Sample records for quality assessment plan

  1. Quality Management Plan for the Environmental Assessment and Innovation Division

    EPA Pesticide Factsheets

    Quality management plan (QMP) which identifies the mission, roles, responsibilities of personnel with regard to quality assurance and quality management for the environmental assessment and innovation division.

  2. Quality assessment for VMAT prostate radiotherapy planning based on data envelopment analysis

    NASA Astrophysics Data System (ADS)

    Lin, Kuan-Min; Simpson, John; Sasso, Giuseppe; Raith, Andrea; Ehrgott, Matthias

    2013-08-01

    The majority of commercial radiotherapy treatment planning systems requires planners to iteratively adjust the plan parameters in order to find a satisfactory plan. This iterative trial-and-error nature of radiotherapy treatment planning results in an inefficient planning process and in order to reduce such inefficiency, plans can be accepted without achieving the best attainable quality. We propose a quality assessment method based on data envelopment analysis (DEA) to address this inefficiency. This method compares a plan of interest to a set of past delivered plans and searches for evidence of potential further improvement. With the assistance of DEA, planners will be able to make informed decisions on whether further planning is required and ensure that a plan is only accepted when the plan quality is close to the best attainable one. We apply the DEA method to 37 prostate plans using two assessment parameters: rectal generalized equivalent uniform dose (gEUD) as the input and D95 (the minimum dose that is received by 95% volume of a structure) of the planning target volume (PTV) as the output. The percentage volume of rectum overlapping PTV is used to account for anatomical variations between patients and is included in the model as a non-discretionary output variable. Five plans that are considered of lesser quality by DEA are re-optimized with the goal to further improve rectal sparing. After re-optimization, all five plans improve in rectal gEUD without clinically considerable deterioration of the PTV D95 value. For the five re-optimized plans, the rectal gEUD is reduced by an average of 1.84 Gray (Gy) with only an average reduction of 0.07 Gy in PTV D95. The results demonstrate that DEA can correctly identify plans with potential improvements in terms of the chosen input and outputs.

  3. Assessing quality of care for migraineurs: a model health plan measurement set.

    PubMed

    Leas, Brian F; Gagne, Joshua J; Goldfarb, Neil I; Rupnow, Marcia F T; Silberstein, Stephen

    2008-08-01

    Quality of care measures are increasingly important to health plans, purchasers, physicians, and patients. Appropriate measures can be used to assess quality and evaluate improvement and are necessary components of pay-for-performance programs. Despite the broad scope of activity in the development of quality measures, migraine headache has received little attention. Given the enormous costs associated with migraine, especially in terms of lost productivity and preventable health care utilization, health plans could gain from a structured approach to measuring the quality of migraine care their beneficiaries receive. A potential migraine quality measurement set was developed through a review of migraine care literature and guidelines, interviews with leaders in migraine care, health care purchasing, and managed care, and the assembly of an advisory board. The board discussed candidate measures and established consensus on a testable measurement set. Twenty measures were developed, focused primarily on diagnosis and utilization. Areas of utilization include physician visits, emergency department visits, hospitalizations, and imaging. Use of both acute and preventive medications is included. More complex aspects of migraine care are also addressed, including triptan overuse, the relationship between acute and preventive medications, and follow-up after emergency department visits. The measures are currently being tested in health plans to assess their feasibility and value. A compelling case can be made for the development of migraine-specific quality measures for health plans. This effort to develop and test a starter set of measures should lead to new and innovative efforts to assess and improve quality of care for migraineurs.

  4. Considerations for using data envelopment analysis for the assessment of radiotherapy treatment plan quality.

    PubMed

    Simpson, John; Raith, Andrea; Rouse, Paul; Ehrgott, Matthias

    2017-10-09

    Purpose The operations research method of data envelopment analysis (DEA) shows promise for assessing radiotherapy treatment plan quality. The purpose of this paper is to consider the technical requirements for using DEA for plan assessment. Design/methodology/approach In total, 41 prostate treatment plans were retrospectively analysed using the DEA method. The authors investigate the impact of DEA weight restrictions with reference to the ability to differentiate plan performance at a level of clinical significance. Patient geometry influences plan quality and the authors compare differing approaches for managing patient geometry within the DEA method. Findings The input-oriented DEA method is the method of choice when performing plan analysis using the key undesirable plan metrics as the DEA inputs. When considering multiple inputs, it is necessary to constrain the DEA input weights in order to identify potential plan improvements at a level of clinical significance. All tested approaches for the consideration of patient geometry yielded consistent results. Research limitations/implications This work is based on prostate plans and individual recommendations would therefore need to be validated for other treatment sites. Notwithstanding, the method that requires both optimised DEA weights according to clinical significance and appropriate accounting for patient geometric factors is universally applicable. Practical implications DEA can potentially be used during treatment plan development to guide the planning process or alternatively used retrospectively for treatment plan quality audit. Social implications DEA is independent of the planning system platform and therefore has the potential to be used for multi-institutional quality audit. Originality/value To the authors' knowledge, this is the first published examination of the optimal approach in the use of DEA for radiotherapy treatment plan assessment.

  5. Quality control and quality assurance plan for bridge channel-stability assessments in Massachusetts

    USGS Publications Warehouse

    Parker, Gene W.; Pinson, Harlow

    1993-01-01

    A quality control and quality assurance plan has been implemented as part of the Massachusetts bridge scour and channel-stability assessment program. This program is being conducted by the U.S. Geological Survey, Massachusetts-Rhode Island District, in cooperation with the Massachusetts Highway Department. Project personnel training, data-integrity verification, and new data-management technologies are being utilized in the channel-stability assessment process to improve current data-collection and management techniques. An automated data-collection procedure has been implemented to standardize channel-stability assessments on a regular basis within the State. An object-oriented data structure and new image management tools are used to produce a data base enabling management of multiple data object classes. Data will be reviewed by assessors and data base managers before being merged into a master bridge-scour data base, which includes automated data-verification routines.

  6. Renewing focus on family planning service quality globally.

    PubMed

    Hancock, Nancy L; Stuart, Gretchen S; Tang, Jennifer H; Chibwesha, Carla J; Stringer, Jeffrey S A; Chi, Benjamin H

    2016-01-01

    Reducing the global unmet need for contraception is currently a priority for many governments, multi-lateral initiatives, non-governmental organizations, and donors. Evidence strongly suggests that the provision of quality family planning services can increase uptake, prevalence, and continuation of contraception. While an accepted framework to define the components of family planning service quality exists, translating this framework into assessment tools that are accessible, easily utilized, and valid for service providers has remained a challenge. We propose new approaches to improve the standardization and accessibility of family planning service quality assessment tools to simplify family planning service quality evaluation. With easier approaches to program evaluation, quality improvements can be performed more swiftly to help increase uptake and continuation of contraception to improve the health of women and their families.

  7. Reviewing the quality of strategic environmental assessment reports for English spatial plan core strategies

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

    Fischer, Thomas B., E-mail: fischer@liverpool.ac.u

    This paper summarises the results of a research project from early 2008, involving the author of this paper, as well as 18 post-graduate University of Liverpool students, in which the quality of European Directive based strategic environmental assessment (SEA) reports of English spatial plan core strategies (conducted within the context of the spatial planning sustainability appraisal-SA-regime) was reviewed. The project aimed at establishing the extensiveness of emerging spatial plan related SEA practice, as well as highlighting shortcomings and problems. Overall, it was found that whilst some aspects of assessment were done well, others were not of a satisfactory quality. Shortcomingsmore » were connected particularly with the practice of listing potentially relevant baseline documents and data without distinguishing sufficiently between those that are important in terms of significant impacts and those that are not. Problems were also found to exist with the evaluation of options and impacts, the consideration of substantive aspects, such as health, as well as regarding the formulation of final recommendations and monitoring.« less

  8. SU-E-T-616: Plan Quality Assessment of Both Treatment Planning System Dose and Measurement-Based 3D Reconstructed Dose in the Patient

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

    Olch, A

    2015-06-15

    Purpose: Systematic radiotherapy plan quality assessment promotes quality improvement. Software tools can perform this analysis by applying site-specific structure dose metrics. The next step is to similarly evaluate the quality of the dose delivery. This study defines metrics for acceptable doses to targets and normal organs for a particular treatment site and scores each plan accordingly. The input can be the TPS or the measurement-based 3D patient dose. From this analysis, one can determine whether the delivered dose distribution to the patient receives a score which is comparable to the TPS plan score, otherwise replanning may be indicated. Methods: Elevenmore » neuroblastoma patient plans were exported from Eclipse to the Quality Reports program. A scoring algorithm defined a score for each normal and target structure based on dose-volume parameters. Each plan was scored by this algorithm and the percentage of total possible points was obtained. Each plan also underwent IMRT QA measurements with a Mapcheck2 or ArcCheck. These measurements were input into the 3DVH program to compute the patient 3D dose distribution which was analyzed using the same scoring algorithm as the TPS plan. Results: The mean quality score for the TPS plans was 75.37% (std dev=14.15%) compared to 71.95% (std dev=13.45%) for the 3DVH dose distribution. For 3/11 plans, the 3DVH-based quality score was higher than the TPS score, by between 0.5 to 8.4 percentage points. Eight/11 plans scores decreased based on IMRT QA measurements by 1.2 to 18.6 points. Conclusion: Software was used to determine the degree to which the plan quality score differed between the TPS and measurement-based dose. Although the delivery score was generally in good agreement with the planned dose score, there were some that improved while there was one plan whose delivered dose quality was significantly less than planned. This methodology helps evaluate both planned and delivered dose quality. Sun Nuclear

  9. Do consumer reports of health plan quality affect health plan selection?

    PubMed Central

    Spranca, M; Kanouse, D E; Elliott, M; Short, P F; Farley, D O; Hays, R D

    2000-01-01

    OBJECTIVE: To learn whether consumer reports of health plan quality can affect health plan selection. DATA SOURCES: A sample of 311 privately insured adults from Los Angeles County. STUDY DESIGN: The design was a fractional factorial experiment. Consumers reviewed materials on four hypothetical health plans and selected one. The health plans varied as to cost, coverage, type of plan, ability to keep one's doctor, and quality, as measured by the Consumer Assessment of Health Plans Study (CAHPS) survey. DATA ANALYSIS: We used multinomial logistic regression to model each consumer's choice among health plans. PRINCIPAL FINDINGS: In the absence of CAHPS information, 86 percent of consumers preferred plans that covered more services, even though they cost more. When CAHPS information was provided, consumers shifted to less expensive plans covering fewer services if CAHPS ratings identified those plans as higher quality (59 percent of consumers preferred plans covering more services). Consumer choices were unaffected when CAHPS ratings identified the more expensive plans covering more services as higher quality (89 percent of consumers preferred plans covering more services). CONCLUSIONS: This study establishes that, under certain realistic conditions, CAHPS ratings could affect consumer selection of health plans and ultimately contain costs. Other studies are needed to learn how to enhance exposure and use of CAHPS information in the real world as well as to identify other conditions in which CAHPS ratings could make a difference. PMID:11130805

  10. Quality Assessment of Family Planning Sterilization Services at Health Care Facilities: Case Record Audit.

    PubMed

    Mathur, Medha; Goyal, Ram Chandra; Mathur, Navgeet

    2017-05-01

    Quality of sterilization services is a matter of concern in India because population control is a necessity. Family Planning Sterilization (FPS) services provided at public health care facilities need to be as per Standard Operating Procedures. To assess the quality of FPS services by audit of case records at selected health care facilities. This cross-sectional study was conducted for two and a half year duration at selected public health care facilities of central India by simple random sampling where FPS services were provided. As per the standards of Government of India, case records were audited and compliance was calculated to assess the quality of services. Results of record audit were satisfactory but important criteria like previous contraceptive history and postoperative counselling were found to be deviated from standards. At Primary Health Centres (PHCs) only 89.5% and at Community Health Centres (CHCs) 58.7% of records were having details of previous contraceptive history. Other criteria like mental illness (only 70% at CHCs) assessment were also inadequate. Although informed consent was found to be having 100% compliance in all records. Quality of care in FPS services is the matter of concern in present scenario for better quality of services. This study may enlighten the policy makers regarding improvements needed for providing quality care.

  11. A Total Quality-Control Plan with Right-Sized Statistical Quality-Control.

    PubMed

    Westgard, James O

    2017-03-01

    A new Clinical Laboratory Improvement Amendments option for risk-based quality-control (QC) plans became effective in January, 2016. Called an Individualized QC Plan, this option requires the laboratory to perform a risk assessment, develop a QC plan, and implement a QC program to monitor ongoing performance of the QC plan. Difficulties in performing a risk assessment may limit validity of an Individualized QC Plan. A better alternative is to develop a Total QC Plan including a right-sized statistical QC procedure to detect medically important errors. Westgard Sigma Rules provides a simple way to select the right control rules and the right number of control measurements. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Model development for the assessment of terrestrial and aquatic habitat quality in conservation planning.

    PubMed

    Terrado, Marta; Sabater, Sergi; Chaplin-Kramer, Becky; Mandle, Lisa; Ziv, Guy; Acuña, Vicenç

    2016-01-01

    There is a growing pressure of human activities on natural habitats, which leads to biodiversity losses. To mitigate the impact of human activities, environmental policies are developed and implemented, but their effects are commonly not well understood because of the lack of tools to predict the effects of conservation policies on habitat quality and/or diversity. We present a straightforward model for the simultaneous assessment of terrestrial and aquatic habitat quality in river basins as a function of land use and anthropogenic threats to habitat that could be applied under different management scenarios to help understand the trade-offs of conservation actions. We modify the InVEST model for the assessment of terrestrial habitat quality and extend it to freshwater habitats. We assess the reliability of the model in a severely impaired basin by comparing modeled results to observed terrestrial and aquatic biodiversity data. Estimated habitat quality is significantly correlated with observed terrestrial vascular plant richness (R(2)=0.76) and diversity of aquatic macroinvertebrates (R(2)=0.34), as well as with ecosystem functions such as in-stream phosphorus retention (R(2)=0.45). After that, we analyze different scenarios to assess the suitability of the model to inform changes in habitat quality under different conservation strategies. We believe that the developed model can be useful to assess potential levels of biodiversity, and to support conservation planning given its capacity to forecast the effects of management actions in river basins. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Design of Cycle 3 of the National Water-Quality Assessment Program, 2013-23: Part 2: Science plan for improved water-quality information and management

    USGS Publications Warehouse

    Rowe, Gary L.; Belitz, Kenneth; Demas, Charlie R.; Essaid, Hedeff I.; Gilliom, Robert J.; Hamilton, Pixie A.; Hoos, Anne B.; Lee, Casey J.; Munn, Mark D.; Wolock, David W.

    2013-01-01

    This report presents a science strategy for the third decade of the National Water-Quality Assessment (NAWQA) Program, which since 1991, has been responsible for providing nationally consistent information on the quality of the Nation's streams and groundwater; how water quality is changing over time; and the major natural and human factors that affect current water quality conditions and trends. The strategy is based on an extensive evaluation of the accomplishments of NAWQA over its first two decades, the current status of water-quality monitoring activities by USGS and its partners, and an updated analysis of stakeholder priorities. The plan is designed to address priority issues and national needs identified by NAWQA stakeholders and the National Research Council (2012) irrespective of budget constraints. This plan describes four major goals for the third decade (Cycle 3), the approaches for monitoring, modeling, and scientific studies, key partnerships required to achieve these goals, and products and outcomes that will result from planned assessment activities. The science plan for 2013–2023 is a comprehensive approach to meet stakeholder priorities for: (1) rebuilding NAWQA monitoring networks for streams, rivers, and groundwater, and (2) upgrading models used to extrapolate and forecast changes in water-quality and stream ecosystem condition in response to changing climate and land use. The Cycle 3 plan continues approaches that have been central to the Program’s long-term success, but adjusts monitoring intensities and study designs to address critical information needs and identified data gaps. Restoration of diminished monitoring networks and new directions in modeling and interpretative studies address growing and evolving public and stakeholder needs for water-quality information and improved management, particularly in the face of increasing challenges related to population growth, increasing demands for water, and changing land use and climate

  14. Strategic environmental assessment in tourism planning - Extent of application and quality of documentation

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

    Carvalho Lemos, Clara, E-mail: clara@sc.usp.br; Fischer, Thomas B., E-mail: fischer@liverpool.ac.uk; Pereira Souza, Marcelo, E-mail: mps@usp.br

    Strategic environmental assessment (SEA) has been applied throughout the world in different sectors and in various ways. This paper reports on results of a PhD research on SEA applied to tourism development planning, reflecting the situation in mid-2010. First, the extent of tourism specific SEA application world-wide is established. Then, based on a review of the quality of 10 selected SEA reports, good practice, as well as challenges, trends and opportunities for tourism specific SEA are identified. Shortcomings of SEA in tourism planning are established and implications for future research are outlined. - Highlights: Black-Right-Pointing-Pointer The extent of tourism specificmore » SEA practice is identified. Black-Right-Pointing-Pointer Selected SEA/Tourism reports are evaluated. Black-Right-Pointing-Pointer SEA application to tourism planning is still limited. Black-Right-Pointing-Pointer A number of shortcomings can be pointed out.« less

  15. 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.

  16. Use of plan quality degradation to evaluate tradeoffs in delivery efficiency and clinical plan metrics arising from IMRT optimizer and sequencer compromises

    PubMed Central

    Wilkie, Joel R.; Matuszak, Martha M.; Feng, Mary; Moran, Jean M.; Fraass, Benedick A.

    2013-01-01

    Purpose: Plan degradation resulting from compromises made to enhance delivery efficiency is an important consideration for intensity modulated radiation therapy (IMRT) treatment plans. IMRT optimization and/or multileaf collimator (MLC) sequencing schemes can be modified to generate more efficient treatment delivery, but the effect those modifications have on plan quality is often difficult to quantify. In this work, the authors present a method for quantitative assessment of overall plan quality degradation due to tradeoffs between delivery efficiency and treatment plan quality, illustrated using comparisons between plans developed allowing different numbers of intensity levels in IMRT optimization and/or MLC sequencing for static segmental MLC IMRT plans. Methods: A plan quality degradation method to evaluate delivery efficiency and plan quality tradeoffs was developed and used to assess planning for 14 prostate and 12 head and neck patients treated with static IMRT. Plan quality was evaluated using a physician's predetermined “quality degradation” factors for relevant clinical plan metrics associated with the plan optimization strategy. Delivery efficiency and plan quality were assessed for a range of optimization and sequencing limitations. The “optimal” (baseline) plan for each case was derived using a clinical cost function with an unlimited number of intensity levels. These plans were sequenced with a clinical MLC leaf sequencer which uses >100 segments, assuring delivered intensities to be within 1% of the optimized intensity pattern. Each patient's optimal plan was also sequenced limiting the number of intensity levels (20, 10, and 5), and then separately optimized with these same numbers of intensity levels. Delivery time was measured for all plans, and direct evaluation of the tradeoffs between delivery time and plan degradation was performed. Results: When considering tradeoffs, the optimal number of intensity levels depends on the treatment

  17. Situation analysis: assessing family planning and reproductive health services. Quality of care.

    PubMed

    1997-01-01

    This issue of Population Briefs contains articles on researches conducted by the Population Council concerning the delivery of quality of care, contraceptive development, safe abortion, family planning, demography, and medical anthropology. The cover story focuses on a systematic data collection tool called Situation Analysis that helps managers in program evaluation. This tool has a handbook entitled "The Situation Analysis Approach to Assessing Family Planning and Reproductive Health Services" that contains all the information needed to conduct a Situation Analysis study. The second article reports about a new contraceptive method, the two-rod levonorgestrel, which was developed at the Population Council and was recently approved by the US Food and Drug Administration. The third article reports on a medical abortion procedure that was proven to be safe, effective, and acceptable to women in developing countries. Moreover, the fourth article presents initial findings of the Community Health and Family Planning Project conducted in Northern Ghana. The fifth article discusses the paper written by the Population Council demographer, Mark Montgomery entitled "Learning and lags in mortality perceptions". Finally, the sixth article deals with another paper that reports on women's health perceptions and reproductive health in the Middle East.

  18. The Relationship between Health Plan Performance Measures and Physician Network Overlap: Implications for Measuring Plan Quality

    PubMed Central

    Maeng, Daniel D; Scanlon, Dennis P; Chernew, Michael E; Gronniger, Tim; Wodchis, Walter P; McLaughlin, Catherine G

    2010-01-01

    Objective To examine the extent to which health plan quality measures capture physician practice patterns rather than plan characteristics. Data Source We gathered and merged secondary data from the following four sources: a private firm that collected information on individual physicians and their health plan affiliations, The National Committee for Quality Assurance, InterStudy, and the Dartmouth Atlas. Study Design We constructed two measures of physician network overlap for all health plans in our sample and linked them to selected measures of plan performance. Two linear regression models were estimated to assess the relationship between the measures of physician network overlap and the plan performance measures. Principal Findings The results indicate that in the presence of a higher degree of provider network overlap, plan performance measures tend to converge to a lower level of quality. Conclusions Standard health plan performance measures reflect physician practice patterns rather than plans' effort to improve quality. This implies that more provider-oriented measurement, such as would be possible with accountable care organizations or medical homes, may facilitate patient decision making and provide further incentives to improve performance. PMID:20403064

  19. Groundwater Quality Assessment Plan: Dickson County Landfill, Dickson County, Tennessee, including Application for Authorization for Class V Underground Injection Well

    EPA Pesticide Factsheets

    Contains site investigation plan & data for assessment of groundwater quality at Dickson County Landfill, Dickson, Tennessee, with figures, tables, appendices, November 1994, including Application for Authorization for Class V Underground Injection Well.

  20. Region 7 States Air Quality Monitoring Plans - Iowa

    EPA Pesticide Factsheets

    National Ambient Air Quality Standard (NAAQS) - Iowa, Kansas, Missouri, and Nebraska; Annual Monitoring Network Plans, Five-Year Monitoring Network Assessments, and approval documentation. Each year, states are required to submit an annual monitoring netwo

  1. Region 7 States Air Quality Monitoring Plans - Missouri

    EPA Pesticide Factsheets

    National Ambient Air Quality Standard (NAAQS) - Iowa, Kansas, Missouri, and Nebraska; Annual Monitoring Network Plans, Five-Year Monitoring Network Assessments, and approval documentation. Each year, states are required to submit an annual monitoring netwo

  2. Region 7 States Air Quality Monitoring Plans - Nebraska

    EPA Pesticide Factsheets

    National Ambient Air Quality Standard (NAAQS) - Iowa, Kansas, Missouri, and Nebraska; Annual Monitoring Network Plans, Five-Year Monitoring Network Assessments, and approval documentation. Each year, states are required to submit an annual monitoring netwo

  3. Region 7 States Air Quality Monitoring Plans - Kansas

    EPA Pesticide Factsheets

    National Ambient Air Quality Standard (NAAQS) - Iowa, Kansas, Missouri, and Nebraska; Annual Monitoring Network Plans, Five-Year Monitoring Network Assessments, and approval documentation. Each year, states are required to submit an annual monitoring netwo

  4. Progress Made on a Plan To Integrate Planning, Budgeting, Assessment and Quality Principles To Achieve Institutional Improvement. First Year Report. AIR 1996 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Griffith, Susan R.; And Others

    This paper describes first year implementation efforts of Southwest Texas (SWT) State University to develop a system to integrate planning, budgeting, assessment, and quality to improve the delivery of education and other services to all the institution's customers. The document addresses the common situation when an organization already has…

  5. WE-AB-209-07: Explicit and Convex Optimization of Plan Quality Metrics in Intensity-Modulated Radiation Therapy Treatment Planning

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

    Engberg, L; KTH Royal Institute of Technology, Stockholm; Eriksson, K

    Purpose: To formulate objective functions of a multicriteria fluence map optimization model that correlate well with plan quality metrics, and to solve this multicriteria model by convex approximation. Methods: In this study, objectives of a multicriteria model are formulated to explicitly either minimize or maximize a dose-at-volume measure. Given the widespread agreement that dose-at-volume levels play important roles in plan quality assessment, these objectives correlate well with plan quality metrics. This is in contrast to the conventional objectives, which are to maximize clinical goal achievement by relating to deviations from given dose-at-volume thresholds: while balancing the new objectives means explicitlymore » balancing dose-at-volume levels, balancing the conventional objectives effectively means balancing deviations. Constituted by the inherently non-convex dose-at-volume measure, the new objectives are approximated by the convex mean-tail-dose measure (CVaR measure), yielding a convex approximation of the multicriteria model. Results: Advantages of using the convex approximation are investigated through juxtaposition with the conventional objectives in a computational study of two patient cases. Clinical goals of each case respectively point out three ROI dose-at-volume measures to be considered for plan quality assessment. This is translated in the convex approximation into minimizing three mean-tail-dose measures. Evaluations of the three ROI dose-at-volume measures on Pareto optimal plans are used to represent plan quality of the Pareto sets. Besides providing increased accuracy in terms of feasibility of solutions, the convex approximation generates Pareto sets with overall improved plan quality. In one case, the Pareto set generated by the convex approximation entirely dominates that generated with the conventional objectives. Conclusion: The initial computational study indicates that the convex approximation outperforms the conventional

  6. Quality planning in Construction Project

    NASA Astrophysics Data System (ADS)

    Othman, I.; Shafiq, Nasir; Nuruddin, M. F.

    2017-12-01

    The purpose of this paper is to investigate deeper on the factors that contribute to the effectiveness of quality planning, identifying the common problems encountered in quality planning, practices and ways for improvements in quality planning for construction projects. This paper involves data collected from construction company representatives across Malaysia that are obtained through semi-structured interviews as well as questionnaire distributions. Results shows that design of experiments (average index: 4.61), inspection (average index: 4.45) and quality audit as well as other methods (average index: 4.26) rank first, second and third most important factors respectively.

  7. 42 CFR 460.132 - Quality assessment and performance improvement plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.132 Quality...

  8. 42 CFR 460.132 - Quality assessment and performance improvement plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.132 Quality...

  9. Region 7 Quality Management Plan

    EPA Pesticide Factsheets

    To document adherence to EPA Order 5360.1 A2, EPA requires each organizational unitto develop a quality management plan per the specifications in EPA Requirements for QualityManagement Plans, EPA QA R-2.

  10. 75 FR 54031 - Approval and Promulgation of Implementation Plans; Designation of Areas for Air Quality Planning...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-03

    ... below. FOR FURTHER INFORMATION CONTACT: Doris Lo, EPA Region IX, (415) 972- 3959, lo[email protected] Meredith Kurpius, EPA Region 9, Air Quality Assessment Office, to Doris Lo, EPA Region 9, Air Planning... Officer, GBUAPCD, to Doris Lo, EPA Region 9, Air Planning Office, with attachments. The Coso Operating...

  11. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

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

    Turgeon, Jennifer L.; Minana, Molly A.; Hackney, Patricia

    2009-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and themore » software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices.« less

  12. The Individualized Quality Control Plan - Coming Soon to Clinical Microbiology Laboratories Everywhere!

    PubMed

    Anderson, Nancy

    2015-11-15

    As of January 1, 2016, microbiology laboratories can choose to adopt a new quality control option, the Individualized Quality Control Plan (IQCP), under the Clinical Laboratory Improvement Amendments of 1988 (CLIA). This voluntary approach increases flexibility for meeting regulatory requirements and provides laboratories the opportunity to customize QC for their testing in their unique environments and by their testing personnel. IQCP is an all-inclusive approach to quality based on risk management to address potential errors in the total testing process. It includes three main steps, (1) performing a risk assessment, (2) developing a QC plan, and (3) monitoring the plan through quality assessment. Resources are available from the Centers for Medicare & Medicaid Services, Centers for Disease Control and Prevention, American Society for Microbiology, Clinical and Laboratory Standards Institute, and accrediting organizations, such as the College of American Pathologists and Joint Commission, to assist microbiology laboratories implementing IQCP.

  13. Uniform Federal Policy for Quality Assurance Project Plans: Evaluating, Assessing, and Documenting Environmental Data Collection and Use Programs. Part 1. UFP-QAPP Manual

    DTIC Science & Technology

    2004-07-01

    sampler, project manager, data reviewer, statistician , risk assessor, assessment personnel, and laboratory QC manager. In addition, a complete copy of...sample • Corrective actions to be taken if the QC sample fails these criteria • A description of how the QC data and results are to be documented and...Intergovernmental Data Quality Task Force Uniform Federal Policy for Quality Assurance Project Plans Evaluating, Assessing, and Documenting

  14. Integrating Planning, Assessment, and Improvement in Higher Education

    ERIC Educational Resources Information Center

    Sherlock, Barbara J.

    2009-01-01

    Based on Penn State's popular "Innovation Insights" series, this book brings together in one handy reference nearly a decade of tried and true insights into continuous quality improvements in higher education. Their five-step model for integrating planning, assessment, and improvement moves plans off the shelf and into the weekly and daily…

  15. 242-A Evaporator quality assurance plan. Revision 2

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

    Basra, T.S.

    1995-05-04

    The purpose of this quality assurance project plan (Plan) is to provide requirements for activities pertaining to sampling, shipping, and analyses associated with candidate feed tank samples for the 242-A Evaporator project. The purpose of the 242-A Evaporator project is to reduce the volume of aqueous waste in the Double Shell Tank (DST) System and will result in considerable savings to the disposal of mixed waste. The 242-A Evaporator feed stream originates from DSTs identified as candidate feed tanks. The 242-A Evaporator reduces the volume of aqueous waste contained in DSTs by boiling off water and sending the condensate (calledmore » process condensate) to the Liquid Effluent Retention Facility (LEPF) storage basin where it is stored prior to treatment in the Effluent Treatment Facility (ETF). The objective of this quality assurance project plan is to provide the planning, implementation, and assessment of sample collection and analysis, data issuance, and validation activities for the candidate feed tanks.« less

  16. 40 CFR 130.6 - Water quality management plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Water quality management plans. 130.6... QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM... and certified and approved updates to those plans. Continuing water quality planning shall be based...

  17. Assessing Assessment Texts: Where Is Planning?

    ERIC Educational Resources Information Center

    Fives, Helenrose; Barnes, Nicole; Dacey, Charity; Gillis, Anna

    2016-01-01

    We conducted a content analysis of 27 assessment textbooks to determine how assessment planning was framed in texts for preservice teachers. We identified eight assessment planning themes: alignment, assessment purpose and types, reliability and validity, writing goals and objectives, planning specific assessments, unpacking, overall assessment…

  18. Writing Plan Quality: Relevance to Writing Scores

    ERIC Educational Resources Information Center

    Chai, Constance

    2006-01-01

    If writing matters, how can we improve it? This study investigated the nature of writing plan quality and its relationship to the ensuing writing scores. Data were drawn from the 1998 Provincial Learning Assessment Programme (PLAP) in Writing, which was administered to pupils in Grades 4, 7, and 10 across British Columbia, Canada. Common features…

  19. Can high quality overcome consumer resistance to restricted provider access? Evidence from a health plan choice experiment.

    PubMed

    Harris, Katherine M

    2002-06-01

    To investigate the impact of quality information on the willingness of consumers to enroll in health plans that restrict provider access. A survey administered to respondents between the ages of 25 and 64 in the West Los Angeles area with private health insurance. An experimental approach is used to measure the effect of variation in provider network features and information about the quality of network physicians on hypothetical plan choices. Conditional logit models are used to analyze the experimental choice data. Next, choice model parameter estimates are used to simulate the impact of changes in plan features on the market shares of competing health plans and to calculate the quality level required to make consumers indifferent to changes in provider access. The presence of quality information reduced the importance of provider network features in plan choices as hypothesized. However, there were not statistically meaningful differences by type of quality measure (i.e., consumer assessed versus expert assessed). The results imply that large quality differences are required to make consumers indifferent to changes in provider access. The impact of quality on plan choices depended more on the particular measure and less on the type of measure. Quality ratings based on the proportion of survey respondents "extremely satisfied with results of care" had the greatest impact on plan choice while the proportion of network doctors "affiliated with university medical centers" had the least. Other consumer and expert assessed measures had more comparable effects. Overall the results provide empirical evidence that consumers are willing to trade high quality for restrictions on provider access. This willingness to trade implies that relatively small plans that place restrictions on provider access can successfully compete against less restrictive plans when they can demonstrate high quality. However, the results of this study suggest that in many cases, the level of

  20. Can High Quality Overcome Consumer Resistance to Restricted Provider Access? Evidence from a Health Plan Choice Experiment

    PubMed Central

    Harris, Katherine M

    2002-01-01

    Objective To investigate the impact of quality information on the willingness of consumers to enroll in health plans that restrict provider access. Data Sources and Setting A survey administered to respondents between the ages of 25 and 64 in the West Los Angeles area with private health insurance. Study Design An experimental approach is used to measure the effect of variation in provider network features and information about the quality of network physicians on hypothetical plan choices. Conditional logit models are used to analyze the experimental choice data. Next, choice model parameter estimates are used to simulate the impact of changes in plan features on the market shares of competing health plans and to calculate the quality level required to make consumers indifferent to changes in provider access. Principal Findings The presence of quality information reduced the importance of provider network features in plan choices as hypothesized. However, there were not statistically meaningful differences by type of quality measure (i.e., consumer assessed versus expert assessed). The results imply that large quality differences are required to make consumers indifferent to changes in provider access. The impact of quality on plan choices depended more on the particular measure and less on the type of measure. Quality ratings based on the proportion of survey respondents “extremely satisfied with results of care” had the greatest impact on plan choice while the proportion of network doctors “affiliated with university medical centers” had the least. Other consumer and expert assessed measures had more comparable effects. Conclusions Overall the results provide empirical evidence that consumers are willing to trade high quality for restrictions on provider access. This willingness to trade implies that relatively small plans that place restrictions on provider access can successfully compete against less restrictive plans when they can demonstrate high

  1. [Quality planning of Family Health Units using Quality Function Deployment (QFD)].

    PubMed

    Volpato, Luciana Fernandes; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

    2010-08-01

    Quality is an indispensible requirement in the health field, and its pursuit is necessary in order to meet demands by a population that is aware of its rights, as part of the essence of good work relations, and to decrease technological costs. Quality thus involves all parties to the process (users and professionals), and is no longer merely an attribute of the health service. This study aimed to verify the possibility of quality planning in the Family Health Units, using Quality Function Deployment (QFD). QFD plans quality according to user satisfaction, involving staff professionals and identifying new approaches to improve work processes. Development of the array, called the House of Quality, is this method's most important characteristics. The results show a similarity between the quality demanded by users and the quality planned by professionals. The current study showed that QFD is an efficient tool for quality planning in public health services.

  2. Air Quality Implementation Plans

    EPA Pesticide Factsheets

    States must develop plans to attain and maintain air quality standards. These plans, known as SIPs, are submitted to EPA for approval. This web site contains information about this process and the current status of the submittals.

  3. Assessing the image quality of pelvic MR images acquired with a flat couch for radiotherapy treatment planning.

    PubMed

    McJury, M; O'Neill, A; Lawson, M; McGrath, C; Grey, A; Page, W; O'Sullivan, J M

    2011-08-01

    To improve the integration of MRI with radiotherapy treatment planning, our department fabricated a flat couch top for our MR scanner. Setting up using this couch top meant that the patients were physically higher up in the scanner and, posteriorly, a gap was introduced between the patient and radiofrequency coil. Phantom measurements were performed to assess the quantitative impact on image quality. A phantom was set up with and without the flat couch insert in place, and measurements of image uniformity and signal to noise were made. To assess clinical impact, six patients with pelvic cancer were recruited and scanned on both couch types. The image quality of pairs of scans was assessed by two consultant radiologists. The use of the flat couch insert led to a drop in image signal to noise of approximately 14%. Uniformity in the anteroposterior direction was affected the most, with little change in right-to-left and feet-to-head directions. All six patients were successfully scanned on the flat couch, although one patient had to be positioned with their arms by their sides. The image quality scores showed no statistically significant change between scans with and without the flat couch in place. Although the quantitative performance of the coil is affected by the integration of a flat couch top, there is no discernible deterioration of diagnostic image quality, as assessed by two consultant radiologists. Although the flat couch insert moved patients higher in the bore of the scanner, all patients in the study were successfully scanned.

  4. Analyzing the quality robustness of chemotherapy plans with respect to model uncertainties.

    PubMed

    Hoffmann, Anna; Scherrer, Alexander; Küfer, Karl-Heinz

    2015-01-01

    Mathematical models of chemotherapy planning problems contain various biomedical parameters, whose values are difficult to quantify and thus subject to some uncertainty. This uncertainty propagates into the therapy plans computed on these models, which poses the question of robustness to the expected therapy quality. This work introduces a combined approach for analyzing the quality robustness of plans in terms of dosing levels with respect to model uncertainties in chemotherapy planning. It uses concepts from multi-criteria decision making for studying parameters related to the balancing between the different therapy goals, and concepts from sensitivity analysis for the examination of parameters describing the underlying biomedical processes and their interplay. This approach allows for a profound assessment of a therapy plan, how stable its quality is with respect to parametric changes in the used mathematical model. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Request for Correction 15003 - Information Quality Act request for Correction of the TSCA Work Plan

    EPA Pesticide Factsheets

    This RFC concerns the Information Quality Act request for correction of the TSCA Work Plan for Chemical Assessments: 20154 Update and the TSCA Work Plan Chemicals: Methods Document (February 2012) regarding assessment of phthalic anhydride

  6. 7 CFR 634.23 - Water quality plan.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Water quality plan. 634.23 Section 634.23 Agriculture... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.23 Water quality plan. (a) The participant's water quality plan, developed with technical assistance by the NRCS or its...

  7. 7 CFR 634.23 - Water quality plan.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Water quality plan. 634.23 Section 634.23 Agriculture... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.23 Water quality plan. (a) The participant's water quality plan, developed with technical assistance by the NRCS or its...

  8. 7 CFR 634.23 - Water quality plan.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Water quality plan. 634.23 Section 634.23 Agriculture... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.23 Water quality plan. (a) The participant's water quality plan, developed with technical assistance by the NRCS or its...

  9. 30 CFR 28.31 - Quality control plans; contents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Quality control plans; contents. 28.31 Section... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.31 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the management of quality, including: (1...

  10. Does human resource management improve family planning service quality? Analysis from the Kenya Service Provision Assessment 2010.

    PubMed

    Thatte, Nandita; Choi, Yoonjoung

    2015-04-01

    Human resource (HR) management is a priority for health systems strengthening in developing countries, yet few studies have empirically examined associations with service quality. The purpose of this study was to assess the relationship between HR management and family planning (FP) service quality. Data came from the 2010 Kenya Service Provision Assessment, a nationally representative health facility assessment. In total, 912 FP consultations from 301 facilities were analysed. Four indices were created to measure quality on reproductive history taking, physical examination, sexually transmitted infections prevention and pill/injectable specific counselling. HR management variables included training in the past year, any and supportive (i.e. with feedback, technical updates and discussion) in-person supervision in the past 6 months and having a written job description. Multivariate linear regression analyses were conducted to estimate coefficients of HR management variables on each of the four quality indices, adjusting for background characteristics of clients, provider and facilities. The level of service quality ranged from 16 to 53 out of a maximum score of 100 across the indices. Fifty-two per cent of consultations were done by providers who received supportive in-person supervision in the previous 6 months. In 23% and 38% of consultations, the provider was trained in the past year and had a written job description, respectively. Multivariate analyses indicated that having a written job description was associated with higher service quality in history taking, physical examination and the pill/injectable specific counselling. Other HR management variables were not significantly associated with service quality. Having a written job description was significantly associated with higher service quality and may be a useful tool for strengthening management practices. The details of such job descriptions and the quality of other management indicators should be

  11. 48 CFR 37.604 - Quality assurance surveillance plans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... surveillance plans. 37.604 Section 37.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... assurance surveillance plans. Requirements for quality assurance and quality assurance surveillance plans are in Subpart 46.4. The Government may either prepare the quality assurance surveillance plan or...

  12. 48 CFR 37.604 - Quality assurance surveillance plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... surveillance plans. 37.604 Section 37.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... assurance surveillance plans. Requirements for quality assurance and quality assurance surveillance plans are in Subpart 46.4. The Government may either prepare the quality assurance surveillance plan or...

  13. 48 CFR 37.604 - Quality assurance surveillance plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... surveillance plans. 37.604 Section 37.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... assurance surveillance plans. Requirements for quality assurance and quality assurance surveillance plans are in Subpart 46.4. The Government may either prepare the quality assurance surveillance plan or...

  14. 48 CFR 37.604 - Quality assurance surveillance plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... surveillance plans. 37.604 Section 37.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... assurance surveillance plans. Requirements for quality assurance and quality assurance surveillance plans are in Subpart 46.4. The Government may either prepare the quality assurance surveillance plan or...

  15. 48 CFR 37.604 - Quality assurance surveillance plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... surveillance plans. 37.604 Section 37.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... assurance surveillance plans. Requirements for quality assurance and quality assurance surveillance plans are in Subpart 46.4. The Government may either prepare the quality assurance surveillance plan or...

  16. Analyzing the efficiency of short-term air quality plans in European cities, using the CHIMERE air quality model.

    PubMed

    Thunis, P; Degraeuwe, B; Pisoni, E; Meleux, F; Clappier, A

    2017-01-01

    Regional and local authorities have the obligation to design air quality plans and assess their impacts when concentration levels exceed the limit values. Because these limit values cover both short- (day) and long-term (year) effects, air quality plans also follow these two formats. In this work, we propose a methodology to analyze modeled air quality forecast results, looking at emission reduction for different sectors (residential, transport, agriculture, etc.) with the aim of supporting policy makers in assessing the impact of short-term action plans. Regarding PM 10 , results highlight the diversity of responses across European cities, in terms of magnitude and type that raises the necessity of designing area-specific air quality plans. Action plans extended from 1 to 3 days (i.e., emissions reductions applied for 24 and 72 h, respectively) point to the added value of trans-city coordinated actions. The largest benefits are seen in central Europe (Vienna, Prague) while major cities (e.g., Paris) already solve a large part of the problem on their own. Eastern Europe would particularly benefit from plans based on emission reduction in the residential sectors; while in northern cities, agriculture seems to be the key sector on which to focus attention. Transport is playing a key role in most cities whereas the impact of industry is limited to a few cities in south-eastern Europe. For NO 2 , short-term action plans focusing on traffic emission reductions are efficient in all cities. This is due to the local character of this type of pollution. It is important, however, to stress that these results remain dependent on the selected months available for this study.

  17. 40 CFR 130.6 - Water quality management plans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Water quality management plans. 130.6... QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM... when they are needed to address water quality problems. (1) Total maximum daily loads. TMDLs in...

  18. Managed care quality of care and plan choice in New York SCHIP.

    PubMed

    Liu, Hangsheng; Phelps, Charles E; Veazie, Peter J; Dick, Andrew W; Klein, Jonathan D; Shone, Laura P; Noyes, Katia; Szilagyi, Peter G

    2009-06-01

    To examine whether low-income parents of children enrolled in the New York State Children's Health Insurance Program (SCHIP) choose managed care plans with better quality of care. 2001 New York SCHIP evaluation data; 2001 New York State Managed Care Plan Performance Report; 2000 New York State Managed Care Enrollment Report. Each market was defined as a county. A final sample of 2,325 new enrollees was analyzed after excluding those in markets with only one SCHIP plan. Plan quality was measured using seven Consumer Assessment of Health Plans Survey (CAHPS) and three Health Plan Employer Data and Information Set (HEDIS) scores. A conditional logit model was applied with plan and individual/family characteristics as covariates. There were 30 plans in the 45 defined markets. The choice probability increased 2.5 percentage points for each unit increase in the average CAHPS score, and the association was significantly larger in children with special health care needs. However, HEDIS did not show any statistically significant association with plan choice. Low-income parents do choose managed care plans with higher CAHPS scores for their newly enrolled children, suggesting that overall quality could improve over time because of the dynamics of enrollment.

  19. 40 CFR 130.6 - Water quality management plans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Water quality management plans. 130.6 Section 130.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM...

  20. 40 CFR 130.6 - Water quality management plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 23 2013-07-01 2013-07-01 false Water quality management plans. 130.6 Section 130.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM...

  1. 40 CFR 130.6 - Water quality management plans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 22 2014-07-01 2013-07-01 true Water quality management plans. 130.6 Section 130.6 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING AND MANAGEMENT § 130.6 Water quality management plans. (a) Water quality management (WQM...

  2. Evaluating which plan quality metrics are appropriate for use in lung SBRT.

    PubMed

    Yaparpalvi, Ravindra; Garg, Madhur K; Shen, Jin; Bodner, William R; Mynampati, Dinesh K; Gafar, Aleiya; Kuo, Hsiang-Chi; Basavatia, Amar K; Ohri, Nitin; Hong, Linda X; Kalnicki, Shalom; Tome, Wolfgang A

    2018-02-01

    Several dose metrics in the categories-homogeneity, coverage, conformity and gradient have been proposed in literature for evaluating treatment plan quality. In this study, we applied these metrics to characterize and identify the plan quality metrics that would merit plan quality assessment in lung stereotactic body radiation therapy (SBRT) dose distributions. Treatment plans of 90 lung SBRT patients, comprising 91 targets, treated in our institution were retrospectively reviewed. Dose calculations were performed using anisotropic analytical algorithm (AAA) with heterogeneity correction. A literature review on published plan quality metrics in the categories-coverage, homogeneity, conformity and gradient was performed. For each patient, using dose-volume histogram data, plan quality metric values were quantified and analysed. For the study, the radiation therapy oncology group (RTOG) defined plan quality metrics were: coverage (0.90 ± 0.08); homogeneity (1.27 ± 0.07); conformity (1.03 ± 0.07) and gradient (4.40 ± 0.80). Geometric conformity strongly correlated with conformity index (p < 0.0001). Gradient measures strongly correlated with target volume (p < 0.0001). The RTOG lung SBRT protocol advocated conformity guidelines for prescribed dose in all categories were met in ≥94% of cases. The proportion of total lung volume receiving doses of 20 Gy and 5 Gy (V 20 and V 5 ) were mean 4.8% (±3.2) and 16.4% (±9.2), respectively. Based on our study analyses, we recommend the following metrics as appropriate surrogates for establishing SBRT lung plan quality guidelines-coverage % (ICRU 62), conformity (CN or CI Paddick ) and gradient (R 50% ). Furthermore, we strongly recommend that RTOG lung SBRT protocols adopt either CN or CI Padddick in place of prescription isodose to target volume ratio for conformity index evaluation. Advances in knowledge: Our study metrics are valuable tools for establishing lung SBRT plan quality guidelines.

  3. 42 CFR 84.41 - Quality control plans; contents.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

  4. 42 CFR 84.41 - Quality control plans; contents.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

  5. 42 CFR 84.41 - Quality control plans; contents.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

  6. 42 CFR 84.41 - Quality control plans; contents.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

  7. 42 CFR 84.41 - Quality control plans; contents.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Quality control plans; contents. 84.41 Section 84... AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality Control § 84.41 Quality control plans; contents. (a) Each quality control plan shall contain provisions for the...

  8. Assessment of the Quality Management Models in Higher Education

    ERIC Educational Resources Information Center

    Basar, Gulsun; Altinay, Zehra; Dagli, Gokmen; Altinay, Fahriye

    2016-01-01

    This study involves the assessment of the quality management models in Higher Education by explaining the importance of quality in higher education and by examining the higher education quality assurance system practices in other countries. The qualitative study was carried out with the members of the Higher Education Planning, Evaluation,…

  9. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1: ASC software quality engineering practices, Version 2.0.

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

    Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  10. Urban land-use study plan for the National Water-Quality Assessment Program

    USGS Publications Warehouse

    Squillace, P.J.; Price, C.V.

    1996-01-01

    This study plan is for Urban Land-Use Studies initiated as part of the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program. There are two Urban Land-Use Study objectives: (1) Define the water quality in recharge areas of shallow aquifers underlying areas of new residential and commercial land use in large metropolitan areas, and (2) determine which natural and human factors most strongly affect the occurrence of contaminants in these shallow aquifers. To meet objective 1, each NAWQA Study Unit will install and collect water samples from at least 30 randomly located monitoring wells in a metropolitan area. To meet objective 2, aquifer characteristics and land-use information will be documented. This includes particle-size analysis of each major lithologic unit both in the unsaturated zone and in the aquifer near the water table. The percentage of organic carbon also will be determined for each lithologic unit. Geographic information system coverages will be created that document existing land use around the wells. These data will aid NAWQA personnel in relating natural and human factors to the occurrence of contaminants. Water samples for age dating also will be collected from all monitoring wells, but the samples will be stored until the occurrence of contaminants has been determined. Age-date analysis will be done only on those samples that have no detectable concentrations of anthropogenic contaminants.

  11. Air Quality Modeling | Air Quality Planning & Standards | US ...

    EPA Pesticide Factsheets

    2016-06-08

    The basic mission of the Office of Air Quality Planning and Standards is to preserve and improve the quality of our nation's air. One facet of accomplishing this goal requires that new and existing air pollution sources be modeled for compliance with the National Ambient Air Quality Standards (NAAQS).

  12. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1 : ASC software quality engineering practices version 1.0.

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

    Minana, Molly A.; Sturtevant, Judith E.; Heaphy, Robert

    2005-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in DOE/AL Quality Criteria (QC-1) as conformance to customer requirements and expectations. This quality plan defines the ASC program software quality practices and provides mappings of these practices to the SNL Corporate Process Requirements (CPR 1.3.2 and CPR 1.3.6) and the Department of Energy (DOE) document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines (GP&G). This quality plan identifies ASC management andmore » software project teams' responsibilities for cost-effective software engineering quality practices. The SNL ASC Software Quality Plan establishes the signatories commitment to improving software products by applying cost-effective software engineering quality practices. This document explains the project teams opportunities for tailoring and implementing the practices; enumerates the practices that compose the development of SNL ASC's software products; and includes a sample assessment checklist that was developed based upon the practices in this document.« less

  13. Managed Care Quality of Care and Plan Choice in New York SCHIP

    PubMed Central

    Liu, Hangsheng; Phelps, Charles E; Veazie, Peter J; Dick, Andrew W; Klein, Jonathan D; Shone, Laura P; Noyes, Katia; Szilagyi, Peter G

    2009-01-01

    Objective To examine whether low-income parents of children enrolled in the New York State Children's Health Insurance Program (SCHIP) choose managed care plans with better quality of care. Data Sources 2001 New York SCHIP evaluation data; 2001 New York State Managed Care Plan Performance Report; 2000 New York State Managed Care Enrollment Report. Study Design Each market was defined as a county. A final sample of 2,325 new enrollees was analyzed after excluding those in markets with only one SCHIP plan. Plan quality was measured using seven Consumer Assessment of Health Plans Survey (CAHPS) and three Health Plan Employer Data and Information Set (HEDIS) scores. A conditional logit model was applied with plan and individual/family characteristics as covariates. Principle Findings There were 30 plans in the 45 defined markets. The choice probability increased 2.5 percentage points for each unit increase in the average CAHPS score, and the association was significantly larger in children with special health care needs. However, HEDIS did not show any statistically significant association with plan choice. Conclusions Low-income parents do choose managed care plans with higher CAHPS scores for their newly enrolled children, suggesting that overall quality could improve over time because of the dynamics of enrollment. PMID:19208091

  14. A Preliminary Investigation of the Utility of the "Behavior Support Plan Quality Evaluation Guide II" for Use in Australia

    ERIC Educational Resources Information Center

    Webber, Lynne S.; McVilly, Keith R.; Fester, Tarryn; Zazelis, Telly

    2011-01-01

    Background: The quality of behaviour support plans (BSPs) can be an important influence on the quality of the support provided to people with disability who show challenging behaviours. The Behavior Support Plan Quality Evaluation Guide II (BSP-QE II) is one tool that may be useful in assessing the quality of behaviour support plans. It has…

  15. Addendum to Air Quality: Decision Support Tools, Partner Plans, Working Groups, Committees

    NASA Technical Reports Server (NTRS)

    Holekamp, Kara; Frisbie, Troy; Estep, Lee

    2005-01-01

    In the original report dated February 11, 2005, the utility of NASA Earth science data in the air quality activities of other agencies and organizations was assessed by reviewing strategic and mission plans and by conducting personal interviews with agency experts to identify and investigate agencies with the potential for partnership with NASA. The overarching agency strategic plans were reviewed and commonalities such as the desire for partnerships and technology development were noted. This addendum to the original report contains such information about the Tennessee Valley Authority and will be inserted as Section 2.6 of "Air Quality: Decision Support Tools, Partner Plans, Working Groups, Committees."

  16. Addendum to Air Quality: Decision Support Tools, Partner Plans, Working Groups, Committees

    NASA Technical Reports Server (NTRS)

    Holekamp, Kara; Frisbie, Troy; Estep, Lee

    2005-01-01

    In the original report dated February 11, 2005, the utility of the NASA Earth science data in the air quality activities of other agencies and organizations was assessed by reviewing strategic and mission plans and by conducting personal interviews with agency experts to identify and investigate agencies with the potential for partnership with NASA. The overarching agency strategic plans were reviewed and commonalities such as the desire for partnerships and technology development were noted. The addendum to the original report contains such information about the Tennessee Valley Authority and will be inserted in Section 2.6 of "Air Quality Decision Support Tools, Partner Plans, Working Groups, Committees".

  17. 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

  18. Soil quality assessment using weighted fuzzy association rules

    USGS Publications Warehouse

    Xue, Yue-Ju; Liu, Shu-Guang; Hu, Yue-Ming; Yang, Jing-Feng

    2010-01-01

    Fuzzy association rules (FARs) can be powerful in assessing regional soil quality, a critical step prior to land planning and utilization; however, traditional FARs mined from soil quality database, ignoring the importance variability of the rules, can be redundant and far from optimal. In this study, we developed a method applying different weights to traditional FARs to improve accuracy of soil quality assessment. After the FARs for soil quality assessment were mined, redundant rules were eliminated according to whether the rules were significant or not in reducing the complexity of the soil quality assessment models and in improving the comprehensibility of FARs. The global weights, each representing the importance of a FAR in soil quality assessment, were then introduced and refined using a gradient descent optimization method. This method was applied to the assessment of soil resources conditions in Guangdong Province, China. The new approach had an accuracy of 87%, when 15 rules were mined, as compared with 76% from the traditional approach. The accuracy increased to 96% when 32 rules were mined, in contrast to 88% from the traditional approach. These results demonstrated an improved comprehensibility of FARs and a high accuracy of the proposed method.

  19. The Roles of Cost and Quality Information in Medicare Advantage Plan Enrollment Decisions: an Observational Study.

    PubMed

    Reid, Rachel O; Deb, Partha; Howell, Benjamin L; Conway, Patrick H; Shrank, William H

    2016-02-01

    To facilitate informed decision-making in the Medicare Advantage marketplace, the Centers for Medicare & Medicaid Services publishes plan information on the Medicare Plan Finder website, including costs, benefits, and star ratings reflecting quality. Little is known about how beneficiaries weigh costs versus quality in enrollment decisions. We aimed to assess associations between publicly reported Medicare Advantage plan attributes (i.e., costs, quality, and benefits) and brand market share and beneficiaries' enrollment decisions. We performed a nationwide, beneficiary-level cross-sectional analysis of 847,069 beneficiaries enrolling in Medicare Advantage for the first time in 2011. Matching beneficiaries with their plan choice sets, we used conditional logistic regression to estimate associations between plan attributes and enrollment to assess the proportion of enrollment variation explained by plan attributes and willingness to pay for quality. Relative to the total variation explained by the model, the variation in plan choice explained by premiums (25.7 %) and out-of-pocket costs (11.6 %) together explained nearly three times as much as quality ratings (13.6 %), but brand market share explained the most variation (35.3 %). Further, while beneficiaries were willing to pay more in total annual combined premiums and out-of-pocket costs for higher-rated plans (from $4,154.93 for 2.5-star plans to $5,698.66 for 5-star plans), increases in willingness to pay diminished at higher ratings, from $549.27 (95 %CI: $541.10, $557.44) for a rating increase from 2.5 to 3 stars to $68.22 (95 %CI: $61.44, $75.01) for an increase from 4.5 to 5 stars. Willingness to pay varied among subgroups: beneficiaries aged 64-65 years were more willing to pay for higher-rated plans, while black and rural beneficiaries were less willing to pay for higher-rated plans. While beneficiaries prefer higher-quality and lower-cost Medicare Advantage plans, marginal utility for quality

  20. The Best Laid Plans: An Examination of School Plan Quality and Implementation in a School Improvement Initiative

    ERIC Educational Resources Information Center

    Strunk, Katharine O.; Marsh, Julie A.; Bush-Mecenas, Susan C.; Duque, Matthew R.

    2016-01-01

    Purpose: A common strategy used in school improvement efforts is a mandated process of formal planning, yet little is known about the quality of plans or the relationship between plan quality and implementation. This mixed-methods article investigates plan quality, factors associated with plan quality, and the relationship between plan quality and…

  1. Combining administrative data feedback, reflection and action planning to engage primary care professionals in quality improvement: qualitative assessment of short term program outcomes.

    PubMed

    Vachon, Brigitte; Désorcy, Bruno; Gaboury, Isabelle; Camirand, Michel; Rodrigue, Jean; Quesnel, Louise; Guimond, Claude; Labelle, Martin; Huynh, Ai-Thuy; Grimshaw, Jeremy

    2015-09-18

    Improving primary care for chronic disease management requires a coherent, integrated approach to quality improvement. Evidence in the continuing professional development (CPD) field suggests the importance of using strategies such as feedback delivery, reflective practice and action planning to facilitate recognition of gaps and service improvement needs. Our study explored the outcomes of a CPD intervention, named the COMPAS Project, which consists of a three-hour workshop composed of three main activities: feedback, critical reflection and action planning. The feedback intervention is delivered face-to-face and presents performance indicators extracted from clinical-administrative databases. This aim of this study was to assess the short term outcomes of this intervention to engage primary care professional in continuous quality improvement (QI). In order to develop an understanding of our intervention and of its short term outcomes, a program evaluation approach was used. Ten COMPAS workshops on diabetes management were directly observed and qualitative data was collected to assess the intervention short term outcomes. Data from both sources were combined to describe the characteristics of action plans developed by professionals. Two independent coders analysed the content of these plans to assess if they promoted engagement in QI and interprofessional collaboration. During the ten workshops held, 26 interprofessional work teams were formed. Twenty-two of them developed a QI project they could implement themselves and that targeted aspects of their own practice they perceived in need of change. Most frequently prioritized strategies for change were improvement of systematic clientele follow-up, medication compliance, care pathway and support to improve adoption of healthier life habits. Twenty-one out of 22 action plans were found to target some level of improvement of interprofessional collaboration in primary care. Our study results demonstrate that the

  2. Quality-Assurance Plan for Water-Quality Activities in the USGS Ohio Water Science Center

    USGS Publications Warehouse

    Francy, Donna S.; Shaffer, Kimberly H.

    2008-01-01

    In accordance with guidelines set forth by the Office of Water Quality in the Water Resources Discipline of the U.S. Geological Survey, a quality-assurance plan has been written for use by the Ohio Water Science Center in conducting water-quality activities. This quality-assurance plan documents the standards, policies, and procedures used by the Ohio Water Science Center for activities related to the collection, processing, storage, analysis, and publication of water-quality data. The policies and procedures documented in this quality-assurance plan for water-quality activities are meant to complement the Ohio Water Science Center quality-assurance plans for water-quality monitors, the microbiology laboratory, and surface-water and ground-water activities.

  3. 7 CFR 634.23 - Water quality plan.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... quality management plan. Such BMP's must reduce the amount of pollutants that enter a stream or lake by... 7 Agriculture 6 2010-01-01 2010-01-01 false Water quality plan. 634.23 Section 634.23 Agriculture... AGRICULTURE LONG TERM CONTRACTING RURAL CLEAN WATER PROGRAM Participant RCWP Contracts § 634.23 Water quality...

  4. 40 CFR 35.2102 - Water quality management planning.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Water quality management planning. 35... Administrator shall first determine that the project is: (a) Included in any water quality management plan being implemented for the area under section 208 of the Act or will be included in any water quality management plan...

  5. SWiFT Software Quality Assurance Plan.

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

    Berg, Jonathan Charles

    This document describes the software development practice areas and processes which contribute to the ability of SWiFT software developers to provide quality software. These processes are designed to satisfy the requirements set forth by the Sandia Software Quality Assurance Program (SSQAP). APPROVALS SWiFT Software Quality Assurance Plan (SAND2016-0765) approved by: Department Manager SWiFT Site Lead Dave Minster (6121) Date Jonathan White (6121) Date SWiFT Controls Engineer Jonathan Berg (6121) Date CHANGE HISTORY Issue Date Originator(s) Description A 2016/01/27 Jon Berg (06121) Initial release of the SWiFT Software Quality Assurance Plan

  6. Quality plan for a product line.

    PubMed

    Lanza, M L; Binus, G K; McMillan, F J

    1997-12-01

    Continuous Quality improvement (CQI) has undergone radical change as health care facilities merge, expand, and modify their existing services. CQI has shifted from a centralized position in health care organizations, to unit based, to product lines. This paper describes one product line's endeavors to develop a Quality Plan to direct CQI activities. One particular strength of our innovation is that the Quality Plan was developed with attention to the important balance of interdisciplinary cooperation and maintenance of appropriate discipline boundaries.

  7. The Role of the Quality Enhancement Plan in Engendering a Culture of Assessment

    ERIC Educational Resources Information Center

    Loughman, Thomas P.; Hickson, Joyce; Sheeks, Gina L.; Hortman, J. William

    2008-01-01

    During the past two decades, colleges and universities have used best practices from corporate management such as total quality management, strategic planning, management by objectives, benchmarking, data warehousing, and performance indicators. Many institutions of higher learning now have adopted comprehensive and multifaceted approaches to…

  8. 30 CFR 28.30 - Quality control plans; filing requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Quality control plans; filing requirements. 28... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.30 Quality control plans; filing... part, each applicant shall file with MSHA a proposed quality control plan which shall be designed to...

  9. 30 CFR 28.30 - Quality control plans; filing requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Quality control plans; filing requirements. 28... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.30 Quality control plans; filing... part, each applicant shall file with MSHA a proposed quality control plan which shall be designed to...

  10. 30 CFR 28.30 - Quality control plans; filing requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.30 Quality control plans; filing... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Quality control plans; filing requirements. 28... part, each applicant shall file with MSHA a proposed quality control plan which shall be designed to...

  11. 30 CFR 28.30 - Quality control plans; filing requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.30 Quality control plans; filing... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Quality control plans; filing requirements. 28... part, each applicant shall file with MSHA a proposed quality control plan which shall be designed to...

  12. 30 CFR 28.30 - Quality control plans; filing requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.30 Quality control plans; filing... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Quality control plans; filing requirements. 28... part, each applicant shall file with MSHA a proposed quality control plan which shall be designed to...

  13. PLANNING QUALITY IN GEOSPATIAL PROJECTS

    EPA Science Inventory

    This presentation will briefly review some legal drivers and present a structure for the writing of geospatial Quality Assurance Projects Plans. In addition, the Geospatial Quality Council geospatial information life-cycle and sources of error flowchart will be reviewed.

  14. 78 FR 30770 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-23

    ... Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards Revision AGENCY... Illinois state implementation plan (SIP) to reflect current National Ambient Air Quality Standards (NAAQS... Implementation Plan at 35 Illinois Administrative Code part 243, which updates National Ambient Air Quality...

  15. Total Quality Management Implementation Plan.

    DTIC Science & Technology

    1989-06-01

    Quality Management Implementation Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION Defense General...E 14. SUBJECT TERMS 15. NUMBER OF PAGES TOM (Total Quality Management ), Continuous Process Improvement,_________ Depot Operations, Supply Support 16

  16. A new plan quality index for nasopharyngeal cancer SIB IMRT.

    PubMed

    Jin, X; Yi, J; Zhou, Y; Yan, H; Han, C; Xie, C

    2014-02-01

    A new plan quality index integrating dosimetric and radiobiological indices was proposed to facilitate the evaluation and comparison of simultaneous integrated boost (SIB) intensity modulated radiotherapy (IMRT) plans for nasopharyngeal cancer (NPC) patients. Ten NPC patients treated by SIB-IMRT were enrolled in the study. Custom software was developed to read dose-volume histogram (DVH) curves from the treatment planning system (TPS). A plan filtering matrix was introduced to filter plans that fail to satisfy treatment protocol. Target plan quality indices and organ at risk (OAR) plan quality indices were calculated for qualified plans. A unique composite plan quality index (CPQI) was proposed based on the relative weight of these indices to evaluate and compare competing plans. Plan ranking results were compared with detailed statistical analysis, radiation oncology quality system (ROQS) scoring results and physician's evaluation results to verify the accuracy of this new plan quality index. The average CPQI values for plans with OAR priority of low, normal, high, and PTV only were 0.22 ± 0.08, 0.49 ± 0.077, 0.71 ± 0.062, and -0.21 ± 0.16, respectively. There were significant differences among these plan quality indices (One-way ANOVA test, p < 0.01). This was consistent with statistical analysis, ROQS results and physician's ranking results in which 90% OAR high plans were selected. Plan filtering matrix was able to speed up the plan evaluation process. The new matrix plan quality index CPQI showed good consistence with physician ranking results. It is a promising index for NPC SIB-IMRT plan evaluation. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

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

    USGS Publications Warehouse

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

    2014-01-01

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

  18. 222-S Laboratory Quality Assurance Plan. Revision 1

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

    Meznarich, H.K.

    1995-07-31

    This Quality Assurance Plan provides,quality assurance (QA) guidance, regulatory QA requirements (e.g., 10 CFR 830.120), and quality control (QC) specifications for analytical service. This document follows the U.S Department of Energy (DOE) issued Hanford Analytical Services Quality Assurance Plan (HASQAP). In addition, this document meets the objectives of the Quality Assurance Program provided in the WHC-CM-4-2, Section 2.1. Quality assurance elements required in the Guidelines and Specifications for Preparing Quality Assurance Program Plans (QAMS-004) and Interim Guidelines and Specifications for Preparing Quality Assurance Project Plans (QAMS-005) from the US Environmental Protection Agency (EPA) are covered throughout this document. A qualitymore » assurance index is provided in the Appendix A. This document also provides and/or identifies the procedural information that governs laboratory operations. The personnel of the 222-S Laboratory and the Standards Laboratory including managers, analysts, QA/QC staff, auditors, and support staff shall use this document as guidance and instructions for their operational and quality assurance activities. Other organizations that conduct activities described in this document for the 222-S Laboratory shall follow this QA/QC document.« less

  19. 42 CFR 441.474 - Quality assurance and improvement plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assurance and improvement plan. 441.474... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance and improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State...

  20. 42 CFR 441.474 - Quality assurance and improvement plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Quality assurance and improvement plan. 441.474... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance and improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State...

  1. 42 CFR 441.474 - Quality assurance and improvement plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Quality assurance and improvement plan. 441.474... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance and improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State...

  2. 42 CFR 441.474 - Quality assurance and improvement plan.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Quality assurance and improvement plan. 441.474... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance and improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State...

  3. 42 CFR 441.474 - Quality assurance and improvement plan.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Quality assurance and improvement plan. 441.474... SERVICES Optional Self-Directed Personal Assistance Services Program § 441.474 Quality assurance and improvement plan. (a) The State must provide a quality assurance and improvement plan that describes the State...

  4. Southwest principal aquifers regional ground-water quality assessment

    USGS Publications Warehouse

    Anning, D.W.; Thiros, Susan A.; Bexfield, L.M.; McKinney, T.S.; Green, J.M.

    2009-01-01

    The National Water-Quality Assessment (NAWQA) Program of the U.S. Geological Survey is conducting a regional analysis of water quality in the principal aquifers in the southwestern United States. The Southwest Principal Aquifers (SWPA) study is building a better understanding of the susceptibility and vulnerability of basin-fill aquifers in the region to ground-water contamination by synthesizing the baseline knowledge of ground-water quality conditions in 15 basins previously studied by the NAWQA Program. The improved understanding of aquifer susceptibility and vulnerability to contamination is assisting in the development of tools that water managers can use to assess and protect the quality of ground-water resources. This fact sheet provides an overview of the basin-fill aquifers in the southwestern United States and description of the completed and planned regional analyses of ground-water quality being performed by the SWPA study.

  5. 78 FR 10589 - Revision of Air Quality Implementation Plan; California; Sacramento Metropolitan Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... Quality Implementation Plan; California; Sacramento Metropolitan Air Quality Management District... Sacramento Metropolitan Air Quality Management District (SMAQMD or District) portion of the California State... sources within the areas covered by the plan as necessary to assure that the National Ambient Air Quality...

  6. 40 CFR 35.2023 - Water quality management planning.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Water quality management planning. 35... to the States to carry out water quality management planning including but not limited to: (1... ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2023 Water quality...

  7. 40 CFR 35.2023 - Water quality management planning.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Water quality management planning. 35... ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2023 Water quality... to the States to carry out water quality management planning including but not limited to: (1...

  8. 40 CFR 35.2023 - Water quality management planning.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Water quality management planning. 35... ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2023 Water quality... to the States to carry out water quality management planning including but not limited to: (1...

  9. 40 CFR 35.2023 - Water quality management planning.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2023 Water quality... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Water quality management planning. 35... to the States to carry out water quality management planning including but not limited to: (1...

  10. Integrating impact assessment and conflict management in urban planning: Experiences from Finland

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

    Peltonen, Lasse, E-mail: lasse.peltonen@tkk.f; Sairinen, Rauno, E-mail: rauno.sairinen@joensuu.f

    2010-09-15

    The article examines the interlinkages between recent developments in conflict management and impact assessment procedures in the context of urban planning in Finland. It sets out by introducing the fields of impact assessment and conflict mediation. It then proceeds to discuss the development of impact assessment practices and the status of conflict mediation in Finnish land use planning. The case of Korteniitty infill development plan in Jyvaeskylae is used to demonstrate how the Finnish planning system operates in conflict situations - and how social impact assessment can contribute to managing planning conflicts. The authors ask how the processes of impactmore » assessment contribute to conflict management. Based on the Finnish experience, it is argued that social impact assessment of land use plans can contribute to conflict management, especially in the absence of institutionalised conflict mediation processes. In addition, SIA may acquire features of conflict mediation, depending on extent and intensity of stakeholder participation in the process, and the quality of linkages it between knowledge production and decision-making. Simultaneously, conflict mediation practices and theoretical insights can inform the application of SIA to help it address land use conflicts more consciously.« less

  11. 40 CFR 35.2102 - Water quality management planning.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Water quality management planning. 35... ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2102 Water quality... Administrator shall first determine that the project is: (a) Included in any water quality management plan being...

  12. 40 CFR 35.2102 - Water quality management planning.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Water quality management planning. 35... ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2102 Water quality... Administrator shall first determine that the project is: (a) Included in any water quality management plan being...

  13. Quality improvement initiatives: the missed opportunity for health plans.

    PubMed

    Fernandez-Lopez, Sara; Lennert, Barbara

    2009-11-01

    The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations.

  14. Revision 2 of the Enbridge Quality Assurance Project Plan

    EPA Pesticide Factsheets

    This Quality Assurance Project Plan (QAPP) presents Revision 2 of the organization, objectives, planned activities, and specific quality assurance/quality control (QA/QC) procedures associated with the Enbridge Marshall Pipeline Release Project.

  15. Reliability and utility of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII) for auditing and quality development in services for adults with intellectual disability and challenging behaviour.

    PubMed

    McVilly, K; Webber, L; Paris, M; Sharp, G

    2013-08-01

    Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II (BSP-QEII) was developed to monitor and assess BSPs prepared by teachers to support children with disability in the school system. This study investigated the application of the BSP-QEII to the assessment of BSPs for adults with ID in community support services. The inter-rater reliability of the BSP-QEII was assessed. The utility of the BPS-QEII was then investigated with reference to a time series study of matched pairs of BSPs, developed for the same clients over a period of approximately 3 years. Differences in plan quality measured across a number of service and systemic variables were also investigated. The BSP-QEII was found to have good inter-rater reliability and good utility for audit purposes. It was able to discriminate changes in plan quality over time. Differences in plan quality were also evident across different service types, where specialist staff had or had not been involved, and in some instances where a statutory format for the plan had or had not been used. There were no differences between plans developed by government and community sector agencies, nor were there any regional differences across the jurisdiction. The BSP-QEII could usefully be adopted as an audit tool for measuring the quality of BSPs for adults with ID. In addition to being used for research and administrative auditing, the principles underpinning the BSP-QEII could also be useful to guide policy and educational activities for staff in community based services for adults with ID. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

  16. Improving plan quality for prostate volumetric-modulated arc therapy.

    PubMed

    Wright, Katrina; Ferrari-Anderson, Janet; Barry, Tamara; Bernard, Anne; Brown, Elizabeth; Lehman, Margot; Pryor, David

    2017-01-01

    We critically evaluated the quality and consistency of volumetric-modulated arc therapy (VMAT) prostate planning at a single institution to quantify objective measures for plan quality and establish clear guidelines for plan evaluation and quality assurance. A retrospective analysis was conducted on 34 plans generated on the Pinnacle 3 version 9.4 and 9.8 treatment planning system to deliver 78 Gy in 39 fractions to the prostate only using VMAT. Data were collected on contoured structure volumes, overlaps and expansions, planning target volume (PTV) and organs at risk volumes and relationship, dose volume histogram, plan conformity, plan homogeneity, low-dose wash, and beam parameters. Standard descriptive statistics were used to describe the data. Despite a standardized planning protocol, we found variability was present in all steps of the planning process. Deviations from protocol contours by radiation oncologists and radiation therapists occurred in 12% and 50% of cases, respectively, and the number of optimization parameters ranged from 12 to 27 (median 17). This contributed to conflicts within the optimization process reflected by the mean composite objective value of 0.07 (range 0.01 to 0.44). Methods used to control low-intermediate dose wash were inconsistent. At the PTV rectum interface, the dose-gradient distance from the 74.1 Gy to 40 Gy isodose ranged from 0.6 cm to 2.0 cm (median 1.0 cm). Increasing collimator angle was associated with a decrease in monitor units and a single full 6 MV arc was sufficient for the majority of plans. A significant relationship was found between clinical target volume-rectum distance and rectal tolerances achieved. A linear relationship was determined between the PTV volume and volume of 40 Gy isodose. Objective values and composite objective values were useful in determining plan quality. Anatomic geometry and overlap of structures has a measurable impact on the plan quality achieved for prostate patients

  17. Quality Improvement Initiatives: The Missed Opportunity for Health Plans

    PubMed Central

    Fernandez-Lopez, Sara; Lennert, Barbara

    2009-01-01

    Background The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. Objectives To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. Methods We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. Results The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Conclusion Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations. PMID:25126303

  18. 77 FR 73320 - Approval of Air Quality Implementation Plans; California; South Coast Air Quality Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-10

    ... Quality Implementation Plans; California; South Coast Air Quality Management District; Prevention of... Implementation Plan (SIP) revision for the South Coast Air Quality Management District (SCAQMD or District... in a August 15, 2012 letter from the South Coast Air Quality Management District regarding specific...

  19. Quality Assurance Planning for Region 9

    EPA Pesticide Factsheets

    The ultimate success of an environmental program or project depends on the quality of the environmental data collected and used in decision-making. EPA has developed guidances to help state and tribal governments develop Quality Assurance Program Plans.

  20. 45 CFR 1304.60 - Deficiencies and quality improvement plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the approved Quality Improvement Plan, the responsible HHS official will issue a letter of termination... 45 Public Welfare 4 2010-10-01 2010-10-01 false Deficiencies and quality improvement plans. 1304... GRANTEE AND DELEGATE AGENCIES Implementation and Enforcement § 1304.60 Deficiencies and quality...

  1. Patient-specific dosimetric endpoints based treatment plan quality control in radiotherapy.

    PubMed

    Song, Ting; Staub, David; Chen, Mingli; Lu, Weiguo; Tian, Zhen; Jia, Xun; Li, Yongbao; Zhou, Linghong; Jiang, Steve B; Gu, Xuejun

    2015-11-07

    In intensity modulated radiotherapy (IMRT), the optimal plan for each patient is specific due to unique patient anatomy. To achieve such a plan, patient-specific dosimetric goals reflecting each patient's unique anatomy should be defined and adopted in the treatment planning procedure for plan quality control. This study is to develop such a personalized treatment plan quality control tool by predicting patient-specific dosimetric endpoints (DEs). The incorporation of patient specific DEs is realized by a multi-OAR geometry-dosimetry model, capable of predicting optimal DEs based on the individual patient's geometry. The overall quality of a treatment plan is then judged with a numerical treatment plan quality indicator and characterized as optimal or suboptimal. Taking advantage of clinically available prostate volumetric modulated arc therapy (VMAT) treatment plans, we built and evaluated our proposed plan quality control tool. Using our developed tool, six of twenty evaluated plans were identified as sub-optimal plans. After plan re-optimization, these suboptimal plans achieved better OAR dose sparing without sacrificing the PTV coverage, and the dosimetric endpoints of the re-optimized plans agreed well with the model predicted values, which validate the predictability of the proposed tool. In conclusion, the developed tool is able to accurately predict optimally achievable DEs of multiple OARs, identify suboptimal plans, and guide plan optimization. It is a useful tool for achieving patient-specific treatment plan quality control.

  2. Approved Air Quality Implementation Plans in Region 10

    EPA Pesticide Factsheets

    Landing page for information about EPA-approved air quality State Implementation Plans (SIPs), Tribal Implementation Plans (TIPs), and Federal Implementation Plans (FIPs) in Alaska, Idaho, Oregon, Washington.

  3. Quality assurance program plan for radionuclide airborne emissions monitoring

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

    Boom, R.J.

    1995-12-01

    This Quality Assurance Program Plan identifies quality assurance program requirements and addresses the various Westinghouse Hanford Company organizations and their particular responsibilities in regards to sample and data handling of radiological airborne emissions. This Quality Assurance Program Plan is prepared in accordance with and to written requirements.

  4. Quality-assurance plan for water-quality activities in the U.S. Geological Survey Washington Water Science Center

    USGS Publications Warehouse

    Conn, Kathleen E.; Huffman, Raegan L.; Barton, Cynthia

    2017-05-08

    In accordance with guidelines set forth by the Office of Water Quality in the Water Mission Area of the U.S. Geological Survey, a quality-assurance plan has been created for use by the Washington Water Science Center (WAWSC) in conducting water-quality activities. This qualityassurance plan documents the standards, policies, and procedures used by the WAWSC for activities related to the collection, processing, storage, analysis, and publication of water-quality data. The policies and procedures documented in this quality-assurance plan for water-quality activities complement the quality-assurance plans for surface-water and groundwater activities at the WAWSC.

  5. Quality-Assurance Plan for Water-Quality Activities of the U.S. Geological Survey Montana Water Science Center

    USGS Publications Warehouse

    Lambing, John H.

    2006-01-01

    In accordance with guidelines set forth by the Office of Water Quality in the Water Resources Discipline of the U.S. Geological Survey (USGS), a quality-assurance plan has been created for use by the USGS Montana Water Science Center in conducting water-quality activities. This quality-assurance plan documents the standards, policies, and procedures used by the USGS Montana Water Science Center for activities related to the collection, processing, storage, analysis, and publication of water-quality data. The policies and procedures presented in this quality-assurance plan for water-quality activities complement the quality-assurance plans for surface-water and ground-water activities and suspended-sediment analysis.

  6. 40 CFR 35.2102 - Water quality management planning.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2102 Water quality management planning. Before grant assistance can be awarded for any treatment works project, the Regional... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Water quality management planning. 35...

  7. Automatic treatment planning facilitates fast generation of high-quality treatment plans for esophageal cancer.

    PubMed

    Hansen, Christian Rønn; Nielsen, Morten; Bertelsen, Anders Smedegaard; Hazell, Irene; Holtved, Eva; Zukauskaite, Ruta; Bjerregaard, Jon Kroll; Brink, Carsten; Bernchou, Uffe

    2017-11-01

    The quality of radiotherapy planning has improved substantially in the last decade with the introduction of intensity modulated radiotherapy. The purpose of this study was to analyze the plan quality and efficacy of automatically (AU) generated VMAT plans for inoperable esophageal cancer patients. Thirty-two consecutive inoperable patients with esophageal cancer originally treated with manually (MA) generated volumetric modulated arc therapy (VMAT) plans were retrospectively replanned using an auto-planning engine. All plans were optimized with one full 6MV VMAT arc giving 60 Gy to the primary target and 50 Gy to the elective target. The planning techniques were blinded before clinical evaluation by three specialized oncologists. To supplement the clinical evaluation, the optimization time for the AU plan was recorded along with DVH parameters for all plans. Upon clinical evaluation, the AU plan was preferred for 31/32 patients, and for one patient, there was no difference in the plans. In terms of DVH parameters, similar target coverage was obtained between the two planning methods. The mean dose for the spinal cord increased by 1.8 Gy using AU (p = .002), whereas the mean lung dose decreased by 1.9 Gy (p < .001). The AU plans were more modulated as seen by the increase of 12% in mean MUs (p = .001). The median optimization time for AU plans was 117 min. The AU plans were in general preferred and showed a lower mean dose to the lungs. The automation of the planning process generated esophageal cancer treatment plans quickly and with high quality.

  8. Total Quality Management Office for Contracting Integrity Implementation Plan

    DTIC Science & Technology

    1989-07-01

    REPORT______ANDDATESCOVERED 4. TITLE AND SUBTITLE S. FUNDING NUMBERS Total Quality Management Office for Contracting Integrity Implementatiun Plan 6. AUTHOR(S) 7...01-280-5500 Standard Form 298 (Rev. 2-89) P’,croed 1:, ANSI Std 3J9-16 29d. 102 4 TOTAL QUALITY MANAGEMENT OFFICE FOR CONTRACTING INTEGRITY...IMPLEMENTATION PLAN According to the Total Quality Management (TQM) Master Plan, each PSE head, supported by Working Groups, will implement the HQ DLA Master

  9. Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

    PubMed Central

    Tessema, Gizachew Assefa; Streak Gomersall, Judith; Mahmood, Mohammad Afzal; Laurence, Caroline O.

    2016-01-01

    Background Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa. Methods Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings. Results From 4334 records, 11 studies (eight quantitative, three qualitative) met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client’s waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as ‘pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers’ behaviour. Conclusion There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary

  10. An Automated Treatment Plan Quality Control Tool for Intensity-Modulated Radiation Therapy Using a Voxel-Weighting Factor-Based Re-Optimization Algorithm.

    PubMed

    Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura

    2016-01-01

    Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be

  11. An Automated Treatment Plan Quality Control Tool for Intensity-Modulated Radiation Therapy Using a Voxel-Weighting Factor-Based Re-Optimization Algorithm

    PubMed Central

    Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura

    2016-01-01

    Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be

  12. Three Methods of Assessing Values for Advance Care Planning

    PubMed Central

    Karel, Michele J.; Moye, Jennifer; Bank, Adam; Azar, Armin R.

    2016-01-01

    Advance care planning ideally includes communication about values between patients, family members, and care providers. This study examined the utility of health care values assessment tools for older adults with and without dementia. Adults aged 60 and older, with and without dementia, completed three values assessment tools—open-ended, forced-choice, and rating scale questions—and named a preferred surrogate decision maker. Responses to forced-choice items were examined at 9-month retest. Adults with and without dementia appeared equally able to respond meaningfully to questions about values regarding quality of life and health care decisions. People with dementia were generally as able as controls to respond consistently after 9 months. Although values assessment methods show promise, further item and scale development work is needed. Older adults with dementia should be included in clarifying values for advance care planning to the extent that they desire and are able. PMID:17215205

  13. Transition Assessment and Planning for Youth with Severe Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Carter, Erik W.; Brock, Matthew E.; Trainor, Audrey A.

    2014-01-01

    Although federal law now mandates age-appropriate transition assessment as a key component of high-quality transition planning, little research exists to guide educators on what they might learn when undertaking this process. In this study, the authors examined teacher and parent assessments of the transition-related strengths and needs of 134…

  14. 40 CFR 35.2102 - Water quality management planning.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Water quality management planning. 35.2102 Section 35.2102 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2102 Water quality management planning. Before grant...

  15. A Systematic Review to Uncover a Universal Protocol for Accuracy Assessment of 3-Dimensional Virtually Planned Orthognathic Surgery.

    PubMed

    Gaber, Ramy M; Shaheen, Eman; Falter, Bart; Araya, Sebastian; Politis, Constantinus; Swennen, Gwen R J; Jacobs, Reinhilde

    2017-11-01

    The aim of this study was to systematically review methods used for assessing the accuracy of 3-dimensional virtually planned orthognathic surgery in an attempt to reach an objective assessment protocol that could be universally used. A systematic review of the currently available literature, published until September 12, 2016, was conducted using PubMed as the primary search engine. We performed secondary searches using the Cochrane Database, clinical trial registries, Google Scholar, and Embase, as well as a bibliography search. Included articles were required to have stated clearly that 3-dimensional virtual planning was used and accuracy assessment performed, along with validation of the planning and/or assessment method. Descriptive statistics and quality assessment of included articles were performed. The initial search yielded 1,461 studies. Only 7 studies were included in our review. An important variability was found regarding methods used for 1) accuracy assessment of virtually planned orthognathic surgery or 2) validation of the tools used. Included studies were of moderate quality; reviewers' agreement regarding quality was calculated to be 0.5 using the Cohen κ test. On the basis of the findings of this review, it is evident that the literature lacks consensus regarding accuracy assessment. Hence, a protocol is suggested for accuracy assessment of virtually planned orthognathic surgery with the lowest margin of error. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  16. 30 CFR 28.32 - Proposed quality control plans; approval by MSHA.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Proposed quality control plans; approval by...-CIRCUIT PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.32 Proposed quality control plans; approval by MSHA. (a) Each proposed quality control plan submitted in accordance with this...

  17. 30 CFR 28.32 - Proposed quality control plans; approval by MSHA.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...-CIRCUIT PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.32 Proposed quality control plans; approval by MSHA. (a) Each proposed quality control plan submitted in accordance with this... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Proposed quality control plans; approval by...

  18. 30 CFR 28.32 - Proposed quality control plans; approval by MSHA.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...-CIRCUIT PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.32 Proposed quality control plans; approval by MSHA. (a) Each proposed quality control plan submitted in accordance with this... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Proposed quality control plans; approval by...

  19. 30 CFR 28.32 - Proposed quality control plans; approval by MSHA.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...-CIRCUIT PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.32 Proposed quality control plans; approval by MSHA. (a) Each proposed quality control plan submitted in accordance with this... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Proposed quality control plans; approval by...

  20. 77 FR 52277 - Approval of Air Quality Implementation Plans; California; South Coast Air Quality Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

    ... Quality Implementation Plans; California; South Coast Air Quality Management District; Prevention of... rule. SUMMARY: EPA is proposing approval of a permitting rule submitted for the South Coast Air Quality Management District (District) portion of the California State Implementation Plan (SIP). The State is...

  1. 78 FR 30829 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-23

    ... Promulgation of Air Quality Implementation Plans; Illinois; Air Quality Standards Revision AGENCY... the Illinois State Implementation Plan (SIP) to reflect current national ambient air quality standards...) 692-2450. 4. Mail: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U...

  2. 40 CFR 35.2023 - Water quality management planning.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Water quality management planning. 35.2023 Section 35.2023 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works § 35.2023 Water quality management planning. (a) From funds...

  3. Quality-assurance and data-management plan for water-quality activities in the Kansas Water Science Center, 2014

    USGS Publications Warehouse

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

    2014-01-01

    As the Nation’s largest water, earth, and biological science and civilian mapping information agency, the U.S. Geological Survey is relied on to collect high-quality data, and produce factual and impartial interpretive reports. This quality-assurance and data-management plan provides guidance for water-quality activities conducted by the Kansas Water Science Center. Policies and procedures are documented for activities related to planning, collecting, storing, documenting, tracking, verifying, approving, archiving, and disseminating water-quality data. The policies and procedures described in this plan complement quality-assurance plans for continuous water-quality monitoring, surface-water, and groundwater activities in Kansas.

  4. Leading quality through the development of a multi-year corporate quality plan: sharing The Ottawa Hospital experience.

    PubMed

    Hunter, Linda; Myles, Joanne; Worthington, James R; Lebrun, Monique

    2011-01-01

    This article discusses the background and process for developing a multi-year corporate quality plan. The Ottawa Hospital's goal is to be a top 10% performer in quality and patient safety in North America. In order to create long-term measurable and sustainable changes in the quality of patient care, The Ottawa Hospital embarked on the development of a three-year strategic corporate quality plan. This was accomplished by engaging the organization at all levels and defining quality frameworks, aligning with internal and external expectations, prioritizing strategic goals, articulating performance measurements and reporting to stakeholders while maintaining a transparent communication process. The plan was developed through an iterative process that engaged a broad base of health professionals, physicians, support staff, administration and senior management. A literature review of quality frameworks was undertaken, a Quality Plan Working Group was established, 25 key stakeholder interviews were conducted and 48 clinical and support staff consultations were held. The intent was to gather information on current quality initiatives and challenges encountered and to prioritize corporate goals and then create the quality plan. Goals were created and then prioritized through an affinity exercise. Action plans were developed for each goal and included objectives, tasks and activities, performance measures (structure, process and outcome), accountabilities and timelines. This collaborative methodology resulted in the development of a three-year quality plan. Six corporate goals were outlined by the tenets of the quality framework for The Ottawa Hospital: access to care, appropriate care (effective and efficient), safe care and satisfaction with care. Each of the six corporate goals identified objectives and supporting action plans with accountabilities outlining what would be accomplished in years one, two and three. The three-year quality plan was approved by senior

  5. Plan-provider integration, premiums, and quality in the Medicare Advantage market.

    PubMed

    Frakt, Austin B; Pizer, Steven D; Feldman, Roger

    2013-12-01

    To investigate how integration between Medicare Advantage plans and health care providers is related to plan premiums and quality ratings. We used public data from the Centers for Medicare and Medicaid Services (CMS) and the Area Resource File and private data from one large insurer. Premiums and quality ratings are from 2009 CMS administrative files and some control variables are historical. We estimated ordinary least-squares models for premiums and plan quality ratings, with state fixed effects and firm random effects. The key independent variable was an indicator of plan-provider integration. With the exception of Medigap premium data, all data were publicly available. We ascertained plan-provider integration through examination of plans' websites and governance documents. We found that integrated plan-providers charge higher premiums, controlling for quality. Such plans also have higher quality ratings. We found no evidence that integration is associated with more generous benefits. Current policy encourages plan-provider integration, although potential effects on health insurance products and markets are uncertain. Policy makers and regulators may want to closely monitor changes in premiums and quality after integration and consider whether quality improvement (if any) justifies premium increases (if they occur). © Health Research and Educational Trust.

  6. Defense Depot Mechanicsburg Total Quality Management Implementation Plan

    DTIC Science & Technology

    1989-06-01

    B T I TLEE 5 . FUNDING NUMBERS Defense Depot Mechanicsburg Total Quality Management Implementation Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME...Form 298 (Rev. 2-89) L296- 102 Acces.ion For NYI J ... I:: ted DEFENSE DEPOT MECHANICSBURG PENNSYLVANIAL--I By_ TOTAL QUALITY MANAGEMENT K_~ t buty-n...IMPLEMENTATION PLAN Avmail-t!Ilty Codes IvLl c 2Dd/or JUN 3 0 1989 iDizt Special PURPOSE The purpose of this Total Quality Management Implementation

  7. DESC (Defense Electronics Supply Center) Total Quality Management Plan

    DTIC Science & Technology

    1989-04-01

    Paoerwort Reduction Proodt(0704.01 ge. Washington. DC 20S03 4. TITLE AND SUBTITLE Api598 . FUNDING NUMBERS DESC Total Quality Management Master Plan...OF PAGES TQM (Total Quality Management ), Continuous Process Improvement,_________ cTainingManagement 16. PRICE CODE 17. SECURITY CLASSIFICATION 18... QUALITY MANAGEMENT As you read the DESC Total Quality Management Plan, I ask each of you to make a commitment to continuously strive for improvement

  8. 7 CFR 634.23 - Water quality plan.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... quality improvement. These measures are not eligible for cost sharing under this program. The installation... Conservation Service will certify as to the technical adequacy of the water-quality plan. (g) The soil...

  9. Noncoplanar VMAT for nasopharyngeal tumors: Plan quality versus treatment time

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

    Wild, Esther, E-mail: e.wild@dkfz.de; Bangert, Mark; Nill, Simeon

    Purpose: The authors investigated the potential of optimized noncoplanar irradiation trajectories for volumetric modulated arc therapy (VMAT) treatments of nasopharyngeal patients and studied the trade-off between treatment plan quality and delivery time in radiation therapy. Methods: For three nasopharyngeal patients, the authors generated treatment plans for nine different delivery scenarios using dedicated optimization methods. They compared these scenarios according to dose characteristics, number of beam directions, and estimated delivery times. In particular, the authors generated the following treatment plans: (1) a 4π plan, which is a not sequenced, fluence optimized plan that uses beam directions from approximately 1400 noncoplanar directionsmore » and marks a theoretical upper limit of the treatment plan quality, (2) a coplanar 2π plan with 72 coplanar beam directions as pendant to the noncoplanar 4π plan, (3) a coplanar VMAT plan, (4) a coplanar step and shoot (SnS) plan, (5) a beam angle optimized (BAO) coplanar SnS IMRT plan, (6) a noncoplanar BAO SnS plan, (7) a VMAT plan with rotated treatment couch, (8) a noncoplanar VMAT plan with an optimized great circle around the patient, and (9) a noncoplanar BAO VMAT plan with an arbitrary trajectory around the patient. Results: VMAT using optimized noncoplanar irradiation trajectories reduced the mean and maximum doses in organs at risk compared to coplanar VMAT plans by 19% on average while the target coverage remains constant. A coplanar BAO SnS plan was superior to coplanar SnS or VMAT; however, noncoplanar plans like a noncoplanar BAO SnS plan or noncoplanar VMAT yielded a better plan quality than the best coplanar 2π plan. The treatment plan quality of VMAT plans depended on the length of the trajectory. The delivery times of noncoplanar VMAT plans were estimated to be 6.5 min in average; 1.6 min longer than a coplanar plan but on average 2.8 min faster than a noncoplanar SnS plan with comparable

  10. Noncoplanar VMAT for nasopharyngeal tumors: Plan quality versus treatment time.

    PubMed

    Wild, Esther; Bangert, Mark; Nill, Simeon; Oelfke, Uwe

    2015-05-01

    The authors investigated the potential of optimized noncoplanar irradiation trajectories for volumetric modulated arc therapy (VMAT) treatments of nasopharyngeal patients and studied the trade-off between treatment plan quality and delivery time in radiation therapy. For three nasopharyngeal patients, the authors generated treatment plans for nine different delivery scenarios using dedicated optimization methods. They compared these scenarios according to dose characteristics, number of beam directions, and estimated delivery times. In particular, the authors generated the following treatment plans: (1) a 4π plan, which is a not sequenced, fluence optimized plan that uses beam directions from approximately 1400 noncoplanar directions and marks a theoretical upper limit of the treatment plan quality, (2) a coplanar 2π plan with 72 coplanar beam directions as pendant to the noncoplanar 4π plan, (3) a coplanar VMAT plan, (4) a coplanar step and shoot (SnS) plan, (5) a beam angle optimized (BAO) coplanar SnS IMRT plan, (6) a noncoplanar BAO SnS plan, (7) a VMAT plan with rotated treatment couch, (8) a noncoplanar VMAT plan with an optimized great circle around the patient, and (9) a noncoplanar BAO VMAT plan with an arbitrary trajectory around the patient. VMAT using optimized noncoplanar irradiation trajectories reduced the mean and maximum doses in organs at risk compared to coplanar VMAT plans by 19% on average while the target coverage remains constant. A coplanar BAO SnS plan was superior to coplanar SnS or VMAT; however, noncoplanar plans like a noncoplanar BAO SnS plan or noncoplanar VMAT yielded a better plan quality than the best coplanar 2π plan. The treatment plan quality of VMAT plans depended on the length of the trajectory. The delivery times of noncoplanar VMAT plans were estimated to be 6.5 min in average; 1.6 min longer than a coplanar plan but on average 2.8 min faster than a noncoplanar SnS plan with comparable treatment plan quality. The authors

  11. Explicit optimization of plan quality measures in intensity-modulated radiation therapy treatment planning.

    PubMed

    Engberg, Lovisa; Forsgren, Anders; Eriksson, Kjell; Hårdemark, Björn

    2017-06-01

    To formulate convex planning objectives of treatment plan multicriteria optimization with explicit relationships to the dose-volume histogram (DVH) statistics used in plan quality evaluation. Conventional planning objectives are designed to minimize the violation of DVH statistics thresholds using penalty functions. Although successful in guiding the DVH curve towards these thresholds, conventional planning objectives offer limited control of the individual points on the DVH curve (doses-at-volume) used to evaluate plan quality. In this study, we abandon the usual penalty-function framework and propose planning objectives that more closely relate to DVH statistics. The proposed planning objectives are based on mean-tail-dose, resulting in convex optimization. We also demonstrate how to adapt a standard optimization method to the proposed formulation in order to obtain a substantial reduction in computational cost. We investigated the potential of the proposed planning objectives as tools for optimizing DVH statistics through juxtaposition with the conventional planning objectives on two patient cases. Sets of treatment plans with differently balanced planning objectives were generated using either the proposed or the conventional approach. Dominance in the sense of better distributed doses-at-volume was observed in plans optimized within the proposed framework. The initial computational study indicates that the DVH statistics are better optimized and more efficiently balanced using the proposed planning objectives than using the conventional approach. © 2017 American Association of Physicists in Medicine.

  12. Quality of family planning services in primary health centers of Jimma Zone, Southwest Ethiopia.

    PubMed

    Tafese, Fikru; Woldie, Mirkuzie; Megerssa, Berhane

    2013-11-01

    Good quality of care in family planning (FP) services help individuals and couples to meet their reproductive health needs safely and effectively. Therefore, assessment and improvement of the quality of family planning services could enhance family planning services utilization. This study was thus conducted to assess the quality of family planning services in primary health centers of Jimma Zone, Southwest Ethiopia. A cross-sectional facility based study was conducted from March 1(st)-25(th), 2011 among family planning clients of government primary health care centers in southwest Ethiopia. Exit interview of 301 family planning clients identified through systematic random sampling technique was carried out using a pre-tested structured questionnaire. Availability of resources was checked using provider interview and inventory checklist. Moreover, a total of 150 consultation sessions were observed using checklist. Descriptive statistics and linear regression coefficients were generated to meet the objective of the study. There was a shortage of some medical equipment, trained staffs, and information education and communication materials (IEC) in all of the family planning clinics. The mean waiting time at the service delivery points and consultation duration were 16.4 and 10.5 minutes, respectively. The providers used at least one information education and communication material in 33.3% of the consultation sessions. The overall satisfaction score was 8.64. Clients' perception on adequacy of information during consultation (β=0.24; ( 95%CI=0.02-0.16) ease of getting the clinic site, short waiting time (β=0.17; 95%CI=0.15-029) and educational level (β=0.09; 95%CI =0.09-0.29) were significantly associated with overall satisfaction. The findings of this study showed that there was lack of critical resources for the provision of quality family planning services in all of the primary health care centers included in the study. This has affected important aspects of

  13. Orion Entry Handling Qualities Assessments

    NASA Technical Reports Server (NTRS)

    Bihari, B.; Tiggers, M.; Strahan, A.; Gonzalez, R.; Sullivan, K.; Stephens, J. P.; Hart, J.; Law, H., III; Bilimoria, K.; Bailey, R.

    2011-01-01

    The Orion Command Module (CM) is a capsule designed to bring crew back from the International Space Station (ISS), the moon and beyond. The atmospheric entry portion of the flight is deigned to be flown in autopilot mode for nominal situations. However, there exists the possibility for the crew to take over manual control in off-nominal situations. In these instances, the spacecraft must meet specific handling qualities criteria. To address these criteria two separate assessments of the Orion CM s entry Handling Qualities (HQ) were conducted at NASA s Johnson Space Center (JSC) using the Cooper-Harper scale (Cooper & Harper, 1969). These assessments were conducted in the summers of 2008 and 2010 using the Advanced NASA Technology Architecture for Exploration Studies (ANTARES) six degree of freedom, high fidelity Guidance, Navigation, and Control (GN&C) simulation. This paper will address the specifics of the handling qualities criteria, the vehicle configuration, the scenarios flown, the simulation background and setup, crew interfaces and displays, piloting techniques, ratings and crew comments, pre- and post-fight briefings, lessons learned and changes made to improve the overall system performance. The data collection tools, methods, data reduction and output reports will also be discussed. The objective of the 2008 entry HQ assessment was to evaluate the handling qualities of the CM during a lunar skip return. A lunar skip entry case was selected because it was considered the most demanding of all bank control scenarios. Even though skip entry is not planned to be flown manually, it was hypothesized that if a pilot could fly the harder skip entry case, then they could also fly a simpler loads managed or ballistic (constant bank rate command) entry scenario. In addition, with the evaluation set-up of multiple tasks within the entry case, handling qualities ratings collected in the evaluation could be used to assess other scenarios such as the constant bank angle

  14. National Water-Quality Assessment Program: Central Arizona Basins

    USGS Publications Warehouse

    Cordy, Gail E.

    1994-01-01

    In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface-water and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water-quality information that will be useful to policymakers and managers at the National, State, and local levels. Studies of 60 hydrologic systems that include parts of most major river basins and aquifer systems (study-unit investigations) are the building blocks of the national assessment. The 60 study units range in size from 1,000 to about 60,000 mi2 and represent 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty study-unit investigations were started in 1991, 20 additional studies started in 1994, and 20 more are planned to start in 1997. The Central Arizona Basins study unit began assessment activities in 1994.

  15. Checklist for Reviewing EPA Quality Management Plans

    EPA Pesticide Factsheets

    This checklist will be used to review the Quality Management Plans (QMPs) that are submitted to the Quality Staff of the Office of Environmental Information (OEI) for Agency review under EPA Order 5360.1 A2.

  16. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Quality improvement plan (QIP) requirements. 64.8 Section 64.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements. (a...

  17. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Quality improvement plan (QIP) requirements. 64.8 Section 64.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements. (a...

  18. Association Between Health Plan Exit From Medicaid Managed Care and Quality of Care, 2006-2014

    PubMed Central

    Schpero, William L.; Schlesinger, Mark J.; Trivedi, Amal N.

    2017-01-01

    Importance State Medicaid programs have increasingly contracted with insurers to provide medical care services for enrollees (Medicaid managed care plans). Insurers that provide these plans can exit Medicaid programs each year, with unclear effects on quality of care and health care experiences. Objective To determine the frequency and interstate variation of health plan exit from Medicaid managed care and evaluate the relationship between health plan exit and market-level quality. Design, Setting, and Participants Retrospective cohort of all comprehensive Medicaid managed care plans (N = 390) during the interval 2006-2014. Exposures Plan exit, defined as the withdrawal of a managed care plan from a state’s Medicaid program. Main Outcomes and Measures Eight measures from the Healthcare Effectiveness Data and Information Set were used to construct 3 composite indicators of quality (preventive care, chronic disease care management, and maternity care). Four measures from the Consumer Assessment of Healthcare Providers and Systems were combined into a composite indicator of patient experience, reflecting the proportion of beneficiaries rating experiences as 8 or above on a 0-to-10–point scale. Outcome data were available for 248 plans (68% of plans operating prior to 2014, representing 78% of beneficiaries). Results Of the 366 comprehensive Medicaid managed care plans operating prior to 2014, 106 exited Medicaid. These exiting plans enrolled 4 848 310 Medicaid beneficiaries, with a mean of 606 039 beneficiaries affected by plan exits annually. Six states had a mean of greater than 10% of Medicaid managed care recipients enrolled in plans that exited, whereas 10 states experienced no plan exits. Plans that exited from a state’s Medicaid market performed significantly worse prior to exiting than those that remained in terms of preventive care (57.5% vs 60.4%; difference, 2.9% [95% CI, 0.3% to 5.5%]), maternity care (69.7% vs 73.6%; difference, 3.8% [95

  19. Association Between Health Plan Exit From Medicaid Managed Care and Quality of Care, 2006-2014.

    PubMed

    Ndumele, Chima D; Schpero, William L; Schlesinger, Mark J; Trivedi, Amal N

    2017-06-27

    State Medicaid programs have increasingly contracted with insurers to provide medical care services for enrollees (Medicaid managed care plans). Insurers that provide these plans can exit Medicaid programs each year, with unclear effects on quality of care and health care experiences. To determine the frequency and interstate variation of health plan exit from Medicaid managed care and evaluate the relationship between health plan exit and market-level quality. Retrospective cohort of all comprehensive Medicaid managed care plans (N = 390) during the interval 2006-2014. Plan exit, defined as the withdrawal of a managed care plan from a state's Medicaid program. Eight measures from the Healthcare Effectiveness Data and Information Set were used to construct 3 composite indicators of quality (preventive care, chronic disease care management, and maternity care). Four measures from the Consumer Assessment of Healthcare Providers and Systems were combined into a composite indicator of patient experience, reflecting the proportion of beneficiaries rating experiences as 8 or above on a 0-to-10-point scale. Outcome data were available for 248 plans (68% of plans operating prior to 2014, representing 78% of beneficiaries). Of the 366 comprehensive Medicaid managed care plans operating prior to 2014, 106 exited Medicaid. These exiting plans enrolled 4 848 310 Medicaid beneficiaries, with a mean of 606 039 beneficiaries affected by plan exits annually. Six states had a mean of greater than 10% of Medicaid managed care recipients enrolled in plans that exited, whereas 10 states experienced no plan exits. Plans that exited from a state's Medicaid market performed significantly worse prior to exiting than those that remained in terms of preventive care (57.5% vs 60.4%; difference, 2.9% [95% CI, 0.3% to 5.5%]), maternity care (69.7% vs 73.6%; difference, 3.8% [95% CI, 1.7% to 6.0%]), and patient experience (73.5% vs 74.8%; difference, 1.3% [95% CI, 0.6% to 1

  20. Defense Depot Tracy Total Quality Management Plan

    DTIC Science & Technology

    1989-07-01

    PAGES TQM (Total Quality Management ), Depot Operations, Continuous Process Improvement 16. PRICE CODE 17. SECURITY CLASSIFICATION 18. SECURITY...make up our pcrceptions of Total Quality Management . Our goal is to improve those proven management processes that have brought us success while being...MANIAGEMENT F. QUALITY AUDITS OF PRODUCTS AND OPERATIONS ASSETS MANAGEMENT 00 i .......... / ~899 29 03 1 EFENSE DEPOT TACY TOTAL QUALITY MANAGEMENT PLAN

  1. Office of General Counsel Total Quality Management Plan

    DTIC Science & Technology

    1989-07-01

    20503. IRT DATE 3. REPORT TYPE AND DATES COVERED y 1989 5. FUNDING NUMBERS Office of General Counsel Total Quality Management Plan 6. AUTHOR(S) 7...of General Counsel. - r DTIC 65 LE- E CTEn’" SEP291 989 14. SUBJECT TERMS 15. NUMBER OF PAGES TQM (Total Quality Management ), Office of General...89) Pra-ifcr~bed ANSI Sid 139-1S ""-"’- ", ~ mmmmmu10n S S OFFICE OF GENERAL COUNSEL TOTAL QUALITY MANAGEMENT PLAN Acc’, ’ 7or. .?:" t ’_7 Codes K 89

  2. 40 CFR 35.925-2 - Water quality management plans and agencies.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Water quality management plans and... Water Act § 35.925-2 Water quality management plans and agencies. That the project is consistent with any applicable water quality management (WQM) plan approved under section 208 or section 303(e) of the...

  3. The CHPRC Groundwater and Technical Integration Support (Master Project) Quality Assurance Management Plan

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

    Fix, N. J.

    The scope of the CH2M Hill Plateau Remediation Company, LLC (CHPRC) Groundwater and Technical Integration Support (Master Project) is for Pacific Northwest National Laboratory staff to provide technical and integration support to CHPRC. This work includes conducting investigations at the 300-FF-5 Operable Unit and other groundwater operable units, and providing strategic integration, technical integration and assessments, remediation decision support, and science and technology. The projects under this Master Project will be defined and included within the Master Project throughout the fiscal year, and will be incorporated into the Master Project Plan. This Quality Assurance Management Plan provides the quality assurancemore » requirements and processes that will be followed by the CHPRC Groundwater and Technical Integration Support (Master Project) and all releases associated with the CHPRC Soil and Groundwater Remediation Project. The plan is designed to be used exclusively by project staff.« less

  4. 75 FR 65594 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-26

    ... Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality Standards AGENCY... the Ohio Administrative Code (OAC) relating to the consolidation of Ohio's Ambient Air Quality Standards (AAQS) into Ohio's State Implementation Plan (SIP) under the Clean Air Act. On April 8, 2009, and...

  5. 77 FR 12524 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Lead Ambient Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... Promulgation of Air Quality Implementation Plans; Indiana; Lead Ambient Air Quality Standards AGENCY... Indiana State Implementation Plan (SIP) for lead (Pb) under the Clean Air Act (CAA). This submittal incorporates the National Ambient Air Quality Standards (NAAQS) for Pb promulgated by EPA in 2008. DATES...

  6. Quality-assurance plan for water-quality activities in the North Florida Program Office, Florida District

    USGS Publications Warehouse

    Berndt, Marian P.; Katz, Brian G.

    2000-01-01

    In accordance with guidelines set forth by the Office of Water Quality in the Water Resources Division of the U.S. Geological Survey, a quality-assurance plan was created for use by the Florida District's North Florida Program Office in conducting water-quality activities. This plan documents the standards, policies, and procedures used by the North Florida Program Office for activities related to the collection, processing, storage, analysis, and publication of water-quality data.

  7. Quality Assessment of TPB-Based Questionnaires: A Systematic Review

    PubMed Central

    Oluka, Obiageli Crystal; Nie, Shaofa; Sun, Yi

    2014-01-01

    Objective This review is aimed at assessing the quality of questionnaires and their development process based on the theory of planned behavior (TPB) change model. Methods A systematic literature search for studies with the primary aim of TPB-based questionnaire development was conducted in relevant databases between 2002 and 2012 using selected search terms. Ten of 1,034 screened abstracts met the inclusion criteria and were assessed for methodological quality using two different appraisal tools: one for the overall methodological quality of each study and the other developed for the appraisal of the questionnaire content and development process. Both appraisal tools consisted of items regarding the likelihood of bias in each study and were eventually combined to give the overall quality score for each included study. Results 8 of the 10 included studies showed low risk of bias in the overall quality assessment of each study, while 9 of the studies were of high quality based on the quality appraisal of questionnaire content and development process. Conclusion Quality appraisal of the questionnaires in the 10 reviewed studies was successfully conducted, highlighting the top problem areas (including: sample size estimation; inclusion of direct and indirect measures; and inclusion of questions on demographics) in the development of TPB-based questionnaires and the need for researchers to provide a more detailed account of their development process. PMID:24722323

  8. Assessing Family Planning Service Quality And User Experiences In Social Franchising Programme - Case Studies From Two Rural Districts In Pakistan.

    PubMed

    Azmat, Syed Khurram; Ali, Moazzam; Hameed, Waqas; Awan, Muhammad Ali

    2018-01-01

    Studies have documented the impact of quality family planning services on improved contraceptive uptake and continuation, however, relatively little is known about their quality of service provision especially in the context of social franchising. This study examined the quality of clinical services and user experiences among two models in franchised service providers in rural Pakistan. This facility-based assessment was carried out during May-June 2015 at the 20 randomly selected social franchise providers from Chakwal and Faisalabad. In our case, a franchise health facility was a private clinic (mostly) run by a single provider, supported by an assistant. Within the selected health facilities, a total 39 user-provider interactions were observed and same users were interviewed separately. Most of the health facilities were in the private sector. Comparatively, service providers at Greenstar Social Marketing/Population Services International (GSM/PSI) model franchised facilities had higher number of rooms and staff employed, with more providers' ownership. Quality of service indices showed high scores for both Marie Stopes Society (MSS) and GSM/PSI franchised providers. MSS franchised providers demonstrated comparative edge in terms of clinical governance, better method mix and they were more user-focused, while PSI providers offered broader range of non-FP services. Quality of counselling services were similar among both models. Service providers performed well on all indicators of interpersonal care however overall low scores were noted in technical care. For both models, service providers attained an average score of 6.7 (out of the maximum value of 8) on waste disposal mechanism, supplies 12.5 (out of the maximum value of 15), user-centred facility 2.7 (out of the maximum value of 4), and clinical governance 6.5 (out of the maximum value of 11) and respecting clients' privacy. The exit interviews yielded high user satisfaction in both service models. The

  9. 40 CFR 58.10 - Annual monitoring network plan and periodic network assessment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 5 2011-07-01 2011-07-01 false Annual monitoring network plan and periodic network assessment. 58.10 Section 58.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) AMBIENT AIR QUALITY SURVEILLANCE Monitoring Network § 58.10 Annual...

  10. 40 CFR 58.10 - Annual monitoring network plan and periodic network assessment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 5 2010-07-01 2010-07-01 false Annual monitoring network plan and periodic network assessment. 58.10 Section 58.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) AMBIENT AIR QUALITY SURVEILLANCE Monitoring Network § 58.10 Annual...

  11. Effects of Case Manager Feedback on the Quality of Individual Habilitation Plan Objectives.

    ERIC Educational Resources Information Center

    Horner, Robert H.; And Others

    1990-01-01

    The functional relation between feedback and improved writing of Individual Habilitation Plan objectives in four adult service agencies serving the retarded was assessed. The agencies improved the quality of their written objectives after receiving feedback from the case manager and maintained those gains 18 months after feedback was terminated.…

  12. Approved Air Quality Implementation Plans in The Virgin Islands

    EPA Pesticide Factsheets

    This site contains information about air quality regulations called State Implementation Plans (SIPs), Federal Implementation Plans (FIPs), and Tribal Implementation Plans (TIPs) approved by EPA within the U.S. Virgin Islands.

  13. Texas Quality Workforce Planning: 1993 Key Industries and Targeted Occupations for Texas' 24 Quality Work Force Planning Regions.

    ERIC Educational Resources Information Center

    Texas State Dept. of Commerce, Austin.

    In 1993, Texas' 24 quality work force planning committees used a state-developed targeted occupations planning methodology to identify key industries and targeted occupations with the greatest potential for job openings in their respective regions. Between 11 and 20 key industries (13.5 on average) were identified for each region. The following 10…

  14. SU-E-T-654: Quantifying Plan Quality Can Effectively Distinguish Between Competing Equivocal IMRT Prostate Plans

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

    Price, A; Lo, J; Department of Radiology, Duke University Medical Center, Durham, NC

    2015-06-15

    Purpose: The purpose of this study was to create a prostate IMRT plan quality index (PQI) that may be used to quantitatively compare competing plans using a methodology that mimics physician preference. This methodology allows planners to choose between plans with equivocal characteristics, prior to physician scrutiny. Methods: An observer study was conducted to gather data from 3 radiation oncology physicians who ranked a set of 20 patients (each with 5 plans). The rankings were used to optimize a PQI that combined weighted portions of the rectum, bladder, and planning target volume DVHs, such that the relative PQI mimicked physicianmore » rankings as best as possible. Once optimized, a test study assessed the PQI by comparison to physician rankings in a new set of 25 patients (each with 4 plans). The physician group in the test study included 6 physicians, 5 of whom were not included in the modeling study. PQI scores were evaluated against the physicians’ rank list using Spearman rank correlation. Results: The optimized plan quality index combined the following DVH features: high dose regions above 40Gy/60Gy (rectum/bladder), organ weightings, and PTV shoulder coverage. Mean correlation of the PQI vs. physicians’ rankings in the modeling study was 0.507 (range: 0.345–0.706). By comparison, the mean correlation between physicians was 0.301 (range: 0.242–0.334). The mean correlation of the PQI vs. physician rankings in test study was 0.726 (range: 0.416–0.936), indicating robustness of the PQI by virtue of producing similar results to the modeling study. Intra-physician correlation was 0.564 (range: 0.398–0.689). Conclusion: The correlation coefficients of the PQI vs. physicians were similar to the correlation coefficients of the physicians with each other, implying that the PQI developed in this work shows promise in reflecting physician clinical preference when selecting between competing, dosimetrically equivocal plans.« less

  15. Quality Assurance Project Plan for Citizen Science Projects

    EPA Pesticide Factsheets

    The Quality Assurance Project Plan is necessary for every project that collects or uses environmental data. It documents the project planning process and serves as a blueprint for how your project will run.

  16. 78 FR 53270 - Revision of Air Quality Implementation Plan; California; Sacramento Metropolitan Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... Quality Implementation Plan; California; Sacramento Metropolitan Air Quality Management District... to the Sacramento Metropolitan Air Quality Management District (SMAQMD or District) portion of the..., Sacramento Metropolitan Air Quality Management District, Rule 214 (Federal New Source Review), Rule 203...

  17. 42 CFR 84.40 - Quality control plans; filing requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality... proposed quality control plan which shall be designed to assure the quality of respiratory protection...

  18. 42 CFR 84.40 - Quality control plans; filing requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality... proposed quality control plan which shall be designed to assure the quality of respiratory protection...

  19. 42 CFR 84.40 - Quality control plans; filing requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality... proposed quality control plan which shall be designed to assure the quality of respiratory protection...

  20. 42 CFR 84.40 - Quality control plans; filing requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality... proposed quality control plan which shall be designed to assure the quality of respiratory protection...

  1. 42 CFR 84.40 - Quality control plans; filing requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Quality... proposed quality control plan which shall be designed to assure the quality of respiratory protection...

  2. Air Pollution Monitoring | Air Quality Planning & Standards ...

    EPA Pesticide Factsheets

    2016-06-08

    The basic mission of the Office of Air Quality Planning and Standards is to preserve and improve the quality of our nation's air. To accomplish this, OAQPS must be able to evaluate the status of the atmosphere as compared to clean air standards and historical information.

  3. Integrating strategic environmental assessment with industry planning: a case study of the Pasquai-Porcupine forest management plan, Saskatchewan, Canada.

    PubMed

    Noble, Bram F

    2004-03-01

    Strategic environmental assessment (SEA) is gaining widespread recognition as a tool for integrating environmental considerations in policy, plan, and program development and decision-making. Notwithstanding the potential of SEA to improve higher-order decision processes, there has been very little attention given to integrating SEA with industry planning practices. As a result, the benefits of SEA have yet to be fully realized among industrial proponents. That said, SEA practice is ongoing, albeit informally and often under a different label, and is proving to be a valuable tool for industry planning and decision-making. Based on a case study of the Pasquai-Porcupine forest management plan in Saskatchewan, Canada, this paper illustrates how an integrated approach to SEA can contribute to industry environmental decision-making and can enhance the quality and deliverability of industry plans.

  4. Self-guided training for deep brain stimulation planning using objective assessment.

    PubMed

    Holden, Matthew S; Zhao, Yulong; Haegelen, Claire; Essert, Caroline; Fernandez-Vidal, Sara; Bardinet, Eric; Ungi, Tamas; Fichtinger, Gabor; Jannin, Pierre

    2018-04-04

    Deep brain stimulation (DBS) is an increasingly common treatment for neurodegenerative diseases. Neurosurgeons must have thorough procedural, anatomical, and functional knowledge to plan electrode trajectories and thus ensure treatment efficacy and patient safety. Developing this knowledge requires extensive training. We propose a training approach with objective assessment of neurosurgeon proficiency in DBS planning. To assess proficiency, we propose analyzing both the viability of the planned trajectory and the manner in which the operator arrived at the trajectory. To improve understanding, we suggest a self-guided training course for DBS planning using real-time feedback. To validate the proposed measures of proficiency and training course, two experts and six novices followed the training course, and we monitored their proficiency measures throughout. At baseline, experts planned higher quality trajectories and did so more efficiently. As novices progressed through the training course, their proficiency measures increased significantly, trending toward expert measures. We developed and validated measures which reliably discriminate proficiency levels. These measures are integrated into a training course, which quantitatively improves trainee performance. The proposed training course can be used to improve trainees' proficiency, and the quantitative measures allow trainees' progress to be monitored.

  5. ICP Corporate Customer Assessment - Sampling Plan

    DTIC Science & Technology

    1995-07-01

    CORPORATE CUSTOMER ASSESSMENT - SAMPLING PLAN JULY 1995 Lead Analyst: Lieutenant Commander William J. Wilkinson, USN Associate Analyst: Mr. Henry J...project developed a plan for conducting recurring surveys of Defense Logistics Agency customers , in support of the DLA Corporate Customer Assessment...Team. The primary product was a sampling plan, including stratification of customers by Military Service or Federal Agency and by commodity purchased

  6. A semi-automated tool for treatment plan-quality evaluation and clinical trial quality assurance

    NASA Astrophysics Data System (ADS)

    Wang, Jiazhou; Chen, Wenzhou; Studenski, Matthew; Cui, Yunfeng; Lee, Andrew J.; Xiao, Ying

    2013-07-01

    The goal of this work is to develop a plan-quality evaluation program for clinical routine and multi-institutional clinical trials so that the overall evaluation efficiency is improved. In multi-institutional clinical trials evaluating the plan quality is a time-consuming and labor-intensive process. In this note, we present a semi-automated plan-quality evaluation program which combines MIMVista, Java/MATLAB, and extensible markup language (XML). More specifically, MIMVista is used for data visualization; Java and its powerful function library are implemented for calculating dosimetry parameters; and to improve the clarity of the index definitions, XML is applied. The accuracy and the efficiency of the program were evaluated by comparing the results of the program with the manually recorded results in two RTOG trials. A slight difference of about 0.2% in volume or 0.6 Gy in dose between the semi-automated program and manual recording was observed. According to the criteria of indices, there are minimal differences between the two methods. The evaluation time is reduced from 10-20 min to 2 min by applying the semi-automated plan-quality evaluation program.

  7. Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement.

    PubMed

    Mpunga, Dieudonné; Lumbayi, J P; Dikamba, Nelly; Mwembo, Albert; Ali Mapatano, Mala; Wembodinga, Gilbert

    2017-06-27

    To determine the availability and quality of family planning services within health facilities throughout the Democratic Republic of the Congo (DRC). Data were collected for the cross-sectional study from April 2014 to June 2014 by the Ministry of Public Health. A total of 1,568 health facilities that reported data to the National Health Information System were selected by multistage random sampling in the 11 provinces of the DRC existing at that time. Data were collected through interviews, document review, and direct observation. Two dependent variables were measured: availability of family planning services (consisting of a room for services, staff assigned to family planning, and evidence of client use of family planning) and quality of family planning services (assessed as "high" if the facility had at least 1 trained staff member, family planning service delivery guidelines, at least 3 types of methods, and a sphygmomanometer, or "low" if the facility did not meet any of these 4 criteria). Pearson's chi-square test and odds ratios (ORs) were used to test for significant associations, using the alpha significance level of .05. We successfully surveyed 1,555 facilities (99.2%) of those included in the sample. One in every 3 facilities (33%) offered family planning services as assessed by the index of availability, of which 20% met all 4 criteria for providing high-quality services. Availability was greatest at the highest level of the health system (hospitals) and decreased incrementally with each health system level, with disparities between provinces and urban and rural areas. Facilities in urban areas were more likely than in rural areas to meet the standard for high-quality services ( P <.001). Public facilities were less likely than private facilities to have high-quality services ( P =.02). Among all 1,555 facilities surveyed, 14% had at least 3 types of methods available at the time of the survey; the most widely available methods were male condoms

  8. Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement

    PubMed Central

    Mpunga, Dieudonné; Lumbayi, JP; Dikamba, Nelly; Mwembo, Albert; Ali Mapatano, Mala; Wembodinga, Gilbert

    2017-01-01

    Objective: To determine the availability and quality of family planning services within health facilities throughout the Democratic Republic of the Congo (DRC). Methods: Data were collected for the cross-sectional study from April 2014 to June 2014 by the Ministry of Public Health. A total of 1,568 health facilities that reported data to the National Health Information System were selected by multistage random sampling in the 11 provinces of the DRC existing at that time. Data were collected through interviews, document review, and direct observation. Two dependent variables were measured: availability of family planning services (consisting of a room for services, staff assigned to family planning, and evidence of client use of family planning) and quality of family planning services (assessed as “high” if the facility had at least 1 trained staff member, family planning service delivery guidelines, at least 3 types of methods, and a sphygmomanometer, or “low” if the facility did not meet any of these 4 criteria). Pearson's chi-square test and odds ratios (ORs) were used to test for significant associations, using the alpha significance level of .05. Results: We successfully surveyed 1,555 facilities (99.2%) of those included in the sample. One in every 3 facilities (33%) offered family planning services as assessed by the index of availability, of which 20% met all 4 criteria for providing high-quality services. Availability was greatest at the highest level of the health system (hospitals) and decreased incrementally with each health system level, with disparities between provinces and urban and rural areas. Facilities in urban areas were more likely than in rural areas to meet the standard for high-quality services (P<.001). Public facilities were less likely than private facilities to have high-quality services (P=.02). Among all 1,555 facilities surveyed, 14% had at least 3 types of methods available at the time of the survey; the most widely

  9. Quality Assurance Project Plan Development Tool

    EPA Pesticide Factsheets

    This tool contains information designed to assist in developing a Quality Assurance (QA) Project Plan that meets EPA requirements for projects that involve surface or groundwater monitoring and/or the collection and analysis of water samples.

  10. DLA-X Total Quality Management (TQM) Implementation Plan

    DTIC Science & Technology

    1989-07-01

    PAGES TOM (Total Quality Management ), Continuous Process Improvement.( .) 4L-- Administration 16. PRICE CODE 17. SECURITY CLASSIFICATION 18. SECURITY...NSN 7540-01-280-5500 Standard Form 298 (Rev. 2-89) Pr.-cr,bed by ANSI Std ,,fl.f 296-102 DLA-X TOTAL QUALITY MANAGEMENT (TQM) IMPLEMENTATION PLAN o...application of proven Total Quality Management techniques. Quality Policy: Responsibility for quality is delegated to every employee ;11 DLA-X. Every

  11. Process quality planning of quality function deployment for carrot syrup

    NASA Astrophysics Data System (ADS)

    Ekawati, Yurida; Noya, Sunday; Widjaja, Filemon

    2017-06-01

    Carrot products are rarely available in the market. Based on previous research that had been done using QFD to generate product design of carrots products, the research to produce the process quality planning had been carried out. The carrot product studied was carrot syrup. The research resulted in a process planning matrix for carrot syrup. The matrix gives information about critical process plan and the priority of the critical process plan. The critical process plan on the production process of carrot syrup consists of carrots sorting, carrots peeling, carrots washing, blanching process, carrots cutting, the making of pureed carrots, filtering carrot juice, the addition of sugar in carrot juice, the addition of food additives in carrot juice, syrup boiling, syrup filtering, syrup filling into the bottle, the bottle closure and cooling. The information will help the design of the production process of carrot syrup.

  12. Hurricane Sandy science plan: coastal impact assessments

    USGS Publications Warehouse

    Stronko, Jakob M.

    2013-01-01

    Hurricane Sandy devastated some of the most heavily populated eastern coastal areas of the Nation. With a storm surge peaking at more than 19 feet, the powerful landscape-altering destruction of Hurricane Sandy is a stark reminder of why the Nation must become more resilient to coastal hazards. In response to this natural disaster, the U.S. Geological Survey (USGS) received a total of $41.2 million in supplemental appropriations from the Department of the Interior (DOI) to support response, recovery, and rebuilding efforts. These funds support a science plan that will provide critical scientific information necessary to inform management decisions for recovery of coastal communities, and aid in preparation for future natural hazards. This science plan is designed to coordinate continuing USGS activities with stakeholders and other agencies to improve data collection and analysis that will guide recovery and restoration efforts. The science plan is split into five distinct themes: coastal topography and bathymetry, impacts to coastal beaches and barriers, impacts of storm surge, including disturbed estuarine and bay hydrology, impacts on environmental quality and persisting contaminant exposures, impacts to coastal ecosystems, habitats, and fish and wildlife. This fact sheet focuses assessing impacts to coastal beaches and barriers.

  13. Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project) Quality Assurance Management Plan

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

    Fix, N. J.

    The scope of the Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project) is to provide technical and integration support to Fluor Hanford, Inc., including operable unit investigations at 300-FF-5 and other groundwater operable units, strategic integration, technical integration and assessments, remediation decision support, and science and technology. This Quality Assurance Management Plan provides the quality assurance requirements and processes that will be followed by the Fluor Hanford, Inc. Groundwater and Technical Integration Support (Master Project).

  14. 76 FR 23755 - Release of Draft Risk and Exposure Assessments and Final Integrated Review Plan for the National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-28

    ... titled, ``Ozone National Ambient Air Quality Standards: Scope and Methods Plan for Health Risk and... Standards: Scope and Methods Plan for Welfare Risk and Exposure Assessment'' (REA Plan for the secondary... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Parts 50 and 58 [EPA-HQ-OAR-2008-0699; FRL-9300-4] RIN 2060...

  15. Measuring migraine-related quality of care across 10 health plans.

    PubMed

    Pracilio, Valerie P; Silberstein, Stephen; Couto, Joseph; Bumbaugh, Jon; Hopkins, Mary; Ng-Mak, Daisy; Sennett, Cary; Goldfarb, Neil I

    2012-08-01

    To refine a previously published standardized quality and utilization measurement set for migraine care and to establish performance benchmarks. Retrospective application of the migraine measurement set to health plan data in order to assess patterns of health service utilization. Measurement specifications were applied to data from 10 health plans for measurement year 2009. Of the 2.9 million continuously enrolled members of the health plans, 138,004 (4.7%) met inclusion criteria for the migraine population. Of these, 26% did not have a migraine diagnosis, but were utilizing migraine drugs; 12% had a computed tomography scan within the year (range 8%-25% across plans); and 8% had magnetic resonance imaging (range 6%-11%). Nearly 18% of the migraineurs had 1 or more visits to an emergency department/urgent care center for migraine; few (6%) were followed up with primary care visits. Approximately one-fourth of the migraineurs were not being routinely monitored by a physician. Medication utilization also was examined for members of the migraine population with pharmacy benefits. A significant proportion (42%) were given a migraine preventive, 38% had at least 1 prescription for a triptan, and 2% of those on triptans were potentially overutilizing the medication. Among patients aged 18 to 49 years who were given triptans, 3% had a cardiac contraindication; this percentage rose to 7% for patients aged 50 to 64 years. This study demonstrates the value of standardized measures in identifying potential quality issues for migraine care, including underdiagnosis, overutilization of imaging, and underutilization of preventive drugs.

  16. Air Quality Planning Unit | Ground-level Ozone | New England ...

    EPA Pesticide Factsheets

    2017-09-05

    Looking for answers about a specific air quality issue? Here's a list of topics and programs related to air quality and Air Quality Planning (AQP) staff who can answer questions and provide information about them.

  17. Air Quality Planning Unit | Ground-level Ozone | New England ...

    EPA Pesticide Factsheets

    2017-04-10

    Looking for answers about a specific air quality issue? Here's a list of topics and programs related to air quality and Air Quality Planning (AQP) staff who can answer questions and provide information about them.

  18. Assessment of the Monitor Unit Objective tool for VMAT in the Eclipse treatment planning system.

    PubMed

    Jiménez-Puertas, Sara; Sánchez-Artuñedo, David; Hermida-López, Marcelino

    2018-01-01

    This work aims to achieve the highest possible monitor units (MU) reduction using the MU Objective tool included in the Eclipse treatment planning system, while preserving the plan quality. The treatment planning system Eclipse (Varian Medical Systems, Palo Alto, CA) includes a control mechanism for the number of monitor units of volumetric modulated arc therapy (VMAT) plans, named the MU Objective tool. Forty prostate plans, 20 gynecological plans and 20 head and neck plans designed with VMAT were retrospectively studied. Each plan ( base plan ) was optimized without using the MU Objective tool, and it was re-optimized with different values of the Maximum MU ( MaxMU ) parameter of the MU Objective tool. MU differences were analyzed with a paired samples t -test and changes in plan quality were assessed with a set of parameters for OARs and PTVs. The average relative MU difference [Formula: see text] considering all treatment sites, was the highest when MaxMU  = 400 (-4.2%, p  < 0.001). For prostate plans, the lowest [Formula: see text] was obtained (-3.7%, p  < 0.001). For head and neck plans [Formula: see text] was -7.3% ( p  < 0.001) and for gynecological plans [Formula: see text] was 7.0% ( p  = 0.002). Although similar MU reductions were observed for both sites, for some gynecological plans maximum differences were greater than 10%. All the assessed parameters for PTVs and OARs sparing showed average differences below 2%. For the three studied clinical sites, establishing MaxMU  = 400 led to the optimum MU reduction, maintaining the original dose distribution and dosimetric parameters practically unaltered.

  19. Total Quality Management Implementation Plan: Defense Depot, Ogden

    DTIC Science & Technology

    1989-07-01

    NUMBERS Total Quality Management Implementation Plan Defense Depot Ogden 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING...PAGES TQM (Total Quality Management ), Continuous Process Improvement, Depot Operations, Process Action Teams 16. PRICE CODE 17. SECURITY...034 A Message From The Commander On Total Quality Management i fully support the DLA aoproacii to Total Quality Management . As stated by General

  20. Internal quality control: planning and implementation strategies.

    PubMed

    Westgard, James O

    2003-11-01

    The first essential in setting up internal quality control (IQC) of a test procedure in the clinical laboratory is to select the proper IQC procedure to implement, i.e. choosing the statistical criteria or control rules, and the number of control measurements, according to the quality required for the test and the observed performance of the method. Then the right IQC procedure must be properly implemented. This review focuses on strategies for planning and implementing IQC procedures in order to improve the quality of the IQC. A quantitative planning process is described that can be implemented with graphical tools such as power function or critical-error graphs and charts of operating specifications. Finally, a total QC strategy is formulated to minimize cost and maximize quality. A general strategy for IQC implementation is recommended that employs a three-stage design in which the first stage provides high error detection, the second stage low false rejection and the third stage prescribes the length of the analytical run, making use of an algorithm involving the average of normal patients' data.

  1. Comprehensive Care Plan Development Using Resident Assessment Instrument Framework: Past, Present, and Future Practices

    PubMed Central

    Dellefield, Mary Ellen; Corazzini, Kirsten

    2015-01-01

    Development of the comprehensive care plan (CCP) is a requirement for nursing homes participating in the federal Medicare and Medicaid programs, referred to as skilled nursing facilities. The plan must be developed within the context of the comprehensive interdisciplinary assessment framework—the Resident Assessment Instrument (RAI). Consistent compliance with this requirement has been difficult to achieve. To improve the quality of CCP development within this framework, an increased understanding of complex factors contributing to inconsistent compliance is required. In this commentary, we examine the history of the comprehensive care plan; its development within the RAI framework; linkages between the RAI and registered nurse staffing; empirical evidence of the CCP’s efficacy; and the limitations of extant standards of practices in CCP development. Because of the registered nurse’s educational preparation, professional practice standards, and licensure obligations, the essential contributions of professional nurses in CCP development are emphasized. Recommendations for evidence-based micro and macro level practice changes with the potential to improve the quality of CCP development and regulatory compliance are presented. Suggestions for future research are given. PMID:27417811

  2. A broad scope knowledge based model for optimization of VMAT in esophageal cancer: validation and assessment of plan quality among different treatment centers.

    PubMed

    Fogliata, Antonella; Nicolini, Giorgia; Clivio, Alessandro; Vanetti, Eugenio; Laksar, Sarbani; Tozzi, Angelo; Scorsetti, Marta; Cozzi, Luca

    2015-10-31

    To evaluate the performance of a broad scope model-based optimisation process for volumetric modulated arc therapy applied to esophageal cancer. A set of 70 previously treated patients in two different institutions, were selected to train a model for the prediction of dose-volume constraints. The model was built with a broad-scope purpose, aiming to be effective for different dose prescriptions and tumour localisations. It was validated on three groups of patients from the same institution and from another clinic not providing patients for the training phase. Comparison of the automated plans was done against reference cases given by the clinically accepted plans. Quantitative improvements (statistically significant for the majority of the analysed dose-volume parameters) were observed between the benchmark and the test plans. Of 624 dose-volume objectives assessed for plan evaluation, in 21 cases (3.3 %) the reference plans failed to respect the constraints while the model-based plans succeeded. Only in 3 cases (<0.5 %) the reference plans passed the criteria while the model-based failed. In 5.3 % of the cases both groups of plans failed and in the remaining cases both passed the tests. Plans were optimised using a broad scope knowledge-based model to determine the dose-volume constraints. The results showed dosimetric improvements when compared to the benchmark data. Particularly the plans optimised for patients from the third centre, not participating to the training, resulted in superior quality. The data suggests that the new engine is reliable and could encourage its application to clinical practice.

  3. Risk adjusting community rated health plan premiums: a survey of risk assessment literature and policy applications.

    PubMed

    Giacomini, M; Luft, H S; Robinson, J C

    1995-01-01

    This paper surveys recent health care reform debates and empirical evidence regarding the potential role for risk adjusters in addressing the problem of competitive risk segmentation under capitated financing. We discuss features of health plan markets affecting risk selection, methodological considerations in measuring it, and alternative approaches to financial correction for risk differentials. The appropriate approach to assessing risk differences between health plans depends upon the nature of market risk selection allowed under a given reform scenario. Because per capita costs depend on a health plan's population risk, efficiency, and quality of service, risk adjustment will most strongly promote efficiency in environments with commensurately strong incentives for quality care.

  4. CONSUMER ASSESSMENT OF HEALTH PLANS SURVEY (CAHPS)

    EPA Science Inventory

    This 5-year project has been used for consumers to identify the best health care plans and services for their needs. The goals of the Consumer Assessment of Health Plans (CAHPS?) are to (1) develop and test questionnaires that assess health plans and services, (2) produce easily ...

  5. A comprehensive comparison of IMRT and VMAT plan quality for prostate cancer treatment

    PubMed Central

    QUAN, ENZHUO M.; LI, XIAOQIANG; LI, YUPENG; WANG, XIAOCHUN; KUDCHADKER, RAJAT J.; JOHNSON, JENNIFER L.; KUBAN, DEBORAH A.; LEE, ANDREW K.; ZHANG, XIAODONG

    2013-01-01

    Purpose We performed a comprehensive comparative study of the plan quality between volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) for the treatment of prostate cancer. Methods and Materials Eleven patients with prostate cancer treated at our institution were randomly selected for this study. For each patient, a VMAT plan and a series of IMRT plans using an increasing number of beams (8, 12, 16, 20, and 24 beams) were examined. All plans were generated using our in-house-developed automatic inverse planning (AIP) algorithm. An existing 8-beam clinical IMRT plan, which was used to treat the patient, was used as the reference plan. For each patient, all AIP-generated plans were optimized to achieve the same level of planning target volume (PTV) coverage as the reference plan. Plan quality was evaluated by measuring mean dose to and dose-volume statistics of the organs-at-risk, especially the rectum, from each type of plan. Results For the same PTV coverage, the AIP-generated VMAT plans had significantly better plan quality in terms of rectum sparing than the 8-beam clinical and AIP-generated IMRT plans (p < 0.0001). However, the differences between the IMRT and VMAT plans in all the dosimetric indices decreased as the number of beams used in IMRT increased. IMRT plan quality was similar or superior to that of VMAT when the number of beams in IMRT was increased to a certain number, which ranged from 12 to 24 for the set of patients studied. The superior VMAT plan quality resulted in approximately 30% more monitor units than the 8-beam IMRT plans, but the delivery time was still less than 3 minutes. Conclusions Considering the superior plan quality as well as the delivery efficiency of VMAT compared with that of IMRT, VMAT may be the preferred modality for treating prostate cancer. PMID:22704703

  6. Total Quality Management Implementation Plan: DLA-N

    DTIC Science & Technology

    1989-07-01

    e Wastimto , n. Othe 20 Seato3 4. TITLE AND SUBTITLE S. FUNDING NUMBERS DLA-N Total Quality Management 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S...PAGES TQM (Total Quality Management ), Continuous Process Improvement.(; , Defense National Stockpile 16. PRICE CODEI17. SECURITY CLASSIFICATION 18...IUNCLASSIFIED UL NSN 7540-01-280-5500 Standard Form 298 (Rev. 2-89) pr"!Cbed ty ANSI Std Z39’B6 296-102 DLA - N TOTAL QUALITY MANAGEMENT IMPLEMENTATION PLAN I

  7. SU-E-T-43: A Methodology for Quality Control of IMPT Treatment Plan Based On VMAT Plan

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

    Jiang, S; Tianjin Medical University Cancer Institute and Hospital; Yang, Y

    Purpose: IMPT plan design is highly dependent on planner’s experiences. VMAT plan design is relatively mature and can even be automated. The quality of IMPT plan designed by in-experienced planner could be inferior to that of VMAT plan designed by experienced planner or automatic planning software. Here we introduce a method for designing IMPT plan based on VMAT plan to ensure the IMPT plan be superior to IMRT/VMAT plan for majority clinical scenario. Methods: To design a new IMPT plan, a VMAT plan is first generated either by experienced planner or by in-house developed automatic planning system. An in-house developedmore » tool is used to generate the dose volume constrains for the IMPT plan as plan template to Eclipse TPS. The beam angles for IMPT plan are selected based on the preferred angles in the VMAT plan. IMPT plan is designed by importing the plan objectives generated from VMAT plan. Majority thoracic IMPT plans are designed using this plan approach in our center. In this work, a thoracic IMPT plan under RTOG 1308 protocol is selected to demonstrate the effectiveness and efficiency of this approach. The dosimetric indices of IMPT are compared with VMAT plan. Results: The PTV D95, lung V20, MLD, mean heart dose, esophagus D1, cord D1 are 70Gy, 31%, 17.8Gy, 25.5Gy, 73Gy, 45Gy for IMPT plan and 65.3Gy, 34%, 21.6Gy, 35Gy, 74Gy, 48Gy for VMAT plan. For majority cases, the high dose region of the normal tissue which is in proximity of PTV is comparable between IMPT and VMAT plan. The low dose region of the IMPT plan is significantly better than VMAT plan. Conclusion: Using the knowledge gained in VMAT plan design can help efficiently and effectively design high quality IMPT plan. The quality of IMPT plan can be controlled to ensure the superiority of IMPT plan compared to VMAT/IMRT plan.« less

  8. A global quality assurance system for personalized radiation therapy treatment planning for the prostate (or other sites)

    NASA Astrophysics Data System (ADS)

    Nwankwo, Obioma; Sihono, Dwi Seno K.; Schneider, Frank; Wenz, Frederik

    2014-09-01

    Introduction: the quality of radiotherapy treatment plans varies across institutions and depends on the experience of the planner. For the purpose of intra- and inter-institutional homogenization of treatment plan quality, we present an algorithm that learns the organs-at-risk (OARs) sparing patterns from a database of high quality plans. Thereafter, the algorithm predicts the dose that similar organs will receive in future radiotherapy plans prior to treatment planning on the basis of the anatomies of the organs. The predicted dose provides the basis for the individualized specification of planning objectives, and for the objective assessment of the quality of radiotherapy plans. Materials and method: one hundred and twenty eight (128) Volumetric Modulated Arc Therapy (VMAT) plans were selected from a database of prostate cancer plans. The plans were divided into two groups, namely a training set that is made up of 95 plans and a validation set that consists of 33 plans. A multivariate analysis technique was used to determine the relationships between the positions of voxels and their dose. This information was used to predict the likely sparing of the OARs of the plans of the validation set. The predicted doses were visually and quantitatively compared to the reference data using dose volume histograms, the 3D dose distribution, and a novel evaluation metric that is based on the dose different test. Results: a voxel of the bladder on the average receives a higher dose than a voxel of the rectum in optimized radiotherapy plans for the treatment of prostate cancer in our institution if both voxels are at the same distance to the PTV. Based on our evaluation metric, the predicted and reference dose to the bladder agree to within 5% of the prescribed dose to the PTV in 18 out of 33 cases, while the predicted and reference doses to the rectum agree to within 5% in 28 out of the 33 plans of the validation set. Conclusion: We have described a method to predict the

  9. Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

    PubMed Central

    2011-01-01

    Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health

  10. Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

    PubMed

    Hutchinson, Paul L; Do, Mai; Agha, Sohail

    2011-08-24

    Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory

  11. QUALITY MANAGEMENT PLAN FOR THE NATIONAL CHILDREN'S STUDY

    EPA Science Inventory

    EPA has taken the lead, in consort with NIH, in developing the Quality Management Plan (QMP) for the National Children's Study (NCS); the QMP will delineate a systematic planning process for the implementation of the NCS. The QMP will state the goals and objectives of the NCS, th...

  12. Ecocity mapping using GIS: introducing a planning method for assessing and improving neighborhood vitality.

    PubMed

    Smith, Richard; Miller, Kirstin

    2013-01-01

    Assessing neighborhood vitality is important to understanding how to improve quality of life and health outcomes. The ecocity model recognizes that cities are part of natural systems and favors walkable neighborhoods. This article introduces ecocity mapping, an innovative planning method, to the public health literature on community engagement by describing a pilot project with a new affordable housing development in Oakland, California between 2007 and 2009. Although ecocity mapping began as a paper technology, advances in geographic information systems (GIS) moved it forward. This article describes how Ecocity Builders used GIS to conduct ecocity mapping to (1) assess vitality of neighborhoods and urban centers to prioritize community health intervention pilot sites and (2) create scenario maps for use in community health planning. From fall 2007 to summer 2008, Ecocity Builders assessed neighborhood vitality using walking distance from parks, schools, rapid transit stops, grocery stores, and retail outlets. In 2008, ecocity maps were shared with residents to create a neighborhood health and sustainability plan. In 2009, Ecocity Builders developed scenario maps to show how changes to the built environment would improve air quality by reducing greenhouse gas emissions from vehicles, while increasing access to basic services and natural amenities. Community organizing with GIS was more useful than GIS alone for final site selection. GIS was useful in mapping scenarios after residents shared local neighborhood knowledge and ideas for change. Residents were interested in long-term environmental planning, provided they could meet immediate needs.

  13. Principles and Practices for Quality Assurance and Quality Control

    USGS Publications Warehouse

    Jones, Berwyn E.

    1999-01-01

    Quality assurance and quality control are vital parts of highway runoff water-quality monitoring projects. To be effective, project quality assurance must address all aspects of the project, including project management responsibilities and resources, data quality objectives, sampling and analysis plans, data-collection protocols, data quality-control plans, data-assessment procedures and requirements, and project outputs. Quality control ensures that the data quality objectives are achieved as planned. The historical development and current state of the art of quality assurance and quality control concepts described in this report can be applied to evaluation of data from prior projects.

  14. Achieving performance breakthroughs in an HMO business process through quality planning.

    PubMed

    Hanan, K B

    1993-01-01

    Kaiser Permanente's Georgia Region commissioned a quality planning team to design a new process to improve payments to its suppliers and vendors. The result of the team's effort was a 73 percent reduction in cycle time. This team's experiences point to the advantages of process redesign as a quality planning model, as well as some general guidelines for its most effective use in teams. If quality planning project teams are carefully configured, sufficiently expert in the existing process, and properly supported by management, organizations can achieve potentially dramatic improvements in process performance using this approach.

  15. DATA QUALITY OBJECTIVES IN RESEARCH PLANNING AT MED: THREE CASE STUDIES

    EPA Science Inventory

    This course will give a quality assurance perspective to research planning by describing the Data Quality Objective Process....Written plans are mandatory for all EPA environmental data collection activities according to EPA Order 5360.1 CHG 1 and Federal Acquisition Regulations,...

  16. Standard Review Plan for Environmental Restoration Program Quality Management Plans. Revision 2

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

    Not Available

    1993-12-01

    The Department of Energy, Richland Operations Office (RL) Manual Environmental Restoration Program Quality System Requirements (QSR) for the Hanford Site, defines all quality requirements governing Hanford Environmental Restoration (ER) Program activities. The QSR requires that ER Program participants develop Quality Management Plans (QMPs) that describe how the QSR requirements will be implemented for their assigned scopes of work. This standard review plan (SRP) describes the ER program participant responsibilities for submittal of QMPs to the RL Environmental Restoration Division for review and the RL methodology for performing the reviews of participant QMPS. The SRP serves the following functions: acts asmore » a guide in the development or revision of QMPs to assure that the content is complete and adequate; acts as a checklist to be used by the RL staff in their review of participant QMPs; acts as an index or matrix between the requirements of the QSR and implementing methodologies described in the QMPs; decreases the time and subjectivity of document reviews; and provides a formal, documented method for describing exceptions, modifications, or waivers to established ER Program quality requirements.« less

  17. Design and realization of high quality prime farmland planning and management information system

    NASA Astrophysics Data System (ADS)

    Li, Manchun; Liu, Guohong; Liu, Yongxue; Jiang, Zhixin

    2007-06-01

    The article discusses the design and realization of a high quality prime farmland planning and management information system based on SDSS. Models in concept integration, management planning are used in High Quality Prime Farmland Planning in order to refine the current model system and the management information system is deigned with a triangular structure. Finally an example of Tonglu county high quality prime farmland planning and management information system is introduced.

  18. 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

  19. The ends of uncertainty: Air quality science and planning in Central California

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

    Fine, James

    Air quality planning in Central California is complicated and controversial despite millions of dollars invested to improve scientific understanding. This research describes and critiques the use of photochemical air quality simulation modeling studies in planning to attain standards for ground-level ozone in the San Francisco Bay Area and the San Joaquin Valley during the 1990's. Data are gathered through documents and interviews with planners, modelers, and policy-makers at public agencies and with representatives from the regulated and environmental communities. Interactions amongst organizations are diagramed to identify significant nodes of interaction. Dominant policy coalitions are described through narratives distinguished by theirmore » uses of and responses to uncertainty, their exposures to risks, and their responses to the principles of conservatism, civil duty, and caution. Policy narratives are delineated using aggregated respondent statements to describe and understand advocacy coalitions. I found that models impacted the planning process significantly, but were used not purely for their scientific capabilities. Modeling results provided justification for decisions based on other constraints and political considerations. Uncertainties were utilized opportunistically by stakeholders instead of managed explicitly. Ultimately, the process supported the partisan views of those in control of the modeling. Based on these findings, as well as a review of model uncertainty analysis capabilities, I recommend modifying the planning process to allow for the development and incorporation of uncertainty information, while addressing the need for inclusive and meaningful public participation. By documenting an actual air quality planning process these findings provide insights about the potential for using new scientific information and understanding to achieve environmental goals, most notably the analysis of uncertainties in modeling applications. Concurrently

  20. Draft Plan for Development of the Integrated Science Assessment for Nitrogen Oxides - Health Criteria

    EPA Science Inventory

    EPA has announced a draft development plan for the next Integrated Science Assessment (ISA) for the health effects of nitrogen oxides (NOX) which will serve as the scientific basis for review of the primary (health-based) National Ambient Air Quality Standard for nitrogen dioxide...

  1. Innovative Stormwater Quality Tools by SARA for Holistic Watershed Master Planning

    NASA Astrophysics Data System (ADS)

    Thomas, S. M.; Su, Y. C.; Hummel, P. R.

    2016-12-01

    Stormwater management strategies such as Best Management Practices (BMP) and Low-Impact Development (LID) have increasingly gained attention in urban runoff control, becoming vital to holistic watershed master plans. These strategies can help address existing water quality impairments and support regulatory compliance, as well as guide planning and management of future development when substantial population growth and urbanization is projected to occur. However, past efforts have been limited to qualitative planning due to the lack of suitable tools to conduct quantitative assessment. The San Antonio River Authority (SARA), with the assistance of Lockwood, Andrews & Newnam, Inc. (LAN) and AQUA TERRA Consultants (a division of RESPEC), developed comprehensive hydrodynamic and water quality models using the Hydrological Simulation Program-FORTRAN (HSPF) for several urban watersheds in the San Antonio River Basin. These models enabled watershed management to look at water quality issues on a more refined temporal and spatial scale than the limited monitoring data. They also provided a means to locate and quantify potential water quality impairments and evaluate the effects of mitigation measures. To support the models, a suite of software tools were developed. including: 1) SARA Timeseries Utility Tool for managing and processing of large model timeseries files, 2) SARA Load Reduction Tool to determine load reductions needed to achieve screening levels for each modeled constituent on a sub-basin basis, and 3) SARA Enhanced BMP Tool to determine the optimal combination of BMP types and units needed to achieve the required load reductions. Using these SARA models and tools, water quality agencies and stormwater professionals can determine the optimal combinations of BMP/LID to accomplish their goals and save substantial stormwater infrastructure and management costs. The tools can also help regulators and permittees evaluate the feasibility of achieving compliance

  2. Assessment of shrimp farming impact on groundwater quality using analytical hierarchy process

    NASA Astrophysics Data System (ADS)

    Anggie, Bernadietta; Subiyanto, Arief, Ulfah Mediaty; Djuniadi

    2018-03-01

    Improved shrimp farming affects the groundwater quality conditions. Assessment of shrimp farming impact on groundwater quality conventionally has less accuracy. This paper presents the implementation of Analytical Hierarchy Process (AHP) method for assessing shrimp farming impact on groundwater quality. The data used is the impact data of shrimp farming in one of the regions in Indonesia from 2006-2016. Criteria used in this study were 8 criteria and divided into 49 sub-criteria. The weighting by AHP performed to determine the importance level of criteria and sub-criteria. Final priority class of shrimp farming impact were obtained from the calculation of criteria's and sub-criteria's weights. The validation was done by comparing priority class of shrimp farming impact and water quality conditions. The result show that 50% of the total area was moderate priority class, 37% was low priority class and 13% was high priority class. From the validation result impact assessment for shrimp farming has been high accuracy to the groundwater quality conditions. This study shows that assessment based on AHP has a higher accuracy to shrimp farming impact and can be used as the basic fisheries planning to deal with impacts that have been generated.

  3. Dependence of Achievable Plan Quality on Treatment Technique and Planning Goal Refinement: A Head-and-Neck Intensity Modulated Radiation Therapy Application

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

    Qi, X. Sharon, E-mail: xqi@mednet.ucla.edu; Ruan, Dan; Lee, Steve P.

    2015-03-15

    higher parotid doses for C-arm linear accelerator–based IMRT and RAPIDARC plans. Conclusion: Patient registry–based processes allowed easy and systematic dosimetric assessment of treatment plan quality and consistency. Our analysis revealed the dependence of certain dosimetric endpoints on the treatment techniques. Technique-specific refinement of planning goals may lead to improvement in plan consistency and plan quality.« less

  4. EPA Guidance for Geospatially Related Quality Assurance Project Plans

    EPA Pesticide Factsheets

    This March 2003 document discusses EPA's Quality Assurance (QA) Project Plan as a tool for project managers and planners to document the type and quality of data and information needed for making environmental decisions

  5. 75 FR 76332 - Approval and Promulgation of Air Quality Implementation Plans; Illinois

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection Agency (EPA... attaining the 1997 8-hour ozone National Ambient Air Quality Standard (NAAQS). The State's NO X RACT waiver... classification of an area. The air quality planning and control requirements for the reduction of NO X emissions...

  6. Impact of tumour motion compensation and delineation methods on FDG PET-based dose painting plan quality for NSCLC radiation therapy.

    PubMed

    Thomas, Hannah Mary; Kinahan, Paul E; Samuel, James Jebaseelan E; Bowen, Stephen R

    2018-02-01

    To quantitatively estimate the impact of different methods for both boost volume delineation and respiratory motion compensation of [18F] FDG PET/CT images on the fidelity of planned non-uniform 'dose painting' plans to the prescribed boost dose distribution. Six locally advanced non-small cell lung cancer (NSCLC) patients were retrospectively reviewed. To assess the impact of respiratory motion, time-averaged (3D AVG), respiratory phase-gated (4D GATED) and motion-encompassing (4D MIP) PET images were used. The boost volumes were defined using manual contour (MANUAL), fixed threshold (FIXED) and gradient search algorithm (GRADIENT). The dose painting prescription of 60 Gy base dose to the planning target volume and an integral dose of 14 Gy (total 74 Gy) was discretized into seven treatment planning substructures and linearly redistributed according to the relative SUV at every voxel in the boost volume. Fifty-four dose painting plan combinations were generated and conformity was evaluated using quality index VQ0.95-1.05, which represents the sum of planned dose voxels within 5% deviation from the prescribed dose. Trends in plan quality and magnitude of achievable dose escalation were recorded. Different segmentation techniques produced statistically significant variations in maximum planned dose (P < 0.02), as well as plan quality between segmentation methods for 4D GATED and 4D MIP PET images (P < 0.05). No statistically significant differences in plan quality and maximum dose were observed between motion-compensated PET-based plans (P > 0.75). Low variability in plan quality was observed for FIXED threshold plans, while MANUAL and GRADIENT plans achieved higher dose with lower plan quality indices. The dose painting plans were more sensitive to segmentation of boost volumes than PET motion compensation in this study sample. Careful consideration of boost target delineation and motion compensation strategies should guide the design of NSCLC dose

  7. 30 CFR 28.31 - Quality control plans; contents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28.31 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.31 Quality control plans; contents. (a... Specification MIL-F-15160D is available for examination at the U.S. Department of Labor, Mine Safety and Health...

  8. 30 CFR 28.31 - Quality control plans; contents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28.31 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.31 Quality control plans; contents. (a... Specification MIL-F-15160D is available for examination at the U.S. Department of Labor, Mine Safety and Health...

  9. 30 CFR 28.31 - Quality control plans; contents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28.31 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.31 Quality control plans; contents. (a... Specification MIL-F-15160D is available for examination at the U.S. Department of Labor, Mine Safety and Health...

  10. 30 CFR 28.31 - Quality control plans; contents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28.31 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING... PROTECTION FOR TRAILING CABLES IN COAL MINES Quality Control § 28.31 Quality control plans; contents. (a... Specification MIL-F-15160D is available for examination at the U.S. Department of Labor, Mine Safety and Health...

  11. Quality assessment of decision-making in colorectal cancer multidisciplinary meetings.

    PubMed

    Seretis, Charalampos; Mankotia, Rajnish; Goonetilleke, Kolitha; Rawstorne, Edward

    2014-01-01

    The quality of decision-making in the colorectal multidisciplinary team (MDT) meetings can significantly affect the quality of care delivered to patients with colorectal cancer. We performed a prospective study to assess the quality of the MDT meetings in a specialized colorectal unit using an externally observational validated tool. An externally validated observational tool, the Colorectal Multidisciplinary Team Metric for Observation of Decision-Making (cMDT-MODe), was used to assess the quality of clinical decision-making in 64 cases. Although case history information presented by the responsible surgeon was rated high (4.4/5), the quality of radiological and histopathological information regarding each patient's case which was available at the time was less adequate, scoring 3.9/5 and 3.8/5, respectively. Moreover, the precise knowledge of patients' personal views and circumstances was a field requiring further improvement. In a general overview however, the quality and extent of the available information enabled the MDT to provide a clear recommendation regarding the patients' treatment plans in 87.5% of the cases. The cMDT-MODe tool can be used to prospectively audit the quality of clinical decision-making in the colorectal MDT meetings and highlight the fields of potential improvement.

  12. KCBX Quality Assurance Project Plan - February 2014

    EPA Pesticide Factsheets

    This plan's standards for data quality, sampling and testing methods, and task management guide the implementation of Ambient Air Monitoring, by URS Corporation, at the KCBX Terminals Company North and South Terminals in Chicago, IL.

  13. Measuring patient experience in dialysis: a new paradigm of quality assessment.

    PubMed

    Rhee, Connie M; Brunelli, Steven M; Subramanian, Lalita; Tentori, Francesca

    2018-04-01

    Patients' experience of care (PEC) is as an important dimension in quality of care. As a distinct entity from patient satisfaction and patient health-related quality of life, PEC is defined as patients' perceptions of the range of interactions they have with the health care system, including care from providers, facilities, and health plans. While traditionally PEC may be ascertained via informal assessments, in recent years, especially in the United States, there has been a shift towards standardized surveillance of PEC amongst dialysis patients in order to: (1) set a normative expectation regarding the importance of PEC; (2) standardize the components of patients' experience that are assessed to minimize potential "blind spots"; (3) provide a direct "voice" to the patient in communicating perceptions of their care; (4) facilitate comparisons of quality across facilities; and (5) broaden accountability for PEC to the entire multidisciplinary dialysis care team. In this review, we will discuss the significance of PEC as a quality of care metric in dialysis patients; the history of PEC assessment across other health care arenas; the development of the In-Center Hemodialysis Consumer Assessment of Healthcare Provider and Systems survey as a means to standardize PEC assessment among US dialysis patients; experiences in PEC assessment across international dialysis populations; and future areas of research needed to refine the ascertainment of PEC and its impact upon patient outcomes.

  14. Determinants of Quality of Family Planning Counseling among Private Health Facilities in Lagos.

    PubMed

    Johnson, Doug; Ugaz, Jorge

    2016-09-01

    We use a unique dataset that includes an objective measure of the quality of family planning counseling from 927 private health facilities in Lagos State, Nigeria, to determine which variables at the facility and provider levels are most closely correlated with the quality of family planning counseling. Our data on quality come from mystery client surveys in which the clients posed as women seeking family planning counseling. We find that quality is strongly associated with the cadre of provider, with doctors delivering substantially higher-quality counselling than nurses. Doctors not only outperform nurses overall, but also perform better on each category of quality and spend nearly three minutes longer on average counseling the mystery client. Location, fees charged for the service, and facility type are also strongly correlated with quality. The degree to which a facility specializes in family planning and facility size are only weakly predictive of quality. © 2016 The Population Council, Inc.

  15. Hospital nurses' work environment, quality of care provided and career plans.

    PubMed

    Hinno, S; Partanen, P; Vehviläinen-Julkunen, K

    2011-06-01

    In several European countries, the availability of qualified nurses is insufficient to meet current healthcare requirements. Nurses are highly dissatisfied with the rising demands of the healthcare environment and increasingly considering leaving their jobs. The study aims to investigate the relationships between the characteristics of hospital nurses' work environment and the quality of care provided, and furthermore to examine Dutch nurses' career plans. A cross-sectional, questionnaire survey of registered nurses (n = 334) working in the academic and district hospitals was conducted in 2005/2006. Previously validated questionnaires translated into the participants' language were used. Factor and regression analysis were used for data analysis. Overall, nurses rated their work environment rather favourably. Five work environment characteristics were identified: support for professional development, adequate staffing, nursing competence, supportive management and teamwork. Significant relationships were found between nurses' perceptions of their work environment characteristics and quality of care provided and nurses' career plans. When work environment characteristics were evaluated to be better, nurse-assessed quality of care also increased and intentions to leave current job decreased linearly. Study findings suggest that nurses' perceptions of their work environment are important for nurse outcomes in hospital settings. Further research is needed to explore the predictive ability of the work environment for nurse, patient and organizational outcomes in hospitals. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

  16. 40 CFR 35.925-2 - Water quality management plans and agencies.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Water quality management plans and... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.925-2 Water quality management plans and agencies. That the project is consistent with...

  17. 40 CFR 35.925-2 - Water quality management plans and agencies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Water quality management plans and... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.925-2 Water quality management plans and agencies. That the project is consistent with...

  18. 40 CFR 35.925-2 - Water quality management plans and agencies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Water quality management plans and... OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.925-2 Water quality management plans and agencies. That the project is consistent with...

  19. On the role of the optimization algorithm of RapidArc(®) volumetric modulated arc therapy on plan quality and efficiency.

    PubMed

    Vanetti, Eugenio; Nicolini, Giorgia; Nord, Janne; Peltola, Jarkko; Clivio, Alessandro; Fogliata, Antonella; Cozzi, Luca

    2011-11-01

    The RapidArc volumetric modulated arc therapy (VMAT) planning process is based on a core engine, the so-called progressive resolution optimizer (PRO). This is the optimization algorithm used to determine the combination of field shapes, segment weights (with dose rate and gantry speed variations), which best approximate the desired dose distribution in the inverse planning problem. A study was performed to assess the behavior of two versions of PRO. These two versions mostly differ in the way continuous variables describing the modulated arc are sampled into discrete control points, in the planning efficiency and in the presence of some new features. The analysis aimed to assess (i) plan quality, (ii) technical delivery aspects, (iii) agreement between delivery and calculations, and (iv) planning efficiency of the two versions. RapidArc plans were generated for four groups of patients (five patients each): anal canal, advanced lung, head and neck, and multiple brain metastases and were designed to test different levels of planning complexity and anatomical features. Plans from optimization with PRO2 (first generation of RapidArc optimizer) were compared against PRO3 (second generation of the algorithm). Additional plans were optimized with PRO3 using new features: the jaw tracking, the intermediate dose and the air cavity correction options. Results showed that (i) plan quality was generally improved with PRO3 and, although not for all parameters, some of the scored indices showed a macroscopic improvement with PRO3. (ii) PRO3 optimization leads to simpler patterns of the dynamic parameters particularly for dose rate. (iii) No differences were observed between the two algorithms in terms of pretreatment quality assurance measurements and (iv) PRO3 optimization was generally faster, with a time reduction of a factor approximately 3.5 with respect to PRO2. These results indicate that PRO3 is either clinically beneficial or neutral in terms of dosimetric quality while

  20. Embedding systematic quality assessments in supportive supervision at primary healthcare level: application of an electronic Tool to Improve Quality of Healthcare in Tanzania.

    PubMed

    Mboya, Dominick; Mshana, Christopher; Kessy, Flora; Alba, Sandra; Lengeler, Christian; Renggli, Sabine; Vander Plaetse, Bart; Mohamed, Mohamed A; Schulze, Alexander

    2016-10-13

    Assessing quality of health services, for example through supportive supervision, is essential for strengthening healthcare delivery. Most systematic health facility assessment mechanisms, however, are not suitable for routine supervision. The objective of this study is to describe a quality assessment methodology using an electronic format that can be embedded in supervision activities and conducted by council health staff. An electronic Tool to Improve Quality of Healthcare (e-TIQH) was developed to assess the quality of primary healthcare provision. The e-TIQH contains six sub-tools, each covering one quality dimension: infrastructure and equipment of the facility, its management and administration, job expectations, clinical skills of the staff, staff motivation and client satisfaction. As part of supportive supervision, council health staff conduct quality assessments in all primary healthcare facilities in a given council, including observation of clinical consultations and exit interviews with clients. Using a hand-held device, assessors enter data and view results in real time through automated data analysis, permitting immediate feedback to health workers. Based on the results, quality gaps and potential measures to address them are jointly discussed and actions plans developed. For illustrative purposes, preliminary findings from e-TIQH application are presented from eight councils of Tanzania for the period 2011-2013, with a quality score <75 % classed as 'unsatisfactory'. Staff motivation (<50 % in all councils) and job expectations (≤50 %) scored lowest of all quality dimensions at baseline. Clinical practice was unsatisfactory in six councils, with more mixed results for availability of infrastructure and equipment, and for administration and management. In contrast, client satisfaction scored surprisingly high. Over time, each council showed a significant overall increase of 3-7 % in mean score, with the most pronounced improvements in staff

  1. KCBX Quality Assurance Project Plan - October 2014

    EPA Pesticide Factsheets

    This revised plan's standards for data quality, sampling and testing methods, and task management guide the implementation of Ambient Air Monitoring by URS Corporation at the KCBX Terminals Company North and South Terminals in Chicago, Ill.

  2. 75 FR 65572 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-26

    ... Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality Standards AGENCY... Ohio Administrative Code (OAC) relating to the consolidation of Ohio's Ambient Air Quality Standards... apply to Ohio's SIP. Incorporating the air quality standards into Ohio's SIP helps assure that...

  3. Subjective Quality Assessment of Underwater Video for Scientific Applications.

    PubMed

    Moreno-Roldán, José-Miguel; Luque-Nieto, Miguel-Ángel; Poncela, Javier; Díaz-del-Río, Víctor; Otero, Pablo

    2015-12-15

    Underwater video services could be a key application in the better scientific knowledge of the vast oceanic resources in our planet. However, limitations in the capacity of current available technology for underwater networks (UWSNs) raise the question of the feasibility of these services. When transmitting video, the main constraints are the limited bandwidth and the high propagation delays. At the same time the service performance depends on the needs of the target group. This paper considers the problems of estimations for the Mean Opinion Score (a standard quality measure) in UWSNs based on objective methods and addresses the topic of quality assessment in potential underwater video services from a subjective point of view. The experimental design and the results of a test planned according standardized psychometric methods are presented. The subjects used in the quality assessment test were ocean scientists. Video sequences were recorded in actual exploration expeditions and were processed to simulate conditions similar to those that might be found in UWSNs. Our experimental results show how videos are considered to be useful for scientific purposes even in very low bitrate conditions.

  4. Factors affecting quality of care in family planning clinics: a study from Iran.

    PubMed

    Shahidzadeh-Mahani, Ali; Omidvari, Sepideh; Baradaran, Hamid-Reza; Azin, Seyyed-Ali

    2008-08-01

    Despite good contraceptive coverage rates, recent studies in Iran have shown an alarmingly high incidence of unplanned pregnancy. To determine factors affecting quality of family planning services, a cross-sectional study was performed from June to August 2006 on women visiting urban Primary Health Care clinics in a provincial capital in western Iran. The primary focus of the study was on provider-client interaction. We used a slightly edited version of a UNICEF checklist and a convenient sampling method to assess quality of care in 396 visits to the family planning sections at 25 delivery points. Poor performance was observed notably in Counselling and Choice of method sections. In logistic regression analysis, the following factors were found to be associated with higher quality of care: provider experience [OR (odds ratio)=1.9, CI(0.95) (confidence interval)=1.2-3.0], low provider education (OR=6.7, CI(0.95)=4.0-10.8), smaller workload at the clinic (OR=3.7, CI(0.95)=2.0-6.7), and 'new client' status (OR=4.2, CI(0.95)=2.6-6.7). This study identified the issues of counselling and information exchange as the quality domains in serious need of improvement; these areas are expected to be the focus of future training programmes for care providers. Also, priority should be given to devising effective supervision mechanisms and on-the-job training of senior nursing and midwifery graduates to make them more competent in delivering basic family planning services.

  5. Development of an integrated data base for land use and water quality planning

    NASA Technical Reports Server (NTRS)

    Adams, J.; Vanschayk, C.; Istvan, L. B.

    1977-01-01

    To help understand the role played by different land resources in water quality management a computer based data system was created. The Land Resource Information System (LRIS) allows data to be readily retrieved or statistically analyzed for a variety of purposes. It is specifically formatted to perform coordination of water quality data with logy, etc. New understanding of the region gained through the use of LRIS has gone well beyond the initial purpose of assessing water quality conditions. The land use and natural features information has provided a well defined starting point for a systematic evaluation of proposed land uses, transportation, housing, and other public investments. It has laid the foundation for a comprehensive and integrated approach to many different planning and investment programs presently underway.

  6. Comparison of Planning Quality and Efficiency Between Conventional and Knowledge-based Algorithms in Nasopharyngeal Cancer Patients Using Intensity Modulated Radiation Therapy.

    PubMed

    Chang, Amy T Y; Hung, Albert W M; Cheung, Fion W K; Lee, Michael C H; Chan, Oscar S H; Philips, Helen; Cheng, Yung-Tang; Ng, Wai-Tong

    2016-07-01

    Intensity modulated radiation therapy (IMRT) is widely used to achieve a highly conformal dose and improve treatment outcome. However, plan quality and planning time are institute and planner dependent, and no standardized tool exists to recognize an optimal plan. RapidPlan, a knowledge-based algorithm, can generate constraints to assist optimization and produce high-quality IMRT plans. This report evaluated the quality and efficiency of using RapidPlan in nasopharyngeal carcinoma (NPC) IMRT planning. RapidPlan was configured using 79 radical IMRT plans for NPC; 20 consecutive NPC patients indicated for radical radiation therapy between October 2014 and May 2015 were then recruited to assess its performance. The ability of RapidPlan to produce acceptable plans was evaluated. For plans that could not achieve clinical acceptance, manual touch-up was performed. The IMRT plans produced without RapidPlan (manual plans) and with RapidPlan (RP-2 plans, including those with manual touch-up) were compared in terms of dosimetric quality and planning efficiency. RapidPlan by itself could produce clinically acceptable plans for 9 of the 20 patients; manual touch-up increased the number of acceptable plans (RP-2 plans) to 19. The target dose coverage and conformity were very similar. No difference was found in the maximum dose to the brainstem and optic chiasm. RP-2 plans delivered a higher maximum dose to the spinal cord (46.4 Gy vs 43.9 Gy, P=.002) but a lower dose to the parotid (mean dose to right parotid, 37.3 Gy vs 45.4 Gy; left, 34.4 Gy vs 43.1 Gy; P<.001) and the right cochlea (mean dose, 48.6 Gy vs 52.6 Gy; P=.02). The total planning time for RP-2 plans was significantly less than that for manual plans (64 minutes vs 295 minutes, P<.001). This study shows that RapidPlan can significantly improve planning efficiency and produce quality IMRT plans for NPC patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. SU-F-T-453: Improved Head and Neck SBRT Treatment Planning Using PlanIQ

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

    Wang, H; Wang, C; Phan, J

    Purpose: Treatment planning for Head and Neck(HN) re-irradiation is a challenge because of ablative doses to target volume and strict critical structure constraints. PlanIQ(Sun Nuclear Corporation) can assess the feasibility of clinical goals and quantitatively measure plan quality. Here, we assess whether incorporation of PlanIQ in our SBRT treatment planning process can improve plan quality and planning efficiency. Methods: From 2013–2015, 35 patients (29 retrospective, 6 prospective) with recurrent HN tumors were treated with SBRT using VMAT treatment plans. The median prescription dose was 45 Gy in 5 fractions. We retrospectively reviewed the treatment plans and physician directives of ourmore » first 29 patients and generated score functions of the dosimetric goals used in our practice and obtained a baseline histogram. We then re-optimized 12 plans that had potential to further reduce organs-at-risk (OAR) doses according to PlanIQ feasibility DVH and plan quality analysis and compared them to the original plans. We applied our new PlanIQ-assisted planning process for our 6 most recently treated patients and evaluated the plan quality and planning efficiency. Results: The mean plan quality metric(PQM) and feasibility adjusted PQM(APQM) scores of our initial 29 treatment plans were 77.1±13.1 and 88.7±11.9, respectively (0–100 scale). The PQM and APQM scores for the 12 optimized plans improved from 75.9±11.0 and 85.1±10.2 to 80.7±9.3 and 90.2±8.0, respectively (p<0.005). Using our newly developed PlanIQ-assisted planning process, the PQM and APQM scores for the 6 most recently treated patients were 93.6±6.5 and 99.1±0.6, respectively. The planning goals were more straightforward to minimize OAR doses during optimization, thus less planning and revision time were used than before. Conclusion: PlanIQ has the potential to provide achievable planning goals and also improve plan quality and planning efficiency.« less

  8. Planned hospital birth versus planned home birth

    PubMed Central

    Olsen, Ole; Clausen, Jette A

    2014-01-01

    Background Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998. Objectives To assess the effects of planned hospital birth compared with planned home birth in selected low-risk women, assisted by an experienced midwife with collaborative medical back up in case transfer should be necessary. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 March 2012) and contacted editors and authors involved with possible trials. Selection criteria Randomised controlled trials comparing planned hospital birth with planned home birth in low-risk women as described in the objectives. Data collection and analysis The two review authors as independently as possible assessed trial quality and extracted data. We contacted study authors for additional information. Main results Two trials met the inclusion criteria but only one trial involving 11 women provided some outcome data and was included. The evidence from this trial was of moderate quality and too small to allow conclusions to be drawn. Authors’ conclusions There is no strong evidence from randomised trials to favour either planned hospital birth or planned home birth for low-risk pregnant women. However, the trials show that women living in areas where they are not well informed about home birth may welcome ethically well-designed trials that would ensure an informed choice. As the quality of evidence in favour of home birth from observational studies seems to be steadily increasing, it might be as important to prepare a regularly updated systematic review including observational studies as described in the Cochrane Handbook for Systematic Reviews of Interventions as to attempt to set up new randomised controlled trials. PMID:22972043

  9. National Ignition Facility quality assurance program plan revision 2

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

    Wolfe, C R

    1998-06-01

    NIF Project activities will be conducted in a manner consistent with the guidance and direction of the DOE Order on Quality Assurance (414.1), the LLNL QA Program, and the Laser Directorate QA Plan. Quality assurance criteria will be applied in a graded manner to achieve a balance between the rigor of application of QA measures and the scale, cost, and complexity of the work involved. Accountability for quality is everyone's, extending from the Project Manager through established lines of authority to all Project personnel, who are responsible for the requisite quality of their own work. The NLF QA Program willmore » be implemented by personnel conducting their activities to meet requirements and expectations, according to established plans and procedures that reflect the way business is to be conducted on the Project.« less

  10. Groundwater quality assessment plan for single-shell waste management area B-BX-BY at the Hanford Site

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

    SM Narbutovskih

    2000-03-31

    Pacific Northwest National Laboratory conducted a first determination groundwater quality assessment at the Hanford Site. This work was performed for the US Department of Energy, Richland Operations Office, in accordance with the Federal Facility Compliance Agreement during the time period 1996--1998. The purpose of the assessment was to determine if waste from the Single-Shell Tank (SST) Waste Management Area (WMA) B-BX-BY had entered the groundwater at levels above the drinking water standards (DWS). The resulting assessment report documented evidence demonstrating that waste from the WMA has, most likely, impacted groundwater quality. Based on 40 CFR 265.93 [d] paragraph (7), themore » owner-operator must continue to make the minimum required determinations of contaminant level and of rate/extent of migrations on a quarterly basis until final facility closure. These continued determinations are required because the groundwater quality assessment was implemented prior to final closure of the facility.« less

  11. 77 FR 35285 - Approval of Air Quality Implementation Plan; Arizona; Attainment Plan for 1997 8-Hour Ozone Standard

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-13

    ... Quality Implementation Plan; Arizona; Attainment Plan for 1997 8-Hour Ozone Standard AGENCY: U.S... 1997 8-hour ozone national ambient air quality standards (NAAQS) in the Phoenix-Mesa nonattainment area... required for ozone nonattainment areas under title I, part D, subpart 1 of the Clean Air Act (CAA) for the...

  12. 78 FR 49409 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Infrastructure...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-14

    ...] Approval and Promulgation of Air Quality Implementation Plans; Delaware; Infrastructure Requirements for the 2010 Nitrogen Dioxide National Ambient Air Quality Standards AGENCY: Environmental Protection... national ambient air quality standards (NAAQS) are promulgated, the CAA requires states to submit a plan...

  13. Guidance for Quality Assurance Project Plans, EPA QA/G-5

    EPA Pesticide Factsheets

    provides guidance to EPA employees and other organizations involved in developing Quality Assurance (QA) Project Plans that address the specifications listed in EPA Requirements for QA Project Plans (QA/R-5)

  14. 78 FR 63934 - Approval of Air Quality Implementation Plans; California; El Dorado County Air Quality Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ...] Approval of Air Quality Implementation Plans; California; El Dorado County Air Quality Management District... California for the El Dorado County Air Quality Management District (EDAQMD) portion of the California SIP... 24, 1987 Federal Register, May 25, 1988, U.S. EPA, Air Quality Management Division, Office of Air...

  15. 78 FR 19990 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-03

    ... Promulgation of Air Quality Implementation Plans; Ohio; Ohio Ambient Air Quality Standards; Correction AGENCY... approved revisions to Ohio regulations that consolidated air quality standards in a new chapter of rules... State's air quality standards into Ohio Administrative Code (OAC) 3745-25 and modifying an assortment of...

  16. 77 FR 12482 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Lead Ambient Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... Promulgation of Air Quality Implementation Plans; Indiana; Lead Ambient Air Quality Standards AGENCY... incorporates the National Ambient Air Quality Standards (NAAQS) for Pb promulgated by EPA in 2008. DATES: This... FR 66964) and codified at 40 CFR 50.16, ``National primary and secondary ambient air quality...

  17. Early Discharge Planning and Improved Care Transitions: Pre-Admission Assessment for Readmission Risk in an Elective Orthopedic and Cardiovascular Surgical Population

    PubMed Central

    Mola, Ana; Rosenfeld, Peri; Ford, Shauna

    2016-01-01

    Background/Methods: Readmission prevention is a marker of patient care quality and requires comprehensive, early discharge planning for safe hospital transitions. Effectively performed, this process supports patient satisfaction, efficient resource utilization, and care integration. This study developed/tested the utility of a predictive early discharge risk assessment with 366 elective orthopedic/cardiovascular surgery patients. Quality improvement cycles were undertaken for the design and to inform analytic plan. An 8-item questionnaire, which includes patient self-reported health, was integrated into care managers’ telephonic pre-admission assessments during a 12-month period. Results: Regression models found the questionnaire to be predictive of readmission (p ≤ .005; R2 = .334) and length-of-stay (p ≤ .001; R2 = .314). Independent variables of “lives-alone” and “self-rated health” were statistically significant for increased readmission odds, as was “self-rated health” for increased length-of-stay. Quality measures, patient experience and increased rates of discharges-to-home further supported the benefit of embedding these questions into the pro-active planning process. Conclusion: The pilot discharge risk assessment was predictive of readmission risk and length-of-stay for elective orthopedic/cardiovascular patients. Given the usability of the questionnaire in advance of elective admissions, it can facilitate pro-active discharge planning essential for producing quality outcomes and addressing new reimbursement methodologies for continuum-based episodes of care. PMID:27616965

  18. 78 FR 53709 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Infrastructure...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ...] Approval and Promulgation of Air Quality Implementation Plans; Delaware; Infrastructure Requirements for the 2008 Ozone National Ambient Air Quality Standards AGENCY: Environmental Protection Agency (EPA... ambient air quality standards (NAAQS) are promulgated, the CAA requires states to submit a plan for the...

  19. TU-FG-201-10: Quality Management of Accelerated Partial Breast Irradiation (APBI) Plans

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

    Ji, H; Lorio, V; Cernica, G

    2016-06-15

    Purpose: Since 2008, over 700 patients received high dose rate (HDR) APBI treatment at Virginia Hospital Center. The complexity involved in the planning process demonstrated a broad variation between patient geometry across all applicators, in relation to anatomical regions of interest. A quality management program instituting various metrics was implemented in March 2013 with the goal of ensuring an optimal plan is achieved for each patient. Methods: For each plan, an in-house complexity index, geometric conformity index, and plan quality index were defined. These indices were obtained for all patients treated. For patients treated after the implementation, the conformity indexmore » and quality index were maximized while other dosimetric limits, such as maximum skin and rib doses, were strictly kept. Subsequently, all evaluation parameters and applicator information were placed in a database for cross-evaluation with similar complexity. Results: Both the conformity and quality indices show good correlation with the complexity index. They decrease as complexity increases for all applicators. Multi lumen type balloon applicators demonstrate a minimal advantage over single lumen applicators in increasingly complex patient geometries, as compared to SAVI applicators which showed considerably greater advantage in these circumstances. After the implementation of the in-house planning protocol, there is a direct improvement of quality for SAVI plans. Conclusion: Due to their interstitial nature, SAVI devices show a better conformity in comparison to balloon-based devices regardless of the number of lumens, especially in complex cases. The quality management program focuses on optimizing indices by utilizing prior planning knowledge based on complexity levels. The database of indices assists in decision making and has subsequently aided in balancing the experience level among planners. This approach has made APBI planning more robust for patient care, with a measurable

  20. Holistic needs assessment and care plans for women with gynaecological cancer: do they improve cancer-specific health-related quality of life? A randomised controlled trial using mixed methods.

    PubMed

    Sandsund, Catherine; Towers, Richard; Thomas, Karen; Tigue, Ruth; Lalji, Amyn; Fernandes, Andreia; Doyle, Natalie; Jordan, Jake; Gage, Heather; Shaw, Clare

    2017-08-28

    Holistic needs assessment (HNA) and care planning are proposed to address unmet needs of people treated for cancer. We tested whether HNA and care planning by an allied health professional improved cancer-specific quality of life for women following curative treatment for stage I-III gynaecological cancer. Consecutive women were invited to participate in a randomised controlled study (HNA and care planning vs usual care) at a UK cancer centre. Data were collected by questionnaire at baseline, 3 and 6 months. The outcomes were 6-month change in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (version 3), global score (primary) and, in EORTC subscales, generic quality of life and self-efficacy (secondary). The study was blinded for data management and analysis. Differences in outcomes were compared between groups. Health service utilisation and quality-adjusted life years (QALY) (from Short Form-6) were gathered for a cost-effectiveness analysis. Thematic analysis was used to interpret data from an exit interview. 150 women consented (75 per group); 10 undertook interviews. For 124 participants (61 intervention, 63 controls) with complete data, no statistically significant differences were seen between groups in the primary endpoint. The majority of those interviewed reported important personal gains they attributed to the intervention, which reflected trends to improvement seen in EORTC functional and symptom scales. Economic analysis suggests a 62% probability of cost-effectiveness at a £30 000/QALY threshold. Care plan development with an allied health professional is cost-effective, acceptable and useful for some women treated for stage I-III gynaecological cancer. We recommend its introduction early in the pathway to support person-centred care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless

  1. Software quality assurance plan for GCS

    NASA Technical Reports Server (NTRS)

    Duncan, Stephen E.; Bailey, Elizabeth K.

    1990-01-01

    The software quality assurance (SQA) function for the Guidance and Control Software (GCS) project which is part of a software error studies research program is described. The SQA plan outlines all of the procedures, controls, and audits to be carried out by the SQA organization to ensure adherence to the policies, procedures, and standards for the GCS project.

  2. Threat Assessment Plans

    ERIC Educational Resources Information Center

    Pascopella, Angela

    2008-01-01

    With every new case of school violence, district leaders are urged to be proactive in hopes of averting potential violence. Experts say part of that proactive work comes from a threat assessment plan that every district should have. While every district that receives funds from the U.S. Department of Education for school safety is required to have…

  3. Evaluative methodology for comprehensive water quality management planning

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

    Dyer, H. L.

    Computer-based evaluative methodologies have been developed to provide for the analysis of coupled phenomena associated with natural resource comprehensive planning requirements. Provisions for planner/computer interaction have been included. Each of the simulation models developed is described in terms of its coded procedures. An application of the models for water quality management planning is presented; and the data requirements for each of the models are noted.

  4. 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.

  5. 45 CFR 1304.60 - Deficiencies and quality improvement plans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Deficiencies and quality improvement plans. 1304.60 Section 1304.60 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... GRANTEE AND DELEGATE AGENCIES Implementation and Enforcement § 1304.60 Deficiencies and quality...

  6. 45 CFR 1304.60 - Deficiencies and quality improvement plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Deficiencies and quality improvement plans. 1304.60 Section 1304.60 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... GRANTEE AND DELEGATE AGENCIES Implementation and Enforcement § 1304.60 Deficiencies and quality...

  7. 45 CFR 1304.60 - Deficiencies and quality improvement plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Deficiencies and quality improvement plans. 1304.60 Section 1304.60 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... GRANTEE AND DELEGATE AGENCIES Implementation and Enforcement § 1304.60 Deficiencies and quality...

  8. National Water-Quality Assessment program: The Trinity River Basin

    USGS Publications Warehouse

    Land, Larry F.

    1991-01-01

    In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water-quality information that will be useful to policy makers and managers at the national, State, and local levels. A major design feature of the NAWQA program will enable water-quality information at different areal scales to be integrated. A major component of the program is study-unit investigations, which comprise the principal building blocks of the program on which national-level assessment activities will be based. The 60 study-unit investigations that make up the program are hydrologic systems that include parts of most major river basins and aquifer systems. These study units cover areas of 1,200 to more than 65,000 square miles and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the Trinity River basin study was among the first 20 NAWQA study units selected for study under the full-scale implementation plan.

  9. Astronomical Instrumentation Systems Quality Management Planning: AISQMP

    NASA Astrophysics Data System (ADS)

    Goldbaum, Jesse

    2017-06-01

    The capability of small aperture astronomical instrumentation systems (AIS) to make meaningful scientific contributions has never been better. The purpose of AIS quality management planning (AISQMP) is to ensure the quality of these contributions such that they are both valid and reliable. The first step involved with AISQMP is to specify objective quality measures not just for the AIS final product, but also for the instrumentation used in its production. The next step is to set up a process to track these measures and control for any unwanted variation. The final step is continual effort applied to reducing variation and obtaining measured values near optimal theoretical performance. This paper provides an overview of AISQMP while focusing on objective quality measures applied to astronomical imaging systems.

  10. SU-F-P-64: The Impact of Plan Complexity Parameters On the Plan Quality and Deliverability of Volumetric Modulated Arc Therapy with Canonical Correlation Analysis

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

    Jin, X; Yi, J; Xie, C

    Purpose: To evaluate the impact of complexity indices on the plan quality and deliverability of volumetric modulated arc therapy (VMAT), and to determine the most significant parameters in the generation of an ideal VMAT plan. Methods: A multi-dimensional exploratory statistical method, canonical correlation analysis (CCA) was adopted to study the correlations between VMAT parameters of complexity, quality and deliverability, as well as their contribution weights with 32 two-arc VMAT nasopharyngeal cancer (NPC) patients and 31 one-arc VMAT prostate cancer patients. Results: The MU per arc (MU/Arc) and MU per control point (MU/CP) of NPC were 337.8±25.2 and 3.7±0.3, respectively, whichmore » were significantly lower than those of prostate cancer patients (MU/Arc : 506.9±95.4, MU/CP : 5.6±1.1). The plan complexity indices indicated that two-arc VMAT plans were more complex than one-arc VMAT plans. Plan quality comparison confirmed that one-arc VMAT plans had a high quality than two-arc VMAT plans. CCA results implied that plan complexity parameters were highly correlated with plan quality with the first two canonical correlations of 0.96, 0.88 (both p<0.001) and significantly correlated with deliverability with the first canonical correlation of 0.79 (p<0.001), plan quality and deliverability was also correlated with the first canonical correlation of 0.71 (p=0.02). Complexity parameters of MU/CP, segment area (SA) per CP, percent of MU/CP less 3 and planning target volume (PTV) were weighted heavily in correlation with plan quality and deliveability . Similar results obtained from individual NPC and prostate CCA analysis. Conclusion: Relationship between complexity, quality, and deliverability parameters were investigated with CCA. MU, SA related parameters and PTV volume were found to have strong effect on the plan quality and deliverability. The presented correlation among different quantified parameters could be used to improve the plan quality and the

  11. An assessment of drinking-water quality post-Haiyan.

    PubMed

    Magtibay, Bonifacio; Anarna, Maria Sonabel; Fernando, Arturo

    2015-01-01

    Access to safe drinking-water is one of the most important public health concerns in an emergency setting. This descriptive study reports on an assessment of water quality in drinking-water supply systems in areas affected by Typhoon Haiyan immediately following and 10 months after the typhoon. Water quality testing and risk assessments of the drinking-water systems were conducted three weeks and 10 months post-Haiyan. Portable test kits were used to determine the presence of Escherichia coli and the level of residual chlorine in water samples. The level of risk was fed back to the water operators for their action. Of the 121 water samples collected three weeks post-Haiyan, 44% were contaminated, while 65% (244/373) of samples were found positive for E. coli 10 months post-Haiyan. For the three components of drinking-water systems - source, storage and distribution - the proportions of contaminated systems were 70%, 67% and 57%, respectively, 10 months after Haiyan. Vulnerability to faecal contamination was attributed to weak water safety programmes in the drinking-water supply systems. Poor water quality can be prevented or reduced by developing and implementing a water safety plan for the systems. This, in turn, will help prevent waterborne disease outbreaks caused by contaminated water post-disaster.

  12. Management self assessment plan

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

    Debban, B.L.

    Duke Engineering and Services Hanford Inc., Spent Nuclear Fuel Project is responsible for the operation of fuel storage facilities. The SNF project mission includes the safe removal, processing and transportation of Spent Nuclear Fuel from 100 K Area fuel storage basins to a new Storage facility in the Hanford 200 East Area. Its mission is the modification of the 100 K area fuel storage facilities and the construction of two new facilities: the 100 K Area Cold Vacuum Drying Facility, and the 200 East Area Canister Storage Building. The management self assessment plan described in this document is scheduled tomore » begin in April of 1999 and be complete in May of 1999. The management self assessment plan describes line management preparations for declaring that line management is ready to commence operations.« less

  13. State landscape in public health planning and quality improvement: results of the ASTHO survey.

    PubMed

    Madamala, Kusuma; Sellers, Katie; Pearsol, Jim; Dickey, Michael; Jarris, Paul E

    2010-01-01

    Limited data exist on state public health agencies and their use of planning and quality improvement (QI) initiatives. Using the 2007 Association of State and Territorial Health Officials (ASTHO) State Public Health Survey, this article describes how state public health agencies perform tasks related to planning, performance management (PM), and QI. While 82 percent of respondents report having a QI process in place, only 9.8 percent have it fully implemented departmentwide. Seventy-six percent reported having a PM process in place, with 16 percent (n = 8) having it fully implemented departmentwide. A state health improvement plan was used by 80.4 percent of respondents, with 56.9 percent of respondents completing the plan more than 3 years ago. More than two-thirds (68.2%) of the respondents developed the plan by using results of their state health assessment. Analysis of state health department level planning, PM, and QI initiatives can inform states' efforts to ready themselves to meet the proposed national voluntary accreditation standards of the Public Health Accreditation Board.

  14. The Columbia River Protection Supplemental Technologies Quality Assurance Project Plan

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

    Fix, N. J.

    The U.S. Department of Energy (DOE) has conducted interim groundwater remedial activities on the Hanford Site since the mid-1990s for several groundwater contamination plumes. DOE established the Columbia River Protection Supplemental Technologies Project (Technologies Project) in 2006 to evaluate alternative treatment technologies. The objectives for the technology project are as follows: develop a 300 Area polyphosphate treatability test to immobilize uranium, design and test infiltration of a phosphate/apatite technology for Sr-90 at 100-N, perform carbon tetrachloride and chloroform attenuation parameter studies, perform vadose zone chromium characterization and geochemistry studies, perform in situ biostimulation of chromium studies for a reducing barriermore » at 100-D, and perform a treatability test for phytoremediation for Sr-90 at 100-N. This document provides the quality assurance guidelines that will be followed by the Technologies Project. This Quality Assurance Project Plan is based on the quality assurance requirements of DOE Order 414.1C, Quality Assurance, and 10 CFR 830, Subpart A--Quality Assurance Requirements as delineated in Pacific Northwest National Laboratory’s Standards-Based Management System. In addition, the technology project is subject to the Environmental Protection Agency (EPA) Requirements for Quality Assurance Project Plans (EPA/240/B-01/003, QA/R-5). The Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD, DOE/RL-96-68) apply to portions of this project and to the subcontractors. HASQARD requirements are discussed within applicable sections of this plan.« less

  15. 7 CFR 1710.408 - Quality assurance plan.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURE GENERAL AND PRE-LOAN POLICIES AND PROCEDURES COMMON TO ELECTRIC LOANS AND GUARANTEES Energy... accordance with quality assurance plans meeting standards designed to achieve the purposes of this subpart... pump) the new system must be designed and installed by certified and insured professionals acceptable...

  16. The Northeast Stream Quality Assessment

    USGS Publications Warehouse

    Van Metre, Peter C.; Riva-Murray, Karen; Coles, James F.

    2016-04-22

    In 2016, the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) is assessing stream quality in the northeastern United States. The goal of the Northeast Stream Quality Assessment (NESQA) is to assess the quality of streams in the region by characterizing multiple water-quality factors that are stressors to aquatic life and evaluating the relation between these stressors and biological communities. The focus of NESQA in 2016 will be on the effects of urbanization and agriculture on stream quality in all or parts of eight states: Connecticut, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont.Findings will provide the public and policymakers with information about the most critical factors affecting stream quality, thus providing insights about possible approaches to protect the health of streams in the region. The NESQA study will be the fourth regional study conducted as part of NAWQA and will be of similar design and scope to the first three, in the Midwest in 2013, the Southeast in 2014, and the Pacific Northwest in 2015 (http://txpub.usgs.gov/RSQA/).

  17. Case study: reconciling the quality and safety gap through strategic planning.

    PubMed

    Jeffs, Lianne; Merkley, Jane; Jeffrey, Jana; Ferris, Ella; Dusek, Janice; Hunter, Catherine

    2006-05-01

    An essential outcome of professional practice environments is the provision of high-quality, safe nursing care. To mitigate the quality and safety chasm, nursing leadership at St. Michael's Hospital undertook a strategic plan to enhance the nursing professional practice environment. This case study outlines the development of the strategic planning process: the driving forces (platform); key stakeholders (process and players); vision, guiding principles, strategic directions, framework for action and accountability (plan); lessons learned (pearls); and next steps to moving forward the vision, strategic directions and accountability mechanisms (passion and perseverance).

  18. Quality assessment of urban environment

    NASA Astrophysics Data System (ADS)

    Ovsiannikova, T. Y.; Nikolaenko, M. N.

    2015-01-01

    This paper is dedicated to the research applicability of quality management problems of construction products. It is offered to expand quality management borders in construction, transferring its principles to urban systems as economic systems of higher level, which qualitative characteristics are substantially defined by quality of construction product. Buildings and structures form spatial-material basis of cities and the most important component of life sphere - urban environment. Authors justify the need for the assessment of urban environment quality as an important factor of social welfare and life quality in urban areas. The authors suggest definition of a term "urban environment". The methodology of quality assessment of urban environment is based on integrated approach which includes the system analysis of all factors and application of both quantitative methods of assessment (calculation of particular and integrated indicators) and qualitative methods (expert estimates and surveys). The authors propose the system of indicators, characterizing quality of the urban environment. This indicators fall into four classes. The authors show the methodology of their definition. The paper presents results of quality assessment of urban environment for several Siberian regions and comparative analysis of these results.

  19. SU-G-TeP4-14: Quality Control of Treatment Planning Using Knowledge-Based Planning Across a System of Radiation Oncology Practices

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

    Masi, K; Ditman, M; Marsh, R

    Purpose: There is potentially a wide variation in plan quality for a certain disease site, even for clinics located in the same system of hospitals. We have used a prostate-specific knowledge-based planning (KBP) model as a quality control tool to investigate the variation in prostate treatment planning across a network of affiliated radiation oncology departments. Methods: A previously created KBP model was applied to 10 patients each from 4 community-based clinics (Clinics A, B, C, and D). The KBP model was developed using RapidPlan (Eclipse v13.5, Varian Medical Systems) from 60 prostate/prostate bed IMRT plans that were originally planned usingmore » an in-house treatment planning system at the central institution of the community-based clinics. The dosimetric plan quality (target coverage and normal-tissue sparing) of each model-generated plan was compared to the respective clinically-used plan. Each community-based clinic utilized the same planning goals to develop the clinically-used plans that were used at the main institution. Results: Across all 4 clinics, the model-generated plans decreased the mean dose to the rectum by varying amounts (on average, 12.5, 2.6, 4.5, and 2.7 Gy for Clinics A, B, C, and D, respectively). The mean dose to the bladder also decreased with the model-generated plans (5.4, 2.3, 3.0, and 4.1 Gy, respectively). The KBP model also identified that target coverage (D95%) improvements were possible for for Clinics A, B, and D (0.12, 1.65, and 2.75%) while target coverage decreased by 0.72% for Clinic C, demonstrating potentially different trade-offs made in clinical plans at different institutions. Conclusion: Quality control of dosimetric plan quality across a system of radiation oncology practices is possible with knowledge-based planning. By using a quality KBP model, smaller community-based clinics can potentially identify the areas of their treatment plans that may be improved, whether it be in normal-tissue sparing or improved

  20. National Water-Quality Assessment Program; the Allegheny-Monongahela River Basin

    USGS Publications Warehouse

    McAuley, Steven D.

    1995-01-01

    In 1991, the U.S. Geological Survey (USGS) began a National Water-Quality Assessment (NAWQA) program. The three major objectives of the NAWQA program are to provide a consistent description of current water-quality conditions for a large part of the Nation's water resources, define long-term trends in water quality, and identify, describe, and explain the major factors that affect water-quality conditions and trends. The program produces water-quality information that is useful to policy makers and managers at the National, State, and local levels.The program will be implemented through 60 separate investigations of river basins and aquifer systems called study units. These study-unit investigations will be conducted at the State and local level and will form the foundation on which national- and regional-level assessments are based. The 60 study units are hydrologic systems that include parts of most major river basins and aquifer systems. The study-unit areas range from 1,000 to more than 60,000 square miles and include about 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty studyunit investigations were started in 1991, 20 started in 1994, and 20 more are planned to start in 1997. The Allegheny-Monongahela River Basin was selected to begin assessment activities as a NAWQA study unit in 1994. The study team will work from the office of the USGS in Pittsburgh, Pa.

  1. Validation of the relative insensitivity of volumetric-modulated arc therapy (VMAT) plan quality to gantry space resolution

    PubMed Central

    Cora, Stefania; Khan, Ehsan Ullah

    2017-01-01

    Abstract Volumetric-modulated arc therapy (VMAT) is an efficient form of radiotherapy used to deliver intensity-modulated radiotherapy beams. The aim of this study was to investigate the relative insensitivity of VMAT plan quality to gantry angle spacing (GS). Most previous VMAT planning and dosimetric work for GS resolution has been conducted for single arc VMAT. In this work, a quantitative comparison of dose–volume indices (DIs) was made for partial-, single- and double-arc VMAT plans optimized at 2°, 3° and 4° GS, representing a large variation in deliverable multileaf collimator segments. VMAT plans of six prostate cancer and six head-and-neck cancer patients were simulated for an Elekta SynergyS® Linac (Elekta Ltd, Crawley, UK), using the SmartArc™ module of Pinnacle³ TPS, (version 9.2, Philips Healthcare). All optimization techniques generated clinically acceptable VMAT plans, except for the single-arc for the head-and-neck cancer patients. Plan quality was assessed by comparing the DIs for the planning target volume, organs at risk and normal tissue. A GS of 2°, with finest resolution and consequently highest intensity modulation, was considered to be the reference, and this was compared with GS 3° and 4°. The differences between the majority of reference DIs and compared DIs were <2%. The metrics, such as treatment plan optimization time and pretreatment (phantom) dosimetric calculation time, supported the use of a GS of 4°. The ArcCHECK™ phantom–measured dosimetric agreement verifications resulted in a >95.0% passing rate, using the criteria for γ (3%, 3 mm). In conclusion, a GS of 4° is an optimal choice for minimal usage of planning resources without compromise of plan quality. PMID:27974507

  2. Groundwater Monitoring Plan. Volume 2. Final Quality Assurance Project Plan

    DTIC Science & Technology

    1993-10-01

    5 Table 4-2. US EPA Drinking Water MCLs ........................................ 4-6 Table 5-1. Sample Bottle Requirements, Preservation, and Holding... drinking water . " The types of quality control samples that will be collected during the Canal Creek groundwater monitoring program. ]- Jacobs...Revision No.: 0 Date: 10/27/93 Page: 6 of 9 Canal Creek Area, APG-EA, Maryland Groundwater Monitoring Plan, VOLUME I1 Table 4-2. US EPA Drinking Water

  3. A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

    PubMed

    Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

    2017-01-01

    This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

  4. Using COPE To Improve Quality of Care: The Experience of the Family Planning Association of Kenya.

    ERIC Educational Resources Information Center

    Bradley, Janet

    1998-01-01

    COPE (Client-Oriented, Provider-Efficient) methodology, a self-assessment tool that has been used in 35 countries around the world, was used to improve the quality of care in family planning clinics in Kenya. COPE involves a process that legitimately invests power with providers and clinic-level staff. It gives providers more control over their…

  5. Concepts of Quality in Student Assessment.

    ERIC Educational Resources Information Center

    Harlen, Wynne

    This paper gives an overview of the methods of moderation, or quality assurance and quality control, as they may be more widely known, that are used to enhance the quality of student assessment. The discussion is based on the educational systems of the United Kingdom but is applicable to assessment in other countries. Quality in assessment is seen…

  6. Managing Air Quality - Multi-Pollutant Planning and Control

    EPA Pesticide Factsheets

    Describes how planning controls for multiple pollutants at the same time can save money and time and achieve significant benefits, and how control strategies can address both climate change and air quality.

  7. Subjective Quality Assessment of Underwater Video for Scientific Applications

    PubMed Central

    Moreno-Roldán, José-Miguel; Luque-Nieto, Miguel-Ángel; Poncela, Javier; Díaz-del-Río, Víctor; Otero, Pablo

    2015-01-01

    Underwater video services could be a key application in the better scientific knowledge of the vast oceanic resources in our planet. However, limitations in the capacity of current available technology for underwater networks (UWSNs) raise the question of the feasibility of these services. When transmitting video, the main constraints are the limited bandwidth and the high propagation delays. At the same time the service performance depends on the needs of the target group. This paper considers the problems of estimations for the Mean Opinion Score (a standard quality measure) in UWSNs based on objective methods and addresses the topic of quality assessment in potential underwater video services from a subjective point of view. The experimental design and the results of a test planned according standardized psychometric methods are presented. The subjects used in the quality assessment test were ocean scientists. Video sequences were recorded in actual exploration expeditions and were processed to simulate conditions similar to those that might be found in UWSNs. Our experimental results show how videos are considered to be useful for scientific purposes even in very low bitrate conditions. PMID:26694400

  8. Environmental Assessment for the Implementation of the Integrated Natural Resources Management Plan for 45th Space Wing

    DTIC Science & Technology

    2008-08-01

    the Proposed Action and as a basis for assessing the significance of potential impacts. The areas of environmental consideration were air quality... ENVIRONMENTAL ASSESSMENT FOR THE IMPLEMENTATION OF THE INTEGRATED NATURAL RESOURCES MANAGEMENT PLAN FOR 45th SPACE WING August...DATE AUG 2008 2. REPORT TYPE 3. DATES COVERED 00-00-2008 to 00-00-2008 4. TITLE AND SUBTITLE Environmental Assessment for the Implementation of

  9. 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

  10. Is it possible for knowledge-based planning to improve intensity modulated radiation therapy plan quality for planners with different planning experiences in left-sided breast cancer patients?

    PubMed

    Wang, Juanqi; Hu, Weigang; Yang, Zhaozhi; Chen, Xiaohui; Wu, Zhiqiang; Yu, Xiaoli; Guo, Xiaomao; Lu, Saiquan; Li, Kaixuan; Yu, Gongyi

    2017-05-22

    Knowledge-based planning (KBP) is a promising technique that can improve plan quality and increase planning efficiency. However, no attempts have been made to extend the domain of KBP for planners with different planning experiences so far. The purpose of this study was to quantify the potential gains for planners with different planning experiences after implementing KBP in intensity modulated radiation therapy (IMRT) plans for left-sided breast cancer patients. The model libraries were populated with 80 expert clinical plans from treated patients who previously received left-sided breast-conserving surgery and IMRT with simultaneously integrated boost. The libraries were created on the RapidPlan TM . 6 planners with different planning experiences (2 beginner planners, 2 junior planners and 2 senior planners) generated manual and KBP optimized plans for additional 10 patients, similar to those included in the model libraries. The plan qualities were compared between manual and KBP plans. All plans were capable of achieving the prescription requirement. There were almost no statistically significant differences in terms of the planning target volume (PTV) coverage and dose conformality. It was demonstrated that the doses for most of organs-at-risk (OARs) were on average lower or equal in KBP plans compared to manual plans except for the senior planners, where the very small differences were not statistically significant. KBP data showed a systematic trend to have superior dose sparing at most parameters for the heart and ipsilateral lung. The observed decrease in the doses to these OARs could be achieved, particularly for the beginner and junior planners. Many differences were statistically significant. It is feasible to generate acceptable IMRT plans after implementing KBP for left-sided breast cancer. KBP helps to effectively improve the quality of IMRT plans against the benchmark of manual plans for less experienced planners without any manual intervention. KBP

  11. 75 FR 61369 - Revisions to the California State Implementation Plan; Sacramento Metropolitan Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ... the California State Implementation Plan; Sacramento Metropolitan Air Quality Management District... approve a revision to the Sacramento Metropolitan Air Quality Management District's portion of the... Metropolitan Air Quality Management District (SMAQMD) adopted the ``Ozone State Implementation Plan Revision...

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

    ERIC Educational Resources Information Center

    Kaufman, Roger

    1996-01-01

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

  13. Improve strategic supplier performance using DMAIC to develop a Quality Improvement Plan

    NASA Astrophysics Data System (ADS)

    Jardim, Kevin P.

    Supplier performance that meets the requirements of the customer has long plagued quality professionals. Despite the vast efforts by organizations to improve supplier performance, little has been done to standardize the plan to improve performance. This project presents a guideline and problem-solving strategy using a Define, Measure, Analyze, Improve, and Control (DMAIC) structured tool that will assist in the management and improvement of supplier performance. An analysis of benchmarked Quality Improvement Plans indicated that this topic needs more focus on how to accomplish improved supplier performance. This project is part of a growing body of supplier continuous improvement efforts. With the input of Zodiac Aerospace quality professionals this project's results provide a solution to Quality Improvement Plans and show objective evidence of its benefits. This project contributes to the future research on similar topics.

  14. DRMS (Defense Reutilization and Marketing Service) Total Quality Management (TQM) Implementation Plan

    DTIC Science & Technology

    1989-07-01

    FUNDING NUMBERS DRMS Total Quality Management (TQM) Implementation Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING...OF PAGES TOM (Total Quality Management ), Continuous Process Improvement. ’f’ - Management 16. PRICE CODE 17. SECURITY CLASSIFICATION 18. SECURITY...7540-01-280-5500 Standard Form 298 (Rev. 2-89) Pr"cried by ANi SWt 139-i 296-101 DRMS TOTAL QUALITY MANAGEMENT (TQM) IMPLEMENTATION PLAN PURPOSE The

  15. Lake Champlain TMDL Modeling Quality Assurance Project Plan

    EPA Pesticide Factsheets

    This document presents the quality assurance project plan for providing support to US EPA Region 1 in revising the Lake Champlain Total Maximum Daily Load, under Contract Number EP-C-08-004, Task Order 80.

  16. Quality of diet plans for weight loss featured in women's magazines. A cross-sectional descriptive study.

    PubMed

    Martinighi, Maiara; Koga da Silva, Edina Mariko

    2017-01-01

    Brazil has the fifth largest population of obese individuals in the world. Women's magazines publish a large number of diet plans, and therefore the objective of this study was to assess the quality of these plans. Cross-sectional descriptive study. We included the Brazilian women's magazines of highest circulation published between January and June 2014 that advertised diets for weight loss on their covers. We extracted the quantities of macro and micronutrients from each of these diet plans and compared these quantities with the World Health Organization nutritional guidelines for adult women. We also checked the total energy quantities of these plans, and any recommendations about water intake and physical activity. We identified 136 potentially eligible magazine issues; 41 were excluded and 95 issues of 6 different magazines were included in the study. We found that 83.1 % of the plans had carbohydrate and fiber levels below the recommendations. On the other hand, the protein and saturated fatty acid levels were above the recommendations in 97.8% and 95.7% of the plans, respectively; 75.7% of the diets had inadequate calcium levels and 70.5% had low iron levels. Only 30 plans specified the total daily quantity of dietary energy and in 53.3% of these, the information was inconsistent with our estimates; 20% of the plans had no recommendations on daily water intake and 37.5% did not give recommendations regarding physical activity practices. The diet plans for weight loss featured in Brazilian women's magazines are of low quality.

  17. Using the Program Sustainability Assessment Tool to Assess and Plan for Sustainability

    PubMed Central

    Mainor, Avia; Moreland-Russell, Sarah; Maier, Ryan C.; Brossart, Laura; Luke, Douglas A.

    2014-01-01

    Implementing and growing a public health program that benefits society takes considerable time and effort. To ensure that positive outcomes are maintained over time, program managers and stakeholders should plan and implement activities to build sustainability capacity within their programs. We describe a 3-part sustainability planning process that programs can follow to build their sustainability capacity. First, program staff and stakeholders take the Program Sustainability Assessment Tool to measure their program’s sustainability across 8 domains. Next, managers and stakeholders use results from the assessment to inform and prioritize sustainability action planning. Lastly, staff members implement the plan and keep track of progress toward their sustainability goals. Through this process, staff can more holistically address the internal and external challenges and pressures associated with sustaining a program. We include a case example of a chronic disease program that completed the Program Sustainability Assessment Tool and engaged in program sustainability planning. PMID:24456644

  18. The California stream quality assessment

    USGS Publications Warehouse

    Van Metre, Peter C.; Egler, Amanda L.; May, Jason T.

    2017-03-06

    In 2017, the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) project is assessing stream quality in coastal California, United States. The USGS California Stream Quality Assessment (CSQA) will sample streams over most of the Central California Foothills and Coastal Mountains ecoregion (modified from Griffith and others, 2016), where rapid urban growth and intensive agriculture in the larger river valleys are raising concerns that stream health is being degraded. Findings will provide the public and policy-makers with information regarding which human and natural factors are the most critical in affecting stream quality and, thus, provide insights about possible approaches to protect the health of streams in the region.

  19. IRIS Assessment Plan for Uranium (Scoping and Problem Formulation Materials)

    EPA Science Inventory

    In January 2018, EPA released the IRIS Assessment Plan for Uranium (Oral Reference Dose) (Scoping and Problem Formulation Materials). An IRIS Assessment Plan (IAP) communicates to the public the plan for assessing each individual chemical and includes summary informatio...

  20. A deterministic aggregate production planning model considering quality of products

    NASA Astrophysics Data System (ADS)

    Madadi, Najmeh; Yew Wong, Kuan

    2013-06-01

    Aggregate Production Planning (APP) is a medium-term planning which is concerned with the lowest-cost method of production planning to meet customers' requirements and to satisfy fluctuating demand over a planning time horizon. APP problem has been studied widely since it was introduced and formulated in 1950s. However, in several conducted studies in the APP area, most of the researchers have concentrated on some common objectives such as minimization of cost, fluctuation in the number of workers, and inventory level. Specifically, maintaining quality at the desirable level as an objective while minimizing cost has not been considered in previous studies. In this study, an attempt has been made to develop a multi-objective mixed integer linear programming model that serves those companies aiming to incur the minimum level of operational cost while maintaining quality at an acceptable level. In order to obtain the solution to the multi-objective model, the Fuzzy Goal Programming approach and max-min operator of Bellman-Zadeh were applied to the model. At the final step, IBM ILOG CPLEX Optimization Studio software was used to obtain the experimental results based on the data collected from an automotive parts manufacturing company. The results show that incorporating quality in the model imposes some costs, however a trade-off should be done between the cost resulting from producing products with higher quality and the cost that the firm may incur due to customer dissatisfaction and sale losses.

  1. 78 FR 18936 - Revision to the California State Implementation Plan, South Coast Air Quality Management Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0920; FRL-9779-1] Revision to the California State Implementation Plan, South Coast Air Quality Management Plan AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule. SUMMARY: EPA is proposing to approve a revision to the South...

  2. Air Quality Conformity Determination Of the Constrained Long Range Plan And The FY99-2004 Transportation Improvement Program For The Washington Metropolitan Region

    DOT National Transportation Integrated Search

    1998-07-15

    This report documents the assessment of the Constrained Long Range Plan (CLRP) and the FY99-2004 Transportation Improvement Program (TIP) with respect to air quality conformity requirements under the 1990 Clean Air Act Amendments. The assessment used...

  3. RELAP-7 Code Assessment Plan and Requirement Traceability Matrix

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

    Yoo, Junsoo; Choi, Yong-joon; Smith, Curtis L.

    2016-10-01

    The RELAP-7, a safety analysis code for nuclear reactor system, is under development at Idaho National Laboratory (INL). Overall, the code development is directed towards leveraging the advancements in computer science technology, numerical solution methods and physical models over the last decades. Recently, INL has also been putting an effort to establish the code assessment plan, which aims to ensure an improved final product quality through the RELAP-7 development process. The ultimate goal of this plan is to propose a suitable way to systematically assess the wide range of software requirements for RELAP-7, including the software design, user interface, andmore » technical requirements, etc. To this end, we first survey the literature (i.e., international/domestic reports, research articles) addressing the desirable features generally required for advanced nuclear system safety analysis codes. In addition, the V&V (verification and validation) efforts as well as the legacy issues of several recently-developed codes (e.g., RELAP5-3D, TRACE V5.0) are investigated. Lastly, this paper outlines the Requirement Traceability Matrix (RTM) for RELAP-7 which can be used to systematically evaluate and identify the code development process and its present capability.« less

  4. Total Quality Management Implementation Plan for Military Personnel Management

    DTIC Science & Technology

    1989-09-01

    2050.. )ATE 3. REPORT TYPE AND DATES CO VERED 4. TITLE AND SUBTITLE 5,rrmir18 . FUNDING NUMBERS Total Quality Management Implementation Plan for...SUBJECT TERMS 15. NUMBER OF PAGES TQM (Total Quality Management ), Military Personnel Management, Continuous Process Improvement 16. PRICE CODE 17. SECURITY...UNCLASSIFIED UNCLASSIFIED UL NSN 7540-01-280-5500 Standard Form 298 (Rev. 2-89) Prescribed by ANSI Std Z39-16 296-102 TOTAL QUALITY MANAGEMENT I

  5. 78 FR 23524 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Particulate Matter...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-19

    ... Promulgation of Air Quality Implementation Plans; Indiana; Particulate Matter Ambient Air Quality Standards... revise the Indiana State Implementation Plan (SIP) for particulate matter under the Clean Air Act. This submission contains the 24-hour fine particle National Ambient Air Quality Standards (NAAQS) promulgated by...

  6. IRIS Assessment Plan for Uranium (Scoping and Problem Formulation Materials)

    EPA Science Inventory

    In January 2018, EPA released the IRIS Assessment Plan for Uranium (Oral Reference Dose) (Scoping and Problem Formulation Materials). An IRIS Assessment Plan , or IAP communicates to the public the plan for assessing each individual chemical and includes summary informat...

  7. An aquatic multiscale assessment and planning framework approach—forest plan revision case study

    Treesearch

    Kerry Overton; Ann D. Carlson; Cynthia Tait

    2010-01-01

    The Aquatic Multiscale Assessment and Planning Framework is a Web-based decision-support tool developed to assist aquatic practitioners in managing fisheries and watershed information. This tool, or framework, was designed to assist resource assessments and planning efforts from the broad scale to the fine scale, to document procedures, and to link directly to relevant...

  8. Experience-based quality control of clinical intensity-modulated radiotherapy planning.

    PubMed

    Moore, Kevin L; Brame, R Scott; Low, Daniel A; Mutic, Sasa

    2011-10-01

    To incorporate a quality control tool, according to previous planning experience and patient-specific anatomic information, into the intensity-modulated radiotherapy (IMRT) plan generation process and to determine whether the tool improved treatment plan quality. A retrospective study of 42 IMRT plans demonstrated a correlation between the fraction of organs at risk (OARs) overlapping the planning target volume and the mean dose. This yielded a model, predicted dose = prescription dose (0.2 + 0.8 [1 - exp(-3 overlapping planning target volume/volume of OAR)]), that predicted the achievable mean doses according to the planning target volume overlap/volume of OAR and the prescription dose. The model was incorporated into the planning process by way of a user-executable script that reported the predicted dose for any OAR. The script was introduced to clinicians engaged in IMRT planning and deployed thereafter. The script's effect was evaluated by tracking δ = (mean dose-predicted dose)/predicted dose, the fraction by which the mean dose exceeded the model. All OARs under investigation (rectum and bladder in prostate cancer; parotid glands, esophagus, and larynx in head-and-neck cancer) exhibited both smaller δ and reduced variability after script implementation. These effects were substantial for the parotid glands, for which the previous δ = 0.28 ± 0.24 was reduced to δ = 0.13 ± 0.10. The clinical relevance was most evident in the subset of cases in which the parotid glands were potentially salvageable (predicted dose <30 Gy). Before script implementation, an average of 30.1 Gy was delivered to the salvageable cases, with an average predicted dose of 20.3 Gy. After implementation, an average of 18.7 Gy was delivered to salvageable cases, with an average predicted dose of 17.2 Gy. In the prostate cases, the rectum model excess was reduced from δ = 0.28 ± 0.20 to δ = 0.07 ± 0.15. On surveying dosimetrists at the end of the study, most reported that the script

  9. The European water framework directive: water quality classification and implications to engineering planning.

    PubMed

    Achleitner, Stefan; De Toffol, Sara; Engelhard, Carolina; Rauch, Wolfgang

    2005-04-01

    The European Water framework directive (WFD) is probably the most important environmental management directive that has been enacted over the last decade in the European Union. The directive aims at achieving an overall good ecological status in all European water bodies. In this article, we discuss the implementation steps of the WFD and their implications for environmental engineering practice while focusing on rivers as the main receiving waters. Arising challenges for engineers and scientists are seen in the quantitative assessment of water quality, where standardized systems are needed to estimate the biological status. This is equally of concern in engineering planning, where the prediction of ecological impacts is required. Studies dealing with both classification and prediction of the ecological water quality are reviewed. Further, the combined emission-water quality approach is discussed. Common understanding of this combined approach is to apply the most stringent of either water quality or emission standard to a certain case. In contrast, for example, the Austrian water act enables the application of only the water quality based approach--at least on a temporary basis.

  10. Prostate seed implant quality assessment using MR and CT image fusion.

    PubMed

    Amdur, R J; Gladstone, D; Leopold, K A; Harris, R D

    1999-01-01

    After a seed implant of the prostate, computerized tomography (CT) is ideal for determining seed distribution but soft tissue anatomy is frequently not well visualized. Magnetic resonance (MR) images soft tissue anatomy well but seed visualization is problematic. We describe a method of fusing CT and MR images to exploit the advantages of both of these modalities when assessing the quality of a prostate seed implant. Eleven consecutive prostate seed implant patients were imaged with axial MR and CT scans. MR and CT images were fused in three dimensions using the Pinnacle 3.0 version of the ADAC treatment planning system. The urethra and bladder base were used to "line up" MR and CT image sets during image fusion. Alignment was accomplished using translation and rotation in the three ortho-normal planes. Accuracy of image fusion was evaluated by calculating the maximum deviation in millimeters between the center of the urethra on axial MR versus CT images. Implant quality was determined by comparing dosimetric results to previously set parameters. Image fusion was performed with a high degree of accuracy. When lining up the urethra and base of bladder, the maximum difference in axial position of the urethra between MR and CT averaged 2.5 mm (range 1.3-4.0 mm, SD 0.9 mm). By projecting CT-derived dose distributions over MR images of soft tissue structures, qualitative and quantitative evaluation of implant quality is straightforward. The image-fusion process we describe provides a sophisticated way of assessing the quality of a prostate seed implant. Commercial software makes the process time-efficient and available to any clinical practice with a high-quality treatment planning system. While we use MR to image soft tissue structures, the process could be used with any imaging modality that is able to visualize the prostatic urethra (e.g., ultrasound).

  11. Sulfur Oxides Risk and Exposure Assessment Planning ...

    EPA Pesticide Factsheets

    In conducting risk/exposure assessments for the Sulfur Oxides NAAQS review, EPA will first develop a draft Scope and Methods Plan which will describe the proposed scope of the quantitative and qualitative analyses to be performed and the tools/methods that may be employed Provide opportunity for CASAC feedback on EPA's plans for the risk and exposure assessment for the Sulfur Oxides NAAQS review

  12. Remediation plans in family medicine residency

    PubMed Central

    Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert

    2015-01-01

    Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

  13. An assessment of drinking-water quality post-Haiyan

    PubMed Central

    Anarna, Maria Sonabel; Fernando, Arturo

    2015-01-01

    Introduction Access to safe drinking-water is one of the most important public health concerns in an emergency setting. This descriptive study reports on an assessment of water quality in drinking-water supply systems in areas affected by Typhoon Haiyan immediately following and 10 months after the typhoon. Methods Water quality testing and risk assessments of the drinking-water systems were conducted three weeks and 10 months post-Haiyan. Portable test kits were used to determine the presence of Escherichia coli and the level of residual chlorine in water samples. The level of risk was fed back to the water operators for their action. Results Of the 121 water samples collected three weeks post-Haiyan, 44% were contaminated, while 65% (244/373) of samples were found positive for E. coli 10 months post-Haiyan. For the three components of drinking-water systems – source, storage and distribution – the proportions of contaminated systems were 70%, 67% and 57%, respectively, 10 months after Haiyan. Discussion Vulnerability to faecal contamination was attributed to weak water safety programmes in the drinking-water supply systems. Poor water quality can be prevented or reduced by developing and implementing a water safety plan for the systems. This, in turn, will help prevent waterborne disease outbreaks caused by contaminated water post-disaster. PMID:26767136

  14. 78 FR 63878 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Revised Ambient Air...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ...] Approval and Promulgation of Air Quality Implementation Plans; Virginia; Revised Ambient Air Quality... State Implementation Plan (SIP). The revisions add ambient air quality standards and associated... Ambient Air Quality Standards (NAAQS) for PM 2.5 . EPA is approving these revisions in accordance with the...

  15. Teacher Performance Assessment Instruments: Plans for Practice Rating.

    ERIC Educational Resources Information Center

    Capie, William; And Others

    This manual consists of lesson plans developed to train data collectors in the use of the Teacher Performance Assessment Instruments (TPAI). Each set of plans was designed for one of three purposes. Lesson plans developed for the Teaching Plans and Materials Instrument (TPM) simulate a portfolio prepared by the teacher. One-day plans developed for…

  16. Arizona Air Quality State Implementation Plans; Final Approval; Douglas, Arizona; Second 10-Year Sulfur Dioxide Maintenance Plan

    EPA Pesticide Factsheets

    EPA is taking final rulemaking action to approve, as part of the State Implementation Plan (SIP) for the State of Arizona, the second 10-year maintenance plan for the Douglas maintenance area for the 1971 National Ambient Air Quality Standards for SO2.

  17. 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

  18. Landscape ecological assessment: a tool for integrating biodiversity issues in strategic environmental assessment and planning.

    PubMed

    Mörtberg, U M; Balfors, B; Knol, W C

    2007-03-01

    To achieve a sustainable development, impacts on biodiversity of urbanisation, new infrastructure projects and other land use changes must be considered on landscape and regional scales. This requires that important decisions are made after a systematic evaluation of environmental impacts. Landscape ecology can provide a conceptual framework for the assessment of consequences of long-term development processes like urbanisation on biodiversity components, and for evaluating and visualising the impacts of alternative planning scenarios. The aim of this paper was to develop methods for integrating biodiversity issues in planning and strategic environmental assessment in an urbanising environment, on landscape and regional levels. In order to test developed methods, a case study was conducted in the region of Stockholm, the capital of Sweden, and the study area embraced the city centre, suburbs and peri-urban areas. Focal species were tested as indicators of habitat quality, quantity and connectivity in the landscape. Predictive modelling of habitat distribution in geographic information systems involved the modelling of focal species occurrences based on empirical data, incorporated in a landscape ecological decision support system. When habitat models were retrieved, they were applied on future planning scenarios in order to predict and assess the impacts on focal species. The scenario involving a diffuse exploitation pattern had the greatest negative impacts on the habitat networks of focal species. The scenarios with concentrated exploitation also had negative impacts, although they were possible to mitigate quite easily. The predictions of the impacts on habitats networks of focal species made it possible to quantify, integrate and visualise the effects of urbanisation scenarios on aspects of biodiversity on a landscape level.

  19. Guidelines for preparing a quality assurance plan for district offices of the U.S. Geological Survey

    USGS Publications Warehouse

    Schroder, L.J.; Shampine, W.J.

    1992-01-01

    The U.S. Geological Survey has a policy that requires each District office to prepare a Quality Assurance Plan. This plan is a combination of a District's management principles and quality assurance processes. The guidelines presented in this report provide a framework or expanded outline that a District can use to prepare a plan. Parti- cular emphasis is given to a District's: (1) quality assurance policies; (2) organization and staff responsibilities; and (3) program and project planning. The guidelines address the 'how', 'what', and 'who' questions that need to be answered when a District Quality Assurance Plan is prepared.

  20. DPSC (Defense Personnel Support Center) Total Quality Management Master Plan

    DTIC Science & Technology

    1989-07-01

    SUBTITLE 5. FUNDING NUMBERS DPSC Total Quality Management Master Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) B. PERFORMING...quality supported solider, sailor, airman and marine. % j cl 1 14. SUBJECT TERMS I 1S. NUMBER OF PAGES TQM (Total Quality Management ), Continuous...THE COMMANDER ON TOTAL QUALITY MANAGEMENT i SECTION I INTRODUCTION 1 II CONCEPTS 6 TQM Basics 7 Continuous Process Improvement 7 DoD TQM Philosophy 9

  1. Patient geometry-driven information retrieval for IMRT treatment plan quality control

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

    Wu Binbin; Ricchetti, Francesco; Sanguineti, Giuseppe

    Purpose: Intensity modulated radiation therapy (IMRT) treatment plan quality depends on the planner's level of experience and the amount of time the planner invests in developing the plan. Planners often unwittingly accept plans when further sparing of the organs at risk (OARs) is possible. The authors propose a method of IMRT treatment plan quality control that helps planners to evaluate the doses of the OARs upon completion of a new plan. Methods: It is achieved by comparing the geometric configurations of the OARs and targets of a new patient with those of prior patients, whose plans are maintained in amore » database. They introduce the concept of a shape relationship descriptor and, specifically, the overlap volume histogram (OVH) to describe the spatial configuration of an OAR with respect to a target. The OVH provides a way to infer the likely DVHs of the OARs by comparing the relative spatial configurations between patients. A database of prior patients is built to serve as an external reference. At the conclusion of a new plan, planners search through the database and identify related patients by comparing the OAR-target geometric relationships of the new patient with those of prior patients. The treatment plans of these related patients are retrieved from the database and guide planners in determining whether lower doses delivered to the OARs in the new plan are feasible. Results: Preliminary evaluation is promising. In this evaluation, they applied the analysis to the parotid DVHs of 32 prior head-and-neck patients, whose plans are maintained in a database. Each parotid was queried against the other 63 parotids to determine whether a lower dose was possible. The 17 parotids that promised the greatest reduction in D{sub 50} (DVH dose at 50% volume) were flagged. These 17 parotids came from 13 patients. The method also indicated that the doses of the other nine parotids of the 13 patients could not be reduced, so they were included in the replanning

  2. Quality program plan for the Ultraviolet Spectrometer Experiment S169, Revision C

    NASA Technical Reports Server (NTRS)

    Vinson, W. W.

    1971-01-01

    The quality progress plan establishes the requirements for a system of controls to assure compliance with the quality assurance requirements as set forth in NASA quality program provisions for aeronautical and space system contractors.

  3. Higher Education Quality Assessment Model: Towards Achieving Educational Quality Standard

    ERIC Educational Resources Information Center

    Noaman, Amin Y.; Ragab, Abdul Hamid M.; Madbouly, Ayman I.; Khedra, Ahmed M.; Fayoumi, Ayman G.

    2017-01-01

    This paper presents a developed higher education quality assessment model (HEQAM) that can be applied for enhancement of university services. This is because there is no universal unified quality standard model that can be used to assess the quality criteria of higher education institutes. The analytical hierarchy process is used to identify the…

  4. State Policies and Planning to Increase Attainment, Quality, and Productivity

    ERIC Educational Resources Information Center

    Lingenfelter, Paul E.

    2007-01-01

    This article examines why state planning and policy for higher education are increasingly focused on increasing educational attainment, quality, and the productivity of the system. It presents four "stories" which illustrate initiatives to improve attainment, quality, and productivity, but fall far short of exhausting the available material.

  5. 78 FR 59840 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-30

    ...] Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management District... of plan. * * * * * (c) * * * (428) * * * (i) * * * (B) Antelope Valley Air Quality Management...) * * * (i) * * * (B) Antelope Valley Air Quality Management District. (1) Rule 431.1, ``Sulfur Content of...

  6. Quality of governance and effectiveness of protected areas: crucial concepts for conservation planning.

    PubMed

    Eklund, Johanna; Cabeza, Mar

    2017-07-01

    Protected areas (PAs) are a key tool for biodiversity conservation and play a central role in the Convention on Biological Diversity. Recently, the effectiveness of PAs has been questioned, and assessing how effective they are in enabling the future persistence of biodiversity is not trivial. Here, we focus on terrestrial PAs and clarify the terminology related to PA effectiveness, distinguishing between management and ecological aspects. We suggest that the quality of governance affects both aspects of effectiveness but recognize a lack of synthetic understanding of the topic. We present a conceptual framework linking the underlying mechanisms by which the quality of governance affects conservation outcomes in PAs and how this relates to conservation planning. We show that it is crucial to separate pressure and response and how these together will lead to the observed conservation outcomes. We urge for more focused attention on governance factors and in particular more empirical research on how to address causality and how to account for the quality of governance when prioritizing actions. Our framework is linked to the classic concepts of systematic conservation planning and clarifies the strategies available to achieve a comprehensive and effective network of PAs. © 2016 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of New York Academy of Sciences.

  7. Astronomical Instrumentation Systems Quality Management Planning: AISQMP (Abstract)

    NASA Astrophysics Data System (ADS)

    Goldbaum, J.

    2017-12-01

    (Abstract only) The capability of small aperture astronomical instrumentation systems (AIS) to make meaningful scientific contributions has never been better. The purpose of AIS quality management planning (AISQMP) is to ensure the quality of these contributions such that they are both valid and reliable. The first step involved with AISQMP is to specify objective quality measures not just for the AIS final product, but also for the instrumentation used in its production. The next step is to set up a process to track these measures and control for any unwanted variation. The final step is continual effort applied to reducing variation and obtaining measured values near optimal theoretical performance. This paper provides an overview of AISQMP while focusing on objective quality measures applied to astronomical imaging systems.

  8. Assessing the quality of healthcare provided to children.

    PubMed

    Mangione-Smith, R; McGlynn, E A

    1998-10-01

    pediatric population that can be most affected by variations in the quality of care. Improving the care provided to these children is likely to have the largest impact on quality of life and longevity. The low prevalence of most severe pediatric diseases also makes it difficult to evaluate the effectiveness of new treatment modalities; multi-center trials or long enrollment periods are usually required to obtain a large enough patient sample to conduct the necessary randomized controlled trials or cohort studies. Another challenge encountered when measuring quality of care for children is that, in most cases, they depend on adults to both obtain care and to report on the outcomes of that care. Parents and their children may have different perceptions of what defines health or have different levels of satisfaction with the care they receive. Children, particularly those with special needs, also depend on a broad range of services including the medical system, community intervention programs, social programs, and school-based services. Dependency on these various services adds to the difficulty of measuring and appropriately attributing health outcomes observed in children to a particular service delivery entity. Adolescents also depend on adults for access to some of their care; however, they have special needs related to confidentiality and parent-child information sharing. Adolescents commonly seek care at facilities, such as school-based clinics, that allow them to obtain confidential care. These facilities usually provide out-of-health plan care for these children, which raises special issues related to information availability for quality assessments and for assessing utilization patterns in this population. If the source of poor health outcomes is not known, quality improvement is not possible. The many challenges faced when constructing pediatric (this term will be used to refer to both children and adolescents) quality of care measures have resulted in few of these

  9. 77 FR 60661 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; South Bend-Elkhart...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... Promulgation of Air Quality Implementation Plans; Indiana; South Bend-Elkhart, Indiana Ozone Maintenance Plan..., Indiana 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP) by replacing the... Vehicle Emissions Simulator (MOVES) 2010a emissions model. Indiana submitted this request to EPA for...

  10. Service User- and Carer-Reported Measures of Involvement in Mental Health Care Planning: Methodological Quality and Acceptability to Users

    PubMed Central

    Gibbons, Chris J.; Bee, Penny E.; Walker, Lauren; Price, Owen; Lovell, Karina

    2014-01-01

    Background: Increasing service user and carer involvement in mental health care planning is a key healthcare priority but one that is difficult to achieve in practice. To better understand and measure user and carer involvement, it is crucial to have measurement questionnaires that are both psychometrically robust and acceptable to the end user. Methods: We conducted a systematic review using the terms “care plan$,” “mental health,” “user perspective$,” and “user participation” and their linguistic variants as search terms. Databases were searched from inception to November 2012, with an update search at the end of September 2014. We included any articles that described the development, validation or use of a user and/or carer-reported outcome measures of involvement in mental health care planning. We assessed the psychometric quality of each instrument using the “Evaluating the Measurement of Patient-Reported Outcomes” (EMPRO) criteria. Acceptability of each instrument was assessed using novel criteria developed in consultation with a mental health service user and carer consultation group. Results: We identified eleven papers describing the use, development, and/or validation of nine user/carer-reported outcome measures. Psychometric properties were sparsely reported and the questionnaires met few service user/carer-nominated attributes for acceptability. Where reported, basic psychometric statistics were of good quality, indicating that some measures may perform well if subjected to more rigorous psychometric tests. The majority were deemed to be too long for use in practice. Discussion: Multiple instruments are available to measure user/carer involvement in mental health care planning but are either of poor quality or poorly described. Existing measures cannot be considered psychometrically robust by modern standards, and cannot currently be recommended for use. Our review has identified an important knowledge gap, and an urgent need to

  11. 78 FR 8485 - Approval and Promulgation of Air Quality Implementation Plans; Michigan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ... Promulgation of Air Quality Implementation Plans; Michigan AGENCY: Environmental Protection Agency (EPA... control), R336.1240 (Required air quality models), R336.1241 (Air quality modeling demonstration... nonattainment air quality permitting regulations found in 40 CFR 51.165(a) and (b). EPA has found that the rules...

  12. A non-linear optimization programming model for air quality planning including co-benefits for GHG emissions.

    PubMed

    Turrini, Enrico; Carnevale, Claudio; Finzi, Giovanna; Volta, Marialuisa

    2018-04-15

    This paper introduces the MAQ (Multi-dimensional Air Quality) model aimed at defining cost-effective air quality plans at different scales (urban to national) and assessing the co-benefits for GHG emissions. The model implements and solves a non-linear multi-objective, multi-pollutant decision problem where the decision variables are the application levels of emission abatement measures allowing the reduction of energy consumption, end-of pipe technologies and fuel switch options. The objectives of the decision problem are the minimization of tropospheric secondary pollution exposure and of internal costs. The model assesses CO 2 equivalent emissions in order to support decision makers in the selection of win-win policies. The methodology is tested on Lombardy region, a heavily polluted area in northern Italy. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. 78 FR 7703 - Revisions to the California State Implementation Plan, South Coast Air Quality Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ... the California State Implementation Plan, South Coast Air Quality Management District, Proposed Rule... approve a revision to the South Coast Air Quality Management District (SCAQMD) portion of the California... digesters. Rule 1127 was designed to implement the 2003 Air Quality Management Plan (AQMP) control measure...

  14. Supply Operations (DLA-O) Total Quality Management (TQM) Master Plan

    DTIC Science & Technology

    1989-07-01

    This document briefly outlines the DLA Directorate of Supply Operations plan to implement total quality management . It seeks to provide better...service to customers at a lower cost through continuous process improvement and commitment from everyone in the organization. Keywords: TQM (total Quality Management ), Supply operations; Continuous process improvement. (KR)

  15. 75 FR 19886 - Approval and Promulgation of Air Quality Implementation Plans; Wyoming; Revisions to the Wyoming...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ... Promulgation of Air Quality Implementation Plans; Wyoming; Revisions to the Wyoming Air Quality Standards and.... Wyoming has revised its Air Quality Standards and Regulations, specifically Chapter 1, Section 5... Wyoming's State Implementation Plan (SIP). These revisions amend Wyoming's Air Quality Standards and...

  16. SPIDERplan: A tool to support decision-making in radiation therapy treatment plan assessment.

    PubMed

    Ventura, Tiago; Lopes, Maria do Carmo; Ferreira, Brigida Costa; Khouri, Leila

    2016-01-01

    In this work, a graphical method for radiotherapy treatment plan assessment and comparison, named SPIDERplan, is proposed. It aims to support plan approval allowing independent and consistent comparisons of different treatment techniques, algorithms or treatment planning systems. Optimized plans from modern radiotherapy are not easy to evaluate and compare because of their inherent multicriterial nature. The clinical decision on the best treatment plan is mostly based on subjective options. SPIDERplan combines a graphical analysis with a scoring index. Customized radar plots based on the categorization of structures into groups and on the determination of individual structures scores are generated. To each group and structure, an angular amplitude is assigned expressing the clinical importance defined by the radiation oncologist. Completing the graphical evaluation, a global plan score, based on the structures score and their clinical weights, is determined. After a necessary clinical validation of the group weights, SPIDERplan efficacy, to compare and rank different plans, was tested through a planning exercise where plans had been generated for a nasal cavity case using different treatment planning systems. SPIDERplan method was applied to the dose metrics achieved by the nasal cavity test plans. The generated diagrams and scores successfully ranked the plans according to the prescribed dose objectives and constraints and the radiation oncologist priorities, after a necessary clinical validation process. SPIDERplan enables a fast and consistent evaluation of plan quality considering all targets and organs at risk.

  17. Community-based assessment and planning of energy futures

    NASA Astrophysics Data System (ADS)

    Carnes, S. A.

    1981-04-01

    The decentralized solar energy technology assessment program is discussed. Four communities were involved in an assessment of the compatibility of diverse conservation and renewable energy supply technologies and community values and goals and in community planning for the implementation of compatible energy demand and supply alternatives. The community approach has several basic components: (1) recruiting and organizing for the assessment planning process; (2) collection and analysis of data related to community energy use and indigenous renewable energy resources; (3) creation and maintenance of a community education and information program; (4) development of policies favorable to the development of preferred community futures; and (5) development of implementation or action strategies. The role of public participation, group decision making techniques, the role of technical information in citizen and group decision making, and linkage between assessment planning and the relevant policy process are emphasized.

  18. Individualized Quality Control Plan (IQCP): Is It Value-Added for Clinical Microbiology?

    PubMed Central

    Miller, Melissa B.; Hindler, Janet

    2015-01-01

    The Center for Medicaid and Medicare Services (CMS) recently published their Individualized Quality Control Plan (IQCP [https://www.cms.gov/regulations-and-guidance/legislation/CLIA/Individualized_Quality_Control_Plan_IQCP.html]), which will be the only option for quality control (QC) starting in January 2016 if laboratories choose not to perform Clinical Laboratory Improvement Act (CLIA) [U.S. Statutes at Large 81(1967):533] default QC. Laboratories will no longer be able to use “equivalent QC” (EQC) or the Clinical and Laboratory Standards Institute (CLSI) standards alone for quality control of their microbiology systems. The implementation of IQCP in clinical microbiology laboratories will most certainly be an added burden, the benefits of which are currently unknown. PMID:26447112

  19. 42 CFR 460.140 - Additional quality assessment activities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Additional quality assessment activities. 460.140... FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.140 Additional quality assessment activities. A PACE organization must meet external quality assessment and reporting requirements...

  20. 75 FR 59180 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Control Technique...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-27

    ... Promulgation of Air Quality Implementation Plans; Maryland; Control Technique Guidelines for Paper, Film, and... Technique Guidelines (CTG) for paper, film, and foil coatings. These amendments will reduce volatile organic... Promulgation of Air Quality Implementation Plans; Maryland; Control Technique Guidelines for Paper, Film, and...

  1. SU-F-T-617: Remotely Pre-Planned Stereotactic Ablative Radiation Therapy: Validation of Treatment Plan Quality

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

    Juang, T; Bush, K; Loo, B

    Purpose: We propose a workflow to improve access to stereotactic ablative radiation therapy (SABR) for rural patients. When implemented, a separate trip to the central facility for simulation can be eliminated. Two elements are required: (1) Fabrication of custom immobilization devices to match positioning on prior diagnostic CT (dxCT). (2) Remote radiation pre-planning on dxCT, with transfer of contours/plan to simulation CT (simCT) and initiation of treatment same-day or next day. In this retrospective study, we validated part 2 of the workflow using patients already treated with SABR for upper lobe lung tumors. Methods: Target/normal structures were contoured on dxCT;more » a plan was created and approved by the physician. Structures were transferred to simCT using deformable image registration and the plan was re-optimized on simCT. Plan quality was evaluated through comparison to gold-standard structures contoured on simCT and a gold-standard plan based on these structures. Workflow-generated plan quality in this study represents a worst-case scenario as these patients were not treated using custom immobilization to match dxCT position as would be done when the workflow is implemented clinically. Results: 5/6 plans created through the pre-planning workflow were clinically acceptable. For all six plans, the gold-standard GTV received full prescription dose, along with median PTV V95%=95.2% and median PTV D95%=95.4%. Median GTV DSC=0.80, indicating high degree of similarity between the deformed and gold-standard GTV contours despite small GTV sizes (mean=3.0cc). One outlier (DSC=0.49) resulted in inadequate PTV coverage (V95%=62.9%) in the workflow plan; in clinical practice, this mismatch between deformed/gold-standard GTV would be revised by the physician after deformable registration. For all patients, normal tissue doses were comparable to the gold-standard plan and well within constraints. Conclusion: Pre-planning SABR cases on diagnostic imaging

  2. Standardised care plans for in hospital stroke care improve documentation of health care assessments.

    PubMed

    Pöder, Ulrika; Dahm, Marie Fogelberg; Karlsson, Nina; Wadensten, Barbro

    2015-10-01

    To compare stroke unit staff members' documentation of care in line with evidence-based guidelines pre- and postimplementation of a multi-professional, evidence-based standardised care plan for stroke care in the electronic health record. Rapid and effective measures for patients with stroke or suspected stroke can limit the extent of damage; it is imperative that patients be observed, assessed and treated in accordance with evidence-based practice in hospital. Quantitative, comparative. Structured retrospective health record reviews were made prior to (n 60) and one and a half years after implementation (n 60) of a multi-professional evidence-based standardised care plan with a quality standard for stroke care in the electronic health record. Significant improvements were found in documentation of assessed vital signs, except for body temperature, Day 1 post compared with preimplementation. Documentation frequency regarding body temperature Day 1 and blood pressure and pulse Day 2 decreased post compared with preimplementation. Improvements were also detected in documented observations of patients' micturition capacity, swallowing capacity and mouth status and the proportion of physiotherapist-documented aid assessments. Observations of blood glucose, mobilisation ability and speech and communication ability were unchanged. An evidence-based standardised care plan in an electronic health record assists staff in improving documentation of health status assessments during the first days after a stroke diagnosis. Use of a standardised care plan seems to have the potential to help staff adhere to evidence-based patient care and, thereby, to increase patient safety. © 2015 John Wiley & Sons Ltd.

  3. Dental hygiene self-assessment: a key to quality care.

    PubMed

    DeVore, L; Fried, J L; Dailey, J; Qori, C G

    2000-01-01

    To help achieve the goal of delivering quality care to the public, this study applied the Theory of Reasoned Action to dental hygienists' self-assessment (appraisal of one's performance). This theory suggests that individuals are likely to exhibit a given behavior, i.e., self-assessment, when they view it positively and when they believe that important others think they should perform it. To date, no research has been conducted on the self-assessment (SA) behaviors of practicing dental hygienists. The following research questions were addressed: what/who are the (1) behavioral beliefs; (2) normative beliefs; (3) salient referents; (4) attitudes toward self-assessment; (5) intentions to perform self-assessment; (6) outcomes associated with self-assessment; and (7) motivations to comply with self-assessment in a representative sample of dental hygienists? This study consisted of two phases: Phase I, telephone interviews (N = 30) and Phase II, a mailed survey of 600 randomly selected subjects. Interview responses from Phase I determined questionnaire items. Survey data analysis included descriptive statistics and correlations of component mean scores. A total of 273 usable surveys were returned, achieving a 46% response rate. Respondents valued the potential benefits of SA with a statistical mean of 2.70 on a six point scale ranging from minus three to plus three. Attitude correlated strongly with intention to self-assess (R = .7455). Survey respondents are motivated by their own beliefs and perceived benefits of SA rather than by the values of others. The insights that were derived from this study will permit the development of strategies to enable dental hygiene educators and practitioners to incorporate self-assessment as part of quality assurance plans. Application of well-developed self-assessment strategies promises potential benefits for dental hygienists and the public they serve.

  4. National water-quality assessment program : the Albemarle- Pamlico drainage

    USGS Publications Warehouse

    Lloyd, O.B.; Barnes, C.R.; Woodside, M.D.

    1991-01-01

    In 1991, the U.S. Geological Survey (USGS) began to implement a full-scale National Water-Quality Assessment (NAWQA) program. Long-term goals of the NAWQA program are to describe the status and trends in the quality of a large, representative part of the Nation's surface- and ground-water resources and to provide a sound, scientific understanding of the primary natural and human factors affecting the quality of these resources. In meeting these goals, the program will produce a wealth of water quality information that will be useful to policy makers and managers at the national, State, and local levels. Study-unit investigations constitute a major component of the NAWQA program, forming the principal building blocks on which national-level assessment activities are based. The 60 study-unit investigations that make up the program are hydrologic systems that include parts of most major river basins and aquifer systems. These study units cover areas of 1,200 to more than 65,000 square miles and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the Albemarle-Pamlico drainage was among the first 20 NAWQA study units selected for study under the full-scale implementation plan. The Albemarle-Pamlico drainage study will examine the physical, chemical, and biological aspects of water quality issues in a coordinated investigation of surface water and ground water in the Albemarle-Pamlico drainage basin. The quantity and quality of discharge from the Albemarle-Pamlico drainage basin contribute to some water quality problems in the biologically sensitive waters of Albemarle and Pamlico Sounds. A retrospective analysis of existing water quality data will precede a 3-year period of intensive data-collection and analysis activities. The data resulting from this study and the improved understanding of important processes and issues in the upstream part of the study unit will enhance understanding of the quality of

  5. Quality Assurance in Teachers' Assessment.

    ERIC Educational Resources Information Center

    Gipps, Caroline V.

    The teacher assessment that is the subject of this paper is an essentially informal activity. The teacher assesses the student by posing questions, observing activities, and evaluating work in a planned or ad hoc way. The information obtained may be partial or fragmented, but repeating such assessments over time will allow the buildup of a solid…

  6. 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.

  7. Mathematics: Program Assessment and Improvement Planning Manual.

    ERIC Educational Resources Information Center

    Whitman, Nancy C.; And Others

    This document provides a model for assessing a school's mathematics program and planning for program improvement. A systematic process for instructional improvement focuses upon students' needs and the identification of successful instructional strategies to meet these needs. The improvement plan and the implementation of intervention strategies…

  8. A Markovian model for assessment of personnel hiring plans

    NASA Technical Reports Server (NTRS)

    Katz, L. G.

    1974-01-01

    As a result of the current economic environment, many organizations are having to operate with fewer resources. In the manpower area, these constraints have forced organizations to operate within well-defined hiring plans. Exceeding personnel ceilings is in most cases an intolerable situation. A mathematical model, based on the theory of Markov processes, is presented which can be used to assess the chances of success of personnel hiring plans. The model considers a plan to be successful if the final population size, at the end of the planning period, lies within a range specified by management. Although this model was developed to assess personnel hiring plans at the Goddard Space Flight Center, it is directly applicable wherever personnel hiring plans are used.

  9. Research Notes - Openness and Evolvability - Documentation Quality Assessment

    DTIC Science & Technology

    2016-08-01

    UNCLASSIFIED UNCLASSIFIED Notes – Openness and Evolvability – Documentation Quality Assessment Michael Haddy* and Adam Sbrana...Methods and Processes. This set of Research Notes focusses on Documentation Quality Assessment. This work was undertaken from the late 1990s to 2007...1 2. DOCUMENTATION QUALITY ASSESSMENT ......................................................... 1 2.1 Documentation Quality Assessment

  10. Individualized Quality Control Plan (IQCP): Is It Value-Added for Clinical Microbiology?

    PubMed

    Sharp, Susan E; Miller, Melissa B; Hindler, Janet

    2015-12-01

    The Center for Medicaid and Medicare Services (CMS) recently published their Individualized Quality Control Plan (IQCP [https://www.cms.gov/regulations-and-guidance/legislation/CLIA/Individualized_Quality_Control_Plan_IQCP.html]), which will be the only option for quality control (QC) starting in January 2016 if laboratories choose not to perform Clinical Laboratory Improvement Act (CLIA) [U.S. Statutes at Large 81(1967):533] default QC. Laboratories will no longer be able to use "equivalent QC" (EQC) or the Clinical and Laboratory Standards Institute (CLSI) standards alone for quality control of their microbiology systems. The implementation of IQCP in clinical microbiology laboratories will most certainly be an added burden, the benefits of which are currently unknown. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  11. Impact assessment of land use planning driving forces on environment

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

    Chen, Longgao, E-mail: chenlonggao@163.com; Yang, Xiaoyan; School of Environment and Spatial Informatics, China University of Mining and Technology, Xuzhou 221116

    Land use change may exert a negative impact on environmental quality. A state–impact–state (SIS) model describing a state transform under certain impacts has been integrated into land use planning (LUP) environmental impact assessment (LUPEA). This logical model is intuitive and easy to understand, but the exploration of impact is essential to establish the indicator system and to identify the scope of land use environmental impact when it is applied to a specific region. In this study, we investigated environmental driving forces from land use planning (LUPF), along with the conception, components, scope, and impact of LUPF. This method was illustratedmore » by a case study in Zoucheng, China. Through the results, we concluded that (1) the LUPF on environment are impacts originated from the implementation of LUP on a regional environment, which are characterized by four aspects: magnitude, direction, action point, and its owner; (2) various scopes of LUPF on individual environmental elements based on different standards jointly define the final scope of LUPEA; (3) our case study in Zoucheng demonstrates the practicability of this proposed approach; (4) this method can be embedded into LUPEA with direction, magnitudes, and scopes of the LUPF on individual elements obtained, and the identified indicator system can be directly employed into LUPEA and (5) the assessment helps to identify key indicators and to set up a corresponding strategy to mitigate the negative impact of LUP on the environment, which are two important objectives of strategic environmental assessment (SEA) in LUP. - Highlights: • Environmental driving forces from land use planning (LUPF) are investigated and categorized. • Our method can obtains the direction, magnitudes and scopes of environmental driving forces. • The LUPEA scope is determined by the combination of various scopes of LUPF on individual elements. • LUPF assessment can be embedded into LUPEA. • The method can help to

  12. Chip Design Process Optimization Based on Design Quality Assessment

    NASA Astrophysics Data System (ADS)

    Häusler, Stefan; Blaschke, Jana; Sebeke, Christian; Rosenstiel, Wolfgang; Hahn, Axel

    2010-06-01

    Nowadays, the managing of product development projects is increasingly challenging. Especially the IC design of ASICs with both analog and digital components (mixed-signal design) is becoming more and more complex, while the time-to-market window narrows at the same time. Still, high quality standards must be fulfilled. Projects and their status are becoming less transparent due to this complexity. This makes the planning and execution of projects rather difficult. Therefore, there is a need for efficient project control. A main challenge is the objective evaluation of the current development status. Are all requirements successfully verified? Are all intermediate goals achieved? Companies often develop special solutions that are not reusable in other projects. This makes the quality measurement process itself less efficient and produces too much overhead. The method proposed in this paper is a contribution to solve these issues. It is applied at a German design house for analog mixed-signal IC design. This paper presents the results of a case study and introduces an optimized project scheduling on the basis of quality assessment results.

  13. Surface-Water Quality-Assurance Plan for the Tallahassee Office, U.S. Geological Survey

    USGS Publications Warehouse

    Tomlinson, Stewart A.

    2006-01-01

    This Tallahassee Office Surface-Water Quality-Assurance Plan documents the standards, policies, and procedures used by the Tallahassee Office for activities related to the collection, processing, storage, analysis, and publication of surface-water data. This plan serves as a guide to all Tallahassee Office personnel involved in surface-water data activities, and changes as the needs and requirements of the Tallahassee Office, Florida Integrated Science Center, and Water Discipline change. Reg-ular updates to this Plan represent an integral part of the quality-assurance process. In the Tallahassee Office, direct oversight and responsibility by the employee(s) assigned to a surface-water station, combined with team approaches in all work efforts, assure high-quality data, analyses, reviews, and reports for cooperating agencies and the public.

  14. The Quest for Quality 1964. A Report on School Planning Laboratory Efforts to Encourage Better Planning for Better Schools in 1964.

    ERIC Educational Resources Information Center

    MacConnell, James D.

    The Fourth Annual Report from the School Planning Laboratory discusses the quest for quality and explains how better schools have been planned at the Center through--(1) systems construction, (2) an airborne institute, (3) school planning education, (4) service to visitors, (5) community college planning, (6) direct assistance, and (7) continued…

  15. Water Quality Assessment and Management

    EPA Pesticide Factsheets

    Overview of Clean Water Act (CWA) restoration framework including; water quality standards, monitoring/assessment, reporting water quality status, TMDL development, TMDL implementation (point & nonpoint source control)

  16. 76 FR 55621 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY: Environmental...-Solano Air Quality Management District portion of the California State Implementation Plan (SIP). This... the following local rule: Yolo-Solano Air Quality Management District Rule 2.41, Expandable...

  17. 75 FR 25778 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

    ... the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... approve revisions to the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California... Identification of plan. * * * * * (c) * * * (377) * * * (i) * * * (B) Yolo Solano Air Quality Management District...

  18. 76 FR 30896 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-27

    ... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District (SCAQMD) portion of the California State... overwhelmingly formed as a secondary pollutant. (South Coast 2007 Air Quality Management Plan, page ES-9...

  19. 78 FR 76064 - Approval and Promulgation of Air Quality Implementation Plans; Michigan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ...] Approval and Promulgation of Air Quality Implementation Plans; Michigan AGENCY: Environmental Protection... nonattainment air quality permitting regulations found in 40 CFR 51.165(a) and (b). EPA has found that the rules... progress toward achieving the National Ambient Air Quality Standards. II. Statutory and Executive Order...

  20. 75 FR 11461 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-11

    ... Promulgation of Air Quality Implementation Plans; Minnesota AGENCY: Environmental Protection Agency (EPA.... Because the PM 10 emission limits are being reduced, the air quality of Ramsey County will be protected... culpable source in the Childs Road area's nonattainment of the PM 10 National Ambient Air Quality Standards...

  1. Automation and Intensity Modulated Radiation Therapy for Individualized High-Quality Tangent Breast Treatment Plans

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

    Purdie, Thomas G., E-mail: Tom.Purdie@rmp.uhn.on.ca; Department of Radiation Oncology, University of Toronto, Toronto, Ontario; Techna Institute, University Health Network, Toronto, Ontario

    Purpose: To demonstrate the large-scale clinical implementation and performance of an automated treatment planning methodology for tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: Automated planning was used to prospectively plan tangential breast IMRT treatment for 1661 patients between June 2009 and November 2012. The automated planning method emulates the manual steps performed by the user during treatment planning, including anatomical segmentation, beam placement, optimization, dose calculation, and plan documentation. The user specifies clinical requirements of the plan to be generated through a user interface embedded in the planning system. The automated method uses heuristic algorithms to definemore » and simplify the technical aspects of the treatment planning process. Results: Automated planning was used in 1661 of 1708 patients receiving tangential breast IMRT during the time interval studied. Therefore, automated planning was applicable in greater than 97% of cases. The time for treatment planning using the automated process is routinely 5 to 6 minutes on standard commercially available planning hardware. We have shown a consistent reduction in plan rejections from plan reviews through the standard quality control process or weekly quality review multidisciplinary breast rounds as we have automated the planning process for tangential breast IMRT. Clinical plan acceptance increased from 97.3% using our previous semiautomated inverse method to 98.9% using the fully automated method. Conclusions: Automation has become the routine standard method for treatment planning of tangential breast IMRT at our institution and is clinically feasible on a large scale. The method has wide clinical applicability and can add tremendous efficiency, standardization, and quality to the current treatment planning process. The use of automated methods can allow centers to more rapidly adopt IMRT and enhance access to the documented

  2. Automation and intensity modulated radiation therapy for individualized high-quality tangent breast treatment plans.

    PubMed

    Purdie, Thomas G; Dinniwell, Robert E; Fyles, Anthony; Sharpe, Michael B

    2014-11-01

    To demonstrate the large-scale clinical implementation and performance of an automated treatment planning methodology for tangential breast intensity modulated radiation therapy (IMRT). Automated planning was used to prospectively plan tangential breast IMRT treatment for 1661 patients between June 2009 and November 2012. The automated planning method emulates the manual steps performed by the user during treatment planning, including anatomical segmentation, beam placement, optimization, dose calculation, and plan documentation. The user specifies clinical requirements of the plan to be generated through a user interface embedded in the planning system. The automated method uses heuristic algorithms to define and simplify the technical aspects of the treatment planning process. Automated planning was used in 1661 of 1708 patients receiving tangential breast IMRT during the time interval studied. Therefore, automated planning was applicable in greater than 97% of cases. The time for treatment planning using the automated process is routinely 5 to 6 minutes on standard commercially available planning hardware. We have shown a consistent reduction in plan rejections from plan reviews through the standard quality control process or weekly quality review multidisciplinary breast rounds as we have automated the planning process for tangential breast IMRT. Clinical plan acceptance increased from 97.3% using our previous semiautomated inverse method to 98.9% using the fully automated method. Automation has become the routine standard method for treatment planning of tangential breast IMRT at our institution and is clinically feasible on a large scale. The method has wide clinical applicability and can add tremendous efficiency, standardization, and quality to the current treatment planning process. The use of automated methods can allow centers to more rapidly adopt IMRT and enhance access to the documented improvements in care for breast cancer patients, using

  3. 76 FR 69927 - Approval of Air Quality Implementation Plans; California; South Coast; Attainment Plan for 1997...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ...EPA is approving in part and disapproving in part state implementation plan (SIP) revisions submitted by California to provide for attainment of the 1997 fine particulate matter (PM2.5) national ambient air quality standards in the Los Angeles-South Coast area (South Coast). These SIP revisions are the South Coast 2007 Air Quality Management Plan (South Coast 2007 AQMP) (revised 2011) and South Coast-related provisions of the 2007 State Strategy (revised 2009 and 2011). EPA is approving the emissions inventory; reasonably available control measures/reasonably available control technology demonstration; the reasonable further progress and attainment demonstrations and associated air quality modeling; and the transportation conformity motor vehicle emissions budgets. EPA is also granting California's request to extend the attainment deadline for the South Coast to April 5, 2015 and approving commitments to measures and reductions by the South Coast Air Quality Management District and the California Air Resources Board. Finally, we are disapproving the SIP's contingency measures and issuing a protective finding under 40 CFR 93.120(a)(3), and we are rejecting the assignment of 10 tons per day (tpd) of nitrogen oxide (NOX) reductions to the federal government.

  4. Objective Video Quality Assessment Based on Machine Learning for Underwater Scientific Applications

    PubMed Central

    Moreno-Roldán, José-Miguel; Luque-Nieto, Miguel-Ángel; Poncela, Javier; Otero, Pablo

    2017-01-01

    Video services are meant to be a fundamental tool in the development of oceanic research. The current technology for underwater networks (UWNs) imposes strong constraints in the transmission capacity since only a severely limited bitrate is available. However, previous studies have shown that the quality of experience (QoE) is enough for ocean scientists to consider the service useful, although the perceived quality can change significantly for small ranges of variation of video parameters. In this context, objective video quality assessment (VQA) methods become essential in network planning and real time quality adaptation fields. This paper presents two specialized models for objective VQA, designed to match the special requirements of UWNs. The models are built upon machine learning techniques and trained with actual user data gathered from subjective tests. Our performance analysis shows how both of them can successfully estimate quality as a mean opinion score (MOS) value and, for the second model, even compute a distribution function for user scores. PMID:28333123

  5. 76 FR 47094 - Revisions to the California State Implementation Plan; South Coast Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-04

    ... the California State Implementation Plan; South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan... following local rule: South Coast Air Quality Management District Rule 1175, Control of Emissions from the...

  6. Training and Learning as Drivers of US Microenterprise Business Plan Quality

    ERIC Educational Resources Information Center

    Cook, Ronald G.; Belliveau, Paul; Sandberg, Mark E.

    2004-01-01

    This study examined the output quality of a US microenterprise training program created to help entrepreneurs develop business plans for their ventures. The program concludes with the entrepreneurs' plans being scored by a panel of experts. Hypotheses were developed and tested to determine the importance of feedback, key components of business…

  7. Assessing family planning service-delivery skills in Kenya.

    PubMed

    Valadez, J J; Transgrud, R; Mbugua, M; Smith, T

    1997-06-01

    This report demonstrates the use of Lot Quality Assurance Sampling (LQAS) to evaluate the technical competence of two cohorts of family planning service providers in Kenya trained with a new curriculum. One cohort had just finished training within two months of the study. The other cohort was the first group trained with the new curriculum about one year before the study. LQAS was adapted from industrial and other public health applications to assess both the individual competence of 30 service providers and the competence of each cohort. Results show that Cohorts One and Two did not differ markedly in the number of tasks needing improvement. However, both cohorts exhibited more tasks needing improvement in counseling skills as compared with physical examination skills or with all other skills. Care-givers who were not currently providing services accounted for most service-delivery problems. This result suggests that providers' use of their skills explains their ability to retain service-delivery skills learned in training to a greater degree than does the amount of time elapsed since they were trained. LQAS proved to be a rapid, easy-to-use empirical method for management decisionmaking for improvement of a family planning training curriculum and services.

  8. Guidelines for quality assurance and quality control of fish taxonomic data collected as part of the National Water-Quality Assessment Program

    USGS Publications Warehouse

    Walsh, Stephen Joseph; Meador, Michael R.

    1998-01-01

    Fish community structure is characterized by the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program as part of a perennial, multidisciplinary approach to evaluating the physical, chemical, and biological conditions of the Nation's water resources. The objective of quality assurance and quality control of fish taxonomic data that are collected as part of the NAWQA Program is to establish uniform guidelines and protocols for the identification, processing, and archiving of fish specimens to ensure that accurate and reliable data are collected. Study unit biologists, collaborating with regional biologists and fish taxonomic specialists, prepare a pre-sampling study plan that includes a preliminary faunal list and identification of an ichthyological curation center for receiving preserved fish specimens. Problematic taxonomic issues and protected taxa also are identified in the study plan, and collecting permits are obtained in advance of sampling activities. Taxonomic specialists are selected to identify fish specimens in the field and to assist in determining what fish specimens should be sacrificed, fixed, and preserved for laboratory identification, independent taxonomic verification, and long-term storage in reference or voucher collections. Quantitative and qualitative sampling of fishes follows standard methods previously established for the NAWQA Program. Common ichthyological techniques are used to process samples in the field and prepare fish specimens to be returned to the laboratory or sent to an institutional repository. Taxonomic identifications are reported by using a standardized list of scientific names that provides nomenclatural consistency and uniformity across study units.

  9. Quality Assurance Plans under the Renewable Fuel Standard Program

    EPA Pesticide Factsheets

    Quality Assurance Plan or (QAP) is a voluntary program where independent third-parties may audit and verify that RINs have been properly generated and are valid for compliance purposes. RINs verified under a QAP may be purchased by regulated parties.

  10. SU-E-T-268: Differences in Treatment Plan Quality and Delivery Between Two Commercial Treatment Planning Systems for Volumetric Arc-Based Radiation Therapy

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

    Chen, S; Zhang, H; Zhang, B

    2015-06-15

    Purpose: To clinically evaluate the differences in volumetric modulated arc therapy (VMAT) treatment plan and delivery between two commercial treatment planning systems. Methods: Two commercial VMAT treatment planning systems with different VMAT optimization algorithms and delivery approaches were evaluated. This study included 16 clinical VMAT plans performed with the first system: 2 spine, 4 head and neck (HN), 2 brain, 4 pancreas, and 4 pelvis plans. These 16 plans were then re-optimized with the same number of arcs using the second treatment planning system. Planning goals were invariant between the two systems. Gantry speed, dose rate modulation, MLC modulation, planmore » quality, number of monitor units (MUs), VMAT quality assurance (QA) results, and treatment delivery time were compared between the 2 systems. VMAT QA results were performed using Mapcheck2 and analyzed with gamma analysis (3mm/3% and 2mm/2%). Results: Similar plan quality was achieved with each VMAT optimization algorithm, and the difference in delivery time was minimal. Algorithm 1 achieved planning goals by highly modulating the MLC (total distance traveled by leaves (TL) = 193 cm average over control points per plan), while maintaining a relatively constant dose rate (dose-rate change <100 MU/min). Algorithm 2 involved less MLC modulation (TL = 143 cm per plan), but greater dose-rate modulation (range = 0-600 MU/min). The average number of MUs was 20% less for algorithm 2 (ratio of MUs for algorithms 2 and 1 ranged from 0.5-1). VMAT QA results were similar for all disease sites except HN plans. For HN plans, the average gamma passing rates were 88.5% (2mm/2%) and 96.9% (3mm/3%) for algorithm 1 and 97.9% (2mm/2%) and 99.6% (3mm/3%) for algorithm 2. Conclusion: Both VMAT optimization algorithms achieved comparable plan quality; however, fewer MUs were needed and QA results were more robust for Algorithm 2, which more highly modulated dose rate.« less

  11. 78 FR 34903 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; 1997 8-Hour Ozone...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... Promulgation of Air Quality Implementation Plans; Ohio; 1997 8-Hour Ozone Maintenance Plan Revision; Motor... request by Ohio to revise the 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP) to... area with budgets developed using EPA's Motor Vehicle Emissions Simulator (MOVES) emissions model. Ohio...

  12. 78 FR 16826 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Cleveland-Akron-Lorain and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-19

    ...-9790-1] Approval and Promulgation of Air Quality Implementation Plans; Ohio; Cleveland-Akron-Lorain and Columbus 1997 8-Hour Ozone Maintenance Plan Revisions to Approved Motor Vehicle Emissions Budgets AGENCY... quality State Implementation Plans (SIPs) under the Clean Air Act to replace the previously approved motor...

  13. A multi-model assessment of the co-benefits of climate mitigation for global air quality

    NASA Astrophysics Data System (ADS)

    Rao, Shilpa; Klimont, Zbigniew; Leitao, Joana; Riahi, Keywan; van Dingenen, Rita; Aleluia Reis, Lara; Calvin, Katherine; Dentener, Frank; Drouet, Laurent; Fujimori, Shinichiro; Harmsen, Mathijs; Luderer, Gunnar; Heyes, Chris; Strefler, Jessica; Tavoni, Massimo; van Vuuren, Detlef P.

    2016-12-01

    We present a model comparison study that combines multiple integrated assessment models with a reduced-form global air quality model to assess the potential co-benefits of global climate mitigation policies in relation to the World Health Organization (WHO) goals on air quality and health. We include in our assessment, a range of alternative assumptions on the implementation of current and planned pollution control policies. The resulting air pollution emission ranges significantly extend those in the Representative Concentration Pathways. Climate mitigation policies complement current efforts on air pollution control through technology and fuel transformations in the energy system. A combination of stringent policies on air pollution control and climate change mitigation results in 40% of the global population exposed to PM levels below the WHO air quality guideline; with the largest improvements estimated for India, China, and Middle East. Our results stress the importance of integrated multisector policy approaches to achieve the Sustainable Development Goals.

  14. Planning for land use and conservation: Assessing GIS-based conservation software for land use planning

    Treesearch

    Rob Baldwin; Ryan Scherzinger; Don Lipscomb; Miranda Mockrin; Susan Stein

    2014-01-01

    Recent advances in planning and ecological software make it possible to conduct highly technical analyses to prioritize conservation investments and inform local land use planning. We review these tools, termed conservation planning tools, and assess the knowledge of a key set of potential users: the land use planning community. We grouped several conservation software...

  15. Quality-assurance plan and field methods for quality-of-water activities, U.S. Geological Survey, Idaho National Engineering Laboratory, Idaho

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

    Mann, L.J.

    1996-10-01

    Water-quality activities at the Idaho National Engineering Laboratory (INEL) Project Office are part of the US Geological Survey`s (USGS) Water Resources Division (WRD) mission of appraising the quantity and quality of the Nation`s water resources. The purpose of the Quality Assurance Plan (QAP) for water-quality activities performed by the INEL Project Office is to maintain and improve the quality of technical products, and to provide a formal standardization, documentation, and review of the activities that lead to these products. The principles of this plan are as follows: (1) water-quality programs will be planned in a competent manner and activities willmore » be monitored for compliance with stated objectives and approaches; (2) field, laboratory, and office activities will be performed in a conscientious and professional manner in accordance with specified WRD practices and procedures by qualified and experienced employees who are well trained and supervised, if or when, WRD practices and procedures are inadequate, data will be collected in a manner that its quality will be documented; (3) all water-quality activities will be reviewed for completeness, reliability, credibility, and conformance to specified standards and guidelines; (4) a record of actions will be kept to document the activity and the assigned responsibility; (5) remedial action will be taken to correct activities that are deficient.« less

  16. Portfolio Assessment and Quality Teaching

    ERIC Educational Resources Information Center

    Kim, Youb; Yazdian, Lisa Sensale

    2014-01-01

    Our article focuses on using portfolio assessment to craft quality teaching. Extant research literature on portfolio assessment suggests that the primary purpose of assessment is to serve learning, and portfolio assessments facilitate the process of making linkages among assessment, curriculum, and student learning (Asp, 2000; Bergeron, Wermuth,…

  17. AutoLock: a semiautomated system for radiotherapy treatment plan quality control.

    PubMed

    Dewhurst, Joseph M; Lowe, Matthew; Hardy, Mark J; Boylan, Christopher J; Whitehurst, Philip; Rowbottom, Carl G

    2015-05-08

    A semiautomated system for radiotherapy treatment plan quality control (QC), named AutoLock, is presented. AutoLock is designed to augment treatment plan QC by automatically checking aspects of treatment plans that are well suited to computational evaluation, whilst summarizing more subjective aspects in the form of a checklist. The treatment plan must pass all automated checks and all checklist items must be acknowledged by the planner as correct before the plan is finalized. Thus AutoLock uniquely integrates automated treatment plan QC, an electronic checklist, and plan finalization. In addition to reducing the potential for the propagation of errors, the integration of AutoLock into the plan finalization workflow has improved efficiency at our center. Detailed audit data are presented, demonstrating that the treatment plan QC rejection rate fell by around a third following the clinical introduction of AutoLock.

  18. IT-based soil quality evaluation for agroecologically smart land-use planning in RF conditions

    NASA Astrophysics Data System (ADS)

    Vasenev, Ivan

    2016-04-01

    Activated in the first decades of XXI century global climate, economy and farming changes sharply actualized novel IT-based approaches in soil quality evaluation to address modern agricultural issues with agroecologically smart land-use planning. Despite global projected climate changes will affect a general decline of crop yields (IPCC 2014), RF boreal and subboreal regions will benefit from predicted and already particularly verified temperature warming and increased precipitation (Valentini, Vasenev, 2015) due to essential increasing of growing season length and mild climate conditions favorable for most prospective crops and best available agrotechnologies. However, the essential spatial heterogeneity is mutual feature for most natural and man-changed soils at the Central European region of Russia which is one of the biggest «food baskets» in RF. In these conditions potentially favorable climate circumstances will increase not only soil fertility and workability features but also their dynamics and spatial variability that determine crucial issues of IT-based soil quality evaluation systems development and agroecologically smart farming planning. Developed and verified within the LAMP project (RF Governmental projects #11.G34.31.0079 and #14.120.14.4266) regionally adapted DSS (ACORD-R - RF #2012612944) gives effective informational and methodological support for smart farming agroecological optimization in global climate and farming changes challenges. Information basis for agroecologically smart land-use planning consists of crops and agrotechnologies requirements, regional and local systems of agroecological zoning, local landscape and soil cover patterns, land quality and degradation risk assessments, current and previous farming practices results, agroclimatic predictions and production agroecological models, environmental limitations and planned profitability, fertilizing efficiency DSS ACORD-R. Smart land-use practice refers to sustainable balance

  19. NHEXAS PHASE I MARYLAND STUDY--QUALITY SYSTEMS AND IMPLEMENTATION PLAN (HSPH QSIP)

    EPA Science Inventory

    This document describes the project design and quality systems used by the Maryland Study for NHEXAS Phase 1. It contains the following sections: Project Planning and Organization, Project Implementation Plan, Data Acquisition and Management, Records Usage and Management, Routin...

  20. Effectiveness of presence of physician and midwife in quantity and quality of family planning services in health care centers.

    PubMed

    Jabbari, Hossein; Bakhshian, Fariba; Velayati, Atefeh; Mehrabi, Esmat; Allahverdizadeh, Shirin; Alikhah, Hossein; Maleki, Ahdieh; Ahadi, Hamid-Reza; Ghorbaniyan, Maryam; Naghavi-Behzad, Mohammad

    2014-01-01

    Iran's health sector has been engaging the services of physicians and midwives in healthcare centers since 2005, with the hope of improving the quantity and quality of family planning services. The aim of this study was to assess the effect of serving physicians and midwives on the quantity and quality of family planning services in the healthcare centers of Iran. The present cross-sectional study (Jan 2010 until Sep 2011) was carried out on 600 eligible families who were clients of healthcare centers of Tabriz, Azarshahr and Osku, cities of Northwest Iran from 2006 until 2011, in two groups (before and after). Some of the characteristics of the participants and the data on the quality and quantity of family planning services provided were grouped in a checklist of 16 variables by comparing the patients' past medical histories. In comparison with 3 years prior to engaging physician and midwife services in health care centers, the Couple Year Protection (CYP) and the quantity of family planning service indexes significantly increased among eligible families. The family size of participants declined significantly after family physicians and midwives became available in the healthcare centers (P < 0.005). Our findings showed some improvement in the quantity of services without any noticeable changes in the quality of services provided as a consequence of this huge intervention. Therefore, it is suggested that there should be proper oversight of the duties of the health team in order to keep a close watch on primary healthcare, design of proper mechanisms for collecting and maintaining performance reports and statistics, and continuously monitor and control the quality of services.

  1. Quality-assurance plan for the analysis of suspended sediment by the U.S. Geological Survey in Montana

    USGS Publications Warehouse

    Dodge, Kent A.; Lambing, John H.

    2006-01-01

    A quality-assurance plan has been developed for use by the sediment laboratory of the U.S. Geological Survey Montana Water Science Center in conducting activities related to the analysis of suspended sediment. The plan documents quality-assurance policies for sediment-laboratory certification, personnel responsibilities and training, documentation requirements, and laboratory safety. The plan also documents quality-assurance procedures related to laboratory equipment and supplies, sample management, sample analysis, analytical quality control, and data management.

  2. Planning for Quality. Papers presented at the Annual Meeting of the North East Association for Institutional Research (8th, Princeton, New Jersey, November 5-7, 1981).

    ERIC Educational Resources Information Center

    North East Association for Institutional Research.

    The proceedings of the annual conference of the North East Association for Institutional Research, whose theme was "Planning for Quality," are presented. The 26 papers were divided into the following topics: admissions, assessment, enrollment, faculty and staff, outcomes, planning, programs and retention, the environment, and the field of…

  3. Cone beam computed tomography radiation dose and image quality assessments.

    PubMed

    Lofthag-Hansen, Sara

    2010-01-01

    Diagnostic radiology has undergone profound changes in the last 30 years. New technologies are available to the dental field, cone beam computed tomography (CBCT) as one of the most important. CBCT is a catch-all term for a technology comprising a variety of machines differing in many respects: patient positioning, volume size (FOV), radiation quality, image capturing and reconstruction, image resolution and radiation dose. When new technology is introduced one must make sure that diagnostic accuracy is better or at least as good as the one it can be expected to replace. The CBCT brand tested was two versions of Accuitomo (Morita, Japan): 3D Accuitomo with an image intensifier as detector, FOV 3 cm x 4 cm and 3D Accuitomo FPD with a flat panel detector, FOVs 4 cm x 4 cm and 6 cm x 6 cm. The 3D Accuitomo was compared with intra-oral radiography for endodontic diagnosis in 35 patients with 46 teeth analyzed, of which 41 were endodontically treated. Three observers assessed the images by consensus. The result showed that CBCT imaging was superior with a higher number of teeth diagnosed with periapical lesions (42 vs 32 teeth). When evaluating 3D Accuitomo examinations in the posterior mandible in 30 patients, visibility of marginal bone crest and mandibular canal, important anatomic structures for implant planning, was high with good observer agreement among seven observers. Radiographic techniques have to be evaluated concerning radiation dose, which requires well-defined and easy-to-use methods. Two methods: CT dose index (CTDI), prevailing method for CT units, and dose-area product (DAP) were evaluated for calculating effective dose (E) for both units. An asymmetric dose distribution was revealed when a clinical situation was simulated. Hence, the CTDI method was not applicable for these units with small FOVs. Based on DAP values from 90 patient examinations effective dose was estimated for three diagnostic tasks: implant planning in posterior mandible and

  4. Quality of care in family planning services in Morocco.

    PubMed

    Brown, L; Tyane, M; Bertrand, J; Lauro, D; Abou-ouakil, M; deMaria, L

    1995-01-01

    This study was conducted to heighten awareness of quality of care as a programmatic issue in the Moroccan governmental family planning program and to test modified Situation Analysis instruments for measuring quality of care. Data were collected from 50 service-delivery points in five provinces to measure six elements of quality in accordance with the Bruce/Jain framework. A procedure for calculating quality-indicator scores is presented. Although facilities varied by province and within provinces, most had the equipment and supplies needed to deliver services; service personnel were trained and regularly supervised; the service-delivery points scored well on mechanisms to ensure continuity of use. Notable shortcomings included a dearth of materials for counseling and a widespread unavailability of the Ovrette pill. This study raises issues regarding the complexity of measuring quality, the ownership of results, and the appropriateness of a centralized study of quality in a decentralized program.

  5. MO-B-BRB-02: Maintain the Quality of Treatment Planning for Time-Constraint Cases

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

    Chang, J.

    The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d

  6. 78 FR 34965 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; 1997 8-Hour Ozone...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... Promulgation of Air Quality Implementation Plans; Ohio; 1997 8-Hour Ozone Maintenance Plan Revision; Motor... request by Ohio to revise the 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP...) emissions model. Ohio submitted the SIP revision request to EPA on December 7, 2012. DATES: Comments must be...

  7. Sunway Medical Laboratory Quality Control Plans Based on Six Sigma, Risk Management and Uncertainty.

    PubMed

    Jairaman, Jamuna; Sakiman, Zarinah; Li, Lee Suan

    2017-03-01

    Sunway Medical Centre (SunMed) implemented Six Sigma, measurement uncertainty, and risk management after the CLSI EP23 Individualized Quality Control Plan approach. Despite the differences in all three approaches, each implementation was beneficial to the laboratory, and none was in conflict with another approach. A synthesis of these approaches, built on a solid foundation of quality control planning, can help build a strong quality management system for the entire laboratory. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. 78 FR 63877 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Infrastructure...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ...] Approval and Promulgation of Air Quality Implementation Plans; Delaware; Infrastructure Requirements for the 2010 Nitrogen Dioxide National Ambient Air Quality Standards AGENCY: Environmental Protection... ambient air quality standard (NAAQS). EPA is approving this SIP revision in accordance with the...

  9. Application of a short term air quality action plan in Madrid (Spain) under a high-pollution episode - Part II: Assessment from multi-scale modelling.

    PubMed

    Borge, Rafael; Santiago, Jose Luis; de la Paz, David; Martín, Fernando; Domingo, Jessica; Valdés, Cristina; Sánchez, Beatriz; Rivas, Esther; Rozas, Mª Teresa; Lázaro, Sonia; Pérez, Javier; Fernández, Álvaro

    2018-05-05

    Air pollution continues to be one of the main issues in urban areas. In addition to air quality plans and emission abatement policies, additional measures for high pollution episodes are needed to avoid exceedances of hourly limit values under unfavourable meteorological conditions such as the Madrid's short-term action NO 2 protocol. In December 2016 there was a strong atmospheric stability episode that turned out in generalized high NO 2 levels, causing the stage 3 of the NO 2 protocol to be triggered for the first time in Madrid (29th December). In addition to other traffic-related measures, this involves access restrictions to the city centre (50% to private cars). We simulated the episode with and without measures under a multi-scale modelling approach. A 1 km 2 resolution modelling system based on WRF-SMOKE-CMAQ was applied to assess city-wide effects while the Star-CCM+ (RANS CFD model) was used to investigate the effect at street level in a microscale domain in the city centre, focusing on Gran Vía Avenue. Changes in road traffic were simulated with the mesoscale VISUM model, incorporating real flux measurements during those days. The corresponding simulations suggest that the application of the protocol during this particular episode may have prevented concentrations to increase by 24 μg·m -3 (14% respect to the hypothetical no action scenario) downtown although it may have cause NO 2 to slightly increase in the city outskirts due to traffic redistribution. Speed limitation and parking restrictions alone (stages 1 and 2 respectively) have a very limited effect. The microscale simulation provides consistent results but shows an important variability at street level, with reduction above 100 μg·m -3 in some spots inside Gran Vía. Although further research is needed, these results point out the need to implement short-term action plans and to apply a consistent multi-scale modelling assessment to optimize urban air quality abatement strategies

  10. Meal planning is associated with food variety, diet quality and body weight status in a large sample of French adults.

    PubMed

    Ducrot, Pauline; Méjean, Caroline; Aroumougame, Vani; Ibanez, Gladys; Allès, Benjamin; Kesse-Guyot, Emmanuelle; Hercberg, Serge; Péneau, Sandrine

    2017-02-02

    Meal planning could be a potential tool to offset time scarcity and therefore encourage home meal preparation, which has been linked with an improved diet quality. However, to date, meal planning has received little attention in the scientific literature. The aim of our cross-sectional study was to investigate the association between meal planning and diet quality, including adherence to nutritional guidelines and food variety, as well as weight status. Meal planning, i.e. planning ahead the foods that will be eaten for the next few days, was assessed in 40,554 participants of the web-based observational NutriNet-Santé study. Dietary measurements included intakes of energy, nutrients, food groups, and adherence to the French nutritional guidelines (mPNNS-GS) estimated through repeated 24-h dietary records. A food variety score was also calculated using Food Frequency Questionnaire. Weight and height were self-reported. Association between meal planning and dietary intakes were assessed using ANCOVAs, while associations with quartiles of mPNNS-GS scores, quartiles of food variety score and weight status categories (overweight, obesity) were evaluated using logistic regression models. A total of 57% of the participants declared to plan meals at least occasionally. Meal planners were more likely to have a higher mPNNS-GS (OR quartile 4 vs. 1 = 1.13, 95% CI: [1.07-1.20]), higher overall food variety (OR quartile 4 vs. 1 = 1.25, 95% CI: [1.18-1.32]). In women, meal planning was associated with lower odds of being overweight (OR = 0.92 [0.87-0.98]) and obese (OR = 0.79 [0.73-0.86]). In men, the association was significant for obesity only (OR = 0.81 [0.69-0.94]). Meal planning was associated with a healthier diet and less obesity. Although no causality can be inferred from the reported associations, these data suggest that meal planning could potentially be relevant for obesity prevention.

  11. 78 FR 42482 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Infrastructure...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ... Promulgation of Air Quality Implementation Plans; Pennsylvania; Infrastructure Requirements for the 2008 Lead National Ambient Air Quality Standards AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule... Environmental Protection, Bureau of Air Quality Control, P.O. Box 8468, 400 Market Street, Harrisburg...

  12. AutoLock: a semiautomated system for radiotherapy treatment plan quality control

    PubMed Central

    Lowe, Matthew; Hardy, Mark J.; Boylan, Christopher J.; Whitehurst, Philip; Rowbottom, Carl G.

    2015-01-01

    A semiautomated system for radiotherapy treatment plan quality control (QC), named AutoLock, is presented. AutoLock is designed to augment treatment plan QC by automatically checking aspects of treatment plans that are well suited to computational evaluation, whilst summarizing more subjective aspects in the form of a checklist. The treatment plan must pass all automated checks and all checklist items must be acknowledged by the planner as correct before the plan is finalized. Thus AutoLock uniquely integrates automated treatment plan QC, an electronic checklist, and plan finalization. In addition to reducing the potential for the propagation of errors, the integration of AutoLock into the plan finalization workflow has improved efficiency at our center. Detailed audit data are presented, demonstrating that the treatment plan QC rejection rate fell by around a third following the clinical introduction of AutoLock. PACS number: 87.55.Qr PMID:26103498

  13. Tying Resource Allocation and TQM into Planning and Assessment Efforts.

    ERIC Educational Resources Information Center

    Mullendore, Richard H.; Wang, Li-Shing

    1996-01-01

    Describes the evolution of a model, developed by student affairs officials, which outlines a planning process for implementing Total Quality Management. Presents step-by-step instructions for the model's deployment and discusses such issues as transitions, planning forms, goals, and professional and personal growth needs. (RJM)

  14. POSTER FOR NRMRL QUALITY MANAGEMENT PLAN (QMP) TRAINING COURSE

    EPA Science Inventory


    NRMRL QMP Training Course
    Contact: Lauren Drees, NRMRL/STD (drees.lauren@epa.gov)

    NRMRL has developed a computer-based course to train personnel in the requirements of the NRMRL Quality Management Plan (QMP). This training course was developed using Trainersoft s...

  15. Advance Care Planning and the Quality of End-of-Life Care among Older Adults

    PubMed Central

    Bischoff, Kara E.; Sudore, Rebecca; Miao, Yinghui; Boscardin, W. John; Smith, Alexander K.

    2013-01-01

    Background Advance care planning is increasingly common, but whether it influences end-of-life quality of care remains controversial. Design Medicare data and survey data from the Health and Retirement Study were combined to determine whether advance care planning was associated with quality metrics. Setting The nationally representative Health and Retirement Study. Participants 4394 decedent subjects (mean age 82.6 years at death, 55% women). Measurements Advance care planning was defined as having an advance directive, durable power of attorney or having discussed preferences for end-of-life care with a next-of-kin. Outcomes included previously reported quality metrics observed during the last month of life (rates of hospital admission, in-hospital death, >14 days in the hospital, intensive care unit admission, >1 emergency department visit, hospice admission, and length of hospice ≤3 days). Results Seventy-six percent of subjects engaged in advance care planning. Ninety-two percent of advance directives stated a preference to prioritize comfort. After adjustment, subjects who engaged in advance care planning were less likely to die in a hospital (adjusted RR 0.87, 95% CI 0.80-0.94), more likely to be enrolled in hospice (aRR 1.68, 1.43-1.97), and less likely to receive hospice for ≤3 days before death (aRR 0.88, 0.85-0.91). Having an advance directive, a durable-power-of-attorney or an advance care planning discussion were each independently associated with a significant increase in hospice use (p<0.01 for all). Conclusion Advance care planning was associated with improved quality of care at the end of life, including less in-hospital death and increased use of hospice. Having an advance directive, assigning a durable power of attorney and conducting advance care planning discussions are all important elements of advance care planning. PMID:23350921

  16. Wyoming Basin Rapid Ecoregional Assessment: Work Plan

    USGS Publications Warehouse

    Carr, Natasha B.; Garman, Steven L.; Walters, Annika; Ray, Andrea; Melcher, Cynthia P.; Wesner, Jeff S.; O’Donnell, Michael S.; Sherrill, Kirk R.; Babel, Nils C.; Bowen, Zachary H.

    2013-01-01

    The overall goal of the Rapid Ecoregional Assessments (REAs) being conducted for the Bureau of Land Management (BLM) is to provide information that supports regional planning and analysis for the management of ecological resources. The REA provides an assessment of baseline ecological conditions, an evaluation of current risks from drivers of ecosystem change, and a predictive capacity for evaluating future risks. The REA also may be used for identifying priority areas for conservation or restoration and for assessing the cumulative effects of a variety of land uses. There are several components of the REAs. Management Questions, developed by the BLM and partners for the ecoregion, identify the information needed for addressing land-management responsibilities. Conservation Elements represent regionally significant aquatic and terrestrial species and communities that are to be conserved and (or) restored. The REA also will evaluate major drivers of ecosystem change (Change Agents) currently affecting or likely to affect the status of Conservation Elements. We selected 8 major biomes and 19 species or species assemblages to be included as Conservation Elements. We will address the four primary Change Agents—development, fire, invasive species, and climate change—required for the REA. The purpose of the work plan for the Wyoming Basin REA is to document the selection process for, and final list of, Management Questions, Conservation Elements, and Change Agents. The work plan also presents the overall assessment framework that will be used to assess the status of Conservation Elements and answer Management Questions.

  17. 75 FR 25775 - Disapproval of State Implementation Plan Revisions, South Coast Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2009-0573; FRL-9146-5] Disapproval of State Implementation Plan Revisions, South Coast Air Quality Management District AGENCY: Environmental... South Coast Air Quality Management District (SCAQMD) portion of the California State Implementation Plan...

  18. 78 FR 28173 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Sulfur Dioxide and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-14

    ...-9811-5] Approval and Promulgation of Air Quality Implementation Plans; Indiana; Sulfur Dioxide and Nitrogen Dioxide Ambient Air Quality Standards AGENCY: Environmental Protection Agency (EPA). ACTION... implementation plan (SIP) for nitrogen dioxide (NO 2 ) and sulfur dioxide (SO 2 ) under the Clean Air Act. This...

  19. Recommendations for assessing water quality and safety on board merchant ships.

    PubMed

    Grappasonni, Iolanda; Cocchioni, Mario; Degli Angioli, Rolando; Saturnino, Andrea; Sibilio, Fabio; Scuri, Stefania; Amenta, Francesco

    2013-01-01

    Health and diseases on board ships may depend on water. Interventions to improve the quality of water may bring to significant benefits to health and water stores/supply and should be controlledto protect health. This paper has reviewed the main regulations for the control of water safety and qualityon board ships and presents some practical recommendations for keeping water healthy and safe in passenger and cargo merchant ships. The main international regulations and guidelines on the topic were analysed. Guidelines forWater Quality on Board Merchant Ships Including Passenger Vessels of Health Protection Agency, World Health Organisation (WHO) Guide to Ship Sanitation, WHO Guidelines for Drinking Water Quality, WHO Water Safety Plan and the United States Center for Disease Control and Prevention Vessel Sanitation Program were examined. Recommendations for passenger and, if available, for cargo ships were collected and compared. Recommended questionnaire: A questionnaire summarising the main information to collect for assessingthe enough quality of water for the purposes it should be used on board is proposed. The need of havinga crew member with water assessment duties on board, trained for performing these activities properlyis discussed. Water quality on board ships should be monitored routinely. Monitoring should be directedto chemical and microbiological parameters for identifying possible contamination sources, using specifickits by a designed crew member. More detailed periodic assessments should be under the responsibility ofspecialised personnel/laboratories and should be based on sample collection from all tanks and sites of waterdistribution. It is important to select a properly trained crew member on board for monitoring water quality.

  20. 75 FR 40726 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-14

    ... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... Metropolitan Air Quality Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD...

  1. Quality-assurance plan for water-resources activities of the U.S. Geological Survey in Idaho

    USGS Publications Warehouse

    Packard, F.A.

    1996-01-01

    To ensure continued confidence in its products, the Water Resources Division of the U.S. Geological Survey implemented a policy that all its scientific work be performed in accordance with a centrally managed quality-assurance program. This report establishes and documents a formal policy for current (1995) quality assurance within the Idaho District of the U.S. Geological Survey. Quality assurance is formalized by describing district organization and operational responsibilities, documenting the district quality-assurance policies, and describing district functions. The districts conducts its work through offices in Boise, Idaho Falls, Twin Falls, Sandpoint, and at the Idaho National Engineering Laboratory. Data-collection programs and interpretive studies are conducted by two operating units, and operational and technical assistance is provided by three support units: (1) Administrative Services advisors provide guidance on various personnel issues and budget functions, (2) computer and reports advisors provide guidance in their fields, and (3) discipline specialists provide technical advice and assistance to the district and to chiefs of various projects. The district's quality-assurance plan is based on an overall policy that provides a framework for defining the precision and accuracy of collected data. The plan is supported by a series of quality-assurance policy statements that describe responsibilities for specific operations in the district's program. The operations are program planning; project planning; project implementation; review and remediation; data collection; equipment calibration and maintenance; data processing and storage; data analysis, synthesis, and interpretation; report preparation and processing; and training. Activities of the district are systematically conducted under a hierarchy of supervision an management that is designed to ensure conformance with Water Resources Division goals quality assurance. The district quality

  2. 78 FR 50369 - Approval and Promulgation of Air Quality Implementation Plans; Michigan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ...] Approval and Promulgation of Air Quality Implementation Plans; Michigan AGENCY: Environmental Protection... the State of Michigan's Clean Air Act State Implementation Plan (SIP) that Michigan had submitted on March 24, 2009. Michigan's submittal included revisions to Part 1, Definitions; Part 2, Air Use Approval...

  3. Performance Assessment Examples from the Quality Performance Assessment Network

    ERIC Educational Resources Information Center

    Kuriacose, Christina

    2017-01-01

    In this brief article, Christina Kuriacose provides four sample performance assessments. Spanning grade levels, these assessments are strong examples of teacher-developed performance assessments from schools within the Center for Collaborative Education's Quality Performance Assessment network. These performance tasks demonstrate the pedagogical…

  4. Analysis of strategic plans to assess planning for sustainability of comprehensive community initiatives.

    PubMed

    Sridharan, Sanjeev; Go, Sodam; Zinzow, Heidi; Gray, Aracelis; Barrett, Melissa Gutierrez

    2007-02-01

    In order to achieve the intended impact on a community, comprehensive community initiatives must sustain programs once they have been implemented. However, planning for sustainability is challenging and is rarely incorporated in the planning process of an initiative. The current study examined 19 5-year plans developed during the planning phase of the Comprehensive Strategy for Serious, Violent and Chronic Juvenile Offenders. Quantitative and qualitative methods were employed to assess the extent to which the construct of sustainability was incorporated. The plan analysis was supplemented with results from other components of the complex evaluation design implemented as part of the process evaluation of Comprehensive Strategy. Results suggested that sustainability was not accounted for during the planning phase of this initiative. The implications of these findings, including the importance of planning for sustainability in order to achieve sustainability, are discussed.

  5. 76 FR 54384 - California State Implementation Plan, South Coast Air Quality Management District; Withdrawal of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-01

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2011-0537; FRL-9457-6] California State Implementation Plan, South Coast Air Quality Management District; Withdrawal of Direct Final Rule... Implementation Plan (SIP). This revision concerned South Coast Air Quality Management District (SCAQMD) Rule 1143...

  6. 78 FR 54813 - Approval and Promulgation of Air Quality Implementation Plans; Maine; Oxides of Nitrogen...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Parts 52 [EPA-R01-OAR-2012-0895; FRL- 9900-85-Region1] Approval and Promulgation of Air Quality Implementation Plans; Maine; Oxides of Nitrogen Exemption and... proposed Approval and Promulgation of Air Quality Implementation Plans; Maine; Oxides of Nitrogen Exemption...

  7. Partnerships for Quality: A Statewide Plan for Developing and Implementing a Total Quality Curriculum Delivered through Oregon's Community Colleges.

    ERIC Educational Resources Information Center

    Oregon State Economic Development Dept., Salem.

    The Oregon Advanced Technology Consortium (OATC) created the Partnerships for Quality Project (PQP) to improve Oregon's community colleges by developing a total quality curriculum (TQC) based on the beliefs and practices of total quality management (TQM). This report summarizes the recommendations of the PQP and presents a plan of action for the…

  8. Planning and design of studies for river-quality assessment in the Truckee and Carson River basins, California and Nevada

    USGS Publications Warehouse

    Nowlin, Jon O.; Brown, W.M.; Smith, L.H.; Hoffman, R.J.

    1980-01-01

    The objectives of the Geological Survey 's river-quality assessment in the Truckee and Carson River basins in California and Nevada are to identify the significant resource management problems; to develop techniques to assess the problems; and to effectively communicate results to responsible managers. Six major elements of the assessment to be completed by October 1981 are (1) a detailing of the legal, institutional, and structural development of water resources in the basins and the current problems and conflicts; (2) a compilation and synthesis of the physical hydrology of the basins; (3) development of a special workshop approach to involve local management in the direction and results of the study; (4) development of a comprehensive streamflow model emcompassing both basins to provide a quantitative hydrologic framework for water-quality analysis; (5) development of a water-quality transport model for selected constituents and characteristics on selected reaches of the Truckee River; and (6) a detailed examination of selected fish habitats for specified reaches of the Truckee River. Progress will be periodically reported in reports, maps, computer data files, mathematical models, a bibliography, and public presentations. In building a basic framework to develop techniques, the basins were viewed as a single hydrologic unit because of interconnecting diversion structures. The framework comprises 13 hydrographic subunits to facilitate modeling and sampling. Several significant issues beyond the scope of the assessment were considered as supplementary proposals; water-quality loadings in Truckee and Carson Rivers, urban runoff in Reno and management alternatives, and a model of limnological processes in Lahontan Reservoir. (USGS)

  9. Care Planning, Quality Assurance, and Personnel Management in Long-Term Care Facilities. Final Report.

    ERIC Educational Resources Information Center

    Patchner, Michael A.; Balgopal, Pallassana R.

    Three studies were undertaken to examine topics of care planning, personnel management, and quality assurance in long-term care facilities. The first study examined the formulation and implementation processes of care planning for nursing home residents. The exemplary homes' care planning included the existence of strong care planning leadership,…

  10. Assessing climate impacts of planning policies-An estimation for the urban region of Leipzig (Germany)

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

    Schwarz, Nina, E-mail: nina.schwarz@ufz.de; Bauer, Annette, E-mail: annette.bauer@ufz.de; Haase, Dagmar, E-mail: dagmar.haase@ufz.d

    2011-03-15

    Local climate regulation by urban green areas is an important urban ecosystem service, as it reduces the extent of the urban heat island and therefore enhances quality of life. Local and regional planning policies can control land use changes in an urban region, which in turn alter local climate regulation. Thus, this paper describes a method for estimating the impacts of current land uses as well as local and regional planning policies on local climate regulation, using evapotranspiration and land surface emissivity as indicators. This method can be used by practitioners to evaluate their policies. An application of this methodmore » is demonstrated for the case study Leipzig (Germany). Results for six selected planning policies in Leipzig indicate their distinct impacts on climate regulation and especially the role of their spatial extent. The proposed method was found to easily produce a qualitative assessment of impacts of planning policies on climate regulation.« less

  11. 78 FR 28497 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Canton-Massillon 1997 8-Hour...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... Promulgation of Air Quality Implementation Plans; Ohio; Canton-Massillon 1997 8-Hour Ozone Maintenance Plan... the Canton-Massillon, Ohio 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP... using EPA's Motor Vehicle Emissions Simulator (MOVES) emissions model. Ohio submitted the SIP revision...

  12. 43 CFR 11.31 - What does the Assessment Plan include?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....31 Section 11.31 Public Lands: Interior Office of the Secretary of the Interior NATURAL RESOURCE.... The Assessment Plan shall include descriptions of the natural resources and the geographical areas... co-trusteeship, for those natural resources considered within the Assessment Plan. The authorized...

  13. Integrated watershed planning across jurisdictional boundaries

    NASA Astrophysics Data System (ADS)

    Watts, A. W.; Roseen, R.; Stacey, P.; Bourdeau, R.

    2014-12-01

    We will present the foundation for an Coastal Watershed Integrated Plan for three communities in southern New Hampshire. Small communities are often challenged by complex regulatory requirements and limited resources, but are wary of perceived risks in engaging in collaborative projects with other communities. Potential concerns include loss of control, lack of resources to engage in collaboration, technical complexity, and unclear benefits. This project explores a multi-town subwatershed application of integrated planning across jurisdictional boundaries that addresses some of today's highest priority water quality issues: wastewater treatment plant upgrades for nutrient removal; green infrastructure stormwater management for developing and re-developing areas; and regional monitoring of ecosystem indicators in support of adaptive management to achieve nutrient reduction and other water quality goals in local and downstream waters. The project outcome is a collaboratively-developed inter-municipal integrated plan, and a monitoring framework to support cross jurisdictional planning and assess attainment of water quality management goals. This research project has several primary components: 1) assessment of initial conditions, including both the pollutant load inputs and the political, economic and regulatory status within each community, 2) a pollutant load model for point and non-point sources, 3) multi-criteria evaluation of load reduction alternatives 4) a watershed management plan optimized for each community, and for Subwatersheds combining multiple communities. The final plan will quantify the financial and other benefits/drawbacks to each community for both inter municipal and individual pollution control approaches. We will discuss both the technical and collaborative aspects of the work, with lessons learned regarding science to action, incorporation of social, economic and water quality assessment parameters, and stakeholder/researcher interaction.

  14. 75 FR 11503 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-11

    ... Promulgation of Air Quality Implementation Plans; Minnesota AGENCY: Environmental Protection Agency (EPA... PM 10 emission limits are being reduced, the air quality of Ramsey County will be protected. DATES...: (312) 385-5501. 4. Mail: Genevieve Damico, Acting Chief, Criteria Pollutant Section, Air Programs...

  15. [Quality of health care, accreditation, and health technology assessment in Croatia: role of agency for quality and accreditation in health].

    PubMed

    Mittermayer, Renato; Huić, Mirjana; Mestrović, Josipa

    2010-12-01

    Avedis Donabedian defined the quality of care as the kind of care, which is expected to maximize an inclusive measure of patient welfare, after taking into account the balance of expected gains and losses associated with the process of care in all its segments. According to the World Medical Assembly, physicians and health care institutions have an ethical and professional obligation to strive for continuous quality improvement of services and patient safety with the ultimate goal to improve both individual patient outcomes as well as population health. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology in a systematic, transparent, unbiased, robust manner, with the aim to formulate safe and effective health policies that are patient focused and seek to achieve the highest value. The Agency for Quality and Accreditation in Health was established in 2007 as a legal, public, independent, nonprofit institution under the Act on Quality of Health Care. The Agency has three departments: Department of Quality and Education, Department of Accreditation, and Department of Development, Research, and Health Technology Assessment. According to the Act, the Agency should provide the procedure of granting, renewal and cancellation of accreditation of healthcare providers; proposing to the Minister, in cooperation with professional associations, the plan and program for healthcare quality assurance, improvement, promotion and monitoring; proposing the healthcare quality standards as well as the accreditation standards to the Minister; keeping a register of accreditations and providing a database related to accreditation, healthcare quality improvement, and education; providing education in the field of healthcare quality assurance, improvement and promotion; providing the HTA procedure and HTA database, supervising the healthcare insurance

  16. 77 FR 48061 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Regional Haze State...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-13

    ... Promulgation of Air Quality Implementation Plans; Pennsylvania; Regional Haze State Implementation Plan...'s limited approval of Pennsylvania's Regional Haze State Implementation Plan (SIP). DATES: Effective... announcing our limited approval of Pennsylvania's Regional Haze SIP. In this document, we inadvertently...

  17. 34 CFR 200.57 - Plans to increase teacher quality.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Plans to increase teacher quality. 200.57 Section 200.57 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED...

  18. 34 CFR 200.57 - Plans to increase teacher quality.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Plans to increase teacher quality. 200.57 Section 200.57 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED...

  19. 78 FR 28551 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Canton-Massillon 1997 8-Hour...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... Promulgation of Air Quality Implementation Plans; Ohio; Canton-Massillon 1997 8-Hour Ozone Maintenance Plan..., Ohio, 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP) under the Clean Air Act... Motor Vehicle Emissions Simulator (MOVES) emissions model. Ohio submitted the SIP revision request to...

  20. The OBRA-87 nursing home regulations and implementation of the Resident Assessment Instrument: effects on process quality.

    PubMed

    Hawes, C; Mor, V; Phillips, C D; Fries, B E; Morris, J N; Steele-Friedlob, E; Greene, A M; Nennstiel, M

    1997-08-01

    To characterize changes in key aspects of process quality received by nursing home residents before and after the implementation of the national nursing home Resident Assessment Instrument (RAI) and other aspects of the Omnibus Budget Reconciliation Act (OBRA) nursing home reforms. A quasi-experimental study using a complex, multistage probability-based sample design, with data collected before (1990) and after (1993) implementation of the RAI and other OBRA provisions. Two independent cohorts (n > 2000) of residents in a random sample of 254 nursing facilities located in metropolitan statistical areas in 10 states. OBRA-87 enhanced the regulation of nursing homes and included new requirements on quality of care, resident assessment, care planning, and the use of neuroleptic drugs and physical restraints. One of the key provisions, used to help implement the OBRA requirements in daily nursing home practice, was the mandatory use of a standardized, comprehensive system, known as the RAI, to assist in assessment and care planning. OBRA provisions went into effect in federal law on October 1, 1990, although delays issuing the regulations led to actual implementation of the RAI during the Spring of 1991. MEASUREMENTS AND ANALYSES: Research nurses spent an average of 4 days per facility in each data collection round, assessing a sample of residents, collecting data through interviews with and observations of residents, interviews with multiple shifts of direct staff caregivers for the sampled residents, and review of medical records, including physician's orders, treatment and care plans, nursing progress notes, and medication records. The RNs collected data on the characteristics of the sampled residents, on the care they received, and on facility practices. The effect of being a member of the 1990 pre-OBRA or the 1993 post-OBRA cohort was assessed on the accuracy of information in the residents' medical records, the comprehensiveness of care plans, and on other key

  1. Environmental Assessment of the City of El Cerrito, CA: Creek, Trash and Air Quality Analysis

    NASA Astrophysics Data System (ADS)

    Moore, A.; Ilan, A.

    2015-12-01

    The City of El Cerrito, CA is located within Western Contra Costa County and adjacent to the San Francisco Bay. Local land-uses that affect its overall public and environmental health include major freeways, railways, and commercial and industrial zones. In an effort to assess the overall health of the local environment, students at Korematsu Middle School conducted a comprehensive analysis that included street litter auditing, water monitoring of Cerritos Creek and air quality measurements made along local streets. In 2014 the City of El Cerrito adopted a long-term trash plan that included strategies for reducing trash loads of local stormwater sewer systems. This plan called for load reduction of 70% by July 1, 2017 and 100% by July 1, 2022. To evaluate the effectiveness of the trash plan, our team quantified and scored trash concentration levels at two locations—one in a residential neighborhood and the other in a commercial zone. We also monitored water quality at nearby Cerritos Creek to investigate the impacts that each area's trash concentrations had on water quality. We also monitored particulate matter (PM) concentration levels in air within these locations to determine whether or not differences exist between residential and commercial areas. Preliminary analysis of litter data suggests that the Long Term Trash Plan has thus far been effective in reducing concentrations of street litter along San Pablo Avenue, which is located within a major commercial zone, but has been inadequate in reducing trash in nearby parks. Water quality results indicate that Cerritos Creek contains waters that are quite healthy with respect to Ammonia and Nitrate concentration levels (i.e., very low values for every sample collected). However, elevated concentration levels of Phosphates were detected in every sample collected. Air quality data surprisingly revealed that extremely high PM concentration levels occur in air surrounding a residential park in El Cerrito.

  2. Four aspects of the scope and quality of family planning services in US publicly funded health centers: Results from a survey of health center administrators.

    PubMed

    Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B

    2016-10-01

    This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations. Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each. Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices. Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types. As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess

  3. Strategic environmental assessment and national development plans in Turkey: Towards legal framework and operational procedure

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

    Say, Nuriye Peker; Yuecel, Muzaffer

    National development plans were started to be prepared in Turkey in 1963. These plans are mandatory for public investments and guiding principles for private investments. They have a quality which guides and sets objectives for other plans in the country. Therefore, they can be evaluated as the main reason of successes and failures of sectoral investments or the problems that they cause directly or indirectly. Turkey is undergoing rapid industrialization, urbanization and population growth, thus environmental problems are on the increase. Although Environmental Impact Assessment (EIA) has been applied to individual investments in Turkey since 1993, natural environment has continuedmore » to be affected because of human activities. Today, parallel to the developments in the world, it has been discussed that it is necessary to strengthen project-level Environmental Assessment (EA) and to practice Strategic Environmental Assessment (SEA). The interest in SEA, that is, EA at the level of proposed policies, plans and programs has grown significantly since 2000 in the country. Discussions and preparations have started about regulation which provides the legal and institutional framework for SEA in The Ministry of Environment and Forestry. However, since the scientific approach into the subject is very new in Turkey, it will take time to answer the questions about how and in what fields to practice. This research project aims at analyzing the possible practice opportunities of SEA in Turkey and the practicability of SEA into the National Five-Year Development Plan (FYDP) which is assumed at the highest level of planning hierarchy in the country. The research is conducted on two sections. In the first section, procedural approaches to SEA on national development plans are investigated and a framework for these approaches is adapted at the institutional level. In the second section, SEA form for energy sector in the development plans is developed. In this article, the

  4. Blind image quality assessment based on aesthetic and statistical quality-aware features

    NASA Astrophysics Data System (ADS)

    Jenadeleh, Mohsen; Masaeli, Mohammad Masood; Moghaddam, Mohsen Ebrahimi

    2017-07-01

    The main goal of image quality assessment (IQA) methods is the emulation of human perceptual image quality judgments. Therefore, the correlation between objective scores of these methods with human perceptual scores is considered as their performance metric. Human judgment of the image quality implicitly includes many factors when assessing perceptual image qualities such as aesthetics, semantics, context, and various types of visual distortions. The main idea of this paper is to use a host of features that are commonly employed in image aesthetics assessment in order to improve blind image quality assessment (BIQA) methods accuracy. We propose an approach that enriches the features of BIQA methods by integrating a host of aesthetics image features with the features of natural image statistics derived from multiple domains. The proposed features have been used for augmenting five different state-of-the-art BIQA methods, which use statistical natural scene statistics features. Experiments were performed on seven benchmark image quality databases. The experimental results showed significant improvement of the accuracy of the methods.

  5. National Assessment of Data Quality and Associated Systems-Level Factors in Malawi

    PubMed Central

    O'Hagan, Richael; Marx, Melissa A; Finnegan, Karen E; Naphini, Patrick; Ng'ambi, Kumbukani; Laija, Kingsley; Wilson, Emily; Park, Lois; Wachepa, Sautso; Smith, Joseph; Gombwa, Lewis; Misomali, Amos; Mleme, Tiope; Yosefe, Simeon

    2017-01-01

    ABSTRACT Background: Routine health data can guide health systems improvements, but poor quality of these data hinders use. To address concerns about data quality in Malawi, the Ministry of Health and National Statistical Office conducted a data quality assessment (DQA) in July 2016 to identify systems-level factors that could be improved. Methods: We used 2-stage stratified random sampling methods to select health centers and hospitals under Ministry of Health auspices, included those managed by faith-based entities, for this DQA. Dispensaries, village clinics, police and military facilities, tertiary-level hospitals, and private facilities were excluded. We reviewed client registers and monthly reports to verify availability, completeness, and accuracy of data in 4 service areas: antenatal care (ANC), family planning, HIV testing and counseling, and acute respiratory infection (ARI). We also conducted interviews with facility and district personnel to assess health management information system (HMIS) functioning and systems-level factors that may be associated with data quality. We compared systems and quality factors by facility characteristics using 2-sample t tests with Welch's approximation, and calculated verification ratios comparing total entries in registers to totals from summarized reports. Results: We selected 16 hospitals (of 113 total in Malawi), 90 health centers (of 466), and 16 district health offices (of 28) in 16 of Malawi's 28 districts. Nearly all registers were available and complete in health centers and district hospitals, but data quality varied across service areas; median verification ratios comparing register and report totals at health centers ranged from 0.78 (interquartile range [IQR]: 0.25, 1.07) for ARI and 0.99 (IQR: 0.82, 1.36) for family planning to 1.00 (IQR: 0.96, 1.00) for HIV testing and counseling and 1.00 (IQR: 0.80, 1.23) for ANC. More than half (60%) of facilities reported receiving a documented supervisory visit for

  6. 76 FR 16285 - Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-23

    ... Plan to update the Commission's human health and aquatic life stream quality objectives (also called... DELAWARE RIVER BASIN COMMISSION 18 CFR Part 410 Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water Quality Criteria for Toxic Pollutants in the Delaware...

  7. 40 CFR 35.925-2 - Water quality management plans and agencies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Water quality management plans and agencies. 35.925-2 Section 35.925-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.925-2 Water quality management...

  8. 76 FR 44535 - Revisions to the California State Implementation Plan, Northern Sierra Air Quality Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... the California State Implementation Plan, Northern Sierra Air Quality Management District, Sacramento Metropolitan Air Quality Management District, and South Coast Air Quality Management District AGENCY... the Northern Sierra Air Quality Management District (NSAQMD), Sacramento Metropolitan Air Quality...

  9. The new national ambient air quality standards in transportation planning

    DOT National Transportation Integrated Search

    2004-03-01

    The purpose of this project is to identify the strategies adopted by several states around the country for preparing to adjust their transportation planning practices to the regulatory requirements associated with designation as an air quality nonatt...

  10. 78 FR 5292 - Approval and Promulgation of Air Quality Implementation Plans; Massachusetts and New Hampshire...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-25

    ... and New Hampshire. The revised programs in Massachusetts and New Hampshire include a test and repair..., EPA New England Regional Office, Office of Ecosystem Protection, Air Quality Planning Unit, 5 Post... Protection, Air Quality Planning Unit, 5 Post Office Square--Suite 100, (Mail code OEP05-2), Boston, MA 02109...

  11. [Quality assessment in anesthesia].

    PubMed

    Kupperwasser, B

    1996-01-01

    Quality assessment (assurance/improvement) is the set of methods used to measure and improve the delivered care and the department's performance against pre-established criteria or standards. The four stages of the self-maintained quality assessment cycle are: problem identification, problem analysis, problem correction and evaluation of corrective actions. Quality assessment is a measurable entity for which it is necessary to define and calibrate measurement parameters (indicators) from available data gathered from the hospital anaesthesia environment. Problem identification comes from the accumulation of indicators. There are four types of quality indicators: structure, process, outcome and sentinel indicators. The latter signal a quality defect, are independent of outcomes, are easier to analyse by statistical methods and closely related to processes and main targets of quality improvement. The three types of methods to analyse the problems (indicators) are: peer review, quantitative methods and risks management techniques. Peer review is performed by qualified anaesthesiologists. To improve its validity, the review process should be explicited and conclusions based on standards of practice and literature references. The quantitative methods are statistical analyses applied to the collected data and presented in a graphic format (histogram, Pareto diagram, control charts). The risks management techniques include: a) critical incident analysis establishing an objective relationship between a 'critical' event and the associated human behaviours; b) system accident analysis, based on the fact that accidents continue to occur despite safety systems and sophisticated technologies, checks of all the process components leading to the impredictable outcome and not just the human factors; c) cause-effect diagrams facilitate the problem analysis in reducing its causes to four fundamental components (persons, regulations, equipment, process). Definition and implementation

  12. Image quality assessment using deep convolutional networks

    NASA Astrophysics Data System (ADS)

    Li, Yezhou; Ye, Xiang; Li, Yong

    2017-12-01

    This paper proposes a method of accurately assessing image quality without a reference image by using a deep convolutional neural network. Existing training based methods usually utilize a compact set of linear filters for learning features of images captured by different sensors to assess their quality. These methods may not be able to learn the semantic features that are intimately related with the features used in human subject assessment. Observing this drawback, this work proposes training a deep convolutional neural network (CNN) with labelled images for image quality assessment. The ReLU in the CNN allows non-linear transformations for extracting high-level image features, providing a more reliable assessment of image quality than linear filters. To enable the neural network to take images of any arbitrary size as input, the spatial pyramid pooling (SPP) is introduced connecting the top convolutional layer and the fully-connected layer. In addition, the SPP makes the CNN robust to object deformations to a certain extent. The proposed method taking an image as input carries out an end-to-end learning process, and outputs the quality of the image. It is tested on public datasets. Experimental results show that it outperforms existing methods by a large margin and can accurately assess the image quality on images taken by different sensors of varying sizes.

  13. 78 FR 44494 - Approval and Promulgation of Implementation Plans; Designation of Areas for Air Quality Planning...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-24

    ...EPA is proposing to approve, as a revision of the California state implementation plan, the State's request to redesignate the Sacramento nonattainment area to attainment for the 24-hour particulate matter of ten microns or less (PM10) National Ambient Air Quality Standard (NAAQS). EPA is also proposing to approve the PM10 maintenance plan and the associated motor vehicle emissions budgets for use in transportation conformity determinations necessary for the Sacramento area. Finally, EPA is proposing to approve the attainment year emissions inventory. EPA is proposing these actions because the SIP revision meets the requirements of the Clean Air Act and EPA guidance for such plans and motor vehicle emissions budgets.

  14. 78 FR 70497 - Approval and Promulgation of Air Quality Implementation Plans; Illinois

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ...] Approval and Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection... VOC for purposes of preparing SIPs to attain the national ambient air quality standard for ozone [email protected] . 3. Fax: (312) 692-2450. 4. Mail: Pamela Blakley, Chief, Control Strategies Section, Air...

  15. 78 FR 34965 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Lima 1997 8-Hour Ozone...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... Promulgation of Air Quality Implementation Plans; Ohio; Lima 1997 8-Hour Ozone Maintenance Plan Revision; Motor... 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP) to replace the previously... Simulator (MOVES) emissions model. Ohio submitted the SIP revision request to EPA on January 11, 2013. DATES...

  16. 78 FR 34906 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Lima 1997 8-Hour Ozone...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-11

    ... Promulgation of Air Quality Implementation Plans; Ohio; Lima 1997 8-Hour Ozone Maintenance Plan Revision to... Lima, Ohio 1997 8-hour ozone maintenance air quality State Implementation Plan (SIP) to replace motor... (MOVES) emissions model. Ohio submitted the SIP revision request to EPA on January 11, 2013. DATES: This...

  17. Assessment of long-term and large-scale even-odd license plate controlled plan effects on urban air quality and its implication

    NASA Astrophysics Data System (ADS)

    Zhao, Suping; Yu, Ye; Qin, Dahe; Yin, Daiying; He, Jianjun

    2017-12-01

    To solve traffic congestion and to improve urban air quality, long-lasting and large-scale even-odd license plate controlled plan was implemented by local government during 20 November to 26 December 2016 in urban Lanzhou, a semi-arid valley city of northwest China. The traffic control measures provided an invaluable opportunity to evaluate its effects on urban air quality in less developed cities of northwest China. Based on measured simultaneously air pollutants and meteorological parameters, the abatement of traffic-related pollutants induced by the implemented control measures such as CO, PM2.5 and PM10 (the particulate matter with diameter less than 2.5 μm and 10 μm) concentrations were firstly quantified by comparing the air quality data in urban areas with those in rural areas (uncontrolled zones). The concentrations of CO, NO2 from motor vehicles and fine particulate matter (PM2.5) were shown to have significant decreases of 15%-23% during traffic control period from those measured before control period with hourly maximum CO, PM2.5, and NO2/SO2 reduction of 43%, 35% and 141.4%, respectively. The influence of the control measures on AQI (air quality index) and ozone was less as compared to its effect on other air pollutants. Therefore, to alleviate serious winter haze pollution in China and to protect human health, the stringent long-term and large-scale even-odd license plate controlled plan should be implemented aperiodically in urban areas, especially for the periods with poor diffusion conditions.

  18. Operational CryoSat Product Quality Assessment

    NASA Astrophysics Data System (ADS)

    Mannan, Rubinder; Webb, Erica; Hall, Amanda; Bouzinac, Catherine

    2013-12-01

    The performance and quality of the CryoSat data products are routinely assessed by the Instrument Data quality Evaluation and Analysis Service (IDEAS). This information is then conveyed to the scientific and user community in order to allow them to utilise CryoSat data with confidence. This paper presents details of the Quality Control (QC) activities performed for CryoSat products under the IDEAS contract. Details of the different QC procedures and tools deployed by IDEAS to assess the quality of operational data are presented. The latest updates to the Instrument Processing Facility (IPF) for the Fast Delivery Marine (FDM) products and the future update to Baseline-C are discussed.

  19. 77 FR 38246 - Revisions to the Arizona State Implementation Plan, Arizona Department of Environmental Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... the Arizona State Implementation Plan, Arizona Department of Environmental Quality, Maricopa County Air Quality Department, and Pima County Department of Environmental Quality AGENCY: Environmental... Department of Environmental Quality (ADEQ), Maricopa County Air Quality Department (MCAQD), and Pima County...

  20. The Columbia River Protection Supplemental Technologies Quality Assurance Project Plan

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

    Fix, N. J.

    Pacific Northwest National Laboratory researchers are working on the Columbia River Protection Supplemental Technologies Project. This project is a U. S. Department of Energy, Office of Environmental Management-funded initiative designed to develop new methods, strategies, and technologies for characterizing, modeling, remediating, and monitoring soils and groundwater contaminated with metals, radionuclides, and chlorinated organics. This Quality Assurance Project Plan provides the quality assurance requirements and processes that will be followed by the Technologies Project staff.

  1. 76 FR 43598 - Approval and Promulgation of Air Quality Plans: State of Missouri

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-21

    ... Promulgation of Air Quality Plans: State of Missouri AGENCY: Environmental Protection Agency (EPA). ACTION... Control Technology (RACT) for purposes of attaining the 1997 8-hour ozone National Ambient Air Quality...-assured ozone air quality data for 2008-2010, which demonstrate that the 1997 8-hour ozone NAAQS has been...

  2. 77 FR 30212 - Approval and Promulgation of Air Quality Implementation Plans; Vermont; Regional Haze

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-22

    ... Promulgation of Air Quality Implementation Plans; Vermont; Regional Haze AGENCY: Environmental Protection... Implementation Plan (SIP) that addresses regional haze for the first planning period from 2008 through 2018. The... numerous sources located over a wide geographic area (also referred to as the ``regional haze program...

  3. GEOSPATIAL QUALITY COUNCIL

    EPA Science Inventory

    Geospatial Science is increasingly becoming an important tool in making Agency decisions. QualIty Control and Quality Assurance are required to be integrated during the planning, implementation and assessment of geospatial databases, processes and products. In order to ensure Age...

  4. Towards Quality Assessment in an EFL Programme

    ERIC Educational Resources Information Center

    Ali, Holi Ibrahim Holi; Al Ajmi, Ahmed Ali Saleh

    2013-01-01

    Assessment is central in education and the teaching-learning process. This study attempts to explore the perspectives and views about quality assessment among teachers of English as a Foreign Language (EFL), and to find ways of promoting quality assessment. Quantitative methodology was used to collect data. To answer the study questions, a…

  5. 76 FR 43183 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-20

    ... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... Metropolitan Air Quality Management District (SMAQMD or District) portion of the California State... Designee. (i) Incorporation by Reference. (A) Sacramento Metropolitan Air Quality Management District. (1...

  6. 75 FR 18068 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-09

    ... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District... final action to approve revisions to the Sacramento Metropolitan Air Quality Management District (SMAQMD...) * * * (362) * * * (i) * * * (C) Sacramento Metropolitan Air Quality Management District. (1) Rule 450...

  7. 76 FR 23196 - Approval and Promulgation of Air Quality Implementation Plans; IL

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-26

    ... Promulgation of Air Quality Implementation Plans; IL AGENCY: Environmental Protection Agency (EPA). ACTION... VOC for purposes of preparing SIPs to attain the national ambient air quality standard for ozone under... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard...

  8. Functional Behavioral Assessments and Intervention Plans in Early Intervention Settings.

    ERIC Educational Resources Information Center

    LaRocque, Michelle; Brown, Sharan E.; Johnson, Kurt L.

    2001-01-01

    This article advocates the use of functional behavioral assessments (FBAs) and behavior intervention plans (BIPs) in the development of Individualized Family Service Plans for children with or at risk of developing behavioral disorders. It describes the FBA and BIP processes and proposes a parent collaborative model for assessment and…

  9. 77 FR 5191 - Approval and Promulgation of Air Quality Implementation Plans; District of Columbia; Regional...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ... Promulgation of Air Quality Implementation Plans; District of Columbia; Regional Haze State Implementation Plan... of Columbia Regional Haze Plan, a revision to the District of Columbia State Implementation Plan (SIP... existing anthropogenic impairment of visibility in mandatory Class I areas through a regional haze program...

  10. National Water-Quality Assessment Program--Southern High Plains, Texas and New Mexico

    USGS Publications Warehouse

    Woodward, Dennis G.; Diniz, Cecilia G.

    1994-01-01

    BACKGROUND In 1991, the U.S. Geological Survey (USGS) began a National Water-Quality Assessment (NAWQA) program. The long-term goals of the NAWQA program are to describe the status of, and trends in, the quality of a large, representative part of the Nation's surface- and ground-water resources and to identify the major natural and human factors that affect the quality of these resources. In addressing these goals, the program will produce a wealth of water-quality information that will be useful to policy makers and managers at the National, State, and local levels. The NAWQA program emphasis is on regional water-quality problems. The program will not diminish the need for smaller studies and monitoring designed and currently being conducted by Federal, State, and local agencies to meet their individual needs. The NAWQA program, however, will provide a large-scale framework for conducting many of these activities and an understanding about National and regional water-quality conditions that cannot be acquired from individual, small-scale programs and studies. Studies of 60 hydrologic systems that include parts of most major river basins and aquifer systems (study-unit investigations) are the building blocks of the National assessment. The 60 study units range in size from 1,000 mi 2 (square miles) to more than 60,000 mi 2 and represent 60 to 70 percent of the Nation's water use and population served by public water supplies. Twenty study-unit investigations were started in 1991, 20 additional are starting in 1994, and 20 more are planned to start in 1997. The Southern High Plains study unit was selected as one of 20 study units to begin assessment activities in 1994. This study will be run from the New Mexico District office of the USGS in Albuquerque, New Mexico.

  11. 76 FR 20242 - Revisions to the California State Implementation Plan; Sacramento Metropolitan Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... the California State Implementation Plan; Sacramento Metropolitan Air Quality Management District... a revision to the Sacramento Metropolitan Air Quality Management District's portion of the... (Permit No. 17359), which was issued by the Sacramento Metropolitan Air Quality Management District...

  12. 75 FR 40762 - Revisions to the California State Implementation Plan, Sacramento Metropolitan Air Quality...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-14

    ... the California State Implementation Plan, Sacramento Metropolitan Air Quality Management District and South Coast Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION... Management District (SMAQMD) and South Coast Air Quality Management District (SCAQMD) portions of the...

  13. 76 FR 76115 - Revisions to the California State Implementation Plan, Feather River Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-06

    ... the California State Implementation Plan, Feather River Air Quality Management District AGENCY... limited disapproval of revisions to the Feather River Air Quality Management District (FRAQMD) portion of..., Regulatory Planning and Review The Office of Management and Budget (OMB) has exempted this regulatory action...

  14. 76 FR 72142 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-22

    ... the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan... Office of Management and Budget under Executive Order 12866 (58 FR 51735, October 4, 1993); Does not...

  15. 76 FR 59344 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Transportation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-26

    ... Promulgation of Air Quality Implementation Plans; Maryland; Transportation Conformity Regulations AGENCY... Implementation Plan (SIP) revision submitted by Maryland to establish transportation conformity regulations. In the Final Rules section of this Federal Register, EPA is approving the State's SIP submittal as a...

  16. Summary of strategies for planning Productivity Improvement and Quality Enhancement (PIQE)

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The Summary of NASA Strategies for Productivity Improvement and Quality Enhancement respond to NASA's eighth top goal: Establish NASA as a leader in the development and application of advanced technology and management practices which contribute to significant increases in both Agency and national productivity. The Strategies provide the framework for development of the agency-wide Productivity Improvement and Quality Enhancement (PIQE) Plans.

  17. Market and plan characteristics related to HMO quality and improvement.

    PubMed

    Scanlon, Dennis P; Swaminathan, Shailender; Chernew, Michael; Lee, Woolton

    2006-12-01

    Existing research on health plan performance examines whether variation in plans' scores is related to enrollee and health plan traits, primarily using cross-sectional research designs. This study extends that literature by incorporating data on market characteristics using a longitudinal framework. We estimate multivariate growth models that relate plan performance on standard measures to market and HMO characteristics using an unbalanced panel of data for 1998 to 2002. We find that HMO competition is not associated with better performance or greater rates of improvement in performance on the HEDIS chronic care measures. HMO penetration, on the other hand, is positively associated with HEDIS performance in several of the chronic care process-and-outcomes measures but not with a greater rate of improvement through time. Our analysis indicates that a significant percentage of the unexplained variation in quality improvement is because of permanent, unobserved plan-level characteristics that future research should strive to identify.

  18. SU-D-BRB-04: Plan Quality Comparison of Intracranial Stereotactic Radiosurgery (SRS) for Gamma Knife and VMAT Treatments

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

    Keeling, V; Algan, O; Ahmad, S

    2015-06-15

    Purpose: To compare treatment plan quality of intracranial stereotactic radiosurgery (SRS) for VMAT (RapidArc) and Gamma Knife (GK) systems. Methods: Ten patients with 24 tumors (seven with 1–2 and three with 4–6 lesions), previously treated with GK 4C (prescription doses ranging from 14–23 Gy) were re-planned for RapidArc. Identical contour sets were kept on MRI images for both plans with tissues assigned a CT number of zero. RapidArc plans were performed using 6 MV flattening-filter-free (FFF) beams with dose rate of 1400 MU/minute using two to eight arcs with the following combinations: 2 full coplanar arcs and the rest non-coplanarmore » half arcs. Beam selection was based on target depth. Areas that penetrated more than 10 cm of tissue were avoided by creating smaller arcs or using avoidance sectors in optimization. Plans were optimized with jaw tracking and a high weighting to the normal-brain-tissue and Normal-Tissue-Objective without compromising PTV coverage. Plans were calculated on a 1 mm grid size using AAA algorithm and then normalized so that 99% of each target volume received the prescription dose. Plan quality was assessed by target coverage using Paddick Conformity Index (PCI), sparing of normal-brain-tissue through analysis of V4, V8, and V12 Gy, and integral dose. Results: In all cases critical structure dose criteria were met. RapidArc had a higher PCI than GK plans for 23 out of 24 lesions. The average PCI was 0.76±0.21 for RapidArc and 0.46±0.20 for GK plans (p≤0.001), respectively. Integral dose and normal-brain-tissue doses for all criteria were lower for RapidArc in nearly all patients. The average ratio of GK to RapidArc plans was 1.28±0.27 (p=0.018), 1.31±0.25 (p=0.017), 1.81±0.43 (p=0.005), and 1.50±0.61 (p=0.006) for V4, V8, and V12 Gy, and integral dose, respectively. Conclusion: VMAT was capable of producing higher quality treatment plans than GK when using optimal beam geometries and proper optimization techniques.« less

  19. Automatic quality assessment of planetary images

    NASA Astrophysics Data System (ADS)

    Sidiropoulos, P.; Muller, J.-P.

    2015-10-01

    A significant fraction of planetary images are corrupted beyond the point that much scientific meaning can be extracted. For example, transmission errors result in missing data which is unrecoverable. The available planetary image datasets include many such "bad data", which both occupy valuable scientific storage resources and create false impressions about planetary image availability for specific planetary objects or target areas. In this work, we demonstrate a pipeline that we have developed to automatically assess the quality of planetary images. Additionally, this method discriminates between different types of image degradation, such as low-quality originating from camera flaws or low-quality triggered by atmospheric conditions, etc. Examples of quality assessment results for Viking Orbiter imagery will be also presented.

  20. 75 FR 54805 - Approval and Promulgation of Air Quality Implementation Plans; Minnesota; Carbon Monoxide (CO...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ... Promulgation of Air Quality Implementation Plans; Minnesota; Carbon Monoxide (CO) Limited Maintenance Plan for... June 16, 2010, to revise the Minnesota State Implementation Plan (SIP) for carbon monoxide (CO) under the Clean Air Act (CAA). The State has submitted a limited maintenance plan for CO showing continued...

  1. Poster - Thur Eve - 76: A quality control to achieve planning consistency in arc radiotherapy of the prostate.

    PubMed

    Zeng, G; Murphy, J; Annis, S-L; Wu, X; Wang, Y; McGowan, T; Macpherson, M

    2012-07-01

    To report a quality control program in prostate radiation therapy at our center that includes semi-automated planning process to generate high quality plans and in-house software to track plan quality in the subsequent clinical application. Arc planning in Eclipse v10.0 was preformed for both intact prostate and post-prostatectomy treatments. The planning focuses on DVH requirements and dose distributions being able to tolerate daily setup variations. A modified structure set is used to standardize the optimization, including short rectum and bladder in the fields to effectively tighten dose to target and a rectum expansion with 1cm cropped from PTV to block dose and shape posterior isodose lines. Structure, plan and optimization templates are used to streamline plan generation. DVH files are exported from Eclipse to a quality tracking software with GUI written in Matlab that can report the dose-volume data either for an individual patient or over a patient population. For 100 intact prostate patients treated with 78Gy, rectal D50, D25, D15 and D5 are 30.1±6.2Gy, 50.6±7.9Gy, 65.9±6.0Gy and 76.6±1.4Gy respectively, well below the limits 50Gy, 65Gy, 75Gy and 78Gy respectively. For prostate bed with prescription of 66Gy, rectal D50 is 35.9±6.9Gy. In both sites, PTV is covered by 95% prescription and the hotspots are less than 5%. The semi-automated planning method can efficiently create high quality plans while the tracking software can monitor the feedback from clinical application. It is a comprehensive and robust quality control program in radiation therapy. © 2012 American Association of Physicists in Medicine.

  2. 78 FR 21540 - Revisions to the California State Implementation Plan, Butte County Air Quality Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-11

    ... the California State Implementation Plan, Butte County Air Quality Management District and Sacramento Metropolitan Air Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Direct... Quality Management District (BCAQMD) and Sacramento Metropolitan Air Quality Management District (SMAQMD...

  3. 76 FR 44493 - Revisions to the California State Implementation Plan, Northern Sierra Air Quality Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... California State Implementation Plan, Northern Sierra Air Quality Management District, Sacramento Metropolitan Air Quality Management District, and South Coast Air Quality Management District AGENCY... approve revisions to the Northern Sierra Air Quality Management District (NSAQMD), Sacramento Metropolitan...

  4. 77 FR 23193 - Revisions to the California State Implementation Plan, Yolo-Solano Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-18

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0180; FRL-9652-3] Revisions to the California State Implementation Plan, Yolo- Solano Air Quality Management District AGENCY... the Yolo-Solano Air Quality Management District portion of the California State Implementation Plan...

  5. 77 FR 32483 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-01

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2012-0236; FRL-9670-9] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan...

  6. 75 FR 32353 - Revisions to the California State Implementation Plan, South Coast Air Quality Management District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-08

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R09-OAR-2010-0276; FRL-9139-8] Revisions to the California State Implementation Plan, South Coast Air Quality Management District AGENCY... the South Coast Air Quality Management District portion of the California State Implementation Plan...

  7. 75 FR 48894 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Revisions to Emissions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-12

    ... Promulgation of Air Quality Implementation Plans; New Mexico; Revisions to Emissions Inventory Reporting.... SUMMARY: The EPA is proposing to approve revisions to the New Mexico State Implementation Plan (SIP... Quality Standards that EPA has established for criteria pollutants such as ozone, particulate matter, and...

  8. NATIONAL WATER-QUALITY ASSESSMENT (NAWQA) PROGRAM

    EPA Science Inventory

    The National Water-Quality Assessment (NAWQA) Program is designed to describe the status and trends in the quality of the Nations ground- and surface-water resources and to provide a sound understanding of the natural and human factors that affect the quality of these resources. ...

  9. 78 FR 65593 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Infrastructure...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ...] Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Infrastructure Requirements for the 2010 Nitrogen Dioxide National Ambient Air Quality Standards AGENCY: Environmental Protection... revised national ambient air quality standards (NAAQS) are promulgated, the CAA requires states to submit...

  10. Summarized Costs, Placement Of Quality Stars, And Other Online Displays Can Help Consumers Select High-Value Health Plans.

    PubMed

    Greene, Jessica; Hibbard, Judith H; Sacks, Rebecca M

    2016-04-01

    Starting in 2017, all state and federal health insurance exchanges will present quality data on health plans in addition to cost information. We analyzed variations in the current design of information on state exchanges to identify presentation approaches that encourage consumers to take quality as well as cost into account when selecting a health plan. Using an online sample of 1,025 adults, we randomly assigned participants to view the same comparative information on health plans, displayed in different ways. We found that consumers were much more likely to select a high-value plan when cost information was summarized instead of detailed, when quality stars were displayed adjacent to cost information, when consumers understood that quality stars signified the quality of medical care, and when high-value plans were highlighted with a check mark or blue ribbon. These approaches, which were equally effective for participants with higher and lower numeracy, can inform the development of future displays of plan information in the exchanges. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Assessment of air quality in Haora River basin using fuzzy multiple-attribute decision making techniques.

    PubMed

    Singh, Ajit Pratap; Chakrabarti, Sumanta; Kumar, Sumit; Singh, Anjaney

    2017-08-01

    This paper deals with assessment of air quality in Haora River basin using two techniques. Initially, air quality indices were evaluated using a modified EPA method. The indices were also evaluated using a fuzzy comprehensive assessment (FCA) method. The results obtained from the fuzzy comprehensive assessment method were compared to that obtained from the modified EPA method. To illustrate the applicability of the methodology proposed herein, a case study has been presented. Air samples have been collected at 10 sampling sites located along Haora River. Six important air pollutants, namely, carbon monoxide, sulfur dioxide, nitrogen dioxide, suspended particulate matter (SPM), PM 10 , and lead, were monitored continuously, and air quality maps were generated on the GIS platform. Comparison of the methodologies has clearly highlighted superiority and robustness of the fuzzy comprehensive assessment method in determining air quality indices under study. It has effectively addressed the inherent uncertainties involved in the evaluation, modeling, and interpretation of sampling data, which was beyond the scope of the traditional weighted approaches employed otherwise. The FCA method is robust and prepares a credible platform of air quality evaluation and identification, in face of the uncertainties that remain eclipsed in the traditional approaches like the modified EPA method. The insights gained through the present study are believed to be of pivotal significance in guiding the development and implementation of effective environmental remedial action plans in the study area.

  12. PNNL Apatite Investigation at 100-NR-2 Quality Assurance Project Plan

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

    Fix, N. J.

    In 2004, the U.S. Department of Energy, Fluor Hanford, Inc., Pacific Northwest National Laboratory (PNNL), and the Washington Department of Ecology agreed that the long-term strategy for groundwater remediation at the 100-N Area would include apatite sequestration as the primary treatment, followed by a secondary treatment if necessary. Since then, the agencies have worked together to agree on which apatite sequestration technology has the greatest chance of reducing strontium-90 flux to the Columbia River. This Quality Assurance Project Plan provides the quality assurance requirements and processes that will be followed by staff working on the PNNL Apatite Investigation at 100-NR-2more » Project. The plan is designed to be used exclusively by project staff.« less

  13. The Assessment, Development, Assurance Pharmacist's Tool (ADAPT) for ensuring quality implementation of health promotion programs.

    PubMed

    Truong, Hoai-An; Taylor, Catherine R; DiPietro, Natalie A

    2012-02-10

    To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs. The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes. Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated. The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.

  14. Learning Receptive Fields and Quality Lookups for Blind Quality Assessment of Stereoscopic Images.

    PubMed

    Shao, Feng; Lin, Weisi; Wang, Shanshan; Jiang, Gangyi; Yu, Mei; Dai, Qionghai

    2016-03-01

    Blind quality assessment of 3D images encounters more new challenges than its 2D counterparts. In this paper, we propose a blind quality assessment for stereoscopic images by learning the characteristics of receptive fields (RFs) from perspective of dictionary learning, and constructing quality lookups to replace human opinion scores without performance loss. The important feature of the proposed method is that we do not need a large set of samples of distorted stereoscopic images and the corresponding human opinion scores to learn a regression model. To be more specific, in the training phase, we learn local RFs (LRFs) and global RFs (GRFs) from the reference and distorted stereoscopic images, respectively, and construct their corresponding local quality lookups (LQLs) and global quality lookups (GQLs). In the testing phase, blind quality pooling can be easily achieved by searching optimal GRF and LRF indexes from the learnt LQLs and GQLs, and the quality score is obtained by combining the LRF and GRF indexes together. Experimental results on three publicly 3D image quality assessment databases demonstrate that in comparison with the existing methods, the devised algorithm achieves high consistent alignment with subjective assessment.

  15. 75 FR 34669 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Transportation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-18

    ... Promulgation of Air Quality Implementation Plans; Maryland; Transportation Conformity Regulations AGENCY... Implementation Plan (SIP) revision submitted by Maryland for Transportation Conformity Regulations. In the Final Rules section of this Federal Register, EPA is approving the State's SIP submittal as a direct final...

  16. Design and methods of the Midwest Stream Quality Assessment (MSQA), 2013

    USGS Publications Warehouse

    Garrett, Jessica D.; Frey, Jeffrey W.; Van Metre, Peter C.; Journey, Celeste A.; Nakagaki, Naomi; Button, Daniel T.; Nowell, Lisa H.

    2017-10-18

    During 2013, the U.S. Geological Survey (USGS) National Water-Quality Assessment Project (NAWQA), in collaboration with the USGS Columbia Environmental Research Center, the U.S. Environmental Protection Agency (EPA) National Rivers and Streams Assessment (NRSA), and the EPA Office of Pesticide Programs assessed stream quality across the Midwestern United States. This Midwest Stream Quality Assessment (MSQA) simultaneously characterized watershed and stream-reach water-quality stressors along with instream biological conditions, to better understand regional stressor-effects relations. The MSQA design focused on effects from the widespread agriculture in the region and urban development because of their importance as ecological stressors of particular concern to Midwest region resource managers.A combined random stratified selection and a targeted selection based on land-use data were used to identify and select sites representing gradients in agricultural intensity across the region. During a 14-week period from May through August 2013, 100 sites were selected and sampled 12 times for contaminants, nutrients, and sediment. This 14-week water-quality “index” period culminated with an ecological survey of habitat, periphyton, benthic macroinvertebrates, and fish at all sites. Sediment was collected during the ecological survey for analysis of sediment chemistry and toxicity testing. Of the 100 sites, 50 were selected for the MSQA random stratified group from 154 NRSA sites planned for the region, and the other 50 MSQA sites were selected as targeted sites to more evenly cover agricultural and urban stressor gradients in the study area. Of the 50 targeted sites, 12 were in urbanized watersheds and 21 represented “good” biological conditions or “least disturbed” conditions. The remaining 17 targeted sites were selected to improve coverage of the agricultural intensity gradient or because of historical data collection to provide temporal context for the

  17. Standardizing Quality Assessment of Fused Remotely Sensed Images

    NASA Astrophysics Data System (ADS)

    Pohl, C.; Moellmann, J.; Fries, K.

    2017-09-01

    The multitude of available operational remote sensing satellites led to the development of many image fusion techniques to provide high spatial, spectral and temporal resolution images. The comparison of different techniques is necessary to obtain an optimized image for the different applications of remote sensing. There are two approaches in assessing image quality: 1. Quantitatively by visual interpretation and 2. Quantitatively using image quality indices. However an objective comparison is difficult due to the fact that a visual assessment is always subject and a quantitative assessment is done by different criteria. Depending on the criteria and indices the result varies. Therefore it is necessary to standardize both processes (qualitative and quantitative assessment) in order to allow an objective image fusion quality evaluation. Various studies have been conducted at the University of Osnabrueck (UOS) to establish a standardized process to objectively compare fused image quality. First established image fusion quality assessment protocols, i.e. Quality with No Reference (QNR) and Khan's protocol, were compared on varies fusion experiments. Second the process of visual quality assessment was structured and standardized with the aim to provide an evaluation protocol. This manuscript reports on the results of the comparison and provides recommendations for future research.

  18. Task-based image quality assessment in radiation therapy: initial characterization and demonstration with CT simulation images

    NASA Astrophysics Data System (ADS)

    Dolly, Steven R.; Anastasio, Mark A.; Yu, Lifeng; Li, Hua

    2017-03-01

    In current radiation therapy practice, image quality is still assessed subjectively or by utilizing physically-based metrics. Recently, a methodology for objective task-based image quality (IQ) assessment in radiation therapy was proposed by Barrett et al.1 In this work, we present a comprehensive implementation and evaluation of this new IQ assessment methodology. A modular simulation framework was designed to perform an automated, computer-simulated end-to-end radiation therapy treatment. A fully simulated framework was created that utilizes new learning-based stochastic object models (SOM) to obtain known organ boundaries, generates a set of images directly from the numerical phantoms created with the SOM, and automates the image segmentation and treatment planning steps of a radiation therapy work ow. By use of this computational framework, therapeutic operating characteristic (TOC) curves can be computed and the area under the TOC curve (AUTOC) can be employed as a figure-of-merit to guide optimization of different components of the treatment planning process. The developed computational framework is employed to optimize X-ray CT pre-treatment imaging. We demonstrate that use of the radiation therapy-based-based IQ measures lead to different imaging parameters than obtained by use of physical-based measures.

  19. Developing a multidisciplinary robotic surgery quality assessment program.

    PubMed

    Gonsenhauser, Iahn; Abaza, Ronney; Mekhjian, Hagop; Moffatt-Bruce, Susan D

    2012-01-01

    The objective of this study was to test the feasibility of a novel quality-improvement (QI) program designed to incorporate multiple robotic surgical sub-specialties in one health care system. A robotic surgery quality assessment program was developed by The Ohio State University College of Medicine (OSUMC) in conjunction with The Ohio State University Medical Center Quality Improvement and Operations Department. A retrospective review of cases was performed using data interrogated from the OSUMC Information Warehouse from January 2007 through August 2009. Robotic surgery cases (n=2200) were assessed for operative times, length of stay (LOS), conversions, returns to surgery, readmissions and cancellations as potential quality indicators. An actionable and reproducible framework for the quality measurement and assessment of a multidisciplinary and interdepartmental robotic surgery program was successfully completed demonstrating areas for improvement opportunities. This report supports that standard quality indicators can be applied to multiple specialties within a health care system to develop a useful quality tracking and assessment tool in the highly specialized area of robotic surgery. © 2012 National Association for Healthcare Quality.

  20. BASIS FOR PRIMARY AIR QUALITY CRITERIA AND STANDARDS

    EPA Science Inventory

    The Environmental Criteria and Assessment Office and the Office of Air Quality Planning and Standards are charged with responsibility for reviewing and assessing air quality criteria and air quality standards, respectively. Since adoption of the 1977 Clean Air Act Amendments, the...

  1. 77 FR 12495 - Revisions to the California State Implementation Plan, Antelope Valley Air Quality Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ... the California State Implementation Plan, Antelope Valley Air Quality Management District and Mojave Desert Quality Management District AGENCY: Environmental Protection Agency (EPA). ACTION: Direct final... Quality Management District (AVAQMD) and Mojave Desert Air Quality Management District (MDAQMD) portion of...

  2. A new metric for assessing IMRT modulation complexity and plan deliverability.

    PubMed

    McNiven, Andrea L; Sharpe, Michael B; Purdie, Thomas G

    2010-02-01

    To evaluate the utility of a new complexity metric, the modulation complexity score (MCS), in the treatment planning and quality assurance processes and to evaluate the relationship of the metric with deliverability. A multisite (breast, rectum, prostate, prostate bed, lung, and head and neck) and site-specific (lung) dosimetric evaluation has been completed. The MCS was calculated for each beam and the overall treatment plan. A 2D diode array (MapCHECK, Sun Nuclear, Melbourne, FL) was used to acquire measurements for each beam. The measured and planned dose (PINNACLE3, Phillips, Madison, WI) was evaluated using different percent differences and distance to agreement (DTA) criteria (3%/ 3 mm and 2%/ 1 mm) and the relationship between the dosimetric results and complexity (as measured by the MCS or simple beam parameters) assessed. For the multisite analysis (243 plans total), the mean MCS scores for each treatment site were breast (0.92), rectum (0.858), prostate (0.837), prostate bed (0.652), lung (0.631), and head and neck (0.356). The MCS allowed for compilation of treatment site-specific statistics, which is useful for comparing different techniques, as well as for comparison of individual treatment plans with the typical complexity levels. For the six plans selected for dosimetry, the average diode percent pass rate was 98.7% (minimum of 96%) for 3%/3 mm evaluation criteria. The average difference in absolute dose measurement between the planned and measured dose was 1.7 cGy. The detailed lung analysis also showed excellent agreement between the measured and planned dose, as all beams had a diode percentage pass rate for 3%/3 mm criteria of greater than 95.9%, with an average pass rate of 99.0%. The average absolute maximum dose difference for the lung plans was 0.7 cGy. There was no direct correlation between the MCS and simple beam parameters which could be used as a surrogate for complexity level (i.e., number of segments or MU). An evaluation criterion of

  3. 77 FR 41279 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Regional Haze State...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-13

    ... Promulgation of Air Quality Implementation Plans; Pennsylvania; Regional Haze State Implementation Plan AGENCY... the Regional Haze State Implementation Plan (SIP) (hereafter RH SIP) revision submitted by the... anthropogenic impairment of visibility in mandatory Class I areas [[Page 41280

  4. 77 FR 28338 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Reasonably Available...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-14

    ... Promulgation of Air Quality Implementation Plans; Maryland; Reasonably Available Control Technology for the 1997 8-Hour Ozone National Ambient Air Quality Standard AGENCY: Environmental Protection Agency (EPA... available control technology (RACT) for the 1997 8-hour ozone national ambient air quality standard (NAAQS...

  5. 78 FR 75902 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Philadelphia County...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-13

    ...] Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Philadelphia County Reasonably Available Control Technology Under the 1997 8-Hour Ozone National Ambient Air Quality Standard AGENCY... Department of Environmental Protection, Bureau of Air Quality Control, P.O. Box 8468, 400 Market Street...

  6. Framework for a ground-water quality monitoring and assessment program for California

    USGS Publications Warehouse

    Belitz, Kenneth; Dubrovsky, Neil M.; Burow, Karen; Jurgens, Bryant C.; John, Tyler

    2003-01-01

    The State of California uses more ground water than any other State in the Nation. With a population of over 30 million people, an agricultural economy based on intensive irrigation, large urban industrial areas, and naturally elevated concentrations of some trace elements, there is a wide range of contaminant sources that have the potential to contaminate ground water and limit its beneficial uses. In response to the many-and different-potential sources of ground-water contamination, the State of California has evolved an extensive set of rules and programs to protect ground-water quality, and agencies to implement the rules and programs. These programs have in common a focus on compliance with regulations governing chemical use and (or) ground-water quality. Although appropriate for, and successful at, their specific missions, these programs do not at present provide a comprehensive view of ground-water quality in the State of California. In October 2001, The California Assembly passed a bill, AB 599, establishing the Ground-Water- Quality Monitoring Act of 2001.' The goal of AB 599 is to improve Statewide comprehensive ground-water monitoring and increase availability of information about ground-water quality to the public. AB 599 requires the State Water Resources Control Board (SWRCB), in collaboration with an interagency task force (ITF) and a public advisory committee (PAC), to develop a plan for a comprehensive ground-water monitoring program. AB 599 specifies that the comprehensive program should be capable of assessing each ground-water basin in the State through direct and other statistically reliable sampling approaches, and that the program should integrate existing monitoring programs and design new program elements, as necessary. AB 599 also stresses the importance of prioritizing ground-water basins that provide drinking water. The United States Geological Survey (USGS), in cooperation with the SWRCB, and in coordination with the ITF and PAC, has

  7. Installation Restoration Program Stage 3. McClellan Air Force Base Quality Assurance Project Plan

    DTIC Science & Technology

    1989-08-30

    QUALITY ASSURANCE PROJECT PLAN TDTM FINAL ELECTE C\\ JAUG 3 119891 .. .. . .. 0.. ... PREPARD.FOR HEDURTR FL/E WRGTPATRO .. F... OHI.443 ........ 1N...P.E. Contract Program Manager \\ 0 RADMAN 0 TABLE OF CONTENTS Section Page 1.0 INTRODUCTION ................................................... 1 of 6...Section: 1.0 RADM Revision: 1 CO PO AIO NDate: 04/12/89 O Page 1 of 6 1.0 INTRODUCTION The Quality Assurance Project Plan (QAPP) presents in specific

  8. Managing Uncertainty: Thinking and Planning Strategically.

    ERIC Educational Resources Information Center

    Lorenzo, Albert L.

    1993-01-01

    Argues that rapid change and tight resources demand reality-based planning, rather than planning models that ignore internal and external customers or emphasize process over product. Describes the Strategic Guidance Model (SGM) which provides colleges with strategic visioning, organizational assessment, environmental scanning, quality improvement,…

  9. Impact of database quality in knowledge-based treatment planning for prostate cancer.

    PubMed

    Wall, Phillip D H; Carver, Robert L; Fontenot, Jonas D

    2018-03-13

    resulting from manually optimized clinical plans, which significantly improved KBP-assisted plan quality. This work investigates how the plan quality of knowledge databases affects the performance and achievability of dose-volume predictions from a common knowledge-based planning approach for prostate cancer. Bladder and rectum dose-volume predictions derived from a database of standardized Pareto-optimal plans were compared with those derived from clinical plans manually designed by various planners. Dose-volume predictions from the Pareto plan database were significantly lower overall than those from the clinical plan database, without compromising achievability. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Institutional Consequences of Quality Assessment

    ERIC Educational Resources Information Center

    Joao Rosa, Maria; Tavares, Diana; Amaral, Alberto

    2006-01-01

    This paper analyses the opinions of Portuguese university rectors and academics on the quality assessment system and its consequences at the institutional level. The results obtained show that university staff (rectors and academics, with more of the former than the latter) held optimistic views of the positive consequences of quality assessment…

  11. Maximising Confidence in Assessment Decision-Making: A Springboard to Quality in Assessment.

    ERIC Educational Resources Information Center

    Clayton, Berwyn; Booth, Robin; Roy, Sue

    The introduction of training packages has focused attention on the quality of assessment in the Australian vocational education and training (VET) sector on the quality of assessment. For the process of mutual recognition under the Australian Recognition Framework (ARF) to work effectively, there needs to be confidence in assessment decisions made…

  12. Quality of care provided in a special needs plan using a nurse care manager model.

    PubMed

    Wenger, Neil S; Roth, Carol P; Martin, David; Nickels, Lorraine; Beckman, Robin; Kamberg, Caren; Mach, John; Ganz, David A

    2011-10-01

    To comprehensively evaluate the quality of care provided in special needs plans (SNPs; Medicare Advantage plans that aim to provide specialized care for complex older adults) and specifically the nurse care management model in the community setting. We adapted 107 process-of-care quality measures across 12 conditions from the Assessing Care of Vulnerable Elders set to obtain a clinically detailed evaluation of the quality of care received by complex older enrollees in a dual eligible Evercare SNP. We abstracted 13 months of primary care medical records to delineate quality of care provided by physicians and whether there was value added from the nurse care manager model. Dual eligible Evercare SNP located in central Florida. Two-hundred thirty-one vulnerable older enrollees in the SNP who had complex disease. Based on physician medical records alone, the 231 high-risk participants (mean age 77, 67% women) received recommended care for 53% of 5,569 evaluated clinical circumstances, ranging from 12% for end-of-life care to 78% for diabetes mellitus. In fewer than 40% of these clinical circumstances was recommended care provided for dementia, falls, and urinary incontinence. In a second analysis accounting for care provided by both the Evercare nurse and the physician, recommended care was provided to patients in 69% of the 5,684 evaluated clinical circumstances. Comprehensive quality measurement applied to vulnerable older adults enrolled in one mature SNP showed that the Evercare nurse model addresses important deficits in physician care for geriatric conditions. Such measurement should be applied to other SNP models and to compare SNP care with that for complex, older, fee-for-service Medicare cohorts. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

  13. Classification management plan of groundwater quality in Taiwan

    NASA Astrophysics Data System (ADS)

    Chen, Chun Ming; Chen, Yu Ying; Pan, Shih Cheng; Li, Hui Jun; Hsiao, Fang Ke

    2017-04-01

    Taiwan Environmental Protection Administration has been monitoring regional water quality for 14 years. Since the beginning of 2002 till now, there are 453 regional groundwater monitoring wells in ten groundwater subregions in Taiwan, and the monitoring of groundwater quality has been carried out for a long time. Currently, water quality monitoring project has reached 50 items, while the number of water quality monitoring data has reached more than 20,000. In order to use the monitoring data efficiently, this study constructed the localized groundwater quality indicators of Taiwan. This indicator takes into account the different users' point of view, incorporating the Taiwan groundwater pollution monitoring standards (Category II), irrigation water quality standard and drinking water source water quality standard. 50 items of water quality monitoring projects were simplified and classified. The groundwater quality parameters were divided into five items, such as potability for drinking water, salting, external influence, health influences and toxicity hazard. The weight of the five items of groundwater was calculated comprehensively, and the groundwater quality of each monitoring well was evaluated with three grades of good, ordinary, and poor. According to the monitoring results of the groundwater monitoring wells in October to December of 2016, about 70% of groundwater quality in Taiwan is in good to ordinary grades. The areas with poor groundwater quality were mostly distributed in coastal, agriculture and part of the urban areas. The conductivity or ammonia nitrogen concentration was higher in those regions, showing that groundwater may be salinized or affected by external influences. Groundwater quality indicators can clearly show the current comprehensive situation of the groundwater environment in Taiwan and can be used as a tool for groundwater quality classification management. The indicators can coordinate with the Taiwan land planning policy in the

  14. Groundwater quality data from the National Water-Quality Assessment Project, May 2012 through December 2013

    USGS Publications Warehouse

    Arnold, Terri L.; Desimone, Leslie A.; Bexfield, Laura M.; Lindsey, Bruce D.; Barlow, Jeannie R.; Kulongoski, Justin T.; Musgrove, MaryLynn; Kingsbury, James A.; Belitz, Kenneth

    2016-06-20

    Groundwater-quality data were collected from 748 wells as part of the National Water-Quality Assessment Project of the U.S. Geological Survey National Water-Quality Program from May 2012 through December 2013. The data were collected from four types of well networks: principal aquifer study networks, which assess the quality of groundwater used for public water supply; land-use study networks, which assess land-use effects on shallow groundwater quality; major aquifer study networks, which assess the quality of groundwater used for domestic supply; and enhanced trends networks, which evaluate the time scales during which groundwater quality changes. Groundwater samples were analyzed for a large number of water-quality indicators and constituents, including major ions, nutrients, trace elements, volatile organic compounds, pesticides, and radionuclides. These groundwater quality data are tabulated in this report. Quality-control samples also were collected; data from blank and replicate quality-control samples are included in this report.

  15. Application of an uncertainty analysis approach to strategic environmental assessment for urban planning.

    PubMed

    Liu, Yi; Chen, Jining; He, Weiqi; Tong, Qingyuan; Li, Wangfeng

    2010-04-15

    Urban planning has been widely applied as a regulatory measure to guide a city's construction and management. It represents official expectations on future population and economic growth and land use over the urban area. No doubt, significant variations often occur between planning schemes and actual development; in particular in China, the world's largest developing country experiencing rapid urbanization and industrialization. This in turn leads to difficulty in estimating the environmental consequences of the urban plan. Aiming to quantitatively analyze the uncertain environmental impacts of the urban plan's implementation, this article developed an integrated methodology combining a scenario analysis approach and a stochastic simulation technique for strategic environmental assessment (SEA). Based on industrial development scenarios, Monte Carlo sampling is applied to generate all possibilities of the spatial distribution of newly emerged industries. All related environmental consequences can be further estimated given the industrial distributions as input to environmental quality models. By applying a HSY algorithm, environmentally unacceptable urban growth, regarding both economic development and land use spatial layout, can be systematically identified, providing valuable information to urban planners and decision makers. A case study in Dalian Municipality, Northeast China, is used to illustrate applicability of this methodology. The impacts of Urban Development Plan for Dalian Municipality (2003-2020) (UDP) on atmospheric environment are also discussed in this article.

  16. 76 FR 36471 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ... Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised Nitrogen Dioxide Standard... of adding the new 1-hour nitrogen dioxide (NO 2 ) standard at a level of 100 parts per billion (ppb... Promulgation of Air Quality Implementation Plans; Virginia; Adoption of the Revised Nitrogen Dioxide Standards...

  17. 77 FR 42686 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; the 2002 Base Year...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... Promulgation of Air Quality Implementation Plans; Maryland; the 2002 Base Year Inventory AGENCY: Environmental... matter (PM 2.5 ) 2002 base year emissions inventory portion of the Maryland State Implementation Plan... National Ambient Air Quality Standard (NAAQS) SIP. EPA is proposing to approve the 2002 base year PM 2.5...

  18. INTERIM EPA GUIDANCE FOR GEOSPATIAL-RELATED QUALITY ASSURANCE PROJECT PLANS

    EPA Science Inventory

    This guidance supplements EPA Guidance for Quality,Assurance Project Plans (EPA QA/G-5), in that the focus here is on collection and use of geospatial rather than other environmental data (e.g., strictly chemical or biological data), including unique aspects of data storage, retr...

  19. Planning, Teaching, and Assessing Elementary Education Interdisciplinary Curriculum

    ERIC Educational Resources Information Center

    Campbell, Cynthia; Henning, Mary Beth

    2010-01-01

    This paper describes an innovative teaching collaboration between two university professors to prepare undergraduate preservice teachers for planning, designing, and assessing interdisciplinary curriculum. Specifically, we were interested in whether deliberate efforts to integrate social studies and assessment methods courses would facilitate our…

  20. 77 FR 64422 - Approval and Promulgation of Air Quality Implementation Plans; Illinois; Greif Packaging, LLC...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ... Promulgation of Air Quality Implementation Plans; Illinois; Greif Packaging, LLC Adjusted Standard AGENCY...) 408-2279. 4. Mail: Doug Aburano, Chief, Attainment Planning and Maintenance Section, Air Programs.... 5. Hand Delivery: Doug Aburano, Chief, Attainment Planning and Maintenance Section, Air Programs...

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