42 CFR 476.86 - Correlation of Title XI functions with Title XVIII functions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... functions. 476.86 Section 476.86 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

Quality assessment concept of the World Data Center for Climate and its application to CMIP5 data

NASA Astrophysics Data System (ADS)

Stockhause, M.; Höck, H.; Toussaint, F.; Lautenschlager, M.

2012-08-01

The preservation of data in a high state of quality which is suitable for interdisciplinary use is one of the most pressing and challenging current issues in long-term archiving. For high volume data such as climate model data, the data and data replica are no longer stored centrally but distributed over several local data repositories, e.g. the data of the Climate Model Intercomparison Project Phase 5 (CMIP5). The most important part of the data is to be archived, assigned a DOI, and published according to the World Data Center for Climate's (WDCC) application of the DataCite regulations. The integrated part of WDCC's data publication process, the data quality assessment, was adapted to the requirements of a federated data infrastructure. A concept of a distributed and federated quality assessment procedure was developed, in which the workload and responsibility for quality control is shared between the three primary CMIP5 data centers: Program for Climate Model Diagnosis and Intercomparison (PCMDI), British Atmospheric Data Centre (BADC), and WDCC. This distributed quality control concept, its pilot implementation for CMIP5, and first experiences are presented. The distributed quality control approach is capable of identifying data inconsistencies and to make quality results immediately available for data creators, data users and data infrastructure managers. Continuous publication of new data versions and slow data replication prevents the quality control from check completion. This together with ongoing developments of the data and metadata infrastructure requires adaptations in code and concept of the distributed quality control approach.

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.

42 CFR 431.810 - Basic elements of the Medicaid eligibility quality control (MEQC) program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Basic elements of the Medicaid eligibility quality control (MEQC) program. 431.810 Section 431.810 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... elements of the Medicaid eligibility quality control (MEQC) program. (a) General requirements. The agency...

78 FR 44954 - Clinical Laboratory Improvement Advisory Committee (CLIAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Clinical... and Human Services; the Assistant Secretary for Health; the Director, Centers for Disease Control and... laboratory quality and laboratory [[Page 44955

Quality of pancreatic transplant program assessment using a risk-adjusted cumulative sum chart: experience from a single, small center.

PubMed

Grochowiecki, T; Jakimowicz, T; Grabowska-Derlatka, L; Szmidt, J

2014-10-01

The high rate of complication after pancreas transplantation not only had an impact on recipient quality of life and survival but also had significant financial implications. Thus, monitoring transplant center performance was crucial to indentifying changes in clinical practice that result in quality deterioration. To evaluate retrospectively the quality of the single, small pancreatic transplant program and to establish prospective monitoring of the center using risk-adjusted cumulative sum (CUSUM). From 1988 to 2014, 119 simultaneous pancreas and the kidney transplantations (SPKTx) were performed. The program was divided into 3 eras, based on surgical technique and immunosuppression. Analyses of the 15 fatal outcomes due to complication from pancreatic graft were performed. The risk model was developed using multivariable logistic regression analysis based on retrospective data of 112 SPKTx recipients. The risk-adjusted 1-sided CUSUM chart was plotted for retrospective and prospective events. The upper control limit was set to 2. There were 2 main causes of death: multiorgan failure (73.3%; 11/15) and septic hemorrhage (26.7%; 4/15). Quality analysis using the CUSUM chart revealed that the process was not homogeneous; however, no significant signal of program deterioration was obtained and the performance of the whole program was within the settled control limit. For a single pancreatic transplant center. The risk-adjusted CUSUM chart was a useful tool for quality program assessment. It could support decision making during traditional surgical morbidity and mortality conferences. For small transplant centers, increasing the sensitivity of the CUSUM method by lowering the upper control limit should be considered. However, an individual assessment approach of the for particular centers is recommended.

Ambient Monitoring Technology Information Center (AMTIC)

EPA Pesticide Factsheets

This site contains information on ambient air quality monitoring programs, monitoring methods, quality assurance and control procedures, and federal regulations related to ambient air quality monitoring.

What Does it Mean to Publish Data in Earth System Science Data Journal?

NASA Astrophysics Data System (ADS)

Carlson, D.; Pfeiffenberger, H.

2015-12-01

The availability of more than 120 data sets in ESSD represents an unprecedented effort by providers, data centers and ESSD. ESSD data sets and their accompanying data descriptions undergo rigorous review. The data sets reside at any of more than 20 cooperating data centers. The ESSD publication process depends on but challenges the concepts of digital object identification and exacerbates the varied interpretations of the phrase 'data publication'. ESSD adopts the digital object identifier (doi). Key questions apply to doi's and other identifiers. How will persistent identifiers point accurately to distributed or replicated data? How should data centers and data publishers use identifier technologies to ensure authenticity and integrity? Should metadata associated with identifiers distinguish among raw, quality controlled and derived data processing levels, or indicate license or copyright status?Data centers publish data sets according to internal metadata standards but without indicators of quality control. Publication in this sense indicates availability. National data portals compile, serve and publish data products as a service to national researchers and, often, to meet national requirements. Publication in this second case indicates availability in a national context; the data themselves may still reside at separate data centers. Data journals such as ESSD or Scientific Data publish peer-reviewed, quality controlled data sets. These data sets almost always reside at a separate data center - the journal and the center maintain explicit identifier linkages. Data journals add quality to the feature of availability. A single data set processed through these layers will generate three independent doi's but the doi's will provide little information about availability or quality. Could the data world learn from the URL world to consider additions? Suffixes? Could we use our experience with processing levels or data maturity to propose and agree such extensions?

[Accesibility and use of spirometry in primary care centers in Catalonia].

PubMed

Llauger, M Antònia; Rosas, Alba; Burgos, Felip; Torrente, Elena; Tresserras, Ricard; Escarrabill, Joan

2014-01-01

Examine the accessibility and use of forced spirometry (FS) in public primary care facilities centers in Catalonia. Cross-sectional study using a survey. Three hundred sixty-six Primary Care Teams (PCT) in Catalonia. Third quarter of 2010. Survey with information on spirometers, training, interpretation and quality control, and the priority that the quality of spirometry had for the team. Indicators FS/100 inhabitants/year, FS/month/PCT; FS/month/10,000 inhabitants. Response rate: 75%. 97.5% of PCT had spirometer and made an average of 2.01 spirometries/100 inhabitants (34.68 spirometry/PCT/month). 83% have trained professionals.>50% centers perform formal training but no information is available on the quality. 70% performed some sort of calibration. Interpretation was made by the family physician in 87.3% of cases. In 68% of cases not performed any quality control of exploration. 2/3 typed data manually into the computerized medical record.>50% recognized a high priority strategies for improving the quality. Despite the accessibility of EF efforts should be made to standardize training, increasing the number of scans test and promote systematic quality control. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Complete Quantum Control of a Single Silicon-Vacancy Center in a Diamond Nanopillar

NASA Astrophysics Data System (ADS)

Zhang, Jingyuan Linda; Lagoudakis, Konstantinos G.; Tzeng, Yan-Kai; Dory, Constantin; Radulaski, Marina; Kelaita, Yousif; Shen, Zhi-Xun; Melosh, Nicholas A.; Chu, Steven; Vuckovic, Jelena

Coherent quantum control of a quantum bit (qubit) is an important step towards its use in a quantum network. SiV- center in diamond offers excellent physical qualities such as low inhomogeneous broadening, fast photon emission, and a large Debye-Waller factor, while the fast spin manipulation and techniques to extend the spin coherence time are under active investigation. Here, we demonstrate full coherent control over the state of a single SiV- center in a diamond nanopillar using ultrafast optical pulses. The high quality of the chemical vapor deposition grown SiV- centers allows us to coherently manipulate and quasi-resonantly read out the state of the single SiV- center. Moreover, the SiV- centers being coherently controlled are integrated into diamond nanopillar arrays in a site-controlled, individually addressable manner with high yield, low strain, and high spectral stability, which paves the way for scalable on chip optically accessible quantum system in a quantum photonic network. Financial support is provided by the DOE Office of Basic Energy Sciences, Division of Materials Sciences through Stanford Institute for Materials and Energy Sciences (SIMES) under contract DE-AC02-76SF00515.

A Novel Diffusion MRI Phantom, and a Method for Enhancing MR Image Quality | NCI Technology Transfer Center | TTC

Cancer.gov

The use of Polyvinyl Pyrrolidone (PVP) solutions of varying concentrations as phantoms for diffusion MRI calibration and quality control is disclosed. This diffusion MRI phantom material is already being adopted by radiologists for quality control and assurance in clinical studies.

42 CFR 475.100 - Scope and applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.100 Scope and applicability. This subpart implements...

[The external evaluation of study quality: the role in maintaining the reliability of laboratory information].

PubMed

Men'shikov, V V

2013-08-01

The external evaluation of quality of clinical laboratory examinations was gradually introduced in USSR medical laboratories since 1970s. In Russia, in the middle of 1990 a unified all-national system of external evaluation quality was organized known as the Federal center of external evaluation of quality at the basis of laboratory of the state research center of preventive medicine. The main positions of policy in this area were neatly formulated in the guidance documents of ministry of Health. Nowadays, the center of external evaluation of quality proposes 100 and more types of control studies and permanently extends their specter starting from interests of different disciplines of clinical medicine. The consistent participation of laboratories in the cycles of external evaluation of quality intrinsically promotes improvement of indicators of properness and precision of analysis results and increases reliability of laboratory information. However, a significant percentage of laboratories does not participate at all in external evaluation of quality or takes part in control process irregularly and in limited number of tests. The managers of a number of medical organizations disregard the application of the proposed possibilities to increase reliability of laboratory information and limit financing of studies in the field of quality control. The article proposes to adopt the national standard on the basis of ISO 17043 "Evaluation of compliance. The common requirements of professional competence testing".

42 CFR 480.108 - Penalties for unauthorized disclosure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 480.108 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations...

77 FR 2066 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-13

... dataset, which is used to assess non-response bias, for quality control, to improve the ability of MMP to... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [60Day-12-0740... on proposed data collection projects, the Centers for Disease Control and Prevention (CDC) will...

42 CFR 480.109 - Applicability of other statutes and regulations.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 480.109 Section 480.109 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality...

42 CFR 480.106 - Exceptions to QIO notice requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 480.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations...

42 CFR 480.104 - Procedures for disclosure by a QIO.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 480.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations...

42 CFR 475.107 - QIO contract award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.107 QIO contract award. CMS, in awarding QIO contracts, will take...

42 CFR 475.103 - Eligibility of physician-access organizations.

Code of Federal Regulations, 2010 CFR

2010-10-01

....103 Section 475.103 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.103 Eligibility of physician-access...

Adult Day Health Center Participation and Health-Related Quality of Life

ERIC Educational Resources Information Center

Schmitt, Eva M.; Sands, Laura P.; Weiss, Sara; Dowling, Glenna; Covinsky, Kenneth

2010-01-01

Purpose: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Design and Methods: Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable…

Views of the mission control center during STS-9

NASA Technical Reports Server (NTRS)

1983-01-01

Busy moment in the customer management room (CMR) of JSC's mission control center during Spacelab 1 day 2. Three personnel from the European Space Agency (ESA) huddle around a console along with Ralph Hoodless (seated at left), of the George C. Marshall Space Flight Center. Others pictured are Lars Tedeman and Hildegard Binck (standing); and Frank Longhurst (seated right). Tedeman is with ESA's quality control division and Longhurst is Spacelab operations manager.

42 CFR 480.135 - Disclosure necessary to perform review responsibilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... responsibilities. 480.135 Section 480.135 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... stage renal disease services. ...

42 CFR 480.135 - Disclosure necessary to perform review responsibilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... responsibilities. 480.135 Section 480.135 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... stage renal disease services. ...

42 CFR 480.135 - Disclosure necessary to perform review responsibilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... responsibilities. 480.135 Section 480.135 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... stage renal disease services. ...

42 CFR 480.135 - Disclosure necessary to perform review responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... responsibilities. 480.135 Section 480.135 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... stage renal disease services. ...

42 CFR 480.135 - Disclosure necessary to perform review responsibilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... responsibilities. 480.135 Section 480.135 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... stage renal disease services. ...

Fourth NASA Inter-Center Control Systems Conference

NASA Technical Reports Server (NTRS)

1978-01-01

Space vehicle control applications are discussed, along with aircraft guidance, control, and handling qualities. System simulation and identification, engine control, advanced propulsion techniques, and advanced control techniques are also included.

Home-based versus center-based aerobic exercise on cardiopulmonary performance, physical function, quality of life and quality of sleep of overweight patients with chronic kidney disease.

PubMed

Aoike, Danilo Takashi; Baria, Flavia; Kamimura, Maria Ayako; Ammirati, Adriano; Cuppari, Lilian

2018-02-01

The association between chronic kidney disease (CKD) and obesity can decrease the patients' cardiopulmonary capacity, physical functioning and quality of life. The search for effective and practical alternative methods of exercise to engage patients in training programs is of great importance. Therefore, we aimed to compare the effects of home-based versus center-based aerobic exercise on the cardiopulmonary and functional capacities, quality of life and quality of sleep of overweight non-dialysis-dependent patients with CKD (NDD-CKD). Forty sedentary overweight patients CKD stages 3 and 4 were randomly assigned to an exercise group [home-based group (n = 12) or center-based exercise group (n = 13)] or to a control group (n = 15) that did not perform any exercise. Cardiopulmonary exercise test, functional capacity tests, quality of life, quality of sleep and clinical parameters were assessed at baseline, 12 and 24 weeks. The VO 2peak and all cardiopulmonary parameters evaluated were similarly improved (p < 0.05) after 12 and 24 weeks in both exercise groups. The functional capacity tests improved during the follow-up in the home-based group (p < 0.05) and reached values similar to those obtained in the center-based group. The benefits achieved in both exercise groups were also reflected in improvement of quality of life and sleep (p < 0.05). No differences were observed between the exercise groups, and no changes in any of the parameters investigated were found in the control group. Home-based aerobic training was as effective as center-based training in improving the physical and functional capabilities, quality of life and sleep in overweight NDD-CKD patients.

42 CFR 480.116 - Notice to individuals and institutions under review.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 480.116 Section 480.116 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality...

42 CFR 480.105 - Notice of disclosures made by a QIO.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 480.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations...

42 CFR 480.102 - Statutory bases for acquisition and maintenance of information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... information. 480.102 Section 480.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality...

42 CFR 480.102 - Statutory bases for acquisition and maintenance of information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... information. 480.102 Section 480.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality...

42 CFR 480.102 - Statutory bases for acquisition and maintenance of information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... information. 480.102 Section 480.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality...

42 CFR 480.145 - Beneficiary authorization of use of confidential information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... information. 480.145 Section 480.145 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality...

42 CFR 480.145 - Beneficiary authorization of use of confidential information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... information. 480.145 Section 480.145 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality...

42 CFR 475.101 - Eligibility requirements for QIO contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 475.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.101 Eligibility requirements for QIO contracts. In...

42 CFR 475.106 - Prohibition against contracting with payor organizations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... organizations. 475.106 Section 475.106 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.106 Prohibition against contracting...

42 CFR 478.14 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement... issues: (1) Reasonableness of services. (2) Medical necessity of services. (3) Appropriateness of the...

Development of quality control and instrumentation performance metrics for diffuse optical spectroscopic imaging instruments in the multi-center clinical environment

NASA Astrophysics Data System (ADS)

Keene, Samuel T.; Cerussi, Albert E.; Warren, Robert V.; Hill, Brian; Roblyer, Darren; Leproux, AnaÑ--s.; Durkin, Amanda F.; O'Sullivan, Thomas D.; Haghany, Hosain; Mantulin, William W.; Tromberg, Bruce J.

2013-03-01

Instrument equivalence and quality control are critical elements of multi-center clinical trials. We currently have five identical Diffuse Optical Spectroscopic Imaging (DOSI) instruments enrolled in the American College of Radiology Imaging Network (ACRIN, #6691) trial located at five academic clinical research sites in the US. The goal of the study is to predict the response of breast tumors to neoadjuvant chemotherapy in 60 patients. In order to reliably compare DOSI measurements across different instruments, operators and sites, we must be confident that the data quality is comparable. We require objective and reliable methods for identifying, correcting, and rejecting low quality data. To achieve this goal, we developed and tested an automated quality control algorithm that rejects data points below the instrument noise floor, improves tissue optical property recovery, and outputs a detailed data quality report. Using a new protocol for obtaining dark-noise data, we applied the algorithm to ACRIN patient data and successfully improved the quality of recovered physiological data in some cases.

42 CFR 480.102 - Statutory bases for acquisition and maintenance of information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... information. 480.102 Section 480.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality...

42 CFR 475.104 - Requirements for demonstrating ability to perform review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... review. 475.104 Section 475.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.104 Requirements for demonstrating...

42 CFR 475.105 - Prohibition against contracting with health care facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facilities. 475.105 Section 475.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.105 Prohibition against contracting...

Proposed MIL Standard and Handbook - Flying Qualities of Air Vehicles. Volume I. Proposed MIL Standard

DTIC Science & Technology

1982-11-01

control 4centering and breakout forces 21 3.2.9.6 Pitch axis control forces- free play 21 3.2.9.7 Pitch axis control force limits 21 3.2.9.7.1 Pitch axis...axis control forces - control centering and breakout forces 31 *3.5.10.5 Roll axis control forces -- free play 31 3.5.10.6 Roll axis control force limits...vs. deflection 3.2.9.5 Control centering and -- no(-) to homin and hOax breakout forces no(*) 3.2.9.6 Free play I 3.2.9.7.1 Force limits -- takeoff

42 CFR 478.36 - Record of reconsideration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.36 Record of reconsideration. (a...

Taking advantage of ground data systems attributes to achieve quality results in testing software

NASA Technical Reports Server (NTRS)

Sigman, Clayton B.; Koslosky, John T.; Hageman, Barbara H.

1994-01-01

During the software development life cycle process, basic testing starts with the development team. At the end of the development process, an acceptance test is performed for the user to ensure that the deliverable is acceptable. Ideally, the delivery is an operational product with zero defects. However, the goal of zero defects is normally not achieved but is successful to various degrees. With the emphasis on building low cost ground support systems while maintaining a quality product, a key element in the test process is simulator capability. This paper reviews the Transportable Payload Operations Control Center (TPOCC) Advanced Spacecraft Simulator (TASS) test tool that is used in the acceptance test process for unmanned satellite operations control centers. The TASS is designed to support the development, test and operational environments of the Goddard Space Flight Center (GSFC) operations control centers. The TASS uses the same basic architecture as the operations control center. This architecture is characterized by its use of distributed processing, industry standards, commercial off-the-shelf (COTS) hardware and software components, and reusable software. The TASS uses much of the same TPOCC architecture and reusable software that the operations control center developer uses. The TASS also makes use of reusable simulator software in the mission specific versions of the TASS. Very little new software needs to be developed, mainly mission specific telemetry communication and command processing software. By taking advantage of the ground data system attributes, successful software reuse for operational systems provides the opportunity to extend the reuse concept into the test area. Consistency in test approach is a major step in achieving quality results.

42 CFR 431.832 - Reporting requirements for claims processing assessment systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... assessment systems. 431.832 Section 431.832 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... GENERAL ADMINISTRATION Quality Control Medicaid Quality Control (mqc) Claims Processing Assessment System § 431.832 Reporting requirements for claims processing assessment systems. (a) The agency must submit...

21 CFR 107.50 - Terms and conditions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Center for Food Safety and Applied Nutrition concludes that additional or modified quality control... also typically represented and labeled for use to provide dietary management for diseases or conditions... regulations promulgated under section 412(a)(2) of the act, the quality control procedure requirements of part...

Asthma Triggers: Gain Control

MedlinePlus

... Centers Asthma Contact Us Share Asthma Triggers: Gain Control Breathing Freely: Controlling Asthma Triggers This video features ... Air Quality: Biological Pollutants Help Your Child Gain Control Over Asthma Top of Page Molds About Molds ...

76 FR 66070 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-25

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [30-Day-12-0800... Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC). Background and... detection, better treatment, and improved quality of life for cancer survivors. Toward this end, the DCPC...

In-flight investigation of the effects of pilot location and control system design on airplane flying qualities for approach and landing

NASA Technical Reports Server (NTRS)

Weingarten, N. C.; Chalk, C. R.

1982-01-01

The handling qualities of large airplanes in the approach and landing flight phase were studied. The primary variables were relative pilot position with respect to center of rotation, command path time delays and phase shifts, augmentation schemes and levels of augmentation. It is indicated that the approach and landing task with large airplanes is a low bandwidth task. Low equivalent short period frequencies and relatively long time delays are tolerated only when the pilot is located at considerable distance forward of the center of rotation. The control problem experienced by the pilots, when seated behind the center of rotation, tended to occur at low altitude when they were using visual cues of rate of sink and altitude. A direct lift controller improved final flight path control of the shuttle like configurations.

Quality Control and Reproducibility in M-mode, Two-dimensional, and Speckle Tracking Echocardiography Acquisition and Analysis: The CARDIA Study, Year-25 Examination Experience

PubMed Central

Armstrong, Anderson C.; Ricketts, Erin P.; Cox, Christopher; Adler, Paul; Arynchyn, Alexander; Liu, Kiang; Stengel, Ellen; RDCS; Sidney, Stephen; Lewis, Cora E.; Schreiner, Pamela J.; Shikany, James M.; Keck, Kimberly; Merlo, Jamie; Gidding, Samuel S.; Lima, João A. C.

2014-01-01

Introduction Few large studies describe quality control procedures and reproducibility findings in cardiovascular ultra-sound, particularly in novel techniques such as Speckle Tracking (STE). We evaluate the echocardiography assessment performance in the CARDIA study Y25 examination (2010-2011) and report findings from a quality control and reproducibility program conducted to assess Field Center image acquisition and Reading Center (RC) accuracy. Methods The CARDIA Y25 examination had 3,475 echocardiograms performed in 4 US Field Centers and analyzed in a Reading Center, assessing standard echocardiography (LA dimension, aortic root, LV mass, LV end-diastolic volume [LVEDV], ejection fraction [LVEF]), and STE (2- and 4-chamber longitudinal, circumferential, and radial strains). Reproducibility was assessed using intra-class correlation coefficients (ICC), coefficients of variation (CV), and Bland-Altman plots. Results For standard echocardiography reproducibility, LV mass and LVEDV consistently had CV above 10% and aortic root below 6%. Intra-sonographer aortic root and LV mass had the most robust values of ICC in standard echocardiography. For STE, the number of properly tracking segments was above 80% in short-axis and 4-chamber and 58% in 2-chamber. Longitudinal strain parameters were the most robust and radial strain showed the highest variation. Comparing Field Centers with Echo RC STE readings, mean differences ranged from 0.4% to 4.1% and ICC from 0.37 to 0.66, with robust results for longitudinal strains. Conclusion Echocardiography image acquisition and reading processes in the CARDIA study were highly reproducible, including robust results for STE analysis. Consistent quality control may increase the reliability of echocardiography measurements in large cohort studies. PMID:25382818

CDC's 6|18 Initiative: A Cross-Sector Approach to Translating Evidence Into Practice.

PubMed

Seeff, Laura C; McGinnis, Tricia; Heishman, Hilary

2018-02-22

As the US health care system continues to undergo dynamic change, the increased alignment between health care quality and payment has provided new opportunities for public health and health care sectors to work together. The Centers for Disease Control and Prevention's 6|18 Initiative accelerates cross-sector collaboration between public health and health care purchasers, payers, and providers and highlights 6 high-burden conditions and 18 associated interventions with evidence of cost reduction/neutrality and improved health outcomes. This evidence can inform payment, utilization, and quality of prevention and control interventions. The Centers for Disease Control and Prevention focused initially on public payer health insurance interventions for asthma control, unintended pregnancy prevention, and tobacco cessation. Nine state Medicaid and public health agency teams-in Colorado, Georgia, Louisiana, Massachusetts, Michigan, Minnesota, New York, Rhode Island, and South Carolina-participated in the initiative because they had previously prioritized the health condition(s) and specific intervention(s) and had secured state-level leadership support for state agency collaboration. The Centers for Disease Control and Prevention, the Centers for Medicare & Medicaid Services, the Center for Health Care Strategies, the Robert Wood Johnson Foundation, and other partners supported state implementation and dissemination of early lessons learned. The Centers for Disease Control and Prevention conducted exploratory interviews to guide improvement of the 6|18 Initiative and to understand facilitators, barriers, and complementary roles played by each sector. Monthly technical assistance calls conducted with state teams documented collaborative activities between state Medicaid agencies and health departments and state processes to increase coverage and utilization. The 6|18 Initiative is strengthening partnerships between state health departments and Medicaid agencies and contributing to state progress in helping improve Medicaid coverage and utilization of effective prevention and control interventions. This initiative highlights early successes for others interested in strengthening collaboration between state agencies and between public and private sectors to improve payment, utilization, and quality of evidence-based interventions.

Automated daily quality control analysis for mammography in a multi-unit imaging center.

PubMed

Sundell, Veli-Matti; Mäkelä, Teemu; Meaney, Alexander; Kaasalainen, Touko; Savolainen, Sauli

2018-01-01

Background The high requirements for mammography image quality necessitate a systematic quality assurance process. Digital imaging allows automation of the image quality analysis, which can potentially improve repeatability and objectivity compared to a visual evaluation made by the users. Purpose To develop an automatic image quality analysis software for daily mammography quality control in a multi-unit imaging center. Material and Methods An automated image quality analysis software using the discrete wavelet transform and multiresolution analysis was developed for the American College of Radiology accreditation phantom. The software was validated by analyzing 60 randomly selected phantom images from six mammography systems and 20 phantom images with different dose levels from one mammography system. The results were compared to a visual analysis made by four reviewers. Additionally, long-term image quality trends of a full-field digital mammography system and a computed radiography mammography system were investigated. Results The automated software produced feature detection levels comparable to visual analysis. The agreement was good in the case of fibers, while the software detected somewhat more microcalcifications and characteristic masses. Long-term follow-up via a quality assurance web portal demonstrated the feasibility of using the software for monitoring the performance of mammography systems in a multi-unit imaging center. Conclusion Automated image quality analysis enables monitoring the performance of digital mammography systems in an efficient, centralized manner.

42 CFR 478.12 - Statutory basis.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality... of the Act, a QIO may make an initial determination that services furnished or proposed to be...

42 CFR 476.71 - QIO review requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... care) for the palliation and management of terminal illness; (2) Whether the quality of the services... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities...

Lot quality assurance sampling of sputum acid-fast bacillus smears for assessing sputum smear microscopy centers.

PubMed

Selvakumar, N; Murthy, B N; Prabhakaran, E; Sivagamasundari, S; Vasanthan, Samuel; Perumal, M; Govindaraju, R; Chauhan, L S; Wares, Fraser; Santha, T; Narayanan, P R

2005-02-01

Assessment of 12 microscopy centers in a tuberculosis unit by blinded checking of eight sputum smears selected by using a lot quality assurance sampling (LQAS) method and by unblinded checking of all positive and five negative slides, among the slides examined in a month in a microscopy centre, revealed that the LQAS method can be implemented in the field to monitor the performance of acid-fast bacillus microscopy centers in national tuberculosis control programs.

Lot Quality Assurance Sampling of Sputum Acid-Fast Bacillus Smears for Assessing Sputum Smear Microscopy Centers

PubMed Central

Selvakumar, N.; Murthy, B. N.; Prabhakaran, E.; Sivagamasundari, S.; Vasanthan, Samuel; Perumal, M.; Govindaraju, R.; Chauhan, L. S.; Wares, Fraser; Santha, T.; Narayanan, P. R.

2005-01-01

Assessment of 12 microscopy centers in a tuberculosis unit by blinded checking of eight sputum smears selected by using a lot quality assurance sampling (LQAS) method and by unblinded checking of all positive and five negative slides, among the slides examined in a month in a microscopy centre, revealed that the LQAS method can be implemented in the field to monitor the performance of acid-fast bacillus microscopy centers in national tuberculosis control programs. PMID:15695704

Transportable Payload Operations Control Center reusable software: Building blocks for quality ground data systems

NASA Technical Reports Server (NTRS)

Mahmot, Ron; Koslosky, John T.; Beach, Edward; Schwarz, Barbara

1994-01-01

The Mission Operations Division (MOD) at Goddard Space Flight Center builds Mission Operations Centers which are used by Flight Operations Teams to monitor and control satellites. Reducing system life cycle costs through software reuse has always been a priority of the MOD. The MOD's Transportable Payload Operations Control Center development team established an extensive library of 14 subsystems with over 100,000 delivered source instructions of reusable, generic software components. Nine TPOCC-based control centers to date support 11 satellites and achieved an average software reuse level of more than 75 percent. This paper shares experiences of how the TPOCC building blocks were developed and how building block developer's, mission development teams, and users are all part of the process.

Developing and implementing a computerized nursing quality control system in a tertiary general medical center in Israel.

PubMed

Kagan, Ilya; Cohen, Rachel; Fish, Miri; Mezare, Henia Perry

2014-01-01

This article describes the development and implementation of the Nursing Quality Indicators Scale and a quality control system for hospital nursing care, which allows universal access to all external and internal audit results, thus ensuring complete data transparency. Standardized indicators make departments' performance comparable. Key to the new system is nurses' self-audit and responsibility for making quality improvements at the ward level.

42 CFR 431.834 - Access to records: Claims processing assessment systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Access to records: Claims processing assessment systems. 431.834 Section 431.834 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... ADMINISTRATION Quality Control Medicaid Quality Control (mqc) Claims Processing Assessment System § 431.834...

42 CFR 431.834 - Access to records: Claims processing assessment systems.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Access to records: Claims processing assessment systems. 431.834 Section 431.834 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... ADMINISTRATION Quality Control Medicaid Quality Control (mqc) Claims Processing Assessment System § 431.834...

42 CFR 431.836 - Corrective action under the MQC claims processing assessment system.

Code of Federal Regulations, 2010 CFR

2010-10-01

... assessment system. 431.836 Section 431.836 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... ADMINISTRATION Quality Control Medicaid Quality Control (mqc) Claims Processing Assessment System § 431.836 Corrective action under the MQC claims processing assessment system. The agency must— (a) Take action to...

21 CFR 640.56 - Quality control test for potency.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., Center for Biologics Evaluation and Research, Food and Drug Administration. Such testing shall not be... Evaluation and Research, Food and Drug Administration. (d) If the average potency level of antihemophilic... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Quality control test for potency. 640.56 Section...

42 CFR 478.40 - Beneficiary's right to a hearing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 478.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.40 Beneficiary's right to a...

42 CFR 478.46 - Departmental Appeals Board and judicial review.

Code of Federal Regulations, 2010 CFR

2010-10-01

....46 Section 478.46 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.46...

42 CFR 478.26 - Delegation of the reconsideration function.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 478.26 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.26 Delegation of the...

42 CFR 478.20 - Time limits for requesting reconsideration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 478.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.20 Time limits for...

42 CFR 478.34 - Notice of a reconsidered determination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 478.34 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.34 Notice of a...

42 CFR 478.38 - Effect of a reconsidered determination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 478.38 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.38 Effect of a...

Measuring the Quality of Care for Psychological Health Conditions in the Military Health System: Candidate Quality Measures for Posttraumatic Stress Disorder and Major Depressive Disorder

DTIC Science & Technology

2015-01-01

therapy CDC Centers for Disease Control and Prevention CESD Center for Epidemiologic Studies Depression Scale CGI-BP Clinical Global Impressions Scale for...dimensions GDS Geriatric Depression Scale HEDIS Healthcare Effectiveness Data and Information Set HOS Health Outcomes Survey HRQOL health-related quality of...TBI traumatic brain injury TF-CBT Trauma-Focused Cognitive–Behavioral Therapy TSC-40 Trauma Symptom Checklist—40 TSI Trauma Symptom Inventory VA U.S

42 CFR 478.42 - Submitting a request for a hearing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 478.42 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.42 Submitting a request for a...

42 CFR 478.44 - Determining the amount in controversy for a hearing.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 478.44 Section 478.44 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.44...

42 CFR 478.18 - Location for submitting requests for reconsideration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... reconsideration. 478.18 Section 478.18 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.18...

Factors which contributed for low quality sputum smears for the detection of acid fast bacilli (AFB) at selected health centers in Ethiopia: A quality control perspective.

PubMed

Mekonen, Ayehu; Ayele, Yeshi; Berhan, Yifru; Woldeyohannes, Desalegn; Erku, Woldaregay; Sisay, Solomon

2018-01-01

Quality of tuberculosis (TB) microscopy diagnosis is not a guarantee despite implementation of External Quality Assurance (EQA) service in all laboratories of health facilities. Hence, we aimed at evaluating the technical quality and the findings of sputum smear microscopy for acid fast bacilli (AFB) at health centers in Hararge Zone, Oromia Region, Ethiopia. A cross-sectional study was carried out between July 8, 2014 and July 7, 2015.A pre-tested structured questionnaire was used to collect data. Lot Quality Assurance Sampling (LQAS) method was put into practice for collecting all necessary sample slides. Data were analyzed by using SPSS (Statistical Package for Social Sciences) version 20 software. P-value < 0.05 was considered as statistically significant. Of the total55 health center laboratories which had been assessed during the study period, 20 (36.4%) had major technical errors; 13 (23.6%) had 15 false negative results and 17 (30.9%) had 22 false positive results. Moreover, poor specimen quality, smear size, smear thickness, staining and evenness were indicated in 40 (72.7%), 39 (70.9%), 37 (67.3%), 27(49.1%) and 37 (67.3%) of the collected samples, respectively. False negative AFB findings were significantly associated with lack of Internal Quality Control (IQC) measures (AOR (Adjusted Odds Ratio): 2.90 (95% CI (Confidence Interval): 1.25,6.75) and poor staining procedures (AOR: 2.16(95% CI: 1.01, 5.11). The qualities of AFB smear microscopy reading and smearing were low in most of the laboratories of the health centers. Therefore, it is essential to strength EQA program through building the capacity of laboratory professionals.

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

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

PubMed

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

2016-01-01

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

ENVIRONMENTAL TECHNOLOGY VERIFICATION--TEST REPORT OF MOBILE SOURCE EMISSION CONTROL DEVICES, CUMMINS EMISSION SOLUTIONS AND CUMMINS FILTRATION DIESEL OXIDATION CATALYST AND CLOSED CRANKCASE VENTILATION SYSTEM

EPA Science Inventory

The U.S. EPA has created the Environmental Technology Verification (ETV) Program. ETV seeks to provide high-quality, peer-reviewed data on technology performance. The Air Pollution Control Technology (APCT) Verification Center, a center under the ETV Program, is operated by Res...

42 CFR 478.24 - Opportunity for a party to obtain and submit information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... information. 478.24 Section 478.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.24...

42 CFR 478.30 - Evidence to be considered by the reconsideration reviewer.

Code of Federal Regulations, 2010 CFR

2010-10-01

... reviewer. 478.30 Section 478.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.30...

42 CFR 478.32 - Time limits for issuance of the reconsidered determination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... determination. 478.32 Section 478.32 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.32...

Quality-assurance and data management plan for groundwater activities by the U.S. Geological Survey in Kansas, 2014

USGS Publications Warehouse

Putnam, James E.; Hansen, Cristi V.

2014-01-01

As the Nation’s principle earth-science information agency, the U.S. Geological Survey (USGS) is depended on to collect data of the highest quality. This document is a quality-assurance plan for groundwater activities (GWQAP) of the Kansas Water Science Center. The purpose of this GWQAP is to establish a minimum set of guidelines and practices to be used by the Kansas Water Science Center to ensure quality in groundwater activities. Included within these practices are the assignment of responsibilities for implementing quality-assurance activities in the Kansas Water Science Center and establishment of review procedures needed to ensure the technical quality and reliability of the groundwater products. In addition, this GWQAP is intended to complement quality-assurance plans for surface-water and water-quality activities and similar plans for the Kansas Water Science Center and general project activities throughout the USGS. This document provides the framework for collecting, analyzing, and reporting groundwater data that are quality assured and quality controlled. This GWQAP presents policies directing the collection, processing, analysis, storage, review, and publication of groundwater data. In addition, policies related to organizational responsibilities, training, project planning, and safety are presented. These policies and practices pertain to all groundwater activities conducted by the Kansas Water Science Center, including data-collection programs, interpretive and research projects. This report also includes the data management plan that describes the progression of data management from data collection to archiving and publication.

[The Destruction of Pharmaceutical Products as an Element of the Efficiency of State Control (Supervision) Over the Circulation of Medicines].

PubMed

Bidarova, F N

2015-01-01

The modern system of state quality control over medicine makes it possible to reveal and withdraw drugs, that do not meet the requirements. However the problem of the turnover of substandard andfake drug and their destruction in the Russian Federation is still urgent. to evaluate the effectiveness of state quality control over medicine and the practice offake medicine destruction. data of the official websites of the Ministry of Health of the Russian Federation and the Republic of North Ossetia--Alania, Russian Sanitary Inspection, National Center of Quality control and Certification of Drugs were included in the investigation. Method of unrepeated samples was used in sociological investigations. 225 questionnaires have been worked out. The research was carried out in the North-Ossetian State Medical academy during the periodfrom 2013 to 2015 with the help of the National Center of Quality Control and Certification of Drugs. The shortcomings of the state quality control over the rules of fake drug destruction were studied. It was found out that the mechanism ofpermanent data collection monitoring of revealing, moving and destruction of substandard and fake drug destruction has not been determined. The ineffectiveness of controlling measures under the condition of critical legal base deficiency has been confirmed. The analysis of terminology characterizing the order of fake drug destruction was carried out. deficiencies related to the implementation of the state quality control over the fake drug destruction rules revealed during the course of investigations prove the necessity of adopting measures in creating new model of controlfunctions, increasing the results of activity.

42 CFR 476.102 - Involvement of health care practitioners other than physicians.

Code of Federal Regulations, 2010 CFR

2010-10-01

... physicians. 476.102 Section 476.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL... determinations regarding medical necessity of services or the quality of the services they furnish, these...

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.

Quality Control and Reproducibility in M-Mode, Two-Dimensional, and Speckle Tracking Echocardiography Acquisition and Analysis: The CARDIA Study, Year 25 Examination Experience.

PubMed

Armstrong, Anderson C; Ricketts, Erin P; Cox, Christopher; Adler, Paul; Arynchyn, Alexander; Liu, Kiang; Stengel, Ellen; Sidney, Stephen; Lewis, Cora E; Schreiner, Pamela J; Shikany, James M; Keck, Kimberly; Merlo, Jamie; Gidding, Samuel S; Lima, João A C

2015-08-01

Few large studies describe quality control procedures and reproducibility findings in cardiovascular ultrasound, particularly in novel techniques such as speckle tracking echocardiography (STE). We evaluate the echocardiography assessment performance in the Coronary Artery Risk Development in Young Adults (CARDIA) study Year 25 (Y25) examination (2010-2011) and report findings from a quality control and reproducibility program conducted to assess Field Center image acquisition and reading center (RC) accuracy. The CARDIA Y25 examination had 3475 echocardiograms performed in 4 US Field Centers and analyzed in a RC, assessing standard echocardiography (LA dimension, aortic root, LV mass, LV end-diastolic volume [LVEDV], ejection fraction [LVEF]), and STE (two- and four-chamber longitudinal, circumferential, and radial strains). Reproducibility was assessed using intraclass correlation coefficients (ICC), coefficients of variation (CV), and Bland-Altman plots. For standard echocardiography reproducibility, LV mass and LVEDV consistently had CV above 10% and aortic root below 6%. Intra-sonographer aortic root and LV mass had the most robust values of ICC in standard echocardiography. For STE, the number of properly tracking segments was above 80% in short-axis and four-chamber and 58% in two-chamber views. Longitudinal strain parameters were the most robust and radial strain showed the highest variation. Comparing Field Centers with echocardiography RC STE readings, mean differences ranged from 0.4% to 4.1% and ICC from 0.37 to 0.66, with robust results for longitudinal strains. Echocardiography image acquisition and reading processes in the CARDIA study were highly reproducible, including robust results for STE analysis. Consistent quality control may increase the reliability of echocardiography measurements in large cohort studies. © 2014, Wiley Periodicals, Inc.

Power quality load management for large spacecraft electrical power systems

NASA Technical Reports Server (NTRS)

Lollar, Louis F.

1988-01-01

In December, 1986, a Center Director's Discretionary Fund (CDDF) proposal was granted to study power system control techniques in large space electrical power systems. Presented are the accomplishments in the area of power system control by power quality load management. In addition, information concerning the distortion problems in a 20 kHz ac power system is presented.

Lung Quality and Utilization in Controlled Donation after Circulatory Determination of Death Donors within the United States

PubMed Central

Mooney, Joshua J; Hedlin, Haley; Mohabir, Paul K; Vazquez, Rodrigo; Nguyen, John; Ha, Richard; Chiu, Peter; Patel, Kapilkumar; Zamora, Martin R.; Weill, David; Nicolls, Mark R; Dhillon, Gundeep S

2016-01-01

While controlled donation after circulatory determination of death (cDCDD) donors could increase the supply of donor lungs within the United States, the yield of lungs from cDCDD donors remain low compared to donation after neurologic determination of death (DNDD) donors. To explore the reason for low lung yield from cDCDD donors, Scientific Registry of Transplant Recipient data were used to assess the impact of donor lung quality on cDCDD lung utilization by fitting a logistic regression model. The relationship between center volume and cDCDD use was assessed and distance between center and donor hospital was calculated by cDCDD status. Recipient survival was compared using a multivariable Cox regression model. Lung utilization was 2.1% for cDCDD donors and 21.4% for DNDD donors. Being a cDCDD donor decreased lung donation (adjusted OR 0.101, CI 0.085–0.120). A minority of centers have performed cDCDD transplant with higher volume centers generally performing more cDCDD transplants. There was no difference in center to donor distance or recipient survival (adjusted HR 1.03, CI 0.78–1.37) between cDCDD and DNDD transplants. cDCDD lungs are underutilized compared to DNDD lungs after adjusting for lung quality. Increasing transplant center expertise and commitment to cDCDD lung procurement is needed to improve utilization. PMID:26844673

Multicenter Cell Processing for Cardiovascular Regenerative Medicine Applications - The Cardiovascular Cell Therapy Research Network (CCTRN) Experience

PubMed Central

Gee, Adrian P.; Richman, Sara; Durett, April; McKenna, David; Traverse, Jay; Henry, Timothy; Fisk, Diann; Pepine, Carl; Bloom, Jeannette; Willerson, James; Prater, Karen; Zhao, David; Koç, Jane Reese; Ellis, Steven; Taylor, Doris; Cogle, Christopher; Moyé, Lemuel; Simari, Robert; Skarlatos, Sonia

2013-01-01

Background Aims Multi-center cellular therapy clinical trials require the establishment and implementation of standardized cell processing protocols and associated quality control mechanisms. The aims here were to develop such an infrastructure in support of the Cardiovascular Cell Therapy Research Network (CCTRN) and to report on the results of processing for the first 60 patients. Methods Standardized cell preparations, consisting of autologous bone marrow mononuclear cells, prepared using the Sepax device were manufactured at each of the five processing facilities that supported the clinical treatment centers. Processing staff underwent centralized training that included proficiency evaluation. Quality was subsequently monitored by a central quality control program that included product evaluation by the CCTRN biorepositories. Results Data from the first 60 procedures demonstrate that uniform products, that met all release criteria, could be manufactured at all five sites within 7 hours of receipt of the bone marrow. Uniformity was facilitated by use of the automated systems (the Sepax for processing and the Endosafe device for endotoxin testing), standardized procedures and centralized quality control. Conclusions Complex multicenter cell therapy and regenerative medicine protocols can, where necessary, successfully utilize local processing facilities once an effective infrastructure is in place to provide training, and quality control. PMID:20524773

[Study on manpower allocation criteria of center of disease prevention and control in the context of province level, city level and county level].

PubMed

Luo, Li; Waang, Ying; Sun, Mei; Su, Zhong-Xin; Ma, Ning; Xie, Hongbin; Wang, Weicheng; Yu, Jingjin; Yu, Mingzhu; Duan, Yong; Gong, Xiangguang; Chen, Zheng; Wang, Hua; Shi, Peiwu; Liang, Zhankai; Yang, Feng; Wang, Dunzhi; Yue, Jianning; Luo, Shi; Hao, Mo

2006-01-01

To set the manpower allocation criteria of center of disease prevention and control. Expected allocation manpower criteria was obtained through adjusting the current manpower allocation of disease prevention and control centers. The principle was to fulfill public function and promote professional efficiency. Based on function requirement, in 3 - 5 years, the manpower allocation criteria of center of disease prevention and control at provincial-level is 336 persons, at city-level is 102 persons, and at county-level is 33 persons, that means in whole country 140016 persons should be needed. In 10 years, the manpower allocation criteria of center of disease prevention and control at provincial-level is 386 persons, at city-level is 112 persons, and at county-level is 38 persons, that means in whole country 159086 persons should be needed. The manpower allocation criteria advanced in the study indicated that current manpower quantity should be greatly reduced. It is an inevitable trend that disease prevention and control centers reduce the staff quantity and promote their quality.

Feasibility study of transmission of OTV camera control information in the video vertical blanking interval

NASA Technical Reports Server (NTRS)

White, Preston A., III

1994-01-01

The Operational Television system at Kennedy Space Center operates hundreds of video cameras, many remotely controllable, in support of the operations at the center. This study was undertaken to determine if commercial NABTS (North American Basic Teletext System) teletext transmission in the vertical blanking interval of the genlock signals distributed to the cameras could be used to send remote control commands to the cameras and the associated pan and tilt platforms. Wavelength division multiplexed fiberoptic links are being installed in the OTV system to obtain RS-250 short-haul quality. It was demonstrated that the NABTS transmission could be sent over the fiberoptic cable plant without excessive video quality degradation and that video cameras could be controlled using NABTS transmissions over multimode fiberoptic paths as long as 1.2 km.

42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

Code of Federal Regulations, 2010 CFR

2010-10-01

... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

Relationship between Sleep Quality and Health Risk Behaviors in Undergraduate College Students

ERIC Educational Resources Information Center

Vail-Smith, Karen; Felts, W. Michael; Becker, Craig

2009-01-01

The Sleep Quality Index (SQI) and the Centers for Disease Control's National College Health Risk Survey (NCHRS) were administered to 859 undergraduates at a large southeastern university. Results indicated that 76.6% reported occasional sleep problems and 11.8 % experienced poor sleep quality. Among the problems reported, "general morning…

Investigation of Control System and Display Variations on Spacecraft Handling Qualities for Docking with Stationary and Rotating Targets

NASA Technical Reports Server (NTRS)

Jackson, E. Bruce; Goodrich, Kenneth H.; Bailey, Randall E.; Barnes, James R.; Ragsdale, William A.; Neuhaus, Jason R.

2010-01-01

This paper documents the investigation into the manual docking of a preliminary version of the Crew Exploration Vehicle with stationary and rotating targets in Low Earth Orbit. The investigation was conducted at NASA Langley Research Center in the summer of 2008 in a repurposed fixed-base transport aircraft cockpit and involved nine evaluation astronauts and research pilots. The investigation quantified the benefits of a feed-forward reaction control system thruster mixing scheme to reduce translation-into-rotation coupling, despite unmodeled variations in individual thruster force levels and off-axis center of mass locations up to 12 inches. A reduced rate dead-band in the phase-plane attitude controller also showed some promise. Candidate predictive symbology overlaid on a docking ring centerline camera image did not improve handling qualities, but an innovative attitude status indicator symbol was beneficial. The investigation also showed high workload and handling quality problems when manual dockings were performed with a rotating target. These concerns indicate achieving satisfactory handling quality ratings with a vehicle configuration similar to the nominal Crew Exploration Vehicle may require additional automation.

[Urinalysis in Italy in 2006].

PubMed

Gai, M; Lanfranco, G

2007-01-01

Urinalysis and proteinuria testing represent fundamental tests for the clinician, even though they too often lack standardization. Through the Italian Society of Nephrology Mailing List we sent a questionnaire to 282 centers, in order to assess the state of the art in Italy in the year 2006. 82% of the questionnaires were completed (nephrology laboratories: 64%, general laboratories: 36%). The questionnaire dealt with the main steps of preparation, analysis and report of urinalysis, and proteinuria / microalbuminuria measurement. 85% of the centers use first morning urine, and 7% second morning urine; only 57% of the centers supply with written instructions, 189 laboratories (82%) have only one bright field microscope, rate and time of centrifugation are very varied among centers, different units of measurement are used in reports. Few laboratories measure routinely the proteinuria / creatininuria ratio, there is no agreement on the urine sample type for microalbuminuria assay, total urinary proteins are measured through different methods. 92% of the centers is endowed with an internal quality control system, but only 47% participate in an external quality control program. These data confirm the lack of standardization for urine analysis methods and procedures.

Current status of quality evaluation of nursing care through director review and reflection from the Nursing Quality Control Centers

PubMed Central

Duan, Xia; Shi, Yan

2014-01-01

Background: The quality evaluation of nursing care is a key link in medical quality management. It is important and worth studying for the nursing supervisors to know the disadvantages during the process of quality evaluation of nursing care and then to improve the whole nursing quality. This study was to provide director insight on the current status of quality evaluation of nursing care from Nursing Quality Control Centers (NQCCs). Material and Methods: This qualitative study used a sample of 12 directors from NQCCs who were recruited from 12 provinces in China to evaluate the current status of quality evaluation of nursing care. Data were collected by in-depth interviews. Content analysis method was used to analyze the data. Results: Four themes emerged from the data: 1) lag of evaluation index; 2) limitations of evaluation content; 3) simplicity of evaluation method; 4) excessive emphasis on terminal quality. Conclusion: It is of great realistic significance to ameliorate nursing quality evaluation criteria, modify the evaluation content based on patient needs-oriented idea, adopt scientific evaluation method to evaluate nursing quality, and scientifically and reasonably draw horizontal comparisons of nursing quality between hospitals, as well as longitudinal comparisons of a hospital’s nursing quality. These methods mentioned above can all enhance a hospital’s core competitiveness and benefit more patients. PMID:25419427

Regional Evaluation and Research Center for Head Start. Southern University, Annual Report, November 28, 1969. Final Report.

ERIC Educational Resources Information Center

Southern Univ. and Agricultural and Mechanical Coll., Baton Rouge, LA.

This final report of the third year of the Southern University-Tulane University Regional Head Start Evaluation and Research Center is a statement of activities engaged in since September 1968. Chapter I includes an introduction and description of the centers; Chapter II, evaluation guidelines, test battery, quality control, evaluation design and…

Quality of life 15 years after sex reassignment surgery for transsexualism.

PubMed

Kuhn, Annette; Bodmer, Christine; Stadlmayr, Werner; Kuhn, Peter; Mueller, Michael D; Birkhäuser, Martin

2009-11-01

To evaluate quality of life and patients' satisfaction in transsexual patients (TS) after sex reassignment operation compared with healthy controls. A case-control study. A tertiary referral center. Patients after sex reassignment operation were compared with a similar group of healthy controls in respect to quality of life and general satisfaction. For quality of life we used the King's Health Questionnaire, which was distributed to the patients and to the control group. Visual analogue scale was used for the determination of satisfaction. Main outcome measures were quality of life and satisfaction. Fifty-five transsexuals participated in this study. Fifty-two were male-to-female and 3 female-to-male. Quality of life as determined by the King's Health Questionnaire was significantly lower in general health, personal, physical and role limitations. Patients' satisfaction was significantly lower compared with controls. Emotions, sleep, and incontinence impact as well as symptom severity is similar to controls. Overall satisfaction was statistically significant lower in TS compared with controls. Fifteen years after sex reassignment operation quality of life is lower in the domains general health, role limitation, physical limitation, and personal limitation.

A Study to Develop an Assessment Tool and Evaluate the Social Work Service Quality Assurance Plan at Walter Reed Army Medical Center, Brooke Army Medical Center, and Fitzsimons Army Medical Center

DTIC Science & Technology

1987-07-01

the plan identify methods of integration with other military services (Army Community Service, Ariny Drug and Alcohol Prevention and Control Program...home care or out-of-home care setting. 1 2 3 4 5 NA 21.2.2.4 Patient safety and infection control . 1 2 3 4 5 NA 21.2.3 Personnel who provide social...4 5 NA SO2.2.4 Patient safety and infection control . 1 2 3 4 5 NA SO.2.3 Personnel who provide social work services participate in relevant continuing

Lung Quality and Utilization in Controlled Donation After Circulatory Determination of Death Within the United States.

PubMed

Mooney, J J; Hedlin, H; Mohabir, P K; Vazquez, R; Nguyen, J; Ha, R; Chiu, P; Patel, K; Zamora, M R; Weill, D; Nicolls, M R; Dhillon, G S

2016-04-01

Although controlled donation after circulatory determination of death (cDCDD) could increase the supply of donor lungs within the United States, the yield of lungs from cDCDD donors remains low compared with donation after neurologic determination of death (DNDD). To explore the reason for low lung yield from cDCDD donors, Scientific Registry of Transplant Recipient data were used to assess the impact of donor lung quality on cDCDD lung utilization by fitting a logistic regression model. The relationship between center volume and cDCDD use was assessed, and the distance between center and donor hospital was calculated by cDCDD status. Recipient survival was compared using a multivariable Cox regression model. Lung utilization was 2.1% for cDCDD donors and 21.4% for DNDD donors. Being a cDCDD donor decreased lung donation (adjusted odds ratio 0.101, 95% confidence interval [CI] 0.085-0.120). A minority of centers have performed cDCDD transplant, with higher volume centers generally performing more cDCDD transplants. There was no difference in center-to-donor distance or recipient survival (adjusted hazard ratio 1.03, 95% CI 0.78-1.37) between cDCDD and DNDD transplants. cDCDD lungs are underutilized compared with DNDD lungs after adjusting for lung quality. Increasing transplant center expertise and commitment to cDCDD lung procurement is needed to improve utilization. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

42 CFR 423.162 - Quality improvement organization activities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Quality improvement organization activities. 423.162 Section 423.162 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control...

Handling Qualities Implications for Crewed Spacecraft Operations

NASA Technical Reports Server (NTRS)

Bailey, Randall E.; Jackson, E. Bruce; Arthur, J. J.

2012-01-01

Abstract Handling qualities embody those qualities or characteristics of an aircraft that govern the ease and precision with which a pilot is able to perform the tasks required in support of an aircraft role. These same qualities are as critical, if not more so, in the operation of spacecraft. A research, development, test, and evaluation process was put into effect to identify, understand, and interpret the engineering and human factors principles which govern the pilot-vehicle dynamic system as they pertain to space exploration missions and tasks. Toward this objective, piloted simulations were conducted at the NASA Langley Research Center and Ames Research Center for earth-orbit proximity operations and docking and lunar landing. These works provide broad guidelines for the design of spacecraft to exhibit excellent handling characteristics. In particular, this work demonstrates how handling qualities include much more than just stability and control characteristics of a spacecraft or aircraft. Handling qualities are affected by all aspects of the pilot-vehicle dynamic system, including the motion, visual and aural cues of the vehicle response as the pilot performs the required operation or task. A holistic approach to spacecraft design, including the use of manual control, automatic control, and pilot intervention/supervision is described. The handling qualities implications of design decisions are demonstrated using these pilot-in-the-loop evaluations of docking operations and lunar landings.

The Automation of Nowcast Model Assessment Processes

DTIC Science & Technology

2016-09-01

that will automate real-time WRE-N model simulations, collect and quality control check weather observations for assimilation and verification, and...domains centered near White Sands Missile Range, New Mexico, where the Meteorological Sensor Array (MSA) will be located. The MSA will provide...observations and performing quality -control checks for the pre-forecast data assimilation period. 2. Run the WRE-N model to generate model forecast data

Method of analysis at the U.S. Geological Survey California Water Science Center, Sacramento Laboratory - determination of haloacetic acid formation potential, method validation, and quality-control practices

USGS Publications Warehouse

Zazzi, Barbara C.; Crepeau, Kathryn L.; Fram, Miranda S.; Bergamaschi, Brian A.

2005-01-01

An analytical method for the determination of haloacetic acid formation potential of water samples has been developed by the U.S. Geological Survey California Water Science Center Sacramento Laboratory. The haloacetic acid formation potential is measured by dosing water samples with chlorine under specified conditions of pH, temperature, incubation time, darkness, and residual-free chlorine. The haloacetic acids formed are bromochloroacetic acid, bromodichloroacetic acid, dibromochloroacetic acid, dibromoacetic acid, dichloroacetic acid, monobromoacetic acid, monochloroacetic acid, tribromoacetic acid, and trichloroacetic acid. They are extracted, methylated, and then analyzed using a gas chromatograph equipped with an electron capture detector. Method validation experiments were performed to determine the method accuracy, precision, and detection limit for each of the compounds. Method detection limits for these nine haloacetic acids ranged from 0.11 to 0.45 microgram per liter. Quality-control practices include the use of blanks, quality-control samples, calibration verification standards, surrogate recovery, internal standard, matrix spikes, and duplicates.

[Comparative quality measurements part 3: funnel plots].

PubMed

Kottner, Jan; Lahmann, Nils

2014-02-01

Comparative quality measurements between organisations or institutions are common. Quality measures need to be standardised and risk adjusted. Random error must also be taken adequately into account. Rankings without consideration of the precision lead to flawed interpretations and enhances "gaming". Application of confidence intervals is one possibility to take chance variation into account. Funnel plots are modified control charts based on Statistical Process Control (SPC) theory. The quality measures are plotted against their sample size. Warning and control limits that are 2 or 3 standard deviations from the center line are added. With increasing group size the precision increases and so the control limits are forming a funnel. Data points within the control limits are considered to show common cause variation; data points outside special cause variation without the focus of spurious rankings. Funnel plots offer data based information about how to evaluate institutional performance within quality management contexts.

Quality Control Practices for Chemistry and Immunochemistry in a Cohort of 21 Large Academic Medical Centers.

PubMed

Rosenbaum, Matthew W; Flood, James G; Melanson, Stacy E F; Baumann, Nikola A; Marzinke, Mark A; Rai, Alex J; Hayden, Joshua; Wu, Alan H B; Ladror, Megan; Lifshitz, Mark S; Scott, Mitchell G; Peck-Palmer, Octavia M; Bowen, Raffick; Babic, Nikolina; Sobhani, Kimia; Giacherio, Donald; Bocsi, Gregary T; Herman, Daniel S; Wang, Ping; Toffaletti, John; Handel, Elizabeth; Kelly, Kathleen A; Albeiroti, Sami; Wang, Sihe; Zimmer, Melissa; Driver, Brandon; Yi, Xin; Wilburn, Clayton; Lewandrowski, Kent B

2018-05-29

In the United States, minimum standards for quality control (QC) are specified in federal law under the Clinical Laboratory Improvement Amendment and its revisions. Beyond meeting this required standard, laboratories have flexibility to determine their overall QC program. We surveyed chemistry and immunochemistry QC procedures at 21 clinical laboratories within leading academic medical centers to assess if standardized QC practices exist for chemistry and immunochemistry testing. We observed significant variation and unexpected similarities in practice across laboratories, including QC frequency, cutoffs, number of levels analyzed, and other features. This variation in practice indicates an opportunity exists to establish an evidence-based approach to QC that can be generalized across institutions.

Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis.

PubMed

Kim, Sun Kyung; Park, Myonghwa

2017-01-01

Person-centered care is a holistic and integrative approach designed to maintain well-being and quality of life for people with dementia, and it includes the elements of care, the individual, the carers, and the family. A systematic literature review and meta-analysis were undertaken to investigate the effectiveness of person-centered care for people with dementia. Literature searches were undertaken using six databases including Medline, EMBASE, CINAHL, PsycINFO, Cochrane Database, and KoreaMed using the following keywords: cognition disorder, dementia, person-centered care, patient-centered care, client-centered care, relationship-centered care, and dementia care. The searches were limited to interventional studies written in English and Korean and included randomized controlled studies and noncontrolled studies for people with dementia living in any setting. Nineteen interventional studies, including 3,985 participants, were identified. Of these, 17 studies were from long-term care facilities and two studies were from homecare settings. The pooled data from randomized controlled studies favored person-centered care in reducing agitation, neuropsychiatric symptoms, and depression and improving the quality of life. Subgroup analysis identified greater effectiveness of person-centered care when implemented for people with less severe dementia. For agitation, short-term interventions had a greater effect (standardized mean difference [SMD]: -0.434; 95% conference interval [CI]: -0.701 to -0.166) than long-term interventions (SMD: -0.098; 95% CI: -0.190 to 0.007). Individualized activities resulted in a significantly greater beneficial effect than standard care (SMD: 0.513; 95% CI: -0.994 to -0.032). However, long-term, staff education, and cultural change interventions had a greater effect on improving the quality of life for people with dementia (SMD: 0.191; 95% CI: 0.079 to 0.302). This systematic review and meta-analysis provided evidence for person-centered care in clinical practice for people with dementia. Person-centered care interventions were shown to reduce agitation, neuropsychiatric symptoms, and depression and to improve the quality of life. Person-centered care interventions can effectively reduce agitation for a short term using intensive and activity-based intervention. However, an educational strategy that promotes learning and skill development of internal care staff is needed to enhance patient's quality of life and to ensure the sustainability of the effects of behavioral problems. The feasibility and effectiveness of the intervention, the severity of patient disease, and intervention type and duration should be considered as part of an intervention design.

Verification Testing of Air Pollution Control Technology Quality Management Plan Revision 2.3

EPA Pesticide Factsheets

The Air Pollution Control Technology Verification Center was established in 1995 as part of the EPA’s Environmental Technology Verification Program to accelerate the development and commercialization of improved environmental technologies’ performance.

ENVIRONMENTAL TECHNOLOGY VERIFICATION FOR AIR POLLUTION CONTROL TECHNOLOGIES: FINAL REPORT

EPA Science Inventory

The technical objective of the Environmental Technology Verification (ETV) Program's Air Pollution Control Technology (APCT) Center is to verify environmental technology performance by obtaining objective quality-assured data, thus providing potential purchasers and permitters wi...

42 CFR 476.150 - Abandoned complaints and reopening rights.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Abandoned complaints and reopening rights. 476.150 Section 476.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review...

Quality Assurance and Quality Control, Part 2.

PubMed

Akers, Michael J

2015-01-01

The tragedy surrounding the New England Compounding Center and contaminated steroid syringe preparations clearly points out what can happen if quality-assurance and quality-control procedures are not strictly practiced in the compounding of sterile preparations. This article is part 2 of a two-part article on requirements to comply with United States Pharmacopeia general chapters <797> and <1163> with respect to quality assurance of compounded sterile preparations. Part 1 covered documentation requirements, inspection procedures, compounding accuracy checks, and part of a discussion on bacterial endotoxin testing. Part 2 covers sterility testing, the completion from part 1 on bacterial endotoxin testing, a brief dicussion of United States Pharmacopeia <1163>, and advances in pharmaceutical quality systems.

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

NASA Technical Reports Server (NTRS)

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

2002-01-01

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

Long-lasting effects of a new memory self-efficacy training for stroke patients: a randomized controlled trial.

PubMed

Aben, Laurien; Heijenbrok-Kal, Majanka H; Ponds, Rudolf W H M; Busschbach, Jan J V; Ribbers, Gerard M

2014-01-01

This study aims to determine the long-term effects of a new Memory Self-efficacy (MSE) training program for stroke patients on MSE, depression, and quality of life. In a randomized controlled trial, patients were allocated to a MSE training or a peer support group. Outcome measures were MSE, depression, and quality of life, measured with the Metamemory-In-Adulthood questionnaire, Center for Epidemiological Studies-Depression Scale (CES-D), and the Who-Qol Bref questionnaire, respectively. We used linear mixed models to compare the outcomes of both groups immediately after training, after 6 months, and after 12 months, adjusted for baseline. In total, 153 former inpatients from 2 rehabilitation centers were randomized-77 to the experimental and 76 to the control group. MSE increased significantly more in the experimental group and remained significantly higher than in the control group after 6 and 12 months (B = 0.42; P = .010). Psychological quality of life also increased more in the experimental group but not significantly (B = 0.09; P = .077). However, in the younger subgroup of patients (<65 years old), psychological quality of life significantly improved in the experimental group compared to the control group and remained significantly higher over time (B = 0.14; P = .030). Other outcome measures were not significantly different between both groups. An MSE training program improved MSE and psychological quality of life in stroke patients aged <65 years. These effects persisted during 12 months of follow-up.

Data Quality Control of the French Permanent Broadband Network in the RESIF Framework.

NASA Astrophysics Data System (ADS)

Grunberg, M.; Lambotte, S.; Engels, F.

2014-12-01

In the framework of the RESIF (Réseau Sismologique et géodésique Français) project, a new information system is setting up, allowing the improvement of the management and the distribution of high quality data from the different elements of RESIF. Within this information system, EOST (in Strasbourg) is in charge of collecting real-time permanent broadband seismic waveform, and performing Quality Control on these data. The real-time and validated data set are pushed to the French National Distribution Center (Isterre/Grenoble) to make them publicly available. Furthermore EOST hosts the BCSF-ReNaSS, in charge of the French metropolitan seismic bulletin. This allows to benefit from some high-end quality control based on the national and world-wide seismicity. Here we present the real-time seismic data flow from the stations of the French National Broad Band Network to EOST, and then, the data Quality Control procedures that were recently installed, including some new developments.The data Quality Control consists in applying a variety of processes to check the consistency of the whole system from the stations to the data center. This allows us to verify that instruments and data transmission are operating correctly. Moreover, time quality is critical for most of the scientific data applications. To face this challenge and check the consistency of polarities and amplitudes, we deployed several high-end processes including a noise correlation procedure to check for timing accuracy (intrumental time errors result in a time-shift of the whole cross-correlation, clearly distinct from those due to change in medium physical properties), and a systematic comparison of synthetic and real data for teleseismic earthquakes of magnitude larger than 6.5 to detect timing errors as well as polarity and amplitude problems.

Inter-laboratory quality control for hormone-dependent gene expression in human breast tumors using real-time reverse transcription-polymerase chain reaction.

PubMed

de Cremoux, P; Bieche, I; Tran-Perennou, C; Vignaud, S; Boudou, E; Asselain, B; Lidereau, R; Magdelénat, H; Becette, V; Sigal-Zafrani, B; Spyratos, F

2004-09-01

Quantitative reverse transcription-polymerase chain reaction (RT-PCR) used to detect minor changes in specific mRNA concentrations may be associated with poor reproducibility. Stringent quality control is therefore essential at each step of the protocol, including the PCR procedure. We performed inter-laboratory quality control of quantitative PCR between two independent laboratories, using in-house RT-PCR assays on a series of hormone-related target genes in a retrospective consecutive series of 79 breast tumors. Total RNA was reverse transcribed in a single center. Calibration curves were performed for five target genes (estrogen receptor (ER)alpha, ERbeta, progesterone receptor (PR), CYP19 (aromatase) and Ki 67) and for two reference genes (human acidic ribosomal phosphoprotein PO (RPLPO) and TATA box-binding protein (TBP)). Amplification efficiencies of the calibrator were determined for each run and used to calculate mRNA expression. Correlation coefficients were evaluated for each target and each reference gene. A good correlation was observed for all target and reference genes in both centers using their own protocols and kits (P < 0.0001). The correlation coefficients ranged from 0.90 to 0.98 for the various target genes in the two centers. A good correlation was observed between the level of expression of the ERalpha and the PR transcripts (P < 0.001). A weak inverse correlation was observed in both centers between ERalpha and ERbeta levels, but only when TBP was the reference gene. No other correlation was observed with other parameters. Real-time PCR assays allow convenient quantification of target mRNA transcripts and quantification of target-derived nucleic acids in clinical specimens. This study addresses the importance of inter-laboratory quality controls for the use of a panel of real-time PCR assays devoted to clinical samples and protocols and to ensure their appropriate accuracy. This can also facilitate exchanges and multicenter comparison of data.

Effect of Sahaja yoga meditation on quality of life, anxiety, and blood pressure control.

PubMed

Chung, Sheng-Chia; Brooks, Maria M; Rai, Madhur; Balk, Judith L; Rai, Sandeep

2012-06-01

The present study investigates the effect of Sahaja yoga meditation on quality of life, anxiety, and blood pressure control. The prospective observational cohort study enrolled two study groups: those receiving treatment from the International Sahaja Yoga Research and Health Center (meditation group) and those receiving treatment from the Mahatma Gandhi Mission Hospital (control group). Researchers measured quality of life, anxiety, and blood pressure before and after treatment. Sixty-seven (67) participants in the meditation group and 62 participants in the control group completed the study. The two groups were comparable in demographic and clinical characteristics. At baseline, the meditation group had higher quality of life (p<0.001) than controls but similar anxiety level (p=0.74) to controls. Within-group pre- versus post-treatment comparisons showed significant improvement in quality of life, anxiety, and blood pressure in the meditation group (p<0.001), while in controls, quality of life deteriorated and there was no improvement in blood pressure. The improvement in quality of life, anxiety reduction, and blood pressure control was greater in the meditation group. The beneficial effect of meditation remained significant after adjusting for confounders. Meditation treatment was associated with significant improvements in quality of life, anxiety reduction, and blood pressure control.

Quality-assurance plan for the analysis of fluvial sediment by the U.S. Geological Survey Kentucky Water Science Center Sediment Laboratory

USGS Publications Warehouse

Shreve, Elizabeth A.; Downs, Aimee C.

2005-01-01

This report describes laboratory procedures used by the U.S. Geological Survey Kentucky Water Science Center Sediment Laboratory for the processing and analysis of fluvial-sediment samples for concentration of sand and finer material. The report details the processing of a sediment sample through the laboratory from receiving the sediment sample, through the analytical process, to compiling results of the requested analysis. Procedures for preserving sample integrity, calibrating and maintaining of laboratory and field instruments and equipment, analyzing samples, internal quality assurance and quality control, and validity of the sediment-analysis results also are described. The report includes a list of references cited and a glossary of sediment and quality-assurance terms.

Self-Ratings of Eight Factors of Quality Management at Naval Avionics Center

DTIC Science & Technology

1991-12-01

revised edition, North Rivers Press, Inc., 1986. Ishikawa , Kaoru , What is Total Quality Control? the Japanese Way, Prentice-Hall, Inc., 1985. Jaeger...including such authors as Deming, Juran, Ishikawa , and Crosby. The questionnaire was validated using a sample from private sector organizations in

Quality Space and Launch Requirements, Addendum to AS9100C

DTIC Science & Technology

2015-05-08

45 8.9.1 Statistical Process Control (SPC) .......................................................................... 45...SMC Space and Missile Systems Center SME Subject Matter Expert SOW Statement of Work SPC Statistical Process Control SPO System Program Office SRP...occur without any individual data exceeding the control limits. Control limits are developed using standard statistical methods or other approved

76 FR 9787 - NIOSH Dose Reconstruction Program Ten Year Review-Phase I Report on Quality of Science; Request...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention NIOSH Dose Reconstruction Program Ten Year Review--Phase I Report on Quality of Science; Request for Public Review and... Ten Year Review--Phase I Report on Quality of Science.'' This publication is part of a review by NIOSH...

Impact on seniors of the patient-centered medical home: evidence from a pilot study.

PubMed

Fishman, Paul A; Johnson, Eric A; Coleman, Kathryn; Larson, Eric B; Hsu, Clarissa; Ross, Tyler R; Liss, David; Tufano, James; Reid, Robert J

2012-10-01

To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated health care system in Washington State. A prospective before-and-after evaluation of the experience of seniors receiving primary care services at 1 pilot clinic compared with seniors enrolled at the remaining 19 primary care clinics owned and operated by Group Health. Analyses of secondary data on quality and cost were conducted for 1,947 seniors in the PCMH clinic and 39,396 seniors in the 19 control clinics. Patient experience with care was based on survey data collected from 487 seniors in the PCMH clinic and of 668 in 2 specific control clinics that were selected for their similarities in organization and patient composition to the pilot clinic. After adjusting for baseline, seniors in the PCMH clinic reported higher ratings than controls on 3 of 7 patient experience scales. Seniors in the PCMH clinic had significantly greater quality outcomes over time, but this difference was not significant relative to control. PCMH patients used more e-mail, phone, and specialist visits but fewer emergency services and inpatient admissions for ambulatory care sensitive conditions. At 1 and 2 years, the PCMH and control clinics did not differ significantly in overall costs. A PCMH redesign can be associated with improvements in patient experience and quality without increasing overall cost.

[The OPTIMISE study (Optimal Type 2 Diabetes Management Including Benchmarking and Standard Treatment]. Results for Luxembourg].

PubMed

Michel, G

2012-01-01

The OPTIMISE study (NCT00681850) has been run in six European countries, including Luxembourg, to prospectively assess the effect of benchmarking on the quality of primary care in patients with type 2 diabetes, using major modifiable vascular risk factors as critical quality indicators. Primary care centers treating type 2 diabetic patients were randomized to give standard care (control group) or standard care with feedback benchmarked against other centers in each country (benchmarking group). Primary endpoint was percentage of patients in the benchmarking group achieving pre-set targets of the critical quality indicators: glycated hemoglobin (HbAlc), systolic blood pressure (SBP) and low-density lipoprotein (LDL) cholesterol after 12 months follow-up. In Luxembourg, in the benchmarking group, more patients achieved target for SBP (40.2% vs. 20%) and for LDL-cholesterol (50.4% vs. 44.2%). 12.9% of patients in the benchmarking group met all three targets compared with patients in the control group (8.3%). In this randomized, controlled study, benchmarking was shown to be an effective tool for improving critical quality indicator targets, which are the principal modifiable vascular risk factors in diabetes type 2.

Advanced automation in space shuttle mission control

NASA Technical Reports Server (NTRS)

Heindel, Troy A.; Rasmussen, Arthur N.; Mcfarland, Robert Z.

1991-01-01

The Real Time Data System (RTDS) Project was undertaken in 1987 to introduce new concepts and technologies for advanced automation into the Mission Control Center environment at NASA's Johnson Space Center. The project's emphasis is on producing advanced near-operational prototype systems that are developed using a rapid, interactive method and are used by flight controllers during actual Shuttle missions. In most cases the prototype applications have been of such quality and utility that they have been converted to production status. A key ingredient has been an integrated team of software engineers and flight controllers working together to quickly evolve the demonstration systems.

Patient Satisfaction with Spanish Pain Centers: Observational Study with More than 3,000 Patients

PubMed Central

Hernández-Puiggròs, Patricia; Tesedo Nieto, Javier; Acín Lázaro, María Pilar; Carrera González, Alfredo; Soler, Miguel José Arranz; Maldonado Vega, Sergio

2016-01-01

Chronic pain is a serious problem in Spain. This multicenter, epidemiological 3-month follow-up study investigates pain management efficacy in Spanish centers using patient satisfaction criteria. 3,414 eligible adult patients (65,6% female) with moderate to severe chronic pain from 146 pain centers were included. Patient satisfaction was assessed based onto question 18 of Spanish healthcare barometer-CSI. Pain evolution (Brief Pain Inventory-Short Form (BPI-SF) and visual analog scale (VAS)), quality of life/EuroQol-5, and pain control expectations fulfillment were also assessed. Mean age was 61.3 years. 64.4% of participating centers employed multidisciplinary pain management approach. After 3 months, mean patient satisfaction was 7.8 (1–10) on the CIS barometer. Medical staff received the highest scores, whereas waiting for tests, appointment request to appointment date time, and waiting times at the center the lowest. Mean pain decreased from 7.4 to 4.0; BPI-SF intensity decreased from 6.5 to 3.8; pain control expectations were met in 78.7% of patients; EuroQoL-5D utility index increased from 0.37 to 0.62, p < 0.001, and health status (VAS) from 40.6 to 61.9, p < 0.001. Chronic pain patients (90%) are satisfied with Spanish centers care; 80% had their pain control expectations met. Quality of life improved remarkably: 71% felt moderately to significantly better. However, waiting times need improvement. PMID:27516902

75 FR 29561 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Surveillance...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Surveillance, Natural History, Quality of Care and Outcomes of Diabetes Mellitus with Onset in Childhood and Adolescence, RFA DP 10-001...

The UK Stem Cell Bank: a UK government-funded, international resource center for stem cell research.

PubMed

Stacey, Glyn; Hunt, Charles J

2006-01-01

The UK Stem Cell Bank is a UK Research Council-funded initiative that aims to provide ethically sourced and quality controlled stocks of cells for researchers and also establish seed stocks of cell lines for clinical trials. Whilst the Bank is prohibited from carrying out basic stem cell research (to avoid conflicts of interest) it is working to improve stem cell banking procedures including cryopreservation, characterization and quality control. The Bank also supports training activities and has provided the hub for the International Stem Cell Initiative, which includes 17 expert stem cell centers aiming to characterize a large number of human embryonic stem cell lines in a standardized way to improve our understanding of the characteristics of these cells.

42 CFR 476.90 - Lack of cooperation by a provider or practitioner.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Lack of cooperation by a provider or practitioner. 476.90 Section 476.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW...

42 CFR 476.90 - Lack of cooperation by a provider or practitioner.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Lack of cooperation by a provider or practitioner. 476.90 Section 476.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW...

Quality Control Specialist | Center for Cancer Research

Cancer.gov

Within the Leidos Biomedical Research Inc.’s Clinical Research Directorate, the Clinical Monitoring Research Program (CMRP) provides high-quality comprehensive and strategic operational support to the high-profile domestic and international clinical research initiatives of the National Cancer Institute (NCI), National Institute of Allergy and Infectious Diseases (NIAID),

Emergency Medical Operations at Kennedy Space Center in Support of Space Shuttle

NASA Technical Reports Server (NTRS)

Myers, K. Jeffrey; Tipton, David A.; Woodard, Daniel; Long, Irene D.

1992-01-01

The unique environment of the Kennedy Space Center includes a wide variety of industrial processes culminating in launch and spaceflight. Many are potentially hazardous to the work force and the astronauts. Technology, planning, training, and quality control are utilized to prevent contingencies and expedite response should a contingency occur.

Emergency medical operations at Kennedy Space Center in support of space shuttle

NASA Technical Reports Server (NTRS)

Myers, K. J.; Tipton, D. A.; Woodard, D.; Long, I. D.

1992-01-01

The unique environment of the Kennedy Space Center includes a wide variety of industrial processes culminating in launch and spaceflight. Many are potentially hazardous to the work force and the astronauts. Technology, planning, training, and quality control are utilized to prevent contingencies and expedite response should a contingency occur.

Joint CDRH (Center for Devices and Radiological Health) and state quality-assurance surveys in nuclear medicine: Phase 2 - radiopharmaceuticals

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

Hamilton, D.R.; Evans, C.D.

The report discusses survey results on aspects of the quality assurance of radio-pharmaceuticals from 180 nuclear-medicine facilities in the United States. Data were collected from facilities in 8 states. Demographic information about nuclear-medicine operations and quality-assurance programs was gathered by state radiation-control-program personnel. The data collected from the survey show an incomplete acceptance of quality-assurance practices for radiopharmaceuticals. Most of the facilities in the survey indicated that, because an inferior radiopharmaceutical was prepared so infrequently, they did not believe it was cost-effective to perform extensive quality-assurance testing. The Center for Devices and Radiological Health hopes that the information from themore » survey will stimulate nuclear-medicine professionals and their organizations to encourage appropriate testing of all radiopharmaceuticals.« less

[A strategy of constructing the technological system for quality control of Chinese medicine based on process control and management].

PubMed

Cheng, Yi-Yu; Qian, Zhong-Zhi; Zhang, Bo-Li

2017-01-01

The current situation, bottleneck problems and severe challenges in quality control technology of Chinese Medicine (CM) are briefly described. It is presented to change the phenomenon related to the post-test as the main means and contempt for process control in drug regulation, reverse the situation of neglecting the development of process control and management technology for pharmaceutical manufacture and reconstruct the technological system for quality control of CM products. The regulation and technology system based on process control and management for controlling CM quality should be established to solve weighty realistic problems of CM industry from the root causes, including backwardness of quality control technology, weakness of quality risk control measures, poor reputation of product quality and so on. By this way, the obstacles from poor controllability of CM product quality could be broken. Concentrating on those difficult problems and weak links in the technical field of CM quality control, it is proposed to build CMC (Chemistry, Manufacturing and Controls) regulation for CM products with Chinese characteristics and promote the regulation international recognition as soon as possible. The CMC technical framework, which is clinical efficacy-oriented, manufacturing manner-centered and process control-focused, was designed. To address the clinical characteristics of traditional Chinese medicine (TCM) and the production feature of CM manufacture, it is suggested to establish quality control engineering for CM manufacturing by integrating pharmaceutical analysis, TCM chemistry, TCM pharmacology, pharmaceutical engineering, control engineering, management engineering and other disciplines. Further, a theoretical model of quality control engineering for CM manufacturing and the methodology of digital pharmaceutical engineering are proposed. A technology pathway for promoting CM standard and realizing the strategic goal of CM internationalization is elaborated. Copyright© by the Chinese Pharmaceutical Association.

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.

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.

R&D control study : plan for future jet fuel distribution quality control and description of fuel properties catalog

DOT National Transportation Integrated Search

2014-05-09

The Broad Agency Announcement Alternative Aviation Fuels was a solicitation released by the U.S. Department of Transportation Research and Innovative Technology Administration (RITA) / John A. Volpe National Transportation Systems Center with funding...

76 FR 29756 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Director, Division of Healthcare Quality Promotion regarding (1) The practice of healthcare infection... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

76 FR 63622 - Healthcare Infection Control Practices Advisory Committee, (HICPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Director, Division of Healthcare Quality Promotion regarding (1) The practice of healthcare infection... infections), antimicrobial resistance, and related events in settings where healthcare is provided; and (3...

Results-driven approach to improving quality and productivity

Treesearch

John Dramm

2000-01-01

Quality control (QC) programs do not often realize their full potential. Elaborate and expensive QC programs can easily get side tracked by the process of building a program with promises of “Someday, this will all pay off.” Training employees in QC methods is no guarantee that quality will improve. Several documented cases show that such activity-centered efforts...

Quality Space and Launch Requirements Addendum to AS9100C

DTIC Science & Technology

2015-03-05

45 8.9.1 Statistical Process Control (SPC) .......................................................................... 45 8.9.1.1 Out of Control...Systems Center SME Subject Matter Expert SOW Statement of Work SPC Statistical Process Control SPO System Program Office SRP Standard Repair...individual data exceeding the control limits. Control limits are developed using standard statistical methods or other approved techniques and are based on

Double-quality control reveals high-level toxicity in gloves used for operator protection in assisted reproductive technology.

PubMed

Lierman, Sylvie; De Sutter, Petra; Dhont, Marc; Van der Elst, Josiane

2007-10-01

To submit different glove brands to double-quality control tests using mouse embryo assay (MEA) and the human sperm motility assay (HuSMA). Operator protection against infectious body fluid contamination is a safety issue in assisted reproductive technology (ART). When using gloves in the ART laboratory, toxic substances can be transmitted to culture media, even during brief contact. Quality control study of gloves in ART. University hospital-based infertility center. Seven- to 8-week-old female B6D2F1 hybrid mice. We tested two surgical, two cleanroom, and six examination glove brands. Only gloves brands that passed both HuSMA and MEA were submitted to further QC using zona-free and/or cryopreserved MEA. Sperm motility index, two-cell and blastocyst development, blastocyst total cell number. Quality control by MEA and HuSMA identified two glove brands to be nontoxic. Our study shows that gloves used in ART can be toxic and should be tested as part of an ongoing quality control program.

Design and Methodological Considerations of the Centers for Disease Control and Prevention Urologic and Renal Protocol for the Newborn and Young Child with Spina Bifida

PubMed Central

Routh, Jonathan C.; Cheng, Earl Y.; Austin, J. Christopher; Baum, Michelle A.; Gargollo, Patricio C.; Grady, Richard W.; Herron, Adrienne R.; Kim, Steven S.; King, Shelly J.; Koh, Chester J.; Paramsothy, Pangaja; Raman, Lisa; Schechter, Michael S.; Smith, Kathryn A.; Tanaka, Stacy T.; Thibadeau, Judy K.; Walker, William O.; Wallis, M. Chad; Wiener, John S.; Joseph, David B.

2016-01-01

Purpose Care of children with spina bifida has significantly advanced in the last half century, resulting in gains in longevity and quality of life for affected children and caregivers. Bladder dysfunction is the norm in patients with spina bifida and may result in infection, renal scarring and chronic kidney disease. However, the optimal urological management for spina bifida related bladder dysfunction is unknown. Materials and Methods In 2012 the Centers for Disease Control and Prevention convened a working group composed of pediatric urologists, nephrologists, epidemiologists, methodologists, community advocates and Centers for Disease Control and Prevention personnel to develop a protocol to optimize urological care of children with spina bifida from the newborn period through age 5 years. Results An iterative quality improvement protocol was selected. In this model participating institutions agree to prospectively treat all newborns with spina bifida using a single consensus based protocol. During the 5-year study period outcomes will be routinely assessed and the protocol adjusted as needed to optimize patient and process outcomes. Primary study outcomes include urinary tract infections, renal scarring, renal function and bladder characteristics. The protocol specifies the timing and use of testing (eg ultrasonography, urodynamics) and interventions (eg intermittent catheterization, prophylactic antibiotics, antimuscarinic medications). Starting in 2014 the Centers for Disease Control and Prevention began funding 9 study sites to implement and evaluate the protocol. Conclusions The Centers for Disease Control and Prevention Urologic and Renal Protocol for the Newborn and Young Child with Spina Bifida began accruing patients in 2015. Assessment in the first 5 years will focus on urinary tract infections, renal function, renal scarring and clinical process improvements. PMID:27475969

Design and Methodological Considerations of the Centers for Disease Control and Prevention Urologic and Renal Protocol for the Newborn and Young Child with Spina Bifida.

PubMed

Routh, Jonathan C; Cheng, Earl Y; Austin, J Christopher; Baum, Michelle A; Gargollo, Patricio C; Grady, Richard W; Herron, Adrienne R; Kim, Steven S; King, Shelly J; Koh, Chester J; Paramsothy, Pangaja; Raman, Lisa; Schechter, Michael S; Smith, Kathryn A; Tanaka, Stacy T; Thibadeau, Judy K; Walker, William O; Wallis, M Chad; Wiener, John S; Joseph, David B

2016-12-01

Care of children with spina bifida has significantly advanced in the last half century, resulting in gains in longevity and quality of life for affected children and caregivers. Bladder dysfunction is the norm in patients with spina bifida and may result in infection, renal scarring and chronic kidney disease. However, the optimal urological management for spina bifida related bladder dysfunction is unknown. In 2012 the Centers for Disease Control and Prevention convened a working group composed of pediatric urologists, nephrologists, epidemiologists, methodologists, community advocates and Centers for Disease Control and Prevention personnel to develop a protocol to optimize urological care of children with spina bifida from the newborn period through age 5 years. An iterative quality improvement protocol was selected. In this model participating institutions agree to prospectively treat all newborns with spina bifida using a single consensus based protocol. During the 5-year study period outcomes will be routinely assessed and the protocol adjusted as needed to optimize patient and process outcomes. Primary study outcomes include urinary tract infections, renal scarring, renal function and bladder characteristics. The protocol specifies the timing and use of testing (eg ultrasonography, urodynamics) and interventions (eg intermittent catheterization, prophylactic antibiotics, antimuscarinic medications). Starting in 2014 the Centers for Disease Control and Prevention began funding 9 study sites to implement and evaluate the protocol. The Centers for Disease Control and Prevention Urologic and Renal Protocol for the Newborn and Young Child with Spina Bifida began accruing patients in 2015. Assessment in the first 5 years will focus on urinary tract infections, renal function, renal scarring and clinical process improvements. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Evaluation of a standardized patient education program for inpatient asthma rehabilitation: Impact on patient-reported health outcomes up to one year.

PubMed

Bäuerle, Kathrin; Feicke, Janine; Scherer, Wolfgang; Spörhase, Ulrike; Bitzer, Eva-Maria

2017-05-01

To modify and evaluate a patient education program for adult asthma patients in consideration of quality criteria for teaching. This was a prospective single-center controlled trial in an inpatient rehabilitation center. The control group (n=215) received the usual lecture-based education program, and the intervention group (n=209) the modified patient education program. Data were assessed at admission, discharge, 6 and 12 months post discharge. The primary outcome was asthma control, the secondary outcomes were asthma knowledge, quality of life, and program acceptance. Analysis of change was performed by ANCOVA for each follow-up, adjusting for baseline values. Statistically significant increases in all health outcomes and in asthma control were maintained in both groups at 12 months: CG: +1.9 (95%-CI 1.3-2.6) IG: +1.6 (95%-CI 0.8-2.3). We observed no significant differences between the programs for asthma control and quality of life. Regarding practical asthma knowledge, after 12 months, a group*time interaction emerged with a small effect size (P=0.06, η2=0.01). The modified program was not superior to traditional patient education concerning asthma control. It permanently increased self-management knowledge. Structured and behavioral patient education fosters patient's disease management ability. Possible ways of improving asthma control need to be explored. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Symptom Severity and Quality of Life Among Long-term Colorectal Cancer Survivors Compared With Matched Control Subjects: A Population-Based Study.

PubMed

Hart, Tae L; Charles, Susan T; Gunaratne, Mekhala; Baxter, Nancy N; Cotterchio, Michelle; Cohen, Zane; Gallinger, Steven

2018-03-01

Data are lacking regarding physical functioning, psychological well-being, and quality of life among colorectal cancer survivors >10 years postdiagnosis. The purpose of this study was to examine self-reported physical functioning, quality of life, and psychological well-being in long-term colorectal cancer survivors compared with age- and sex-matched unaffected control subjects. Participants completed a cross-sectional survey. The colorectal cancer survivors and unaffected control subjects were recruited from the Ontario Familial Colorectal Cancer Registry. A population-based sample of colorectal cancer survivors (N = 296) and their age- and sex-matched unaffected control subjects (N = 255) were included. Survivors were, on average, 15 years postdiagnosis. Quality of life was measured with the Functional Assessment of Cancer Therapy-General scale, bowel dysfunction with the Memorial Sloan-Kettering Cancer Center scale, urinary dysfunction with the International Consultation on Incontinence Questionnaire-Short Form, fatigue with the Functional Assessment of Chronic Illness Therapy-Fatigue scale, and depression with the Center for Epidemiologic Studies-Depression scale. In linear mixed-model analyses adjusting for income, education, race, and comorbid medical conditions, survivors reported good emotional, functional, physical, and overall quality of life, comparable to control subjects. Fatigue and urinary functioning did not differ significantly between survivors and control subjects. Survivors reported significantly higher social quality of life and lower depression compared with unaffected control subjects. The only area where survivors reported significantly worse deficits was in bowel dysfunction, but the magnitude of differences was relatively small. Generalizability is limited by moderately low participation rates. Findings are likely biased toward healthy participants. No baseline assessment was available to examine change in outcomes over time. Long-term colorectal cancer survivors appear to have comparable quality of life and, in some areas, better well-being than their unaffected peers. Bowel dysfunction may continue to be an ongoing issue even 15 years after colorectal cancer diagnosis. Overall quality of life can be expected to be good in this group of older survivors. See Video Abstract at http://links.lww.com/DCR/A476.

The Role of Liposomal Bupivacaine in Value-Based Care.

PubMed

Iorio, Richard

Multimodal pain control strategies are crucial in reducing opioid use and delivering effective pain management to facilitate improved surgical outcomes. The utility of liposomal bupivacaine in enabling effective pain control in multimodal strategies has been demonstrated in several studies, but others have found the value of liposomal bupivacaine in such approaches to be insignificant. At New York University Langone Medical Center, liposomal bupivacaine injection and femoral nerve block were compared in their delivery of efficacious and cost-effective multimodal analgesia among patients undergoing total joint arthroplasty (TJA). Retrospective analysis revealed that including liposomal bupivacaine in a multimodal pain control protocol for TJA resulted in improved quality and efficiency metrics, decreased narcotic use, and faster mobilization, all relative to femoral nerve block, and without a significant increase in admission costs. In addition, liposomal bupivacaine use was associated with elimination of the need for patient-controlled analgesia in TJA. Thus, at Langone Medical Center, the introduction of liposomal bupivacaine to TJA has been instrumental in achieving adequate pain control, delivering high-level quality of care, and controlling costs.

Criteria for Side-Force Control in Air-to-Ground Target Acquisition and Tracking

NASA Technical Reports Server (NTRS)

Sammonds, Robert I.; McNeill, Walter E.; Bunnell, John W.

1982-01-01

A moving-base simulator experiment conducted at Ames Research Center demonstrated that a wings-level-turn control mode improved flying qualities for air-to-ground weapons delivery compared with those of a conventional aircraft. Evaluations of criteria for dynamic response for this system have shown that pilot ratings correlate well with equivalent time constant of the initial response and with system bandwidth. Ranges of this time constant, as well as digital-system transport delays and lateral-acceleration control authorities that encompassed level 1 through level 3 handling qualities, were determined.

Evidence for the Spread of the Human Immunodeficiency Virus Epidemic into Low Prevalence Areas of the United States

DTIC Science & Technology

1989-01-01

inmune Defllenq Syndrpmes,. Vol. 2. NVo, 6, 1989 524 L. 1. GARDNER, JR. ET AL. prevalence territory. For uniformity, we assigned limits around rate...Conference on AIDS, Washington, D.C., June black males in the intravenous drug abuser popula- 1987. 4. Centers for Disease Control. Coolfont report. A...18. Centers for Disease Control. Acquired immunodeficiency ato and Sally Fuller assured the quality of laboratory test- syndrome in the San -Francisco

Data Quality Control of the French Permanent Broadband Network in the RESIF Framework

NASA Astrophysics Data System (ADS)

Grunberg, Marc; Lambotte, Sophie; Engels, Fabien; Dretzen, Remi; Hernandez, Alain

2014-05-01

In the framework of the RESIF (Réseau Sismologique et géodésique Français) project, a new information system is being setting up, allowing the improvement of the management and the distribution of high quality data from the different elements of RESIF and the associated networks. Within this information system, EOST (in Strasbourg) is in charge of collecting real-time permanent broadband seismic waveform, and performing Quality Control on these data. The real-time and validated data set are pushed to the French National Distribution Center (Isterre/Grenoble) in order to make them publicly available. Furthermore EOST hosts the BCSF-ReNaSS, in charge of the French metropolitan seismic bulletin. This allows to benefit from some high-end quality control based on the national and world-wide seismicity. Here we present first the real-time seismic data flow from the stations of the French National Broad Band Network to EOST, and then, the data Quality Control procedures that were recently installed, including some new developments. The data Quality Control consists in applying a variety of subprocesses to check the consistency of the whole system and process from the stations to the data center. This allows us to verify that instruments and data transmission are operating correctly. Moreover analysis of the ambient noise helps to characterize intrinsic seismic quality of the stations and to identify other kind of disturbances. The deployed Quality Control consist in a pipeline that starts with low-level procedures : check the real-time miniseed data file (file naming convention, data integrity), check for inconsistencies between waveform and meta-data (channel name, sample rate, etc.), compute waveform statistics (data availability, gap/overlap, mean, rms, time quality, spike). It is followed by some high-level procedures such as : power spectral density computation (PSD), STA/LTA computation to be correlated to the seismicity, phases picking and stations magnitudes discrepancies. The results of quality control is visualized through a web interface. This latter gathers data from different information systems to provide a global view on last events that could impact the data (like intervention on site or seismic events, etc.). This work is still an ongoing project. We intend to add more sophisticated procedures to enhanced our data Quality Control. Among them, we will deploy a seismic moment tensor inversion tool for amplitude, time and polarity control and a noise correlation procedure for time drift detections.

Metadata: Pure and Simple, or Is It?

ERIC Educational Resources Information Center

Chalmers, Marilyn

2002-01-01

Discusses issues concerning metadata in Web pages based on experiences in a vocational education center library in Queensland (Australia). Highlights include Dublin Core elements; search engines; controlled vocabulary; performance measurement to assess usage patterns and provide quality control over the vocabulary; and considerations given the…

Applications of flight control system methods to an advanced combat rotorcraft

NASA Technical Reports Server (NTRS)

Tischler, Mark B.; Fletcher, Jay W.; Morris, Patrick M.; Tucker, George T.

1989-01-01

Advanced flight control system design, analysis, and testing methodologies developed at the Ames Research Center are applied in an analytical and flight test evaluation of the Advanced Digital Optical Control System (ADOCS) demonstrator. The primary objectives are to describe the knowledge gained about the implications of digital flight control system design for rotorcraft, and to illustrate the analysis of the resulting handling-qualities in the context of the proposed new handling-qualities specification for rotorcraft. Topics covered in-depth are digital flight control design and analysis methods, flight testing techniques, ADOCS handling-qualities evaluation results, and correlation of flight test results with analytical models and the proposed handling-qualities specification. The evaluation of the ADOCS demonstrator indicates desirable response characteristics based on equivalent damping and frequency, but undersirably large effective time-delays (exceeding 240 m sec in all axes). Piloted handling-qualities are found to be desirable or adequate for all low, medium, and high pilot gain tasks; but handling-qualities are inadequate for ultra-high gain tasks such as slope and running landings.

Unraveling the Importance of the Quantity and the Quality of Workers' Motivation for Well-Being: A Person-Centered Perspective

ERIC Educational Resources Information Center

Van den Broeck, Anja; Lens, Willy; De Witte, Hans; Van Coillie, Hermina

2013-01-01

The current study compares the quantitative and the qualitative viewpoints on work motivation by relying on Self-Determination Theory's differentiation between autonomous and controlled motivation. Specifically, we employed a person-centered approach to identify workers' naturally occurring motivational profiles and compared them in terms of…

Quality Control of Meteorological Observations

NASA Technical Reports Server (NTRS)

Collins, William; Dee, Dick; Rukhovets, Leonid

1999-01-01

For the first time, a problem of the meteorological observation quality control (QC) was formulated by L.S. Gandin at the Main Geophysical Observatory in the 70's. Later in 1988 L.S. Gandin began adapting his ideas in complex quality control (CQC) to the operational environment at the National Centers for Environmental Prediction. The CQC was first applied by L.S.Gandin and his colleagues to detection and correction of errors in rawinsonde heights and temperatures using a complex of hydrostatic residuals.Later, a full complex of residuals, vertical and horizontal optimal interpolations and baseline checks were added for the checking and correction of a wide range of meteorological variables. some other of Gandin's ideas were applied and substantially developed at other meteorological centers. A new statistical QC was recently implemented in the Goddard Data Assimilation System. The central component of any quality control is a buddy check which is a test of individual suspect observations against available nearby non-suspect observations. A novel feature of this test is that the error variances which are used for QC decision are re-estimated on-line. As a result, the allowed tolerances for suspect observations can depend on local atmospheric conditions. The system is then better able to accept extreme values observed in deep cyclones, jet streams and so on. The basic statements of this adaptive buddy check are described. Some results of the on-line QC including moisture QC are presented.

Flying-qualities criteria for wings-level-turn maneuvering during an air-to-ground weapon delivery task

NASA Technical Reports Server (NTRS)

Sammonds, R. I.; Bunnell, J. W., Jr.

1980-01-01

A moving-base simulator experiment conducted at Ames Research Center demonstrated that a wings-level-turn control mode improved flying qualities for air-to-ground weapons delivery compared with those of a conventional aircraft. Evaluations of criteria for dynamic response for this system have shown that pilot ratings correlate well on the basis of equivalent time constant of the initial response. Ranges of this time constant, as well as digital-system transport delays and lateral-acceleration control authorities that encompassed Level I through Level III handling qualities, were determined.

The Relationship between Costs and Quality in Veterans Health Administration Community Living Centers: An Analysis Using Longitudinal Data.

PubMed

Burgess, James F; Shwartz, Michael; Stolzmann, Kelly; Sullivan, Jennifer L

2018-05-18

To examine the relationship between cost and quality in Veterans Health Administration (VA) nursing homes (called Community Living Centers, CLCs) using longitudinal data. One hundred and thirty CLCs over 13 quarters (from FY2009 to FY2012) were studied. Costs, resident days, and resident severity (RUGs score) were obtained from the VA Managerial Cost Accounting System. Clinical quality measures were obtained from the Minimum Data Set, and resident-centered care (RCC) was measured using the Artifacts of Culture Change Tool. We used a generalized estimating equation model with facilities included as fixed effects to examine the relationship between total cost and quality after controlling for resident days and severity. The model included linear and squared terms for all independent variables and interactions with resident days. With the exception of RCC, all other variables had a statistically significant relationship with total costs. For most poorer performing smaller facilities (lower size quartile), improvements in quality were associated with higher costs. For most larger facilities, improvements in quality were associated with lower costs. The relationship between cost and quality depends on facility size and current level of performance. © Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Annual Report, Reservoir Control Center, Southwestern Division (1989)

DTIC Science & Technology

1990-01-01

Division in the water quality field . This provides for water quality objectives being included as an effective part of our total water management...WES) selected Canyon Lake as a research field site for developing techniques to evaluate the impacts associated with installation of hydropower at Corps...term continuous goals of this Division, and consequently the Water Management Branch, in the water quality field . (1) To obtain sufficient water

Analysis of mental workload of electrical power plant operators of control and operation centers.

PubMed

Vitório, Daiana Martins; Masculo, Francisco Soares; Melo, Miguel O B C

2012-01-01

Electrical systems can be categorized as critical systems where failure can result in significant financial loss, injury or threats to human life. The operators of the electric power control centers perform an activity in a specialized environment and have to carry it out by mobilizing knowledge and reasoning to which they have adequate training under the terms of the existing rules. To reach this there is a common mental request of personnel involved in these centers due the need to maintain attention, memory and reasoning request. In this sense, this study aims to evaluate the Mental Workload of technical workers of the Control Centers of Electrical Energy. It was undertaken a research on operators control centers of the electricity sector in Northeast Brazil. It was used for systematic observations, followed by interview and application of the instrument National Aeronautics and Space Administration Task Load Index known as NASA-TLX. As a result there will be subsidies for an assessment of mental workload of operators, and a contribution to improving the processes of managing the operation of electric utilities and the quality of workers.

Patient-centered Medical Home Capability and Clinical Performance in HRSA-supported Health Centers

PubMed Central

Shi, Leiyu; Lock, Diana C.; Lee, De-Chih; Lebrun-Harris, Lydie A.; Chin, Marshall H.; Chidambaran, Preeta; Nocon, Robert S.; Zhu, Jinsheng; Sripipatana, Alek

2015-01-01

Objectives To evaluate the relationship between Patient-centered Medical Home (PCMH) model adoption in health centers (HCs) and clinical performance measures and to determine if adoption of PCMH characteristics is associated with better clinical performance. Research Design Data came from the Health Resources and Services Administration’s 2009 Uniform Data System and the 2009 Commonwealth Fund National Survey of Federally Qualified Health Centers. Clinical performance measures included 2 process measures (childhood immunization and cervical cancer screening) and 2 outcome measures (hypertension control and diabetes control). Total and subscale PCMH scores were regressed on the clinical performance measures, adjusting for patient, provider, financial, and institutional characteristics. Results The findings showed different directional relationships, with some PCMH domains (care management, test/referral tracking, quality improvement, and external coordination) showing little or no effect on outcome measures of interest, 1 domain (access/communication) associated with improved outcomes, and 1 domain (patient tracking/registry) associated with worse outcomes. Conclusions This study is among the first to examine the association between PCMH transformation and clinical performance in HCs, providing an understanding of the impact of PCMH adoption within safety-net settings. The mixed results highlight the importance of examining relationships between specific PCMH domains and specific clinical quality measures, in addition to analyzing overall PCMH scores which could yield distorted findings. PMID:25793267

A Field Study of Control Systems in Environments with Ill-Defined Technology and Output

DTIC Science & Technology

1989-12-01

Care Center B was a privately owned, client- funded, profit-seeking child care center. It was a certified Montessori school established in 1978. The...third, provide a quality, Montessori education. Of these three goals, only the third was written in the organization’s literature (in the Parent’s...that Child Care Center B generated its own SOPs. The director/owner stated that the state-regulations binder, along with the Montessori manuals

Care coordination and the essential role of the nurse.

PubMed

Cropley, Stacey; Sandrs, Ellare Duis

2013-01-01

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

The Oncology Care Model: Perspectives From the Centers for Medicare & Medicaid Services and Participating Oncology Practices in Academia and the Community.

PubMed

Kline, Ron; Adelson, Kerin; Kirshner, Jeffrey J; Strawbridge, Larissa M; Devita, Marsha; Sinanis, Naralys; Conway, Patrick H; Basch, Ethan

2017-01-01

Cancer care delivery in the United States is often fragmented and inefficient, imposing substantial burdens on patients. Costs of cancer care are rising more rapidly than other specialties, with substantial regional differences in quality and cost. The Centers for Medicare & Medicaid Services (CMS) Innovation Center (CMMIS) recently launched the Oncology Care Model (OCM), which uses payment incentives and practice redesign requirements toward the goal of improving quality while controlling costs. As of March 2017, 190 practices were participating, with approximately 3,200 oncologists providing care for approximately 150,000 unique beneficiaries per year (approximately 20% of the Medicare Fee-for-Service population receiving chemotherapy for cancer). This article provides an overview of the program from the CMS perspective, as well as perspectives from two practices implementing OCM: an academic health system (Yale Cancer Center) and a community practice (Hematology Oncology Associates of Central New York). Requirements of OCM, as well as implementation successes, challenges, financial implications, impact on quality, and future visions, are provided from each perspective.

Neural networks with fuzzy Petri nets for modeling a machining process

NASA Astrophysics Data System (ADS)

Hanna, Moheb M.

1998-03-01

The paper presents an intelligent architecture based a feedforward neural network with fuzzy Petri nets for modeling product quality in a CNC machining center. It discusses how the proposed architecture can be used for modeling, monitoring and control a product quality specification such as surface roughness. The surface roughness represents the output quality specification manufactured by a CNC machining center as a result of a milling process. The neural network approach employed the selected input parameters which defined by the machine operator via the CNC code. The fuzzy Petri nets approach utilized the exact input milling parameters, such as spindle speed, feed rate, tool diameter and coolant (off/on), which can be obtained via the machine or sensors system. An aim of the proposed architecture is to model the demanded quality of surface roughness as high, medium or low.

Microgravity

NASA Image and Video Library

1998-10-21

The Glenn Research Center (GRC) Telescience Support Center (TSC) is a NASA telescience ground facility that provides the capability to execute ground support operations of on-orbit International Space Station (ISS) and Space Shuttle payloads. This capability is provided with the coordination with the Marshall Space Flight Center (MSFC) Huntsville Operations Support Center (HOSC), the Johnson Space Center (JSC) Mission Control Center in Houston (MCC-H) and other remote ground control facilities. The concept of telescience is a result of NASA's vision to provide worldwide distributed ISS ground operations that will enable payload developers and scientists to control and monitor their on-board payloads from any location -- not necessarily a NASA site. This concept enhances the quality of scientific and technological data while decreasing operation costs of long-term support activities by providing ground operation services to a Principal Investigator and Engineering Team at their home site. The TSC acts as a hub in which users can either locate their operations staff within the walls of the TSC or request the TSC operation capabilities be extended to a location more convenient such as a university.

Dahuk Rehabilitation Center. Dahuk, Iraq

DTIC Science & Technology

2007-01-08

this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services , Directorate for Information...construction services . As a result, it was very likely that the project would be successfully completed without major issues related to inadequate design...visit. Specifically, Quality Control and Quality Assurance personnel were well informed about the history and progression of the project and its

Support Center for Regulatory Atmospheric Modeling (SCRAM)

EPA Pesticide Factsheets

This technical site provides access to air quality models (including computer code, input data, and model processors) and other mathematical simulation techniques used in assessing air emissions control strategies and source impacts.

Effectiveness of nurse-led patient-centered care behavioral risk modification on secondary prevention of coronary heart disease: A systematic review.

PubMed

Chiang, Chung-Yan; Choi, Kai-Chow; Ho, Ka-Ming; Yu, Sau-Fung

2018-04-22

Despite establishment of advocacies centered on using patient-centered care to improve disease-related behavioral changes and health outcomes, studies have seldom discussed incorporation of patient-centered care concept in the design of secondary cardiac prevention. This review aimed to identify, appraise, and examine existing evidence on the effectiveness of nurse-led patient-centered care for secondary cardiac prevention in patients with coronary heart disease. A systematic review of randomized controlled trials focusing on nurse-led patient-centered care for secondary cardiac prevention was conducted. Primary outcomes were behavioral risks (e.g. smoking, physical activity), secondary outcomes were clinically relevant physiological parameters (e.g. body weight, blood pressure, blood glucose, blood lipoproteins), health-related quality of life, mortality, and self efficacy. Twenty-three English and seven Chinese electronic databases were searched to identify the trials. The studies' eligibility and methodological quality were assessed by two reviewers independently according to the Joanna Briggs Institute guidelines. Statistical heterogeneities of the included studies were assessed by Higgins I2 and quantitative pooling was performed when studies showed sufficient comparability. 15 articles on 12 randomized controlled trials were included in this review. Methodological quality of the included studies was fair. Based on the Joanna Briggs Institute critical appraisal tool for experimental studies, the included studies had met a mean of six criteria out the ten in this appraisal tool. The meta-analyses of the included studies revealed that nurse-led patient-centered care had significantly improved patients' smoking habits, adherence toward physical activity advices, and total cholesterol level with medical regime optimization, in short- to medium-term. The intervention was also favorable in improving the patients' health-related quality of life in several domains of SF-36. Furthermore, from single-study results, the intervention was favorable in improving the patients' weight management and alcohol consumption. However, it did not show significant effects on improving the patient's dietary habits, certain cardiac physiological parameters, mortality and self-efficacy. Currently, no addition long-term benefit of the intervention on secondary cardiac prevention was identified. This review has systematically analyzed the effects of nurseledpatient-centered care on patients' behavioral risks, cardiacphysiological parameters, mortality, health-related quality of life and self-efficacy. Given limited quantity of existing evidence regarding certain outcomes and long-term follow-up period; cross-trial heterogeneity of the interventions, measurement methods and statistical results; high or unclear risk of bias in some quality dimensions, the effectiveness of the intervention on secondary cardiac prevention remains inconclusive and subject to additional trials and evidences. Copyright © 2018 Elsevier Ltd. All rights reserved.

SPOT4 Operational Control Center (CMP)

NASA Technical Reports Server (NTRS)

Zaouche, G.

1993-01-01

CNES(F) is responsible for the development of a new generation of Operational Control Center (CMP) which will operate the new heliosynchronous remote sensing satellite (SPOT4). This Operational Control Center takes large benefit from the experience of the first generation of control center and from the recent advances in computer technology and standards. The CMP is designed for operating two satellites all the same time with a reduced pool of controllers. The architecture of this CMP is simple, robust, and flexible, since it is based on powerful distributed workstations interconnected through an Ethernet LAN. The application software uses modern and formal software engineering methods, in order to improve quality and reliability, and facilitate maintenance. This software is table driven so it can be easily adapted to other operational needs. Operation tasks are automated to the maximum extent, so that it could be possible to operate the CMP automatically with very limited human interference for supervision and decision making. This paper provides an overview of the SPOTS mission and associated ground segment. It also details the CMP, its functions, and its software and hardware architecture.

Healthcare Transformation and Changing Roles for Nursing

PubMed Central

Salmond, Susan W.; Echevarria, Mercedes

2017-01-01

Factors driving healthcare transformation include fragmentation, access problems, unsustainable costs, suboptimal outcomes, and disparities. Cost and quality concerns along with changing social and disease-type demographics created the greatest urgency for the need for change. Caring for and paying for medical treatments for patients suffering from chronic health conditions are a significant concern. The Affordable Care Act includes programs now led by the Centers for Medicare & Medicaid Services aiming to improve quality and control cost. Greater coordination of care—across providers and across settings—will improve quality care, improve outcomes, and reduce spending, especially attributed to unnecessary hospitalization, unnecessary emergency department utilization, repeated diagnostic testing, repeated medical histories, multiple prescriptions, and adverse drug interactions. As a nation, we have taken incremental steps toward achieving better quality and lower costs for decades. Nurses are positioned to contribute to and lead the transformative changes that are occurring in healthcare by being a fully contributing member of the interprofessional team as we shift from episodic, provider-based, fee-for-service care to team-based, patient-centered care across the continuum that provides seamless, affordable, and quality care. These shifts require a new or an enhanced set of knowledge, skills, and attitudes around wellness and population care with a renewed focus on patient-centered care, care coordination, data analytics, and quality improvement. PMID:28107295

Patient- and Family-Centered Care as an approach to reducing disparities in asthma outcomes in urban African American children: A review of the literature.

PubMed

Harper, Felicity W K; Eggly, Susan; Crider, Beverly; Kobayashi, Hitomi; Kathleen, R N; Meert, L; Ball, Allison; Penner, Louis A; Gray, Herman; Albrecht, Terrance L

2015-06-01

We thank Cathy Eames (Director, Library Services, Detroit Medical Center) for valuable input and assistance with the search strategy. Funding for this research was supported by a grant from Children's Hospital of Michigan Research Foundation (Principal Investigator: Terrance L. Albrecht, Ph.D.). Patient- and family-centered care (PFCC) has the potential to address disparities in access and quality of healthcare for African American pediatric asthma patients by accommodating and responding to the individual needs of patients and families. To identify and evaluate research on the impact of family-provider interventions that reflect elements of PFCC on reducing disparities in the provision, access, quality, and use of healthcare services for African American pediatric asthma patients. Electronic searches were conducted using PubMed, CINAHL, and Psyclnfo databases. Inclusion criteria were peer-reviewed, English-language articles on family-provider interventions that (a) reflected one or more elements of PFCC and (b) addressed healthcare disparities in urban African American pediatric asthma patients (≤18years). Thirteen interventions or programs were identified and reviewed. Designs included randomized clinical trials, controlled clinical trials, pre- and post-interventions, and program evaluations. Few interventions were identified as explicitly providing PFCC in a pediatric asthma context, possibly because of a lack of consensus on what constitutes PFCC in practice. Some studies have demonstrated that PFCC improves satisfaction and communication during clinical interactions. More empirical research is needed to understand whether PFCC interventions reduce care disparities and improve the provision, access, and quality of asthma healthcare for urban African American children. PubMed, CINAHL, and Psyclnfo AA-African American: CCT-Controlled clinical trial; ED-Emergency Department; ETS-Environmental tobacco smoke; FCC- Family Centered Care; PFCC-Patient and Family Centered Care; RCT- Randomized, controlled trial. © 2015 National Medical Association. Published by Elsevier Inc. All rights reserved.

Computerized Decision Aids for Shared Decision Making in Serious Illness: Systematic Review.

PubMed

Staszewska, Anna; Zaki, Pearl; Lee, Joon

2017-10-06

Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients. PubMed and Scopus databases were searched to identify randomized controlled trials (RCTs) that assessed the impact of computerized decision aids on patient-centered outcomes and SDM in serious illness. Six RCTs were identified and data were extracted on study population, design, and results. Risk of bias was assessed by a modified Cochrane Risk of Bias Tool for Quality Assessment of Randomized Controlled Trials. Six RCTs tested decision tools in varying serious illnesses. Three studies compared different computerized decision aids against each other and a control. All but one study demonstrated improvement in at least one patient-centered outcome. Computerized decision tools may reduce unnecessary treatment in patients with low disease severity in comparison with informational pamphlets. Additionally, electronic health record (EHR) portals may provide the opportunity to manage care from the home for individuals affected by illness. The quality of decision aids is of great importance. Furthermore, satisfaction with the use of tools is associated with increased patient satisfaction and reduced decisional conflict. Finally, patients may benefit from computerized decision tools without the need for increased physician involvement. Most computerized decision aids improved at least one patient-centered outcome. All RCTs identified were at a High Risk of Bias or Unclear Risk of Bias. Effort should be made to improve the quality of RCTs testing SDM aids in serious illness. ©Anna Staszewska, Pearl Zaki, Joon Lee. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 06.10.2017.

75 FR 43190 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... human and animal health; (5) ensures scientific quality and ethical and regulatory compliance of center... investigations on the biology, ecology, and control of arthropod vectors of viral, rickettsial, and bacterial...

Antiretroviral therapy supply chain quality control and assurance in improving people living with HIV therapeutic outcomes in Cameroon.

PubMed

Djobet, M P Ngogang; Singhe, David; Lohoue, Julienne; Kuaban, Christopher; Ngogang, Jeanne; Tambo, Ernest

2017-04-04

Evaluation of medication efficacy and safety is an essential guarantee to successful therapeutic outcome in public health practices. However, larger distribution chain supply in developing countries such as Cameroon is often challenged by counterfeit drugs, poor manufacturing, storage and degradation leading to health and patient adverse consequences. Yet, access to supply chain management in strengthening ARVs quality assurance and outcomes remains poorly documented. More than 53,000 patients have been enrolled on free ARVs medications, but little is documented on quality assurance and validity of safety for affected populations along the supply chain management since 2008. The cross sectional study was conducted in ARVs distribution units and centers in central, littoral and south west regions of Cameroon. ARVs drugs samples included Nevirapine, Efavirenz, and fixed dose combinations of Zidovudine + Lamivudine, Lamivudine + Stavudine and Zidovudine + Lamivudine + Nevirapine. Drugs packaging and labeling was assessed and galenic assays were performed at National Laboratory of quality Control of Medications and Expertise (LANACOME), Yaoundé, Cameroon. The study covered 16 structures located in eight different towns including the central ARVs store, two regional pharmaceutical procurement centers and thirteen HIV approved treatment centers and management units. A total of 35 ARVs products were collected. Only eight ARVs drugs containing Lamivudine and Stavudine presented with white stains on tablets, however these drugs were standard for all other tests performed. The others 28 ARVs products were standards to all assays performed. We concluded that ARVs drugs freely accessible and distributed to PLWHA are of good quality in Cameroon. However, with the increase number of patients under HAART since 2013, adoption of "Test and Treat" approach to reach the 90-90-90 goals and with the implementation of new national antiretroviral regimen guidelines and molecules such as boosted protease inhibitors, continuous quality control and assurance surveillance, monitoring and evaluation is recommended. Assessment of quality of formulations that are more susceptible to degradation such as pediatric formulations for averting the rising multidrug resistance trend is also desired.

Effects of a pulsed electromagnetic therapy on multiple sclerosis fatigue and quality of life: a double-blind, placebo controlled trial.

PubMed

Lappin, Martha S; Lawrie, Fraser Wilson; Richards, Todd L; Kramer, Eric D

2003-01-01

There is a growing literature on the biological and clinical effects of pulsed electromagnetic fields. Some studies suggest that electromagnetic therapies may be useful in the treatment of chronic illnesses. This study is a follow-up to a placebo controlled pilot study in which multiple sclerosis (MS) patients exposed to weak, extremely low frequency pulsed electromagnetic fields showed significant improvements on a composite symptom measure. To evaluate the effects of a pulsed electromagnetic therapy on MS related fatigue, spasticity, bladder control, and overall quality of life. A multi-site, double-blind, placebo controlled, crossover trial. Each subject received 4 weeks of the active and placebo treatments separated by a 2-week washout period. The University of Washington Medical Center in Seattle Wash, the Neurology Center of Fairfax in Fairfax, Va, and the headquarters of the Multiple Sclerosis Association of America in Cherry Hill, NJ. 117 patients with clinically definite MS. Daily exposure to a small, portable pulsing electromagnetic field generator. The MS Quality of Life Inventory (MSQLI) was used to assess changes in fatigue, bladder control, spasticity, and a quality of life composite. Paired t-tests were used to assess treatment differences in the 117 subjects (81% of the initial sample) who completed both treatment sessions. Improvements in fatigue and overall quality of life were significantly greater on the active device. There were no treatment effects for bladder control and a disability composite, and mixed results for spasticity. Evidence from this randomized, double-bind, placebo controlled trial is consistent with results from smaller studies suggesting that exposure to pulsing, weak electromagnetic fields can alleviate symptoms of MS. The clinical effects were small, however, and need to be replicated. Additional research is also needed to examine the possibility that ambulatory patients and patients taking interferons for their MS may be most responsive to this kind of treatment.

[Effectiveness of aquatic biodance on sleep quality, anxiety and other symptoms in patients with fibromyalgia].

PubMed

López-Rodríguez, María Mar; Fernández-Martínez, Manuel; Matarán-Peñarrocha, Guillermo A; Rodríguez-Ferrer, María Encarnación; Granados Gámez, Genoveva; Aguilar Ferrándiz, Encarnación

2013-12-07

To analyze the effects of an aquatic biodance based therapy on sleep quality, anxiety, depression, pain and quality of life in fibromyalgia patients. Randomized controlled trial with 2 groups. Fifty-nine patients were assigned to 2 groups: experimental group (aquatic biodance) and control group (stretching). The outcome measures were quality of sleep (Pittsburgh questionnaire), anxiety (State Anxiety Inventory), depression (Center for Epidemiologic Studies Depression Scale), pain (visual analogue scale, pressure algometry and McGill) and quality of life (Fibromyalgia Impact Questionnaire) before and after a 12-week therapy. After treatment, we observed significant differences in the experimental group (P<.05) on sleep quality (49.7%), anxiety (14.1%), impact of fibromyalgia (18.3%), pain (27.9%), McGill (23.7%) and tender points (34.4%). Aquatic biodance contributed to improvements in sleep quality, anxiety, pain and other fibromyalgia symptoms. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Is it safe? Talking to teens with HIV/AIDS about death and dying: a 3-month evaluation of Family Centered Advance Care (FACE) planning – anxiety, depression, quality of life

PubMed Central

Lyon, Maureen E; Garvie, Patricia A; Briggs, Linda; He, Jianping; Malow, Robert; D’Angelo, Lawrence J; McCarter, Robert

2010-01-01

Purpose To determine the safety of engaging HIV-positive (HIV+) adolescents in a Family Centered Advance Care (FACE) planning intervention. Patients and methods We conducted a 2-armed, randomized controlled clinical trial in 2 hospital-based outpatient clinics from 2006–2008 with HIV+ adolescents and their surrogates (n = 76). Three 60–90 minutes sessions were conducted weekly. FACE intervention groups received: Lyon FCACP Survey©, the Respecting Choices® interview, and completion of The Five Wishes©. The Healthy Living Control (HLC) received: Developmental History, Healthy Tips, Future Planning (vocational, school or vocational rehabilitation). Three-month post-intervention outcomes were: completion of advance directive (Five Wishes©); psychological adjustment (Beck Depression, Anxiety Inventories); quality of life (PedsQL™); and HIV symptoms (General Health Self-Assessment). Results Adolescents had a mean age, 16 years; 40% male; 92% African-American; 68% with perinatally acquired HIV, 29% had AIDS diagnosis. FACE participants completed advance directives more than controls, using time matched comparison (P < 0.001). Neither anxiety, nor depression, increased at clinically or statistically significant levels post-intervention. FACE adolescents maintained quality of life. FACE families perceived their adolescents as worsening in their school (P = 0.018) and emotional (P = 0.029) quality of life at 3 months, compared with controls. Conclusions Participating in advance care planning did not unduly distress HIV+ adolescents. PMID:22096382

KSC Center Director Bridges accepts an ISO 9001 certificate from DNV

NASA Technical Reports Server (NTRS)

1998-01-01

Center Director Roy Bridges displays the ISO 9001 certificate he was awarded by Det Norske Veritas (DNV), Inc., an international ISO certification organization, at a ceremony at KSC. Dalton Lyon of DNV made the presentation, which included a 2000th ISO Certificate Plaque. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already world-class team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification.

Manufacturing Aids

NASA Astrophysics Data System (ADS)

1983-01-01

Contractor's work for Lewis Research Center on "thermal barrier" coatings designed to improve aircraft engine efficiency resulted in two related but separate spinoffs. The Materials and Manufacturing Technology Center of TRW, Inc. invented a robotic system for applying the coating, and in the course of that research found it necessary to develop a new, extremely accurate type of optical gage that offers multiple improvements in controlling the quality of certain manufactured parts.

Primary care quality: community health center and health maintenance organization.

PubMed

Shi, Leiyu; Starfield, Barbara; Xu, Jiahong; Politzer, Robert; Regan, Jerrilyn

2003-08-01

This study compares the primary health care quality of community health centers (CHCs) and health maintenance organizations (HMOs) in South Carolina to elucidate the quality of CHC performance relative to mainstream settings such as the HMO. Mail surveys were used to obtain data from 350 randomly selected HMO users. Surveys with follow-up interviews were conducted to obtain data from 540 randomly selected CHC users. A validated adult primary care assessment tool was used in both surveys. Multivariate analyses were performed to assess the association of health care setting (HMO versus CHC) with primary care quality while controlling for sociodemographic and health care characteristics. After controlling for sociodemographic and health care use measures, CHC patients demonstrated higher scores in several primary care domains (ongoing care, coordination of service, comprehensiveness, and community orientation) as well as total primary care performance. Users of CHC are more likely than HMO users to rate their primary health care provider as good, except in the area of ease of first contact. The positive rating of the CHC is particularly impressive after taking into account that many CHC users have characteristics associated with poorer ratings of care.

A User-Centered Educational Modeling Language Improving the Controllability of Learning Design Quality

ERIC Educational Resources Information Center

Zendi, Asma; Bouhadada, Tahar; Bousbia, Nabila

2016-01-01

Semiformal EMLs are developed to facilitate the adoption of educational modeling languages (EMLs) and to address practitioners' learning design concerns, such as reusability and readability. In this article, SDLD (Structure Dialogue Learning Design) is presented, which is a semiformal EML that aims to improve controllability of learning design…

FAmily CEntered (FACE) advance care planning: Study design and methods for a patient-centered communication and decision-making intervention for patients with HIV/AIDS and their surrogate decision-makers.

PubMed

Kimmel, Allison L; Wang, Jichuan; Scott, Rachel K; Briggs, Linda; Lyon, Maureen E

2015-07-01

Although the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become a chronic illness, disease-specific advance care planning has not yet been evaluated for the palliative care needs of adults with HIV/AIDS. This prospective, longitudinal, randomized, two-arm controlled clinical trial aims to test the efficacy of FAmily CEntered advance care planning among adults living with AIDS and/or HIV with co-morbidities on congruence in treatment preferences, healthcare utilization, and quality of life. The FAmily CEntered intervention arm is two face-to-face sessions with a trained, certified facilitator: Session 1) Disease-Specific Advance Care Planning Respecting Choices Interview; Session 2) Completion of advance directive. The Healthy Living Control arm is: Session 1) Developmental/Relationship History; Session 2) Nutrition. Follow-up data will be collected at 3, 6, 12, and 18 months post-intervention. A total of 288 patient/surrogate dyads will be enrolled from five hospital-based, out-patient clinics in Washington, District of Columbia. Participants will be HIV positive and ≥ 21 years of age; surrogates will be ≥ 18 years of age. Exclusion criteria are homicidality, suicidality, psychosis, and impaired cognitive functioning. We hypothesize that this intervention will enhance patient-centered communication with a surrogate decision-maker about end of life treatment preferences over time, enhance patient quality of life and decrease health care utilization. We further hypothesize that this intervention will decrease health disparities for Blacks in completion of advance directives. If proposed aims are achieved, the benefits of palliative care, particularly increased treatment preferences about end-of-life care and enhanced quality of life, will be extended to people living with AIDS. Copyright © 2015 Elsevier Inc. All rights reserved.

Neuropsychologic assessment of a population-based sample of Gulf War veterans.

PubMed

Wallin, Mitchell T; Wilken, Jeffrey; Alfaro, Mercedes H; Rogers, Catherine; Mahan, Clare; Chapman, Julie C; Fratto, Timothy; Sullivan, Cynthia; Kang, Han; Kane, Robert

2009-09-01

The objective of this project was to compare neuropsychologic performance and quality of life in a population-based sample of deployed Gulf War (GW) veterans with and without multisymptom complaints. The study participants were obtained from the 30,000 member population-based National Health Survey of GW-era veterans conducted in 1995. Cases (N=25) were deployed to the year 1990 and 1991 GW and met Center for Disease Control and Prevention criteria for multisymptom GW illness (GWI). Controls (N=16) were deployed to the 1990 and 1991 GW but did not meet Center for Disease Control and Prevention criteria for GWI. There were no significant differences in composite scores on the traditional and computerized neuropsychologic battery (automated neuropsychologic assessment metrics) between GW cases and controls using bivariate techniques. Multiple linear regression analyses controlling for demographic and clinical variables revealed composite automated neuropsychologic assessment metrics scores were associated with age (b=-7.8; P=0.084), and education (b=22.9; P=0.0012), but not GW case or control status (b=-63.9; P=0.22). Compared with controls, GW cases had significantly more impairment on the Personality Assessment Inventory and the short form-36. Compared with GW controls, GW cases meeting criteria for GWI had preserved cognition function but had significant psychiatric symptoms and lower quality of life.

Clinical process analysis and activity-based costing at a heart center.

PubMed

Ridderstolpe, Lisa; Johansson, Andreas; Skau, Tommy; Rutberg, Hans; Ahlfeldt, Hans

2002-08-01

Cost studies, productivity, efficiency, and quality of care measures, the links between resources and patient outcomes, are fundamental issues for hospital management today. This paper describes the implementation of a model for process analysis and activity-based costing (ABC)/management at a Heart Center in Sweden as a tool for administrative cost information, strategic decision-making, quality improvement, and cost reduction. A commercial software package (QPR) containing two interrelated parts, "ProcessGuide and CostControl," was used. All processes at the Heart Center were mapped and graphically outlined. Processes and activities such as health care procedures, research, and education were identified together with their causal relationship to costs and products/services. The construction of the ABC model in CostControl was time-consuming. However, after the ABC/management system was created, it opened the way for new possibilities including process and activity analysis, simulation, and price calculations. Cost analysis showed large variations in the cost obtained for individual patients undergoing coronary artery bypass grafting (CABG) surgery. We conclude that a process-based costing system is applicable and has the potential to be useful in hospital management.

Clinical quality is independently associated with favorable bond ratings.

PubMed

Haydar, Ziad; Nicewander, David; Convery, Paul; Black, Michael; Ballard, David

2010-01-01

The relation between clinical quality and bond rating for nonprofit hospitals has been proposed but never fully studied. We analyzed the relation between bond rating, clinical quality measures (The Joint Commission/Centers for Medicare and Medicaid Services [CMS] core measures), and balance sheet and income statement financial measures of 236 hospitals across the United States that are rated by Moody's Investors Service and that reported clinical quality measures to CMS during the study period. We found a statistically significant relation between higher quality measures and more favorable bond ratings. This association remained significant after controlling for traditional financial parameters.

Analysis of Gap in Service Quality in Drug Addiction Treatment Centers of Kerman, Iran, Using SERVQUAL Model.

PubMed

Naqavi, Mohammad Reza; Refaiee, Raheleh; Baneshi, Mohammad Reza; Nakhaee, Nouzar

2014-01-01

Treatment of drug addicts is one of the main strategies of drug control in Iran. Client satisfaction strongly influences the success of any treatment program. This study aimed to explore the difference between customer expectations and perceptions in drug addiction treatment centers of Kerman, Iran, using SERVQUAL model. Using a cross-sectional design 260 clients referring to drug addiction treatment centers of Kerman, were enrolled in 2012. From among 84 clinics, 20 centers were selected randomly. Based on the number of clients registered in each center, a random sample proportional to the size was selected and 290 subjects were invited for interviews. A well validated 22-item questionnaire, which measured the 5 dimensions of service quality (reliability, assurance, tangibility, empathy, and responsiveness), was completed by participants. Each item measured 2 aspects of service quality; expectations and perceptions. Mean ± SD (Standard deviation) age of the subjects was 37.7 ± 9.4. Most of them were male (87.7%). Less than half of them had an educational level lower than diploma. The total score of clients` expectations was higher than their perceptions (P < 0.001). Considering the 5 dimensions of the SERVQUAL model, only 1 dimension (i.e., assurance) showed no difference between perceptions and expectations of the participants (P = 0.134). There was a gap between the clients' expectations and what they actually perceived in the clinics. Thus, more attention should be devoted to the clients' views regarding service quality in addiction treatment clinics.

Music therapy in Huntington's disease: a protocol for a multi-center randomized controlled trial.

PubMed

van Bruggen-Rufi, Monique; Vink, Annemieke; Achterberg, Wilco; Roos, Raymund

2016-07-26

Huntington's disease is a progressive, neurodegenerative disease with autosomal dominant inheritance, characterized by motor disturbances, cognitive decline and behavioral and psychological symptoms. Since there is no cure, all treatment is aimed at improving quality of life. Music therapy is a non-pharmacological intervention, aiming to improve the quality of life, but its use and efficacy in patients with Huntington's disease has hardly been studied. In this article, a protocol is described to study the effects of music therapy in comparison with a control intervention to improve quality of life through stimulating expressive and communicative skills. By targeting these skills we assume that the social-cognitive functioning will improve, leading to a reduction in behavioral problems, resulting in an overall improvement of the quality of life in patients with Huntington's disease. The study is designed as a multi-center single-blind randomised controlled intervention trial. Sixty patients will be randomised using centre-stratified block-permuted randomisation. Patients will be recruited from four long-term care facilities specialized in Huntington's disease-care in The Netherlands. The outcome measure to assess changes in expressive and communication skills is the Behaviour Observation Scale Huntington and changes in behavior will be assessed by the Problem Behaviour Assesment-short version and by the BOSH. Measurements take place at baseline, then 8, 16 (end of intervention) and 12 weeks after the last intervention (follow-up). This randomized controlled study will provide greater insight into the effectiveness of music therapy on activities of daily living, social-cognitive functioning and behavior problems by improving expressive and communication skills, thus leading to a better quality of life for patients with Huntington's disease. Netherlands Trial Register: NTR4904 , registration date Nov. 15, 2014.

The NCC project: A quality management perspective

NASA Technical Reports Server (NTRS)

Lee, Raymond H.

1993-01-01

The Network Control Center (NCC) Project introduced the concept of total quality management (TQM) in mid-1990. The CSC project team established a program which focused on continuous process improvement in software development methodology and consistent deliveries of high quality software products for the NCC. The vision of the TQM program was to produce error free software. Specific goals were established to allow continuing assessment of the progress toward meeting the overall quality objectives. The total quality environment, now a part of the NCC Project culture, has become the foundation for continuous process improvement and has resulted in the consistent delivery of quality software products over the last three years.

Intelligent Control Approaches for Aircraft Applications

NASA Technical Reports Server (NTRS)

Gundy-Burlet, Karen; KrishnaKumar, K.; Soloway, Don; Kaneshige, John; Clancy, Daniel (Technical Monitor)

2001-01-01

This paper presents an overview of various intelligent control technologies currently being developed and studied under the Intelligent Flight Control (IFC) program at the NASA Ames Research Center. The main objective of the intelligent flight control program is to develop the next generation of flight controllers for the purpose of automatically compensating for a broad spectrum of damaged or malfunctioning aircraft components and to reduce control law development cost and time. The approaches being examined include: (a) direct adaptive dynamic inverse controller and (b) an adaptive critic-based dynamic inverse controller. These approaches can utilize, but do not require, fault detection and isolation information. Piloted simulation studies are performed to examine if the intelligent flight control techniques adequately: 1) Match flying qualities of modern fly-by-wire flight controllers under nominal conditions; 2) Improve performance under failure conditions when sufficient control authority is available; and 3) Achieve consistent handling qualities across the flight envelope and for different aircraft configurations. Results obtained so far demonstrate the potential for improving handling qualities and significantly increasing survivability rates under various simulated failure conditions.

KSC Center Director Bridges addresses the audience at an ISO 9001 certification ceremony

NASA Technical Reports Server (NTRS)

1998-01-01

Center Director Roy Bridges speaks to KSC employees at the ISO certification ceremony held at the Training Auditorium. Bridges was presented an ISO 9001 certificate and plaque awarded to KSC by Det Norske Veritas (DNV), Inc., an international ISO certification organization. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already world- class team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification. Next to Bridges is Heidi Hollingsworth, with the Center for Independent Living, who uses American Sign Language for any hearing-impaired employees in the audience.

Health care reform at trauma centers--mortality, complications, and length of stay.

PubMed

Shafi, Shahid; Barnes, Sunni; Nicewander, David; Ballard, David; Nathens, Avery B; Ingraham, Angela M; Hemmila, Mark; Goble, Sandra; Neal, Melanie; Pasquale, Michael; Fildes, John J; Gentilello, Larry M

2010-12-01

The Trauma Quality Improvement Program has demonstrated existence of significant variations in risk-adjusted mortality across trauma centers. However, it is unknown whether centers with lower mortality rates also have reduced length of stay (LOS), with associated cost savings. We hypothesized that LOS is not primarily determined by unmodifiable factors, such as age and injury severity, but is primarily dependent on the development of potentially preventable complications. The National Trauma Data Bank (2002-2006) was used to include patients (older than 16 years) with at least one severe injury (Abbreviated Injury Scale score ≥ 3) from Level I and II trauma centers (217,610 patients, 151 centers). A previously validated risk-adjustment algorithm was used to calculate observed-to-expected mortality ratios for each center. Poisson regression was used to determine the relationship between LOS, observed-to-expected mortality ratios, and complications while controlling for confounding factors, such as age, gender, mechanism, insurance status, comorbidities, and injuries and their severity. Large variations in LOS (median, 4-8 days) were observed across trauma centers. There was no relationship between mortality and LOS. The most important predictor of LOS was complications, which were associated with a 62% increase. Injury severity score, shock, gunshot wounds, brain injuries, intensive care unit admission, and comorbidities were less important predictors of LOS. Quality improvement programs focusing on mortality alone may not be associated with reduced LOS. Hence, the Trauma Quality Improvement Program should also focus on processes of care that reduce complications, thereby shortening LOS, which may lead to significant cost savings at trauma centers.

Initial Flight Test of the Production Support Flight Control Computers at NASA Dryden Flight Research Center

NASA Technical Reports Server (NTRS)

Carter, John; Stephenson, Mark

1999-01-01

The NASA Dryden Flight Research Center has completed the initial flight test of a modified set of F/A-18 flight control computers that gives the aircraft a research control law capability. The production support flight control computers (PSFCC) provide an increased capability for flight research in the control law, handling qualities, and flight systems areas. The PSFCC feature a research flight control processor that is "piggybacked" onto the baseline F/A-18 flight control system. This research processor allows for pilot selection of research control law operation in flight. To validate flight operation, a replication of a standard F/A-18 control law was programmed into the research processor and flight-tested over a limited envelope. This paper provides a brief description of the system, summarizes the initial flight test of the PSFCC, and describes future experiments for the PSFCC.

Quality control and improvement of cancer care: what is needed? 4th European Roundtable Meeting (ERTM) May 5th, 2017, Berlin, Germany.

PubMed

Ortmann, Olaf; Helbig, Ulrike; Torode, Julie; Schreck, Stefan; Karjalainen, Sakari; Bettio, Manola; Ringborg, Ulrik; Klinkhammer-Schalke, Monika; Bray, Freddy

2018-06-01

National Cancer Control Plans (NCCPs) often describe structural requirements for high quality cancer care. During the fourth European Roundtable Meeting (ERTM) participants shared learnings from their own national setting to formulate best practice in optimizing communication strategies between parties involved in clinical cancer registries, cancer centers and guideline groups. A decentralized model of data collection close to the patient and caregiver enhances timely completion and the quality of the data captured. Nevertheless, central coordination is necessary to define datasets, indicators, standard settings, education, training and quality control to maintain standards across the network. In particular, interaction of parties in cancer care network has to be established and maintained on a regular basis. After establishing the structural requirements of cancer care networks, communication between the different components and parties is required to analyze outcome data, provide regular reporting to all and develop strategies for continuous improvement of quality across the network.

Remote-area health care delivery through space technology - STARPAHC

NASA Technical Reports Server (NTRS)

Belasco, N.; Johnston, R. S.; Stonesifer, J. C.; Pool, S. L.

1977-01-01

A joint NASA/HEW project called Space Technology Applied to Rural Papage Advanced Health Care (STARPAHC) has been developed to deliver quality health care to inhabitants of remote geographical areas. The system consists of a hospital-based support control center, a fixed clinic, a mobile clinic, and a referral center with access to specialists via television links to the control center. A strategically located relay station routes television, voice, and data transmissions between system elements. A model system has been installed on the Papage Indian Reservation in Arizona, and is undergoing a 2-year evaluation. The system has been shown to be both effective and cost-efficient, and applications of the concept are planned for future manned spacecraft flights.

External quality assurance of malaria nucleic acid testing for clinical trials and eradication surveillance.

PubMed

Murphy, Sean C; Hermsen, Cornelus C; Douglas, Alexander D; Edwards, Nick J; Petersen, Ines; Fahle, Gary A; Adams, Matthew; Berry, Andrea A; Billman, Zachary P; Gilbert, Sarah C; Laurens, Matthew B; Leroy, Odile; Lyke, Kristen E; Plowe, Christopher V; Seilie, Annette M; Strauss, Kathleen A; Teelen, Karina; Hill, Adrian V S; Sauerwein, Robert W

2014-01-01

Nucleic acid testing (NAT) for malaria parasites is an increasingly recommended diagnostic endpoint in clinical trials of vaccine and drug candidates and is also important in surveillance of malaria control and elimination efforts. A variety of reported NAT assays have been described, yet no formal external quality assurance (EQA) program provides validation for the assays in use. Here, we report results of an EQA exercise for malaria NAT assays. Among five centers conducting controlled human malaria infection trials, all centers achieved 100% specificity and demonstrated limits of detection consistent with each laboratory's pre-stated expectations. Quantitative bias of reported results compared to expected results was generally <0.5 log10 parasites/mL except for one laboratory where the EQA effort identified likely reasons for a general quantitative shift. The within-laboratory variation for all assays was low at <10% coefficient of variation across a range of parasite densities. Based on this study, we propose to create a Molecular Malaria Quality Assessment program that fulfills the need for EQA of malaria NAT assays worldwide.

Comparison of CDE data in phacoemulsification between an open hospital-based ambulatory surgical center and a free-standing ambulatory surgical center

PubMed Central

Chen, Ming; Chen, Mindy

2010-01-01

Mean CDE (cumulative dissipated energy) values were compared for an open hospital- based surgical center and a free-standing surgical center. The same model of phacoemulsifier (Alcon Infiniti Ozil) was used. Mean CDE values showed that surgeons (individual private practice) at the free-standing surgical center were more efficient than surgeons (individual private practice) at the open hospital-based surgical center (mean CDE at the hospital-based surgical center 18.96 seconds [SD = 12.51]; mean CDE at the free-standing surgical center 13.2 seconds [SD = 9.5]). CDE can be used to monitor the efficiency of a cataract surgeon and surgical center in phacoemulsification. The CDE value may be used by institutions as one of the indicators for quality control and audit in phacoemulsification. PMID:21151334

Comparison of CDE data in phacoemulsification between an open hospital-based ambulatory surgical center and a free-standing ambulatory surgical center.

PubMed

Chen, Ming; Chen, Mindy

2010-11-12

Mean CDE (cumulative dissipated energy) values were compared for an open hospital- based surgical center and a free-standing surgical center. The same model of phacoemulsifier (Alcon Infiniti Ozil) was used. Mean CDE values showed that surgeons (individual private practice) at the free-standing surgical center were more efficient than surgeons (individual private practice) at the open hospital-based surgical center (mean CDE at the hospital-based surgical center 18.96 seconds [SD = 12.51]; mean CDE at the free-standing surgical center 13.2 seconds [SD = 9.5]). CDE can be used to monitor the efficiency of a cataract surgeon and surgical center in phacoemulsification. The CDE value may be used by institutions as one of the indicators for quality control and audit in phacoemulsification.

Economies of Scale: 9-1-1 Center Consolidation as a Means to Strengthen the Homeland Security Enterprise

DTIC Science & Technology

2014-03-01

searching existing data sources, gathering and maintaining the data needed , and completing and reviewing the collection of information. Send...facility, personnel, and technology needs exist.  Consolidation leads to more focused, institutionalized quality control and service improvement...and the numerous variables that exist between 9-1-1 center budgets. Further research is needed to accurately quantify these pre- and post

Cost-effectiveness analysis of a patient-centered care model for management of psoriasis.

PubMed

Parsi, Kory; Chambers, Cindy J; Armstrong, April W

2012-04-01

Cost-effectiveness analyses help policymakers make informed decisions regarding funding allocation of health care resources. Cost-effectiveness analysis of technology-enabled models of health care delivery is necessary to assess sustainability of novel online, patient-centered health care models. We sought to compare cost-effectiveness of conventional in-office care with a patient-centered, online model for follow-up treatment of patients with psoriasis. Cost-effectiveness analysis was performed from a societal perspective on a randomized controlled trial comparing a patient-centered online model with in-office visits for treatment of patients with psoriasis during a 24-week period. Quality-adjusted life expectancy was calculated using the life table method. Costs were generated from the original study parameters and national averages for salaries and services. No significant difference existed in the mean change in Dermatology Life Quality Index scores between the two groups (online: 3.51 ± 4.48 and in-office: 3.88 ± 6.65, P value = .79). Mean improvement in quality-adjusted life expectancy was not significantly different between the groups (P value = .93), with a gain of 0.447 ± 0.48 quality-adjusted life years for the online group and a gain of 0.463 ± 0.815 quality-adjusted life years for the in-office group. The cost of follow-up psoriasis care with online visits was 1.7 times less than the cost of in-person visits ($315 vs $576). Variations in travel time existed among patients depending on their distance from the dermatologist's office. From a societal perspective, the patient-centered online care model appears to be cost saving, while maintaining similar effectiveness to standard in-office care. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

The whole earth telescope - A new astronomical instrument

NASA Technical Reports Server (NTRS)

Nather, R. E.; Winget, D. E.; Clemens, J. C.; Hansen, C. J.; Hine, B. P.

1990-01-01

A new multimirror ground-based telescope for time-series photometry of rapid variable stars, designed to minimize or eliminate gaps in the brightness record caused by the rotation of the earth, is described. A sequence of existing telescopes distributed in longitude, coordinated from a single control center, is used to measure designated target stars so long as they are in darkness. Data are returned by electronic mail to the control center, where they are analyzed in real time. This instrument is the first to provide data of continuity and quality that permit true high-resolution power spectroscopy of pulsating white dwarf stars.

Chronic exposure to emissions from photocopiers in copy shops causes oxidative stress and systematic inflammation among photocopier operators in India.

PubMed

Elango, Nithya; Kasi, Vallikkannu; Vembhu, Bhuvaneswari; Poornima, Jeyanthi Govindasamy

2013-09-11

We assessed indoor air quality in photocopier centers and investigated whether occupational exposure to emissions from photocopiers is associated with decline in lung function or changes in haematological parameters, oxidative stress and inflammatory status. Indoor air quality was monitored in five photocopier centers. Pulmonary function was assessed by spirometry in 81 photocopier operators (64 male and 17 female) and 43 healthy control (31 male and 12 female) subjects. Hematological status, serum thio-barbituric acid reactive substances (TBARS), total ferric reducing antioxidant capacity (FRAC), leukotriene B4 (LTB4), 8-isoprostane, C reactive protein (CRP), interleukin 8 (IL-8), clara cell protein (CC-16), intercellular adhesion molecule 1 (ICAM-1) and eosinophilic cationic protein (ECP) were analyzed. Relationships between cumulative exposure, lung function and inflammatory markers were assessed. PM10 and PM2.5 were above the permissible levels in all the photocopier centers, whereas the levels of carbon monoxide, nitrogen oxides, ozone, sulphur dioxide, lead, arsenic, nickel, ammonia, benzene and benzo(a)pyrene were within Indian ambient air quality standards. Lung function was similar in the photocopier operators and control subjects. Serum TBARS was significantly higher and FRAC was lower among photocopier operators when compared to healthy controls. Plasma IL-8, LTB4, ICAM-1 and ECP were significantly higher in the photocopier exposed group. Photocopiers emit high levels of particulate matter. Long term exposure to emissions from photocopiers was not associated with decreased lung function, but resulted in high oxidative stress and systemic inflammation leading to high risk of cardiovascular diseases.

Chronic exposure to emissions from photocopiers in copy shops causes oxidative stress and systematic inflammation among photocopier operators in India

PubMed Central

2013-01-01

Background We assessed indoor air quality in photocopier centers and investigated whether occupational exposure to emissions from photocopiers is associated with decline in lung function or changes in haematological parameters, oxidative stress and inflammatory status. Methods Indoor air quality was monitored in five photocopier centers. Pulmonary function was assessed by spirometry in 81 photocopier operators (64 male and 17 female) and 43 healthy control (31 male and 12 female) subjects. Hematological status, serum thio-barbituric acid reactive substances (TBARS), total ferric reducing antioxidant capacity (FRAC), leukotriene B4 (LTB4), 8-isoprostane, C reactive protein (CRP), interleukin 8 (IL-8), clara cell protein (CC-16), intercellular adhesion molecule 1 (ICAM-1) and eosinophilic cationic protein (ECP) were analyzed. Relationships between cumulative exposure, lung function and inflammatory markers were assessed. Results PM10 and PM2.5 were above the permissible levels in all the photocopier centers, whereas the levels of carbon monoxide, nitrogen oxides, ozone, sulphur dioxide, lead, arsenic, nickel, ammonia, benzene and benzo(a)pyrene were within Indian ambient air quality standards. Lung function was similar in the photocopier operators and control subjects. Serum TBARS was significantly higher and FRAC was lower among photocopier operators when compared to healthy controls. Plasma IL-8, LTB4, ICAM-1 and ECP were significantly higher in the photocopier exposed group. Conclusions Photocopiers emit high levels of particulate matter. Long term exposure to emissions from photocopiers was not associated with decreased lung function, but resulted in high oxidative stress and systemic inflammation leading to high risk of cardiovascular diseases. PMID:24025094

Effects of Patient-Centered Medical Home Attributes on Patients’ Perceptions of Quality in Federally Supported Health Centers

PubMed Central

Lebrun-Harris, Lydie A.; Shi, Leiyu; Zhu, Jinsheng; Burke, Matthew T.; Sripipatana, Alek; Ngo-Metzger, Quyen

2013-01-01

PURPOSE We sought to assess patients’ ratings of patient-centered medical home (PCMH) attributes and overall quality of care within federally supported health centers. METHODS Data were collected through the 2009 Health Center Patient Survey (n = 4,562), which consisted of in-person interviews and included a nationally representative sample of patients seen in health centers. Quality measures included patients’ perceptions of overall quality of services, perceptions of quality of clinician advice/treatment, and likelihood of referring friends and relatives to the health center. PCMH attributes included (1) access to care getting to health center, (2) access to care during visit, (3) patient-centered communication with health care clinicians, (4) patient-centered communication with support staff, (5) self-management support for chronic conditions, (6) self-management support for behavioral risks, and (7) comprehensive preventive care. Bivariate analysis and logistic regressions were used to examine associations between patients’ perceptions of PCMH attributes and patient-reported quality of care. RESULTS Eighty-four percent of patients reported excellent/very good overall quality of services, 81% reported excellent/very good quality of clinician care, and 84% were very likely to refer friends and relatives. Higher patient ratings on the access to care and patient-centered communication attributes were associated with higher odds of patient-reported high quality of care on the 3 outcome measures. CONCLUSIONS More than 80% of patients perceived high quality of care in health centers. PCMH attributes related to access to care and communication were associated with greater likelihood of patients reporting high-quality care. PMID:24218374

Effectiveness of Life Review Therapy on Quality of Life in the Late Life at Day Care Centers of Shiraz, Iran: A Randomized Controlled Trial.

PubMed

Sharif, Farkhondeh; Jahanbin, Iran; Amirsadat, Afsar; Hosseini Moghadam, Mahboobeh

2018-04-01

Life review therapy, used as part of a comprehensive therapy plan for increasing the quality of life of the elderly, helps them to resolve their past conflicts, reconstruct their life stories, and accept their present conditions. The present study aimed to explore the effectiveness of life review therapy on the quality of life of the elderly. The present study was a randomized controlled trial with a pre-posttest design during April to Aug 2014. The study was conducted on 35 members of the elderly day care centers in Shiraz, Iran, that were randomly assigned to two groups (experimental and control). The subjects in the experimental group attended 8 two-hour sessions of life review therapy. The quality of life of the elderly participants was evaluated before, immediately, one month, and three months after the intervention using the quality of life questionnaire (WHOQOL_BREF). Data analysis was conducted through SPSS version 22, using statistical tests including Chi-square, repeated measures test and T-test, with the significance level of 0.05. The results of the study showed that life review therapy interventions significantly improved the quality of life of the elderly (P<0.05). Moreover, group interaction with passage of time was also significant, which indicates that the pattern of changes has been different between the two groups. The findings of the study confirm the research hypotheses, showing that the application of life review is effective and viable. It is recommended that all nursing homes and even the families of the elderly should employ this convenient, inexpensive, quick, and practical method. Trial Registration Number: IRCT2015021621106N1.

Impact of yoga on blood pressure and quality of life in patients with hypertension – a controlled trial in primary care, matched for systolic blood pressure

PubMed Central

2013-01-01

Background Medical treatment of hypertension is not always sufficient to achieve blood pressure control. Despite this, previous studies on supplementary therapies, such as yoga, are relatively few. We investigated the effects of two yoga interventions on blood pressure and quality of life in patients in primary health care diagnosed with hypertension. Methods Adult patients (age 20–80 years) with diagnosed hypertension were identified by an electronic chart search at a primary health care center in southern Sweden. In total, 83 subjects with blood pressure values of 120–179/≤109 mmHg at baseline were enrolled. At baseline, the patients underwent standardized blood pressure measurement at the health care center and they completed a questionnaire on self-rated quality of life (WHOQOL-BREF). There were three groups: 1) yoga class with yoga instructor (n = 28); 2) yoga at home (n = 28); and 3) a control group (n = 27). The participants were matched at the group level for systolic blood pressure. After 12 weeks of intervention, the assessments were performed again. At baseline a majority of the patients (92%) were on antihypertensive medication, and the patients were requested not to change their medication during the study. Results The yoga class group showed no improvement in blood pressure or self-rated quality of life, while in the yoga at home group there was a decline in diastolic blood pressure of 4.4 mmHg (p < 0.05) compared to the control group. Moreover, the yoga at home group showed significant improvement in self-rated quality of life compared to the control group (p < 0.05). Conclusions A short yoga program for the patient to practice at home seems to have an antihypertensive effect, as well as a positive effect on self-rated quality of life compared to controls. This implies that simple yoga exercises may be useful as a supplementary blood pressure therapy in addition to medical treatment when prescribed by primary care physicians. Trial registration ClinicalTrials.gov (NCT01302535) PMID:24314119

Remote sensing applications program

NASA Technical Reports Server (NTRS)

1984-01-01

The activities of the Mississippi Remote Sensing Center are described in addition to technology transfer and information dissemination, remote sensing topics such as timber identification, water quality, flood prevention, land use, erosion control, animal habitats, and environmental impact studies are also discussed.

Development and status of data quality assurance program at NASA Langley research center: Toward national standards

NASA Technical Reports Server (NTRS)

Hemsch, Michael J.

1996-01-01

As part of a continuing effort to re-engineer the wind tunnel testing process, a comprehensive data quality assurance program is being established at NASA Langley Research Center (LaRC). The ultimate goal of the program is routing provision of tunnel-to-tunnel reproducibility with total uncertainty levels acceptable for test and evaluation of civilian transports. The operational elements for reaching such levels of reproducibility are: (1) statistical control, which provides long term measurement uncertainty predictability and a base for continuous improvement, (2) measurement uncertainty prediction, which provides test designs that can meet data quality expectations with the system's predictable variation, and (3) national standards, which provide a means for resolving tunnel-to-tunnel differences. The paper presents the LaRC design for the program and discusses the process of implementation.

Continuous on-line steam quality monitoring system of the Bacman Geothermal Production Field, Philippines

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

Solis, R.P.; Chavez, F.C.; Garcia, S.E.

1997-12-31

In any operating geothermal power plant, steam quality is one of the most important parameters being monitored. In the Bacon-Manito Geothermal Production Field (BGPF), an online steam quality monitoring system have been installed in two operating power plants which provides an accurate, efficient and continuous real-time data which is more responsive to the various requirements of the field operation. The system utilizes sodium as an indicator of steam purity. Sodium concentration is read by the flame photometer located at the interface after aspirating a sample of the condensed steam through a continuous condensate sampler. The condensate has been degassed throughmore » a condensate-NCG separator. The flame photometer analog signal is then converted by a voltage-to-current converter/transmitter and relayed to the processor which is located at the control center through electrical cable to give a digital sodium concentration read-out at the control panel. The system features a high and high-high sodium level alarm, a continuous strip-chart recorder and a central computer for data capture, retrieval, and processing for further interpretation. Safety devices, such as the flame-off indicator at the control center and the automatic fuel cut-off device along the fuel line, are incorporated in the system.« less

The Palliative Care in Heart Failure (PAL-HF) Trial: Rationale and Design

PubMed Central

Mentz, Robert J.; Tulsky, James A.; Granger, Bradi B.; Anstrom, Kevin J.; Adams, Patricia A.; Dodson, Gwen C.; Fiuzat, Mona; Johnson, Kimberly S.; Patel, Chetan B.; Steinhauser, Karen E.; Taylor, Donald H.; O’Connor, Christopher M.; Rogers, Joseph G.

2014-01-01

Background The progressive nature of heart failure (HF) coupled with high mortality and poor quality of life mandates greater attention to palliative care as a routine component of advanced HF management. Limited evidence exists from randomized, controlled trials supporting the use of interdisciplinary palliative care in HF. Methods The Palliative Care in Heart Failure trial (PAL-HF) is a prospective, controlled, unblinded, single-center study of an interdisciplinary palliative care intervention in 200 patients with advanced HF estimated to have a high likelihood of mortality or re-hospitalization in the ensuing 6 months. The 6-month PAL-HF intervention focuses on physical and psychosocial symptom relief, attention to spiritual concerns and advanced care planning. The primary endpoint is health-related quality of life measured by the Kansas City Cardiomyopathy Questionnaire and the Functional Assessment of Chronic Illness Therapy with Palliative Care Subscale score at 6 months. Secondary endpoints include changes in anxiety/depression, spiritual well-being, caregiver satisfaction, cost and resource utilization, and a composite of death, HF hospitalization and quality of life. Conclusions PAL-HF is a randomized, controlled clinical trial that will help evaluate the efficacy and cost-effectiveness of palliative care in advanced HF using a patient-centered outcome as well as clinical and economic endpoints. PMID:25440791

The palliative care in heart failure trial: rationale and design.

PubMed

Mentz, Robert J; Tulsky, James A; Granger, Bradi B; Anstrom, Kevin J; Adams, Patricia A; Dodson, Gwen C; Fiuzat, Mona; Johnson, Kimberly S; Patel, Chetan B; Steinhauser, Karen E; Taylor, Donald H; O'Connor, Christopher M; Rogers, Joseph G

2014-11-01

The progressive nature of heart failure (HF) coupled with high mortality and poor quality of life mandates greater attention to palliative care as a routine component of advanced HF management. Limited evidence exists from randomized, controlled trials supporting the use of interdisciplinary palliative care in HF. PAL-HF is a prospective, controlled, unblinded, single-center study of an interdisciplinary palliative care intervention in 200 patients with advanced HF estimated to have a high likelihood of mortality or rehospitalization in the ensuing 6 months. The 6-month PAL-HF intervention focuses on physical and psychosocial symptom relief, attention to spiritual concerns, and advanced care planning. The primary end point is health-related quality of life measured by the Kansas City Cardiomyopathy Questionnaire and the Functional Assessment of Chronic Illness Therapy with Palliative Care Subscale score at 6 months. Secondary end points include changes in anxiety/depression, spiritual well-being, caregiver satisfaction, cost and resource utilization, and a composite of death, HF hospitalization, and quality of life. PAL-HF is a randomized, controlled clinical trial that will help evaluate the efficacy and cost effectiveness of palliative care in advanced HF using a patient-centered outcome as well as clinical and economic end points. Copyright © 2014 Elsevier Inc. All rights reserved.

Evaluation of Bacteriological and Chemical Quality of Dialysis Water and Fluid in Isfahan, Central Iran

PubMed Central

SHAHRYARI, Ali; NIKAEEN, Mahnaz; HATAMZADEH, Maryam; VAHID DASTJERDI, Marzieh; HASSANZADEH, Akbar

2016-01-01

Background: Chemical and microbial quality of water used in hemodialysis play key roles in a number of dialysis-related complications. In order to avoid the complications and to guarantee safety and health of patients therefore, vigorous control of water quality is essential. The objective of present study was to investigate the chemical and bacteriological characteristics of water used in dialysis centers of five hospitals in Isfahan, central Iran. Methods: A total of 30 water samples from the input of dialysis purification system and dialysis water were analyzed for chemical parameters. Heterotrophic plate count and endotoxin concentration of drinking water, dialysis water and dialysis fluid of 40 machines were also monitored over a 5-month period in 2011–2012. Results: Concentration of the determined chemicals (copper, zinc, sulfate, fluoride, chloramines and free chlorine) did not exceed the recommended concentration by the Association for the Advancement of Medical Instrumentation (AAMI) exclude lead, nitrate, aluminum and calcium. Furthermore, the magnesium; cadmium and chromium concentration exceeded the maximum level in some centers. No contamination with heterotrophic bacteria was observed in all samples, while the AMMI standard for endotoxin level in dialysis fluid (<2 EU/ml) was achieved in 95% of samples. Conclusion: Dialysis water and fluid failed to meet the all chemical and bacteriological requirements for hemodialysis. To minimize the risk of contaminants for hemodialysis patients therefore, a water quality management program including monitoring, maintenance and development of water treatment system in hemodialysis centers is extremely important. In addition, an appropriate disinfection program is needed to guarantee better control of bacterial growth and biofilm formation. PMID:27398338

Insomnia Severity, Subjective Sleep Quality, and Risk for Obstructive Sleep Apnea in Veterans With Gulf War Illness.

PubMed

Chao, Linda L; Abadjian, Linda R; Esparza, Iva L; Reeb, Rosemary

2016-09-01

Despite the fact that sleep disturbances are common in veterans with Gulf War Illness (GWI), there has been a paucity of published sleep studies in this veteran population to date. Therefore, the present study examined subjective sleep quality (assessed with the Pittsburgh Sleep Quality Index), insomnia severity (assessed with the Insomnia Severity Index), and risk for obstructive sleep apnea (assessed with the STOP questionnaire) in 98 Gulf War veterans. Veterans with GWI, defined either by the Kansas or Centers for Disease Control and Prevention criteria, had greater risk for obstructive sleep apnea (i.e., higher STOP scores) than veterans without GWI. This difference persisted even after accounting for potentially confounding demographic (e.g., age, gender) and clinical variables. Veterans with GWI, defined by either the Kansas or Centers for Disease Control and Prevention criteria, also had significantly greater insomnia severity and poorer sleep quality than veterans without GWI (p < 0.05), even after accounting for potentially confounding variables. Furthermore, there were significant, positive correlations between insomnia severity, subjective sleep quality, and GWI symptom severity (p ≤ 0.01). In stepwise linear regression models, insomnia severity significantly predicted GWI status over and above demographic and clinical variables. Together these findings provide good rationale for treating sleep disturbances in the management of GWI. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

[Physical and technical quality assurance in German breast cancer screening: progress report of the Reference Center Muenster after three years].

PubMed

Sommer, A; Girnus, R; Wendt, B; Czwoydzinski, J; Wüstenbecker, C; Heindel, W; Lenzen, H

2009-05-01

German breast cancer screening is monitored by a large physical quality assurance program. This report refers to the first experiences of the Reference Center (RC) Muenster after three years of the technical quality control of digital and analog mammography units (MU). This paper also shows whether the presently used quality assurance (QA) method is able to ensure that the MUs in the screening program are functioning without any serious problems. RC Muenster supervises 95 units (May 2008). The daily, weekly and monthly quality assurance of these units is controlled by web-based QA software named "MammoConrol" and developed by RC Muenster. The annual QA for the units must be conducted in the form of an on-site inspection by medical physics experts of the RC and is scored by an objective ranking system. The results of these QA routines were evaluated and analyzed for this paper. During the period from 3/1/2006 to 5/31/2008, 8 % of the analog systems and 1 % of the digital systems exhibited problems in the daily QA. For 9 % of the analog MUs and 17 % of the digital MUs, failures appeared in the monthly QA. In the annual control, 86.7 % of the analog units exhibited slight problems and 13.3 % had serious problems. With respect to the digital units, 12 % were without any defects, 58 % had slight problems, 27 % had serious failures and 3 % had to be reported to the responsible authorities and were temporarily shut down. The special quality control requirements for German breast cancer screening, including annual on-site checks of the units, have shown in the last three years that QA with a high monitoring standard can be ensured for a large number of decentralized MUs. The currently used QA method sufficiently ensures that the screening program is technically safe. Further studies must show whether the density and focus of the QA measures must be reconfigured.

SPOT satellite family: Past, present, and future of the operations in the mission and control center

NASA Technical Reports Server (NTRS)

Philippe, Pacholczyk

1993-01-01

SPOT sun-synchronous remote sensing satellites are operated by CNES since February 1986. Today, the SPOT mission and control center (CCM) operates SPOT1, SPOT2, and is ready to operate SPOT3. During these seven years, the way to operate changed and the CCM, initially designed for the control of one satellite, has been modified and upgraded to support these new operating modes. All these events have shown the performances and the limits of the system. A new generation of satellite (SPOT4) will continue the remote sensing mission during the second half of the 90's. Its design takes into account the experience of the first generation and supports several improvements. A new generation of control center (CMP) has been developed and improves the efficiency, quality, and reliability of the operations. The CMP is designed for operating two satellites at the same time during launching, in-orbit testing, and operating phases. It supports several automatic procedures and improves data retrieval and reporting.

Quality assurance in nuclear medicine facilities; availability of final recommendations--FDA. Notice.

PubMed

1985-05-13

The Food and Drug Administration (FDA) is announcing the availability of final recommendations prepared by its Center for Devices and Radiological Health (CDRH) on quality assurance programs in nuclear medicine facilities. The final recommendations include the agency's rationale for the recommendations as well as references that can be used as well as references that can be used as guides in conducting quality control monitoring. These final recommendations are available as a technical report in CDRH's radiation recommendations series. They are intended to encourage and promote the development of voluntary quality assurance programs in nuclear medicine facilities.

Analysis of Gap in Service Quality in Drug Addiction Treatment Centers of Kerman, Iran, Using SERVQUAL Model

PubMed Central

Naqavi, Mohammad Reza; Refaiee, Raheleh; Baneshi, Mohammad Reza; Nakhaee, Nouzar

2014-01-01

Background Treatment of drug addicts is one of the main strategies of drug control in Iran. Client satisfaction strongly influences the success of any treatment program. This study aimed to explore the difference between customer expectations and perceptions in drug addiction treatment centers of Kerman, Iran, using SERVQUAL model. Methods Using a cross-sectional design 260 clients referring to drug addiction treatment centers of Kerman, were enrolled in 2012. From among 84 clinics, 20 centers were selected randomly. Based on the number of clients registered in each center, a random sample proportional to the size was selected and 290 subjects were invited for interviews. A well validated 22-item questionnaire, which measured the 5 dimensions of service quality (reliability, assurance, tangibility, empathy, and responsiveness), was completed by participants. Each item measured 2 aspects of service quality; expectations and perceptions. Findings Mean ± SD (Standard deviation) age of the subjects was 37.7 ± 9.4. Most of them were male (87.7%). Less than half of them had an educational level lower than diploma. The total score of clients` expectations was higher than their perceptions (P < 0.001). Considering the 5 dimensions of the SERVQUAL model, only 1 dimension (i.e., assurance) showed no difference between perceptions and expectations of the participants (P = 0.134). Conclusion There was a gap between the clients’ expectations and what they actually perceived in the clinics. Thus, more attention should be devoted to the clients’ views regarding service quality in addiction treatment clinics. PMID:25984274

Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis.

PubMed

Panitch, Hillel S; Thisted, Ronald A; Smith, Richard A; Wynn, Daniel R; Wymer, James P; Achiron, Anat; Vollmer, Timothy L; Mandler, Raul N; Dietrich, Dennis W; Fletcher, Malcolm; Pope, Laura E; Berg, James E; Miller, Ariel

2006-05-01

To evaluate the efficacy and safety of DM/Q (capsules containing dextromethorphan [DM] and quinidine [Q]) compared with placebo, taken twice daily, for the treatment of pseudobulbar affect over a 12-week period in multiple sclerosis patients. A total of 150 patients were randomized in a double-blind, placebo-controlled study to assess pseudobulbar affect with the validated Center for Neurologic Study-Lability Scale. Each patient also recorded the number of episodes experienced between visits, estimated quality of life and quality of relationships on visual analog scales, and completed a pain rating scale. Patients receiving DM/Q had greater reductions in Center for Neurologic Study-Lability Scale scores than those receiving placebo (p < 0.0001) at all clinic visits (days 15, 29, 57, and 85). All secondary end points also favored DM/Q, including the number of crying or laughing episodes (p

Changes in the quality of care during progress from stage 1 to stage 2 of Meaningful Use.

PubMed

Levine, David M; Healey, Michael J; Wright, Adam; Bates, David W; Linder, Jeffrey A; Samal, Lipika

2017-03-01

The Centers for Medicare and Medicaid Services (CMS) canceled Meaningful Use (MU), replacing it with Advancing Care Information, which preserves many MU elements. Therefore, transitioning from MU stage 1 to MU stage 2 has important implications for the new policy, yet the quality of care provided by physicians transitioning from MU1 to MU2 is unknown. Retrospective longitudinal evaluation of the quality of care delivered by outpatient physicians at an academic medical center in the transition between MU1 and MU2. Between MU1 and MU2, 4 measures improved: hypertension control (35% vs 40%), influenza immunization (63% vs 68%), tobacco use assessment/counseling (86% vs 96%), and diabetes control (93% vs 96%; P all <.01). One worsened: senior weight screening/follow-up (54% vs 49%; P  < .01). Two were unchanged: chlamydia screening and adult weight screening/follow-up. In this single-site study, when clinicians progressed from MU1 to MU2, 4 quality measures improved, 2 were unchanged, and 1 worsened. Analysis of national data should guide policy decisions about the content of MU's successor. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

KSC Center Director Bridges accepts an ISO 9001 certification plaque from DNV

NASA Technical Reports Server (NTRS)

1998-01-01

Center Director Roy Bridges (right) displays the 2000th ISO Certificate Plaque he was given by Dalton Lyon (left) of Det Norske Veritas (DNV), Inc., an international ISO certification organization, at a ceremony at KSC. The plaque is a representation of the ISO 9001 certification awarded to KSC by DNV. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already world- class team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification.

KSC-98pc909

NASA Image and Video Library

1998-08-11

Center Director Roy Bridges speaks to KSC employees at the ISO certification ceremony held at the Training Auditorium. Bridges was presented an ISO 9001 certificate and plaque awarded to KSC by Det Norske Veritas (DNV), Inc., an international ISO certification organization. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already worldclass team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification. Next to Bridges is Heidi Hollingsworth, with the Center for Independent Living, who uses American Sign Language for any hearing-impaired employees in the audience

Research References Related to Indoor Air Quality in Schools

EPA Pesticide Factsheets

A healthy school environment is one of the keys to keeping young minds and bodies strong. In fact, a healthy school environment is one of eight core components in the Centers for Disease Control and Prevention (CDC) model Healthy Youth!

42 CFR 423.150 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Scope. 423.150 Section 423.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements...

42 CFR 423.168 - Accreditation organizations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Accreditation organizations. 423.168 Section 423.168 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

RELATING AIR QUALITY AND ENVIRONMENTAL PUBLIC HEALTH TRACKING DATA

EPA Science Inventory

Initiated in February 2004, the Public Health Air Surveillance Evaluation (PHASE) Project is a multi-disciplinary collaboration between the Centers for Disease Control and Prevention (CDC), the U.S Environmental Protection Agency (EPA), and three Environmental Public Health Track...

Hot and Cold Therapy Eases Pain

NASA Technical Reports Server (NTRS)

2004-01-01

In the 1960s, NASA civil servant Tom Hughes worked for Marshall Space Flight Center s Quality Control Laboratory as a systems engineer. Reporting directly to Dr. Wernher von Braun, Marshall s first director, Hughes was assigned as a NASA representative for quality control at the Michoud Assembly Facility in New Orleans, Louisiana, to oversee the Saturn V rocket project. During this time, Hughes invented several technologies to improve the safety of the rocket, earning several commendations from von Braun. He also gained technical expertise in microwave technology, as NASA researched it to determine its relationship to radar.

Complete coherent control of silicon vacancies in diamond nanopillars containing single defect centers

DOE PAGES

Zhang, Jingyuan Linda; Lagoudakis, Konstantinos G.; Tzeng, Yan -Kai; ...

2017-10-23

Arrays of identical and individually addressable qubits lay the foundation for the creation of scalable quantum hardware such as quantum processors and repeaters. Silicon-vacancy (SiV) centers in diamond offer excellent physical properties such as low inhomogeneous broadening, fast photon emission, and a large Debye–Waller factor. The possibility for all-optical ultrafast manipulation and techniques to extend the spin coherence times makes them promising candidates for qubits. Here, we have developed arrays of nanopillars containing single (SiV) centers with high yield, and we demonstrate ultrafast all-optical complete coherent control of the excited state population of a single SiV center at the opticalmore » transition frequency. The high quality of the chemical vapor deposition (CVD) grown SiV centers provides excellent spectral stability, which allows us to coherently manipulate and quasi-resonantly read out the excited state population of individual SiV centers on picosecond timescales using ultrafast optical pulses. Furthermore, this work opens new opportunities to create a scalable on-chip diamond platform for quantum information processing and scalable nanophotonics applications.« less

Complete coherent control of silicon vacancies in diamond nanopillars containing single defect centers

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

Zhang, Jingyuan Linda; Lagoudakis, Konstantinos G.; Tzeng, Yan -Kai

Arrays of identical and individually addressable qubits lay the foundation for the creation of scalable quantum hardware such as quantum processors and repeaters. Silicon-vacancy (SiV) centers in diamond offer excellent physical properties such as low inhomogeneous broadening, fast photon emission, and a large Debye–Waller factor. The possibility for all-optical ultrafast manipulation and techniques to extend the spin coherence times makes them promising candidates for qubits. Here, we have developed arrays of nanopillars containing single (SiV) centers with high yield, and we demonstrate ultrafast all-optical complete coherent control of the excited state population of a single SiV center at the opticalmore » transition frequency. The high quality of the chemical vapor deposition (CVD) grown SiV centers provides excellent spectral stability, which allows us to coherently manipulate and quasi-resonantly read out the excited state population of individual SiV centers on picosecond timescales using ultrafast optical pulses. Furthermore, this work opens new opportunities to create a scalable on-chip diamond platform for quantum information processing and scalable nanophotonics applications.« less

Correlates of quality of life among individuals with epilepsy enrolled in self-management research: From the US Centers for Disease Control and Prevention Managing Epilepsy Well Network.

PubMed

Sajatovic, Martha; Tatsuoka, Curtis; Welter, Elisabeth; Friedman, Daniel; Spruill, Tanya M; Stoll, Shelley; Sahoo, Satya S; Bukach, Ashley; Bamps, Yvan A; Valdez, Joshua; Jobst, Barbara C

2017-04-01

Epilepsy is a chronic neurological condition that causes substantial burden on patients and families. Quality of life may be reduced due to the stress of coping with epilepsy. For nearly a decade, the Centers for Disease Control (CDC) Prevention Research Center's Managing Epilepsy Well (MEW) Network has been conducting research on epilepsy self-management to address research and practice gaps. Studies have been conducted by independent centers across the U.S. Recently, the MEW Network sites, collaboratively, began compiling an integrated database to facilitate aggregate secondary analysis of completed and ongoing studies. In this preliminary analysis, correlates of quality of life in people with epilepsy (PWE) were analyzed from pooled baseline data from the MEW Network. For this analysis, data originated from 6 epilepsy studies conducted across 4 research sites and comprised 459 PWE. Descriptive comparisons assessed common data elements that included gender, age, ethnicity, race, education, employment, income, seizure frequency, quality of life, and depression. Standardized rating scales were used for quality of life (QOLIE-10) and for depression (Patient Health Questionnaire, PHQ-9). While not all datasets included all common data elements, baseline descriptive analysis found a mean age of 42 (SD 13.22), 289 women (63.0%), 59 African Americans (13.7%), and 58 Hispanics (18.5%). Most, 422 (92.8%), completed at least high school, while 169 (61.7%) were unmarried, divorced/separated, or widowed. Median 30-day seizure frequency was 0.71 (range 0-308). Depression at baseline was common, with a mean PHQ-9 score of 8.32 (SD 6.04); 69 (29.0%) had depression in the mild range (PHQ-9 score 5-9) and 92 (38.7%) had depression in the moderate to severe range (PHQ-9 score >9). Lower baseline quality of life was associated with greater depressive severity (p<.001), more frequent seizures (p<.04) and lower income (p<.05). The MEW Network Integrated Database offers a unique opportunity for secondary analysis of data from multiple community-based epilepsy research studies. While findings must be tempered by potential sample bias, i.e. a relative under-representation of men and relatively small sample of some racial/ethnic subgroups, results of analyses derived from this first integrated epilepsy self-management database have potential to be useful to the field. Associations between depression severity and lower QOL in PWE are consistent with previous studies derived from clinical samples. Self-management efforts that focus on mental health comorbidity and seizure control may be one way to address modifiable factors that affect quality of life in PWE. Copyright © 2017 Elsevier Inc. All rights reserved.

Disease management: a leap of faith to lower-cost, higher-quality health care.

PubMed

Short, Ashley; Mays, Glen; Mittler, Jessica

2003-10-01

With managed care's promise to reduce costs and improve quality waning, employers and health plans are exploring more targeted ways to control rapidly rising health costs. Disease management programs, which focus on patients with chronic conditions such as asthma and diabetes, are growing in popularity, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. In addition to condition-based disease management programs, some health plans and employers are using intensive case management services to coordinate care for high-risk patients with potentially costly and complex medical conditions. Despite high expectations, evidence of both disease management and case management programs' success in controlling costs and improving quality remains limited.

Handling Qualities of Large Rotorcraft in Hover and Low Speed

NASA Technical Reports Server (NTRS)

Malpica, Carlos; Theodore, Colin R.; Lawrence , Ben; Blanken, Chris L.

2015-01-01

According to a number of system studies, large capacity advanced rotorcraft with a capability of high cruise speeds (approx.350 mph) as well as vertical and/or short take-off and landing (V/STOL) flight could alleviate anticipated air transportation capacity issues by making use of non-primary runways, taxiways, and aprons. These advanced aircraft pose a number of design challenges, as well as unknown issues in the flight control and handling qualities domains. A series of piloted simulation experiments have been conducted on the NASA Ames Research Center Vertical Motion Simulator (VMS) in recent years to systematically investigate the fundamental flight control and handling qualities issues associated with the characteristics of large rotorcraft, including tiltrotors, in hover and low-speed maneuvering.

Introduction to HACCP.

USDA-ARS?s Scientific Manuscript database

Introduction to HACCP Deana R. Jones, Ph.D. Egg Safety and Quality Research Unit USDA-Agricultural Research Service Russell Research Center Athens, GA Deana.Jones@ars.usda.gov HACCP is an acronym for Hazard Analysis and Critical Control Point and was initially developed by the Pillsbury Company a...

42 CFR 423.156 - Consumer satisfaction surveys.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Consumer satisfaction surveys. 423.156 Section 423.156 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

Case Management: Service or Symptom?

ERIC Educational Resources Information Center

Netting, F. Ellen

1992-01-01

Provides overview of case management, its history, and contemporary models. Examines challenges that case management poses for social work profession: covering up issue that health and human services delivery system is nonsystem; maintaining client-centered perspective in cost-obsessed environment; dealing with quality control; coping with…

42 CFR 431.806 - State plan requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false State plan requirements. 431.806 Section 431.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Quality Control General...

42 CFR 431.806 - State plan requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false State plan requirements. 431.806 Section 431.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Quality Control General...

42 CFR 431.806 - State plan requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false State plan requirements. 431.806 Section 431.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Quality Control General...

42 CFR 431.806 - State plan requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false State plan requirements. 431.806 Section 431.806 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION Quality Control General...

Flu vaccine shortage creates ethical issues, safety challenges.

PubMed

2004-12-01

Decisions may have to be made as to whether staff or patients get priority. Centers for Disease Control and Prevention guidelines help ease choices when it comes to inoculating workers. Quality professionals should be aware of the legal implications of their decisions.

Glenn's Telescience Support Center Provided Around-the-Clock Operations Support for Space Experiments on the International Space Station

NASA Technical Reports Server (NTRS)

Malarik, Diane C.

2005-01-01

NASA Glenn Research Center s Telescience Support Center (TSC) allows researchers on Earth to operate experiments onboard the International Space Station (ISS) and the space shuttles. NASA s continuing investment in the required software, systems, and networks provides distributed ISS ground operations that enable payload developers and scientists to monitor and control their experiments from the Glenn TSC. The quality of scientific and engineering data is enhanced while the long-term operational costs of experiments are reduced because principal investigators and engineering teams can operate their payloads from their home institutions.

[Central online quality assurance in radiology: an IT solution exemplified by the German Breast Cancer Screening Program].

PubMed

Czwoydzinski, J; Girnus, R; Sommer, A; Heindel, W; Lenzen, H

2011-09-01

Physical-technical quality assurance is one of the essential tasks of the National Reference Centers in the German Breast Cancer Screening Program. For this purpose the mammography units are required to transfer the measured values of the constancy tests on a daily basis and all phantom images created for this purpose on a weekly basis to the reference centers. This is a serious logistical challenge. To meet these requirements, we developed an innovative software tool. By the end of 2005, we had already developed web-based software (MammoControl) allowing the transmission of constancy test results via entry forms. For automatic analysis and transmission of the phantom images, we then introduced an extension (MammoControl DIANA). This was based on Java, Java Web Start, the NetBeans Rich Client Platform, the Pixelmed Java DICOM Toolkit and the ImageJ library. MammoControl DIANA was designed to run locally in the mammography units. This allows automated on-site image analysis. Both results and compressed images can then be transmitted to the reference center. We developed analysis modules for the daily and monthly consistency tests and additionally for a homogeneity test. The software we developed facilitates the immediate availability of measurement results, phantom images, and DICOM header data in all reference centers. This allows both targeted guidance and short response time in the case of errors. We achieved a consistent IT-based evaluation with standardized tools for the entire screening program in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

Earth Observation Data Quality Monitoring and Control: A Case Study of STAR Central Data Repository

NASA Astrophysics Data System (ADS)

Han, W.; Jochum, M.

2017-12-01

Earth observation data quality is very important for researchers and decision makers involved in weather forecasting, severe weather warning, disaster and emergency response, environmental monitoring, etc. Monitoring and control earth observation data quality, especially accuracy, completeness, and timeliness, is very useful in data management and governance to optimize data flow, discover potential transmission issues, and better connect data providers and users. Taking a centralized near real-time satellite data repository, STAR (Center for Satellite Applications and Research of NOAA) Central Data Repository (SCDR), as an example, this paper describes how to develop new mechanism to verify data integrity, check data completeness, and monitor data latency in an operational data management system. Such quality monitoring and control of large volume satellite data help data providers and managers improve data transmission of near real-time satellite data, enhance its acquisition and management, and overcome performance and management issues to better serve research and development activities.

Effectiveness of a new health care organization model in primary care for chronic cardiovascular disease patients based on a multifactorial intervention: the PROPRESE randomized controlled trial.

PubMed

Orozco-Beltran, Domingo; Ruescas-Escolano, Esther; Navarro-Palazón, Ana Isabel; Cordero, Alberto; Gaubert-Tortosa, María; Navarro-Perez, Jorge; Carratalá-Munuera, Concepción; Pertusa-Martínez, Salvador; Soler-Bahilo, Enrique; Brotons-Muntó, Francisco; Bort-Cubero, Jose; Nuñez-Martinez, Miguel Angel; Bertomeu-Martinez, Vicente; Gil-Guillen, Vicente Francisco

2013-08-02

To evaluate the effectiveness of a new multifactorial intervention to improve health care for chronic ischemic heart disease patients in primary care. The strategy has two components: a) organizational for the patient/professional relationship and b) training for professionals. Experimental study. Randomized clinical trial. Follow-up period: one year. primary care, multicenter (15 health centers). For the intervention group 15 health centers are selected from those participating in ESCARVAL study. Once the center agreed to participate patients are randomly selected from the total amount of patients with ischemic heart disease registered in the electronic health records. For the control group a random sample of patients with ischemic heart disease is selected from all 72 health centers electronic records. This study aims to evaluate the efficacy of a multifactorial intervention strategy involving patients with ischemic heart disease for the improvement of the degree of control of the cardiovascular risk factors and of the quality of life, number of visits, and number of hospitalizations. NCT01826929.

The Development of the CONDUIT Advanced Control System Design and Evaluation Interface with a Case Study Application to an Advanced Fly by Wire Helicopter Design

NASA Technical Reports Server (NTRS)

Colbourne, Jason

1999-01-01

This report details the development and use of CONDUIT (Control Designer's Unified Interface). CONDUIT is a design tool created at Ames Research Center for the purpose of evaluating and optimizing aircraft control systems against handling qualities. Three detailed design problems addressing the RASCAL UH-60A Black Hawk are included in this report to show the application of CONDUIT to helicopter control system design.

Data Quality Assurance and Control for AmeriFlux Network at CDIAC, ORNL

NASA Astrophysics Data System (ADS)

Shem, W.; Boden, T.; Krassovski, M.; Yang, B.

2014-12-01

The Carbon Dioxide Information Analysis Center (CDIAC) at the Oak Ridge National Laboratory (ORNL) serves as the long-term data repository for the AmeriFlux network. Datasets currently available include hourly or half-hourly meteorological and flux observations, biological measurement records, and synthesis data products. Currently there is a lack of standardized nomenclature and specifically designed procedures for data quality assurance/control in processing and handling micrometeorological and ecological data at individual flux sites. CDIAC's has bridged this gap by providing efficient and accurate procedures for data quality control and standardization of the results for easier assimilation by the models used in climate science. In this presentation we highlight the procedures we have put in place to scrutinize continuous flux and meteorological data within Ameriflux network. We itemize some basic data quality issues that we have observed over the past years and include some examples of typical data quality issues. Such issues, e.g., incorrect time-stamping, poor calibration or maintenance of instruments, missing or incomplete metadata and others that are commonly over-looked by PI's, invariably impact the time-series observations.

Handling qualities of a wide-body transport airplane utilizing Pitch Active Control Systems (PACS) for relaxed static stability application

NASA Technical Reports Server (NTRS)

Grantham, William D.; Person, Lee H., Jr.; Brown, Philip W.; Becker, Lawrence E.; Hunt, George E.; Rising, J. J.; Davis, W. J.; Willey, C. S.; Weaver, W. A.; Cokeley, R.

1985-01-01

Piloted simulation studies have been conducted to evaluate the effectiveness of two pitch active control systems (PACS) on the flying qualities of a wide-body transport airplane when operating at negative static margins. These two pitch active control systems consisted of a simple 'near-term' PACS and a more complex 'advanced' PACS. Eight different flight conditions, representing the entire flight envelope, were evaluated with emphasis on the cruise flight conditions. These studies were made utilizing the Langley Visual/Motion Simulator (VMS) which has six degrees of freedom. The simulation tests indicated that (1) the flying qualities of the baseline aircraft (PACS off) for the cruise and other high-speed flight conditions were unacceptable at center-of-gravity positions aft of the neutral static stability point; (2) within the linear static stability flight envelope, the near-term PACS provided acceptable flying qualities for static stabilty margins to -3 percent; and (3) with the advanced PACS operative, the flying qualities were demonstrated to be good (satisfactory to very acceptable) for static stabilty margins to -20 percent.

Enhancing the usability of CRT displays in test flight monitoring

NASA Astrophysics Data System (ADS)

Granaas, Michael M.; Sredinski, Victoria E.

1991-01-01

Enhancing the usability of Mission Control Center (MCC) CRT displays stands to improve the quality, productivity, and safety of flight-test research at the NASA Ames-Dryden Flight Research Facility. The results of this research suggests that much can be done to assist the user and improve the quality of flight research through the enhancement of current displays. This research has applications to a variety of flight data monitoring displays.

The Transforming Maternity Care Project: Goals, Methods, and Outcomes of a National Maternity Care Policy Initiative, With Construction of a Theoretical Model to Explain the Process

DTIC Science & Technology

2011-03-21

to and receive comprehensive high-quality, high-value reproductive health and maternity care. • Comprehensive health care reform strategies...and its implementation, ensure that access to comprehensive, high-quality reproductive health and maternity care services are essential benefits for... Reproductive Health, Centers for Disease Control and Prevention Stakeholder Workgroup Consumers and their Advocates Chair: Judy Norsigian

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.

Pocket change: a simple educational intervention increases hospitalist documentation of comorbidities and improves hospital quality performance measures.

PubMed

Sparks, Rachel; Salskov, Alex H; Chang, Anita S; Wentworth, Kelly L; Gupta, Pritha P; Staiger, Thomas O; Anawalt, Bradley D

2015-01-01

Complete documentation of patient comorbidities in the medical record is important for clinical care, hospital reimbursement, and quality performance measures. We designed a pocket card reminder and brief educational intervention aimed at hospitalists with the goal of improving documentation of 6 common comorbidities present on admission: coagulation abnormalities, metastatic cancer, anemia, fluid and electrolyte abnormalities, malnutrition, and obesity. Two internal medicine inpatient teams led by 10 hospitalist physicians at an academic medical center received the educational intervention and pocket card reminder (n = 520 admissions). Two internal medicine teams led by nonhospitalist physicians served as a control group (n = 590 admissions). Levels of documentation of 6 common comorbidities, expected length of stay, and expected mortality were measured at baseline and during the 9-month study period. The intervention was associated with increased documentation of anemia, fluid and electrolyte abnormalities, malnutrition, and obesity in the intervention group, both compared to baseline and compared to the control group during the study period. The expected length of stay increased in the intervention group during the study period. A simple educational intervention and pocket card reminder were associated with improved documentation and hospital quality measures at an academic medical center.

Quality of oral anticoagulation with phenprocoumon in regular medical care and its potential for improvement in a telemedicine-based coagulation service--results from the prospective, multi-center, observational cohort study thrombEVAL.

PubMed

Prochaska, Jürgen H; Göbel, Sebastian; Keller, Karsten; Coldewey, Meike; Ullmann, Alexander; Lamparter, Heidrun; Jünger, Claus; Al-Bayati, Zaid; Baer, Christina; Walter, Ulrich; Bickel, Christoph; ten Cate, Hugo; Münzel, Thomas; Wild, Philipp S

2015-01-23

The majority of studies on quality of oral anticoagulation (OAC) therapy with vitamin K-antagonists are performed with short-acting warfarin. Data on long-acting phenprocoumon, which is frequently used in Europe for OAC therapy and is considered to enable more stable therapy adjustment, are scarce. In this study, we aimed to assess quality of OAC therapy with phenprocoumon in regular medical care and to evaluate its potential for optimization in a telemedicine-based coagulation service. In the prospective observational cohort study program thrombEVAL we investigated 2,011 patients from regular medical care in a multi-center cohort study and 760 patients from a telemedicine-based coagulation service in a single-center cohort study. Data were obtained from self-reported data, computer-assisted personal interviews, and laboratory measurements according to standard operating procedures with detailed quality control. Time in therapeutic range (TTR) was calculated by linear interpolation method to assess quality of OAC therapy. Study monitoring was carried out by an independent institution. Overall, 15,377 treatment years and 48,955 international normalized ratio (INR) measurements were analyzed. Quality of anticoagulation, as measured by median TTR, was 66.3% (interquartile range (IQR) 47.8/81.9) in regular medical care and 75.5% (IQR 64.2/84.4) in the coagulation service (P <0.001). Stable anticoagulation control within therapeutic range was achieved in 63.8% of patients in regular medical care with TTR at 72.1% (IQR 58.3/84.7) as compared to 96.4% of patients in the coagulation service with TTR at 76.2% [(IQR 65.6/84.7); P = 0.001)]. Prospective follow-up of coagulation service patients with pretreatment in regular medical care showed an improvement of the TTR from 66.2% (IQR 49.0/83.6) to 74.5% (IQR 62.9/84.2; P <0.0001) in the coagulation service. Treatment in the coagulation service contributed to an optimization of the profile of time outside therapeutic range, a 2.2-fold increase of stabile INR adjustment and a significant decrease in TTR variability by 36% (P <0.001). Quality of anticoagulation with phenprocoumon was comparably high in this real-world sample of regular medical care. Treatment in a telemedicine-based coagulation service substantially improved quality of OAC therapy with regard to TTR level, frequency of stable anticoagulation control, and TTR variability. ClinicalTrials.gov, unique identifier NCT01809015, March 8, 2013.

Efficient use of automatic exposure control systems in computed tomography requires correct patient positioning.

PubMed

Gudjonsdottir, J; Svensson, J R; Campling, S; Brennan, P C; Jonsdottir, B

2009-11-01

Image quality and radiation dose to the patient are important factors in computed tomography (CT). To provide constant image quality, tube current modulation (TCM) performed by automatic exposure control (AEC) adjusts the tube current to the patient's size and shape. To evaluate the effects of patient centering on tube current-time product (mAs) and image noise. An oval-shaped acrylic phantom was scanned in various off-center positions, at 30-mm intervals within a 500-mm field of view, using three different CT scanners. Acquisition parameters were similar to routine abdomen examinations at each site. The mAs was recorded and noise measured in the images. The correlation of mAs and noise with position was calculated using Pearson correlation. In all three scanners, the mAs delivered by the AEC changed with y-position of the phantom (P<0.001), with correlation values of 0.98 for scanners A and B and -0.98 for scanner C. With x-position, mAs changes were 4.9% or less. As the phantom moved into the y-positions, compared with the iso-center, the mAs varied by up to +70%, -34%, and +56% in scanners A, B, and C, respectively. For scanners A and B, noise in two regions of interest in the lower part of the phantom decreased with elevation, with correlation factors from -0.95 to -0.86 (P<0.02). In the x-direction, significant noise relationships (P<0.005) were only seen in scanner A. This study demonstrates that patient centering markedly affects the efficacy of AEC function and that tube current changes vary between scanners. Tube position when acquiring the scout projection radiograph is decisive for the direction of the mAs change. Off-center patient positions cause errors in tube current modulation that can outweigh the dose reduction gained by AEC use, and image quality is affected.

Capacity and reliability analyses with applications to power quality

NASA Astrophysics Data System (ADS)

Azam, Mohammad; Tu, Fang; Shlapak, Yuri; Kirubarajan, Thiagalingam; Pattipati, Krishna R.; Karanam, Rajaiah

2001-07-01

The deregulation of energy markets, the ongoing advances in communication networks, the proliferation of intelligent metering and protective power devices, and the standardization of software/hardware interfaces are creating a dramatic shift in the way facilities acquire and utilize information about their power usage. The currently available power management systems gather a vast amount of information in the form of power usage, voltages, currents, and their time-dependent waveforms from a variety of devices (for example, circuit breakers, transformers, energy and power quality meters, protective relays, programmable logic controllers, motor control centers). What is lacking is an information processing and decision support infrastructure to harness this voluminous information into usable operational and management knowledge to handle the health of their equipment and power quality, minimize downtime and outages, and to optimize operations to improve productivity. This paper considers the problem of evaluating the capacity and reliability analyses of power systems with very high availability requirements (e.g., systems providing energy to data centers and communication networks with desired availability of up to 0.9999999). The real-time capacity and margin analysis helps operators to plan for additional loads and to schedule repair/replacement activities. The reliability analysis, based on computationally efficient sum of disjoint products, enables analysts to decide the optimum levels of redundancy, aids operators in prioritizing the maintenance options for a given budget and monitoring the system for capacity margin. The resulting analytical and software tool is demonstrated on a sample data center.

Improving the Quality of Welding Seam of Automatic Welding of Buckets Based on TCP

NASA Astrophysics Data System (ADS)

Hu, Min

2018-02-01

Since February 2014, the welding defects of the automatic welding line of buckets have been frequently appeared. The average repair time of each bucket is 26min, which seriously affects the production efficiency and welding quality. We conducted troubleshooting, and found the main reasons for the welding defects of the buckets were the deviations of the center points of the robot tools and the poor quality of the locating welding. We corrected the gripper, welding torch, and accuracy of repeat positioning of robots to control the quality of positioning welding. The welding defect rate of buckets was reduced greatly, ensuring the production efficiency and welding quality.

Quality Control of Wind Data from 50-MHz Doppler Radar Wind Profiler

NASA Technical Reports Server (NTRS)

Vacek, Austin

2016-01-01

Upper-level wind profiles obtained from a 50-MHz Doppler Radar Wind Profiler (DRWP) instrument at Kennedy Space Center are incorporated in space launch vehicle design and day-of-launch operations to assess wind effects on the vehicle during ascent. Automated and manual quality control (QC) techniques are implemented to remove spurious data in the upper-level wind profiles caused from atmospheric and non-atmospheric artifacts over the 2010-2012 period of record (POR). By adding the new quality controlled profiles with older profiles from 1997-2009, a robust database will be constructed of upper-level wind characteristics. Statistical analysis will determine the maximum, minimum, and 95th percentile of the wind components from the DRWP profiles over recent POR and compare against the older database. Additionally, this study identifies specific QC flags triggered during the QC process to understand how much data is retained and removed from the profiles.

Quality Control of Wind Data from 50-MHz Doppler Radar Wind Profiler

NASA Technical Reports Server (NTRS)

Vacek, Austin

2015-01-01

Upper-level wind profiles obtained from a 50-MHz Doppler Radar Wind Profiler (DRWP) instrument at Kennedy Space Center are incorporated in space launch vehicle design and day-of-launch operations to assess wind effects on the vehicle during ascent. Automated and manual quality control (QC) techniques are implemented to remove spurious data in the upper-level wind profiles caused from atmospheric and non-atmospheric artifacts over the 2010-2012 period of record (POR). By adding the new quality controlled profiles with older profiles from 1997-2009, a robust database will be constructed of upper-level wind characteristics. Statistical analysis will determine the maximum, minimum, and 95th percentile of the wind components from the DRWP profiles over recent POR and compare against the older database. Additionally, this study identifies specific QC flags triggered during the QC process to understand how much data is retained and removed from the profiles.

Langley Wind Tunnel Data Quality Assurance-Check Standard Results

NASA Technical Reports Server (NTRS)

Hemsch, Michael J.; Grubb, John P.; Krieger, William B.; Cler, Daniel L.

2000-01-01

A framework for statistical evaluation, control and improvement of wind funnel measurement processes is presented The methodology is adapted from elements of the Measurement Assurance Plans developed by the National Bureau of Standards (now the National Institute of Standards and Technology) for standards and calibration laboratories. The present methodology is based on the notions of statistical quality control (SQC) together with check standard testing and a small number of customer repeat-run sets. The results of check standard and customer repeat-run -sets are analyzed using the statistical control chart-methods of Walter A. Shewhart long familiar to the SQC community. Control chart results are presented for. various measurement processes in five facilities at Langley Research Center. The processes include test section calibration, force and moment measurements with a balance, and instrument calibration.

Testing the Implementation of the Veder Contact Method: A Theatre-Based Communication method in Dementia Care.

PubMed

Boersma, Petra; van Weert, Julia C M; Lissenberg-Witte, Birgit I; van Meijel, Berno; Dröes, Rose-Marie

2018-01-08

There is a lack of research on implementation of person-centered care in nursing home care. The purpose of this study was to assess the implementation of the Veder contact method (VCM), a new person-centered method using theatrical, poetic and musical communication for application in 24-hr care. Caregivers (n = 136) and residents (n = 141) participated in a 1-year quasi-experimental study. Foundation Theater Veder implemented VCM on six experimental wards and rated implementation quality. Six control wards delivered care-as-usual. Before and after implementation, caregiver behavior was assessed during observations using the Veder-observation list and Quality of Caregivers' Behavior-list. Caregiver attitude was rated with the Approaches to Dementia Questionnaire. Quality of life, behavior, and mood of the residents were measured with QUALIDEM, INTERACT and FACE. Residents' care plans were examined for person-centered background information. Significant improvements in caregivers' communicative behavior (i.e., the ability to apply VCM, establishing positive interactions) and some aspects of residents' behavior and quality of life (i.e., positive affect, social relations) were found on the experimental wards with a high implementation score, as compared to the experimental wards with a low implementation score, and the control wards. No significant differences were found between the groups in caregivers' attitudes, residents' care plans, or mood. The positive changes in caregivers' behavior and residents' well-being on the high implementation score wards confirm the partly successful VCM implementation. Distinguishing between wards with a high and low implementation score provided insight into factors which are crucial for successful implementation. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Energy Savings Analysis for Energy Monitoring and Control Systems

DTIC Science & Technology

1995-01-01

for evaluating design and construction a:-0 quality, and for studying the effectiveness of air - tightening AC retrofits. No simple relationship...Energy These models of residential infiltration are based on statistical "Resource Center (1983) include information on air tightening in fits of

42 CFR 423.160 - Standards for electronic prescribing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Standards for electronic prescribing. 423.160 Section 423.160 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

42 CFR 423.159 - Electronic prescription drug program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Electronic prescription drug program. 423.159 Section 423.159 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

13 CFR 130.330 - Operating requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... assessment and evaluation, and internal quality control. (c) The Lead Center shall be open to the public... provide administrative services and coordination for the SBDC network, including program development... Project Officer as soon as is feasible. Other SBDC service providers shall be open during the normal...

Flight Tests of a Ministick Controller in an F/A-18 Airplane

NASA Technical Reports Server (NTRS)

Stoliker, Patrick C.; Carter, John

2003-01-01

In March of 1999, five pilots performed flight tests to evaluate the handling qualities of an F/A-18 research airplane equipped with a small-displacement center stick (ministick) controller that had been developed for the JAS 39 Gripen airplane (a fighter/attack/ reconnaissance airplane used by the Swedish air force). For these tests, the ministick was installed in the aft cockpit (see figure) and production support flight control computers (PSFCCs) were used as interfaces between the controller hardware and the standard F/A-18 flight-control laws. The primary objective of the flight tests was to assess any changes in handling qualities of the F/A-18 airplane attributable to the mechanical characteristics of the ministick. The secondary objective was to demonstrate the capability of the PSFCCs to support flight-test experiments.

[What is the methodological quality of articles on therapeutic procedures published in Cirugía Española?].

PubMed

Manterola, Carlos; Busquets, Juli; Pascual, Marta; Grande, Luis

2006-02-01

The aim of this study was to determine the methodological quality of articles on therapeutic procedures published in Cirugía Española and to study its association with the publication year, center, and subject-matter. A bibliometric study that included all articles on therapeutic procedures published in Cirugía Española between 2001 and 2004 was performed. All kinds of clinical designs were considered, excluding editorials, review articles, letters to editor, and experimental studies. The variables analyzed were: year of publication, center, design, and methodological quality. Methodological quality was determined by a valid and reliable scale. Descriptive statistics (calculation of means, standard deviation and medians) and analytical statistics (Pearson's chi2, nonparametric, ANOVA and Bonferroni tests) were used. A total of 244 articles were studied (197 case series [81%], 28 cohort studies [12%], 17 clinical trials [7%], 1 cross sectional study and 1 case-control study [0.8%]). The studies were performed mainly in Catalonia and Murcia (22% and 16%, respectively). The most frequent subject areas were soft tissue and hepatobiliopancreatic surgery (23% and 19%, respectively). The mean and median of the methodological quality score calculated for the entire series was 10.2 +/- 3.9 points and 9.5 points, respectively. Methodological quality significantly increased by publication year (p < 0.001). An association between methodological quality and subject area was observed but no association was detected with the center performing the study. The methodological quality of articles on therapeutic procedures published in Cirugía Española between 2001 and 2004 is low. However, a statistically significant trend toward improvement was observed.

Implementation of "Quality by Design (QbD)" Approach for the Development of 5-Fluorouracil Loaded Thermosensitive Hydrogel.

PubMed

Dalwadi, Chintan; Patel, Gayatri

2016-01-01

The purpose of this study was to investigate Quality by Design (QbD) principle for the preparation of hydrogel products to prove both practicability and utility of executing QbD concept to hydrogel based controlled release systems. Product and process understanding will help in decreasing the variability of critical material and process parameters, which give quality product output and reduce the risk. This study includes the identification of the Quality Target Product Profiles (QTPPs) and Critical Quality Attributes (CQAs) from literature or preliminary studies. To identify and control the variability in process and material attributes, two tools of QbD was utilized, Quality Risk Management (QRM) and Experimental Design. Further, it helps to identify the effect of these attributes on CQAs. Potential risk factors were identified from fishbone diagram and screened by risk assessment and optimized by 3-level 2- factor experimental design with center points in triplicate, to analyze the precision of the target process. This optimized formulation was further characterized by gelling time, gelling temperature, rheological parameters, in-vitro biodegradation and in-vitro drug release. Design space was created using experimental design tool that gives the control space and working within this controlled space reduces all the failure modes below the risk level. In conclusion, QbD approach with QRM tool provides potent and effectual pyramid to enhance the quality into the hydrogel.

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

Malkoske, Kyle; Nielsen, Michelle; Brown, Erika

The Canadian Partnership for Quality Radiotherapy (CPQR) and the Canadian Organization of Medical Physicist’s (COMP) Quality Assurance and Radiation Safety Advisory Committee (QARSAC) have worked together in the development of a suite of Technical Quality Control (TQC) Guidelines for radiation treatment equipment and technologies, that outline specific performance objectives and criteria that equipment should meet in order to assure an acceptable level of radiation treatment quality. Early community engagement and uptake survey data showed 70% of Canadian centers are part of this process and that the data in the guideline documents reflect, and are influencing the way Canadian radiation treatmentmore » centres run their technical quality control programs. As the TQC development framework matured as a cross-country initiative, guidance documents have been developed in many clinical technologies. Recently, there have been new TQC documents initiated for Gamma Knife and Cyberknife technologies where the entire communities within Canada are involved in the review process. At the same time, QARSAC reviewed the suite as a whole for the first time and it was found that some tests and tolerances overlapped across multiple documents as single tests could pertain to multiple quality control areas. The work to streamline the entire suite has allowed for improved usability of the suite while keeping the integrity of single quality control areas. The suite will be published by the JACMP, in the coming year.« less

Measuring quality of adolescent preventive services of health plan enrollees and school-based health center users.

PubMed

Klein, Jonathan D; Handwerker, Lisa; Sesselberg, Tracy S; Sutter, Erika; Flanagan, Erinn; Gawronski, Beth

2007-08-01

To evaluate whether quality of care provided to adolescents enrolled in a community-based managed care plan was better for those who also received some care at school-based health centers (SBHCs). The Young Adult Health Care Survey (YAHCS) was administered to 374 adolescents (commercially insured, Medicaid-insured, and SBHC users) to assess risk behaviors, provision of preventive screening and counseling, and quality of care. SBHC users were most likely to report that their provider told them their discussions were confidential, and that they received screening/counseling on sexually transmitted diseases (STDs), HIV/AIDS, condom use, and birth control. Commercially insured adolescents were least likely to report discussion of sexual health issues. SBHC users had the highest mean YAHCS quality measure scores for screening/counseling on pregnancy/STDs, diet and exercise, and helpfulness of counseling provided; Medicaid-insured teens had the lowest scores on four of seven measures. Regression models controlled for demographics, use of screener, and site of care showed that use of a screener had a significant impact on six of seven quality measure models. Younger age predicted screening for risk behaviors; being female, African-American, and an SBHC user predicted screening on pregnancy/STDs. SBHCs may increase adolescents' access to confidential care, and SBHC providers may be more likely than those in other settings to screen and counsel patients about sexual health. Overall quality of preventive care reported by commercially insured adolescents may be better in some health content areas and worse in others compared with care reported by Medicaid-insured youth and SBHC users.

From Many to Many More: Instant Interoperability Through the Integrated Ocean Observing System Data Assembly Center

NASA Astrophysics Data System (ADS)

Burnett, W.; Bouchard, R.; Hervey, R.; Crout, R.; Luke, R.

2008-12-01

As the Integrated Ocean Observing System (IOOS) Data Assembly Center (DAC), NOAA's National Data Buoy Center (NDBC) collects data from many ocean observing systems, quality controls the data, and distributes them nationally and internationally. The DAC capabilities provide instant interoperability of any ocean observatory with the national and international agencies responsible for critical forecasts and warnings and with the national media. This interoperability is an important milestone in an observing system's designation as an operational system. Data collection begins with NDBC's own observing systems - Meteorological and Oceanographic Buoys and Coastal Stations, the Tropical Atmosphere Ocean Array, and the NOAA tsunameter network. Leveraging the data management functions that support NDBC systems, the DAC can support data partners including ocean observations from IOOS Regional Observing Systems, the meteorological observations from the National Water Level Observing Network, meteorological and oceanographic observations from the National Estuarine Research Reserve System, Integrated Coral Observing Network, merchant ship observations from the Voluntary Observing Ship program, and ocean current measurements from oil and gas platforms in the Gulf of Mexico and from Coastal HF Radars. The DAC monitors and quality controls IOOS Partner data alerting the data provider to outages and quality discrepancies. After performing automated and manual quality control procedures, the DAC prepares the observations for distribution. The primary means of data distribution is in standard World Meteorological Organization alphanumeric coded messages distributed via the Global Telecommunications System, NOAAPort, and Family of Services. Observing systems provide their data via ftp to an NDBC server using a simple XML. The DAC also posts data in real-time to the NDBC webpages in columnar text format and data plots that maritime interests (e.g., surfing, fishing, boating) widely use. The webpage text feeds the Dial-A-Buoy capability that reads the latest data from webpages and the latest NWS forecast for the station to a user via telephone. The DAC also operates a DODS/OPenDAP server to provide data in netCDF. Recently the DAC implemented the NOAA IOOS Data Integration Framework, which facilitates the exchange of data between IOOS Regional Observing Systems by standardizing data exchange formats and incorporating needed metadata for the correct application of the data. The DAC has become an OceanSITES Global Data Assembly Center - part of the Initial Global Observing System for Climate. Supported by the NOAA IOOS Program, the DAC provides round-the-clock monitoring, quality control, and data distribution to ensure that its IOOS Partners can conduct operations that meet the NOAA definition of: Sustained, systematic, reliable, and robust mission activities with an institutional commitment to deliver appropriate, cost-effective products and services.

A Flying Qualities Study of Longitudinal Long-Term Dynamics of Hypersonic Planes

NASA Technical Reports Server (NTRS)

Cox, Timothy H.; Sachs, G.; Knoll, A.; Stich, R.

1995-01-01

The NASA Dryden Flight Research Center and the Technical University of Munich are cooperating in a research program to assess the impact of unstable long-term dynamics on the flying qualities of planes in hypersonic flight. These flying qualities issues are being investigated with a dedicated flight simulator for hypersonic vehicles located at NASA Dryden. Several NASA research pilots have flown the simulator through well defined steady-level turns with varying phugoid and height mode instabilities. The data collected include Pilot ratings and comments, performance measurements, and Pilot workload measurements. The results presented in this paper include design guidelines for height and Phugoid mode instabilities, an evaluation of the tapping method used to measure pilot workload, a discussion of techniques developed by the pilots to control large instabilities, and a discussion of how flying qualities of unstable long-term dynamics influence control Power design requirements.

A flying qualities study of longitudinal long-term dynamics of hypersonic planes

NASA Technical Reports Server (NTRS)

Cox, T.; Sachs, G.; Knoll, A.; Stich, R.

1995-01-01

The NASA Dryden Flight Research Center and the Technical University of Munich are cooperating in a research program to assess the impact of unstable long-term dynamics on the flying qualities of planes in hypersonic flight. These flying qualities issues are being investigated with a dedicated flight simulator for hypersonic vehicles located at NASA Dryden. Several NASA research pilots have flown the simulator through well-defined steady-level turns with varying phugoid and height mode instabilities. Th data collected include pilot ratings and comments, performance measurements, and pilot workload measurements. The results presented in this paper include design guidelines for height and phugoid mode instabilities, an evaluation of the tapping method used to measure pilot workload, a discussion of techniques developed by the pilots to control large instabilities, and a discussion of how flying qualities of unstable long-term dynamics influence control power design requirements.

A proficiency testing program of hemoglobin analysis in prevention and control of severe hemoglobinopathies in Thailand.

PubMed

Karnpean, Rossarin; Fucharoen, Goonnapa; Pansuwan, Anupong; Changtrakul, Duangrudee; Fucharoen, Supan

2013-06-01

No external quality assessment program for hemoglobin (Hb) analysis in the prevention and control of thalassemia has been established in Thailand. To improve the first line provisional diagnostics, the first proficiency testing (PT) program has been established. External Hb controls prepared at our center were sent to Hb analysis laboratories all over the country. Three cycles per year were performed in 2010 and 2011. In each cycle, two control samples with corresponding hematological parameters, designated as husband and his pregnant wife were supplied for Hb analysis. Each member analyzed the control samples in their routine practices. The results of Hb analysis, laboratory interpretation and risk assessment of the expected fetus for severe thalassemia diseases targeted for prevention and control were entered into the report form and sent back to our center. Participants reports were analyzed and classified into four different quality groups; Excellent (when all the three parameters are correct), Good (correct Hb analysis and interpretation but incorrect risk assessment), Fair (correct Hb analysis but incorrect interpretation and risk assessment) and Needs improvement (incorrect Hb analysis). It was found that most participants could report correct Hb types and quantifications but some misinterpretations and risk assessments were noted. These were clearly seen when control samples with more complexity were supplied. These results indicate a further improvement is required in the laboratory interpretation and knowledge of the laboratory diagnosis of thalassemia. The established system should facilitate the prevention and control program of thalassemia in the region.

Preschool Center Quality and School Readiness: Quality Effects and Variation by Demographic and Child Characteristics

PubMed Central

Keys, Tran D.; Farkas, George; Burchinal, Margaret R.; Duncan, Greg J.; Vandell, Deborah L.; Li, Weilin; Ruzek, Erik A.; Howes, Carollee

2014-01-01

This article examines associations between observed quality in preschool center classrooms for approximately 6,250 three- to five-year-olds and their school readiness skills at kindergarten entry. Secondary analyses were conducted using data from four large-scale studies to estimate the effects of preschool center quality and interactions between quality and demographic characteristics and child entry skills and behaviors. Findings were summarized across studies using meta-analytic methods. Results indicate small, but statistically significant associations for preschool center quality main effects on language and mathematics outcomes with little evidence of moderation by demographic characteristics or child entry skills and behaviors. Preschool center quality was not reliably related to socioemotional outcomes. The authors discuss possible explanations for the small effect sizes and lack of differential effects. PMID:23331043

[Pay for performance in rehabilitation after stroke - results of a pilot project 2001-2008].

PubMed

Gerdes, N; Funke, U-N; Schüwer, U; Kunze, H; Walle, E; Kleinfeld, A; Reiland, M; Jäckel, W H

2009-08-01

The project aimed at developing and testing a new payment system which provides financial incentives for rehabilitation centers to achieve the best outcomes possible for their patients but does not create additional costs for the insurance funds. The system is conceived as a "quality competition" organized by the centers among themselves with a scientific institute acting as a "referee". Centers with outcomes above average receive a bonus financed by a corresponding malus from the centers below average. In a stepwise process which started in 2001 and was continually accompanied by a scientific institute, we developed the methodological and organizational prerequisites for the new payment system and tested them in two multicentric studies with large case numbers (n=1,058 and n=700, respectively). As a first step, a new assessment instrument (SINGER) was developed and validated in order to measure the outcomes in a reliable, valid, and change-sensitive way. In the second phase, we developed a regression analytic model which predicted the central outcome variable with >84% variance explained. With this model, the different case-mix in the participating centers can be controlled, so that comparisons of outcomes across centers can take place under fair conditions. In the recently completed third phase, we introduced an internet-based programme SINGER-online into which the centers can enter all relevant data. This programme ensures a high quality of all data and makes comparisons of outcomes across all centers possible at any chosen time. The programme contains a special module accessible to the medical services of the health insurance only, which allows sample checks of the data entered by the clinics and helps to ensure that all centers keep to the principles of a fair competition for better quality for their patients. After successful testing of these elements, a functioning model of pay-for-performance in rehabilitation after stroke is now available. (c) Georg Thieme Verlag KG Stuttgart, New York.

Effectiveness of person- and family-centered care transition interventions: a systematic review protocol.

PubMed

Backman, Chantal; Chartrand, Julie; Dingwall, Orvie; Shea, Beverley

2017-08-08

Care transitions from the hospital to home are critical to the sustainability of our health care system. Ineffective care transitions can be caused by high incidences of post-discharge adverse events, by poor communication with patients, and/or by inadequate information transfer between providers from the hospital to home. Any one of these can lead to fragmented care, high readmission rates, increased visits to the emergency department, and ultimately poor patient outcomes. Despite the ongoing improvement efforts of health care organizations, the efficacy of person- and family-centered care transition interventions on the quality of care and on the patient experience are not known. The aim of this systematic review is to critically analyze the body of evidence regarding the effectiveness of person- and family-centered care transition interventions on the quality of care, and the experience of patients. We will conduct a systematic review using the Cochrane Handbook's guidelines and will adhere to a standardized reporting format: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search strategy will be conducted in the following databases: MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and the Cochrane Consumers and Communication Group. Following a two-step screening process, data including the full reference, objectives, target population, description of the intervention and control intervention, outcome measures, design, length of post-intervention follow-up period, and the study results will be extracted, synthesized, and reported. Risk of bias and quality of the studies will also be assessed. This systematic review will summarize and present the evidence base for person- and family-centered care transition interventions. This review will also inform further research and will lay the groundwork for more empirical studies on person- and family-centered care transitions. Specifically, the results of this systematic review may inform the development of measures to monitor safe and effective person- and family-centered transitions from the hospital to home. These results may also be important for policy makers, decision-makers, clinicians, and patients/families who are involved in navigating the health care system. PROSPERO CRD42017067990.

42 CFR 422.4 - Types of MA plans.

Code of Federal Regulations, 2010 CFR

2010-10-01

... availability, service area, and quality. (ii) Coordinated care plans may include mechanisms to control... requirements of sections 138 and 220 of the Internal Revenue Code. (3) MA private fee-for-service plan. An MA... Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...

Biomedical Information Dissemination: Alternative Systems.

ERIC Educational Resources Information Center

Farquhar, J. A.

This memorandum is the result of an investigation into the three existing biomedical information services; MEDLARS (Medical Literature Analysis and Retrieval System), the interlibrary loan (ILL) service, and the network of Poison Control Centers. This research is intended to provide an understanding of the structure, quality, and coverage of these…

Real-time simulation model of the HL-20 lifting body

NASA Technical Reports Server (NTRS)

Jackson, E. Bruce; Cruz, Christopher I.; Ragsdale, W. A.

1992-01-01

A proposed manned spacecraft design, designated the HL-20, has been under investigation at Langley Research Center. Included in that investigation are flight control design and flying qualities studies utilizing a man-in-the-loop real-time simulator. This report documents the current real-time simulation model of the HL-20 lifting body vehicle, known as version 2.0, presently in use at NASA Langley Research Center. Included are data on vehicle aerodynamics, inertias, geometries, guidance and control laws, and cockpit displays and controllers. In addition, trim case and dynamic check case data is provided. The intent of this document is to provide the reader with sufficient information to develop and validate an equivalent simulation of the HL-20 for use in real-time or analytical studies.

Developing a space network interface simulator: The NTS approach

NASA Technical Reports Server (NTRS)

Hendrzak, Gary E.

1993-01-01

This paper describes the approach used to redevelop the Network Control Center (NCC) Test System (NTS), a hardware and software facility designed to make testing of the NCC Data System (NCCDS) software efficient, effective, and as rigorous as possible prior to operational use. The NTS transmits and receives network message traffic in real-time. Data transfer rates and message content are strictly controlled and are identical to that of the operational systems. NTS minimizes the need for costly and time-consuming testing with the actual external entities (e.g., the Hubble Space Telescope (HST) Payload Operations Control Center (POCC) and the White Sands Ground Terminal). Discussed are activities associated with the development of the NTS, lessons learned throughout the project's lifecycle, and resulting productivity and quality increases.

Job demand and control interventions: a stakeholder-centered best-evidence synthesis of systematic reviews on workplace disability.

PubMed

Williams-Whitt, K; White, M I; Wagner, S L; Schultz, I Z; Koehn, C; Dionne, C E; Koehoorn, M; Harder, H; Pasca, R; Warje, O; Hsu, V; McGuire, L; Schulz, W; Kube, D; Hook, A; Wright, M D

2015-04-01

Physical and psychological job demands in combination with the degree of control a worker has over task completion, play an important role in reducing stress. Occupational stress is an important, modifiable factor affecting work disability. However, the effectiveness of reducing job demands or increasing job control remains unclear, particularly for outcomes of interest to employers, such as absenteeism or productivity. This systematic review reports on job demand and control interventions that impact absenteeism, productivity and financial outcomes. A stakeholder-centered best-evidence synthesis was conducted with researcher and stakeholder collaboration throughout. Databases and grey literature were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO, TRIP, health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC), and Institute for Work and Health. Articles were assessed independently by two researchers for inclusion criteria and methodological quality. Differences were resolved through consensus. The search resulted in 3363 unique titles. After review of abstracts, 115 articles were retained for full-text review. 11 articles finally met the inclusion criteria and are summarized in this synthesis. The best level of evidence we found indicates that multimodal job demand reductions for either at-work or off-work workers will reduce disability-related absenteeism. In general, the impacts of interventions that aim to reduce job demands or increase job control can be positive for the organization in terms of reducing absenteeism, increasing productivity and cost-effectiveness. However, more high quality research is needed to further assess the relationships and quantify effect sizes for the interventions and outcomes reviewed in this study.

The national database of hospital-based cancer registries: a nationwide infrastructure to support evidence-based cancer care and cancer control policy in Japan.

PubMed

Higashi, Takahiro; Nakamura, Fumiaki; Shibata, Akiko; Emori, Yoshiko; Nishimoto, Hiroshi

2014-01-01

Monitoring the current status of cancer care is essential for effective cancer control and high-quality cancer care. To address the information needs of patients and physicians in Japan, hospital-based cancer registries are operated in 397 hospitals designated as cancer care hospitals by the national government. These hospitals collect information on all cancer cases encountered in each hospital according to precisely defined coding rules. The Center for Cancer Control and Information Services at the National Cancer Center supports the management of the hospital-based cancer registry by providing training for tumor registrars and by developing and maintaining the standard software and continuing communication, which includes mailing lists, a customizable web site and site visits. Data from the cancer care hospitals are submitted annually to the Center, compiled, and distributed as the National Cancer Statistics Report. The report reveals the national profiles of patient characteristics, route to discovery, stage distribution, and first-course treatments of the five major cancers in Japan. A system designed to follow up on patient survival will soon be established. Findings from the analyses will reveal characteristics of designated cancer care hospitals nationwide and will show how characteristics of patients with cancer in Japan differ from those of patients with cancer in other countries. The database will provide an infrastructure for future clinical and health services research and will support quality measurement and improvement of cancer care. Researchers and policy-makers in Japan are encouraged to take advantage of this powerful tool to enhance cancer control and their clinical practice.

Enteral glutamine supplementation in surgical patients with head and neck malignancy: A randomized controlled trial.

PubMed

Azman, Mawaddah; Mohd Yunus, Mohd Razif; Sulaiman, Suhaina; Syed Omar, Syed Nabil

2015-12-01

Glutamine supplementation is a novel approach to perioperative nutritional management. This study was a prospective randomized clinical trial of effects of enteral glutamine supplementation in surgical patients with head and neck malignancy in a tertiary center. This study measured the effects of supplementation within 4 weeks of the postoncologic surgical period in relation to fat-free mass, serum albumin, and quality of life scores. The study population consisted of 44 patients. There was significant difference in serum albumin (p < .001), fat-free mass (p < .001), and quality of life scores (p < .05) between control and interventional groups. Significant correlation exists between fat-free mass and quality of life score difference in our study population (p < .05). Enteral glutamine supplementation significantly improves fat-free mass, serum albumin, and quality of life scores postoperatively and maintenance of lean body mass correlated with improved postoperative outcomes in terms of the patient's quality of life. © 2014 Wiley Periodicals, Inc.

Quantitative evaluation of plasma after methylene blue and white light treatment in four Chinese blood centers.

PubMed

Chunhui, Yang; Guohui, Bian; Hong, Yang; Xiaopu, Xiao; Zherong, Bai; Mingyuan, Wang; Xinsheng, Zhang; Juanjuan, Wang; Changqing, Li; Wuping, Li

2013-12-01

Pathogen reduction technology is an important process in the blood safety system, including solvent/detergent treatment, filtration and methylene blue-photochemical technology (MB-PCT). To investigate the quality of MB-PCT-treated plasma, plasma samples from four Chinese blood centers were analyzed over 12 months of storage to determine the recovery of activities and levels of various plasma proteins. Ten plasma units each from the Suzhou, Yancheng, Chongqing and Shandong blood centers were divided into two aliquots. One was subjected to treatment with one of two methylene blue-photochemical technology instruments and the other was used as control. The treated and untreated sample pairs were stored at -30°C. The recovery rates of coagulation factors, inhibitor proteins, total protein, immunoglobulins, and complement proteins were measured at different time points after storage. The mean recovery of most proteins exceeded 80% after MB treatment. The exceptions were factor XI and fibrinogen, of which only 71.3-74% and 69.0-92.3% were retained during storage. The two equipment types differed in terms of residual MB concentration in the plasma samples (0.18 μM and 0.29 μM, respectively). They had similar protein recovery rates at 0.5 month but differed at later time points. The four blood centers differed significantly with regard to factor II, V, VIII and fibrinogen activities. Only the samples from the Shandong blood center met the methylene blue treated fresh frozen plasma requirement. The major factor that influenced the quality of the MB-FFP samples was the time taken between blood collection and storage. Methylene blue treated plasma showed reduced coagulation factor (CF) activity and protein levels. The MB treatment-induced damage to the proteins was acceptable at the four Chinese blood centers, but the quality of the MB-treated plasma in general was not satisfactory. The main factor affecting plasma quality may be the duration of the collection and processing. Copyright © 2013 Elsevier Ltd. All rights reserved.

V/STOLAND avionics system flight-test data on a UH-1H helicopter

NASA Technical Reports Server (NTRS)

Baker, F. A.; Jaynes, D. N.; Corliss, L. D.; Liden, S.; Merrick, R. B.; Dugan, D. C.

1980-01-01

The flight-acceptance test results obtained during the acceptance tests of the V/STOLAND (versatile simplex digital avionics system) digital avionics system on a Bell UH-1H helicopter in 1977 at Ames Research Center are presented. The system provides navigation, guidance, control, and display functions for NASA terminal area VTOL research programs and for the Army handling qualities research programs at Ames Research Center. The acceptance test verified system performance and contractual acceptability. The V/STOLAND hardware navigation, guidance, and control laws resident in the digital computers are described. Typical flight-test data are shown and discussed as documentation of the system performance at acceptance from the contractor.

[About the problems and prospects of improving of governance in the modern hospital associations].

PubMed

Maksimov, I B; Stoliar, V P

2011-10-01

The problems of efficiency of management of officials of hospital healthcare association of manage of remote branch offices and the structural units of the Main Military Clinical Hospital n. a. N.N. Burdenko is examined. Emphasizes the role of improved information exchange, collect and analyze medical and other information. As a tool, that can provide consolidation and optimal utilization of institutional capacity, and all the information and analytical resources offered to create a situational control center (div) of hospital health-care associations. The result of the introduction will increase div validity and quality of management decisions of the leadership of the words: management, hospital treatment and prevention association, communication, situational control center.

[Challenges to implementation of the ECG reading center in ELSA-Brasil].

PubMed

Ribeiro, Antonio Luiz; Pereira, Samuel Vianney da Cunha; Bergmann, Kaiser; Ladeira, Roberto Marini; Oliveira, Rackel Aguiar Mendes; Lotufo, Paulo A; Mill, José Geraldo; Barreto, Sandhi Maria

2013-06-01

Electrocardiography is an established low-cost method of cardiovascular assessment, utilized for decades large epidemiological studies. Nonetheless, its use in large epidemiological studies presents challenges, especially when seeking to develop a reading center. This article describes the process, difficulties and challenges of implementing an electrocardiogram reading center in Brazilian Longitudinal Study for Adult Health (ELSA-Brasil). Among the issues discussed, we have emphasized: the criteria for selection of the electrocardiography machine and the central for storage and management of the machines; the required personnel; the procedures for acquisition and transmission of electrocardiographs to the Reading Center; coding systems, with emphasis on the Minnesota code; ethical and practical issues regarding the delivery of reports to study participants; and aspects related to quality control.

Computer modeling with randomized-controlled trial data informs the development of person-centered aged care homes.

PubMed

Chenoweth, Lynn; Vickland, Victor; Stein-Parbury, Jane; Jeon, Yun-Hee; Kenny, Patricia; Brodaty, Henry

2015-10-01

To answer questions on the essential components (services, operations and resources) of a person-centered aged care home (iHome) using computer simulation. iHome was developed with AnyLogic software using extant study data obtained from 60 Australian aged care homes, 900+ clients and 700+ aged care staff. Bayesian analysis of simulated trial data will determine the influence of different iHome characteristics on care service quality and client outcomes. Interim results: A person-centered aged care home (socio-cultural context) and care/lifestyle services (interactional environment) can produce positive outcomes for aged care clients (subjective experiences) in the simulated environment. Further testing will define essential characteristics of a person-centered care home.

The association of cumulative discrimination on quality of care, patient-centered care, and dissatisfaction with care in adults with type 2 diabetes.

PubMed

Cykert, David M; Williams, Joni S; Walker, Rebekah J; Davis, Kimberly S; Egede, Leonard E

2017-01-01

Discrimination is linked to negative health outcomes, but little research has investigated how the cumulative effect of discrimination impacts perceptions of care. This study investigated the influence of cumulative perceived discrimination on quality of care, patient-centeredness, and dissatisfaction with care in adults with type 2 diabetes. Six hundred two patients from two primary care clinics in Charleston, SC. Linear regression models assessed associations between perceived discrimination and quality of care, patient-centered care, and dissatisfaction with care. The models control for race, site, age, gender, marital status, duration of diabetes, education, hours worked weekly, income, and health status. The mean age was 61.5years, with 66.3% non-Hispanic blacks, and 41.9% earning less than $20,000 annually. In final adjusted analyses, lower patient-centered care was associated with a higher discrimination score (β=-0.28; p=0.006), reporting at least 1 category of discrimination (β=-1.47; p=0.002), and reporting at least 2 categories of discrimination (β=-1.34; p=0.004). Dissatisfaction with care was associated with at least 2 categories of discrimination (β=0.45; p=0.002). No significant associations were seen with quality of care indicators. Increased cumulative discrimination was associated with decreased feeling of patient-centeredness and increased dissatisfaction with care. However, these perceptions of discrimination were not significantly associated with quality indicators. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality Control Algorithms for the Kennedy Space Center 50-Megahertz Doppler Radar Wind Profiler Winds Database

NASA Technical Reports Server (NTRS)

Barbre, Robert E., Jr.

2012-01-01

This paper presents the process used by the Marshall Space Flight Center Natural Environments Branch (EV44) to quality control (QC) data from the Kennedy Space Center's 50-MHz Doppler Radar Wind Profiler for use in vehicle wind loads and steering commands. The database has been built to mitigate limitations of using the currently archived databases from weather balloons. The DRWP database contains wind measurements from approximately 2.7-18.6 km altitude at roughly five minute intervals for the August 1997 to December 2009 period of record, and the extensive QC process was designed to remove spurious data from various forms of atmospheric and non-atmospheric artifacts. The QC process is largely based on DRWP literature, but two new algorithms have been developed to remove data contaminated by convection and excessive first guess propagations from the Median Filter First Guess Algorithm. In addition to describing the automated and manual QC process in detail, this paper describes the extent of the data retained. Roughly 58% of all possible wind observations exist in the database, with approximately 100 times as many complete profile sets existing relative to the EV44 balloon databases. This increased sample of near-continuous wind profile measurements may help increase launch availability by reducing the uncertainty of wind changes during launch countdown

76 FR 1167 - Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-07

... Organization, Functions, and Delegations of Authority Part C (Centers for Disease Control and Prevention) of the Statement of Organization, Functions, and Delegations of Authority of the Department of Health and... Functions, is hereby amended as follows: Delete in its entirety the title for the Office of Science Quality...

77 FR 13131 - Proposed Collection: Comment Request Post-Award Reporting Requirements Including New Research...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-05

... submitted to the Office of Management and Budget (OMB) for review and approval. Proposed Collection: Title... Administration, Centers for Disease Control and Prevention, and Agency for Healthcare Research and Quality (AHRQ... and principal investigators. The annual reporting burden is as follows: Total Estimated Number of...

Strategies to Improve Marketing and Promotion of Foods and Beverages at School

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2014

2014-01-01

Food and beverage marketing often appears throughout schools in the form of posters, vending machine fronts, in-school television advertisements, school newspapers, textbook covers, sports equipment, and scoreboards. Many foods marketed in schools are of poor nutritional quality. The Centers for Disease Control and Prevention, Institute of…

[2011 after-service customer satisfaction survey of monitoring devices in Shanghai area].

PubMed

Wang, Lijun; Li, Bin; Qian, Jianguo; Cao, Shaoping; He, Dehua; Zheng, Yunxin

2013-01-01

In 2011, Shanghai Medical Equipment Management Quality Control Center launched the fifth after-sale service satisfaction survey for medical devices in Shanghai area. There are 8 classes medical devices involving in the survey. This paper demonstrates the investigation results of monitoring devices which are from different manufacturers.

78 FR 25484 - Public Access to Federally Supported Research and Development Data and Publications: Two Planning...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

... NATIONAL SCIENCE FOUNDATION Public Access to Federally Supported Research and Development Data and... for Health and Human Services, Agency for Healthcare Research and Quality, Centers for Disease Control... Veterans Affairs, Environmental Protection Agency, Institute of Museum and Library Services, National...

Early Childhood Education: The Long-Term Benefits

ERIC Educational Resources Information Center

Bakken, Linda; Brown, Nola; Downing, Barry

2017-01-01

This study was designed to substantiate the positive, long-term outcomes demonstrated by children from economically disadvantaged homes who received a high-quality, early education. Children who attended The Opportunity Project (TOP) Early Learning Centers in a midwestern city in the United States were matched with a like control sample from a…

Tethered gravity laboratories study

NASA Technical Reports Server (NTRS)

Lucchetti, F.

1989-01-01

The use is studied of tether systems to improve the lowest possible steady gravity level on the Space Station. Particular emphasis is placed by the microgravity community on the achievement of high quality microgravity conditions. The tether capability is explored for active control of the center of gravity and the analysis of possible tethered configurations.

QUALITY CONTROL OF SEMI-CONTINUOUS MOBILITY SIZE-FRACTIONATED PARTICLE NUMBER CONCENTRATION DATA. (R827352)

EPA Science Inventory

Fine and ultrafine particles have been postulated to play an important role in the association between ambient particulate matters and adverse health effects. As part of the EPA Supersite Program, the Southern California Particle Center & Supersite has conducted a series o...

Quality improvement prototype: Johnson Space Center, National Aeronautics and Space Administration

NASA Technical Reports Server (NTRS)

1990-01-01

The Johnson Space Flight Center was recognized by the Office of Management and Budget as a model for its high standards of quality. Included are an executive summary of the center's activities, an organizational overview, techniques for improving quality, the status of the quality effort and a listing of key personnel.

World Ocean Database and the Global Temperature and Salinity Profile Program Database: Synthesis of historical and near real-time ocean profile data

NASA Astrophysics Data System (ADS)

Boyer, T.; Sun, L.; Locarnini, R. A.; Mishonov, A. V.; Hall, N.; Ouellet, M.

2016-02-01

The World Ocean Database (WOD) contains systematically quality controlled historical and recent ocean profile data (temperature, salinity, oxygen, nutrients, carbon cycle variables, biological variables) ranging from Captain Cooks second voyage (1773) to this year's Argo floats. The US National Centers for Environmental Information (NCEI) also hosts the Global Temperature and Salinity Profile Program (GTSPP) Continuously Managed Database (CMD) which provides quality controlled near-real time ocean profile data and higher level quality controlled temperature and salinity profiles from 1990 to present. Both databases are used extensively for ocean and climate studies. Synchronization of these two databases will allow easier access and use of comprehensive regional and global ocean profile data sets for ocean and climate studies. Synchronizing consists of two distinct phases: 1) a retrospective comparison of data in WOD and GTSPP to ensure that the most comprehensive and highest quality data set is available to researchers without the need to individually combine and contrast the two datasets and 2) web services to allow the constantly accruing near-real time data in the GTSPP CMD and the continuous addition and quality control of historical data in WOD to be made available to researchers together, seamlessly.

Center Size and Center Performance.

ERIC Educational Resources Information Center

Helburn, Suzanne; Morris, John

1996-01-01

Examined the impact of child care center size on cost, quality, and profits per child. Examined centers ranging from 40 to 80 children and found total cost and revenue per child were similar for small, medium, and large centers. Found profits per child were highest in large centers and that there was no relationship between center quality and…

The prevention research centers' managing epilepsy well network.

PubMed

DiIorio, Colleen K; Bamps, Yvan A; Edwards, Ariele L; Escoffery, Cam; Thompson, Nancy J; Begley, Charles E; Shegog, Ross; Clark, Noreen M; Selwa, Linda; Stoll, Shelley C; Fraser, Robert T; Ciechanowski, Paul; Johnson, Erica K; Kobau, Rosemarie; Price, Patricia H

2010-11-01

The Managing Epilepsy Well (MEW) Network was created in 2007 by the Centers for Disease Control and Prevention's (CDC) Prevention Research Centers and Epilepsy Program to promote epilepsy self-management research and to improve the quality of life for people with epilepsy. MEW Network membership comprises four collaborating centers (Emory University, University of Texas Health Science Center at Houston, University of Michigan, and University of Washington), representatives from CDC, affiliate members, and community stakeholders. This article describes the MEW Network's background, mission statement, research agenda, and structure. Exploratory and intervention studies conducted by individual collaborating centers are described, as are Network collaborative projects, including a multisite depression prevention intervention and the development of a standard measure of epilepsy self-management. Communication strategies and examples of research translation programs are discussed. The conclusion outlines the Network's role in the future development and dissemination of evidence-based epilepsy self-management programs. Copyright © 2010 Elsevier Inc. All rights reserved.

Community health centers and primary care access and quality for chronically-ill patients - a case-comparison study of urban Guangdong Province, China.

PubMed

Shi, Leiyu; Lee, De-Chih; Liang, Hailun; Zhang, Luwen; Makinen, Marty; Blanchet, Nathan; Kidane, Ruth; Lindelow, Magnus; Wang, Hong; Wu, Shaolong

2015-11-30

Reform of the health care system in urban areas of China has prompted concerns about the utilization of Community Health Centers (CHC). This study examined which of the dominant primary care delivery models, i.e., the public CHC model, the 'gate-keeper' CHC model, or the hospital-owned CHC models, was most effective in enhancing access to and quality of care for patients with chronic illness. The case-comparison design was used to study nine health care organizations in Guangzhou, Dongguan, and Shenzhen cities within Guangdong province, China. 560 patients aged 50 or over with hypertension or diabetes who visited either CHCs or hospitals in these three cities were surveyed by using face-to-face interviews. Bivariate analyses were performed to compare quality and value of care indicators among subjects from the three cities. Multivariate analyses were used to assess the association between type of primary care delivery and quality as well as value of chronic care after controlling for patients' demographic and health status characteristics. Patients from all three cities chose their current health care providers primarily out of concern for quality of care (both provider expertise and adequate medical equipment), patient-centered care, and insurance plan requirement. Compared with patients from Guangzhou, those from Dongguan performed significantly better on most quality and value of care indicators. Most of these indicators remained significantly better even after controlling for patients' demographic and health status characteristics. The Shenzhen model (hospital-owned and -managed CHC) was generally effective in enhancing accessibility and continuity. However, coordination suffered due to seemingly duplicating primary care outpatients at the hospital setting. Significant associations between types of health care facilities and quality of care were also observed such that patients from CHCs were more likely to be satisfied with traveling time and follow-up care by their providers. The study suggested that the Dongguan model (based on insurance mandate and using family practice physicians as 'gate-keepers') seemed to work best in terms of improving access and quality for patients with chronic conditions. The study suggested adequately funded and well-organized primary care system can play a gatekeeping role and has the potential to provide a reasonable level of care to patients.

Analytical study of beam handling and emittance control

NASA Astrophysics Data System (ADS)

Thompson, James R.; Sloan, M. L.

1993-12-01

The thrust of our research on beam handling and emittance control was to explore how one might design high current electron accelerators, with the preservation of high beam quality designed as the primary design consideration. We considered high current, induction linacs in the parameter class of the ETA/ATA accelerators at LLNL, but with improvements to the accelerator gap design and other features to permit a significant increase in the deliverable beam brightness. Our approach for beam quality control centered on the use of solenoidal magnetic focusing through such induction accelerators, together with gently-shaped (adiabatic) acceleration gaps. This approach offers several tools for the control of beam quality. The strength and axial variation in the solenoidal magnetic field may be designed, as may the length and shape of the acceleration gaps, the loading of the gaps, and the axial spacing from gap to gap. This research showed that each of these design features may individually be optimized to contribute to improved beam quality control, and by exploiting these features, it appears feasible to produce high current, high energy electron beams possessing breakthrough beam quality and brightness. Applications which have been technologically unachievable may for the first time become possible. One such application is the production of high performance free electron lasers at very short wavelengths, extending down to the optical (less than 1 micron) regime.

[Implementation of quality standard UNE-EN ISO/IEC 17043 in the External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology].

PubMed

Poveda Gabaldón, Marta; Ovies, María Rosario; Orta Mira, Nieves; Serrano, M del Remedio Guna; Avila, Javier; Giménez, Alicia; Cardona, Concepción Gimeno

2011-12-01

The quality standard "UNE-EN-ISO 17043: 2010. Conformity assessment. General requirements for proficiency testing" applies to centers that organize intercomparisons in all areas. In the case of clinical microbiology laboratories, these intercomparisons must meet the management and technical standards required to achieve maximum quality in the performance of microbiological analysis and the preparation of test items (sample, product, data or other information used in the proficiency test) to enable them to be accredited. Once accredited, these laboratories can operate as a tool for quality control laboratories and competency assessment. In Spain, accreditation is granted by the Spanish Accreditation Body [Entidad Nacional de Acreditación (ENAC)]. The objective of this review is to explain how to apply the requirements of the standard to laboratories providing intercomparisons in the field of clinical microbiology (the organization responsible for all the tasks related to the development and operation of a proficiency testing program). This requires defining the scope and specifying the technical requirements (personnel management, control of equipment, facilities and environment, the design of the proficiency testing and data analysis for performance evaluation, communication with participants and confidentiality) and management requirements (document control, purchasing control, monitoring of complaints / claims, non-compliance, internal audits and management reviews). Copyright © 2011 Elsevier España S.L. All rights reserved.

Long-term treatment outcomes of acromegaly patients presenting biochemically-uncontrolled at a tertiary pituitary center.

PubMed

Carmichael, John D; Broder, Michael S; Cherepanov, Dasha; Chang, Eunice; Mamelak, Adam; Said, Qayyim; Neary, Maureen P; Bonert, Vivien

2017-08-04

Acromegaly is a rare, slowly progressive disorder resulting from excessive growth hormone (GH) production by a pituitary somatotroph tumor. The objective of this study was to examine acromegaly treatment outcomes during long-term care at a specialized pituitary center in patients presenting with lack of biochemical control. Data came from an acromegaly registry at the Cedars-Sinai Medical Center Pituitary Center (center). Acromegaly patients included in this study were those who presented biochemically-uncontrolled for care at the center. Biochemical control status, based on serum insulin-like growth factor-1 values, was determined at presentation and at study end. Patient characteristics and acromegaly treatments were reported before and after presentation by presenting treatment status and final biochemical control status. Data on long-term follow-up were recorded from 1985 through June 2013. Seventy-four patients presented uncontrolled: 40 untreated (54.1%) and 34 (45.9%) previously-treated. Mean (SD) age at diagnosis was 43.2 (14.7); 32 (43.2%) were female patients. Of 65 patients with tumor size information, 59 (90.8%) had macroadenomas. Prior treatments among the 34 previously-treated patients were pituitary surgery alone (47.1%), surgery and medication (41.2%), and medication alone (11.8%). Of the 40 patients without prior treatment, 82.5% achieved control by study end. Of the 34 with prior treatment, 50% achieved control by study end. This observational study shows that treatment outcomes of biochemically-uncontrolled acromegaly patients improve with directed care, particularly for those that initially present untreated. Patients often require multiple modalities of treatment, many of which are offered with the highest quality at specialized pituitary centers. Despite specialized care, some patients were not able to achieve biochemical control with methods of treatment that were available at the time of their treatment, showing the need for additional treatment options.

Wide bandwidth and high resolution planar filter array based on DBR-metasurface-DBR structures

DOE PAGES

Horie, Yu; Arbabi, Amir; Arbabi, Ehsan; ...

2016-05-19

Here, we propose and experimentally demonstrate a planar array of optical bandpass filters composed of low loss dielectric metasurface layers sandwiched between two distributed Bragg reflectors (DBRs). The two DBRs form a Fabry-Perot resonator whose center wavelength is controlled by the design of the transmissive metasurface layer which functions as a phase shifting element. We demonstrate an array of bandpass filters with spatially varying center wavelengths covering a wide range of operation wavelengths of 250nm around λ = 1550nm (Δλ/λ = 16%). The center wavelengths of each filter are independently controlled only by changing the in-plane geometry of the sandwichedmore » metasurfaces, and the experimentally measured quality factors are larger than 700. The demonstrated filter array can be directly integrated on top of photodetector arrays to realize on-chip high-resolution spectrometers with free-space coupling.« less

Development and Flight Testing of a Neural Network Based Flight Control System on the NF-15B Aircraft

NASA Technical Reports Server (NTRS)

Bomben, Craig R.; Smolka, James W.; Bosworth, John T.; Silliams-Hayes, Peggy S.; Burken, John J.; Larson, Richard R.; Buschbacher, Mark J.; Maliska, Heather A.

2006-01-01

The Intelligent Flight Control System (IFCS) project at the NASA Dryden Flight Research Center, Edwards AFB, CA, has been investigating the use of neural network based adaptive control on a unique NF-15B test aircraft. The IFCS neural network is a software processor that stores measured aircraft response information to dynamically alter flight control gains. In 2006, the neural network was engaged and allowed to learn in real time to dynamically alter the aircraft handling qualities characteristics in the presence of actual aerodynamic failure conditions injected into the aircraft through the flight control system. The use of neural network and similar adaptive technologies in the design of highly fault and damage tolerant flight control systems shows promise in making future aircraft far more survivable than current technology allows. This paper will present the results of the IFCS flight test program conducted at the NASA Dryden Flight Research Center in 2006, with emphasis on challenges encountered and lessons learned.

Development and validation of a protocol for optimizing the use of paraffin blocks in molecular epidemiological studies: The example from the HPV-AHEAD study.

PubMed

Mena, Marisa; Lloveras, Belen; Tous, Sara; Bogers, Johannes; Maffini, Fausto; Gangane, Nitin; Kumar, Rekha Vijay; Somanathan, Thara; Lucas, Eric; Anantharaman, Devasena; Gheit, Tarik; Castellsagué, Xavier; Pawlita, Michael; de Sanjosé, Silvia; Alemany, Laia; Tommasino, Massimo

2017-01-01

Worldwide use of formalin-fixed paraffin-embedded blocks (FFPE) is extensive in diagnosis and research. Yet, there is a lack of optimized/standardized protocols to process the blocks and verify the quality and presence of the targeted tissue. In the context of an international study on head and neck cancer (HNC)-HPV-AHEAD, a standardized protocol for optimizing the use of FFPEs in molecular epidemiology was developed and validated. First, a protocol for sectioning the FFPE was developed to prevent cross-contamination and distributed between participating centers. Before processing blocks, all sectioning centers underwent a quality control to guarantee a satisfactory training process. The first and last sections of the FFPEs were used for histopathological assessment. A consensus histopathology evaluation form was developed by an international panel of pathologists and evaluated for four indicators in a pilot analysis in order to validate it: 1) presence/type of tumor tissue, 2) identification of other tissue components that could affect the molecular diagnosis and 3) quality of the tissue. No HPV DNA was found in sections from empty FFPE generated in any histology laboratories of HPV-AHEAD consortium and all centers passed quality assurance for processing after quality control. The pilot analysis to validate the histopathology form included 355 HNC cases. The form was filled by six pathologists and each case was randomly assigned to two of them. Most samples (86%) were considered satisfactory. Presence of >50% of invasive carcinoma was observed in all sections of 66% of cases. Substantial necrosis (>50%) was present in <2% of samples. The concordance for the indicators targeted to validate the histopathology form was very high (kappa > 0.85) between first and last sections and fair to high between pathologists (kappa/pabak 0.21-0.72). The protocol allowed to correctly process without signs of contamination all FFPE of the study. The histopathology evaluation of the cases assured the presence of the targeted tissue, identified the presence of other tissues that could disturb the molecular diagnosis and allowed the assessment of tissue quality.

Flight evaluation of advanced controls and displays for transition and landing on the NASA V/STOL systems research aircraft

NASA Technical Reports Server (NTRS)

Franklin, James A.; Stortz, Michael W.; Borchers, Paul F.; Moralez, Ernesto, III

1996-01-01

Flight experiments were conducted on Ames Research Center's V/STOL Systems Research Aircraft (VSRA) to assess the influence of advanced control modes and head-up displays (HUD's) on flying qualities for precision approach and landing operations. Evaluations were made for decelerating approaches to hover followed by a vertical landing and for slow landings for four control/display mode combinations: the basic YAV-8B stability augmentation system; attitude command for pitch, roll, and yaw; flightpath/acceleration command with translational rate command in the hover; and height-rate damping with translational-rate command. Head-up displays used in conjunction with these control modes provided flightpath tracking/pursuit guidance and deceleration commands for the decelerating approach and a mixed horizontal and vertical presentation for precision hover and landing. Flying qualities were established and control usage and bandwidth were documented for candidate control modes and displays for the approach and vertical landing. Minimally satisfactory bandwidths were determined for the translational-rate command system. Test pilot and engineer teams from the Naval Air Warfare Center, the Boeing Military Airplane Group, Lockheed Martin, McDonnell Douglas Aerospace, Northrop Grumman, Rolls-Royce, and the British Defense Research Agency participated in the program along with NASA research pilots from the Ames and Lewis Research Centers. The results, in conjunction with related ground-based simulation data, indicate that the flightpath/longitudinal acceleration command response type in conjunction with pursuit tracking and deceleration guidance on the HUD would be essential for operation to instrument minimums significantly lower than the minimums for the AV-8B. It would also be a superior mode for performing slow landings where precise control to an austere landing area such as a narrow road is demanded. The translational-rate command system would reduce pilot workload for demanding vertical landing tasks aboard ship and in confined land-based sites.

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.

Rotorcraft handling-qualities design criteria development

NASA Technical Reports Server (NTRS)

Aiken, Edwin W.; Lebacqz, J. Victor; Chen, Robert T. N.; Key, David L.

1988-01-01

Joint NASA/Army efforts at the Ames Research Center to develop rotorcraft handling-qualities design criteria began in earnest in 1975. Notable results were the UH-1H VSTOLAND variable stability helicopter, the VFA-2 camera-and-terrain-board simulator visual system, and the generic helicopter real-time mathematical model, ARMCOP. An initial series of handling-qualities studies was conducted to assess the effects of rotor design parameters, interaxis coupling, and various levels of stability and control augmentation. The ability to conduct in-flight handling-qualities research was enhanced by the development of the NASA/Army CH-47 variable-stability helicopter. Research programs conducted using this vehicle include vertical-response investigations, hover augmentation systems, and the effects of control-force characteristics. The handling-qualities data base was judged to be sufficient to allow an update of the military helicopter handling-qualities specification, MIL-H-8501. These efforts, including not only the in-house experimental work but also contracted research and collaborative programs performed under the auspices of various international agreements. The report concludes by reviewing the topics that are currently most in need of work, and the plans for addressing these topics.

Performance of Local Light Microscopy and the ParaScreen Pan/Pf Rapid Diagnostic Test to Detect Malaria in Health Centers in Northwest Ethiopia

PubMed Central

Endeshaw, Tekola; Graves, Patricia M.; Ayele, Berhan; Mosher, Aryc W.; Gebre, Teshome; Ayalew, Firew; Genet, Asrat; Mesfin, Alemayehu; Shargie, Estifanos Biru; Tadesse, Zerihun; Teferi, Tesfaye; Melak, Berhanu; Richards, Frank O.; Emerson, Paul M.

2012-01-01

Background Diagnostic tests are recommended for suspected malaria cases before treatment, but comparative performance of microscopy and rapid diagnostic tests (RDTs) at rural health centers has rarely been studied compared to independent expert microscopy. Methods Participants (N = 1997) with presumptive malaria were recruited from ten health centers with a range of transmission intensities in Amhara Regional State, Northwest Ethiopia during October to December 2007. Microscopy and ParaScreen Pan/Pf® RDT were done immediately by health center technicians. Blood slides were re-examined later at a central laboratory by independent expert microscopists. Results Of 1,997 febrile patients, 475 (23.8%) were positive by expert microscopists, with 57.7% P.falciparum, 24.6% P.vivax and 17.7% mixed infections. Sensitivity of health center microscopists for any malaria species was >90% in five health centers (four of which had the highest prevalence), >70% in nine centers and 44% in one site with lowest prevalence. Specificity for health center microscopy was very good (>95%) in all centers. For ParaScreen RDT, sensitivity was ≥90% in three centers, ≥70% in six and <60% in four centers. Specificity was ≥90% in all centers except one where it was 85%. Conclusions Health center microscopists performed well in nine of the ten health centers; while for ParaScreen RDT they performed well in only six centers. Overall the accuracy of local microscopy exceeded that of RDT for all outcomes. This study supports the introduction of RDTs only if accompanied by appropriate training, frequent supervision and quality control at all levels. Deficiencies in RDT use at some health centers must be rectified before universal replacement of good routine microscopy with RDTs. Maintenance and strengthening of good quality microscopy remains a priority at health center level. PMID:22536317

Performance of local light microscopy and the ParaScreen Pan/Pf rapid diagnostic test to detect malaria in health centers in Northwest Ethiopia.

PubMed

Endeshaw, Tekola; Graves, Patricia M; Ayele, Berhan; Mosher, Aryc W; Gebre, Teshome; Ayalew, Firew; Genet, Asrat; Mesfin, Alemayehu; Shargie, Estifanos Biru; Tadesse, Zerihun; Teferi, Tesfaye; Melak, Berhanu; Richards, Frank O; Emerson, Paul M

2012-01-01

Diagnostic tests are recommended for suspected malaria cases before treatment, but comparative performance of microscopy and rapid diagnostic tests (RDTs) at rural health centers has rarely been studied compared to independent expert microscopy. Participants (N = 1997) with presumptive malaria were recruited from ten health centers with a range of transmission intensities in Amhara Regional State, Northwest Ethiopia during October to December 2007. Microscopy and ParaScreen Pan/Pf® RDT were done immediately by health center technicians. Blood slides were re-examined later at a central laboratory by independent expert microscopists. Of 1,997 febrile patients, 475 (23.8%) were positive by expert microscopists, with 57.7% P. falciparum, 24.6% P. vivax and 17.7% mixed infections. Sensitivity of health center microscopists for any malaria species was >90% in five health centers (four of which had the highest prevalence), >70% in nine centers and 44% in one site with lowest prevalence. Specificity for health center microscopy was very good (>95%) in all centers. For ParaScreen RDT, sensitivity was ≥90% in three centers, ≥70% in six and <60% in four centers. Specificity was ≥90% in all centers except one where it was 85%. Health center microscopists performed well in nine of the ten health centers; while for ParaScreen RDT they performed well in only six centers. Overall the accuracy of local microscopy exceeded that of RDT for all outcomes. This study supports the introduction of RDTs only if accompanied by appropriate training, frequent supervision and quality control at all levels. Deficiencies in RDT use at some health centers must be rectified before universal replacement of good routine microscopy with RDTs. Maintenance and strengthening of good quality microscopy remains a priority at health center level.

Does working with the Veder Contact Method influence the job satisfaction of caregivers? A non-randomized controlled trial in nursing homes for people with dementia.

PubMed

Boersma, P; Dröes, R M; Lissenberg-Witte, B I; van Meijel, B; van Weert, J C M

2017-12-01

Person-centered care interventions can improve the quality of life and decrease behavioral problems of people with dementia. Although not convincingly proven, person-centered care interventions may benefit the caregivers as well. This study aims to gain insight into how working with the Veder Contact Method (VCM) - a new person-centered care method - influences the job satisfaction of caregivers. Within a quasi-experimental study, the job satisfaction of caregivers of six experimental wards (n = 75) was compared with caregivers of six control wards (n = 36) that applied Care-As-Usual. The Leiden Quality of Work Questionnaire (LQWQ) was filled in by caregivers in both conditions. Additionally, on the experimental wards, qualitative research, i.e. focus groups with 42 caregivers and interviews with 11 managers, was conducted to obtain a deeper understanding of the influence of applying VCM on caregivers' job satisfaction. The transcripts were analyzed using deductive analysis. No quantitatively significant differences were found on the subscales of the LQWQ: work and time pressure, job satisfaction, autonomous decision making, social support from colleagues, and social support from supervisors. From the qualitative research, some caregivers and managers reported that implementing VCM contributed to their job satisfaction and that applying VCM supported handling difficult behavior and depressed mood of residents and contributed to team building. No significant effects on job satisfaction were demonstrated. Qualitative findings indicate that VCM positively influences the daily work performances of nursing home caregivers. The relation between the experience of offering quality care and job satisfaction of caregivers needs further investigation.

Preschool Center Quality and School Readiness: Quality Effects and Variation by Demographic and Child Characteristics

ERIC Educational Resources Information Center

Keys, Tran D.; Farkas, George; Burchinal, Margaret R.; Duncan, Greg J.; Vandell, Deborah L.; Li, Weilin; Ruzek, Erik A.; Howes, Carollee

2013-01-01

This article examines associations between observed quality in preschool center classrooms for approximately 6,250 three- to five-year-olds and their school readiness skills at kindergarten entry. Secondary analyses were conducted using data from four large-scale studies to estimate the effects of preschool center quality and interactions between…

The Effect of Aerobic Exercise on Quantity and Quality of Sleep Among Elderly People Referring to Health Centers of Lar City, Southern of Iran; A Randomized Controlled Clinical Trial.

PubMed

Sharif, Farkhondeh; Seddigh, Maryam; Jahanbin, Iran; Keshavarzi, Sareh

2015-01-01

Aging is associated with reduced quality and quantity of sleep. 50% of senior citizens living in the community and 70% of those living in nursing homes suffer from sleep disorders. Moreover, insomnia increases the risk of mortality and morbidity in older adults. We aimed to investigate the effect of aerobic exercise on quantity and quality of sleep among the elderly people referring to health centers of Lar city, southern Iran. We enrolled 60 elderly people whose age range was 60-75 years and (mean ±SD) age was (64.8±5.2). Participants were randomly assigned into two groups of 30 each (case group= 30 and control group=30). The patients in the case group participated in exercise trainings consisted of three one-hour sessions per week for 12 consecutive weeks. Sleep quantity and quantity in the participants was evaluated before and after intervention using Pittsburgh Sleep Quality Index (PSQI). Independent t-test showed that sleep quality score was improved by 44.46% in the case group (p<0.0001). Furthermore, sleep duration was improved by 98/16% (p=0.038) and sleep latency was improved by 76/6% in the case group; while, the difference between the two groups regarding the changes in the sleep latency was not statistically significant (p=0.089). Aerobic exercise program could improve the sleep quality and quantity in the elderly. It could also be used as a cost effective and long lasting method of therapy with no side effect which could be used for the treatment of insomnia in older people.

Evaluation of green roof as green technology for urban stormwater quantity and quality controls

NASA Astrophysics Data System (ADS)

Kok, K. H.; Sidek, L. M.; Abidin, M. R. Z.; Basri, H.; Muda, Z. C.; Beddu, S.

2013-06-01

Promoting green design, construction, reconstruction and operation of buildings has never been more critical than now due to the ever increasing greenhouse gas emissions and rapid urbanizations that are fuelling climate change more quickly. Driven by environmental needs, Green Building Index (GBI) was founded in Malaysia to drive initiative to lead the property industry towards becoming more environment-friendly. Green roof system is one of the assessment criteria of this rating system which is under category of sustainable site planning and management. An extensive green roof was constructed in Humid Tropics Center (HTC) Kuala Lumpur as one of the components for Stormwater Management Ecohydrology (SME) in order to obtain scientific data of the system. This paper evaluates the performance of extensive green roof at Humid Tropics Center with respect to urban heat island mitigation and stormwater quantity and quality controls. Findings indicate that there was a reduction of around 1.5°C for indoor temperature of the building after installation of green roof. Simulations showed that the peak discharge was reduced up to 24% relative to impervious brown roof. The results show an increment of pH and high concentration of phosphate for the runoff generated from the green roof and the runoff water quality ranged between class I and II under INWQS.

Interpreting and Reporting Radiological Water-Quality Data

USGS Publications Warehouse

McCurdy, David E.; Garbarino, John R.; Mullin, Ann H.

2008-01-01

This document provides information to U.S. Geological Survey (USGS) Water Science Centers on interpreting and reporting radiological results for samples of environmental matrices, most notably water. The information provided is intended to be broadly useful throughout the United States, but it is recommended that scientists who work at sites containing radioactive hazardous wastes need to consult additional sources for more detailed information. The document is largely based on recognized national standards and guidance documents for radioanalytical sample processing, most notably the Multi-Agency Radiological Laboratory Analytical Protocols Manual (MARLAP), and on documents published by the U.S. Environmental Protection Agency and the American National Standards Institute. It does not include discussion of standard USGS practices including field quality-control sample analysis, interpretive report policies, and related issues, all of which shall always be included in any effort by the Water Science Centers. The use of 'shall' in this report signifies a policy requirement of the USGS Office of Water Quality.

Effect of animal-assisted activity on balance and quality of life in home-dwelling persons with dementia.

PubMed

Olsen, Christine; Pedersen, Ingeborg; Bergland, Astrid; Enders-Slegers, Marie-José; Ihlebæk, Camilla

2016-01-01

Purpose of the study was to examine if animal-assisted activity with a dog (AAA) in home-dwelling persons with dementia (PWDs) attending day-care centers would have an effect on factors related to risk of fall accidents, with balance (Berg balance scale) and quality of life (Quality of Life in Late-stage Dementia) as main outcome. The project was conducted as a prospective and cluster-randomized multicenter trial with a follow-up. 16 adapted day-care centers recruited respectively 42 (intervention group) and 38 (control group with treatment as usual) home-dwelling PWDs. The intervention consisted of 30 min sessions with AAA led by a qualified dog handler twice a week for 12 weeks in groups of 3-7 participants. The significant positive effect on balance indicates that AAA might work as a multifactorial intervention in dementia care and have useful clinical implication by affecting risk of fall. ClinicalTrial.gov; NCT02008630. Copyright © 2016 Elsevier Inc. All rights reserved.

KSC-98pc907

NASA Image and Video Library

1998-08-11

Center Director Roy Bridges displays the ISO 9001 certificate he was awarded by Det Norske Veritas (DNV), Inc., an international ISO certification organization, at a ceremony at KSC. Dalton Lyon of DNV made the presentation, which included a 2000th ISO Certificate Plaque. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already world-class team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification

KSC-98pc908

NASA Image and Video Library

1998-08-11

Center Director Roy Bridges (right) displays the 2000th ISO Certificate Plaque he was given by Dalton Lyon (left) of Det Norske Veritas (DNV), Inc., an international ISO certification organization, at a ceremony at KSC. The plaque is a representation of the ISO 9001 certification awarded to KSC by DNV. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already worldclass team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification

Manufacturing Bms/Iso System Review

NASA Technical Reports Server (NTRS)

Gomez, Yazmin

2004-01-01

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

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

PubMed Central

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

2017-01-01

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

Practical Software Measurement: Measuring for Process Management and Improvement,

DTIC Science & Technology

1997-04-01

Ishikawa , Kaoru . Guide to Quality Control, Second Revised Edition. White Plains, N.Y.: UNIPUB-Kraus International Publications, 1986. CMU/SEI-97...begin, you may want to assemble a group of people who work within the process to brainstorm possible reasons for the unusual behavior. Ishikawa charts...control limits and center line. • Cause-and-effect diagrams (also know as Ishikawa charts) allow you to probe for, map, and prioritize a set of factors

Quality control and assurance for validation of DOS/I measurements

NASA Astrophysics Data System (ADS)

Cerussi, Albert; Durkin, Amanda; Kwong, Richard; Quang, Timothy; Hill, Brian; Tromberg, Bruce J.; MacKinnon, Nick; Mantulin, William W.

2010-02-01

Ongoing multi-center clinical trials are crucial for Biophotonics to gain acceptance in medical imaging. In these trials, quality control (QC) and assurance (QA) are key to success and provide "data insurance". Quality control and assurance deal with standardization, validation, and compliance of procedures, materials and instrumentation. Specifically, QC/QA involves systematic assessment of testing materials, instrumentation performance, standard operating procedures, data logging, analysis, and reporting. QC and QA are important for FDA accreditation and acceptance by the clinical community. Our Biophotonics research in the Network for Translational Research in Optical Imaging (NTROI) program for breast cancer characterization focuses on QA/QC issues primarily related to the broadband Diffuse Optical Spectroscopy and Imaging (DOS/I) instrumentation, because this is an emerging technology with limited standardized QC/QA in place. In the multi-center trial environment, we implement QA/QC procedures: 1. Standardize and validate calibration standards and procedures. (DOS/I technology requires both frequency domain and spectral calibration procedures using tissue simulating phantoms and reflectance standards, respectively.) 2. Standardize and validate data acquisition, processing and visualization (optimize instrument software-EZDOS; centralize data processing) 3. Monitor, catalog and maintain instrument performance (document performance; modularize maintenance; integrate new technology) 4. Standardize and coordinate trial data entry (from individual sites) into centralized database 5. Monitor, audit and communicate all research procedures (database, teleconferences, training sessions) between participants ensuring "calibration". This manuscript describes our ongoing efforts, successes and challenges implementing these strategies.

Factors influencing histologic confirmation of high-grade squamous intraepithelial lesion cytology.

PubMed

Castle, Philip E; Cox, J Thomas; Schiffman, Mark; Wheeler, Cosette M; Solomon, Diane

2008-09-01

To examine the predictors of histologic confirmation of high-grade squamous intraepithelial lesion (HSIL) cytology occurring in follow-up of young women originally referred into a trial because of less severe cytology. We used enrollment HSIL cytology (N=411) as read by clinical center pathologists for women participating in the ASCUS-LSIL Triage Study (ALTS). The primary outcome was histologic cervical intraepithelial neoplasia (CIN) grade 3 and early cancer (n=195; 191 CIN 3 and four cancers) as diagnosed by the Pathology Quality Control Group during the 2-year duration of ALTS. The 2-year absolute risk of CIN 3 or worse after an HSIL cytology was 47.4% (95% confidence interval 42.5-52.4%). The 2-year absolute risk of CIN 3 or worse was lowest (14.3%) for women who were human papillomavirus (HPV)-16-negative, had colposcopic impression of less than low-grade, and whose HSIL cytology as called by the clinical center was not also called HSIL or equivocal HSIL cytology by the Pathology Quality Control Group. The 2-year absolute risk of CIN 3 or worse was highest (82.4%) for women who were HPV16-positive, had colposcopic impression of low-grade or worse, and whose HSIL cytology also was called HSIL or equivocal HSIL cytology by the Pathology Quality Control Group. Histologic confirmation of precancer among young women with HSIL cytology was more likely when other risk factors (eg, HPV16) for cervical precancer were present.

The concept of a composite perioperative quality index in kidney transplantation.

PubMed

Taber, David J; McGillicuddy, John W; Bratton, Charles F; Lin, Angello; Chavin, Kenneth D; Baliga, Prabhakar K

2014-04-01

Public reporting of patient and graft outcomes in a national registry and close Centers for Medicare and Medicaid Services oversight has resulted in transplantation being a highly regulated surgical discipline. Despite this, transplantation surgery lacks comprehensive tracking and reporting of perioperative quality measures. Therefore, the aim of this study was to determine the association between a kidney transplantation centers' perioperative quality benchmarking and graft and patient outcomes. This was an analysis of 2011 aggregate data compiled from 2 national datasets that track outcomes from member hospitals and transplantation centers. The transplantation centers included in this study were composed of accredited US kidney transplantation centers that report data through the national registry and are associate members of the University HealthSystem Consortium. A total of 16,811 kidney transplantations were performed at 236 centers in the United States in 2011, of which 10,241 (61%) from 93 centers were included in the analysis. Of the 6 perioperative quality indicators, 3 benchmarked metrics were significantly associated with a kidney transplantation center's underperformance: mean ICU length of stay (C-statistic 0.731; p = 0.002), 30-day readmissions (C-statistic 0.697; p = 0.012) and in-hospital complications (C-statistic 0.785; p = 0.001). The composite quality index strongly correlated with inadequate center performance (C-statistic 0.854; p < 0.001, R(2) = 0.349). The centers in the lowest quartile of the quality index performed 2,400 kidney transplantations in 2011, which led to 2,640 more hospital days, 4,560 more ICU days, 120 more postoperative complications, and 144 more patients with 30-day readmissions, when compared with centers in the 3 higher-quality quartiles. An objective index of a transplantation center's quality of perioperative care is significantly associated with patient and graft survival. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Quality controls for gamma cameras and PET cameras: development of a free open-source ImageJ program

NASA Astrophysics Data System (ADS)

Carlier, Thomas; Ferrer, Ludovic; Berruchon, Jean B.; Cuissard, Regis; Martineau, Adeline; Loonis, Pierre; Couturier, Olivier

2005-04-01

Acquisition data and treatments for quality controls of gamma cameras and Positron Emission Tomography (PET) cameras are commonly performed with dedicated program packages, which are running only on manufactured computers and differ from each other, depending on camera company and program versions. The aim of this work was to develop a free open-source program (written in JAVA language) to analyze data for quality control of gamma cameras and PET cameras. The program is based on the free application software ImageJ and can be easily loaded on any computer operating system (OS) and thus on any type of computer in every nuclear medicine department. Based on standard parameters of quality control, this program includes 1) for gamma camera: a rotation center control (extracted from the American Association of Physics in Medicine, AAPM, norms) and two uniformity controls (extracted from the Institute of Physics and Engineering in Medicine, IPEM, and National Electronic Manufacturers Association, NEMA, norms). 2) For PET systems, three quality controls recently defined by the French Medical Physicist Society (SFPM), i.e. spatial resolution and uniformity in a reconstructed slice and scatter fraction, are included. The determination of spatial resolution (thanks to the Point Spread Function, PSF, acquisition) allows to compute the Modulation Transfer Function (MTF) in both modalities of cameras. All the control functions are included in a tool box which is a free ImageJ plugin and could be soon downloaded from Internet. Besides, this program offers the possibility to save on HTML format the uniformity quality control results and a warning can be set to automatically inform users in case of abnormal results. The architecture of the program allows users to easily add any other specific quality control program. Finally, this toolkit is an easy and robust tool to perform quality control on gamma cameras and PET cameras based on standard computation parameters, is free, run on any type of computer and will soon be downloadable from the net (http://rsb.info.nih.gov/ij/plugins or http://nucleartoolkit.free.fr).

Improving the quality of depression and pain care in multiple sclerosis using collaborative care: The MS-care trial protocol.

PubMed

Ehde, Dawn M; Alschuler, Kevin N; Sullivan, Mark D; Molton, Ivan P; Ciol, Marcia A; Bombardier, Charles H; Curran, Mary C; Gertz, Kevin J; Wundes, Annette; Fann, Jesse R

2018-01-01

Evidence-based pharmacological and behavioral interventions are often underutilized or inaccessible to persons with multiple sclerosis (MS) who have chronic pain and/or depression. Collaborative care is an evidence-based patient-centered, integrated, system-level approach to improving the quality and outcomes of depression care. We describe the development of and randomized controlled trial testing a novel intervention, MS Care, which uses a collaborative care model to improve the care of depression and chronic pain in a MS specialty care setting. We describe a 16-week randomized controlled trial comparing the MS Care collaborative care intervention to usual care in an outpatient MS specialty center. Eligible participants with chronic pain of at least moderate intensity (≥3/10) and/or major depressive disorder are randomly assigned to MS Care or usual care. MS Care utilizes a care manager to implement and coordinate guideline-based medical and behavioral treatments with the patient, clinic providers, and pain/depression treatment experts. We will compare outcomes at post-treatment and 6-month follow up. We hypothesize that participants randomly assigned to MS Care will demonstrate significantly greater control of both pain and depression at post-treatment (primary endpoint) relative to those assigned to usual care. Secondary analyses will examine quality of care, patient satisfaction, adherence to MS care, and quality of life. Study findings will aid patients, clinicians, healthcare system leaders, and policy makers in making decisions about effective care for pain and depression in MS healthcare systems. (PCORI- IH-1304-6379; clinicaltrials.gov: NCT02137044). This trial is registered at ClinicalTrials.gov, protocol NCT02137044. Copyright © 2017 Elsevier Inc. All rights reserved.

Development and usability testing of a web-based cancer symptom and quality-of-life support intervention.

PubMed

Wolpin, S E; Halpenny, B; Whitman, G; McReynolds, J; Stewart, M; Lober, W B; Berry, D L

2015-03-01

The feasibility and acceptability of computerized screening and patient-reported outcome measures have been demonstrated in the literature. However, patient-centered management of health information entails two challenges: gathering and presenting data using "patient-tailored" methods and supporting "patient-control" of health information. The design and development of many symptom and quality-of-life information systems have not included opportunities for systematically collecting and analyzing user input. As part of a larger clinical trial, the Electronic Self-Report Assessment for Cancer-II project, participatory design approaches were used to build and test new features and interfaces for patient/caregiver users. The research questions centered on patient/caregiver preferences with regard to the following: (a) content, (b) user interface needs, (c) patient-oriented summary, and (d) patient-controlled sharing of information with family, caregivers, and clinicians. Mixed methods were used with an emphasis on qualitative approaches; focus groups and individual usability tests were the primary research methods. Focus group data were content analyzed, while individual usability sessions were assessed with both qualitative and quantitative methods. We identified 12 key patient/caregiver preferences through focus groups with 6 participants. We implemented seven of these preferences during the iterative design process. We deferred development for some of the preferences due to resource constraints. During individual usability testing (n = 8), we were able to identify 65 usability issues ranging from minor user confusion to critical errors that blocked task completion. The participatory development model that we used led to features and design revisions that were patient centered. We are currently evaluating new approaches for the application interface and for future research pathways. We encourage other researchers to adopt user-centered design approaches when building patient-centered technologies. © The Author(s) 2014.

Land cover controls on summer discharge and runoff solution chemistry of semi-arid urban catchments

NASA Astrophysics Data System (ADS)

Gallo, Erika L.; Brooks, Paul D.; Lohse, Kathleen A.; McLain, Jean E. T.

2013-04-01

SummaryRecharge of urban runoff to groundwater as a stormwater management practice has gained importance in semi-arid regions where water resources are scarce and urban centers are growing. Despite this trend, the importance of land cover in controlling semi-arid catchment runoff quantity and quality remains unclear. Here we address the question: How do land cover characteristics control the amount and quality of storm runoff in semi-arid urban catchments? We monitored summertime runoff quantity and quality from five catchments dominated by distinct urban land uses: low, medium, and high density residential, mixed use, and commercial. Increasing urban land cover increased runoff duration and the likelihood that a rainfall event would result in runoff, but did not increase the time to peak discharge of episodic runoff. The effect of urban land cover on hydrologic responses was tightly coupled to the magnitude of rainfall. At distinct rainfall thresholds, roads, percent impervious cover and the stormwater drainage network controlled runoff frequency, runoff depth and runoff ratios. Contrary to initial expectations, runoff quality did not vary in repose to impervious cover or land use. We identified four major mechanisms controlling runoff quality: (1) variable solute sourcing due to land use heterogeneity and above ground catchment connectivity; (2) the spatial extent of pervious and biogeochemically active areas; (3) the efficiency of overland flow and runoff mobilization; and (4) solute flushing and dilution. Our study highlights the importance of the stormwater drainage systems characteristics in controlling urban runoff quantity and quality; and suggests that enhanced wetting and in-stream processes may control solute sourcing and retention. Finally, we suggest that the characteristics of the stormwater drainage system should be integrated into stormwater management approaches.

Flight Hardware Fabricated for Combustion Science in Space

NASA Technical Reports Server (NTRS)

OMalley, Terence F.; Weiland, Karen J.

2005-01-01

NASA Glenn Research Center s Telescience Support Center (TSC) allows researchers on Earth to operate experiments onboard the International Space Station (ISS) and the space shuttles. NASA s continuing investment in the required software, systems, and networks provides distributed ISS ground operations that enable payload developers and scientists to monitor and control their experiments from the Glenn TSC. The quality of scientific and engineering data is enhanced while the long-term operational costs of experiments are reduced because principal investigators and engineering teams can operate their payloads from their home institutions.

Integrating High-Reliability Principles to Transform Access and Throughput by Creating a Centralized Operations Center.

PubMed

Davenport, Paul B; Carter, Kimberly F; Echternach, Jeffrey M; Tuck, Christopher R

2018-02-01

High-reliability organizations (HROs) demonstrate unique and consistent characteristics, including operational sensitivity and control, situational awareness, hyperacute use of technology and data, and actionable process transformation. System complexity and reliance on information-based processes challenge healthcare organizations to replicate HRO processes. This article describes a healthcare organization's 3-year journey to achieve key HRO features to deliver high-quality, patient-centric care via an operations center powered by the principles of high-reliability data and software to impact patient throughput and flow.

Beyond coverage: improving the quality of antenatal care delivery through integrated mentorship and quality improvement at health centers in rural Rwanda.

PubMed

Manzi, Anatole; Nyirazinyoye, Laetitia; Ntaganira, Joseph; Magge, Hema; Bigirimana, Evariste; Mukanzabikeshimana, Leoncie; Hirschhorn, Lisa R; Hedt-Gauthier, Bethany

2018-02-23

Inadequate antenatal care (ANC) can lead to missed diagnosis of danger signs or delayed referral to emergency obstetrical care, contributing to maternal mortality. In developing countries, ANC quality is often limited by skill and knowledge gaps of the health workforce. In 2011, the Mentorship, Enhanced Supervision for Healthcare and Quality Improvement (MESH-QI) program was implemented to strengthen providers' ANC performance at 21 rural health centers in Rwanda. We evaluated the effect of MESH-QI on the completeness of danger sign assessments. Completeness of danger sign assessments was measured by expert nurse mentors using standardized observation checklists. Checklists completed from October 2010 to May 2011 (n = 330) were used as baseline measurement and checklists completed between February and November 2012 (12-15 months after the start of MESH-QI implementation) were used for follow-up. We used a mixed-effects linear regression model to assess the effect of the MESH-QI intervention on the danger sign assessment score, controlling for potential confounders and the clustering of effect at the health center level. Complete assessment of all danger signs improved from 2.1% at baseline to 84.2% after MESH-QI (p <  0.001). Similar improvements were found for 20 of 23 other essential ANC screening items. After controlling for potential confounders, the improvement in danger sign assessment score was significant. However, the effect of the MESH-QI was different by intervention district and type of observed ANC visit. In Southern Kayonza District, the increase in the danger sign assessment score was 6.28 (95% CI: 5.59, 6.98) for non-first ANC visits and 5.39 (95% CI: 4.62, 6.15) for first ANC visits. In Kirehe District, the increase in danger sign assessment score was 4.20 (95% CI: 3.59, 4.80) for non-first ANC visits and 3.30 (95% CI: 2.80, 3.81) for first ANC visits. Assessment of critical danger signs improved under MESH-QI, even when controlling for nurse-mentees' education level and previous training in focused ANC. MESH-QI offers an approach to enhance quality of care after traditional training and may be an approach to support newer providers who have not yet attended content-focused courses.

Modeling Study on Air Quality Improvement due to Mobile Source Emission control Plan in Seoul Metropolitan Area

NASA Astrophysics Data System (ADS)

Kim, Y. J.; Sunwoo, Y.; Hwang, I.; Song, S.; Sin, J.; Kim, D.

2015-12-01

A very high population and corresponding high number of vehicles in the Seoul Metropolitan Area (SMA) are aggravating the air quality of this region. The Korean government continues to make concerted efforts to improve air quality. One of the major policies that the Ministry of Environment of Korea enforced is "The Special Act for Improvement of Air Quality in SMA" and "The 1st Air Quality Management Plan of SMA". Mobile Source emission controls are an important part of the policy. Thus, it is timely to evaluate the air quality improvement due to the controls. Therefore, we performed a quantitative analysis of the difference in air quality using the Community Multiscale Air Quality (CMAQ) model and December, 2011 was set as the target period to capture the impact of the above control plans. We considered four fuel-type vehicle emission scenarios and compared the air quality improvement differences between them. The scenarios are as follows: no-control, gasoline vehicle control only, diesel vehicle control only, and control of both; utilizing the revised mobile source emissions from the Clean Air Policy Support System (CAPSS), which is the national emission inventory reflecting current policy.In order to improve the accuracy of the modeling data, we developed new temporal allocation coefficients based on traffic volume observation data and spatially reallocated the mobile source emissions using vehicle flow survey data. Furthermore, we calculated the PM10 and PM2.5 emissions of gasoline vehicles which is omitted in CAPSS.The results of the air quality modeling shows that vehicle control plans for both gasoline and diesel lead to a decrease of 0.65ppb~8.75ppb and 0.02㎍/㎥~7.09㎍/㎥ in NO2 and PM10 monthly average concentrations, respectively. The large percentage decreases mainly appear near the center of the metropolis. However, the largest NO2 decrease percentages are found in the northeast region of Gyeonggi-do, which is the province that surrounds the capital of Seoul. Comparing the results between the different scenarios, diesel vehicle control impact dominates relative to the impact of gasoline control. The diesel-only reduction plan shows that NO2 and PM10 improved by 2.93ppb and 3.32㎍/㎥, respectively.

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.

77 FR 38843 - Submission for OMB Review; Comment Request: Post-Award Reporting Requirements Including New...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... 1995, the National Institutes of Health (NIH) has submitted to the Office of Management and Budget (OMB..., Centers for Disease Control and Prevention, and Agency for Healthcare Research and Quality (AHRQ) grantees... investigators. The annual reporting burden is as follows: Total Estimated Number of Respondents: 112,986...

42 CFR 423.171 - Procedures for approval of accreditation as a basis for deeming compliance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... BENEFIT Cost Control and Quality Improvement Requirements § 423.171 Procedures for approval of... 42 Public Health 3 2010-10-01 2010-10-01 false Procedures for approval of accreditation as a basis for deeming compliance. 423.171 Section 423.171 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...

Enabling next-gen sequencing and analysis at the USDA-ARS U.S. Meat Animal Research Center with MiniLIMS

USDA-ARS?s Scientific Manuscript database

There is a growing need to combine DNA sequencing technologies to address complex problems in genome biology. These genomic studies routinely generate voluminous image, sequence, and mapping files that should be associated with quality control information (gels, spectra, etc.), and other important ...

Spirometry quality-control strategies in a multinational study of the prevalence of chronic obstructive pulmonary disease.

PubMed

Pérez-Padilla, Rogelio; Vázquez-García, Juan Carlos; Márquez, María Nelly; Menezes, Ana Maria B

2008-08-01

We report the characteristics of a centralized spirometry quality-control program developed for a population-based survey of the prevalence of chronic obstructive pulmonary disease in 5 cities: São Paulo, Brazil; México City, México; Montevideo, Uruguay; Santiago, Chile; and Caracas, Venezuela (the Latin American Project for the Investigation of Obstructive Lung Diseases [PLATINO]). We developed and used a 3-level quality-control system. Level 1: The spirometer used in the survey (EasyOne), gives quality-control messages to the user/clinician. All the spirometry technicians were trained by the same team, with the aim of meeting what became the 2005 spirometry quality criteria of the American Thoracic Society/European Respiratory Society (ATS/ERS). Level 2: In each of the 5 cities a local supervisor identified poor-quality spirometries that needed to be repeated. Level 3: Once a week during the survey, all spirometry results were sent via e-mail to the study's quality-control center in México City for review and feedback. In the overall totals at the end of the study, 94% of the 5,315 subjects had spirometries that met the 1994 ATS quality criteria, and 89% met the 2005 ATS/ERS criteria. In their overall totals at the end of the study, 90% of the 64 spirometry technicians were successful in getting 86% of their subjects to meet the 1994 ATS criteria, and got 75% of their subjects to meet the 2005 ATS/ERS criteria. In the first 10 subjects they tested, 90% of the 64 spirometry technicians were successful in getting 70% of their subjects to meet the 1994 ATS criteria, and got 60% of their subjects to meet the 2005 ATS/ERS criteria. Standardization of equipment, training, and supervision of spirometry is essential in a multinational spirometry survey. Centralized quality control can be done via e-mail with good reliability and low cost.

Computer network for improving quality and efficiency of children's primary health care

NASA Astrophysics Data System (ADS)

Deutsch, Larry

1995-10-01

Health care is at its best when both the practitioner and patient are well-informed. In many central urban and remote rural areas, however, health care is characterized by a lack of continuity and coordination among providers. In these areas, a local information infrastructure and a patient-centered system of primary care are missing. Decision-making and ability to follow through is hampered, with limited involvement of patients in planning care and insufficient aggregate data for cost analysis, outcome research, community health planning, and other purposes. A Children's Health Network has been designed to extend current information technology to these underserved areas. Our approach to improving quality of individual care and controlling costs emphasizes use of computerized clinical information networks for better decision making and continuity, and secondarily through data aggregation for financial, research, and public health functions. This is in distinction to information systems centered on billing and administrative needs and to cost-control efforts which rely on fiscal and managerial ('gatekeeper') mechanisms. A uniform data base among sites serving the same population will answer several clinical and public health needs.

High-Performance Integrated Control of water quality and quantity in urban water reservoirs

NASA Astrophysics Data System (ADS)

Galelli, S.; Castelletti, A.; Goedbloed, A.

2015-11-01

This paper contributes a novel High-Performance Integrated Control framework to support the real-time operation of urban water supply storages affected by water quality problems. We use a 3-D, high-fidelity simulation model to predict the main water quality dynamics and inform a real-time controller based on Model Predictive Control. The integration of the simulation model into the control scheme is performed by a model reduction process that identifies a low-order, dynamic emulator running 4 orders of magnitude faster. The model reduction, which relies on a semiautomatic procedural approach integrating time series clustering and variable selection algorithms, generates a compact and physically meaningful emulator that can be coupled with the controller. The framework is used to design the hourly operation of Marina Reservoir, a 3.2 Mm3 storm-water-fed reservoir located in the center of Singapore, operated for drinking water supply and flood control. Because of its recent formation from a former estuary, the reservoir suffers from high salinity levels, whose behavior is modeled with Delft3D-FLOW. Results show that our control framework reduces the minimum salinity levels by nearly 40% and cuts the average annual deficit of drinking water supply by about 2 times the active storage of the reservoir (about 4% of the total annual demand).

The Minnesota Center for Twin and Family Research Genome-Wide Association Study

PubMed Central

Miller, Michael B.; Basu, Saonli; Cunningham, Julie; Eskin, Eleazar; Malone, Steven M.; Oetting, William S.; Schork, Nicholas; Sul, Jae Hoon; Iacono, William G.; Mcgue, Matt

2012-01-01

As part of the Genes, Environment and Development Initiative (GEDI), the Minnesota Center for Twin and Family Research (MCTFR) undertook a genome-wide association study (GWAS), which we describe here. A total of 8405 research participants, clustered in 4-member families, have been successfully genotyped on 527,829 single nucleotide polymorphism (SNP) markers using Illumina’s Human660W-Quad array. Quality control screening of samples and markers as well as SNP imputation procedures are described. We also describe methods for ancestry control and how the familial clustering of the MCTFR sample can be accounted for in the analysis using a Rapid Feasible Generalized Least Squares algorithm. The rich longitudinal MCTFR assessments provide numerous opportunities for collaboration. PMID:23363460

Orion Handling Qualities During ISS Proximity Operations and Docking

NASA Technical Reports Server (NTRS)

Stephens, John-Paul; Vos, Gordon A.; Bilimoria, Karl D.; Mueller, Eric R.; Brazzel, Jack; Spehar, Pete

2011-01-01

NASA's Orion spacecraft is designed to autonomously rendezvous and dock with many vehicles including the International Space Station. However, the crew is able to assume manual control of the vehicle s attitude and flight path. In these instances, Orion must meet handling qualities requirements established by NASA. Two handling qualities assessments were conducted at the Johnson Space Center to evaluate preliminary designs of the vehicle using a six degree of freedom, high-fidelity guidance, navigation, and control simulation. The first assessed Orion s handling qualities during the last 20 ft before docking, and included both steady and oscillatory motions of the docking target. The second focused on manual acquisition of the docking axis during the proximity operations phase and subsequent station-keeping. Cooper-Harper handling qualities ratings, workload ratings and comments were provided by 10 evaluation pilots for the docking study and 5 evaluation pilots for the proximity operations study. For the docking task, both cases received 90% Level 1 (satisfactory) handling qualities ratings, exceeding NASA s requirement. All ratings for the ProxOps task were Level 1. These evaluations indicate that Orion is on course to meet NASA's handling quality requirements for ProxOps and docking.

The Effects of Aromatherapy Massage on Sleep Quality of Nurses on Monthly Rotating Night Shifts

PubMed Central

Lin, Chao-Ling

2017-01-01

The goal of this study is to examine the effects of aromatherapy massage on sleep quality of nurses with monthly rotating night shifts. Subjects were enrolled at a medical center in central Taiwan with overall score ≥ 5 of Pittsburgh Sleep Quality Index (PSQI) and randomly assigned to the treatment or control groups. They were validated by pretests during their first graveyard shift in the trial period and the sleep quality information was collected by using the PSQI and sleep detectors. During the second graveyard shift, the treatment group received aromatherapy massage and the control group rested in the same aromatherapy room after work. All subjects filled out the PSQI surveys and the sleep quality information was collected during massage or resting and the following night. We found that the total PSQI was significantly decreased in the treatment group following the aromatherapy massage. Specifically, the components such as subjective sleep quality, sleep disturbance, and daytime dysfunction were significantly decreased. However, there were no significant changes of average PSQI scores between the two groups before and after intervention. Taken together, our study suggested that aromatherapy massage could improve sleep quality of nurses with monthly rotating night shift. PMID:28761497

The Effects of Aromatherapy Massage on Sleep Quality of Nurses on Monthly Rotating Night Shifts.

PubMed

Chang, Ying-Ying; Lin, Chao-Ling; Chang, Li-Yin

2017-01-01

The goal of this study is to examine the effects of aromatherapy massage on sleep quality of nurses with monthly rotating night shifts. Subjects were enrolled at a medical center in central Taiwan with overall score ≥ 5 of Pittsburgh Sleep Quality Index (PSQI) and randomly assigned to the treatment or control groups. They were validated by pretests during their first graveyard shift in the trial period and the sleep quality information was collected by using the PSQI and sleep detectors. During the second graveyard shift, the treatment group received aromatherapy massage and the control group rested in the same aromatherapy room after work. All subjects filled out the PSQI surveys and the sleep quality information was collected during massage or resting and the following night. We found that the total PSQI was significantly decreased in the treatment group following the aromatherapy massage. Specifically, the components such as subjective sleep quality, sleep disturbance, and daytime dysfunction were significantly decreased. However, there were no significant changes of average PSQI scores between the two groups before and after intervention. Taken together, our study suggested that aromatherapy massage could improve sleep quality of nurses with monthly rotating night shift.

Longitudinal handling qualities during approach and landing of a powered lift STOL aircraft

NASA Technical Reports Server (NTRS)

Franklin, J. A.; Innis, R. C.

1972-01-01

Longitudinal handling qualities evaluations were conducted on the Ames Research Center Flight Simulator for Advanced Aircraft (FSAA) for the approach and landing tasks of a powered lift STOL research aircraft. The test vehicle was a C-8A aircraft modified with a new wing incorporating internal blowing over an augmentor flap. The investigation included: (1) use of various flight path and airspeed control techniques for the basic vehicle; (2) assessment of stability and command augmentation schemes for pitch attitude and airspeed control; (3) determination of the influence of longitudinal and vertical force coupling for the power control; (4) determination of the influence of pitch axis coupling with the thrust vector control; and (5) evaluations of the contribution of stability and command augmentation to recovery from a single engine failure. Results are presented in the form of pilot ratings and commentary substantiated by landing approach time histories.

The Impact of Regulations on the Supply and Quality of Care in Child Care Markets

PubMed Central

Joseph Hotz, V.; Xiao, Mo

2011-01-01

We examine the impact of state child care regulations on the supply and quality of care in child care markets. We exploit panel data on both individual establishments and local markets to control for state, time, and, where possible, establishment-specific fixed effects to mitigate the potential bias due to policy endogeneity. We find that the imposition of regulations reduces the number of center-based child care establishments, especially in lower income markets. However, such regulations increase the quality of services provided, especially in higher income areas. Thus, there are winners and losers from the regulation of child care services. PMID:24991060

Application of machine learning and expert systems to Statistical Process Control (SPC) chart interpretation

NASA Technical Reports Server (NTRS)

Shewhart, Mark

1991-01-01

Statistical Process Control (SPC) charts are one of several tools used in quality control. Other tools include flow charts, histograms, cause and effect diagrams, check sheets, Pareto diagrams, graphs, and scatter diagrams. A control chart is simply a graph which indicates process variation over time. The purpose of drawing a control chart is to detect any changes in the process signalled by abnormal points or patterns on the graph. The Artificial Intelligence Support Center (AISC) of the Acquisition Logistics Division has developed a hybrid machine learning expert system prototype which automates the process of constructing and interpreting control charts.

Quality site seasonal report, Tucson Job Corps Center, SFBP (Solar in Federal Buildings Program) 1751, November 1984 through July 1985

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

Logee, T.L.

1987-10-15

The active solar Domestic Hot Water (DHW) system at the Tucson Job Corps Center was designed and constructed as part of the Solar in Federal Buildings Program (SFBP). This retrofitted system is one of eight of the systems in the SFBP selected for quality monitoring. The purpose of this monitoring effort is to document the performance of quality state-of-the-art solar systems in large Federal buildings. The systems are unique prototypes. Design errors and system faults discovered during the monitoring period could not always be corrected. Therefore, the aggregated overall performance is often considerably below what might be expected had similarmore » systems been constructed consecutively with each repetition incorporating corrections and improvements. The solar collector system is installed on a two story dormitory at the Job Corps Center. The solar system preheats hot water for about two hundred students. The solar system provided about 50% of the energy needed for water heating in the winter and nearly 100% of the water heating needs in the summer. There are about 70,000 gallons of water used per month. There are seventy-nine L.O.F. panels or 1659 square feet of collectors (1764 square feet before freeze damage occurred) mounted in two rows on the south facing roof. Collected solar energy is stored in the 2200-gallon storage tank. The control system is by Johnson Controls. City water is piped directly to the storage tank and is circulated in the collectors. Freeze protection is provided by recirculation of storage water. There is an auxiliary gas fired boiler and 750 gallon DHW storage tank to provide backup for the solar system. Highlights of the performance monitoring from the solar collection system at the Tucson Job Corps Center during the November 1984 through July 1985 monitoring period are presented in this report.« less

Informatics and data quality at collaborative multicenter Breast and Colon Cancer Family Registries.

PubMed

McGarvey, Peter B; Ladwa, Sweta; Oberti, Mauricio; Dragomir, Anca Dana; Hedlund, Erin K; Tanenbaum, David Michael; Suzek, Baris E; Madhavan, Subha

2012-06-01

Quality control and harmonization of data is a vital and challenging undertaking for any successful data coordination center and a responsibility shared between the multiple sites that produce, integrate, and utilize the data. Here we describe a coordinated effort between scientists and data managers in the Cancer Family Registries to implement a data governance infrastructure consisting of both organizational and technical solutions. The technical solution uses a rule-based validation system that facilitates error detection and correction for data centers submitting data to a central informatics database. Validation rules comprise both standard checks on allowable values and a crosscheck of related database elements for logical and scientific consistency. Evaluation over a 2-year timeframe showed a significant decrease in the number of errors in the database and a concurrent increase in data consistency and accuracy.

Informatics and data quality at collaborative multicenter Breast and Colon Cancer Family Registries

PubMed Central

McGarvey, Peter B; Ladwa, Sweta; Oberti, Mauricio; Dragomir, Anca Dana; Hedlund, Erin K; Tanenbaum, David Michael; Suzek, Baris E

2012-01-01

Quality control and harmonization of data is a vital and challenging undertaking for any successful data coordination center and a responsibility shared between the multiple sites that produce, integrate, and utilize the data. Here we describe a coordinated effort between scientists and data managers in the Cancer Family Registries to implement a data governance infrastructure consisting of both organizational and technical solutions. The technical solution uses a rule-based validation system that facilitates error detection and correction for data centers submitting data to a central informatics database. Validation rules comprise both standard checks on allowable values and a crosscheck of related database elements for logical and scientific consistency. Evaluation over a 2-year timeframe showed a significant decrease in the number of errors in the database and a concurrent increase in data consistency and accuracy. PMID:22323393

Engineered diamond nanopillars as mobile probes for high sensitivity metrology in fluid

NASA Astrophysics Data System (ADS)

Andrich, P.; de Las Casas, C. F.; Heremans, F. J.; Awschalom, D. D.; Aleman, B. J.; Ohno, K.; Lee, J. C.; Hu, E. L.

2015-03-01

The nitrogen-vacancy (NV) center`s optical addressability and exceptional spin coherence properties at room temperature, along with diamond`s biocompatibility, has put this defect at the frontier of metrology applications in biological environments. To push the spatial resolution to the nanoscale, extensive research efforts focus on using NV centers embedded in nanodiamonds (NDs). However, this approach has been hindered by degraded spin coherence properties in NDs and the lack of a platform for spatial control of the nanoparticles in fluid. In this work, we combine the use of high quality diamond membranes with a top-down patterning technique to fabricate diamond nanoparticles with engineered and highly reproducible shape, size, and NV center density. We obtain NDs, easily releasable from the substrate into a water suspension, which contain single NV centers exhibiting consistently long spin coherence times (up to 700 μs). Additionally, we demonstrate highly stable, three-dimensional optical trapping of the nanoparticles within a microfluidic circuit. This level of control enables a bulk-like DC magnetic sensitivity and gives access to dynamical decoupling techniques on contactless, miniaturized diamond probes. This work was supported by DARPA, AFOSR, and the DIAMANT program.

A comprehensive analysis of the IMRT dose delivery process using statistical process control (SPC)

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

Gerard, Karine; Grandhaye, Jean-Pierre; Marchesi, Vincent

The aim of this study is to introduce tools to improve the security of each IMRT patient treatment by determining action levels for the dose delivery process. To achieve this, the patient-specific quality control results performed with an ionization chamber--and which characterize the dose delivery process--have been retrospectively analyzed using a method borrowed from industry: Statistical process control (SPC). The latter consisted in fulfilling four principal well-structured steps. The authors first quantified the short term variability of ionization chamber measurements regarding the clinical tolerances used in the cancer center ({+-}4% of deviation between the calculated and measured doses) by calculatingmore » a control process capability (C{sub pc}) index. The C{sub pc} index was found superior to 4, which implies that the observed variability of the dose delivery process is not biased by the short term variability of the measurement. Then, the authors demonstrated using a normality test that the quality control results could be approximated by a normal distribution with two parameters (mean and standard deviation). Finally, the authors used two complementary tools--control charts and performance indices--to thoroughly analyze the IMRT dose delivery process. Control charts aim at monitoring the process over time using statistical control limits to distinguish random (natural) variations from significant changes in the process, whereas performance indices aim at quantifying the ability of the process to produce data that are within the clinical tolerances, at a precise moment. The authors retrospectively showed that the analysis of three selected control charts (individual value, moving-range, and EWMA control charts) allowed efficient drift detection of the dose delivery process for prostate and head-and-neck treatments before the quality controls were outside the clinical tolerances. Therefore, when analyzed in real time, during quality controls, they should improve the security of treatments. They also showed that the dose delivery processes in the cancer center were in control for prostate and head-and-neck treatments. In parallel, long term process performance indices (P{sub p}, P{sub pk}, and P{sub pm}) have been analyzed. Their analysis helped defining which actions should be undertaken in order to improve the performance of the process. The prostate dose delivery process has been shown statistically capable (0.08% of the results is expected to be outside the clinical tolerances) contrary to the head-and-neck dose delivery process (5.76% of the results are expected to be outside the clinical tolerances).« less

A comprehensive analysis of the IMRT dose delivery process using statistical process control (SPC).

PubMed

Gérard, Karine; Grandhaye, Jean-Pierre; Marchesi, Vincent; Kafrouni, Hanna; Husson, François; Aletti, Pierre

2009-04-01

The aim of this study is to introduce tools to improve the security of each IMRT patient treatment by determining action levels for the dose delivery process. To achieve this, the patient-specific quality control results performed with an ionization chamber--and which characterize the dose delivery process--have been retrospectively analyzed using a method borrowed from industry: Statistical process control (SPC). The latter consisted in fulfilling four principal well-structured steps. The authors first quantified the short-term variability of ionization chamber measurements regarding the clinical tolerances used in the cancer center (+/- 4% of deviation between the calculated and measured doses) by calculating a control process capability (C(pc)) index. The C(pc) index was found superior to 4, which implies that the observed variability of the dose delivery process is not biased by the short-term variability of the measurement. Then, the authors demonstrated using a normality test that the quality control results could be approximated by a normal distribution with two parameters (mean and standard deviation). Finally, the authors used two complementary tools--control charts and performance indices--to thoroughly analyze the IMRT dose delivery process. Control charts aim at monitoring the process over time using statistical control limits to distinguish random (natural) variations from significant changes in the process, whereas performance indices aim at quantifying the ability of the process to produce data that are within the clinical tolerances, at a precise moment. The authors retrospectively showed that the analysis of three selected control charts (individual value, moving-range, and EWMA control charts) allowed efficient drift detection of the dose delivery process for prostate and head-and-neck treatments before the quality controls were outside the clinical tolerances. Therefore, when analyzed in real time, during quality controls, they should improve the security of treatments. They also showed that the dose delivery processes in the cancer center were in control for prostate and head-and-neck treatments. In parallel, long-term process performance indices (P(p), P(pk), and P(pm)) have been analyzed. Their analysis helped defining which actions should be undertaken in order to improve the performance of the process. The prostate dose delivery process has been shown statistically capable (0.08% of the results is expected to be outside the clinical tolerances) contrary to the head-and-neck dose delivery process (5.76% of the results are expected to be outside the clinical tolerances).

Patient satisfaction among Spanish-speaking patients in a public health setting.

PubMed

Welty, Elisabeth; Yeager, Valerie A; Ouimet, Claude; Menachemi, Nir

2012-01-01

Despite the growing literature on health care quality, few patient satisfaction studies have focused upon the public health setting; where many Hispanic patients receive care. The purpose of this study was to examine the differences in satisfaction between English and Spanish-speaking patients in a local health department clinical setting. We conducted a paper-based satisfaction survey of patients that visited any of the seven Jefferson County Department of Health primary care centers from March 19 to April 19, 2008. Using Chi-squared analyses we found 25% of the Spanish-speaking patients reported regularly having problems getting an appointment compared to 16.8% among English-speakers (p < .001). Results of logistic regression analyses indicated that, despite the availability of interpreters at all JCDH primary care centers, differences in satisfaction existed between Spanish and English speaking patients controlling for center location, purpose of visit, and time spent waiting. Specifically, Spanish speaking patients were more likely to report problems getting an appointment and less likely to report having their medical problems resolved when leaving their visit as compared to those who spoke English. Findings presented herein may provide insight regarding the quality of care received, specifically regarding patient satisfaction in the public health setting. © 2011 National Association for Healthcare Quality.

Hypergol Systems: Design, Buildup, and Operation

NASA Technical Reports Server (NTRS)

Baker, David; Rathgeber, Kurt

2006-01-01

This course was developed by personnel at the NASA JSC White Sands Test Facility in conjunction with the NASA Safety Training Center (NSTC). The NSTC was established in May 1991 by the NASA Headquarters Safety Directorate to provide up-to-date, high-quality, NASA specific safety training on location at NASA centers, or simultaneously to multiple centers over the Video Teleconferencing System (ViTS). Our desire is to establish and maintain a strong, long-lasting relationship with all NASA centers in order to fulfill your safety training needs on a cost-effective basis. Our ultimate goal is to provide a positive contribution to safe operations at NASA. NSTC Course 055 is a 2-day course discussing the safe usage of hypergols (hydrazine fuels and nitrogen tetroxide). During the course we will identify the hazards associated with hypergols including toxicity, reactivity, fire, and explosion. Management of risk is discussed in terms of the primary engineering controls design, buildup, and operation; and secondary controls personal protective equipment and detectors/monitors. The emphasis is on the design and buildup of compatible systems and the safe operation of these systems by technicians and engineers.

Virtual and flexible digital signal processing system based on software PnP and component works

NASA Astrophysics Data System (ADS)

He, Tao; Wu, Qinghua; Zhong, Fei; Li, Wei

2005-05-01

An idea about software PnP (Plug & Play) is put forward according to the hardware PnP. And base on this idea, a virtual flexible digital signal processing system (FVDSPS) is carried out. FVDSPS is composed of a main control center, many sub-function modules and other hardware I/O modules. Main control center sends out commands to sub-function modules, and manages running orders, parameters and results of sub-functions. The software kernel of FVDSPS is DSP (Digital Signal Processing) module, which communicates with the main control center through some protocols, accept commands or send requirements. The data sharing and exchanging between the main control center and the DSP modules are carried out and managed by the files system of the Windows Operation System through the effective communication. FVDSPS real orients objects, orients engineers and orients engineering problems. With FVDSPS, users can freely plug and play, and fast reconfigure a signal process system according to engineering problems without programming. What you see is what you get. Thus, an engineer can orient engineering problems directly, pay more attention to engineering problems, and promote the flexibility, reliability and veracity of testing system. Because FVDSPS orients TCP/IP protocol, through Internet, testing engineers, technology experts can be connected freely without space. Engineering problems can be resolved fast and effectively. FVDSPS can be used in many fields such as instruments and meter, fault diagnosis, device maintenance and quality control.

Cardiac rehabilitation using the Family-Centered Empowerment Model versus home-based cardiac rehabilitation in patients with myocardial infarction: a randomised controlled trial

PubMed Central

Vahedian-Azimi, Amir; Hajiesmaieli, Mohammadreza; Kangasniemi, Mari; Alhani, Fatemah; Jelvehmoghaddam, Hosseinali; Fathi, Mohammad; Farzanegan, Behrooz; Ardehali, Seyed H; Hatamian, Sevak; Gahremani, Mehdi; Mosavinasab, Seyed M M; Rostami, Zohreh; Madani, Seyed J; Izadi, Morteza

2016-01-01

Objective To determine if a hybrid cardiac rehabilitation (CR) programme using the Family-Centered Empowerment Model (FCEM) as compared with standard CR will improve patient quality of life, perceived stress and state anxiety of patients with myocardial infarction (MI). Methods We conducted a randomised controlled trial in which patients received either standard home CR or CR using the FCEM strategy. Patient empowerment was measured with FCEM questionnaires preintervention and postintervention for a total of 9 assessments. Quality of life, perceived stress, and state and trait anxiety were assessed using the 36-Item Short Form Health Survey (SF-36), the 14-item Perceived Stress, and the 20-item State and 20-item Trait Anxiety questionnaires, respectively. Results 70 patients were randomised. Baseline characteristics were similar. Ejection fraction was significantly higher in the intervention group at measurements 2 (p=0.01) and 3 (p=0.001). Exercise tolerance measured as walking distance was significantly improved in the intervention group throughout the study. The quality of life results in the FCEM group showed significant improvement both within the group over time (p<0.0001) and when compared with control (p<0.0001). Similarly, the perceived stress and state anxiety results showed significant improvement both within the FCEM group over time (p<0.0001) and when compared with control (p<0.0001). No significant difference was found either within or between groups for trait anxiety. Conclusions The family-centred empowerment model may be an effective hybrid cardiac rehabilitation method for improving the physical and mental health of patients post-MI; however, further study is needed to validate these findings. Clinical Trials.gov identifier NCT02402582. Trial registration number NCT02402582. PMID:27110376

Results of the Medicare Health Support disease-management pilot program.

PubMed

McCall, Nancy; Cromwell, Jerry

2011-11-03

In the Medicare Modernization Act of 2003, Congress required the Centers for Medicare and Medicaid Services to test the commercial disease-management model in the Medicare fee-for-service program. The Medicare Health Support Pilot Program was a large, randomized study of eight commercial programs for disease management that used nurse-based call centers. We randomly assigned patients with heart failure, diabetes, or both to the intervention or to usual care (control) and compared them with the use of a difference-in-differences method to evaluate the effects of the commercial programs on the quality of clinical care, acute care utilization, and Medicare expenditures for Medicare fee-for-service beneficiaries. The study included 242,417 patients (163,107 in the intervention group and 79,310 in the control group). The eight commercial disease-management programs did not reduce hospital admissions or emergency room visits, as compared with usual care. We observed only 14 significant improvements in process-of-care measures out of 40 comparisons. These modest improvements came at substantial cost to the Medicare program in fees paid to the disease-management companies ($400 million), with no demonstrable savings in Medicare expenditures. In this large study, commercial disease-management programs using nurse-based call centers achieved only modest improvements in quality-of-care measures, with no demonstrable reduction in the utilization of acute care or the costs of care.

Efficacy of group meaning centered hope therapy of cancer patients and their families on patients' quality of life.

PubMed

Farhadi, Mehran; Reisi-Dehkordi, Negar; Kalantari, Mehrdad; Zargham-Boroujeni, Ali

2014-05-01

Quality of life (QOL) is a multidimensional concept which has nowadays turned to a supportive interventional goal in chronic diseases like cancer. Numerous interventions have been carried out to improve the QOL in patients with cancer, but the effect of indirect interventions on the patients' QOL has not been investigated yet. This study aimed to compare the efficacy of group meaning centered hope therapy of cancer patients and their families on the patients' QOL. This is a clinical trial conducted in three groups with a pre-test post-test design in which the effect of independent variable of meaning centered hope therapy on the dependent variable of QOL was investigated. The subjects were selected from the cancer patients who were aware of their diagnosis, were in primary stages of the disease, and had passed one period of chemotherapy. In this study, 42 patients (16 in control group, 14 in patients' group therapy, and 12 in patients' families' group therapy) were studied, and WHOQOL was adopted to investigate their QOL. Data were analyzed in two forms of descriptive and inferential statistical tests. The results obtained showed that group meaning centered hope therapy of cancer patients and their families had a positive effect on patients' QOL compared to the control group. The notable finding of the present study was that holding group sessions either for the patients or for their families equally improved patients' QOL. QOL of the cancer patients can be improved by either group meaning centered hope therapy for patients or group meaning centered hope therapy for their families. This finding is important for therapists, as when the patients cannot attend group therapy sessions due to complications of chemotherapy, these sessions can be held for their families to improve patients' QOL. This conclusion is very helpful in nurses' interaction with the patients and their families.

The Relationship Between Poor Quality of Life and Desire to Hasten Death: A Multiple Mediation Model Examining the Contributions of Depression, Demoralization, Loss of Control, and Low Self-worth.

PubMed

Robinson, Sophie; Kissane, David W; Brooker, Joanne; Hempton, Courtney; Burney, Susan

2017-02-01

The risk of suicide is elevated in palliative care patients compared with the general population. Various psychological factors, including depression, demoralization, loss of control, and low self-worth, have been associated with a desire to hasten death. The aim of this study was to investigate whether depression, demoralization, loss of control, and low self-worth mediated the relationship between global quality of life and desire to hasten death. A sample of 162 palliative care patients completed measures of global quality of life, depression, demoralization, perceived control, self-worth, and desire to hasten death. A multiple mediation model with bootstrapping sampling tested the total (combined) indirect effect and individual indirect effects of depression, the two subscales of demoralization (Meaning and Purpose, and Distress and Coping Ability), perceived control, and self-worth. Depressive symptoms, loss of meaning and purpose, loss of control, and low self-worth mediated the direct effect of global quality of life on desire to hasten death. The Distress and Coping Ability component of demoralization was not a significant mediator. Depression, loss of meaning and purpose, loss of control, and low self-worth are strong clinical markers for desire to hasten death. Targeting these symptoms through existentially oriented therapies, such as meaning-centered therapy, may ameliorate suicidal thinking. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Research Vessel Meteorological and Oceanographic Systems Support Satellite and Model Validation Studies

NASA Astrophysics Data System (ADS)

Smith, S. R.; Lopez, N.; Bourassa, M. A.; Rolph, J.; Briggs, K.

2012-12-01

The research vessel data center at the Florida State University routinely acquires, quality controls, and distributes underway surface meteorological and oceanographic observations from vessels. The activities of the center are coordinated by the Shipboard Automated Meteorological and Oceanographic System (SAMOS) initiative in partnership with the Rolling Deck to Repository (R2R) project. The data center evaluates the quality of the observations, collects essential metadata, provides data quality feedback to vessel operators, and ensures the long-term data preservation at the National Oceanographic Data Center. A description of the SAMOS data stewardship protocols will be provided, including dynamic web tools that ensure users can select the highest quality observations from over 30 vessels presently recruited to the SAMOS initiative. Research vessels provide underway observations at high-temporal frequency (1 min. sampling interval) that include navigational (position, course, heading, and speed), meteorological (air temperature, humidity, wind, surface pressure, radiation, rainfall), and oceanographic (surface sea temperature and salinity) samples. Recruited vessels collect a high concentration of data within the U.S. continental shelf and also frequently operate well outside routine shipping lanes, capturing observations in extreme ocean environments (Southern Ocean, Arctic, South Atlantic and Pacific). The unique quality and sampling locations of research vessel observations and there independence from many models and products (RV data are rarely distributed via normal marine weather reports) makes them ideal for validation studies. We will present comparisons between research vessel observations and model estimates of the sea surface temperature and salinity in the Gulf of Mexico. The analysis reveals an underestimation of the freshwater input to the Gulf from rivers, resulting in an overestimation of near coastal salinity in the model. Additional comparisons between surface atmospheric products derived from satellite observations and the underway research vessel observations will be shown. The strengths and limitations of research observations for validation studies will be highlighted through these case studies.

Analysis of Nitrogen Dioxide and Sulphur Dioxide in Lima, Peru: Trends and Seasonal Variations

NASA Astrophysics Data System (ADS)

Pacsi, S.; Rappenglueck, B.

2007-12-01

This research was carried out to show a general analysis of the monthly and yearly variation (1996-2002) and the tendency of the nitrogen dioxide (NO2) and sulfur dioxide (SO2) for the 5 stations of the air quality network of Lima. The SO2 and NO2 concentrations were measured by the Dirección General de Salud Ambiental (DIGESA), using the active sampling method and the chemical analysis has been determined by Turbidimetry and Colorimetry for the SO2 and NO2 respectively. The monthly average variation (1996-2001) of SO2 in the Lima Center station has a small annual range (32,4 mikrograms/m3) with maximum values in autumn (April) and minimum in winter (June). The NO2 presents a higher annual range (128,2 mikrograms/m3) and its minimum values occur in the summer and the maximum in spring. The annual averages analysis (2000-2002) of the air quality monitoring network of Lima shows that the SO2 and NO2 values are maximum in the Lima Center station and exceed the Peruvian air quality standard (ECAs) in 30% and 75% respectively. The yearly variation (1996-2001) in the Lima Center station show an increasing tendency in the SO2 (significant) and NO2 (not significant) values, which indicates the critical level of the air quality in Lima, therefore the implementation of the air pollution control programs is urgent.

JPL's Real-Time Weather Processor project (RWP) metrics and observations at system completion

NASA Technical Reports Server (NTRS)

Loesh, Robert E.; Conover, Robert A.; Malhotra, Shan

1990-01-01

As an integral part of the overall upgraded National Airspace System (NAS), the objective of the Real-Time Weather Processor (RWP) project is to improve the quality of weather information and the timeliness of its dissemination to system users. To accomplish this, an RWP will be installed in each of the Center Weather Service Units (CWSUs), located in 21 of the 23 Air Route Traffic Control Centers (ARTCCs). The RWP System is a prototype system. It is planned that the software will be GFE and that production hardware will be acquired via industry competitive procurement. The ARTCC is a facility established to provide air traffic control service to aircraft operating on Instrument Flight Rules (IFR) flight plans within controlled airspace, principally during the en route phase of the flight. Covered here are requirement metrics, Software Problem Failure Reports (SPFRs), and Ada portability metrics and observations.

Building a Quality Controlled Database of Meteorological Data from NASA Kennedy Space Center and the United States Air Force's Eastern Range

NASA Technical Reports Server (NTRS)

Brenton, James C.; Barbre. Robert E., Jr.; Decker, Ryan K.; Orcutt, John M.

2018-01-01

The National Aeronautics and Space Administration's (NASA) Marshall Space Flight Center (MSFC) Natural Environments Branch (EV44) has provided atmospheric databases and analysis in support of space vehicle design and day-of-launch operations for NASA and commercial launch vehicle programs launching from the NASA Kennedy Space Center (KSC), co-located on the United States Air Force's Eastern Range (ER) at the Cape Canaveral Air Force Station. The ER complex is one of the most heavily instrumented sites in the United States with over 31 towers measuring various atmospheric parameters on a continuous basis. An inherent challenge with large sets of data consists of ensuring erroneous data is removed from databases, and thus excluded from launch vehicle design analyses. EV44 has put forth great effort in developing quality control (QC) procedures for individual meteorological instruments, however no standard QC procedures for all databases currently exists resulting in QC databases that have inconsistencies in variables, methodologies, and periods of record. The goal of this activity is to use the previous efforts by EV44 to develop a standardized set of QC procedures from which to build meteorological databases from KSC and the ER, while maintaining open communication with end users from the launch community to develop ways to improve, adapt and grow the QC database. Details of the QC procedures will be described. As the rate of launches increases with additional launch vehicle programs, it is becoming more important that weather databases are continually updated and checked for data quality before use in launch vehicle design and certification analyses.

Evolution of quality at the Organ Center of the Organ Procurement and Transplantation Network/United Network for Organ Sharing.

PubMed

Brown, Roger S; Belton, A Matthew; Martin, Judith M; Simmons, Dee Dee; Taylor, Gloria J; Willard, Ellie

2009-09-01

One of the goals of the Organ Center of the Organ Procurement and Transplantation Network/United Network for Organ Sharing is to increase the efficiency of equitable organ allocation in the United States. Recognizing the ever-growing need for organ donors and transplants, leaders at the Organ Center increased its commitment to quality improvement initiatives through the development of a quality management team in 2001. The Organ Center began to focus on ways to capture data on processes and pinpoint areas for improvement. As the collection and analysis of data evolved, the Organ Center embraced formal quality standards, such as improvement cycles. Using these cycles, the Organ Center has seen significant improvement. One initiative involving lifesaving heart, lung, and liver placement showed success by doubling the Organ Center's organ placement rate. Another project involving the validation of donor information demonstrated that the accuracy of organ allocation can be improved by 5% on a consistent basis. As stewards for the gift of life and leaders in organ allocation, the Organ Center uses continuous quality improvement to achieve the goal of increasing the efficiency of equitable organ allocation.

Effects of laser polar-body biopsy on embryo quality.

PubMed

Levin, Ishai; Almog, Benny; Shwartz, Tamar; Gold, Veronica; Ben-Yosef, Dalit; Shaubi, Michal; Amit, Ami; Malcov, Mira

2012-05-01

To evaluate the effect of laser polar-body biopsy (PBB) for preimplantation genetic diagnosis on embryo quality. Retrospective case-control analysis. The quality of 145 embryos after PBB was compared to 276 embryos of the same group of women without biopsy. University-based tertiary-care medical center. Women with inherited genetics disease. Laser PBB of IVF embryos for genetic diagnosis. The study and control embryos were compared for fertilization rate, pronuclear grading, and cleavage-stage parameters on days 1, 2, and 3 after oocyte retrieval. The study embryos demonstrated higher rates of cleavage arrest (3.6% vs. 0.7%), higher rate of significant fragmentation on day 2 (9.5% vs. 3.0%), and lower rate of good cleavage embryos on day 2 (69.1% vs. 78.4%) compared with control embryos. On day 3, the study embryos had lower cleavage rates (six or more blastomeres; 56.5% vs. 74.5%), higher fragmentation (11.7% vs. 3.9%), higher rate of embryos presenting inferior cleavage pattern (57.2% vs. 38.5%), and lower mean blastomere number (5.8 ± 2.1 vs. 6.6 ± 1.9) compared with control embryos. Polar-body biopsy may have a negative effect on embryo quality. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia.

PubMed

Reid, Kathryn J; Baron, Kelly Glazer; Lu, Brandon; Naylor, Erik; Wolfe, Lisa; Zee, Phyllis C

2010-10-01

To assess the efficacy of moderate aerobic physical activity with sleep hygiene education to improve sleep, mood and quality of life in older adults with chronic insomnia. Seventeen sedentary adults aged >or=55 years with insomnia (mean age 61.6 [SD±4.3] years; 16 female) participated in a randomized controlled trial comparing 16 weeks of aerobic physical activity plus sleep hygiene to non-physical activity plus sleep hygiene. Eligibility included primary insomnia for at least 3 months, habitual sleep duration <6.5h and a Pittsburgh Sleep Quality Index (PSQI) score >5. Outcomes included sleep quality, mood and quality of life questionnaires (PSQI, Epworth Sleepiness Scale [ESS], Short-form 36 [SF-36], Center for Epidemiological Studies Depression Scale [CES-D]). The physical activity group improved in sleep quality on the global PSQI (p<.0001), sleep latency (p=.049), sleep duration (p=.04), daytime dysfunction (p=.027), and sleep efficiency (p=.036) PSQI sub-scores compared to the control group. The physical activity group also had reductions in depressive symptoms (p=.044), daytime sleepiness (p=.02) and improvements in vitality (p=.017) compared to baseline scores. Aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life in older adults with chronic insomnia.

Plan–Provider Integration, Premiums, and Quality in the Medicare Advantage Market

PubMed Central

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

2013-01-01

Objective. To investigate how integration between Medicare Advantage plans and health care providers is related to plan premiums and quality ratings. Data Source. 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. Study Design. 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. Data Collection. 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. Principal Findings. 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. Conclusions. 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). PMID:23800017

Costs and clinical quality among Medicare beneficiaries: associations with health center penetration of low-income residents.

PubMed

Sharma, Ravi; Lebrun-Harris, Lydie A; Ngo-Metzger, Quyen

2014-01-01

Determine the association between access to primary care by the underserved and Medicare spending and clinical quality across hospital referral regions (HRRs). Data on elderly fee-for-service beneficiaries across 306 HRRs came from CMS' Geographic Variation in Medicare Spending and Utilization database (2010). We merged data on number of health center patients (HRSA's Uniform Data System) and number of low-income residents (American Community Survey). We estimated access to primary care in each HRR by "health center penetration" (health center patients as a proportion of low-income residents). We calculated total Medicare spending (adjusted for population size, local input prices, and health risk). We assessed clinical quality by preventable hospital admissions, hospital readmissions, and emergency department visits. We sorted HRRs by health center penetration rate and compared spending and quality measures between the high- and low-penetration deciles. We also employed linear regressions to estimate spending and quality measures as a function of health center penetration. The high-penetration decile had 9.7% lower Medicare spending ($926 per capita, p=0.01) than the low-penetration decile, and no different clinical quality outcomes. Compared with elderly fee-for-service beneficiaries residing in areas with low-penetration of health center patients among low-income residents, those residing in high-penetration areas may accrue Medicare cost savings. Limited evidence suggests that these savings do not compromise clinical quality.

Patient-centered medical home transformation with payment reform: patient experience outcomes.

PubMed

Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R

2014-01-01

To examine changes in patient experience across key domains of the patient-centered medical home (PCMH) following practice transformation with Lean quality improvement methodology inclusive of payment reform. Pre-intervention/post-intervention analysis of intervention with a comparison group, a quasi-experimental design. We surveyed patients following office visits at the intervention (n = 2502) and control (n = 1622) practices during the 15-month period before and 14-month period after PCMH Lean transformation (April-October 2009). We measured and compared pre-intervention and post-intervention levels of patient satisfaction and other indicators of patient-centered care. Propensity weights adjusted for potential case-mix differences in intervention and control groups; propensity-adjusted proportions accounted for physician-level clustering. More intervention patients were very satisfied with their care after the PCMH Lean intervention (68%) compared with pre-intervention (62%). Among control patients, there was no corresponding increase in satisfaction (63% very satisfied pre-intervention vs 64% very satisfied post-intervention). This comparison resulted in a statistical trend (P = .10) toward greater overall satisfaction attributable to the intervention. Post-intervention, patients in the intervention practice consistently rated indicators of patient-centered care higher than patients in the control practice, particularly in the personal physician and communication domain. In this domain, intervention patients reported superior provider explanations, time spent, provider concern, and follow-up instructions compared with control participants, whereas control group ratings fell in the post-intervention period (P for difference <.05). In a pilot PCMH transformation including Lean enhancement with payment reform, patient experience was sustained or improved across key PCMH domains.

Intrinsic Versus Extrinsic Goal Contents in Self-Determination Theory: Another Look at the Quality of Academic Motivation

ERIC Educational Resources Information Center

Vansteenkiste, Maarten; Lens, Willy; Deci, Edward L.

2006-01-01

Examination of motivational dynamics in academic contexts within self-determination theory has centered primarily around both the motives (initially intrinsic vs. extrinsic, later autonomous vs. controlled) that regulate learners' study behavior and the contexts that promote or hinder these regulations. Less attention has been paid to the goal…

Supplier Assessment System (SAS)

NASA Technical Reports Server (NTRS)

Dietrich, Kristen

2016-01-01

Background: Sponsored by NASA Headquarters; Charter - provide information to assist the quality assurance community in evaluating and determining supplier risk; Comprehensive on-line repository of supplier information; Available to approved civil service personnel from all NASA Centers, other U.S. Government Agencies, Prime Contractors, and NASA direct support contractors; User access to specific data types or documents is controlled as needed.

Precursor to the TRICARE Next Generation Program

DTIC Science & Technology

2004-06-01

Precursor to T-NEX 6 Appendix A - Maps of Interest 84 Appendix B - International Classification of Diseases Codes 86...utilization management, and disease management (Lupo, 2003). Health management will be demonstrated by measurable quality improvements, population...National Association of County and City Health Officials and the Center for Disease Control and Prevention that helps key officials review community

Meter Designs Reduce Operation Costs for Industry

NASA Technical Reports Server (NTRS)

2013-01-01

Marshall Space Flight Center collaborated with Quality Monitoring and Control (QMC) of Humble, Texas, through a Space Act Agreement to design a balanced flow meter for the Space Shuttle Program. QMC founded APlus-QMC LLC to commercialize the technology, which has contributed to 100 new jobs, approximately $250,000 in yearly sales, and saved customers an estimated $10 million.

Bulletin of Courses, July 1970 to December 1971, Water Pollution Control Training Program.

ERIC Educational Resources Information Center

Department of the Interior, Washington, DC. Federal Water Pollution Control Administration.

This bulletin describes the courses offered at the five Federal Water Quality Administration training centers in the U.S. from July 1970 to December 1971. Information for applicants, applications for training forms and addresses of related Environmental Training Programs are included. The objective of the program is to provide specialized training…

Easing the strain of unnecessary antibiotic requests. Physicians called on to change patient expectations about antibiotic use; experts say it's about communication.

PubMed

Hertz, Beth Thomas

2014-01-10

Antibiotic resistance is one of the world's major public health challenges, according to the Centers for Disease Control and Prevention. While medical providers are heeding the call, patient pressure about receiving antibiotic prescriptions remains a significant influencer, says the National Committee for Quality Assurance.

The Scope & Sequence of Fitness Education for PreK-16 Programs: NASPE Fitness Education Project

ERIC Educational Resources Information Center

National Association for Sport and Physical Education, 2012

2012-01-01

In May 2006, the National Association for Sport and Physical Education (NASPE) received funding from the Centers for Disease Control and Prevention's (CDC) Division of Adolescent and School Health to improve the quality and quantity of physical education and physical activity programs across the United States. The cooperative agreement project…

Praying Hands: Influences of Religiosity and Spirituality on Sexual Risk-Taking among Black, College-Attending Emerging Adults

ERIC Educational Resources Information Center

Triplett, Tralonda C.

2012-01-01

The Centers for Disease Control and Prevention have confirmed persistent disproportionate burdens of HIV/AIDS among Black populations in the United States. While treatment advancements have greatly improved qualities of life for persons living with HIV/AIDS, prevention efforts remain focused to reduce incidence among vulnerable populations.…

Considerations In The Design And Specifications Of An Automatic Inspection System

NASA Astrophysics Data System (ADS)

Lee, David T.

1980-05-01

Considerable activities have been centered around the automation of manufacturing quality control and inspection functions. Several reasons can be cited for this development. The continuous pressure of direct and indirect labor cost increase is only one of the obvious motivations. With the drive for electronics miniaturization come more and more complex processes where control parameters are critical and the yield is highly susceptible to inadequate process monitor and inspection. With multi-step, multi-layer process for substrate fabrication, process defects that are not detected and corrected at certain critical points may render the entire subassembly useless. As a process becomes more complex, the time required to test the product increases significantly in the total build cycle. The urgency to reduce test time brings more pressure to improve in-process control and inspection. The advances and improvements of components, assemblies and systems such as micro-processors, micro-computers, programmable controllers, and other intelligent devices, have made the automation of quality control much more cost effective and justifiable.

Quality of Care: A National Sample.

ERIC Educational Resources Information Center

Ferrari, Monica

This survey of 25 day care centers in 5 regions of Italy was designed to determine the characteristics of competent centers and the effects of differing local regulations on the quality of care provided. The Infant and Toddler Environment Rating Scale (ITERS) and a questionnaire were utilized to assess the quality of the day care centers in the…

Alternative Fuels Data Center: Natural Gas Street Sweepers Improve Air

Science.gov Websites

Quality in New York Natural Gas Street Sweepers Improve Air Quality in New York to someone by E -mail Share Alternative Fuels Data Center: Natural Gas Street Sweepers Improve Air Quality in New York on Facebook Tweet about Alternative Fuels Data Center: Natural Gas Street Sweepers Improve Air

The National Quality Improvement Center on the Privatization of Child Welfare Services: A Program Description

ERIC Educational Resources Information Center

Collins-Camargo, Crystal; Ensign, Karl; Flaherty, Chris

2008-01-01

Quality improvement centers were created by the U.S. Department of Health and Human Services' Children's Bureau beginning in 2001 to promote knowledge development through an innovative approach to applied collaborative research in child welfare. The National Quality Improvement Center on the Privatization of Child Welfare Services was funded to…

The European general thoracic surgery database project.

PubMed

Falcoz, Pierre Emmanuel; Brunelli, Alessandro

2014-05-01

The European Society of Thoracic Surgeons (ESTS) Database is a free registry created by ESTS in 2001. The current online version was launched in 2007. It runs currently on a Dendrite platform with extensive data security and frequent backups. The main features are a specialty-specific, procedure-specific, prospectively maintained, periodically audited and web-based electronic database, designed for quality control and performance monitoring, which allows for the collection of all general thoracic procedures. Data collection is the "backbone" of the ESTS database. It includes many risk factors, processes of care and outcomes, which are specially designed for quality control and performance audit. The user can download and export their own data and use them for internal analyses and quality control audits. The ESTS database represents the gold standard of clinical data collection for European General Thoracic Surgery. Over the past years, the ESTS database has achieved many accomplishments. In particular, the database hit two major milestones: it now includes more than 235 participating centers and 70,000 surgical procedures. The ESTS database is a snapshot of surgical practice that aims at improving patient care. In other words, data capture should become integral to routine patient care, with the final objective of improving quality of care within Europe.

Dosimetry quality audit of high energy photon beams in greek radiotherapy centers.

PubMed

Hourdakis, Constantine J; Boziari, A

2008-04-01

Dosimetry quality audits and intercomparisons in radiotherapy centers is a useful tool in order to enhance the confidence for an accurate therapy and to explore and dissolve discrepancies in dose delivery. This is the first national comprehensive study that has been carried out in Greece. During 2002--2006 the Greek Atomic Energy Commission performed a dosimetry quality audit of high energy external photon beams in all (23) Greek radiotherapy centers, where 31 linacs and 13 Co-60 teletherapy units were assessed in terms of their mechanical performance characteristics and relative and absolute dosimetry. The quality audit in dosimetry of external photon beams took place by means of on-site visits, where certain parameters of the photon beams were measured, calculated and assessed according to a specific protocol and the IAEA TRS 398 dosimetry code of practice. In each radiotherapy unit (Linac or Co-60), certain functional parameters were measured and the results were compared to tolerance values and limits. Doses in water under reference and non reference conditions were measured and compared to the stated values. Also, the treatment planning systems (TPS) were evaluated with respect to irradiation time calculations. The results of the mechanical tests, dosimetry measurements and TPS evaluation have been presented in this work and discussed in detail. This study showed that Co-60 units had worse performance mechanical characteristics than linacs. 28% of all irradiation units (23% of linacs and 42% of Co-60 units) exceeded the acceptance limit at least in one mechanical parameter. Dosimetry accuracy was much worse in Co60 units than in linacs. 61% of the Co60 units exhibited deviations outside +/-3% and 31% outside +/-5%. The relevant percentages for the linacs were 24% and 7% respectively. The results were grouped for each hospital and the sources of errors (functional and human) have been investigated and discussed in details. This quality audit proved to be a useful tool for the improvement of quality in radiotherapy. It succeeded to disseminate the IAEA TRS-398 protocol in nearly all radiotherapy centers achieving homogenization and consistency of dosimetry within the country. Also, it detected discrepancies in dosimetry and provided guidance and recommendations to eliminate sources of errors. Finally, it proved that quality assurance programs, periodic quality control tests, maintenance and service play an important role for achieving accuracy and safe operation in radiotherapy.

Through the patient's eyes: the value of a comprehensive brain tumor center.

PubMed

Robin, Adam M; Walbert, Tobias; Mikkelsen, Tom; Kalkanis, Steven N; Rock, Jack; Lee, Ian; Rosenblum, Mark L

2014-09-01

Since the founding of the Tumor Section of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) in 1984 much in neurosurgical oncology has changed. More than 40,000 papers have been published on glioma since the arrival of the AANS/CNS Tumor Section. Increasingly, research is focusing on more patient-centered care and quality of life. Preliminary work suggests that a greater emphasis on the patient and caregiver's experience of disease is crucial. Also, the provision of hope and appropriate information and communication with health care providers helps to lessen anxiety and promote improved quality of life. Lastly, our patients need a mechanism for continued symptom control and psychosocial support throughout their experience of this disease. An excellent venue for providing these facets of neurooncological patient care is the multidisciplinary brain tumor board and symptom management team. Herein, we present the philosophy and practice of the Hermelin Brain Tumor Center at the Henry Ford Health System as one type of approach to caring for the patient with a malignant glioma. The authors are aware of several brain tumor centers that share our philosophy and approach to patient care. Our comments are not meant to be exclusive to our experience and should be interpreted as representative of the growing movement in neurosurgery to provide comprehensive, multidisciplinary, patient-centered care.

Evaluating the impact of AMDAR data quality control in China on the short-range convection forecasts using the WRF model

NASA Astrophysics Data System (ADS)

Wang, Xiaofeng; Jiang, Qin; Zhang, Lei

2016-04-01

A quality control system for the Aircraft Meteorological Data Relay (AMDAR) data has been implemented in China. This system is an extension to the AMDAR quality control system used at the US National Centers for Environmental Prediction. We present a study in which the characteristics of each AMDAR data quality type were examined and the impact of the AMDAR data quality system on short-range convective weather forecasts using the WRF model was investigated. The main results obtained from this study are as follows. (1) The hourly rejection rate of AMDAR data during 2014 was 5.79%, and most of the rejections happened in Near Duplicate Check. (2) There was a significant diurnal variation for both quantity and quality of AMDAR data. Duplicated reports increased with the increase of data quantity, while suspicious and disorderly reports decreased with the increase of data quantity. (3) The characteristics of the data quality were different in each model layer, with the quality problems occurring mainly at the surface as well as at the height where the power or the flight mode of the aircraft underwent adjustment. (4) Assimilating the AMDAR data improved the forecast accuracy, particularly over the region where strong convection occurred. (5) Significant improvements made by assimilating AMDAR data were found after six hours into the model forecast. The conclusion from this study is that the newly implemented AMDAR data quality system can help improve the accuracy of short-range convection forecasts using the WRF model.

A Study on the Knowledge, Perception, and Use of Breast Cancer Screening Methods and Quality of Care Among Women from Central Mexico.

PubMed

Cruz-Castillo, Andrea B; Hernández-Valero, María A; Hovick, Shelly R; Campuzano-González, Martha Elva; Karam-Calderón, Miguel Angel; Bustamante-Montes, L Patricia

2015-09-01

Studies on health behaviors have observed several barriers to breast cancer screening, including lack of breast cancer knowledge, distrust of health care providers, and long waiting times to be screened or to receive screening results. We conducted a nested case-control study among a subsample of 200 women 21 years of age and older [100 patients (cases)], who had been diagnosed with breast cancer, and 100 controls, who were screened and found to be free of breast cancer), all residing in the Toluca metropolitan area in central Mexico. We examined how knowledge of breast cancer screening guidelines, perceptions of screening methods, and quality of health care influenced the use of breast cancer screening among study participants. Our study found that the most important factor associated with the decision to have breast cancer screenings was having a positive perception of the quality of care provided by the local health care centers, such as having competent clinic personnel, sufficient screening equipment, and reasonable waiting times to receive screening and to receive the screening results. Therefore, individual health care centers need to focus on the patients' perception of the services received by optimizing the care provided and, in so doing, increase the rates of early diagnosis and reduce the rate of mortality from breast cancer as well as its associated treatment costs.

A Study on the knowledge, perception and use of breast cancer screening methods and quality of care among women from central Mexico

PubMed Central

Cruz-Castillo, Andrea B.; Hernández-Valero, María A.; Hovick, Shelly R.; Campuzano-González, Martha Elva; Karam-Calderón, Miguel Angel; Bustamante-Montes, L. Patricia

2014-01-01

Studies on health behaviors have observed several barriers to breast cancer screening, including lack of breast cancer knowledge, distrust of health care providers, long waiting times to be screened or to receive screening results. We conducted a nested case-control study among a subsample of 200 women 21 years of age and older (100 cases, who had been diagnosed with breast cancer, and 100 controls, who were screened and found to be free of breast cancer), all residing in the Toluca metropolitan area in central Mexico. We examined how knowledge of breast cancer screening guidelines, perceptions of screening methods, and quality of health care influenced the use of breast cancer screening among study participants. Our study found that the most important factors associated with the decision to have breast cancer screenings was having a positive perception of the quality of care provided by the local health care centers, such as having competent clinic personnel, sufficient screening equipment, and reasonable waiting times to receive screening and to receive the screening results. Therefore, individual health care centers need to focus on the patients’ perception of the services received by optimizing the care provided, and in so doing increase the rates of early diagnosis, reduce the rate of mortality from breast cancer as well as its associated treatment costs. PMID:25182506

SAMOS Surface Fluxes

NASA Astrophysics Data System (ADS)

Smith, Shawn; Bourassa, Mark

2014-05-01

The development of a new surface flux dataset based on underway meteorological observations from research vessels will be presented. The research vessel data center at the Florida State University routinely acquires, quality controls, and distributes underway surface meteorological and oceanographic observations from over 30 oceanographic vessels. These activities are coordinated by the Shipboard Automated Meteorological and Oceanographic System (SAMOS) initiative in partnership with the Rolling Deck to Repository (R2R) project. Recently, the SAMOS data center has used these underway observations to produce bulk flux estimates for each vessel along individual cruise tracks. A description of this new flux product, along with the underlying data quality control procedures applied to SAMOS observations, will be provided. Research vessels provide underway observations at high-temporal frequency (1 min. sampling interval) that include navigational (position, course, heading, and speed), meteorological (air temperature, humidity, wind, surface pressure, radiation, rainfall), and oceanographic (surface sea temperature and salinity) samples. Vessels recruited to the SAMOS initiative collect a high concentration of data within the U.S. continental shelf and also frequently operate well outside routine shipping lanes, capturing observations in extreme ocean environments (Southern, Arctic, South Atlantic, and South Pacific oceans). These observations are atypical for their spatial and temporal sampling, making them very useful for many applications including validation of numerical models and satellite retrievals, as well as local assessments of natural variability. Individual SAMOS observations undergo routine automated quality control and select vessels receive detailed visual data quality inspection. The result is a quality-flagged data set that is ideal for calculating turbulent flux estimates. We will describe the bulk flux algorithms that have been applied to the observations and the choices of constants that are used. Analysis of the preliminary SAMOS flux products will be presented, including spatial and temporal coverage for each derived parameter. The unique quality and sampling locations of research vessel observations and their independence from many models and products makes them ideal for validation studies. The strengths and limitations of research observations for flux validation studies will be discussed. The authors welcome a discussion with the flux community regarding expansion of the SAMOS program to include additional international vessels, thus facilitating and expansion of this research vessel-based flux product.

Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity.

PubMed

Sudhinaraset, May; Afulani, Patience; Diamond-Smith, Nadia; Bhattacharyya, Sanghita; Donnay, France; Montagu, Dominic

2017-11-06

Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care-across its many dimensions-is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women's reproductive health: societal and community determinants of health equity, women's health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women's reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.

Healthy caregivers-healthy children (HC2) phase 2: Integrating culturally sensitive childhood obesity prevention strategies into childcare center policies.

PubMed

Messiah, Sarah E; Lebron, Cynthia; Moise, Rhoda; Sunil Mathew, M; Sardinas, Krystal; Chang, Catherina; Palenzuela, Joanne; Walsh, Jennifer; Shelnutt, Karla P; Spector, Rachel; Altare, Fiorella; Natale, Ruby

2017-02-01

Despite the high prevalence of obesity among preschool-aged children, most states lack childcare center (CCC) nutrition and physical activity policies. The Healthy Caregivers, Healthy Children (HC) Phase 2 project is examining the relationship between the CCC nutrition and physical activity environment and child dietary intake/physical activity patterns and body mass index (BMI). A total of 24 "Quality Counts" (Miami Dade County, Florida's Quality Rating Improvement System [QRIS)]) CCCs serving low resource families with ≥50 2-to-5year olds attending have been randomized to either intervention (n=12) or control (n=12). The HC2 intervention arm CCCs receive implementation of a daily curricula for (1) teachers/parents; (2) children; (3) snack, beverage, physical activity, and screen time policies; and (4) technical assistance with menu modifications. Control arm schools receive an attention control safety curriculum. HC2 is delivered once a month in year 1, quarterly in year 2 and will be disseminated throughout the Quality Counts network in year 3. Primary outcome measures include the Environment and Policy Assessment and Observation tool (EPAO), standardized dietary intake and physical activity patterns surveys, and child BMI. The 'Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM)' framework will guide the interpretation of outcome measures. CCCs are in need of evidence-based standardized nutrition and physical activity policies. The intersection of RE-AIM and early childhood obesity prevention in the childcare setting could generate robust and new information to the field about potential barriers, facilitators, adoption, and sustainability in this setting. Copyright © 2016 Elsevier Inc. All rights reserved.

Pilot evaluation of sailplane handling qualities

NASA Technical Reports Server (NTRS)

Bennett, A. G., Jr.

1978-01-01

The evaluation sailplanes were found generally deficient in the area of cockpit layout. The pilots indicated general dissatisfaction with high pitch sensitivity especially when coupled with inertially induced stick forces. While all sailplanes were judged satisfactory for centering thermals and in the ease of speed control in circling flight, pilot opinions diverged on the maneuvering response, pull-out characteristics from a dive, and on phugoid damping. Lateral-directional control problems were noted mainly during takeoff and landing for most sailplanes with the landing wheel ahead of center of gravity. Pilot opinion of in-flight lateral-directional stability and control was generally satisfactory. Five of the evaluation sailplanes exhibited a very narrow airspeed band in which perceptible stall warning buffet occurred. However, this characteristic was considered not objectionable when stall recovery was easy. The pilots objected to the characteristics of a wide airspeed band of stall warning followed by a stall with yawing and rolling tendency and substantial loss of altitude during the stall. Glide path control for the evaluation sailplanes was found to be generally objectionable.

Power Grid Maintenance Scheduling Intelligence Arrangement Supporting System Based on Power Flow Forecasting

NASA Astrophysics Data System (ADS)

Xie, Chang; Wen, Jing; Liu, Wenying; Wang, Jiaming

With the development of intelligent dispatching, the intelligence level of network control center full-service urgent need to raise. As an important daily work of network control center, the application of maintenance scheduling intelligent arrangement to achieve high-quality and safety operation of power grid is very important. By analyzing the shortages of the traditional maintenance scheduling software, this paper designs a power grid maintenance scheduling intelligence arrangement supporting system based on power flow forecasting, which uses the advanced technologies in maintenance scheduling, such as artificial intelligence, online security checking, intelligent visualization techniques. It implements the online security checking of maintenance scheduling based on power flow forecasting and power flow adjusting based on visualization, in order to make the maintenance scheduling arrangement moreintelligent and visual.

Mood, anxiety, and incomplete seizure control affect quality of life after epilepsy surgery

PubMed Central

Blackmon, Karen; Cong, Xiangyu; Dziura, James; Atlas, Lauren Y.; Vickrey, Barbara G.; Berg, Anne T.; Bazil, Carl W.; Langfitt, John T.; Walczak, Thaddeus S.; Sperling, Michael R.; Shinnar, Shlomo; Devinsky, Orrin

2014-01-01

Objective: We examined the complex relationship between depression, anxiety, and seizure control and quality of life (QOL) outcomes after epilepsy surgery. Methods: Seven epilepsy centers enrolled 373 patients and completed a comprehensive diagnostic workup and psychiatric and follow-up QOL evaluation. Subjects were evaluated before surgery and then at 3, 6, 12, 24, 48, and 60 months after surgery. Standardized assessments included the Quality of Life in Epilepsy Inventory–89, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). A mixed-model repeated-measures analysis was used to analyze associations of depression, anxiety, seizure outcome, and seizure history with overall QOL score and QOL subscores (cognitive distress, physical health, mental health, epilepsy-targeted) prospectively. Results: The groups with excellent and good seizure control showed a significant positive effect on the overall QOL compared to the groups with fair and poor seizure control. The BDI and BAI scores were both highly and negatively associated with overall QOL; increases in BDI and BAI scores were associated with decreased overall QOL score. Conclusions: Depression and anxiety are strongly and independently associated with worse QOL after epilepsy surgery. Interestingly, even partial seizure control, controlling for depression and anxiety levels, improved QOL. Management of mood and anxiety is a critical component to postsurgical care. PMID:24489129

Efficient management of cardiovascular risk screening programs

NASA Technical Reports Server (NTRS)

Roth, Carol

1993-01-01

The Environmental Health Unit, located on-site at the the Goddard Space Flight Center (GSFC), is responsible for the implementation of the Center's Employee Environmental and Occupational Health Program. The Health Unit, Health Physics (HP), and Industrial Hygiene (IH) staffs collaborate to provide quality service to the employees at GSFC. The Health Unit staff identifies, evaluates, and ensures the control of occupational hazards on the Center. In the past, components of the Industrial Hygiene Program have included the Industrial Hygiene Health Hazard Identification Program (IHHIP), the Hearing Conservation Program (HCP), the Hazard Communication Program, and the bi-annual fume hood survey. More recently, the Environmental Health Unit has expanded its services by adding the Ergonomics Program. Various aspects of the Ergonomics Program are discussed.

Vehicle design considerations for active control application to subsonic transport aircraft

NASA Technical Reports Server (NTRS)

Hofmann, L. G.; Clement, W. F.

1974-01-01

The state of the art in active control technology is summarized. How current design criteria and airworthiness regulations might restrict application of this emerging technology to subsonic CTOL transports of the 1980's are discussed. Facets of active control technology considered are: (1) augmentation of relaxed inherent stability; (2) center-of-gravity control; (3) ride quality control; (4) load control; (5) flutter control; (6) envelope limiting, and (7) pilot interface with the control system. A summary and appraisal of the current state of the art, design criteria, and recommended practices, as well as a projection of the risk in applying each of these facets of active control technology is given. A summary of pertinent literature and technical expansions is included.

Institutional environmental impact statement (space shuttle development and operations) amendment no. 1. [space shuttle operations at Kennedy Space Center

NASA Technical Reports Server (NTRS)

1973-01-01

Data are presented to support the environmental impact statement on space shuttle actions at Kennedy Space Center. Studies indicate that land use to accommodate space shuttle operations may have the most significant impact. The impacts on air, water and noise quality are predicted to be less on the on-site environment. Considerations of operating modes indicate that long and short term land use will not affect wildlife productivity. The potential for adverse environmental impact is small and such impacts will be local, short in duration, controllable, and environmentally acceptable.

Robotic and automatic welding development at the Marshall Space Flight Center

NASA Technical Reports Server (NTRS)

Jones, C. S.; Jackson, M. E.; Flanigan, L. A.

1988-01-01

Welding automation is the key to two major development programs to improve quality and reduce the cost of manufacturing space hardware currently undertaken by the Materials and Processes Laboratory of the NASA Marshall Space Flight Center. Variable polarity plasma arc welding has demonstrated its effectiveness on class 1 aluminum welding in external tank production. More than three miles of welds were completed without an internal defect. Much of this success can be credited to automation developments which stabilize the process. Robotic manipulation technology is under development for automation of welds on the Space Shuttle's main engines utilizing pathfinder systems in development of tooling and sensors for the production applications. The overall approach to welding automation development undertaken is outlined. Advanced sensors and control systems methodologies are described that combine to make aerospace quality welds with a minimum of dependence on operator skill.

Implementation of Patient-Centered Medical Homes in Adult Primary Care Practices.

PubMed

Alexander, Jeffrey A; Markovitz, Amanda R; Paustian, Michael L; Wise, Christopher G; El Reda, Darline K; Green, Lee A; Fetters, Michael D

2015-08-01

There has been relatively little empirical evidence about the effects of patient-centered medical home (PCMH) implementation on patient-related outcomes and costs. Using a longitudinal design and a large study group of 2,218 Michigan adult primary care practices, our study examined the following research questions: Is the level of, and change in, implementation of PCMH associated with medical surgical cost, preventive services utilization, and quality of care in the following year? Results indicated that both level and amount of change in practice implementation of PCMH are independently and positively associated with measures of quality of care and use of preventive services, after controlling for a variety of practice, patient cohort, and practice environmental characteristics. Results also indicate that lower overall medical and surgical costs are associated with higher levels of PCMH implementation, although change in PCMH implementation did not achieve statistical significance. © The Author(s) 2015.

Acetic Acid Bacteria and the Production and Quality of Wine Vinegar

PubMed Central

Torija, María Jesús; García-Parrilla, María del Carmen; Troncoso, Ana María

2014-01-01

The production of vinegar depends on an oxidation process that is mainly performed by acetic acid bacteria. Despite the different methods of vinegar production (more or less designated as either “fast” or “traditional”), the use of pure starter cultures remains far from being a reality. Uncontrolled mixed cultures are normally used, but this review proposes the use of controlled mixed cultures. The acetic acid bacteria species determine the quality of vinegar, although the final quality is a combined result of technological process, wood contact, and aging. This discussion centers on wine vinegar and evaluates the effects of these different processes on its chemical and sensory properties. PMID:24574887

Alignment of CTE Centers with the Baldrige Quality Award in Education Criteria: Perceptions of Leaders and Faculty

ERIC Educational Resources Information Center

Crum-Allen, Patricia; Palmer, Louann Bierlein

2016-01-01

This study examined career and technical education (CTE) centers in Michigan and their potential alignment with the Malcolm Baldrige Quality Award in Education. CTE center leaders and their faculty were asked to provide their perceptions of how well their organizations meet Baldrige quality elements, using a version of the Baldrige Assessment…

Role of a center of excellence program in improving the quality of peritoneal dialysis--a Chinese experience.

PubMed

Yao, Qiang; Zhou, George

2014-06-01

Improving the quality of peritoneal dialysis (PD) in areas with a rapid increase in PD patient numbers constitutes the most significant PD challenge in China. Here, we share our experience of implementing a quality improvement program in 8 PD centers, with guidance from matched experienced centers. Copyright © 2014 International Society for Peritoneal Dialysis.

Lean Six Sigma in health care and the challenge of implementation of Six Sigma methodologies at a Veterans Affairs Medical Center.

PubMed

Pocha, Christine

2010-01-01

Six Sigma and Lean Thinking are quality initiatives initially deployed in industry to improve operational efficiency leading to better quality and subsequent cost savings. The financial rationale for embarking on this quality journey is clear; applying it to today's health care remains challenging. The cost of medical care is increasing at an alarming rate; most of these cost increases are attributed to an aging population and technological advances; therefore, largely beyond control. Furthermore, health care cost increases are caused by unnecessary operational inefficiency associated with the direct medical service delivery process. This article describes the challenging journey of implementing Six Sigma methodology at a tertiary care medical center. Many lessons were learned; however, of utmost importance were team approach, "buy in" of the stakeholders, and the willingness of team members to change daily practice and to adapt new and innovative ways how health care can be delivered. Six Sigma incorporated as part of the "company's or hospital's culture" would be most desirable but the learning curve will be steep.

Impact of a pharmacist-led warfarin self-management program on quality of life and anticoagulation control: a randomized trial.

PubMed

Verret, Lucie; Couturier, Justine; Rozon, Andréanne; Saudrais-Janecek, Sarah; St-Onge, Amélie; Nguyen, Angela; Basmadjian, Arsène; Tremblay, Simon; Brouillette, Denis; de Denus, Simon

2012-10-01

To evaluate the impact of a pharmacist-led warfarin patient self-management program on quality of life and anticoagulation control compared with management in a physician-led specialized anticoagulation clinic. Prospective, randomized, controlled, open-label trial. Tertiary care academic medical center. A total of 114 patients aged 18-75 years who were followed at a specialized anticoagulation clinic, had received warfarin for at least 6 months, and were expected to continue warfarin for a minimum of 4 months. All patients attended an educational session on anticoagulation provided by a pharmacist. Patients randomized to the self-management group (58 patients) also received practical training to use the CoaguChek XS device and a self-management dosing algorithm. Patients in the control group (56 patients) continued to undergo standard management at the anticoagulation clinic. Patients completed a validated quality-of-life questionnaire and the validated Oral Anticoagulation Knowledge test at the beginning and end of the study. The quality of anticoagulation control was evaluated by using the time spent in therapeutic range. After 4 months of follow-up, a significant improvement in the self-management group was observed compared with the control group in four of the five quality-of-life topics (p<0.05). Improvements in knowledge were observed in both groups after the training session and persisted after 4 months (p<0.05 for all). The time spent in the therapeutic range (80.0% in the self-management group vs 75% in the control group, p=0.79) and in the extended therapeutic range ([target international normalized ratio ± 0.3] 93.2% in the self-management group vs 91.1% in the control group, p=0.30) were similar between groups. A self-management warfarin program led by pharmacists resulted in significant improvement in the quality of life of patients receiving warfarin therapy as well as a reduction in the time required for anticoagulation monitoring, while maintaining a level of anticoagulation control similar to a high-quality specialized anticoagulation clinic. © 2012 Pharmacotherapy Publications, Inc.

Effects of a computerized cardiac teletriage decision support system on nurse performance: results of a controlled human factors experiment using a mid-fidelity prototype.

PubMed

Somoza, Kirsten Carroll; Momtahan, Kathryn; Lindgaard, Gitte

2007-01-01

A gap exists in cardiac care between known best practices and the actual level of care administered. To help bridge this gap, a proof of concept interface for a PDA-based decision support system (DSS) was designed for cardiac care nurses engaged in teletriage. This interface was developed through a user-centered design process. Quality of assessment, quality of recommendations, and number of questions asked were measured. Cardiac floor nurses' assessment quality performance, but not their recommendation quality performance, improved with the DSS. Nurses asked more questions with the DSS than without it, and these additional questions were predominantly classifiable as essential or beneficial to a good assessment. The average participant satisfaction score with the DSS was above neutral.

Costs and Clinical Quality Among Medicare Beneficiaries: Associations with Health Center Penetration of Low-Income Residents

PubMed Central

Sharma, Ravi; Lebrun-Harris, Lydie A.; Ngo-Metzger, Quyen

2014-01-01

Objective Determine the association between access to primary care by the underserved and Medicare spending and clinical quality across hospital referral regions (HRRs). Data Sources Data on elderly fee-for-service beneficiaries across 306 HRRs came from CMS’ Geographic Variation in Medicare Spending and Utilization database (2010). We merged data on number of health center patients (HRSA’s Uniform Data System) and number of low-income residents (American Community Survey). Study Design We estimated access to primary care in each HRR by “health center penetration” (health center patients as a proportion of low-income residents). We calculated total Medicare spending (adjusted for population size, local input prices, and health risk). We assessed clinical quality by preventable hospital admissions, hospital readmissions, and emergency department visits. We sorted HRRs by health center penetration rate and compared spending and quality measures between the high- and low-penetration deciles. We also employed linear regressions to estimate spending and quality measures as a function of health center penetration. Principal Findings The high-penetration decile had 9.7% lower Medicare spending ($926 per capita, p=0.01) than the low-penetration decile, and no different clinical quality outcomes. Conclusions Compared with elderly fee-for-service beneficiaries residing in areas with low-penetration of health center patients among low-income residents, those residing in high-penetration areas may accrue Medicare cost savings. Limited evidence suggests that these savings do not compromise clinical quality. PMID:25243096

Computerization and its contribution to care quality improvement: the nurses' perspective.

PubMed

Kagan, Ilya; Fish, Miri; Farkash-Fink, Naomi; Barnoy, Sivia

2014-12-01

Despite the widely held belief that the computerization of hospital medical systems contributes to improved patient care management, especially in the context of ordering medications and record keeping, extensive study of the attitudes of medical staff to computerization has found them to be negative. The views of nursing staff have been barely studied and so are unclear. The study reported here investigated the association between nurses' current computer use and skills, the extent of their involvement in quality control and improvement activities on the ward and their perception of the contribution of computerization to improving nursing care. The study was made in the context of a Joint Commission International Accreditation (JCIA) in a large tertiary medical center in Israel. The perception of the role of leadership commitment in the success of a quality initiative was also tested for. Two convenience samples were drawn from 33 clinical wards and units of the medical center. They were questioned at two time points, one before the JCIA and a second after JCIA completion. Of all nurses (N=489), 89 were paired to allow analysis of the study data in a before-and-after design. Thus, this study built three data sets: a pre-JCIA set, a post-JCIA set and a paired sample who completed the questionnaire both before and after JCIA. Data were collected by structured self-administered anonymous questionnaire. After the JCIA the participants ranked the role of leadership in quality improvement, the extent of their own quality control activity, and the contribution of computers to quality improvement higher than before the JCIA. Significant Pearson correlations were found showing that the higher the rating given to quality improvement leadership the more nurses reported quality improvement activities undertaken by them and the higher nurses rated the impact of computerization on the quality of care. In a regression analysis quality improvement leadership and computer use/skills accounted for 30% of the variance in the perceived contribution of computerization to quality improvement. (a) The present study is the first to show a relationship between organizational leadership and computer use by nurses for the purpose of improving clinical care. (b) The nurses' appreciation of the contribution computerization can make to data management and to clinical care quality improvement were both increased by the JCI accreditation process. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Child care under pressure: the quality of Dutch centers in 1995 and in 2001.

PubMed

Deynoot-Schaub, Mirjam J J M Gevers; Riksen-Walraven, J Marianne

2005-09-01

In 2001, the authors assessed the quality of care provided to children in 51 care groups from 39 child-care centers in The Netherlands using the Infant/Toddler Environment Rating Scale (T. Harms, D. Cryer, & R. M. Clifford, 1990) and compared the results with the quality of child care assessed in 1995 (M. H. van IJzendoorn, L. W. C. Tavecchio, G. J. Stams, M. J. E. Verhoeven, & E. J. Reiling, 1998). The overall quality and scale scores for language and learning activities were significantly lower in 2001 than in 1995. Child-care centers founded within the past 6 years (all nonsubsidized centers) scored considerably lower than did older, mostly subsidized, centers. The results are discussed from the perspective of changes in the socioeconomic and political context of child care.

The Effectiveness of the BITSEA as a Tool to Early Detect Psychosocial Problems in Toddlers, a Cluster Randomized Trial

PubMed Central

Kruizinga, Ingrid; Jansen, Wilma; van Sprang, Nicolien C.; Carter, Alice S.; Raat, Hein

2015-01-01

Objective Effective early detection tools are needed in child health care to detect psychosocial problems among young children. This study aimed to evaluate the effectiveness of the Brief Infant-Toddler Social and Emotional Assessment (BITSEA), in reducing psychosocial problems at one year follow-up, compared to care as usual. Method Well-child centers in Rotterdam, the Netherlands, were allocated in a cluster randomized controlled trial to the intervention condition (BITSEA—15 centers), or to the control condition (‘care-as-usual’- 16 centers). Parents of 2610 2-year-old children (1,207 intervention; 1,403 control) provided informed consent and completed the baseline and 1-year follow-up questionnaire. Multilevel regression analyses were used to evaluate the effect of condition on psychosocial problems and health related quality of life (i.e. respectively Child Behavior Checklist and Infant-Toddler Quality of Life). The number of (pursuits of) referrals and acceptability of the BITSEA were also evaluated. Results Children in the intervention condition scored more favourably on the CBCL at follow-up than children in the control condition: B = -2.43 (95% confidence interval [95%CI] = -3.53;-1.33 p<0.001). There were no differences between conditions regarding ITQOL. Child health professionals reported referring fewer children in the intervention condition (n = 56, 5.7%), compared to the control condition (n = 95, 7.9%; p<0.05). There was no intervention effect on parents’ reported number of referrals pursued. It took less time to complete (parents) or work with (child health professional) the BITSEA, compared to care as usual. In the control condition, 84.2% of the parents felt (very) well prepared for the well-child visit, compared to 77.9% in the intervention condition (p<0.001). Conclusion The results support the use of the BITSEA as a tool for child health professionals in the early detection of psychosocial problems in 2-year-olds. We recommend future studies in large and varied populations to replicate these findings. Trial registration Current Controlled Trials NTR2035 PMID:26383910

Service quality and patient experiences of ambulatory care in a specialized clinic vs. a general hospital.

PubMed

De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro

2017-04-01

Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.

Optimal preparation-to-colonoscopy interval in split-dose PEG bowel preparation determines satisfactory bowel preparation quality: an observational prospective study.

PubMed

Seo, Eun Hee; Kim, Tae Oh; Park, Min Jae; Joo, Hee Rin; Heo, Nae Yun; Park, Jongha; Park, Seung Ha; Yang, Sung Yeon; Moon, Young Soo

2012-03-01

Several factors influence bowel preparation quality. Recent studies have indicated that the time interval between bowel preparation and the start of colonoscopy is also important in determining bowel preparation quality. To evaluate the influence of the preparation-to-colonoscopy (PC) interval (the interval of time between the last polyethylene glycol dose ingestion and the start of the colonoscopy) on bowel preparation quality in the split-dose method for colonoscopy. Prospective observational study. University medical center. A total of 366 consecutive outpatients undergoing colonoscopy. Split-dose bowel preparation and colonoscopy. The quality of bowel preparation was assessed by using the Ottawa Bowel Preparation Scale according to the PC interval, and other factors that might influence bowel preparation quality were analyzed. Colonoscopies with a PC interval of 3 to 5 hours had the best bowel preparation quality score in the whole, right, mid, and rectosigmoid colon according to the Ottawa Bowel Preparation Scale. In multivariate analysis, the PC interval (odds ratio [OR] 1.85; 95% CI, 1.18-2.86), the amount of PEG ingested (OR 4.34; 95% CI, 1.08-16.66), and compliance with diet instructions (OR 2.22l 95% CI, 1.33-3.70) were significant contributors to satisfactory bowel preparation. Nonrandomized controlled, single-center trial. The optimal time interval between the last dose of the agent and the start of colonoscopy is one of the important factors to determine satisfactory bowel preparation quality in split-dose polyethylene glycol bowel preparation. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

Day care quality and children's free play activities.

PubMed

Vandell, D L; Powers, C P

1983-07-01

Social and nonsocial behavior of white, middle-class preschoolers in high, moderate, and low quality day care centers were contrasted. Children in high quality centers were more likely to interact positively with adults, while children in lower quality programs were more likely to engage in solitary play and aimless wandering.

Total Quality Management in the Defense Fuel Supply Center: Issues and Observations.

ERIC Educational Resources Information Center

Matysek, Eugene F., Jr.

1993-01-01

Examines the Total Quality Management (TQM) activities at a federal government agency (i.e., the Defense Fuel Supply Center) using the following criteria established by the Federal Quality Institute: top management leadership and support; strategic quality planning; customer focus; training and recognition; employee empowerment and teamwork; and…

Stakeholder Perspectives on Changes in Hypertension Care Under the Patient-Centered Medical Home.

PubMed

O'Donnell, Alison J; Bogner, Hillary R; Cronholm, Peter F; Kellom, Katherine; Miller-Day, Michelle; McClintock, Heather F de Vries; Kaye, Elise M; Gabbay, Robert

2016-02-25

Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patient-centered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control. The PCMH transformation initiative conducted 118 semistructured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. Clinicians (n = 47), medical assistants (n = 26), office administrators (n = 12), care managers (n = 11), front office staff (n = 7), patient educators (n = 4), nurses (n = 4), social workers (n = 4), and other administrators (n = 3) participated in interviews. Study personnel used thematic analysis to identify themes related to hypertension care. Clinicians described difficulties in expanding services under PCMH to meet the needs of the growing number of patients with hypertension as well as how perceptions of hypertension control differed from actual performance. Staff and office administrators discussed achieving patient-centered hypertension care through patient education and self-management support with personalized care plans. They indicated that patient report cards were helpful tools. Participants across all groups discussed a team- and systems-based approach to hypertension care. Practices undergoing PCMH transformation may consider stakeholder perspectives about patient-centered, team-based, and systems-based approaches as they work to optimize hypertension care.

BACT Simulation User Guide (Version 7.0)

NASA Technical Reports Server (NTRS)

Waszak, Martin R.

1997-01-01

This report documents the structure and operation of a simulation model of the Benchmark Active Control Technology (BACT) Wind-Tunnel Model. The BACT system was designed, built, and tested at NASA Langley Research Center as part of the Benchmark Models Program and was developed to perform wind-tunnel experiments to obtain benchmark quality data to validate computational fluid dynamics and computational aeroelasticity codes, to verify the accuracy of current aeroservoelasticity design and analysis tools, and to provide an active controls testbed for evaluating new and innovative control algorithms for flutter suppression and gust load alleviation. The BACT system has been especially valuable as a control system testbed.

Comparison of architect I 2000 for determination of cyclosporine with axsym.

PubMed

Serdarevic, Nafija; Zunic, Lejla

2012-12-01

Cyclosporine has been shown effective drug in suppressing acute rejection in recipients of allograft organ transplants. The cyclosporine concentration of 96 blood samples was determined using CMIA (chemiluminesecent microparticle immnoassay) Architect i 2000 and FPIA (fluorescence polarization immunoassay) AxSYM Abbott diagnostic. All patients have transplantation of kidneys and were hospitalized at Department of Nephrology at the Clinical center of University of Sarajevo. The reference serum range of cyclosporine for kidney organ transplantation for maintenance lies between 50 and 150 ng/mL. The quality control, precision and accurancy of Architect i 2000 were assessed. The quality control was done using quality control serums for low (= 91 ng/mL), medium (= 328 ng/mL) and high (= 829 ng/mL). We have used commercial BIORAD controls and got reproducibility CV 5.83 % to 13 % for Architect i 2000. It was established that the main difference between Architect i 2000 and AxSYM and it was statistically significant for P < 0.05 according to Student t-test. Correlation coefficient was r = 0.903. The CMIA Architect assay has significant reduced cyclosporine metabolite interference relative to other immunoassay and is a convenient and sensitive automated method to measure cyclosporine in whole blood.

Spaceport Command and Control System Automated Testing

NASA Technical Reports Server (NTRS)

Stein, Meriel

2017-01-01

The Spaceport Command and Control System (SCCS) is the National Aeronautics and Space Administrations (NASA) launch control system for the Orion capsule and Space Launch System, the next generation manned rocket currently in development. This large system requires high quality testing that will properly measure the capabilities of the system. Automating the test procedures would save the project time and money. Therefore, the Electrical Engineering Division at Kennedy Space Center (KSC) has recruited interns for the past two years to work alongside full-time engineers to develop these automated tests, as well as innovate upon the current automation process.

Spaceport Command and Control System Automation Testing

NASA Technical Reports Server (NTRS)

Hwang, Andrew

2017-01-01

The Spaceport Command and Control System (SCCS) is the National Aeronautics and Space Administrations (NASA) launch control system for the Orion capsule and Space Launch System, the next generation manned rocket currently in development. This large system requires high quality testing that will properly measure the capabilities of the system. Automating the test procedures would save the project time and money. Therefore, the Electrical Engineering Division at Kennedy Space Center (KSC) has recruited interns for the past two years to work alongside full-time engineers to develop these automated tests, as well as innovate upon the current automation process.

Analysis of the longitudinal handling qualities and pilot-induced-oscillation tendencies of the High-Angle-of-Attack Research Vehicle (HARV)

NASA Technical Reports Server (NTRS)

Hess, Ronald A.

1994-01-01

The NASA High-Angle-of Attack Research Vehicle (HARV), a modified F-18 aircraft, experienced handling qualities problems in recent flight tests at NASA Dryden Research Center. Foremost in these problems was the tendency of the pilot-aircraft system to exhibit a potentially dangerous phenomenon known as a pilot-induced oscillation (PIO). When they occur, PIO's can severely restrict performance, sharply dimish mission capabilities, and can even result in aircraft loss. A pilot/vehicle analysis was undertaken with the goal of reducing these PIO tendencies and improving the overall vehicle handling qualities with as few changes as possible to the existing feedback/feedforward flight control laws. Utilizing a pair of analytical pilot models developed by the author, a pilot/vehicle analysis of the existing longitudinal flight control system was undertaken. The analysis included prediction of overall handling qualities levels and PIO susceptability. The analysis indicated that improvement in the flight control system was warranted and led to the formulation of a simple control stick command shaping filter. Analysis of the pilot/vehicle system with the shaping filter indicated significant improvements in handling qualities and PIO tendencies could be achieved. A non-real time simulation of the modified control system was undertaken with a realistic, nonlinear model of the current HARV. Special emphasis was placed upon those details of the command filter implementation which could effect safety of flight. The modified system is currently awaiting evaluation in the real-time, pilot-in-the-loop, Dual-Maneuvering-Simulator (DMS) facility at Langley.

First CLIPS Conference Proceedings, volume 1

NASA Technical Reports Server (NTRS)

1990-01-01

The first Conference of C Language Production Systems (CLIPS) hosted by the NASA-Lyndon B. Johnson Space Center in August 1990 is presented. Articles included engineering applications, intelligent tutors and training, intelligent software engineering, automated knowledge acquisition, network applications, verification and validation, enhancements to CLIPS, space shuttle quality control/diagnosis applications, space shuttle and real-time applications, and medical, biological, and agricultural applications.

Final Environmental Assessment: Demolition of Barracks (Building T-2) at Ipswich Antenna Test Facility

DTIC Science & Technology

2011-12-01

EIAP), managed the preparation and was the primary author of this environmental assessment. QAULITY ASSURANCE LEADER Cravedi, Gregory. 66 ABG/CE...BMP Best Management Practice CEQ Council on Environmental Quality CERCLA Comprehensive Environmental Response, Compensation, and Liability Act...Assessment EMCS Energy Management Control System ESC Electronic Systems Center FEMA Federal Emergency Management Agency FIRM Federal

A National Assessment of the Impact of the Institutes for Higher Education Academy on School Health Faculty

ERIC Educational Resources Information Center

Huelskamp, Amelia C.; Dake, Joseph A.; Telljohann, Susan K.; Tappe, Marlene K.; Jordan, Timothy

2016-01-01

Background: Many school health teacher preparation programs do not train teacher candidates in the use of online resources available through the Centers for Disease Control and Prevention (CDC). Some CDC resources, such as the School Health Index, could significantly improve the quality of school health programs. To address this, the CDC and the…

Shedding Further Light on the Effects of Various Types and Quality of Early Child Care on Infant-Mother Attachment Relationship: The Haifa Study of Early Child Care.

ERIC Educational Resources Information Center

Sagi, Abraham; Koren-Karie, Nina; Gini, Motti; Ziv, Yair; Joels, Tirtsa

2002-01-01

The Haifa Study of Early Child Care examined the unique contribution of various child-care-related correlates to infant-mother attachment. Findings indicated that, after controlling for other potential contributing variables (including mother characteristics, mother-child interaction, and mother- father relationship), center care adversely…

Organizational Analysis of Food Service Management

DTIC Science & Technology

2011-06-01

35  d.  Senior Culinary Specialists on “Twilight” Tour ...................35  e.  NAVSUP Controls Quality of Life...Supply Centers COMSUBFOR Commander Submarine Force CS Culinary Specialist CSCS Culinary Specialist Senior Chief CVN Carrier Vessel Nuclear DDG Guided...attention of the Culinary Specialists. The type of assist visit can be tailored to the requirements identified by the requesting command. Normally

DOE Center of Excellence in Medical Laser Applications. Final report

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

Jacques, S.L.

1998-01-01

An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland, OR, Houston, TX, and Galveston, TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several newmore » video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulation of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.« less

DOE Center of Excellence in Medical Laser Applications. Final report, December 1, 1994--November 30, 1997

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

Jacques, S.L.

1998-01-01

An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland OR, Houston TX, and Galveston TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several newmore » video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulant of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.« less

The Quality Control Algorithms Used in the Process of Creating the NASA Kennedy Space Center Lightning Protection System Towers Meteorological Database

NASA Technical Reports Server (NTRS)

Orcutt, John M.; Brenton, James C.

2016-01-01

The methodology and the results of the quality control (QC) process of the meteorological data from the Lightning Protection System (LPS) towers located at Kennedy Space Center (KSC) launch complex 39B (LC-39B) are documented in this paper. Meteorological data are used to design a launch vehicle, determine operational constraints, and to apply defined constraints on day-of-launch (DOL). In order to properly accomplish these tasks, a representative climatological database of meteorological records is needed because the database needs to represent the climate the vehicle will encounter. Numerous meteorological measurement towers exist at KSC; however, the engineering tasks need measurements at specific heights, some of which can only be provided by a few towers. Other than the LPS towers, Tower 313 is the only tower that provides observations up to 150 m. This tower is located approximately 3.5 km from LC-39B. In addition, data need to be QC'ed to remove erroneous reports that could pollute the results of an engineering analysis, mislead the development of operational constraints, or provide a false image of the atmosphere at the tower's location.

Performance Assessment of a Communicable Disease Surveillance System in Response to the Twin Earthquakes of East Azerbaijan.

PubMed

Babaie, Javad; Ardalan, Ali; Vatandoost, Hasan; Goya, Mohammad Mehdi; Akbari Sari, Ali

2015-08-01

Following the twin earthquakes on August 11, 2012, in the East Azerbaijan province of Iran, the provincial health center set up a surveillance system to monitor communicable diseases. This study aimed to assess the performance of this surveillance system. In this quantitative-qualitative study, performance of the communicable diseases surveillance system was assessed by using the updated guidelines of the Centers for Disease Control and Prevention (CDC). Qualitative data were collected through interviews with the surveillance system participants, and quantitative data were obtained from the surveillance system. The surveillance system was useful, simple, representative, timely, and flexible. The data quality, acceptability, and stability of the surveillance system were 65.6%, 10.63%, and 100%, respectively. The sensitivity and positive predictive value were not calculated owing to the absence of a gold standard. The surveillance system satisfactorily met the goals expected for its setup. The data obtained led to the control of communicable diseases in the affected areas. Required interventions based on the incidence of communicable disease were designed and implemented. The results also reassured health authorities and the public. However, data quality and acceptability should be taken into consideration and reviewed for implementation in future disasters.

Evaluation of Two Unique Side Stick Controllers in a Fixed-Base Flight Simulator

NASA Technical Reports Server (NTRS)

Mayer, Jann; Cox, Timothy H.

2003-01-01

A handling qualities analysis has been performed on two unique side stick controllers in a fixed-base F-18 flight simulator. Each stick, which uses a larger range of motion than is common for similar controllers, has a moving elbow cup that accommodates movement of the entire arm for control. The sticks are compared to the standard center stick in several typical fighter aircraft tasks. Several trends are visible in the time histories, pilot ratings, and pilot comments. The aggressive pilots preferred the center stick, because the side sticks are underdamped, causing overshoots and oscillations when large motions are executed. The less aggressive pilots preferred the side sticks, because of the smooth motion and low breakout forces. The aggressive pilots collectively gave the worst ratings, probably because of increased sensitivity of the simulator (compared to the actual F-18 aircraft), which can cause pilot-induced oscillations when aggressive inputs are made. Overall, the elbow cup is not a positive feature, because using the entire arm for control inhibits precision. Pilots had difficulty measuring their performance, particularly during the offset landing task, and tended to overestimate.

A Multi-center Study on Improvement in Life Quality of Pediatric Patients with Asthma via Continuous Care

PubMed Central

CAI, Ying; CAO, Junhua; KAN, Ruixue; LIU, Yuping; ZHAO, Li; HU, Ming; ZHANG, Xuemei

2017-01-01

Background: To analyze and summarize the effect of continuous care on the life quality and control of asthma of pediatric patients with asthma discharged from multiple hospitals. Methods: Retrospective analysis was carried out on 172 pediatric patients with asthma aged between 6 and 11 yr old randomly selected from those admitted to five hospitals between January 2014 and December 2015. Among these 172 patients, only 86 (intervention group) received the continuous care between January 2015 and December 2015, while the rest (control group) did not receive from January 2014 and December 2014. Results: After the patients in the intervention group were discharged from the hospital, the ratio of practical forced expiratory volume in one second (FEV1) to the expected FEV1 at the 12th month was (90.28±10.35)%, and the ratio of peak expiratory flow to the expected value was (84.24±3.43)%, respectively higher than those [(82.73±8.86)% and (75.80±4.67)%] in the control group. Regarding pediatric asthma quality of life questionnaire (PAQLQ) between the intervention group and the control group, the difference had statistical significance (Z=−7.254, P<0.05). Childhood asthma control test (C-ACT) comparison between the intervention group and the control group indicated that the difference had statistical significance (Z=−7.918, P<0.05). Conclusion: Continuous care can improve the pediatric patient’s pulmonary function and life quality, and effectively control the asthmatic symptoms. PMID:29167770

Randomized controlled trials and neuro-oncology: should alternative designs be considered?

PubMed

Mansouri, Alireza; Shin, Samuel; Cooper, Benjamin; Srivastava, Archita; Bhandari, Mohit; Kondziolka, Douglas

2015-09-01

Deficiencies in design and reporting of randomized controlled trials (RCTs) hinders interpretability and critical appraisal. The reporting quality of recent RCTs in neuro-oncology was analyzed to assess adequacy of design and reporting. The MEDLINE and EMBASE databases were searched to identify non-surgical RCTs (years 2005-2014, inclusive). The CONSORT and Jadad scales were used to assess the quality of design/reporting. Studies published in 2005-2010 were compared as a cohort against studies published in 2011-2014, in terms of general characteristics and reporting quality. A PRECIS-based scale was used to designate studies on the pragmatic-explanatory continuum. Spearman's test was used to assess correlations. Regression analysis was used to assess associations. Overall 68 RCTs were identified. Studies were often chemotherapy-based (n = 41 studies) focusing upon high grade gliomas (46 %) and metastases (41 %) as the top pathologies. Multi-center trials (71 %) were frequent. The overall median CONSORT and Jadad scores were 34.5 (maximum 44) and 2 (maximum 5), respectively; these scores were similar in radiation and chemotherapy-based trials. Major areas of deficiency pertained to allocation concealment, implementation of methods, and blinding whereby less than 20 % of articles fulfilled all criteria. Description of intervention, random sequence generation, and the details regarding recruitment were also deficient; less than 50 % of studies fulfilled all criteria. Description of sample size calculations and blinding improved in later published cohorts. Journal impact factor was significantly associated with higher quality (p = 0.04). Large academic consortia, multi-center designs, ITT analysis, collaboration with biostatisticians, larger sample sizes, and studies with pragmatic objectives were more likely to achieve positive primary outcomes on univariate analysis; none of these variables were significant on multivariate analysis. Deficiencies in the quality of design/reporting of RCTs in neuro-oncology persist. Quality improvement is necessary. Consideration of alternative strategies should be considered.

Piloted Evaluation of Modernized Limited Authority Control Laws in the NASA-Ames Vertical Motion Simulator (VMS)

NASA Technical Reports Server (NTRS)

Sahasrabudhe, Vineet; Melkers, Edgar; Faynberg, Alexander; Blanken, Chris L.

2003-01-01

The UH-60 BLACK HAWK was designed in the 1970s, when the US Army primarily operated during the day in good visual conditions. Subsequently, the introduction of night-vision goggles increased the BLACK HAWK'S mission effectiveness, but the accident rate also increased. The increased accident rate is strongly tied to increased pilot workload as a result of a degradation in visual cues. Over twenty years of research in helicopter flight control and handling qualities has shown that these degraded handling qualities can be recovered by modifying the response type of the helicopter in low speed flight. Sikorsky Aircraft Corporation initiated a project under the National Rotorcraft Technology Center (NRTC) to develop modern flight control laws while utilizing the existing partial authority Stability Augmentation System (SAS) of the BLACK HAWK. This effort resulted in a set of Modernized Control Laws (MCLAWS) that incorporate rate command and attitude command response types. Sikorsky and the US Army Aeroflightdynamics Directorate (AFDD) conducted a piloted simulation on the NASA-Ames Vertical h4otion Simulator, to assess potential handling qualities and to reduce the risk of subsequent implementation and flight test of these modern control laws on AFDD's EH-60L helicopter. The simulation showed that Attitude Command Attitude Hold control laws in pitch and roll improve handling qualities in the low speed flight regime. These improvements are consistent across a range of mission task elements and for both good and degraded visual environments. The MCLAWS perform better than the baseline UH-60A control laws in the presence of wind and turbulence. Finally, while the improved handling qualities in the pitch and roll axis allow the pilot to pay more attention to the vertical axis and hence altitude performance also improves, it is clear from pilot comments and altitude excursions that the addition of an Altitude Hold function would further reduce workload and improve overall handling qualities of the aircraft.

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

PubMed

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

2007-12-01

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

Eutrophication and contaminant data management for EU marine policies: the EMODnet Chemistry infrastructure.

NASA Astrophysics Data System (ADS)

Vinci, Matteo; Lipizer, Marina; Giorgetti, Alessandra

2016-04-01

The European Marine Observation and Data Network (EMODnet) initiative has the following purposes: to assemble marine metadata, data and products, to make these fragmented resources more easily available to public and private users and to provide quality-assured, standardised and harmonised marine data. EMODnet Chemistry was launched by DG MARE in 2009 to support the Marine Strategy Framework Directive (MSFD) requirements for the assessment of eutrophication and contaminants, following INSPIRE Directive rules. The aim is twofold: the first task is to make available and reusable the big amount of fragmented and inaccessible data, hosted in the European research institutes and environmental agencies. The second objective is to develop visualization services useful for the tasks of the MSFD. The technical set-up is based on the principle of adopting and adapting the SeaDataNet infrastructure for ocean and marine data which are managed by National Oceanographic Data Centers and relies on a distributed network of data centers. Data centers contribute to data harvesting and enrichment with the relevant metadata. Data are processed into interoperable formats (using agreed standards ISO XML, ODV) with the use of common vocabularies and standardized quality control procedures .Data quality control is a key issue when merging heterogeneous data coming from different sources and a data validation loop has been agreed within EMODnet Chemistry community and is routinely performed. After data quality control done by the regional coordinators of the EU marine basins (Atlantic, Baltic, North, Mediterranean and Black Sea), validated regional datasets are used to develop data products useful for the requirements of the MSFD. EMODnet Chemistry provides interpolated seasonal maps of nutrients and services for the visualization of time series and profiles of several chemical parameters. All visualization services are developed following OGC standards as WMS and WPS. In order to test new strategies for data storage, reanalysis and to upgrade the infrastructure performances, EMODnet Chemistry has chosen the Cloud environment offered by Cineca (the Consortium of Italian Universities and research institutes) where both regional aggregated datasets and analysis and visualization services are hosted. Finally, beside the delivery of data and the visualization products, the results of the data harvesting provide a useful tool to identify data gaps where the future monitoring efforts should be focused.

Guidance and Control Software Project Data - Volume 4: Configuration Management and Quality Assurance Documents

NASA Technical Reports Server (NTRS)

Hayhurst, Kelly J. (Editor)

2008-01-01

The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes configuration management and quality assurance documents from the GCS project. Volume 4 contains six appendices: A. Software Accomplishment Summary for the Guidance and Control Software Project; B. Software Configuration Index for the Guidance and Control Software Project; C. Configuration Management Records for the Guidance and Control Software Project; D. Software Quality Assurance Records for the Guidance and Control Software Project; E. Problem Report for the Pluto Implementation of the Guidance and Control Software Project; and F. Support Documentation Change Reports for the Guidance and Control Software Project.

Development and Testing of Control Laws for the Active Aeroelastic Wing Program

NASA Technical Reports Server (NTRS)

Dibley, Ryan P.; Allen, Michael J.; Clarke, Robert; Gera, Joseph; Hodgkinson, John

2005-01-01

The Active Aeroelastic Wing research program was a joint program between the U.S. Air Force Research Laboratory and NASA established to investigate the characteristics of an aeroelastic wing and the technique of using wing twist for roll control. The flight test program employed the use of an F/A-18 aircraft modified by reducing the wing torsional stiffness and adding a custom research flight control system. The research flight control system was optimized to maximize roll rate using only wing surfaces to twist the wing while simultaneously maintaining design load limits, stability margins, and handling qualities. NASA Dryden Flight Research Center developed control laws using the software design tool called CONDUIT, which employs a multi-objective function optimization to tune selected control system design parameters. Modifications were made to the Active Aeroelastic Wing implementation in this new software design tool to incorporate the NASA Dryden Flight Research Center nonlinear F/A-18 simulation for time history analysis. This paper describes the design process, including how the control law requirements were incorporated into constraints for the optimization of this specific software design tool. Predicted performance is also compared to results from flight.

An experimental evaluation of the Sternberg task as a workload metric for helicopter Flight Handling Qualities (FHQ) research

NASA Technical Reports Server (NTRS)

Hemingway, J. C.

1984-01-01

The objective was to determine whether the Sternberg item-recognition task, employed as a secondary task measure of spare mental capacity for flight handling qualities (FHQ) simulation research, could help to differentiate between different flight-control conditions. FHQ evaluations were conducted on the Vertical Motion Simulator at Ames Research Center to investigate different primary flight-control configurations, and selected stability and control augmentation levels for helicopters engaged in low-level flight regimes. The Sternberg task was superimposed upon the primary flight-control task in a balanced experimental design. The results of parametric statistical analysis of Sternberg secondary task data failed to support the continued use of this task as a measure of pilot workload. In addition to the secondary task, subjects provided Cooper-Harper pilot ratings (CHPR) and responded to workload questionnaire. The CHPR data also failed to provide reliable statistical discrimination between FHQ treatment conditions; some insight into the behavior of the secondary task was gained from the workload questionnaire data.

The Sternberg Task as a Workload Metric in Flight Handling Qualities Research

NASA Technical Reports Server (NTRS)

Hemingway, J. C.

1984-01-01

The objective of this research was to determine whether the Sternberg item-recognition task, employed as a secondary task measure of spare mental capacity for flight handling qualities (FHQ) simulation research, could help to differentiate between different flight-control conditions. FHQ evaluations were conducted on the Vertical Motion Simulator at Ames Research Center to investigate different primary flight-control configurations, and selected stability and control augmentation levels for helicopers engaged in low-level flight regimes. The Sternberg task was superimposed upon the primary flight-control task in a balanced experimental design. The results of parametric statistical analysis of Sternberg secondary task data failed to support the continued use of this task as a measure of pilot workload. In addition to the secondary task, subjects provided Cooper-Harper pilot ratings (CHPR) and responded to a workload questionnaire. The CHPR data also failed to provide reliable statistical discrimination between FHQ treatment conditions; some insight into the behavior of the secondary task was gained from the workload questionnaire data.

Protective Controller against Cascade Outages with Selective Harmonic Compensation Function

NASA Astrophysics Data System (ADS)

Abramovich, B. N.; Kuznetsov, P. A.; Sychev, Yu A.

2018-05-01

The paper presents data on the power quality and development of protective devices for the power networks with distributed generation (DG).The research has shown that power quality requirements for DG networks differ from conventional ones. That is why main tendencies, protective equipment and filters should be modified. There isa developed algorithm for detection and prevention of cascade outages that can lead to the blackoutin DG networks and there was a proposed structural scheme for a new active power filter for selective harmonics compensation. Analysis of these theories and equipment led to the development of protective device that could monitor power balance and cut off non-important consumers. The last part of the article describes a microcontroller prototype developed for connection to the existing power station control center.

NASA. Langley Research Center dry powder towpreg system

NASA Technical Reports Server (NTRS)

Baucom, Robert M.; Marchello, Joseph M.

1990-01-01

Dry powder polymer impregnated carbon fiber tows were produced for preform weaving and composite materials molding applications. In the process, fluidized powder is deposited on spread tow bundles and melted on the fibers by radiant heating to adhere the polymer to the fiber. Unit design theory and operating correlations were developed to provide the basis for scale up of the process to commercial operation. Special features of the operation are the pneumatic tow spreader, fluidized bed, resin feeder, and quality control system. Bench scale experiments, at tow speeds up to 50 cm/sec, demonstrated that process variables can be controlled to produce weavable LARC-TPI carbon fiber towpreg. The towpreg made by the dry powder process was formed into unidirectional fiber moldings and was woven and molded into preform material of good quality.

Joint-probability Analysis of the Natural Variability of Tropical Oceanic Precipitation

NASA Technical Reports Server (NTRS)

Yuter, Sandra E.

2004-01-01

Data projects pertaining to KWAJEX are described.Data sets delivered to the Goddard Distributed Active Archive Center (DAAC): 1) Kwajalein Experiment (KWAJEX) S-band calibrated, quality-controlled radar data, 1221 1 files of 3D volume data and 6832 files of 2D low-level reflectivity. 2) Raw and quality-control- processed versions of University of Washington Joss-Waldvogel disdrometer measurements obtained during KWAJEX. 3) A time series of synoptic-scale gif images of the Geostationary Meteorological Satellite (GMS) IR data for the KWAJEX period. The GMS satellite data set for the KWAJEX period was obtained from the University of Wisconsin and reprocessed into format amenable for comparison with radar data.Aircraft microphysics flight-leg definitions for all aircraft and all missions during KWAJEX were completed to facilitate microphysics data processing.

Does exposure to computers affect the routine parameters of semen quality?

PubMed

Sun, Yue-Lian; Zhou, Wei-Jin; Wu, Jun-Qing; Gao, Er-Sheng

2005-09-01

To assess whether exposure to computers harms the semen quality of healthy young men. A total of 178 subjects were recruited from two maternity and children healthcare centers in Shanghai, 91 with a history of exposure to computers (i.e., exposure for 20 h or more per week in the last 2 years) and 87 persons to act as control (no or little exposure to computers). Data on the history of exposure to computers and other characteristics were obtained by means of a structured questionnaire interview. Semen samples were collected by masturbation in the place where the semen samples were analyzed. No differences in the distribution of the semen parameters (semen volume, sperm density, percentage of progressive sperm, sperm viability and percentage of normal form sperm) were found between the exposed group and the control group. Exposure to computers was not found to be a risk factor for inferior semen quality after adjusting for potential confounders, including abstinence days, testicle size, occupation, history of exposure to toxic substances. The present study did not find that healthy men exposed to computers had inferior semen quality.

The Integrated Ocean Observing System Data Assembly Center

NASA Astrophysics Data System (ADS)

Bouchard, R. H.; Henderson, D.; Burnett, W.; Hervey, R. V.; Crout, R.

2008-05-01

The Integrated Ocean Observing System (IOOS) is the U.S. contribution to the Global Ocean Observing System and the Global Earth Observing System of Systems (GEOSS). As the Integrated Ocean Observing System Data Assembly Center (IOOS DAC), the National Oceanic and Atmospheric Administration`s (NOAA) National Data Buoy Center (NDBC) collects data from ocean observing systems and performs quality control on the data. Once the IOOS DAC performs the quality control, it distributes them in real-time: (1) in World Meteorological Organization alphanumeric data formats via the Global Telecommunications System (GTS) that provides instant availability to national and international users (2) in text files via its website (http://www.ndbc.noaa.gov) that provide easy access and use, and (3) in netCDF format via its OPeNDAP/DODS Server (http://dods.ndbc.noaa.gov) that provides higher resolution data than available in WMO alphanumeric or text file formats. The IOOS DAC routinely checks and distributes data from about 200 NDBC stations that include meteorological and oceanographic observations from buoys and coastal stations, water-level estimations from tsunameters (DART), and climate monitoring from buoys (Tropical Atmosphere Ocean array (TAO)). The IOOS DAC operates continuously - 24 hours per day, 7 days per week. In addition to data from NDBC`s platforms, the IOOS DAC applies its scientific expertise and data management and communications capabilities to facilitate partnerships for the exchange and application of data and to coordinate and leverage regional assets and resources from about 350 IOOS Partner stations. The IOOS DAC through its quality control process provides feedback to its partners on the quality of their observation that can lead to improved quality of the observations. The NDBC-IOOS Data Partnerships span the Western Hemisphere with data collection from the Beaufort Sea to the Peru Current, from the International Date Line to the central Atlantic Ocean, and include some 70 government organizations, non-government organizations, industry and academia. Data exchange is facilitated by the IOOS DAC`s capability to ingest some sensor native formats and its own eXtensible Mark-up Language (XML). The IOOS DAC handles a variety of observations among them atmospheric winds, pressure, and temperature, rainfall, directional waves, solar radiation, tides and water-levels, water-quality parameters, such as dissolved oxygen, turbidity, pH, chlorophyll, surface and subsurface currents, temperature, and salinity (conductivity) and from a diverse collection of observing platforms - moored and drifting buoys, coastal stations, oil and gas platforms, and HF Radar stations. The IOOS DAC efforts have resulted in making more than seven million in situ observations available in real- time to the global community during 2007.

Bacteriological water quality in the Lake Pontchartrain basin Louisiana following Hurricanes Katrina and Rita, September 2005

USGS Publications Warehouse

Stoeckel, Donald M.; Bushon, Rebecca N.; Demcheck, Dennis K.; Skrobialowski, Stanley C.; Kephart, Christopher M.; Bertke, Erin E.; Mailot, Brian E.; Mize, Scott V.; Fendick, Robert B.

2005-01-01

The U.S. Geological Survey (USGS), in collaboration with the Louisiana Department of Environmental Quality, monitored bacteriological quality of water at 22 sites in and around Lake Pontchartrain, La., for three consecutive weeks beginning September 13, 2005, following hurricanes Katrina and Rita and the associated flooding. Samples were collected and analyzed by USGS personnel from the USGS Louisiana Water Science Center and the USGS Ohio Water Microbiology Laboratory. Fecal-indicator bacteria (Escherichia coli, enterococci, and fecal coliform) concentrations ranged from the detection limit to 36,000 colony-forming units per 100 milliliters. Data are presented in tabular form and as plots of data in the context of available historical data and water-quality standards and criteria for each site sampled. Quality-control data were reviewed to ensure that methods performed as expected in a mobile laboratory setting.

Development of a quality assurance program for ionizing radiation secondary calibration laboratories

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

Heaton, H.T. II; Taylor, A.R. Jr.

For calibration laboratories, routine calibrations of instruments meeting stated accuracy goals are important. One method of achieving the accuracy goals is to establish and follow a quality assurance program designed to monitor all aspects of the calibration program and to provide the appropriate feedback mechanism if adjustments are needed. In the United States there are a number of organizations with laboratory accreditation programs. All existing accreditation programs require that the laboratory implement a quality assurance program with essentially the same elements in all of these programs. Collectively, these elements have been designated as a Measurement Quality Assurance (MQA) program. Thismore » paper will briefly discuss the interrelationship of the elements of an MQA program. Using the Center for Devices and Radiological Health (CDRH) X-ray Calibration Laboratory (XCL) as an example, it will focus on setting up a quality control program for the equipment in a Secondary Calibration Laboratory.« less

Effects of organizational scheme and labeling on task performance in product-centered and user-centered retail Web sites.

PubMed

Resnick, Marc L; Sanchez, Julian

2004-01-01

As companies increase the quantity of information they provide through their Web sites, it is critical that content is structured with an appropriate architecture. However, resource constraints often limit the ability of companies to apply all Web design principles completely. This study quantifies the effects of two major information architecture principles in a controlled study that isolates the incremental effects of organizational scheme and labeling on user performance and satisfaction. Sixty participants with a wide range of Internet and on-line shopping experience were recruited to complete a series of shopping tasks on a prototype retail shopping Web site. User-centered labels provided a significant benefit in performance and satisfaction over labels obtained through company-centered methods. User-centered organization did not result in improved performance except when the label quality was poor. Significant interactions suggest specific guidelines for allocating resources in Web site design. Applications of this research include the design of Web sites for any commercial application, particularly E-commerce.

The Value of Reliable Data: Interactive Data Tools from the National Comprehensive Center for Teacher Quality. Policy-to-Practice Brief. Number 1

ERIC Educational Resources Information Center

National Comprehensive Center for Teacher Quality, 2008

2008-01-01

The National Comprehensive Center for Teacher Quality (TQ Center) designed the Interactive Data Tools to provide users with access to state and national data that can be helpful in assessing the qualifications of teachers in the states and the extent to which a state's teacher policy climate generally supports teacher quality. The Interactive Data…

Measuring school health center impact on access to and quality of primary care.

PubMed

Gibson, Erica J; Santelli, John S; Minguez, Mara; Lord, Alyssa; Schuyler, Ashley C

2013-12-01

School health centers (SHC) that provide comprehensive health care may improve access and quality of care for students; however, published impact data are limited. We evaluated access and quality of health services at an urban high school with a SHC compared with a school without a SHC, using a quasiexperimental research design. Data were collected at the beginning of the school year, using a paper and pencil classroom questionnaire (n = 2,076 students). We measured SHC impact in several ways including grade by school interaction terms. Students at the SHC school were more likely to report having a regular healthcare provider, awareness of confidential services, support for health services in their school, and willingness to utilize those services. Students in the SHC school reported higher quality of care as measured by: respect for their health concerns, adequate time with the healthcare provider, understandable provider communications, and greater provider discussion at their last visit on topics such as sexual activity, birth control, emotions, future plans, diet, and exercise. Users of the SHC were also more likely to report higher quality of care, compared with either nonusers or students in the comparison school. Access to comprehensive health services via a SHC led to improved access to health care and improved quality of care. Impact was measureable on a school-wide basis but was greater among SHC users. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Interlaboratory Study of Quality Control Isolates for a Broth Microdilution Method (Modified CLSI M38-A) for Testing Susceptibilities of Dermatophytes to Antifungals▿

PubMed Central

Ghannoum, M. A.; Arthington-Skaggs, B.; Chaturvedi, V.; Espinel-Ingroff, A.; Pfaller, M. A.; Rennie, R.; Rinaldi, M. G.; Walsh, T. J.

2006-01-01

The Clinical and Laboratory Standards Institute (CLSI; formerly National Committee for Clinical Laboratory Standards, or NCCLS) M38-A standard for the susceptibility testing of filamentous fungi does not specifically address the testing of dermatophytes. In 2003, a multicenter study investigated the reproducibility of the microdilution method developed at the Center for Medical Mycology, Cleveland, Ohio, for testing the susceptibility of dermatophytes. Data from that study supported the introduction of this method for testing dermatophytes in the future version of the CLSI M38-A standard. In order for the method to be accepted by CLSI, appropriate quality control isolates needed to be identified. To that end, an interlaboratory study, involving the original six laboratories plus two additional sites, was conducted to evaluate potential candidates for quality control isolates. These candidate strains included five Trichophyton rubrum strains known to have elevated MICs to terbinafine and five Trichophyton mentagrophytes strains. Antifungal agents tested included ciclopirox, fluconazole, griseofulvin, itraconazole, posaconazole, terbinafine, and voriconazole. Based on the data generated, two quality control isolates, one T. rubrum isolate and one T. mentagrophytes isolate, were identified and submitted to the American Type Culture Collection (ATCC) for inclusion as reference strains. Ranges encompassing 95.2 to 97.9% of all data points for all seven drugs were established. PMID:17050812

Development and Validation of Quality Criteria for Providing Patient- and Family-centered Injury Care.

PubMed

Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T

2017-08-01

The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.

Accuracy of Marketing Claims by Providers of Stereotactic Radiation Therapy

PubMed Central

Narang, Amol K.; Lam, Edwin; Makary, Martin A.; DeWeese, Theodore L.; Pawlik, Timothy M.; Pronovost, Peter J.; Herman, Joseph M.

2013-01-01

Purpose: Direct-to-consumer advertising by industry has been criticized for encouraging overuse of unproven therapies, but advertising by health care providers has not been as carefully scrutinized. Stereotactic radiation therapy is an emerging technology that has sparked controversy regarding the marketing campaigns of some manufacturers. Given that this technology is also being heavily advertised on the Web sites of health care providers, the accuracy of providers' marketing claims should be rigorously evaluated. Methods: We reviewed the Web sites of all US hospitals and private practices that provide stereotactic radiation using two leading brands of stereotactic radiosurgery technology. Centers were identified by using data from the manufacturers. Centers without Web sites were excluded. The final study population consisted of 212 centers with online advertisements for stereotactic radiation. Web sites were evaluated for advertisements that were inconsistent with advertising guidelines provided by the American Medical Association. Results: Most centers (76%) had individual pages dedicated to the marketing of their brand of stereotactic technology that frequently contained manufacturer-authored images (50%) or text (55%). Advertising for the treatment of tumors that have not been endorsed by professional societies was present on 66% of Web sites. Centers commonly claimed improved survival (22%), disease control (20%), quality of life (17%), and toxicity (43%) with stereotactic radiation. Although 40% of Web sites championed the center's regional expertise in delivering stereotactic treatments, only 15% of Web sites provided data to support their claims. Conclusion: Provider advertisements for stereotactic radiation were prominent and aggressive. Further investigation of provider advertising, its effects on quality of care, and potential oversight mechanisms is needed. PMID:23633973

Accuracy of marketing claims by providers of stereotactic radiation therapy.

PubMed

Narang, Amol K; Lam, Edwin; Makary, Martin A; Deweese, Theodore L; Pawlik, Timothy M; Pronovost, Peter J; Herman, Joseph M

2013-01-01

Direct-to-consumer advertising by industry has been criticized for encouraging overuse of unproven therapies, but advertising by health care providers has not been as carefully scrutinized. Stereotactic radiation therapy is an emerging technology that has sparked controversy regarding the marketing campaigns of some manufacturers. Given that this technology is also being heavily advertised on the Web sites of health care providers, the accuracy of providers' marketing claims should be rigorously evaluated. We reviewed the Web sites of all U.S. hospitals and private practices that provide stereotactic radiation using two leading brands of stereotactic radiosurgery technology. Centers were identified by using data from the manufacturers. Centers without Web sites were excluded. The final study population consisted of 212 centers with online advertisements for stereotactic radiation. Web sites were evaluated for advertisements that were inconsistent with advertising guidelines provided by the American Medical Association. Most centers (76%) had individual pages dedicated to the marketing of their brand of stereotactic technology that frequently contained manufacturer-authored images (50%) or text (55%). Advertising for the treatment of tumors that have not been endorsed by professional societies was present on 66% of Web sites. Centers commonly claimed improved survival (22%), disease control (20%), quality of life (17%), and toxicity (43%) with stereotactic radiation. Although 40% of Web sites championed the center's regional expertise in delivering stereotactic treatments, only 15% of Web sites provided data to support their claims. Provider advertisements for stereotactic radiation were prominent and aggressive. Further investigation of provider advertising, its effects on quality of care, and potential oversight mechanisms is needed.

Effectiveness of aerobic gymnastic exercise on stress, fatigue, and sleep quality during postpartum: A pilot randomized controlled trial.

PubMed

Yang, Chiu-Ling; Chen, Chung-Hey

2018-01-01

Gymnastics is a preferable safe exercise for postnatal women performing regularly. The aim of this pilot randomized controlled trial was to determine whether the aerobic gymnastic exercise improves stress, fatigue, sleep quality and depression in postpartum women. Single-blinded, randomized controlled trial held from December 2014 until September 2015. Postnatal clinic of a medical center in southern Taiwan. 140 eligible postnatal women were systematically assigned, with a random start to experimental (n=70) or a control (n=70) group. Engage in aerobic gymnastic exercise at least three times (15min per section) a week for three months using compact disc in the home. Perceived Stress Scale, Postpartum Fatigue Scale, Postpartum Sleep Quality Scale, and Edinburgh Postnatal Depression Scale. In a two-way ANOVA with repeated measures, the aerobic gymnastic exercise group showed significant decrease in fatigue after practicing exercise 4 weeks and the positive effects extended to the 12-week posttests. Paired t-tests revealed that aerobic gymnastic exercise participants had improved significantly in perceived stress and fatigue after 4 weeks gymnastic exercise; these positive effects extended to the 12-week posttests. In addition, the changes in physical symptoms-related sleep inefficiency after 12 weeks gymnastic exercise were significantly decreased in the experimental group compared with the control group. The findings can be used to encourage postnatal women to perform moderate-intensity gymnastic exercise in their daily life to reduce their stress, fatigue and improve sleep quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Infection prevention and control practice for Crimean-Congo hemorrhagic fever-A multi-center cross-sectional survey in Eurasia.

PubMed

Fletcher, Tom E; Gulzhan, Abuova; Ahmeti, Salih; Al-Abri, Seif S; Asik, Zahide; Atilla, Aynur; Beeching, Nick J; Bilek, Heval; Bozkurt, Ilkay; Christova, Iva; Duygu, Fazilet; Esen, Saban; Khanna, Arjun; Kader, Çiğdem; Mardani, Masoud; Mahmood, Faisal; Mamuchishvili, Nana; Pshenichnaya, Natalia; Sunbul, Mustafa; Yalcin, Tuğba Y; Leblebicioglu, Hakan

2017-01-01

Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers. Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia. A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016. Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23). Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs.

Infection prevention and control practice for Crimean-Congo hemorrhagic fever—A multi-center cross-sectional survey in Eurasia

PubMed Central

Gulzhan, Abuova; Ahmeti, Salih; Al-Abri, Seif S.; Asik, Zahide; Atilla, Aynur; Beeching, Nick J.; Bilek, Heval; Bozkurt, Ilkay; Christova, Iva; Duygu, Fazilet; Esen, Saban; Khanna, Arjun; Kader, Çiğdem; Mardani, Masoud; Mahmood, Faisal; Mamuchishvili, Nana; Pshenichnaya, Natalia; Sunbul, Mustafa; Yalcin, Tuğba Y.; Leblebicioglu, Hakan

2017-01-01

Background Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers. Aim Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia. Methods A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016. Results Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23). Conclusions Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs. PMID:28886039

The effect of spouses' educational classes held for primiparous women referring to Hajar hospital on their quality of life and pregnancy outcomes.

PubMed

Dehcheshmeh, Faranak Safdari; Salehian, Tahmineh; Parvin, Neda

2014-02-01

With regard to the importance of quality of life in pregnant women, the present study aimed to determine the effect of spouses' educational classes held for primaparous women referring to Hajar hospital on women's quality of life and pregnancy outcomes. This clinical trial was conducted from September 2011 to June 2012 in the clinic of the Hajar university center in Shahrekord. Eligible primiparous women who registered for physiologic delivery educational classes were randomly assigned to study (n = 31) and control (n = 27) groups. In the control group, eight physiologic delivery educational sessions were held. In the study group, in addition to attendance of pregnant women, their husbands also attended the third and the eighth sessions of these classes. Women's quality of life was investigated with SF36 questionnaire and pregnancy outcomes after delivery were investigated. Data were analyzed by t-test and Chi-square test. Before intervention, there was no significant difference between scores of quality of life and demographic characteristics (P > 0.05). After intervention, there was a significant difference only in the dimensions of mental health, hugging time, kissing, and breast feeding between the study and control groups (P < 0.05). There was no significant difference in gestational age, gravida, number of miscarriages, pregnancy outcomes, and spouses' age (P > 0.05). Educational classes held for the pregnant women's husbands during pregnancy can be efficient in promotion of pregnant women's quality of life, especially in improving their mental health.

MO-A-16A-01: QA Procedures and Metrics: In Search of QA Usability

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

Sathiaseelan, V; Thomadsen, B

Radiation therapy has undergone considerable changes in the past two decades with a surge of new technology and treatment delivery methods. The complexity of radiation therapy treatments has increased and there has been increased awareness and publicity about the associated risks. In response, there has been proliferation of guidelines for medical physicists to adopt to ensure that treatments are delivered safely. Task Group recommendations are copious, and clinical physicists' hours are longer, stretched to various degrees between site planning and management, IT support, physics QA, and treatment planning responsibilities.Radiation oncology has many quality control practices in place to ensure themore » delivery of high-quality, safe treatments. Incident reporting systems have been developed to collect statistics about near miss events at many radiation oncology centers. However, tools are lacking to assess the impact of these various control measures. A recent effort to address this shortcoming is the work of Ford et al (2012) who recently published a methodology enumerating quality control quantification for measuring the effectiveness of safety barriers. Over 4000 near-miss incidents reported from 2 academic radiation oncology clinics were analyzed using quality control quantification, and a profile of the most effective quality control measures (metrics) was identified.There is a critical need to identify a QA metric to help the busy clinical physicists to focus their limited time and resources most effectively in order to minimize or eliminate errors in the radiation treatment delivery processes. In this symposium the usefulness of workflows and QA metrics to assure safe and high quality patient care will be explored.Two presentations will be given:Quality Metrics and Risk Management with High Risk Radiation Oncology ProceduresStrategies and metrics for quality management in the TG-100 Era Learning Objectives: Provide an overview and the need for QA usability metrics: Different cultures/practices affecting the effectiveness of methods and metrics. Show examples of quality assurance workflows, Statistical process control, that monitor the treatment planning and delivery process to identify errors. To learn to identify and prioritize risks and QA procedures in radiation oncology. Try to answer the question: Can a quality assurance program aided by quality assurance metrics help minimize errors and ensure safe treatment delivery. Should such metrics be institution specific.« less

Performance evaluation of data center service localization based on virtual resource migration in software defined elastic optical network.

PubMed

Yang, Hui; Zhang, Jie; Ji, Yuefeng; Tan, Yuanlong; Lin, Yi; Han, Jianrui; Lee, Young

2015-09-07

Data center interconnection with elastic optical network is a promising scenario to meet the high burstiness and high-bandwidth requirements of data center services. In our previous work, we implemented cross stratum optimization of optical network and application stratums resources that allows to accommodate data center services. In view of this, this study extends the data center resources to user side to enhance the end-to-end quality of service. We propose a novel data center service localization (DCSL) architecture based on virtual resource migration in software defined elastic data center optical network. A migration evaluation scheme (MES) is introduced for DCSL based on the proposed architecture. The DCSL can enhance the responsiveness to the dynamic end-to-end data center demands, and effectively reduce the blocking probability to globally optimize optical network and application resources. The overall feasibility and efficiency of the proposed architecture are experimentally verified on the control plane of our OpenFlow-based enhanced SDN testbed. The performance of MES scheme under heavy traffic load scenario is also quantitatively evaluated based on DCSL architecture in terms of path blocking probability, provisioning latency and resource utilization, compared with other provisioning scheme.

Public reporting of colonoscopy quality is associated with an increase in endoscopist adenoma detection rate.

PubMed

Abdul-Baki, Heitham; Schoen, Robert E; Dean, Katie; Rose, Sherri; Leffler, Daniel A; Kuganeswaran, Eliathamby; Morris, Michele; Carrell, David; Mehrotra, Ateev

2015-10-01

Colonoscopy is the predominant method for colorectal cancer screening in the United States. Previous studies have documented variation across physicians in colonoscopy quality as measured by the adenoma detection rate (ADR). ADR is the primary quality measure of colonoscopy examinations and an indicator of the likelihood of subsequent colorectal cancer. There is interest in mechanisms to improve the ADR. In Central Illinois, a local employer and a quality improvement organization partnered to publically report physician colonoscopy quality. We assessed whether this initiative was associated with an improvement in the ADR. We compared ADRs before and after public reporting at a private practice endoscopy center with 11 gastroenterologists in Peoria, Illinois, who participated in the initiative. To generate the ADR, colonoscopy and pathology reports from examinations performed over 4 years at the endoscopy center were analyzed by using previously validated natural language processing software. A central Illinois endoscopy center. The ADR in the pre-public reporting period was 34.3% and 39.2% in the post-public reporting period (an increase of 4.9%, P < .001). The increase in the right-sided ADR was 5.1% (P < .01), whereas the increase in the left-sided ADR was 2.1% (P < .05). The increase in the ADR was 7.8% for screening colonoscopies (P < 0.05) and 3.5% for nonscreening colonoscopies (P < .05). All but 1 physician's ADR increased (range -2.7% to 10.5%). There was no statistically significant change in the advanced ADR (increase of 0.8%, P = .22). There was no concurrent control group to assess whether the increased ADR was due to a secular trend. A public reporting initiative on colonoscopy quality was associated with an increase in ADR. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

42 CFR 482.96 - Condition of participation: Quality assessment and performance improvement (QAPI).

Code of Federal Regulations, 2010 CFR

2010-10-01

... performance improvement (QAPI). 482.96 Section 482.96 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... FOR HOSPITALS Requirements for Specialty Hospitals Transplant Center Process Requirements § 482.96 Condition of participation: Quality assessment and performance improvement (QAPI). Transplant centers must...

Parameter Estimation for a Hybrid Adaptive Flight Controller

NASA Technical Reports Server (NTRS)

Campbell, Stefan F.; Nguyen, Nhan T.; Kaneshige, John; Krishnakumar, Kalmanje

2009-01-01

This paper expands on the hybrid control architecture developed at the NASA Ames Research Center by addressing issues related to indirect adaptation using the recursive least squares (RLS) algorithm. Specifically, the hybrid control architecture is an adaptive flight controller that features both direct and indirect adaptation techniques. This paper will focus almost exclusively on the modifications necessary to achieve quality indirect adaptive control. Additionally this paper will present results that, using a full non -linear aircraft model, demonstrate the effectiveness of the hybrid control architecture given drastic changes in an aircraft s dynamics. Throughout the development of this topic, a thorough discussion of the RLS algorithm as a system identification technique will be provided along with results from seven well-known modifications to the popular RLS algorithm.

Post-traumatic stress disorder dimensions and asthma morbidity in World Trade Center rescue and recovery workers.

PubMed

Mindlis, I; Morales-Raveendran, E; Goodman, E; Xu, K; Vila-Castelar, C; Keller, K; Crawford, G; James, S; Katz, C L; Crowley, L E; de la Hoz, R E; Markowitz, S; Wisnivesky, J P

2017-09-01

Using data from a cohort of World Trade Center (WTC) rescue and recovery workers with asthma, we assessed whether meeting criteria for post-traumatic stress disorder (PTSD), sub-threshold PTSD, and for specific PTSD symptom dimensions are associated with increased asthma morbidity. Participants underwent a Structured Clinical Interview for Diagnostic and Statistical Manual to assess the presence of PTSD following DSM-IV criteria during in-person interviews between December 2013 and April 2015. We defined sub-threshold PTSD as meeting criteria for two of three symptom dimensions: re-experiencing, avoidance, or hyper-arousal. Asthma control, acute asthma-related healthcare utilization, and asthma-related quality of life data were collected using validated scales. Unadjusted and multiple regression analyses were performed to assess the relationship between sub-threshold PTSD and PTSD symptom domains with asthma morbidity measures. Of the 181 WTC workers with asthma recruited into the study, 28% had PTSD and 25% had sub-threshold PTSD. Patients with PTSD showed worse asthma control, higher rates of inpatient healthcare utilization, and poorer asthma quality of life than those with sub-threshold or no PTSD. After adjusting for potential confounders, among patients not meeting the criteria for full PTSD, those presenting symptoms of re-experiencing exhibited poorer quality of life (p = 0.003). Avoidance was associated with increased acute healthcare use (p = 0.05). Sub-threshold PTSD was not associated with asthma morbidity (p > 0.05 for all comparisons). There may be benefit in assessing asthma control in patients with sub-threshold PTSD symptoms as well as those with full PTSD to more effectively identify ongoing asthma symptoms and target management strategies.

An evaluation of the effect of infertility on marital, sexual satisfaction indices and health-related quality of life in women.

PubMed

Valsangkar, Sameer; Bodhare, Trupti; Bele, Samir; Sai, Surendranath

2011-05-01

The effect of infertility on marital and sexual functioning, health-related quality of life (QoL) and the acceptability of the treatment modalities is a poorly researched area in India. To measure and compare the impact of infertility on marital adjustment, sexual functioning, QoL and the acceptability of various treatment modalities in infertility. Hospital-based cross-sectional controlled study. Data regarding infertility, socio-demographic characteristics and treatment acceptability was obtained via a semi-structured questionnaire. validated, standardized scales were used to measure marital adjustment (abbreviated dyadic adjustment scale), sexual functioning (abbreviated sexual functioning questionnaire) in cases and controls, and quality of life (FertiQol) in cases. Data from 106 women attending tertiary infertility centers who met the definition of primary infertility and 212 controls attending the medical outpatient department in the same centers was obtained. Body mass index and socioeconomic status were significant (P < 0.006 and < 0.0001 respectively) for infertility. Fertility-enhancing regimens and adoption had the highest acceptability with a wide dispersion of range for adoption and least acceptance for sperm, egg, embryo donation and surrogate motherhood. Logistic regression analysis revealed a significant effect size of infertility on marital adjustment (Nagelkerke R(2) 0.725, Cohen's D 0.86) and sexual functioning (Nagelkerke R(2) 0.73, Cohen's D 0.815). QoL showed a decrease in mean scores on the FertiQol scale similar to normative data. Effective counseling, reassurance and measures to reduce the impact of the condition on marital and sexual life, overall QoL are needed to impart a holistic treatment in infertility.

An evaluation of the effect of infertility on marital, sexual satisfaction indices and health-related quality of life in women

PubMed Central

Valsangkar, Sameer; Bodhare, Trupti; Bele, Samir; Sai, Surendranath

2011-01-01

BACKGROUND: The effect of infertility on marital and sexual functioning, health-related quality of life (QoL) and the acceptability of the treatment modalities is a poorly researched area in India. AIMS AND OBJECTIVES: To measure and compare the impact of infertility on marital adjustment, sexual functioning, QoL and the acceptability of various treatment modalities in infertility. DESIGN AND SETTING: Hospital-based cross-sectional controlled study. MATERIALS AND METHODS: Data regarding infertility, socio-demographic characteristics and treatment acceptability was obtained via a semi-structured questionnaire. validated, standardized scales were used to measure marital adjustment (abbreviated dyadic adjustment scale), sexual functioning (abbreviated sexual functioning questionnaire) in cases and controls, and quality of life (FertiQol) in cases. Data from 106 women attending tertiary infertility centers who met the definition of primary infertility and 212 controls attending the medical outpatient department in the same centers was obtained. RESULTS: Body mass index and socioeconomic status were significant (P < 0.006 and < 0.0001 respectively) for infertility. Fertility-enhancing regimens and adoption had the highest acceptability with a wide dispersion of range for adoption and least acceptance for sperm, egg, embryo donation and surrogate motherhood. Logistic regression analysis revealed a significant effect size of infertility on marital adjustment (Nagelkerke R2 0.725, Cohen's D 0.86) and sexual functioning (Nagelkerke R2 0.73, Cohen's D 0.815). QoL showed a decrease in mean scores on the FertiQol scale similar to normative data. CONCLUSIONS: Effective counseling, reassurance and measures to reduce the impact of the condition on marital and sexual life, overall QoL are needed to impart a holistic treatment in infertility. PMID:22065832

Variability in baseline laboratory measurements of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

PubMed

Ladwig, R; Vigo, A; Fedeli, L M G; Chambless, L E; Bensenor, I; Schmidt, M I; Vidigal, P G; Castilhos, C D; Duncan, B B

2016-08-01

Multi-center epidemiological studies must ascertain that their measurements are accurate and reliable. For laboratory measurements, reliability can be assessed through investigation of reproducibility of measurements in the same individual. In this paper, we present results from the quality control analysis of the baseline laboratory measurements from the ELSA-Brasil study. The study enrolled 15,105 civil servants at 6 research centers in 3 regions of Brazil between 2008-2010, with multiple biochemical analytes being measured at a central laboratory. Quality control was ascertained through standard laboratory evaluation of intra- and inter-assay variability and test-retest analysis in a subset of randomly chosen participants. An additional sample of urine or blood was collected from these participants, and these samples were handled in the same manner as the original ones, locally and at the central laboratory. Reliability was assessed with the intraclass correlation coefficient (ICC), estimated through a random effects model. Coefficients of variation (CV) and Bland-Altman plots were additionally used to assess measurement variability. Laboratory intra and inter-assay CVs varied from 0.86% to 7.77%. From test-retest analyses, the ICCs were high for the majority of the analytes. Notably lower ICCs were observed for serum sodium (ICC=0.50; 95%CI=0.31-0.65) and serum potassium (ICC=0.73; 95%CI=0.60-0.83), due to the small biological range of these analytes. The CVs ranged from 1 to 14%. The Bland-Altman plots confirmed these results. The quality control analyses showed that the collection, processing and measurement protocols utilized in the ELSA-Brasil produced reliable biochemical measurements.

Bloodstream infection rates in outpatient hemodialysis facilities participating in a collaborative prevention effort: a quality improvement report.

PubMed

Patel, Priti R; Yi, Sarah H; Booth, Stephanie; Bren, Virginia; Downham, Gemma; Hess, Sally; Kelley, Karen; Lincoln, Mary; Morrissette, Kathy; Lindberg, Curt; Jernigan, John A; Kallen, Alexander J

2013-08-01

Bloodstream infections (BSIs) cause substantial morbidity in hemodialysis patients. In 2009, the US Centers for Disease Control and Prevention (CDC) sponsored a collaborative project to prevent BSIs in outpatient hemodialysis facilities. We sought to assess the impact of a set of interventions on BSI and access-related BSI rates in participating facilities using data reported to the CDC's National Healthcare Safety Network (NHSN). Quality improvement project. Patients in 17 outpatient hemodialysis facilities that volunteered to participate. Facilities reported monthly event and denominator data to NHSN, received guidance from the CDC, and implemented an evidence-based intervention package that included chlorhexidine use for catheter exit-site care, staff training and competency assessments focused on catheter care and aseptic technique, hand hygiene and vascular access care audits, and feedback of infection and adherence rates to staff. Crude and modeled BSI and access-related BSI rates. Up to 12 months of preintervention (January 2009 through December 2009) and 15 months of intervention period (January 2010 through March 2011) data from participating centers were analyzed. Segmented regression analysis was used to assess changes in BSI and access-related BSI rates during the preintervention and intervention periods. Most (65%) participating facilities were hospital based. Pooled mean BSI and access-related BSI rates were 1.09 and 0.73 events per 100 patient-months during the preintervention period and 0.89 and 0.42 events per 100 patient-months during the intervention period, respectively. Modeled rates decreased 32% (P = 0.01) for BSIs and 54% (P < 0.001) for access-related BSIs at the start of the intervention period. Participating facilities were not representative of all outpatient hemodialysis centers nationally. There was no control arm to this quality improvement project. Facilities participating in a collaborative successfully decreased their BSI and access-related BSI rates. The decreased rates appeared to be maintained in the intervention period. These findings suggest that improved implementation of recommended practices can reduce BSIs in hemodialysis centers. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc.

Kennedy Space Center's NASA/Contractor Team-Centered Total Quality Management Seminar: Results, methods, and lessons learned

NASA Technical Reports Server (NTRS)

Kinlaw, Dennis C.; Eads, Jeannette

1992-01-01

It is apparent to everyone associated with the Nation's aeronautics and space programs that the challenge of continuous improvement can be reasonably addressed only if NASA and its contractors act together in a fully integrated and cooperative manner that transcends the traditional boundaries of proprietary interest. It is, however, one thing to assent to the need for such integration and cooperation; it is quite another thing to undertake the hard tasks of turning such a need into action. Whatever else total quality management is, it is fundamentally a team-centered and team-driven process of continuous improvement. The introduction of total quality management at KSC, therefore, has given the Center a special opportunity to translate the need for closer integration and cooperation among all its organizations into specific initiatives. One such initiative that NASA and its contractors have undertaken at KSC is a NASA/Contractor team-centered Total Quality Management Seminar. It is this seminar which is the subject of this paper. The specific purposes of this paper are to describe the following: Background, development, and evolution of Kennedy Space Center's Total Quality Management Seminar; Special characteristics of the seminar; Content of the seminar; Meaning and utility of a team-centered design for TQM training; Results of the seminar; Use that one KSC contractor, EG&G Florida, Inc. has made of the seminar in its Total Quality Management initiative; and Lessons learned.

Langley Research Center's Unitary Plan Wind Tunnel: Testing Capabilities and Recent Modernization Activities

NASA Technical Reports Server (NTRS)

Micol, John R.

2001-01-01

Description, capabilities, initiatives, and utilization of the NASA Langley Research Center's Unitary Plan Wind Tunnel are presented. A brief overview of the facility's operational capabilities and testing techniques is provided. A recent Construction of Facilities (CoF) project to improve facility productivity and efficiency through facility automation has been completed and is discussed. Several new and maturing thrusts are underway that include systematic efforts to provide credible assessment for data quality, modifications to the new automation control system for increased compatibility with the Modern Design Of Experiments (MDOE) testing methodology, and process improvements for better test coordination, planning, and execution.

Langley Research Center's Unitary Plan Wind Tunnel: Testing Capabilities and Recent Modernization Activities

NASA Technical Reports Server (NTRS)

Micol, John R.

2001-01-01

Description, capabilities, initiatives, and utilization of the NASA Langley Research Center's Unitary Plan Wind Tunnel are presented. A brief overview of the facility's operational capabilities and testing techniques is provided. A recent Construction of Facilities (Car) project to improve facility productivity and efficiency through facility automation has been completed and is discussed. Several new and maturing thrusts are underway that include systematic efforts to provide credible assessment for data quality, modifications to the new automation control system for increased compatibility with the Modern Design of Experiments (MDOE) testing methodology, and process improvements for better test coordination, planning, and execution.

Health Management Technology as a General Solution Framework

NASA Astrophysics Data System (ADS)

Nakajima, Hiroshi; Hasegawa, Yoshifumi; Tasaki, Hiroshi; Iwami, Taro; Tsuchiya, Naoki

Health maintenance and improvement of humans, artifacts, and nature are pressing requirements considering the problems human beings have faced. In this article, the health management technology is proposed by centering cause-effect structure. The important aspect of the technology is evolvement through human-machine collaboration in response to changes of target systems. One of the reasons why the cause-effect structure is centered in the technology is its feature of transparency to humans by instinct point of view. The notion has been spreaded over wide application areas such as quality control, energy management, and healthcare. Some experiments were conducted to prove effectiveness of the technology in the article.

YouTube as a potential training method for laparoscopic cholecystectomy.

PubMed

Lee, Jun Suh; Seo, Ho Seok; Hong, Tae Ho

2015-08-01

The purpose of this study was to analyze the educational quality of laparoscopic cholecystectomy (LC) videos accessible on YouTube, one of the most important sources of internet-based medical information. The keyword 'laparoscopic cholecystectomy' was used to search on YouTube and the first 100 videos were analyzed. Among them, 27 videos were excluded and 73 videos were included in the study. An arbitrary score system for video quality, devised from existing LC guidelines, were used to evaluate the quality of the videos. Video demographics were analyzed by the quality and source of the video. Correlation analysis was performed. When analyzed by video quality, 11 (15.1%) were evaluated as 'good', 40 (54.8%) were 'moderate', and 22 (30.1%) were 'poor', and there were no differences in length, views per day, or number of likes, dislikes, and comments. When analyzed by source, 27 (37.0%) were uploaded by primary centers, 20 (27.4%) by secondary centers, 15 (20.5%) by tertiary centers, 5 (6.8%) by academic institutions, and 6 (8.2%) by commercial institutions. The mean score of the tertiary center group (6.0 ± 2.0) was significantly higher than the secondary center group (3.9 ± 1.4, P = 0.001). The video score had no correlation with views per day or number of likes. Many LC videos are accessible on YouTube with varying quality. Videos uploaded by tertiary centers showed the highest educational value. This discrepancy in video quality was not recognized by viewers. More videos with higher quality need to be uploaded, and an active filtering process is necessary.

The effect of supportive educative program on the quality of life in family caregivers of hemodialysis patients

PubMed Central

Ghane, Golnar; Farahani, Mansoreh Ashghali; Seyedfatemi, Naime; Haghani, Hamid

2017-01-01

BACKGROUND: Previous studies showed that family caregivers of hemodialysis patients have low level of quality of life. However, these caregivers are mostly neglected, and no studies are available on improving their quality of lives. Therefore, this study aimed to examine the effects of supportive educative program on the quality of life in family caregivers of hemodialysis patients. MATERIALS AND METHODS: A randomized controlled clinical trial was conducted on 76 family caregivers of hemodialysis patients referred to Shahid Hasheminejad Hemodialysis Center in Tehran, Iran in 2015. The subjects were equally allocated into two groups of 38. Caregivers of patients were randomly assigned into the intervention group and the control group. The intervention group received six training sessions on supportive educative program. Both groups answered demographic information and short form-36 questionnaires before and 6 weeks after the intervention. Descriptive statistics, Chi-square and Fisher exact tests, independent samples t-test, and t-couple, was used to analyze the data. RESULTS: No significant difference was found between the baseline mean scores of “quality of life” of the intervention and the control groups (P = 0.775). However, the mean scores of quality of life of the intervention group increased at the end of the study, and the two groups were significantly different in this regard (P < 0.001). CONCLUSIONS: Supportive educative program improved the quality of life in caregivers of hemodialysis patients. Therefore, it is suggested that health system managers encourage their staff to implement such programs for improving the health status of the caregivers. PMID:29114548

The relationship between spiritual well-being and health-related quality of life in college students.

PubMed

Anye, Ernest Tamanji; Gallien, Tara L; Bian, Hui; Moulton, Michael

2013-01-01

This study investigated the relationship between spiritual well-being (SWB) and various aspects of health-related quality of life (HRQL) of college students. Two hundred twenty-five participants were surveyed during October 2010 to assess SWB and HRQL using the Spiritual Well-Being Scale and questions from the Centers for Disease Control and Prevention's scale for HRQL, respectively. Hierarchical multiple linear regression analyses tested the relationship between SWB and multiple measures of HRQL while controlling for sex, age, and race. Participants who reported higher SWB scores were more likely to participate in religious-type activities and report better HRQL compared with students who reported a moderate sense of SWB. Jointly, SWB and participation in religious activities explained 18% of the variance in HQRL in this sample. SWB made a significant contribution to HRQL in a sample of college students. Such a relationship should be considered by campus health program planners to improve the quality of life of young adults.

Pharmaceutical Price Controls and Minimum Efficacy Regulation: Evidence from the United States and Italy

PubMed Central

Atella, Vincenzo; Bhattacharya, Jay; Carbonari, Lorenzo

2012-01-01

Objective This article examines the relationship between drug price and drug quality and how it varies across two of the most common regulatory regimes in the pharmaceutical market: minimum efficacy standards (MES) and a mix of MES and price control mechanisms (MES + PC). Data Sources Our primary data source is the Tufts-New England Medical Center-Cost Effectiveness Analysis Registry which have been merged with price data taken from MEPS (for the United States) and AIFA (for Italy). Study Design Through a simple model of adverse selection we model the interaction between firms, heterogeneous buyers, and the regulator. Principal Findings The theoretical analysis provides two results. First, an MES regime provides greater incentives to produce high-quality drugs. Second, an MES + PC mix reduces the difference in price between the highest and lowest quality drugs on the market. Conclusion The empirical analysis based on United States and Italian data corroborates these results. PMID:22091623

Orion Handling Qualities During ISS Rendezvous and Docking

NASA Technical Reports Server (NTRS)

Hart, Jeremy J.; Stephens, J. P.; Spehar, P.; Bilimoria, K.; Foster, C.; Gonzalex, R.; Sullivan, K.; Jackson, B.; Brazzel, J.; Hart, J.

2011-01-01

The Orion spacecraft was designed to rendezvous with multiple vehicles in low earth orbit (LEO) and beyond. To perform the required rendezvous and docking task, Orion must provide enough control authority to perform coarse translational maneuvers while maintaining precision to perform the delicate docking corrections. While Orion has autonomous docking capabilities, it is expected that final approach and docking operations with the International Space Station (ISS) will initially be performed in a manual mode. A series of evaluations was conducted by NASA and Lockheed Martin at the Johnson Space Center to determine the handling qualities (HQ) of the Orion spacecraft during different docking and rendezvous conditions using the Cooper-Harper scale. This paper will address the specifics of the handling qualities methodology, vehicle configuration, scenarios flown, data collection tools, and subject ratings and comments. The initial Orion HQ assessment examined Orion docking to the ISS. This scenario demonstrates the Translational Hand Controller (THC) handling qualities of Orion. During this initial assessment, two different scenarios were evaluated. The first was a nominal docking approach to a stable ISS, with Orion initializing with relative position dispersions and a closing rate of approximately 0.1 ft/sec. The second docking scenario was identical to the first, except the attitude motion of the ISS was modeled to simulate a stress case ( 1 degree deadband per axis and 0.01 deg/sec rate deadband per axis). For both scenarios, subjects started each run on final approach at a docking port-to-port range of 20 ft. Subjects used the THC in pulse mode with cues from the docking camera image, window views, and range and range rate data displayed on the Orion display units. As in the actual design, the attitude of the Orion vehicle was held by the automated flight control system at 0.5 degree deadband per axis. Several error sources were modeled including Reaction Control System (RCS) jet angular and position misalignment, RCS thrust magnitude uncertainty, RCS jet force direction uncertainty due to self plume impingement, and Orion center of mass uncertainty.

Aloe vera herbal dentifrices for plaque and gingivitis control: a systematic review.

PubMed

Dhingra, K

2014-04-01

To evaluate the effectiveness of aloe vera containing herbal dentifrices in improving plaque control and gingival health. A manual and electronic literature (MEDLINE and Cochrane Central Register of Controlled Trials) search was performed up to July 2012, for randomized controlled trials presenting clinical, microbiological, immunological, and patient-centered data for the efficacy of aloe vera herbal dentifrices for controlling plaque and gingival inflammation in patients with gingivitis. From 79 titles and abstracts, eight full-text articles were screened and finally two randomized controlled trials were selected. These randomized controlled trials reported that aloe vera dentifrices were similar in efficacy to control dentifrices in effectively reducing plaque and gingival inflammation in gingivitis patients based on the assessment of clinical, microbiological, and patient-centered treatment outcomes. However, many important details (composition and characteristics of aloe vera and control dentifrices along with appropriate randomization, blinding, and outcomes assessed) were lacking in these trials, and therefore, the quality of reporting and methods was generally flawed with high risk of bias. Even though there are some promising results, the clinical effectiveness of aloe vera herbal dentifrices is not sufficiently defined at present and warrants further investigations based on reporting guidelines of herbal CONSORT statement. © 2013 John Wiley & Sons A/S.

Environmental Impact Statement. Peacekeeper Rail Garrison Program. Volume 1

DTIC Science & Technology

1989-02-01

Dupree Steve Coop Shannon Dupree Ernest Cooper Thomas W. Dupree Wainright Copass, Jr. Steve Dust Robert M. Corrie Dean Easton William Couchigian Arthur...located within the Shreveport- Texarkana -Tyler Interstate Air Quality Control Region (No. 022). There are no Prevention of Significant Deterioration Class...Master of Environmental Laws, National Law Center, The George Washington Univerqity, Washington, DC Years of Experience: 14 William R. Livingstone

A corporate partner in the endoscopic ambulatory surgery center. A business relationship that works.

PubMed

Overholt, Bergein F

2002-04-01

Although doubts persist in the minds of some, physician owners-developers of EASCs are increasingly entering into long-term business relationships with a CP by jointly developing an EASC or by selling a controlling financial interest in their EASC to the CP. In exchange, the physicians benefit through improved quality of care, increased patient and physician satisfaction, and enhanced EASC revenues.

Massage therapy for patients with metastatic cancer: a pilot randomized controlled trial.

PubMed

Toth, Maria; Marcantonio, Edward R; Davis, Roger B; Walton, Tracy; Kahn, Janet R; Phillips, Russell S

2013-07-01

The study objectives were to determine the feasibility and effects of providing therapeutic massage at home for patients with metastatic cancer. This was a randomized controlled trial. Patients were enrolled at Oncology Clinics at a large urban academic medical center; massage therapy was provided in patients' homes. Subjects were patients with metastatic cancer. There were three interventions: massage therapy, no-touch intervention, and usual care. Primary outcomes were pain, anxiety, and alertness; secondary outcomes were quality of life and sleep. In this study, it was possible to provide interventions for all patients at home by professional massage therapists. The mean number of massage therapy sessions per patient was 2.8. A significant improvement was found in the quality of life of the patients who received massage therapy after 1-week follow-up, which was not observed in either the No Touch control or the Usual Care control groups, but the difference was not sustained at 1 month. There were trends toward improvement in pain and sleep of the patients after therapeutic massage but not in patients in the control groups. There were no serious adverse events related to the interventions. The study results showed that it is feasible to provide therapeutic massage at home for patients with advanced cancer, and to randomize patients to a no-touch intervention. Providing therapeutic massage improves the quality of life at the end of life for patients and may be associated with further beneficial effects, such as improvement in pain and sleep quality. Larger randomized controlled trials are needed to substantiate these findings.

[Internal quality control on HER2 status determination in breast cancers: Experience of a cancer center].

PubMed

Ngo, Carine; Laé, Marick; Ratour, Julia; Hamel, Frédérique; Taris, Corinne; Caly, Martial; Le Cunff, Annie; Reyal, Fabien; Kirova, Youlia; Pierga, Jean-Yves; Vincent-Salomon, Anne

The implementation of an internal quality control is mandatory to guarantee the accuracy of HER2 status in invasive breast cancers. To evaluate the impact of our quality control assurance on HER2 status results in invasive breast carcinomas from 2008 to 2014. HER2 status was determined by immunohistochemistry as the first-line indication, completed by fluorescence in situ hybridization (FISH) for scores 2+ by immunohistochemistry. Internal quality control of HER2 status relied on the standardization of pre-analytical phases, the use of external controls with a known number of HER2 gene copies determined by FISH and continued monitoring of concordance between immunohistochemistry and FISH. The proportion of HER2-positive cases corresponding to scores 3+ by immunohistochemistry and 2+ amplified by FISH varied from 10.6% to 13.8% (median of 11.3%). The proportion of scores 2+ amplified by FISH varied from 13.3% to 32.7% during period of study. The rate of concordance between FISH and immunohistochemistry for score 0/1+ and 3+ cases were≥97%. Eight among 12 discordant cases were false positive resulting from errors in interpretation of immunohistochemistry (score 2+ instead of 3+). Calibration of immunohistochemistry on FISH for HER2 status contributes to limit variability of immunohistochemistry results due to technical issues or interpretation. The implementation of an external control of score 3+ on each slide enables accurate interpretation of score 2+ and 3+ by immunohistochemistry. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Thermo-optic locking of a semiconductor laser to a microcavity resonance.

PubMed

McRae, T G; Lee, Kwan H; McGovern, M; Gwyther, D; Bowen, W P

2009-11-23

We experimentally demonstrate thermo-optic locking of a semiconductor laser to an integrated toroidal optical microcavity. The lock is maintained for time periods exceeding twelve hours, without requiring any electronic control systems. Fast control is achieved by optical feedback induced by scattering centers within the microcavity, with thermal locking due to optical heating maintaining constructive interference between the cavity and the laser. Furthermore, the optical feedback acts to narrow the laser linewidth, with ultra high quality microtoroid resonances offering the potential for ultralow linewidth on-chip lasers.

Measurement and Control of the Variability of Scanning Pressure Transducer Measurements

NASA Technical Reports Server (NTRS)

Kuhl, David D.; Everhart, Joel L.; Hallissy, James B.

2003-01-01

This paper describes the new wall pressure measurement system and data-quality monitoring software installed at 14x22 Ft subsonic tunnel at the NASA Langley Research Center. The monitoring software was developed to enable measurement and control of the variability of the reference pressures and approximately 400 tunnel wall pressure measurements. Variability of the system, based upon data acquired over a year of wind tunnel tests and calibrations, is presented. The level of variation of the wall pressure measurements is shown to be predictable.