Total Quality Management Simplified.

ERIC Educational Resources Information Center

Arias, Pam

1995-01-01

Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

Developing Water Quality Critera for Suspended and Bedded Sediments-Illustrative Example Application.

EPA Science Inventory

The U. S. EPA's Framework for Developing Suspended and Bedded Sediments (SABS) Water Quality Criteria (SABS Framework) provides a consistent process, technical methods, and supporting materials to enable resource managers to develop ambient water quality criteria for one of the m...

Air Command Staff College AY98 Quality of Life Survey

DTIC Science & Technology

1998-04-01

This research project concentrated on a study of ACSC student perceptions concerning Quality of Life (QOL). The research team used a survey...program fails to provide a quality of life consistent with student expectations. The research team conducted secondary research to select valid and

A Survey of Mathematics Education Technology Dissertation Scope and Quality: 1968-2009

ERIC Educational Resources Information Center

Ronau, Robert N.; Rakes, Christopher R.; Bush, Sarah B.; Driskell, Shannon O.; Niess, Margaret L.; Pugalee, David K.

2014-01-01

We examined 480 dissertations on the use of technology in mathematics education and developed a Quality Framework (QF) that provided structure to consistently define and measure quality. Dissertation studies earned an average of 64.4% of the possible quality points across all methodology types, compared to studies in journals that averaged 47.2%.…

42 CFR 422.205 - Provider antidiscrimination rules.

Code of Federal Regulations, 2014 CFR

2014-10-01

... designed to maintain quality and control costs consistent with its responsibilities. [65 FR 40324, June 29... certification. If an MA organization declines to include a given provider or group of providers in its network...

42 CFR 422.205 - Provider antidiscrimination rules.

Code of Federal Regulations, 2012 CFR

2012-10-01

... designed to maintain quality and control costs consistent with its responsibilities. [65 FR 40324, June 29... certification. If an MA organization declines to include a given provider or group of providers in its network...

Disparities in perceived patient-provider communication quality in the United States: Trends and correlates.

PubMed

Spooner, Kiara K; Salemi, Jason L; Salihu, Hamisu M; Zoorob, Roger J

2016-05-01

This study aimed to describe disparities and temporal trends in the level of perceived patient-provider communication quality (PPPCQ) in the United States, and to identify sociodemographic and health-related factors associated with elements of PPPCQ. A cross-sectional analysis was conducted using nationally-representative data from the 2011-2013 iterations of the Health Information National Trends Survey (HINTS). Descriptive statistics, multivariable linear and logistic regression analyses were conducted to examine associations. PPPCQ scores, the composite measure of patients' ratings of communication quality, were positive overall (82.8; 95% CI: 82.1-83.5). However, less than half (42-46%) of respondents perceived that providers always addressed their feelings, spent enough time with them, or helped with feelings of uncertainty about their health. Older adults and those with a regular provider consistently had higher PPPCQ scores, while those with poorer perceived general health were consistently less likely to have positive perceptions of their providers' communication behaviors. Disparities in PPPCQ can be attributed to patients' age, race/ethnicity, educational attainment, employment status, income, healthcare access and general health. These findings may inform educational and policy efforts which aim to improve patient-provider communication, enhance the quality of care, and reduce health disparities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

33 CFR 338.2 - Activities involving the discharge of dredged or fill material into waters of the U.S.

Code of Federal Regulations, 2010 CFR

2010-07-01

... quality certifications and, if applicable, coastal zone consistency determinations. For activities which... and, if applicable, coastal zone consistency determinations should be provided using the procedures of...

33 CFR 338.2 - Activities involving the discharge of dredged or fill material into waters of the U.S.

Code of Federal Regulations, 2011 CFR

2011-07-01

... quality certifications and, if applicable, coastal zone consistency determinations. For activities which... and, if applicable, coastal zone consistency determinations should be provided using the procedures of...

Moving beyond quality control in diagnostic radiology and the role of the clinically qualified medical physicist.

PubMed

Delis, H; Christaki, K; Healy, B; Loreti, G; Poli, G L; Toroi, P; Meghzifene, A

2017-09-01

Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality. In order to assure quality practices more organized activities and efforts are required in the modern era of diagnostic radiology. The complete system of QC is just one element of a comprehensive quality assurance (QA) program that aims at ensuring that the requirements of quality of a product or service will consistently be fulfilled. A comprehensive Quality system, starts even before the procurement of any equipment, as the need analysis and the development of specifications are important components under the QA framework. Further expanding this framework of QA, a comprehensive Quality Management System can provide additional benefits to a Diagnostic Radiology service. Harmonized policies and procedures and elements such as mission statement or job descriptions can provide clarity and consistency in the services provided, enhancing the outcome and representing a solid platform for quality improvement. The International Atomic Energy Agency (IAEA) promotes this comprehensive quality approach in diagnostic imaging and especially supports the field of comprehensive clinical audits as a tool for quality improvement. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

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.…

23 CFR 637.207 - Quality assurance program.

Code of Federal Regulations, 2012 CFR

2012-04-01

... program. (a) Each STD's quality assurance program shall provide for an acceptance program and an independent assurance (IA) program consisting of the following: (1) Acceptance program. (i) Each STD's... STD shall establish a dispute resolution system. The dispute resolution system shall address the...

23 CFR 637.207 - Quality assurance program.

Code of Federal Regulations, 2014 CFR

2014-04-01

... program. (a) Each STD's quality assurance program shall provide for an acceptance program and an independent assurance (IA) program consisting of the following: (1) Acceptance program. (i) Each STD's... STD shall establish a dispute resolution system. The dispute resolution system shall address the...

23 CFR 637.207 - Quality assurance program.

Code of Federal Regulations, 2013 CFR

2013-04-01

... program. (a) Each STD's quality assurance program shall provide for an acceptance program and an independent assurance (IA) program consisting of the following: (1) Acceptance program. (i) Each STD's... STD shall establish a dispute resolution system. The dispute resolution system shall address the...

USGS Laboratory Review Program Ensures Analytical Quality

USGS Publications Warehouse

Erdmann, David E.

1995-01-01

The USGS operates a review program for laboratories that analyze samples for USGS environmental investigations. This program has been effective in providing QA feedback to laboratories while ensuring that analytical data are consistent, of satisfactory quality, and meet the data objectives of the investigation.

42 CFR 438.12 - Provider discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-10-01

... designed to maintain quality of services and control costs and are consistent with its responsibilities to..., or PAHP declines to include individual or groups of providers in its network, it must give the...

42 CFR 438.12 - Provider discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-10-01

... designed to maintain quality of services and control costs and are consistent with its responsibilities to..., or PAHP declines to include individual or groups of providers in its network, it must give the...

Dedicated education unit: student perspectives.

PubMed

Nishioka, Vicki M; Coe, Michael T; Hanita, Makoto; Moscato, Susan R

2014-01-01

The study compared students' perceptions of their clinical learning experiences in a dedicated education unit (DEU) with their experiences in traditional clinical education. Unlike traditional academic-instructor models, expert nurses in the DEU provide clinical education to students with faculty support. This repeated measures design used student surveys, supplemented by focus group data. Students were more likely to agree that their clinical learning experience was high quality and they had a consistent mentoring relationship during DEU rotations. Students also reported the quality of the unit's learning environment, the leadership style of the nurse manager, and the nursing care on the unit was more favorable in DEUs than traditional units. Consistent with their changed role in DEUs, faculty members were less active in helping students integrate theory and practice. These findings provide additional evidence of the value that the DEU model contributes to high-quality clinical education.

The National Water-Quality Assessment (NAWQA) Program planned monitoring and modeling activities for Texas, 2013–23

USGS Publications Warehouse

Ging, Patricia

2013-01-01

The U.S. Geological Survey’s (USGS) National Water-Quality Assessment (NAWQA) Program was established by Congress in 1992 to answer the following question: What is the status of the Nation’s water quality and is it getting better or worse? Since 1992, NAWQA has been a primary source of nationally consistent data and information on the quality of the Nation’s streams and groundwater. Data and information obtained from objective and nationally consistent water-quality monitoring and modeling activities provide answers to where, when, and why the Nation’s water quality is degraded and what can be done to improve and protect it for human and ecosystem needs. For NAWQA’s third decade (2013–23), a new strategic Science Plan has been developed that describes a strategy for building upon and enhancing the USGS’s ongoing assessment of the Nation’s freshwater quality and aquatic ecosystems.

DairyBeef: maximizing quality and profits--a consistent food safety message.

PubMed

Moore, D A; Kirk, J H; Klingborg, D J; Garry, F; Wailes, W; Dalton, J; Busboom, J; Sams, R W; Poe, M; Payne, M; Marchello, J; Looper, M; Falk, D; Wright, T

2004-01-01

To respond to meat safety and quality issues in dairy market cattle, a collaborative project team for 7 western states was established to develop educational resources providing a consistent meat safety and quality message to dairy producers, farm advisors, and veterinarians. The team produced an educational website and CD-ROM course that included videos, narrated slide sets, and on-farm tools. The objectives of this course were: 1) to help producers and their advisors understand market cattle food safety and quality issues, 2) help maintain markets for these cows, and 3) help producers identify ways to improve the quality of dairy cattle going to slaughter. DairyBeef. Maximizing Quality & Profits consists of 6 sections, including 4 core segments. Successful completion of quizzes following each core segment is required for participants to receive a certificate of completion. A formative evaluation of the program revealed the necessity for minor content and technological changes with the web-based course. All evaluators considered the materials relevant to dairy producers. After editing, course availability was enabled in February, 2003. Between February and May, 2003, 21 individuals received certificates of completion.

Explaining the amount and consistency of medical care and self-management support in asthma: a survey of primary care providers in France and the United Kingdom.

PubMed

de Bruin, Marijn; Dima, Alexandra L; Texier, Nathalie; van Ganse, Eric

2018-05-09

The quality of asthma primary care may vary between countries, health care practices, and health care professionals (HCPs). Identifying and explaining such differences is critical for health services improvement. To examine the quality of asthma primary care in France and United Kingdom, and identify within-country and between-country predictors amenable to intervention. An online questionnaire to capture asthma medical care and self-management support, practice characteristics, and psychosocial determinants, was completed by 276 HCPs. Mokken Scaling analyses were used to examine item structure and consistency. Hierarchical regression analyses were used to identify predictors of the amount (number of asthma care activities HCPs delivered) and consistency (the degree to which HCPs deliver similar care) of asthma medical care and self-management support. On average, HCPs reported delivering 74,2% of guideline-recommended care. Consistency of medical care and self-management support was lower among HCPs delivering a lower amount of care (r=.58 and r=.57, p<.001). UK HCPs provided more and more consistent asthma self-management support -but not medical care- than French HCPs, which was explained by the presence of practice nurses in the UK. More training, positive social norms, and higher behavioural control explained better quality of care across all HCPs. Using carefully-developed questionnaires and advanced psychometric analyses, this study suggests that involving practice nurses, making social expectations visible, and providing more training to enhance skills and confidence in asthma care delivery could enhance the amount and consistency of asthma primary care. This needs to be corroborated in a future intervention trial. Copyright © 2018. Published by Elsevier Inc.

Correlation consistent basis sets for the atoms In–Xe

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

Mahler, Andrew; Wilson, Angela K., E-mail: akwilson@unt.edu

In this work, the correlation consistent family of Gaussian basis sets has been expanded to include all-electron basis sets for In–Xe. The methodology for developing these basis sets is described, and several examples of the performance and utility of the new sets have been provided. Dissociation energies and bond lengths for both homonuclear and heteronuclear diatomics demonstrate the systematic convergence behavior with respect to increasing basis set quality expected by the family of correlation consistent basis sets in describing molecular properties. Comparison with recently developed correlation consistent sets designed for use with the Douglas-Kroll Hamiltonian is provided.

Social Justice and School Improvement: Improving the Quality of Schooling in the Poorest Neighbourhoods

ERIC Educational Resources Information Center

Lupton, Ruth

2005-01-01

Social justice in education demands, at the very least, that all students should have access to the same quality of educational processes, even if their outcomes turn out to be unequal. Yet schools in the poorest neighbourhoods are consistently adjudged to provide a lower quality of education than those in more advantaged areas. Based on a…

Water Quality Sensing and Spatio-Temporal Monitoring Structure with Autocorrelation Kernel Methods.

PubMed

Vizcaíno, Iván P; Carrera, Enrique V; Muñoz-Romero, Sergio; Cumbal, Luis H; Rojo-Álvarez, José Luis

2017-10-16

Pollution on water resources is usually analyzed with monitoring campaigns, which consist of programmed sampling, measurement, and recording of the most representative water quality parameters. These campaign measurements yields a non-uniform spatio-temporal sampled data structure to characterize complex dynamics phenomena. In this work, we propose an enhanced statistical interpolation method to provide water quality managers with statistically interpolated representations of spatial-temporal dynamics. Specifically, our proposal makes efficient use of the a priori available information of the quality parameter measurements through Support Vector Regression (SVR) based on Mercer's kernels. The methods are benchmarked against previously proposed methods in three segments of the Machángara River and one segment of the San Pedro River in Ecuador, and their different dynamics are shown by statistically interpolated spatial-temporal maps. The best interpolation performance in terms of mean absolute error was the SVR with Mercer's kernel given by either the Mahalanobis spatial-temporal covariance matrix or by the bivariate estimated autocorrelation function. In particular, the autocorrelation kernel provides with significant improvement of the estimation quality, consistently for all the six water quality variables, which points out the relevance of including a priori knowledge of the problem.

Water Quality Sensing and Spatio-Temporal Monitoring Structure with Autocorrelation Kernel Methods

PubMed Central

Vizcaíno, Iván P.; Muñoz-Romero, Sergio; Cumbal, Luis H.

2017-01-01

Pollution on water resources is usually analyzed with monitoring campaigns, which consist of programmed sampling, measurement, and recording of the most representative water quality parameters. These campaign measurements yields a non-uniform spatio-temporal sampled data structure to characterize complex dynamics phenomena. In this work, we propose an enhanced statistical interpolation method to provide water quality managers with statistically interpolated representations of spatial-temporal dynamics. Specifically, our proposal makes efficient use of the a priori available information of the quality parameter measurements through Support Vector Regression (SVR) based on Mercer’s kernels. The methods are benchmarked against previously proposed methods in three segments of the Machángara River and one segment of the San Pedro River in Ecuador, and their different dynamics are shown by statistically interpolated spatial-temporal maps. The best interpolation performance in terms of mean absolute error was the SVR with Mercer’s kernel given by either the Mahalanobis spatial-temporal covariance matrix or by the bivariate estimated autocorrelation function. In particular, the autocorrelation kernel provides with significant improvement of the estimation quality, consistently for all the six water quality variables, which points out the relevance of including a priori knowledge of the problem. PMID:29035333

Clarification of the Use of Biological Data and Information in the 2002 Integrated Water Quality Monitoring and Assessment Report Guidance

EPA Pesticide Factsheets

The memorandum modifies the 2002 Integrated Water Quality Monitoring and Assessment Report Guidance to provide clarity and promote consistency in the manner in which states use biological data and information in developing their 2002 submissions.

Quality Document Examples (Record of Decision of the Year Contest)

EPA Pesticide Factsheets

This page provides document examples with clear documentation that are consistent with the Superfund Program's policy and regulations. The examples provided here are the winners of the Superfund ROD of the Year Contest (1999-2004)

Quality in restorative dentistry: a report of an advanced postgraduate dental symposium.

PubMed

Wilson, N H

1996-08-01

A joint Royal College of Surgeons of Edinburgh--Royal College of Physicians and Surgeons of Glasgow Advanced Postgraduate Dental Symposium addressed the issue of quality in restorative dentistry. The overall view was that quality in clinical care, including all aspects of restorative dentistry, is the consistent achievement of successful outcome. Ongoing developments and effective audit processes were recognized to provide important opportunities for continuous quality improvement in restorative dentistry.

Expectations and perceptions of clients concerning the quality of care provided at a Brazilian hospital facility.

PubMed

Mendes, Isabel Amélia Costa; Trevizan, Maria Auxiliadora; de Godoy, Simone; Nogueira, Paula Cristina; Ventura, Carla Aparecida Arena; Furlan, Claudia Elizangela Bis

2018-02-01

To identify the expectations and perceptions of clients concerning the quality of hospital care provided to them and their respective companions at a private Brazilian hospital using SERVQUAL. The SERVQUAL questionnaire can provide information concerning expectations and perceptions of clients. In addition, it is able to identify the participation of frontline employees and how they contribute to the organization's end product (service delivery). In total, 172 inpatients for surgical reasons answered the SERVQUAL questionnaire. It consists of 23 pairs of statements, 22 of which are distributed into the dimensions of tangibles, reliability, responsiveness, assurance and empathy. Statement 23 refers to the overall quality of care. Exploratory analysis, internal consistency (Cronbach's alpha) and the kappa Coefficient were calculated using the Statistical Package for Social Sciences and SAS 9.2. Ethical approval was obtained from the Institutional Review Board at the Hospital das Clínicas at the University of São Paulo at Ribeirao Preto Medical School. Most participants had a bachelor's degree and were over than 60years old. Cronbach's alpha coefficients indicated good internal consistency (α=0.93) and high levels of agreement were observed (91.10%). The SERVQUAL questionnaire was sensitive to items in each dimension for which clients' perceptions surpassed their expectations. The continuous quality assessment of health services is mandatory for nursing leadership. The nursing leadership can further explore the SERVQUAL with a view to better attending to the clients' expectations. Copyright © 2017. Published by Elsevier Inc.

In Urban And Rural India, A Standardized Patient Study Showed Low Levels Of Provider Training And Huge Quality Gaps

PubMed Central

Das, Jishnu; Holla, Alaka; Das, Veena; Mohanan, Manoj; Tabak, Diana; Chan, Brian

2013-01-01

This article reports on the quality of care delivered by private and public providers of primary health care services in rural and urban India. To measure quality, the study used standardized patients recruited from the local community and trained to present consistent cases of illness to providers. We found low overall levels of medical training among health care providers; in rural Madhya Pradesh, for example, 67 percent of health care providers who were sampled reported no medical qualifications at all. What’s more, we found only small differences between trained and untrained doctors in such areas as adherence to clinical checklists. Correct diagnoses were rare, incorrect treatments were widely prescribed, and adherence to clinical checklists was higher in private than in public clinics. Our results suggest an urgent need to measure the quality of health care services systematically and to improve the quality of medical education and continuing education programs, among other policy changes. PMID:23213162

A MARINE RECREATIONAL WATER QUALITY CRITERION CONSISTENT WITH INDICATOR CONCEPTS AND RISK ANALYSIS

EPA Science Inventory

An overivew is provided of water quality criteria developed for marine recreational waters by EPA in 1979. The crierion used is the strength of the association with the rates of the important symptoms, such as those that correlate best with swimming in wastewater-polluted waters....

Predicting Observer Training Satisfaction and Certification

ERIC Educational Resources Information Center

Bell, Courtney A.; Jones, Nathan D.; Lewis, Jennifer M.; Liu, Shuangshuang

2013-01-01

The last decade produced numerous studies that show that students learn more from high-quality teachers than they do from lower quality teachers. If instruction is to improve through the use of more rigorous teacher evaluation systems, the implementation of these systems must provide consistent and interpretable information about which aspects of…

42 CFR 422.205 - Provider antidiscrimination rules.

Code of Federal Regulations, 2010 CFR

2010-10-01

... an MA organization declines to include a given provider or group of providers in its network, it must... or for different practitioners in the same specialty. (3) Implementation of measures designed to maintain quality and control costs consistent with its responsibilities. [65 FR 40324, June 29, 2000] ...

Healthcare service quality: towards a broad definition.

PubMed

Mosadeghrad, Ali Mohammad

2013-01-01

The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Quality healthcare is defined as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient's needs and satisfies providers". Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. This is the first time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations.

To QC or not to QC: the key to a consistent laboratory?

PubMed

Lane, Michelle; Mitchell, Megan; Cashman, Kara S; Feil, Deanne; Wakefield, Sarah; Zander-Fox, Deirdre L

2008-01-01

A limiting factor in every embryology laboratory is its capacity to grow 'normal' embryos. In human in vitro fertilisation (IVF), there is considerable awareness that the environment of the laboratory itself can alter the quality of the embryos produced and the industry as a whole has moved towards the implementation of auditable quality management systems. Furthermore, in some countries, such as Australia, an established quality management system is mandatory for clinical IVF practice, but such systems are less frequently found in other embryology laboratories. Although the same challenges of supporting consistent and repeatable embryo development are paramount to success in all embryology laboratories, it could be argued that they are more important in a research setting where often the measured outcomes are at an intracellular or molecular level. In the present review, we have outlined the role and importance of quality control and quality assurance systems in any embryo laboratory and have highlighted examples of how simple monitoring can provide consistency and avoid the induction of artefacts, irrespective of the laboratory's purpose, function or species involved.

Quality of working life of nurses and its related factors.

PubMed

Moradi, Tayebeh; Maghaminejad, Farzaneh; Azizi-Fini, Ismail

2014-06-01

Nurses as the largest group of health care providers should enjoy a satisfactory quality of working life to be able to provide quality care to their patients. Therefore, attention should be paid to the nurses' working life. This study aimed to investigate the quality of nurses' working life in Kashans' hospitals during 2012. This cross-sectional study was conducted on 200 nurses during 2012. The data-gathering instrument consisted of two parts. The first part consisted of questions on demographic information and the second part was the Walton's quality of work life questionnaire. Data were analyzed using the SPSS software. For statistical analysis T test and one way ANOVA were used. The results of the study showed that 60% of nurses reported that they had moderate level of quality of working life while 37.1% and 2% had undesirable and good quality of working life, respectively. Nurses with associate degrees reported a better quality of working life than others. A significant relationship was found between variables such as education level, work experience, and type of hospital with quality of working life score (P < 0.05). No significant differences were observed between quality of working life score of nurses with employment status (P = 0.061), salary (P = 0.052), age, gender and marital status (P > 0.05). Nurses' quality of work life was at the moderate level. As quality of work life has an important impact on attracting and retaining employees, it is necessary to pay more attention to the nurses' quality of work life and its affecting factors.

Evaluation of beef eating quality by Irish consumers.

PubMed

McCarthy, S N; Henchion, M; White, A; Brandon, K; Allen, P

2017-10-01

A consumer's decision to purchase beef is strongly linked to its sensory properties and consistent eating quality is one of the most important attributes. Consumer taste panels were held according to the Meat Standards Australia guidelines and consumers scored beef according to its palatability attributes and completed a socio-demographic questionnaire. Consumers were able to distinguish between beef quality on a scale from unsatisfactory to premium with high accuracy. Premium cuts of beef scored significantly higher on all of the scales compared to poorer quality cuts. Men rated grilled beef higher on juiciness and flavour scales compared to women. Being the main purchaser of beef had no impact on rating scores. Overall the results show that consumers can judge eating quality with high accuracy. Further research is needed to determine how best to communicate inherent benefits that are not visible into extrinsic eating quality indicators, to provide the consumer with consistent indications of quality at the point of purchase. Copyright © 2017 Elsevier Ltd. All rights reserved.

Are nutrition messages lost in transmission? Assessing the quality and consistency of diabetes guideline recommendations on the delivery of nutrition therapy.

PubMed

Hale, Kelli; Capra, Sandra; Bauer, Judy

2016-12-01

To provide an overview of (1) the consistency of Type 2 Diabetes Clinical Practice Guidelines recommendations on the delivery of nutrition therapy and (2) Clinical Practice Guideline quality. Large international clinical practice guideline repositories, diabetes organisation websites, and electronic databases (Pubmed, Scopus), were searched to identify Clinical Practice Guidelines for adults with type 2 diabetes published 2005 to August 2014. Recommendations on the delivery of nutrition therapy were extracted and inductive content analysis was used to analyse consistency. Two researchers independently assessed guideline quality using the AGREE II tool. Nine topics were identified from the recommendations. Overall the consistency of the recommendations was related to guideline type. Compared with nutrition-specific guidelines, the broad ones had a broader focus and included more patient-focused recommendations. The ten Clinical Practice Guidelines assessed included six broad guidelines and four nutrition specific guidelines. Based on AGREE II analysis, the broad guidelines were higher quality than nutrition-specific ones. Broad Clinical Practice Guidelines were higher quality and included more patient-focused recommendations than nutrition-specific ones. Our findings suggest a need for nutrition-specific guidelines to be modified to include greater patient-focus, or for practitioners delivering nutrition therapy to adopt broad Clinical Practice Guidelines. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The immunization data quality audit: verifying the quality and consistency of immunization monitoring systems.

PubMed Central

Ronveaux, O.; Rickert, D.; Hadler, S.; Groom, H.; Lloyd, J.; Bchir, A.; Birmingham, M.

2005-01-01

OBJECTIVE: To evaluate the consistency and quality of immunization monitoring systems in 27 countries during 2002-03 using standardized data quality audits (DQAs) that had been launched within the framework of the Global Alliance for Vaccines and Immunization. METHODS: The consistency of reporting systems was estimated by determining the proportion of third doses of diphtheria-tetanuspertussis (DTP-3) vaccine reported as being administered that could be verified by written documentation at health facilities and districts. The quality of monitoring systems was measured using quality indices for different components of the monitoring systems. These indices were applied to each level of the health service (health unit, district and national). FINDINGS: The proportion of verified DTP-3 doses was lower than 85% in 16 countries. Difficulties in verifying the doses administered often arose at the peripheral level of the health service, usually as the result of discrepancies in information between health units and their corresponding districts or because completed recording forms were not available from health units. All countries had weaknesses in their monitoring systems; these included the inconsistent use of monitoring charts; inadequate monitoring of vaccine stocks, injection supplies and adverse events; unsafe computer practices; and poor monitoring of completeness and timeliness of reporting. CONCLUSION: Inconsistencies in immunization data occur in many countries, hampering their ability to manage their immunization programmes. Countries should use these findings to strengthen monitoring systems so that data can reliably guide programme activities. The DQA is an innovative tool that provides a way to independently assess the quality of immunization monitoring systems at all levels of a health service and serves as a point of entry to make improvements. It provides a useful example for other global health initiatives. PMID:16175824

Cost-Effective Adjustments to Nursing Home Staffing to Improve Quality.

PubMed

Bowblis, John R; Roberts, Amy Restorick

2018-06-01

Health care providers face fixed reimbursement rates from government sources and need to carefully adjust staffing to achieve the highest quality within a given cost structure. With data from the Certification and Survey Provider Enhanced Reports (1999-2015), this study holistically examined how staffing levels affect two publicly reported measures of quality in the nursing home industry, the number of deficiency citations and the deficiency score. While higher staffing consistently yielded better quality, the largest quality improvements resulted from increasing administrative registered nurses and social service staffing. After adjusting for wages, the most cost-effective investment for improving overall deficiency outcomes was increasing social services. Deficiencies related to quality of care were improved most by increasing administrative nursing and social service staff. Quality of life deficiencies were improved most by increasing social service and activities staff. Approaches to improve quality through staffing adjustments should target specific types of staff to maximize return on investment.

Real-time product attribute control to manufacture antibodies with defined N-linked glycan levels.

PubMed

Zupke, Craig; Brady, Lowell J; Slade, Peter G; Clark, Philip; Caspary, R Guy; Livingston, Brittney; Taylor, Lisa; Bigham, Kyle; Morris, Arvia E; Bailey, Robert W

2015-01-01

Pressures for cost-effective new therapies and an increased emphasis on emerging markets require technological advancements and a flexible future manufacturing network for the production of biologic medicines. The safety and efficacy of a product is crucial, and consistent product quality is an essential feature of any therapeutic manufacturing process. The active control of product quality in a typical biologic process is challenging because of measurement lags and nonlinearities present in the system. The current study uses nonlinear model predictive control to maintain a critical product quality attribute at a predetermined value during pilot scale manufacturing operations. This approach to product quality control ensures a more consistent product for patients, enables greater manufacturing efficiency, and eliminates the need for extensive process characterization by providing direct measures of critical product quality attributes for real time release of drug product. © 2015 American Institute of Chemical Engineers.

Assessing Metadata Quality of a Federally Sponsored Health Data Repository.

PubMed

Marc, David T; Beattie, James; Herasevich, Vitaly; Gatewood, Laël; Zhang, Rui

2016-01-01

The U.S. Federal Government developed HealthData.gov to disseminate healthcare datasets to the public. Metadata is provided for each datasets and is the sole source of information to find and retrieve data. This study employed automated quality assessments of the HealthData.gov metadata published from 2012 to 2014 to measure completeness, accuracy, and consistency of applying standards. The results demonstrated that metadata published in earlier years had lower completeness, accuracy, and consistency. Also, metadata that underwent modifications following their original creation were of higher quality. HealthData.gov did not uniformly apply Dublin Core Metadata Initiative to the metadata, which is a widely accepted metadata standard. These findings suggested that the HealthData.gov metadata suffered from quality issues, particularly related to information that wasn't frequently updated. The results supported the need for policies to standardize metadata and contributed to the development of automated measures of metadata quality.

Assessing Metadata Quality of a Federally Sponsored Health Data Repository

PubMed Central

Marc, David T.; Beattie, James; Herasevich, Vitaly; Gatewood, Laël; Zhang, Rui

2016-01-01

The U.S. Federal Government developed HealthData.gov to disseminate healthcare datasets to the public. Metadata is provided for each datasets and is the sole source of information to find and retrieve data. This study employed automated quality assessments of the HealthData.gov metadata published from 2012 to 2014 to measure completeness, accuracy, and consistency of applying standards. The results demonstrated that metadata published in earlier years had lower completeness, accuracy, and consistency. Also, metadata that underwent modifications following their original creation were of higher quality. HealthData.gov did not uniformly apply Dublin Core Metadata Initiative to the metadata, which is a widely accepted metadata standard. These findings suggested that the HealthData.gov metadata suffered from quality issues, particularly related to information that wasn’t frequently updated. The results supported the need for policies to standardize metadata and contributed to the development of automated measures of metadata quality. PMID:28269883

The Implementation of an Automated Assessment Feedback and Quality Assurance System for ICT Courses

ERIC Educational Resources Information Center

Debuse, J.; Lawley, M.; Shibl, R.

2007-01-01

Providing detailed, constructive and helpful feedback is an important contribution to effective student learning. Quality assurance is also required to ensure consistency across all students and reduce error rates. However, with increasing workloads and student numbers these goals are becoming more difficult to achieve. An automated feedback…

The Pivotal Role of Teacher Motivation in Tanzanian Education

ERIC Educational Resources Information Center

Davidson, Euan

2007-01-01

In Tanzania, the integral role that teachers play in providing a quality education for students has been recognized consistently in government documents (e.g., Ministry of Education and Culture [MOEC] 1995; 2001). However, concerns about the quality of teachers and teaching in Tanzania persist) Massawe and Kipingu 2000; Kuleana Center for…

Water-quality trends in the nation's rivers

USGS Publications Warehouse

Smith, R.A.; Alexander, R.B.; Wolman, M.G.

1987-01-01

Water-quality records from two nationwide sampling networks now permit nationally consistent analysis of long-term water-quality trends at more than 300 locations on major U.S. rivers. Observed trends in 24 measures of water quality for the period from 1974 to 1981 provide new insight into changes in stream quality that occurred during a time of major changes in both terrestrial and atmospheric influences on surface waters. Particularly noteworthy are widespread decreases in fecal bacteria and lead concentrations and widespread increases in nitrate, chloride, arsenic, and cadmium concentrations. Recorded increases in municipal waste treatment, use of salt on highways, and nitrogen fertilizer application, along with decreases in leaded gasoline consumption and regionally variable trends in coal production and combustion during the period appear to be reflected in water-quality changes.Water-quality records from two nationwide sampling networks now permit nationally consistent analysis of long-term water-quality trends at more than 300 locations on major U. S. rivers. Observed trends in 24 measures of water quality for the period from 1974 to 1981 provide new insight into changes in stream quality that occurred during a time of major changes in both terrestrial and atmospheric influences on surface waters. Particularly noteworthy are widespread decreases in fecal bacteria and lead concentrations and widespread increases in nitrate, chloride, arsenic, and cadmium concentrations. Recorded increases in municipal waste treatment, use of salt on highways, and nitrogen fertilizer application, along with decreases in leaded gasoline consumption and regionally variable trends in coal production and combustion during the period appear to be reflected in water-quality changes.

Vidicon intensifier

NASA Technical Reports Server (NTRS)

Carpentier, R. P.; Pietrzyk, J. P.; Beyer, R. R.; Kalafut, J. S.

1976-01-01

Computer-designed sensor, consisting of single-stage electrostatically-focused, triode image intensifier, provides high quality imaging characterized by exceptionally low geometric distortion, low shading, and high center-and-corner modulation transfer function.

A Quality Instrument for Effective Honors Program Review

ERIC Educational Resources Information Center

Smith, Patricia Joanne

2015-01-01

Although the number of honors programs and colleges has grown dramatically over the last twenty years to over a thousand programs nationally, little has been done to develop consistency of standards in honors. In the interest of seeking consistency, the author designed a research study to provide initial insights into assessable measures that a…

Water quality in the Albemarle-Pamlico drainage basin, North Carolina and Virginia, 1992-95

USGS Publications Warehouse

Spruill, Timothy B.; Harned, Douglas A.; Ruhl, Peter M.; Eimers, Jo Leslie; McMahon, Gerard; Smith, Kelly E.; Galeone, David R.; Woodside, Michael D.

1998-01-01

The NAWQA Program is assessing the water-quality conditions of more than 50 of the Nation's largest river basins and aquifers, known as Study Units. Collectively, these Study Units cover about one-half of the United States and include sources of drinking water used by about 70 percent of the U.S. population. Comprehensive assessments of about one-third of the Study Units are ongoing at a given time. Each Study Unit is scheduled to be revisited every decade to evaluate changes in water-quality conditions. NAWQA assessments rely heavily on existing information collected by the USGS and many other agencies as well as the use of nationally consistent study designs and methods of sampling and analysis. Such consistency simultaneously provides information about the status and trends in water-quality conditions in a particular stream or aquifer and, more importantly, provides the basis to make comparisons among watersheds and improve our understanding of the factors that affect water-quality conditions regionally and nationally. This report is intended to summarize major findings that emerged between 1992 and 1995 from the water-quality assessment of the Albemarle-Pamlico Drainage Study Unit and to relate these findings to water-quality issues of regional and national concern. The information is primarily intended for those who are involved in water-resource management. Indeed, this report addresses many of the concerns raised by regulators, water-utility managers, industry representatives, and other scientists, engineers, public officials, and members of stakeholder groups who provided advice and input to the USGS during this NAWQA Study-Unit investigation. Yet, the information contained here may also interest those who simply wish to know more about the quality of water in the rivers and aquifers in the area where they live.

Implementation workshop of WHO guidelines on evaluation of malaria vaccines: Current regulatory concepts and issues related to vaccine quality, Pretoria, South Africa 07 Nov 2014.

PubMed

Ho, Mei Mei; Baca-Estrada, Maria; Conrad, Christoph; Karikari-Boateng, Eric; Kang, Hye-Na

2015-08-26

The current World Health Organization (WHO) guidelines on the quality, safety and efficacy of recombinant malaria vaccines targeting the pre-erythrocytic and blood stages of Plasmodium falciparum were adopted by the WHO Expert Committee on Biological Standardization in 2012 to provide guidance on the quality, nonclinical and clinical aspects of recombinant malaria vaccines. A WHO workshop was organised to facilitate implementation into African (national/regional) regulatory practices, of the regulatory evaluation principles outlined in the guidelines regarding quality aspects. The workshop was used also to share knowledge and experience on regulatory topics of chemistry, manufacturing and control with a focus on vaccines through presentations and an interactive discussion using a case study approach. The basic principles and concepts of vaccine quality including consistency of production, quality control and manufacturing process were presented and discussed in the meeting. By reviewing and practicing a case study, better understanding on the relationship between consistency of production and batch release tests of an adjuvanted pre-erythrocytic recombinant malaria vaccine was reached. The case study exercise was considered very useful to understand regulatory evaluation principles of vaccines and a suggestion was made to WHO to provide such practices also through its Global Learning Opportunities for Vaccine Quality programme. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Sentinel 2 products and data quality status

NASA Astrophysics Data System (ADS)

Clerc, Sebastien; Gascon, Ferran; Bouzinac, Catherine; Touli-Lebreton, Dimitra; Francesconi, Benjamin; Lafrance, Bruno; Louis, Jerome; Alhammoud, Bahjat; Massera, Stephane; Pflug, Bringfried; Viallefont, Francoise; Pessiot, Laetitia

2017-04-01

Since July 2015, Sentinel-2A provides high-quality multi-spectral images with 10 m spatial resolution. With the launch of Sentinel-2B scheduled for early March 2017, the mission will create a consistent time series with a revisit time of 5 days. The consistency of the time series is ensured by some specific performance requirements such as multi-temporal spatial co-registration and radiometric stability, routinely monitored by the Sentinel-2 Mission Performance Centre (S2MPC). The products also provide a rich set of metadata and auxiliary data to support higher-level processing. This presentation will focus on the current status of the Sentinel-2 L1C and L2A products, including dissemination and product format aspects. Up-to-date mission performance estimations will be presented. Finally we will provide an outlook on the future evolutions: commissioning tasks for Sentinel-2B, geometric refinement, product format and processing improvements.

[Clinical trial data management and quality metrics system].

PubMed

Chen, Zhao-hua; Huang, Qin; Deng, Ya-zhong; Zhang, Yue; Xu, Yu; Yu, Hao; Liu, Zong-fan

2015-11-01

Data quality management system is essential to ensure accurate, complete, consistent, and reliable data collection in clinical research. This paper is devoted to various choices of data quality metrics. They are categorized by study status, e.g. study start up, conduct, and close-out. In each category, metrics for different purposes are listed according to ALCOA+ principles such us completeness, accuracy, timeliness, traceability, etc. Some general quality metrics frequently used are also introduced. This paper contains detail information as much as possible to each metric by providing definition, purpose, evaluation, referenced benchmark, and recommended targets in favor of real practice. It is important that sponsors and data management service providers establish a robust integrated clinical trial data quality management system to ensure sustainable high quality of clinical trial deliverables. It will also support enterprise level of data evaluation and bench marking the quality of data across projects, sponsors, data management service providers by using objective metrics from the real clinical trials. We hope this will be a significant input to accelerate the improvement of clinical trial data quality in the industry.

Statistical monitoring of data quality and consistency in the Stomach Cancer Adjuvant Multi-institutional Trial Group Trial.

PubMed

Timmermans, Catherine; Doffagne, Erik; Venet, David; Desmet, Lieven; Legrand, Catherine; Burzykowski, Tomasz; Buyse, Marc

2016-01-01

Data quality may impact the outcome of clinical trials; hence, there is a need to implement quality control strategies for the data collected. Traditional approaches to quality control have primarily used source data verification during on-site monitoring visits, but these approaches are hugely expensive as well as ineffective. There is growing interest in central statistical monitoring (CSM) as an effective way to ensure data quality and consistency in multicenter clinical trials. CSM with SMART™ uses advanced statistical tools that help identify centers with atypical data patterns which might be the sign of an underlying quality issue. This approach was used to assess the quality and consistency of the data collected in the Stomach Cancer Adjuvant Multi-institutional Trial Group Trial, involving 1495 patients across 232 centers in Japan. In the Stomach Cancer Adjuvant Multi-institutional Trial Group Trial, very few atypical data patterns were found among the participating centers, and none of these patterns were deemed to be related to a quality issue that could significantly affect the outcome of the trial. CSM can be used to provide a check of the quality of the data from completed multicenter clinical trials before analysis, publication, and submission of the results to regulatory agencies. It can also form the basis of a risk-based monitoring strategy in ongoing multicenter trials. CSM aims at improving data quality in clinical trials while also reducing monitoring costs.

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

PubMed Central

Yan, Bin-jun; Qu, Hai-bin

2013-01-01

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

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

PubMed

Yan, Bin-jun; Qu, Hai-bin

2013-11-01

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

Environmental Response Laboratory Network (ERLN) Data Submission Requirements

EPA Pesticide Factsheets

These Environmental Response Laboratory Network specifications are essential to the mission of providing consistent analytical data of know and documented quality for each Analytical Service Request (ASR).

Clinic Workload, the Quality of Staff Relationships and Diabetes Management in Community Health Centers Catering to Latino and Chinese Patients.

PubMed

Vargas Bustamante, Arturo; Martinez, Ana; Chen, Xiao; Rodriguez, Hector P

2017-06-01

We examine whether workplace climate-quality of staff relationships (QSR) and manageable clinic workload (MCW) are related to better patient care experiences and diabetes care in community health centers (CHCs) catering to Latino and Chinese patients. Patient experience surveys of adult patients with type 2 diabetes and workplace climate surveys of clinicians and staff from CHCs were included in an analytic sample. Comparisons of means analyses examine patient and provider characteristics. The associations of QSR, MCW and the diabetes care management were examined using regression analyses. Diabetes care process were more consistently provided in CHCs with high quality staff relations and more manageable clinic workload, but HbA1c, LDL cholesterol, and blood pressure outcomes were no different between clinics with high vs. low QSR and MCW. Focusing efforts on improvements in practice climate may lead to more consistent provision of important processes of diabetes care for these patients.

The Bottom Line: Quality/Consumer-Oriented Child Care.

ERIC Educational Resources Information Center

Jackson, Cheryl D.

Arguing that the provision of child care services is consistent with the role of the community college, this paper provides an overview of the current demand for and delivery of child care services and briefly discusses ways in which community colleges can assist in the development and provision of consumer-oriented, high-quality child care.…

Relating instrumental texture, determined relating instrumental texture, determined attachments, to sensory analysis of rainbow trout, Oncorhynchus mykiss, fillets

USDA-ARS?s Scientific Manuscript database

Texture is one of the most important quality attributes of fish fillets, and accurate assessment of variation in this attribute, as affected by storage and handling, is critical in providing consistent quality product. Trout fillets received 4 treatments: 3-d refrigeration (R3), 7-d refrigeration (R...

Developing a Scale for Perceptions of Competency in Teaching Quality

ERIC Educational Resources Information Center

Tasci, Guntay; Atar, Burcu

2016-01-01

The purpose of this study was to develop a measurement instrument for determining pre-service teachers' perceptions of competency in providing quality teaching. The initial phase of the instrument was consisted of 54 items that were composed based on theory and literature. The initial form was applied to 232 pre-service teachers. An exploratory…

General introduction for the “National Field Manual for the Collection of Water-Quality Data”

USGS Publications Warehouse

,

2018-02-28

BackgroundAs part of its mission, the U.S. Geological Survey (USGS) collects data to assess the quality of our Nation’s water resources. A high degree of reliability and standardization of these data are paramount to fulfilling this mission. Documentation of nationally accepted methods used by USGS personnel serves to maintain consistency and technical quality in data-collection activities. “The National Field Manual for the Collection of Water-Quality Data” (NFM) provides documented guidelines and protocols for USGS field personnel who collect water-quality data. The NFM provides detailed, comprehensive, and citable procedures for monitoring the quality of surface water and groundwater. Topics in the NFM include (1) methods and protocols for sampling water resources, (2) methods for processing samples for analysis of water quality, (3) methods for measuring field parameters, and (4) specialized procedures, such as sampling water for low levels of mercury and organic wastewater chemicals, measuring biological indicators, and sampling bottom sediment for chemistry. Personnel who collect water-quality data for national USGS programs and projects, including projects supported by USGS cooperative programs, are mandated to use protocols provided in the NFM per USGS Office of Water Quality Technical Memorandum 2002.13. Formal training, for example, as provided in the USGS class, “Field Water-Quality Methods for Groundwater and Surface Water,” and field apprenticeships supplement the guidance provided in the NFM and ensure that the data collected are high quality, accurate, and scientifically defensible.

Participation in Performance-Evaluation Studies by U.S. Geological Survey National Water Quality Laboratory

USGS Publications Warehouse

Glodt, Stephen R.; Pirkey, Kimberly D.

1998-01-01

Performance-evaluation studies provide customers of the U.S. Geological Survey National Water Quality Laboratory (NWQL) with data needed to evaluate performance and to compare of select laboratories for analytical work. The NWQL participates in national and international performance-evaluation (PE) studies that consist of samples of water, sediment, and aquatic biological materials for the analysis of inorganic constituents, organic compounds, and radionuclides. This Fact Sheet provides a summary of PE study results from January 1993 through April 1997. It should be of particular interest to USGS customers and potential customers of the NWQL, water-quality specialists, cooperators, and agencies of the Federal Government.

Methods and Sources of Data Used to Develop Selected Water-Quality Indicators for Streams and Ground Water for EPA's 2007 Report on the Environment: Science Report

USGS Publications Warehouse

Baker, Nancy T.; Wilson, John T.; Moran, Michael J.

2008-01-01

The U.S. Geological Survey (USGS) was one of numerous governmental agencies, private organizations, and the academic community that provided data and interpretations for the U.S. Environmental Protection Agency?s (USEPA) 2007 Report on the Environment: Science Report. This report documents the sources of data and methods used to develop selected water?quality indicators for the 2007 edition of the report compiled by USEPA. Stream and ground?water?quality data collected nationally in a consistent manner as part of the USGS?s National Water?Quality Assessment Program (NAWQA) were provided for several water?quality indicators, including Nitrogen and Phosphorus in Streams in Agricultural Watersheds; Pesticides in Streams in Agricultural Watersheds; and Nitrate and Pesticides in Shallow Ground Water in Agricultural Watersheds. In addition, the USGS provided nitrate (nitrate plus nitrite) and phosphorus riverine load estimates calculated from water?quality and streamflow data collected as part of its National Stream Water Quality Accounting Network (NASQAN) and its Federal?State Cooperative Program for the Nitrogen and Phosphorus Discharge from Large Rivers indicator.

Developing evidence-based physical therapy clinical practice guidelines.

PubMed

Kaplan, Sandra L; Coulter, Colleen; Fetters, Linda

2013-01-01

Recommended strategies for developing evidence-based clinical practice guidelines (CPGs) are provided. The intent is that future CPGs developed with the support of the Section on Pediatrics of the American Physical Therapy Association would consistently follow similar developmental processes to yield consistent quality and presentation. Steps in the process of developing CPGs are outlined and resources are provided to assist CPG developers in carrying out their task. These recommended processes may also be useful to CPG developers representing organizations with similar structures, objectives, and resources.

Separation of pigment formulations by high-performance thin-layer chromatography with automated multiple development.

PubMed

Stiefel, Constanze; Dietzel, Sylvia; Endress, Marc; Morlock, Gertrud E

2016-09-02

Food packaging is designed to provide sufficient protection for the respective filling, legally binding information for the consumers like nutritional facts or filling information, and an attractive appearance to promote the sale. For quality and safety of the package, a regular quality control of the used printing materials is necessary to get consistently good print results, to avoid migration of undesired ink components into the food and to identify potentially faulty ink batches. Analytical approaches, however, have hardly been considered for quality assurance so far due to the lack of robust, suitable methods for the analysis of rarely soluble pigment formulations. Thus, a simple and generic high-performance thin-layer chromatography (HPTLC) method for the separation of different colored pigment formulations was developed on HPTLC plates silica gel 60 by automated multiple development. The gradient system provided a sharp resolution for differently soluble pigment constituents like additives and coating materials. The results of multi-detection allowed a first assignment of the differently detectable bands to particular chemical substance classes (e.g., lipophilic components), enabled the comparison of different commercially available pigment batches and revealed substantial variations in the composition of the batches. Hyphenation of HPTLC with high resolution mass spectrometry and infrared spectroscopy allowed the characterization of single unknown pigment constituents, which may partly be responsible for known quality problems during printing. The newly developed, precise and selective HPTLC method can be used as part of routine quality control for both, incoming pigment batches and monitoring of internal pigment production processes, to secure a consistent pigment composition resulting in consistent ink quality, a faultless print image and safe products. Hyphenation of HPTLC with the A. fischeri bioassay gave first information on the bioactivity or rather on the toxicological potential of different compounds of the pigment formulations. The results of the bioassay might be helpful to choose pigment compositions that provide both, a high printing quality but at the same time guarantee a high consumer safety, especially in regard to smaller pigment components, which tend to migrate through the packaging. Copyright © 2016 Elsevier B.V. All rights reserved.

Collaborative problem solving with a total quality model.

PubMed

Volden, C M; Monnig, R

1993-01-01

A collaborative problem-solving system committed to the interests of those involved complies with the teachings of the total quality management movement in health care. Deming espoused that any quality system must become an integral part of routine activities. A process that is used consistently in dealing with problems, issues, or conflicts provides a mechanism for accomplishing total quality improvement. The collaborative problem-solving process described here results in quality decision-making. This model incorporates Ishikawa's cause-and-effect (fishbone) diagram, Moore's key causes of conflict, and the steps of the University of North Dakota Conflict Resolution Center's collaborative problem solving model.

Guidelines for planting along Virginia's roadways.

DOT National Transportation Integrated Search

1986-01-01

This Guideline for Planting along Virginia Roadways provides broad policy : statements for highway landscaping. The guideline's purpose is to ensure quality : and consistency that conform with accepted landscape architectural principles : and practic...

The quality of family planning services and client satisfaction in the public and private sectors in Kenya.

PubMed

Agha, Sohail; Do, Mai

2009-04-01

To compare the quality of family planning services delivered at public and private facilities in Kenya. Data from the 2004 Kenya Service Provision Assessment were analysed. The Kenya Service Provision Assessment is a representative sample of health facilities in the public and private sectors, and comprises data obtained from a facility inventory, service provider interviews, observations of client-provider interactions and exit interviews. Quality-of-care indicators are compared between the public and private sectors along three dimensions: structure, process and outcome. Private facilities were superior to public sector facilities in terms of physical infrastructure and the availability of services. Public sector facilities were more likely to have management systems in place. There was no difference between public and private providers in the technical quality of care provided. Private providers were better at managing interpersonal aspects of care. The higher level of client satisfaction at private facilities could not be explained by differences between public and private facilities in structural and process aspects of care. Formal private sector facilities providing family planning services exhibit greater readiness to provide services and greater attention to client needs than public sector facilities in Kenya. Consistent with this, client satisfaction is much higher at private facilities. Technical quality of care provided is similar in public and private facilities.

Public Reporting and Demand Rationing: Evidence from the Nursing Home Industry.

PubMed

He, Daifeng; Konetzka, R Tamara

2015-11-01

This paper examines an under-explored unintended consequence of public reporting: the potential for demand rationing. Public reporting, although intended to increase consumer access to high-quality products, may have provided the perverse incentive for high-quality providers facing fixed capacity and administrative pricing to avoid less profitable types of residents. Using data from the nursing home industry before and after the implementation of the public reporting system in 2002, we find that high-quality nursing homes facing capacity constraints reduced admissions of less profitable Medicaid residents while increasing the more profitable Medicare and private-pay admissions, relative to low-quality nursing homes facing no capacity constraints. These effects, although small in magnitude, are consistent with provider rationing of demand on the basis of profitability and underscore the important role of institutional details in designing effective public reporting systems for regulated industries. Copyright © 2014 John Wiley & Sons, Ltd.

36 CFR 223.30 - Consistency with plans, environmental standards, and other management requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER...) Providing favorable conditions of water flow and quality; (f) Utilization of the timber resource to provide... characteristics; (g) Reduction of the likelihood of loss to destructive agencies; and (h) Minimizing adverse...

Development Strategies for Online Volunteer Training Modules: A Team Approach

ERIC Educational Resources Information Center

Robideau, Kari; Vogel, Eric

2014-01-01

Volunteers are central to the delivery of 4-H programs, and providing quality, relevant training is key to volunteer success. Online, asynchronous modules are an enhancement to a training delivery menu for adult volunteers, providing consistent, accessible options traditionally delivered primarily face to face. This article describes how Minnesota…

proGenomes: a resource for consistent functional and taxonomic annotations of prokaryotic genomes.

PubMed

Mende, Daniel R; Letunic, Ivica; Huerta-Cepas, Jaime; Li, Simone S; Forslund, Kristoffer; Sunagawa, Shinichi; Bork, Peer

2017-01-04

The availability of microbial genomes has opened many new avenues of research within microbiology. This has been driven primarily by comparative genomics approaches, which rely on accurate and consistent characterization of genomic sequences. It is nevertheless difficult to obtain consistent taxonomic and integrated functional annotations for defined prokaryotic clades. Thus, we developed proGenomes, a resource that provides user-friendly access to currently 25 038 high-quality genomes whose sequences and consistent annotations can be retrieved individually or by taxonomic clade. These genomes are assigned to 5306 consistent and accurate taxonomic species clusters based on previously established methodology. proGenomes also contains functional information for almost 80 million protein-coding genes, including a comprehensive set of general annotations and more focused annotations for carbohydrate-active enzymes and antibiotic resistance genes. Additionally, broad habitat information is provided for many genomes. All genomes and associated information can be downloaded by user-selected clade or multiple habitat-specific sets of representative genomes. We expect that the availability of high-quality genomes with comprehensive functional annotations will promote advances in clinical microbial genomics, functional evolution and other subfields of microbiology. proGenomes is available at http://progenomes.embl.de. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

Capturing Accurate and Useful Information on Medication-Related Telenursing Triage Calls.

PubMed

Lake, R; Li, L; Baysari, M; Byrne, M; Robinson, M; Westbrook, J I

2016-01-01

Registered nurses providing telenursing triage and advice services record information on the medication related calls they handle. However the quality and consistency of these data were rarely examined. Our aim was to examine medication related calls made to the healthdirect advice service in November 2014, to assess their basic characteristics and how the data entry format influenced information collected and data consistency. Registered nurses selected the patient question type from a range of categories, and entered the medications involved in a free text field. Medication names were manually extracted from the free text fields. We also compared the selected patient question type with the free text description of the call, in order to gauge data consistency. Results showed that nurses provided patients with advice on medication-related queries in a timely matter (the median call duration of 9 minutes). From 1835 calls, we were able to identify and classify 2156 medications into 384 generic names. However, in 204 cases (11.2% of calls) no medication name was entered. A further 308 (15.0%) of the medication names entered were not identifiable. When we compared the selected patient question with the free text description of calls, we found that these were consistent in 63.27% of cases. Telenursing and triage advice services provide a valuable resource to the public with quick and easily accessible advice. To support nurses provide quality services and record accurate information about the queries, appropriate data entry format and design would be beneficial.

Environmental Response Laboratory Network

EPA Pesticide Factsheets

The ERLN as a national network of laboratories that can be ramped up as needed to support large scale environmental responses. It integrates capabilities of existing public and private sector labs, providing consistent capacity and quality data.

1990 National Water Quality Laboratory Services Catalog

USGS Publications Warehouse

Pritt, Jeffrey; Jones, Berwyn E.

1989-01-01

PREFACE This catalog provides information about analytical services available from the National Water Quality Laboratory (NWQL) to support programs of the Water Resources Division of the U.S. Geological Survey. To assist personnel in the selection of analytical services, the catalog lists cost, sample volume, applicable concentration range, detection level, precision of analysis, and preservation techniques for samples to be submitted for analysis. Prices for services reflect operationa1 costs, the complexity of each analytical procedure, and the costs to ensure analytical quality control. The catalog consists of five parts. Part 1 is a glossary of terminology; Part 2 lists the bottles, containers, solutions, and other materials that are available through the NWQL; Part 3 describes the field processing of samples to be submitted for analysis; Part 4 describes analytical services that are available; and Part 5 contains indices of analytical methodology and Chemical Abstract Services (CAS) numbers. Nomenclature used in the catalog is consistent with WATSTORE and STORET. The user is provided with laboratory codes and schedules that consist of groupings of parameters which are measured together in the NWQL. In cases where more than one analytical range is offered for a single element or compound, different laboratory codes are given. Book 5 of the series 'Techniques of Water Resources Investigations of the U.S. Geological Survey' should be consulted for more information about the analytical procedures included in the tabulations. This catalog supersedes U.S. Geological Survey Open-File Report 86-232 '1986-87-88 National Water Quality Laboratory Services Catalog', October 1985.

Preliminary investigation of the STBBI Stigma Scale: Description and pilot results.

PubMed

Wagner, Anne C; MacLean, Rachel

2017-11-09

Sexually transmitted and blood-borne infections (STBBIs) are associated with stigmatizing attitudes and beliefs, which can affect the quality of and access to health care, as well as mental health and quality of life. The current study describes the adaptation from an HIV-related stigma scale and pilot testing of a new STBBI Stigma Scale, assessing the stigmatizing attitudes and beliefs of health and social service providers in Canada. 144 health and social service providers from across Canada completed the newly adapted scale assessing stigma associated with HIV, hepatitis C, other viral STBBIs and bacterial STBBIs, as well as demographic information, a scale of social desirability and measures of convergent and divergent validity. Participants were recruited through listservs and completed the scale online. The new scale, consisting of 21 items for each category, demonstrated excellent internal consistency, reliability, and convergent and divergent validity. The factor structure of the scale supports a tripartite model of stigma consisting of stereotyping, prejudice and discrimination. Stereotyping had the highest relative scores on the subscales, and attitudes regarding other viral STBBIs differed significantly from the other STBBI categories. The new scale provides a contextually relevant and applicable psychometrically valid tool to assess STBBI-related stigma among health and social service providers in Canada. The tool can be used to assess attitudes and beliefs, as well as guide self-assessment and possible trainings for providers.

Quality systems in veterinary diagnostics laboratories.

PubMed

de Branco, Freitas Maia L M

2007-01-01

Quality assurance of services provided by veterinary diagnostics laboratories is a fundamental element promoted by international animal health organizations to establish trust, confidence and transparency needed for the trade of animals and their products at domestic and international levels. It requires, among other things, trained personnel, consistent and rigorous methodology, choice of suitable methods as well as appropriate calibration and traceability procedures. An important part of laboratory quality management is addressed by ISO/IEC 17025, which aims to facilitate cooperation among laboratories and their associated parties by assuring the generation of credible and consistent information derived from analytical results. Currently, according to OIE recommendation, veterinary diagnostics laboratories are only subject to voluntary compliance with standard ISO/IEC 17025; however, it is proposed here that OIE reference laboratories and collaboration centres strongly consider its adoption.

Including quality attributes in efficiency measures consistent with net benefit: creating incentives for evidence based medicine in practice.

PubMed

Eckermann, Simon; Coelli, Tim

2013-01-01

Evidence based medicine supports net benefit maximising therapies and strategies in processes of health technology assessment (HTA) for reimbursement and subsidy decisions internationally. However, translation of evidence based medicine to practice is impeded by efficiency measures such as cost per case-mix adjusted separation in hospitals, which ignore health effects of care. In this paper we identify a correspondence method that allows quality variables under control of providers to be incorporated in efficiency measures consistent with maximising net benefit. Including effects framed from a disutility bearing (utility reducing) perspective (e.g. mortality, morbidity or reduction in life years) as inputs and minimising quality inclusive costs on the cost-disutility plane is shown to enable efficiency measures consistent with maximising net benefit under a one to one correspondence. The method combines advantages of radial properties with an appropriate objective of maximising net benefit to overcome problems of inappropriate objectives implicit with alternative methods, whether specifying quality variables with utility bearing output (e.g. survival, reduction in morbidity or life years), hyperbolic or exogenous variables. This correspondence approach is illustrated in undertaking efficiency comparison at a clinical activity level for 45 Australian hospitals allowing for their costs and mortality rates per admission. Explicit coverage and comparability conditions of the underlying correspondence method are also shown to provide a robust framework for preventing cost-shifting and cream-skimming incentives, with appropriate qualification of analysis and support for data linkage and risk adjustment where these conditions are not satisfied. Comparison on the cost-disutility plane has previously been shown to have distinct advantages in comparing multiple strategies in HTA, which this paper naturally extends to a robust method and framework for comparing efficiency of health care providers in practice. Consequently, the proposed approach provides a missing link between HTA and practice, to allow active incentives for evidence based net benefit maximisation in practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

Overview of the Nordic Seas CARINA data and salinity measurements

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

Olsen, Are; Key, Robert; Jeansson, Emil

2009-01-01

Water column data of carbon and carbon relevant hydrographic and hydrochemical parameters from 188 previously non-publicly available cruises in the Arctic, Atlantic, and Southern Ocean have been retrieved and merged into a new database: CARINA (CARbon IN the Atlantic). The data have been subject to rigorous quality control (QC) in order to ensure highest possible quality and consistency. The data for most of the parameters included were examined in order to quantify systematic biases in the reported values, i.e. secondary quality control. Significant biases have been corrected for in the data products, i.e. the three merged files with measured, calculatedmore » and interpolated values for each of the three CARINA regions; the Arctic Mediterranean Seas (AMS), the Atlantic (ATL) and the Southern Ocean (SO).With the adjustments the CARINA database is consistent both internally as well as with GLODAP (Key et al., 2004) and is suitable for accurate assessments of, for example, oceanic carbon inventories and uptake rates and for model validation. The Arctic Mediterranean Seas include the Arctic Ocean and the Nordic Seas, and the quality control was carried out separately in these two areas. This contribution provides an overview of the CARINA data from the Nordic Seas and summaries the findings of the QC of the salinity data. One cruise had salinity data that were of questionable quality, and these have been removed from the data product. An evaluation of the consistency of the quality controlled salinity data suggests that they are consistent to at least 0.005.« less

Providing Behavioral Feedback to Students in an Alternative High School Setting

ERIC Educational Resources Information Center

Whitcomb, Sara A.; Hefter, Sheera; Barker, Elizabeth

2016-01-01

This column provides an example method for improving the consistency and quality of daily behavioral feedback provided to students in an alternative high school setting. Often, homeroom or advisory periods are prime points in the day for students to review their behavior from the previous day and set goals for a successful day to come. The method…

Real-time feedback can improve infant manikin cardiopulmonary resuscitation by up to 79%--a randomised controlled trial.

PubMed

Martin, Philip; Theobald, Peter; Kemp, Alison; Maguire, Sabine; Maconochie, Ian; Jones, Michael

2013-08-01

European and Advanced Paediatric Life Support training courses. Sixty-nine certified CPR providers. CPR providers were randomly allocated to a 'no-feedback' or 'feedback' group, performing two-thumb and two-finger chest compressions on a "physiological", instrumented resuscitation manikin. Baseline data was recorded without feedback, before chest compressions were repeated with one group receiving feedback. Indices were calculated that defined chest compression quality, based upon comparison of the chest wall displacement to the targets of four, internationally recommended parameters: chest compression depth, release force, chest compression rate and compression duty cycle. Baseline data were consistent with other studies, with <1% of chest compressions performed by providers simultaneously achieving the target of the four internationally recommended parameters. During the 'experimental' phase, 34 CPR providers benefitted from the provision of 'real-time' feedback which, on analysis, coincided with a statistical improvement in compression rate, depth and duty cycle quality across both compression techniques (all measures: p<0.001). Feedback enabled providers to simultaneously achieve the four targets in 75% (two-finger) and 80% (two-thumb) of chest compressions. Real-time feedback produced a dramatic increase in the quality of chest compression (i.e. from <1% to 75-80%). If these results transfer to a clinical scenario this technology could, for the first time, support providers in consistently performing accurate chest compressions during infant CPR and thus potentially improving clinical outcomes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Service employees give as they get: internal service as a moderator of the service climate-service outcomes link.

PubMed

Ehrhart, Karen Holcombe; Witt, L A; Schneider, Benjamin; Perry, Sara Jansen

2011-03-01

We lend theoretical insight to the service climate literature by exploring the joint effects of branch service climate and the internal service provided to the branch (the service received from corporate units to support external service delivery) on customer-rated service quality. We hypothesized that service climate is related to service quality most strongly when the internal service quality received is high, providing front-line employees with the capability to deliver what the service climate motivates them to do. We studied 619 employees and 1,973 customers in 36 retail branches of a bank. We aggregated employee perceptions of the internal service quality received from corporate units and the local service climate and external customer perceptions of service quality to the branch level of analysis. Findings were consistent with the hypothesis that high-quality internal service is necessary for branch service climate to yield superior external customer service quality. PsycINFO Database Record (c) 2011 APA, all rights reserved.

Underground Test Area Activity Quality Assurance Plan Nevada National Security Site, Nevada. Revision 1

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

Farnham, Irene; Krenzien, Susan

This Quality Assurance Plan (QAP) provides the overall quality assurance (QA) requirements and general quality practices to be applied to the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Underground Test Area (UGTA) activities. The requirements in this QAP are consistent with DOE Order 414.1C, Quality Assurance (DOE, 2005); U.S. Environmental Protection Agency (EPA) Guidance for Quality Assurance Project Plans for Modeling (EPA, 2002); and EPA Guidance on the Development, Evaluation, and Application of Environmental Models (EPA, 2009). NNSA/NSO, or designee, must review this QAP every two years. Changes that do not affect the overallmore » scope or requirements will not require an immediate QAP revision but will be incorporated into the next revision cycle after identification. Section 1.0 describes UGTA objectives, participant responsibilities, and administrative and management quality requirements (i.e., training, records, procurement). Section 1.0 also details data management and computer software requirements. Section 2.0 establishes the requirements to ensure newly collected data are valid, existing data uses are appropriate, and environmental-modeling methods are reliable. Section 3.0 provides feedback loops through assessments and reports to management. Section 4.0 provides the framework for corrective actions. Section 5.0 provides references for this document.« less

Monitoring the quality consistency of Weibizhi tablets by micellar electrokinetic chromatography fingerprints combined with multivariate statistical analyses, the simple quantified ratio fingerprint method, and the fingerprint-efficacy relationship.

PubMed

Liu, Yingchun; Sun, Guoxiang; Wang, Yan; Yang, Lanping; Yang, Fangliang

2015-06-01

Micellar electrokinetic chromatography fingerprinting combined with quantification was successfully developed and applied to monitor the quality consistency of Weibizhi tablets, which is a classical compound preparation used to treat gastric ulcers. A background electrolyte composed of 57 mmol/L sodium borate, 21 mmol/L sodium dodecylsulfate and 100 mmol/L sodium hydroxide was used to separate compounds. To optimize capillary electrophoresis conditions, multivariate statistical analyses were applied. First, the most important factors influencing sample electrophoretic behavior were identified as background electrolyte concentrations. Then, a Box-Benhnken design response surface strategy using resolution index RF as an integrated response was set up to correlate factors with response. RF reflects the effective signal amount, resolution, and signal homogenization in an electropherogram, thus, it was regarded as an excellent indicator. In fingerprint assessments, simple quantified ratio fingerprint method was established for comprehensive quality discrimination of traditional Chinese medicines/herbal medicines from qualitative and quantitative perspectives, by which the quality of 27 samples from the same manufacturer were well differentiated. In addition, the fingerprint-efficacy relationship between fingerprints and antioxidant activities was established using partial least squares regression, which provided important medicinal efficacy information for quality control. The present study offered an efficient means for monitoring Weibizhi tablet quality consistency. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Application of Pre-heating to Improve the Consistency and Quality in AA5052 Resistance Spot Welding

NASA Astrophysics Data System (ADS)

Luo, Zhen; Ao, Sansan; Chao, Yuh Jin; Cui, Xuetuan; Li, Yang; Lin, Ye

2015-10-01

Making consistent resistance spot welds of aluminum alloy with good quality and at high volume has several obstacles in automotive industry. One of the difficult issues arises from the presence of a tough non-conducting oxide film on the aluminum sheet surface. The oxide film develops over time and often is non-uniform across the surface of the aluminum alloy sheet, which makes the contact resistance characteristics irregular at the faying interface during welding. The consistency in quality of the final spot welds is therefore problematic to control. To suppress the effect of the irregular oxide film on the spot weld quality, application of a pre-heating treatment in the welding schedule for aluminum alloy 5052 is investigated in this present work. The current level of the pre-heating required to reduce the scatter of the contact resistance at the W/W (workpiece-to-workpiece) faying interface is quantified experimentally. The results indicate that the contact resistance at the W/W faying interface with a pre-heating treatment becomes much consistent and can be reduced by two orders of magnitude. Having the uncertain variation of the contact resistance at the W/W faying surface virtually reduced or removed, the quality of the spot welds in terms of the peak load and nugget diameter is examined and shows a great improvement. The proposed method may provide a robust method for high-volume spot welding of aluminum alloy sheets in auto industry.

Assessing the Implementation and Cost of High Quality Early Care and Education: A Review of the Literature. OPRE Report 2016-31

ERIC Educational Resources Information Center

Caronongan, Pia; Kirby, Gretchen; Boller, Kimberly; Modlin, Emily; Lyskawa, Julia

2016-01-01

This report summarizes the findings of a literature review conducted as part of the Assessing the Implementation and Cost of High-Quality Early Care and Education (ECE-ICHQ) project. The project's goal is to create a technically sound and feasible instrument that will provide consistent, systematic measures of the implementation and costs of…

Robotic Telesurgery Research

DTIC Science & Technology

2010-03-01

piece of tissue. Full Mobility Manipulator Robot The primary challenge with the design of a full mobility robot is meeting the competing design...streamed through an embedded plug-in for VLC player using asf/wmv encoding with 200ms buffering. A benchtop test of the remote user interface was...encountered in ensuring quality video is being made available to the surgeon. A significant challenge has been to consistently provide high quality video

Assessing values of air quality and visibility at risk from wildland fires.

Treesearch

Sue A. Ferguson; Steven J. McKay; David E. Nagel; Trent Piepho; Miriam L. Rorig; Casey Anderson; Lara Kellogg

2003-01-01

To assess values of air quality and visibility at risk from wildland fire in the United States, we generated a 40-year database that includes twice daily values of wind, mixing height, and a ventilation index that is the product of windspeed and mixing height. The database provides the first nationally consistent map of surface wind and ventilation index. In addition,...

Challenges Encountered by Vietnamese Nurses When Caring for Patients With Cancer.

PubMed

Thuy Nguyen, Ly; Clemenceau Annoussamy, Lourdes; LeBaron, Virginia T

2017-03-01

Providing holistic care is acknowledged as central to providing quality care for patients with cancer, but providing competent nursing care consistent with these approaches remains a challenge for nurses in Vietnam. Obstacles for Vietnamese oncology nurses include their low status, the limited scope of nursing practice, work overload in a hierarchical system, and cultural beliefs that view death and dying as taboo. Additional research to support oncology nurses in Vietnam must acknowledge the merits of improving nursing education as an important strategy for enhancing nursing autonomy, quality of care, and outcomes for the increasing number of patients with cancer in low- and middle-income countries.

Using the SIOP Model for Effective Content Teaching with Second and Foreign Language Learners

ERIC Educational Resources Information Center

Kareva, Veronika; Echevarria, Jana

2013-01-01

In this paper we present a comprehensive model of instruction for providing consistent, high quality teaching to L2 students. This model, the SIOP Model (Sheltered Instruction Observation Protocol), provides an explicit framework for organizing instructional practices to optimize the effectiveness of teaching second and foreign language learners.…

2008-09 Financial Aid Report

ERIC Educational Resources Information Center

Nevada System of Higher Education, 2010

2010-01-01

The mission of the Nevada System of Higher Education (NSHE) is to provide higher education services to the citizens of the State at an excellent level of quality consistent with the state's resources. The information in this report is provided by the financial aid officers at each NSHE institution. Each fall, institutions submit a detailed…

[Special aspects of quality of Tibetan medicines--insights from over 40 years of manufacturing experience in Switzerland].

PubMed

Schwabl, Alexandra; Gämperle, Erich

2013-01-01

Tibetan recipes are complex formulas from plant and mineral ingredients. Padma Inc. has been producing selected formulas from Tibetan Medicine in Switzerland since more than 40 years. Modern quality standards and Good Manufacturing Practice (GMP) guidelines are followed, ensuring the quality of the raw materials through the manufacturing processes to the finished product. The aim is to provide these valuable formulas to people in the West in a consistently high quality 'made in Switzerland'. The production according to modern quality standards is challenging, draws on many resources, and requires specialized expertise, e.g. in the procurement of raw materials and the quality analysis including pharmacognostic and botanical knowledge.

Evaluation of service quality in family planning clinics in Lusaka, Zambia.

PubMed

Hancock, Nancy L; Vwalika, Bellington; Sitali, Elizabeth Siyama; Mbwili-Muleya, Clara; Chi, Benjamin H; Stuart, Gretchen S

2015-10-01

To determine the quality of contraceptive services in family planning clinics in Lusaka, Zambia, using a standardized approach. We utilized the Quick Investigation of Quality, a cross-sectional survey tool consisting of a facility assessment, client-provider observation and client exit interview, in public-sector family planning clinics. Data were collected on availability of seven contraceptive methods, information given to clients, interpersonal relations between providers and clients, providers' technical competence and mechanisms for continuity and follow-up. Data were collected from five client-provider observations and client exit interviews in each of six public-sector family planning clinics. All clinics had at least two contraceptive methods continuously available for the preceding 6 months. Most providers asked clients about concerns with their contraceptive method (80%) and told clients when to return to the clinic (87%). Most clients reported that the provider advised what to do if a problem develops (93%), described possible side effects (89%), explained how to use the method effectively (85%) and told them when to come for follow-up (83%). Clients were satisfied with services received (93%). This application of the Quick Investigation of Quality showed that the participating family planning clinics in Lusaka, Zambia, were prepared to offer high-quality services with the available commodities and that clients were satisfied with the received services. Despite the subjective client satisfaction, quality improvement efforts are needed to increase contraceptive availability. Although clients perceived the quality of care received to be high, family planning service quality could be improved to continuously offer the full spectrum of contraceptive options. The Quick Investigation of Quality was easily implemented in Lusaka, Zambia, and this simple approach could be utilized in a variety of settings as a modality for quality improvement. Copyright © 2015 Elsevier Inc. All rights reserved.

Quality assurance and the need to evaluate interventions and audit programme outcomes.

PubMed

Zhao, Min; Vaartjes, Ilonca; Klipstein-Grobusch, Kerstin; Kotseva, Kornelia; Jennings, Catriona; Grobbee, Diederick E; Graham, Ian

2017-06-01

Evidence-based clinical guidelines provide standards for the provision of healthcare. However, these guidelines have been poorly implemented in daily practice. Clinical audit is a quality improvement tool to promote quality of care in daily practice and to improve outcomes through the systematic review of care delivery and implementation of changes. A major priority in the management of subjects with cardiovascular disease (CVD) management is secondary prevention by controlling cardiovascular risk factors and providing appropriate medical treatment. Clinical audits can be applied to monitor modifiable risk factors and evaluate quality improvements of CVD management in daily practice. Existing clinical audits have provided an overview of the burden of risk factors in subjects with CVD and reflect real-world risk factor recording and management. However, consistent and representative data from clinic audits are still insufficient to fully monitor quality improvement of CVD management. Data are lacking in particular from low- and middle-income countries, limiting the evaluation of CVD management quality by clinical audit projects in many settings. To support the development of clinical standards, monitor daily practice performance, and improve quality of care in CVD management at national and international levels, more widespread clinical audits are warranted.

Validation of an image-based technique to assess the perceptual quality of clinical chest radiographs with an observer study

NASA Astrophysics Data System (ADS)

Lin, Yuan; Choudhury, Kingshuk R.; McAdams, H. Page; Foos, David H.; Samei, Ehsan

2014-03-01

We previously proposed a novel image-based quality assessment technique1 to assess the perceptual quality of clinical chest radiographs. In this paper, an observer study was designed and conducted to systematically validate this technique. Ten metrics were involved in the observer study, i.e., lung grey level, lung detail, lung noise, riblung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm-lung contrast, and subdiaphragm area. For each metric, three tasks were successively presented to the observers. In each task, six ROI images were randomly presented in a row and observers were asked to rank the images only based on a designated quality and disregard the other qualities. A range slider on the top of the images was used for observers to indicate the acceptable range based on the corresponding perceptual attribute. Five boardcertificated radiologists from Duke participated in this observer study on a DICOM calibrated diagnostic display workstation and under low ambient lighting conditions. The observer data were analyzed in terms of the correlations between the observer ranking orders and the algorithmic ranking orders. Based on the collected acceptable ranges, quality consistency ranges were statistically derived. The observer study showed that, for each metric, the averaged ranking orders of the participated observers were strongly correlated with the algorithmic orders. For the lung grey level, the observer ranking orders completely accorded with the algorithmic ranking orders. The quality consistency ranges derived from this observer study were close to these derived from our previous study. The observer study indicates that the proposed image-based quality assessment technique provides a robust reflection of the perceptual image quality of the clinical chest radiographs. The derived quality consistency ranges can be used to automatically predict the acceptability of a clinical chest radiograph.

International Conference on Harmonisation; guidance on Q9 Quality Risk Management; availability. Notice.

PubMed

2006-06-02

The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q9 Quality Risk Management."' The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance provides principles and examples of tools for quality risk management that can be applied to all aspects of pharmaceutical quality throughout the lifecycle of drug substances, drug products, and biological and biotechnological products. The guidance is intended to enable regulators and industry to make more effective and consistent risk-based decisions.

Underground Test Area Quality Assurance Project Plan Nevada National Security Site, Nevada, Revision 0

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

Irene Farnham

This Quality Assurance Project Plan (QAPP) provides the overall quality assurance (QA) program requirements and general quality practices to be applied to the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Underground Test Area (UGTA) Sub-Project (hereafter the Sub-Project) activities. The requirements in this QAPP are consistent with DOE Order 414.1C, Quality Assurance (DOE, 2005); U.S. Environmental Protection Agency (EPA) Guidance for Quality Assurance Project Plans for Modeling (EPA, 2002); and EPA Guidance on the Development, Evaluation, and Application of Environmental Models (EPA, 2009). The QAPP Revision 0 supersedes DOE--341, Underground Test Area Quality Assurancemore » Project Plan, Nevada Test Site, Nevada, Revision 4.« less

Novice teen driving : education and training administrative standards.

DOT National Transportation Integrated Search

2009-10-09

The Novice Teen Driver Education and Training Administrative Standards set forth in this document serve to guide all novice teen driver education and training programs in States striving to provide quality, consistent driver education and training. W...

A consistent and uniform research earthquake catalog for the AlpArray region: preliminary results.

NASA Astrophysics Data System (ADS)

Molinari, I.; Bagagli, M.; Kissling, E. H.; Diehl, T.; Clinton, J. F.; Giardini, D.; Wiemer, S.

2017-12-01

The AlpArray initiative (www.alparray.ethz.ch) is a large-scale European collaboration ( 50 institutes involved) to study the entire Alpine orogen at high resolution with a variety of geoscientific methods. AlpArray provides unprecedentedly uniform station coverage for the region with more than 650 broadband seismic stations, 300 of which are temporary. The AlpArray Seismic Network (AASN) is a joint effort of 25 institutes from 10 nations, operates since January 2016 and is expected to continue until the end of 2018. In this study, we establish a uniform earthquake catalogue for the Greater Alpine region during the operation period of the AASN with a aimed completeness of M2.5. The catalog has two main goals: 1) calculation of consistent and precise hypocenter locations 2) provide preliminary but uniform magnitude calculations across the region. The procedure is based on automatic high-quality P- and S-wave pickers, providing consistent phase arrival times in combination with a picking quality assessment. First, we detect all events in the region in 2016/2017 using an STA/LTA based detector. Among the detected events, we select 50 geographically homogeneously distributed events with magnitudes ≥2.5 representative for the entire catalog. We manually pick the selected events to establish a consistent P- and S-phase reference data set, including arrival-time time uncertainties. The reference data, are used to adjust the automatic pickers and to assess their performance. In a first iteration, a simple P-picker algorithm is applied to the entire dataset, providing initial picks for the advanced MannekenPix (MPX) algorithm. In a second iteration, the MPX picker provides consistent and reliable automatic first arrival P picks together with a pick-quality estimate. The derived automatic P picks are then used as initial values for a multi-component S-phase picking algorithm. Subsequently, automatic picks of all well-locatable earthquakes will be considered to calculate final minimum 1D P and S velocity models for the region with appropriate stations corrections. Finally, all the events are relocated with the NonLinLoc algorithm in combination with the updated 1D models. The proposed procedure represents the first step towards uniform earthquake catalog for the entire greater Alpine region using the AASN.

Development of quality indicators for transition from pediatric to adult care in sickle cell disease: A modified Delphi survey of adult providers.

PubMed

Sobota, Amy E; Shah, Nishita; Mack, Jennifer W

2017-06-01

Transition from pediatric to adult care is a vulnerable time for young adults with sickle cell disease (SCD); however, improvements in transition are limited by a lack of quality indicators. The purpose of this study was to establish quality indicators for transition in SCD and to determine the optimal timing between the final pediatric visit and the first adult provider visit. We conducted a modified Delphi survey to reach a consensus on which quality indicators are most important for a successful transition. Our expert panel consisted of members of the Sickle Cell Adult Provider Network. In the first round, the participants ranked a list of quality indicators by importance. In the second round, the participants chose their "top 5" quality indicators in terms of importance and also ranked them on feasibility. The response rates for the two rounds were 68 and 96%, respectively. Nine quality indicators were chosen as "top 5" by a majority of respondents, including communication between pediatric and adult providers, timing of first adult visit, patient self-efficacy, quality of life, and trust with their adult provider. Based on the comments from round 1, respondents were also asked for the optimal timing between leaving pediatric care and entering adult care. Most recommended a first adult visit within 2 months of the final pediatric visit. By using these quality indicators chosen by the majority of respondents, we can better develop and evaluate transition programs for young adults with SCD and improve health outcomes for these vulnerable patients. © 2016 Wiley Periodicals, Inc.

The Federal Trade Commission, clinical integration, and the organization of physician practice.

PubMed

Casalino, Lawrence P

2006-06-01

This article examines Federal Trade Commission (FTC) policy--in particular, the agency's controversial 1996 statements on clinical integration--toward joint negotiations for nonrisk contracts with health plans by physicians organized into independent practice associations (IPAs) and (with hospitals) into physician-hospital organizations (PHOs). The article concludes that the policy is consistent with anti-trust principles, consistent with current thinking on the use of organized processes to improve medical care quality, specific enough to provide guidance to physicians wanting to integrate clinically, and general enough to encourage ongoing innovations in physician organization. The FTC should consider stronger sanctions for IPAs and PHOs whose clinical integration is nothing more than a sham intended to provide cover for joint negotiations, should give the benefit of the doubt to organizations whose clinical integration appears to be reasonably consonant with the statements, and should clarify several ambiguities in the statements. Health plans should facilitate IPA and PHO efforts to improve care by rewarding quality and efficiency and by providing clinically integrated organizations with claims information on individual patients. Though creating clinically integrated organizations is difficult and expensive, physicians should recognize that clinical integration can help them both to gain some negotiating leverage with health plans and to improve the quality of care for their patients.

A summary of the U.S. Geological Survey National Water-Quality Assessment program

USGS Publications Warehouse

Hirsch, R.M.; Alley, W.M.; Wilber, W.G.

1988-01-01

Beginning in 1986, the Congress appropriated funds for the U.S. Geological Survey to test and refine concepts for a National Water Quality Assessment Program. At present, the program is in a pilot phase with field studies occurring in seven areas around the Nation. In 1990, a committee of the National Academy of Sciences will complete an evaluation of the design and potential utility of the program. A decision about moving to full-scale implementation will be made upon completion of this evaluation. The program is intended to address a wide range of national water quality issues that include chemical contamination, acidification, eutrophication, salinity, sedimentation, and sanitary quality. The goals of the program are to: (1) provide nationally consistent descriptions of current water quality conditions for a large part of the Nation 's water resources; (2) define long-term trends (or lack of trends) in water quality; and (3) identify and describe the relations of both current conditions and trends in water quality to natural and human factors. This information will be provided to water managers, policy makers, and the public to provide an improved scientific basis for evaluating the effectiveness of water quality management programs and for predicting the likely effects of contemplated changes in land- and water-management practices. (USGS)

Patient satisfaction and willingness to return to the provider among women undergoing gynecological surgery.

PubMed

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

2014-10-01

To identify factors associated with 'patient satisfaction' and 'willingness to return to the provider' in gynecology and to assess similarities as well as differences between the two concepts. Study data were obtained from 968 randomly selected gynecology patients discharged from 22 hospitals who responded to a mailed survey. The validated instrument consisted of 37 items and assessed medical and service aspects of care, patient and visit characteristics. The dependent variables consisted of ratings of willingness to return to the provider and overall satisfaction. Bivariate and multivariate techniques were used to reveal relationships between indicators and both dependent variables. The multivariate analyses identified individualized medical care, kindness of medical practitioners, treatment outcome and organization of discharge as the most consistent predictors of the patients' likelihood to return and overall satisfaction. Differences between both concepts pertained to the significance of service variables (cleanliness and quality of food) for patient satisfaction and visit-related characteristics (length of stay and occurrence of complications) for willingness to return. Study findings suggest that patient satisfaction and willingness to return to the provider do not reflect the same concepts. Although service aspects such as quality of food influence satisfaction ratings, they do not increase the likelihood that patients choose the same hospital in case of another treatment. Communication between patients and medical practitioners is highly important. Revealed predictors of both concepts are alterable by healthcare professionals and should be focused on to enhance patient satisfaction and to increase the probability patients return to their provider.

The role of food quality assurance and product certification systems on marketing aspects

NASA Astrophysics Data System (ADS)

Petrović, Z.; Milićević, D.; Nastasijević, I.; Đorđević, V.; Trbović, D.; Velebit, B.

2017-09-01

The level of quality that a product offers to consumers is a fundamental aspect of competition in many markets. Consumers’ confidence in the safety and quality of foods they buy and consume is a significant support to the economic development of production organizations of this type, and therefore the overall economic development. Consumer concerns about food safety as well as the globalization of food production have also led to the existence of a global internationally linked food production and distribution system. The necessity demanded by the consumer population to provide safe food with consistent quality at an attractive price imposes a choice of an appropriate quality assurance model in accordance with the specific properties of the product and the production processes. Modern trends, especially for the last ten years in quality assurance within specific production, such as the food industry, have marked the trend of hyperproduction and a number of production and safety standards, as well as a change of approach in the certification process of organizations according to one or more standards. This can be an additional source of costs for organizations, and can burden the food business operator`s budget in order to ensure their consistent application and maintenance. Quality assurance (QA) standards are considered to be a proven mechanism for delivering quality of product.

The Kubler-Ross model, physician distress, and performance reporting.

PubMed

Smaldone, Marc C; Uzzo, Robert G

2013-07-01

Physician performance reporting has been proposed as an essential component of health-care reform, with the aim of improving quality by providing transparency and accountability. Despite strong evidence demonstrating regional variation in practice patterns and lack of evidence-based care, public outcomes reporting has been met with resistance from medical professionals. Application of the Kubler-Ross 'five stages of grief' model--a conceptual framework consisting of a series of emotional stages (denial, anger, bargaining, depression, and acceptance) inspired by work with terminally ill patients--could provide some insight into why physicians are reluctant to accept emerging quality-reporting mechanisms. Physician-led quality-improvement initiatives are vital to contemporary health-care reform efforts and applications in urology, as well as other medical disciplines, are currently being explored.

Maintaining High Quality Data and Consistency Across a Diverse Flux Network: The Ameriflux QA/QC Technical Team

NASA Astrophysics Data System (ADS)

Chan, S.; Billesbach, D. P.; Hanson, C. V.; Biraud, S.

2014-12-01

The AmeriFlux quality assurance and quality control (QA/QC) technical team conducts short term (<2 weeks) intercomparisons using a portable eddy covariance system (PECS) to maintain high quality data observations and data consistency across the AmeriFlux network (http://ameriflux.lbl.gov/). Site intercomparisons identify discrepancies between the in situ and portable measurements and calculated fluxes. Findings are jointly discussed by the site staff and the QA/QC team to improve in the situ observations. Despite the relatively short duration of an individual site intercomparison, the accumulated record of all site visits (numbering over 100 since 2002) is a unique dataset. The ability to deploy redundant sensors provides a rare opportunity to identify, quantify, and understand uncertainties in eddy covariance and ancillary measurements. We present a few specific case studies from QA/QC site visits to highlight and share new and relevant findings related to eddy covariance instrumentation and operation.

Competition or coordination in hospital markets with unionised labour.

PubMed

Brekke, Kurt R

2004-03-01

This paper study labour market responses to hospital mergers. The market consists of two hospitals providing horizontally and vertically differentiated services. Hospitals compete either in price and quality or just in quality (non-price competition). To provide medical care, hospitals employ health care workers (e.g., physicians, nurses). The workers collectively bargain wages either at a central level, firm level or plant level. Anticipating wage responses, hospitals decide whether or not to merge. The main finding is that the bargaining structure, the nature of competition and the patient copayment rate have a crucial impact on the profitability of hospital mergers.

Implementation of 350-2500 nm diffuse reflectance spectroscopy and High-Performance Thin-Layer Chromatography to rapidly assess manufacturing consistency and quality of cotrimoxazole tablets in Tanzania.

PubMed

Kaale, Eliangiringa; Hope, Samuel M; Jenkins, David; Layloff, Thomas

2016-01-01

To assess the quality of cotrimoxazole tablets produced by a Tanzanian manufacturer by a newly instituted quality assurance programme. Tablets underwent a diffuse reflectance spectroscopy procedure with periodic quality assessment confirmation by assay and dissolution testing using validated HPTLC techniques (including weight variation and disintegration evaluations). Based on results from the primary test methods, the first group of product was <80% compliant, whereas subsequent groups reached >99% compliance. This approach provides a model for rapidly assuring product quality of future procurements of other products that is more cost-effective than traditional pharmaceutical testing techniques. © 2015 John Wiley & Sons Ltd.

[Which one is more important, raw materials or productive technology?--a case study for quality consistency control of Gegen Qinlian decoction].

PubMed

Zhong, Wen; Chen, Sha; Zhang, Jun; Wang, Yu-Sheng; Liu, An

2016-03-01

To investigate the effect of Chinese medicine raw materials and production technology on quality consistency of Chinese patent medicines with Gegen Qinlian decoction as an example, and establish a suitable method for the quality consistency control of Chinese patent medicines. The results showed that the effect of production technology on the quality consistency was generally not more than 5%, while the effect of raw materials was even more than 30%, indicating that the effect of raw materials was much greater than that of the production technology. In this study, blend technology was used to improve the quality consistency of raw materials. As a result, the difference between the product produced by raw materials and reference groups was less than 5%, thus increasing the quality consistence of finished products. The results showed that under the current circumstances, the main factor affecting the quality consistency of Chinese patent medicines was raw materials, so we shall pay more attention to the quality of Chinese medicine's raw materials. Finally, a blend technology can improve the quality consistency of Chinese patent medicines. Copyright© by the Chinese Pharmaceutical Association.

Assessment of response consistency and respective participant profiles in the Internet-based NutriNet-Santé Cohort.

PubMed

Andreeva, Valentina A; Galan, Pilar; Julia, Chantal; Castetbon, Katia; Kesse-Guyot, Emmanuelle; Hercberg, Serge

2014-04-01

Whereas the feasibility and effectiveness of Internet-based epidemiologic research have been established, methodological support for the quality of such data is still accumulating. We aimed to identify sociodemographic differences among members of a French cohort according to willingness to provide part of one's 15-digit national identification number (personal Social Security number (PSSN)) and to assess response consistency based on information reported on the sociodemographic questionnaire and that reflected in the PSSN. We studied 100,118 persons enrolled in an Internet-based prospective cohort study, the NutriNet-Santé Study, between 2009 and 2013. Persons aged 18 years or more who resided in France and had Internet access were eligible for enrollment. The sociodemographic profiles of participants with discordant data were compared against those of participants with concordant data via 2-sided polytomous logistic regression. In total, 84,442 participants (84.3%) provided the first 7 digits of their PSSN, and among them 5,141 (6.1%) had discordant data. Our multivariate analysis revealed differences by sex, age, education, and employment as regards response consistency patterns. The results support the quality of sociodemographic data obtained online from a large and diverse volunteer sample. The quantitative description of participant profiles according to response consistency patterns could inform future methodological work in e-epidemiology.

Male great bowerbirds create forced perspective illusions with consistently different individual quality

PubMed Central

Kelley, Laura A.; Endler, John A.

2012-01-01

Males often produce elaborate displays that increase their attractiveness to females, and some species extend their displays to include structures or objects that are not part of their body. Such “extended phenotypes” may communicate information that cannot be transmitted by bodily signals or may provide a more reliable signal than bodily signals. However, it is unclear whether these signals are individually distinct and whether they are consistent over long periods of time. Male bowerbirds construct and decorate bowers that function in mate choice. Bower display courts constructed by male great bowerbirds (Ptilonorhynchus nuchalis) induce a visual illusion known as forced perspective for the female viewing the male’s display over the court, and the quality of illusion is associated with mating success. We improved the quality of the forced perspective to determine whether males maintained it at the new higher level, decreased the perspective quality back to its original value, or allowed it to decay at random over time. We found that the original perspective quality was actively recovered to individual original values within 3 d. We measured forced perspective over the course of one breeding season and compared the forced perspective of individual males between two successive breeding seasons. We found that differences in the quality of visual illusion among males were consistent within and between two breeding seasons. This suggests that forced perspective is actively and strongly maintained at a different level by each individual male. PMID:23213203

Groundwater-quality data from the eastern Snake River Plain Aquifer, Jerome and Gooding Counties, south-central Idaho, 2017

USGS Publications Warehouse

Skinner, Kenneth D.

2018-05-11

Groundwater-quality samples and water-level data were collected from 36 wells in the Jerome/Gooding County area of the eastern Snake River Plain aquifer during June 2017. The wells included 30 wells sampled for the U.S. Geological Survey’s National Water-Quality Assessment project, plus an additional 6 wells were selected to increase spatial distribution. The data provide water managers with the ability for an improved understanding of groundwater quality and flow directions in the area. Groundwater-quality samples were analyzed for nutrients, major ions, trace elements, and stable isotopes of water. Quality-assurance and quality-control measures consisted of multiple blank samples and a sequential replicate sample. All data are available online at the USGS National Water Information System.

Disclosure of Complementary and Alternative Medicine to Conventional Medical Providers: Variation by Race/Ethnicity and Type of CAM

PubMed Central

Chao, Maria T.; Wade, Christine; Kronenberg, Fredi

2009-01-01

Background Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet fewer than half of patients disclose CAM use to medical doctors. CAM disclosure is particularly low among racial/ethnic minorities, but reasons for differences, such as type of CAM used or quality of conventional healthcare, have not been explored. Objective We tested the hypotheses that disclosure of CAM use to medical doctors is higher for provider-based CAM and among non-Hispanic whites, and that access to and quality of conventional medical care account for racial/ethnic differences in CAM disclosure. Methods Bivariate and multiple variable analyses of the 2002 National Health Interview Survey and 2001 Health Care Quality Survey were performed. Results Disclosure of CAM use to medical providers was higher for provider-based than self-care CAM. Disclosure of any CAM was associated with access to and quality of conventional care and higher among non-Latino whites relative to minorities. Having a regular doctor and quality patient–provider relationship mitigated racial/ethnic differences in CAM disclosure. Conclusion Insufficient disclosure of CAM use to conventional providers, particularly for self-care practices and among minority populations, represents a serious challenge in medical encounter communications. Efforts to improve disclosure of CAM use should be aimed at improving consistency of care and patient–physician communication across racial/ethnic groups. PMID:19024232

Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

PubMed

McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

2015-01-01

Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001), out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association.

PubMed

Meaney, Peter A; Bobrow, Bentley J; Mancini, Mary E; Christenson, Jim; de Caen, Allan R; Bhanji, Farhan; Abella, Benjamin S; Kleinman, Monica E; Edelson, Dana P; Berg, Robert A; Aufderheide, Tom P; Menon, Venu; Leary, Marion

2013-07-23

The "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" increased the focus on methods to ensure that high-quality cardiopulmonary resuscitation (CPR) is performed in all resuscitation attempts. There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation. Although it is clear that high-quality CPR is the primary component in influencing survival from cardiac arrest, there is considerable variation in monitoring, implementation, and quality improvement. As such, CPR quality varies widely between systems and locations. Victims often do not receive high-quality CPR because of provider ambiguity in prioritization of resuscitative efforts during an arrest. This ambiguity also impedes the development of optimal systems of care to increase survival from cardiac arrest. This consensus statement addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance; monitoring, feedback, and integration of the patient's response to CPR; team-level logistics to ensure performance of high-quality CPR; and continuous quality improvement on provider, team, and systems levels. Clear definitions of metrics and methods to consistently deliver and improve the quality of CPR will narrow the gap between resuscitation science and the victims, both in and out of the hospital, and lay the foundation for further improvements in the future.

Product quality considerations for mammalian cell culture process development and manufacturing.

PubMed

Gramer, Michael J

2014-01-01

The manufacturing of a biologic drug from mammalian cells results in not a single substance, but an array of product isoforms, also known as variants. These isoforms arise due to intracellular or extracellular events as a result of biological or chemical modification. The most common examples related to biomanufacturing include amino acid modifications (glycosylation, isomerization, oxidation, adduct formation, pyroglutamate formation, phosphorylation, sulfation, amidation), amino acid sequence variants (genetic mutations, amino acid misincorporation, N- and C-terminal heterogeneity, clipping), and higher-order structure modifications (misfolding, aggregation, disulfide pairing). Process-related impurities (HCP, DNA, media components, viral particles) are also important quality attributes related to product safety. The observed ranges associated with each quality attribute define the product quality profile. A biologic drug must have a correct and consistent quality profile throughout clinical development and scale-up to commercial production to ensure product safety and efficacy. In general, the upstream process (cell culture) defines the quality of product-related substances, whereas the downstream process (purification) defines the residual level of process- and product-related impurities. The purpose of this chapter is to review the impact of the cell culture process on product quality. Emphasis is placed on studies with industrial significance and where the direct mechanism of product quality impact was determined. Where possible, recommendations for maintaining consistent or improved quality are provided.

Addressing data access challenges in seismology

NASA Astrophysics Data System (ADS)

Trabant, C. M.; Ahern, T.; Weertman, B.; Benson, R. B.; Van Fossen, M.; Weekly, R. T.; Casey, R. E.; Suleiman, Y. Y.; Stults, M.

2016-12-01

The development of web services at the IRIS Data Management Center (DMC) over the last 6 years represents the most significant enhancement of data access ever introduced at the DMC. These web services have allowed the us to focus our internal operations around a single, consistent data access layer while facilitating development of a new generation of tools and methods for researchers to conduct their work. This effort led the DMC to propose standardized web service interfaces within the International Federation of Digital Seismograph Networks (FDSN), enabling other seismological data centers to offer data using compatible interfaces. With this new foundation, we now turn our attention to more advanced data access challenges. In particular, we will present the status of two developments intending to address 1) access to data of consistent quality for science and 2) discovery and access of data from multiple data centers. To address the challenge of requesting high or consistent quality data we will introduce our Research-Ready Data Sets (RRDS) initiative. The purpose of the RRDS project is to reduce the time a researcher spends culling and otherwise identifying data appropriate for given study. RRDS will provide users with additional criteria related to data quality that can be specified when requesting data. Leveraging the data quality measurements provided by our MUSTANG system, these criteria will include ambient noise, completeness, dead channel identification and more. To address the challenge of seismological data discovery and access, we have built and continue to improve the IRIS Federator. The Federator takes advantage of the FDSN-standard web services at various data centers to help a user locate specific channels, wherever they may be offered globally. The search interface provides results that are pre-formatted requests, ready for submission to each data center that serves that data. These two developments are aimed squarely at reducing the time researchers spend searching for, collecting and preparing data for processing.

Development of an analysis tool for cloud base height and visibility

NASA Astrophysics Data System (ADS)

Umdasch, Sarah; Reinhold, Steinacker; Manfred, Dorninger; Markus, Kerschbaum; Wolfgang, Pöttschacher

2014-05-01

The meteorological variables cloud base height (CBH) and horizontal atmospheric visibility (VIS) at surface level are of vital importance for safety and effectiveness in aviation. Around 20% of all civil aviation accidents in the USA from 2003 to 2007 were due to weather related causes, around 18% of which were owing to decreased visibility or ceiling (main CBH). The aim of this study is to develop a system generating quality-controlled gridded analyses of the two parameters based on the integration of various kinds of observational data. Upon completion, the tool is planned to provide guidance for nowcasting during take-off and landing as well as for flights operated under visual flight rules. Primary input data consists of manual as well as instrumental observation of CBH and VIS. In Austria, restructuring of part of the standard meteorological stations from human observation to automatic measurement of VIS and CBH is currently in progress. As ancillary data, satellite derived products can add 2-dimensional information, e.g. Cloud Type by NWC SAF (Nowcasting Satellite Application Facilities) MSG (Meteosat Second Generation). Other useful available data are meteorological surface measurements (in particular of temperature, humidity, wind and precipitation), radiosonde, radar and high resolution topography data. A one-year data set is used to study the spatial and weather-dependent representativeness of the CBH and VIS measurements. The VERA (Vienna Enhanced Resolution Analysis) system of the Institute of Meteorology and Geophysics of the University of Vienna provides the framework for the analysis development. Its integrated "Fingerprint" technique allows the insertion of empirical prior knowledge and ancillary information in the form of spatial patterns. Prior to the analysis, a quality control of input data is performed. For CBH and VIS, quality control can consist of internal consistency checks between different data sources. The possibility of two-dimensional consistency checks has to be explored. First results in the development of quality control features and fingerprints will be shown.

The quality, safety and governance of telephone triage and advice services - an overview of evidence from systematic reviews.

PubMed

Lake, Rebecca; Georgiou, Andrew; Li, Julie; Li, Ling; Byrne, Mary; Robinson, Maureen; Westbrook, Johanna I

2017-08-30

Telephone triage and advice services (TTAS) are increasingly being implemented around the world. These services allow people to speak to a nurse or general practitioner over the telephone and receive assessment and healthcare advice. There is an existing body of research on the topic of TTAS, however the diffuseness of the evidence base makes it difficult to identify key lessons that are consistent across the literature. Systematic reviews represent the highest level of evidence synthesis. We aimed to undertake an overview of such reviews to determine the scope, consistency and generalisability of findings in relation to the governance, safety and quality of TTAS. We searched PubMed, MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Library for English language systematic reviews focused on key governance, quality and safety findings related to telephone based triage and advice services, published since 1990. The search was undertaken by three researchers who reached consensus on all included systematic reviews. An appraisal of the methodological quality of the systematic reviews was independently undertaken by two researchers using A Measurement Tool to Assess Systematic Reviews. Ten systematic reviews from a potential 291 results were selected for inclusion. TTAS was examined either alone, or as part of a primary care service model or intervention designed to improve primary care. Evidence of TTAS performance was reported across nine key indicators - access, appropriateness, compliance, patient satisfaction, cost, safety, health service utilisation, physician workload and clinical outcomes. Patient satisfaction with TTAS was generally high and there is some consistency of evidence of the ability of TTAS to reduce clinical workload. Measures of the safety of TTAS tended to show that there is no major difference between TTAS and traditional care. Taken as a whole, current evidence does not provide definitive answers to questions about the quality of care provided, access and equity of the service, its costs and outcomes. The available evidence also suggests that there are many interactional factors (e.g., relationship with other health service providers) which can impact on measures of performance, and also affect the external validity of the research findings.

Highly Superior Autobiographical Memory: Quality and Quantity of Retention Over Time

PubMed Central

LePort, Aurora K. R.; Stark, Shauna M.; McGaugh, James L.; Stark, Craig E. L.

2016-01-01

Individuals who have Highly Superior Autobiographical Memory (HSAM) are able to recall, with considerable accuracy, details of daily experiences that occurred over many previous decades. The present study parametrically investigates the quantity and quality of details of autobiographical memories acquired 1-week, 1-month, 1-year, and 10-years prior in HSAMs and controls. In addition, we tested the consistency of details provided at the 1-week delay by testing the subjects 1 month later with a surprise assessment. At the 1-week delay, HSAMs and controls recalled an equivalent number of events. In contrast, HSAM recall performance was superior at more remote delays, with remarkable consistency following a 1-month delay. Further, we revealed a relationship between the consistency of recall and HSAMs’ obsessive–compulsive tendencies. These data suggest that HSAMs experience normal encoding, yet enhanced consolidation and later recall of autobiographical events. PMID:26834661

Quality Assurance and Control Considerations in Environmental Measurements and Monitoring

NASA Astrophysics Data System (ADS)

Sedlet, Jacob

1982-06-01

Quality assurance and quality control have become accepted as essential parts of all environmental surveillance, measurements, and monitoring programs, both nuclear and non-nuclear. The same principles and details apply to each. It is primarily the final measurement technique that differs. As the desire and need to measure smaller amounts of pollutants with greater accuracy has increased, it has been recognized that quality assurance and control programs are cost-effective in achieving the expected results. Quality assurance (QA) consists of all the actions necessary to provide confidence in the results. Quality control (QC) is a part of QA, and consists of those actions and activities that permit the control of the individual steps in the environmental program. The distinction between the two terms is not always clearly defined, but a sharp division is not necessary. The essential principle of QA and QC is a commitment to high quality results. The essential components of a QA and QC program are a complete, written procedures manual for all parts of the environmental program, the use of standard or validated procedures, participation in applicable interlaboratory comparison or QA programs, replicate analysis and measurement, training of personnel, and a means of auditing or checking that the QA and QC programs are properly conducted. These components are discussed below in some detail.

Evaluation of the Consumer Assessment of Healthcare Providers and Systems In-Center Hemodialysis Survey

PubMed Central

Paoli, Carly J.; Hays, Ron D.; Taylor-Stokes, Gavin; Piercy, James; Gitlin, Matthew

2014-01-01

Background and objectives The US Centers for Medicare and Medicaid Services (CMS) End Stage Renal Disease Prospective Payment System and Quality Incentive Program requires that dialysis centers meet predefined criteria for quality of patient care to ensure future funding. The CMS selected the Consumer Assessment of Healthcare Providers and Systems In-Center Hemodialysis (CAHPS-ICH) survey for the assessment of patient experience of care. This analysis evaluated the psychometric properties of the CAHPS-ICH survey in a sample of hemodialysis patients. Design, setting, participants, & measurements Data were drawn from the Adelphi CKD Disease Specific Program (a retrospective, cross-sectional survey of nephrologists and patients). Selected United States–based nephrologists treating patients receiving hemodialysis completed patient record forms and provided information on their dialysis center. Patients (n=404) completed the CAHPS-ICH survey (comprising 58 questions) providing six scores for the assessment of patient experience of care. CAHPS-ICH item-scale convergence, discrimination, and reliability were evaluated for multi-item scales. Floor and ceiling effects were estimated for all six scores. Patient (demographics, dialysis history, vascular access method) and facility characteristics (size, ratio of patients-to-physicians, nurses, and technicians) associated with the CAHPS-ICH scores were also evaluated. Results Item-scale correlations and internal consistency reliability estimates provided support for the nephrologists’ communication (range, 0.16–0.71; α=0.81) and quality of care (range, 0.16–0.76; α=0.90) composites. However, the patient information composite had low internal consistency reliability (α=0.55). Provider-to-patient ratios (range, 2.37 for facilities with >36 patients per physician to 2.8 for those with <8 patients per physician) and time spent in the waiting room (3.44 for >15 minutes of waiting time to 3.75 for 5 to <10 minutes) were characteristics most consistently related to patients’ perceptions of dialysis care. Conclusions CAHPS-ICH is a potentially valuable and informative tool for the evaluation of patients’ experiences with dialysis care. Additional studies are needed to estimate clinically meaningful differences between care providers. PMID:24832092

Piloting a generic cancer consumer quality index in six European countries.

PubMed

Wind, Anke; Roeling, Mark Patrick; Heerink, Jana; Sixma, Herman; Presti, Pietro; Lombardo, Claudio; van Harten, Wim

2016-09-02

Accounting for patients' perspective has become increasingly important. Based on the Consumer Quality Index method (founded on Consumer Assessment of Healthcare Providers and Systems) a questionnaire was recently developed for Dutch cancer patients. As a next step, this study aimed to adapt and pilot this questionnaire for international comparison of cancer patients experience and satisfaction with care in six European countries. The Consumer Quality Index was translated into the local language at the participating pilot sites using cross-translation. A minimum of 100 patients per site were surveyed through convenience sampling. Data from seven pilot sites in six countries was collected through an online and paper-based survey. Internal consistency was tested by calculating Cronbach's alpha and validity by means of cognitive interviews. Demographic factors were compared as possible influencing factors. A total of 698 patients from six European countries filled the questionnaire. Cronbach's alpha was good or satisfactory in 8 out of 10 categories. Patient satisfaction significantly differed between the countries. We observed no difference in patient satisfaction for age, gender, education, and tumor type, but satisfaction was significantly higher in patients with a higher level of activation. This European Cancer Consumer Quality Index(ECCQI) showed promising scores on internal consistency (reliability) and a good internal validity. The ECCQI is to our knowledge the first to measure and compare experiences and satisfaction of cancer patients on an international level, it may enable healthcare providers to improve the quality of cancer care.

Beyond technology acceptance to effective technology use: a parsimonious and actionable model.

PubMed

Holahan, Patricia J; Lesselroth, Blake J; Adams, Kathleen; Wang, Kai; Church, Victoria

2015-05-01

To develop and test a parsimonious and actionable model of effective technology use (ETU). Cross-sectional survey of primary care providers (n = 53) in a large integrated health care organization that recently implemented new medication reconciliation technology. Surveys assessed 5 technology-related perceptions (compatibility with work values, implementation climate, compatibility with work processes, perceived usefulness, and ease of use) and 1 outcome variable, ETU. ETU was measured as both consistency and quality of technology use. Compatibility with work values and implementation climate were found to have differential effects on consistency and quality of use. When implementation climate was strong, consistency of technology use was high. However, quality of technology use was high only when implementation climate was strong and values compatibility was high. This is an important finding and highlights the importance of users' workplace values as a key determinant of quality of use. To extend our effectiveness in implementing new health care information technology, we need parsimonious models that include actionable determinants of ETU and account for the differential effects of these determinants on the multiple dimensions of ETU. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Implicit Review Instrument to Evaluate Quality of Care Delivered by Physicians to Children in Emergency Departments.

PubMed

Marcin, James P; Romano, Patrick S; Dharmar, Madan; Chamberlain, James M; Dudley, Nanette; Macias, Charles G; Nigrovic, Lise E; Powell, Elizabeth C; Rogers, Alexander J; Sonnett, Meridith; Tzimenatos, Leah; Alpern, Elizabeth R; Andrews-Dickert, Rebecca; Borgialli, Dominic A; Sidney, Erika; Casper, Charlie; Dean, Jonathan Michael; Kuppermann, Nathan

2018-06-01

To evaluate the consistency, reliability, and validity of an implicit review instrument that measures the quality of care provided to children in the emergency department (ED). Medical records of randomly selected children from 12 EDs in the Pediatric Emergency Care Applied Research Network (PECARN). Eight pediatric emergency medicine physicians applied the instrument to 620 medical records. We determined internal consistency using Cronbach's alpha and inter-rater reliability using the intraclass correlation coefficient (ICC). We evaluated the validity of the instrument by correlating scores with four condition-specific explicit review instruments. Individual reviewers' Cronbach's alpha had a mean of 0.85 with a range of 0.76-0.97; overall Cronbach's alpha was 0.90. The ICC was 0.49 for the summary score with a range from 0.40 to 0.46. Correlations between the quality of care score and the four condition-specific explicit review scores ranged from 0.24 to 0.38. The quality of care instrument demonstrated good internal consistency, moderate inter-rater reliability, high inter-rater agreement, and evidence supporting validity. The instrument could be useful for systems' assessment and research in evaluating the care delivered to children in the ED. © Health Research and Educational Trust.

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.

Distributed media server for the support of multimedia teaching

NASA Astrophysics Data System (ADS)

Liepert, Michael; Griwodz, Carsten; On, Giwon; Zink, Michael; Steinmetz, Ralf

1999-11-01

One major problem of using multimedia material in lecturing is the trade-off between actuality of the content and quality of the presentations. A frequent need for content refreshment exists, but high quality presentations can not be authored by the individual teacher alone at the required rate. Several past and current projects have had the goal of developing so-called learning archives, a variation of digital libraries. On demand, these deliver material with limited structure to students. For lecturing, these systems provide just as insufficient service as the unreliable WWW. Based on our system HyNoDe [HYN97] we address these issues in our distributed media server built of 'medianodes.' We add content management that addresses teachers' needs and provide guaranteed service for connected as well as disconnected operation of their presentation systems. Medianode aims at a scenario for non-real-time, shared creation and modification of presentations and presentation elements. It provides user authentication, administrative roles and authorization mechanisms. It requires an understanding of consistency, versioning and alternative content tailored to lecturing. To allow for predictable presentation quality, medianode provides application level QoS supporting alternative media and alternative presentations. Viable presentation tracks are dynamically generated based on user requests, user profiles and hardware profiles. For machines that are removed from the system according to a schedule, the systems guarantees availability of consistent, complete tracks of selected presentations at disconnect time. In this paper we present the scope of the medianode project and afterwards its architecture, following the realization steps.

New England Lakes & Ponds Project

EPA Science Inventory

The New England Lakes and Ponds Project provides a consistent and first time comprehensive assessment of the ecological and water quality condition of lakes and ponds across the New England region. The project is being conducted by EPA along with the New England Interstate Water...

Determining the Ecosystem Services Important for Urban Landscapes-Slides

EPA Science Inventory

This presentation consists of introductory slides on ecosystem services in urban landscapes and then a discussion of two case studies concerning the provision of water quality in urban landscapes. The introductory slides will explore the range of ecosystem services provided by u...

Development of a computer-based training (CBT) course for the FSUTMS comprehensive modeling workshop.

DOT National Transportation Integrated Search

2008-09-01

FSUTMS training is a major activity of the Systems Planning Office of the Florida Department of : Transportation (FDOT). The training aims to establish and maintain quality assurance for consistent : statewide modeling standards and provide up-to-dat...

Quality of online information on type 2 diabetes: a cross-sectional study.

PubMed

Weymann, Nina; Härter, Martin; Dirmaier, Jörg

2015-12-01

Evidence-based health information is a prerequisite for patients with type 2 diabetes to engage in self-management and to make informed medical decisions. The Internet is an important source of health information. In the present study, we systematically assessed formal quality, quality of decision support and usability of German and English language websites on type 2 diabetes. The search term 'type 2 diabetes' was entered in the two most popular search engines. Descriptive data on website quality are presented. Additionally, associations between website quality and affiliation (commercial vs. non-commercial), presence of the HON code quality seal and website traffic were explored. Forty-six websites were included. Most websites provided basic information necessary for decision-making, while only one website also provided decision support. Websites with a HON code had significantly better formal quality than websites without HON code. We found a highly significant correlation between usability and website traffic and a significant correlation between formal quality and website traffic. Most websites do not provide sufficient information to support patients in medical decision-making. Our finding that usability and website traffic are tightly associated is consistent with previous research indicating that design is the most important cue for users assessing website credibility. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Caring for patients who are deaf or hard of hearing.

PubMed

Brown, Heather L; Hughes-Bell, Aileen; McDuffie, Anna W

2015-12-01

Patients who are deaf and hard of hearing often find the American healthcare system to be inaccessible due to communication barriers. This article describes facilities' and providers' requirements under the Americans with Disabilities Act to provide qualified interpreters and other assistive devices to patients who are deaf or hard of hearing. Removing communication barriers can protect healthcare providers from potential legal action and lets them deliver consistent, quality healthcare to all patients.

Flared landing approach flying qualities. Volume 2: Appendices

NASA Technical Reports Server (NTRS)

Weingarten, Norman C.; Berthe, Charles J., Jr.; Rynaski, Edmund G.; Sarrafian, Shahan K.

1986-01-01

An in-flight research study was conducted utilizing the USAF/Total In-Flight Simulator (TIFS) to investigate longitudinal flying qualities for the flared landing approach phase of flight. A consistent set of data were generated for: determining what kind of command response the pilot prefers/requires in order to flare and land an aircraft with precision, and refining a time history criterion that took into account all the necessary variables and the characteristics that would accurately predict flying qualities. Seven evaluation pilots participated representing NASA Langley, NASA Dryden, Calspan, Boeing, Lockheed, and DFVLR (Braunschweig, Germany). The results of the first part of the study provide guidelines to the flight control system designer, using MIL-F-8785-(C) as a guide, that yield the dynamic behavior pilots prefer in flared landings. The results of the second part provide the flying qualities engineer with a derived flying qualities predictive tool which appears to be highly accurate. This time-domain predictive flying qualities criterion was applied to the flight data as well as six previous flying qualities studies, and the results indicate that the criterion predicted the flying qualities level 81% of the time and the Cooper-Harper pilot rating, within + or - 1%, 60% of the time.

Flared landing approach flying qualities. Volume 1: Experiment design and analysis

NASA Technical Reports Server (NTRS)

Weingarten, Norman C.; Berthe, Charles J., Jr.; Rynaski, Edmund G.; Sarrafian, Shahan K.

1986-01-01

An inflight research study was conducted utilizing the USAF Total Inflight Simulator (TIFS) to investigate longitudinal flying qualities for the flared landing approach phase of flight. The purpose of the experiment was to generate a consistent set of data for: (1) determining what kind of commanded response the pilot prefers in order to flare and land an airplane with precision, and (2) refining a time history criterion that took into account all the necessary variables and their characteristics that would accurately predict flying qualities. The result of the first part provides guidelines to the flight control system designer, using MIL-F-8785-(C) as a guide, that yield the dynamic behavior pilots perfer in flared landings. The results of the second part provides the flying qualities engineer with a newly derived flying qualities predictive tool which appears to be highly accurate. This time domain predictive flying qualities criterion was applied to the flight data as well as six previous flying qualities studies, and the results indicate that the criterion predicted the flying qualities level 81% of the time and the Cooper-Harper pilot rating, within + or - 1, 60% of the time.

Model-assisted template extraction SRAF application to contact holes patterns in high-end flash memory device fabrication

NASA Astrophysics Data System (ADS)

Seoud, Ahmed; Kim, Juhwan; Ma, Yuansheng; Jayaram, Srividya; Hong, Le; Chae, Gyu-Yeol; Lee, Jeong-Woo; Park, Dae-Jin; Yune, Hyoung-Soon; Oh, Se-Young; Park, Chan-Ha

2018-03-01

Sub-resolution assist feature (SRAF) insertion techniques have been effectively used for a long time now to increase process latitude in the lithography patterning process. Rule-based SRAF and model-based SRAF are complementary solutions, and each has its own benefits, depending on the objectives of applications and the criticality of the impact on manufacturing yield, efficiency, and productivity. Rule-based SRAF provides superior geometric output consistency and faster runtime performance, but the associated recipe development time can be of concern. Model-based SRAF provides better coverage for more complicated pattern structures in terms of shapes and sizes, with considerably less time required for recipe development, although consistency and performance may be impacted. In this paper, we introduce a new model-assisted template extraction (MATE) SRAF solution, which employs decision tree learning in a model-based solution to provide the benefits of both rule-based and model-based SRAF insertion approaches. The MATE solution is designed to automate the creation of rules/templates for SRAF insertion, and is based on the SRAF placement predicted by model-based solutions. The MATE SRAF recipe provides optimum lithographic quality in relation to various manufacturing aspects in a very short time, compared to traditional methods of rule optimization. Experiments were done using memory device pattern layouts to compare the MATE solution to existing model-based SRAF and pixelated SRAF approaches, based on lithographic process window quality, runtime performance, and geometric output consistency.

Implementation of basic quality control tests for malaria medicines in Amazon Basin countries: results for the 2005–2010 period

PubMed Central

2012-01-01

Background Ensuring the quality of malaria medicines is crucial in working toward malaria control and eventual elimination. Unlike other validated tests that can assess all critical quality attributes, which is the standard for determining the quality of medicines, basic tests are significantly less expensive, faster, and require less skilled labour; yet, these tests provide reproducible data and information on several critical quality attributes, such as identity, purity, content, and disintegration. Visual and physical inspection also provides valuable information about the manufacturing and the labelling of medicines, and in many cases this inspection is sufficient to detect counterfeit medicines. The Promoting the Quality of Medicines (PQM) programme has provided technical assistance to Amazon Malaria Initiative (AMI) countries to implement the use of basic tests as a key screening mechanism to assess the quality of malaria medicines available to patients in decentralized regions. Methods Trained personnel from the National Malaria Control Programmes (NMCPs), often in collaboration with country’s Official Medicine Control Laboratory (OMCL), developed country- specific protocols that encompassed sampling methods, sample analysis, and data reporting. Sampling sites were selected based on malaria burden, accessibility, and geographical location. Convenience sampling was performed and countries were recommended to store the sampled medicines under conditions that did not compromise their quality. Basic analytical tests, such as disintegration and thin layer chromatography (TLC), were performed utilizing a portable mini-laboratory. Results Results were originally presented at regional meetings in a non-standardized format that lacked relevant medicines information. However, since 2008 information has been submitted utilizing a template specifically developed by PQM for that purpose. From 2005 to 2010, the quality of 1,663 malaria medicines from seven AMI countries was evaluated, mostly collected from the public sector, 1,445/1,663 (86.9%). Results indicate that 193/1,663 (11.6%) were found not to meet quality specifications. Most failures were reported during visual and physical inspection, 142/1663 (8.5%), and most of these were due to expired medicines, 118/142 (83.1%). Samples failing TLC accounted for 27/1,663 (1.6%) and those failing disintegration accounted for 24/1,663 (1.4%). Medicines quality failures decreased significantly during the last two years. Conclusions Basic tests revealed that the quality of medicines in the public sector improved over the years, since the implementation of this type of quality monitoring programme in 2005. However, the lack of consistent confirmatory tests in the quality control (QC) laboratory, utilizing methods that can also evaluate additional quality attributes, could still mask quality issues. In the future, AMI countries should improve coordination with their health authorities and their QC lab consistently, to provide a more complete picture of malaria medicines quality and support the implementation of corrective actions. Facilities in the private and informal sectors also should be included when these sectors constitute an important source of medicines used by malaria patients. PMID:22704680

Implementation of basic quality control tests for malaria medicines in Amazon Basin countries: results for the 2005-2010 period.

PubMed

Pribluda, Victor S; Barojas, Adrian; Añez, Arletta; López, Cecilia G; Figueroa, Ruth; Herrera, Roxana; Nakao, Gladys; Nogueira, Fernando Ha; Pianetti, Gerson A; Povoa, Marinete M; Viana, Giselle Mr; Gomes, Margarete S Mendonça; Escobar, Jose P; Sierra, Olga L Muñoz; Norena, Susana P Rendon; Veloz, Raúl; Bravo, Marcy Silva; Aldás, Martha R; Hindssemple, Alison; Collins, Marilyn; Ceron, Nicolas; Krishnalall, Karanchand; Adhin, Malti; Bretas, Gustavo; Hernandez, Nelly; Mendoza, Marjorie; Smine, Abdelkrim; Chibwe, Kennedy; Lukulay, Patrick; Evans, Lawrence

2012-06-15

Ensuring the quality of malaria medicines is crucial in working toward malaria control and eventual elimination. Unlike other validated tests that can assess all critical quality attributes, which is the standard for determining the quality of medicines, basic tests are significantly less expensive, faster, and require less skilled labour; yet, these tests provide reproducible data and information on several critical quality attributes, such as identity, purity, content, and disintegration. Visual and physical inspection also provides valuable information about the manufacturing and the labelling of medicines, and in many cases this inspection is sufficient to detect counterfeit medicines. The Promoting the Quality of Medicines (PQM) programme has provided technical assistance to Amazon Malaria Initiative (AMI) countries to implement the use of basic tests as a key screening mechanism to assess the quality of malaria medicines available to patients in decentralized regions. Trained personnel from the National Malaria Control Programmes (NMCPs), often in collaboration with country's Official Medicine Control Laboratory (OMCL), developed country- specific protocols that encompassed sampling methods, sample analysis, and data reporting. Sampling sites were selected based on malaria burden, accessibility, and geographical location. Convenience sampling was performed and countries were recommended to store the sampled medicines under conditions that did not compromise their quality. Basic analytical tests, such as disintegration and thin layer chromatography (TLC), were performed utilizing a portable mini-laboratory. Results were originally presented at regional meetings in a non-standardized format that lacked relevant medicines information. However, since 2008 information has been submitted utilizing a template specifically developed by PQM for that purpose. From 2005 to 2010, the quality of 1,663 malaria medicines from seven AMI countries was evaluated, mostly collected from the public sector, 1,445/1,663 (86.9%). Results indicate that 193/1,663 (11.6%) were found not to meet quality specifications. Most failures were reported during visual and physical inspection, 142/1663 (8.5%), and most of these were due to expired medicines, 118/142 (83.1%). Samples failing TLC accounted for 27/1,663 (1.6%) and those failing disintegration accounted for 24/1,663 (1.4%). Medicines quality failures decreased significantly during the last two years. Basic tests revealed that the quality of medicines in the public sector improved over the years, since the implementation of this type of quality monitoring programme in 2005. However, the lack of consistent confirmatory tests in the quality control (QC) laboratory, utilizing methods that can also evaluate additional quality attributes, could still mask quality issues. In the future, AMI countries should improve coordination with their health authorities and their QC lab consistently, to provide a more complete picture of malaria medicines quality and support the implementation of corrective actions. Facilities in the private and informal sectors also should be included when these sectors constitute an important source of medicines used by malaria patients.

Manufacturing Bms/Iso System Review

NASA Technical Reports Server (NTRS)

Gomez, Yazmin

2004-01-01

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

Quality indexing with computer-aided lexicography

NASA Technical Reports Server (NTRS)

Buchan, Ronald L.

1992-01-01

Indexing with computers is a far cry from indexing with the first indexing tool, the manual card sorter. With the aid of computer-aided lexicography, both indexing and indexing tools can provide standardization, consistency, and accuracy, resulting in greater quality control than ever before. A brief survey of computer activity in indexing is presented with detailed illustrations from NASA activity. Applications from techniques mentioned, such as Retrospective Indexing (RI), can be made to many indexing systems. In addition to improving the quality of indexing with computers, the improved efficiency with which certain tasks can be done is demonstrated.

Spacelab Data Processing Facility (SLDPF) quality assurance expert systems development

NASA Technical Reports Server (NTRS)

Kelly, Angelita C.; Basile, Lisa; Ames, Troy; Watson, Janice; Dallam, William

1987-01-01

Spacelab Data Processing Facility (SLDPF) expert system prototypes were developed to assist in the quality assurance of Spacelab and/or Attached Shuttle Payload (ASP) processed telemetry data. The SLDPF functions include the capturing, quality monitoring, processing, accounting, and forwarding of mission data to various user facilities. Prototypes for the two SLDPF functional elements, the Spacelab Output Processing System and the Spacelab Input Processing Element, are described. The prototypes have produced beneficial results including an increase in analyst productivity, a decrease in the burden of tedious analyses, the consistent evaluation of data, and the providing of concise historical records.

Spacelab Data Processing Facility (SLDPF) quality assurance expert systems development

NASA Technical Reports Server (NTRS)

Kelly, Angelita C.; Basile, Lisa; Ames, Troy; Watson, Janice; Dallam, William

1987-01-01

Spacelab Data Processing Facility (SLDPF) expert system prototypes have been developed to assist in the quality assurance of Spacelab and/or Attached Shuttle Payload (ASP) processed telemetry data. SLDPF functions include the capturing, quality monitoring, processing, accounting, and forwarding of mission data to various user facilities. Prototypes for the two SLDPF functional elements, the Spacelab Output Processing System and the Spacelab Input Processing Element, are described. The prototypes have produced beneficial results including an increase in analyst productivity, a decrease in the burden of tedious analyses, the consistent evaluation of data, and the providing of concise historical records.

Quality aspects of the Wegener Center multi-satellite GPS radio occultation record OPSv5.6

NASA Astrophysics Data System (ADS)

Angerer, Barbara; Ladstädter, Florian; Scherllin-Pirscher, Barbara; Schwärz, Marc; Steiner, Andrea K.; Foelsche, Ulrich; Kirchengast, Gottfried

2017-12-01

The demand for high-quality atmospheric data records, which are applicable in climate studies, is undisputed. Using such records requires knowledge of the quality and the specific characteristics of all contained data sources. The latest version of the Wegener Center (WEGC) multi-satellite Global Positioning System (GPS) radio occultation (RO) record, OPSv5.6, provides globally distributed upper-air satellite data of high quality, usable for climate and other high-accuracy applications. The GPS RO technique has been deployed in several satellite missions since 2001. Consistency among data from these missions is essential to create a homogeneous long-term multi-satellite climate record. In order to enable a qualified usage of the WEGC OPSv5.6 data set we performed a detailed analysis of satellite-dependent quality aspects from 2001 to 2017. We present the impact of the OPSv5.6 quality control on the processed data and reveal time-dependent and satellite-specific quality characteristics. The highest quality data are found for MetOp (Meteorological Operational satellite) and GRACE (Gravity Recovery and Climate Experiment). Data from FORMOSAT-3/COSMIC (Formosa Satellite mission-3/Constellation Observing System for Meteorology, Ionosphere, and Climate) are also of high quality. However, comparatively large day-to-day variations and satellite-dependent irregularities need to be taken into account when using these data. We validate the consistency among the various satellite missions by calculating monthly mean temperature deviations from the multi-satellite mean, including a correction for the different sampling characteristics. The results are highly consistent in the altitude range from 8 to 25 km, with mean temperature deviations less than 0.1 K. At higher altitudes the OPSv5.6 RO temperature record is increasingly influenced by the characteristics of the bending angle initialization, with the amount of impact depending on the receiver quality.

Rural Productivity Zones (RPZs) for microenterprises

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

Hansen, R.D.

1997-12-01

In this paper the authors discuss the concept of rural productivity zones (RPZs) which are defined as a business incubator to foster income-producing opportunities for the rural poor. The essential ingredients of such a program include: electric power; business development assistance; office services; and quality work space. The electric power source must be a good quality system, consisting of a diesel/wind/photovoltaic hybrid type system, providing reliable service, with a local maintenance program and a functional load management program.

Improving quality of tuberculosis care in India.

PubMed

Pai, Madhukar; Satyanarayana, Srinath; Hopewell, Phil

2014-01-01

In India, the quality of care that tuberculosis (TB) patients receive varies considerably and is often not in accordance with the national and international standards. In this article, we provide an overview of the third (latest) edition of the International Standards of Tuberculosis Care (ISTC). These standards are supported by the existing World Health Organization guidelines and policy statements pertaining to TB care and have been endorsed by a number of international organizations. We call upon all health care providers in the country to practice TB care that is consistent with these standards, as well as the upcoming Standards for TB Care in India (STCI).

A design of wireless sensor networks for a power quality monitoring system.

PubMed

Lim, Yujin; Kim, Hak-Man; Kang, Sanggil

2010-01-01

Power grids deal with the business of generation, transmission, and distribution of electric power. Recently, interest in power quality in electrical distribution systems has increased rapidly. In Korea, the communication network to deliver voltage, current, and temperature measurements gathered from pole transformers to remote monitoring centers employs cellular mobile technology. Due to high cost of the cellular mobile technology, power quality monitoring measurements are limited and data gathering intervals are large. This causes difficulties in providing the power quality monitoring service. To alleviate the problems, in this paper we present a communication infrastructure to provide low cost, reliable data delivery. The communication infrastructure consists of wired connections between substations and monitoring centers, and wireless connections between pole transformers and substations. For the wireless connection, we employ a wireless sensor network and design its corresponding data forwarding protocol to improve the quality of data delivery. For the design, we adopt a tree-based data forwarding protocol in order to customize the distribution pattern of the power quality information. We verify the performance of the proposed data forwarding protocol quantitatively using the NS-2 network simulator.

Underground Test Area Activity Quality Assurance Plan Nevada National Security Site, Nevada. Revision 2

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

Krenzien, Susan; Farnham, Irene

This Quality Assurance Plan (QAP) provides the overall quality assurance (QA) requirements and general quality practices to be applied to the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO) Underground Test Area (UGTA) activities. The requirements in this QAP are consistent with DOE Order 414.1D, Change 1, Quality Assurance (DOE, 2013a); U.S. Environmental Protection Agency (EPA) Guidance for Quality Assurance Project Plans for Modeling (EPA, 2002); and EPA Guidance on the Development, Evaluation, and Application of Environmental Models (EPA, 2009). If a participant’s requirement document differs from this QAP, the stricter requirement will take precedence.more » NNSA/NFO, or designee, must review this QAP every two years. Changes that do not affect the overall scope or requirements will not require an immediate QAP revision but will be incorporated into the next revision cycle after identification. Section 1.0 describes UGTA objectives, participant responsibilities, and administrative and management quality requirements (i.e., training, records, procurement). Section 1.0 also details data management and computer software requirements. Section 2.0 establishes the requirements to ensure newly collected data are valid, existing data uses are appropriate, and environmental-modeling methods are reliable. Section 3.0 provides feedback loops through assessments and reports to management. Section 4.0 provides the framework for corrective actions. Section 5.0 provides references for this document.« less

The Communication AssessmenT Checklist in Health (CATCH): a tool for assessing the quality of printed educational materials for clinicians.

PubMed

Genova, Juliana; Nahon-Serfaty, Isaac; Dansokho, Selma Chipenda; Gagnon, Marie-Pierre; Renaud, Jean-Sébastien; Giguère, Anik M C

2014-01-01

There is little guidance available on strategies to improve the communication quality of printed educational materials (PEMs) for clinicians. The purposes of this study were to conceptualize PEM communication quality, develop a checklist based on this conceptualization, and validate the checklist with a selection of PEMs. From a literature review of the strategies influencing communication quality, we generated a conceptual map and developed the Communication AssessmenT Checklist in Health (CATCH) consisting of 55 items nested in 12 concepts. Two raters independently applied CATCH to 45 PEMs evaluated in the studies included in a Cochrane systematic review. From these results, we conducted an item analysis and assessed content validity of CATCH using a hierarchical cluster analysis to explore the extent to which our CATCH operationalization truly represented the communication quality concepts. Some concepts were better covered in the studied PEMs, whereas others were not covered consistently. We observed 3 contrasting PEM clusters. A first cluster (n = 22) was characterized by longer PEMs and comprised mostly high-impact peer-reviewed scientific articles or clinical practice guidelines. A second cluster (n = 22) consisted of PEMs shorter than 4 pages that used special fonts, color, pictures, and graphics. A third cluster consisted of a single brief PEM. With CATCH it is possible to categorize and understand the mechanisms that can trigger a change in behavior in health care providers. Additional research is needed to validate CATCH before it can be recommended for use. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

46 CFR 162.018-3 - Materials.

Code of Federal Regulations, 2010 CFR

2010-10-01

... best quality spring steel consistent with the design of the valve and the service requirement. [CGFR 52... materials melting above 1700 °F. for liquefied flammable gas service. Consideration of lower melting materials for internal pressure-containing parts will be given if their use provides significant improvement...

XENOPUS LAEVIS: A CULTURING AND REARING PROTOCOL

EPA Science Inventory

Xenopus laevis are used extensively here at MED-Duluth as a model for assessing development toxicity to xenobiotics. As a result, a culturing system has been developed that provides eggs and tadpoles of consistent high quality for use by researchers at the facility. The methods ...

Using Ecosystem Services to Inform Decisions on U.S. Air Quality Standards

EPA Science Inventory

The ecosystem services (ES) framework provides a link between changes in a natural system’s structure and function and public welfare. This systematic integration of ecology and economics allows for more consistency and transparency in environmental decision making by enab...

PROPOSAL FOR A SIMPLE AND EFFICIENT MONTHLY QUALITY MANAGEMENT PROGRAM ASSESSING THE CONSISTENCY OF ROBOTIC IMAGE-GUIDED SMALL ANIMAL RADIATION SYSTEMS

PubMed Central

Brodin, N. Patrik; Guha, Chandan; Tomé, Wolfgang A.

2015-01-01

Modern pre-clinical radiation therapy (RT) research requires high precision and accurate dosimetry to facilitate the translation of research findings into clinical practice. Several systems are available that provide precise delivery and on-board imaging capabilities, highlighting the need for a quality management program (QMP) to ensure consistent and accurate radiation dose delivery. An ongoing, simple, and efficient QMP for image-guided robotic small animal irradiators used in pre-clinical RT research is described. Protocols were developed and implemented to assess the dose output constancy (based on the AAPM TG-61 protocol), cone-beam computed tomography (CBCT) image quality and object representation accuracy (using a custom-designed imaging phantom), CBCT-guided target localization accuracy and consistency of the CBCT-based dose calculation. To facilitate an efficient read-out and limit the user dependence of the QMP data analysis, a semi-automatic image analysis and data representation program was developed using the technical computing software MATLAB. The results of the first six months experience using the suggested QMP for a Small Animal Radiation Research Platform (SARRP) are presented, with data collected on a bi-monthly basis. The dosimetric output constancy was established to be within ±1 %, the consistency of the image resolution was within ±0.2 mm, the accuracy of CBCT-guided target localization was within ±0.5 mm, and dose calculation consistency was within ±2 s (± 3 %) per treatment beam. Based on these results, this simple quality assurance program allows for the detection of inconsistencies in dosimetric or imaging parameters that are beyond the acceptable variability for a reliable and accurate pre-clinical RT system, on a monthly or bi-monthly basis. PMID:26425981

Proposal for a Simple and Efficient Monthly Quality Management Program Assessing the Consistency of Robotic Image-Guided Small Animal Radiation Systems.

PubMed

Brodin, N Patrik; Guha, Chandan; Tomé, Wolfgang A

2015-11-01

Modern pre-clinical radiation therapy (RT) research requires high precision and accurate dosimetry to facilitate the translation of research findings into clinical practice. Several systems are available that provide precise delivery and on-board imaging capabilities, highlighting the need for a quality management program (QMP) to ensure consistent and accurate radiation dose delivery. An ongoing, simple, and efficient QMP for image-guided robotic small animal irradiators used in pre-clinical RT research is described. Protocols were developed and implemented to assess the dose output constancy (based on the AAPM TG-61 protocol), cone-beam computed tomography (CBCT) image quality and object representation accuracy (using a custom-designed imaging phantom), CBCT-guided target localization accuracy and consistency of the CBCT-based dose calculation. To facilitate an efficient read-out and limit the user dependence of the QMP data analysis, a semi-automatic image analysis and data representation program was developed using the technical computing software MATLAB. The results of the first 6-mo experience using the suggested QMP for a Small Animal Radiation Research Platform (SARRP) are presented, with data collected on a bi-monthly basis. The dosimetric output constancy was established to be within ±1 %, the consistency of the image resolution was within ±0.2 mm, the accuracy of CBCT-guided target localization was within ±0.5 mm, and dose calculation consistency was within ±2 s (±3%) per treatment beam. Based on these results, this simple quality assurance program allows for the detection of inconsistencies in dosimetric or imaging parameters that are beyond the acceptable variability for a reliable and accurate pre-clinical RT system, on a monthly or bi-monthly basis.

Surface-water-quality assessment of the Kentucky River Basin, Kentucky; fixed-station network and selected water-quality data, April 1987 through August 1991

USGS Publications Warehouse

Griffin, M.S.; Martin, G.R.; White, K.D.

1994-01-01

This report describes selected data-collection activities and the associated data collected during the Kentucky River Basin pilot study of the U.S. Geological Survey's National Water-Quality Assessment Program. The data are intended to provide a nationally consistent description and improved understanding of current water quality in the basin. The data were collected at seven fixed stations that represent stream cross sections where constituent transport and water-quality trends can be evaluated. The report includes descriptions of (1) the basin; (2) the design of the fixed-station network; (3) the fixed-station sites; (4) the physical and chemical measurements; (5) the methods of sample collection, processing, and analysis; and (6) the quality-assurance and quality-control procedures. Water-quality data collected at the fixed stations during routine periodic sampling and supplemental high-flow sampling from April 1987 to August 1991 are presented.

Water quality assessment and meta model development in Melen watershed - Turkey.

PubMed

Erturk, Ali; Gurel, Melike; Ekdal, Alpaslan; Tavsan, Cigdem; Ugurluoglu, Aysegul; Seker, Dursun Zafer; Tanik, Aysegul; Ozturk, Izzet

2010-07-01

Istanbul, being one of the highly populated metropolitan areas of the world, has been facing water scarcity since the past decade. Water transfer from Melen Watershed was considered as the most feasible option to supply water to Istanbul due to its high water potential and relatively less degraded water quality. This study consists of two parts. In the first part, water quality data covering 26 parameters from 5 monitoring stations were analyzed and assessed due to the requirements of the "Quality Required of Surface Water Intended for the Abstraction of Drinking Water" regulation. In the second part, a one-dimensional stream water quality model with simple water quality kinetics was developed. It formed a basic design for more advanced water quality models for the watershed. The reason for assessing the water quality data and developing a model was to provide information for decision making on preliminary actions to prevent any further deterioration of existing water quality. According to the water quality assessment at the water abstraction point, Melen River has relatively poor water quality with regard to NH(4)(+), BOD(5), faecal streptococcus, manganese and phenol parameters, and is unsuitable for drinking water abstraction in terms of COD, PO(4)(3-), total coliform, total suspended solids, mercury and total chromium parameters. The results derived from the model were found to be consistent with the water quality assessment. It also showed that relatively high inorganic nitrogen and phosphorus concentrations along the streams are related to diffuse nutrient loads that should be managed together with municipal and industrial wastewaters. Copyright 2010 Elsevier Ltd. All rights reserved.

Improving Diabetes care through Examining, Advising, and prescribing (IDEA): protocol for a theory-based cluster randomised controlled trial of a multiple behaviour change intervention aimed at primary healthcare professionals

PubMed Central

2014-01-01

Background New clinical research findings may require clinicians to change their behaviour to provide high-quality care to people with type 2 diabetes, likely requiring them to change multiple different clinical behaviours. The present study builds on findings from a UK-wide study of theory-based behavioural and organisational factors associated with prescribing, advising, and examining consistent with high-quality diabetes care. Aim To develop and evaluate the effectiveness and cost of an intervention to improve multiple behaviours in clinicians involved in delivering high-quality care for type 2 diabetes. Design/methods We will conduct a two-armed cluster randomised controlled trial in 44 general practices in the North East of England to evaluate a theory-based behaviour change intervention. We will target improvement in six underperformed clinical behaviours highlighted in quality standards for type 2 diabetes: prescribing for hypertension; prescribing for glycaemic control; providing physical activity advice; providing nutrition advice; providing on-going education; and ensuring that feet have been examined. The primary outcome will be the proportion of patients appropriately prescribed and examined (using anonymised computer records), and advised (using anonymous patient surveys) at 12 months. We will use behaviour change techniques targeting motivational, volitional, and impulsive factors that we have previously demonstrated to be predictive of multiple health professional behaviours involved in high-quality type 2 diabetes care. We will also investigate whether the intervention was delivered as designed (fidelity) by coding audiotaped workshops and interventionist delivery reports, and operated as hypothesised (process evaluation) by analysing responses to theory-based postal questionnaires. In addition, we will conduct post-trial qualitative interviews with practice teams to further inform the process evaluation, and a post-trial economic analysis to estimate the costs of the intervention and cost of service use. Discussion Consistent with UK Medical Research Council guidance and building on previous development research, this pragmatic cluster randomised trial will evaluate the effectiveness of a theory-based complex intervention focusing on changing multiple clinical behaviours to improve quality of diabetes care. Trial registration ISRCTN66498413. PMID:24886606

Trends and Issues in U.S. Navy Manpower

DTIC Science & Technology

1985-01-01

Planning (ADSTAP) system7, consists of several subsystems and models for planning and managing enlisted manpower, personnel, and training. It was... models to provide information for formulating goals and planning the transition from current inventory to estab- lished objectives 9 Operational...planning models to provide information for formulating operating plans to control the size and quality (ratings or skills and pay grades) of the active-duty

A new unconditionally stable and consistent quasi-analytical in-stream water quality solution scheme for CSTR-based water quality simulators

NASA Astrophysics Data System (ADS)

Woldegiorgis, Befekadu Taddesse; van Griensven, Ann; Pereira, Fernando; Bauwens, Willy

2017-06-01

Most common numerical solutions used in CSTR-based in-stream water quality simulators are susceptible to instabilities and/or solution inconsistencies. Usually, they cope with instability problems by adopting computationally expensive small time steps. However, some simulators use fixed computation time steps and hence do not have the flexibility to do so. This paper presents a novel quasi-analytical solution for CSTR-based water quality simulators of an unsteady system. The robustness of the new method is compared with the commonly used fourth-order Runge-Kutta methods, the Euler method and three versions of the SWAT model (SWAT2012, SWAT-TCEQ, and ESWAT). The performance of each method is tested for different hypothetical experiments. Besides the hypothetical data, a real case study is used for comparison. The growth factors we derived as stability measures for the different methods and the R-factor—considered as a consistency measure—turned out to be very useful for determining the most robust method. The new method outperformed all the numerical methods used in the hypothetical comparisons. The application for the Zenne River (Belgium) shows that the new method provides stable and consistent BOD simulations whereas the SWAT2012 model is shown to be unstable for the standard daily computation time step. The new method unconditionally simulates robust solutions. Therefore, it is a reliable scheme for CSTR-based water quality simulators that use first-order reaction formulations.

Quality assessment of SPR sensor chips; case study on L1 chips.

PubMed

Olaru, Andreea; Gheorghiu, Mihaela; David, Sorin; Polonschii, Cristina; Gheorghiu, Eugen

2013-07-15

Surface quality of the Surface Plasmon Resonance (SPR) chips is a major limiting issue in most SPR analyses, even more for supported lipid membranes experiments, where both the organization of the lipid matrix and the subsequent incorporation of the target molecule depend on the surface quality. A novel quantitative method to characterize the quality of SPR sensors chips is described for L1 chips subject to formation of lipid films, injection of membrane disrupting compounds, followed by appropriate regeneration procedures. The method consists in analysis of the SPR reflectivity curves for several standard solutions (e.g. PBS, HEPES or deionized water). This analysis reveals the decline of sensor surface as a function of the number of experimental cycles (consisting in biosensing assay and regeneration step) and enables active control of surface regeneration for enhanced reproducibility. We demonstrate that quantitative evaluation of the changes in reflectivity curves (shape of the SPR dip) and of the slope of the calibration curve provides a rapid and effective procedure for surface quality assessment. Whereas the method was tested on L1 SPR sensors chips, we stress on its amenability to assess the quality of other types of SPR chips, as well. Copyright © 2013 Elsevier B.V. All rights reserved.

Quality-of-life and spirituality.

PubMed

Panzini, Raquel Gehrke; Mosqueiro, Bruno Paz; Zimpel, Rogério R; Bandeira, Denise Ruschel; Rocha, Neusa S; Fleck, Marcelo P

2017-06-01

Spirituality has been identified as an important dimension of quality-of-life. The objective of this study was to review the literature on quality-of-life and spirituality, their association, and assessment tools. A search was conducted of the keyterms 'quality-of-life' and 'spirituality' in abstract or title in the databases PsycINFO and PubMed/Medline between 1979-2005, complemented by a new search at PUBMED from 2006-2016. Quality-of-life is a new concept, which encompasses and transcends the concept of health, being composed of multiple domains: physical, psychological, environmental, among others. The missing measure in health has been defined as the individual's perception of their position in life in the context of culture and value system in which they live and in relation to their goals, expectations, standards, and concerns. There is consistent evidence of an association between quality-of-life and religiosity/spirituality (R/S), through studies with reasonable methodological rigour, using several variables to assess R/S (e.g. religious affiliation, religious coping, and prayer/spirituality). There are also several valid and reliable instruments to evaluate quality-of-life and spirituality. Further studies are needed, however, especially in Brazil. Such studies will provide empirical data to be used in planning health interventions based on spirituality, seeking a better quality-of-life. In the last 10 years, research is consistently growing about quality-of-life and spirituality in many countries, and also in many areas of health research.

Nursing home consumer complaints and their potential role in assessing quality of care.

PubMed

Stevenson, David G

2005-02-01

State survey agencies collect and investigate consumer complaints for care in nursing homes and other health care settings. Complaint investigations play a key role in quality assurance, because they can respond to concerns of consumers and families. This study uses 5 years of nursing home complaints data from Massachusetts (1998-2002) to investigate whether complaints might be used to assess nursing home quality of care. The investigator matches facility-level complaints data with On-Line Survey Certification and Reporting (OSCAR) data and Minimum Data Set Quality Indicator (MDS QI) data to evaluate the association between consumer complaints, facility and resident characteristics, and other nursing home quality measures. Consumer complaints varied across facility characteristics in ways consistent with the nursing home quality literature. Complaints were consistently and significantly associated with survey deficiencies, the presence of a serious survey deficiency, and nurse aide staffing. Complaints were not significantly associated with nurse staffing, and associations with 6 MDS QIs were mixed. The number of complaints was significantly predictive of survey deficiencies identified at the subsequent inspection. Nursing home consumer complaints provide a supplemental tool with which to differentiate nursing homes on quality. Despite limitations, complaints data have potential strengths when used in combination with other quality measures. The potential of using consumer complaints to assess nursing home quality of care should be evaluated in states beyond Massachusetts. Evaluating consumer complaints also might be a productive area of inquiry for other health care settings such as hospitals and home health agencies.

Management of government quality assurance functions for NASA contracts

NASA Technical Reports Server (NTRS)

1993-01-01

This handbook sets forth requirements for NASA direction and management of government quality assurance functions performed for NASA contracts and is applicable to all NASA installations. These requirements will standardize management to provide the minimum oversight and effective use of resources. This handbook implements Federal Acquisition Regulation (FAR) Part 46, NASA FAR Supplement 18-46, Quality Assurance, and NMI 7410.1. Achievement of established quality and reliability goals at all levels is essential to the success of NASA programs. Active participation by NASA and other agency quality assurance personnel in all phases of contract operations, including precontract activity, will assist in the economic and timely achievement of program results. This involves broad participation in design, development, procurement, inspection, testing, and preventive and corrective actions. Consequently, government, as well as industry, must place strong emphasis on the accomplishment of all functions having a significant bearing on quality and reliability from program initiation through end-use of supplies and services produced. For purposes of implementing NASA and other agency agreements, and to provide for uniformity and consistency, the terminology and definitions prescribed herein and in a future handbook shall be utilized for all NASA quality assurance delegations and subsequent redelegations.

Management of government quality assurance functions for NASA contracts

NASA Astrophysics Data System (ADS)

1993-04-01

This handbook sets forth requirements for NASA direction and management of government quality assurance functions performed for NASA contracts and is applicable to all NASA installations. These requirements will standardize management to provide the minimum oversight and effective use of resources. This handbook implements Federal Acquisition Regulation (FAR) Part 46, NASA FAR Supplement 18-46, Quality Assurance, and NMI 7410.1. Achievement of established quality and reliability goals at all levels is essential to the success of NASA programs. Active participation by NASA and other agency quality assurance personnel in all phases of contract operations, including precontract activity, will assist in the economic and timely achievement of program results. This involves broad participation in design, development, procurement, inspection, testing, and preventive and corrective actions. Consequently, government, as well as industry, must place strong emphasis on the accomplishment of all functions having a significant bearing on quality and reliability from program initiation through end-use of supplies and services produced. For purposes of implementing NASA and other agency agreements, and to provide for uniformity and consistency, the terminology and definitions prescribed herein and in a future handbook shall be utilized for all NASA quality assurance delegations and subsequent redelegations.

Gauging the Health of New England's Lakes and Ponds

EPA Science Inventory

The New England Lakes and Ponds Project provides a consistent and first time comprehensive assessment of the ecological and water quality condition of lakes and ponds across the New England region. The project is being conducted by EPA along with the New England Interstate Water...

Factors predicting quality of work life among nurses in tertiary-level hospitals, Bangladesh.

PubMed

Akter, N; Akkadechanunt, T; Chontawan, R; Klunklin, A

2018-06-01

This study examined the level of quality of work life and predictability of years of education, monthly income, years of experience, job stress, organizational commitment and work environment on quality of work life among nurses in tertiary-level hospitals in the People's Republic of Bangladesh. There is an acute shortage of nurses worldwide including Bangladesh. Quality of work life is important for quality of patient care and nurse retention. Nurses in Bangladesh are fighting to provide quality care for emerging health problems for the achievement of sustainable development goals. We collected data from 288 randomly selected registered nurses, from six tertiary-level hospitals. All nurses were requested to fill questionnaire consisted of Demographic Data Sheet, Quality of Nursing Work Life Survey, Expanded Nursing Stress Scale, Questionnaire of Organizational Commitment and Practice Environment Scale of the Nursing Work Index. Data were analysed by descriptive statistics and multiple regression. The quality of work life as perceived by nurses in Bangladesh was at moderate level. Monthly income was found as the best predictor followed by work environment, organizational commitment and job stress. A higher monthly income helps nurses to fulfil their personal needs; positive work environment helps to provide quality care to the patients. Quality of work life and predictors measured by self-report only may not reflect the original picture of the quality of work life among nurses. Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress. © 2017 International Council of Nurses.

Ecological Consistency of SSU rRNA-Based Operational Taxonomic Units at a Global Scale

PubMed Central

Schmidt, Thomas S. B.; Matias Rodrigues, João F.; von Mering, Christian

2014-01-01

Operational Taxonomic Units (OTUs), usually defined as clusters of similar 16S/18S rRNA sequences, are the most widely used basic diversity units in large-scale characterizations of microbial communities. However, it remains unclear how well the various proposed OTU clustering algorithms approximate ‘true’ microbial taxa. Here, we explore the ecological consistency of OTUs – based on the assumption that, like true microbial taxa, they should show measurable habitat preferences (niche conservatism). In a global and comprehensive survey of available microbial sequence data, we systematically parse sequence annotations to obtain broad ecological descriptions of sampling sites. Based on these, we observe that sequence-based microbial OTUs generally show high levels of ecological consistency. However, different OTU clustering methods result in marked differences in the strength of this signal. Assuming that ecological consistency can serve as an objective external benchmark for cluster quality, we conclude that hierarchical complete linkage clustering, which provided the most ecologically consistent partitions, should be the default choice for OTU clustering. To our knowledge, this is the first approach to assess cluster quality using an external, biologically meaningful parameter as a benchmark, on a global scale. PMID:24763141

JPEG2000 encoding with perceptual distortion control.

PubMed

Liu, Zhen; Karam, Lina J; Watson, Andrew B

2006-07-01

In this paper, a new encoding approach is proposed to control the JPEG2000 encoding in order to reach a desired perceptual quality. The new method is based on a vision model that incorporates various masking effects of human visual perception and a perceptual distortion metric that takes spatial and spectral summation of individual quantization errors into account. Compared with the conventional rate-based distortion minimization JPEG2000 encoding, the new method provides a way to generate consistent quality images at a lower bit rate.

Factors influencing the quality of Myrmecia pilosula (Jack Jumper) ant venom for use in in vitro and in vivo diagnoses of allergen sensitization and in allergen immunotherapy.

PubMed

Wanandy, T; Dwyer, H E; McLean, L; Davies, N W; Nichols, D; Gueven, N; Brown, S G A; Wiese, M D

2017-11-01

Allergen immunotherapy uses pharmaceutical preparations derived from naturally occurring source materials, which contain water-soluble allergenic components responsible for allergic reactions. The success of in vivo and in vitro diagnoses in allergen sensitization and allergen immunotherapy largely depends on the quality, composition and uniformity of allergenic materials used to produce the active ingredients, and the formulation employed to prepare finished products. We aimed to examine the factors influencing batch-to-batch consistency of Jack Jumper (Myrmecia pilosula) ant venom (JJAV) in the form of active pharmaceutical ingredient (AI) and informed whether factors such as temperature, artificial light and container materials influence the quality of JJAV AIs. We also aimed to establish handling and storage requirements of JJAV AIs to ensure preservation of allergenic activities during usage in the diagnosis of allergen sensitization and in allergen immunotherapy. The quality and consistency of JJAV AIs were analysed using a combination of bicinchoninic acid assay for total protein quantification, HPLC-UV for JJAV allergen peptides quantification, ELISA inhibition for total allergenic potency, SDS-PAGE, AU-PAGE and immunoblot for qualitative assessment of JJAV components, and Limulus Amebocyte Lysate assay for the quantification of endotoxin concentration. API-ZYM and Zymogram assays were used to probe the presence of enzymatic activities in JJAV. Pharmaceutical-grade JJAV for allergen immunotherapy has good batch-to-batch consistency. Temporary storage at 4°C and light exposure do not affect the quality of JJAV. Exposure to temperature above 40°C degrades high MW allergens in JJAV. Vials containing JJAV must be stored frozen and in upright position during long-term storage. We have identified factors, which can influence the quality and consistency of JJAV AIs, and provided a framework for appropriate handling, transporting and storage of JJAV to be used for the diagnosis of allergen sensitization and in AIT. © 2017 John Wiley & Sons Ltd.

Clinical decision support systems: data quality management and governance.

PubMed

Liaw, Siaw-Teng

2013-01-01

This chapter examines data quality management (DQM) and information governance (IG) of electronic decision support (EDS) systems so that they are safe and fit for use by clinicians and patients and their carers. This is consistent with the ISO definition of data quality as being fit for purpose. The scope of DQM & IG should range from data creation and collection in clinical settings, through cleaning and, where obtained from multiple sources, linkage, storage, use by the EDS logic engine and algorithms, knowledge base and guidance provided, to curation and presentation. It must also include protocols and mechanisms to monitor the safety of EDS, which will feedback into DQM & IG activities. Ultimately, DQM & IG must be integrated across the data cycle to ensure that the EDS systems provide guidance that leads to safe and effective clinical decisions and care.

Geology, ground-water flow, and dissolved-solids concentrations in ground water along hydrogeologic sections through Wisconsin aquifers

USGS Publications Warehouse

Kammerer, P.A.

1998-01-01

A cooperative project between the U.S. Geological Survey (USGS) and the Wisconsin Department of Natural Resources (DNR) was begun with the objectives of describing water quality and its relation to the hydrology of Wisconsin's principal aquifers and summarizing instances of ground-water contamination and quality problems from information available in DNR files. The first objective was met by a hydrologic investigation done by the USGS, and the second, by preparation of a report by the DNR, for their internal use, that describes the State's water resources and known ground-water quality and contamination problems and makes policy recommendations for ground-water management.The USGS investigation was divided into two phases. The first phase consisted of compiling available water-quality and hydrogeologic data and collecting new data to describe general regional water-quality and hydrogeologic relations within and between Wisconsin aquifers. The second phase began concurrently with the later part of the first phase and consisted of an areal description of water quality and flow in the State's shallow aquifer system (Kammerer, 1995). The overall purpose of this investigation was to provide a regional framework that could serve as a basis for intensive local and site specific ground-water investigations by State and local government agencies.This report presents the results of the first phase of the USGS investigation. Regional hydrogeologic and water-quality relations within and between aquifers are shown along 15 hydrogeologic sections that traverse the State. Maps are used to show surficial geology of bedrock and unconsolidated deposits and horizontal direction of ground-water flow. Interpretations on the maps and hydrogeologic sections are based on data from a variety of sources and provide the basis for the areal appraisal of water quality in the State's shallow aquifer system in the second phase of the investigation.

Analysis and interpretation of water-quality trends in major U.S. rivers, 1974-81

USGS Publications Warehouse

Smith, Richard A.; Alexander, Richard B.; Wolman, M. Gordon

1987-01-01

Water-quality records from two nationwide sampling networks are now of sufficient length to permit nationally consistent analysis of long-term water-quality trends at more than 300 locations on major U.S. rivers. Observed trends in 24 water-quality measures for the period 1974--81 provide evidence of both improvement and deterioration in stream quality during a time of major changes in atmospheric and terrestrial influences on surface waters. Particularly noteworthy are widespread decreases in lead and fecal bacteria concentrations and widespread increases in nitrate, arsenic, and cadmium concentrations. Changes in municipal waste treatment, leaded-gasoline consumption, highway-salt use, and nitrogen-fertilizer application, and regionally variable trends in coal production and combustion during the period, appear to be reflected in water-quality changes. There is evidence that atmospheric deposition of a variety of substances has played a surprisingly large role in water-quality changes.

Young Adults’ Provision of Support to Middle-Aged Parents

PubMed Central

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

2015-01-01

Objectives. Middle-aged adults often provide support to aging parents, but researchers know little about support that young adults provide middle-aged parents. This study examined support that young adults provide parents and explanations for that support from both offspring’s and parents’ perspectives. Method. Young adults (n = 515, mean age = 22.34) and their parents (n = 364, mean age = 50.09) from the Family Exchanges Study reported support that offspring provide parents. Participants also reported parental personal problems, parental disability status, relationship quality, and support that parents provide offspring. Results. Offspring provided parents with emotional support and listening more often than other forms of support. Offspring reported providing more frequent support than parents reported receiving. We examined factors associated with support using multilevel models. Both offspring and parents reported more frequent support provided to parents when they had higher quality relationships and when parents gave more frequent support to offspring. Offspring (but not parents) reported providing more frequent support to parents when parents were disabled. Discussion. Findings are consistent with solidarity theory, which suggests that high-quality relationships may explain support. The concept of self-enhancement and generativity in middle-aged parents may explain the intergenerational differences in the association between parental disability and support. PMID:24162441

Evaluation of Flying Qualities and Guidance Displays for an Advanced Tilt-Wing STOL Transport Aircraft in Final Approach and Landing

NASA Technical Reports Server (NTRS)

Frost, Chad R.; Franklin, James A.; Hardy, Gordon H.

2002-01-01

A piloted simulation was performed on the Vertical Motion Simulator at NASA Ames Research Center to evaluate flying qualities of a tilt-wing Short Take-Off and Landing (STOL) transport aircraft during final approach and landing. The experiment was conducted to assess the design s handling qualities, and to evaluate the use of flightpath-centered guidance for the precision approach and landing tasks required to perform STOL operations in instrument meteorological conditions, turbulence, and wind. Pilots rated the handling qualities to be satisfactory for all operations evaluated except those encountering extreme crosswinds and severe windshear; even in these difficult meteorological conditions, adequate handling qualities were maintained. The advanced flight control laws and guidance displays provided consistent performance and precision landings.

Quality dementia care: Prerequisites and relational ethics among multicultural healthcare providers.

PubMed

Sellevold, Gerd Sylvi; Egede-Nissen, Veslemøy; Jakobsen, Rita; Sørlie, Venke

2017-01-01

Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. The aim of this study is to illuminate multi-ethnic healthcare providers' lived experiences of their own working relationship, and its importance to quality care for people with dementia. The study is part of a greater participatory action research project: 'Hospice values in the care for persons with dementia'. The data material consists of extensive notes from seminars, project meetings and dialogue-based teaching. The text material was subjected to phenomenological-hermeneutical interpretation. Participants and research context: Participants in the project were healthcare providers working in a nursing home unit. The participants came from 15 different countries, had different formal qualifications, varied backgrounds and ethnic origins. Ethical considerations: The study is approved by the Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services. The results show that good working relationships, characterized by understanding each other's vulnerability and willingness to learn from each other through shared experiences, are prerequisites for quality care. The healthcare providers further described ethical challenges as uncertainty and different understandings. The results are discussed in the light of Lögstrup's relational philosophy of ethics and the concepts of vulnerability, ethic responsibility, trust and openness of speech. The prerequisite for quality care for persons with dementia in a multicultural working environment is to create arenas for open discussions between the healthcare providers. Leadership is of great importance.

Standardizing the care of detox patients to achieve quality outcomes.

PubMed

Becker, Kathy; Semrow, Sue

2006-03-01

Providing appropriate treatment for detoxification patients is both challenging and difficult because alcohol abuse and dependence are largely underestimated in the acute hospital setting. Alcohol withdrawal syndrome is treated not only by addictionologists on chemical dependency units, but also by primary care physicians in acute inpatient settings. The need for consistent inpatient treatment through the use of identified protocols can help provide safe and effective care. The need for consistent, inpatient medical-surgical detoxification treatment in our organization became apparent with the staff's identification of patient care concerns. Using an organizational approach, a multidisciplinary team was created to standardize the care of detoxification patients, beginning with patient admission and ending with discharge and referral for outpatient management. Standardization would ensure consistent assessment and intervention, and improve communication among the clinical team members. A protocol was developed for both the emergency department and the inpatient units. The goals of the team were to decrease the adverse events related to detoxification, such as seizures and aggression, and provide a consistent method of treatment for staff to follow.

The endoscopy Global Rating Scale – Canada: Development and implementation of a quality improvement tool

PubMed Central

MacIntosh, Donald; Dubé, Catherine; Hollingworth, Roger; van Zanten, Sander Veldhuyzen; Daniels, Sandra; Ghattas, George

2013-01-01

BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer. OBJECTIVE: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided. METHODS: Based on feedback from 22 sites across Canada that completed the UK endoscopy GRS, and integrating results of the Canadian consensus on safety and quality indicators in endoscopy and other Canadian consensus reports, a working group of endoscopists experienced with the GRS developed the GRS-Canada (GRS-C). RESULTS: The GRS-C mirrors the two dimensions (clinical quality and quality of the patient experience) and 12 patient-centred items of the UK-GRS, but was modified to apply to Canadian health care infrastructure, language and current practice. Each item is assessed by a yes/no response to eight to 12 statements that are divided into levels graded D (basic) through A (advanced). A core team consisting of a booking clerk, charge nurse and the physician responsible for the unit is recommended to complete the GRS-C twice yearly. CONCLUSION: The GRS-C is intended to improve endoscopic services in Canada by providing endoscopy units with a straightforward process to review the quality of the service they provide. PMID:23472242

NTP comparison process

NASA Technical Reports Server (NTRS)

Corban, Robert

1993-01-01

The systems engineering process for the concept definition phase of the program involves requirements definition, system definition, and consistent concept definition. The requirements definition process involves obtaining a complete understanding of the system requirements based on customer needs, mission scenarios, and nuclear thermal propulsion (NTP) operating characteristics. A system functional analysis is performed to provide a comprehensive traceability and verification of top-level requirements down to detailed system specifications and provides significant insight into the measures of system effectiveness to be utilized in system evaluation. The second key element in the process is the definition of system concepts to meet the requirements. This part of the process involves engine system and reactor contractor teams to develop alternative NTP system concepts that can be evaluated against specific attributes, as well as a reference configuration against which to compare system benefits and merits. Quality function deployment (QFD), as an excellent tool within Total Quality Management (TQM) techniques, can provide the required structure and provide a link to the voice of the customer in establishing critical system qualities and their relationships. The third element of the process is the consistent performance comparison. The comparison process involves validating developed concept data and quantifying system merits through analysis, computer modeling, simulation, and rapid prototyping of the proposed high risk NTP subsystems. The maximum amount possible of quantitative data will be developed and/or validated to be utilized in the QFD evaluation matrix. If upon evaluation of a new concept or its associated subsystems determine to have substantial merit, those features will be incorporated into the reference configuration for subsequent system definition and comparison efforts.

Solar hot water system installed at Quality Inn, Key West, Florida

NASA Astrophysics Data System (ADS)

1980-04-01

The solar energy hot water system installed in the Quality Inn, Key West, Florida, which consists of four buildings is described. Three buildings are low-rise, two-story buildings containing 100 rooms. The fourth is a four-story building with 48 rooms. The solar system was designed to provide approximately 50 percent of the energy required for the domestic hot water system. The solar system consists of approximately 1400 square feet of flat plate collector, two 500 gallon storage tanks, a circulating pump, and a controller. Operation of the system was begun in April 1978, and has continued to date with only three minor interruptions for pump repair. In the first year of operation, it was determined that the use of the solar facility resulted in forty percent fuel savings.

Solar hot water system installed at Quality Inn, Key West, Florida

NASA Technical Reports Server (NTRS)

1980-01-01

The solar energy hot water system installed in the Quality Inn, Key West, Florida, which consists of four buildings is described. Three buildings are low-rise, two-story buildings containing 100 rooms. The fourth is a four-story building with 48 rooms. The solar system was designed to provide approximately 50 percent of the energy required for the domestic hot water system. The solar system consists of approximately 1400 square feet of flat plate collector, two 500 gallon storage tanks, a circulating pump, and a controller. Operation of the system was begun in April 1978, and has continued to date with only three minor interruptions for pump repair. In the first year of operation, it was determined that the use of the solar facility resulted in forty percent fuel savings.

NRL Radar Division C++ Coding Standard

DTIC Science & Technology

2016-12-05

The coding standard provides tools aimed at helping C++ programmers develop programs that are free of common types of errors, maintainable by...different programmers , portable to other operating systems, easy to read and understand, and have a consistent style. Questions of design, such as how to...mandatory for any organization with quality goals. The purpose of this standard is to provide tools aimed at helping C++ programmers develop programs that

Concreteness Effects and Syntactic Modification in Written Composition.

ERIC Educational Resources Information Center

Sadoski, Mark; Goetz, Ernest T.

1998-01-01

Investigates whether concreteness was related to a key characteristic of written composition--the cumulative sentence with a final modifier--which has been consistently associated with higher quality writing. Supports the conceptual-peg hypothesis of dual coding theory, with concrete verbs providing the pegs on which cumulative sentences are…

77 FR 45523 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Prevention of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

....'' Virginia's Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

76 FR 77150 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; General Conformity...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-12

....'' Virginia's Immunity Law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

75 FR 8249 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Opacity Source...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-24

....'' Virginia's Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

Alabama's Education Report Card, 2009-2010

ERIC Educational Resources Information Center

Alabama Department of Education, 2011

2011-01-01

In a more consistent and viable manner than ever before, education in Alabama is moving toward its ultimate goal of providing every student with a quality education, thereby preparing them for work, college, and life after high school. Alabama's graduation rates from 2002 to 2008 increased significantly, tripling the national average increase and…

76 FR 14584 - Approval and Promulgation of Air Quality Implementation Plans; Montana; Attainment Plan for Libby...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

... the timeframe provided in the statute. It must also include supporting technical analyses and... emissions inventory (EI), a woodstove air pollution control calculation, and a technical analysis showing... year (2010); and (2) an attainment demonstration consisting of: (a) Technical analyses that locate...

76 FR 2853 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Infrastructure State...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-18

... technical analysis submitted for parallel-processing by DNREC on December 9, 2010, to address significant... technical analysis submitted by DNREC for parallel-processing on December 9, 2010, to satisfy the... consists of a technical analysis that provides detailed support for Delaware's position that it has...

75 FR 47618 - Final Environmental Impact Statement for the Proposed Enterprise Rancheria Gaming Facility and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... (consisting of a buffet, gourmet restaurant, and bar), meeting space, guest support services, offices, and a... resources, water resources, air quality, biological resources, cultural and paleontological resources..., Cultural Resources Management and Safety, at the BIA address above or at the telephone number provided in...

High Tech Training at Arthur Andersen and Co.

ERIC Educational Resources Information Center

Dennis, Verl E.

1984-01-01

Discusses Arthur Andersen and Company's reasons for using high technology in job training, including its ability to improve productivity, provide training on demand, reduce training costs, and keep educational quality consistent. A Life Cycle Model which is used to integrate high technology into this accounting company's educational programs is…

Low-inductance bus lines

NASA Technical Reports Server (NTRS)

Kernick, A.

1977-01-01

Laminated bus strips and bifilar litz cable connectors for high-power rectifiers, thrisistors, and transistors provide low inductance and eliminate electromagnetic interference in high-power circuits. These techniques offer significant cost advantages because of ease of assembly and consistent high quality of product. Effectiveness makes general usage in static power conversion likely.

Level I water-quality inventory and monitoring, Richmond National Battlefield Park, Virginia

USGS Publications Warehouse

Moberg, Roger M.; Rice, Karen C.

2002-01-01

The U.S. Geological Survey conducted a Level I Water-Quality Inventory and Monitoring (WAQIM) data-collection effort for Richmond National Battlefield Park (Richmond NBP) from August 2001 through April 2002. The primary objective of the WAQIM program was to provide the National Park Service (NPS) and Richmond NBP with at least a nominal inventory of its natural resources and to provide those data in a data-management system consistent with park management needs. Water-quality inventory data (physical, chemical, and biological) were collected from "key" water bodies within the boundaries of Richmond NBP. The key water bodies are those waters within park boundaries that are essential to the central cultural, historical or natural resources management themes of the parks or provide habitats to threatened or endangered plants and animals. Data were collected during the fall, winter, spring, and summer over a range of hydrologic conditions. Because of the drought conditions that persisted during the study period, variations in flow between seasons were less pronounced than during normal hydrologic conditions.

Improvement in the performance of external quality assessment in Korean HIV clinical laboratories using unrecalcified human plasma.

PubMed

Wang, Jin-Sook; Kee, Mee-Kyung; Choi, Byeong-Sun; Kim, Chan-Wha; Kim, Hyon-Suk; Kim, Sung Soon

2012-01-01

The external quality assessment schemes (EQAS) organizer provides a suitable program to monitor and improve the quality of human immunodeficiency virus (HIV) testing laboratories with EQAS panels prepared under various conditions. The aim of the current study was to investigate the effects of human plasma samples on the EQAS results of HIV obtained from hospital-based clinical laboratories. From 2007 to 2009, HIV EQAS panels consisted of four to six samples that consisted of undiluted positive and negative samples and were provided to laboratories twice per year. Up until the first half EQAS in 2008, EQAS panel materials were obtained by converting acid citrate dextrose treated plasma to serum via chemical treatment with CaCl2. Beginning with the second EQAS in 2008, all materials were prepared without the defibrination process. Approximately 300 HIV clinical laboratories participated in this program. The overall performance of clinical laboratories was shown to be improved when using unrecalcified plasma panels compared with recalcified panels. Significant differences were observed in EIA analyses of plasma for both positive (p<0.001) and negative (p<0.001) samples between the recalcified and unrecalcified groups. Our finding suggested that defibrination status of EQAS panels might affect the results of anti-HIV EQAS of Korean HIV testing laboratories.

[Application of bioassay in quality control of Chinese materia medica-taking Radix Isatidis as an example].

PubMed

Yan, Dan; Ren, Yongshen; Luo, Jiaoyang; Li, Hanbing; Feng, Xue; Xiao, Xiaohe

2010-10-01

Bioassay, which construct the characteristics consistents with Chinese medical science, is the core mode and methods for the quality control of Chinese materia medica. Taking the bioassay of Radix Isatidis as an example, the contribution, status and application of bioassay in the quality control of Chinese materia medica were introduced in this article, and two key issue (the selection of reference and measurement methods) in the process of establishing bioassay were also explained. This article expects to provide a reference for the development and improvement of the bioassay of Chinese materia medica in a practical manipulation level.

Quality management of human resources. Providers should begin by focusing on education, performance management, and reward systems.

PubMed

Blair, C S; Fordyce, M; Barney, S M

1993-10-01

For a quality management transformation to occur, a healthcare organization must focus on education and development, performance management, and recognition and reward systems during the first years of implementation. Education and development are perhaps the most important human resource management functions when implementing quality management principles and processes because behavioral changes will be required at all organizational levels. Specific programs that support an organization's quality management effort will vary but should include the conceptual, cultural, and technical aspects of quality management. The essence of quality management is to always satisfy the customer and to continuously improve the services and products the organization offers. The approach to performance management should therefore rely on customer feedback and satisfaction. An organization committed to quality management should base its performance management approach on customer orientation, process improvement, employee involvement, decision making with data, and continuous improvement. Managers and trustees are being challenged to provide innovative recognition and reward systems that reinforce the values and behaviors consistent with quality management. Such systems must also be aligned with the behaviors and outcomes that support the philosophy, mission, and values of the Catholic healthcare ministry. The following components should be considered for a recognition and reward system: base pay, incentives, benefits, and nonmonetary rewards.

SU-E-T-649: Quality Assurances for Proton Therapy Delivery Equipment

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

Arjomandy, B; Kase, Y; Flanz, J

2015-06-15

Purpose: The number of proton therapy centers has increased dramatically over the past decade. Currently, there is no comprehensive set of guidelines that addresses quality assurance (QA) procedures for the different technologies used for proton therapy. The AAPM has charged task group 224 (TG-224) to provide recommendations for QA required for accurate and safe dose delivery, using existing and next generation proton therapy delivery equipment. Methods: A database comprised of QA procedures and tolerance limits was generated from many existing proton therapy centers in and outside of the US. These consist of proton therapy centers that possessed double scattering, uniformmore » scanning, and pencil beams delivery systems. The diversity in beam delivery systems as well as the existing devices to perform QA checks for different beam parameters is the main subject of TG-224. Based on current practice at the clinically active proton centers participating in this task group, consensus QA recommendations were developed. The methodologies and requirements of the parameters that must be verified for consistency of the performance of the proton beam delivery systems are discussed. Results: TG-224 provides procedures and QA checks for mechanical, imaging, safety and dosimetry requirements for different proton equipment. These procedures are categorized based on their importance and their required frequencies in order to deliver a safe and consistent dose. The task group provides daily, weekly, monthly, and annual QA check procedures with their tolerance limits. Conclusions: The procedures outlined in this protocol provide sufficient information to qualified medical physicists to perform QA checks for any proton delivery system. Execution of these procedures should provide confidence that proton therapy equipment is functioning as commissioned for patient treatment and delivers dose safely and accurately within the established tolerance limits. The report will be published in late 2015.« less

Co-precipitation of protein and polyester as a method to isolate high molecular weight DNA.

PubMed

Dixson, Jamie D

2005-02-01

DNA isolation is often the limiting step in genetic analysis using PCR and automated fragment analysis due to low quality or purity of DNA, the need to determine and adjust DNA concentrations after isolation etc. Several protocols have been developed which are either safe and provide good quality DNA or hazardous and provide excellent quality DNA. In this brief communication I describe a new and rapid method of DNA isolation which employs the co-precipitation of protein and polyester, in the presence of acetone, to remove contaminating proteins from a lysed-tissue sample, thus leaving high quality pure DNA. The advantages of this method are increased safety over the phenol:chloroform and the chaotrophic salt methods and increased purity over the salting-out method. Since the concentrations of DNA isolated using this method are relatively consistent regardless of the amount of starting tissue (within limits), adjustments of the DNA concentrations before use as templates in PCR's are not necessary.

Setting Standards at the Forefront of Delivery System Reform: Aligning Care Coordination Quality Measures for Multiple Chronic Conditions

PubMed Central

DuGoff, Eva H.; Dy, Sydney; Giovannetti, Erin R.; Leff, Bruce; Boyd, Cynthia M.

2015-01-01

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 health care providers and policymakers 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. PMID:24004040

Data quality assessment for comparative effectiveness research in distributed data networks

PubMed Central

Brown, Jeffrey; Kahn, Michael; Toh, Sengwee

2015-01-01

Background Electronic health information routinely collected during healthcare delivery and reimbursement can help address the need for evidence about the real-world effectiveness, safety, and quality of medical care. Often, distributed networks that combine information from multiple sources are needed to generate this real-world evidence. Objective We provide a set of field-tested best practices and a set of recommendations for data quality checking for comparative effectiveness research (CER) in distributed data networks. Methods Explore the requirements for data quality checking and describe data quality approaches undertaken by several existing multi-site networks. Results There are no established standards regarding how to evaluate the quality of electronic health data for CER within distributed networks. Data checks of increasing complexity are often employed, ranging from consistency with syntactic rules to evaluation of semantics and consistency within and across sites. Temporal trends within and across sites are widely used, as are checks of each data refresh or update. Rates of specific events and exposures by age group, sex, and month are also common. Discussion Secondary use of electronic health data for CER holds promise but is complex, especially in distributed data networks that incorporate periodic data refreshes. The viability of a learning health system is dependent on a robust understanding of the quality, validity, and optimal secondary uses of routinely collected electronic health data within distributed health data networks. Robust data quality checking can strengthen confidence in findings based on distributed data network. PMID:23793049

An Integrated Modeling Framework Forecasting Ecosystem Exposure-- A Systems Approach to the Cumulative Impacts of Multiple Stressors

NASA Astrophysics Data System (ADS)

Johnston, J. M.

2013-12-01

Freshwater habitats provide fishable, swimmable and drinkable resources and are a nexus of geophysical and biological processes. These processes in turn influence the persistence and sustainability of populations, communities and ecosystems. Climate change and landuse change encompass numerous stressors of potential exposure, including the introduction of toxic contaminants, invasive species, and disease in addition to physical drivers such as temperature and hydrologic regime. A systems approach that includes the scientific and technologic basis of assessing the health of ecosystems is needed to effectively protect human health and the environment. The Integrated Environmental Modeling Framework 'iemWatersheds' has been developed as a consistent and coherent means of forecasting the cumulative impact of co-occurring stressors. The Framework consists of three facilitating technologies: Data for Environmental Modeling (D4EM) that automates the collection and standardization of input data; the Framework for Risk Assessment of Multimedia Environmental Systems (FRAMES) that manages the flow of information between linked models; and the Supercomputer for Model Uncertainty and Sensitivity Evaluation (SuperMUSE) that provides post-processing and analysis of model outputs, including uncertainty and sensitivity analysis. Five models are linked within the Framework to provide multimedia simulation capabilities for hydrology and water quality processes: the Soil Water Assessment Tool (SWAT) predicts surface water and sediment runoff and associated contaminants; the Watershed Mercury Model (WMM) predicts mercury runoff and loading to streams; the Water quality Analysis and Simulation Program (WASP) predicts water quality within the stream channel; the Habitat Suitability Index (HSI) model scores physicochemical habitat quality for individual fish species; and the Bioaccumulation and Aquatic System Simulator (BASS) predicts fish growth, population dynamics and bioaccumulation of toxic substances. The capability of the Framework to address cumulative impacts will be demonstrated for freshwater ecosystem services and mountaintop mining.

Why do women choose private over public facilities for family planning services? A qualitative study of post-partum women in an informal urban settlement in Kenya.

PubMed

Keesara, Sirina R; Juma, Pamela A; Harper, Cynthia C

2015-08-20

Nearly 40% of women in developing countries seek contraceptives services from the private sector. However, the reasons that contraceptive clients choose private or public providers are not well studied. We conducted six focus groups discussions and 51 in-depth interviews with postpartum women (n = 61) to explore decision-making about contraceptive use after delivery, including facility choice. When seeking contraceptive services, women in this study preferred private over public facilities due to convenience and timeliness of services. Women avoided public facilities due to long waits and disrespectful providers. Study participants reported, however, that they felt more confident about the technical medical quality in public facilities than in private, and believed that private providers prioritized profit over safe medical practice. Women reported that public facilities offered comprehensive counseling and chose these facilities when they needed contraceptive decision-support. Provision of comprehensive counseling and screening, including side effects counseling and management, determined perception of quality. Women believed private providers offered the advantages of convenience, efficiency and privacy, though they did not consistently offer high-quality care. Quality-improvement of contraceptive care at private facilities could include technical standardization and accreditation. Development of support and training for side effect management may be an important intervention to improve perceived quality of care.

Barriers to providing quality emergency obstetric care in Addis Ababa, Ethiopia: Healthcare providers' perspectives on training, referrals and supervision, a mixed methods study.

PubMed

Austin, Anne; Gulema, Hanna; Belizan, Maria; Colaci, Daniela S; Kendall, Tamil; Tebeka, Mahlet; Hailemariam, Mengistu; Bekele, Delayehu; Tadesse, Lia; Berhane, Yemane; Langer, Ana

2015-03-29

Increasing women's access to and use of facilities for childbirth is a critical national strategy to improve maternal health outcomes in Ethiopia; however coverage alone is not enough as the quality of emergency obstetric services affects maternal mortality and morbidity. Addis Ababa has a much higher proportion of facility-based births (82%) than the national average (11%), but timely provision of quality emergency obstetric care remains a significant challenge for reducing maternal mortality and improving maternal health. The purpose of this study was to assess barriers to the provision of emergency obstetric care in Addis Ababa from the perspective of healthcare providers by analyzing three factors: implementation of national referral guidelines, staff training, and staff supervision. A mixed methods approach was used to assess barriers to quality emergency obstetric care. Qualitative analyses included twenty-nine, semi-structured, key informant interviews with providers from an urban referral network consisting of a hospital and seven health centers. Quantitative survey data were collected from 111 providers, 80% (111/138) of those providing maternal health services in the same referral network. Respondents identified a lack of transportation and communication infrastructure, overcrowding at the referral hospital, insufficient pre-service and in-service training, and absence of supportive supervision as key barriers to provision of quality emergency obstetric care. Dedicated transportation and communication infrastructure, improvements in pre-service and in-service training, and supportive supervision are needed to maximize the effective use of existing human resources and infrastructure, thus increasing access to and the provision of timely, high quality emergency obstetric care in Addis Ababa, Ethiopia.

Groundwater studies: principal aquifer surveys

USGS Publications Warehouse

Burow, Karen R.; Belitz, Kenneth

2014-01-01

In 1991, the U.S. Congress established the National Water-Quality Assessment (NAWQA) program within the U.S. Geological Survey (USGS) to develop nationally consistent long-term datasets and provide information about the quality of the Nation’s streams and groundwater. The USGS uses objective and reliable data, water-quality models, and systematic scientific studies to assess current water-quality conditions, to identify changes in water quality over time, and to determine how natural factors and human activities affect the quality of streams and groundwater. NAWQA is the only non-regulatory Federal program to perform these types of studies; participation is voluntary. In the third decade (Cycle 3) of the NAWQA program (2013–2023), the USGS will evaluate the quality and availability of groundwater for drinking supply, improve our understanding of where and why water quality is degraded, and assess how groundwater quality could respond to changes in climate and land use. These goals will be addressed through the implementation of a new monitoring component in Cycle 3: Principal Aquifer Surveys.

Formation and psychometric evaluation of a health-related quality of life instrument for children living with HIV in India.

PubMed

Das, Aritra; Detels, Roger; Afifi, Abdelmonem A; Javanbakht, Marjan; Sorvillo, Frank; Panda, Samiran

2018-03-01

In-depth interviews and focus group discussions were conducted to inform the development of an instrument to measure the health-related quality of life of children living with HIV. The QOL-CHAI instrument consists of four generic core scales of the "Pediatric Quality of Life Inventory" and two HIV-targeted scales-"symptoms" and "discrimination." A piloting exercise involving groups of children living with HIV and HIV-negative children born to HIV-infected parents provided evidence for the acceptable psychometric properties and usability of the instrument. It is expected that the QOL-CHAI can serve well as a brief, standardized, and culturally appropriate instrument for assessing health-related quality of life of Indian children living with HIV.

Assessment of the NASA-USGS Global Land Survey (GLS) Datasets

USGS Publications Warehouse

Gutman, Garik; Huang, Chengquan; Chander, Gyanesh; Noojipady, Praveen; Masek, Jeffery G.

2013-01-01

The Global Land Survey (GLS) datasets are a collection of orthorectified, cloud-minimized Landsat-type satellite images, providing near complete coverage of the global land area decadally since the early 1970s. The global mosaics are centered on 1975, 1990, 2000, 2005, and 2010, and consist of data acquired from four sensors: Enhanced Thematic Mapper Plus, Thematic Mapper, Multispectral Scanner, and Advanced Land Imager. The GLS datasets have been widely used in land-cover and land-use change studies at local, regional, and global scales. This study evaluates the GLS datasets with respect to their spatial coverage, temporal consistency, geodetic accuracy, radiometric calibration consistency, image completeness, extent of cloud contamination, and residual gaps. In general, the three latest GLS datasets are of a better quality than the GLS-1990 and GLS-1975 datasets, with most of the imagery (85%) having cloud cover of less than 10%, the acquisition years clustered much more tightly around their target years, better co-registration relative to GLS-2000, and better radiometric absolute calibration. Probably, the most significant impediment to scientific use of the datasets is the variability of image phenology (i.e., acquisition day of year). This paper provides end-users with an assessment of the quality of the GLS datasets for specific applications, and where possible, suggestions for mitigating their deficiencies.

Data Quality Parameters and Web Services Facilitate User Access to Research-Ready Seismic Data

NASA Astrophysics Data System (ADS)

Trabant, C. M.; Templeton, M. E.; Van Fossen, M.; Weertman, B.; Ahern, T. K.; Casey, R. E.; Keyson, L.; Sharer, G.

2016-12-01

IRIS Data Services has the mission of providing efficient access to a wide variety of seismic and related geoscience data to the user community. With our vast archive of freely available data, we recognize that there is a constant challenge to provide data to scientists and students that are of a consistently useful level of quality. To address this issue, we began by undertaking a comprehensive survey of the data and generating metrics measurements that provide estimates of data quality. These measurements can inform the scientist of the level of suitability of a given set of data for their scientific investigation. They also serve as a quality assurance check for network operators, who can act on this information to improve their current recording or mitigate issues with already recorded data and metadata. Following this effort, IRIS Data Services is moving forward to focus on providing tools for the scientist that make it easier to access data of a quality and characteristic that suits their investigation. Data that fulfill this criterion are termed "research-ready". In addition to filtering data by type, geographic location, proximity to events, and specific time ranges, we will offer the ability to filter data based on specific quality assessments. These include signal-to-noise ratio measurements, data continuity, timing quality, absence of channel cross-talk, and potentially many other factors. Our goal is to ensure that the user receives only the data that meets their specifications and will not require extensive review and culling after delivery. We will present the latest developments of the MUSTANG automated data quality system and introduce the Research-Ready Data Sets (RRDS) service. Together these two technologies serve as a data quality assurance ecosystem that will provide benefit to the scientific community by aiding efforts to readily find appropriate and suitable data for use in any number of objectives.

Quality geriatric care as perceived by nurses in long-term and acute care settings.

PubMed

Barba, Beth Ellen; Hu, Jie; Efird, Jimmy

2012-03-01

This study focused on differences in nurses' satisfaction with the quality of care of older people and with organisational characteristics and work environment in acute care and long-term care settings. Numerous studies have explored links between nurses' satisfaction with care and work environments on the one hand and a variety of physical, behavioural and psychological reactions of nurses on the other. One key to keeping nurses in the workplace is a better understanding of nurses' satisfaction with the quality of care they provide. Descriptive design. The self-selected sample included 298 registered nurses and licensed practical nurses who provide care to minority, underserved and disadvantaged older populations in 89 long-term care and <100 bed hospitals in 38 rural counties and eight metropolitan areas in a Southern state. All completed the Agency Geriatric Nursing Care survey, which consisted of a 13-item scale measuring nurses' satisfaction with the quality of geriatric care in their practice settings and an 11-item scale examining obstacles to providing quality geriatric care. Demographic variables were compared with chi-square. Independent t-tests were used to examine differences between nurses in long-term care and acute care settings. Significant differences were found in level of satisfaction and perceived obstacles to providing quality care to older adults between participants from acute and long-term care. Participants in long-term care had greater satisfaction with the quality of geriatric care than those in acute facilities. Nurses in long-term care were more satisfied that care was evidence-based; specialised to individual needs of older adults; promoted autonomy and independence of elders; and was continuous across settings. Participants in acute facilities perceived more obstacles to providing quality geriatric care than nurses in long-term care facilities. Modification of hospital geriatric practice environments and leadership commitment to evidence-based practice guidelines that promote autonomy and independence of patients and staff could improve acute care nurses' perceptions of quality of geriatric care. © 2011 Blackwell Publishing Ltd.

High-resolution geological mapping at 3D Environments: A case study from the fold-and-thrust belt in northern Taiwan

NASA Astrophysics Data System (ADS)

Chan, Y. C.; Shih, N. C.; Hsieh, Y. C.

2016-12-01

Geologic maps have provided fundamental information for many scientific and engineering applications in human societies. Geologic maps directly influence the reliability of research results or the robustness of engineering projects. In the past, geologic maps were mainly produced by field geologists through direct field investigations and 2D topographic maps. However, the quality of traditional geologic maps was significantly compromised by field conditions, particularly, when the map area is covered by heavy forest canopies. Recent developments in airborne LiDAR technology may virtually remove trees or buildings, thus, providing a useful data set for improving geological mapping. Because high-quality topographic information still needs to be interpreted in terms of geology, there are many fundamental questions regarding how to best apply the data set for high-resolution geological mapping. In this study, we aim to test the quality and reliability of high-resolution geologic maps produced by recent technological methods through an example from the fold-and-thrust belt in northern Taiwan. We performed the geological mapping by applying the LiDAR-derived DEM, self-developed program tools and many layers of relevant information at interactive 3D environments. Our mapping results indicate that the proposed methods will considerably improve the quality and consistency of the geologic maps. The study also shows that in order to gain consistent mapping results, future high-resolution geologic maps should be produced at interactive 3D environments on the basis of existing geologic maps.

Work motivation among healthcare professionals.

PubMed

Kjellström, Sofia; Avby, Gunilla; Areskoug-Josefsson, Kristina; Andersson Gäre, Boel; Andersson Bäck, Monica

2017-06-19

Purpose The purpose of this paper is to explore work motivation among professionals at well-functioning primary healthcare centers subject to a national healthcare reform which include financial incentives. Design/methodology/approach Five primary healthcare centers in Sweden were purposively selected for being well-operated and representing public/private and small/large units. In total, 43 interviews were completed with different medical professions and qualitative deductive content analysis was conducted. Findings Work motivation exists for professionals when their individual goals are aligned with the organizational goals and the design of the reform. The centers' positive management was due to a unique combination of factors, such as clear direction of goals, a culture of non-hierarchical collaboration, and systematic quality improvement work. The financial incentives need to be translated in terms of quality patient care to provide clear direction for the professionals. Social processes where professionals work together as cohesive groups, and provided space for quality improvement work is pivotal in addressing how alignment is created. Practical implications Leaders need to consistently translate and integrate reforms with the professionals' drives and values. This is done by encouraging participation through teamwork, time for structured reflection, and quality improvement work. Social implications The design of the reforms and leadership are essential preconditions for work motivation. Originality/value The study offers a more complete picture of how reforms are managed at primary healthcare centers, as different medical professionals are included. The value also consists of showing how a range of aspects combine for primary healthcare professionals to successfully manage external reforms.

Quality indicators for pharmaceutical care: a comprehensive set with national scores for Dutch community pharmacies.

PubMed

Teichert, Martina; Schoenmakers, Tim; Kylstra, Nico; Mosk, Berend; Bouvy, Marcel L; van de Vaart, Frans; De Smet, Peter A G M; Wensing, Michel

2016-08-01

Background The quality of pharmaceutical care in community pharmacies in the Netherlands has been assessed annually since 2008. The initial set has been further developed with pharmacists and patient organizations, the healthcare inspectorate, the government and health insurance companies. The set over 2012 was the first set of quality indicators for community pharmacies which was validated and supported by all major stakeholders. The aims of this study were to describe the validated set of quality indicators for community pharmacies and to report their scores over 2012. In subanalyses the score development over 5 years was described for those indicators, that have been surveyed before and remained unchanged. Methods Community pharmacists in the Netherlands were invited in 2013 to provide information for the set of 2012. Quality indicators were mapped by categories relevant for pharmaceutical care and defined for structures, processes and dispensing outcomes. Scores for categorically-measured quality indicators were presented as the percentage of pharmacies reporting the presence of a quality aspect. For numerical quality indicators, the mean of all reported scores was expressed. In subanalyses for those indicators that had been questioned previously, scores were collected from earlier measurements for pharmacies providing their scores in 2012. Multilevel analysis was used to assess the consistency of scores within one pharmacy over time by the intra-class correlation coefficient (ICC). Results For the set in 2012, 1739 Dutch community pharmacies (88 % of the total) provided information for 66 quality indicators in 10 categories. Indicator scores on the presence of quality structures showed relatively high quality levels. Scores for processes and dispensing outcomes were lower. Subanalyses showed that overall indicators scores improved within pharmacies, but this development differed between pharmacies. Conclusions A set of validated quality indicators provided insight into the quality of pharmaceutical care in the Netherlands. The quality of pharmaceutical care improved over time. As of 2012 quality structures were present in at least 80 % of the community pharmacies. Variation in scores on care processes and outcomes between individual pharmacies and over time can initiate future research to better understand and facilitate quality improvement in community pharmacies.

Quality of antenatal care and client satisfaction in Kenya and Namibia.

PubMed

Do, Mai; Wang, Wenjuan; Hembling, John; Ametepi, Paul

2017-04-01

Despite much progress in maternal health service coverage, the quality of care has not seen parallel improvement. This study assessed the quality of antenatal care (ANC), an entry point to the health system for many women. The study used data from recent Service Provision Assessment (SPA) surveys of nationally representative health facilities in Kenya and Namibia. Kenya and Namibia represent the situation in much of sub-Saharan Africa, where ANC is relatively common but maternal mortality remains high. The SPA comprised an inventory of health facilities that provided ANC, interviews with ANC providers and clients, and observations of service delivery. Not applicable. Quality was measured in terms of structure and process of service provision, and client satisfaction as the outcome of service provision. Wide variations in structural and process attributes of quality of care existed in both Kenya and Namibia; however, better structural quality did not translate to better service delivery process or greater client satisfaction. Long waiting time was a common problem and was generally more serious in hospitals and health centers than in clinics and smaller facilities; it was consistently associated with lower client satisfaction. The study also indicates that the provider's technical preparedness may not be sufficient to provide good-quality services and to ensure client satisfaction. Findings highlight important program implications, including improving ANC services and promoting their use at health clinics and lower-level facilities, and ensuring that available supplies and equipment are used for service provision. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The vaccines consistency approach project: an EPAA initiative.

PubMed

De Mattia, F; Hendriksen, C; Buchheit, K H; Chapsal, J M; Halder, M; Lambrigts, D; Redhead, K; Rommel, E; Scharton-Kersten, T; Sesardic, T; Viviani, L; Ragan, I

2015-01-01

The consistency approach for release testing of established vaccines promotes the use of in vitro, analytical, non-animal based systems allowing the monitoring of quality parameters during the whole production process. By using highly sensitive non-animal methods, the consistency approach has the potential to improve the quality of testing and to foster the 3Rs (replacement, refinement and reduction of animal use) for quality control of established vaccines. This concept offers an alternative to the current quality control strategy which often requires large numbers of laboratory animals. In order to facilitate the introduction of the consistency approach for established human and veterinary vaccine quality control, the European Partnership for Alternatives to Animal Testing (EPAA) initiated a project, the "Vaccines Consistency Approach Project", aiming at developing and validating the consistency approach with stakeholders from academia, regulators, OMCLs, EDQM, European Commission and industry. This report summarises progress since the project's inception.

Semen Quality of Post-Thawed Local Ram’s in Tris-Egg Yolk Extender with Different Glutathione Level

NASA Astrophysics Data System (ADS)

Solihati, N.; Rasad, S. D.; Setiawan, R.; Foziah, E. N.; Wigiyanti, E. T.

2018-02-01

The aims of this research were to find out the effect of glutathione level on semen quality of local ram and to find out the glutathione level that provide the best quality of local ram semen. This research use Completely Randomized Design (CRD) with five treatments of glutathione level (0 mM, 4 mM, 5 mM, 6 mM and 7mM) and was repeated for 10 times. Data were analyzed using analysis of varians (ANOVA) and differences between treatment was analyzed using Duncan test. The parameter were semen quality consist of motility, intact plasma membrane (IPM), abnormality, and recovery rate. Result of this research showed that glutathione level significantly (p<0.05) affect on motility, IPM, abnormality and recovery rate. Duncan test result showed that recovery rate from treatment of 5 mM glutathione level have significantly higher than other treatment, whereas for motility, IPM and abnormality were not significant different with 4 mM, and 6 mM. It is concluded that semen quality of local ram was affected by glutathione level, and the level of 5 mM in egg yolk tris extender provide the best quality of local ram semen.

College quality and hourly wages: evidence from the self-revelation model, sibling models and instrumental variables.

PubMed

Borgen, Nicolai T

2014-11-01

This paper addresses the recent discussion on confounding in the returns to college quality literature using the Norwegian case. The main advantage of studying Norway is the quality of the data. Norwegian administrative data provide information on college applications, family relations and a rich set of control variables for all Norwegian citizens applying to college between 1997 and 2004 (N = 141,319) and their succeeding wages between 2003 and 2010 (676,079 person-year observations). With these data, this paper uses a subset of the models that have rendered mixed findings in the literature in order to investigate to what extent confounding biases the returns to college quality. I compare estimates obtained using standard regression models to estimates obtained using the self-revelation model of Dale and Krueger (2002), a sibling fixed effects model and the instrumental variable model used by Long (2008). Using these methods, I consistently find increasing returns to college quality over the course of students' work careers, with positive returns only later in students' work careers. I conclude that the standard regression estimate provides a reasonable estimate of the returns to college quality. Copyright © 2014 Elsevier Inc. All rights reserved.

Improving health worker performance of abortion services: an assessment of post-training support to providers in India, Nepal and Nigeria.

PubMed

Benson, Janie; Healy, Joan; Dijkerman, Sally; Andersen, Kathryn

2017-11-21

Health worker performance has been the focus of numerous interventions and evaluation studies in low- and middle-income countries. Few have examined changes in individual provider performance with an intervention encompassing post-training support contacts to improve their clinical practice and resolve programmatic problems. This paper reports the results of an intervention with 3471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period, designed to address their individual practice issues. The intervention also included technical assistance to and upgrades in facilities where the providers worked. Quantitative measures to assess provider performance were established, including: 1) Increase in service provision; 2) Consistent service provision; 3) Provision of high quality of care through use of World Health Organization-recommended uterine evacuation technologies, management of pain and provision of post-abortion contraception; and 4) Post-abortion contraception method mix. Descriptive univariate analysis was conducted, followed by examination of the bivariate relationships between all independent variables and the four dependent performance outcome variables by calculating unadjusted odds ratios, by country and overall. Finally, multivariate logistic regression was performed for each outcome. Providers received an average of 5.7 contacts. Sixty-two percent and 46% of providers met measures for consistent service provision and quality of care, respectively. Fewer providers achieved an increased number of services (24%). Forty-six percent provided an appropriate postabortion contraceptive mix to clients. Most providers met the quality components for use of WHO-recommended abortion methods and provision of pain management. Factors significantly associated with achievement of all measures were providers working in sites offering community outreach and those trained in intervention year two. The number of in-person contacts was significantly associated with achievement of three of four measures. Post-training support holds promise for strengthening health worker performance. Further research is needed to compare this intervention with other approaches and assess how post-training contacts could be incorporated into current health system supervision.

Data collection automation and total quality management: case studies in the health-service industry.

PubMed

Smith, Alan D; Offodile, O Felix

2008-01-01

The limitations, immeasurable, and seemly unquantifiable aspects of the healthcare service industry, make it imperative that quality assurance programs include total quality management (TQM) and automatic identification and data capture (AIDC)-related technologies. Most of standards used in TQM and AIDC require data, to measure improvement and achieve standardization. Major difference between managing a service firm and managing a product-manufacturing firm is the difficulty of achieving consistently high quality. Examination of two different healthcare service providers in the Pittsburgh, Pennsylvania area offers different views as to the implementation and practice of total quality management techniques and AIDC integration. Since the healthcare service industry must take into account its high customization needs, there are positive steps to make the hospital structure itself more patient friendly and quality related; hence improving its heath-marketing strategies to the general public.

Open and endovascular aneurysm repair in the Society for Vascular Surgery Vascular Quality Initiative.

PubMed

Spangler, Emily L; Beck, Adam W

2017-12-01

The Society for Vascular Surgery Vascular Quality Initiative is a patient safety organization and a collection of procedure-based registries that can be utilized for quality improvement initiatives and clinical outcomes research. The Vascular Quality Initiative consists of voluntary participation by centers to collect data prospectively on all consecutive cases within specific registries which physicians and centers elect to participate. The data capture extends from preoperative demographics and risk factors (including indications for operation), through the perioperative period, to outcomes data at up to 1-year of follow-up. Additionally, longer-term follow-up can be achieved by matching with Medicare claims data, providing long-term longitudinal follow-up for a majority of patients within the Vascular Quality Initiative registries. We present the unique characteristics of the Vascular Quality Initiative registries and highlight important insights gained specific to open and endovascular abdominal aortic aneurysm repair. Copyright © 2017 Elsevier Inc. All rights reserved.

An Integrated Decision Support System for Water Quality Management of Songhua River Basin

NASA Astrophysics Data System (ADS)

Zhang, Haiping; Yin, Qiuxiao; Chen, Ling

2010-11-01

In the Songhua River Basin of China, many water resource and water environment conflicts interact. A Decision Support System (DSS) for the water quality management has been established for the Basin. The System is featured by the incorporation of a numerical water quality model system into a conventional water quality management system which usually consists of geographic information system (GIS), WebGIS technology, database system and network technology. The model system is built based on DHI MIKE software comprising of a basin rainfall-runoff module, a basin pollution load evaluation module, a river hydrodynamic module and a river water quality module. The DSS provides a friendly graphical user interface that enables the rapid and transparent calculation of various water quality management scenarios, and also enables the convenient access and interpretation of the modeling results to assist the decision-making.

Methods for collecting benthic invertebrate samples as part of the National Water-Quality Assessment Program

USGS Publications Warehouse

Cuffney, Thomas F.; Gurtz, Martin E.; Meador, Michael R.

1993-01-01

Benthic invertebrate communities are evaluated as part of the ecological survey component of the U.S. Geological Survey's National Water-Quality Assessment Program. These biological data are collected along with physical and chemical data to assess water-quality conditions and to develop an understanding of the factors that affect water-quality conditions locally, regionally, and nationally. The objectives of benthic invertebrate community characterizations are to (1) develop for each site a list of tax a within the associated stream reach and (2) determine the structure of benthic invertebrate communities within selected habitats of that reach. A nationally consistent approach is used to achieve these objectives. This approach provides guidance on site, reach, and habitat selection and methods and equipment for qualitative multihabitat sampling and semi-quantitative single habitat sampling. Appropriate quality-assurance and quality-control guidelines are used to maximize the ability to analyze data within and among study units.

Components of quality of life for persons with a quadriplegic and paraplegic spinal cord injury.

PubMed

Manns, P J; Chad, K E

2001-11-01

This investigation determined the themes that represented quality of life for persons with a spinal cord injury. Fifteen people (6 females, 9 males; 7 persons with quadriplegia, 8 with paraplegia) participated in this study, which used naturalistic inquiry methodologies. Results showed that quality of life for this population, regardless of severity of impairment, consisted of nine themes: (a) physical function and independence, (b) accessibility, (c) emotional well-being, (d) stigma, (e) spontaneity, (f) relationships and social function, (g) occupation, (h) finances, and (i) physical well-being. The themes of life quality were similar for quadriplegics and paraplegics; however, physical function and independence and physical well-being affected the quality of life of persons with a quadriplegic injury to a greater extent. These findings may provide health professionals with information necessary to assist in the development of programs to enhance quality of life.

Are Low Patient Satisfaction Scores Always Due to the Provider?: Determinants of Patient Satisfaction Scores During Spine Clinic Visits.

PubMed

Bible, Jesse E; Shau, David N; Kay, Harrison F; Cheng, Joseph S; Aaronson, Oran S; Devin, Clinton J

2018-01-01

A prospective study. The aim of this study was to investigate the impact of various components on patient satisfaction scores SUMMARY OF BACKGROUND DATA.: Patient satisfaction has become an important component of quality assessments. However, with many of these sources collecting satisfaction data reluctant to disclose detailed information, little remains known about the potential determinants of patient satisfaction. Two hundred patients were contacted via phone within 3 weeks of new patient encounter with 11 spine providers. Standardized patient satisfaction phone survey consisting of 25 questions (1-10 rating scale) was administered. Questions inquired about scheduling, parking, office staff, teamwork, wait-time, radiology, provider interactions/behavior, treatment, and follow-up communication. Potential associations between these factors and three main outcome measures were investigated: (1) provider satisfaction, (2) overall clinic visit satisfaction, and (3) quality of care. Significant associations (P < 0.0001) with provider satisfaction, overall clinic visit satisfaction, and perceived overall quality of care were found with appointment scheduling, parking, office staff, teamwork, wait time, radiology, provider interactions/behavior, treatment, and follow-up communication. Nurse-practitioner/resident involvement was positively associated with scores (P ≤ 0.03). A "candy-man" effect was not noted, as pain medication prescribing did not play a significant role in satisfaction (P > 0.05).In multivariate regression analysis, explanation of medical condition/treatment (P = 0.002) and provider empathy (P = 0.04) were significantly associated with provider satisfaction scores, while the amount of time spent with the provider was not. Conversely, teamwork of staff/provider and follow-up communication were significantly associated with both overall clinic visit satisfaction and quality of care (P ≤ 0.03), while provider behaviors or satisfaction were not. Satisfaction with the provider was associated with better explanations of the spine condition/treatment plan and provider empathy, but was not a significant factor in either overall clinic visit satisfaction or perceived quality of care. Patients' perception of teamwork between staff and providers along with reliable follow-up communication were found to be significant determinants of overall patient satisfaction and perceived quality of care. 3.

Establishment of a Quality Management System Based on ISO 9001 Standard in a Public Service Fungal Culture Collection.

PubMed

Simões, Marta F; Dias, Nicolina; Santos, Cledir; Lima, Nelson

2016-06-22

Collaborations between different Microbiological Resource Centres (mBRCs) and ethical sourcing practices are mandatory to guarantee biodiversity conservation, successful and sustainable preservation and fair share of benefits that arise from the use of genetic resources. Since microbial Culture Collections (CCs) are now engaged in meeting high quality operational standards, they are facing the challenge of establishing quality control criteria to certify their biological materials. The authentication/certification of strains is nowadays a demand from the bioeconomy sector for the global operation of mBRCs. The achievement of consistent quality assurance and trust within the mBRCs and microbial CCs context is a dynamic and never-ending process. A good option to facilitate that process is to implement a Quality Management System (QMS) based on the ISO 9001 standard. Here, we report a detailed description of all the steps taken for the QMS implementation at the Portuguese CC of filamentous fungi: Micoteca da Universidade do Minho (MUM). Our aim is to provide guidelines for the certification of other CCs, so that they can also enhance the search and choice of the most consistent, reliable, and effective operating methods, with assured procedures and validation of preservation; and guarantee trustworthy relations with all stakeholders.

Establishment of a Quality Management System Based on ISO 9001 Standard in a Public Service Fungal Culture Collection

PubMed Central

Simões, Marta F.; Dias, Nicolina; Santos, Cledir; Lima, Nelson

2016-01-01

Collaborations between different Microbiological Resource Centres (mBRCs) and ethical sourcing practices are mandatory to guarantee biodiversity conservation, successful and sustainable preservation and fair share of benefits that arise from the use of genetic resources. Since microbial Culture Collections (CCs) are now engaged in meeting high quality operational standards, they are facing the challenge of establishing quality control criteria to certify their biological materials. The authentication/certification of strains is nowadays a demand from the bioeconomy sector for the global operation of mBRCs. The achievement of consistent quality assurance and trust within the mBRCs and microbial CCs context is a dynamic and never-ending process. A good option to facilitate that process is to implement a Quality Management System (QMS) based on the ISO 9001 standard. Here, we report a detailed description of all the steps taken for the QMS implementation at the Portuguese CC of filamentous fungi: Micoteca da Universidade do Minho (MUM). Our aim is to provide guidelines for the certification of other CCs, so that they can also enhance the search and choice of the most consistent, reliable, and effective operating methods, with assured procedures and validation of preservation; and guarantee trustworthy relations with all stakeholders. PMID:27681915

Mobile phone-based clinical guidance for rural health providers in India.

PubMed

Gautham, Meenakshi; Iyengar, M Sriram; Johnson, Craig W

2015-12-01

There are few tried and tested mobile technology applications to enhance and standardize the quality of health care by frontline rural health providers in low-resource settings. We developed a media-rich, mobile phone-based clinical guidance system for management of fevers, diarrhoeas and respiratory problems by rural health providers. Using a randomized control design, we field tested this application with 16 rural health providers and 128 patients at two rural/tribal sites in Tamil Nadu, Southern India. Protocol compliance for both groups, phone usability, acceptability and patient feedback for the experimental group were evaluated. Linear mixed-model analyses showed statistically significant improvements in protocol compliance in the experimental group. Usability and acceptability among patients and rural health providers were very high. Our results indicate that mobile phone-based, media-rich procedural guidance applications have significant potential for achieving consistently standardized quality of care by diverse frontline rural health providers, with patient acceptance. © The Author(s) 2014.

The RACE (Research and Development in Advanced Technologies for Europe) Program: A 1989 Update

DTIC Science & Technology

1989-12-15

Definition TV (HDTV) Expcrimcntal Usage . A......a.d..r Dist special 1081 - Broadband User Network Interface (BUNI)..................... 4 1082 ...develop man/machine which will provide a traffic analyzer and generator. interfaces that are consistent across a wide range of ap-plications. 1082 ... 1082 are to provide usage reference models for the different types of e Define IBC quality of service rquiremnts by usage design issue. It deals with

A variation reduction allocation model for quality improvement to minimize investment and quality costs by considering suppliers’ learning curve

NASA Astrophysics Data System (ADS)

Rosyidi, C. N.; Jauhari, WA; Suhardi, B.; Hamada, K.

2016-02-01

Quality improvement must be performed in a company to maintain its product competitiveness in the market. The goal of such improvement is to increase the customer satisfaction and the profitability of the company. In current practice, a company needs several suppliers to provide the components in assembly process of a final product. Hence quality improvement of the final product must involve the suppliers. In this paper, an optimization model to allocate the variance reduction is developed. Variation reduction is an important term in quality improvement for both manufacturer and suppliers. To improve suppliers’ components quality, the manufacturer must invest an amount of their financial resources in learning process of the suppliers. The objective function of the model is to minimize the total cost consists of investment cost, and quality costs for both internal and external quality costs. The Learning curve will determine how the employee of the suppliers will respond to the learning processes in reducing the variance of the component.

Methods for collecting algal samples as part of the National Water-Quality Assessment Program

USGS Publications Warehouse

Porter, Stephen D.; Cuffney, Thomas F.; Gurtz, Martin E.; Meador, Michael R.

1993-01-01

Benthic algae (periphyton) and phytoplankton communities are characterized in the U.S. Geological Survey's National Water-Quality Assessment Program as part of an integrated physical, chemical, and biological assessment of the Nation's water quality. This multidisciplinary approach provides multiple lines of evidence for evaluating water-quality status and trends, and for refining an understanding of the factors that affect water-quality conditions locally, regionally, and nationally. Water quality can be characterized by evaluating the results of qualitative and quantitative measurements of the algal community. Qualitative periphyton samples are collected to develop of list of taxa present in the sampling reach. Quantitative periphyton samples are collected to measure algal community structure within selected habitats. These samples of benthic algal communities are collected from natural substrates, using the sampling methods that are most appropriate for the habitat conditions. Phytoplankton samples may be collected in large nonwadeable streams and rivers to meet specific program objectives. Estimates of algal biomass (chlorophyll content and ash-free dry mass) also are optional measures that may be useful for interpreting water-quality conditions. A nationally consistent approach provides guidance on site, reach, and habitat selection, as well as information on methods and equipment for qualitative and quantitative sampling. Appropriate quality-assurance and quality-control guidelines are used to maximize the ability to analyze data locally, regionally, and nationally.

Context-dependent colonization dynamics: Regional reward contagion drives local compression in aquatic beetles.

PubMed

Pintar, Matthew R; Resetarits, William J

2017-09-01

Habitat selection by colonizing organisms is an important factor in determining species abundance and community dynamics at multiple spatial scales. Many organisms select habitat patches based on intrinsic patch quality, but patches exist in complex landscapes linked by dispersal and colonization, forming metapopulations and metacommunities. Perceived patch quality can be influenced by neighbouring patches through spatial contagion, wherein perceived quality of one patch can extend beyond its borders and either increase or decrease the colonization of neighbouring patches and localities. These spatially explicit colonization dynamics can result in habitat compression, wherein more colonists occupy a patch or locality than in the absence of spatial context dependence. Previous work on contagion/compression focused primarily on the role of predators in driving colonization patterns. Our goal was to determine whether resource abundance can drive multi-scale colonization dynamics of aquatic beetles through the processes of contagion and compression in naturally colonized experimental pools. We established two levels (high/low quality) of within-patch resource abundances (leaf litter) using an experimental landscape of mesocosms, and assayed colonization by 35 species of aquatic beetles. Patches were arranged in localities (sets of two patches), which consisted of a combination of two patch-level resource levels in a 2 × 2 factorial design, allowing us to assay colonization at both locality and patch levels. We demonstrate that patterns of species abundance and richness of colonizing aquatic beetles are determined by patch quality and context-dependent processes at multiple spatial scales. Localities that consisted of at least one high-quality patch were colonized at equivalent rates that were higher than localities containing only low-quality patches, displaying regional reward contagion. In localities that consisted of one high- and one low-quality patch, reward contagion produced by higher leaf litter levels resulted in greater abundance of beetles in such localities, which then compressed into the highest quality patches. Our results provide further support for the critical roles of habitat selection and spatial context, particularly the quality of neighbouring habitat patches, in generating patterns of species abundances and community structure across landscapes. © 2017 The Authors. Journal of Animal Ecology © 2017 British Ecological Society.

The quest to standardize hemodialysis care.

PubMed

Hegbrant, Jörgen; Gentile, Giorgio; Strippoli, Giovanni F M

2011-01-01

A large global dialysis provider's core activities include providing dialysis care with excellent quality, ensuring a low variability across the clinic network and ensuring strong focus on patient safety. In this article, we summarize the pertinent components of the quality assurance and safety program of the Diaverum Renal Services Group. Concerning medical performance, the key components of a successful quality program are setting treatment targets; implementing evidence-based guidelines and clinical protocols; consistently, regularly, prospectively and accurately collecting data from all clinics in the network; processing collected data to provide feedback to clinics in a timely manner, incorporating information on interclinic and intercountry variations; and revising targets, guidelines and clinical protocols based on sound scientific data. The key activities for ensuring patient safety include a standardized approach to education, i.e. a uniform education program including control of theoretical knowledge and clinical competencies; implementation of clinical policies and procedures in the organization in order to reduce variability and potential defects in clinic practice; and auditing of clinical practice on a regular basis. By applying a standardized and systematic continuous quality improvement approach throughout the entire organization, it has been possible for Diaverum to progressively improve medical performance and ensure patient safety. Copyright © 2011 S. Karger AG, Basel.

Forging a novel provider and payer partnership in Wisconsin to compensate pharmacists for quality-driven pharmacy and medication therapy management services.

PubMed

Trapskin, Kari; Johnson, Curtis; Cory, Patrick; Sorum, Sarah; Decker, Chris

2009-01-01

To describe the Wisconsin Pharmacy Quality Collaborative (WPQC), a quality-based network of pharmacies and payers with the common goals of improving medication use and safety, reducing health care costs for payers and patients, and increasing professional recognition and compensation for pharmacist-provided services. Wisconsin between 2006 and 2009. Community (independent, chain, and health-system) pharmacies and private and public health care payers/purchasers with support from the McKesson Corporation. This initiative aligns incentives for pharmacies and payers through implementation of 12 quality-based pharmacy requirements as conditions of pharmacy participation in a practice-advancement pilot. Payers compensate network pharmacies that meet the quality-based requirements for two levels of pharmacy professional services (level 1, intervention-based services; level 2, comprehensive medication review and assessment services). The pilot project is designed to measure the following outcomes: medication-use quality improvements, frequency and types of services provided, drug therapy problems, patient safety, cost savings, identification of factors that facilitate pharmacist participation, and patient satisfaction. The Pharmacy Society of Wisconsin created the WPQC network, which consists of 53 pharmacies, 106 trained pharmacists, 45 student pharmacists, 6 pharmacy technicians, and 2 initial payers. A quality assurance process is followed approximately quarterly to audit the 12 network quality requirements. An evaluation of this collaboration is being conducted. This program demonstrates that collaboration among payers and pharmacists is possible and can result in the development of an incentive-aligned program that stresses quality patient care, standardized services, and professional service compensation for pharmacists. This combination of a quality-based credentialing process with a professional services reimbursement schedule is unique and has the promise to enhance the ambulatory pharmacy practice model.

Berber Dialects. Materials Status Report.

ERIC Educational Resources Information Center

Center for Applied Linguistics, Washington, DC. Language/Area Reference Center.

The materials status report for the Berber languages, minority languages spoken in northern Africa, is one of a series intended to provide the nonspecialist with a picture of the availability and quality of texts for teaching various languages to English speakers. The report consists of: (1) a brief narrative description of the Berber language,…

Objectively Assessing Underwater Image Quality for the Purpose of Automated Restoration

DTIC Science & Technology

2007-10-01

are accounted for and treated accordingly in the current approach. Initial results show that the metric defined provides a consistent measure to both...Image Communication 19, 163-172 (2004). 8. S. J. Erasmus, and K. C. A. Smith, "An automatic focusing and astigmatism correction system for the SEM

77 FR 55168 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Permits for Major...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

....'' Virginia's Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

76 FR 36326 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-22

....'' Virginia's Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

78 FR 68365 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Removal of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-14

....'' Virginia's Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

78 FR 47264 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Section 110(a)(2...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

... Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with requirements imposed... immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion states that... programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties because...

78 FR 58462 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Section 110(a)(2...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-24

....'' Virginia's Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

76 FR 58206 - Approval and Promulgation of Air Quality Implementation Plans; District of Columbia, Maryland...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

....'' Virginia's Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

76 FR 2829 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of 8-hour Ozone...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-18

....'' Virginia's Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

76 FR 63859 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Amendments to Virginia's...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... Immunity Law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with requirements imposed... immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion states that... programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties because...

76 FR 3023 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Amendments to Existing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-19

....'' Virginia's Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

77 FR 5400 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Amendments to Virginia's...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-03

....'' Virginia's Immunity Law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

76 FR 52275 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Revisions to Clean Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

....'' Virginia's Immunity law, Va. Code Sec. 10.1-1199, provides that ``[t]o the extent consistent with... granted immunity from administrative or civil penalty. The Attorney General's January 12, 1998 opinion... authorized programs, since ``no immunity could be afforded from administrative, civil, or criminal penalties...

Healthcare Students' Perceptions of Electronic Feedback through GradeMark®

ERIC Educational Resources Information Center

Watkins, Diane; Dummer, Paul; Hawthorne, Kamila; Cousins, Judy; Emmett, Catherine; Johnson, Mike

2014-01-01

This paper reports on the findings from a study undertaken to explore students' perceptions of the timeliness, accessibility, consistency, and quality of feedback and grading received electronically. The system used was GradeMark®, an electronic tool available through the plagiarism software provider, Turnitin®. 296 students from the Schools of…

World Wide Web Server Standards and Guidelines.

ERIC Educational Resources Information Center

Stubbs, Keith M.

This document defines the specific standards and general guidelines which the U.S. Department of Education (ED) will use to make information available on the World Wide Web (WWW). The purpose of providing such guidance is to ensure high quality and consistent content, organization, and presentation of information on ED WWW servers, in order to…

Kurdish. Materials Status Report.

ERIC Educational Resources Information Center

Center for Applied Linguistics, Washington, DC. Language/Area Reference Center.

The materials status report for Kurdish is one of a series intended to provide the nonspecialist with a picture of the availability and quality of texts for teaching a given language to English speakers. Each report consists of: (1) a brief narrative description of the language, the areas where it is spoken, its major dialects, its writing system,…

Preliminary results of the global forest biomass survey

Treesearch

S. Healey; E. Lindquist

2014-01-01

Many countries do not yet have well-established national forest inventories, and among those that do, significant methodological differences exist, particularly in the estimation of standing forest biomass. Global space-based LiDAR (Light Detection and Ranging) from NASA’s now-completed ICESat mission provided consistent, high-quality measures of canopy height and...

Environmental Scan of Weight Bias Exposure in Primary Health Care Training Programs

ERIC Educational Resources Information Center

Russell-Mayhew, Shelly; Nutter, Sarah; Alberga, Angela; Jelinski, Susan; Ball, Geoff D. C.; Edwards, Alun; Oddie, Scott; Sharma, Arya M.; Pickering, Barbara; Forhan, Mary

2016-01-01

Negative attitudes and beliefs about individuals with obesity (also known as weight bias) have negative consequences for physical and mental health for individuals with obesity and impact the quality of care provided by health professionals. A preliminary environmental scan of college and university training programs was conducted consisting of 67…

Somali. Materials Status Report.

ERIC Educational Resources Information Center

Center for Applied Linguistics, Washington, DC. Language/Area Reference Center.

The materials status report for Somali, the official language of Somalia, is one of a series intended to provide the nonspecialist with a picture of the availability and quality of texts for teaching various languages to English speakers. The report consists of: (1) a brief narrative description of Somali, the areas where it is spoken, its major…

The Case for Ecoregion Rather than Regional Extension Water Education

ERIC Educational Resources Information Center

Mahler, Robert. L.

2009-01-01

In 2000 the National Water Quality program (USDA-CSREES) was refocused to provide water resources education to citizens on a regional basis. The Pacific Northwest--consisting of Alaska, Idaho, Oregon, and Washington--comprises one of these regions. Even though the Pacific Northwest appears to be a relatively homogeneous region, there are large…

Academy Update (Early Childhood Professionals Collaborating for Quality), 1986-1992.

ERIC Educational Resources Information Center

Academy Update, 1992

1992-01-01

This document consists of the first 15 consecutive issues of a newsletter published by the National Academy of Early Childhood Programs (The Academy), a division of the National Association for the Education of Young Children (NAEYC). The newsletter focuses on providing information and feedback on early childhood programs for early childhood…

Redesigning Continuing Education in the Health Professions

ERIC Educational Resources Information Center

National Academies Press, 2010

2010-01-01

Today in the United States, the professional health workforce is not consistently prepared to provide high quality health care and assure patient safety, even as the nation spends more per capita on health care than any other country. The absence of a comprehensive and well-integrated system of continuing education (CE) in the health professions…

Exploring the explaining quality of physics online explanatory videos

NASA Astrophysics Data System (ADS)

Kulgemeyer, Christoph; Peters, Cord H.

2016-11-01

Explaining skills are among the most important skills educators possess. Those skills have also been researched in recent years. During the same period, another medium has additionally emerged and become a popular source of information for learners: online explanatory videos, chiefly from the online video sharing website YouTube. Their content and explaining quality remain to this day mostly unmonitored, as well is their educational impact in formal contexts such as schools or universities. In this study, a framework for explaining quality, which has emerged from surveying explaining skills in expert-novice face-to-face dialogues, was used to explore the explaining quality of such videos (36 YouTube explanatory videos on Kepler’s laws and 15 videos on Newton’s third law). The framework consists of 45 categories derived from physics education research that deal with explanation techniques. YouTube provides its own ‘quality measures’ based on surface features including ‘likes’, views, and comments for each video. The question is whether or not these measures provide valid information for educators and students if they have to decide which video to use. We compared the explaining quality with those measures. Our results suggest that there is a correlation between explaining quality and only one of these measures: the number of content-related comments.

Open-pit coal mine production sequencing incorporating grade blending and stockpiling options: An application from an Indian mine

NASA Astrophysics Data System (ADS)

Kumar, Ashish; Chatterjee, Snehamoy

2017-05-01

Production scheduling is a crucial aspect of the mining industry. An optimal and efficient production schedule can increase the profits manifold and reduce the amount of waste to be handled. Production scheduling for coal mines is necessary to maintain consistency in the quality and quantity parameters of coal supplied to power plants. Irregularity in the quality parameters of the coal can lead to heavy losses in coal-fired power plants. Moreover, the stockpiling of coal poses environmental and fire problems owing to low incubation periods. This article proposes a production scheduling formulation for open-pit coal mines including stockpiling and blending opportunities, which play a major role in maintaining the quality and quantity of supplied coal. The proposed formulation was applied to a large open-pit coal mine in India. This contribution provides an efficient production scheduling formulation for coal mines after utilizing the stockpile coal within the incubation periods with the maximization of discounted cash flows. At the same time, consistency is maintained in the quality and quantity of coal to power plants through blending and stockpiling options to ensure smooth functioning.

Ontology Based Quality Evaluation for Spatial Data

NASA Astrophysics Data System (ADS)

Yılmaz, C.; Cömert, Ç.

2015-08-01

Many institutions will be providing data to the National Spatial Data Infrastructure (NSDI). Current technical background of the NSDI is based on syntactic web services. It is expected that this will be replaced by semantic web services. The quality of the data provided is important in terms of the decision-making process and the accuracy of transactions. Therefore, the data quality needs to be tested. This topic has been neglected in Turkey. Data quality control for NSDI may be done by private or public "data accreditation" institutions. A methodology is required for data quality evaluation. There are studies for data quality including ISO standards, academic studies and software to evaluate spatial data quality. ISO 19157 standard defines the data quality elements. Proprietary software such as, 1Spatial's 1Validate and ESRI's Data Reviewer offers quality evaluation based on their own classification of rules. Commonly, rule based approaches are used for geospatial data quality check. In this study, we look for the technical components to devise and implement a rule based approach with ontologies using free and open source software in semantic web context. Semantic web uses ontologies to deliver well-defined web resources and make them accessible to end-users and processes. We have created an ontology conforming to the geospatial data and defined some sample rules to show how to test data with respect to data quality elements including; attribute, topo-semantic and geometrical consistency using free and open source software. To test data against rules, sample GeoSPARQL queries are created, associated with specifications.

TH-A-BRC-02: AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance

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

Goetsch, S.

AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance -more » Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline of possible dosimetry protocols. The report will be reviewed by the AAPM Working Group on Recommendations for Radiotherapy External Beam Quality Assurance and then by the AAPM Science Council before publication in Medical Physics Survey of possible calibration protocols for calibration of Gamma Stereotactic Radiosurgery (GSR) devices Overview of modern Quality Assurance techniques for GSR AAPM TG-218 Tolerance Levels and Methodologies for IMRT Verification QA - Moyed Miften Patient-specific IMRT QA measurement is a process designed to identify discrepancies between calculated and delivered doses. Error tolerance limits are not well-defined or consistently applied across centers. The AAPM TG-218 report has been prepared to improve the understanding and consistency of this process by providing recommendations for methodologies and tolerance limits in patient-specific IMRT QA. Learning Objectives: Review measurement methods and methodologies for absolute dose verification Provide recommendations on delivery methods, data interpretation, the use of analysis routines and choice of tolerance limits for IMRT QA Sonja Dieterich has a research agreement with Sun Nuclear Inc. Steven Goetsch is a part-time consultant for Elekta.« less

Perceived quality in Day Surgery Units Proposal of an enquiry postoperative questionnaire.

PubMed

Palumbo, Piergaspare; Perotti, Bruno; Amatucci, Chiara; Pangrazi, Maria Pia; Leuzzi, Barbara; Vietri, Francesco; Illuminati, Giulio

2016-01-01

Assessing patient satisfaction could be particularly useful in Day Surgery Units, as it helps maintaining and increasing medical care demand. Moreover, it provides feedback that turns out useful for improving quality in departments, and for assessing competence and skill of the whole staff. Background and aim - The purpose of this study was to evaluate the quality perceived in a day surgery unit through a questionnaire, covering the 10 main aspects of the care pathway. The results of a questionnaire filled by patients undergoing Day Surgery between January 2007 and December 2012 were retrospectively reviewed. Patients undergoing surgery between 2007 and 2009 filled up the questionnaire at the time of the discharge, whereas those operated on between 2009 and 2012 filled up the same questionnaire 30 days after discharge. The results were good in terms of number of returned questionnaires, underlining its comprehensibility and suitability to be filled out. The questionnaires' scores were good in both groups, although quality perceived by the group that completed it in 30 days after surgery were lightly better than the other group's. The advantages of the questionnaire consisted of an overall improvement of the quality of care, whereas limitations consisted of the difficulty in setting up the questionnaire accurately, interpreting patients' answers correctly, and dispensing the questionnaire in a timely fashion, in order to evaluate the quality perceived by the patients without any bias related to delay, pain and anxiety. Day Surgery, Nursing, Questionnaire, Quality.

Methodological quality of economic evaluations of new pharmaceuticals in The Netherlands.

PubMed

Hoomans, Ties; Severens, Johan L; van der Roer, Nicole; Delwel, Gepke O

2012-03-01

In the Netherlands, decisions about the reimbursement of new pharmaceuticals are based on cost effectiveness, as well as therapeutic value and budget impact. Since 1 January 2005, drug manufacturers are formally required to substantiate the cost effectiveness of drugs that have therapeutic added value in comparison with existing ones through pharmacoeconomic evaluations. Dutch guidelines for pharmacoeconomic research provide methods guidance, ensuring consistency in both the evidence and the decision-making process about drug reimbursement. This study reviewed the methodological quality of all 21 formally required pharmacoeconomic evaluations of new pharmaceuticals between 1 January 2005 and 1 October 2008, and verified whether these evaluations complied with pharmacoeconomic guidelines. Data on the quality of the pharmacoeconomic evaluations were extracted from the pharmacoeconomic reports published by the Dutch Health Care Insurance Board (CVZ). The Board's newsletters provided information on the advice to, and reimbursement decisions made by, the Dutch Minister of Health. All data extraction was carried out by two independent reviewers, and descriptive analyses were conducted. The methodological quality was sound in only 8 of the 21 pharmacoeconomic evaluations. In most cases, the perspective of analysis, the comparator drugs, and the reporting of both total and incremental costs and effects were correct. However, drug indication, form (i.e. cost utility/cost effectiveness) and time horizon of the evaluations were frequently flawed. Moreover, the costs and effects of the pharmaceuticals were not always analysed correctly, and modelling studies were often non-transparent. Twelve drugs were reimbursed, and nine were not. The compliance with pharmacoeconomic guidelines in economic evaluations of new pharmaceuticals can be improved. This would improve the methodological quality of the pharmacoeconomic evaluations and ensure consistency in the evidence and the decision-making process for drug reimbursement in the Netherlands.

Water quality, health, and human occupations.

PubMed

Blakeney, Anne B; Marshall, Amy

2009-01-01

To introduce evidence of the critical link between water quality and human occupations. A participatory action research design was used to complete a three-phase project. Phase 1 included mapping the watershed of Letcher County, Kentucky. Phase 2 consisted of surveying 122 Letcher County health professionals. Phase 3, the primary focus of this article, consisted of interviews with Letcher County adults regarding their lived experiences with water. The Occupational Therapy Practice Framework: Domain and Process (American Occupational Therapy Association, 2002) was used to structure questions. The Model of Occupational Justice provided the theoretical framework for presentation of the results. The watershed in Letcher County, Kentucky, is polluted as a result of specific coal mining practices and a lack of adequate infrastructure. As a result, citizens experience occupational injustice in the forms of occupational imbalance, occupational deprivation, and occupational alienation.

Langley Mobile Ozone Lidar: Ozone and Aerosol Atmospheric Profiling for Air Quality Research

NASA Technical Reports Server (NTRS)

De Young, Russell; Carrion, William; Ganoe, Rene; Pliutau, Denis; Gronoff, Guillaume; Berkoff, Timothy; Kuang, Shi

2017-01-01

The Langley mobile ozone lidar (LMOL) is a mobile ground-based ozone lidar system that consists of a pulsed UV laser producing two UV wavelengths of 286 and 291 nm with energy of approximately 0.2 mJ/pulse 0.2 mJ/pulse and repetition rate of 1 kHz. The 527 nm pump laser is also transmitted for aerosol measurements. The receiver consists of a 40 cm parabolic telescope, which is used for both backscattered analog and photon counting. The lidar is very compact and highly mobile. This demonstrates the utility of very small lidar systems eventually leading to space-based ozone lidars. The lidar has been validated by numerous ozonesonde launches and has provided ozone curtain profiles from ground to approximately 4 km in support of air quality field missions.

Funneling Child Welfare Consumers into and through the Mental Health System: Assessment, Referral, and Quality Issues

PubMed Central

Fedoravicius, Nicole; McMillen, J. Curtis; Rowe, Jill E.; Kagotho, Njeri; Ware, Norma C.

2012-01-01

This qualitative study explores how consumers of child welfare services reach nonpsychiatric mental health providers and the perceived quality of these services. It relies on iterative interviews with individuals and groups, as well as on court observations from one metropolitan area. Results suggest that, consistent with theories of street-level bureaucracy, efficiency issues drive mental health service use, as clients are routinely subjected to psychological evaluations and funneled into mental health services as a matter of course. Referral practices are shaped by child welfare professionals' routines, discretion, and desire to meet such system objectives as providing short turnaround times for reports. The results suggest that, despite stakeholders' best intentions, maltreated children are not benefiting from thoughtful processes geared to screen for, assess, and provide targeted treatment for unmet mental health needs. PMID:22740722

Quality and consistency of guidelines for the management of mild traumatic brain injury in the emergency department.

PubMed

Tavender, Emma J; Bosch, Marije; Green, Sally; O'Connor, Denise; Pitt, Veronica; Phillips, Kate; Bragge, Peter; Gruen, Russell L

2011-08-01

The objective was to provide an overview of the recommendations and quality of evidence-based clinical practice guidelines (CPGs) for the emergency management of mild traumatic brain injury (mTBI), with a view to informing best practice and improving the consistency of recommendations. Electronic searches of health databases (MEDLINE, EMBASE, The Cochrane Library, PsycINFO), CPG clearinghouse websites, CPG developer websites, and Internet search engines up to January 2010 were conducted. CPGs were included if 1) they were published in English and freely accessible, 2) their scope included the management of mTBI in the emergency department (ED), 3) the date of last search was within the past 10 years (2000 onward), 4) systematic methods were used to search for evidence, and 5) there was an explicit link between the recommendations and the supporting evidence. Four authors independently assessed the quality of the included CPGs using the Appraisal of Guidelines, Research and Evaluation (AGREE) Instrument. The authors extracted and categorized recommendations according to initial clinical assessment, imaging, management, observation, discharge planning, and patient information and follow-up. The search identified 18 potential CPGs, of which six met the inclusion criteria. The included CPGs varied in scope, target population, size, and guideline development processes. Four CPGs were assessed as "strongly recommended." The majority of CPGs did not provide information about the level of stakeholder involvement (mean AGREE standardized domain score = 57%, range = 25% to 81%), nor did they address the organizational/cost implications of applying the recommendations or provide criteria for monitoring and review of recommendations in practice (mean AGREE standardized domain score = 46.6%, range = 19% to 94%). Recommendations were mostly consistent in terms of the use of the Glasgow Coma Scale (GCS) score (adult and pediatric) to assess the level of consciousness, initial assessment criteria, the use of computed tomography (CT) scanning as imaging investigation of choice, and the provision of patient information. The CPGs defined mTBI in a variety of ways and described different rules to determine the need for CT scanning and therefore used different criteria to identify high-risk patients. Higher-quality CPGs for mTBI are consistent in their recommendations about assessment, imaging, and provision of patient information. There is not, however, an agreed definition of mTBI, and the quality of future CPGs could be improved with better reporting of stakeholder involvement, procedures for updating, and greater consideration of the applicability of the recommendations (cost implications, monitoring procedures). Nevertheless, guideline developers may benefit from adapting existing CPGs to their local context rather than investing in developing CPGs de novo. © 2011 by the Society for Academic Emergency Medicine.

Increasing the quality, comparability and accessibility of phytoplankton species composition time-series data

NASA Astrophysics Data System (ADS)

Zingone, Adriana; Harrison, Paul J.; Kraberg, Alexandra; Lehtinen, Sirpa; McQuatters-Gollop, Abigail; O'Brien, Todd; Sun, Jun; Jakobsen, Hans H.

2015-09-01

Phytoplankton diversity and its variation over an extended time scale can provide answers to a wide range of questions relevant to societal needs. These include human health, the safe and sustained use of marine resources and the ecological status of the marine environment, including long-term changes under the impact of multiple stressors. The analysis of phytoplankton data collected at the same place over time, as well as the comparison among different sampling sites, provide key information for assessing environmental change, and evaluating new actions that must be made to reduce human induced pressures on the environment. To achieve these aims, phytoplankton data may be used several decades later by users that have not participated in their production, including automatic data retrieval and analysis. The methods used in phytoplankton species analysis vary widely among research and monitoring groups, while quality control procedures have not been implemented in most cases. Here we highlight some of the main differences in the sampling and analytical procedures applied to phytoplankton analysis and identify critical steps that are required to improve the quality and inter-comparability of data obtained at different sites and/or times. Harmonization of methods may not be a realistic goal, considering the wide range of purposes of phytoplankton time-series data collection. However, we propose that more consistent and detailed metadata and complementary information be recorded and made available along with phytoplankton time-series datasets, including description of the procedures and elements allowing for a quality control of the data. To keep up with the progress in taxonomic research, there is a need for continued training of taxonomists, and for supporting and complementing existing web resources, in order to allow a constant upgrade of knowledge in phytoplankton classification and identification. Efforts towards the improvement of metadata recording, data annotation and quality control procedures will ensure the internal consistency of phytoplankton time series and facilitate their comparability and accessibility, thus strongly increasing the value of the precious information they provide. Ultimately, the sharing of quality controlled data will allow one to recoup the high cost of obtaining the data through the multiple use of the time-series data in various projects over many decades.

Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden.

PubMed

Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas

2017-07-14

Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier findings. The fact that privately operated homes, including those operated by for-profit companies, had higher processual quality is more unexpected, given previous research. Finally, no significant quality differences were found between private ownership types, i.e. for-profit, non-profit, and private equity companies, which indicates that profit motives are less important for determining quality in Swedish nursing home care than in other countries where similar studies have been carried out.

Can current analytical quality performance of UK clinical laboratories support evidence-based guidelines for diabetes and ischaemic heart disease?--A pilot study and a proposal.

PubMed

Jassam, Nuthar; Yundt-Pacheco, John; Jansen, Rob; Thomas, Annette; Barth, Julian H

2013-08-01

The implementation of national and international guidelines is beginning to standardise clinical practice. However, since many guidelines have decision limits based on laboratory tests, there is an urgent need to ensure that different laboratories obtain the same analytical result on any sample. A scientifically-based quality control process will be a pre-requisite to provide this level of analytical performance which will support evidence-based guidelines and movement of patients across boundaries while maintaining standardised outcomes. We discuss the finding of a pilot study performed to assess UK clinical laboratories readiness to work to a higher grade quality specifications such as biological variation-based quality specifications. Internal quality control (IQC) data for HbA1c, glucose, creatinine, cholesterol and high density lipoprotein (HDL)-cholesterol were collected from UK laboratories participating in the Bio-Rad Unity QC programme. The median of the coefficient of variation (CV%) of the participating laboratories was evaluated against the CV% based on biological variation. Except creatinine, the other four analytes had a variable degree of compliance with the biological variation-based quality specifications. More than 75% of the laboratories met the biological variation-based quality specifications for glucose, cholesterol and HDL-cholesterol. Slightly over 50% of the laboratories met the analytical goal for HBA1c. Only one analyte (cholesterol) had a performance achieving the higher quality specifications consistent with 5σ. Our data from IQC do not consistently demonstrate that the results from clinical laboratories meet evidence-based quality specifications. Therefore, we propose that a graded scale of quality specifications may be needed at this stage.

An Approach Based on HPLC-Fingerprint and Chemometrics to Quality Consistency Evaluation of Matricaria chamomilla L. Commercial Samples

PubMed Central

Viapiana, Agnieszka; Struck-Lewicka, Wiktoria; Konieczynski, Pawel; Wesolowski, Marek; Kaliszan, Roman

2016-01-01

Chamomile has been used as an herbal medication since ancient times and is still popular because it contains various bioactive phytochemicals that could provide therapeutic effects. In this study, a simple and reliable HPLC method was developed to evaluate the quality consistency of nineteen chamomile samples through establishing a chromatographic fingerprint, quantification of phenolic compounds and determination of antioxidant activity. For fingerprint analysis, 12 peaks were selected as the common peaks to evaluate the similarities of commercial samples of chamomile obtained from different manufacturers. A similarity analysis was performed to assess the similarity/dissimilarity of chamomile samples where values varied from 0.868 to 0.990 what indicating that samples from different manufacturers were consistent. Additionally, simultaneous quantification of five phenolic acids (gallic, caffeic, syringic, p-coumaric, ferulic) and four flavonoids (rutin, myricetin, quercetin and keampferol) was performed to interpret the quality consistency. In quantitative analysis, the nine individual phenolic compounds showed good regression (r > 0.9975). Inter- and intra-day precisions for all analyzed compounds expressed as relative standard deviation (CV) ranged from 0.05% to 3.12%. Since flavonoids and other polyphenols are commonly recognized as natural antioxidants, the antioxidant activity of chamomile samples was evaluated using 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity and ferric reducing/antioxidant power (FRAP) assay. Correlation analysis was used to assess the relationship between antioxidant activity and phenolic composition, and multivariate analysis (PCA and HCA) were applied to distinguish chamomile samples. Results shown in the study indicate high similarity of chamomile samples among them, widely spread in the market and commonly used by people as infusions or teas, as well as that there were no statistically significant differences among them, which in turn is a proof of high quality of commercially available samples of chamomile. The study indicated that the combination of chromatographic fingerprint and quantitative analysis can be readily utilized as a quality consistency method for chamomile and related medicinal preparations. Moreover, the applied strategy seems to be the most promising for the assessment of the investigated plant material. PMID:27818668

The Relationship between Case-Volume, Care Quality, and Outcomes of Complex Cancer Surgery

PubMed Central

Auerbach, Andrew D; Maselli, Judith; Carter, Jonathan; Pekow, Penelope S; Lindenauer, Peter K

2010-01-01

Background How case volume and quality of care relate to each other and to results of complex cancer surgery is not well understood. Study Design Observational cohort of 14,170 patients 18 or older who underwent pneumonectomy, esophagectomy, pancreatectomy, or pelvic surgery for cancer between 10/1/2003 and 9/1/2005 at a United States hospital participating in a large benchmarking database. Case volumes were estimated within our dataset. Quality was measured by determining whether ideal patients did not receive appropriate perioperative medications (such as antibiotics to prevent surgical site infections) both as individual ‘missed’ measures, as well as the overall number missed. We used hierarchical models to estimate effects of volume and quality on 30-day readmission, in-hospital mortality, length of stay, and costs. Results After adjustment, we noted no consistent associations between higher hospital or surgeon volume and mortality, readmission, length of stay, or costs. Adherence to individual measures was not consistently associated with improvement in readmission, mortality, or other outcomes. For example, continuing antimicrobials past 24 hours was associated with longer length of stay (21.5% higher, 95% CI 19.5% to 23.6%) and higher costs (17% higher, 95% CI 16% to 19%). In contrast, overall adherence, while not not associated with differences in mortality or readmission, was consistently associated with longer length of stay (7.4% longer with one missed measure and 16.4% longer with 2 or more) and higher costs (5% higher with one missed measure, and 11% higher with 2 or more). Conclusions While hospital and surgeon volume were not associated with outcomes, lower overall adherence to quality measures is associated with higher costs, but not improved outcomes. This finding may provide a rationale for improving care systems by maximizing care consistency, even if outcomes are not affected. PMID:20829079

Preventive Home Visits for Mortality, Morbidity, and Institutionalization in Older Adults: A Systematic Review and Meta-Analysis

PubMed Central

Mayo-Wilson, Evan; Grant, Sean; Burton, Jennifer; Parsons, Amanda; Underhill, Kristen; Montgomery, Paul

2014-01-01

Background Home visits for older adults aim to prevent cognitive and functional impairment, thus reducing institutionalization and mortality. Visitors may provide information, investigate untreated problems, encourage medication compliance, and provide referrals to services. Methods and Findings Data Sources: Ten databases including CENTRAL and Medline searched through December 2012. Study Selection: Randomized controlled trials enrolling community-dwelling persons without dementia aged over 65 years. Interventions included visits at home by a health or social care professional that were not related to hospital discharge. Data Extraction and Synthesis: Two authors independently extracted data. Outcomes were pooled using random effects. Main Outcomes and Measures: Mortality, institutionalization, hospitalization, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness. Results Sixty-four studies with 28642 participants were included. Home visits were not associated with absolute reductions in mortality at longest follow-up, but some programs may have small relative effects (relative risk = 0.93 [0.87 to 0.99]; absolute risk = 0.00 [−0.01 to 0.00]). There was moderate quality evidence of no overall effect on the number of people institutionalized (RR = 1.02 [0.88 to 1.18]) or hospitalized (RR = 0.96 [0.91 to 1.01]). There was high quality evidence for number of people who fell, which is consistent with no effect or a small effect (odds ratio = 0.86 [0.73 to 1.01]), but there was no evidence that these interventions increased independent living. There was low and very low quality evidence of effects for quality of life (standardised mean difference = −0.06 [−0.11 to −0.01]) and physical functioning (SMD = −0.10 [−0.17 to −0.03]) respectively, but these may not be clinically important. Conclusions Home visiting is not consistently associated with differences in mortality or independent living, and investigations of heterogeneity did not identify any programs that are associated with consistent benefits. Due to poor reporting of intervention components and delivery, we cannot exclude the possibility that some programs may be effective. PMID:24622676

[Managing a health research institute: towards research excellence through continuous improvement].

PubMed

Olmedo, Carmen; Buño, Ismael; Plá, Rosa; Lomba, Irene; Bardinet, Thierry; Bañares, Rafael

2015-01-01

Health research institutes are a strategic commitment considered the ideal environment to develop excellence in translational research. Achieving quality research requires not only a powerful scientific and research structure but also the quality and integrity of management systems that support it. The essential instruments in our institution were solid strategic planning integrated into and consistent with the system of quality management, systematic evaluation through periodic indicators, measurement of key user satisfaction and internal audits, and implementation of an innovative information management tool. The implemented management tools have provided a strategic thrust to our institute while ensuring a level of quality and efficiency in the development and management of research that allows progress towards excellence in biomedical research. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Information management for aged care provision in Australia: development of an aged care minimum dataset and strategies to improve quality and continuity of care.

PubMed

Davis, Jenny; Morgans, Amee; Burgess, Stephen

2016-04-01

Efficient information systems support the provision of multi-disciplinary aged care and a variety of organisational purposes, including quality, funding, communication and continuity of care. Agreed minimum data sets enable accurate communication across multiple care settings. However, in aged care multiple and poorly integrated data collection frameworks are commonly used for client assessment, government reporting and funding purposes. To determine key information needs in aged care settings to improve information quality, information transfer, safety, quality and continuity of care to meet the complex needs of aged care clients. Modified Delphi methods involving five stages were employed by one aged care provider in Victoria, Australia, to establish stakeholder consensus for a derived minimum data set and address barriers to data quality. Eleven different aged care programs were identified; with five related data dictionaries, three minimum data sets, five program standards or quality frameworks. The remaining data collection frameworks related to diseases classification, funding, service activity reporting, and statistical standards and classifications. A total of 170 different data items collected across seven internal information systems were consolidated to a derived set of 60 core data items and aligned with nationally consistent data collection frameworks. Barriers to data quality related to inconsistencies in data items, staff knowledge, workflow, system access and configuration. The development an internal aged care minimum data set highlighted the critical role of primary data quality in the upstream and downstream use of client information; and presents a platform to build national consistency across the sector.

Identifying Consistent and Coherent Dimensions of Nursing Home Quality: Exploratory Factor Analysis of Quality Indicators.

PubMed

Xu, Dongjuan; Kane, Robert L; Shippee, Tetyana; Lewis, Teresa M

2016-12-01

There is a general belief that the markers of nursing home quality do not aggregate easily. Identifying consistent and coherent dimensions of quality that usefully summarize the multiplicity of nursing home quality measures is an important goal. It would simplify interpretation and help consumers, their families and advocates to choose nursing facilities. This study uses quality indicators (QIs) from a state nursing home report card to explore the dimensionality of quality in nursing homes and to determine whether aggregation at the resident versus facility level yields the same underlying dimensions. Cross-sectional study. 382 Medicare- and/or Medicaid-certified nursing homes in Minnesota. Residents admitted to the nursing homes during 2011-2012. 16 QIs obtained from the Minimum Data Set 3.0 assessment instrument between 2011 and 2012 were used in the exploratory factor analysis. Factor analysis results suggest four main factors or dimensions to characterize facility performance: continence care (including 4 QIs), restraints and behavioral symptoms (including 3 QIs), care for specific conditions (including 6 QIs), and physical functioning (including 3 QIs). The resident-level and facility-level results generally agreed for 11 QIs. Nursing home quality of care can be captured in summary measures, which can be used by consumers, providers and researchers. Reporting at the resident or facility level will depend on the purpose. These summary measures can be used by policy-makers to identify and reward high-performing facilities and by families to choose nursing facilities for care. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Instrument Psychometrics: Parental Satisfaction and Quality Indicators of Perinatal Palliative Care.

PubMed

Wool, Charlotte

2015-10-01

Despite a life-limiting fetal diagnosis, prenatal attachment often occurs in varying degrees resulting in role identification by an individual as a parent. Parents recognize quality care and report their satisfaction when interfacing with health care providers. The aim was to test an instrument measuring parental satisfaction and quality indicators with parents electing to continue a pregnancy after learning of a life-limiting fetal diagnosis. A cross sectional survey design gathered data using a computer-mediated platform. Subjects were parents (n=405) who opted to continue a pregnancy affected by a life-limiting diagnosis. Factor analysis using principal component analysis with Varimax rotation was used to validate the instrument, evaluate components, and summarize the explained variance achieved among quality indicator items. The Prenatal Scale was reduced to 37 items with a three-component solution explaining 66.19% of the variance and internal consistency reliability of 0.98. The Intrapartum Scale included 37 items with a four-component solution explaining 66.93% of the variance and a Cronbach α of 0.977. The Postnatal Scale was reduced to 44 items with a six-component solution explaining 67.48% of the variance. Internal consistency reliability was 0.975. The Parental Satisfaction and Quality Indicators of Perinatal Palliative Care Instrument is a valid and reliable measure for parent-reported quality care and satisfaction. Use of this instrument will enable clinicians and researchers to measure quality indicators and parental satisfaction. The instrument is useful for assessing, analyzing, and reporting data on quality for care delivered during the prenatal, intrapartum, and postnatal periods.

Towards more patient centred healthcare: A new Consumer Quality Index instrument to assess patients' experiences with breast care.

PubMed

Damman, Olga C; Hendriks, Michelle; Sixma, Herman J

2009-06-01

To develop a Consumer Quality Index (CQ-index) Breast Care instrument that measures quality of care from the perspective of patients with (suspicion of) breast cancer. To develop a pilot questionnaire, three focus group discussions with breast cancer patients were performed. The questionnaire was sent to 1197 patients. We performed psychometric and descriptive analyses to optimise the new instrument. Focus group discussions revealed nine main themes related to breast care quality. Psychometric analyses resulted in 15 reliable scales. The final instrument consisted of 152 items, of which 118 items regarded patients' experiences. The aspect with the highest need for quality improvement was informing patients about a second opinion. The CQ-index Breast Care (CQI-BC) instrument provides a good starting point for further research on the quality of breast care seen from the perspective of patients. The newly developed instrument can be used by different stakeholders for future quality monitoring.

Factors affecting dental service quality.

PubMed

Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia

2015-01-01

Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.

Physician level reporting of surgical and pathology performance indicators: a regional study to assess feasibility and impact on quality.

PubMed

McFadyen, Craig; Lankshear, Sara; Divaris, Dimitrios; Berry, Mark; Hunter, Amber; Srigley, John; Irish, Jonathan

2015-02-01

There is increased awareness that, to minimize variation in clinician practice and improve quality, performance reporting should be implemented at the provider level. This optimizes physician engagement and creates a sense of professional responsibility for quality and performance measurement at the individual and organizational levels. Individual provider level reporting was implemented within a provincial health region involving 56 clinicians (general surgeons, surgical oncologists, urologists and pathologists). The 2 surgical pathology indicators chosen were colorectal cancer (CRC) lymph node retrieval rate and pT2 prostate cancer margin positivity rate. Surgical resections for all prostate and colorectal cancer performed between Jan. 1, 2011, and Mar. 30, 2012, were included. We used a pre- and postsurvey design to obtain physician perceptions and focus groups with program leadership to determine organizational impact. Survey results showed that respondents felt the data provided in the reports were valid (67%), consistent with expectations (70%), maintained confidentiality (80%) and were not used in a punitive manner (77%). During the study period the pT2 prostate margin positivity rate decreased from 57.1% to 27.5%. For the CRC lymph node retrieval rate indicator, high baseline performance was maintained. We developed a robust process for providing physicians with confidential, individualized surgical and pathology quality indicator reports. Our results reinforce the importance of individual physician feedback as a strategy for improving and sustaining quality in surgical and diagnostic oncology.

Tuberculosis management practices of private practitioners in Pune municipal corporation, India.

PubMed

Bharaswadkar, Sandeep; Kanchar, Avinash; Thakur, Narendra; Shah, Shubhangi; Patnaik, Brinda; Click, Eleanor S; Kumar, Ajay M V; Dewan, Puneet Kumar

2014-01-01

Private Practitioners (PP) are the primary source of health care for patients in India. Limited representative information is available on TB management practices of Indian PP or on the efficacy of India's Revised National Tuberculosis Control Programme (RNTCP) to improve the quality of TB management through training of PP. We conducted a cross-sectional survey of a systematic random sample of PP in one urban area in Western India (Pune, Maharashtra). We presented sample clinical vignettes and determined the proportions of PPs who reported practices consistent with International Standards of TB Care (ISTC). We examined the association between RNTCP training and adherence to ISTC by calculating odds ratios and 95% confidence intervals. Of 3,391 PP practicing allopathic medicine, 249 were interviewed. Of these, 55% had been exposed to RNTCP. For new pulmonary TB patients, 63% (158/249) of provider responses were consistent with ISTC diagnostic practices, and 34% (84/249) of responses were consistent with ISTC treatment practices. However, 48% (120/249) PP also reported use of serological tests for TB diagnosis. In the new TB case vignette, 38% (94/249) PP reported use of at least one second line anti-TB drug in the treatment regimen. RNTCP training was not associated with diagnostic or treatment practices. In Pune, India, despite a decade of training activities by the RNTCP, high proportions of providers resorted to TB serology for diagnosis and second-line anti-TB drug use in new TB patients. Efforts to achieve universal access to quality TB management must account for the low quality of care by PP and the lack of demonstrated effect of current training efforts.

Tuberculosis Management Practices of Private Practitioners in Pune Municipal Corporation, India

PubMed Central

Bharaswadkar, Sandeep; Kanchar, Avinash; Thakur, Narendra; Shah, Shubhangi; Patnaik, Brinda; Click, Eleanor S.; Kumar, Ajay M. V.; Dewan, Puneet Kumar

2014-01-01

Background Private Practitioners (PP) are the primary source of health care for patients in India. Limited representative information is available on TB management practices of Indian PP or on the efficacy of India’s Revised National Tuberculosis Control Programme (RNTCP) to improve the quality of TB management through training of PP. Methods We conducted a cross-sectional survey of a systematic random sample of PP in one urban area in Western India (Pune, Maharashtra). We presented sample clinical vignettes and determined the proportions of PPs who reported practices consistent with International Standards of TB Care (ISTC). We examined the association between RNTCP training and adherence to ISTC by calculating odds ratios and 95% confidence intervals. Results Of 3,391 PP practicing allopathic medicine, 249 were interviewed. Of these, 55% had been exposed to RNTCP. For new pulmonary TB patients, 63% (158/249) of provider responses were consistent with ISTC diagnostic practices, and 34% (84/249) of responses were consistent with ISTC treatment practices. However, 48% (120/249) PP also reported use of serological tests for TB diagnosis. In the new TB case vignette, 38% (94/249) PP reported use of at least one second line anti-TB drug in the treatment regimen. RNTCP training was not associated with diagnostic or treatment practices. Conclusion In Pune, India, despite a decade of training activities by the RNTCP, high proportions of providers resorted to TB serology for diagnosis and second-line anti-TB drug use in new TB patients. Efforts to achieve universal access to quality TB management must account for the low quality of care by PP and the lack of demonstrated effect of current training efforts. PMID:24897374

Improved Hourly and Sub-Hourly Gauge Data for Assessing Precipitation Extremes in the U.S.

NASA Astrophysics Data System (ADS)

Lawrimore, J. H.; Wuertz, D.; Palecki, M. A.; Kim, D.; Stevens, S. E.; Leeper, R.; Korzeniewski, B.

2017-12-01

The NOAA/National Weather Service (NWS) Fischer-Porter (F&P) weighing bucket precipitation gauge network consists of approximately 2000 stations that comprise a subset of the NWS Cooperative Observers Program network. This network has operated since the mid-20th century, providing one of the longest records of hourly and 15-minute precipitation observations in the U.S. The lengthy record of this dataset combined with its relatively high spatial density, provides an important source of data for many hydrological applications including understanding trends and variability in the frequency and intensity of extreme precipitation events. In recent years NOAA's National Centers for Environmental Information initiated an upgrade of its end-to-end processing and quality control system for these data. This involved a change from a largely manual review and edit process to a fully automated system that removes the subjectivity that was previously a necessary part of dataset quality control and processing. An overview of improvements to this dataset is provided along with the results of an analysis of observed variability and trends in U.S. precipitation extremes since the mid-20th century. Multi-decadal trends in many parts of the nation are consistent with model projections of an increase in the frequency and intensity of heavy precipitation in a warming world.

Surface water-quality assessment of the lower Kansas River basin, Kansas and Nebraska: analysis of available water-quality data through 1986

USGS Publications Warehouse

Jordan, P.R.; Stamer, J.K.

1991-01-01

Beginning in 1986, the U.S. Congress appropriated funds for the U.S. Geological Survey to test and refine concepts for a National Water-Quality Assessment (NAWQA) Program. The long-term goals of the full-scale program are to: (1) provide a nationally consistent description of current water-quality conditions for a large part of the Nation's surface- and ground-water resources; (2) define long-term trends (or lack of trends) in water quality; and (3) identify, describe, and explain, insofar as possible, the major factors that affect current conditions and trends in water quality. This information, obtained on a continuing basis, will be made available to water managers, policy makers, and the public to provide an improved scientific basis for evaluating the effectiveness of water-quality-management programs and for predicting the likely effects of contemplated changes in land-and water-management practices. At present (1990), the assessment program is in a pilot phase in seven areas that represent diverse hydrologic environments and water-quality conditions.This report completes one of the first activities undertaken as part of the lower Kansas River basin pilot study, which was to compile, screen, and interpret available water-quality data for the study unit through 1986. The report includes information on the sources and types of water-quality data available, the utility of available water-quality data for assessment purposes, and a description of current water-quality conditions and trends and their relation to natural and human factors.

Why and How Teachers Transform Their Instruction

NASA Astrophysics Data System (ADS)

Light, Barbara J.

In his 2011 book The highly qualified teacher: What is teacher quality and how do we measure it? Strong argues that as a profession, education has struggled to measure teacher quality and therefore cannot provide a proven system to consistently develop high-quality teachers. In order to move toward an operational definition of teacher quality, Kennedy, in her 2008 journal article entitled "Contributions of qualitative research to research on teacher qualifications" suggests that the causal mechanisms of the development of teachers who are identified as high-quality teachers must be researched, documented, and then used in teacher preparation and development. Instructional ability is a key component of teacher effectiveness. This case study examines instructional transformations made by four teachers to explore why and how teachers make transformations in their teaching. The overarching conclusion of the study is the importance of student-centeredness as a component of teacher effectiveness.

Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

PubMed

Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

2017-02-01

We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Personal Branding: A Primer for Radiology Trainees and Radiologists.

PubMed

Kalia, Vivek; Patel, Amy K; Moriarity, Andrew K; Canon, Cheri L

2017-07-01

A radiologist's personal brand is a composite of many parts in one's professional life. In an age where work quality and digital footprints are tracked and measured more than ever before, it behooves radiologists to develop and curate their own individual brands in effective ways. Personal branding consists of the decisions we make, both consciously and unconsciously, which affect our reputation and the likelihood of seeking our services in the future for both patients and referring providers. As hospital systems are increasingly adjusting their systems to cater to better patient experiences, it is imperative that radiologists similarly adjust our practice patterns to accommodate the needs of the new paradigm of value-based care. It is no longer sufficient to only practice excellent clinical radiology; one's service experience to clinical providers, report quality, and digital presence must all be robust and compelling. Defining your brand and promoting your vision and quality standards have become as important to radiologists' future as keeping up with advancements in radiologic technology. One must select the proper platforms and types of interactions in which to engage from available social media options. Developing a consistent brand and presence in the work setting, on social media accounts, and in professional organizations at the local, national, and international levels is the ultimate goal. At present, very little, if any, formal training is provided on personal branding skills such as these in current residency curricula, and it is critical for radiologists to fill their gaps in knowledge through additional means. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Acute effects of verbal feedback on upper-body performance in elite athletes.

PubMed

Argus, Christos K; Gill, Nicholas D; Keogh, Justin Wl; Hopkins, Will G

2011-12-01

Argus, CK, Gill, ND, Keogh, JWL, and Hopkins, WG. Acute effects of verbal feedback on upper-body performance in elite athletes. J Strength Cond Res 25(12): 3282-3287, 2011-Improved training quality has the potential to enhance training adaptations. Previous research suggests that receiving feedback improves single-effort maximal strength and power tasks, but whether quality of a training session with repeated efforts can be improved remains unclear. The purpose of this investigation was to determine the effects of verbal feedback on upper-body performance in a resistance training session consisting of multiple sets and repetitions in well-trained athletes. Nine elite rugby union athletes were assessed using the bench throw exercise on 4 separate occasions each separated by 7 days. Each athlete completed 2 sessions consisting of 3 sets of 4 repetitions of the bench throw with feedback provided after each repetition and 2 identical sessions where no feedback was provided after each repetition. When feedback was received, there was a small increase of 1.8% (90% confidence limits, ±2.7%) and 1.3% (±0.7%) in mean peak power and velocity when averaged over the 3 sets. When individual sets were compared, there was a tendency toward the improvements in mean peak power being greater in the second and third sets. These results indicate that providing verbal feedback produced acute improvements in upper-body power output of well-trained athletes. The benefits of feedback may be greatest in the latter sets of training and could improve training quality and result in greater long-term adaptation.

Sting_RDB: a relational database of structural parameters for protein analysis with support for data warehousing and data mining.

PubMed

Oliveira, S R M; Almeida, G V; Souza, K R R; Rodrigues, D N; Kuser-Falcão, P R; Yamagishi, M E B; Santos, E H; Vieira, F D; Jardine, J G; Neshich, G

2007-10-05

An effective strategy for managing protein databases is to provide mechanisms to transform raw data into consistent, accurate and reliable information. Such mechanisms will greatly reduce operational inefficiencies and improve one's ability to better handle scientific objectives and interpret the research results. To achieve this challenging goal for the STING project, we introduce Sting_RDB, a relational database of structural parameters for protein analysis with support for data warehousing and data mining. In this article, we highlight the main features of Sting_RDB and show how a user can explore it for efficient and biologically relevant queries. Considering its importance for molecular biologists, effort has been made to advance Sting_RDB toward data quality assessment. To the best of our knowledge, Sting_RDB is one of the most comprehensive data repositories for protein analysis, now also capable of providing its users with a data quality indicator. This paper differs from our previous study in many aspects. First, we introduce Sting_RDB, a relational database with mechanisms for efficient and relevant queries using SQL. Sting_rdb evolved from the earlier, text (flat file)-based database, in which data consistency and integrity was not guaranteed. Second, we provide support for data warehousing and mining. Third, the data quality indicator was introduced. Finally and probably most importantly, complex queries that could not be posed on a text-based database, are now easily implemented. Further details are accessible at the Sting_RDB demo web page: http://www.cbi.cnptia.embrapa.br/StingRDB.

Effective interventions on service quality improvement in a physiotherapy clinic.

PubMed

Gharibi, Farid; Tabrizi, JafarSadegh; Eteraf Oskouei, MirAli; AsghariJafarabadi, Mohammad

2014-01-01

Service quality is considered as a main domain of quality associ-ated with non-clinical aspect of healthcare. This study aimed to survey and im-proves service quality of delivered care in the Physiotherapy Clinic affiliated with the Tabriz University of Medical Sciences, Tabriz, Iran. A quasi experimental interventional study was conducted in the Physiotherapy Clinic, 2010-2011. Data were collected using a validated and reli-able researcher made questionnaire with participation of 324 patients and their coadjutors. The study questionnaire consisted of 7 questions about demographic factors and 38 questions for eleven aspects of service quality. Data were then analyzed using paired samples t-test by SPSS16. In the pre intervention phase, six aspects of service quality including choice of provider, safety, prevention and early detection, dignity, autonomy and availability achieved non-acceptable scores. Following interventions, all aspects of the service quality improved and also total service quality score improved from 8.58 to 9.83 (P<0.001). Service quality can be improved by problem implementation of appropriate interventions. The acquired results can be used in health system fields to create respectful environments for healthcare customers.

MASQOT: a method for cDNA microarray spot quality control

PubMed Central

Bylesjö, Max; Eriksson, Daniel; Sjödin, Andreas; Sjöström, Michael; Jansson, Stefan; Antti, Henrik; Trygg, Johan

2005-01-01

Background cDNA microarray technology has emerged as a major player in the parallel detection of biomolecules, but still suffers from fundamental technical problems. Identifying and removing unreliable data is crucial to prevent the risk of receiving illusive analysis results. Visual assessment of spot quality is still a common procedure, despite the time-consuming work of manually inspecting spots in the range of hundreds of thousands or more. Results A novel methodology for cDNA microarray spot quality control is outlined. Multivariate discriminant analysis was used to assess spot quality based on existing and novel descriptors. The presented methodology displays high reproducibility and was found superior in identifying unreliable data compared to other evaluated methodologies. Conclusion The proposed methodology for cDNA microarray spot quality control generates non-discrete values of spot quality which can be utilized as weights in subsequent analysis procedures as well as to discard spots of undesired quality using the suggested threshold values. The MASQOT approach provides a consistent assessment of spot quality and can be considered an alternative to the labor-intensive manual quality assessment process. PMID:16223442

The impact of post-traumatic stress disorder symptomatology on quality of life: The sentinel experience of anger, hypervigilance and restricted affect.

PubMed

Forbes, David; Nickerson, Angela; Bryant, Richard A; Creamer, Mark; Silove, Derrick; McFarlane, Alexander C; Van Hooff, Miranda; Phelps, Andrea; Felmingham, Kim L; Malhi, Gin S; Steel, Zachary; Fredrickson, Julia; Alkemade, Nathan; O'Donnell, Meaghan

2018-05-01

It is unclear which specific symptoms of post-traumatic stress disorder are related to poor perceived quality of life. To investigate the influence of post-traumatic stress disorder symptomatology on quality of life in traumatic injury survivors. Traumatic injury survivors completed questionnaires on post-traumatic stress disorder symptomatology and quality of life at 3 months ( n = 987), 12 months ( n = 862), 24 months ( n = 830) and 6 years ( n = 613) post trauma. Low quality of life was reported by 14.5% of injury survivors at 3 months and 8% at 6 years post event. The post-traumatic stress disorder symptom clusters that contributed most to poor perceived quality of life were numbing and arousal, the individual symptoms that contributed most were anger, hypervigilance and restricted affect. There was variability in the quality of life of traumatic injury survivors in the 6 years following trauma and a consistent proportion reported low quality of life. Early intervention to reduce anger, hypervigilance and restricted affect symptoms may provide a means to improving the quality of life of traumatic injury survivors.

Design and implementation of software for automated quality control and data analysis for a complex LC/MS/MS assay for urine opiates and metabolites.

PubMed

Dickerson, Jane A; Schmeling, Michael; Hoofnagle, Andrew N; Hoffman, Noah G

2013-01-16

Mass spectrometry provides a powerful platform for performing quantitative, multiplexed assays in the clinical laboratory, but at the cost of increased complexity of analysis and quality assurance calculations compared to other methodologies. Here we describe the design and implementation of a software application that performs quality control calculations for a complex, multiplexed, mass spectrometric analysis of opioids and opioid metabolites. The development and implementation of this application improved our data analysis and quality assurance processes in several ways. First, use of the software significantly improved the procedural consistency for performing quality control calculations. Second, it reduced the amount of time technologists spent preparing and reviewing the data, saving on average over four hours per run, and in some cases improving turnaround time by a day. Third, it provides a mechanism for coupling procedural and software changes with the results of each analysis. We describe several key details of the implementation including the use of version control software and automated unit tests. These generally useful software engineering principles should be considered for any software development project in the clinical lab. Copyright © 2012 Elsevier B.V. All rights reserved.

Child center closures: Does nonprofit status provide a comparative advantage?

PubMed

Lam, Marcus; Klein, Sacha; Freisthler, Bridget; Weiss, Robert E

2013-03-01

Reliable access to dependable, high quality childcare services is a vital concern for large numbers of American families. The childcare industry consists of private nonprofit, private for-profit, and governmental providers that differ along many dimensions, including quality, clientele served, and organizational stability. Nonprofit providers are theorized to provide higher quality services given comparative tax advantages, higher levels of consumer trust, and management by mission driven entrepreneurs. This study examines the influence of ownership structure, defined as nonprofit, for-profit sole proprietors, for-profit companies, and governmental centers, on organizational instability, defined as childcare center closures. Using a cross sectional data set of 15724 childcare licenses in California for 2007, we model the predicted closures of childcare centers as a function of ownership structure as well as center age and capacity. Findings indicate that for small centers (capacity of 30 or less) nonprofits are more likely to close, but for larger centers (capacity 30+) nonprofits are less likely to close. This suggests that the comparative advantages available for nonprofit organizations may be better utilized by larger centers than by small centers. We consider the implications of our findings for parents, practitioners, and social policy.

Child center closures: Does nonprofit status provide a comparative advantage?

PubMed Central

Lam, Marcus; Klein, Sacha; Freisthler, Bridget; Weiss, Robert E.

2013-01-01

Reliable access to dependable, high quality childcare services is a vital concern for large numbers of American families. The childcare industry consists of private nonprofit, private for-profit, and governmental providers that differ along many dimensions, including quality, clientele served, and organizational stability. Nonprofit providers are theorized to provide higher quality services given comparative tax advantages, higher levels of consumer trust, and management by mission driven entrepreneurs. This study examines the influence of ownership structure, defined as nonprofit, for-profit sole proprietors, for-profit companies, and governmental centers, on organizational instability, defined as childcare center closures. Using a cross sectional data set of 15724 childcare licenses in California for 2007, we model the predicted closures of childcare centers as a function of ownership structure as well as center age and capacity. Findings indicate that for small centers (capacity of 30 or less) nonprofits are more likely to close, but for larger centers (capacity 30+) nonprofits are less likely to close. This suggests that the comparative advantages available for nonprofit organizations may be better utilized by larger centers than by small centers. We consider the implications of our findings for parents, practitioners, and social policy. PMID:23543882

New Developments in Undergraduate Education in Public Health: Implications for Health Education and Health Promotion

ERIC Educational Resources Information Center

Barnes, Michael D.; Wykoff, Randy; King, Laura Rasar; Petersen, Donna J.

2012-01-01

The article provides an overview of efforts to improve public health and health education training and on the potential use of Critical Component Elements (CCEs) for undergraduate health education programs toward more consistent quality assurance across programs. Considered in the context of the Galway Consensus Conference, the authors discuss the…

Assessment of the Measurement Properties of the NHCAHPS Family Survey: A Rasch Scaling Approach

ERIC Educational Resources Information Center

O'Connor, Matthew S.

2013-01-01

The introduction of the Consumer Assessment of Healthcare Providers and Systems (CAHPS), a family of survey instruments designed to capture and report people's experiences obtaining health care could soon add satisfaction as a consistent dimension of quality that skilled nursing facilities (SNFs) are required to assess and report. The SNF setting…

Addressing the Missing Instructional Data Problem: Using a Teacher Log to Document Tier 1 Instruction

ERIC Educational Resources Information Center

Kurz, Alexander; Elliott, Stephen N.; Roach, Andrew T.

2015-01-01

Response-to-intervention (RTI) systems posit that Tier 1 consists of high-quality general classroom instruction using evidence-based methods to address the needs of most students. However, data on the extent to which general education teachers provide such instruction are rarely collected. This missing instructional data problem may result in RTI…

[Design and implementation of a questionnaire to evaluate the dietary quality of school meals].

PubMed

de Mateo Silleras, Beatriz; Camina Martín, M Alicia; Ojeda Sainz, Berta; Carreño Enciso, Laura; de la Cruz Marcos, Sandra; Marugán de Miguelsanz, José Manuel; Redondo del Río, Paz

2014-10-03

The school canteen provides a substantial proportion of the daily nutritional intake for many children. There are nutritional standards for school meals, however, it is still difficult to assess the dietary quality. To design a questionnaire for assessing the dietary quality of school meals, quickly and easily. A dietary questionnaire (COMES) was designed on the basis of the current recommendations. COMES consist of 15 items related to the food-frequency and to other characteristics of school meals. Then, a longitudinal prospective study was performed in order to analyze, with COMES, 36 school meals of 4 catering companies from Castilla y León during the academic years 2006-2007 to 2010-2011. Differences in dietary quality menus according to the management system of catering companies (in situ vs. transported) were analyzed by using the Mann-Whitney and the Kruskal-Wallis tests. The significance was reached at p <0,05. The frequency intake of meat, dairy and prepared products was higher to the recommended in 97,2%, 94,4% and 27,8% of the analyzed menus, respectively. By contrast, the frequency intake of fish, fruit, legume, and vegetable garnishes were lower to the recommended in 83,3%, 94,4%, 91,7% and 75% of menus, respectively. Nevertheless, recommendations established by our consensus document for school meals are complied for all food groups, except for dairy and fruits. The variety of foods and culinary techniques were appropriate. No significant differences were found in the COMES score according to the management system (p=0,87), although catering system provides higher dietary quality. A new tool to assess quickly and easily the nutritional quality of school meals has been proposed. The assessment of the frequency intake of the most problematic foods for schoolchildren with this scale is much more demanding than the current recommendations. Even so, menus analyzed showed an acceptable quality in terms of variety of foods and culinary techniques, although milk frequency in the menus was excessive at the expense of fresh fruit. On the other hand, the transported system (i.e. catering, both hot and cold-holding) provides menus more consistent with the dietary recommendations. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Orienting health care information systems toward quality: how Group Health Cooperative of Puget Sound did it.

PubMed

Goverman, I L

1994-11-01

Group Health Cooperative of Puget Sound (GHC), a large staff-model health maintenance organization based in Seattle, is redesigning its information systems to provide the systems and information needed to support its quality agenda. Long-range planning for GHC's information resources was done in three phases. In assessment, interviews, surveys, and a benchmarking effort identified strengths and weaknesses of the existing information systems. We concluded that we needed to improve clinical care and patient management systems and enhance health plan applications. In direction setting, we developed six objectives (for example, approach information systems in a way that is consistent with quality improvement principles). Detailed planning was used to define projects, timing, and resource allocations. Some of the most important efforts in the resulting five-year plan include the development of (1) a computerized patient record; (2) a provider-based clinical workstation for access to patient information, order entry, results reporting, guidelines, and reminders; (3) a comprehensive set of patient management and service quality systems; (4) reengineered structures, policies, and processes within the health plan, supported by a complete set of integrated information systems; (5) a standardized, high-capacity communications network to provide linkages both within GHC and among its business partners; and (6) a revised oversight structure for information services, which forms partnerships with users. A quality focus ensured that each project not only produced its own benefits but also supported the larger organizational goals associated with "total" quality.

Reconciling medical expenditure estimates from the MEPS and NHEA, 2007.

PubMed

Bernard, Didem; Cowan, Cathy; Selden, Thomas; Cai, Liming; Catlin, Aaron; Heffler, Stephen

2012-01-01

Provide a comparison of health care expenditure estimates for 2007 from the Medical Expenditure Panel Survey (MEPS) and the National Health Expenditure Accounts (NHEA). Reconciling these estimates serves two important purposes. First, it is an important quality assurance exercise for improving and ensuring the integrity of each source's estimates. Second, the reconciliation provides a consistent baseline of health expenditure data for policy simulations. Our results assist researchers to adjust MEPS to be consistent with the NHEA so that the projected costs as well as budgetary and tax implications of any policy change are consistent with national health spending estimates. The Medical Expenditure Panel Survey produced by the Agency for Healthcare Research and Quality, and the National Health Center for Health Statistics and the National Health Expenditures produced by the Centers for Medicare & Medicaid Service's Office of the Actuary. In this study, we focus on the personal health care (PHC) sector, which includes the goods and services rendered to treat or prevent a specific disease or condition in an individual. The official 2007 NHEA estimate for PHC spending is $1,915 billion and the MEPS estimate is $1,126 billion. Adjusting the NHEA estimates for differences in underlying populations, covered services, and other measurement concepts reduces the NHEA estimate for 2007 to $1,366 billion. As a result, MEPS is $240 billion, or 17.6 percent, less than the adjusted NHEA total.

A comprehensive clinical assessment tool to inform policy and practice: applications of the minimum data set.

PubMed

Mor, Vincent

2004-04-01

The Minimum Data Set (MDS) for nursing home (NH) resident assessment, designed to assess elders functional status and care needs, exemplifies how the information needs of clinical practice are congruent with those of research. Building on a review of the published literature, this article describes the development of the MDS, its reliability and validity testing, as well as the variety of different policy and research uses to which it has been applied. Interrater reliability of items and internal consistency of MDS summary scales is generally good to excellent. Validation studies reveal good correspondence to research quality instruments for cognition, activities of daily living, and diagnoses with more variable results for vision, pain, mood, and behavior scales. To date, no consistent evidence suggests that applications of MDS data for case-mix reimbursement and quality indicator monitoring systematically bias the data. Although facility variation in data quality could compromise some applications, creation of the MDS as a clinical tool for care planning provides an example of how assessment tools with clinical use can be used in administrative databases for research and policy applications.

Automated locomotor activity monitoring as a quality control assay for mass-reared tephritid flies.

PubMed

Dominiak, Bernard C; Fanson, Benjamin G; Collins, Samuel R; Taylor, Phillip W

2014-02-01

The Sterile Insect Technique (SIT) requires vast numbers of consistently high quality insects to be produced over long periods. Quality control (QC) procedures are critical to effective SIT, both providing quality assurance and warning of operational deficiencies. We here present a potential new QC assay for mass rearing of Queensland fruit flies (Bactrocera tryoni Froggatt) for SIT; locomotor activity monitoring. We investigated whether automated locomotor activity monitors (LAMs) that simply detect how often a fly passes an infrared sensor in a glass tube might provide similar insights but with much greater economy. Activity levels were generally lower for females than for males, and declined over five days in the monitor for both sexes. Female activity levels were not affected by irradiation, but males irradiated at 60 or 70 Gy had reduced activity levels compared with unirradiated controls. We also found some evidence that mild heat shock of pupae results in adults with reduced activity. LAM offers a convenient, effective and economical assay to probe such changes. © 2013 Society of Chemical Industry.

Quality of care in patients with psoriasis: an initial clinical study of an international disease management programme.

PubMed

de Korte, J; Van Onselen, J; Kownacki, S; Sprangers, M A G; Bos, J D

2005-01-01

Patients with psoriasis have to cope with their disease for many years or even throughout their entire life. To provide optimal care, a disease management programme was developed. This programme consisted of disease education, disease management training, and psychological support, together with topical treatment. To test a disease management programme in dermatological practice, to assess patients' satisfaction with this programme, and adherence to topical treatment. Additionally, disease severity and quality of life were assessed. An initial clinical investigation was conducted in 10 European treatment centres. A total of 330 patients were included. Patient satisfaction, adherence, disease severity and quality of life were measured with study-specific and standardized self-report questionnaires. Patients reported a high degree of satisfaction with the programme, and a high degree of adherence to topical treatment. Disease severity and quality of life significantly improved. The programme was well received by the participating professionals. The disease management programme was found to be a useful tool in the management of psoriasis, providing patients with relief from the burden of psoriasis in everyday life. A full-scale evaluation is recommended.

Imaging and Data Acquisition in Clinical Trials for Radiation Therapy

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

FitzGerald, Thomas J., E-mail: Thomas.Fitzgerald@umassmed.edu; Bishop-Jodoin, Maryann; Followill, David S.

2016-02-01

Cancer treatment evolves through oncology clinical trials. Cancer trials are multimodal and complex. Assuring high-quality data are available to answer not only study objectives but also questions not anticipated at study initiation is the role of quality assurance. The National Cancer Institute reorganized its cancer clinical trials program in 2014. The National Clinical Trials Network (NCTN) was formed and within it was established a Diagnostic Imaging and Radiation Therapy Quality Assurance Organization. This organization is Imaging and Radiation Oncology Core, the Imaging and Radiation Oncology Core Group, consisting of 6 quality assurance centers that provide imaging and radiation therapy qualitymore » assurance for the NCTN. Sophisticated imaging is used for cancer diagnosis, treatment, and management as well as for image-driven technologies to plan and execute radiation treatment. Integration of imaging and radiation oncology data acquisition, review, management, and archive strategies are essential for trial compliance and future research. Lessons learned from previous trials are and provide evidence to support diagnostic imaging and radiation therapy data acquisition in NCTN trials.« less

Measures of symptoms and life quality to predict emergent use of institutional health care resources in chronic obstructive airways disease.

PubMed

Traver, G A

1988-11-01

Thirty subjects with severe chronic obstructive airways disease participated in a study to identify differences in symptoms and life quality between those with high and low emergent use of institutional health care resources. Emergent use was defined as care obtained through unscheduled, nonroutine methods of access to health care providers. There were 15 subjects in each group; the groups had similar sex distribution and were not significantly different for percent predicted forced expiratory volume in 1 second (mean 29.8%), use of home oxygen (15 of 30 subjects), or prevalence of CO2 retention (nine of 30). Symptoms and life quality were measured by using three paper and pencil tests, the Bronchitis-Emphysema Symptom Checklist, the Sickness-Impact Profile, and the Katz Adjustment Scale for relatives. Findings demonstrated consistently more symptoms and impairment of life quality in the "high emergent" group. The differences reached statistical significance for irritability, anxiety, helplessness, nervousness, peripheral sensory complaints, alienation, social interaction, and emotional behavior. Discriminant analysis provided a prediction formula that yielded 80% correct prediction for the two groups.

Application of a tablet film coating model to define a process-imposed transition boundary for robust film coating.

PubMed

van den Ban, Sander; Pitt, Kendal G; Whiteman, Marshall

2018-02-01

A scientific understanding of interaction of product, film coat, film coating process, and equipment is important to enable design and operation of industrial scale pharmaceutical film coating processes that are robust and provide the level of control required to consistently deliver quality film coated product. Thermodynamic film coating conditions provided in the tablet film coating process impact film coat formation and subsequent product quality. A thermodynamic film coating model was used to evaluate film coating process performance over a wide range of film coating equipment from pilot to industrial scale (2.5-400 kg). An approximate process-imposed transition boundary, from operating in a dry to a wet environment, was derived, for relative humidity and exhaust temperature, and used to understand the impact of the film coating process on product formulation and process control requirements. This approximate transition boundary may aid in an enhanced understanding of risk to product quality, application of modern Quality by Design (QbD) based product development, technology transfer and scale-up, and support the science-based justification of critical process parameters (CPPs).

Groundwater-quality data for the Sierra Nevada study unit, 2008: Results from the California GAMA program

USGS Publications Warehouse

Shelton, Jennifer L.; Fram, Miranda S.; Munday, Cathy M.; Belitz, Kenneth

2010-01-01

Groundwater quality in the approximately 25,500-square-mile Sierra Nevada study unit was investigated in June through October 2008, as part of the Priority Basin Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA Priority Basin Project is being conducted by the U.S. Geological Survey (USGS) in cooperation with the California State Water Resources Control Board (SWRCB). The Sierra Nevada study was designed to provide statistically robust assessments of untreated groundwater quality within the primary aquifer systems in the study unit, and to facilitate statistically consistent comparisons of groundwater quality throughout California. The primary aquifer systems (hereinafter, primary aquifers) are defined by the depth of the screened or open intervals of the wells listed in the California Department of Public Health (CDPH) database of wells used for public and community drinking-water supplies. The quality of groundwater in shallower or deeper water-bearing zones may differ from that in the primary aquifers; shallow groundwater may be more vulnerable to contamination from the surface. In the Sierra Nevada study unit, groundwater samples were collected from 84 wells (and springs) in Lassen, Plumas, Butte, Sierra, Yuba, Nevada, Placer, El Dorado, Amador, Alpine, Calaveras, Tuolumne, Madera, Mariposa, Fresno, Inyo, Tulare, and Kern Counties. The wells were selected on two overlapping networks by using a spatially-distributed, randomized, grid-based approach. The primary grid-well network consisted of 30 wells, one well per grid cell in the study unit, and was designed to provide statistical representation of groundwater quality throughout the entire study unit. The lithologic grid-well network is a secondary grid that consisted of the wells in the primary grid-well network plus 53 additional wells and was designed to provide statistical representation of groundwater quality in each of the four major lithologic units in the Sierra Nevada study unit: granitic, metamorphic, sedimentary, and volcanic rocks. One natural spring that is not used for drinking water was sampled for comparison with a nearby primary grid well in the same cell. Groundwater samples were analyzed for organic constituents (volatile organic compounds [VOC], pesticides and pesticide degradates, and pharmaceutical compounds), constituents of special interest (N-nitrosodimethylamine [NDMA] and perchlorate), naturally occurring inorganic constituents (nutrients, major ions, total dissolved solids, and trace elements), and radioactive constituents (radium isotopes, radon-222, gross alpha and gross beta particle activities, and uranium isotopes). Naturally occurring isotopes and geochemical tracers (stable isotopes of hydrogen and oxygen in water, stable isotopes of carbon, carbon-14, strontium isotopes, and tritium), and dissolved noble gases also were measured to help identify the sources and ages of the sampled groundwater. Three types of quality-control samples (blanks, replicates, and samples for matrix spikes) each were collected at approximately 10 percent of the wells sampled for each analysis, and the results for these samples were used to evaluate the quality of the data for the groundwater samples. Field blanks rarely contained detectable concentrations of any constituent, suggesting that contamination from sample collection, handling, and analytical procedures was not a significant source of bias in the data for the groundwater samples. Differences between replicate samples were within acceptable ranges, with few exceptions. Matrix-spike recoveries were within acceptable ranges for most compounds. This study did not attempt to evaluate the quality of water delivered to consumers; after withdrawal from the ground, groundwater typically is treated, disinfected, or blended with other waters to maintain water quality. Regulatory benchmarks apply to finished drinking water that is served to the consumer, not to untre

Total suspended solids concentrations and yields for water-quality monitoring stations in Gwinnett County, Georgia, 1996-2009

USGS Publications Warehouse

Landers, Mark N.

2013-01-01

The U.S. Geological Survey, in cooperation with the Gwinnett County Department of Water Resources, established a water-quality monitoring program during late 1996 to collect comprehensive, consistent, high-quality data for use by watershed managers. As of 2009, continuous streamflow and water-quality data as well as discrete water-quality samples were being collected for 14 watershed monitoring stations in Gwinnett County. This report provides statistical summaries of total suspended solids (TSS) concentrations for 730 stormflow and 710 base-flow water-quality samples collected between 1996 and 2009 for 14 watershed monitoring stations in Gwinnett County. Annual yields of TSS were estimated for each of the 14 watersheds using methods described in previous studies. TSS yield was estimated using linear, ordinary least-squares regression of TSS and explanatory variables of discharge, turbidity, season, date, and flow condition. The error of prediction for estimated yields ranged from 1 to 42 percent for the stations in this report; however, the actual overall uncertainty of the estimated yields cannot be less than that of the observed yields (± 15 to 20 percent). These watershed yields provide a basis for evaluation of how watershed characteristics, climate, and watershed management practices affect suspended sediment yield.

Human visual system consistent quality assessment for remote sensing image fusion

NASA Astrophysics Data System (ADS)

Liu, Jun; Huang, Junyi; Liu, Shuguang; Li, Huali; Zhou, Qiming; Liu, Junchen

2015-07-01

Quality assessment for image fusion is essential for remote sensing application. Generally used indices require a high spatial resolution multispectral (MS) image for reference, which is not always readily available. Meanwhile, the fusion quality assessments using these indices may not be consistent with the Human Visual System (HVS). As an attempt to overcome this requirement and inconsistency, this paper proposes an HVS-consistent image fusion quality assessment index at the highest resolution without a reference MS image using Gaussian Scale Space (GSS) technology that could simulate the HVS. The spatial details and spectral information of original and fused images are first separated in GSS, and the qualities are evaluated using the proposed spatial and spectral quality index respectively. The overall quality is determined without a reference MS image by a combination of the proposed two indices. Experimental results on various remote sensing images indicate that the proposed index is more consistent with HVS evaluation compared with other widely used indices that may or may not require reference images.

Measuring the quality of provided services for patients with chronic kidney disease.

PubMed

Bahadori, Mohammadkarim; Raadabadi, Mehdi; Heidari Jamebozorgi, Majid; Salesi, Mahmood; Ravangard, Ramin

2014-09-01

The healthcare organizations need to develop and implement quality improvement plans for their survival and success. Measuring quality in the healthcare competitive environment is an undeniable necessity for these organizations and will lead to improved patient satisfaction. This study aimed to measure the quality of provided services for patients with chronic kidney disease in Kerman in 2014. This cross-sectional, descriptive-analytic study was performed from 23 January 2014 to 14 February 2014 in four hemodialysis centers in Kerman. All of the patients on chronic hemodialysis (n = 195) who were referred to these four centers were selected and studied using census method. The required data were collected using the SERVQUAL questionnaire, consisting of two parts: questions related to the patients' demographic characteristics, and 28 items to measure the patients' expectations and perceptions of the five dimensions of service quality, including tangibility, reliability, responsiveness, assurance, and empathy. The collected data were analyzed using SPSS 21.0 through some statistical tests, including independent-samples t test, one-way ANOVA, and paired-samples t test. The results showed that the means of patients' expectations were more than their perceptions of the quality of provided services in all dimensions, which indicated that there were gaps in all dimensions. The highest and lowest means of negative gaps were related to empathy (-0.52 ± 0.48) and tangibility (-0.29 ± 0.51). In addition, among the studied patients' demographic characteristics and the five dimensions of service quality, only the difference between the patients' income levels and the gap in assurance were statistically significant (P < 0.001). Overall, the results of the present study showed that the expectations of patients on hemodialysis were more than their perceptions of provided services. The healthcare providers and employees should pay more attention to the patients' opinions and comments and use their feedback to solve the workplace problems and improve the quality of provided services. In addition, training the health staff to meet the patients' emotional needs and expectations is suggested.

Evaluation of cross-cultural adaptation and measurement properties of breast cancer-specific quality-of-life questionnaires: a systematic review.

PubMed

Oliveira, Indiara Soares; da Cunha Menezes Costa, Lucíola; Fagundes, Felipe Ribeiro Cabral; Cabral, Cristina Maria Nunes

2015-05-01

To assess the procedures of translation, cross-cultural adaptation, and measurement properties of breast cancer-specific quality-of-life questionnaires. Searches were conducted in the databases MEDLINE, EMBASE, CINAHL, and SciELO using the keywords: "Questionnaires," "Quality of life," and "Breast cancer." The studies were analyzed in terms of methodological quality according to the guidelines for the procedure of cross-cultural adaptation and the quality criteria for measurement properties of questionnaires. We found 24 eligible studies. Most of the articles assessed the translation and measurement properties of the instrument EORTC QLQ-BR23. Description about translation and cross-cultural adaptation was incomplete in 11 studies. Translation and back translation were the most tested phases, and synthesis of the translation was the most omitted phase in the articles. Information on assessing measurement properties was provided incompletely in 23 articles. Internal consistency was the most tested property in all of the eligible articles, but none of them provided information on agreement. Construct validity was adequately tested in only three studies that used the FACT-B and QLQ-BR23. Eight articles provided information on reliability; however, only four found positive classification. Responsiveness was tested in four articles, and ceiling and floor effects were tested in only three articles. None of the instruments showed fully adequate quality. There is limited evidence on cross-cultural adaptations and measurement properties; therefore, it is recommended that caution be exercised when using breast cancer-specific quality-of-life questionnaires that have been translated, adapted, and tested.

Toward population management in an integrated care model.

PubMed

Maddux, Franklin W; McMurray, Stephen; Nissenson, Allen R

2013-04-01

Under the Patient Protection and Affordable Care Act of 2010, accountable care organizations (ACOs) will be the primary mechanism for achieving the dual goals of high-quality patient care at managed per capita costs. To achieve these goals in the newly emerging health care environment, the nephrology community must plan for and direct integrated delivery and coordination of renal care, focusing on population management. Even though the ESRD patient population is a complex group with comorbid conditions that may confound integration of care, the nephrology community has unique experience providing integrated care through ACO-like programs. Specifically, the recent ESRD Management Demonstration Project sponsored by the Centers for Medicare & Medicaid Services and the current ESRD Prospective Payment System with it Quality Incentive Program have demonstrated that integrated delivery of renal care can be accomplished in a manner that provides improved clinical outcomes with some financial margin of savings. Moving forward, integrated renal care will probably be linked to provider performance and quality outcomes measures, and clinical integration initiatives will share several common elements, namely performance-based payment models, coordination of communication via health care information technology, and development of best practices for care coordination and resource utilization. Integration initiatives must be designed to be measured and evaluated, and, consistent with principles of continuous quality improvement, each initiative will provide for iterative improvements of the initiative.

Toward population management in an integrated care model.

PubMed

Maddux, Franklin W; McMurray, Stephen; Nissenson, Allen R

2013-01-01

Under the Patient Protection and Affordable Care Act of 2010, accountable care organizations (ACOs) will be the primary mechanism for achieving the dual goals of high-quality patient care at managed per capita costs. To achieve these goals in the newly emerging health care environment, the nephrology community must plan for and direct integrated delivery and coordination of renal care, focusing on population management. Even though the ESRD patient population is a complex group with comorbid conditions that may confound integration of care, the nephrology community has unique experience providing integrated care through ACO-like programs. Specifically, the recent ESRD Management Demonstration Project sponsored by the Centers for Medicare & Medicaid Services and the current ESRD Prospective Payment System with it Quality Incentive Program have demonstrated that integrated delivery of renal care can be accomplished in a manner that provides improved clinical outcomes with some financial margin of savings. Moving forward, integrated renal care will probably be linked to provider performance and quality outcomes measures, and clinical integration initiatives will share several common elements, namely performance-based payment models, coordination of communication via health care information technology, and development of best practices for care coordination and resource utilization. Integration initiatives must be designed to be measured and evaluated, and, consistent with principles of continuous quality improvement, each initiative will provide for iterative improvements of the initiative. © 2013 S. Karger AG, Basel.

Surface-water-quality assessment of the upper Illinois River basin in Illinois, Indiana, and Wisconsin; project description

USGS Publications Warehouse

Mades, D.M.

1987-01-01

In 1986, the U.S. Geological Survey began a National Water-Quality Assessment program to (1) provide nationally consistent descriptions of the current status of water quality for a large, diverse, and geographically distributed part of the Nation's surface- and ground-water resources; (2) define, where possible, trends in water quality; and (3) identify and describe the relations of both status and trends in water quality to natural factors and the history of land use and land- and waste-management activities. The program is presently in a pilot phase that will test and modify, as necessary, concepts and approaches in preparation for possible full implementation of the program in the future. The upper Illinois River basin is one of four basins selected to test the concepts and approaches of the surface-water-quality element of the national program. The basin drains 10,949 square miles of Illinois, Indiana, and Wisconsin. Three principal tributaries are the Kankakee and Des Plaines Rivers that join to form the Illinois River and the Fox River. Land use is predominantly agricultural; about 75 percent of the basin is cultivated primarily for production of corn and soybeans. About 13 percent of the basin is urban area, most of which is located in the Chicago metropolitan area. The population of the basin is about 7 million. About 6 million people live in the Des Plaines River basin. Many water-quality issues in the upper Illinois River basin are related to sediment, nutrients, potentially toxic inorganic and organic constituents, and to water-management practices. Occurrence of sediment and the chemical constituents in the rivers and lakes within the basin has the potential to adversely affect the water's suitability for aquatic life, recreation, or, through the consumption of fish, human health. The upper Illinois River basin project consists of five major activities. The first activity--analysis of existing information and preparation of a report that describes recent water-quality conditions and trends--is currently underway. The second activity--fixed-station water-quality sampling at eight stations--began in April 1987 and will last at least 3 years. Water-quality data collected at these stations will be used to determine the frequency of occurrence of constituent concentrations, their annual and seasonal loads, and time trends in concentrations for a selected number of constituents. The third activity will be synoptic water-quality studies. Each study will involve sampling many sites at specific flow conditions and for selected water-quality constituents. Information gained from these studies will supplement informa tion gained from fixed-station sampling. A synoptic study of streambed sediments is tentatively planned for the summer of 1987 to describe the occurrence and distribution of trace elements in the basin. The fourth activity will consist of one or more topical subbasin or river-reach studies. The purpose of such studies is to better define certain water-quality conditions in specific areas and gain an understanding of the processes affecting the observed conditions. The fifth activity is the preparation of reports that will describe results from each of the first four activities. Quality assurance and coordination are being provided at both the national and pilot-project levels. A technical quality-assurance plan that addresses all aspects of sample collection, analysis, and reporting is being prepared at the national level. This plan will be appended as needed at the pilot-project level. A National Coordinating Work Group that functions under the auspices of the Interagency Advisory Committee on Water Data and the Advisory Committee on Water Data for Public Use has been established at the national level. A local liaison committee consisting of representatives from Federal, State, and local agencies has been established to enhance communication and to ensure that the scientific information produced by the

Quality assurance audits of medical surveillance programs for hazardous waste workers.

PubMed

Udasin, I G; Buckler, G; Gochfeld, M

1991-11-01

The Occupational Safety and Health Administration (OSHA) Hazardous Waste Operations and Emergency Response Regulation (29 CFR 1910.120) requires medical surveillance examinations for hazardous waste workers. We investigated the consistency and appropriateness of the services provided under OSHA 29 CFR 1910.120 as part of a quality control audit. Our study revealed that in most cases the required paperwork including fitness for duty and restrictions or limitations was completed. However, it is also apparent that many of the components of a complete occupational history were not performed. Spirometric examinations often were performed incorrectly. Documentation of baseline tests was not uniformly done, nor were patients always informed of the findings of their examinations. Our study indicated there may be a lack of education, training, and experience of occupational health providers. This suggests that further efforts should be made to educate physicians and nurses providing medical surveillance and other services to hazardous waste workers.

An Empirical Study of the Impact of Service Quality on Patient Satisfaction in Private Hospitals, Iran

PubMed Central

Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

2015-01-01

Objective: Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. Method: This cross-sectional study was conducted in the year 2010. The study’s sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. Result: this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Conclusions: Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers. PMID:25560338

An empirical study of the impact of service quality on patient satisfaction in private hospitals, Iran.

PubMed

Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

2014-07-29

Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. This cross-sectional study was conducted in the year 2010. The study's sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers.

Development and Validation of a Quality-of-Life Instrument for Infantile Hemangiomas.

PubMed

Chamlin, Sarah L; Mancini, Anthony J; Lai, Jin-Shei; Beaumont, Jennifer L; Cella, David; Adams, Denise; Drolet, Beth; Baselga, Eulalia; Frieden, Ilona J; Garzon, Maria; Holland, Kristin; Horii, Kimberly A; Lucky, Anne W; McCuaig, Catherine; Metry, Denise; Morel, Kimberly D; Newell, Brandon D; Nopper, Amy J; Powell, Julie; Siegel, Dawn; Haggstrom, Anita N

2015-06-01

Infantile hemangiomas (IH) are common tumors for which there is no validated disease-specific instrument to measure the quality of life in infants and their parents/caregivers during the critical first months of life. This study prospectively developed and validated a quality-of-life instrument for patients with IH and their parents/caregivers and correlated demographic and clinical features to the effects on the quality of life. A total of 220 parents/caregivers completed the 35-item Infantile Hemangioma Quality-of-Life (IH-QoL) instrument and provided demographic information. The dimensionality of the items was evaluated using factor analysis, with results suggesting four factors: child physical symptoms, child social interactions, parent emotional functioning, and parent psychosocial functioning. Each factor fit the Rasch measurement model with acceptable fit index (mean square <1.4) and demonstrated excellent internal consistency, with alpha ranging from 0.76 to 0.88. The final instrument consists of four scales with a total of 29 items. Content validity was verified by analyzing parents' responses to an open-ended question. Test-retest reliability at a 48-hour interval was supported by a total IH-QoL intraclass correlation coefficient of 0.84. Certain clinical characteristics of hemangioma, including those located on the head and neck, in the proliferative stage, and requiring treatment, are associated with a greater impact on QoL.

The consistency approach for quality control of vaccines - a strategy to improve quality control and implement 3Rs.

PubMed

De Mattia, Fabrizio; Chapsal, Jean-Michel; Descamps, Johan; Halder, Marlies; Jarrett, Nicholas; Kross, Imke; Mortiaux, Frederic; Ponsar, Cecile; Redhead, Keith; McKelvie, Jo; Hendriksen, Coenraad

2011-01-01

Current batch release testing of established vaccines emphasizes quality control of the final product and is often characterized by extensive use of animals. This report summarises the discussions of a joint ECVAM/EPAA workshop on the applicability of the consistency approach for routine release of human and veterinary vaccines and its potential to reduce animal use. The consistency approach is based upon thorough characterization of the vaccine during development and the principle that the quality of subsequent batches is the consequence of the strict application of a quality system and of a consistent production of batches. The concept of consistency of production is state-of-the-art for new-generation vaccines, where batch release is mainly based on non-animal methods. There is now the opportunity to introduce the approach into established vaccine production, where it has the potential to replace in vivo tests with non-animal tests designed to demonstrate batch quality while maintaining the highest quality standards. The report indicates how this approach may be further developed for application to established human and veterinary vaccines and emphasizes the continuing need for co-ordination and harmonization. It also gives recommendations for work to be undertaken in order to encourage acceptance and implementation of the consistency approach. Copyright © 2011. Published by Elsevier Ltd.. All rights reserved.

Physically Challenging Song Traits, Male Quality, and Reproductive Success in House Wrens

PubMed Central

Cramer, Emily R. A.

2013-01-01

Physically challenging signals are likely to honestly indicate signaler quality. In trilled bird song two physically challenging parameters are vocal deviation (the speed of sound frequency modulation) and trill consistency (how precisely syllables are repeated). As predicted, in several species, they correlate with male quality, are preferred by females, and/or function in male-male signaling. Species may experience different selective pressures on their songs, however; for instance, there may be opposing selection between song complexity and song performance difficulty, such that in species where song complexity is strongly selected, there may not be strong selection on performance-based traits. I tested whether vocal deviation and trill consistency are signals of male quality in house wrens (Troglodytes aedon), a species with complex song structure. Males’ singing ability did not correlate with male quality, except that older males sang with higher trill consistency, and males with more consistent trills responded more aggressively to playback (although a previous study found no effect of stimulus trill consistency on males’ responses to playback). Males singing more challenging songs did not gain in polygyny, extra-pair paternity, or annual reproductive success. Moreover, none of the standard male quality measures I investigated correlated with mating or reproductive success. I conclude that vocal deviation and trill consistency do not signal male quality in this species. PMID:23527137

Elixir - how to handle 2 trillion pixels

NASA Astrophysics Data System (ADS)

Magnier, Eugene A.; Cuillandre, Jean-Charles

2002-12-01

The Elixir system at CFHT provides automatic data quality assurance and calibration for the wide-field mosaic imager camera CFH12K. Elixir consists of a variety of tools, including: a real-time analysis suite which runs at the telescope to provide quick feedback to the observers; a detailed analysis of the calibration data; and an automated pipeline for processing data to be distributed to observers. To date, 2.4 × 1012 night-time sky pixels from CFH12K have been processed by the Elixir system.

Defense Small Business Innovation Research Program (SBIR). Volume 3. Air Force Abstracts of Phase 1 Awards

DTIC Science & Technology

1990-01-01

THERE WILL BE A CONTINUING NEED FOR A SENSITIVE, RAPID, AND ECONOMICAL TESTING PROCEDURE CAPABLE OF DETECTING DEFECTS AND PROVIDING FEEDBACK FOR QUALITY...SOLUTIONS. THE DKF METHOD PROVIDES OPTIMAL OR NEAR-OPTIMAL ACCURACY, REDUCE PROCESSING BURDEN, AND IMPROVE FAULT TOLERANCE. THE DKF/MMAE ( DMAE ) TECHNIQUES...DEVICES FOR B-SiC IS TO BE ABLE TO CONSISTENTLY PRODUCE INTRINSIC FILMS WITH VERY LOW DEFECTS AND TO DEVELOP SCHOTTKY AND OHMIC CONTACT MATERIALS THAT WILL

Design of penicillin fermentation process simulation system

NASA Astrophysics Data System (ADS)

Qi, Xiaoyu; Yuan, Zhonghu; Qi, Xiaoxuan; Zhang, Wenqi

2011-10-01

Real-time monitoring for batch process attracts increasing attention. It can ensure safety and provide products with consistent quality. The design of simulation system of batch process fault diagnosis is of great significance. In this paper, penicillin fermentation, a typical non-linear, dynamic, multi-stage batch production process, is taken as the research object. A visual human-machine interactive simulation software system based on Windows operation system is developed. The simulation system can provide an effective platform for the research of batch process fault diagnosis.

Documentation Resources on the ESIP Wiki

NASA Technical Reports Server (NTRS)

Habermann, Ted; Kozimor, John; Gordon, Sean

2017-01-01

The ESIP community includes data providers and users that communicate with one another through datasets and metadata that describe them. Improving this communication depends on consistent high-quality metadata. The ESIP Documentation Cluster and the wiki play an important central role in facilitating this communication. We will describe and demonstrate sections of the wiki that provide information about metadata concept definitions, metadata recommendation, metadata dialects, and guidance pages. We will also describe and demonstrate the ISO Explorer, a tool that the community is developing to help metadata creators.

Quality assurance of the international computerised 24 h dietary recall method (EPIC-Soft).

PubMed

Crispim, Sandra P; Nicolas, Genevieve; Casagrande, Corinne; Knaze, Viktoria; Illner, Anne-Kathrin; Huybrechts, Inge; Slimani, Nadia

2014-02-01

The interview-administered 24 h dietary recall (24-HDR) EPIC-Soft® has a series of controls to guarantee the quality of dietary data across countries. These comprise all steps that are part of fieldwork preparation, data collection and data management; however, a complete characterisation of these quality controls is still lacking. The present paper describes in detail the quality controls applied in EPIC-Soft, which are, to a large extent, built on the basis of the EPIC-Soft error model and are present in three phases: (1) before, (2) during and (3) after the 24-HDR interviews. Quality controls for consistency and harmonisation are implemented before the interviews while preparing the seventy databases constituting an EPIC-Soft version (e.g. pre-defined and coded foods and recipes). During the interviews, EPIC-Soft uses a cognitive approach by helping the respondent to recall the dietary intake information in a stepwise manner and includes controls for consistency (e.g. probing questions) as well as for completeness of the collected data (e.g. system calculation for some unknown amounts). After the interviews, a series of controls can be applied by dietitians and data managers to further guarantee data quality. For example, the interview-specific 'note files' that were created to track any problems or missing information during the interviews can be checked to clarify the information initially provided. Overall, the quality controls employed in the EPIC-Soft methodology are not always perceivable, but prove to be of assistance for its overall standardisation and possibly for the accuracy of the collected data.

The effect of thermal de-phasing on the beam quality of a high-power single-pass second harmonic generation

NASA Astrophysics Data System (ADS)

Sadat Hashemi, Somayeh; Ghavami Sabouri, Saeed; Khorsandi, Alireza

2018-04-01

We present a theoretical model in order to study the effect of a thermally loaded crystal on the quality of a second-harmonic (SH) beam generated in a high-power pumping regime. The model is provided based on using a particular structure of oven considered for MgO:PPsLT nonlinear crystal to compensate for the thermal de-phasing effect that as the pumping power reaches up to 50 W degrades the conversion efficiency and beam quality of the interacting beams. Hereupon, the quality of fundamental beam is involved in the modeling to investigate the final effect on the beam quality of generated SH beam. Beam quality evaluation is subsequently simulated using Hermite-Gaussian modal decomposition approach for a range of fundamental beam qualities varied from 1 to 3 and for different levels of input powers. To provide a meaningful comparison numerical simulation is correlated with real data deduced from a high-power SH generation (SHG) experimental device. It is found that when using the open-top oven scheme and fixing the fundamental M 2-factor at nearly 1, for a range of input powers changing from 15 to 30 W, the M 2-factor of SHG beam is degraded from 9% to 24%, respectively, confirming very good consistency with the reported experimental results.

Gender Differences in the Structure of Marital Quality.

PubMed

Beam, Christopher R; Marcus, Katherine; Turkheimer, Eric; Emery, Robert E

2018-05-01

Marriages consist of shared experiences and interactions between husbands and wives that may lead to different impressions of the quality of the relationship. Few studies, unfortunately, have tested gender differences in the structure of marital quality, and even fewer studies have evaluated whether genetic and environmental influences on marital quality differ across gender. In this study, we evaluated gender differences in the structure of marital quality using independent samples of married male (n = 2406) and married female (n = 2215) participants from the National Survey of Midlife Development in the United States who provided ratings on twenty-eight marital quality items encompassing six marital quality constructs. We further explored gender differences in genetic and environmental influences on marital quality constructs in a subsample of 491 pairs of twins. Results suggest partial metric invariance across gender but structural variability in marital quality constructs. Notably, correlations between constructs were stronger in women than men. Results also support gender differences in the genetic and environmental influences on different aspects of marital quality. We discuss that men and women may approach and react to marriage differently as the primary reason why we observed differences in the structure of marital quality.

The medical director and quality requirements in the dialysis facility.

PubMed

Schiller, Brigitte

2015-03-06

Four decades after the successful implementation of the ESRD program currently providing life-saving dialysis therapy to >430,000 patients, the definitions of and demands for a high-quality program have evolved and increased at the same time. Through substantial technological advances ESRD care improved, with a predominant focus on the technical aspects of care and the introduction of medications such as erythropoiesis-stimulating agents and active vitamin D for anemia and bone disease management. Despite many advances, the size of the program and the increasingly older and multimorbid patient population have contributed to continuing challenges for providing consistently high-quality care. Medicare's Final Rule of the Conditions for Coverage (April 2008) define the medical director of the dialysis center as the leader of the interdisciplinary team and the person ultimately accountable for quality, safety, and care provided in the center. Knowledge and active leadership with a hands-on approach in the quality assessment and performance improvement process (QAPI) is essential for the achievement of high-quality outcomes in dialysis centers. A collaborative approach between the dialysis provider and medical director is required to optimize outcomes and deliver evidence-based quality care. In 2011 the Centers for Medicare & Medicaid Services introduced a pay-for-performance program-the ESRD quality incentive program (QIP)- with yearly varying quality metrics that result in payment reductions in subsequent years when targets are not achieved during the performance period. Success with the QIP requires a clear understanding of the structure, metrics, and scoring methods. Information on achievement and nonachievement is publicly available, both in facilities (through the facility performance score card) and on public websites (including Medicare's Dialysis Facility Compare). By assuming the leadership role in the quality program of dialysis facilities, the medical director is given an important opportunity to improve patients' lives and effect true change in a patient population dealing with a very challenging chronic disease. This article in the series on the role of the medical director summarizes the medical director's specific role in the quality improvement process in the dialysis facility and the associated requirements and programs, including QAPI and QIP. Copyright © 2015 by the American Society of Nephrology.

The geospatial data quality REST API for primary biodiversity data

PubMed Central

Otegui, Javier; Guralnick, Robert P.

2016-01-01

Summary: We present a REST web service to assess the geospatial quality of primary biodiversity data. It enables access to basic and advanced functions to detect completeness and consistency issues as well as general errors in the provided record or set of records. The API uses JSON for data interchange and efficient parallelization techniques for fast assessments of large datasets. Availability and implementation: The Geospatial Data Quality API is part of the VertNet set of APIs. It can be accessed at http://api-geospatial.vertnet-portal.appspot.com/geospatial and is already implemented in the VertNet data portal for quality reporting. Source code is freely available under GPL license from http://www.github.com/vertnet/api-geospatial. Contact: javier.otegui@gmail.com or rguralnick@flmnh.ufl.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:26833340

The geospatial data quality REST API for primary biodiversity data.

PubMed

Otegui, Javier; Guralnick, Robert P

2016-06-01

We present a REST web service to assess the geospatial quality of primary biodiversity data. It enables access to basic and advanced functions to detect completeness and consistency issues as well as general errors in the provided record or set of records. The API uses JSON for data interchange and efficient parallelization techniques for fast assessments of large datasets. The Geospatial Data Quality API is part of the VertNet set of APIs. It can be accessed at http://api-geospatial.vertnet-portal.appspot.com/geospatial and is already implemented in the VertNet data portal for quality reporting. Source code is freely available under GPL license from http://www.github.com/vertnet/api-geospatial javier.otegui@gmail.com or rguralnick@flmnh.ufl.edu Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.

Ground-water quality assessment of the central Oklahoma aquifer, Oklahoma - Analysis of available water-quality data through 1987

USGS Publications Warehouse

Parkhurst, David L.; Christenson, Scott C.; Schlottmann, Jamie L.

1989-01-01

Beginning in 1986, the Congress annually has appropriated funds for the U.S. Geological Survey to test and refine concepts for a National Water-Quality Assessment (NAWQA) Program. The long-term goals of a full-scale program would be to:Provide a nationally consistent description of current water-quality conditions for a large part of the Nation's surface- and ground-water resources;Define long-term trends (or lack of trends) in water quality; andIdentify, describe, and explain, as possible, the major factors that affect the observed water-quality conditions and trends.The results of the NAWQA Program will be made available to water managers, policy makers, and the public, and will provide an improved scientific basis for evaluating the effectiveness of water-quality management programs.At present (1988), the assessment program is in a pilot phase in seven project areas throughout the country that represent diverse hydrologic environments and water-quality conditions. The Central Oklahoma aquifer project is one of three pilot ground-water projects. One of the initial activities performed by each pilot project was to compile, screen, and interpret the large amount of water-quality data available within each study unit.The purpose of this report is to assess the water quality of the Central Oklahoma aquifer using the information available through 1987. The scope of the work includes compiling data from Federal, State, and local agencies; evaluating the suitability of the information for conducting a regional water-quality assessment; mapping regional variations in major-ion chemistry; calculating summary statistics of the available water-quality data; producing maps to show the location and number of samples that exceeded water-quality standards; and performing contingency-table analyses to determine the relation of geologic unit and depth to the occurrence of chemical constituents that exceed water-quality standards. This report provides an initial description of water-quality conditions in the Central Oklahoma aquifer study unit. No attempt was made in this report to determine the causes for regional variations in major-ion chemistry or to examine the reasons that some chemical constituents exceed water-quality standards.

Read Code Quality Assurance

PubMed Central

Schulz, Erich; Barrett, James W.; Price, Colin

1998-01-01

As controlled clinical vocabularies assume an increasing role in modern clinical information systems, so the issue of their quality demands greater attention. In order to meet the resulting stringent criteria for completeness and correctness, a quality assurance system comprising a database of more than 500 rules is being developed and applied to the Read Thesaurus. The authors discuss the requirement to apply quality assurance processes to their dynamic editing database in order to ensure the quality of exported products. Sources of errors include human, hardware, and software factors as well as new rules and transactions. The overall quality strategy includes prevention, detection, and correction of errors. The quality assurance process encompasses simple data specification, internal consistency, inspection procedures and, eventually, field testing. The quality assurance system is driven by a small number of tables and UNIX scripts, with “business rules” declared explicitly as Structured Query Language (SQL) statements. Concurrent authorship, client-server technology, and an initial failure to implement robust transaction control have all provided valuable lessons. The feedback loop for error management needs to be short. PMID:9670131

Read Code quality assurance: from simple syntax to semantic stability.

PubMed

Schulz, E B; Barrett, J W; Price, C

1998-01-01

As controlled clinical vocabularies assume an increasing role in modern clinical information systems, so the issue of their quality demands greater attention. In order to meet the resulting stringent criteria for completeness and correctness, a quality assurance system comprising a database of more than 500 rules is being developed and applied to the Read Thesaurus. The authors discuss the requirement to apply quality assurance processes to their dynamic editing database in order to ensure the quality of exported products. Sources of errors include human, hardware, and software factors as well as new rules and transactions. The overall quality strategy includes prevention, detection, and correction of errors. The quality assurance process encompasses simple data specification, internal consistency, inspection procedures and, eventually, field testing. The quality assurance system is driven by a small number of tables and UNIX scripts, with "business rules" declared explicitly as Structured Query Language (SQL) statements. Concurrent authorship, client-server technology, and an initial failure to implement robust transaction control have all provided valuable lessons. The feedback loop for error management needs to be short.

The role of Environmental Health System air quality monitors in Space Station Contingency Operations

NASA Technical Reports Server (NTRS)

Limero, Thomas F.; Wilson, Steve; Perlot, Susan; James, John

1992-01-01

This paper describes the Space Station Freedom (SSF) Environmental Health System's air-quality monitoring strategy and instrumentation. A two-tier system has been developed, consisting of first-alert instruments that warn the crew of airborne contamination and a volatile organic analyzer that can identify volatile organic contaminants in near-real time. The strategy for air quality monitoring on SSF is designed to provide early detection so that the contamination can be confined to one module and so that crew health and safety can be protected throughout the contingency event. The use of air-quality monitors in fixed and portable modes will be presented as a means of following the progress of decontamination efforts and ensuring acceptable air quality in a module after an incident. The technology of each instrument will be reviewed briefly; the main focus of this paper, however, will be the use of air-quality monitors before, during, and after contingency incidents.

Tracing the influence of land-use change on water quality and coral reefs using a Bayesian model.

PubMed

Brown, Christopher J; Jupiter, Stacy D; Albert, Simon; Klein, Carissa J; Mangubhai, Sangeeta; Maina, Joseph M; Mumby, Peter; Olley, Jon; Stewart-Koster, Ben; Tulloch, Vivitskaia; Wenger, Amelia

2017-07-06

Coastal ecosystems can be degraded by poor water quality. Tracing the causes of poor water quality back to land-use change is necessary to target catchment management for coastal zone management. However, existing models for tracing the sources of pollution require extensive data-sets which are not available for many of the world's coral reef regions that may have severe water quality issues. Here we develop a hierarchical Bayesian model that uses freely available satellite data to infer the connection between land-uses in catchments and water clarity in coastal oceans. We apply the model to estimate the influence of land-use change on water clarity in Fiji. We tested the model's predictions against underwater surveys, finding that predictions of poor water quality are consistent with observations of high siltation and low coverage of sediment-sensitive coral genera. The model thus provides a means to link land-use change to declines in coastal water quality.

A Review of Surface Water Quality Models

PubMed Central

Li, Shibei; Jia, Peng; Qi, Changjun; Ding, Feng

2013-01-01

Surface water quality models can be useful tools to simulate and predict the levels, distributions, and risks of chemical pollutants in a given water body. The modeling results from these models under different pollution scenarios are very important components of environmental impact assessment and can provide a basis and technique support for environmental management agencies to make right decisions. Whether the model results are right or not can impact the reasonability and scientificity of the authorized construct projects and the availability of pollution control measures. We reviewed the development of surface water quality models at three stages and analyzed the suitability, precisions, and methods among different models. Standardization of water quality models can help environmental management agencies guarantee the consistency in application of water quality models for regulatory purposes. We concluded the status of standardization of these models in developed countries and put forward available measures for the standardization of these surface water quality models, especially in developing countries. PMID:23853533

Lattice Cleaving: A Multimaterial Tetrahedral Meshing Algorithm with Guarantees

PubMed Central

Bronson, Jonathan; Levine, Joshua A.; Whitaker, Ross

2014-01-01

We introduce a new algorithm for generating tetrahedral meshes that conform to physical boundaries in volumetric domains consisting of multiple materials. The proposed method allows for an arbitrary number of materials, produces high-quality tetrahedral meshes with upper and lower bounds on dihedral angles, and guarantees geometric fidelity. Moreover, the method is combinatoric so its implementation enables rapid mesh construction. These meshes are structured in a way that also allows grading, to reduce element counts in regions of homogeneity. Additionally, we provide proofs showing that both element quality and geometric fidelity are bounded using this approach. PMID:24356365

Care coordination and the essential role of the nurse.

PubMed

Cropley, Stacey; Sandrs, Ellare Duis

2013-01-01

Quality improvement and cost control rely on effective coordination of patient care. Registered nurses (RNs) across the continuum of care play an essential role in care coordination. Greater health care efficiencies can be realized through coordination of care centered on the needs and preferences of patients and their families. Professional nursing links these approaches, promoting quality, safety, and efficiency in care, resulting in improved health care outcomes that are consistent with nursing's holistic, patient-centered framework of care. This model for RN care coordination provides a guideline for nurses in direct care as well as those in highly specialized care coordination positions.

Construct Validity and Reliability of the Questionnaire on the Quality of Physician-Patient Interaction in Adults With Hypertension.

PubMed

Hickman, Ronald L; Clochesy, John M; Hetland, Breanna; Alaamri, Marym

2017-04-01

There are limited reliable and valid measures of the patient- provider interaction among adults with hypertension. Therefore, the purpose of this report is to describe the construct validity and reliability of the Questionnaire on the Quality of Physician-Patient Interaction (QQPPI), in community-dwelling adults with hypertension. A convenience sample of 109 participants with hypertension was recruited and administered the QQPPI at baseline and 8 weeks later. The exploratory factor analysis established a 12-item, 2-factor structure for the QQPPI was valid in this sample. The modified QQPPI proved to have sufficient internal consistency and test- retest reliability. The modified QQPPI is a valid and reliable measure of the provider-patient interaction, a construct posited to impact self-management, in adults with hypertension.

Measuring the quality of life of people at the end of life: The McGill Quality of Life Questionnaire-Revised.

PubMed

Cohen, S Robin; Sawatzky, Richard; Russell, Lara B; Shahidi, Javad; Heyland, Daren K; Gadermann, Anne M

2017-02-01

The McGill Quality of Life Questionnaire has been widely used with people with life-threatening illnesses without modification since its publication in 1996. With use, areas for improvement have emerged; therefore, various minor modifications were tested over time. To revise the McGill Quality of Life Questionnaire (McGill Quality of Life Questionnaire-Revised) while maintaining or improving its psychometric properties and length, keeping it as close as possible to the McGill Quality of Life Questionnaire to enable reasonable comparison with existing McGill Quality of Life Questionnaire literature. Data sets from eight studies were used (four studies originally used to develop the McGill Quality of Life Questionnaire, two to develop new McGill Quality of Life Questionnaire versions, and two with unrelated purposes). The McGill Quality of Life Questionnaire-Revised was developed using analyses of measurement invariance, confirmatory factor analysis, and calculation of correlations with the McGill Quality of Life Questionnaire's global quality of life item. Data were from 1702 people with life-threatening illnesses recruited from acute and palliative care units, palliative home care services, and oncology and HIV/AIDS outpatient clinics. The McGill Quality of Life Questionnaire-Revised consists of 14 items (plus the global quality of life item). A new Physical subscale was created combining physical symptoms and physical well-being and a new item on physical functioning. The Existential subscale was reduced to four items. The revised Support subscale, renamed Social, focuses more on relationships. The Psychological subscale remains unchanged. Confirmatory factor analysis results provide support for the measurement structure of the McGill Quality of Life Questionnaire-Revised. The overall scale has good internal consistency reliability ( α = 0.94). The McGill Quality of Life Questionnaire-Revised improves on and can replace the McGill Quality of Life Questionnaire since it contains improved wording, a somewhat expanded repertoire of concepts with fewer items, and a single subscale for the physical domain, while retaining good psychometric properties.

Physicochemical and immunochemical assays for monitoring consistent production of tetanus toxoid.

PubMed

Metz, Bernard; Tilstra, Wichard; van der Put, Robert; Spruit, Nanda; van den Ijssel, Jan; Robert, Jolanda; Hendriksen, Coenraad; Kersten, Gideon

2013-07-01

The detoxification of tetanus toxin by formaldehyde is a crucial step in the production of tetanus toxoid. The inactivation results in chemically modified proteins and it determines largely the ultimate efficacy and safety of the vaccine. Currently, the quality of tetanus toxoid lots is evaluated in potency and safety tests performed in animals. As a possible alternative, this article describes a panel of in vitro methods, which provides detailed information about the quality of tetanus toxoid. Ten experimental lots of tetanus toxoid were prepared using increasing concentrations of formaldehyde and glycine to obtain tetanus toxoids having differences in antigenicity, immunogenicity, residual toxicity and protein structure. The structural properties of each individual toxoid were determined using immunochemical and physicochemical methods, including biosensor analysis, ELISA, circular dichroism, TNBS assay, differential scanning calorimetry, fluorescence and SDS-PAGE. The quality of a tetanus toxoid lot can be assessed by these set of analytical techniques. Based on antigenicity, immunogenicity and residual toxicity data, criteria are formulated that tetanus toxoids lot have to meet in order to have a high quality. The in vitro methods are a valuable selection of techniques for monitoring consistency of production of tetanus toxoid, especially for the detoxification process of tetanus toxin. Copyright © 2013 The International Alliance for Biological Standardization. Published by Elsevier Ltd. All rights reserved.

Digital contract approach for consistent and predictable multimedia information delivery in electronic commerce

NASA Astrophysics Data System (ADS)

Konana, Prabhudev; Gupta, Alok; Whinston, Andrew B.

1997-01-01

A pure 'technological' solution to network quality problems is incomplete since any benefits from new technologies are offset by the demand from exponentially growing electronic commerce ad data-intensive applications. SInce an economic paradigm is implicit in electronic commerce, we propose a 'market-system' approach to improve quality of service. Quality of service for digital products takes on a different meaning since users view quality of service differently and value information differently. We propose a framework for electronic commerce that is based on an economic paradigm and mass-customization, and works as a wide-area distributed management system. In our framework, surrogate-servers act as intermediaries between information provides and end- users, and arrange for consistent and predictable information delivery through 'digital contracts.' These contracts are negotiated and priced based on economic principles. Surrogate servers pre-fetched, through replication, information from many different servers and consolidate based on demand expectations. In order to recognize users' requirements and process requests accordingly, real-time databases are central to our framework. We also propose that multimedia information be separated into slowly changing and rapidly changing data streams to improve response time requirements. Surrogate- servers perform the tasks of integration of these data streams that is transparent to end-users.

Associations among physical activity, diet quality, and weight status in US adults.

PubMed

Pate, Russell R; Taverno Ross, Sharon E; Liese, Angela D; Dowda, Marsha

2015-04-01

Nearly 70% of adult Americans are overweight or obese, but the associations between physical activity, diet quality, and weight status have not been examined in a representative sample of US adults. The purpose of this study was to examine the associations among moderate-to-vigorous physical activity (MVPA), diet quality, and weight status within and across age groups in US adults. Participants included 2587 men and 2412 women age 20 to ≥70 yr from the National Health and Nutrition Examination Survey 2003-2004 and 2005-2006. Physical activity was measured by accelerometry. Diet quality was assessed with overall Healthy Eating Index-2005 scores. Measures of weight status, body mass index (BMI), and waist circumference were assessed using standard National Health and Nutrition Examination Survey protocols. Across age groups, MVPA was lower in the older age groups for both men and women, whereas diet quality was higher (P < 0.001). BMI and waist circumference were also higher in the older age groups (P < 0.05). Within age groups, MVPA was inversely associated with BMI and waist circumference for men and women in nearly every age group (P < 0.05). Diet quality was inversely associated with the weight status variables only in men age 30-39, 40-49 (BMI only), and 50-59 yr and women age 50-59 yr (P < 0.05). We observed clear age-related trends for measures of weight status, physical activity, and diet quality in US men and women. MVPA was very consistently related to weight status in both genders. The relation between diet quality and weight status was less consistent. These findings provide support for public health efforts to prevent obesity by promoting increased physical activity in adult Americans.

Quality of work life and its association with workplace violence of the nurses in emergency departments

PubMed Central

Eslamian, Jalil; Akbarpoor, Ali Akbar; Hoseini, Sayed Abbas

2015-01-01

Background: Nurses as the major group of health service providers need to have a satisfactory quality of work life in order to give desirable care to the patients. Workplace violence is one of the most important factors that cause decline in the quality of work life. This study aimed to determine the quality of work life of nurses in selected hospitals of Isfahan University of Medical Sciences and its relationship with workplace violence. Materials and Methods: This was a descriptive-correlational study. A sample of 186 registered nurses was enrolled in the study using quota sampling method. The research instrument used was a questionnaire consisting of three parts: Demographic information, quality of work life, and workplace violence. Collected data were analyzed using descriptive and inferential statistics by SPSS version 16. Results: The subjects consisted of 26.9% men and 73.1% women, whose mean age was 33.76 (7.13) years. 29.6% were single and 70.4% were married. About 76.9% of the subjects were exposed to verbal violence and 26.9% were exposed to physical violence during past year. Mean score of QNWL was 115.88 (30.98). About 45.7% of the subjects had a low level of quality of work life. There was an inverse correlation between the quality of work and the frequency of exposures to workplace violence. Conclusions: According to the results of this study, it is suggested that the managers and decision makers in health care should plan strategies to reduce violence in the workplace and also develop a program to improve the quality of work life of nurses exposed to workplace violence. PMID:25709691

Associations among Physical Activity, Diet Quality, and Weight Status in U.S. Adults

PubMed Central

Pate, Russell R.; Taverno Ross, Sharon E.; Liese, Angela D.; Dowda, Marsha

2015-01-01

Purpose Nearly 70% of adult Americans are overweight or obese, but the associations between physical activity, diet quality, and weight status have not been examined in a representative sample of U.S. adults. The purpose of this study was to examine the associations among moderate-to-vigorous physical activity (MVPA), diet quality, and weight status within and across age groups in U.S. adults. Methods Participants included 2,587 men and 2,412 women ages 20 to ≥70 years from the National Health and Nutrition Examination Survey (NHANES) 2003–2004 and 2005–2006. Physical activity was measured by accelerometry. Diet quality was assessed with overall Healthy Eating Index-2005 scores. Measures of weight status, BMI and waist circumference, were assessed using standard NHANES protocols. Results Across age groups, MVPA was lower in the older age groups for both men and women while diet quality was higher (P<.001). BMI and waist circumference were also higher in the older age groups (P<0.05). Within age groups, MVPA was inversely associated with BMI and waist circumference for men and women in nearly every age group (P<0.05). Diet quality was inversely associated with the weight status variables only in men ages 30–39, 40–49 (BMI only), and 50–59 years, and women ages 50–59 years (P<0.05). Conclusions We observed clear age-related trends for measures of weight status, physical activity, and diet quality in U.S. men and women. MVPA was very consistently related to weight status in both genders. The relationship between diet quality and weight status was less consistent. These findings provide support for public health efforts to prevent obesity by promoting increased physical activity in adult Americans. PMID:25058328

Quality of work life and its association with workplace violence of the nurses in emergency departments.

PubMed

Eslamian, Jalil; Akbarpoor, Ali Akbar; Hoseini, Sayed Abbas

2015-01-01

Nurses as the major group of health service providers need to have a satisfactory quality of work life in order to give desirable care to the patients. Workplace violence is one of the most important factors that cause decline in the quality of work life. This study aimed to determine the quality of work life of nurses in selected hospitals of Isfahan University of Medical Sciences and its relationship with workplace violence. This was a descriptive-correlational study. A sample of 186 registered nurses was enrolled in the study using quota sampling method. The research instrument used was a questionnaire consisting of three parts: Demographic information, quality of work life, and workplace violence. Collected data were analyzed using descriptive and inferential statistics by SPSS version 16. The subjects consisted of 26.9% men and 73.1% women, whose mean age was 33.76 (7.13) years. 29.6% were single and 70.4% were married. About 76.9% of the subjects were exposed to verbal violence and 26.9% were exposed to physical violence during past year. Mean score of QNWL was 115.88 (30.98). About 45.7% of the subjects had a low level of quality of work life. There was an inverse correlation between the quality of work and the frequency of exposures to workplace violence. According to the results of this study, it is suggested that the managers and decision makers in health care should plan strategies to reduce violence in the workplace and also develop a program to improve the quality of work life of nurses exposed to workplace violence.

Development of a Personal Integrated Environmental Monitoring System

PubMed Central

Wong, Man Sing; Yip, Tsan Pong; Mok, Esmond

2014-01-01

Environmental pollution in the urban areas of Hong Kong has become a serious public issue but most urban inhabitants have no means of judging their own living environment in terms of dangerous threshold and overall livability. Currently there exist many low-cost sensors such as ultra-violet, temperature and air quality sensors that provide reasonably accurate data quality. In this paper, the development and evaluation of Integrated Environmental Monitoring System (IEMS) are illustrated. This system consists of three components: (i) position determination and sensor data collection for real-time geospatial-based environmental monitoring; (ii) on-site data communication and visualization with the aid of an Android-based application; and (iii) data analysis on a web server. This system has shown to be working well during field tests in a bus journey and a construction site. It provides an effective service platform for collecting environmental data in near real-time, and raises the public awareness of environmental quality in micro-environments. PMID:25420154

Education of eye health professionals to meet the needs of the Pacific.

PubMed

du Toit, Renee; Brian, Garry; Palagyi, Anna; Williams, Carmel; Ramke, Jacqueline

2009-03-13

Vision impairment has significant impact on quality of life and substantial economic consequences. Yet, in the Pacific Islands, as in other low resource settings, it is predominantly caused by chronic conditions that can be treated or prevented. A whole of health approach is required to rectify this, and must include an increase in workforce capacity, both in size and effectiveness, by providing competency-based education for eye care professionals. Training in curative clinical skills is not sufficient: broader competencies--including those for chronic conditions, issues of care quality, integration into the wider health care system, and commitment to professionalism and life-long learning--need to be addressed. Using current best practice approaches in education, and taking into consideration local needs, The Pacific Eye Institute, an initiative of The Fred Hollows Foundation New Zealand, aims to produce graduates with these core competencies who are capable of effectively and acceptably working in community or hospital settings to provide sustainable high quality, comprehensive eye care with ongoing desirable and consistent eye health outcomes.

QRev—Software for computation and quality assurance of acoustic doppler current profiler moving-boat streamflow measurements—User’s manual for version 2.8

USGS Publications Warehouse

Mueller, David S.

2016-05-12

The software program, QRev computes the discharge from moving-boat acoustic Doppler current profiler measurements using data collected with any of the Teledyne RD Instrument or SonTek bottom tracking acoustic Doppler current profilers. The computation of discharge is independent of the manufacturer of the acoustic Doppler current profiler because QRev applies consistent algorithms independent of the data source. In addition, QRev automates filtering and quality checking of the collected data and provides feedback to the user of potential quality issues with the measurement. Various statistics and characteristics of the measurement, in addition to a simple uncertainty assessment are provided to the user to assist them in properly rating the measurement. QRev saves an extensible markup language file that can be imported into databases or electronic field notes software. The user interacts with QRev through a tablet-friendly graphical user interface. This report is the manual for version 2.8 of QRev.

Spatial Analysis of Air Quality Monitor Data in China, Japan, and South Korea

NASA Astrophysics Data System (ADS)

Rohde, Robert

2016-04-01

In 2015, Berkeley Earth published a widely-reported study concluding that air pollution contributes to 1.6 million deaths per year in China. This presentation will provide an update on that work with additional data for China and new analysis for South Korea and Japan. In China, two years of data from more than 1500 monitoring stations allows local trends to be estimated. Preliminary review indicates a trend towards improving air quality across most of China with decreasing emissions at most major population centers. Such improvements are consistent with tightening emissions standards and the decreasing usage of coal. In addition, new spatial analysis has been applied to ~900 monitoring sites in Japan and ~120 sites in South Korea. This new analysis provides information on air quality, pollutant source distributions, and implied mortality in these countries. Finally, boundary crossing fluxes in South Korea and Japan have been used to estimate the fraction of air pollution in Japan and South Korea that has being imported from sources in China.

Designing a two-rank acceptance sampling plan for quality inspection of geospatial data products

NASA Astrophysics Data System (ADS)

Tong, Xiaohua; Wang, Zhenhua; Xie, Huan; Liang, Dan; Jiang, Zuoqin; Li, Jinchao; Li, Jun

2011-10-01

To address the disadvantages of classical sampling plans designed for traditional industrial products, we originally propose a two-rank acceptance sampling plan (TRASP) for the inspection of geospatial data outputs based on the acceptance quality level (AQL). The first rank sampling plan is to inspect the lot consisting of map sheets, and the second is to inspect the lot consisting of features in an individual map sheet. The TRASP design is formulated as an optimization problem with respect to sample size and acceptance number, which covers two lot size cases. The first case is for a small lot size with nonconformities being modeled by a hypergeometric distribution function, and the second is for a larger lot size with nonconformities being modeled by a Poisson distribution function. The proposed TRASP is illustrated through two empirical case studies. Our analysis demonstrates that: (1) the proposed TRASP provides a general approach for quality inspection of geospatial data outputs consisting of non-uniform items and (2) the proposed acceptance sampling plan based on TRASP performs better than other classical sampling plans. It overcomes the drawbacks of percent sampling, i.e., "strictness for large lot size, toleration for small lot size," and those of a national standard used specifically for industrial outputs, i.e., "lots with different sizes corresponding to the same sampling plan."

The Efficacy of LUCAS in Prehospital Cardiac Arrest Scenarios: A Crossover Mannequin Study.

PubMed

Gyory, Robert A; Buchle, Scott E; Rodgers, David; Lubin, Jeffrey S

2017-04-01

High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines. We performed a crossover-controlled study in which a recording mannequin was placed on the second floor of a building. An emergency medical services (EMS) crew responded, defibrillated, and provided either manual or LUCAS CPR. The team transported the mannequin through hallways and down stairs to an ambulance and drove to the hospital with CPR in progress. Critical events were manually timed while the mannequin recorded data on compressions. Twenty-three EMS providers participated. Median time to defibrillation was not different for LUCAS compared to manual CPR (p=0.97). LUCAS had a lower median number of compressions per minute (112/min vs. 125/min; IQR = 102-128 and 102-126 respectively; p<0.002), which was more consistent with current American Heart Association CPR guidelines, and percent adequate compression rate (71% vs. 40%; IQR = 21-93 and 12-88 respectively; p<0.002). In addition, LUCAS had a higher percent adequate depth (52% vs. 36%; IQR = 25-64 and 29-39 respectively; p<0.007) and lower percent total hands-off time (15% vs. 20%; IQR = 10-22 and 15-27 respectively; p<0.005). LUCAS performed no differently than manual CPR in median compression release depth, percent fully released compressions, median time hands off, or percent correct hand position. In our simulation, LUCAS had a higher rate of adequate compressions and decreased total hands-off time as compared to manual CPR. Chest compression quality may be better when using a mechanical device during patient movement in prehospital cardiac arrest patient.

Service quality in public health clinics: perceptions of users and health professionals.

PubMed

Campos, Domingos Fernandes; Negromonte Filho, Rinaldo Bezerra; Castro, Felipe Nalon

2017-10-09

Purpose The purpose of this paper is to investigate the expectations and quality gaps in services provided at city public health clinics in the city of Natal, Brazil, from the perspective of patients and healthcare service providers. Design/methodology/approach The research sample consisted of 1,200 patients who used public health services and 265 providers - doctors, nutritionists, physiotherapists, psychologists, pharmacists and managers at three health clinics in the city of Natal, Brazil. A scale with 25 health service attributes was used in data collection. Summary statistics and t-test were used to analyze the data. Findings The results show that the providers think that users have lower levels of expectations than those indicated by the users in all attributes. Providers and users have the most approximate insights into what attributes are considered most important: explanations, level of knowledge and attention dispensed by health professionals. Users and providers perceived similar quality gaps for most of the attributes. The gaps were statistically the same, when comparing the mean quality shortcomings by means of a Student's test, considering a significance level of 5 percent, obtained independently by the manifestation of users and providers. Research limitations/implications The results reveal only a photograph of the moment. The study did not consider the differences that may exist between groups with different income levels, genders or age groups. A qualitative study could improve the understanding of the differences and coincidences of the diverse points of views. A more advanced research could even study possibilities so that health managers could promote changes in the service, some of them low cost, as the health professionals training for contact with patients. Practical implications The evaluation of the service quality complemented by the matrix of opportunities, importance × quality gaps generates information to help make decisions in the rational allocation of available resources and improvement of the quality of the service delivered to patients. Besides, it offers a focus to prioritize specific actions. Originality/value It is important to compare the perceptions of service quality between patients and the healthcare service providers who work in direct contact with them. The managers can smooth out these differences and ensure, over time, customer satisfaction. In this study, providers were asked to express what they think about the expectations of patients and about their own service performance delivered. Thus, not only the traditional gap 5 was measured, but it was also possible to evaluate the distance between what providers think that patients need and their actual needs.

State Education Indicators with a Focus on Title I: 2003-04

ERIC Educational Resources Information Center

Williams, Andra; Blank, Rolf K.; Toye, Carla; Petermann, Adam

2007-01-01

"State Education Indicators with a Focus on Title I: 2003-04" is the ninth in a series of reports designed to provide: (1) consistent, reliable indicators to allow analysis of trends for each state over time; (2) high quality, comparable state data; and (3) indicator formats designed for use by a diverse audience. Since its inception,…

State Education Indicators with a Focus on Title I: 2002-03

ERIC Educational Resources Information Center

Williams, Andra; Blank, Rolf K.; Toye, Carla; Petermann, Adam

2007-01-01

This paper is the eighth in a series of reports designed to provide (1) consistent, reliable indicators to allow analysis of trends for each state over time, (2) high data quality for comparability from state to state, and (3) accessible indicator formats aimed toward facilitating use by a variety of audiences. Since its inception, the report has…

Heavy Duty and Industrial Alternative Fuel Applications. Forklift and Material Handling. Alternative Fuels Training.

ERIC Educational Resources Information Center

Eckert, Doug; Casto, Lori

This training manual is designed to lay the foundation for trainers and technicians by showing the steps to achieve and maintain good indoor air quality through use of cleaner-burning forklifts and materials handlers. The first part of the manual consists of nine units that provide informational material and diagrams on these topics: comparison of…

Internal Drivers of External Flexibility: A Detailed Analysis

DTIC Science & Technology

2007-08-14

example, order processing within a supplier’s firm is a competence. Meeting customer demand by providing a consistent delivery schedule is a capability...Focus interview on the following logistics areas: a. order processing b. inventory c. transportation d. warehousing, materials handling...demands. In logistics, superior service depends upon order processing (Byrne and Markham 1991); quality of contact personnel (Innis and LaLonde 1994

City Strategies to Engage Older Youth in Afterschool Programs. Strategy Guide

ERIC Educational Resources Information Center

Russell, Lane; Deich, Sharon; Padgette, Heather Clapp; Cox, Amy

2012-01-01

A wide body of research shows that consistent participation in high-quality afterschool and summer programs, also called out-of-school time or OST, provides substantial benefits to children and youth and their communities. Youth are more prone to engage in juvenile delinquency, substance abuse and other risky behaviors after 3:00 p.m. if there are…

Revising an Engineering Design Rubric: A Case Study Illustrating Principles and Practices to Ensure Technical Quality of Rubrics

ERIC Educational Resources Information Center

Goldberg, Gail Lynn

2014-01-01

This article provides a detailed account of a rubric revision process to address seven common problems to which rubrics are prone: lack of consistency and parallelism; the presence of "orphan" and "widow" words and phrases; redundancy in descriptors; inconsistency in the focus of qualifiers; limited routes to partial credit;…

Applying lessons from commercial aviation safety and operations to resuscitation.

PubMed

Ornato, Joseph P; Peberdy, Mary Ann

2014-02-01

Both commercial aviation and resuscitation are complex activities in which team members must respond to unexpected emergencies in a consistent, high quality manner. Lives are at stake in both activities and the two disciplines have similar leadership structures, standard setting processes, training methods, and operational tools. Commercial aviation crews operate with remarkable consistency and safety, while resuscitation team performance and outcomes are highly variable. This commentary provides the perspective of two physician-pilots showing how commercial aviation training, operations, and safety principles can be adapted to resuscitation team training and performance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

New micro-beam beamline at SPring-8, targeting at protein micro-crystallography

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

Hirata, Kunio; Ueno, Go; Nisawa, Atsushi

2010-06-23

A new protein micro-crystallography beamline BL32XU at SPring-8 is under construction and scheduled to start operation in 2010. The beamline is designed to provide the stabilized and brilliant micro-beam to collect high-quality data from micro-crystals. The beamline consists of a hybrid in-vacuum undulator, a liquid-nitrogen cooled double crystal monochromator, and K-B focusing mirrors with large magnification factor. Development of data acquisition system and end station consists of high-precision diffractometer, high-efficiency area detector, sample auto-changer etc. are also in progress.

Health information exchange: 'lex parsimoniae'.

PubMed

Overhage, J Marc

2007-01-01

The country has identified health information exchange (HIE) as an essential strategy to address our crisis of cost, quality, and safety in health care. The Nationwide Health Information Network (NHIN) will consist of a "network of networks"--interconnected local or regional HIEs. We must create policy and technical interfaces that allow these local exchanges to share data with each other. More importantly, we must create nationwide exchanges that are consistent across the country. The should be parsimonious--not overly constraining how the exchanges operate and maintaining separation between the applications that provide functionality and the network that supports HIE.

Building an ethical organizational culture.

PubMed

Nelson, William A; Taylor, Emily; Walsh, Thom

2014-01-01

The success of a health care institution-as defined by delivering high-quality, high-value care, positive patient outcomes, and financial solvency-is inextricably tied to the culture within that organization. The ability to achieve and sustain alignment between its mission, values, and everyday practices defines a positive organizational culture. An institution that has a diminished organizational culture, reflected in the failure to consistently align management and clinical decisions and practices with its mission and values, will struggle. The presence of misalignment or of ethics gaps affects the quality of care being delivered, the morale of the staff, and the organization's image in the community. Transforming an organizational culture will provide a foundation for success and a framework for daily ethics-grounded operations in any organization. However, building an ethics-grounded organization is a challenging process requiring strong organization leadership and planning. Using a case study, the authors provide a multiyear, continuous step-by-step strategy consisting of identifying ethics culture gaps, establishing an ethics taskforce, clarifying and prioritizing the problems, developing strategy for change, implementing the strategy, and evaluating outcomes. This process will assist organizations in aligning its actions with its mission and values, to find success on all fronts.

Analysis of academic programs: comparing nursing and other university majors in the application of a quality, potential and cost model.

PubMed

Booker, Kathy; Hilgenberg, Cheryl

2010-01-01

Nursing is often considered expensive in the cost analysis of academic programs. Yet nursing programs have the power to attract many students, and the national nursing shortage has resulted in a high demand for nurses. Methods to systematically assess programs across an entire university academic division are often dissimilar in technique and outcome. At a small, private, Midwestern university, a model for comprehensive program assessment, titled the Quality, Potential and Cost (QPC) model, was developed and applied to each major offered at the university through the collaborative effort of directors, chairs, deans, and the vice president for academic affairs. The QPC model provides a means of equalizing data so that single measures (such as cost) are not viewed in isolation. It also provides a common language to ensure that all academic leaders at an institution apply consistent methods for assessment of individual programs. The application of the QPC model allowed for consistent, fair assessments and the ability to allocate resources to programs according to strategic direction. In this article, the application of the QPC model to School of Nursing majors and other selected university majors will be illustrated. Copyright 2010 Elsevier Inc. All rights reserved.

[Ecological regionalization of national cotton fiber quality in China using GGE biplot analysis method].

PubMed

Xu, Nai Yin; Jin, Shi Qiao; Li, Jian

2017-01-01

The distinctive regional characteristics of cotton fiber quality in the major cotton-producing areas in China enhance the textile use efficiency of raw cotton yarn by improving fiber quality through ecological regionalization. The "environment vs. trait" GGE biplot analysis method was adopted to explore the interaction between conventional cotton sub-regions and cotton fiber quality traits based on the datasets collected from the national cotton regional trials from 2011 to 2015. The results showed that the major cotton-producing area in China were divided into four fiber quality ecological regions, namely, the "high fiber quality ecological region", the "low micronaire ecological region", the "high fiber strength and micronaire ecological region", and the "moderate fiber quality ecological region". The high fiber quality ecological region was characterized by harmonious development of cotton fiber length, strength, micronaire value and the highest spinning consistency index, and located in the conventional cotton regions in the upper and lower reaches of Yangtze River Valley. The low micronaire value ecological region composed of the northern and south Xinjiang cotton regions was characterized by low micronaire value, relatively lower fiber strength, and relatively high spinning consistency index performance. The high fiber strength and micronaire value ecological region covered the middle reaches of Yangtze River Valley, Nanxiang Basin and Huaibei Plain, and was prominently characterized by high strength and micronaire value, and moderate performance of other traits. The moderate fiber quality ecological region included North China Plain and Loess Plateau cotton growing regions in the Yellow River Valley, and was characterized by moderate or lower performances of all fiber quality traits. This study effectively applied "environment vs. trait" GGE biplot to regionalize cotton fiber quality, which provided a helpful reference for the regiona-lized cotton growing regions in terms of optimal raw fiber production for textile industry, and gave a good example for the implementation of similar ecological regionalization of other crops as well.

Good Practices in Model‐Informed Drug Discovery and Development: Practice, Application, and Documentation

PubMed Central

Burghaus, R; Cosson, V; Cheung, SYA; Chenel, M; DellaPasqua, O; Frey, N; Hamrén, B; Harnisch, L; Ivanow, F; Kerbusch, T; Lippert, J; Milligan, PA; Rohou, S; Staab, A; Steimer, JL; Tornøe, C; Visser, SAG

2016-01-01

This document was developed to enable greater consistency in the practice, application, and documentation of Model‐Informed Drug Discovery and Development (MID3) across the pharmaceutical industry. A collection of “good practice” recommendations are assembled here in order to minimize the heterogeneity in both the quality and content of MID3 implementation and documentation. The three major objectives of this white paper are to: i) inform company decision makers how the strategic integration of MID3 can benefit R&D efficiency; ii) provide MID3 analysts with sufficient material to enhance the planning, rigor, and consistency of the application of MID3; and iii) provide regulatory authorities with substrate to develop MID3 related and/or MID3 enabled guidelines. PMID:27069774

Following through: The consistency of survivorship care plan use in United States cancer programs

PubMed Central

Deal, Allison M.; Mayer, Deborah K.; Weiner, Bryan J.

2014-01-01

Background The Institute of Medicine suggests that consistent survivorship care plan (SCP) use involves developing and delivering SCPs to all cancer survivors and their primary care providers (PCPs). We describe the consistency of SCP use in US cancer programs and assess its relationship with cancer program-level determinants. Methods We surveyed employees knowledgeable about survivorship practices in cancer programs reporting current SCP use (n=36; 81% response rate). We operationalized consistent SCP use as whether SCPs were (1) developed for ≥75% survivors; (2) delivered to ≥75% survivors; (3) delivered to ≥75% PCPs; and (4) all of the above. We use descriptive statistics to report SCP use consistency and evaluate associations using Fisher’s Exact and Wilcoxon Rank Sum tests. Results SCPs were developed for ≥75% survivors in five programs (15%); eight (25%) delivered ≥75% SCPs to survivors; seven (23%) delivered ≥75% SCPs to PCPs; only one program (4%) met all three criteria. We found relationships between SCP use consistency and geographic region (p = .05); initiating SCP use in response to survivors’ requests (p = .03); and membership in the National Cancer Institute’s National Community Cancer Centers Program (p = .01). Conclusion SCP use is highly inconsistent. Survivors and cancer care quality improvement organizations may play a key role in improving the consistency of SCP use in US cancer programs. Survivors can initiate SCP use. Cancer care quality improvement organizations can specify how cancer programs’ compliance with SCP guidelines will be assessed. Future research should identify mechanisms underlying the relationships that we found. PMID:24577781

Development of An Intelligent Flight Propulsion Control System

NASA Technical Reports Server (NTRS)

Calise, A. J.; Rysdyk, R. T.; Leonhardt, B. K.

1999-01-01

The initial design and demonstration of an Intelligent Flight Propulsion and Control System (IFPCS) is documented. The design is based on the implementation of a nonlinear adaptive flight control architecture. This initial design of the IFPCS enhances flight safety by using propulsion sources to provide redundancy in flight control. The IFPCS enhances the conventional gain scheduled approach in significant ways: (1) The IFPCS provides a back up flight control system that results in consistent responses over a wide range of unanticipated failures. (2) The IFPCS is applicable to a variety of aircraft models without redesign and,(3) significantly reduces the laborious research and design necessary in a gain scheduled approach. The control augmentation is detailed within an approximate Input-Output Linearization setting. The availability of propulsion only provides two control inputs, symmetric and differential thrust. Earlier Propulsion Control Augmentation (PCA) work performed by NASA provided for a trajectory controller with pilot command input of glidepath and heading. This work is aimed at demonstrating the flexibility of the IFPCS in providing consistency in flying qualities under a variety of failure scenarios. This report documents the initial design phase where propulsion only is used. Results confirm that the engine dynamics and associated hard nonlineaaities result in poor handling qualities at best. However, as demonstrated in simulation, the IFPCS is capable of results similar to the gain scheduled designs of the NASA PCA work. The IFPCS design uses crude estimates of aircraft behaviour. The adaptive control architecture demonstrates robust stability and provides robust performance. In this work, robust stability means that all states, errors, and adaptive parameters remain bounded under a wide class of uncertainties and input and output disturbances. Robust performance is measured in the quality of the tracking. The results demonstrate the flexibility of the IFPCS architecture and the ability to provide robust performance under a broad range of uncertainty. Robust stability is proved using Lyapunov like analysis. Future development of the IFPCS will include integration of conventional control surfaces with the use of propulsion augmentation, and utilization of available lift and drag devices, to demonstrate adaptive control capability under a greater variety of failure scenarios. Further work will specifically address the effects of actuator saturation.

TH-A-BRC-00: New Task Groups for External Beam QA: An Overview

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

NONE

2016-06-15

AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance -more » Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline of possible dosimetry protocols. The report will be reviewed by the AAPM Working Group on Recommendations for Radiotherapy External Beam Quality Assurance and then by the AAPM Science Council before publication in Medical Physics Survey of possible calibration protocols for calibration of Gamma Stereotactic Radiosurgery (GSR) devices Overview of modern Quality Assurance techniques for GSR AAPM TG-218 Tolerance Levels and Methodologies for IMRT Verification QA - Moyed Miften Patient-specific IMRT QA measurement is a process designed to identify discrepancies between calculated and delivered doses. Error tolerance limits are not well-defined or consistently applied across centers. The AAPM TG-218 report has been prepared to improve the understanding and consistency of this process by providing recommendations for methodologies and tolerance limits in patient-specific IMRT QA. Learning Objectives: Review measurement methods and methodologies for absolute dose verification Provide recommendations on delivery methods, data interpretation, the use of analysis routines and choice of tolerance limits for IMRT QA Sonja Dieterich has a research agreement with Sun Nuclear Inc. Steven Goetsch is a part-time consultant for Elekta.« less

TH-A-BRC-03: AAPM TG218: Measurement Methods and Tolerance Levels for Patient-Specific IMRT Verification QA

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

Miften, M.

2016-06-15

AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance -more » Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline of possible dosimetry protocols. The report will be reviewed by the AAPM Working Group on Recommendations for Radiotherapy External Beam Quality Assurance and then by the AAPM Science Council before publication in Medical Physics Survey of possible calibration protocols for calibration of Gamma Stereotactic Radiosurgery (GSR) devices Overview of modern Quality Assurance techniques for GSR AAPM TG-218 Tolerance Levels and Methodologies for IMRT Verification QA - Moyed Miften Patient-specific IMRT QA measurement is a process designed to identify discrepancies between calculated and delivered doses. Error tolerance limits are not well-defined or consistently applied across centers. The AAPM TG-218 report has been prepared to improve the understanding and consistency of this process by providing recommendations for methodologies and tolerance limits in patient-specific IMRT QA. Learning Objectives: Review measurement methods and methodologies for absolute dose verification Provide recommendations on delivery methods, data interpretation, the use of analysis routines and choice of tolerance limits for IMRT QA Sonja Dieterich has a research agreement with Sun Nuclear Inc. Steven Goetsch is a part-time consultant for Elekta.« less

TH-A-BRC-01: AAPM TG-135U1 QA for Robotic Radiosurgery

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

Dieterich, S.

AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. Learning Objectives: Understand the progression of technology since the first TG publication Learn which new QA procedures should be implemented for new technologies Be familiar with updates to clinical practice guidelines AAPM TG-178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance -more » Steven Goetsch Purpose: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. Methods: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols. Results: The most consistent results were obtained using the Elekta ABS 16cm diameter phantom, with the TG-51 protocol modified as recommended by Alfonso et al (Med Phys 35, 11, Nov 2008). A key white paper (Med Phys, in press) sponsored by Elekta Corporation, was used to obtain correction factors for the ionization chambers and phantoms used in this intercomparison. Consistent results were obtained for both Elekta Gamma Knife Model 4C and Gamma Knife Perfexion units as measured with each of two miniature ionization chambers. Conclusion: The full report gives clinical history and background of gamma stereotactic radiosurgery, clinical examples and history, quality assurance recommendations and outline of possible dosimetry protocols. The report will be reviewed by the AAPM Working Group on Recommendations for Radiotherapy External Beam Quality Assurance and then by the AAPM Science Council before publication in Medical Physics Survey of possible calibration protocols for calibration of Gamma Stereotactic Radiosurgery (GSR) devices Overview of modern Quality Assurance techniques for GSR AAPM TG-218 Tolerance Levels and Methodologies for IMRT Verification QA - Moyed Miften Patient-specific IMRT QA measurement is a process designed to identify discrepancies between calculated and delivered doses. Error tolerance limits are not well-defined or consistently applied across centers. The AAPM TG-218 report has been prepared to improve the understanding and consistency of this process by providing recommendations for methodologies and tolerance limits in patient-specific IMRT QA. Learning Objectives: Review measurement methods and methodologies for absolute dose verification Provide recommendations on delivery methods, data interpretation, the use of analysis routines and choice of tolerance limits for IMRT QA Sonja Dieterich has a research agreement with Sun Nuclear Inc. Steven Goetsch is a part-time consultant for Elekta.« less

Qualities of Single Electrode Stimulation as a Function of Rate and Place of Stimulation with a Cochlear Implant

PubMed Central

Landsberger, David M.; Vermeire, Katrien; Claes, Annes; Van Rompaey, Vincent; Van de Heyning, Paul

2015-01-01

Objectives Although it has been previously shown that changes in temporal coding produce changes in pitch in all cochlear regions, research has suggested that temporal coding might be best encoded in relatively apical locations. We hypothesized that although temporal coding may provide useable information at any cochlear location, low rates of stimulation might provide better sound quality in apical regions that are more likely to encode temporal information in the normal ear. In the present study, sound qualities of single electrode pulse trains were scaled to provide insight into the combined effects of cochlear location and stimulation rate on sound quality. Design Ten long term users of MED-EL cochlear implants with 31 mm electrode arrays (Standard or FLEXSOFT) were asked to scale the sound quality of single electrode pulse trains in terms of how “Clean”, “Noisy”, “High”, and “Annoying” they sounded. Pulse trains were presented on most electrodes between 1 and 12 representing the entire range of the long electrode array at stimulation rates of 100, 150, 200, 400, or 1500 pulses per second. Results While high rates of stimulation are scaled as having a “Clean” sound quality across the entire array, only the most apical electrodes (typically 1 through 3) were considered “Clean” at low rates. Low rates on electrodes 6 through 12 were not rated as “Clean” while the low rate quality of electrodes 4 and 5 were typically in between. Scaling of “Noisy” responses provided an approximately inverse pattern as “Clean” responses. “High” responses show the trade-off between rate and place of stimulation on pitch. Because “High” responses did not correlate with “Clean” responses, subjects were not rating sound quality based on pitch. Conclusions If explicit temporal coding is to be provided in a cochlear implant, it is likely to sound better when provided apically. Additionally, the finding that low rates sound clean only at apical places of stimulation is consistent with previous findings that a change in rate of stimulation corresponds to an equivalent change in perceived pitch at apical locations. Collectively, the data strongly suggests that temporal coding with a cochlear implant is optimally provided by electrodes placed well into the second cochlear turn. PMID:26583480

Exploring in integrated quality evaluation of Chinese herbal medicines: the integrated quality index (IQI) for aconite.

PubMed

Zhang, Ding-kun; Wang, Jia-bo; Yang, Ming; Peng, Cheng; Xiao, Xiao-he

2015-07-01

Good medicinal herbs, good drugs. Good evaluation method and indices are the prerequisite of good medicinal herbs. However, there exist numerous indices for quality evaluation and control in Chinese medicinal materials. However, most of these indices are non-interrelated each other, as well as having little relationship with efficiency and safety. The results of different evaluatior methods may not be consistent, even contradictory. Considering the complex material properties of Chinese medicinal materials, single method and index is difficult to objectively and comprehensively reflect the quality. Therefore, it is essential to explore the integrated evaluation methods. In this paper, oriented by the integrated evaluation strategies for traditional Chinese medicine quality, a new method called integrated quality index (IQI) by the integration of empirical evaluation, chemical evaluation, and biological evaluation was proposed. In addition, a study case of hypertoxic herb Aconitum carmichaelii Debx. was provided to explain this method in detail. The results suggested that in the view of specifications, the average weight of Jiangyou aconite was the greatest, followed by Weishan aconite, Butuo aconite, Hanzhong aconite, and Anxian aconite; from the point of chemical components, Jiangyou aconite had the characteristic with strong efficacy and weak toxicity, next was Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite; taking toxicity price as the index, Hanzhong aconite and Jiangyou aconite have the lower toxicity, while Butuo aconite, Weishan aconite, and Anxian aconite have the relatively higher one. After the normalization and integration of evaluation results, we calculated the IQI value of Jiangyou aconite, Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite were 0.842 +/- 0.091, 0.597 +/- 0.047, 0.442 +/- 0.033, 0.454 +/- 0.038, 0.170 +/- 0.021, respectively. The quality of Jiangyou aconite is significantly better than the others (P < 0.05) followed by Hanzhong aconite, which is consistent with the traditional understanding of genuineness. It can be concluded that IQI achieves the integrated control and evaluation for the quality of Chinese medicinal materials, and it is an exploration for building the good medicinal herbs standards. In addition, IQI provides technical supports for the geoherbalism evaluation, selective breeding, the development of precision decoction pieces, high quality and favourable price in market circulation, and rational drug use.

A Transparent and Transferable Framework for Tracking Quality Information in Large Datasets

PubMed Central

Smith, Derek E.; Metzger, Stefan; Taylor, Jeffrey R.

2014-01-01

The ability to evaluate the validity of data is essential to any investigation, and manual “eyes on” assessments of data quality have dominated in the past. Yet, as the size of collected data continues to increase, so does the effort required to assess their quality. This challenge is of particular concern for networks that automate their data collection, and has resulted in the automation of many quality assurance and quality control analyses. Unfortunately, the interpretation of the resulting data quality flags can become quite challenging with large data sets. We have developed a framework to summarize data quality information and facilitate interpretation by the user. Our framework consists of first compiling data quality information and then presenting it through 2 separate mechanisms; a quality report and a quality summary. The quality report presents the results of specific quality analyses as they relate to individual observations, while the quality summary takes a spatial or temporal aggregate of each quality analysis and provides a summary of the results. Included in the quality summary is a final quality flag, which further condenses data quality information to assess whether a data product is valid or not. This framework has the added flexibility to allow “eyes on” information on data quality to be incorporated for many data types. Furthermore, this framework can aid problem tracking and resolution, should sensor or system malfunctions arise. PMID:25379884

Tsukamoto fuzzy implementation to identify the pond water quality of koi

NASA Astrophysics Data System (ADS)

Qur'ania, A.; Verananda, D. I.

2017-01-01

The colour quality of koi was affected by the water quality in the pond. Koi fish have a diversity of types differentiated based on the body colour groups, such as one colour pattern, two colour patterns, three colours patterns and even more. Each colour characteristic of the koi have different handling, particularly in the handling of water quality, this is because the colour pigments in the body was affected by the composition of water quality include temperature, pH, TDS, do and salinity. The data of koi fish used were sanke, sowa, kohaku, shiro, yamabuki, ogon and chagoi. The aim of this study is to make an application to inform the condition of the pool water quality that can help breeders to know the water quality that will improve the handling strategies through water media. Tsukamoto Fuzzy method used to produce the three outputs namely water quality, water grade, and water conditions. The output of water quality consists of four categories, namely optimal, moderate, poor, and very poor. The output of water grade consists of grade A to D, while the output of water conditions consist of an excellent, good, bad, and very bad. Input to the application consists of five parameters, namely water temperature, pH, TDS, do and salinity.

The trust-commitment challenge in service quality-loyalty relationships.

PubMed

Moreira, Antonio Carrizo; Silva, Pedro Miguel

2015-01-01

The purpose of this paper is to develop and empirically test a model to examine service quality, satisfaction, trust and commitment as loyalty antecedents in a private healthcare service. The approach was tested using structural equation modelling, involving 175 patients from a private Portuguese healthcare unit, using a revised Service Quality Assessment Scale (SQAS) scale for service quality evaluation. The scale used to evaluate service quality is valid and meaningful. Service quality proved to be a multidimensional construct and relevant to build satisfaction. The path satisfaction→trust→loyalty was validated, whereas the path satisfaction→commitment→loyalty was not statistically supported. The revised SQAS scale showed good internal consistency in healthcare context. Further trust-commitment antecedents must be examined in a private healthcare landscape to generalise the findings. Healthcare quality managers must explore the service quality dimensions to generate satisfaction among their patients. Developing trust generates positive patient attitudes and loyalty. This study explores using the SQAS scale in a private healthcare context. The authors provide further evidence that service quality is an antecedent and different from satisfaction. All the measures used proved to be valid and reliable. Trust and commitment play different roles in their relationship with loyalty.

[Practice report: the process-based indicator dashboard. Visualising quality assurance results in standardised processes].

PubMed

Petzold, Thomas; Hertzschuch, Diana; Elchlep, Frank; Eberlein-Gonska, Maria

2014-01-01

Process management (PM) is a valuable method for the systematic analysis and structural optimisation of the quality and safety of clinical treatment. PM requires a high motivation and willingness to implement changes of both employees and management. Definition of quality indicators is required to systematically measure the quality of the specified processes. One way to represent comparable quality results is the use of quality indicators of the external quality assurance in accordance with Sect. 137 SGB V—a method which the Federal Joint Committee (GBA) and the institutions commissioned by the GBA have employed and consistently enhanced for more than ten years. Information on the quality of inpatient treatment is available for 30 defined subjects throughout Germany. The combination of specified processes with quality indicators is beneficial for the information of employees. A process-based indicator dashboard provides essential information about the treatment process. These can be used for process analysis. In a continuous consideration of these indicator results values can be determined and errors will be remedied quickly. If due consideration is given to these indicators, they can be used for benchmarking to identify potential process improvements. Copyright © 2014. Published by Elsevier GmbH.

Effects of a performance and quality improvement intervention on the work environment in HIV-related care: a quasi-experimental evaluation in Zambia.

PubMed

Bazant, Eva; Sarkar, Supriya; Banda, Joseph; Kanjipite, Webby; Reinhardt, Stephanie; Shasulwe, Hildah; Mulilo, Joyce Monica Chongo; Kim, Young Mi

2014-12-20

Human resource shortages and reforms in HIV-related care make it challenging for frontline health care providers in southern Africa to deliver high-quality services. At health facilities of the Zambian Defence Forces, a performance and quality improvement approach was implemented to improve HIV-related care and was evaluated in 2010/2011. Changes in providers' work environment and perceived quality of HIV-related care were assessed to complement data of provider performance. The intervention involved on-site training, supportive supervision, and action planning focusing on detailed service delivery standards. The quasi-experimental evaluation collected pre- and post-intervention data from eight intervention and comparison facilities matched on defence force branch and baseline client volume. Overall, 101 providers responded to a 24-item questionnaire on the work environment, covering topics of drugs, supplies, and equipment; training, feedback, and supervision; compensation; staffing; safety; fulfilment; and HIV services quality. In bivariate analysis and multivariate analyses, we assessed changes within each study group and between the two groups. In the bivariate analysis, the intervention group providers reported improvements in the work environment on adequacy of equipment, feeling safe from harm, confidence in clinical skills, and reduced isolation, while the comparison group reported worsening of the work environment on supplies, training, safety, and departmental morale.In the multivariate analysis, the intervention group's improvement and the comparison group's decline were significant on perceived adequacy of drugs, supplies, and equipment; constructive feedback received from supervisor and co-workers; and feeling safe from physical harm (all P <0.01, except P <0.04 for equipment). Further, the item "provider lacks confidence in some clinical skills" declined in the intervention group but increased in the comparison group (P = -0.005). In multivariate analysis, changes in perceived quality of HIV care did not differ between study groups. Provider perceptions were congruent with observations of preparing drugs, supplies, equipment, and in service delivery of prevention of mother-to-child transmission of HIV and antiretroviral therapy follow-up care. The performance and quality improvement intervention implemented at Zambian Defence Forces' health facilities was associated with improvements in providers' perceptions of work environment consistent with the intervention's focus on commodities, skills acquisition, and receipt of constructive feedback.

Pragmatic quality metrics for evolutionary software development models

NASA Technical Reports Server (NTRS)

Royce, Walker

1990-01-01

Due to the large number of product, project, and people parameters which impact large custom software development efforts, measurement of software product quality is a complex undertaking. Furthermore, the absolute perspective from which quality is measured (customer satisfaction) is intangible. While we probably can't say what the absolute quality of a software product is, we can determine the relative quality, the adequacy of this quality with respect to pragmatic considerations, and identify good and bad trends during development. While no two software engineers will ever agree on an optimum definition of software quality, they will agree that the most important perspective of software quality is its ease of change. We can call this flexibility, adaptability, or some other vague term, but the critical characteristic of software is that it is soft. The easier the product is to modify, the easier it is to achieve any other software quality perspective. This paper presents objective quality metrics derived from consistent lifecycle perspectives of rework which, when used in concert with an evolutionary development approach, can provide useful insight to produce better quality per unit cost/schedule or to achieve adequate quality more efficiently. The usefulness of these metrics is evaluated by applying them to a large, real world, Ada project.

Service quality perceptions in primary health care centres in Greece

PubMed Central

Papanikolaou, Vicky; Zygiaris, Sotiris

2012-01-01

Abstract Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402

Service quality perceptions in primary health care centres in Greece.

PubMed

Papanikolaou, Vicky; Zygiaris, Sotiris

2014-04-01

The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.

Microbiological monitoring for the US Geological Survey National Water-Quality Assessment Program

USGS Publications Warehouse

Francy, Donna S.; Myers, Donna N.; Helsel, Dennis R.

2000-01-01

Data to characterize the microbiological quality of the Nation?s fresh, marine, and estuarine waters are usually collected for local purposes, most often to judge compliance with standards for protection of public health in swimmable or drinkable waters. Methods and procedures vary with the objectives and practices of the parties collecting data and are continuously being developed or modified. Therefore, it is difficult to provide a nationally consistent picture of the microbial quality of the Nation?s waters. Study objectives and guidelines for a national microbiological monitoring program are outlined in this report, using the framework of the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) program. A national program is designed to provide long-term data on the presence of microbiological pathogens and indicators in ground water and surface water to support effective water policy and management. Three major groups of waterborne pathogens affect the public health acceptability of waters in the United States?bacteria, protozoa, and viruses. Microbiological monitoring in NAWQA would be designed to assess the occurrence, distribution, and trends of pathogenic organisms and indicators in surface waters and ground waters; relate the patterns discerned to factors that help explain them; and improve our understanding of the processes that control microbiological water quality.

Structural barriers to South African volunteer home-based caregivers providing quality care: the need for a policy for caregivers not affiliated to primary healthcare clinics.

PubMed

Morton, David; Mayekiso, Thoko; Cunningham, Peter

2018-03-01

Community home-based care (CHBC) is a critical component of non-formal care in communities in Africa that have a high prevalence of HIV and tuberculosis (TB). Community carers consisting primarily of volunteers are critical role players in African healthcare systems and particularly in South Africa's strategy to fight HIV and AIDS. This paper explores the structural barriers volunteer caregivers need to overcome to provide quality CHBC. The researchers used two focus group discussions with key informants (each with four participants), and semi-structured interviews with six key informants to collect data relating to the meaning of quality CHBC. The data were coded using Tesch's data analysis technique. A major theme that emerged from the results was "Addressing structural challenges to improve the quality of CHBC". Subthemes underpinning this theme were: 1) lack of standardised training of volunteer caregivers; 2) the need for a scope of practice, parameters and legal boundaries; 3) lack of monitoring and evaluation (M&E) of CHBC; and 4) the importance of mentoring and supervision in CHBC. CHBC policy should address the need for standardised training programmes for caregivers, so that they are equipped with multiple skills. Furthermore CHBC policy must emphasise mentoring as well as M&E to encourage quality care. Finally, the policy should provide a clear scope of practice for caregivers to regulate their competencies and boundaries.

A predictive model for turfgrass color and quality evaluation using deep learning and UAV imageries

NASA Astrophysics Data System (ADS)

Phan, Claude; Raheja, Amar; Bhandari, Subodh; Green, Robert L.; Do, Dat

2017-05-01

Millions of Americans come into contact with turfgrass on a daily basis. Often undervalued and seen as visual support stimulus for a larger entity, millions of acres of turfgrass can be found on residential lawns (which also provides an area for recreation), commercial landscape, parks, athletic fields, and golf courses. Besides these uses, turfgrass provides many functional benefits to the environment, such as reducing soil erosion, cooling its surrounding area, and soil carbon sequestration. However, rapidly expanding uses of turfgrass have also raised alarm for natural resources conservation and environmental quality, the largest impact being water consumption. This paper presents a machine learning approach that can assist growers and researchers in determining the overall quality and color rating of turfgrass, thereby assisting in turfgrass management including optimized irrigation water scheduling. Tools from Google and NVIDIA enable models to be trained using deep learning techniques on personal computers or on small form factor processors that can be used aboard small unmanned aerial vehicles (UAVs). The typical evaluation process is a long, laborious process, which is subjective by nature, and thus often exposed to criticism and concern. A computational approach to quality and color assessment will provide faster, accurate, and more consistent ratings, which in turn will help increase irrigation water use efficiency. The overall goal of the ongoing research is to use deep learning techniques and UAV imageries for the turfgrass quality and color assessment and help all the stakeholders to optimize water conservation.

Trust in Physicians, Continuity and Coordination of Care, and Quality of Death in Patients with Advanced Cancer.

PubMed

Hamano, Jun; Morita, Tatsuya; Fukui, Sakiko; Kizawa, Yoshiyuki; Tunetou, Satoru; Shima, Yasuo; Kobayakawa, Makoto; Aoyama, Maho; Miyashita, Mitsunori

2017-11-01

Provider-centered factors contribute to unexplained variation in the quality of death (QOD). The relationship between healthcare providers (HCPs) and patients, bidirectional communication, and consistency of longitudinal care planning are important provider-centered factors. To explore whether the level of trust in HCPs, the quality of continuity of care, and the level of coordination of care among home HCPs are associated with the QOD for cancer patients dying at home. This study was a part of a nationwide multicenter questionnaire survey of bereaved family members of cancer patients evaluating the quality of end-of-life care in Japan. We investigated 702 family members of cancer patients who died at home. The QOD was evaluated from nine core domains of the short version of the Good Death Inventory (GDI). We measured five factors on a Likert scale, including patient and family trust in HCPs, continuity of care by home hospice and hospital physicians, and coordination of care among home hospice staff. A total of 538 responses (77%) were obtained and 486 responses were analyzed. Trust in HCPs was correlated with the GDI score (r = 0.300-0.387, p < 0.001). The quality of care coordination was associated with the GDI score (r = 0.242, p < 0.001). Trust of the patient and family in home hospice staff, as well as coordination of care among hospice staff, are associated with the QOD for cancer patients dying at home.

[Individual medical relevance of headaches. Comorbidities and quality of life].

PubMed

Haag, G

2014-08-01

In a multitude of cases, very frequent primary headaches lead to a clear deterioration in quality of life. Particularly in patients with chronic migraine, chronic tension headache, and cluster headache, quality of life is limited. This contradicts the preconception still encountered today that headaches are not a serious illness. Comorbidities with somatic and above all mental disorders are also very frequently observed in headache patients. In the foreground are the cardiovascular diseases of arterial hypertension, stroke, and coronary heart disease, as well as the mental disorders of depression, anxiety disorders, posttraumatic stress disorders, and sleep disorders. When such comorbidities are present, the quality of life of the sufferers is significantly reduced. Therefore, headache disorders should be taken seriously and sufferers should be provided with a consistent therapy. In cases of severe types of headache and in the presence of comorbidities, it is imperative that therapy is also prophylactic and multimodal in nature.

Competition in the pharmaceutical industry: how do quality differences shape advertising strategies?

PubMed

de Frutos, Maria-Angeles; Ornaghi, Carmine; Siotis, Georges

2013-01-01

We present a Hotelling model of price and advertising competition between prescription drugs that differ in quality/side effects. Promotional effort results in the endogenous formation of two consumer groups: brand loyal and non-brand loyal ones. We show that advertising intensities are strategic substitutes, with the better quality drugs being the ones that are most advertised. This positive association stems from the higher rents that firms can extract from consumers whose brand loyalty is endogenously determined by promotional effort. The model's main results on advertising and pricing strategies are taken to the data. The latter consists of product level data on prices and quantities, product level advertising data, as well as the qualitative information on drug quality contained in the Orange Book compiled by the Food and Drug Administration (FDA). The empirical results provide strong support to the model's predictions. Copyright © 2012 Elsevier B.V. All rights reserved.

Water resources data-West Virginia, water year 2004

USGS Publications Warehouse

Ward, S.M.; Rosier, M.T.; Crosby, G.R.

2005-01-01

Water-resources data for the 2004 water year for West Virginia consist of records of stream discharge, reservoir and ground-water levels, and water quality of streams and ground-water wells. This report contains discharge records for 65 streamflow-gaging stations; discharge records provided by adjacent states for 8 streamflow-gaging stations; annual maximum discharge at 17 crest-stage partial-record stations; stage records for 14 detention reservoirs; water-quality records for 2 stations; and water-level records for 10 observation wells. Locations of streamflow, detention reservoir, and water-quality stations are shown on figure 4. Locations of ground-water observation wells are shown on figure 5. Additional water-quality data were collected at various sites, not involved in the systematic data collection program, and are published as miscellaneous sites. These data represent that part of the National Water Data System collected by the U.S. Geological Survey and cooperating State and Federal agencies in West Virginia.

A Regression-Based Family of Measures for Full-Reference Image Quality Assessment

NASA Astrophysics Data System (ADS)

Oszust, Mariusz

2016-12-01

The advances in the development of imaging devices resulted in the need of an automatic quality evaluation of displayed visual content in a way that is consistent with human visual perception. In this paper, an approach to full-reference image quality assessment (IQA) is proposed, in which several IQA measures, representing different approaches to modelling human visual perception, are efficiently combined in order to produce objective quality evaluation of examined images, which is highly correlated with evaluation provided by human subjects. In the paper, an optimisation problem of selection of several IQA measures for creating a regression-based IQA hybrid measure, or a multimeasure, is defined and solved using a genetic algorithm. Experimental evaluation on four largest IQA benchmarks reveals that the multimeasures obtained using the proposed approach outperform state-of-the-art full-reference IQA techniques, including other recently developed fusion approaches.

Health-Related Quality of Life in University Dance Students.

PubMed

White, Hayley M; Hoch, Johanna M; Hoch, Matthew C

2018-03-01

Injuries are common among dancers and may negatively affect health-related quality of life (HRQL). The modified Disablement in the Physically Active Scale (mDPA) is a generic patient-reported outcome instrument that could be used when providing care to patients participating in performing arts. The objective of this pilot study was to examine the internal consistency of the mDPA and assess overall HRQL using the mDPA in university dance students. Thirty-one female university dance students completed the mDPA during one data collection session. Higher scores on the Physical Summary Component (mDPA-PSC), the Mental Summary Component (mDPAMSC), and mDPA-Total indicated increased disablement. The internal consistency was determined using Cronbachs alpha. The mDPA-Total, mDPA-PSC, and mDPAMSC scores were examined descriptively using mean and standard deviations. Individual item responses were also examined. The proportion of university dance students with clinically relevant levels of disablement on the mDPA-Total was examined using a previously established minimally clinically important difference value. The internal consistency for the mDPA-MSC (a=0.91) and mDPATotal (a=0.90) was excellent and good for the mDPA-PSC (a=0.88). A large proportion (71%) of university dance students demonstrated clinically relevant levels of disablement despite fully participating in dance-related activities. Pain, impaired motion, and stress were the greatest contributors to increased disablement in these individuals. The mDPA scores observed in this pilot study indicate that many dance students experience levels of disablement and decreased HRQL which may warrant physical and mental intervention. Clinicians providing healthcare services to performing artists should consider using the mDPA to provide patient-centered care.

A Methodological Analysis of Randomized Clinical Trials of Computer-Assisted Therapies for Psychiatric Disorders: Toward Improved Standards for an Emerging Field

PubMed Central

Kiluk, Brian D.; Sugarman, Dawn E.; Nich, Charla; Gibbons, Carly J.; Martino, Steve; Rounsaville, Bruce J.; Carroll, Kathleen M.

2013-01-01

Objective Computer-assisted therapies offer a novel, cost-effective strategy for providing evidence-based therapies to a broad range of individuals with psychiatric disorders. However, the extent to which the growing body of randomized trials evaluating computer-assisted therapies meets current standards of methodological rigor for evidence-based interventions is not clear. Method A methodological analysis of randomized clinical trials of computer-assisted therapies for adult psychiatric disorders, published between January 1990 and January 2010, was conducted. Seventy-five studies that examined computer-assisted therapies for a range of axis I disorders were evaluated using a 14-item methodological quality index. Results Results indicated marked heterogeneity in study quality. No study met all 14 basic quality standards, and three met 13 criteria. Consistent weaknesses were noted in evaluation of treatment exposure and adherence, rates of follow-up assessment, and conformity to intention-to-treat principles. Studies utilizing weaker comparison conditions (e.g., wait-list controls) had poorer methodological quality scores and were more likely to report effects favoring the computer-assisted condition. Conclusions While several well-conducted studies have indicated promising results for computer-assisted therapies, this emerging field has not yet achieved a level of methodological quality equivalent to those required for other evidence-based behavioral therapies or pharmacotherapies. Adoption of more consistent standards for methodological quality in this field, with greater attention to potential adverse events, is needed before computer-assisted therapies are widely disseminated or marketed as evidence based. PMID:21536689

Provider Monitoring and Pay-for-Performance When Multiple Providers Affect Outcomes: An Application to Renal Dialysis

PubMed Central

Hirth, Richard A; Turenne, Marc N; Wheeler, John RC; Pan, Qing; Ma, Yu; Messana, Joseph M

2009-01-01

Objective To characterize the influence of dialysis facilities and nephrologists on resource use and patient outcomes in the dialysis population and to illustrate how such information can be used to inform payment system design. Data Sources Medicare claims for all hemodialysis patients for whom Medicare was the primary payer in 2004, combined with the Medicare Enrollment Database and the CMS Medical Evidence Form (CMS Form 2728), which is completed at onset of renal replacement therapy. Study Design Resource use (mainly drugs and laboratory tests) per dialysis session and two clinical outcomes (achieving targets for anemia management and dose of dialysis) were modeled at the patient level with random effects for nephrologist and dialysis facility, controlling for patient characteristics. Results For each measure, both the physician and the facility had significant effects. However, facilities were more influential than physicians, as measured by the standard deviation of the random effects. Conclusions The success of tools such as P4P and provider profiling relies upon the identification of providers most able to enhance efficiency and quality. This paper demonstrates a method for determining the extent to which variation in health care costs and quality of care can be attributed to physicians and institutional providers. Because variation in quality and cost attributable to facilities is consistently larger than that attributable to physicians, if provider profiling or financial incentives are targeted to only one type of provider, the facility appears to be the appropriate locus. PMID:19555398

Plan characteristics and SSI enrollees' access to and quality of care in four TennCare MCOs.

PubMed

Hill, Steven C; Wooldridge, Judith

2002-10-01

To assess hypotheses about which managed care organization (MCO) characteristics affect access to care and quality of care--including access to specialists, providers' knowledge about disability, and coordination of care--for people with disabilities. Survey of blind/disabled Supplemental Security Income (SSI) enrollees in four MCOs serving TennCare, Tennessee's Medicaid managed care program, in Memphis, conducted from 1998 through spring 1999. We compared enrollee reports of access and quality across the four MCOs using regression methods, and we use case study methods to assess whether patterns both within and across MCOs are consistent with the hypotheses. We conducted computer-assisted telephone surveys and used regression analysis to compare access and quality controlling for enrollee characteristics. Although the four MCOs' characteristics varied, access to providers, coordination of care, and access to some services were generally similar across MCOs. Enrollees in one plan, the only MCO with a larger provider network and that paid physicians on a fee-for-service basis, reported their providers were more knowledgeable, and they had more secondary preventive care visits. Differences found in access to specialists and delays in approving care appear to be unrelated to characteristics reported by the MCOs, but instead may be related to how tightly utilization is reviewed. Plan networks, financial incentives, utilization management methods, and state requirements are important areas for further study, and, in the meantime, ongoing monitoring of SSI enrollees in each MCO may be important for detecting problems and successes.

MO-D-213-06: Quantitative Image Quality Metrics Are for Physicists, Not Radiologists: How to Communicate to Your Radiologists Using Their Language

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

Szczykutowicz, T; Rubert, N; Ranallo, F

Purpose: A framework for explaining differences in image quality to non-technical audiences in medial imaging is needed. Currently, this task is something that is learned “on the job.” The lack of a formal methodology for communicating optimal acquisition parameters into the clinic effectively mitigates many technological advances. As a community, medical physicists need to be held responsible for not only advancing image science, but also for ensuring its proper use in the clinic. This work outlines a framework that bridges the gap between the results from quantitative image quality metrics like detectability, MTF, and NPS and their effect on specificmore » anatomical structures present in diagnostic imaging tasks. Methods: Specific structures of clinical importance were identified for a body, an extremity, a chest, and a temporal bone protocol. Using these structures, quantitative metrics were used to identify the parameter space that should yield optimal image quality constrained within the confines of clinical logistics and dose considerations. The reading room workflow for presenting the proposed changes for imaging each of these structures is presented. The workflow consists of displaying images for physician review consisting of different combinations of acquisition parameters guided by quantitative metrics. Examples of using detectability index, MTF, NPS, noise and noise non-uniformity are provided. During review, the physician was forced to judge the image quality solely on those features they need for diagnosis, not on the overall “look” of the image. Results: We found that in many cases, use of this framework settled mis-agreements between physicians. Once forced to judge images on the ability to detect specific structures inter reader agreement was obtained. Conclusion: This framework will provide consulting, research/industrial, or in-house physicists with clinically relevant imaging tasks to guide reading room image review. This framework avoids use of the overall “look” or “feel” to dictate acquisition parameter selection. Equipment grants GE Healthcare.« less

The CRAC cohort model: A computerized low cost registry of interventional cardiology with daily update and long-term follow-up.

PubMed

Rangé, G; Chassaing, S; Marcollet, P; Saint-Étienne, C; Dequenne, P; Goralski, M; Bardiére, P; Beverilli, F; Godillon, L; Sabine, B; Laure, C; Gautier, S; Hakim, R; Albert, F; Angoulvant, D; Grammatico-Guillon, L

2018-05-01

To assess the reliability and low cost of a computerized interventional cardiology (IC) registry to prospectively and systematically collect high-quality data for all consecutive coronary patients referred for coronary angiogram or/and coronary angioplasty. Rigorous clinical practice assessment is a key factor to improve prognosis in IC. A prospective and permanent registry could achieve this goal but, presumably, at high cost and low level of data quality. One multicentric IC registry (CRAC registry), fully integrated to usual coronary activity report software, started in the centre Val-de-Loire (CVL) French region in 2014. Quality assessment of CRAC registry was conducted on five IC CathLab of the CVL region, from January 1st to December 31st 2014. Quality of collected data was evaluated by measuring procedure exhaustivity (comparing with data from hospital information system), data completeness (quality controls) and data consistency (by checking complete medical charts as gold standard). Cost per procedure (global registry operating cost/number of collected procedures) was also estimated. CRAC model provided a high-quality level with 98.2% procedure completeness, 99.6% data completeness and 89% data consistency. The operating cost per procedure was €14.70 ($16.51) for data collection and quality control, including ST-segment elevation myocardial infarction (STEMI) preadmission information and one-year follow-up after angioplasty. This integrated computerized IC registry led to the construction of an exhaustive, reliable and costless database, including all coronary patients entering in participating IC centers in the CVL region. This solution will be developed in other French regions, setting up a national IC database for coronary patients in 2020: France PCI. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Quality assurance: The 10-Group Classification System (Robson classification), induction of labor, and cesarean delivery.

PubMed

Robson, Michael; Murphy, Martina; Byrne, Fionnuala

2015-10-01

Quality assurance in labor and delivery is needed. The method must be simple and consistent, and be of universal value. It needs to be clinically relevant, robust, and prospective, and must incorporate epidemiological variables. The 10-Group Classification System (TGCS) is a simple method providing a common starting point for further detailed analysis within which all perinatal events and outcomes can be measured and compared. The system is demonstrated in the present paper using data for 2013 from the National Maternity Hospital in Dublin, Ireland. Interpretation of the classification can be easily taught. The standard table can provide much insight into the philosophy of care in the population of women studied and also provide information on data quality. With standardization of audit of events and outcomes, any differences in either sizes of groups, events or outcomes can be explained only by poor data collection, significant epidemiological variables, or differences in practice. In April 2015, WHO proposed that the TGCS (also known as the Robson classification) is used as a global standard for assessing, monitoring, and comparing cesarean delivery rates within and between healthcare facilities. Copyright © 2015. Published by Elsevier Ireland Ltd.

Evaluation and Improved Use of Fecal Occult Blood Test in the Constipated Child.

PubMed

Kilway, Denise M

2016-01-01

This quality improvement project examined the use of fecal occult blood test in the constipated child in a pediatric gastroenterology outpatient clinic. A retrospective chart review was completed on 100 children seen for an initial visit with the gastroenterology provider. The number of fecal occult blood tests performed and the child's coinciding symptoms were tallied and compared with the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations. An educational intervention was held with the pediatric gastroenterology providers consisting of a PowerPoint presentation summarizing aims of the quality improvement project and reviewing recommendations for use of fecal occult blood test in the constipated child. Pre- and post-intervention chart review data sets were compared. Results showed a 19.6% decrease in the use of fecal occult blood tests performed during the post-intervention timeframe. However, when used in conjunction with North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations, the appropriateness of fecal occult blood test use increased by 71.4% in the post-intervention patients. Reviewing the recommendations with gastroenterology providers assisted in optimizing the meaningful use of fecal occult blood test, improving quality and safety of care for children seen in the pediatric gastroenterology outpatient clinic.

Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel.

PubMed

Keller, H H; Vesnaver, E; Davidson, B; Allard, J; Laporte, M; Bernier, P; Payette, H; Jeejeebhoy, K; Duerksen, D; Gramlich, L

2014-04-01

Malnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care. Eight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically. Five themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence-based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care. The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed. © 2013 The British Dietetic Association Ltd.

33 CFR 337.5 - General authorizations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... coastal zone consistency, if applicable, and water quality certification can be accomplished in a single... activities including the water quality certification and/or coastal zone consistency requirements of part 336...

33 CFR 337.5 - General authorizations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... coastal zone consistency, if applicable, and water quality certification can be accomplished in a single... activities including the water quality certification and/or coastal zone consistency requirements of part 336...

Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases

PubMed Central

Göbel, Jens; Storf, Holger; Litzkendorf, Svenja; Babac, Ana; Frank, Martin; Lührs, Verena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Thomas OF; Ückert, Frank; Graf von der Schulenburg, Johann-Matthias; Hartz, Tobias

2016-01-01

Background The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. Objective The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. Methods First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. Results We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. Conclusions The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases. Finally, transparently presented quality assessments can help people to find reliable information and to assess its quality. PMID:27562540

Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases.

PubMed

Pauer, Frédéric; Göbel, Jens; Storf, Holger; Litzkendorf, Svenja; Babac, Ana; Frank, Martin; Lührs, Verena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Thomas Of; Ückert, Frank; Graf von der Schulenburg, Johann-Matthias; Hartz, Tobias

2016-08-25

The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases. Finally, transparently presented quality assessments can help people to find reliable information and to assess its quality.

A meta-analytic review of the relationship of cancer coping self-efficacy with distress and quality of life

PubMed Central

Chirico, Andrea; Lucidi, Fabio; Merluzzi, Thomas; Alivernini, Fabio; De Laurentiis, Michelino; Botti, Gerardo; Giordano, Antonio

2017-01-01

Self-efficacy for coping with cancer is a specific construct that refers to behaviors that occur in the course of dealing with a cancer diagnosis, cancer treatments, and transitioning to survivorship. One of the more widely used measures of self-efficacy for coping strategies with cancer is the Cancer Behavior Inventory. The following general questions provide a framework for this research: 1. Is self-efficacy for coping with cancer related to distress and quality of life of a cancer patient?. 2. Do self-efficacy for coping with cancer and the target psychological outcomes (i.e., distress and quality of life) change in longitudinal studies, with or without intervention? One-hundred eighty studies cited the different versions of the Cancer Behavior Inventory and 47 used the scale. Result showed an inverse relationship between self-efficacy for coping with cancer and distress, and a positive relationship between self-efficacy for coping with cancer and Quality of Life, both with a large effect size. The strong relationship of self-efficacy and outcomes, resulted of the specificity of the instrument, which targets specific coping strategies that are closely aligned with positive outcomes in adjusting to cancer. However, the results are consistent with the theory, which states that compared to those with low efficacy, highly efficacious people demonstrate less anxiety and better adjustment in stressful situations and consistent with prior results in which self-efficacy is positively related to quality of life. PMID:28404938

[Physical fingerprint for quality control of traditional Chinese medicine extract powders].

PubMed

Zhang, Yi; Xu, Bing; Sun, Fei; Wang, Xin; Zhang, Na; Shi, Xin-Yuan; Qiao, Yan-Jiang

2016-06-01

The physical properties of both raw materials and excipients are closely correlated with the quality of traditional Chinese medicine preparations in oral solid dosage forms. In this paper, based on the concept of the chemical fingerprint for quality control of traditional Chinese medicine products, the method of physical fingerprint for quality evaluation of traditional Chinese medicine extract powders was proposed. This novel physical fingerprint was built by the radar map, and consisted of five primary indexes (i.e. stackablity, homogeneity, flowability, compressibility and stability) and 12 secondary indexes (i.e. bulk density, tap density, particle size<50 μm percentage, relative homogeneity index, hausner ratio, angle of repose, powder flow time, inter-particle porosity, Carr index, cohesion index, loss on drying, hygroscopicity). Panax notoginseng saponins (PNS) extract was taken for an example. This paper introduced the application of physical fingerprint in the evaluation of source-to-source and batch-to-batch quality consistence of PNS extract powders. Moreover, the physical fingerprint of PNS was built by calculating the index of parameters, the index of parametric profile and the index of good compressibility, in order to successfully predict the compressibility of the PNS extract powder and relevant formulations containing PNS extract powder and conventional pharmaceutical excipients. The results demonstrated that the proposed method could not only provide new insights into the development and process control of traditional Chinese medicine solid dosage forms. Copyright© by the Chinese Pharmaceutical Association.

Ensuring Quality in AFRINEST and SATT

PubMed Central

2013-01-01

Background: Three randomized open-label clinical trials [Simplified Antibiotic Therapy Trial (SATT) Bangladesh, SATT Pakistan and African Neonatal Sepsis Trial (AFRINEST)] were developed to test the equivalence of simplified antibiotic regimens compared with the standard regimen of 7 days of parenteral antibiotics. These trials were originally conceived and designed separately; subsequently, significant efforts were made to develop and implement a common protocol and approach. Previous articles in this supplement briefly describe the specific quality control methods used in the individual trials; this article presents additional information about the systematic approaches used to minimize threats to validity and ensure quality across the trials. Methods: A critical component of quality control for AFRINEST and SATT was striving to eliminate variation in clinical assessments and decisions regarding eligibility, enrollment and treatment outcomes. Ensuring appropriate and consistent clinical judgment was accomplished through standardized approaches applied across the trials, including training, assessment of clinical skills and refresher training. Standardized monitoring procedures were also applied across the trials, including routine (day-to-day) internal monitoring of performance and adherence to protocols, systematic external monitoring by funding agencies and external monitoring by experienced, independent trial monitors. A group of independent experts (Technical Steering Committee/Technical Advisory Group) provided regular monitoring and technical oversight for the trials. Conclusions: Harmonization of AFRINEST and SATT have helped to ensure consistency and quality of implementation, both internally and across the trials as a whole, thereby minimizing potential threats to the validity of the trials’ results. PMID:23945575

Assessing relationship quality in mandated community treatment: blending care with control.

PubMed

Skeem, Jennifer L; Louden, Jennifer Eno; Polaschek, Devon; Camp, Jacqueline

2007-12-01

Traditional measures of the therapeutic alliance do not capture the dual roles inherent in relationships with involuntary clients. Providers not only care for, but also have control over, involuntary clients. In 2 studies of probationers mandated to psychiatric treatment (n=90; n=322), the authors developed and validated the revised Dual-Role Relationships Inventory (DRI-R). The authors found that (a) relationship quality in mandated treatment involves caring and fairness, trust, and an authoritative (not authoritarian) style, (b) the DRI-R assesses these domains of relationship quality, is internally consistent, and relates in a theoretically coherent pattern with ratings of within-session behavior and with measures of the therapeutic alliance, relationship satisfaction, symptoms, and treatment motivation, and (c) the quality of dual-role relationships predicts future compliance with the rules, as assessed by probation violations and revocation. The DRI-R covaries with multiple domains more strongly than a leading measure of the therapeutic alliance, suggesting that it better captures the nature and effect of relationship quality in mandated treatment.

Health benefits from improved outdoor air quality and intervention in China.

PubMed

Li, Shanshan; Williams, Gail; Guo, Yuming

2016-07-01

China is at its most critical stage of outdoor air quality management. In order to prevent further deterioration of air quality and to protect human health, the Chinese government has made a series of attempts to reduce ambient air pollution. Unlike previous literature reviews on the widespread hazards of air pollution on health, this review article firstly summarized the existing evidence of human health benefits from intermittently improved outdoor air quality and intervention in China. Contents of this paper provide concrete and direct clue that improvement in outdoor air quality generates various health benefits in China, and confirm from a new perspective that it is worthwhile for China to shift its development strategy from economic growth to environmental economic sustainability. Greater emphasis on sustainable environment design, consistently strict regulatory enforcement, and specific monitoring actions should be regarded in China to decrease the health risks and to avoid long-term environmental threats. Copyright © 2016 Elsevier Ltd. All rights reserved.

Portable Imagery Quality Assessment Test Field for Uav Sensors

NASA Astrophysics Data System (ADS)

Dąbrowski, R.; Jenerowicz, A.

2015-08-01

Nowadays the imagery data acquired from UAV sensors are the main source of all data used in various remote sensing applications, photogrammetry projects and in imagery intelligence (IMINT) as well as in other tasks as decision support. Therefore quality assessment of such imagery is an important task. The research team from Military University of Technology, Faculty of Civil Engineering and Geodesy, Geodesy Institute, Department of Remote Sensing and Photogrammetry has designed and prepared special test field- The Portable Imagery Quality Assessment Test Field (PIQuAT) that provides quality assessment in field conditions of images obtained with sensors mounted on UAVs. The PIQuAT consists of 6 individual segments, when combined allow for determine radiometric, spectral and spatial resolution of images acquired from UAVs. All segments of the PIQuAT can be used together in various configurations or independently. All elements of The Portable Imagery Quality Assessment Test Field were tested in laboratory conditions in terms of their radiometry and spectral reflectance characteristics.

Associations Among Parental Education, Home Environment Quality, Effortful Control, and Preacademic Knowledge

PubMed Central

Merz, Emily C.; Landry, Susan H.; Williams, Jeffrey M.; Barnes, Marcia A.; Eisenberg, Nancy; Spinrad, Tracy L.; Valiente, Carlos; Assel, Michael; Taylor, Heather B.; Lonigan, Christopher J.; Phillips, Beth M.; Clancy-Menchetti, Jeanine

2014-01-01

This study used a longitudinal design to examine whether effortful control mediated the associations of parental education and home environment quality with preacademic knowledge in toddlers and young preschoolers. The sample consisted of 226 children (2 to 4 years of age at T1) from socioeconomically disadvantaged backgrounds. Parents provided data on parent education and home environment quality. Children completed effortful control, early literacy, and early math assessments. T2 effortful control partially mediated the associations of T1 parental education and T1 home environment quality with T3 emergent literacy after accounting for child age, gender, race/ethnicity, T1 effortful control, and T2 early literacy. T2 effortful control partially mediated the association between T1 parental education and T3 emergent math after accounting for child age, gender, race/ethnicity, T1 effortful control, and T2 early math. Prior to entry into preschool, parental education and home environment quality may shape effortful control which in turn influences preacademic knowledge. PMID:25110382

Post-apartheid challenges: household access and use of health care in South Africa.

PubMed

Gilson, Lucy; McIntyre, Di

2007-01-01

Since 1994 the South African government has placed equity at the heart of its health policy goals. However, there has as yet been surprisingly little assessment of the success of policies in reducing inequity. This article provides insights on these issues by applying the Affordability Ladder conceptual framework in synthesizing evidence drawn from a series of household surveys and studies undertaken between 1992 and 2003. These data suggest that, despite policy efforts, inequities in access and utilization between socioeconomic groups remain. Underlying challenges include worsening community perceptions of the quality of publicly provided care and the influence of insurance status on utilization patterns. Further and more detailed evaluation of household-level policy impacts requires both improvements in the quality of South African survey data, particularly in enhancing consistency in survey design over time, and more detailed, focused studies.

Accommodations quality for students who are d/Deaf or hard of hearing.

PubMed

Cawthon, Stephanie W; Leppo, Rachel

2013-01-01

Students who are d/Deaf or hard of hearing often receive accommodations that are intended to increase access to the educational environment. The authors provide the results of a large national study of accommodations use in secondary and postsecondary settings. The article focuses on three aspects of accommodations use: access, quality, and consistency. The participants were 1,350 professionals working with a diverse group of students who were d/Deaf or hard of hearing in a variety of roles, including educators, administrators, interpreters, vocational rehabilitation agency staff, and allied service providers. Data were collected from both a national survey and a series of focus groups conducted over a 1-year period. The authors discuss the results in light of the crucial nature of accommodations during the transition into a variety of educational, training, and employment options.

Library and information services: impact on patient care quality.

PubMed

Marshall, Joanne Gard; Morgan, Jennifer Craft; Thompson, Cheryl A; Wells, Amber L

2014-01-01

The purpose of this paper is to explore library and information service impact on patient care quality. A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case. Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality. Electronic collections and services provided by the library and the librarian contribute to patient care quality.

Cibachrome testing. [photographic processing and printing materials

NASA Technical Reports Server (NTRS)

Weinstein, M. S.

1974-01-01

The use of Cibachrome products as a solution to problems encountered when contact printing Kodak film type SO-397 onto Kodak Ektrachrome color reversal paper type 1993 is investigated. A roll of aerial imagery consisting of Kodak film types SO-397 and 2443 was contact printed onto Cibachrome and Kodak materials and compared in terms of color quality, resolution, cost, and compatibility with existing equipment and techniques. Objective measurements are given in terms of resolution and sensitometric response. Comparison prints and transparencies were viewed and ranked according to overall quality and aesthetic appeal. It is recommended that Cibachrome Print material be used in place of Kodak Ektachrome paper because it is more easily processed, the cost is equivalent, and it provides improved resolution, color quality, and image fade resistance.

Spatial resampling of IDR frames for low bitrate video coding with HEVC

NASA Astrophysics Data System (ADS)

Hosking, Brett; Agrafiotis, Dimitris; Bull, David; Easton, Nick

2015-03-01

As the demand for higher quality and higher resolution video increases, many applications fail to meet this demand due to low bandwidth restrictions. One factor contributing to this problem is the high bitrate requirement of the intra-coded Instantaneous Decoding Refresh (IDR) frames featuring in all video coding standards. Frequent coding of IDR frames is essential for error resilience in order to prevent the occurrence of error propagation. However, as each one consumes a huge portion of the available bitrate, the quality of future coded frames is hindered by high levels of compression. This work presents a new technique, known as Spatial Resampling of IDR Frames (SRIF), and shows how it can increase the rate distortion performance by providing a higher and more consistent level of video quality at low bitrates.

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

PubMed

Swick, Maureen; Doulaveris, Phyllis; Christensen, Patricia

2012-01-01

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

Medical faculties educational network: multidimensional quality assessment.

PubMed

Komenda, Martin; Schwarz, Daniel; Feberová, Jitka; Stípek, Stanislav; Mihál, Vladimír; Dušek, Ladislav

2012-12-01

Today, World Wide Web technology provides many opportunities in the disclosure of electronic learning and teaching content. The MEFANET project (MEdical FAculties NETwork) has initiated international, effective and open cooperation among all Czech and Slovak medical faculties in the medical education fields. This paper introduces the original MEFANET educational web portal platform. Its main aim is to present the unique collaborative environment, which combines the sharing of electronic educational resources with the use tools for their quality evaluation. It is in fact a complex e-publishing system, which consists of ten standalone portal instances and one central gateway. The fundamental principles of the developed system and used technologies are reported here, as well as procedures of a new multidimensional quality assessment. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Inert-Gas Diffuser For Plasma Or Arc Welding

NASA Technical Reports Server (NTRS)

Gilbert, Jeffrey L.; Spencer, Carl N.; Hosking, Timothy J.

1994-01-01

Inert-gas diffuser provides protective gas cover for weld bead as it cools. Follows welding torch, maintaining continuous flow of argon over newly formed joint and prevents it from oxidizing. Helps to ensure welds of consistently high quality. Devised for plasma arc keyhole welding of plates of 0.25-in. or greater thickness, also used in tungsten/inert-gas and other plasma or arc welding processes.

Experimental realization of an on-chip all-optical analogue to electromagnetically induced transparency.

PubMed

Xu, Qianfan; Sandhu, Sunil; Povinelli, Michelle L; Shakya, Jagat; Fan, Shanhui; Lipson, Michal

2006-03-31

We provide the first experimental observation of structure tuning of the electromagnetically induced transparency-like spectrum in integrated on-chip optical resonator systems. The system consists of coupled silicon ring resonators with 10 microm diameter on silicon, where the coherent interference between the two coupled resonators is tuned. We measured a transparency-resonance mode with a quality factor of 11,800.

Complete Genome Sequence of the Endophytic Bacterium Burkholderia sp. Strain KJ006

PubMed Central

Kwak, Min-Jung; Song, Ju Yeon; Kim, Seon-Young; Jeong, Haeyoung; Kang, Sung Gyun; Kim, Byung Kwon; Kwon, Soon-Kyeong; Lee, Choong Hoon; Yu, Dong Su

2012-01-01

Endophytes live inside plant tissues without causing any harm and may even benefit plants. Here, we provide the high-quality genome sequence of Burkholderia sp. strain KJ006, an endophytic bacterium of rice with antifungal activity. The 6.6-Mb genome, consisting of three chromosomes and a single plasmid, contains genes related to plant growth promotion or degradation of aromatic compounds. PMID:22843575

Providing End-Of-Life Care in Disability Community Living Services: An Organizational Capacity-Building Model Using a Public Health Approach

ERIC Educational Resources Information Center

Grindrod, Andrea; Rumbold, Bruce

2017-01-01

Background: There is broad consensus within the disability field that the end-of-life care offered to people with intellectual disabilities should be of a quality consistent with that advocated by contemporary palliative care. In practice, however, various barriers are encountered when applying palliative care strategies to the end-of-life care of…

Quality requirements for EHR archetypes.

PubMed

Kalra, Dipak; Tapuria, Archana; Austin, Tony; De Moor, Georges

2012-01-01

The realisation of semantic interoperability, in which any EHR data may be communicated between heterogeneous systems and fully understood by computers as well as people on receipt, is a challenging goal. Despite the use of standardised generic models for the EHR and standard terminology systems, too much optionality and variability exists in how particular clinical entries may be represented. Clinical archetypes provide a means of defining how generic models should be shaped and bound to terminology for specific kinds of clinical data. However, these will only contribute to semantic interoperability if libraries of archetypes can be built up consistently. This requires the establishment of design principles, editorial and governance policies, and further research to develop ways for archetype authors to structure clinical data and to use terminology consistently. Drawing on several years of work within communities of practice developing archetypes and implementing systems from them, this paper presents quality requirements for the development of archetypes. Clinical engagement on a wide scale is also needed to help grow libraries of good quality archetypes that can be certified. Vendor and eHealth programme engagement is needed to validate such archetypes and achieve safe, meaningful exchange of EHR data between systems.

Design, analysis, and control of a large transport aircraft utilizing selective engine thrust as a backup system for the primary flight control. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Gerren, Donna S.

1995-01-01

A study has been conducted to determine the capability to control a very large transport airplane with engine thrust. This study consisted of the design of an 800-passenger airplane with a range of 5000 nautical miles design and evaluation of a flight control system, and design and piloted simulation evaluation of a thrust-only backup flight control system. Location of the four wing-mounted engines was varied to optimize the propulsive control capability, and the time constant of the engine response was studied. The goal was to provide level 1 flying qualities. The engine location and engine time constant did not have a large effect on the control capability. The airplane design did meet level 1 flying qualities based on frequencies, damping ratios, and time constants in the longitudinal and lateral-directional modes. Project pilots consistently rated the flying qualities as either level 1 or level 2 based on Cooper-Harper ratings. However, because of the limited control forces and moments, the airplane design fell short of meeting the time required to achieve a 30 deg bank and the time required to respond a control input.

Implementation of a laboratory quality assurance program: the Louisville experience.

PubMed

Metz, Michael J; Abdel-Azim, Tamer; Miller, Cynthia J; Lin, Wei-Shao; ZandiNejad, Amirali; Oliveira, Gustavo M; Morton, Dean

2014-02-01

Remakes, or the refabrication of dental prostheses, can occur as a result of inherent inaccuracies in both clinical and laboratory procedures. Because dental schools manage large numbers of predoctoral dental students with limited familiarity and expertise as related to clinical prosthodontic techniques, it is likely these schools will experience an elevated incidence of laboratory remakes and their ramifications. The University of Louisville School of Dentistry, not unlike other dental schools, has experienced remakes associated with both fixed and removable prosthodontic procedures. Limitations in faculty standardization and variable enforcement of established preclinical protocols have been identified as variables associated with the high percentage of remakes documented. The purpose of this study was to introduce the implementation of a new multidepartmental quality assurance program designed to increase consistency and quality in both information provided to commercial dental laboratories and the prostheses returned. The program has shown to be advantageous in terms of cost-effectiveness and treatment outcomes. A statistically significant decrease in remake percentages has been recorded from inception of this program in December 2010 until December 2012. Furthermore, this program has resulted in more consistent communication between the dental school and commercial dental laboratories, among faculty members, and between faculty and students.

Psychometric properties of the WHOQOL-BREF in an Iranian adult sample.

PubMed

Yousefy, A R; Usefy, A R; Ghassemi, Gh R; Sarrafzadegan, N; Mallik, S; Baghaei, A M; Rabiei, K

2010-04-01

To evaluate discriminant validity, reliability, internal consistency, and dimensional structure of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) in a heterogeneous Iranian population. A clustered randomized sample of 2,956 healthy with 2,936 unhealthy rural and urban inhabitants aged 30 and above from two dissimilar Iranian provinces during 2006 completed the Persian version of the WHOQOL-BREF. We performed descriptive and analytical analysis including t-student, correlation matrix, Cronbach's Alpha, and factor analysis with principal components method and Varimax rotation with SPSS.15. The mean age of the participants was 42.2 +/- 12.1 years and the mean years of education was 9.3 +/- 3.8. The Iranian version of the WHOQOL-BREF domain scores demonstrated good internal consistency, criterion validity, and discriminant validity. The physical health domain contributed most in overall quality of life, while the environment domain made the least contribution. Factor analysis provided evidence for construct validity for four-factor model of the instrument. The scores of all domains discriminated between healthy persons and the patients. The WHOQOL-BREF has adequate psychometric properties and is, therefore, an adequate measure for assessing quality of life at the domain level in an adult Iranian population.

Do European hospitals have quality and safety governance systems and structures in place?

PubMed

Shaw, C; Kutryba, B; Crisp, H; Vallejo, P; Suñol, R

2009-02-01

Internal systems for quality and safety were assessed in 89 hospitals in six European states, by external teams using standardised criteria and procedures, as part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The assessments were made primarily to identify the current use of quality management systems in the sample hospitals, and also to demonstrate a potential tool for comparable assessment of hospitals in general. The large majority of the hospitals had a formal, documented infrastructure to manage quality and safety, but a significant minority had no designated mission, programme or coordination. In two-thirds of hospitals, the governing body was active in defining policy and programmes for improvement, and received reports on quality, safety and patient satisfaction at least once a year. The brief on-site assessments identified systematic variations, within and between countries, in structures and processes of governance and to document the uptake of best practice. Unacceptable variations in practice could be reduced, to the benefit of consumers and providers, by developing and publishing basic organisational standards relevant to all European states. The simple assessment criteria designed for this project could be developed into a practical tool for self-assessment, peer review or benchmarking of hospitals across national borders. This assessment, combined with explicit, relevant and achievable standards, could provide a vehicle to promote the voluntary uptake of best practice and consistency in quality and safety among hospitals in Europe.

Data Quality Control of the French Permanent Broadband Network in the RESIF Framework

NASA Astrophysics Data System (ADS)

Grunberg, Marc; Lambotte, Sophie; Engels, Fabien; Dretzen, Remi; Hernandez, Alain

2014-05-01

In the framework of the RESIF (Réseau Sismologique et géodésique Français) project, a new information system is being setting up, allowing the improvement of the management and the distribution of high quality data from the different elements of RESIF and the associated networks. Within this information system, EOST (in Strasbourg) is in charge of collecting real-time permanent broadband seismic waveform, and performing Quality Control on these data. The real-time and validated data set are pushed to the French National Distribution Center (Isterre/Grenoble) in order to make them publicly available. Furthermore EOST hosts the BCSF-ReNaSS, in charge of the French metropolitan seismic bulletin. This allows to benefit from some high-end quality control based on the national and world-wide seismicity. Here we present first the real-time seismic data flow from the stations of the French National Broad Band Network to EOST, and then, the data Quality Control procedures that were recently installed, including some new developments. The data Quality Control consists in applying a variety of subprocesses to check the consistency of the whole system and process from the stations to the data center. This allows us to verify that instruments and data transmission are operating correctly. Moreover analysis of the ambient noise helps to characterize intrinsic seismic quality of the stations and to identify other kind of disturbances. The deployed Quality Control consist in a pipeline that starts with low-level procedures : check the real-time miniseed data file (file naming convention, data integrity), check for inconsistencies between waveform and meta-data (channel name, sample rate, etc.), compute waveform statistics (data availability, gap/overlap, mean, rms, time quality, spike). It is followed by some high-level procedures such as : power spectral density computation (PSD), STA/LTA computation to be correlated to the seismicity, phases picking and stations magnitudes discrepancies. The results of quality control is visualized through a web interface. This latter gathers data from different information systems to provide a global view on last events that could impact the data (like intervention on site or seismic events, etc.). This work is still an ongoing project. We intend to add more sophisticated procedures to enhanced our data Quality Control. Among them, we will deploy a seismic moment tensor inversion tool for amplitude, time and polarity control and a noise correlation procedure for time drift detections.

Low cost composite manufacturing utilizing intelligent pultrusion and resin transfer molding (IPRTM)

NASA Astrophysics Data System (ADS)

Bradley, James E.; Wysocki, Tadeusz S., Jr.

1993-02-01

This article describes an innovative method for the economical manufacturing of large, intricately-shaped tubular composite parts. Proprietary intelligent process control techniques are combined with standard pultrusion and RTM methodologies to provide high part throughput, performance, and quality while substantially reducing scrap, rework costs, and labor requirements. On-line process monitoring and control is achieved through a smart tooling interface consisting of modular zone tiles installed on part-specific die assemblies. Real-time archiving of process run parameters provides enhanced SPC and SQC capabilities.

Understanding quantitative research: part 1.

PubMed

Hoe, Juanita; Hoare, Zoë

This article, which is the first in a two-part series, provides an introduction to understanding quantitative research, basic statistics and terminology used in research articles. Critical appraisal of research articles is essential to ensure that nurses remain up to date with evidence-based practice to provide consistent and high-quality nursing care. This article focuses on developing critical appraisal skills and understanding the use and implications of different quantitative approaches to research. Part two of this article will focus on explaining common statistical terms and the presentation of statistical data in quantitative research.

Partnerships - Working Together to Build The National Map

USGS Publications Warehouse

,

2004-01-01

Through The National Map, the U.S. Geological Survey (USGS) is working with partners to ensure that current, accurate, and complete base geographic information is available for the Nation. Designed as a network of online digital databases, it provides a consistent geographic data framework for the country and serves as a foundation for integrating, sharing, and using data easily and reliably. It provides public access to high quality geospatial data and information from multiple partners to help inform decisionmaking by resource managers and the public, and to support intergovernmental homeland security and emergency management requirements.

[Quality of service provided to heart surgery patients of the Unified Health System-SUS].

PubMed

Borges, Juliana Bassalobre Carvalho; Carvalho, Sebastião Marcos Ribeiro de; Silva, Marcos Augusto de Moraes

2010-01-01

To evaluate the service quality provided to heart surgery patients during their hospital stay, identifying the patient's expectations and perceptions. To associate service quality with: gender, age and the use of extracorporeal circulation. We studied 82 elective heart surgery patients (52.4% females and 47.6% males), operated by midsternal thoracotomy, age: 31 to 83 years (60.4 +/- 13.2 years); period: March to September 2006. Service quality was evaluated in two instances: the expectations at pre-operative and the perceptions of the service received on the 6th post-operative; through the application of the modified SERVQUAL scale (SERVQUAL-Card). The result was obtained by the difference of the sum of the scores on perception minus those of the expectations, and through statistical analysis. The SERVQUAL-Card scale was statistically validated, showing adequate level of internal consistency. We found a higher frequency of myocardial revascularization 55 (67.0%); first heart surgery 72 (87.8%) and the use of ECC 69 (84.1%). We noticed high mean values for expectations and perceptions with significant results (P<0.05). We observed a significant relationship between the quality of service with: gender, in empathy (P= 0.04) and age, in reliability (P = 0.02). There was no significant association between ECC and quality of service. Service quality was satisfactory. The patient demonstrated a high expectation to hospital medical service. Women present a higher perception of quality in empathy and younger people in reliability. The use of ECC is not related to service quality in this sample. The data obtained in this study suggest that the quality of this health service can be monitored through the periodical application of the SERVQUAL scale.

Does Personalized Water and Hand Quality Information Affect Attitudes, Behavior, and Health in Dar es Salaam, Tanzania?

NASA Astrophysics Data System (ADS)

Davis, J.; Pickering, A.; Horak, H.; Boehm, A.

2008-12-01

Tanzania (TZ) has one of the highest rates of child mortality due to enteric disease in the world. NGOs and local agencies have introduced numerous technologies (e.g., chlorine tablets, borewells) to increase the quantity and quality of water in Dar es Salaam, the capital of Tanzania, in hopes of reducing morbidity and mortality of waterborne disease. The objective of the present study is to determine if providing personalized information about water quality and hand surface quality, as determined by concentrations of enterococci and E. coli, results in improved health and water quality in households. A cohort study was completed in June-September 2008 in 3 communities ranging from urban to per-urban in Dar es Salaam, Tanzania to achieve our objective. The study consisted of 4 cohorts that were visited 4 times over the 3 month study. One cohort received no information about water and hand quality until the end of the summer, while the other groups received either just information on hand surface quality, just information on water quality, and information on both hand surface and water quality after the first (baseline) household visit. We report concentrations of enterococci and E. coli in water sources (surface waters and bore wells), water stored in households, and environmental waters were children and adults swim and bathe. In addition, we report concentrations of enterococci and E. coli on hands of caregivers and children in households. Preliminary results of surveys on health and perceptions of water quality and illness from the households are provided. Ongoing work will integrate the microbiological and sociological data sets to determine if personalized information interventions resulted in changes in health, water quality in the household, or perceptions of water quality, quantity and relation to human health. Future work will analyze DNA samples from hands and water for human-specific Bacteroides bacteria which are only present in human feces. Our study has the potential to provide empirical evidence to promote large scale monitoring and education campaigns in Africa to improve health and reduce the burden of waterborne disease.

Marky: a tool supporting annotation consistency in multi-user and iterative document annotation projects.

PubMed

Pérez-Pérez, Martín; Glez-Peña, Daniel; Fdez-Riverola, Florentino; Lourenço, Anália

2015-02-01

Document annotation is a key task in the development of Text Mining methods and applications. High quality annotated corpora are invaluable, but their preparation requires a considerable amount of resources and time. Although the existing annotation tools offer good user interaction interfaces to domain experts, project management and quality control abilities are still limited. Therefore, the current work introduces Marky, a new Web-based document annotation tool equipped to manage multi-user and iterative projects, and to evaluate annotation quality throughout the project life cycle. At the core, Marky is a Web application based on the open source CakePHP framework. User interface relies on HTML5 and CSS3 technologies. Rangy library assists in browser-independent implementation of common DOM range and selection tasks, and Ajax and JQuery technologies are used to enhance user-system interaction. Marky grants solid management of inter- and intra-annotator work. Most notably, its annotation tracking system supports systematic and on-demand agreement analysis and annotation amendment. Each annotator may work over documents as usual, but all the annotations made are saved by the tracking system and may be further compared. So, the project administrator is able to evaluate annotation consistency among annotators and across rounds of annotation, while annotators are able to reject or amend subsets of annotations made in previous rounds. As a side effect, the tracking system minimises resource and time consumption. Marky is a novel environment for managing multi-user and iterative document annotation projects. Compared to other tools, Marky offers a similar visually intuitive annotation experience while providing unique means to minimise annotation effort and enforce annotation quality, and therefore corpus consistency. Marky is freely available for non-commercial use at http://sing.ei.uvigo.es/marky. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Quality, not just quantity: Lessons learned from HIV testing in Salvador, Brazil

PubMed Central

MacCarthy, Sarah; Rasanathan, Jennifer J. K.; Dourado, Ines; Gruskin, Sofia

2015-01-01

Studies have demonstrated that an early HIV diagnosis is a critical first step toward continued engagement in care. We examined HIV testing experiences in Salvador, Brazil, to understand how a focus on quality services can inform service provision more generally in the post–2015 global health agenda. Seventeen semi-structured interviews were conducted with HIV-positive pregnant women in Salvador, a large urban centre of northeast Brazil. Interviews were transcribed, translated, and coded for analysis. Deductive codes confirmed factors identified in the literature review. Inductive codes highlighted new factors emerging from the initial coding. ‘Quality’ was defined according to global and national guidelines as HIV testing with informed and voluntary consent, counselling, and confidentiality (3Cs). No pregnant woman experienced all elements of the 3Cs. Three women did not experience any informed and voluntary consent, counselling, or confidentiality. Few women provided consent overall and none received pre-test counselling. Post-test counselling and confidentiality of services were more consistently provided. This study suggests that testing in Salvador—the third-largest city in the country—is not of the quality called for by global and national guidelines, despite the fact that HIV testing is being routinely provided for HIV-positive pregnant women in Brazil. Going forward, additional clarity around the 3Cs is necessary to improve how the quality, not just the quantity, of HIV services is measured. PMID:24881693

The development of a quality appraisal tool for studies of diagnostic reliability (QAREL).

PubMed

Lucas, Nicholas P; Macaskill, Petra; Irwig, Les; Bogduk, Nikolai

2010-08-01

In systematic reviews of the reliability of diagnostic tests, no quality assessment tool has been used consistently. The aim of this study was to develop a specific quality appraisal tool for studies of diagnostic reliability. Key principles for the quality of studies of diagnostic reliability were identified with reference to epidemiologic principles, existing quality appraisal checklists, and the Standards for Reporting of Diagnostic Accuracy (STARD) and Quality Assessment of Diagnostic Accuracy Studies (QUADAS) resources. Specific items that encompassed each of the principles were developed. Experts in diagnostic research provided feedback on the items that were to form the appraisal tool. This process was iterative and continued until consensus among experts was reached. The Quality Appraisal of Reliability Studies (QAREL) checklist includes 11 items that explore seven principles. Items cover the spectrum of subjects, spectrum of examiners, examiner blinding, order effects of examination, suitability of the time interval among repeated measurements, appropriate test application and interpretation, and appropriate statistical analysis. QAREL has been developed as a specific quality appraisal tool for studies of diagnostic reliability. The reliability of this tool in different contexts needs to be evaluated. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Quality Evaluation of Raw Moutan Cortex Using the AHP and Gray Correlation-TOPSIS Method

PubMed Central

Zhou, Sujuan; Liu, Bo; Meng, Jiang

2017-01-01

Background: Raw Moutan cortex (RMC) is an important Chinese herbal medicine. Comprehensive and objective quality evaluation of Chinese herbal medicine has been one of the most important issues in the modern herbs development. Objective: To evaluate and compare the quality of RMC using the weighted gray correlation- Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) method. Materials and Methods: The percentage composition of gallic acid, catechin, oxypaeoniflorin, paeoniflorin, quercetin, benzoylpaeoniflorin, paeonol in different batches of RMC was determined, and then adopting MATLAB programming to construct the gray correlation-TOPSIS assessment model for quality evaluation of RMC. Results: The quality evaluation results of model evaluation and objective evaluation were consistent, reliable, and stable. Conclusion: The model of gray correlation-TOPSIS can be well applied to the quality evaluation of traditional Chinese medicine with multiple components and has broad prospect in application. SUMMARY The experiment tries to construct a model to evaluate the quality of RMC using the weighted gray correlation- Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) method. Results show the model is reliable and provide a feasible way in evaluating quality of traditional Chinese medicine with multiple components. PMID:28839384

Guidelines for the processing and quality assurance of benthic invertebrate samples collected as part of the National Water-Quality Assessment Program

USGS Publications Warehouse

Cuffney, T.F.; Gurtz, M.E.; Meador, M.R.

1993-01-01

Benthic invertebrate samples are collected as part of the U.S. Geological Survey's National Water-Quality Assessment Program. This is a perennial, multidisciplinary program that integrates biological, physical, and chemical indicators of water quality to evaluate status and trends and to develop an understanding of the factors controlling observed water quality. The Program examines water quality in 60 study units (coupled ground- and surface-water systems) that encompass most of the conterminous United States and parts of Alaska and Hawaii. Study-unit teams collect and process qualitative and semi-quantitative invertebrate samples according to standardized procedures. These samples are processed (elutriated and subsampled) in the field to produce as many as four sample components: large-rare, main-body, elutriate, and split. Each sample component is preserved in 10-percent formalin, and two components, large-rare and main-body, are sent to contract laboratories for further processing. The large-rare component is composed of large invertebrates that are removed from the sample matrix during field processing and placed in one or more containers. The main-body sample component consists of the remaining sample materials (sediment, detritus, and invertebrates) and is subsampled in the field to achieve a volume of 750 milliliters or less. The remaining two sample components, elutriate and split, are used for quality-assurance and quality-control purposes. Contract laboratories are used to identify and quantify invertebrates from the large-rare and main-body sample components according to the procedures and guidelines specified within this document. These guidelines allow the use of subsampling techniques to reduce the volume of sample material processed and to facilitate identifications. These processing procedures and techniques may be modified if the modifications provide equal or greater levels of accuracy and precision. The intent of sample processing is to determine the quantity of each taxon present in the semi-quantitative samples or to list the taxa present in qualitative samples. The processing guidelines provide standardized laboratory forms, sample labels, detailed sample processing flow charts, standardized format for electronic data, quality-assurance procedures and checks, sample tracking standards, and target levels for taxonomic determinations. The contract laboratory (1) is responsible for identifications and quantifications, (2) constructs reference collections, (3) provides data in hard copy and electronic forms, (4) follows specified quality-assurance and quality-control procedures, and (5) returns all processed and unprocessed portions of the samples. The U.S. Geological Survey's Quality Management Group maintains a Biological Quality-Assurance Unit, located at the National Water-Quality Laboratory, Arvada, Colorado, to oversee the use of contract laboratories and ensure the quality of data obtained from these laboratories according to the guidelines established in this document. This unit establishes contract specifications, reviews contractor performance (timeliness, accuracy, and consistency), enters data into the National Water Information System-II data base, maintains in-house reference collections, deposits voucher specimens in outside museums, and interacts with taxonomic experts within and outside the U.S. Geological Survey. This unit also modifies the existing sample processing and quality-assurance guidelines, establishes criteria and testing procedures for qualifying potential contract laboratories, identifies qualified taxonomic experts, and establishes voucher collections.

A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes.

PubMed

Driessen, Sara R C; Van Zwet, Erik W; Haazebroek, Pascal; Sandberg, Evelien M; Blikkendaal, Mathijs D; Twijnstra, Andries R H; Jansen, Frank Willem

2016-12-01

The current health care system has an urgent need for tools to measure quality. A wide range of quality indicators have been developed in an attempt to differentiate between high-quality and low-quality health care processes. However, one of the main issues of currently used indicators is the lack of case-mix correction and improvement possibilities. Case-mix is defined as specific (patient) characteristics that are known to potentially affect (surgical) outcome. If these characteristics are not taken into consideration, comparisons of outcome among health care providers may not be valid. The objective of the study was to develop and test a quality assessment tool for laparoscopic hysterectomy, which can serve as a new outcome quality indicator. This is a prospective, international, multicenter implementation study. A web-based application was developed with 3 main goals: (1) to measure the surgeon's performance using 3 primary outcomes (blood loss, operative time, and complications); (2) to provide immediate individual feedback using cumulative observed-minus-expected graphs; and (3) to detect consistently suboptimal performance after correcting for case-mix characteristics. All gynecologists who perform laparoscopic hysterectomies were requested to register their procedures in the application. A patient safety risk factor checklist was used by the surgeon for reflection. Thereafter a prospective implementation study was performed, and the application was tested using a survey that included the System Usability Scale. A total of 2066 laparoscopic hysterectomies were registered by 81 gynecologists. Mean operative time was 100 ± 39 minutes, blood loss 127 ± 163 mL, and the complication rate 6.1%. The overall survey response rate was 75%, and the mean System Usability Scale was 76.5 ± 13.6, which indicates that the application was good to excellent. The majority of surgeons reported that the application made them more aware of their performance, the outcomes, and patient safety, and they noted that the application provided motivation for improving future performance. We report the development and test of a real-time, dynamic, quality assessment tool for measuring individual surgical outcome for laparoscopic hysterectomy. Importantly, this tool provides opportunities for improving surgical performance. Our study provides a foundation for helping clinicians develop evidence-based quality indicators for other surgical procedures. Copyright © 2016 Elsevier Inc. All rights reserved.

Science center capabilities to monitor and investigate Michigan’s water resources, 2016

USGS Publications Warehouse

Giesen, Julia A.; Givens, Carrie E.

2016-09-06

Michigan faces many challenges related to water resources, including flooding, drought, water-quality degradation and impairment, varying water availability, watershed-management issues, stormwater management, aquatic-ecosystem impairment, and invasive species. Michigan’s water resources include approximately 36,000 miles of streams, over 11,000 inland lakes, 3,000 miles of shoreline along the Great Lakes (MDEQ, 2016), and groundwater aquifers throughout the State.The U.S. Geological Survey (USGS) works in cooperation with local, State, and other Federal agencies, as well as tribes and universities, to provide scientific information used to manage the water resources of Michigan. To effectively assess water resources, the USGS uses standardized methods to operate streamgages, water-quality stations, and groundwater stations. The USGS also monitors water quality in lakes and reservoirs, makes periodic measurements along rivers and streams, and maintains all monitoring data in a national, quality-assured, hydrologic database.The USGS in Michigan investigates the occurrence, distribution, quantity, movement, and chemical and biological quality of surface water and groundwater statewide. Water-resource monitoring and scientific investigations are conducted statewide by USGS hydrologists, hydrologic technicians, biologists, and microbiologists who have expertise in data collection as well as various scientific specialties. A support staff consisting of computer-operations and administrative personnel provides the USGS the functionality to move science forward. Funding for USGS activities in Michigan comes from local and State agencies, other Federal agencies, direct Federal appropriations, and through the USGS Cooperative Matching Funds, which allows the USGS to partially match funding provided by local and State partners.This fact sheet provides an overview of the USGS current (2016) capabilities to monitor and study Michigan’s vast water resources. More information regarding projects by the Michigan Water Science Center (MI WSC) is available at http://mi.water.usgs.gov/.

Variation in clinical coding lists in UK general practice: a barrier to consistent data entry?

PubMed

Tai, Tracy Waize; Anandarajah, Sobanna; Dhoul, Neil; de Lusignan, Simon

2007-01-01

Routinely collected general practice computer data are used for quality improvement; poor data quality including inconsistent coding can reduce their usefulness. To document the diversity of data entry systems currently in use in UK general practice and highlight possible implications for data quality. General practice volunteers provided screen shots of the clinical coding screen they would use to code a diagnosis or problem title in the clinical consultation. The six clinical conditions examined were: depression, cystitis, type 2 diabetes mellitus, sore throat, tired all the time, and myocardial infarction. We looked at the picking lists generated for these problem titles in EMIS, IPS, GPASS and iSOFT general practice clinical computer systems, using the Triset browser as a gold standard for comparison. A mean of 19.3 codes is offered in the picking list after entering a diagnosis or problem title. EMIS produced the longest picking lists and GPASS the shortest, with a mean number of choices of 35.2 and 12.7, respectively. Approximately three-quarters (73.5%) of codes are diagnoses, one-eighth (12.5%) symptom codes, and the remainder come from a range of Read chapters. There was no readily detectable consistent order in which codes were displayed. Velocity coding, whereby commonly-used codes are placed higher in the picking list, results in variation between practices even where they have the same brand of computer system. Current systems for clinical coding promote diversity rather than consistency of clinical coding. As the UK moves towards an integrated health IT system consistency of coding will become more important. A standardised, limited list of codes for primary care might help address this need.

Motivational Interviewing Skills in Health Care Encounters (MISHCE): Development and psychometric testing of an assessment tool.

PubMed

Petrova, Tatjana; Kavookjian, Jan; Madson, Michael B; Dagley, John; Shannon, David; McDonough, Sharon K

2015-01-01

Motivational interviewing (MI) has demonstrated a significant impact as an intervention strategy for addiction management, change in lifestyle behaviors, and adherence to prescribed medication and other treatments. Key elements to studying MI include training in MI of professionals who will use it, assessment of skills acquisition in trainees, and the use of a validated skills assessment tool. The purpose of this research project was to develop a psychometrically valid and reliable tool that has been designed to assess MI skills competence in health care provider trainees. The goal was to develop an assessment tool that would evaluate the acquisition and use of specific MI skills and principles, as well as the quality of the patient-provider therapeutic alliance in brief health care encounters. To address this purpose, specific steps were followed, beginning with a literature review. This review contributed to the development of relevant conceptual and operational definitions, selecting a scaling technique and response format, and methods for analyzing validity and reliability. Internal consistency reliability was established on 88 video recorded interactions. The inter-rater and test-retest reliability were established using randomly selected 18 from the 88 interactions. The assessment tool Motivational Interviewing Skills for Health Care Encounters (MISHCE) and a manual for use of the tool were developed. Validity and reliability of MISHCE were examined. Face and content validity were supported with well-defined conceptual and operational definitions and feedback from an expert panel. Reliability was established through internal consistency, inter-rater reliability, and test-retest reliability. The overall internal consistency reliability (Cronbach's alpha) for all fifteen items was 0.75. MISHCE demonstrated good inter-rater reliability and good to excellent test-retest reliability. MISHCE assesses the health provider's level of knowledge and skills in brief disease management encounters. MISHCE also evaluates quality of the patient-provider therapeutic alliance, i.e., the "flow" of the interaction. Copyright © 2015 Elsevier Inc. All rights reserved.

The influence of service quality and patients' emotions on satisfaction.

PubMed

Vinagre, Maria Helena; Neves, José

2008-01-01

The purpose of this research is to develop and empirically test a model to examine the major factors affecting patients' satisfaction that depict and estimate the relationships between service quality, patient's emotions, expectations and involvement. The approach was tested using structural equation modeling, with a sample of 317 patients from six Portuguese public healthcare centres, using a revised SERVQUAL scale for service quality evaluation and an adapted DESII scale for assessing patient emotions. The scales used to evaluate service quality and emotional experience appears valid. The results support process complexity that leads to health service satisfaction, which involves diverse phenomena within the cognitive and emotional domain, revealing that all the predictors have a significant effect on satisfaction. The emotions inventory, although showing good internal consistency, might be enlarged to other typologies in further research--needed to confirm these findings. Patient's satisfaction mechanisms are important for improving service quality. The research shows empirical evidence about the effect of both patient's emotions and service quality on satisfaction with healthcare services. Findings also provide a model that includes valid and reliable measures.

Quality control and gap-filling of PM10 daily mean concentrations with the best linear unbiased estimator.

PubMed

Sozzi, R; Bolignano, A; Ceradini, S; Morelli, M; Petenko, I; Argentini, S

2017-10-15

According to the European Directive 2008/50/CE, the air quality assessment consists in the measurement of the concentration fields, and the evaluation of the mean, number of exceedances, etc. of some chemical species dangerous to human health. The measurements provided by an air quality ground-based monitoring network are the main information source but the availability of these data is often limited by several technical and operational problems. In this paper, the best linear unbiased estimator (BLUE) is proposed to validate the pollutant concentration values and to fill the gaps in the measurement of time series collected by a monitoring network. The BLUE algorithm is tested using the daily mean concentrations of particulate matter having aerodynamic diameter less than 10 μ (PM 10 concentrations) measured by the air quality monitoring sensors operating in the Lazio Region in Italy. The comparison between the estimated and measured data evidences an error comparable with the measurement uncertainty. Due to its simplicity and reliability, the BLUE will be used in the routine quality test procedures of the Lazio air quality monitoring network measurements.

Enhancement of the Automated Quality Control Procedures for the International Soil Moisture Network

NASA Astrophysics Data System (ADS)

Heer, Elsa; Xaver, Angelika; Dorigo, Wouter; Messner, Romina

2017-04-01

In-situ soil moisture observations are still trusted to be the most reliable data to validate remotely sensed soil moisture products. Thus, the quality of in-situ soil moisture observations is of high importance. The International Soil Moisture Network (ISMN; http://ismn.geo.tuwien.ac.at/) provides in-situ soil moisture data from all around the world. The data is collected from individual networks and data providers, measured by different sensors in various depths. The data sets which are delivered in different units, time zones and data formats are then transformed into homogeneous data sets. An erroneous behavior of soil moisture data is very difficult to detect, due to annual and daily changes and most significantly the high influence of precipitation and snow melting processes. Only few of the network providers have a quality assessment for their data sets. Therefore, advanced quality control procedures have been developed for the ISMN (Dorigo et al. 2013). Three categories of quality checks were introduced: exceeding boundary values, geophysical consistency checks and a spectrum based approach. The spectrum based quality control algorithms aim to detect erroneous measurements which occur within plausible geophysical ranges, e.g. a sudden drop in soil moisture caused by a sensor malfunction. By defining several conditions which have to be met by the original soil moisture time series and their first and second derivative, such error types can be detected. Since the development of these sophisticated methods many more data providers shared their data with the ISMN and new types of erroneous measurements were identified. Thus, an enhancement of the automated quality control procedures became necessary. In the present work, we introduce enhancements of the existing quality control algorithms. Additionally, six completely new quality checks have been developed, e.g. detection of suspicious values before or after NAN-values, constant values and values that lie in a spectrum where a high majority of values before and after is flagged and therefore a sensor malfunction is certain. For the evaluation of the enhanced automated quality control system many test data sets were chosen, and manually validated to be compared to the existing quality control procedures and the new algorithms. Improvements will be shown that assure an appropriate assessment of the ISMN data sets, which are used for validations of soil moisture data retrieved by satellite data and are the foundation many other scientific publications.

Adaptive weld control for high-integrity welding applications

NASA Technical Reports Server (NTRS)

Powell, Bradley W.

1993-01-01

An advanced adaptive control weld system for high-integrity welding applications is presented. The system consists of a state-of-the-art weld control subsystem, motion control subsystem, and sensor subsystem which closes the loop on the process. The adaptive control subsystem (ACS), which is required to totally close the loop on weld process control, consists of a multiprocessor system, data acquisition hardware, and three welding sensors which provide measurements from all areas around the torch in real time. The ACS acquires all 'measurables' and feeds offset trims back into the weld control and motion control subsystems to modify the 'controllables' in order to maintain a previously defined weld quality.

Development and application of a microarray meter tool to optimize microarray experiments

PubMed Central

Rouse, Richard JD; Field, Katrine; Lapira, Jennifer; Lee, Allen; Wick, Ivan; Eckhardt, Colleen; Bhasker, C Ramana; Soverchia, Laura; Hardiman, Gary

2008-01-01

Background Successful microarray experimentation requires a complex interplay between the slide chemistry, the printing pins, the nucleic acid probes and targets, and the hybridization milieu. Optimization of these parameters and a careful evaluation of emerging slide chemistries are a prerequisite to any large scale array fabrication effort. We have developed a 'microarray meter' tool which assesses the inherent variations associated with microarray measurement prior to embarking on large scale projects. Findings The microarray meter consists of nucleic acid targets (reference and dynamic range control) and probe components. Different plate designs containing identical probe material were formulated to accommodate different robotic and pin designs. We examined the variability in probe quality and quantity (as judged by the amount of DNA printed and remaining post-hybridization) using three robots equipped with capillary printing pins. Discussion The generation of microarray data with minimal variation requires consistent quality control of the (DNA microarray) manufacturing and experimental processes. Spot reproducibility is a measure primarily of the variations associated with printing. The microarray meter assesses array quality by measuring the DNA content for every feature. It provides a post-hybridization analysis of array quality by scoring probe performance using three metrics, a) a measure of variability in the signal intensities, b) a measure of the signal dynamic range and c) a measure of variability of the spot morphologies. PMID:18710498

The MAREDAT Global Database of High Performance Liquid Chromatography Marine Pigment Measurements

NASA Technical Reports Server (NTRS)

Peloquin, J.; Swan, C.; Gruber, N.; Vogt, M.; Claustre, H.; Ras, J.; Uitz, J.; Barlow, R.; Behrenfeld, M.; Bidigare, R.;

In the company of men: quality of life and social support among the Ariaal of northern Kenya.

PubMed

Campbell, Benjamin C; Gray, Peter B; Radak, Jason

2011-09-01

To determine the age-related pattern of well-being among men and its predictors in a subsistence society, we collected anthropometric and questionnaire data among Ariaal pastoral nomads of northern Kenya. The sample consisted of 102 settled and 103 nomadic men ages 20 to 60+ stratified by 10 year age groups. Measures included questions from the WHO quality of life questionnaire (WHOQOL), anthropometrics, and hand grip strength, as well as questions about the number of friends and kin who gave material and emotional support. Results show that while reported quality of life declined significantly across age groups in both sub-populations, nomadic males reported significantly higher overall quality of life than did settled males. Support from other males, but not marital status, was a significant predictor of quality of life, controlled for age group and residence. Among the physical measures, % body fat was positively related to quality of life among the nomads, while grip strength was not related to quality of life. In a multivariate model, male support was the strongest predictor of quality of life. These results provide the first clear demonstration of age-related declines in male quality of life and the importance of social support to men's quality of life in a subsistence population.

A screening mammography program. Staying alive and making it work.

PubMed

Monsees, B S; Destouet, J M

1992-01-01

The success of a mammography screening program requires thorough planning. A dependably high volume and a streamlined efficient operation are essential to survival of the program. Factors that warrant consideration prior to designing such a program include the following: Distinction between screening and diagnostic mammography examinations. Selection of a site that will meet the needs of the community and yet provide a consistently high volume. Low examination cost for screening mammography coupled with a detailed financial analysis and reappraisal on an ongoing basis. A customized marketing program that incorporates methods to increase awareness, compliance, and utilization by women and referring physicians. Well-trained, efficient, and dedicated personnel. An operation that is designed for rapid throughput and expeditious patient flow. An efficient plan for film handling, interpretation, reporting, and storage. Timely communication of examination results. A reliable mechanism for follow-up evaluation and outcome data collection. Establishment of a consistent and reliable quality assurance program and the production of high quality mammograms.

smwrData—An R package of example hydrologic data, version 1.1.1

USGS Publications Warehouse

Lorenz, David L.

2015-11-06

A collection of 24 datasets, including streamflow, well characteristics, groundwater elevations, and discrete water-quality concentrations, is provided to produce a consistent set of example data to demonstrate typical data manipulations or statistical analysis of hydrologic data. These example data are provided in an R package called smwrData. The data in the package have been collected by the U.S. Geological Survey or published in its reports, for example Helsel and Hirsch (2002). The R package provides a convenient mechanism for distributing the data to users of R within the U.S. Geological Survey and other users in the R community.

The Consumer Quality Index in an accident and emergency department: internal consistency, validity and discriminative capacity.

PubMed

Bos, Nanne; Sturms, Leontien M; Stellato, Rebecca K; Schrijvers, Augustinus J P; van Stel, Henk F

2015-10-01

Patients' experiences are an indicator of health-care performance in the accident and emergency department (A&E). The Consumer Quality Index for the Accident and Emergency department (CQI A&E), a questionnaire to assess the quality of care as experienced by patients, was investigated. The internal consistency, construct validity and discriminative capacity of the questionnaire were examined. In the Netherlands, twenty-one A&Es participated in a cross-sectional survey, covering 4883 patients. The questionnaire consisted of 78 questions. Principal components analysis determined underlying domains. Internal consistency was determined by Cronbach's alpha coefficients, construct validity by Pearson's correlation coefficients and the discriminative capacity by intraclass correlation coefficients and reliability of A&E-level mean scores (G-coefficient). Seven quality domains emerged from the principal components analysis: information before treatment, timeliness, attitude of health-care professionals, professionalism of received care, information during treatment, environment and facilities, and discharge management. Domains were internally consistent (range: 0.67-0.84). Five domains and the 'global quality rating' had the capacity to discriminate among A&Es (significant intraclass correlation coefficient). Four domains and the 'global quality rating' were close to or above the threshold for reliably demonstrating differences among A&Es. The patients' experiences score on the domain timeliness showed the largest range between the worst- and best-performing A&E. The CQI A&E is a validated survey to measure health-care performance in the A&E from patients' perspective. Five domains regarding quality of care aspects and the 'global quality rating' had the capacity to discriminate among A&Es. © 2013 John Wiley & Sons Ltd.

A downloadable meshed human canine tooth model with PDL and bone for finite element simulations.

PubMed

Boryor, Andrew; Hohmann, Ansgar; Geiger, Martin; Wolfram, Uwe; Sander, Christian; Sander, Franz Günter

2009-09-01

The aim of this study is to relieve scientists from the complex and time-consuming task of model generation by providing a model of a canine tooth and its periradicular tissues for Finite Element Method (FEM) simulations. This was achieved with diverse commercial software, based on a micro-computed tomography of the specimen. The Finite Element (FE) Model consists of enamel, dentin, nerve (innervation), periodontal ligament (PDL), and the surrounding cortical bone with trabecular structure. The area and volume meshes are of a very high quality in order to represent the model in a detailed form. Material properties are to be set individually by every user. The tooth model is provided for Abaqus, Ansys, HyperMesh, Nastran and as STL files, in an ASCII format for free download. This can help reduce the cost and effort of generating a tooth model for some research institutions, and may encourage other research groups to provide their high quality models for other researchers. By providing FE models, research results, especially FEM simulations, could be easily verified by others.

Service quality of hospital outpatient departments: patients' perspective.

PubMed

Zarei, Ehsan

2015-01-01

Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients' perspective. This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications. Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients' perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor. Practical implications - The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction. According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.

Racial/Ethnic Disparity in NICU Quality of Care Delivery.

PubMed

Profit, Jochen; Gould, Jeffrey B; Bennett, Mihoko; Goldstein, Benjamin A; Draper, David; Phibbs, Ciaran S; Lee, Henry C

2017-09-01

Differences in NICU quality of care provided to very low birth weight (<1500 g) infants may contribute to the persistence of racial and/or ethnic disparity. An examination of such disparities in a population-based sample across multiple dimensions of care and outcomes is lacking. Prospective observational analysis of 18 616 very low birth weight infants in 134 California NICUs between January 1, 2010, and December 31, 2014. We assessed quality of care via the Baby-MONITOR, a composite indicator consisting of 9 process and outcome measures of quality. For each NICU, we calculated a risk-adjusted composite and individual component quality score for each race and/or ethnicity. We standardized each score to the overall population to compare quality of care between and within NICUs. We found clinically and statistically significant racial and/or ethnic variation in quality of care between NICUs as well as within NICUs. Composite quality scores ranged by 5.26 standard units (range: -2.30 to 2.96). Adjustment of Baby-MONITOR scores by race and/or ethnicity had only minimal effect on comparative assessments of NICU performance. Among subcomponents of the Baby-MONITOR, non-Hispanic white infants scored higher on measures of process compared with African Americans and Hispanics. Compared with whites, African Americans scored higher on measures of outcome; Hispanics scored lower on 7 of the 9 Baby-MONITOR subcomponents. Significant racial and/or ethnic variation in quality of care exists between and within NICUs. Providing feedback of disparity scores to NICUs could serve as an important starting point for promoting improvement and reducing disparities. Copyright © 2017 by the American Academy of Pediatrics.

Innovation Networks to Stimulate Public and Private Sector Collaboration for Advisory Services Innovation and Coordination: The Case of Pasture Performance Issues in the New Zealand Dairy Industry

ERIC Educational Resources Information Center

Rijswijk, K.; Brazendale, R.

2017-01-01

Purpose: An innovation network, called the Pasture Improvement Leadership Group (PILG), was formed to improve the quality and consistency of advice provided to dairy farmers in New Zealand, after they expressed dissatisfaction with their pastures. The aim of this paper is to better understand the challenges of forming and maintaining networks to…

Foundations of Observation: Considerations for Developing a Classroom Observation System That Helps Districts Achieve Consistent and Accurate Scores. MET Project, Policy and Practice Brief

ERIC Educational Resources Information Center

Joe, Jilliam N.; Tocci, Cynthia M.; Holtzman, Steven L.; Williams, Jean C.

2013-01-01

The purpose of this paper is to provide states and school districts with processes they can use to help ensure high-quality data collection during teacher observations. Educational Testing Service's (ETS's) goal in writing it is to share the knowledge and expertise they gained: (1) from designing and implementing scoring processes for the Measures…

Autonomous Rendezvous and Docking Conference, volume 1

NASA Technical Reports Server (NTRS)

1990-01-01

This document consists of the presentation submitted at the Autonomous Rendezvous and Docking (ARD) Conference. It contains three volumes: ARD hardware technology; ARD software technology; and ARD operations. The purpose of this conference is to identify the technologies required for an on orbit demonstration of the ARD, assess the maturity of these technologies, and provide the necessary insight for a quality assessment of the programmatic management, technical, schedule, and cost risks.

Autonomous Rendezvous and Docking Conference, volume 3

NASA Technical Reports Server (NTRS)

1990-01-01

This document consists of the presentation submitted at the Autonomous Rendezvous and Docking (ARD) Conference. The document contains three volumes: ARD hardware technology; ARD software technology; and ARD operations. The purpose of this conference is to identify the technologies required for an on orbit demonstration of ARD, assess the maturity of these technologies, and provide the necessary insight for a quality assessment of programmatic management, technical, schedule, and cost risks.

Variations among Primary Care Physicians in Exercise Advice, Imaging, and Analgesics for Musculoskeletal Pain: Results from a Factorial Experiment

PubMed Central

Maserejian, Nancy N.; Fischer, Michael A.; Trachtenberg, Felicia L.; Yu, Jing; Marceau, Lisa D.; McKinlay, John B.; Katz, Jeffrey N.

2014-01-01

Objective To examine whether medical decisions regarding evaluation and management of musculoskeletal pain conditions varied systematically by characteristics of the patient or provider. Methods We conducted a balanced factorial experiment among primary care physicians in the U.S. Physicians (N=192) viewed two videos of different patients (actors) presenting with pain: (1) undiagnosed sciatica symptoms or (2) diagnosed knee osteoarthritis. Systematic variations in patient gender, socioeconomic status (SES), race, physician gender and experience (<20 vs. ≥20 years in practice) permitted estimation of unconfounded effects. Analysis of variance was used to evaluate associations between patient or provider attributes and clinical decisions. Quality of decisions was defined based on the current recommendations of the ACR, American Pain Society, and clinical expert consensus. Results Despite current recommendations, under one-third of physicians would provide exercise advice (30.2% for osteoarthritis, 32.8% for sciatica). Physicians with fewer years in practice were more likely to provide advice on lifestyle changes, particularly exercise (P<0.01), and to prescribe NSAIDs for pain relief, both of which were appropriate and consistent with current recommendations for care. Newer physicians ordered fewer tests, particularly basic laboratory investigations or urinalysis. Test ordering decreased as organizational emphasis on business or profits increased. Patient factors and physician gender had no consistent effects on pain evaluation or treatment. Conclusion Physician education on disease management recommendations regarding exercise and analgesics, and implementation of quality measures may be useful, particularly for physicians with more years in practice. PMID:24376249

Improving Access to MODIS Biophysical Science Products for NACP Investigators

NASA Technical Reports Server (NTRS)

Wolfe, Robert E.; Gao, Feng; Morisette, Jeffrey T.; Ederer, Gregory A.; Pedelty, Jeffrey A.

2007-01-01

MODIS 4 NACP is a NASA-funded project supporting the North American Carbon Program (NACP). The purpose of this Advancing Collaborative Connections for Earth-Sun System Science (ACCESS) project is to provide researchers with Moderate Resolution Imaging Spectroradiometer (MODIS) biophysical data products that are custom tailored for use in NACP model studies. Standard MODIS biophysical products provide used to improve our understanding on the climate and ecosystem changes. However, direct uses of the MODIS biophysical parameters are constrained by retrieval quality and cloud contamination. Another challenge that NACP users face is acquiring MODIS data in formats and at spatial-temporal resolutions consistent with other data sets they use. We have been working closely with key NACP users to tailor the MODIS products to fit their needs. First, we provide new temporally smoothed and spatially continuous MODIS biophysical data sets. Second, we are distributing MODIS data at suitable spatial-temporal resolutions and in formats consistent with other data integration into model studies.

Asan medical information system for healthcare quality improvement.

PubMed

Ryu, Hyeon Jeong; Kim, Woo Sung; Lee, Jae Ho; Min, Sung Woo; Kim, Sun Ja; Lee, Yong Su; Lee, Young Ha; Nam, Sang Woo; Eo, Gi Seung; Seo, Sook Gyoung; Nam, Mi Hyun

2010-09-01

This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. AMIS CONSISTED OF SEVERAL DISTINCTIVE SYSTEMS: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed.

A programmable display layer for virtual reality system architectures.

PubMed

Smit, Ferdi Alexander; van Liere, Robert; Froehlich, Bernd

2010-01-01

Display systems typically operate at a minimum rate of 60 Hz. However, existing VR-architectures generally produce application updates at a lower rate. Consequently, the display is not updated by the application every display frame. This causes a number of undesirable perceptual artifacts. We describe an architecture that provides a programmable display layer (PDL) in order to generate updated display frames. This replaces the default display behavior of repeating application frames until an update is available. We will show three benefits of the architecture typical to VR. First, smooth motion is provided by generating intermediate display frames by per-pixel depth-image warping using 3D motion fields. Smooth motion eliminates various perceptual artifacts due to judder. Second, we implement fine-grained latency reduction at the display frame level using a synchronized prediction of simulation objects and the viewpoint. This improves the average quality and consistency of latency reduction. Third, a crosstalk reduction algorithm for consecutive display frames is implemented, which improves the quality of stereoscopic images. To evaluate the architecture, we compare image quality and latency to that of a classic level-of-detail approach.

Technical Guidance for Assessing Environmental Justice in ...

EPA Pesticide Factsheets

The Technical Guidance for Assessing Environmental Justice in Regulatory Analysis (also referred to as the Environmental Justice Technical Guidance or EJTG) is intended for use by Agency analysts, including risk assessors, economists, and other analytic staff that conduct analyses to evaluate EJ concerns in the context of regulatory actions. Senior EPA managers and decision makers also may find this document useful to understand analytic expectations and to ensure that EJ concerns are appropriately considered in the development of analyses to support regulatory actions under EPA’s action development process. Specifically, the document outlines approaches and methods to help Agency analysts evaluate EJ concerns. The document provides overarching direction to analysts by outlining a series of questions that will ensure the decision maker has appropriate information about baseline risks across population groups, and how those risks are distributed under the options being considered. In addition, the document provides a set of recommendations and requirements as well as best practices for use in analyzing and reporting results from consideration of EJ concerns. These principles will help ensure consistency, quality, and transparency across regulatory actions, while allowing for flexibility needed across different regulatory actions. The purpose of the EJTG is ensure consistency, quality, and transparency in considering environmental justice, while allowing f

Belgian guidelines for budget impact analyses.

PubMed

Neyt, M; Cleemput, I; Sande, S Van De; Thiry, N

2015-06-01

To develop methodological guidelines for budget impact analysis submitted to the Belgian health authorities as part of a reimbursement request. A review of the literature was performed and provided the basis for preliminary budget impact guidelines. These guidelines were improved after discussion with health economists from the Belgian Health Care Knowledge Centre (KCE) and different Belgian stakeholders from both government and industry. Preliminary guidelines were also discussed in a workshop with health economists from The German Institute for Quality and Efficiency in Healthcare. Finally, the guidelines were also externally validated by three external experts. The guidelines give explicit guidance for the following components of a budget impact analysis: perspective of the evaluation, target population, comparator, costs, time horizon, modeling, handling uncertainty and discount rate. Special attention is given to handling varying target population sizes over time, applying a time horizon up to the steady state instead of short-term predictions, and similarities and differences between budget impact analysis and economic evaluations. The guidelines provide a framework for both researchers and assessors to set up budget impact analyses that are transparent, relevant, of high quality and apply a consistent methodology. This might improve the extent to which such evaluations can reliably and consistently be used in the reimbursement decision making process.

The EMBARC European Bronchiectasis Registry: protocol for an international observational study

PubMed Central

Aliberti, Stefano; Polverino, Eva; Vendrell, Montserrat; Crichton, Megan; Loebinger, Michael; Dimakou, Katerina; Clifton, Ian; van der Eerden, Menno; Rohde, Gernot; Murris-Espin, Marlene; Masefield, Sarah; Gerada, Eleanor; Shteinberg, Michal; Ringshausen, Felix; Haworth, Charles; Boersma, Wim; Rademacher, Jessica; Hill, Adam T.; Aksamit, Timothy; O'Donnell, Anne; Morgan, Lucy; Milenkovic, Branislava; Tramma, Leandro; Neves, Joao; Menendez, Rosario; Paggiaro, Perluigi; Botnaru, Victor; Skrgat, Sabina; Wilson, Robert; Goeminne, Pieter; De Soyza, Anthony; Welte, Tobias; Torres, Antoni; Elborn, J. Stuart; Blasi, Francesco

2016-01-01

Bronchiectasis is one of the most neglected diseases in respiratory medicine. There are no approved therapies and few large-scale, representative epidemiological studies. The EMBARC (European Multicentre Bronchiectasis Audit and Research Collaboration) registry is a prospective, pan-European observational study of patients with bronchiectasis. The inclusion criterion is a primary clinical diagnosis of bronchiectasis consisting of: 1) a clinical history consistent with bronchiectasis; and 2) computed tomography demonstrating bronchiectasis. Core exclusion criteria are: 1) bronchiectasis due to known cystic fibrosis; 2) age <18 years; and 3) patients who are unable or unwilling to provide informed consent. The study aims to enrol 1000 patients by April 2016 across at least 20 European countries, and 10 000 patients by March 2020. Patients will undergo a comprehensive baseline assessment and will be followed up annually for up to 5 years with the goal of providing high-quality longitudinal data on outcomes, treatment patterns and quality of life. Data from the registry will be available in the form of annual reports. and will be disseminated in conference presentations and peer-reviewed publications. The European Bronchiectasis Registry aims to make a major contribution to understanding the natural history of the disease, as well as guiding evidence-based decision making and facilitating large randomised controlled trials. PMID:27730179

Capacitated location of collection sites in an urban waste management system

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

Ghiani, Gianpaolo, E-mail: gianpaolo.ghiani@unisalento.it; Itaca S.r.l., via P. Bucci 41C, 87036 Rende; Lagana, Demetrio, E-mail: dlagana@deis.unical.it

2012-07-15

Urban waste management is becoming an increasingly complex task, absorbing a huge amount of resources, and having a major environmental impact. The design of a waste management system consists in various activities, and one of these is related to the location of waste collection sites. In this paper, we propose an integer programming model that helps decision makers in choosing the sites where to locate the unsorted waste collection bins in a residential town, as well as the capacities of the bins to be located at each collection site. This model helps in assessing tactical decisions through constraints that forcemore » each collection area to be capacitated enough to fit the expected waste to be directed to that area, while taking into account Quality of Service constraints from the citizens' point of view. Moreover, we propose an effective constructive heuristic approach whose aim is to provide a good solution quality in an extremely reduced computational time. Computational results on data related to the city of Nardo, in the south of Italy, show that both exact and heuristic approaches provide consistently better solutions than that currently implemented, resulting in a lower number of activated collection sites, and a lower number of bins to be used.« less

Enhancing board oversight on quality of hospital care: an agency theory perspective.

PubMed

Jiang, H Joanna; Lockee, Carlin; Fraser, Irene

2012-01-01

Community hospitals in the United States are almost all governed by a governing board that is legally accountable for the quality of care provided. Increasing pressures for better quality and safety are prompting boards to strengthen their oversight function on quality. In this study, we aimed to provide an update to prior research by exploring the role and practices of governing boards in quality oversight through the lens of agency theory and comparing hospital quality performance in relation to the adoption of those practices. Data on board practices from a survey conducted by The Governance Institute in 2007 were merged with data on hospital quality drawn from two federal sources that measured processes of care and mortality. The study sample includes 445 public and private not-for-profit hospitals. We used factor analysis to explore the underlying dimensions of board practices. We further compared hospital quality performance by the adoption of each individual board practice. Consistent with the agency theory, the 13 board practices included in the survey appear to center around enhancing accountability of the board, management, and the medical staff. Reviewing the hospital's quality performance on a regular basis was the most common practice. A number of board practices, not examined in prior research, showed significant association with better performance on process of care and/or risk-adjusted mortality: requiring major new clinical programs to meet quality-related criteria, setting some quality goals at the "theoretical ideal" level, requiring both the board and the medical staff to be as involved as management in setting the agenda for discussion on quality, and requiring the hospital to report its quality/safety performance to the general public. Hospital governing boards should examine their current practices and consider adopting those that would enhance the accountability of the board itself, management, and the medical staff.

Written Comments Made by Anesthesia Residents When Providing Below Average Scores for the Supervision Provided by the Faculty Anesthesiologist.

PubMed

Dexter, Franklin; Szeluga, Debra; Masursky, Danielle; Hindman, Bradley J

2016-06-01

Anesthesia residents in our department evaluate the supervision provided by the faculty anesthesiologist with whom they worked the previous day. What advice managers can best provide to the faculty who receive below-average supervision scores is unknown. The residents provided numerical answers (1 "never," 2 "rarely," 3 "frequently," or 4 "always") to each of the 9 supervision questions, resulting in a total supervision score. A written comment could also be provided. Over 2.5 years, the response rate to requests for evaluation was 99.1%. There were 13,664 evaluations of 76 faculty including 1387 comments. There were 25 evaluations with a comment of disrespectful behavior. For all 25, the question evaluating whether "the faculty treated me respectfully" was answered <4 (i.e., not "always"). The supervision scores were less than for the other evaluations with comments (P < 0.0001). Each increase in the faculty's number of comments of being disrespectful was associated with a lesser mean score (P = 0.0002). A low supervision score (<3.00; i.e., less than "frequent") had an odds ratio of 85 for disrespectful faculty behavior (P < 0.0001). The predictive value of the supervision score not being low for absence of a comment of disrespectful behavior was 99%. That finding was especially useful because 94% of scores below average (<3.80) were not low (≥3.00). There were 6 evaluations with a comment of insufficient faculty presence. Those evaluations had lesser scores than the other evaluations with comments (P < 0.0001). The 6 faculty with 1 such comment had lesser mean scores than the other faculty (P = 0.0071). There were 34 evaluations with a comment about poor-quality teaching. The evaluations related to poor teaching had lesser scores than the other evaluations with comments (P < 0.0001). The faculty who each received such a comment had lesser mean scores than the other faculty (P < 0.0001). Each increase in the faculty's number of comments of poor-quality teaching was associated with a lesser mean score (P = 0.0002). The 9 supervision questions were internally consistent (Cronbach α = 0.948). A faculty with a comment about poor-quality teaching had significant odds of also having a comment about insufficient presence (P = 0.0044). A comment with negative sentiment had significant odds of being about poor-quality teaching rather than being about insufficient presence (odds ratio, 6.00; P < 0.0001). A faculty who has insufficient presence cannot be providing good teaching. Furthermore, there was negligible correlation between supervision scores and faculty clinical assignments. Thus, insufficient faculty presence accounted for a small proportion of below-average supervision scores and low-quality supervision. Furthermore, scores ≥3 have a predictive value for the absence of disrespectful behavior ≅99%. Approximately 94% of the faculty supervision scores that were below average were still ≥3. Consequently, for the vast majority of the faculty-resident-days, quality of teaching distinguished between below- versus above-average supervision scores. This result is consistent with our prior finding of a strong correlation between 6-month supervision scores and assessments of teaching effectiveness. Taken together, when individual faculty anesthesiologists are counseled about their clinical supervision scores, the attribute to emphasize is quality of clinical teaching.

DataFed: A Federated Data System for Visualization and Analysis of Spatio-Temporal Air Quality Data

NASA Astrophysics Data System (ADS)

Husar, R. B.; Hoijarvi, K.

2017-12-01

DataFed is a distributed web-services-based computing environment for accessing, processing, and visualizing atmospheric data in support of air quality science and management. The flexible, adaptive environment facilitates the access and flow of atmospheric data from provider to users by enabling the creation of user-driven data processing/visualization applications. DataFed `wrapper' components, non-intrusively wrap heterogeneous, distributed datasets for access by standards-based GIS web services. The mediator components (also web services) map the heterogeneous data into a spatio-temporal data model. Chained web services provide homogeneous data views (e.g., geospatial, time views) using a global multi-dimensional data model. In addition to data access and rendering, the data processing component services can be programmed for filtering, aggregation, and fusion of multidimensional data. A complete application software is written in a custom made data flow language. Currently, the federated data pool consists of over 50 datasets originating from globally distributed data providers delivering surface-based air quality measurements, satellite observations, emissions data as well as regional and global-scale air quality models. The web browser-based user interface allows point and click navigation and browsing the XYZT multi-dimensional data space. The key applications of DataFed are for exploring spatial pattern of pollutants, seasonal, weekly, diurnal cycles and frequency distributions for exploratory air quality research. Since 2008, DataFed has been used to support EPA in the implementation of the Exceptional Event Rule. The data system is also used at universities in the US, Europe and Asia.

Effect of Physician Delegation to Other Healthcare Providers on the Quality of Care for Geriatric Conditions.

PubMed

Lichtenstein, Brian J; Reuben, David B; Karlamangla, Arun S; Han, Weijuan; Roth, Carol P; Wenger, Neil S

2015-10-01

The quality of care of older adults in the United States has been consistently shown to be inadequate. This gap between recommended and actual care provides an opportunity to improve the value of health care for older adults. Prior work from the Assessing Care of Vulnerable Elders (ACOVE) investigators first defined, and then sought to improve, clinical practice for common geriatric conditions. A critical component of the ACOVE intervention for practice improvement was an emphasis on the delegation of specific care processes, but the independent effect of delegation on the quality of care has not been evaluated. This study analyzed the pooled results of prior ACOVE projects from 1998 to 2010. Totaled, these studies included 4,776 individuals aged 65 and older of mixed demographic backgrounds and 16,204 ACOVE quality indicators (QIs) for three geriatric conditions: falls, urinary incontinence, and dementia. In unadjusted analyses, QI pass probabilities were 0.36 for physician-performed tasks, 0.55 for nurse practitioner (NP)-, physician assistant (PA)-, and registered nurse (RN)-performed tasks; and 0.61 for medical assistant- and licensed vocational nurse-performed tasks. In multiply adjusted models, the independent pass-probability effect of delegation to NPs, PAs, and RNs was 1.37 (P = .05). These findings suggest that delegation of selected tasks to nonphysician healthcare providers is associated with higher quality of care for these geriatric conditions in community practices and supports the value of interdisciplinary team management for common outpatient conditions in older adults. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Seltzer_et_al_2016

EPA Pesticide Factsheets

This dataset supports the modeling study of Seltzer et al. (2016) published in Atmospheric Environment. In this study, techniques typically used for future air quality projections are applied to a historical 11-year period to assess the performance of the modeling system when the driving meteorological conditions are obtained using dynamical downscaling of coarse-scale fields without correcting toward higher resolution observations. The Weather Research and Forecasting model and the Community Multiscale Air Quality model are used to simulate regional climate and air quality over the contiguous United States for 2000-2010. The air quality simulations for that historical period are then compared to observations from four national networks. Comparisons are drawn between defined performance metrics and other published modeling results for predicted ozone, fine particulate matter, and speciated fine particulate matter. The results indicate that the historical air quality simulations driven by dynamically downscaled meteorology are typically within defined modeling performance benchmarks and are consistent with results from other published modeling studies using finer-resolution meteorology. This indicates that the regional climate and air quality modeling framework utilized here does not introduce substantial bias, which provides confidence in the method??s use for future air quality projections.This dataset is associated with the following publication:Seltzer, K., C

Kpejigaou: an indigenous, high-protein, low-fat, cowpea-based griddled food proposed for coastal West Africa.

PubMed

Amonsou, Eric Oscar; Sakyi-Dawson, Esther; Saalia, Firibu Kwesi; Houssou, Paul

2008-12-01

Griddled cowpea paste foods have high nutritional potential because they are low in fat but high in protein. A good understanding of process and product characteristics of kpejigaou is necessary to improve its quality and enhance acceptability. To describe the product, evaluate critical variables in traditional processing, and determine consumer quality criteria and preferences for kpejigaou. A survey of kpejigaou processing was carried out among processors and regular consumers of kpejigaou. Kpejigaou is flat and circular in shape, with uniform thickness and porous structure. The production process of kpejigaou was found to be simple and rapid, but the quality of the finished product varied among processors and among batches. Critical processing variables affecting quality were dehulling of the cowpeas, type of griddling equipment, and griddling temperature. Texture (sponginess) is the most important quality index that determines the preference and acceptability of kpejigaou by consumers. Traditionally processed kpejigaou does not meet current standards for high-quality foods. This study provides the basis for efforts to standardize the kpejigaou process to ensure consistent product quality and enhance the acceptability of kpejigaou among consumers. Kpejigaou has a potential for success if marketed as a low-fat, nutritious fast food.

Evaluating statistical consistency in the ocean model component of the Community Earth System Model (pyCECT v2.0)

NASA Astrophysics Data System (ADS)

Baker, Allison H.; Hu, Yong; Hammerling, Dorit M.; Tseng, Yu-heng; Xu, Haiying; Huang, Xiaomeng; Bryan, Frank O.; Yang, Guangwen

2016-07-01

The Parallel Ocean Program (POP), the ocean model component of the Community Earth System Model (CESM), is widely used in climate research. Most current work in CESM-POP focuses on improving the model's efficiency or accuracy, such as improving numerical methods, advancing parameterization, porting to new architectures, or increasing parallelism. Since ocean dynamics are chaotic in nature, achieving bit-for-bit (BFB) identical results in ocean solutions cannot be guaranteed for even tiny code modifications, and determining whether modifications are admissible (i.e., statistically consistent with the original results) is non-trivial. In recent work, an ensemble-based statistical approach was shown to work well for software verification (i.e., quality assurance) on atmospheric model data. The general idea of the ensemble-based statistical consistency testing is to use a qualitative measurement of the variability of the ensemble of simulations as a metric with which to compare future simulations and make a determination of statistical distinguishability. The capability to determine consistency without BFB results boosts model confidence and provides the flexibility needed, for example, for more aggressive code optimizations and the use of heterogeneous execution environments. Since ocean and atmosphere models have differing characteristics in term of dynamics, spatial variability, and timescales, we present a new statistical method to evaluate ocean model simulation data that requires the evaluation of ensemble means and deviations in a spatial manner. In particular, the statistical distribution from an ensemble of CESM-POP simulations is used to determine the standard score of any new model solution at each grid point. Then the percentage of points that have scores greater than a specified threshold indicates whether the new model simulation is statistically distinguishable from the ensemble simulations. Both ensemble size and composition are important. Our experiments indicate that the new POP ensemble consistency test (POP-ECT) tool is capable of distinguishing cases that should be statistically consistent with the ensemble and those that should not, as well as providing a simple, subjective and systematic way to detect errors in CESM-POP due to the hardware or software stack, positively contributing to quality assurance for the CESM-POP code.

A New Model for Solving Time-Cost-Quality Trade-Off Problems in Construction

PubMed Central

Fu, Fang; Zhang, Tao

2016-01-01

A poor quality affects project makespan and its total costs negatively, but it can be recovered by repair works during construction. We construct a new non-linear programming model based on the classic multi-mode resource constrained project scheduling problem considering repair works. In order to obtain satisfactory quality without a high increase of project cost, the objective is to minimize total quality cost which consists of the prevention cost and failure cost according to Quality-Cost Analysis. A binary dependent normal distribution function is adopted to describe the activity quality; Cumulative quality is defined to determine whether to initiate repair works, according to the different relationships among activity qualities, namely, the coordinative and precedence relationship. Furthermore, a shuffled frog-leaping algorithm is developed to solve this discrete trade-off problem based on an adaptive serial schedule generation scheme and adjusted activity list. In the program of the algorithm, the frog-leaping progress combines the crossover operator of genetic algorithm and a permutation-based local search. Finally, an example of a construction project for a framed railway overpass is provided to examine the algorithm performance, and it assist in decision making to search for the appropriate makespan and quality threshold with minimal cost. PMID:27911939

A Large-Scale Comparative Metagenomic Study Reveals the Functional Interactions in Six Bloom-Forming Microcystis-Epibiont Communities

PubMed Central

Li, Qi; Lin, Feibi; Yang, Chen; Wang, Juanping; Lin, Yan; Shen, Mengyuan; Park, Min S.; Li, Tao; Zhao, Jindong

2018-01-01

Cyanobacterial blooms are worldwide issues of societal concern and scientific interest. Lake Taihu and Lake Dianchi, two of the largest lakes in China, have been suffering from annual Microcystis-based blooms over the past two decades. These two eutrophic lakes differ in both nutrient load and environmental parameters, where Microcystis microbiota consisting of different Microcystis morphospecies and associated bacteria (epibionts) have dominated. We conducted a comprehensive metagenomic study that analyzed species diversity, community structure, functional components, metabolic pathways and networks to investigate functional interactions among the members of six Microcystis-epibiont communities in these two lakes. Our integrated metagenomic pipeline consisted of efficient assembly, binning, annotation, and quality assurance methods that ensured high-quality genome reconstruction. This study provides a total of 68 reconstructed genomes including six complete Microcystis genomes and 28 high quality bacterial genomes of epibionts belonging to 14 distinct taxa. This metagenomic dataset constitutes the largest reference genome catalog available for genome-centric studies of the Microcystis microbiome. Epibiont community composition appears to be dynamic rather than fixed, and the functional profiles of communities were related to the environment of origin. This study demonstrates mutualistic interactions between Microcystis and epibionts at genetic and metabolic levels. Metabolic pathway reconstruction provided evidence for functional complementation in nitrogen and sulfur cycles, fatty acid catabolism, vitamin synthesis, and aromatic compound degradation among community members. Thus, bacterial social interactions within Microcystis-epibiont communities not only shape species composition, but also stabilize the communities functional profiles. These interactions appear to play an important role in environmental adaptation of Microcystis colonies. PMID:29731741

Competency assessment of microbiology medical laboratory technologists in Ontario, Canada.

PubMed

Desjardins, Marc; Fleming, Christine Ann

2014-08-01

Accreditation in Ontario, Canada, requires that licensed clinical laboratories participate in external quality assessment (also known as proficiency testing) and perform competency evaluation of their staff. To assess the extent of ongoing competency assessment practices, the Quality Management Program--Laboratory Services (QMP-LS) Microbiology Committee surveyed all 112 licensed Ontario microbiology laboratories. The questionnaire consisted of a total of 21 questions that included yes/no, multiple-choice, and short-answer formats. Participants were asked to provide information about existing programs, the frequency of testing, what areas are evaluated, and how results are communicated to the staff. Of the 111 responding laboratories, 6 indicated they did not have a formal evaluation program since they perform only limited bacteriology testing. Of the remaining 105 respondents, 87% perform evaluations at least annually or every 2 years, and 61% include any test or task performed, whereas 16% and 10% focus only on problem areas and high-volume complex tasks, respectively. The most common methods of evaluation were review of external quality assessment (EQA) challenges, direct observation, and worksheet review. With the exception of one participant, all communicate results to staff, and most take remedial action to correct the deficiencies. Although most accredited laboratories have a program to assess the ongoing competency of their staff, the methods used are not standardized or consistently applied, indicating that there is room for improvement. The survey successfully highlighted potential areas for improvement and allowed the QMP-LS Microbiology Committee to provide guidance to Ontario laboratories for establishing or improving existing microbiology-specific competency assessment programs. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Competency Assessment of Microbiology Medical Laboratory Technologists in Ontario, Canada

PubMed Central

Fleming, Christine Ann

2014-01-01

Accreditation in Ontario, Canada, requires that licensed clinical laboratories participate in external quality assessment (also known as proficiency testing) and perform competency evaluation of their staff. To assess the extent of ongoing competency assessment practices, the Quality Management Program—Laboratory Services (QMP-LS) Microbiology Committee surveyed all 112 licensed Ontario microbiology laboratories. The questionnaire consisted of a total of 21 questions that included yes/no, multiple-choice, and short-answer formats. Participants were asked to provide information about existing programs, the frequency of testing, what areas are evaluated, and how results are communicated to the staff. Of the 111 responding laboratories, 6 indicated they did not have a formal evaluation program since they perform only limited bacteriology testing. Of the remaining 105 respondents, 87% perform evaluations at least annually or every 2 years, and 61% include any test or task performed, whereas 16% and 10% focus only on problem areas and high-volume complex tasks, respectively. The most common methods of evaluation were review of external quality assessment (EQA) challenges, direct observation, and worksheet review. With the exception of one participant, all communicate results to staff, and most take remedial action to correct the deficiencies. Although most accredited laboratories have a program to assess the ongoing competency of their staff, the methods used are not standardized or consistently applied, indicating that there is room for improvement. The survey successfully highlighted potential areas for improvement and allowed the QMP-LS Microbiology Committee to provide guidance to Ontario laboratories for establishing or improving existing microbiology-specific competency assessment programs. PMID:24899030

Establishing High-Quality Prostate Brachytherapy Using a Phantom Simulator Training Program

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

Thaker, Nikhil G.; Kudchadker, Rajat J.; Swanson, David A.

2014-11-01

Purpose: To design and implement a unique training program that uses a phantom-based simulator to teach the process of prostate brachytherapy (PB) quality assurance and improve the quality of education. Methods and Materials: Trainees in our simulator program were practicing radiation oncologists, radiation oncology residents, and fellows of the American Brachytherapy Society. The program emphasized 6 core areas of quality assurance: patient selection, simulation, treatment planning, implant technique, treatment evaluation, and outcome assessment. Using the Iodine 125 ({sup 125}I) preoperative treatment planning technique, trainees implanted their ultrasound phantoms with dummy seeds (ie, seeds with no activity). Pre- and postimplant dosimetric parametersmore » were compared and correlated using regression analysis. Results: Thirty-one trainees successfully completed the simulator program during the period under study. The mean phantom prostate size, number of seeds used, and total activity were generally consistent between trainees. All trainees met the V100 >95% objective both before and after implantation. Regardless of the initial volume of the prostate phantom, trainees' ability to cover the target volume with at least 100% of the dose (V100) was not compromised (R=0.99 pre- and postimplant). However, the V150 had lower concordance (R=0.37) and may better reflect heterogeneity control of the implant process. Conclusions: Analysis of implants from this phantom-based simulator shows a high degree of consistency between trainees and uniformly high-quality implants with respect to parameters used in clinical practice. This training program provides a valuable educational opportunity that improves the quality of PB training and likely accelerates the learning curve inherent in PB. Prostate phantom implantation can be a valuable first step in the acquisition of the required skills to safely perform PB.« less

[Creation and validation of the scale for measuring quality of life in patients with cancer: Puerto Rican version (ECVCA-PR). ].

PubMed

Sanoguet, Janelly Muriel; Gómez, José Rodríguez

2013-01-01

The aim of this pioneer study is to begin to create and validate a scale to measure Quality of Life in cancer patients in Puerto Rico (ECVCA-PR) in order to provide local health professionals with a reliable instrument that help to measure attitudes that could affect different patient's quality of life aspects and allows knowing the needs of those cancer patients. Sample consisted of 32 patients (9 men, 23 women), between ages of 30 to 83 years that were receiving services (i.e., hospitalization, treatment, and follow up) at Dr. Isaac González Martínez Oncological Hospital in San Juan, Puerto Rico. The psychometric properties of the instrument indicate a reliability index (Cronbach's Alpha) of 0.927 with 164 items, an excellent index according to the literature.

Evidence-based emergency medicine. Creating a system to facilitate translation of evidence into standardized clinical practice: a preliminary report.

PubMed

Wright, Stewart W; Trott, Alexander; Lindsell, Christopher J; Smith, Carol; Gibler, W Brian

2008-01-01

The Institute of Medicine, through its landmark report concerning errors in medicine, suggests that standardization of practice through systematic development and implementation of evidence-based clinical pathways is an effective way of reducing errors in emergency systems. The specialty of emergency medicine is well positioned to develop a complete system of innovative quality improvement, incorporating best practice guidelines with performance measures and practitioner feedback mechanisms to reduce errors and therefore improve quality of care. This article reviews the construction, ongoing development, and initial impact of such a system at a large, urban, university teaching hospital and at 2 affiliated community hospitals. The Committee for Procedural Quality and Evidence-Based Practice was formed within the Department of Emergency Medicine to establish evidence-based guidelines for nursing and provider care. The committee measures the effect of such guidelines, along with other quality measures, through pre- and postguideline patient care medical record audits. These measures are fed back to the providers in a provider-specific, peer-matched "scorecard." The Committee for Procedural Quality and Evidence-Based Practice affects practice and performance within our department. Multiple physician and nursing guidelines have been developed and put into use. Using asthma as an example, time to first nebulizer treatment and time to disposition from the emergency department decreased. Initial therapeutic agent changed and documentation improved. A comprehensive, guideline-driven, evidence-based approach to clinical practice is feasible within the structure of a department of emergency medicine. High-level departmental support with dedicated personnel is necessary for the success of such a system. Internet site development (available at http://www.CPQE.com) for product storage has proven valuable. Patient care has been improved in several ways; however, consistent and complete change in provider behavior remains elusive. Physician scorecards may play a role in altering these phenomena. Emergency medicine can play a leadership role in the development of quality improvement, error reduction, and pay-for-performance systems.

The Effect of Image Quality, Repeated Study, and Assessment Method on Anatomy Learning

ERIC Educational Resources Information Center

Fenesi, Barbara; Mackinnon, Chelsea; Cheng, Lucia; Kim, Joseph A.; Wainman, Bruce C.

2017-01-01

The use of two-dimensional (2D) images is consistently used to prepare anatomy students for handling real specimen. This study examined whether the quality of 2D images is a critical component in anatomy learning. The visual clarity and consistency of 2D anatomical images was systematically manipulated to produce low-quality and high-quality…

Consumer Quality Index Chronic Skin Disease (CQI-CSD): a new instrument to measure quality of care from the patient's perspective.

PubMed

van Cranenburgh, O D; Krol, M W; Hendriks, M C P; de Rie, M A; Smets, E M A; de Korte, J; Sprangers, M A G

2015-10-01

Assessing quality of care from the patient's perspective is considered to be highly relevant. As a standardized instrument in dermatology was lacking, we developed a patient experience questionnaire regarding chronic skin disease care: the Consumer Quality Index Chronic Skin Disease (CQI-CSD). (i) To evaluate the dimensional structure of the CQI-CSD, (ii) to assess its ability to distinguish between hospitals according to patients' experiences with quality of care, (iii) to explore patients' experiences with dermatological care and priorities for quality improvement according to the patients, and (iv) to optimize the questionnaire based on psychometric results and stakeholders' input. In a cross-sectional study 5647 adult patients who received dermatological care in the past 12 months in 20 hospitals were randomly selected and invited to fill out the questionnaire. Overall 1160 of 3989 eligible respondents (29% response rate, 30-87 per hospital) were included for analysis. The CQI-CSD comprised seven scales with high internal consistency (Cronbach's α = 0·74-0·92). The instrument's discriminative power was limited. Patients were positive about the care provided by nurses and doctors, but the provision of information by healthcare providers, accessibility of care and patient involvement could be improved. We optimized the CQI-CSD, resulting in a revised questionnaire containing 65 items. In conclusion, the CQI-CSD is a useful instrument to measure patient experiences with dermatological care. © 2015 British Association of Dermatologists.

A Simple Sampling Method for Estimating the Accuracy of Large Scale Record Linkage Projects.

PubMed

Boyd, James H; Guiver, Tenniel; Randall, Sean M; Ferrante, Anna M; Semmens, James B; Anderson, Phil; Dickinson, Teresa

2016-05-17

Record linkage techniques allow different data collections to be brought together to provide a wider picture of the health status of individuals. Ensuring high linkage quality is important to guarantee the quality and integrity of research. Current methods for measuring linkage quality typically focus on precision (the proportion of incorrect links), given the difficulty of measuring the proportion of false negatives. The aim of this work is to introduce and evaluate a sampling based method to estimate both precision and recall following record linkage. In the sampling based method, record-pairs from each threshold (including those below the identified cut-off for acceptance) are sampled and clerically reviewed. These results are then applied to the entire set of record-pairs, providing estimates of false positives and false negatives. This method was evaluated on a synthetically generated dataset, where the true match status (which records belonged to the same person) was known. The sampled estimates of linkage quality were relatively close to actual linkage quality metrics calculated for the whole synthetic dataset. The precision and recall measures for seven reviewers were very consistent with little variation in the clerical assessment results (overall agreement using the Fleiss Kappa statistics was 0.601). This method presents as a possible means of accurately estimating matching quality and refining linkages in population level linkage studies. The sampling approach is especially important for large project linkages where the number of record pairs produced may be very large often running into millions.

The availability and consistency of dengue surveillance data provided online by the World Health Organization.

PubMed

Ruberto, Irene; Marques, Ernesto; Burke, Donald S; Van Panhuis, Willem G

2015-04-01

The use of high quality disease surveillance data has become increasingly important for public health action against new threats. In response, countries have developed a wide range of disease surveillance systems enabled by technological advancements. The heterogeneity and complexity of country data systems have caused a growing need for international organizations such as the World Health Organization (WHO) to coordinate the standardization, integration, and dissemination of country disease data at the global level for research and policy. The availability and consistency of currently available disease surveillance data at the global level are unclear. We investigated this for dengue surveillance data provided online by the WHO. We extracted all dengue surveillance data provided online by WHO Headquarters and Regional Offices (RO's). We assessed the availability and consistency of these data by comparing indicators within and between sources. We also assessed the consistency of dengue data provided online by two example countries (Brazil and Indonesia). Data were available from WHO for 100 countries since 1955 representing a total of 23 million dengue cases and 82 thousand deaths ever reported to WHO. The availability of data on DengueNet and some RO's declined dramatically after 2005. Consistency was lacking between sources (84% across all indicators representing a discrepancy of almost half a million cases). Within sources, data at high spatial resolution were often incomplete. The decline of publicly available, integrated dengue surveillance data at the global level will limit opportunities for research, policy, and advocacy. A new financial and operational framework will be necessary for innovation and for the continued availability of integrated country disease data at the global level.

Groundwater quality in the San Diego Drainages Hydrogeologic Province, California

USGS Publications Warehouse

Wright, Michael T.; Belitz, Kenneth

2011-01-01

More than 40 percent of California's drinking water is from groundwater. To protect this vital resource, the State of California created the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The Priority Basin Project of the GAMA Program provides a comprehensive assessment of the State's groundwater quality and increases public access to groundwater-quality information. The San Diego Drainages Hydrogeologic Province (hereinafter referred to as San Diego) is one of the study units being evaluated. The San Diego study unit is approximately 3,900 square miles and consists of the Temecula Valley, Warner Valley, and 12 other alluvial basins (California Department of Water Resources, 2003). The study unit also consists of all areas outside defined groundwater basins that are within 3 kilometers of a public-supply well. The study unit was separated, based primarily on hydrogeologic settings, into four study areas: Temecula Valley, Warner Valley, Alluvial Basins, and Hard Rock (Wright and others, 2005). The sampling density for the Hard Rock study area, which consists of areas outside of groundwater basins, was much lower than for the other study areas. Consequently, aquifer proportions for the Hard Rock study area are not used to calculate the aquifer proportions shown by the pie charts. An assessment of groundwater quality for the Hard Rock study area can be found in Wright and Belitz, 2011. The temperatures in the coastal part of the study unit are mild with dry summers, moist winters, and an average annual rainfall of about 10 inches. The temperatures in the mountainous eastern part of the study unit are cooler than in the coastal part, with an annual precipitation of about 45 inches that occurs mostly in the winter. The primary aquifers consist of Quaternary-age alluvium and weathered bedrock in the Temecula Valley, Warner Valley, and Alluvial Basins study areas, whereas in the Hard Rock study area the primary aquifers consist mainly of fractured and decomposed granite of Mesozoic age. The primary aquifers are defined as those parts of the aquifers corresponding to the perforated intervals of wells listed in the California Department of Public Health (CDPH) database. Public-supply wells typically are drilled to depths between 200 and 700 feet, consist of solid casing from the land surface to a depth of about 60 to 170 feet, and are perforated, or consist of an open hole, below the solid casing. Water quality in the shallow and deep parts of the aquifer system may differ from water quality in the primary aquifers. Municipal water use accounts for approximately 70 percent of water used in the study unit; the majority of the remainder is used for agriculture, industry, and commerce. Groundwater accounts for approximately 8 percent of the municipal supply, and surface water, the majority of which is imported, accounts for the rest. Recharge to groundwater occurs through stream-channel infiltration from rivers and their tributaries, infiltration in engineered recharge basins, and infiltration of water from precipitation and irrigation. The primary source of discharge is water pumped from wells.

Comparative analysis of water quality and toxicity assessment methods for urban highway runoff.

PubMed

Chen, Rui-Hong; Li, Fei-Peng; Zhang, Hai-Ping; Jiang, Yue; Mao, Ling-Chen; Wu, Ling-Ling; Chen, Ling

2016-05-15

In this study, comparative analyses of highway runoff samples obtained from seventeen storm events have been conducted between the traditional water quality assessment method and biotoxicity tests, using zebrafish (Danio rerio) embryos and luminous bacteria (Vibrio qinghaiensis. Q67) to provide useful information for ecotoxicity assessment of urban highway runoff. The study results showed that the Nemerow pollution index based on US EPA recommended Criteria Maximum Concentrations (CMC) (as traditional water quality assessment method) had no significant correlation with luminous bacteria acute toxicity test results, while significant correlation has been observed with two indicators of 72 hpf (hours post fertilization) hour hatching rate and 96 hpf abnormality rate from the toxicity test with zebrafish embryos. It is therefore concluded that the level of mixture toxicity of highway runoff could not be adequately measured by the Nemerow assessment method. Moreover, the key pollutants identified from the water quality assessment and from the biotoxicity evaluation were not consistent. For biotoxic effect evaluation of highway runoff, three indexes were found to be sensitive, i.e. 24 hpf lethality and 96 hpf abnormality of zebrafish embryos, as well as the inhibition rate for luminous bacteria Q67. It is therefore recommended that these indexes could be incorporated into the traditional Nemerow method to provide a more reasonable evaluation of the highway runoff quality and ecotoxicity. Copyright © 2016 Elsevier B.V. All rights reserved.

Psychiatric symptoms and response quality to self-rated personality tests: Evidence from the PsyCoLaus study.

PubMed

Dupuis, Marc; Meier, Emanuele; Rudaz, Dominique; Strippoli, Marie-Pierre F; Castelao, Enrique; Preisig, Martin; Capel, Roland; Vandeleur, Caroline L

2017-06-01

Despite the fact that research has demonstrated consistent associations between self-rated measures of personality dimensions and mental disorders, little has been undertaken to investigate the relation between psychiatric symptoms and response patterns to self-rated tests. The aim of this study was to investigate the association between psychiatric symptoms and response quality using indices from our functional method. A sample of 1,784 participants from a Swiss population-based cohort completed a personality inventory (NEO-FFI) and a symptom checklist of 90 items (SCL-90-R). Different indices of response quality were calculated based on the responses given to the NEO-FFI. Associations among the responses to indices of response quality, sociodemographic characteristics and the SCL-90-R dimensions were then established. Psychiatric symptoms were associated with several important differences in response quality, questioning subjects' ability to provide valid information using self-rated instruments. As suggested by authors, psychiatric symptoms seem associated with differences in personality scores. Nonetheless, our study shows that symptoms are also related to differences in terms of response patterns as sources of differences in personality scores. This could constitute a bias for clinical assessment. Future studies could still determine whether certain subpopulations of subjects are more unable to provide valid information to self-rated questionnaires than others. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.