated and non-accelerated gifted students were measured using a questionnaire and a diary, and parents of these students evaluated their behavioural characteristics. Gender and birth order were studied as personal factors and grade, classroom, teachers' gender, teaching experience, and the quality of parent-school contact as environmental factors. The results showed minimal differences in the social-emotional characteristics of accelerated and non-accelerated gifted students. The few differences we found favoured the accelerated students. We also found that multiple grade skipping does not have negative effects on social-emotional characteristics, and that long-term effects of acceleration tend to be positive. As regards the possible modulation of personal and environmental factors, we merely found an impact of such factors in the non-accelerated group. The results of this study strongly suggest that social-emotional characteristics of accelerated gifted students and non-accelerated gifted students are largely similar. These results thus do not support worries expressed by teachers about the acceleration of gifted students. Our findings parallel the outcomes of earlier studies in the United States and Germany in that we observed that acceleration does not harm gifted students, not even in the case of multiple grade skipping. On the contrary, there is a suggestion in the data that accelerated students are more socially competent than non-accelerated students. The findings in this study can reassure those parents and teachers who worry about the social-emotional consequences of acceleration in school: If a student is gifted, acceleration seems to be a sound and, in many cases, appropriate measure in gifted education. ©2011 The British Psychological Society.

What Predicts Online Health Information-Seeking Behavior Among Egyptian Adults? A Cross-Sectional Study

PubMed Central

Ghweeba, Mayada; Shishi, Sobhi; Abbas, Mostafa; Waheed, Amani; Amer, Shaymaa

2017-01-01

Background Over the last decade, the Internet has become an important source of health-related information for a wide range of users worldwide. Yet, little is known about the personal characteristics of Egyptian Internet users who search for online health information (OHI). Objective The aim of the study was to identify the personal characteristics of Egyptian OHI seekers and to determine any associations between their personal characteristics and their health information-seeking behavior. Methods  This cross-sectional questionnaire study was conducted from June to October 2015. A Web-based questionnaire was sent to Egyptian users aged 18 years and older (N=1400) of a popular Arabic-language health information website. The questionnaire included (1) demographic characteristics; (2) self-reported general health status; and (3) OHI-seeking behavior that included frequency of use, different topics sought, and self-reported impact of obtained OHI on health behaviors. Data were analyzed using descriptive statistics and multiple regression analysis. Results A total of 490 participants completed the electronic questionnaire with a response rate equivalent to 35.0% (490/1400). Regarding personal characteristics, 57.1% (280/490) of participants were females, 63.4% (311/490) had a university level qualification, and 37.1% (182/490) had a chronic health problem. The most commonly sought OHI by the participants was nutrition-related. Results of the multiple regression analysis showed that 31.0% of the variance in frequency of seeking OHI among Egyptian adults can be predicted by personal characteristics. Participants who sought OHI more frequently were likely to be female, of younger age, had higher education levels, and good self-reported general health. Conclusions Our results provide insights into personal characteristics and OHI-seeking behaviors of Egyptian OHI users. This will contribute to better recognize their needs, highlight ways to increase the availability of appropriate OHI, and may lead to the provision of tools allowing Egyptian OHI users to navigate to the highest-quality health information. PMID:28642216

Social support and quality of life in a group of cancer patients (Ankara, Turkey).

PubMed

Yilmaz, Mustafa Soner; Piyal, Birgül; Akdur, Recep

2017-06-12

Cancer has become an important public health challenge all around the world. Though the demographic and clinical features of cancer patients are well documented in Turkey, the establishment of social support networks has been somewhat neglected. The aim of the study was to assess cancer patients' perceived social support and quality of life characteristics. The Multidimensional Perceived Social Support Scale, European Organization of Research and Treatment of Cancer Quality of Life Questionnaire, and Turkish version of the EUROHIS measurements were obtained from the study group. Associations between the scores and sociodemographic variables of the patients were evaluated. Determination of the best predictors that affect social support perception scores was performed by multiple linear regression analysis. A total of 364 patients (217 females, 147 males) were analyzed. Regarding the mean scores of perceived social support, statistically significant differences were found between education, perceived economic status, and ECOG groups (P < 0.001). The best predictors that have an effect on perceived social support need to be studied in depth with further research.

Mixed methods research in music therapy research.

PubMed

Bradt, Joke; Burns, Debra S; Creswell, John W

2013-01-01

Music therapists have an ethical and professional responsibility to provide the highest quality care possible to their patients. Much of the time, high quality care is guided by evidence-based practice standards that integrate the most current, available research in making decisions. Accordingly, music therapists need research that integrates multiple ways of knowing and forms of evidence. Mixed methods research holds great promise for facilitating such integration. At this time, there have not been any methodological articles published on mixed methods research in music therapy. The purpose of this article is to introduce mixed methods research as an approach to address research questions relevant to music therapy practice. This article describes the core characteristics of mixed methods research, considers paradigmatic issues related to this research approach, articulates major challenges in conducting mixed methods research, illustrates four basic designs, and provides criteria for evaluating the quality of mixed methods articles using examples of mixed methods research from the music therapy literature. Mixed methods research offers unique opportunities for strengthening the evidence base in music therapy. Recommendations are provided to ensure rigorous implementation of this research approach.

Of Small Beauties and Large Beasts: The Quality of Distractors on Multiple-Choice Tests Is More Important than Their Quantity

ERIC Educational Resources Information Center

Papenberg, Martin; Musch, Jochen

2017-01-01

In multiple-choice tests, the quality of distractors may be more important than their number. We therefore examined the joint influence of distractor quality and quantity on test functioning by providing a sample of 5,793 participants with five parallel test sets consisting of items that differed in the number and quality of distractors.…

Social characteristics and care needs of older persons with medically unexplained symptoms: a case-control study.

PubMed

Hanssen, Denise J C; Oude Voshaar, Richard C; Naarding, Paul; Rabeling-Keus, Inge M; Olde Hartman, Tim C; Lucassen, Peter L B J

2016-12-01

Research in younger patients with medically unexplained symptoms (MUS) has shown impairments in social functioning, such as loneliness and a reduced quality of the patient-doctor relationship. As far as we know, no studies have been performed on social functioning in older MUS patients; self-reported care needs of older MUS patients remain unknown. To explore social characteristics and care needs of older persons with chronic MUS, when compared to older persons with chronic medically explained symptoms (MES). Patient characteristics of 107 older persons (>60 years) with chronic MUS were compared to 150 older persons with chronic MES in a case-control design. Participants were recruited via advertisements, general practices and a specialized clinic. All participants completed questionnaires on social functioning; the Camberwell Assessment of Need for the Elderly was used to draw up care needs. Linear regression analyses were performed to explore the association between social characteristics and group (MUS/MES), adjusted for demographic and physical determinants. Multiple chi-square tests were performed to detect between-group differences regarding care needs. After adjustments, older MUS patients were slightly but significantly lonelier, reported a somewhat lower quality of their patient-doctor relationship, but reported equal social support levels when compared to MES patients. MUS patients more often reported unmet care needs regarding health and information provision about their health status. Only small differences in social functioning were found between older MUS and MES patients. Possibly, training future doctors in giving acceptable explanations for the patient's complaints could improve the unmet care need of information provision in older MUS patients. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Determinants of patient satisfaction with hospital health care in psychiatry: results based on the SATISPSY-22 questionnaire

PubMed Central

Zendjidjian, Xavier Y; Auquier, Pascal; Lançon, Christophe; Loundou, Anderson; Parola, Nathalie; Faugère, Melanie; Boyer, Laurent

2014-01-01

Background The aim of our study was to identify patient- and care-related factors that are associated with patients’ satisfaction with psychiatric hospital care, using a specific, self-administered questionnaire based exclusively on the patient’s point of view: the Satisfaction with Psychiatry Care Questionnaire-22 (SATISPSY-22). Methods This cross-sectional study was conducted in the psychiatric departments of two French public university teaching hospitals. The data collected included sociodemographic information, clinical characteristics, care characteristics, and the SATISPSY-22. A multivariate analysis using multiple linear regressions was performed to determine the variables potentially associated with satisfaction levels. Results Two hundred seventy patients were enrolled in our study. Only one moderate association was found between satisfaction and sociodemographic characteristics: the personal experience dimension with age (β=0.15). Clinical improvement was moderately associated with higher global satisfaction (β=−0.15), higher satisfaction with quality of care (β=−0.19), and higher satisfaction with food (β=−0.18). Stronger associations with satisfaction were found for care characteristics, particularly the therapeutic alliance with all of the satisfaction dimensions (β, 0.20–0.43) except food, and for seclusion with global satisfaction (β=−0.33) and personal experience (β=−0.32). Patients with previous hospitalization also had a higher level of satisfaction with quality of care compared with patients who were admitted for the first time (β=−0.15). Conclusion This study has identified a number of potential determinants of satisfaction. The therapeutic relationship and seclusion were the most important features associated with a patient’s satisfaction. These factors might be amenable through intervention, which, in turn, might be expected to improve satisfaction, patients’ management, and health outcomes in psychiatric hospitals. PMID:25368515

Risk Factors Associated With Chemotherapy-Induced Nausea in the Week Prior to the Next Cycle and Impact of Nausea on Quality of Life Outcomes.

PubMed

Singh, Komal P; Kober, Kord M; Dhruva, Anand A; Flowers, Elena; Paul, Steve M; Hammer, Marilyn J; Cartwright, Frances; Wright, Fay; Conley, Yvette P; Levine, Jon D; Miaskowski, Christine

2018-05-29

Despite current advances in antiemetic treatments, between 19% to 58% of oncology patients experience chemotherapy-induced nausea (CIN). Aims of this post hoc exploratory analysis were to determine occurrence, severity, and distress of CIN and evaluate for differences in demographic and clinical characteristics, symptom severity, stress; and quality of life (QOL) outcomes between oncology patients who did and did not report CIN in the week prior to CTX. Demographic, clinical, symptom, and stress characteristics associated with CIN occurrence were determined. Patients (n=1296) completed questionnaires that provided information on demographic and clinical characteristics, symptom severity, stress, and QOL. Univariate analyses evaluated for differences in demographic and clinical characteristics, symptom severity, stress, and QOL scores between the two patient groups. Multiple logistic regression analysis was used to evaluate for factors associated with nausea group membership. Of the 1296 patients, 47.5% reported CIN. In the CIN group, 15% rated CIN as severe and 23% reported high distress. Factors associated with CIN included: less education; having childcare responsibilities; poorer functional status; higher levels of depression, sleep disturbance, evening fatigue, and intrusive thoughts; as well as receipt of CTX on a 14-day CTX cycle and receipt of an antiemetic regimen that contained serotonin receptor antagonist and steroid. Patients in the CIN group experienced clinically meaningful decrements in QOL. This study identified new factors (e.g., poorer functional status, stress) associated with CIN occurrence. CIN negatively impacted patients' QOL. Pre-emptive and ongoing interventions may alleviate CIN occurrence in high risk patients. Copyright © 2018. Published by Elsevier Inc.

Snacking and Diet Quality Are Associated With the Coping Strategies Used By a Socioeconomically Diverse Urban Cohort of African-American and White Adults.

PubMed

Fanelli Kuczmarski, Marie; Cotugna, Nancy; Pohlig, Ryan T; Beydoun, May A; Adams, Erica L; Evans, Michele K; Zonderman, Alan B

2017-09-01

Stress affects health-related quality of life through several pathways, including physiological processes and health behaviors. There is always a relationship between stress (the stimulus) and coping (the response). The relationship between snacking and snackers' diet quality and stress coping is a topic overlooked in research. The study was primarily designed to determine whether energy provided by snacks and diet quality were associated with coping behaviors to manage stress. We analyzed a baseline cohort of the Healthy Aging in Neighborhoods of Diversity across the Life Span study (2004 to 2009). The sample was composed of 2,177 socioeconomically diverse African-American and white adults who resided in Baltimore, MD. Energy from snacks was calculated from 2 days of 24-hour dietary recalls collected using the US Department of Agriculture's Automated Multiple Pass Method. Snack occasions were self-reported as distinct eating occasions. Diet quality was evaluated by the Healthy Eating Index-2010. Multiple regression analyses were used to determine whether coping factors were associated with either energy provided by snacks or Healthy Eating Index-2010, adjusting for age, sex, race, socioeconomic status, education, literacy, and perceived stress. Coping was measured by the Brief COPE Inventory with instrument variables categorized into three factors: problem-focused coping, emotion-focused coping, and use of support. Perceived stress was measured with the 4-item Perceived Stress Scale. Adjusting for perceived stress and selected demographic characteristics, emotion-focused coping strategies were associated with greater energy intakes from snacks (P=0.020), and use of coping strategies involving support was positively associated with better diet quality (P=0.009). Energy contributed by snacks and diet quality were affected by the strategy that an individual used to cope with stress. The findings suggest that health professionals working with individuals seeking guidance to modify their eating practices should assess a person's coping strategies to manage stress. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Severely impaired bone material quality in Chihuahua zebrafish resembles classical dominant human osteogenesis imperfecta.

PubMed

Fiedler, Imke A K; Schmidt, Felix N; Wölfel, Eva M; Plumeyer, Christine; Milovanovic, Petar; Gioia, Roberta; Tonelli, Francesca; Bale, Hrishikesh A; Jähn, Katharina; Besio, Roberta; Forlino, Antonella; Busse, Björn

2018-04-17

Excessive skeletal deformations and brittle fractures in the vast majority of patients suffering from osteogenesis imperfecta (OI) are a result of substantially reduced bone quality. Since the mechanical competence of bone is dependent on the tissue characteristics at small length scales, it is of crucial importance to assess how osteogenesis imperfecta manifests at the micro- and nanoscale of bone. In this context, the Chihuahua (Chi/ +) zebrafish, carrying a heterozygous glycine substitution in the α1 chain of collagen type I, has recently been proposed as suitable animal model of classical dominant OI, showing skeletal deformities, altered mineralization patterns and a smaller body size. This study assessed the bone quality properties of Chi/+ at multiple length scales using micro-computed tomography (micro-CT), histomorphometry, quantitative back-scattered electron imaging, Fourier transform infrared spectroscopy, nanoindentation and X-ray microscopy. At the skeletal level, Chi/+ display smaller body size, deformities and fracture calli in the ribs. Morphological changes at the whole bone level showed that the vertebrae in Chi/+ had a smaller size, smaller thickness and distorted shape. At the tissue level, Chi/+ displayed a higher degree of mineralization, lower collagen maturity, lower mineral maturity, altered osteoblast morphology, and lower osteocyte lacunar density compared to WT. The alterations in the cellular, compositional and structural properties of Chi/+ bones bear an explanation for the impaired local mechanical properties, which promote an increase in overall bone fragility in Chi/ +. The quantitative assessment of bone quality in Chi/+ thus further validates this mutant as an important model reflecting osseous characteristics associated with human classical dominant osteogenesis imperfecta. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Psychosocial Characteristics of Children with Central Disorders of Hypersomnolence Versus Matched Healthy Children

PubMed Central

Avis, Kristin T.; Shen, Jiabin; Weaver, Patrick; Schwebel, David C.

2015-01-01

Background: Hypersomnia of central origin from narcolepsy or idiopathic hypersomnia (IHS) is characterized by pathological levels of excessive daytime sleepiness (EDS). Central hypersomnia has historically been underdiagnosed and poorly understood, especially with respect to its impact on daytime functioning and quality of life in children. Objective: Describe the psychosocial adjustment of children treated for narcolepsy or IHS on school performance, quality of life, and physical/extracurricular activities. Methods: Using a matched case control design, we compared child self- and parent-reported data from thirty-three 8- to 16-year-olds with an established diagnosis of narcolepsy or IHS, according to ICSD-2 criteria, to that of 33 healthy children matched by age, race/ethnicity, gender, and household income. Assessments evaluated academic performance, quality of life and wellness, sleepiness, and participation in extracurricular activities. Results: Compared to healthy controls, children with central hypersomnia had poorer daytime functioning in multiple domains. Children with hypersomnia missed more days of school and had lower grades than healthy controls. Children with hypersomnia had poorer quality of life by both parent and child report. Children with hypersomnia were significantly sleepier, had higher BMI, and were more likely to report a history of recent injury. Finally, children with hypersomnia engaged in fewer after-school activities than healthy controls. Conclusions: A range of significant psychosocial consequences are reported in children with hypersomnia even after a diagnosis has been made and treatments initiated. Health care professionals should be mindful of the psychosocial problems that may present in children with hypersomnia over the course of treatment. Citation: Avis KT, Shen J, Weaver P, Schwebel DC. Psychosocial characteristics of children with central disorders of hypersomnolence versus matched healthy children. J Clin Sleep Med 2015;11(11):1281–1288. PMID:26285115

Symptomatic therapy in multiple sclerosis

PubMed Central

Frohman, Teresa C.; Castro, Wanda; Shah, Anjali; Courtney, Ardith; Ortstadt, Jeffrey; Davis, Scott L.; Logan, Diana; Abraham, Thomas; Abraham, Jaspreet; Remington, Gina; Treadaway, Katherine; Graves, Donna; Hart, John; Stuve, Olaf; Lemack, Gary; Greenberg, Benjamin; Frohman, Elliot M.

2011-01-01

Multiple sclerosis is the most common disabling neurological disease of young adults. The ability to impact the quality of life of patients with multiple sclerosis should not only incorporate therapies that are disease modifying, but should also include a course of action for the global multidisciplinary management focused on quality of life and functional capabilities. PMID:21694806

Can job redesign interventions influence a broad range of employee outcomes by changing multiple job characteristics? A quasi-experimental study.

PubMed

Holman, David; Axtell, Carolyn

2016-07-01

Many job redesign interventions are based on a multiple mediator-multiple outcome model in which the job redesign intervention indirectly influences a broad range of employee outcomes by changing multiple job characteristics. As this model remains untested, the aim of this study is to test a multiple mediator-multiple outcome model of job redesign. Multilevel analysis of data from a quasi-experimental job redesign intervention in a call center confirmed the hypothesized model and showed that the job redesign intervention affected a broad range of employee outcomes (i.e., employee well-being, psychological contract fulfillment, and supervisor-rated job performance) through changes in 2 job characteristics (i.e., job control and feedback). The results provide further evidence for the efficacy and mechanisms of job redesign interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The contemporary management of prostate cancer in the United States: lessons from the cancer of the prostate strategic urologic research endeavor (CapSURE), a national disease registry.

PubMed

Cooperberg, Matthew R; Broering, Jeanette M; Litwin, Mark S; Lubeck, Deborah P; Mehta, Shilpa S; Henning, James M; Carroll, Peter R

2004-04-01

The epidemiology and treatment of prostate cancer have changed dramatically in the prostate specific antigen era. A large disease registry facilitates the longitudinal observation of trends in disease presentation, management and outcomes. The Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) is a national disease registry of more than 10000 men with prostate cancer accrued at 31 primarily community based sites across the United States. Demographic, clinical, quality of life and resource use variables are collected on each patient. We reviewed key findings from the data base in the last 8 years in the areas of disease management trends, and oncological and quality of life outcomes. Prostate cancer is increasingly diagnosed with low risk clinical characteristics. With time patients have become less likely to receive pretreatment imaging tests, less likely to pursue watchful waiting and more likely to receive brachytherapy or hormonal therapy. Relatively few patients treated with radical prostatectomy in the database are under graded or under staged before surgery, whereas the surgical margin rate is comparable to that in academic series. CaPSURE data confirm the usefulness of percent positive biopsies in risk assessment and they have further been used to validate multiple preoperative nomograms. CaPSURE results strongly affirm the necessity of patient reported quality of life assessment. Multiple studies have compared the quality of life impact of various treatment options, particularly in terms of urinary and sexual function, and bother. The presentation and management of prostate cancer have changed substantially in the last decade. CaPSURE will continue to track these trends as well as oncological and quality of life outcomes, and will continue to be an invaluable resource for the study of prostate cancer at the national level.

Characteristics of people living with HIV who use community-based services in Ontario, Canada: implications for service providers.

PubMed

Williams, Peter; Narciso, Lea; Browne, Gina; Roberts, Jacqueline; Weir, Robin; Gafni, Amiram

2005-01-01

Community-based AIDS service organizations (CBAOs) direct services to multiple-needs people living with HIV/AIDS who are less likely to use mainstream health promotion services. As people live longer with HIV, the potential to enhance quality of life increases, yet little is known about who uses CBAOs or how this use affects other health and social services. This study of people living with AIDS in Ontario, Canada (n = 297) examined the demographic and health-related characteristics of people with AIDS who do and do not use CBAOs and their patterns of mainstream service utilization. It found that users of CBAOs were significantly less healthy, less able to sustain normal activities, and more often depressed. They reported physical disabilities significantly more often. Their quality of life was also lower along certain dimensions. They were significantly poorer and more reliant on government income supports. They consumed significantly more nonhospital health and social services and had significantly higher out-of-pocket costs. These results suggest CBAOs are being accessed appropriately by those most vulnerable. In an effort to strengthen CBAO capacity to recognize and address depression and physical health problems prevalent among their clients, links to other mainstream health promotion and social services is recommended.

Do item-writing flaws reduce examinations psychometric quality?

PubMed

Pais, João; Silva, Artur; Guimarães, Bruno; Povo, Ana; Coelho, Elisabete; Silva-Pereira, Fernanda; Lourinho, Isabel; Ferreira, Maria Amélia; Severo, Milton

2016-08-11

The psychometric characteristics of multiple-choice questions (MCQ) changed when taking into account their anatomical sites and the presence of item-writing flaws (IWF). The aim is to understand the impact of the anatomical sites and the presence of IWF in the psychometric qualities of the MCQ. 800 Clinical Anatomy MCQ from eight examinations were classified as standard or flawed items and according to one of the eight anatomical sites. An item was classified as flawed if it violated at least one of the principles of item writing. The difficulty and discrimination indices of each item were obtained. 55.8 % of the MCQ were flawed items. The anatomical site of the items explained 6.2 and 3.2 % of the difficulty and discrimination parameters and the IWF explained 2.8 and 0.8 %, respectively. The impact of the IWF was heterogeneous, the Writing the Stem and Writing the Choices categories had a negative impact (higher difficulty and lower discrimination) while the other categories did not have any impact. The anatomical site effect was higher than IWF effect in the psychometric characteristics of the examination. When constructing MCQ, the focus should be in the topic/area of the items and only after in the presence of IWF.

Influence of commercial information on prescription quantity in primary care.

PubMed

Caamaño, Francisco; Figueiras, Adolfo; Gestal-Otero, Juan Jesus

2002-09-01

In the last few years we have witnessed many publicly-financed health services reaching a crisis point. Thus, drug expenditure is nowadays one of the main concerns of health managers, and its containment one of the first goals of health authorities in western countries. The objective of this study is to identify the effect of the perceived quality stated in commercial information, its uses, and how physicians perceive the influence it has on prescription amounts. A cross-sectional study of 405 primary care physicians was conducted in Galicia (north-west Spain). The independent variables physician's education and speciality, physician's perception of the quality of available drug information sources, type of practice, and number of patients were collected, through a postal questionnaire. Environmental characteristics of the practice were obtained from secondary sources. Multiple regression models were constructed using as dependent variables two indicators of prescription volume. The response rate was 75.2%. Prescription amounts was found to be associated with perceived credibility of information provided by medical visitors, regulated physician training, and environmental characteristics of the practice (primary care team practice, urban environment). The study results suggest that in order to decrease prescription amounts it is necessary to limit the role of pharmaceutical companies in physician training, improve physician education and training, and emphasize more objective sources of information.

[The results of Russian multicenter open-label observational study of the efficacy and safety of мelaxen (melatonin) for the treatment of disordered sleep in patients with chronic cerebral ischemia].

PubMed

Poluéktov, M G; Levin, Ia I; Boĭko, A N; Skoromets, A A; Bel'skaia, G N; Gustov, A V; Doronin, B M; Poverennova, I E; Spirin, N N; Iakupov, E Z

2012-01-01

The results of the multicenter open-label observational study of the efficacy and safety of the Melaxen (melatonin) for the treatment of disordered sleep in patients with chronic cerebral ischemia are presented. 2062 patients were studied with the use of subjective psychometric scales: subjective sleep characteristics scale, sleep apnea screening questionnaire, Epworth sleepiness scale, hospital anxiety and depression scale. Mean age of patients was 55.7±9.0 years, there were 74.1% females and 25.9% males. Melaxen was given in dosage of 3 mg. before sleep for 24 days. The use of Melaxen leads to the increase of subjective sleep quality by the subjective sleep characteristics scale from 19.7±3.1 points to и 22.7±3.4 points on day 14 and 22.7±3.4 on day 24 (differences are significant at p<0.0001). There was the decrease of the relative number of patients with frequent night awakenings, prolonged sleep latency, short night sleep, poor quality of morning awakening and multiple bothering dreams. Authors conclude that the use of Melaxen in dosage of 3 mg before sleep is effective and safe insomnia treatment in patients with chronic cerebral ischemia.

Using wire shaping techniques and holographic optics to optimize deposition characteristics in wire-based laser cladding.

PubMed

Goffin, N J; Higginson, R L; Tyrer, J R

2016-12-01

In laser cladding, the potential benefits of wire feeding are considerable. Typical problems with the use of powder, such as gas entrapment, sub-100% material density and low deposition rate are all avoided with the use of wire. However, the use of a powder-based source material is the industry standard, with wire-based deposition generally regarded as an academic curiosity. This is because, although wire-based methods have been shown to be capable of superior quality results, the wire-based process is more difficult to control. In this work, the potential for wire shaping techniques, combined with existing holographic optical element knowledge, is investigated in order to further improve the processing characteristics. Experiments with pre-placed wire showed the ability of shaped wire to provide uniformity of wire melting compared with standard round wire, giving reduced power density requirements and superior control of clad track dilution. When feeding with flat wire, the resulting clad tracks showed a greater level of quality consistency and became less sensitive to alterations in processing conditions. In addition, a 22% increase in deposition rate was achieved. Stacking of multiple layers demonstrated the ability to create fully dense, three-dimensional structures, with directional metallurgical grain growth and uniform chemical structure.

Using wire shaping techniques and holographic optics to optimize deposition characteristics in wire-based laser cladding

PubMed Central

Higginson, R. L.; Tyrer, J. R.

2016-01-01

In laser cladding, the potential benefits of wire feeding are considerable. Typical problems with the use of powder, such as gas entrapment, sub-100% material density and low deposition rate are all avoided with the use of wire. However, the use of a powder-based source material is the industry standard, with wire-based deposition generally regarded as an academic curiosity. This is because, although wire-based methods have been shown to be capable of superior quality results, the wire-based process is more difficult to control. In this work, the potential for wire shaping techniques, combined with existing holographic optical element knowledge, is investigated in order to further improve the processing characteristics. Experiments with pre-placed wire showed the ability of shaped wire to provide uniformity of wire melting compared with standard round wire, giving reduced power density requirements and superior control of clad track dilution. When feeding with flat wire, the resulting clad tracks showed a greater level of quality consistency and became less sensitive to alterations in processing conditions. In addition, a 22% increase in deposition rate was achieved. Stacking of multiple layers demonstrated the ability to create fully dense, three-dimensional structures, with directional metallurgical grain growth and uniform chemical structure. PMID:28119550

Changes among US Cancer Survivors: Comparing Demographic, Diagnostic, and Health Care Findings from the 1992 and 2010 National Health Interview Surveys.

PubMed

Buchanan, Natasha D; King, Jessica B; Rodriguez, Juan L; White, Arica; Trivers, Katrina F; Forsythe, Laura P; Kent, Erin E; Rowland, Julia H; Sabatino, Susan A

2013-01-01

Background. Differences in healthcare and cancer treatment for cancer survivors in the United States (US) have not been routinely examined in nationally representative samples or studied before and after important Institute of Medicine (IOM) recommendations calling for higher quality care provision and attention to comprehensive cancer care for cancer survivors. Methods. To assess differences between survivor characteristics in 1992 and 2010, we conducted descriptive analyses of 1992 and 2010 National Health Interview Survey (NHIS) data. Our study sample consisted of 1018 self-reported cancer survivors from the 1992 NHIS and 1718 self-reported cancer survivors from the 2010 NHIS who completed the Cancer Control (CCS) and Cancer Epidemiology (CES) Supplements. Results. The prevalence of reported survivors increased from 1992 to 2010 (4.2% versus 6.3%). From 1992 to 2010, there was an increase in long-term cancer survivors and a drop in multiple malignancies, and surgery remained the most widely used treatment. Significantly fewer survivors (<10 years after diagnosis) were denied insurance coverage. Survivors continue to report low participation in counseling or support groups. Conclusions. As the prevalence of cancer survivors continues to grow, monitoring differences in survivor characteristics can be useful in evaluating the effects of policy recommendations and the quality of clinical care.

Beef quality labels: A combination of sensory acceptance test, stated willingness to pay, and choice-based conjoint analysis.

PubMed

Meyerding, Stephan G H; Gentz, Maria; Altmann, Brianne; Meier-Dinkel, Lisa

2018-08-01

Consumer perspectives of beef quality are complex, leading to a market that is increasingly differentiating. Thus, ongoing monitoring and assessment of changes in consumer perspectives is essential to identify changing market conditions. Often only credence and search characteristics are evaluated in consumer studies; therefore the object of the present study is to examine consumer preferences and perceptions towards beef steaks, also including experience characteristics, using a mixed methods approach. For this reason, 55 consumers participated in an experiment in Germany, including a sensory acceptance test, stated willingness to pay, and choice-based conjoint analysis (CBCA). Different quality characteristics were included, but a focus on the quality labels of 'dry aged beef', 'Block House beef', and 'Angus beef' was predominant throughout the experiment with the results showing that quality labels significantly increased overall liking as well as the stated willingness to pay. Quality labels were also the one of the most important characteristics in the conjoint analysis, after origin and price. The results of all applied methods are comparable for the characteristic quality label. The combination of sensory acceptance test and CBCA were additionally able to evaluate all three kinds of beef quality characteristics, which could not be evaluated together only using a single method. This suggests that a mixture of methods should be used to gain better knowledge on the true behavior of beef consumers. Experience and credence characteristics, including beef quality labels, present opportunities for future research as well as the potential for determining product and market differentiation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Meta-analysis of cotton fiber quality QTLs across diverse environments in a Gossypium hirsutum x G. barbadense RIL population.

PubMed

Lacape, Jean-Marc; Llewellyn, Danny; Jacobs, John; Arioli, Tony; Becker, David; Calhoun, Steve; Al-Ghazi, Yves; Liu, Shiming; Palaï, Oumarou; Georges, Sophie; Giband, Marc; de Assunção, Henrique; Barroso, Paulo Augusto Vianna; Claverie, Michel; Gawryziak, Gérard; Jean, Janine; Vialle, Michèle; Viot, Christopher

2010-06-28

Cotton fibers (produced by Gossypium species) are the premier natural fibers for textile production. The two tetraploid species, G. barbadense (Gb) and G. hirsutum (Gh), differ significantly in their fiber properties, the former having much longer, finer and stronger fibers that are highly prized. A better understanding of the genetics and underlying biological causes of these differences will aid further improvement of cotton quality through breeding and biotechnology. We evaluated an inter-specific Gh x Gb recombinant inbred line (RIL) population for fiber characteristics in 11 independent experiments under field and glasshouse conditions. Sites were located on 4 continents and 5 countries and some locations were analyzed over multiple years. The RIL population displayed a large variability for all major fiber traits. QTL analyses were performed on a per-site basis by composite interval mapping. Among the 651 putative QTLs (LOD > 2), 167 had a LOD exceeding permutation based thresholds. Coincidence in QTL location across data sets was assessed for the fiber trait categories strength, elongation, length, length uniformity, fineness/maturity, and color. A meta-analysis of more than a thousand putative QTLs was conducted with MetaQTL software to integrate QTL data from the RIL and 3 backcross populations (from the same parents) and to compare them with the literature. Although the global level of congruence across experiments and populations was generally moderate, the QTL clustering was possible for 30 trait x chromosome combinations (5 traits in 19 different chromosomes) where an effective co-localization of unidirectional (similar sign of additivity) QTLs from at least 5 different data sets was observed. Most consistent meta-clusters were identified for fiber color on chromosomes c6, c8 and c25, fineness on c15, and fiber length on c3. Meta-analysis provided a reliable means of integrating phenotypic and genetic mapping data across multiple populations and environments for complex fiber traits. The consistent chromosomal regions contributing to fiber quality traits constitute good candidates for the further dissection of the genetic and genomic factors underlying important fiber characteristics, and for marker-assisted selection.

Benchmarking observational uncertainties for hydrology (Invited)

NASA Astrophysics Data System (ADS)

McMillan, H. K.; Krueger, T.; Freer, J. E.; Westerberg, I.

2013-12-01

There is a pressing need for authoritative and concise information on the expected error distributions and magnitudes in hydrological data, to understand its information content. Many studies have discussed how to incorporate uncertainty information into model calibration and implementation, and shown how model results can be biased if uncertainty is not appropriately characterised. However, it is not always possible (for example due to financial or time constraints) to make detailed studies of uncertainty for every research study. Instead, we propose that the hydrological community could benefit greatly from sharing information on likely uncertainty characteristics and the main factors that control the resulting magnitude. In this presentation, we review the current knowledge of uncertainty for a number of key hydrological variables: rainfall, flow and water quality (suspended solids, nitrogen, phosphorus). We collated information on the specifics of the data measurement (data type, temporal and spatial resolution), error characteristics measured (e.g. standard error, confidence bounds) and error magnitude. Our results were primarily split by data type. Rainfall uncertainty was controlled most strongly by spatial scale, flow uncertainty was controlled by flow state (low, high) and gauging method. Water quality presented a more complex picture with many component errors. For all variables, it was easy to find examples where relative error magnitude exceeded 40%. We discuss some of the recent developments in hydrology which increase the need for guidance on typical error magnitudes, in particular when doing comparative/regionalisation and multi-objective analysis. Increased sharing of data, comparisons between multiple catchments, and storage in national/international databases can mean that data-users are far removed from data collection, but require good uncertainty information to reduce bias in comparisons or catchment regionalisation studies. Recently it has become more common for hydrologists to use multiple data types and sources within a single study. This may be driven by complex water management questions which integrate water quantity, quality and ecology; or by recognition of the value of auxiliary data to understand hydrological processes. We discuss briefly the impact of data uncertainty on the increasingly popular use of diagnostic signatures for hydrological process understanding and model development.

Feasibility and utility of applications of the common data model to multiple, disparate observational health databases

PubMed Central

Makadia, Rupa; Matcho, Amy; Ma, Qianli; Knoll, Chris; Schuemie, Martijn; DeFalco, Frank J; Londhe, Ajit; Zhu, Vivienne; Ryan, Patrick B

2015-01-01

Objectives To evaluate the utility of applying the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) across multiple observational databases within an organization and to apply standardized analytics tools for conducting observational research. Materials and methods Six deidentified patient-level datasets were transformed to the OMOP CDM. We evaluated the extent of information loss that occurred through the standardization process. We developed a standardized analytic tool to replicate the cohort construction process from a published epidemiology protocol and applied the analysis to all 6 databases to assess time-to-execution and comparability of results. Results Transformation to the CDM resulted in minimal information loss across all 6 databases. Patients and observations excluded were due to identified data quality issues in the source system, 96% to 99% of condition records and 90% to 99% of drug records were successfully mapped into the CDM using the standard vocabulary. The full cohort replication and descriptive baseline summary was executed for 2 cohorts in 6 databases in less than 1 hour. Discussion The standardization process improved data quality, increased efficiency, and facilitated cross-database comparisons to support a more systematic approach to observational research. Comparisons across data sources showed consistency in the impact of inclusion criteria, using the protocol and identified differences in patient characteristics and coding practices across databases. Conclusion Standardizing data structure (through a CDM), content (through a standard vocabulary with source code mappings), and analytics can enable an institution to apply a network-based approach to observational research across multiple, disparate observational health databases. PMID:25670757

Model observer design for multi-signal detection in the presence of anatomical noise

NASA Astrophysics Data System (ADS)

Wen, Gezheng; Markey, Mia K.; Park, Subok

2017-02-01

As psychophysical studies are resource-intensive to conduct, model observers are commonly used to assess and optimize medical imaging quality. Model observers are typically designed to detect at most one signal. However, in clinical practice, there may be multiple abnormalities in a single image set (e.g. multifocal multicentric (MFMC) breast cancer), which can impact treatment planning. Prevalence of signals can be different across anatomical regions, and human observers do not know the number or location of signals a priori. As new imaging techniques have the potential to improve multiple-signal detection (e.g. digital breast tomosynthesis may be more effective for diagnosis of MFMC than mammography), image quality assessment approaches addressing such tasks are needed. In this study, we present a model observer to detect multiple signals in an image dataset. A novel implementation of partial least squares (PLS) was developed to estimate different sets of efficient channels directly from the images. The PLS channels are adaptive to the characteristics of signals and the background, and they capture the interactions among signal locations. Corresponding linear decision templates are employed to generate both image-level and location-specific scores on the presence of signals. Our results show that: (1) the model observer can achieve high performance with a reasonably small number of channels; (2) the model observer with PLS channels outperforms that with benchmark modified Laguerre-Gauss channels, especially when realistic signal shapes and complex background statistics are involved; (3) the tasks of clinical interest, and other constraints such as sample size would alter the optimal design of the model observer.

Laser dimpling process parameters selection and optimization using surrogate-driven process capability space

NASA Astrophysics Data System (ADS)

Ozkat, Erkan Caner; Franciosa, Pasquale; Ceglarek, Dariusz

2017-08-01

Remote laser welding technology offers opportunities for high production throughput at a competitive cost. However, the remote laser welding process of zinc-coated sheet metal parts in lap joint configuration poses a challenge due to the difference between the melting temperature of the steel (∼1500 °C) and the vapourizing temperature of the zinc (∼907 °C). In fact, the zinc layer at the faying surface is vapourized and the vapour might be trapped within the melting pool leading to weld defects. Various solutions have been proposed to overcome this problem over the years. Among them, laser dimpling has been adopted by manufacturers because of its flexibility and effectiveness along with its cost advantages. In essence, the dimple works as a spacer between the two sheets in lap joint and allows the zinc vapour escape during welding process, thereby preventing weld defects. However, there is a lack of comprehensive characterization of dimpling process for effective implementation in real manufacturing system taking into consideration inherent changes in variability of process parameters. This paper introduces a methodology to develop (i) surrogate model for dimpling process characterization considering multiple-inputs (i.e. key control characteristics) and multiple-outputs (i.e. key performance indicators) system by conducting physical experimentation and using multivariate adaptive regression splines; (ii) process capability space (Cp-Space) based on the developed surrogate model that allows the estimation of a desired process fallout rate in the case of violation of process requirements in the presence of stochastic variation; and, (iii) selection and optimization of the process parameters based on the process capability space. The proposed methodology provides a unique capability to: (i) simulate the effect of process variation as generated by manufacturing process; (ii) model quality requirements with multiple and coupled quality requirements; and (iii) optimize process parameters under competing quality requirements such as maximizing the dimple height while minimizing the dimple lower surface area.

Effects of Bundle Type and Substitution with Spent Laying Hen Surimi on Quality Characteristics of Imitation Crabsticks.

PubMed

Jin, Sang-Keun; Choi, Jung-Seok; Kim, Gap-Don

2017-01-01

The purpose of this study was to evaluate the effects of bundle type (BT) and substitution with spent laying hen (SH) surimi on quality characteristics of imitation crabsticks made from Alaska Pollack (AP) during 6 wk of cold storage. Diagonally bundled samples had poorer gel characteristics and more lipid oxidation when compared with straight bundled ones ( p <0.05). The color of diagonally bundled imitation crabsticks deteriorated with storage time ( p <0.01). However, BT did not affect sensory characteristics ( p >0.05). SH substitution had an effect on most quality characteristics of imitation crabsticks; darker and poorer gel characteristics were observed and its effect on sensory evaluation was seen at the initial storage. Thus, BT and SH substitution can be considered to have a slight effect on eating quality of imitation crabsticks, despite their negative effects on color, gel characteristics, and lipid oxidation.

Best-Quality Vessel Identification Using Vessel Quality Measure in Multiple-Phase Coronary CT Angiography.

PubMed

Hadjiiski, Lubomir; Liu, Jordan; Chan, Heang-Ping; Zhou, Chuan; Wei, Jun; Chughtai, Aamer; Kuriakose, Jean; Agarwal, Prachi; Kazerooni, Ella

2016-01-01

The detection of stenotic plaques strongly depends on the quality of the coronary arterial tree imaged with coronary CT angiography (cCTA). However, it is time consuming for the radiologist to select the best-quality vessels from the multiple-phase cCTA for interpretation in clinical practice. We are developing an automated method for selection of the best-quality vessels from coronary arterial trees in multiple-phase cCTA to facilitate radiologist's reading or computerized analysis. Our automated method consists of vessel segmentation, vessel registration, corresponding vessel branch matching, vessel quality measure (VQM) estimation, and automatic selection of best branches based on VQM. For every branch, the VQM was calculated as the average radial gradient. An observer preference study was conducted to visually compare the quality of the selected vessels. 167 corresponding branch pairs were evaluated by two radiologists. The agreement between the first radiologist and the automated selection was 76% with kappa of 0.49. The agreement between the second radiologist and the automated selection was also 76% with kappa of 0.45. The agreement between the two radiologists was 81% with kappa of 0.57. The observer preference study demonstrated the feasibility of the proposed automated method for the selection of the best-quality vessels from multiple cCTA phases.

What Determines Alumni Generosity?

ERIC Educational Resources Information Center

Baade, Robert A.; Sundberg, Jeffrey O.

1996-01-01

College alumni giving is correlated with institutional characteristics (quality and development efforts) and student characteristics (quality and wealth). This paper uses a two-step least-squares approach with data and quality/wealth variables to explore the "rich-student, quality-school" alumni generosity phenomenon. Alumni giving is…

Effects of flow diversions on water and habitat quality: Examples from California's highly manipulated Sacramento–San Joaquin Delta

USGS Publications Warehouse

Monsen, Nancy E.; Cloern, James E.; Burau, Jon R.

2007-01-01

We use selected monitoring data to illustrate how localized water diversions from seasonal barriers, gate operations, and export pumps alter water quality across the Sacramento-San Joaquin Delta (California). Dynamics of water-quality variability are complex because the Delta is a mixing zone of water from the Sacramento and San Joaquin Rivers, agricultural return water, and the San Francisco Estuary. Each source has distinct water-quality characteristics, and the contribution of each source varies in response to natural hydrologic variability and water diversions. We use simulations with a tidal hydrodynamic model to reveal how three diversion events, as case studies, influence water quality through their alteration of Delta-wide water circulation patterns and flushing time. Reduction of export pumping decreases the proportion of Sacramento- to San Joaquin-derived fresh water in the central Delta, leading to rapid increases in salinity. Delta Cross Channel gate operations control salinity in the western Delta and alter the freshwater source distribution in the central Delta. Removal of the head of Old River barrier, in autumn, increases the flushing time of the Stockton Ship Channel from days to weeks, contributing to a depletion of dissolved oxygen. Each shift in water quality has implications either for habitat quality or municipal drinking water, illustrating the importance of a systems view to anticipate the suite of changes induced by flow manipulations, and to minimize the conflicts inherent in allocations of scarce resources to meet multiple objectives.

Impact of Information Technology, Clinical Resource Constraints, and Patient-Centered Practice Characteristics on Quality of Care.

PubMed

Baek, JongDeuk; Seidman, Robert L

2015-01-01

Factors in the practice environment, such as health information technology (IT) infrastructure, availability of other clinical resources, and financial incentives, may influence whether practices are able to successfully implement the patient-centered medical home (PCMH) model and realize its benefits. This study investigates the impacts of those PCMH-related elements on primary care physicians' perception of quality of care. A multiple logistic regression model was estimated using the 2004 to 2005 CTS Physician Survey, a national sample of salaried primary care physicians (n = 1733). The patient-centered practice environment and availability of clinical resources increased physicians' perceived quality of care. Although IT use for clinical information access did enhance physicians' ability to provide high quality of care, a similar positive impact of IT use was not found for e-prescribing or the exchange of clinical patient information. Lack of resources was negatively associated with physician perception of quality of care. Since health IT is an important foundation of PCMH, patient-centered practices are more likely to have health IT in place to support care delivery. However, despite its potential to enhance delivery of primary care, simply making health IT available does not necessarily translate into physicians' perceptions that it enhances the quality of care they provide. It is critical for health-care managers and policy makers to ensure that primary care physicians fully recognize and embrace the use of new technology to improve both the quality of care provided and the patient outcomes.

Association between socioeconomic factors and sleep quality in an urban population-based sample in Germany.

PubMed

Anders, Markus P; Breckenkamp, Jürgen; Blettner, Maria; Schlehofer, Brigitte; Berg-Beckhoff, Gabriele

2014-12-01

Good sleep quality is essential for recovery. The risk factors of sleep disorders have been extensively investigated, but there is sparse information on the association of socioeconomic factors with a person's sleep quality. The aim of the present analysis is to investigate this association, taking particularly the effect of health confounders into consideration. The data were extracted from the cross-sectional QUEBEB Study. In total, the study sample consisted of 3281 participants (1817 women and 1464 men, aged 16-72 years). Here socioeconomic status (SES) was collected from the baseline survey taken in 2004. Sleep quality for the same participants was measured with in-depth personal interviews in 2006 using the Pittsburgh Sleep Quality Index, together with other relevant characteristics (e.g. anxiety, depression and health status). Multiple logistic regression analyses were performed. People living in an urban environment with a high or medium SES have a greater probability of good sleep quality (odds ratio 1.65, 95% confidence interval 1.27-2.14; odds ratio 1.40, 95% confidence interval 1.16-1.69) than persons with a low SES. Anxiety and depression, but also health status, are also associated with sleep quality and can influence in part the socioeconomic levels seen in sleep quality. SES and sleep quality are associated. However, there are important additional determinants that influence the level of association between SES and sleep quality. Several factors, such as anxiety, depression and health status, are associated with poorer sleep quality, but at the same time, these factors occur more often within lower social classes. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

An approach to predict water quality in data-sparse catchments using hydrological catchment similarity

NASA Astrophysics Data System (ADS)

Pohle, Ina; Glendell, Miriam; Stutter, Marc I.; Helliwell, Rachel C.

2017-04-01

An understanding of catchment response to climate and land use change at a regional scale is necessary for the assessment of mitigation and adaptation options addressing diffuse nutrient pollution. It is well documented that the physicochemical properties of a river ecosystem respond to change in a non-linear fashion. This is particularly important when threshold water concentrations, relevant to national and EU legislation, are exceeded. Large scale (regional) model assessments required for regulatory purposes must represent the key processes and mechanisms that are more readily understood in catchments with water quantity and water quality data monitored at high spatial and temporal resolution. While daily discharge data are available for most catchments in Scotland, nitrate and phosphorus are mostly available on a monthly basis only, as typified by regulatory monitoring. However, high resolution (hourly to daily) water quantity and water quality data exist for a limited number of research catchments. To successfully implement adaptation measures across Scotland, an upscaling from data-rich to data-sparse catchments is required. In addition, the widespread availability of spatial datasets affecting hydrological and biogeochemical responses (e.g. soils, topography/geomorphology, land use, vegetation etc.) provide an opportunity to transfer predictions between data-rich and data-sparse areas by linking processes and responses to catchment attributes. Here, we develop a framework of catchment typologies as a prerequisite for transferring information from data-rich to data-sparse catchments by focusing on how hydrological catchment similarity can be used as an indicator of grouped behaviours in water quality response. As indicators of hydrological catchment similarity we use flow indices derived from observed discharge data across Scotland as well as hydrological model parameters. For the latter, we calibrated the lumped rainfall-runoff model TUWModel using multiple objective functions. The relationships between indicators of hydrological catchment similarity, physical catchment characteristics and nitrate and phosphorus concentrations in rivers are then investigated using multivariate statistics. This understanding of the relationship between catchment characteristics, hydrological processes and water quality will allow us to implement more efficient regulatory water quality monitoring strategies, to improve existing water quality models and to model mitigation and adaptation scenarios to global change in data-sparse catchments.

Protocol for a scoping review study to identify and classify patient-centred quality indicators.

PubMed

Jolley, Rachel J; Lorenzetti, Diane L; Manalili, Kimberly; Lu, Mingshan; Quan, Hude; Santana, Maria J

2017-01-05

The concept of patient-centred care (PCC) is changing the way healthcare is understood, accepted and delivered. The Institute of Medicine has defined PCC as 1 of its 6 aims to improve healthcare quality. However, in Canada, there are currently no nationwide standards in place for measuring and evaluating healthcare from a patient-centred approach. In this paper, we outline our scoping review protocol to systematically review published and unpublished literature specific to patient-centred quality indicators that have been implemented and evaluated across various care settings. Arksey and O'Malley's scoping review methodology framework will guide the conduct of this scoping review. We will search electronic databases (MEDLINE, EMBASE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Social Work Abstracts, Social Services Abstracts), grey literature sources and the reference lists of key studies to identify studies appropriate for inclusion. 2 reviewers will independently screen all abstracts and full-text studies for inclusion. We will include any study which focuses on quality indicators in the context of PCC. All bibliographic data, study characteristics and indicators will be collected and analysed using a tool developed through an iterative process by the research team. Indicators will be classified according to a predefined conceptual framework and categorised and described using qualitative content analysis. The scoping review will synthesise patient-centred quality indicators and their characteristics as described in the literature. This review will be the first step to formally identify what quality indicators have been used to evaluate PCC across the healthcare continuum, and will be used to inform a stakeholder consensus process exploring the development of a generic set of patient-centred quality indicators applicable to multiple care settings. The results will be disseminated through a peer-reviewed publication, conference presentations and a one-day stakeholder meeting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Simultaneous phylogeny reconstruction and multiple sequence alignment

PubMed Central

Yue, Feng; Shi, Jian; Tang, Jijun

2009-01-01

Background A phylogeny is the evolutionary history of a group of organisms. To date, sequence data is still the most used data type for phylogenetic reconstruction. Before any sequences can be used for phylogeny reconstruction, they must be aligned, and the quality of the multiple sequence alignment has been shown to affect the quality of the inferred phylogeny. At the same time, all the current multiple sequence alignment programs use a guide tree to produce the alignment and experiments showed that good guide trees can significantly improve the multiple alignment quality. Results We devise a new algorithm to simultaneously align multiple sequences and search for the phylogenetic tree that leads to the best alignment. We also implemented the algorithm as a C program package, which can handle both DNA and protein data and can take simple cost model as well as complex substitution matrices, such as PAM250 or BLOSUM62. The performance of the new method are compared with those from other popular multiple sequence alignment tools, including the widely used programs such as ClustalW and T-Coffee. Experimental results suggest that this method has good performance in terms of both phylogeny accuracy and alignment quality. Conclusion We present an algorithm to align multiple sequences and reconstruct the phylogenies that minimize the alignment score, which is based on an efficient algorithm to solve the median problems for three sequences. Our extensive experiments suggest that this method is very promising and can produce high quality phylogenies and alignments. PMID:19208110

Evaluation of Conceptual Frameworks Applicable to the Study of Isolation Precautions Effectiveness

PubMed Central

Crawford, Catherine; Shang, Jingjing

2015-01-01

Aims A discussion of conceptual frameworks applicable to the study of isolation precautions effectiveness according to Fawcett and DeSanto-Madeya’s (2013) evaluation technique and their relative merits and drawbacks for this purpose Background Isolation precautions are recommended to control infectious diseases with high morbidity and mortality, but effectiveness is not established due to numerous methodological challenges. These challenges, such as identifying empirical indicators and refining operational definitions, could be alleviated though use of an appropriate conceptual framework. Design Discussion paper Data Sources In mid-April 2014, the primary author searched five electronic, scientific literature databases for conceptual frameworks applicable to study isolation precautions, without limiting searches by publication date. Implications for Nursing By reviewing promising conceptual frameworks to support isolation precautions effectiveness research, this paper exemplifies the process to choose an appropriate conceptual framework for empirical research. Hence, researchers may build on these analyses to improve study design of empirical research in multiple disciplines, which may lead to improved research and practice. Conclusion Three frameworks were reviewed: the epidemiologic triad of disease, Donabedian’s healthcare quality framework and the Quality Health Outcomes model. Each has been used in nursing research to evaluate health outcomes and contains concepts relevant to nursing domains. Which framework can be most useful likely depends on whether the study question necessitates testing multiple interventions, concerns pathogen-specific characteristics and yields cross-sectional or longitudinal data. The Quality Health Outcomes model may be slightly preferred as it assumes reciprocal relationships, multi-level analysis and is sensitive to cultural inputs. PMID:26179813

[Influence of stress factors and socio-demographic characteristics on the sleep quality of nursing students].

PubMed

Benavente, Sonia Betzabeth Ticona; Silva, Rodrigo Marques da; Higashi, Aline Baraldi; Guido, Laura de Azevedo; Costa, Ana Lucia Siqueira

2014-06-01

To analyze the influence of stress factors and socio-demographic characteristics on the sleep quality of nursing students. An analytical cross-sectional and quantitative study, conducted with 151 nursing students in São Paulo between March and April of 2012. A form for socio-demographic characteristics, the Instrument to Evaluate Stress in Nursing Students and the Pittsburgh Sleep Index were applied. High levels of stress was predominant for Time Management (27.8%) and Professional Training (30.5%) and low sleep quality (78.8%). The Professional Communication, Professional Training and Theoretical Activity are positively correlated to sleep quality. Work activity, academic year and time for daily studies contributed to a low quality of sleep. Few stress factors from the academic environment and some socio-demographic characteristics contributed to the reduction of sleep quality in students.

Perceived Quality of Work Life and Risk for Compassion Fatigue Among Oncology Nurses: A Mixed-Methods Study.

PubMed

Denigris, Jami; Fisher, Kathleen; Maley, MaryKay; Nolan, Elizabeth

2016-05-01

To examine factors that influenced the nurse's perceived quality of work life and risk for compassion fatigue (CF). The specific aims of the study were to describe the (a) relationship among nurse characteristics and perceived quality of work life, (b) relationship between personal life stress and perceived quality of work life, and (c) the nurse's beliefs about his or her risk for CF.
. A descriptive, mixed-methods study.
. A hematology-oncology unit in a large urban teaching hospital in Pennsylvania.
. 20 oncology nurses. 
. Descriptive study using questionnaires and in-depth interviews. The variables were nurse characteristics, personal life stress, and quality of work life. Data were analyzed descriptively and thematically. Scores on the self-report questionnaires were compared to themes.
. Personal life stressors, measured by combining the Impact of Events Scale and Life Events Scale, identified powerful or severe impacts on well-being for 30% of nurse respondents in this study, theoretically placing them at risk for CF. However, qualitative data did not complement the results of the Life Events Scale, and 55% of the nurses described their overall work experiences as "life-affirming and rewarding." The participants provided multiple sources of their work-related stress, including subcategories of communication breakdown, work environment/institution, and care-driven factors. 
. Overall, oncology nurses experienced positive reinforcement at work and they had little concern about individual or organizational effectiveness. Positive experiences offset the negative and balanced out the risk for CF.
. The identification of personal and social contributors, as well as solutions to work-related stress, supports the philosophical premises (i.e., conceptual model) that the circumstances that place a nurse at risk for CF are socially constructed. Nurses can achieve greater empathy through self-understanding and translate this learning to patient care.

Use of standardised patients to assess quality of healthcare in Nairobi, Kenya: a pilot, cross-sectional study with international comparisons.

PubMed

Daniels, Benjamin; Dolinger, Amy; Bedoya, Guadalupe; Rogo, Khama; Goicoechea, Ana; Coarasa, Jorge; Wafula, Francis; Mwaura, Njeri; Kimeu, Redemptar; Das, Jishnu

2017-01-01

The quality of clinical care can be reliably measured in multiple settings using standardised patients (SPs), but this methodology has not been extensively used in Sub-Saharan Africa. This study validates the use of SPs for a variety of tracer conditions in Nairobi, Kenya, and provides new results on the quality of care in sampled primary care clinics. We deployed 14 SPs in private and public clinics presenting either asthma, child diarrhoea, tuberculosis or unstable angina. Case management guidelines and checklists were jointly developed with the Ministry of Health. We validated the SP method based on the ability of SPs to avoid detection or dangerous situations, without imposing a substantial time burden on providers. We also evaluated the sensitivity of quality measures to SP characteristics. We assessed quality of practice through adherence to guidelines and checklists for the entire sample, stratified by case and stratified by sector, and in comparison with previously published results from urban India, rural India and rural China. Across 166 interactions in 42 facilities, detection rates and exposure to unsafe conditions were both zero. There were no detected outcome correlations with SP characteristics that would bias the results. Across all four conditions, 53% of SPs were correctly managed with wide variation across tracer conditions. SPs paid 76% less in public clinics, but proportions of correct management were similar to private clinics for three conditions and higher for the fourth. Kenyan outcomes compared favourably with India and China in all but the angina case. The SP method is safe and effective in the urban Kenyan setting for the assessment of clinical practice. The pilot results suggest that public providers in this setting provide similar rates of correct management to private providers at significantly lower out-of-pocket costs for patients. However, comparisons across countries are sensitive to the tracer condition considered.

Use of standardised patients to assess quality of healthcare in Nairobi, Kenya: a pilot, cross-sectional study with international comparisons

PubMed Central

Daniels, Benjamin; Dolinger, Amy; Bedoya, Guadalupe; Rogo, Khama; Goicoechea, Ana; Coarasa, Jorge; Wafula, Francis; Mwaura, Njeri; Kimeu, Redemptar

2017-01-01

Introduction The quality of clinical care can be reliably measured in multiple settings using standardised patients (SPs), but this methodology has not been extensively used in Sub-Saharan Africa. This study validates the use of SPs for a variety of tracer conditions in Nairobi, Kenya, and provides new results on the quality of care in sampled primary care clinics. Methods We deployed 14 SPs in private and public clinics presenting either asthma, child diarrhoea, tuberculosis or unstable angina. Case management guidelines and checklists were jointly developed with the Ministry of Health. We validated the SP method based on the ability of SPs to avoid detection or dangerous situations, without imposing a substantial time burden on providers. We also evaluated the sensitivity of quality measures to SP characteristics. We assessed quality of practice through adherence to guidelines and checklists for the entire sample, stratified by case and stratified by sector, and in comparison with previously published results from urban India, rural India and rural China. Results Across 166 interactions in 42 facilities, detection rates and exposure to unsafe conditions were both zero. There were no detected outcome correlations with SP characteristics that would bias the results. Across all four conditions, 53% of SPs were correctly managed with wide variation across tracer conditions. SPs paid 76% less in public clinics, but proportions of correct management were similar to private clinics for three conditions and higher for the fourth. Kenyan outcomes compared favourably with India and China in all but the angina case. Conclusions The SP method is safe and effective in the urban Kenyan setting for the assessment of clinical practice. The pilot results suggest that public providers in this setting provide similar rates of correct management to private providers at significantly lower out-of-pocket costs for patients. However, comparisons across countries are sensitive to the tracer condition considered. PMID:29225937

Microhabitat Conditions in Wyoming's Sage-Grouse Core Areas: Effects on Nest Site Selection and Success.

PubMed

Dinkins, Jonathan B; Smith, Kurt T; Beck, Jeffrey L; Kirol, Christopher P; Pratt, Aaron C; Conover, Michael R

2016-01-01

The purpose of our study was to identify microhabitat characteristics of greater sage-grouse (Centrocercus urophasianus) nest site selection and survival to determine the quality of sage-grouse habitat in 5 regions of central and southwest Wyoming associated with Wyoming's Core Area Policy. Wyoming's Core Area Policy was enacted in 2008 to reduce human disturbance near the greatest densities of sage-grouse. Our analyses aimed to assess sage-grouse nest selection and success at multiple micro-spatial scales. We obtained microhabitat data from 928 sage-grouse nest locations and 819 random microhabitat locations from 2008-2014. Nest success was estimated from 924 nests with survival data. Sage-grouse selected nests with greater sagebrush cover and height, visual obstruction, and number of small gaps between shrubs (gap size ≥0.5 m and <1.0 m), while selecting for less bare ground and rock. With the exception of more small gaps between shrubs, we did not find any differences in availability of these microhabitat characteristics between locations within and outside of Core Areas. In addition, we found little supporting evidence that sage-grouse were selecting different nest sites in Core Areas relative to areas outside of Core. The Kaplan-Meier nest success estimate for a 27-day incubation period was 42.0% (95% CI: 38.4-45.9%). Risk of nest failure was negatively associated with greater rock and more medium-sized gaps between shrubs (gap size ≥2.0 m and <3.0 m). Within our study areas, Wyoming's Core Areas did not have differing microhabitat quality compared to outside of Core Areas. The close proximity of our locations within and outside of Core Areas likely explained our lack of finding differences in microhabitat quality among locations within these landscapes. However, the Core Area Policy is most likely to conserve high quality habitat at larger spatial scales, which over decades may have cascading effects on microhabitat quality available between areas within and outside of Core Areas.

A contourlet transform based algorithm for real-time video encoding

NASA Astrophysics Data System (ADS)

Katsigiannis, Stamos; Papaioannou, Georgios; Maroulis, Dimitris

2012-06-01

In recent years, real-time video communication over the internet has been widely utilized for applications like video conferencing. Streaming live video over heterogeneous IP networks, including wireless networks, requires video coding algorithms that can support various levels of quality in order to adapt to the network end-to-end bandwidth and transmitter/receiver resources. In this work, a scalable video coding and compression algorithm based on the Contourlet Transform is proposed. The algorithm allows for multiple levels of detail, without re-encoding the video frames, by just dropping the encoded information referring to higher resolution than needed. Compression is achieved by means of lossy and lossless methods, as well as variable bit rate encoding schemes. Furthermore, due to the transformation utilized, it does not suffer from blocking artifacts that occur with many widely adopted compression algorithms. Another highly advantageous characteristic of the algorithm is the suppression of noise induced by low-quality sensors usually encountered in web-cameras, due to the manipulation of the transform coefficients at the compression stage. The proposed algorithm is designed to introduce minimal coding delay, thus achieving real-time performance. Performance is enhanced by utilizing the vast computational capabilities of modern GPUs, providing satisfactory encoding and decoding times at relatively low cost. These characteristics make this method suitable for applications like video-conferencing that demand real-time performance, along with the highest visual quality possible for each user. Through the presented performance and quality evaluation of the algorithm, experimental results show that the proposed algorithm achieves better or comparable visual quality relative to other compression and encoding methods tested, while maintaining a satisfactory compression ratio. Especially at low bitrates, it provides more human-eye friendly images compared to algorithms utilizing block-based coding, like the MPEG family, as it introduces fuzziness and blurring instead of artificial block artifacts.

Qualities of an effective teacher: what do medical teachers think?

PubMed Central

2013-01-01

Background Effective teaching in medicine is essential to produce good quality doctors. A number of studies have attempted to identify the characteristics of an effective teacher. However, most of literature regarding an effective medical teacher includes student ratings or expert opinions. Furthermore, interdisciplinary studies for the same are even fewer. We did a cross-sectional study of the characteristics of effective teachers from their own perspective across medicine and dentistry disciplines. Methods A questionnaire comprising of 24 statements relating to perceived qualities of effective teachers was prepared and used. The study population included the faculty of medicine and dentistry at the institution. Respondents were asked to mark their response to each statement based on a 5-point Likert scale ranging from strongly disagree to strongly agree. These statements were grouped these into four main subgroups, viz. Class room behaviour/instructional delivery, interaction with students, personal qualities and professional development, and analysed with respect to discipline, cultural background, gender and teaching experience using SPSS v 13.0. For bivariate analysis, t-test and one way ANOVA were used. Multiple linear regression for multivariate analysis was used to control confounding variables. Results The top three desirable qualities of an effective teacher in our study were knowledge of subject, enthusiasm and communication skills. Faculty with longer teaching experienced ranked classroom behaviour/instructional delivery higher than their less experienced counterparts. There was no difference of perspectives based on cultural background, gender or discipline (medicine and dentistry). Conclusion This study found that the faculty perspectives were similar, regardless of the discipline, gender and cultural background. Furthermore, on review of literature similar findings are seen in studies done in allied medical and non-medical fields. These findings support common teacher training programs for the teachers of all disciplines, rather than having separate training programs exclusively for medical teachers. Logistically, this would make it much easier to arrange such programs in universities or colleges with different faculties or disciplines. PMID:24044727

Reporting quality of randomised controlled trial abstracts on age-related macular degeneration health care: a cross-sectional quantification of the adherence to CONSORT abstract reporting recommendations.

PubMed

Baulig, Christine; Krummenauer, Frank; Geis, Berit; Tulka, Sabrina; Knippschild, Stephanie

2018-05-22

To assess the reporting quality of randomised controlled trial (RCT) abstracts on age-related macular degeneration (AMD) healthcare, to evaluate the adherence to the Consolidated Standards of Reporting Trials (CONSORT) statement's recommendations on minimum abstract information and to identify journal characteristics associated with abstract reporting quality. Cross-sectional evaluation of RCT abstracts on AMD healthcare. A PubMed search was implemented to identify RCT abstracts on AMD healthcare published in the English language between January 2004 and December 2013. Data extraction was performed by two parallel readers independently by means of a documentation format in accordance with the 16 items of the CONSORT checklist for abstracts. The total number of criteria fulfilled by an abstract was derived as primary endpoint of the investigation; incidence rate ratios (IRRs) with unadjusted 95% CI were estimated by means of multiple Poisson regression to identify journal and article characteristics (publication year, multicentre design, structured abstract recommendations, effective sample size, effective abstract word counts and journal impact factor) possibly associated with the total number of fulfilled items. 136 of 673 identified abstracts (published in 36 different journals) fulfilled all eligibility criteria. The median number of fulfilled items was 7 (95% CI 7 to 8). No abstract reported all 16 recommended items; the maximum total number was 14, the minimum 3 of 16 items. Multivariate analysis only demonstrated the abstracts' word counts as being significantly associated with a better reporting of abstracts (Poisson regression-based IRR 1.002, 95% CI 1.001 to 1.003). Reporting quality of RCT abstracts on AMD investigations showed a considerable potential for improvement to meet the CONSORT abstract reporting recommendations. Furthermore, word counts of abstracts were identified as significantly associated with the overall abstract reporting quality. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Multilevel analysis of the influence of patients' and general practitioners' characteristics on patented versus multiple-sourced statin prescribing in France.

PubMed

Pichetti, Sylvain; Sermet, Catherine; Godman, Brian; Campbell, Stephen M; Gustafsson, Lars L

2013-06-01

The French National Health Insurance and the Ministry of Health have introduced multiple reforms in recent years to increase prescribing efficiency. These include guidelines, academic detailing, financial incentives for the prescribing and dispensing of generics drugs as well as a voluntary pay-for-performance programme. However, the quality and efficiency of prescribing could be enhanced potentially if there was better understanding of the dynamics of prescribing behaviour in France. To analyse the patient and general practitioner characteristics that influence patented versus multiple-sourced statin prescribing in France. Statistical analysis was performed on the statin prescribing habits from 341 general practitioners (GPs) that were included in the IMS-Health Permanent Survey on Medical Prescription in France, which was conducted between 2009 and 2010 and involved 14,360 patients. Patient characteristics included their age and gender as well as five medical profiles that were constructed from the diagnoses obtained during consultations. These were (1) disorders of lipoprotein metabolism, (2) heart disease, (3) diabetes, (4) complex profiles and (5) profiles based on other diagnoses. Physician characteristics included their age, gender, solo or group practice, weekly workload and payment scheme. Patient age had a statistically significant impact on statin prescribing for patients in profile 1 (disorders of lipoprotein metabolism) and profile 3 (complex profiles) with a greater number of patented statins being prescribed for the youngest patients. For instance, patients older than 76 years with a complex profile were prescribed fewer patented statins than patients aged 68-76 years old with the same medical profile (coefficient: -0.225; p = 0.0008). By contrast, regardless of the patient's age, the medical profile did not affect the probability of prescribing a patented statin except in young patients with heart diseases who were prescribed a greater number of patented statins (coefficient: 0.3992; p = 0.0007). Prescribing was also statistically influenced by physician features, e.g., older male physicians were more likely to prescribe patented statins (coefficient: 0.245; p = 0.0417) and GPs practicing in groups were more likely to prescribe multiple sourced statins (coefficient: -0.178; p = 0.0338), which is an important finding of the study. GPs with a lower workload prescribed a greater number of patented statins. There is significant variability in the prescribing of different statins among patient and physician profiles as well as between solo and group practices. Consequently, there are opportunities to target demand-side measures to enhance the prescribing of multiple-sourced statins. Further studies are warranted, in particular in other therapeutic classes, to provide a counter-balance to the considerable marketing activities of pharmaceutical companies.

Water-quality characteristics of Michigan's inland lakes, 2001-10

USGS Publications Warehouse

Fuller, L.M.; Taricska, C.K.

2012-01-01

The U.S. Geological Survey and the Michigan Department of Environmental Quality (MDEQ) jointly monitored for selected water-quality constituents and properties of inland lakes during 2001–10 as part of Michigan's Lake Water-Quality Assessment program. During 2001–10, 866 lake basins from 729 inland lakes greater than 25 acres were monitored for baseline water-quality conditions and trophic status. This report summarizes the water-quality characteristics and trophic conditions of the monitored lakes throughout the State; the data include vertical-profile measurements, nutrient measurements at three discrete depths, Secchi-disk transparency (SDT) measurements, and chlorophyll a measurements for the spring and summer, with major ions and other chemical indicators measured during the spring at mid-depth and color during the summer from near-surface samples. In about 75 percent of inland lake deep basins (index stations), trophic characteristics were associated with oligotrophic or mesotrophic conditions; 5 percent or less were categorized as hypereutrophic, and 80 percent of hypereutrophic lakes had a maximum depth of 30 feet or less. Comparison of spring and summer measurements shows that water clarity based on SDT measurements were clearer in the spring than in the summer for 63 percent of lakes. For near-surface measurements made in spring, 97 percent of lakes can be considered phosphorus limited and less than half a percent nitrogen limited; for summer measurements, 96 percent of lakes can be considered phosphorus limited and less than half a percent nitrogen limited. Spatial patterns of major ions, alkalinity, and hardness measured in the spring at mid-depth all showed lower values in the Upper Peninsula of Michigan and a southward increase toward the southern areas of the Lower Peninsula, though the location of increase varied by constituent. A spatial analysis of the data based on U.S. Environmental Protection Agency Level III Ecoregions separated potassium, sulfate, and chloride concentrations fairly well, with a pattern of lower values in northern ecoregions trending toward higher values in southern ecoregions; lower and higher concentrations of magnesium, hardness, calcium, and alkalinity were well separated, but middle-range concentrations in central Michigan ecoregions were mixed. The highest concentrations of chloride and sodium were in the southeastern area of the Lower Peninsula. Lakes with multiple basins showed few statistically significant differences in constituent concentrations at the 95-percent confidence level among combinations of depths between basins. The most statistically significant differences were found for water temperature, with significant differences in somewhat less than half the combinations in the spring and just a few combinations in the summer. The lack of significant differences between major basins of multibasin lakes indicates that monitoring of trophic characteristics in all major basins might not be necessary for the majority of constituents in future sampling programs. Trophic characteristics based on the 2001–10 dataset were compared to trophic characteristics resulting from other Michigan sampling programs, including the volunteer Cooperative Lakes Monitoring Program coordinated by the MDEQ (measurements on 250 lakes in 2011), trophic-state predictions produced by relating existing measurements to remotely sensed data (measurements for about 3,000 lakes), and the National Lakes Assessment (NLA) statistically valid, probability-designed lakes program (measurements for 50 lakes in Michigan and about 1,100 lakes nationally). A higher percentage of oligotrophic lakes resulted when using SDT from the volunteer data and the 2001–10 dataset than when using the predicted measurements from remotely sensed data or the NLA. Comparing trophic characteristics from differently designed programs provides multiple interpretations of lake water-quality status in Michigan lakes. No directional statistically significant difference was found at the 95-percent confidence level among historical nutrients and trophic characteristics when comparing 445 lakes with historical data for 1974–84 with the 2001–10 dataset, though SDT did show statistically significant differences at the 95-percent confidence level. Depending on the primary indicator, 50–66 percent of lakes did not change trophic-status class, 13–23 percent moved towards the oligotrophic end of the TSI scale, and 20–25 percent moved a class towards the eutrophic end of the TSI scale. Increasing percentages of urban-dominant land cover in the drainage areas of lakes had a more positive correlation with chloride concentration than did increased percentages of other land-cover classes; there was also a slight correlation of urban-dominant land cover and calcium concentration. Removing data for lakes in southeastern Lower Michigan, known from previous reports to be higher in chloride, still resulted in a positive relation even though the coefficient of determination (R2 value) decreased from 0.55 to 0.39. Dominant land-cover drainage areas were not strongly related to nutrients with respect to a linear relation, nor were lake drainage-area sizes.

Assessing the role of urban developments on storm runoff response through multi-scale catchment experiments

NASA Astrophysics Data System (ADS)

Wilkinson, Mark; Owen, Gareth; Geris, Josie; Soulsby, Chris; Quinn, Paul

2015-04-01

Many communities across the world face the increasing challenge of balancing water quantity and quality issues with accommodating new growth and urban development. Urbanisation is typically associated with detrimental changes in water quality, sediment delivery, and effects on water storage and flow pathways (e.g. increases in flooding). In particular for mixed rural and urban catchments where the spatio-temporal variability of hydrological responses is high, there remains a key research challenge in evaluating the timing and magnitude of storage and flow pathways at multiple scales. This is of crucial importance for appropriate catchment management, for example to aid the design of Green Infrastructure (GI) to mitigate the risk of flooding, among other multiple benefits. The aim of this work was to (i) explore spatio-temporal storm runoff generation characteristics in multi-scale catchment experiments that contain rural and urban land use zones, and (ii) assess the (preliminary) impact of Sustainable Drainage (SuDs) as GI on high flow and flood characteristics. Our key research catchment, the Ouseburn in Northern England (55km2), has rural headwaters (15%) and an urban zone (45%) concentrated in the lower catchment area. There is an intermediate and increasingly expanding peri-urban zone (currently 40%), which is defined here as areas where rural and urban features coexist, alongside GIs. Such a structure is typical for most catchments with urban developments. We monitored spatial precipitation and multiscale nested (five gauges) runoff response, in addition to the storage dynamics in GIs for a period of 6 years (2007-2013). For a range of events, we examined the multiscale nested runoff characteristics (lag time and magnitude) of the rural and urban flow components, assessed how these integrated with changing land use and increasing scale, and discussed the implications for flood management in the catchment. The analyses indicated three distinctly different patterns in the timing and magnitude of the contributions of the different land use zones and their nested integrated runoff response at increasing scales. These can be clearly linked to variations in antecedent conditions and precipitation patterns. For low antecedent flow conditions, the main flood peak is dominated by urban origins (faster responding and larger in relative magnitude); for high antecedent flow conditions, rural (and peri-urban) sources are most dominant. A third type of response involves mixed events, where both rural and urban contributions interact and reinforce the peak flow response. Our analyses showed that the effectiveness of the GIs varied substantially between the different events, suggesting that their design could be improved by introducing variable drainage rates and strategic placements to allow for interactions with the stream network. However, more information is needed on the spatio-temporal variability in water sources, flow pathways and residence times. This is of particular importance to also assess other multiple benefits of GIs, including the impacts on water quality. These challenges are currently addressed in two new case study catchment in the North East of Scotland (10km2) which are undergoing major land use change from rural to urban. Here, integrated tracer and hydrometric data are being collected to characterise the integrated impacts of urbanisation and GIs on flow pathways (nature and length) and associated water quality.

Effect of craniosacral therapy on lower urinary tract signs and symptoms in multiple sclerosis.

PubMed

Raviv, Gil; Shefi, Shai; Nizani, Dalia; Achiron, Anat

2009-05-01

To examine whether craniosacral therapy improves lower urinary tract symptoms of multiple sclerosis (MS) patients. A prospective cohort study. Out-patient clinic of multiple sclerosis center in a referral medical center. Hands on craniosacral therapy (CST). Change in lower urinary tract symptoms, post voiding residual volume and quality of life. Patients from our multiple sclerosis clinic were assessed before and after craniosacral therapy. Evaluation included neurological examination, disability status determination, ultrasonographic post voiding residual volume estimation and questionnaires regarding lower urinary tract symptoms and quality of life. Twenty eight patients met eligibility criteria and were included in this study. Comparison of post voiding residual volume, lower urinary tract symptoms and quality of life before and after craniosacral therapy revealed a significant improvement (0.001>p>0.0001). CST was found to be an effective means for treating lower urinary tract symptoms and improving quality of life in MS patients.

Domains of Quality of Life of People with Profound Multiple Disabilities: The Perspective of Parents and Direct Support Staff

ERIC Educational Resources Information Center

Petry, Katja; Maes, Bea; Vlaskamp, Carla

2005-01-01

Background: This study considered the general validity of the basic domains of quality of life that appear in theoretical models, in relation to people with profound multiple disabilities. The authors examined how parents and direct support staff operationalized these basic domains for people with profound multiple disabilities. They investigated…

Rural-Urban Differences in Medicare Quality Outcomes and the Impact of Risk Adjustment.

PubMed

Henning-Smith, Carrie; Kozhimannil, Katy; Casey, Michelle; Prasad, Shailendra; Moscovice, Ira

2017-09-01

There has been considerable debate in recent years about whether, and how, to risk-adjust quality measures for sociodemographic characteristics. However, geographic location, especially rurality, has been largely absent from the discussion. To examine differences by rurality in quality outcomes, and the impact of adjustment for individual and community-level sociodemographic characteristics on quality outcomes. The 2012 Medicare Current Beneficiary Survey, Access to Care module, combined with the 2012 County Health Rankings. All data used were publicly available, secondary data. We merged the 2012 Medicare Current Beneficiary Survey data with the 2012 County Health Rankings data using county of residence. We compared 6 unadjusted quality of care measures for Medicare beneficiaries (satisfaction with care, blood pressure checked, cholesterol checked, flu shot receipt, change in health status, and all-cause annual readmission) by rurality (rural noncore, micropolitan, and metropolitan). We then ran nested multivariable logistic regression models to assess the impact of adjusting for community and individual-level sociodemographic characteristics to determine whether these mediate the rurality difference in quality of care. The relationship between rurality and change in health status was mediated by the inclusion of community-level characteristics; however, adjusting for community and individual-level characteristics caused differences by rurality to emerge in 2 of the measures: blood pressure checked and cholesterol checked. For all quality scores, model fit improved after adding community and individual characteristics. Quality is multifaceted and is impacted by individual and community-level socio-demographic characteristics, as well as by geographic location. Current debates about risk-adjustment procedures should take rurality into account.

The Need for Mental Health Care Among Informal Caregivers Assisting People with Multiple Sclerosis

PubMed Central

Huang, Chunfeng

2013-01-01

The objective of this study was to identify characteristics of informal caregivers and people with multiple sclerosis (MS) receiving assistance that are associated with the caregiver's perceived need for mental health care. Survey data were collected in interviews with 530 caregivers and analyzed using a logistic regression model. We found that older caregiver age significantly decreased the odds of caregivers' perceived need for mental health treatment. Better mental health domains of health-related quality of life among caregivers, as measured by the 8-item Short Form Health Status Survey (SF-8), also were associated with decreased odds of the need for mental health care. In contrast, the caregiver's feeling that providing assistance was emotionally draining or the belief that this assistance threatened the caregiver/care recipient relationship significantly increased the odds of caregivers' needing mental health treatment. Health professionals treating informal caregivers should be sensitive to the impact that providing assistance has on the emotions, relationships, and mental health needs of caregivers. PMID:24453764

Optimization of laser butt welding parameters with multiple performance characteristics

NASA Astrophysics Data System (ADS)

Sathiya, P.; Abdul Jaleel, M. Y.; Katherasan, D.; Shanmugarajan, B.

2011-04-01

This paper presents a study carried out on 3.5 kW cooled slab laser welding of 904 L super austenitic stainless steel. The joints have butts welded with different shielding gases, namely argon, helium and nitrogen, at a constant flow rate. Super austenitic stainless steel (SASS) normally contains high amount of Mo, Cr, Ni, N and Mn. The mechanical properties are controlled to obtain good welded joints. The quality of the joint is evaluated by studying the features of weld bead geometry, such as bead width (BW) and depth of penetration (DOP). In this paper, the tensile strength and bead profiles (BW and DOP) of laser welded butt joints made of AISI 904 L SASS are investigated. The Taguchi approach is used as a statistical design of experiment (DOE) technique for optimizing the selected welding parameters. Grey relational analysis and the desirability approach are applied to optimize the input parameters by considering multiple output variables simultaneously. Confirmation experiments have also been conducted for both of the analyses to validate the optimized parameters.

LSHSIM: A Locality Sensitive Hashing based method for multiple-point geostatistics

NASA Astrophysics Data System (ADS)

Moura, Pedro; Laber, Eduardo; Lopes, Hélio; Mesejo, Daniel; Pavanelli, Lucas; Jardim, João; Thiesen, Francisco; Pujol, Gabriel

2017-10-01

Reservoir modeling is a very important task that permits the representation of a geological region of interest, so as to generate a considerable number of possible scenarios. Since its inception, many methodologies have been proposed and, in the last two decades, multiple-point geostatistics (MPS) has been the dominant one. This methodology is strongly based on the concept of training image (TI) and the use of its characteristics, which are called patterns. In this paper, we propose a new MPS method that combines the application of a technique called Locality Sensitive Hashing (LSH), which permits to accelerate the search for patterns similar to a target one, with a Run-Length Encoding (RLE) compression technique that speeds up the calculation of the Hamming similarity. Experiments with both categorical and continuous images show that LSHSIM is computationally efficient and produce good quality realizations. In particular, for categorical data, the results suggest that LSHSIM is faster than MS-CCSIM, one of the state-of-the-art methods.

Linear and nonlinear dynamic analysis of redundant load path bearingless rotor systems

NASA Technical Reports Server (NTRS)

Murthy, V. R.

1985-01-01

The bearingless rotorcraft offers reduced weight, less complexity and superior flying qualities. Almost all the current industrial structural dynamic programs of conventional rotors which consist of single load path rotor blades employ the transfer matrix method to determine natural vibration characteristics because this method is ideally suited for one dimensional chain like structures. This method is extended to multiple load path rotor blades without resorting to an equivalent single load path approximation. Unlike the conventional blades, it isk necessary to introduce the axial-degree-of-freedom into the solution process to account for the differential axial displacements in the different load paths. With the present extension, the current rotor dynamic programs can be modified with relative ease to account for the multiple load paths without resorting to the equivalent single load path modeling. The results obtained by the transfer matrix method are validated by comparing with the finite element solutions. A differential stiffness matrix due to blade rotation is derived to facilitate the finite element solutions.

MO-C-18A-01: Advances in Model-Based 3D Image Reconstruction

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

Chen, G; Pan, X; Stayman, J

2014-06-15

Recent years have seen the emergence of CT image reconstruction techniques that exploit physical models of the imaging system, photon statistics, and even the patient to achieve improved 3D image quality and/or reduction of radiation dose. With numerous advantages in comparison to conventional 3D filtered backprojection, such techniques bring a variety of challenges as well, including: a demanding computational load associated with sophisticated forward models and iterative optimization methods; nonlinearity and nonstationarity in image quality characteristics; a complex dependency on multiple free parameters; and the need to understand how best to incorporate prior information (including patient-specific prior images) within themore » reconstruction process. The advantages, however, are even greater – for example: improved image quality; reduced dose; robustness to noise and artifacts; task-specific reconstruction protocols; suitability to novel CT imaging platforms and noncircular orbits; and incorporation of known characteristics of the imager and patient that are conventionally discarded. This symposium features experts in 3D image reconstruction, image quality assessment, and the translation of such methods to emerging clinical applications. Dr. Chen will address novel methods for the incorporation of prior information in 3D and 4D CT reconstruction techniques. Dr. Pan will show recent advances in optimization-based reconstruction that enable potential reduction of dose and sampling requirements. Dr. Stayman will describe a “task-based imaging” approach that leverages models of the imaging system and patient in combination with a specification of the imaging task to optimize both the acquisition and reconstruction process. Dr. Samei will describe the development of methods for image quality assessment in such nonlinear reconstruction techniques and the use of these methods to characterize and optimize image quality and dose in a spectrum of clinical applications. Learning Objectives: Learn the general methodologies associated with model-based 3D image reconstruction. Learn the potential advantages in image quality and dose associated with model-based image reconstruction. Learn the challenges associated with computational load and image quality assessment for such reconstruction methods. Learn how imaging task can be incorporated as a means to drive optimal image acquisition and reconstruction techniques. Learn how model-based reconstruction methods can incorporate prior information to improve image quality, ease sampling requirements, and reduce dose.« less

Teacher's Assessment of the Quality of Their Schools.

ERIC Educational Resources Information Center

Davis, Voyia

Thirty-eight teachers completed the Illinois Quality Schools Index Survey, which measured teachers' attitudes towards characteristics of quality schools. The majority of the teachers felt that the characteristics indicative of a quality school were often implemented in their school. Over half the teachers felt that their schools often or always…

The quality of instruments to assess the process of shared decision making: A systematic review.

PubMed

Gärtner, Fania R; Bomhof-Roordink, Hanna; Smith, Ian P; Scholl, Isabelle; Stiggelbout, Anne M; Pieterse, Arwen H

2018-01-01

To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument's content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations.

Lessons learned from the dog genome.

PubMed

Wayne, Robert K; Ostrander, Elaine A

2007-11-01

Extensive genetic resources and a high-quality genome sequence position the dog as an important model species for understanding genome evolution, population genetics and genes underlying complex phenotypic traits. Newly developed genomic resources have expanded our understanding of canine evolutionary history and dog origins. Domestication involved genetic contributions from multiple populations of gray wolves probably through backcrossing. More recently, the advent of controlled breeding practices has segregated genetic variability into distinct dog breeds that possess specific phenotypic traits. Consequently, genome-wide association and selective sweep scans now allow the discovery of genes underlying breed-specific characteristics. The dog is finally emerging as a novel resource for studying the genetic basis of complex traits, including behavior.

Ultrashort pulse amplification in cryogenically cooled amplifiers

DOEpatents

Backus, Sterling J.; Kapteyn, Henry C.; Murnane, Margaret Mary

2004-10-12

A laser amplifier system amplifies pulses in a single "stage" from .about.10.sup.-9 joules to more than 10.sup.-3 joules, with average power of 1-10 watts, and beam quality M.sup.2 <2. The laser medium is cooled substantially below room temperature, as a means to improve the optical and thermal characteristics of the medium. This is done with the medium inside a sealed, evacuated or purged cell to avoid moisture or other materials condensing on the surface. A "seed" pulse from a separate laser is passed through the laser medium, one or more times, in any of a variety of configurations including single-pass, multiple-pass, and regenerative amplifier configurations.

Temporal and spatial distribution characteristics and influencing factors of air quality index in Xuchang

NASA Astrophysics Data System (ADS)

Wang, Zhenghua; Tian, Zhihui

2018-01-01

In recent years, the problem of air pollution becomes more and more serious. Based on the geographic and seasonal climatic characteristics of Xuchang City, this paper studies the temporal and spatial distribution characteristics of air quality index. The results show that: from the time point of view, air quality index shows seasonal difference. Air quality index is highest in winter and is lowest in summer. From the space point of view, there are differences between the north and the south to a certain extent. Changge City, Yuzhou city and central Xuchang county is higher than the southeast of Xiangcheng county and Yanling county. The spatial and temporal variation characteristics of air quality index in Xuchang are influenced by natural factors and human activities, and the economic development and population are the important factors affecting the urban air quality.

First-time parents' prenatal to postpartum changes in health, and the relation of postpartum health to work and partner characteristics.

PubMed

Gjerdingen, Dwenda K; Center, Bruce A

2003-01-01

The purpose of this study was to evaluate prenatal to postnatal changes in first-time parents' physical and mental health, and to describe social and health predictors of parents' postpartum health. This prospective study surveyed 261 expectant fathers and mothers during pregnancy and again at 6 months' postpartum regarding their health, partner, and work characteristics. Postpartum changes in health were evaluated by paired t tests, and predictors of postpartum health were determined using multiple regression analyses. Both fathers and mothers experienced significant postpartum declines in perceived quality of life. In addition, fathers reported an increase in the number of days ill and a decrease in general health and vitality after childbirth. Mothers perceived an increase in vitality despite their diminishing sleep. Parents' postpartum health was associated with mothers' partner satisfaction, fewer illness days, and certain work characteristics, such as total work time and the balance of work between mothers and fathers. Both mothers and fathers experienced declines in health that persisted at least 6 months after the birth of their first child. Notably, postpartum health was associated with partner satisfaction and work characteristics. This information might be used to develop interventions for improving parents' health during this vulnerable time.

Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews

PubMed Central

2013-01-01

Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words) PMID:23331384

Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews.

PubMed

Wells, Cherie; Kolt, Gregory S; Marshall, Paul; Hill, Bridget; Bialocerkowski, Andrea

2013-01-19

Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words).

Health-related quality of life in a binational population with diabetes at the Texas-Mexico border.

PubMed

Mier, Nelda; Bocanegra-Alonso, Anabel; Zhan, Dongling; Zuniga, Miguel A; Acosta, Rosa I

2008-03-01

To examine physical and mental health domains of health-related quality of life (HRQL) in a binational adult population with type 2 diabetes at the Texas-Mexico border, and to explore individual and social correlates to physical and mental health status. Adults 18 years and older with type 2 diabetes residing in the South Texas Lower Rio Grande Valley and in Reynosa, Tamaulipas, Mexico, were recruited using a convenience sampling technique and interviewed face-to-face with a structured survey. HRQL was measured using physical and mental health summary components of the Medical Outcomes Study Short Form. HRQL correlates included demographic characteristics, health factors, access to healthcare, and family support. Samples characteristics were compared using the Student's t-test or Mann-Whitney U test. Associations between dependent and independent variables were examined using unadjusted and adjusted (multiple variable) logistic regression models. There were no significant differences between Valley and Reynosa respondents in physical or mental health status scores. Valley participants with lower socioeconomic status and those perceiving their supportive relative's level of diabetes-related knowledge as "low" were more likely to report worse physical health than those lacking those characteristics. In the Reynosa group, lower physical health status was associated with duration of diabetes and insulin use. Both sample populations with clinical depressive symptoms were more likely to have worse physical and mental health than those without such symptoms. HRQL is an important outcome in monitoring health status. Understanding the levels and influences of HRQL in U.S.-Mexico border residents with diabetes may help improve diabetes management programs.

Perception of front-of-pack labels according to social characteristics, nutritional knowledge and food purchasing habits.

PubMed

Méjean, Caroline; Macouillard, Pauline; Péneau, Sandrine; Hercberg, Serge; Castetbon, Katia

2013-03-01

To identify patterns of perception of front-of-pack (FOP) nutrition labels and to determine social factors, nutritional knowledge and attention to packaging features related to such patterns. Cross-sectional. Perception was measured using indicators of understanding and acceptability of three simple FOP labels (the 'Green Tick', the logo of the French Nutrition and Health Programme (PNNS logo) and 'simple traffic lights' (STL)) and two detailed formats ('multiple traffic lights' (MTL) and the 'colour range' logo (CR)). Associations of perception patterns with individual characteristics were examined using χ2 tests. Data from the French NutriNet-Santé cohort study. A total of 38,763 adults. Four perception patterns emerged. Poorly educated individuals were most often found in groups favouring simple formats. The 'favourable to CR' group had a high rate of men and older persons. Poor nutritional knowledge was more frequent in the 'favourable to STL' group, while individuals with substantial knowledge were proportionally more numerous in the 'favourable to MTL' group. The 'favourable to STL' group more frequently self-reported noting price and marketing characteristics during purchasing, while the 'favourable to MTL' and 'favourable to CR' groups declared more interest in nutritional information. The 'favourable to Green Tick and PNNS logo' group self-reported paying closer attention to claims and quality guarantee labels. The 'favourable to MTL' cluster was most frequently represented in our survey. However, simple FOP formats may be most appropriate for increasing awareness of healthy eating among targeted groups with poor nutritional knowledge and little interest in the nutritional quality of packaged foods.

Impacts of Agricultural Practices and Individual Life Characteristics on Ecosystem Services: A Case Study on Family Farmers in the Context of an Amazonian Pioneer Front.

PubMed

Solen, Le Clec'h; Nicolas, Jégou; de Sartre Xavier, Arnauld; Thibaud, Decaens; Simon, Dufour; Michel, Grimaldi; Johan, Oszwald

2018-05-01

In tropical forests farmers are among the most important agents of deforestation. At the interface between societies and their environment, ecosystem services (ES) is an integrated working framework through which natural and anthropogenic dimensions can be addressed. Here, we aimed to understand to what extent farmers impact ES availability. Based on case studies in three locations in the Brazilian Amazon rainforest, we performed statistical analyses at 135 sampling points and 110 farms to link socioeconomic and ES data, both derived from field work. The socioeconomic data characterized agricultural production, sociological characteristics, and quality of life. ES data were obtained from statistical analyses that yielded a multiple ES indicator for each sampling point and farm. Our results produced three main findings: first, the establishment of ES associations is due more to agricultural production characteristics than to sociological and quality-of-life factors. Second, the impact of agricultural production on ES availability depends on the level of total incomes. An increase in incomes causes a decrease in the forest cover that provides many ES and an increase in other areas that provide fewer ES. Finally, our analyses show a very strong site effect that probably expresses the heterogeneity of the biophysical contexts, but also the importance for ES availability of the historical depth of deforestation and/or the role of specific public policies. Finding ways of producing an alternative impact on ES availability and establishing specific ES associations will therefore depend more on changes in the global political context than in individual practices.

An urban neo-poverty population-based quality of life and related social characteristics investigation from northeast China.

PubMed

Ou, Fengrong; Li, Kai; Gao, Qian; Liu, Dan; Li, Jinghai; Hu, Liwen; Wu, Xian; Edmiston, E Kale; Liu, Yang

2012-01-01

To investigate quality of life (QOL) and related characteristics among an urban neo-poverty population in northeast China, and to compare this population with a traditional poverty cohort. The research was a cross-sectional survey executed from June 2005 to October 2007, with a sample of 2940 individuals ages 36 to 55 in three different industrial cities of northeast China. Data were collected on QOL status and sociodemographic characteristics. QOL was assessed using the 36-item Short Form Health Survey (Chinese version). Multiple regression analysis was employed to analyze association between sociodemographic variables and QOL. The scores for QOL in the neo-poverty group were higher than those in the traditional poverty group, but lower than those in the general population. When the neo-poverty population was divided into two subgroups by age, 36-45 years and 46-55 years, the differences in QOL scores were not significant. However, there were significant differences in several dimensions between two subgroups according to unemployment time (<5 years and >5 years). Additionally, stepwise regression analysis indicated that disease burden, including disease and medical expenditures, was a common risk factor for declining QOL in the neo-poverty group. Despite some limitations, this study provides initial evidence that the QOL of the urban neo-poverty population lies between that of the general population and traditional poverty. QOL of the neo-poverty group approached QOL of the traditional poverty group with increased unemployment years. In addition to decreased income, disease burden is the most important factor influencing QOL status in urban neo-poverty.

Socio-demographic characteristics and psychosocial consequences of sickle cell disease: the case of patients in a public hospital in Ghana.

PubMed

Adzika, Vincent A; Glozah, Franklin N; Ayim-Aboagye, Desmond; Ahorlu, Collins S K

2017-01-31

Sickle cell disease (SCD) is of major public health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Ghana. The objective of this study was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. A cross-sectional research design was used that involved the completion of questionnaires on socio-demographic characteristics, quality of life, coping mechanisms, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results showed that majority of the patients were single, female, less than 39 years old and had attained secondary school level of education or less. Also, patients were more satisfied by the presence of love, friends and relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having faith in God was the most frequently reported mechanisms for coping with an unbearable SCD attacks. Results of multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. It is recommended that a holistic intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Left-behind children in rural China experience higher levels of anxiety and poorer living conditions.

PubMed

Zhao, Xue; Chen, Jian; Chen, Ming-Chun; Lv, Xiao-Ling; Jiang, Yu-Hong; Sun, Ye-Huan

2014-06-01

The number of rural Chinese parents who leave their children with family members to work in the cities has increased dramatically over the last decade. This study compared the social anxiety of left-behind children (LBC) and children not left behind (non-LBC). We investigated 1694 LBC and 1223 non-LBC, aged seven to 17 years, in a Chinese province using a structured questionnaire that included questions about socio-demographic characteristics, social anxiety, family function, quality of life, neglect and physical abuse. LBC displayed higher social anxiety scores, more neglect, lower parental educational level, lower quality of life, lower family function and lower prevalence of physical abuse than non-LBC. Multiple linear regression models showed that higher Social Anxiety Scales for Children (SASC) scores in LBC were clearly associated with lower quality of life, poorer family function, physical abuse, being female, having more siblings and minorities. In non-LBC, they were associated with lower quality of life, poorer family function, neglect, being female and physical abuse. LBC have a relatively higher level of social anxiety and poorer living conditions than non-LBC, and there are differences in social anxiety, and its relevant factors, between the two groups. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Rapid non-destructive assessment of pork edible quality by using VIS/NIR spectroscopic technique

NASA Astrophysics Data System (ADS)

Zhang, Leilei; Peng, Yankun; Dhakal, Sagar; Song, Yulin; Zhao, Juan; Zhao, Songwei

2013-05-01

The objectives of this research were to develop a rapid non-destructive method to evaluate the edible quality of chilled pork. A total of 42 samples were packed in seal plastic bags and stored at 4°C for 1 to 21 days. Reflectance spectra were collected from visible/near-infrared spectroscopy system in the range of 400nm to 1100nm. Microbiological, physicochemical and organoleptic characteristics such as the total viable counts (TVC), total volatile basic-nitrogen (TVB-N), pH value and color parameters L* were determined to appraise pork edible quality. Savitzky-Golay (SG) based on five and eleven smoothing points, Multiple Scattering Correlation (MSC) and first derivative pre-processing methods were employed to eliminate the spectra noise. The support vector machines (SVM) and partial least square regression (PLSR) were applied to establish prediction models using the de-noised spectra. A linear correlation was developed between the VIS/NIR spectroscopy and parameters such as TVC, TVB-N, pH and color parameter L* indexes, which could gain prediction results with Rv of 0.931, 0.844, 0.805 and 0.852, respectively. The results demonstrated that VIS/NIR spectroscopy technique combined with SVM possesses a powerful assessment capability. It can provide a potential tool for detecting pork edible quality rapidly and non-destructively.

Spatial variation of air quality index and urban driving factors linkages: evidence from Chinese cities.

PubMed

Pu, Haixia; Luo, Kunli; Wang, Pin; Wang, Shaobin; Kang, Shun

2017-02-01

Daily air quality index (AQI) of 161 Chinese cities obtained from the Ministry of Environmental Protection of China in 2015 is conducted. In this study, to better explore spatial distribution and regional characteristic of AQI, global and local spatial autocorrelation is utilized. Pearson's correlation is introduced to determine the influence of single urban indicator on AQI value. Meanwhile, multiple linear stepwise regression is chosen to estimate quantitatively the most influential urban indicators on AQI. The spatial autocorrelation analysis indicates that the AQI value of Chinese 161 cities shows a spatial dependency. Higher AQI is mainly located in north and northwest regions, whereas low AQI is concentrated in the south and the Qinghai-Tibet regions. The low AQI and high AQI values in China both exhibit relative immobility through seasonal variation. The influence degree of three adverse urban driving factors on AQI value is ranked from high to low: coal consumption of manufacturing > building area > coal consumption of the power industry. It is worth noting that the risk of exposed population to poor quality is greater in the northern region than in other regions. The results of the study provide a reference for the formulation of urban policy and improvement of air quality in China.

The influence of psychological variables on health-related quality of life among HIV-positive individuals with a history of intravenous drug use.

PubMed

Psaros, Christina; O'Cleirigh, Conall; Bullis, Jacqueline R; Markowitz, Sarah M; Safren, Steven A

2013-01-01

Intravenous drug use (IDU) remains a prominent pathway of HIV transmission in the United States, though little is known about modifiable factors influencing quality of life among IDUs. The goal of this study was to evaluate the influence of psychological variables (e.g., depression and anxiety) on health-related quality of life among HIV-positive individuals with a history of IDU who were enrolled in outpatient treatment for opioid dependence. 108 HIV-positive individuals with a history of IDU and participating in current outpatient treatment for opiate dependence who were screened for participation in a depression and adherence study reported sociodemographic data, depressive and anxiety symptoms, and health-related quality of life (HRQoL; Multidimensional Health Assessment using the ACTG-SF 21). Multiple regression models controlling for disease stage and background characteristics identified significant negative relationships between General Health Perception and Functioning without Pain for anxiety and depression, and between Role Functioning and Physical Functioning for anxiety. CD4 cell count was significantly related to Physical Functioning only. Results indicate that distress (both depression and anxiety) contribute significantly to variation in HRQoL over and above the effects of disease variables. Effective depression and anxiety treatment may result in improved overall functioning.

Optimization of Fat-Reduced Puff Pastry Using Response Surface Methodology.

PubMed

Silow, Christoph; Zannini, Emanuele; Axel, Claudia; Belz, Markus C E; Arendt, Elke K

2017-02-22

Puff pastry is a high-fat bakery product with fat playing a key role, both during the production process and in the final pastry. In this study, response surface methodology (RSM) was successfully used to evaluate puff pastry quality for the development of a fat-reduced version. The technological parameters modified included the level of roll-in fat, the number of fat layers (50-200) and the final thickness (1.0-3.5 mm) of the laminated dough. Quality characteristics of puff pastry were measured using the Texture Analyzer with an attached Extended Craft Knife (ECK) and Multiple Puncture Probe (MPP), the VolScan and the C-Cell imaging system. The number of fat layers and final dough thickness, in combination with the amount of roll-in fat, had a significant impact on the internal and external structural quality parameters. With technological changes alone, a fat-reduced (≥30%) puff pastry was developed. The qualities of fat-reduced puff pastries were comparable to conventional full-fat (33 wt %) products. A sensory acceptance test revealed no significant differences in taste of fatness or 'liking of mouthfeel'. Additionally, the fat-reduced puff pastry resulted in a significant ( p < 0.05) positive correlation to 'liking of flavor' and overall acceptance by the assessors.

Optimization of Fat-Reduced Puff Pastry Using Response Surface Methodology

PubMed Central

Silow, Christoph; Zannini, Emanuele; Axel, Claudia; Belz, Markus C. E.; Arendt, Elke K.

2017-01-01

Puff pastry is a high-fat bakery product with fat playing a key role, both during the production process and in the final pastry. In this study, response surface methodology (RSM) was successfully used to evaluate puff pastry quality for the development of a fat-reduced version. The technological parameters modified included the level of roll-in fat, the number of fat layers (50–200) and the final thickness (1.0–3.5 mm) of the laminated dough. Quality characteristics of puff pastry were measured using the Texture Analyzer with an attached Extended Craft Knife (ECK) and Multiple Puncture Probe (MPP), the VolScan and the C-Cell imaging system. The number of fat layers and final dough thickness, in combination with the amount of roll-in fat, had a significant impact on the internal and external structural quality parameters. With technological changes alone, a fat-reduced (≥30%) puff pastry was developed. The qualities of fat-reduced puff pastries were comparable to conventional full-fat (33 wt %) products. A sensory acceptance test revealed no significant differences in taste of fatness or ‘liking of mouthfeel’. Additionally, the fat-reduced puff pastry resulted in a significant (p < 0.05) positive correlation to ‘liking of flavor’ and overall acceptance by the assessors. PMID:28231095

Characteristics of psychiatric hospitalizations with multiple mechanical restraint episodes versus hospitalization with a single mechanical restraint episode.

PubMed

Guzman-Parra, Jose; Guzik, Justyna; Garcia-Sanchez, Juan A; Pino-Benitez, Isabel; Aguilera-Serrano, Carlos; Mayoral-Cleries, Fermin

2016-10-30

We investigated the characteristics of multiple episodes of mechanical restraint versus a single episode in a psychiatric ward of a public general hospital. The following characteristics were associated with multiple restraints: young age, length of hospital stay, not being readmitted within 30 days from previous discharge, and admission in the previous year before the implementation of an intervention program to reduce mechanical restraint. The study suggests that both organizational factors and patients' disturbed behaviour are associated with the risk of being mechanically restrained several times. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Factors influencing the quality of life of haemodialysis patients according to symptom cluster.

PubMed

Shim, Hye Yeung; Cho, Mi-Kyoung

2018-05-01

To identify the characteristics in each symptom cluster and factors influencing the quality of life of haemodialysis patients in Korea according to cluster. Despite developments in renal replacement therapy, haemodialysis still restricts the activities of daily living due to pain and impairs physical functioning induced by the disease and its complications. Descriptive survey. Two hundred and thirty dialysis patients aged >18 years. They completed self-administered questionnaires of Dialysis Symptom Index and Kidney Disease Quality of Life instrument-Short Form 1.3. To determine the optimal number of clusters, the collected data were analysed using polytomous variable latent class analysis in R software (poLCA) to estimate the latent class models and the latent class regression models for polytomous outcome variables. Differences in characteristics, symptoms and QOL according to the symptom cluster of haemodialysis patients were analysed using the independent t test and chi-square test. The factors influencing the QOL according to symptom cluster were identified using hierarchical multiple regression analysis. Physical and emotional symptoms were significantly more severe, and the QOL was significantly worse in Cluster 1 than in Cluster 2. The factors influencing the QOL were spouse, job, insurance type and physical and emotional symptoms in Cluster 1, with these variables having an explanatory power of 60.9%. Physical and emotional symptoms were the only influencing factors in Cluster 2, and they had an explanatory power of 37.4%. Mitigating the symptoms experienced by haemodialysis patients and improving their QOL require educational and therapeutic symptom management interventions that are tailored according to the characteristics and symptoms in each cluster. The findings of this study are expected to lead to practical guidelines for addressing the symptoms experienced by haemodialysis patients, and they provide basic information for developing nursing interventions to manage these symptoms and improve the QOL of these patients. © 2017 John Wiley & Sons Ltd.

Groundwater-quality data associated with abandoned underground coal mine aquifers in West Virginia, 1973-2016: Compilation of existing data from multiple sources

USGS Publications Warehouse

McAdoo, Mitchell A.; Kozar, Mark D.

2017-11-14

This report describes a compilation of existing water-quality data associated with groundwater resources originating from abandoned underground coal mines in West Virginia. Data were compiled from multiple sources for the purpose of understanding the suitability of groundwater from abandoned underground coal mines for public supply, industrial, agricultural, and other uses. This compilation includes data collected for multiple individual studies conducted from July 13, 1973 through September 7, 2016. Analytical methods varied by the time period of data collection and requirements of the independent studies.This project identified 770 water-quality samples from 294 sites that could be attributed to abandoned underground coal mine aquifers originating from multiple coal seams in West Virginia.

Health condition and familial factors associated with health-related quality of life in adolescents with congenital heart disease: a cross sectional study.

PubMed

Im, Yu-Mi; Yun, Tae-Jin; Lee, Sunhee

2018-01-10

The focus of clinical care after the repair of congenital heart disease has shifted from saving life of the patient to the patient's quality of life. The purpose of this study was to examine the health condition and familial factors associated with the health related quality of life of adolescents with congenital heart disease. Ninety-eight adolescents aged 13-19 years were collected from a congenital heart clinic from July 22 to August 23, 2013. Perceptions of parental rearing behaviors, health related quality of life of adolescent with congenital heart disease, and general characteristics were measured. We used multiple linear regression analysis to explore factors that are associated with the health related quality of life of adolescents with congenital heart disease. New York heart association class (Adj R 2  = .186, p = .000), presence of siblings (Adj R 2  = .240, p = .010), and mother's emotional warmth (Adj R 2  = .265, p = .043) were significantly associated with the health related quality of life of adolescents with congenital heart disease. Emotionally warm parental rearing behaviors and the presence of siblings were important familial factors that were positively associated with HRQOL in adolescents with CHD. Therefore, it is important for healthcare providers to develop a greater sensitivity to, and awareness of, the familial influences that may be impacting a subject's HRQOL, as well as the exigencies of the CHD, itself.

Disparities in breast cancer treatment and outcomes: biological, social, and health system determinants and opportunities for research.

PubMed

Wheeler, Stephanie B; Reeder-Hayes, Katherine E; Carey, Lisa A

2013-01-01

Racial disparities in breast cancer mortality have been widely documented for several decades and persist despite advances in receipt of mammography across racial groups. This persistence leads to questions about the roles of biological, social, and health system determinants of poor outcomes. Cancer outcomes are a function not only of innate biological factors but also of modifiable characteristics of individual behavior and decision making as well as characteristics of patient-health system interaction and the health system itself. Attempts to explain persistent racial disparities have mostly been limited to discussion of differences in insurance coverage, socioeconomic status, tumor stage at diagnosis, comorbidity, and molecular subtype of the tumor. This article summarizes existing literature exploring reasons for racial disparities in breast cancer mortality, with an emphasis on treatment disparities and opportunities for future research. Because breast cancer care requires a high degree of multidisciplinary team collaboration, ensuring that guideline recommended treatment (such as endocrine therapy for hormone receptor positive patients) is received by all racial/ethnic groups is critical and requires coordination across multiple providers and health care settings. Recognition that variation in cancer care quality may be correlated with race (and socioeconomic and health system factors) may assist policy makers in identifying strategies to more equally distribute clinical expertise and health infrastructure across multiple user populations.

The Immersive Virtual Reality Experience: A Typology of Users Revealed Through Multiple Correspondence Analysis Combined with Cluster Analysis Technique.

PubMed

Rosa, Pedro J; Morais, Diogo; Gamito, Pedro; Oliveira, Jorge; Saraiva, Tomaz

2016-03-01

Immersive virtual reality is thought to be advantageous by leading to higher levels of presence. However, and despite users getting actively involved in immersive three-dimensional virtual environments that incorporate sound and motion, there are individual factors, such as age, video game knowledge, and the predisposition to immersion, that may be associated with the quality of virtual reality experience. Moreover, one particular concern for users engaged in immersive virtual reality environments (VREs) is the possibility of side effects, such as cybersickness. The literature suggests that at least 60% of virtual reality users report having felt symptoms of cybersickness, which reduces the quality of the virtual reality experience. The aim of this study was thus to profile the right user to be involved in a VRE through head-mounted display. To examine which user characteristics are associated with the most effective virtual reality experience (lower cybersickness), a multiple correspondence analysis combined with cluster analysis technique was performed. Results revealed three distinct profiles, showing that the PC gamer profile is more associated with higher levels of virtual reality effectiveness, that is, higher predisposition to be immersed and reduced cybersickness symptoms in the VRE than console gamer and nongamer. These findings can be a useful orientation in clinical practice and future research as they help identify which users are more predisposed to benefit from immersive VREs.

Optimization and validation of moving average quality control procedures using bias detection curves and moving average validation charts.

PubMed

van Rossum, Huub H; Kemperman, Hans

2017-02-01

To date, no practical tools are available to obtain optimal settings for moving average (MA) as a continuous analytical quality control instrument. Also, there is no knowledge of the true bias detection properties of applied MA. We describe the use of bias detection curves for MA optimization and MA validation charts for validation of MA. MA optimization was performed on a data set of previously obtained consecutive assay results. Bias introduction and MA bias detection were simulated for multiple MA procedures (combination of truncation limits, calculation algorithms and control limits) and performed for various biases. Bias detection curves were generated by plotting the median number of test results needed for bias detection against the simulated introduced bias. In MA validation charts the minimum, median, and maximum numbers of assay results required for MA bias detection are shown for various bias. Their use was demonstrated for sodium, potassium, and albumin. Bias detection curves allowed optimization of MA settings by graphical comparison of bias detection properties of multiple MA. The optimal MA was selected based on the bias detection characteristics obtained. MA validation charts were generated for selected optimal MA and provided insight into the range of results required for MA bias detection. Bias detection curves and MA validation charts are useful tools for optimization and validation of MA procedures.

Development of a solenoid actuated planar valveless micropump with single and multiple inlet-outlet arrangements

NASA Astrophysics Data System (ADS)

Kumar, N.; George, D.; Sajeesh, P.; Manivannan, P. V.; Sen, A. K.

2016-07-01

We report a planar solenoid actuated valveless micropump with multiple inlet-outlet configurations. The self-priming characteristics of the multiple inlet-multiple outlet micropump are studied. The filling dynamics of the micropump chamber during start-up and the effects of fluid viscosity, voltage and frequency on the dynamics are investigated. Numerical simulations for multiple inlet-multiple outlet micropumps are carried out using fluid structure algorithm. With DI water and at 5.0 Vp-p, 20 Hz frequency, the two inlet-two outlet micropump provides a maximum flow rate of 336 μl min-1 and maximum back pressure of 441 Pa. Performance characteristics of the two inlet-two outlet micropump are studied for aqueous fluids of different viscosity. Transport of biological cell lines and diluted blood samples are demonstrated; the flow rate-frequency characteristics are studied. Viability of cells during pumping with multiple inlet multiple outlet configuration is also studied in this work, which shows 100% of cells are viable. Application of the proposed micropump for simultaneous pumping, mixing and distribution of fluids is demonstrated. The proposed integrated, standalone and portable micropump is suitable for drug delivery, lab-on-chip and micro-total-analysis applications.

Conduct disorder in girls: neighborhoods, family characteristics, and parenting behaviors.

PubMed

Pajer, Kathleen; Stein, Stefanie; Tritt, Karin; Chang, Chien-Ni; Wang, Wei; Gardner, William

2008-10-06

Little is known about the social context of girls with conduct disorder (CD), a question of increasing importance to clinicians and researchers. The purpose of this study was to examine the associations between three social context domains (neighborhood, family characteristics, and parenting behaviors) and CD in adolescent girls, additionally testing for race moderation effects. We predicted that disadvantaged neighborhoods, family characteristics such as parental marital status, and parenting behaviors such as negative discipline would characterize girls with CD. We also hypothesized that parenting behaviors would mediate the associations between neighborhood and family characteristics and CD. We recruited 93 15-17 year-old girls from the community and used a structured psychiatric interview to assign participants to a CD group (n = 52) or a demographically matched group with no psychiatric disorder (n = 41). Each girl and parent also filled out questionnaires about neighborhood, family characteristics, and parenting behaviors. Neighborhood quality was not associated with CD in girls. Some family characteristics (parental antisociality) and parenting behaviors (levels of family activities and negative discipline) were characteristic of girls with CD, but notll. There was no moderation by race. Our hypothesis that the association between family characteristics and CD would be mediated by parenting behaviors was not supported. This study expanded upon previous research by investigating multiple social context domains in girls with CD and by selecting a comparison group who were not different in age, social class, or race. When these factors are thus controlled, CD in adolescent girls is not significantly associated with neighborhood, but is associated with some family characteristics and some types of parental behaviors. However, the mechanisms underlying these relationships need to be further investigated. We discuss possible explanations for our findings and suggest directions for future research.

Conduct disorder in girls: neighborhoods, family characteristics, and parenting behaviors

PubMed Central

Pajer, Kathleen; Stein, Stefanie; Tritt, Karin; Chang, Chien-Ni; Wang, Wei; Gardner, William

2008-01-01

Background Little is known about the social context of girls with conduct disorder (CD), a question of increasing importance to clinicians and researchers. The purpose of this study was to examine the associations between three social context domains (neighborhood, family characteristics, and parenting behaviors) and CD in adolescent girls, additionally testing for race moderation effects. We predicted that disadvantaged neighborhoods, family characteristics such as parental marital status, and parenting behaviors such as negative discipline would characterize girls with CD. We also hypothesized that parenting behaviors would mediate the associations between neighborhood and family characteristics and CD. Methods We recruited 93 15–17 year-old girls from the community and used a structured psychiatric interview to assign participants to a CD group (n = 52) or a demographically matched group with no psychiatric disorder (n = 41). Each girl and parent also filled out questionnaires about neighborhood, family characteristics, and parenting behaviors. Results Neighborhood quality was not associated with CD in girls. Some family characteristics (parental antisociality) and parenting behaviors (levels of family activities and negative discipline) were characteristic of girls with CD, but notll. There was no moderation by race. Our hypothesis that the association between family characteristics and CD would be mediated by parenting behaviors was not supported. Conclusion This study expanded upon previous research by investigating multiple social context domains in girls with CD and by selecting a comparison group who were not different in age, social class, or race. When these factors are thus controlled, CD in adolescent girls is not significantly associated with neighborhood, but is associated with some family characteristics and some types of parental behaviors. However, the mechanisms underlying these relationships need to be further investigated. We discuss possible explanations for our findings and suggest directions for future research. PMID:18837974

Characteristics of low-slope streams that affect O2 transfer rates

USGS Publications Warehouse

Parker, Gene W.; Desimone, Leslie A.

1991-01-01

Multiple-regression techniques were used to derive the reaeration coefficients estimating equation for low sloped streams: K2 = 3.83 MBAS-0.41 SL0.20 H-0.76, where K2 is the reaeration coefficient in base e units per day; MBAS is the methylene blue active substances concentration in milligrams per liter; SL is the water-surface slope in foot per foot; and H is the mean-flow depth in feet. Fourteen hydraulic, physical, and water-quality characteristics were regressed against 29 measured-reaeration coefficients for low-sloped (water surface slopes less than 0.002 foot per foot) streams in Massachusetts and New York. Reaeration coefficients measured from May 1985 to October 1988 ranged from 0.2 to 11.0 base e units per day for 29 low-sloped tracer studies. Concentration of methylene blue active substances is significant because it is thought to be an indicator of concentration of surfactants which could change the surface tension at the air-water interface.

Gluten-free is not enough--perception and suggestions of celiac consumers.

PubMed

do Nascimento, Amanda Bagolin; Fiates, Giovanna Medeiros Rataichesck; dos Anjos, Adilson; Teixeira, Evanilda

2014-06-01

The present study investigated the perceptions of individuals with celiac disease about gluten-free (GF) products, their consumer behavior and which product is the most desired. A survey was used to collect information. Descriptive analysis, χ² tests and Multiple Logistic Regressions were conducted. Ninety-one questionnaires were analyzed. Limited variety and availability, the high price of products and the social restrictions imposed by the diet were the factors that caused the most dissatisfaction and difficulty. A total of 71% of the participants confirmed having moderate to high difficulty finding GF products. The logistic regression identified a significant relationship between dissatisfaction, texture and variety (p < 0.05) and between variety and difficulty of finding GF products (p < 0.05). The sensory characteristics were the most important variables considered for actual purchases. Bread was the most desired product. The participants were dissatisfaction with GF products. The desire for bread with better sensory characteristics reinforces the challenge to develop higher quality baking products.

Correlates of Quality of Life in New Migrants to Hong Kong from Mainland China.

PubMed

Wong, Winky K F; Chou, Kee-Lee; Chow, Nelson W S

2012-06-01

The concept of Quality of life (QOL) has received considerable attention from different disciplines. The aim of this study was to identify what are the correlates of QOL among Chinese new immigrants in Hong Kong. Data were collected through a cross-sectional survey among 449 Hong Kong new immigrants from Mainland China. Bivariate and multiple regression analyses were performed to examine the association between immigrants' QOL and their demographic characteristics, socio-economic factors, optimism, sense of control, perceived social support, perceived neighborhood disorder, collective efficacy, pre-migration planning, depressive symptoms and acculturation stress. Our findings demonstrated that depressive symptom is the most prominent factor in reducing immigrants' level of QOL, perceived social support and optimism are the two important factors that enhance the QOL of these depressed immigrants. Our results indicate that preventive measures must be developed, and professional counseling and psychological support services must be provided to new immigrants in Hong Kong, especially those who have depressive symptoms.

Experimental Design and Primary Data Analysis Methods for Comparing Adaptive Interventions

PubMed Central

Nahum-Shani, Inbal; Qian, Min; Almirall, Daniel; Pelham, William E.; Gnagy, Beth; Fabiano, Greg; Waxmonsky, Jim; Yu, Jihnhee; Murphy, Susan

2013-01-01

In recent years, research in the area of intervention development is shifting from the traditional fixed-intervention approach to adaptive interventions, which allow greater individualization and adaptation of intervention options (i.e., intervention type and/or dosage) over time. Adaptive interventions are operationalized via a sequence of decision rules that specify how intervention options should be adapted to an individual’s characteristics and changing needs, with the general aim to optimize the long-term effectiveness of the intervention. Here, we review adaptive interventions, discussing the potential contribution of this concept to research in the behavioral and social sciences. We then propose the sequential multiple assignment randomized trial (SMART), an experimental design useful for addressing research questions that inform the construction of high-quality adaptive interventions. To clarify the SMART approach and its advantages, we compare SMART with other experimental approaches. We also provide methods for analyzing data from SMART to address primary research questions that inform the construction of a high-quality adaptive intervention. PMID:23025433

A multilevel reuse system with source separation process for printing and dyeing wastewater treatment: A case study.

PubMed

Wang, Rui; Jin, Xin; Wang, Ziyuan; Gu, Wantao; Wei, Zhechao; Huang, Yuanjie; Qiu, Zhuang; Jin, Pengkang

2018-01-01

This paper proposes a new system of multilevel reuse with source separation in printing and dyeing wastewater (PDWW) treatment in order to dramatically improve the water reuse rate to 35%. By analysing the characteristics of the sources and concentrations of pollutants produced in different printing and dyeing processes, special, highly, and less contaminated wastewaters (SCW, HCW, and LCW, respectively) were collected and treated separately. Specially, a large quantity of LCW was sequentially reused at multiple levels to meet the water quality requirements for different production processes. Based on this concept, a multilevel reuse system with a source separation process was established in a typical printing and dyeing enterprise. The water reuse rate increased dramatically to 62%, and the reclaimed water was reused in different printing and dyeing processes based on the water quality. This study provides promising leads in water management for wastewater reclamation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effect of Laser Power and Scan Speed on Melt Pool Characteristics of Commercially Pure Titanium (CP-Ti)

NASA Astrophysics Data System (ADS)

Kusuma, Chandrakanth; Ahmed, Sazzad H.; Mian, Ahsan; Srinivasan, Raghavan

2017-07-01

Selective laser melting (SLM) is an additive manufacturing technique that creates complex parts by selectively melting metal powder layer-by-layer using a laser. In SLM, the process parameters decide the quality of the fabricated component. In this study, single beads of commercially pure titanium (CP-Ti) were melted on a substrate of the same material using an in-house built SLM machine. Multiple combinations of laser power and scan speed were used for single bead fabrication, while the laser beam diameter and powder layer thickness were kept constant. This experimental study investigated the influence of laser power, scan speed, and laser energy density on the melt pool formation, surface morphology, geometry (width and height), and hardness of solidified beads. In addition, the observed unfavorable effect such as inconsistency in melt pool width formation is discussed. The results show that the quality, geometry, and hardness of solidified melt pool are significantly affected by laser power, scanning speed, and laser energy density.

Preschool Center Quality and School Readiness: Quality Effects and Variation by Demographic and Child Characteristics

PubMed Central

Keys, Tran D.; Farkas, George; Burchinal, Margaret R.; Duncan, Greg J.; Vandell, Deborah L.; Li, Weilin; Ruzek, Erik A.; Howes, Carollee

2014-01-01

This article examines associations between observed quality in preschool center classrooms for approximately 6,250 three- to five-year-olds and their school readiness skills at kindergarten entry. Secondary analyses were conducted using data from four large-scale studies to estimate the effects of preschool center quality and interactions between quality and demographic characteristics and child entry skills and behaviors. Findings were summarized across studies using meta-analytic methods. Results indicate small, but statistically significant associations for preschool center quality main effects on language and mathematics outcomes with little evidence of moderation by demographic characteristics or child entry skills and behaviors. Preschool center quality was not reliably related to socioemotional outcomes. The authors discuss possible explanations for the small effect sizes and lack of differential effects. PMID:23331043

Characteristics of Successful Entrepreneurs.

ERIC Educational Resources Information Center

McClelland, David C.

1987-01-01

Comparison of characteristics of 12 average and 12 superior small business people in three developing nations (India, Malawi, and Ecuador) found proactive qualities such as initiative and assertiveness, achievement orientation, and commitment to others characteristic of successful entrepreneurs. Other expected qualities (self-confidence,…

Multiple Category-Lot Quality Assurance Sampling: A New Classification System with Application to Schistosomiasis Control

PubMed Central

Olives, Casey; Valadez, Joseph J.; Brooker, Simon J.; Pagano, Marcello

2012-01-01

Background Originally a binary classifier, Lot Quality Assurance Sampling (LQAS) has proven to be a useful tool for classification of the prevalence of Schistosoma mansoni into multiple categories (≤10%, >10 and <50%, ≥50%), and semi-curtailed sampling has been shown to effectively reduce the number of observations needed to reach a decision. To date the statistical underpinnings for Multiple Category-LQAS (MC-LQAS) have not received full treatment. We explore the analytical properties of MC-LQAS, and validate its use for the classification of S. mansoni prevalence in multiple settings in East Africa. Methodology We outline MC-LQAS design principles and formulae for operating characteristic curves. In addition, we derive the average sample number for MC-LQAS when utilizing semi-curtailed sampling and introduce curtailed sampling in this setting. We also assess the performance of MC-LQAS designs with maximum sample sizes of n = 15 and n = 25 via a weighted kappa-statistic using S. mansoni data collected in 388 schools from four studies in East Africa. Principle Findings Overall performance of MC-LQAS classification was high (kappa-statistic of 0.87). In three of the studies, the kappa-statistic for a design with n = 15 was greater than 0.75. In the fourth study, where these designs performed poorly (kappa-statistic less than 0.50), the majority of observations fell in regions where potential error is known to be high. Employment of semi-curtailed and curtailed sampling further reduced the sample size by as many as 0.5 and 3.5 observations per school, respectively, without increasing classification error. Conclusion/Significance This work provides the needed analytics to understand the properties of MC-LQAS for assessing the prevalance of S. mansoni and shows that in most settings a sample size of 15 children provides a reliable classification of schools. PMID:22970333

The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection.

PubMed

Gane, Elise M; McPhail, Steven M; Hatton, Anna L; Panizza, Benedict J; O'Leary, Shaun P

2018-05-16

The purpose of this study was to examine the relationship between physical impairments, quality of life and disability in patients following neck dissection, with consideration of patient and clinical characteristics. Cross-sectional study of patients < 5 years after neck dissection for head and neck cancer. Quality of life and self-reported disability were measured with the Neck Dissection Impairment Index, Quick Disabilities of the Arm, Shoulder and Hand, and Neck Disability Index. Active neck and shoulder range of motion and isometric muscle strength were also assessed. Generalised linear modelling was used to explore relationships between variables. Eighty-four participants (68% male, median age 61 years) demonstrated reduced quality of life (median (interquartile range) score = 76 (49, 93) from 0 (worst) to 100 (best)), and mild levels of upper limb (14 (2, 32)) and neck disability (14 (6, 28)) (from 0 (best) to 100 (worst)). Bilateral neck dissection was associated with reduced quality of life (coeff (95% CI) = - 12.49 (- 24.69, - 0.29)). Post-operative chemoradiation therapy was associated with reduced quality of life (- 21.46 (- 37.57, - 5.35)) and neck disability (0.71 (0.10, 1.32)). Measures of shoulder flexibility or strength were associated with quality of life and self-reported disability. Quality of life and musculoskeletal disability after neck dissection are associated with factors from multiple domains including physical motor function and treatment modality. Having reduced shoulder flexibility or strength is related to functional deficits and quality of life after neck dissection for head and neck cancer.

Embodying Meaning: Qualities, Feelings, Selective Attention, and Habits

ERIC Educational Resources Information Center

Andersson, Joacim; Garrison, Jim

2016-01-01

Recently, there has been increasing pedagogical interest in the qualities and characteristics of movement. This article examines these qualities and characteristics in terms of John Dewey's distinction between abstract, linguistic "significant" meanings and concrete, embodied "imminent" meanings. Imminent meanings are comprised…

An efficient approach to understanding and predicting the effects of multiple task characteristics on performance.

PubMed

Richardson, Miles

2017-04-01

In ergonomics there is often a need to identify and predict the separate effects of multiple factors on performance. A cost-effective fractional factorial approach to understanding the relationship between task characteristics and task performance is presented. The method has been shown to provide sufficient independent variability to reveal and predict the effects of task characteristics on performance in two domains. The five steps outlined are: selection of performance measure, task characteristic identification, task design for user trials, data collection, regression model development and task characteristic analysis. The approach can be used for furthering knowledge of task performance, theoretical understanding, experimental control and prediction of task performance. Practitioner Summary: A cost-effective method to identify and predict the separate effects of multiple factors on performance is presented. The five steps allow a better understanding of task factors during the design process.

Guiding phosphorus stewardship for multiple ecosystem services

USDA-ARS?s Scientific Manuscript database

Phosphorus is vital to agricultural production and water quality regulation. While the role of phosphorus in agriculture and water quality has been studied for decades, the benefits of sustainable phosphorus use and management for society due to its downstream impacts on multiple ecosystem services...

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.

Hybrid Modeling Approach to Estimate Exposures of Hazardous Air Pollutants (HAPs) for the National Air Toxics Assessment (NATA).

PubMed

Scheffe, Richard D; Strum, Madeleine; Phillips, Sharon B; Thurman, James; Eyth, Alison; Fudge, Steve; Morris, Mark; Palma, Ted; Cook, Richard

2016-11-15

A hybrid air quality model has been developed and applied to estimate annual concentrations of 40 hazardous air pollutants (HAPs) across the continental United States (CONUS) to support the 2011 calendar year National Air Toxics Assessment (NATA). By combining a chemical transport model (CTM) with a Gaussian dispersion model, both reactive and nonreactive HAPs are accommodated across local to regional spatial scales, through a multiplicative technique designed to improve mass conservation relative to previous additive methods. The broad scope of multiple pollutants capturing regional to local spatial scale patterns across a vast spatial domain is precedent setting within the air toxics community. The hybrid design exhibits improved performance relative to the stand alone CTM and dispersion model. However, model performance varies widely across pollutant categories and quantifiably definitive performance assessments are hampered by a limited observation base and challenged by the multiple physical and chemical attributes of HAPs. Formaldehyde and acetaldehyde are the dominant HAP concentration and cancer risk drivers, characterized by strong regional signals associated with naturally emitted carbonyl precursors enhanced in urban transport corridors with strong mobile source sector emissions. The multiple pollutant emission characteristics of combustion dominated source sectors creates largely similar concentration patterns across the majority of HAPs. However, reactive carbonyls exhibit significantly less spatial variability relative to nonreactive HAPs across the CONUS.

Self-Management Skills in Chronic Disease Management: What Role Does Health Literacy Have?

PubMed

Mackey, Laura M; Doody, Catherine; Werner, Erik L; Fullen, Brona

2016-08-01

Self-management-based interventions can lead to improved health outcomes in people with chronic diseases, and multiple patient characteristics are associated with the development of self-management behaviors. Low health literacy (HL) has been implicated in poorer self-management behaviors and increased costs to health services. However, the mechanisms behind this relationship remain unclear. Therefore, the aim of the current review is to assess the association between HL and patient characteristics related to self-management behaviors (i.e., disease-related knowledge, beliefs, and self-efficacy). The review comprised 3 phases: 1) database searches, 2) eligibility screening, and 3) study quality assessment and strength of evidence. Inclusion criteria specified that a valid HL screening tool was used, that at least one self-management behavior was assessed, and that patients had a chronic condition. An initial search generated a total of 712 articles, of which 31 studies fulfilled the eligibility criteria. A consistent association was found between low HL and poorer disease-related knowledge in respiratory diseases, diabetes, and multiple disease categories. A significant association between low HL and poorer self-efficacy was reported in cardiovascular diseases, diabetes, human immunodeficiency virus, and multiple disease categories. HL was significantly associated with poorer beliefs in respiratory, musculoskeletal, and cardiovascular diseases. The findings from the current review suggest that low HL may affect behaviors necessary for the development of self-management skills. Given that self-management strategies are core components for effective treatment of a range of chronic diseases, low HL poses a considerable health concern. Further research is needed to understand the mediating influence of HL on disease-related knowledge, self-efficacy, and beliefs. From this, HL-sensitive, self-management interventions ought to be devised and implemented. © The Author(s) 2016.

Feasibility and utility of applications of the common data model to multiple, disparate observational health databases.

PubMed

Voss, Erica A; Makadia, Rupa; Matcho, Amy; Ma, Qianli; Knoll, Chris; Schuemie, Martijn; DeFalco, Frank J; Londhe, Ajit; Zhu, Vivienne; Ryan, Patrick B

2015-05-01

To evaluate the utility of applying the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) across multiple observational databases within an organization and to apply standardized analytics tools for conducting observational research. Six deidentified patient-level datasets were transformed to the OMOP CDM. We evaluated the extent of information loss that occurred through the standardization process. We developed a standardized analytic tool to replicate the cohort construction process from a published epidemiology protocol and applied the analysis to all 6 databases to assess time-to-execution and comparability of results. Transformation to the CDM resulted in minimal information loss across all 6 databases. Patients and observations excluded were due to identified data quality issues in the source system, 96% to 99% of condition records and 90% to 99% of drug records were successfully mapped into the CDM using the standard vocabulary. The full cohort replication and descriptive baseline summary was executed for 2 cohorts in 6 databases in less than 1 hour. The standardization process improved data quality, increased efficiency, and facilitated cross-database comparisons to support a more systematic approach to observational research. Comparisons across data sources showed consistency in the impact of inclusion criteria, using the protocol and identified differences in patient characteristics and coding practices across databases. Standardizing data structure (through a CDM), content (through a standard vocabulary with source code mappings), and analytics can enable an institution to apply a network-based approach to observational research across multiple, disparate observational health databases. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Primary packaging considerations in developing medicines for children: oral liquid and powder for constitution.

PubMed

Campbell, Gossett A; Vallejo, Erick

2015-01-01

The packaging presentation of oral liquid pediatric medicines is a critical step in maintaining chemical and physical stability, compliance, adherence, and proper handling by the target patient population, guardians, caregivers, and health-care professionals. The common packaging presentations for commercial oral liquid pediatric drug products are glass bottle, plastic bottle, sachet, and stick pack configurations. The type of pack presentation selected is driven by the quality target product profile (QTPP) that is designed around the physicochemical properties of the drug substance and the desired drug product suitability for the target population. The QTPP defines the intended use of the drug product, drug product quality criteria, dose strength, dosage form, container closure system, storage conditions, stability criteria, dosing device, shelf life, and attributes affecting the pharmacokinetic characteristics. Oral liquid pediatric formulations are typically prepared from a powder that is constituted at the time of use as a suspension or a solution for single or multiple use depending on the stability of the constituted formulation. Active ingredients with high aqueous solubility can be developed as a powder for oral solution and presented in a bottle for multiple use product and a stick pack, packet, or sachet for single-use product. Active ingredients with low aqueous solubility can be developed as a powder for oral suspension and presented in a bottle for multiple use product and a stick pack or sachet for single-use product. A secondary package may be used in cases where the primary pack failed to provide adequate protection against light degradation. This work will help formulation scientists select the most appropriate pack presentation in the early stages of pediatric clinical development. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

Relationships between self-reported sleep quality components and cognitive functioning in breast cancer survivors up to 10 years following chemotherapy.

PubMed

Henneghan, Ashley M; Carter, Patricia; Stuifbergan, Alexa; Parmelee, Brennan; Kesler, Shelli

2018-04-23

Links have been made between aspects of sleep quality and cognitive function in breast cancer survivors (BCS), but findings are heterogeneous. The objective of this study is to examine relationships between specific sleep quality components (latency, duration, efficiency, daytime sleepiness, sleep disturbance, use of sleep aids) and cognitive impairment (performance and perceived), and determine which sleep quality components are the most significant contributors to cognitive impairments in BCS 6 months to 10 years post chemotherapy. Women 21 to 65 years old with a history of non-metastatic breast cancer following chemotherapy completion were recruited. Data collection included surveys to evaluate sleep quality and perceived cognitive impairments, and neuropsychological testing to evaluate verbal fluency and memory. Descriptive statistics, bivariate correlations, and hierarchical multiple regression were calculated. 90 women (mean age 49) completed data collection. Moderate significant correlations were found between daytime dysfunction, sleep efficiency, sleep latency, and sleep disturbance and perceived cognitive impairment (Rs = -0.37 to -0.49, Ps<.00049), but not objective cognitive performance of verbal fluency, memory or attention. After accounting for individual and clinical characteristics, the strongest predictors of perceived cognitive impairments were daytime dysfunction, sleep efficiency, and sleep disturbance. Findings support links between sleep quality and perceived cognitive impairments in BCS and suggest specific components of sleep quality (daytime dysfunction, sleep efficiency, and sleep disturbance) are associated with perceived cognitive functioning in this population. Findings can assist clinicians in guiding survivors to manage sleep and cognitive problems and aid in the design of interventional research. This article is protected by copyright. All rights reserved.

The baby or the bath water? Lessons learned from the National Action Alliance for Suicide Prevention Research Prioritization Task Force literature review.

PubMed

Davis Molock, Sherry; Heekin, Janet M; Matlin, Samantha G; Barksdale, Crystal L; Gray, Ekwenzi; Booth, Chelsea L

2014-09-01

The Research Prioritization Task Force of the National Action Alliance for Suicide Prevention conducted a comprehensive literature review of suicide prevention/intervention trials to assess the quality of the scientific evidence. A literature "review of reviews" was conducted by searching the most widely used databases for mental health and public health research. The quality of the reviews was evaluated using the Revised Assessment of Multiple Systematic Reviews system; the quality of the scientific evidence for the suicide preventions/interventions was assessed using U.S. Preventive Services Task Force criteria. The reviews were limited to peer-reviewed publications with human subjects published in English. Ninety-eight systematic reviews and 45 primary sources on suicide prevention/interventions published between January 2000 and September 2012 were evaluated. The results suggest that the quality of both the systematic reviews and the scientific evidence for suicide preventions/interventions were mixed. The majority of the systematic reviews and prevention/interventions were evaluated as fair to poor in quality. There are many promising suicide prevention/intervention trials, but research findings are often inconclusive because of methodologic problems. Methodologic problems across systematic reviews include not conducting hand searches, not surveying gray literature, and being unable to aggregate data across studies. Methodologic problems with the scientific quality of the prevention/intervention trials include paucity of information on sample demographic characteristics, poorly defined outcomes, and excluding actively suicidal participants. Suggestions for ways to improve the quality of the systematic reviews and suicide preventions/interventions are provided. Copyright © 2014 American Journal of Preventive Medicine. All rights reserved.

Access to Quality Early Childhood Care and Education. Background Paper for the Quality Child Care Think Tank. Draft.

ERIC Educational Resources Information Center

Brandon, Richard N.; Smith, Diana

This background paper discusses the current system of child care finance in Washington State and analyzes options for improvement. It describes prominent characteristics of the early childhood care and education system, findings relating program quality to staff/child ratios and staff educational levels, characteristics of quality, parent…

National Beef Quality Audit-2011: Harvest-floor assessments of targeted characteristics that affect quality and value of cattle, carcasses, and byproducts

USDA-ARS?s Scientific Manuscript database

The National Beef Quality Audit-2011(NBQA-2011) was conducted to assess targeted characteristics on the harvest floor that affect the quality and value of cattle, carcasses, and byproducts. Survey teams evaluated approximately 18,000 cattle/carcasses between May and November 2011 in 8 beef processin...

Soft wheat quality characteristics required for making baking powder biscuits

USDA-ARS?s Scientific Manuscript database

Fifteen soft wheat varieties were evaluated for their grain, milling, flour and dough mixing characteristics, as well as their solvent retention capacities (SRCs), pasting properties and suitability for making baking powder biscuits, to identify wheat quality characteristics required for making bisc...

Requirements for satisfactory flying qualities of airplanes

NASA Technical Reports Server (NTRS)

Gilruth, R R

1943-01-01

Report discusses the results of an analysis of available data to determine what measured characteristics are significant in defining satisfactory flying qualities, what characteristics are reasonable to require of an airplane, and what influence the various design features have on the observed flying qualities.

Patient factors and quality of life outcomes differ among four subgroups of oncology patients based on symptom occurrence.

PubMed

Astrup, Guro Lindviksmoen; Hofsø, Kristin; Bjordal, Kristin; Guren, Marianne Grønlie; Vistad, Ingvild; Cooper, Bruce; Miaskowski, Christine; Rustøen, Tone

2017-03-01

Reviews of the literature on symptoms in oncology patients undergoing curative treatment, as well as patients receiving palliative care, suggest that they experience multiple, co-occurring symptoms and side effects. The purposes of this study were to determine if subgroups of oncology patients could be identified based on symptom occurrence rates and if these subgroups differed on a number of demographic and clinical characteristics, as well as on quality of life (QoL) outcomes. Latent class analysis (LCA) was used to identify subgroups (i.e. latent classes) of patients with distinct symptom experiences based on the occurrence rates for the 13 most common symptoms from the Memorial Symptom Assessment Scale. In total, 534 patients with breast, head and neck, colorectal, or ovarian cancer participated. Four latent classes of patients were identified based on probability of symptom occurrence: all low class [i.e. low probability for all symptoms (n = 152)], all high class (n = 149), high psychological class (n = 121), and low psychological class (n = 112). Patients in the all high class were significantly younger compared with patients in the all low class. Furthermore, compared to the other three classes, patients in the all high class had lower functional status and higher comorbidity scores, and reported poorer QoL scores. Patients in the high and low psychological classes had a moderate probability of reporting physical symptoms. Patients in the low psychological class reported a higher number of symptoms, a lower functional status, and poorer physical and total QoL scores. Distinct subgroups of oncology patients can be identified based on symptom occurrence rates. Patient characteristics that are associated with these subgroups can be used to identify patients who are at greater risk for multiple co-occurring symptoms and diminished QoL, so that these patients can be offered appropriate symptom management interventions.

Evaluation of the Possible Sources and Controlling Factors of Toxic Metals/Metalloids in the Florida Everglades and Their Potential Risk of Exposure.

PubMed

Li, Yanbin; Duan, Zhiwei; Liu, Guangliang; Kalla, Peter; Scheidt, Daniel; Cai, Yong

2015-08-18

The Florida Everglades is an environmentally sensitive wetland ecosystem with a number of threatened and endangered fauna species susceptible to the deterioration of water quality. Several potential toxic metal sources exist in the Everglades, including farming, atmospheric deposition, and human activities in urban areas, causing concerns of potential metal exposure risks. However, little is known about the pollution status of toxic metals/metalloids of potential concern, except for Hg. In this study, eight toxic metals/metalloids (Cd, Cr, Pb, Ni, Cu, Zn, As, and Hg) in Everglades soils were investigated in both dry and wet seasons. Pb, Cr, As, Cu, Cd, and Ni were identified to be above Florida SQGs (sediment quality guidelines) at a number of sampling sites, particularly Pb, which had a level of potential risk to organisms similar to that of Hg. In addition, a method was developed for quantitative source identification and controlling factor elucidation of toxic metals/metalloids by introducing an index, enrichment factor (EF), in the conventional multiple regression analysis. EFs represent the effects of anthropogenic sources on metals/metalloids in soils. Multiple regression analysis showed that Cr and Ni were mainly controlled by anthropogenic loading, whereas soil characteristics, in particular natural organic matter (NOM), played a more important role for Hg, As, Cd, and Zn. NOM may control the distribution of these toxic metals/metalloids by affecting their mobility in soils. For Cu and Pb, the effects of EFs and environmental factors are comparable, suggesting combined effects of loading and soil characteristics. This study is the first comprehensive research with a vast amount of sampling sites on the distribution and potential risks of toxic metals/metalloids in the Everglades. The finding suggests that in addition to Hg other metals/metalloids could also potentially be an environmental problem in this wetland ecosystem.

Motion-related resource allocation in dynamic wireless visual sensor network environments.

PubMed

Katsenou, Angeliki V; Kondi, Lisimachos P; Parsopoulos, Konstantinos E

2014-01-01

This paper investigates quality-driven cross-layer optimization for resource allocation in direct sequence code division multiple access wireless visual sensor networks. We consider a single-hop network topology, where each sensor transmits directly to a centralized control unit (CCU) that manages the available network resources. Our aim is to enable the CCU to jointly allocate the transmission power and source-channel coding rates for each node, under four different quality-driven criteria that take into consideration the varying motion characteristics of each recorded video. For this purpose, we studied two approaches with a different tradeoff of quality and complexity. The first one allocates the resources individually for each sensor, whereas the second clusters them according to the recorded level of motion. In order to address the dynamic nature of the recorded scenery and re-allocate the resources whenever it is dictated by the changes in the amount of motion in the scenery, we propose a mechanism based on the particle swarm optimization algorithm, combined with two restarting schemes that either exploit the previously determined resource allocation or conduct a rough estimation of it. Experimental simulations demonstrate the efficiency of the proposed approaches.

A Framework for Evaluating the Software Product Quality of Pregnancy Monitoring Mobile Personal Health Records.

PubMed

Idri, Ali; Bachiri, Mariam; Fernández-Alemán, José Luis

2016-03-01

Stakeholders' needs and expectations are identified by means of software quality requirements, which have an impact on software product quality. In this paper, we present a set of requirements for mobile personal health records (mPHRs) for pregnancy monitoring, which have been extracted from literature and existing mobile apps on the market. We also use the ISO/IEC 25030 standard to suggest the requirements that should be considered during the quality evaluation of these mPHRs. We then go on to design a checklist in which we contrast the mPHRs for pregnancy monitoring requirements with software product quality characteristics and sub-characteristics in order to calculate the impact of these requirements on software product quality, using the ISO/IEC 25010 software product quality standard. The results obtained show that the requirements related to the user's actions and the app's features have the most impact on the external sub-characteristics of the software product quality model. The only sub-characteristic affected by all the requirements is Appropriateness of Functional suitability. The characteristic Operability is affected by 95% of the requirements while the lowest degrees of impact were identified for Compatibility (15%) and Transferability (6%). Lastly, the degrees of the impact of the mPHRs for pregnancy monitoring requirements are discussed in order to provide appropriate recommendations for the developers and stakeholders of mPHRs for pregnancy monitoring.

The Prevalence and Determinants of Controlled Substance Discrepancies in a Level I Trauma Hospital

PubMed Central

Anyanwu, Chukwuma; Egwim, Oliver

2016-01-01

Background Healthcare institutions are often faced with challenges and accreditation requirements for improving treatment quality, reducing waste, and avoiding diversion of drugs, particularly controlled substances. Many automated systems have replaced manual systems but may be fraught with challenges, especially when multiple users are involved. Objective To describe the characteristics of controlled substance discrepancies observed in a Level I trauma hospital for Medicare. Methods Discrepancy data were captured for each user involved in a transaction for a controlled substance at the Level I trauma hospital (in Ben Taub Hospital, Houston, TX), and the information was stored in a computerized database repository. Data for the 1-year study period (from January 1 through December 31, 2013) were collected for Medicare beneficiaries, using an Excel 2013 spreadsheet, and were analyzed according to basic discrepancy characteristics and descriptive statistics. Results During the 12-month study period, 114,000 controlled substance discrepancies were found for 100,000 Medicare patients at this Level I trauma hospital. Vending activities accounted for the majority (52.6%) of these discrepancies. Discrepancies were most likely to occur on Wednesdays, and the medications involved most frequently were combination drugs of hydrocodone and acetaminophen. Conclusion Approximately 1 (1.14) discrepancy involving a controlled substance occurred for each Medicare patient treated at the study facility. Healthcare institutions need to improve their efforts to ensure high-quality care and prevent diversion of drugs. PMID:27606038

Is the maturity of hospitals' quality improvement systems associated with measures of quality and patient safety?

PubMed Central

2011-01-01

Background Previous research addressed the development of a classification scheme for quality improvement systems in European hospitals. In this study we explore associations between the 'maturity' of the hospitals' quality improvement system and clinical outcomes. Methods The maturity classification scheme was developed based on survey results from 389 hospitals in eight European countries. We matched the hospitals from the Spanish sample (113 hospitals) with those hospitals participating in a nation-wide, voluntary hospital performance initiative. We then compared sample distributions and explored associations between the 'maturity' of the hospitals' quality improvement system and a range of composite outcomes measures, such as adjusted hospital-wide mortality, -readmission, -complication and -length of stay indices. Statistical analysis includes bivariate correlations for parametrically and non-parametrically distributed data, multiple robust regression models and bootstrapping techniques to obtain confidence-intervals for the correlation and regression estimates. Results Overall, 43 hospitals were included. Compared to the original sample of 113, this sample was characterized by a higher representation of university hospitals. Maturity of the quality improvement system was similar, although the matched sample showed less variability. Analysis of associations between the quality improvement system and hospital-wide outcomes suggests significant correlations for the indicator adjusted hospital complications, borderline significance for adjusted hospital readmissions and non-significance for the adjusted hospital mortality and length of stay indicators. These results are confirmed by the bootstrap estimates of the robust regression model after adjusting for hospital characteristics. Conclusions We assessed associations between hospitals' quality improvement systems and clinical outcomes. From this data it seems that having a more developed quality improvement system is associated with lower rates of adjusted hospital complications. A number of methodological and logistic hurdles remain to link hospital quality improvement systems to outcomes. Further research should aim at identifying the latent dimensions of quality improvement systems that predict quality and safety outcomes. Such research would add pertinent knowledge regarding the implementation of organizational strategies related with quality of care outcomes. PMID:22185479

Caregiver staffing in nursing homes and their influence on quality of care: using dynamic panel estimation methods.

PubMed

Castle, Nicholas G; Anderson, Ruth A

2011-06-01

There is inconclusive evidence that nursing home caregiver staffing characteristics influence quality of care. In this research, the relationship of caregiver staffing levels, turnover, agency use, and professional staff mix with quality is further examined using a longitudinal analysis to overcome weaknesses of earlier research. The data used came from a survey of nursing home administrators, Nursing Home Compare, the Online Survey Certification and Reporting data, and the Area Resource File. The staffing variables of Registered Nurses, Licensed Practical Nurses, and Nurse Aides were measured quarterly from 2003 through 2007, and came from 2839 facilities. Generalized method of moments estimation was used to examine the effects of changes in staffing characteristics on changes in 4 quality measures (physical restraint use, catheter use, pain management, and pressure sores). Regression analyses show a robust association between the staffing characteristic variables and quality indicators. A change to more favorable staffing is generally associated with a change to better quality. With longitudinal information and quarterly staffing information, we are able to show that for many nursing homes improving staffing characteristics will improve quality of care.

The characteristics of patients frequently admitted to academic medical centers in the United States

PubMed Central

Williams, Mark V.; Carrier, Danielle; Hensley, Laurie; Thomas, Stephen; Cerese, Julie

2015-01-01

BACKGROUND The recent intense attention to hospital readmissions and their implications for quality, safety, and reimbursement necessitates understanding specific subsets of readmitted patients. Frequently admitted patients, defined as patients who are admitted 5 or more times within 1 year, may have some distinguishing characteristics that require novel solutions. METHODS A comprehensive administrative database (University HealthSystem Consortium's Clinical Data Base/Resource Manager™) was analyzed to identify demographic, social, and clinical characteristics of frequently admitted patients in 101 US academic medical centers. RESULTS We studied 28,291 frequently admitted patients with 180,185 admissions over a 1‐year period (2011–2012). These patients comprise 1.6% of all patients, but account for 8% of all admissions and 7% of direct costs. Their admissions are driven by multiple chronic conditions; compared to other hospitalized patients, they have significantly more comorbidities (an average of 7.1 vs 2.5), and 84% of their admissions are to medical services. A minority, but significantly more than other patients, have comorbidities of psychosis or substance abuse. Moreover, although they are slightly more likely than other patients to be on Medicaid or to be uninsured (27.6% vs 21.6%), nearly three‐quarters have private or Medicare coverage. CONCLUSIONS Patients who are frequently admitted to US academic medical centers are likely to have multiple complex chronic conditions and may have behavioral comorbidities that mediate their health behaviors, resulting in acute episodes requiring hospitalization. This information can be used to identify solutions for preventing repeat hospitalization for this small group of patients who consume a highly disproportionate share of healthcare resources. Journal of Hospital Medicine 2015;10:563–568. © 2015 The Authors Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine PMID:26018340

Modeling the factors associating with health-related habits among Japanese students.

PubMed

Mato, Mie; Tsukasaki, Keiko

2017-11-23

The aim of the present study was to clarify the structural relationship between health-related habits and psychosocial factors during adolescence/early adulthood. An anonymous, self-administered questionnaire was provided to 1141 third- and fourth-year students at eight academic departments from six universities in regional Japanese cities. Surveys included items addressing participants' demographic characteristics, psychosocial factors (individual-level social capital, self-efficacy, mental health (from health-related quality of life SF-36v2), and sense of coherence (SOC)), and health-related habits. A multiple indicator analysis based on structural equation modeling was conducted to examine the structural relationship between health-related habits and these factors. Valid responses were obtained from 952 participants. The final model demonstrated a high level of goodness of fit. While the path from SOC to health-related habits was significant, those from self-efficacy to health-related habits and from mental health to health-related habits were not significant. The path coefficient from SOC to health-related habits was greater than the path coefficient from background characteristics. In the multiple population comparison that considered gender, a nearly identical model was supported for men and women. Psychosocial factors related to health-related habits were social capital, self-efficacy, mental health, and SOC. Furthermore, it was suggested that SOC functions as an intervening factor for maintaining a healthy lifestyle. It was observed that individual psychosocial factors influence health-related habits more than their background characteristics. Findings highlight that supporting the building of social relationships and social environments is essential to promote a healthy lifestyle among university students. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A survey of dietary characteristics in a large population of people with multiple sclerosis.

PubMed

Fitzgerald, Kathryn C; Tyry, Tuula; Salter, Amber; Cofield, Stacey S; Cutter, Gary; Fox, Robert J; Marrie, Ruth Ann

2018-05-01

Dietary approaches to management of MS has been proposed for several decades, yet very little is known concerning dietary composition or adherence to specialized diets in people with multiple sclerosis (MS). We conducted a survey of participants in the North American Research Committee on MS (NARCOMS) registry assessing diet composition and the prevalence of 19 different diets. We characterized prevalence of different diets and compared diet composition with estimated intakes from the National Health and Nutrition Examination Survey (NHANES) survey respondents and across demographics and MS clinical characteristics. Among the 7639 (68%) responders, 6990 provided sufficient information on diet to be included in the analysis. Compared to NHANES participants, responders tended to have comparable intakes of fruit, vegetables and legumes (mean [SD] 2.5 [1.0] servings/day) and whole grains (0.9 [1.3] servings/day) and consume less added sugar (NARCOMS: 9.7 [6.0] vs. NHANES: 18.5[13.5] tsp/day; P < 0.001) and more red meat (NARCOMS: 0.50 [0.47] vs. NHANES: 0.35 [0.97] servings/day; P < 0.001). Of the 3120 (45%) participants who reported any history of following a specific diet, commonly-followed diets were: low-sugar (n = 642), low-carbohydrate (n = 508) and low-calorie (n = 475). Those with no history of following any specific diet were more likely to have progressive MS, be more obese, have worse overall diet quality, not participate in physical activity and smoke (all P < 0.001). In this large survey, we found that diet composition in MS patients may vary by demographic and disease characteristics. Copyright © 2018 Elsevier B.V. All rights reserved.

Parameter optimization of the QUAL2K model for a multiple-reach river using an influence coefficient algorithm.

PubMed

Cho, Jae Heon; Ha, Sung Ryong

2010-03-15

An influence coefficient algorithm and a genetic algorithm (GA) were introduced to develop an automatic calibration model for QUAL2K, the latest version of the QUAL2E river and stream water-quality model. The influence coefficient algorithm was used for the parameter optimization in unsteady state, open channel flow. The GA, used in solving the optimization problem, is very simple and comprehensible yet still applicable to any complicated mathematical problem, where it can find the global-optimum solution quickly and effectively. The previously established model QUAL2Kw was used for the automatic calibration of the QUAL2K. The parameter-optimization method using the influence coefficient and genetic algorithm (POMIG) developed in this study and QUAL2Kw were each applied to the Gangneung Namdaecheon River, which has multiple reaches, and the results of the two models were compared. In the modeling, the river reach was divided into two parts based on considerations of the water quality and hydraulic characteristics. The calibration results by POMIG showed a good correspondence between the calculated and observed values for most of water-quality variables. In the application of POMIG and QUAL2Kw, relatively large errors were generated between the observed and predicted values in the case of the dissolved oxygen (DO) and chlorophyll-a (Chl-a) in the lowest part of the river; therefore, two weighting factors (1 and 5) were applied for DO and Chl-a in the lower river. The sums of the errors for DO and Chl-a with a weighting factor of 5 were slightly lower compared with the application of a factor of 1. However, with a weighting factor of 5 the sums of errors for other water-quality variables were slightly increased in comparison to the case with a factor of 1. Generally, the results of the POMIG were slightly better than those of the QUAL2Kw.

The impact of eating frequency and time of intake on nutrient quality and body mass index: The INTERMAP Study, a population based study

PubMed Central

Aljuraiban, Ghadeer S.; Chan, Queenie; Griep, Linda M. Oude; Brown, Ian J.; Daviglus, Martha L.; Stamler, Jeremiah; Van Horn, Linda; Elliott, Paul; Frost, Gary S.

2014-01-01

Background Epidemiologic evidence is sparse on the effect of dietary behaviors and diet quality on body mass index (BMI) that may be important drivers of the obesity epidemic. Objective This study investigated the relationships of frequency of eating and time of intake to energy density, nutrient quality and BMI using data from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) including 2,696 men and women aged 40-59 from the United States and the United Kingdom. Design INTERMAP is a cross-sectional investigation with four 24-hour dietary recalls and BMI measurements conducted between 1996 and 1999. Consumption of solid foods was aggregated into eating occasion. Nutrient density is expressed using the Nutrient Rich Food (NRF 9.3) index. The ratio of evening/morning energy intake was calculated; mean values of four visits were used. Statistical analyses performed Characteristics across eating occasion categories are presented as adjusted mean with corresponding 95% confidence interval. Multiple linear regression models were used to examine associations of eating occasions, ratio of evening/morning energy intake, dietary energy density, and NRF 9.3 index with BMI. Results Compared to participants with < 4 eating occasions/24-hours, those with ≥ 6 eating occasions/24-hours had lower mean: BMI: 27.3 vs. 29.0 kg/m2; total energy intake: 2,129 vs. 2,472 kcal/24-hours; dietary energy density: 1.5 vs. 2.1 kcal/g; and higher NRF 9.3 index: 34.3 vs. 28.1. In multiple regression analyses, higher evening intake relative to morning intake was directly associated with BMI; however this did not influence the relationship between eating frequency and BMI. Conclusions Our results suggest that a larger number of small meals may be associated with improved diet quality and lower BMI. This may have implications for behavioral approaches to controlling the obesity epidemic. PMID:25620753

Characteristics That Differentiate Telecommuting from Non-Telecommuting Professionals in the Quality Assurance and Quality Control Arena

ERIC Educational Resources Information Center

Claybon, Tina S.

2013-01-01

The interest in working from home in contrast to going to an office continues to be a growing phenomenon. This research examined personal characteristics of telecommuters and non-telecommuters including age, gender, years of working for the organization, and job satisfaction in the quality control and quality assurance arena. This study aimed to…

Correlates of quality educational programs.

PubMed

Chester, Deborah R; Tracy, Jessamyn A; Earp, Emily; Chauhan, Reetu

2002-06-01

Preliminary evaluation findings are presented that explore relationships between educational program quality and program characteristics such as program type, security level, aftercare, teacher certification, facility size, and private versus public provider. Several program characteristics are found to be related to measurements of educational program quality. Among the major quality characteristics are proportion of program teachers that are professionally certified, smaller sized facilities versus larger facilities, level of aftercare services, and provider sources, with private for-profit providers being the lowest performing and public providers being the highest performing. The article closes with description of the Juvenile Justice Educational Enhancement Program's continuing evaluation of correlates to educational program quality through the continued development of a comprehensive database.

Simulated Watershed Mercury and Nitrate Flux Responses to Multiple Land Cover Conversion Scenarios

EPA Science Inventory

Water quality and toxic exposure science is transitioning towards analysis of multiple stressors rather than one particular environmental concern (e.g., mercury) or a group of similarly reacting chemicals (e.g., nutrients). However, two of the most important water quality constit...

The Effects of Job Characteristics on Marital Quality: Specifying Linking Mechanisms.

ERIC Educational Resources Information Center

Hughes, Diane; And Others

1992-01-01

Evaluated conceptual model hypothesizing that two dimensions of work-family interference, structural role difficulties and negative mood spillover, intervene in direct relationship between discrete characteristics of work and marital quality. Findings from 334 male and female white-collar workers indicated that job characteristics predicted…

Guide to the measurement of tree characteristics important to the quality classification for young hardwood trees

Treesearch

David L. Sonderman

1979-01-01

A procedure is shown for measuring external tree characteristics that are important in determining the current and future quality of young hardwood trees. This guide supplements a precious study which describes the quality classification system for young hardwood trees

Configurations of Multiple Disparities in Reading Performance: Longitudinal Observations across France, Germany, Sweden and the United Kingdom

ERIC Educational Resources Information Center

Lenkeit, Jenny; Schwippert, Knut; Knigge, Michel

2018-01-01

Research provides evidence that gender, immigrant background and socio-economic characteristics present multiple disadvantaging characteristics that change their relative importance and configurations over time. When evaluating inequalities researchers tend to focus on one particular aspect and often use composite measures when evaluating…

Relationship between Quality of Life, Relationship Beliefs and Attribution Style in Infertile Couples.

PubMed

Navid, Behnaz; Mohammadi, Maryam; Maroufizadeh, Saman; Amini, Payam; Shirin, Zahra; Omani-Saman, Reza

2018-07-01

Many infertile couples experience psychological distress and suffer from impaired quality of life. Generally, when couples are dealing with uncontrolled events such as infertility, it is important to manage it well and to use the suitable coping style; so this can represent an example of attribution style. The purpose of this study is to investigate the quality of life, relationship beliefs and attribution style in infertile couples. This cross-sectional study consisted of 50 infertile couples, who were at least 18 years of age and could read and write in Persian. Participants provided demographic and general characteristics and completed the quality of life (SF-12), relationship belief inventory (RBI) and attribution style (ASQ) forms. Data was analyzed by the paired t test, Pearson correlation tests and multiple linear regression analysis, using SPSS version 22 statistical software. Overall, 50 infertile couples participated in our study. The males had a significantly higher score for quality of life compared to the females (P=0.019). In RBI subscales except "Disagreement is Destructive" all others significantly higher in wives than husbands. All subscales of RBI had a negative correlation with the quality of life. The quality of life had a significant correlation with positive internal (r=0.213, P=0.033). The adjusted regression model showed that the quality of life for males was higher than in females (β=-3.098, P=0.024). The current data indicate that in infertile couples, the husbands have a higher quality of life in comparison to their wives. Also, all subscales of relationship beliefs have a negative correlation with the quality of life, but in attribution style, just internal attribution style for positive events is associated with the quality of life. In general, there is a correlation between relationship beliefs and the quality of life in infertile couples. Copyright© by Royan Institute. All rights reserved.

Multiple disease resistance to fungal and oomycete pathogens using a recombinant inbred line population in pepper

USDA-ARS?s Scientific Manuscript database

Incorporating disease resistance into cultivars is a primary focus of modern breeding programs. Resistance to pathogens is often introgressed from landrace or wild individuals with poor fruit quality into commercial-quality cultivars. Sites of multiple disease resistance (MDR) are regions or “hotspo...

Teaching Consumer Selection of Market Quality Beef by Observable Characteristics

ERIC Educational Resources Information Center

Halvorson, Dorothy; Jacobson, Marion

1977-01-01

Through a series of five tests, a slide-tape instructional presentation on the identification of beef quality was developed. It was determined that the slide-tape instruction can enable consumers to score more accurately characteristics of raw beef in relation to the characteristics of cooked beef. (Editor/TA)

Post-harvest and post-milling changes in wheat grain and flour quality characteristics

USDA-ARS?s Scientific Manuscript database

Soft red winter (SRW) wheat grain immediately after harvest and flour after milling were stored for 26 weeks and analyzed for comprehensive milling and baking quality characteristics at different time points to examine the consistency of the quality test results. Increases in falling number (FN) of ...

Seedling root targets

Treesearch

Diane L. Haase

2011-01-01

Roots are critical to seedling performance after outplanting. Although root quality is not as quick and simple to measure as shoot quality, target root characteristics should be included in any seedling quality assessment program. This paper provides a brief review of root characteristics most commonly targeted for operational seedling production. These are: root mass...

A Multiple-Item Scale for Assessing E-Government Service Quality

NASA Astrophysics Data System (ADS)

Papadomichelaki, Xenia; Mentzas, Gregoris

A critical element in the evolution of e-governmental services is the development of sites that better serve the citizens’ needs. To deliver superior service quality, we must first understand how citizens perceive and evaluate online citizen service. This involves defining what e-government service quality is, identifying its underlying dimensions, and determining how it can be conceptualized and measured. In this article we conceptualise an e-government service quality model (e-GovQual) and then we develop, refine, validate, confirm and test a multiple-item scale for measuring e-government service quality for public administration sites where citizens seek either information or services.

Relationship characteristics and contraceptive use among dating and cohabiting young adult couples.

PubMed

Wildsmith, Elizabeth; Manlove, Jennifer; Steward-Streng, Nicole

2015-03-01

Contraceptive decision making occurs in the context of relationships. Although many individual-level characteristics have been linked to youths' contraceptive use, less is known about associations between contraceptive use and relationship-level characteristics. Data from the 2001-2002 romantic pair subsample of the National Longitudinal Study of Adolescent Health were used to describe characteristics of 322 dating relationships and 406 cohabiting relationships among young adults aged at least 18 years. Logistic regression was employed to assess associations between these characteristics and hormonal or long-acting contraceptive use and condom use. Data from both partners allowed discordance in reports between partners in some measures to be examined. Cohabiting couples were less likely than dating couples to have used condoms (19% vs. 37%) and hormonal or long-acting methods (40% vs. 57%) at last sex. In dating relationships, couples reporting discordant levels of intimacy and couples in which neither partner reported a high level of intimacy had greater odds of condom use than couples in which both partners reported high intimacy (odds ratios, 4.5 and 3.3, respectively); mistrust and male problem drinking were negatively associated with condom use (0.3 for each). For cohabiting couples, frequency of sex was negatively associated with condom use and hormonal method use (0.8 for each). At least for dating couples, contraceptive use is linked to multiple dimensions of relationships, particularly measures reflecting relationship quality-both positive and negative. Copyright © 2015 by the Guttmacher Institute.

Personality and language characteristics in parents from multiple-incidence autism families.

PubMed

Piven, J; Palmer, P; Landa, R; Santangelo, S; Jacobi, D; Childress, D

1997-07-25

Several studies have suggested that the genetic liability for autism may be expressed in non-autistic relatives of autistic probands, in behavioral characteristics that are milder but qualitatively similar to the defining features of autism. We employ a variety of direct assessment approaches to examine both personality and language in parents ascertained through having two autistic children (multiple-incidence autism parents) and parents of Down syndrome probands. Multiple-incidence autism parents had higher rates of particular personality characteristics (rigidity, aloofness, hypersensitivity to criticism, and anxiousness), speech and pragmatic language deficits, and more limited friendships than parents in the comparison group. The implications of these findings for future genetic studies of autism are discussed.

Cowpea fresh pods - a new legume for the market: assessment of their quality and dietary characteristics of 37 cowpea accessions grown in southern Europe.

PubMed

Karapanos, Ioannis; Papandreou, Anastasia; Skouloudi, Marianna; Makrogianni, Despoina; Fernández, Juan A; Rosa, Eduardo; Ntatsi, Georgia; Bebeli, Penelope J; Savvas, Dimitrios

2017-10-01

Cowpea is traditionally cultivated in some regions of southern Europe for its dried seeds; however, there is a scarcity of information on the quality and dietary characteristics of fresh pods, which are occasionally used in folk diets. This paper aims at covering this gap in knowledge, thereby contributing to the dissemination of fresh cowpea pods as a novel product for the market. The quality and dietary characteristics of pods from 37 accessions (Vigna unguiculata ssp. unguiculata and ssp. sesquipedalis) grown in southern Europe were assessed in an attempt to provide information on pod quality and nutritional properties and to identify relationships between quality traits and accession origin. Pods from the sesquipedalis accessions were heavier and larger, and reached commercial maturity 2 days later, than those from the unguiculata accessions. There were also large differences in the quality and dietary characteristics of the accessions. The pods of most accessions were rich in proteins, chlorophylls, carotenoids and phenolics, and showed high antioxidant activity and low concentrations of nitrates and raffinose-family oligosaccharides. Cluster analysis based on quality, dietary or antinutritional traits did not reveal any apparent grouping among the accessions. All the quality characteristics were independent of accession origin and subspecies. Most of the accessions produced fresh pods of good quality and high dietary value, suitable for introduction in the market and/or for use as valuable genetic material for the development of new improved varieties. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Phenotypic and molecular characteristics associated with various domains of quality of life in oncology patients and their family caregivers.

PubMed

Alexander, Kimberly E; Cooper, Bruce A; Paul, Steven M; Yates, Patsy; Aouizerat, Bradley E; Miaskowski, Christine

2016-11-01

Not all oncology patients and their family caregivers (FCs) experience the same quality of life (QOL). The purposes of this study were to identify latent classes of oncology patients (n = 168) and their FCs (n = 85) with distinct physical, psychological, social, and spiritual well-being trajectories from prior to through 4 months after the completion of radiation therapy and to evaluate for demographic, clinical, and genetic characteristics that distinguished between these latent classes. Using growth mixture modeling, two latent classes were found for three (i.e., physical, psychological, and social well-being) of the four QOL domains evaluated. Across these three domains, the largest percentage of participants reported relatively high well-being scores across the 6 months of the study. Across these three QOL domains, patients and FCs who were younger, female, belonged to an ethnic minority group, had children at home, had multiple comorbid conditions, or had a lower functional status, were more likely to be classified in the lower QOL class. The social well-being domain was the only domain that had a polymorphism in nuclear factor kappa beta 2 (NFKB2) associated with latent class membership. Carrying one or two doses of the rare allele for rs7897947 was associated with a 54 % decrease in the odds of belonging to the lower social well-being class [OR (95 % CI) = .46 (.21, .99), p = .049]. These findings suggest that a number of phenotypic and molecular characteristics contribute to differences in QOL in oncology patients and their FCs.

An Urban Neo-Poverty Population-Based Quality of Life and Related Social Characteristics Investigation from Northeast China

PubMed Central

Ou, Fengrong; Li, Kai; Gao, Qian; Liu, Dan; Li, Jinghai; Hu, Liwen; Wu, Xian; Edmiston, E. Kale; Liu, Yang

2012-01-01

Objective To investigate quality of life (QOL) and related characteristics among an urban neo-poverty population in northeast China, and to compare this population with a traditional poverty cohort. Design The research was a cross-sectional survey executed from June 2005 to October 2007, with a sample of 2940 individuals ages 36 to 55 in three different industrial cities of northeast China. Data were collected on QOL status and sociodemographic characteristics. QOL was assessed using the 36-item Short Form Health Survey (Chinese version). Multiple regression analysis was employed to analyze association between sociodemographic variables and QOL. Results The scores for QOL in the neo-poverty group were higher than those in the traditional poverty group, but lower than those in the general population. When the neo-poverty population was divided into two subgroups by age, 36–45 years and 46–55 years, the differences in QOL scores were not significant. However, there were significant differences in several dimensions between two subgroups according to unemployment time (<5 years and >5 years). Additionally, stepwise regression analysis indicated that disease burden, including disease and medical expenditures, was a common risk factor for declining QOL in the neo-poverty group. Conclusions Despite some limitations, this study provides initial evidence that the QOL of the urban neo-poverty population lies between that of the general population and traditional poverty. QOL of the neo-poverty group approached QOL of the traditional poverty group with increased unemployment years. In addition to decreased income, disease burden is the most important factor influencing QOL status in urban neo-poverty. PMID:22719968

Responses of physical, chemical, and biological indicators of water quality to a gradient of agricultural land use in the Yakima River Basin, Washington

USGS Publications Warehouse

Cuffney, T.F.; Meador, M.R.; Porter, S.D.; Gurtz, M.E.

2000-01-01

The condition of 25 stream sites in the Yakima River Basin, Washington, were assessed by the U.S. Geological Survey's National Water-Quality Assessment Program. Multimetric condition indices were developed and used to rank sites on the basis of physical, chemical, and biological characteristics. These indices showed that sites in the Cascades and Eastern Cascades ecoregions were largely unimpaired. In contrast, all but two sites in the Columbia Basin ecoregion were impaired, some severely. Agriculture (nutrients and pesticides) was the primary factor associated with impairment and all impaired sites were characterized by multiple indicators of impairment. All indices of biological condition (fish, invertebrates, and algae) declined as agricultural intensity increased. The response exhibited by invertebrates and algae suggested a threshold response with conditions declining precipitously at relatively low levels of agricultural intensity and little response at moderate to high levels of agricultural intensity. This pattern of response suggests that the success of mitigation will vary depending upon where on the response curve the mitigation is undertaken. Because the form of the community condition response is critical to effective water-quality management, the National Water-Quality Assessment Program is conducting studies to examine the response of biota to gradients of land-use intensity and the relevance of these responses to water-quality management. These land-use gradient pilot studies will be conducted in several urban areas starting in 1999.

Spatial distribution and source apportionment of water pollution in different administrative zones of Wen-Rui-Tang (WRT) river watershed, China.

PubMed

Yang, Liping; Mei, Kun; Liu, Xingmei; Wu, Laosheng; Zhang, Minghua; Xu, Jianming; Wang, Fan

2013-08-01

Water quality degradation in river systems has caused great concerns all over the world. Identifying the spatial distribution and sources of water pollutants is the very first step for efficient water quality management. A set of water samples collected bimonthly at 12 monitoring sites in 2009 and 2010 were analyzed to determine the spatial distribution of critical parameters and to apportion the sources of pollutants in Wen-Rui-Tang (WRT) river watershed, near the East China Sea. The 12 monitoring sites were divided into three administrative zones of urban, suburban, and rural zones considering differences in land use and population density. Multivariate statistical methods [one-way analysis of variance, principal component analysis (PCA), and absolute principal component score-multiple linear regression (APCS-MLR) methods] were used to investigate the spatial distribution of water quality and to apportion the pollution sources. Results showed that most water quality parameters had no significant difference between the urban and suburban zones, whereas these two zones showed worse water quality than the rural zone. Based on PCA and APCS-MLR analysis, urban domestic sewage and commercial/service pollution, suburban domestic sewage along with fluorine point source pollution, and agricultural nonpoint source pollution with rural domestic sewage pollution were identified to the main pollution sources in urban, suburban, and rural zones, respectively. Understanding the water pollution characteristics of different administrative zones could put insights into effective water management policy-making especially in the area across various administrative zones.

Major depressive disorder, personality disorders, and coping strategies are independent risk factors for lower quality of life in non-metastatic breast cancer patients.

PubMed

Brunault, Paul; Champagne, Anne-Laure; Huguet, Grégoire; Suzanne, Isabelle; Senon, Jean-Louis; Body, Gilles; Rusch, Emmanuel; Magnin, Guillaume; Voyer, Mélanie; Réveillère, Christian; Camus, Vincent

2016-05-01

Our aim was to identify risk factors for lower quality of life (QOL) in non-metastatic breast cancer patients. Our study included 120 patients from the University Hospital Centers of Tours and Poitiers. This cross-sectional study was conducted 7 months after patients' breast cancer diagnosis and assessed QOL (Quality of Life Questionnaire Core 30 = QLQ-C30), socio-demographic characteristics, coping strategies (Brief-COPE), physiological and biological variables (e.g., initial tumor severity and types of treatment received), the existence of major depressive disorder (Mini International Neuropsychiatric Interview), and pain severity (Questionnaire de Douleur Saint Antoine). We assessed personality disorders 3 months after diagnosis (Vragenlijst voor Kenmerken van de Persoonlijkheid questionnaire). We used multiple linear regression models to determine which factors were associated with physical, emotional, and global QOL. Lower physical QOL was associated with major depressive disorder, younger age, a more severe initial tumor stage, and the use of the behavioral disengagement coping. Lower emotional QOL was associated with major depressive disorder, the existence of a personality disorder, a more severe pain level, higher use of self-blame, and lower use of acceptance coping strategies. Lower global QOL was associated with major depressive disorder, the existence of a personality disorder, a more severe pain level, higher use of self-blame, lower use of positive reframing coping strategies, and an absence of hormone therapy. Lower QOL scores were more strongly associated with variables related to the individual's premorbid psychological characteristics and the manner in which this individual copes with the cancer (e.g., depression, personality, and coping) than to cancer-related variables (e.g., treatment types and cancer severity). Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Quality of perinatal care services from the user's perspective: a Dutch study applies the World Health Organization's responsiveness concept.

PubMed

van der Kooy, Jacoba; Birnie, Erwin; Valentine, Nicole B; de Graaf, Johanna P; Denktas, Semiha; Steegers, Eric A P; Bonsel, Gouke J

2017-09-29

The concept of responsiveness was introduced by the World Health Organization (WHO) to address non-clinical aspects of service quality in an internationally comparable way. Responsiveness is defined as aspects of the way individuals are treated and the environment in which they are treated during health system interactions. The aim of this study is to assess responsiveness outcomes, their importance and factors influencing responsiveness outcomes during the antenatal and delivery phases of perinatal care. The Responsiveness in Perinatal and Obstetric Health Care Questionnaire was developed in 2009/10 based on the eight-domain WHO concept and the World Health Survey questionnaire. After ethical approval, a total of 171 women, who were 2 weeks postpartum, were recruited from three primary care midwifery practices in Rotterdam, the Netherlands, using face-to-face interviews. We dichotomized the original five ordinal response categories for responsiveness attainment as 'poor' and good responsiveness and analyzed the ranking of the domain performance and importance according to frequency scores. We used a series of independent variables related to health services and users' personal background characteristics in multiple logistic regression analyses to explain responsiveness. Poor responsiveness outcomes ranged from 5.9% to 31.7% for the antenatal phase and from 9.7% to 27.1% for the delivery phase. Overall for both phases, 'respect for persons' (Autonomy, Dignity, Communication and Confidentiality) domains performed better and were judged to be more important than 'client orientation' domains (Choice and Continuity, Prompt Attention, Quality of Basic Amenities, Social Consideration). On the whole, responsiveness was explained more by health-care and health related issues than personal characteristics. To improve responsiveness outcomes caregivers should focus on domains in the category 'client orientation'.

Fall prevalence in people with multiple sclerosis who use wheelchairs and scooters.

PubMed

Rice, Laura; Kalron, Alon; Berkowitz, Shani H; Backus, Deborah; Sosnoff, Jacob J

2017-09-01

Falls are a serious health concern for persons with multiple sclerosis (PwMS) who use wheelchairs or scooters as their primary mode of mobility. Unfortunately, little is known about the fall prevalence and characteristics of this large segment of the multiple sclerosis (MS) community. The purpose of this study is to determine the prevalence and circumstances of falls in wheelchair and scooter users living with MS. Forty-four PwMS were recruited from research and medical centers in the United States and Asia. Participants completed a survey focusing on prevalence of falls, frequency of injurious falls, circumstances of the fall, and various quality of life indicators. A total of 44 individuals (32 females/11 males/1 not reported) aged 27 to 82 years (mean = 58 yrs) completed the survey. Seventy-five percent (n = 33) reported falling at least once in 6 months and 48% (n = 12) of those that fell sustained an injury. The majority (87.5%) of the falls occurred inside the home. Most individuals (76.7%; n = 33) reported concerns about falling and 65.9% (n = 29) limited their activities because of their concern of falling. Falls are prevalent in wheelchair and scooter users with MS. The observations highlight the need for interventions targeting this segment of the MS community.

Baseline predictors of persistence to first disease-modifying treatment in multiple sclerosis.

PubMed

Zettl, U K; Schreiber, H; Bauer-Steinhusen, U; Glaser, T; Hechenbichler, K; Hecker, M

2017-08-01

Patients with multiple sclerosis (MS) require lifelong therapy. However, success of disease-modifying therapies is dependent on patients' persistence and adherence to treatment schedules. In the setting of a large multicenter observational study, we aimed at assessing multiple parameters for their predictive power with respect to discontinuation of therapy. We analyzed 13 parameters to predict discontinuation of interferon beta-1b treatment during a 2-year follow-up period based on data from 395 patients with MS who were treatment-naïve at study onset. Besides clinical characteristics, patient-related psychosocial outcomes were assessed as well. Among patients without clinically relevant fatigue, males showed a higher persistence rate than females (80.3% vs 64.7%). Clinically relevant fatigue scores decreased the persistence rate in men and especially in women (71.4% and 51.2%). Besides gender and fatigue, univariable and multivariable analyses revealed further factors associated with interferon beta-1b therapy discontinuation, namely lower quality of life, depressiveness, and higher relapse rate before therapy initiation, while higher education, living without a partner, and higher age improved persistence. Patients with higher grades of fatigue and depressiveness are at higher risk to prematurely discontinue MS treatment; especially, women suffering from fatigue have an increased discontinuation rate. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Induction regimens for transplant-eligible patients with newly diagnosed multiple myeloma: a network meta-analysis of randomized controlled trials

PubMed Central

Zeng, Zi-Hang; Chen, Jia-Feng; Li, Yi-Xuan; Zhang, Ran; Xiao, Ling-Fei; Meng, Xiang-Yu

2017-01-01

Objective The aim of this study was to compare the early efficacy and survivals of induction regimens for transplant-eligible patients with untreated multiple myeloma. Materials and methods A comprehensive literature search in electronic databases was conducted for relevant randomized controlled trials (RCTs). Eligible studies were selected according to the predefined selection criteria, before they were evaluated for methodological quality. Basic characteristics and data for network meta-analysis (NMA) were extracted from included trials and pooled in our meta-analysis. The end points were the overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). Results A total of 14 RCTs that included 4,763 patients were analyzed. The post-induction ORR was higher with bortezomib plus thalidomide plus dexamethasone (VTD) regimens, and VTD was better than the majority of other regimens. For OS, VTD plus cyclophosphamide (VTDC) regimens showed potential superiority over other regimens, but the difference was not statistically significant. The PFS was longer with thalidomide plus doxorubicin plus dexamethasone (TAD) regimens for transplant-eligible patients with newly diagnosed multiple myeloma (NDMM). Conclusion The NMA demonstrated that the VTD, VTDC, and TAD regimens are most beneficial in terms of ORR, OS, and PFS for transplant-eligible patients with NDMM, respectively. PMID:28744159

Artificialized land characteristics and sediment connectivity explain muddy flood hazard in Wallonia

NASA Astrophysics Data System (ADS)

de Walque, Baptiste; Bielders, Charles; Degré, Aurore; Maugnard, Alexandre

2017-04-01

Muddy flood occurrence is an off-site erosion problem of growing interest in Europe and in particular in the loess belt and Condroz regions of Wallonia (Belgium). In order to assess the probability of occurrence of muddy floods in specific places, a muddy flood hazard prediction model has been built. It was used to test 11 different explanatory variables in simple and multiple logistic regressions approaches. A database of 442 muddy flood-affected sites and an equal number of homologous non flooded sites was used. For each site, relief, land use, sediment production and sediment connectivity of the contributing area were extracted. To assess the prediction quality of the model, we proceeded to a validation using 48 new pairs of homologous sites. Based on Akaïke Information Criterion (AIC), we determined that the best muddy flood hazard assessment model requires a total of 6 explanatory variable as inputs: the spatial aggregation of the artificialized land, the sediment connectivity, the artificialized land proximity to the outlet, the proportion of artificialized land, the mean slope and the Gravelius index of compactness of the contributive area. The artificialized land properties listed above showed to improve substantially the model quality (p-values from 10e-10 to 10e-4). All of the 3 properties showed negative correlation with the muddy flood hazard. These results highlight the importance of considering the artificialized land characteristics in the sediment transport assessment models. Indeed, artificialized land such as roads may dramatically deviate flows and influence the connectivity in the landscape. Besides the artificialized land properties, the sediment connectivity showed significant explanatory power (p-value of 10e-11). A positive correlation between the sediment connectivity and the muddy flood hazard was found, ranging from 0.3 to 0.45 depending on the sediment connectivity index. Several studies already have highlighted the importance of this parameter in the sediment transport characterization in the landscape. Using the best muddy flood probability of occurrence threshold value of 0.49, the validation of the best multiple logistic regression resulted in a prediction quality of 75.6% (original dataset) and 81.2% (secondary dataset). The developed statistical model could be used as a reliable tool to target muddy floods mitigation measures in sites resulting with the highest muddy floods hazard.

Association between prospective registration and overall reporting and methodological quality of systematic reviews: a meta-epidemiological study.

PubMed

Ge, Long; Tian, Jin-Hui; Li, Ya-Nan; Pan, Jia-Xue; Li, Ge; Wei, Dang; Xing, Xin; Pan, Bei; Chen, Yao-Long; Song, Fu-Jian; Yang, Ke-Hu

2018-01-01

The aim of this study was to investigate the differences in main characteristics, reporting and methodological quality between prospectively registered and nonregistered systematic reviews. PubMed was searched to identify systematic reviews of randomized controlled trials published in 2015 in English. After title and abstract screening, potentially relevant reviews were divided into three groups: registered non-Cochrane reviews, Cochrane reviews, and nonregistered reviews. For each group, random number tables were generated in Microsoft Excel, and the first 50 eligible studies from each group were randomly selected. Data of interest from systematic reviews were extracted. Regression analyses were conducted to explore the association between total Revised Assessment of Multiple Systematic Review (R-AMSTAR) or Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) scores and the selected characteristics of systematic reviews. The conducting and reporting of literature search in registered reviews were superior to nonregistered reviews. Differences in 9 of the 11 R-AMSTAR items were statistically significant between registered and nonregistered reviews. The total R-AMSTAR score of registered reviews was higher than nonregistered reviews [mean difference (MD) = 4.82, 95% confidence interval (CI): 3.70, 5.94]. Sensitivity analysis by excluding the registration-related item presented similar result (MD = 4.34, 95% CI: 3.28, 5.40). Total PRISMA scores of registered reviews were significantly higher than nonregistered reviews (all reviews: MD = 1.47, 95% CI: 0.64-2.30; non-Cochrane reviews: MD = 1.49, 95% CI: 0.56-2.42). However, the difference in the total PRISMA score was no longer statistically significant after excluding the item related to registration (item 5). Regression analyses showed similar results. Prospective registration may at least indirectly improve the overall methodological quality of systematic reviews, although its impact on the overall reporting quality was not significant. Copyright © 2017 Elsevier Inc. All rights reserved.

Multiple Perpetrator Sexual Assault: How Does It Differ from Assault by a Single Perpetrator?

ERIC Educational Resources Information Center

Morgan, Louise; Brittain, Bernadette; Welch, Jan

2012-01-01

Research that attempts to identify characteristic features of multiple perpetrator sexual assault (MPSA) is limited. This study compared demographic and assault related characteristics of 135 cases of MPSA with 139 cases of single perpetrator sexual assault (SPSA) reported to the Haven sexual assault referral centre, Camberwell, London, over a…

Quality characterization and impact assessment of highway runoff in urban and rural area of Guangzhou, China.

PubMed

Gan, Huayang; Zhuo, Muning; Li, Dingqiang; Zhou, Yongzhang

2008-05-01

Accurate knowledge of the quality and environmental impact of the highway runoff in Pear River Delta, South China is required to assess this important non-point pollution source. This paper presents the quality characterization and environmental impact assessment of rainfall runoff from highways in urban and rural area of Guangzhou, the largest city of Pear River Delta over 1 year's investigation. Multiple regression and Pearson correlation analysis were used to determine influence of the rainfall characteristics on water quality and correlations among the constituents in highway runoff. The results and analysis indicates that the runoff water is nearly neutral with low biodegradability. Oil and grease (O&G), suspended solids (SS) and heavy metals are the dominant pollutants in contrast to the low level of nutrient constituents in runoff. Quality of highway runoff at rural site is better than that of at urban site for most constituents. Depth and antecedent dry period are the main rainfall factors influencing quality of highway runoff. The correlation patterns among constituents in highway runoff at urban site are consistent with their dominant phases in water. Strong correlations (r > or = 0.80) are found among chemical oxygen demand (COD), total phosphorus, Cu and Zn as well as conductivity, nitrate nitrogen and total nitrogen. O&G, COD, SS and Pb in highway runoff at urban site substantially exceed their concentrations in receiving water of Pear River. The soil directly discharged by highway runoff at rural site has contaminated seriously by heavy metals in surface layer accompanying with pH conversion from original acidic to alkaline at present.

Relations between mothers' daily work, home, and relationship stress with characteristics of mother-child conflict interactions.

PubMed

Nelson, Jackie A; Boyer, Brittany P; Villarreal, Deyaun L; Smith, Olivia A

2017-06-01

This study examined whether daily variations in levels of mothers' work, home, and relationship stress were related to collaborative and oppositional qualities of mother-child conflict interactions across 1 week. Mothers reported on 1 specific conflict interaction with their 5- to 8-year-old child and their work, home, and relationship stress through online surveys each day for 7 consecutive days. Diary data from 142 mothers were analyzed in 6 multilevel models, each including within- and between-family levels of a stressor predicting collaborative or oppositional conflict qualities. Results suggested that families in the sample differed from each other, and also varied during the week, in collaborative and oppositional conflict qualities as well as stress in all 3 domains. Mothers reported a greater degree of oppositional conflict qualities on days characterized by higher perceptions of home chaos. Additionally, mothers who reported higher average levels of negativity in romantic relationships endorsed oppositional conflict qualities to a greater extent than mothers with lower relationship negativity. Two multilevel models including all 3 stressors in relation to collaborative and oppositional conflict revealed that for mothers managing multiple roles, average romantic relationship stress was the most important unique contributor to mother-child conflict qualities and daily relationship stress was particularly influential among mothers with sons compared to those with daughters. Results support the spillover hypothesis of stress within the family system and are discussed in terms of mothers' coping mechanisms and emotional engagement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Supportive care needs and psychological distress and/or quality of life in ambulatory advanced colorectal cancer patients receiving chemotherapy: a cross-sectional study.

PubMed

Sakamoto, Nobuhiro; Takiguchi, Shuji; Komatsu, Hirokazu; Okuyama, Toru; Nakaguchi, Tomohiro; Kubota, Yosuke; Ito, Yoshinori; Sugano, Koji; Wada, Makoto; Akechi, Tatsuo

2017-12-01

Although currently many advanced colorectal cancer patients continuously receive chemotherapy, there are very few findings with regard to the supportive care needs of such patients. The purposes of this study were to investigate the patients' perceived needs and the association with psychological distress and/or quality of life, and to clarify the characteristics of patients with a high degree of unmet needs. Ambulatory colorectal cancer patients who were receiving chemotherapy were asked to complete the Short-Form Supportive Care Needs Survey questionnaire, which covers five domains of need (health system and information, psychological, physical, care and support, and sexuality needs), the Hospital Anxiety and Depression Scale and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Complete data were available for 100 patients. Almost all of the top 10 most common unmet needs belonged to the psychological domain. The patients' total needs were significantly associated with both psychological distress (r = 0.65, P < 0.001) and quality of life (r = -0.38, P < 0.001). A multiple regression analysis revealed that the female gender was significantly associated with higher total needs. The moderate to strong associations that exist between patients' needs and psychological distress and/or quality of life suggest that interventions that respond to patients' needs may be one possible strategy for ameliorating psychological distress and enhancing quality of life. Female patients' needs should be evaluated more carefully. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

PubMed Central

Damschroder, Laura J; Aron, David C; Keith, Rosalind E; Kirsh, Susan R; Alexander, Jeffery A; Lowery, Julie C

2009-01-01

Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings. PMID:19664226

Regional estimation of extreme suspended sediment concentrations using watershed characteristics

NASA Astrophysics Data System (ADS)

Tramblay, Yves; Ouarda, Taha B. M. J.; St-Hilaire, André; Poulin, Jimmy

2010-01-01

SummaryThe number of stations monitoring daily suspended sediment concentration (SSC) has been decreasing since the 1980s in North America while suspended sediment is considered as a key variable for water quality. The objective of this study is to test the feasibility of regionalising extreme SSC, i.e. estimating SSC extremes values for ungauged basins. Annual maximum SSC for 72 rivers in Canada and USA were modelled with probability distributions in order to estimate quantiles corresponding to different return periods. Regionalisation techniques, originally developed for flood prediction in ungauged basins, were tested using the climatic, topographic, land cover and soils attributes of the watersheds. Two approaches were compared, using either physiographic characteristics or seasonality of extreme SSC to delineate the regions. Multiple regression models to estimate SSC quantiles as a function of watershed characteristics were built in each region, and compared to a global model including all sites. Regional estimates of SSC quantiles were compared with the local values. Results show that regional estimation of extreme SSC is more efficient than a global regression model including all sites. Groups/regions of stations have been identified, using either the watershed characteristics or the seasonality of occurrence for extreme SSC values providing a method to better describe the extreme events of SSC. The most important variables for predicting extreme SSC are the percentage of clay in the soils, precipitation intensity and forest cover.

Use of quality information in decision-making about health and social care services--a systematic review.

PubMed

Turnpenny, Agnes; Beadle-Brown, Julie

2015-07-01

User choice and personalisation have been at the centre of health and social care policies in many countries. Exercising choice can be especially challenging for people with long-term conditions (LTC) or disabilities. Information about the quality, cost and availability of services is central to user choice. This study used systematic review methods to synthesise evidence in three main areas: (i) how people with LTC or disabilities and their family carers find and access information about the quality of services; (ii) how quality information is used in decision-making; and (iii) what type of quality information is most useful. Quality information was defined broadly and could include formal quality reports (e.g. inspection reports, report cards, etc.), information about the characteristics of a service or provider (e.g. number and qualifications of staff, facilities, etc.) and informal reports about quality (e.g. personal experience, etc.). Literature searches were carried out using electronic databases in January 2012. Thirteen papers reporting findings from empirical studies published between 2001 and 2012 were included in the review. The majority of papers (n = 9) had a qualitative design. The analysis highlighted the use of multiple sources of information in decision-making about services and in particular the importance of informal sources and extended social networks in accessing information. There is limited awareness and use of 'official' and online information sources. Service users or family carers place greater emphasis on general information and structural indicators. Clinical or quality-of-life outcomes are often difficult to interpret and apply. Trust emerged a key issue in relation to quality information. Experiential and subjective information is highly valued and trusted. Various barriers to the effective use of quality information in making choices about services are identified. Implications for policy and future research are discussed. © 2014 John Wiley & Sons Ltd.

Setting standards at the forefront of delivery system reform: aligning care coordination quality measures for multiple chronic conditions.

PubMed

DuGoff, Eva H; Dy, Sydney; Giovannetti, Erin R; Leff, Bruce; Boyd, Cynthia M

2013-01-01

The primary study objective is to assess how three major health reform care coordination initiatives (Accountable Care Organizations, Independence at Home, and Community-Based Care Transitions) measure concepts critical to care coordination for people with multiple chronic conditions. We find that there are major differences in quality measurement across these three large and politically important programs. Quality measures currently used or proposed for these new health reform-related programs addressing care coordination primarily capture continuity of care. Other key areas of care coordination, such as care transitions, patient-centeredness, and cross-cutting care across multiple conditions are infrequently addressed. The lack of a comprehensive and consistent measure set for care coordination will pose challenges for healthcare providers and policy makers who seek, respectively, to provide and reward well-coordinated care. In addition, this heterogeneity in measuring care coordination quality will generate new information, but will inhibit comparisons between these care coordination programs. © 2013 National Association for Healthcare Quality.

Taste Quality Confusions: Influences of Age, Smoking, PTC Taster Status, and other Subject Characteristics.

PubMed

Doty, Richard L; Chen, Jonathan H; Overend, Jane

2017-01-01

Many persons misidentify the quality of taste stimuli, a phenomenon termed "taste confusion." In this study of 1000 persons, we examined the influences of age, sex, causes of chemosensory disturbances, and genetically determined phenylthiocarbamide (PTC) taster status on taste quality confusions for four tastants (sucrose, citric acid, sodium chloride, caffeine). Overall, sour-bitter confusions were most common (19.3%), followed by bitter-sour (11.4%), salty-bitter (7.3%), salty-sour (7.0%), bitter-salty (3.5%), bitter-sweet (3.4), and sour-salty (2.4%) confusions. Confusions for sweet were <1%. Asymmetries were common (e.g., bitter-sour confusions were less frequent than sour-bitter confusions). Women had fewer salty-bitter confusions than did men (5.7% vs. 11.4%). Overall, PTC tasters had fewer confusions than non-tasters except for salty-bitter confusions. Confusions typically increased monotonically with age. Current smokers exhibited more sour-bitter confusions than never smokers (48.9% vs. 32.2%), whereas past smokers had more bitter-sour confusions than never smokers (23.8% vs. 14.2%). Previous head trauma was associated with higher bitter-salty and salty-bitter confusions relative to those of some other etiologies. This study demonstrates, for the first time, that multiple subject factors influence taste confusions and, along with literature accounts, supports the view that there are both biological and psychological determinants of taste quality confusions.

Comorbidity in illness-induced posttraumatic stress disorder versus posttraumatic stress disorder due to external events in a nationally representative study.

PubMed

Sommer, Jordana L; Mota, Natalie; Edmondson, Donald; El-Gabalawy, Renée

2018-05-10

The current study compared physical and mental health characteristics and quality of life of illness-induced posttraumatic stress disorder (PTSD) versus those with PTSD due to external traumatic events in a population-based sample. PTSD was assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-5) using DSM-5 criteria in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. Participants with past-year PTSD (n = 1779) were categorized into two groups: illness-induced (6.5%) and other trauma-induced PTSD (92.9%) based on index trauma. Group differences in physical health, mental health, and quality of life were estimated using multiple logistic and linear regressions with adjustment for demographics and medical morbidity. Compared to PTSD due to external events, illness-induced PTSD had higher rates of life-threatening illness in the past year. Illness-induced PTSD compared to PTSD due to external events was associated with reduced odds of depressive/bipolar disorders and antisocial personality disorder, but increased odds of cannabis use disorder. The groups did not differ on quality of life after accounting for medical morbidity. Illness-induced PTSD is common among American adults and has a similar impact on quality of life as PTSD due to external events, but may have distinct mental health correlates. Copyright © 2018 Elsevier Inc. All rights reserved.

Staff Assist: A Resource to Improve Nursing Home Quality and Staffing

ERIC Educational Resources Information Center

Castle, Nicholas G.

2011-01-01

Purpose: This study describes the creation and use of a web-based resource, designed to help nursing homes implement quality improvements through changes in staffing characteristics. Design and Methods: Information on staffing characteristics (i.e., staffing levels, turnover, stability, and use of agency staff), facility characteristics (e.g.,…

CALiPER Retail Lamps Study 3.1: Dimming, Flicker, and Power Quality Characteristics of LED A Lamps

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

none,

2014-12-31

This CALiPER report examines the characteristics of a subset of lamps from CALiPER Retail Lamps Study 3 in more detail. Specifically, it focuses on the dimming, power quality, and flicker characteristics of 14 LED A lamps, as controlled by four different retail-available dimmers.

Predictors of Global Quality in Family Child Care Homes: Structural and Belief Characteristics

ERIC Educational Resources Information Center

Hughes-Belding, Kere; Hegland, Susan; Stein, Amanda; Sideris, John; Bryant, Donna

2012-01-01

Research Findings: With a substantial number of young children receiving care in family child care settings, an examination of the characteristics, both structural and attitudinal, that predict program quality is warranted. The current study examines gaps in the research by examining both structural characteristics and provider beliefs that…

Quality Characteristics of a Graduate Teacher Education Program in Graphic Communications: Results from a Delphi Research Study.

ERIC Educational Resources Information Center

Clark, Aaron C.; Scales, Alice Y.

2000-01-01

Investigates characteristics of a quality program in graphic communications teacher education with involvement of professionals in the field. Uses the Delphi technique to achieve consensus on the characteristics that they felt compromised a good educational program for future graphics teachers. (Contains 27 references.) (Author/YDS)

Characteristics and Quality of Autism Websites

ERIC Educational Resources Information Center

Reichow, Brian; Halpern, Jason I.; Steinhoff, Timothy B.; Letsinger, Nicole; Naples, Adam; Volkmar, Fred R.

2012-01-01

The World Wide Web is a common method for obtaining information on autism spectrum disorders, however, there are no guidelines for finding websites with high quality. We conducted two studies examining the characteristics and/or quality of autism websites in 2009 and 2010. We found websites with a .gov top-level domain had a statistically…

An Examination of the Quality of Leadership Studies Dissertations and Characteristics of Successful Doctoral Graduates

ERIC Educational Resources Information Center

Richardson, Paul Truman

2013-01-01

This qualitative study sought to characterize what constitutes quality in leadership studies dissertations. The individual opinions of twenty doctoral faculty members were solicited to identify characteristics of leadership studies dissertation quality. The study further sought to identify possible areas of agreement among participants about the…