Sample records for quality control efforts

  1. Associations Among Parental Education, Home Environment Quality, Effortful Control, and Preacademic Knowledge

    PubMed Central

    Merz, Emily C.; Landry, Susan H.; Williams, Jeffrey M.; Barnes, Marcia A.; Eisenberg, Nancy; Spinrad, Tracy L.; Valiente, Carlos; Assel, Michael; Taylor, Heather B.; Lonigan, Christopher J.; Phillips, Beth M.; Clancy-Menchetti, Jeanine

    2014-01-01

    This study used a longitudinal design to examine whether effortful control mediated the associations of parental education and home environment quality with preacademic knowledge in toddlers and young preschoolers. The sample consisted of 226 children (2 to 4 years of age at T1) from socioeconomically disadvantaged backgrounds. Parents provided data on parent education and home environment quality. Children completed effortful control, early literacy, and early math assessments. T2 effortful control partially mediated the associations of T1 parental education and T1 home environment quality with T3 emergent literacy after accounting for child age, gender, race/ethnicity, T1 effortful control, and T2 early literacy. T2 effortful control partially mediated the association between T1 parental education and T3 emergent math after accounting for child age, gender, race/ethnicity, T1 effortful control, and T2 early math. Prior to entry into preschool, parental education and home environment quality may shape effortful control which in turn influences preacademic knowledge. PMID:25110382

  2. Image registration assessment in radiotherapy image guidance based on control chart monitoring.

    PubMed

    Xia, Wenyao; Breen, Stephen L

    2018-04-01

    Image guidance with cone beam computed tomography in radiotherapy can guarantee the precision and accuracy of patient positioning prior to treatment delivery. During the image guidance process, operators need to take great effort to evaluate the image guidance quality before correcting a patient's position. This work proposes an image registration assessment method based on control chart monitoring to reduce the effort taken by the operator. According to the control chart plotted by daily registration scores of each patient, the proposed method can quickly detect both alignment errors and image quality inconsistency. Therefore, the proposed method can provide a clear guideline for the operators to identify unacceptable image quality and unacceptable image registration with minimal effort. Experimental results demonstrate that by using control charts from a clinical database of 10 patients undergoing prostate radiotherapy, the proposed method can quickly identify out-of-control signals and find special cause of out-of-control registration events.

  3. Relations of Children's Effortful Control and Teacher-Child Relationship Quality to School Attitudes in a Low-Income Sample

    ERIC Educational Resources Information Center

    Silva, Kassondra M.; Spinrad, Tracy L.; Eisenberg, Nancy; Sulik, Michael J.; Valiente, Carlos; Huerta, Snjezana; Edwards, Alison; Eggum, Natalie D.; Kupfer, Anne S.; Lonigan, Christopher J.; Phillips, Beth M.; Wilson, Shauna B.; Clancy-Menchetti, Jeanine; Landry, Susan H.; Swank, Paul R.; Assel, Michael A.; Taylor, Heather B.

    2011-01-01

    Research Findings: The purpose of this study was to examine the relations of children's effortful control and quality of relationships with teachers to school attitudes longitudinally in an ethnically diverse and economically disadvantaged sample. Data were collected as part of a larger intervention project during mid-fall, winter, and late spring…

  4. A Six-Year Predictive Test of Adolescent Family Relationship Quality and Effortful Control Pathways to Emerging Adult Social and Emotional Health

    PubMed Central

    Fosco, Gregory M.; Caruthers, Allison S.; Dishion, Thomas J.

    2012-01-01

    This longitudinal study examined how a multimethod (youth report, parent report, direct observation) assessment of family relationship quality (cohesion and conflict) in adolescence (age 16 –17) predicted growth and maintenance of effortful control across ages 17, 22, and 23 years old, and, ultimately, subjective well-being, emotional distress, and aggressive behavior in emerging adulthood (23). A diverse sample of 792 youth at age 17 and their families, and youth at ages 22 and 23, were studied to examine family cohesion and conflict and the growth and maintenance of effortful control as predictors of emerging adult social and emotional health. Results indicated that family cohesion and conflict during late adolescence and mean-level effortful control at age 22 each served as unique pathways to emerging adult adjustment. These findings underscore the importance of family functioning during adolescence and the maintenance of effortful control into emerging adulthood for understanding adjustment during the emerging adulthood period. PMID:22709261

  5. Analytical approaches to quality assurance and quality control in rangeland monitoring data

    USDA-ARS?s Scientific Manuscript database

    Producing quality data to support land management decisions is the goal of every rangeland monitoring program. However, the results of quality assurance (QA) and quality control (QC) efforts to improve data quality are rarely reported. The purpose of QA and QC is to prevent and describe non-sampling...

  6. Quality Assurance through ISO 9000.

    ERIC Educational Resources Information Center

    Zuckerman, Amy

    2000-01-01

    Created in 1987 by the International Organization for Standardization, in Geneva, Switzerland, ISO 9000 is attempting to develop a world standard to help companies and other institutions measure and monitor their quality-control efforts. This article describes four school districts' successful efforts to secure ISO 9000 certification. (MLH)

  7. Advanced Quality Control Theory for Training and Education: A Guide to Optimizing Training and Education Efforts

    ERIC Educational Resources Information Center

    Heppler, Brad

    2008-01-01

    This is a book about quality and how to control quality through deliberate actions on the part of the professionals developing and implementing the instances of instruction available at an organization. Quality control theory favors no particular learning philosophy and is only directed towards aspects of how, what, where and when measurements are…

  8. Inferring speaker attributes in adductor spasmodic dysphonia: ratings from unfamiliar listeners.

    PubMed

    Isetti, Derek; Xuereb, Linnea; Eadie, Tanya L

    2014-05-01

    To determine whether unfamiliar listeners' perceptions of speakers with adductor spasmodic dysphonia (ADSD) differ from control speakers on the parameters of relative age, confidence, tearfulness, and vocal effort and are related to speaker-rated vocal effort or voice-specific quality of life. Twenty speakers with ADSD (including 6 speakers with ADSD plus tremor) and 20 age- and sex-matched controls provided speech recordings, completed a voice-specific quality-of-life instrument (Voice Handicap Index; Jacobson et al., 1997), and rated their own vocal effort. Twenty listeners evaluated speech samples for relative age, confidence, tearfulness, and vocal effort using rating scales. Listeners judged speakers with ADSD as sounding significantly older, less confident, more tearful, and more effortful than control speakers (p < .01). Increased vocal effort was strongly associated with decreased speaker confidence (rs = .88-.89) and sounding more tearful (rs = .83-.85). Self-rated speaker effort was moderately related (rs = .45-.52) to listener impressions. Listeners' perceptions of confidence and tearfulness were also moderately associated with higher Voice Handicap Index scores (rs = .65-.70). Unfamiliar listeners judge speakers with ADSD more negatively than control speakers, with judgments extending beyond typical clinical measures. The results have implications for counseling and understanding the psychosocial effects of ADSD.

  9. Linked Analysis of East Asia Emission Reduction Pathways

    NASA Astrophysics Data System (ADS)

    Kim, Y.; Woo, J. H.; Bu, C.; Lee, Y.; Kim, J.; Jang, Y.; Park, M.

    2017-12-01

    Air pollution and its impacts over the Northeast Asia are very severe because of the massive pollutant emissions and high population. Korea has been trying to improve air quality with the enhanced environmental legislation. The air quality over Korea, however, does not entirely dependent on its local emissions. Transboundary air pollution from China highly affects Korean atmosphere. The purpose of this research is to understand role of local and transbounday efforts to improve air quality changes over Korea. In this research, we have tried to set up the multiple emission scenario pathways for Korea and China using IIASA's GAINS (Greenhouse gas - Air pollution Interactions aNd Synergies) modeling framework. More up-to-date growth factors and control policy packets were made using regional socio-economic data and control policy information from local governments and international statistics. Four major scenario pathways, 1) Base (Baseline: current legislation), 2) OTB/OTB(On the book/On the way : existing control measure/planed control measure), 3) BOTW_GHG(Beyond on the way : OTW with GHG reduction plan), 4) BOTW_NH3 (OTW with additional NH3 reduction measure) were developed to represent air quality improvement pathways in consideration of both Korean and Chinese efforts. Strict ambient PM2.5 standards from Seoul metropolitan Air quality Improvement Plan(SAIP) seems too enthusiastic without linking air quality control efforts of China. Step-by-step emission controls and following air quality, control cost, health impact from each scenario will be presented at the conference. This subject is supported by Korea Ministry of Environment as "Climate Change Correspondence Program". And This work was supported under the framework of national strategy project on fine particulate matters by Ministry of Science, ICT and Future Planning.

  10. Quality control and in-service inspection technology for hybrid-composite girder bridges.

    DOT National Transportation Integrated Search

    2014-08-01

    This report describes efforts to develop quality control tools and in-service inspection technologies for the fabrication and construction of Hybrid Composite Beams (HCBs). HCBs are a new bridge technology currently being evaluated by the Missouri De...

  11. Plasticity in Singing Effort and its Relationship with Monoamine Metabolism in the Songbird Telencephalon

    PubMed Central

    Salvante, Katrina G.; Racke, Danielle M.; Campbell, C. Ryan; Sockman, Keith W.

    2010-01-01

    Factors intrinsic or extrinsic to individuals, such as their quality or the quality of competition in their social environment, can influence their communication signalling effort. We hypothesized that telencephalic monoamine secretion mediates the effects of a male’s own quality and quality of his social environment on his sexual signalling effort. The duration of a male European starling’s (Sturnus vulgaris) principal sexual signal, his song, positively correlates with several aspects of his quality, including his reproductive success, immunocompetence, and ability to attract mates. Therefore, the length of songs to which he is exposed reflects, in part, the quality of competition in his social environment. We manipulated the quality of the competitive environment by exposing male starlings to long or short songs for one week. We measured the length of songs produced by experimental males to gauge their quality, counted the number of songs they produced to gauge singing effort, and quantified telencephalic monoamine metabolism using HPLC. Singing effort increased with the length of the males’ own songs and with the length of songs to which we exposed them. Norepinephrine metabolism in Area X of the song control system was negatively correlated with the subjects’ mean song length and singing effort. Serotonin metabolism in the caudomedial mesopallium of the auditory telencephalon increased with the length of songs to which we exposed the subjects and with their singing effort. This raises the hypothesis that serotonin and norepinephrine secretion in the telencephalon help mediate the effects of extrinsic and intrinsic factors on signalling effort. PMID:19899137

  12. Quality of work, well-being, and intended early retirement of older employees: baseline results from the SHARE Study.

    PubMed

    Siegrist, Johannes; Wahrendorf, Morten; von dem Knesebeck, Olaf; Jürges, Hendrik; Börsch-Supan, Axel

    2007-02-01

    Given the challenge of a high proportion of older employees who retire early from work we analyse associations of indicators of a poor psychosocial quality of work with intended premature departure from work in a large sample of older male and female employees in 10 European countries. Baseline data from the 'Survey of Health, Ageing and Retirement in Europe' (SHARE) were obtained from 3523 men and 3318 women in 10 European countries. Data on intended early retirement, four measures of well-being (self-rated health, depressive symptoms, general symptom load, and quality of life), and quality of work (effort-reward imbalance; low control at work) were obtained from structured interviews and questionnaires. Country-specific and total samples are analysed, using logistic regression analysis. Poor quality of work is significantly associated with intended early retirement. After adjustment for well-being odds ratios (OR) of effort-reward imbalance [OR 1.72 (1.43-2.08)] and low control at work [OR 1.51 (1.27-1.80)] on intended early retirement are observed. Poor quality of work and reduced well-being are independently associated with the intention to retire from work. The consistent association of a poor psychosocial quality of work with intended early retirement among older employees across all European countries under study calls for improved investments into better quality of work, in particular increased control and an appropriate balance between efforts spent and rewards received at work.

  13. Elementary Students' Effortful Control and Academic Achievement: The Mediating Role of Teacher-Student Relationship Quality

    PubMed Central

    Hernández, Maciel M.; Valiente, Carlos; Eisenberg, Nancy; Berger, Rebecca H.; Spinrad, Tracy L.; VanSchyndel, Sarah K.; Silva, Kassondra M.; Southworth, Jody; Thompson, Marilyn S.

    2017-01-01

    This study evaluated the association between effortful control in kindergarten and academic achievement one year later (N = 301), and whether teacher–student closeness and conflict in kindergarten mediated the association. Parents, teachers, and observers reported on children's effortful control, and teachers reported on their perceived levels of closeness and conflict with students. Students completed the passage comprehension and applied problems subtests of the Woodcock–Johnson tests of achievement, as well as a behavioral measure of effortful control. Analytical models predicting academic achievement were estimated using a structural equation model framework. Effortful control positively predicted academic achievement even when controlling for prior achievement and other covariates. Mediation hypotheses were tested in a separate model; effortful control positively predicted teacher–student closeness and strongly, negatively predicted teacher–student conflict. Teacher–student closeness and effortful control, but not teacher–student conflict, had small, positive associations with academic achievement. Effortful control also indirectly predicted higher academic achievement through its positive effect on teacher–student closeness and via its positive relation to early academic achievement. The findings suggest that teacher–student closeness is one mechanism by which effortful control is associated with academic achievement. Effortful control was also a consistent predictor of academic achievement, beyond prior achievement levels and controlling for teacher–student closeness and conflict, with implications for intervention programs on fostering regulation and achievement concurrently. PMID:28684888

  14. Elementary Students' Effortful Control and Academic Achievement: The Mediating Role of Teacher-Student Relationship Quality.

    PubMed

    Hernández, Maciel M; Valiente, Carlos; Eisenberg, Nancy; Berger, Rebecca H; Spinrad, Tracy L; VanSchyndel, Sarah K; Silva, Kassondra M; Southworth, Jody; Thompson, Marilyn S

    This study evaluated the association between effortful control in kindergarten and academic achievement one year later ( N = 301), and whether teacher-student closeness and conflict in kindergarten mediated the association. Parents, teachers, and observers reported on children's effortful control, and teachers reported on their perceived levels of closeness and conflict with students. Students completed the passage comprehension and applied problems subtests of the Woodcock-Johnson tests of achievement, as well as a behavioral measure of effortful control. Analytical models predicting academic achievement were estimated using a structural equation model framework. Effortful control positively predicted academic achievement even when controlling for prior achievement and other covariates. Mediation hypotheses were tested in a separate model; effortful control positively predicted teacher-student closeness and strongly, negatively predicted teacher-student conflict. Teacher-student closeness and effortful control, but not teacher-student conflict, had small, positive associations with academic achievement. Effortful control also indirectly predicted higher academic achievement through its positive effect on teacher-student closeness and via its positive relation to early academic achievement. The findings suggest that teacher-student closeness is one mechanism by which effortful control is associated with academic achievement. Effortful control was also a consistent predictor of academic achievement, beyond prior achievement levels and controlling for teacher-student closeness and conflict, with implications for intervention programs on fostering regulation and achievement concurrently.

  15. An Alternative View of Quality Assurance and Enhancement

    ERIC Educational Resources Information Center

    Wong, Viola Yuk-Yue

    2012-01-01

    This paper attempts to deal with the elusive nature of quality in quality management, using a case study to examine quality control measures implemented in an academic context and to show an emergent framework for quality enhancement. This paper introduces the concept of the ecology of quality assurance and examines efforts to maintain and advance…

  16. Work stress, asthma control and asthma-specific quality of life: Initial evidence from a cross-sectional study.

    PubMed

    Hartmann, Bettina; Leucht, Verena; Loerbroks, Adrian

    2017-03-01

    Research has suggested that psychological stress is positively associated with asthma morbidity. One major source of stress in adulthood is one's occupation. However, to date, potential links of work stress with asthma control or asthma-specific quality of life have not been examined. We aimed to address this knowledge gap. In 2014/2015, we conducted a cross-sectional study among adults with asthma in Germany (n = 362). For the current analyses that sample was restricted to participants in employment and reporting to have never been diagnosed with chronic obstructive pulmonary disease (n = 94). Work stress was operationalized by the 16-item effort-reward-imbalance (ERI) questionnaire, which measures the subcomponents "effort", "reward" and "overcommitment." Participants further completed the Asthma Control Test and the Asthma Quality of Life Questionnaire-Sydney. Multivariable associations were quantified by linear regression and logistic regression. Effort, reward and their ratio (i.e. ERI ratio) did not show meaningful associations with asthma morbidity. By contrast, increasing levels of overcommitment were associated with poorer asthma control and worse quality of life in both linear regression (ß = -0.26, p = 0.01 and ß = 0.44, p < 0.01, respectively) and logistic regression (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.14-3.07 and OR = 2.34, 95% CI = 1.32-4.15, respectively). The present study provides initial evidence of a positive relationship of work-related overcommitment with asthma control and asthma-specific quality of life. Longitudinal studies with larger samples are needed to confirm our findings and to disentangle the potential causality of associations.

  17. Business-led efforts to control costs.

    PubMed

    Kenkel, P J

    1991-07-29

    Business-led initiatives to compare medical quality and prices are becoming commonplace as employers seek ways to cap medical expenses. But employers are meeting with varying degrees of cooperation from hospitals. The tale of two cities' efforts to pry open the secrets of controlling costs provides a vivid contrast in the way purchasers have tried to solve the cost-containment puzzle.

  18. Preschoolers' Effortful Control and Negative Emotionality, Immediate Reactions to Disappointment, and Quality of Social Functioning

    ERIC Educational Resources Information Center

    Liew, Jeffrey; Eisenberg, Nancy; Reiser, Mark

    2004-01-01

    Relations among effortful control/low negative emotionality, immediate reactions in a situation that usually calls for the masking of disappointment (i.e., the use of display rules), and social competence/adjustment were investigated for 78 preschool children (mean age=4.87 years). Parents, teachers, and peers rated children on negative…

  19. Improving Quality of Seal Leak Test Product using Six Sigma

    NASA Astrophysics Data System (ADS)

    Luthfi Malik, Abdullah; Akbar, Muhammad; Irianto, Dradjad

    2016-02-01

    Seal leak test part is a polyurethane material-based product. Based on past data, defect level of this product was 8%, higher than the target of 5%. Quality improvement effort was done using six sigma method that included phases of define, measure, analyse, improve, and control. In the design phase, a Delphi method was used to identify factors that were critical to quality. In the measure phase, stability and process capability was measured. Fault tree analysis (FTA) and failure mode and effect analysis (FMEA) were used in the next phase to analize the root cause and to determine the priority issues. Improve phase was done by compiling, selecting, and designing alternative repair. Some improvement efforts were identified, i.e. (i) making a checklist for maintenance schedules, (ii) making written reminder form, (iii) modifying the SOP more detail, and (iv) performing a major service to the vacuum machine. To ensure the continuity of improvement efforts, some control activities were executed, i.e. (i) controlling, monitoring, documenting, and setting target frequently, (ii) implementing reward and punishment system, (iii) adding cleaning tool, and (iv) building six sigma organizational structure.

  20. [Quality control in anesthesiology].

    PubMed

    Muñoz-Ramón, J M

    1995-03-01

    The process of quality control and auditing of anesthesiology allows us to evaluate care given by a service and solve problems that are detected. Quality control is a basic element of care giving and is only secondarily an area of academic research; it is therefore a meaningless effort if the information does not serve to improve departmental procedures. Quality assurance procedures assume certain infrastructural requirements and an initial period of implementation and adjustment. The main objectives of quality control are the reduction of morbidity and mortality due to anesthesia, assurance of the availability and proper management of resources and, finally, the well-being and safety of the patient.

  1. Harmonisation Initiatives of Copernicus Data Quality Control

    NASA Astrophysics Data System (ADS)

    Vescovi, F. D.; Lankester, T.; Coleman, E.; Ottavianelli, G.

    2015-04-01

    The Copernicus Space Component Data Access system (CSCDA) incorporates data contributions from a wide range of satellite missions. Through EO data handling and distribution, CSCDA serves a set of Copernicus Services related to Land, Marine and Atmosphere Monitoring, Emergency Management and Security and Climate Change. The quality of the delivered EO products is the responsibility of each contributing mission, and the Copernicus data Quality Control (CQC) service supports and complements such data quality control activities. The mission of the CQC is to provide a service of quality assessment on the provided imagery, to support the investigation related to product quality anomalies, and to guarantee harmonisation and traceability of the quality information. In terms of product quality control, the CQC carries out analysis of representative sample products for each contributing mission as well as coordinating data quality investigation related to issues found or raised by Copernicus users. Results from the product analysis are systematically collected and the derived quality reports stored in a searchable database. The CQC service can be seen as a privileged focal point with unique comparison capacities over the data providers. The comparison among products from different missions suggests the need for a strong, common effort of harmonisation. Technical terms, definitions, metadata, file formats, processing levels, algorithms, cal/val procedures etc. are far from being homogeneous, and this may generate inconsistencies and confusion among users of EO data. The CSCDA CQC team plays a significant role in promoting harmonisation initiatives across the numerous contributing missions, so that a common effort can achieve optimal complementarity and compatibility among the EO data from multiple data providers. This effort is done in coordination with important initiatives already working towards these goals (e.g. INSPIRE directive, CEOS initiatives, OGC standards, QA4EO etc.). This paper describes the main actions being undertaken by CQC to encourage harmonisation among space-based EO systems currently in service.

  2. Parameter Trending, Geolocation Quality Control and the Procedures to Support Preparation of Next Versions of the TRMM Reprocessing Algorithm

    NASA Technical Reports Server (NTRS)

    Stocker, Erich Franz

    2004-01-01

    TRMM has been an imminently successful mission from an engineering standpoint but even more from a science standpoint. An important part of this science success has been the careful quality control of the TRMM standard products. This paper will present the quality monitoring efforts that the TRMM Science Data and Information System (TSDIS) conducts on a routine basis. The paper will detail parameter trending, geolocation quality control and the procedures to support the preparation of next versions of the algorithm used for reprocessing.

  3. Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana

    PubMed Central

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Ogink, Alice; van Ostenberg, Paul; Rinke de Wit, Tobias F.

    2015-01-01

    Background Patient safety and quality care remain major challenges to Ghana’s healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE) in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed. Purpose This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities. Methods A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities. Findings Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05). Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period. Community groups that were gender balanced, religious/faith-based, and had structured leadership appeared to be better options for effective SCE in healthcare quality assessment. Conclusion Community engagement in healthcare quality assessment is a feasible client-centered quality improvement option that should be discussed for possible scale-up in Ghana and other resource poor countries in Africa. PMID:26619143

  4. Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana.

    PubMed

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Ogink, Alice; van Ostenberg, Paul; Rinke de Wit, Tobias F

    2015-01-01

    Patient safety and quality care remain major challenges to Ghana's healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE) in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed. This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities. A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities. Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05). Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period. Community groups that were gender balanced, religious/faith-based, and had structured leadership appeared to be better options for effective SCE in healthcare quality assessment. Community engagement in healthcare quality assessment is a feasible client-centered quality improvement option that should be discussed for possible scale-up in Ghana and other resource poor countries in Africa.

  5. Efforts To Solve Quality Problems. Background Paper No. 36.

    ERIC Educational Resources Information Center

    Smith, Michael J.; And Others

    Producing goods and services of high quality is not expensive, but correcting poor quality costs U.S. companies as much as 20 percent of sales revenues annually. One survey reported that only 1 out of 300 U.S. companies involved management and engineering staff in quality training. The tendency is to have a quality control department, separate…

  6. An Instructional Delivery System for Manpower Management: A Report for Water Pollution Control Agencies. Second Edition.

    ERIC Educational Resources Information Center

    New York State Dept. of Environmental Conservation, Albany.

    This report contains information to assist organizations and personnel responsible for the quality and quantity of operators available for water quality control efforts. The text discusses in detail the current developments in operator instructional programs. Each of the seven sections of this report deals with a specific aspect of manpower…

  7. Statistical process control methods allow the analysis and improvement of anesthesia care.

    PubMed

    Fasting, Sigurd; Gisvold, Sven E

    2003-10-01

    Quality aspects of the anesthetic process are reflected in the rate of intraoperative adverse events. The purpose of this report is to illustrate how the quality of the anesthesia process can be analyzed using statistical process control methods, and exemplify how this analysis can be used for quality improvement. We prospectively recorded anesthesia-related data from all anesthetics for five years. The data included intraoperative adverse events, which were graded into four levels, according to severity. We selected four adverse events, representing important quality and safety aspects, for statistical process control analysis. These were: inadequate regional anesthesia, difficult emergence from general anesthesia, intubation difficulties and drug errors. We analyzed the underlying process using 'p-charts' for statistical process control. In 65,170 anesthetics we recorded adverse events in 18.3%; mostly of lesser severity. Control charts were used to define statistically the predictable normal variation in problem rate, and then used as a basis for analysis of the selected problems with the following results: Inadequate plexus anesthesia: stable process, but unacceptably high failure rate; Difficult emergence: unstable process, because of quality improvement efforts; Intubation difficulties: stable process, rate acceptable; Medication errors: methodology not suited because of low rate of errors. By applying statistical process control methods to the analysis of adverse events, we have exemplified how this allows us to determine if a process is stable, whether an intervention is required, and if quality improvement efforts have the desired effect.

  8. The Early Development and Evolution of the QARTOD for In-Situ Wave Measurements

    NASA Astrophysics Data System (ADS)

    Bouchard, R. H.; Thomas, J.; Teng, C. C.; Burnett, W.; Castel, D.

    2017-12-01

    In 2013 the US Integrated Ocean Observing System (IOOS) Program Office issued manual was for the Real-Time Quality Control of In-Situ Surface Wave Data. This was one of the first Quality Assurance/Quality Control of Real-Time Oceanographic Data (QARTOD) manuals that now cover 11 different in situ measurements. This landmark document was the product of an effort initiated at a 2002 OCEANS.US workshop. The workshop identified and prioritized ocean variables with directional waves ranked as one of the highest key variables for inclusion into a national backbone of observations. The workshop was the impetus that led to the first QARTOD meeting in 2003 that involved over 80 participants and developed minimum standards for real-time observations. Over three more QARTOD meetings, two ad hoc meetings, and many hours of coordination and review involving dozens of wave measurement users and providers, consensus was reached on a list of essential "must Do's" for quality control tests that eventually formed the basis of the manual. The IOOS QARTOD manual established a standard format, provided greater detail, included codeable examples of the algorithms and established a framework for periodic reviews and updates. While the bulk of the quality control procedures originated with those being used by the Coastal Data Information Program (CDIP) and by NOAA's National Data Buoy Center (NDBC), QARTOD also enlisted the expertise of federal, academic, and industry partners. CDIP and NDBC each operated more than 100 wave measuring buoys and had long histories of wave buoy measurements. In addition to buoy measurements, users and providers of fixed and bottom-mounted wave systems were also included. This paper examines the individual contributions, early developments, and the evolution of the QARTOD wave measurement efforts that culminated in the US IOOS manual. These efforts serve as an example of how individuals with a common interest and dedication can achieve results for the common good. Quality control algorithms of value, but not included in the essential list and further quality control advancements outside of the QARTOD will also be reviewed.

  9. 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.

  10. Total Quality Management (TQM), an Overview

    DTIC Science & Technology

    1991-09-01

    Quality Management (TQM). It discusses the reasons TQM is a current growth industry, what it is, and how one implements it. It describes the basic analytical tools, statistical process control, some advanced analytical tools, tools used by process improvement teams to enhance their own operations, and action plans for making improvements. The final sections discuss assessing quality efforts and measuring the quality to knowledge

  11. Results of a Regional Effort to Improve Warfarin Management.

    PubMed

    Rose, Adam J; Park, Angela; Gillespie, Christopher; Van Deusen Lukas, Carol; Ozonoff, Al; Petrakis, Beth Ann; Reisman, Joel I; Borzecki, Ann M; Benedict, Ashley J; Lukesh, William N; Schmoke, Timothy J; Jones, Ellen A; Morreale, Anthony P; Ourth, Heather L; Schlosser, James E; Mayo-Smith, Michael F; Allen, Arthur L; Witt, Daniel M; Helfrich, Christian D; McCullough, Megan B

    2017-05-01

    Improved anticoagulation control with warfarin reduces adverse events and represents a target for quality improvement. No previous study has described an effort to improve anticoagulation control across a health system. To describe the results of an effort to improve anticoagulation control in the New England region of the Veterans Health Administration (VA). Our intervention encompassed 8 VA sites managing warfarin for more than 5000 patients in New England (Veterans Integrated Service Network 1 [VISN 1]). We provided sites with a system to measure processes of care, along with targeted audit and feedback. We focused on processes of care associated with site-level anticoagulation control, including prompt follow-up after out-of-range international normalized ratio (INR) values, minimizing loss to follow-up, and use of guideline-concordant INR target ranges. We used a difference-in-differences (DID) model to examine changes in anticoagulation control, measured as percentage time in therapeutic range (TTR), as well as process measures and compared VISN 1 sites with 116 VA sites located outside VISN 1. VISN 1 sites improved on TTR, our main indicator of quality, from 66.4% to 69.2%, whereas sites outside VISN 1 improved from 65.9% to 66.4% (DID 2.3%, P < 0.001). Improvement in TTR correlated strongly with the extent of improvement on process-of-care measures, which varied widely across VISN 1 sites. A regional quality improvement initiative, using performance measurement with audit and feedback, improved TTR by 2.3% more than control sites, which is a clinically important difference. Improving relevant processes of care can improve outcomes for patients receiving warfarin.

  12. A quality system for PET: An industry perspective

    NASA Astrophysics Data System (ADS)

    Zigler, Steven S.; Breslow, Kenneth; Nazerias, Michael

    2005-12-01

    Quality systems have been employed in a variety of industries to develop and supply products that meet customer expectations and regulatory requirements. Most quality systems address organizational structure, design controls, production, complaints, audits, corrective actions and preventive actions. This paper describes PETNET's efforts to develop a quality system for use in the production of PET tracers. Our goal is to ensure quality products and to facilitate compliance with impending PET good manufacturing practice (GMP) regulations.

  13. Controlling Urban Air Pollution: A Benefit-Cost Assessment.

    ERIC Educational Resources Information Center

    Krupnick, Alan J.; Portney, Paul R.

    1991-01-01

    The pros and cons of air pollution control efforts are discussed. Both national and regional air pollution control plans are described. Topics of discussion include benefit-cost analysis, air quality regulation, reducing ozone in the urban areas, the Los Angeles plan, uncertainties, and policy implications. (KR)

  14. The Influence of Software Complexity on the Maintenance Effort: Case Study on Software Developed within Educational Process

    ERIC Educational Resources Information Center

    Radulescu, Iulian Ionut

    2006-01-01

    Software complexity is the most important software quality attribute and a very useful instrument in the study of software quality. Is one of the factors that affect most of the software quality characteristics, including maintainability. It is very important to quantity this influence and identify the means to keep it under control; by using…

  15. A Study of University Efforts to Provide Students with the Ability to Comprehend and Apply Total Quality Principles in Their Fields of Study

    DTIC Science & Technology

    1993-09-01

    Geber , 1990:30-31). These steps are a formula to implement and measure quality in a service organization. While guidelines such as these apply to...1991. Evans, James R. and William M. Lindsay. The Management and Control of Quality. Minneapolis/St. Paul: West Publishing Company, 1993. Geber

  16. Cognitive Networks

    DTIC Science & Technology

    2007-06-15

    13 2.1.3 Quality of Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 2.2 Related Efforts...objectives such as resource management, Quality of Service (QoS), security, or access control. The limitations of CN applications should come from the...achieving the best mode of operation in an SDR. 2.1.3 Quality of Service There has been a lot of research on how to define a QoS architecture for the

  17. Predicting Changes in Older Adults' Interpersonal Control Strivings

    ERIC Educational Resources Information Center

    Sorkin, Dara H.; Rook, Karen S.; Heckhausen, Jutta; Billimek, John

    2009-01-01

    People vary in the importance they ascribe to, and efforts they invest in, maintaining positive relationships with others. Research has linked such variation in interpersonal control strivings to the quality of social exchanges experienced, but little work has examined the predictors of interpersonal control strivings. Given the importance of…

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

    NASA Astrophysics Data System (ADS)

    Jardim, Kevin P.

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

  19. The Health Educator as Death Educator: Professional Preparation and Quality Control.

    ERIC Educational Resources Information Center

    Crase, Darrell

    1980-01-01

    Health education curriculum has responded to the need to include teacher preparation experiences in death education. While death education is gaining wide acceptance, little effort has been made to guarantee quality instruction. A list of competencies are provided for the edification of the effective death educator. (JN)

  20. Study of the time and effort signal in cutting operations

    NASA Astrophysics Data System (ADS)

    Grosset, E.; Maillard, A.; Bouhelier, C.; Gasnier, J.

    1990-02-01

    Perception and treatment of an effort signal by computer methods is discussed. An automatic control system used to measure the wear of machine tools and carry out quality control throughout the cutting process is described. The testing system is used to evaluate the performance of tools which have been vacuum plated. The system is used as part of the BRITE study, the goal of which is to develop an expert system for measuring the wear of tools used during drilling and perforation operations.

  1. School climate and delinquency among Chinese adolescents: analyses of effortful control as a moderator and deviant peer affiliation as a mediator.

    PubMed

    Bao, Zhenzhou; Li, Dongping; Zhang, Wei; Wang, Yanhui

    2015-01-01

    School climate is the quality and character of school life and reflects the norms, goals, values, interpersonal relationships, teaching and learning practices, and the organizational structure of a school. There is substantial literature documenting the negative association between positive school climate and adolescent delinquency, but little is known about the moderating and mediating mechanisms underlying this relationship. The aim of this study was to examine whether the direct and indirect pathways between school climate and adolescent delinquency would be moderated by effortful control. A sample of 2,758 Chinese adolescents (M age = 13.53 years, SD = 1.06) from 10 middle schools completed anonymous questionnaires regarding school climate, effortful control, deviant peer affiliation, and delinquency. After gender, age, geographical area, and socioeconomic status were included as covariates, the results revealed that school climate was significantly associated with adolescent delinquent behavior. This direct association was moderated by effortful control, such that the negative relationship between positive school climate and delinquency was only significant among adolescents low in effortful control. Moreover, the indirect association between school climate and delinquency via deviant peer affiliation was also moderated by effortful control. Specifically, the moderating effect of effortful control was not only manifested in the relationship between school climate and deviant peer affiliation, but also in the relationship between deviant peer affiliation and delinquency. These findings contribute to understanding the mechanisms through which positive school climate might reduce delinquent behavior and have important implications for prevention efforts aimed at diminishing adolescent delinquency.

  2. Quality Control and Analysis of Microphysical Data Collected in TRMM Aircraft Validation Experiments

    NASA Technical Reports Server (NTRS)

    Heymsfield, Andrew J.

    2004-01-01

    This report summarizes our efforts on the funded project 'Quality Control and Analysis of Microphysical Data Collected in TRMM Airborne Validation Experiments', NASA NAG5-9663, Andrew Heymsfield, P. I. We begin this report by summarizing our activities in FY2000-FY2004. We then present some highlights of our work. The last part of the report lists the publications that have resulted from our funding through this grant.

  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...

  4. Teaching Citizen Science Skills Online: Implications for Invasive Species Training Programs

    ERIC Educational Resources Information Center

    Newman, Greg; Crall, Alycia; Laituri, Melinda; Graham, Jim; Stohlgren, Tom; Moore, John C.; Kodrich, Kris; Holfelder, Kirstin A.

    2010-01-01

    Citizen science programs are emerging as an efficient way to increase data collection and help monitor invasive species. Effective invasive species monitoring requires rigid data quality assurances if expensive control efforts are to be guided by volunteer data. To achieve data quality, effective online training is needed to improve field skills…

  5. Teacher-Child Relationship Quality: The Roles of Child Temperament and Teacher-Child Interactions

    ERIC Educational Resources Information Center

    Rudasill, Kathleen Moritz; Rimm-Kaufman, Sara E.

    2009-01-01

    Young children's relationships with teachers predict social and academic success. This study examines contributions of child temperament (shyness, effortful control) and gender to teacher-child relationship quality both directly and indirectly through the frequency of teacher-child interactions in the classroom. Using an NICHD SECCYD sample of 819…

  6. World Environmental Quality, A Challenge to the International Community.

    ERIC Educational Resources Information Center

    Department of State, Washington, DC.

    The quality of the world environment cannot be dependent upon the efforts of a single nation. This fact is now recognized by most nations. Only through cooperative international actions can effective pollution control and natural resource conservation be realized. The purpose of this booklet is to publicize the work that the United States and…

  7. Many roads may lead to Rome: Selected features of quality control within environmental assessment systems in the US, NL, CA, and UK

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

    Günther, Markus, E-mail: markus.guenther@tu-berlin.de; Geißler, Gesa; Köppel, Johann

    As there is no one-and-only concept on how to precisely define and establish quality control (QC) or quality assurance (QA) in the making of environmental assessments (EA), this paper presents selected features of international approaches that address quality in EA systems in the USA, the Netherlands, Canada, and the United Kingdom. Based on explanative case studies, we highlight the embedding of specific quality control features within the EA systems, the objectives and processes, and relevant transparency challenges. Such features of QC/QA approaches can be considered in cases where substantial quality control and assurance efforts are still missing. Yet further researchmore » needs to be conducted on the efficacy of these approaches, which remains beyond the scope of this study. - Highlights: • We present four tools for quality control and assurance from different EA systems. • Approaches vary in institutional setting, objectives, procedures, and transparency. • Highlighted features might provide guidance in cases where QC/QA is still lacking.« less

  8. Handling Qualities of Model Reference Adaptive Controllers with Varying Complexity for Pitch-Roll Coupled Failures

    NASA Technical Reports Server (NTRS)

    Schaefer, Jacob; Hanson, Curt; Johnson, Marcus A.; Nguyen, Nhan

    2011-01-01

    Three model reference adaptive controllers (MRAC) with varying levels of complexity were evaluated on a high performance jet aircraft and compared along with a baseline nonlinear dynamic inversion controller. The handling qualities and performance of the controllers were examined during failure conditions that induce coupling between the pitch and roll axes. Results from flight tests showed with a roll to pitch input coupling failure, the handling qualities went from Level 2 with the baseline controller to Level 1 with the most complex MRAC tested. A failure scenario with the left stabilator frozen also showed improvement with the MRAC. Improvement in performance and handling qualities was generally seen as complexity was incrementally added; however, added complexity usually corresponds to increased verification and validation effort required for certification. The tradeoff between complexity and performance is thus important to a controls system designer when implementing an adaptive controller on an aircraft. This paper investigates this relation through flight testing of several controllers of vary complexity.

  9. HydroGrid: Technologies for Global Water Quality and Sustainability

    NASA Astrophysics Data System (ADS)

    Yeghiazarian, L.

    2017-12-01

    Humans have been transforming planet Earth for millennia. We have recently come to understand that the collective impact of our decisions and actions has brought about severe water quality problems, which are likely to worsen in the light of rapid population growth to the projected nine billion by 2050. To sustainably manage our global water resources and possibly reverse these effects requires efforts in real-time monitoring of water contamination, analysis of monitoring data, and control of the state of water contamination. We develop technologies to address all three areas: monitoring, analysis and control. These efforts are carried out in the conceptual framework of the HydroGrid, an interconnected water system, which is (1) firmly rooted in the fundamental understanding of processes that govern microbial dynamics on multiple scales; and (2) used to develop watershed-specific management strategies. In the area of monitoring we are developing mobile autonomous sensors to detect surface water contamination, an effort supported by extensive materials research to provide multifunctional materials. We analyze environmental data within a stochastic modeling paradigm that bridges microscopic particle interactions to macroscopic manifestation of microbial population behavior in time and space in entire watersheds. These models are supported with laboratory and field experiments. Finally, we combine control and graph theories to derive controllability metrics of natural watersheds.

  10. [Quality process control system of Chinese medicine preparation based on "holistic view"].

    PubMed

    Wang, Ya-Qi; Jiao, Jiao-Jiao; Wu, Zhen-Feng; Zheng, Qin; Yang, Ming

    2018-01-01

    "High quality, safety and effectiveness" are the primary principles for the pharmaceutical research and development process in China. The quality of products relies not only on the inspection method, but also on the design and development, process control and standardized management. The quality depends on the process control level. In this paper, the history and current development of quality control of traditional Chinese medicine (TCM) preparations are reviewed systematically. Based on the development model of international drug quality control and the misunderstanding of quality control of TCM preparations, the reasons for impacting the homogeneity of TCM preparations are analyzed and summarized. According to TCM characteristics, efforts were made to control the diversity of TCM, make "unstable" TCM into "stable" Chinese patent medicines, put forward the concepts of "holistic view" and "QbD (quality by design)", so as to create the "holistic, modular, data, standardized" model as the core of TCM preparation quality process control model. Scientific studies shall conform to the actual production of TCM preparations, and be conducive to supporting advanced equipment and technology upgrade, thoroughly applying the scientific research achievements in Chinese patent medicines, and promoting the cluster application and transformation application of TCM pharmaceutical technology, so as to improve the quality and effectiveness of the TCM industry and realize the green development. Copyright© by the Chinese Pharmaceutical Association.

  11. Improving Quality of Shoe Soles Product using Six Sigma

    NASA Astrophysics Data System (ADS)

    Jesslyn Wijaya, Athalia; Trusaji, Wildan; Akbar, Muhammad; Ma’ruf, Anas; Irianto, Dradjad

    2018-03-01

    A manufacture in Bandung produce kind of rubber-based product i.e. trim, rice rollers, shoe soles, etc. After penetrating the shoe soles market, the manufacture has met customer with tight quality control. Based on the past data, defect level of this product was 18.08% that caused the manufacture’s loss of time and money. Quality improvement effort was done using six sigma method that included phases of define, measure, analyse, improve, and control (DMAIC). In the design phase, the object’s problem and definition were defined. Delphi method was also used in this phase to identify critical factors. In the measure phase, the existing process stability and sigma quality level were measured. Fishbone diagram and failure mode and effect analysis (FMEA) were used in the next phase to analyse the root cause and determine the priority issues. Improve phase was done by designing alternative improvement strategy using 5W1H method. Some improvement efforts were identified, i.e. (i) modifying design of the hanging rack, (ii) create pantone colour book and check sheet, (iii) provide pedestrian line at compound department, (iv) buying stop watch, and (v) modifying shoe soles dies. Some control strategies for continuous improvement were proposed such as SOP or reward and punishment system.

  12. Enabling the Usability of Earth Science Data Products and Services by Evaluating, Describing, and Improving Data Quality throughout the Data Lifecycle

    NASA Astrophysics Data System (ADS)

    Downs, R. R.; Peng, G.; Wei, Y.; Ramapriyan, H.; Moroni, D. F.

    2015-12-01

    Earth science data products and services are being used by representatives of various science and social science disciplines, by planning and decision-making professionals, by educators and learners ranging from primary through graduate and informal education, and by the general public. The diversity of users and uses of Earth science data is gratifying and offers new challenges for enabling the usability of these data by audiences with various purposes and levels of expertise. Users and other stakeholders need capabilities to efficiently find, explore, select, and determine the applicability and suitability of data products and services to meet their objectives and information needs. Similarly, they need to be able to understand the limitations of Earth science data, which can be complex, especially when considering combined or simultaneous use of multiple data products and services. Quality control efforts of stakeholders, throughout the data lifecycle, can contribute to the usability of Earth science data to meet the needs of diverse users. Such stakeholders include study design teams, data producers, data managers and curators, archives, systems professionals, data distributors, end-users, intermediaries, sponsoring organizations, hosting institutions, and others. Opportunities for engaging stakeholders to review, describe, and improve the quality of Earth science data products and services throughout the data lifecycle are identified and discussed. Insight is shared from the development of guidelines for implementing the Group on Earth Observations (GEO) Data Management Principles, the recommendations from the Earth Science Data System Working Group (ESDSWG) on Data Quality, and the efforts of the Information Quality Cluster of the Federation of Earth Science Information Partners (ESIP). Examples and outcomes from quality control efforts of data facilities, such as scientific data centers, that contribute to the usability of Earth science data also are offered.

  13. Musculoskeletal pain and effort-reward imbalance- a systematic review

    PubMed Central

    2014-01-01

    Background Musculoskeletal pain may be triggered by physical strains and psychosocial risk factors. The effort-reward imbalance model (ERI model) is a stress model which measures psychosocial factors in the working world. The question is whether workers with an effort-reward imbalance report musculoskeletal pain more frequently than those with no effort-reward imbalance. A systematic review using a best evidence synthesis approach was conducted to answer this question. Methods A literature search was conducted for the period from 1996 to 2012, using three databases (Pubmed, Embase and PsycINFO). The research criteria related to psychosocial, work-related stress as per the ERI model and to musculoskeletal pain. A quality score was developed using various quality criteria to assess the standard of the studies. The level of evidence was graded as in (Am J Ind Med 39:180–193, 2001). Results After applying the inclusion criteria, a total of 19 studies were included in the review: 15 cross-sectional studies, three prospective studies and one case–control study. 74% of all studies exhibited good methodological quality, 53% collected data using the original ERI questionnaire, and in 42% of the studies, there was adequate control for physical working conditions. Furthermore, different cut-off points were used to classify exposed and non-exposed individuals. On the basis of 13 studies with a positive, statistically significant association, a moderate level of evidence was inferred for the association between effort-reward imbalance and musculoskeletal pain. The evidence for a role of over-commitment and for its interaction with effort-reward imbalance was rated as inconclusive - on the basis of eight and five studies, respectively. Conclusions On the basis of the available evidence, no reliable conclusion may be drawn about any association between the psychosocial factors ascertained using the ERI model and musculoskeletal pain. Before a reliable statement can be made on the association between ERI and musculoskeletal pain, additional longitudinal studies must be performed - with a standardised method for recording and classifying exposure, as well as control of physical confounders. Appropriate preventive measures can then be specified. PMID:24428955

  14. Musculoskeletal pain and effort-reward imbalance--a systematic review.

    PubMed

    Koch, Peter; Schablon, Anja; Latza, Ute; Nienhaus, Albert

    2014-01-15

    Musculoskeletal pain may be triggered by physical strains and psychosocial risk factors. The effort-reward imbalance model (ERI model) is a stress model which measures psychosocial factors in the working world. The question is whether workers with an effort-reward imbalance report musculoskeletal pain more frequently than those with no effort-reward imbalance. A systematic review using a best evidence synthesis approach was conducted to answer this question. A literature search was conducted for the period from 1996 to 2012, using three databases (Pubmed, Embase and PsycINFO). The research criteria related to psychosocial, work-related stress as per the ERI model and to musculoskeletal pain. A quality score was developed using various quality criteria to assess the standard of the studies. The level of evidence was graded as in (Am J Ind Med 39:180-193, 2001). After applying the inclusion criteria, a total of 19 studies were included in the review: 15 cross-sectional studies, three prospective studies and one case-control study. 74% of all studies exhibited good methodological quality, 53% collected data using the original ERI questionnaire, and in 42% of the studies, there was adequate control for physical working conditions. Furthermore, different cut-off points were used to classify exposed and non-exposed individuals. On the basis of 13 studies with a positive, statistically significant association, a moderate level of evidence was inferred for the association between effort-reward imbalance and musculoskeletal pain. The evidence for a role of over-commitment and for its interaction with effort-reward imbalance was rated as inconclusive - on the basis of eight and five studies, respectively. On the basis of the available evidence, no reliable conclusion may be drawn about any association between the psychosocial factors ascertained using the ERI model and musculoskeletal pain. Before a reliable statement can be made on the association between ERI and musculoskeletal pain, additional longitudinal studies must be performed - with a standardised method for recording and classifying exposure, as well as control of physical confounders. Appropriate preventive measures can then be specified.

  15. [Incentive spirometry with expiratory positive airway pressure brings benefits after myocardial revascularization].

    PubMed

    Ferreira, Glória Menz; Haeffner, Mauren Porto; Barreto, Sérgio Saldanha Menna; Dall'Ago, Pedro

    2010-02-01

    Patients undergoing coronary artery bypass graft (CABG) surgery have higher risk to develop pulmonary complications (PCs) such as atelectasis, pneumonia and pleural effusion. These complications could increase the length of hospital stay, resources utilization and also are associated with reduced quality of life and functional capacity a long term. To test if the use of incentive spirometry (IS) associated with expiratory positive airway pressure (EPAP), after CABG surgery improves dyspnea, effort perceived and quality of life 18 months after CABG. Sixteen patients submitted to a CABG, were randomized to a control group (n=8) or IS+EPAP group (n=8). The protocol of IS+EPAP was applied in the immediate postoperative period and following for more 4 weeks in the patient's home. Eighteen months after CABG, the strength of the respiratory muscle, the functional capacity, the lung function, the quality of life and the level of physical activity were evaluated. After six minute walk test (6-MWT), the score of the dyspnea (1.6+/-0.6 vs 0.6+/-0.3, P<0.05) and the perceived effort (13.4+/-1.2 vs 9.1+/-0.7, P<0.05) were higher in the control group, when compared with the IS+EPAP group. In quality of life evaluation, the domain related to the physical aspects limitations was better in IS+EPAP group (93.7+/-4.1 vs 50+/-17, P<0.02). Patients that were submitted to IS+EPAP present reduction of dyspnea and lower effort sensation after the 6-MWT, and also a better quality of life 18 months after CABG.

  16. Roles for specialty societies and vascular surgeons in accountable care organizations

    PubMed Central

    Goodney, Philip P.; Fisher, Elliott S.; Cambria, Richard P.

    2012-01-01

    With the passage of the Affordable Care Act, accountable care organizations (ACOs) represent a new paradigm in healthcare payment reform. Designed to limit growth in spending while preserving quality, these organizations aim to incant physicians to lower costs by returning a portion of the savings realized by cost-effective, evidence-based care back to the ACO. In this review, first, we will explore the development of ACOs within the context of prior attempts to control Medicare spending, such as the sustainable growth rate and managed care organizations. Second, we describe the evolution of ACOs, the demonstration projects that established their feasibility, and their current organizational structure. Third, because quality metrics are central to the use and implementation of ACOs, we describe current efforts to design, collect, and interpret quality metrics in vascular surgery. And fourth, because a “seat at the table” will be an important key to success for vascular surgeons in these efforts, we discuss how vascular surgeons can participate and lead efforts within ACOs. PMID:22370029

  17. Depression, Control, and Climate: An Examination of Factors Impacting Teaching Quality in Preschool Classrooms.

    PubMed

    Sandilos, Lia E; Cycyk, Lauren M; Hammer, Carol Scheffner; Sawyer, Brook E; López, Lisa; Blair, Clancy

    This study investigated the relationship of preschool teachers' self-reported depressive symptomatology, perception of classroom control, and perception of school climate to classroom quality as measured by the Classroom Assessment Scoring System Pre-K. The sample consisted of 59 urban preschool classrooms serving low-income and linguistically diverse students in the northeastern and southeastern United States. Results of hierarchical linear modeling revealed that teachers' individual reports of depressive symptomatology were significantly and negatively predictive of the observed quality of their instructional support and classroom organization. The findings of this study have implications for increasing access to mental health supports for teachers in an effort to minimize depressive symptoms and potentially improve classroom quality.

  18. Control of robotic assistance using poststroke residual voluntary effort.

    PubMed

    Makowski, Nathaniel S; Knutson, Jayme S; Chae, John; Crago, Patrick E

    2015-03-01

    Poststroke hemiparesis limits the ability to reach, in part due to involuntary muscle co-activation (synergies). Robotic approaches are being developed for both therapeutic benefit and continuous assistance during activities of daily living. Robotic assistance may enable participants to exert less effort, thereby reducing expression of the abnormal co-activation patterns, which could allow participants to reach further. This study evaluated how well participants could perform a reaching task with robotic assistance that was either provided independent of effort in the vertical direction or in the sagittal plane in proportion to voluntary effort estimated from electromyograms (EMG) on the affected side. Participants who could not reach targets without assistance were enabled to reach further with assistance. Constant anti-gravity force assistance that was independent of voluntary effort did not reduce the quality of reach and enabled participants to exert less effort while maintaining different target locations. Force assistance that was proportional to voluntary effort on the affected side enabled participants to exert less effort and could be controlled to successfully reach targets, but participants had increased difficulty maintaining a stable position. These results suggest that residual effort on the affected side can produce an effective command signal for poststroke assistive devices.

  19. The Long-Term Effectiveness of the Family Check-up on Peer Preference: Parent-Child Interaction and Child Effortful Control as Sequential Mediators.

    PubMed

    Chang, Hyein; Shaw, Daniel S; Shelleby, Elizabeth C; Dishion, Thomas J; Wilson, Melvin N

    2017-05-01

    We examined the longitudinal effects of the Family Check-Up (FCU) intervention beginning in toddlerhood on children's peer preference at school-age. Specifically, a sequential mediational model was proposed in which the FCU was hypothesized to promote peer preference (i.e., higher acceptance and lower rejection by peers) in middle childhood through its positive effects on parent-child interaction and child effortful control in early childhood. Participants were 731 low-income families (49 % female). Qualities of parent-child interaction were observed during structured activities at 2 to 5 years, child effortful control was assessed using behavioral tasks at 5 years, and peer acceptance and rejection were rated by teachers at 7.5 to 10.5 years. Results indicated that the FCU indirectly predicted peer preference by sequentially improving parent-child interaction and child effortful control. The findings are discussed with respect to implications for understanding mechanisms by which early parenting-focused programs may enhance child functioning across time and context.

  20. The Long-Term Effectiveness of the Family Check-up on Peer Preference: Parent-Child Interaction and Child Effortful Control as Sequential Mediators

    PubMed Central

    Shaw, Daniel S.; Shelleby, Elizabeth C.; Dishion, Thomas J.; Wilson, Melvin N.

    2018-01-01

    We examined the longitudinal effects of the Family Check-Up (FCU) intervention beginning in toddlerhood on children’s peer preference at school-age. Specifically, a sequential mediational model was proposed in which the FCU was hypothesized to promote peer preference (i.e., higher acceptance and lower rejection by peers) in middle childhood through its positive effects on parent-child interaction and child effortful control in early childhood. Participants were 731 low-income families (49 % female). Qualities of parent-child interaction were observed during structured activities at 2 to 5 years, child effortful control was assessed using behavioral tasks at 5 years, and peer acceptance and rejection were rated by teachers at 7.5 to 10.5 years. Results indicated that the FCU indirectly predicted peer preference by sequentially improving parent-child interaction and child effortful control. The findings are discussed with respect to implications for understanding mechanisms by which early parenting-focused programs may enhance child functioning across time and context. PMID:27558394

  1. Will the "Fixes" Fall Flat? Prospects for Quality Measures and Payment Incentives to Control Healthcare Spending.

    PubMed

    Hauswald, Erik; Sklar, David

    2017-04-01

    Payment systems in the US healthcare system have rewarded physicians for services and attempted to control healthcare spending, with rewards and penalties based upon projected goals for future spending. The incorporation of quality goals and alternatives to fee-for-service was introduced to replace the previous system of rewards and penalties. We describe the history of the US healthcare payment system, focusing on Medicare and the efforts to control spending through the Sustainable Growth Rate. We describe the latest evolution of the payment system, which emphasizes quality measurement and alternative payment models. We conclude with suggestions for how to influence physician behavior through education and payment reform so that their behavior aligns with alternative care models to control spending in the future.

  2. Chinese vaccine products go global: vaccine development and quality control.

    PubMed

    Xu, Miao; Liang, Zhenglun; Xu, Yinghua; Wang, Junzhi

    2015-05-01

    Through the continuous efforts of several generations, China has become one of the few countries in the world that is capable of independently addressing all the requirements by the Expanded Program on Immunization. Regulatory science is applied to continuously improve the vaccine regulatory system. Passing the prequalification by WHO has allowed Chinese vaccine products to go global. Chinese vaccine products not only secure disease prevention and control domestically but also serve the needs for international public health. This article describes the history of Chinese vaccine development, the current situation of Chinese vaccine industry and its contribution to the prevention and control of infectious diseases. We also share our experience of national quality control and vaccine regulation during the past decades. China's experience in vaccine development and quality control can benefit other countries and regions worldwide, including the developing countries.

  3. Lean six sigma in healthcare.

    PubMed

    de Koning, Henk; Verver, John P S; van den Heuvel, Jaap; Bisgaard, Soren; Does, Ronald J M M

    2006-01-01

    Healthcare, as with any other service operation, requires systematic innovation efforts to remain competitive, cost efficient, and up-to-date. This article outlines a methodology and presents examples to illustrate how principles of Lean Thinking and Six Sigma can be combined to provide an effective framework for producing systematic innovation efforts in healthcare. Controlling healthcare cost increases, improving quality, and providing better healthcare are some of the benefits of this approach.

  4. Consequent use of IT tools as a driver for cost reduction and quality improvements

    NASA Astrophysics Data System (ADS)

    Hein, Stefan; Rapp, Roberto; Feustel, Andreas

    2013-10-01

    The semiconductor industry drives a lot of efforts in the field of cost reductions and quality improvements. The consequent use of IT tools is one possibility to support these goals. With the extensions of its 150mm Fab to 200mm Robert Bosch increased the systematic use of data analysis and Advanced Process Control (APC).

  5. Tire Production and Pollution Control. Environmental Education Curriculum. Revised.

    ERIC Educational Resources Information Center

    Topeka Public Schools, KS.

    This unit was developed to introduce secondary students to the many facets of a typical, large manufacturing plant - the Topeka Goodyear Tire and Rubber Company - in an effort to increase awareness of sound environmental practices in industry. Its five major foci include the production of tires and quality control procedures; applications of…

  6. Controlling Nonpoint-Source Water Pollution: A Citizen's Handbook.

    ERIC Educational Resources Information Center

    Hansen, Nancy Richardson; And Others

    Citizens can play an important role in helping their states develop pollution control programs and spurring effective efforts to deal with nonpoint-source pollution. This guide takes the reader step-by-step through the process that states must follow to comply with water quality legislation relevant to nonpoint-source pollution. Part I provides…

  7. The Relationship of Land Use and Transportation Planning to Air Quality Management.

    ERIC Educational Resources Information Center

    Hagevik, George, Ed.

    Due to a lack of communication between urban, regional, and transportation planning agencies and air pollution control agencies, cooperative efforts in environmental planning have been nearly non-existent. This traditional lack of communication and understanding serves to obscure the fact that air pollution control agencies and planning agencies…

  8. Tobacco control advocates must demand high-quality media campaigns: the California experience.

    PubMed

    Balbach, E D; Glantz, S A

    1998-01-01

    To document efforts on the part of public officials in California to soften the media campaign's attack on the tobacco industry and to analyse strategies to counter those efforts on the part of tobacco control advocates. Data were gathered from interviews with programme participants, direct observation, written materials, and media stories. In addition, internal documents were released by the state's Department of Health Services in response to requests made under the California Public Records Act by Americans for Nonsmokers' Rights. Finally, a draft of the paper was circulated to 11 key players for their comments. In 1988 california voters enacted Proposition 99, an initiative that raised the tobacco tax by $0.25 and allocated 20% of the revenues to anti-tobacco education. A media campaign, which was part of the education programme, directly attacked the tobacco industry, exposing the media campaign to politically based efforts to shut it down or soften it. Through use of outsider strategies such as advertising, press conferences, and public meetings, programme advocates were able to counter the efforts to soften the campaign. Anti-tobacco media campaigns that expose industry manipulation are a key component of an effective tobacco control programme. The effectiveness of these campaigns, however, makes them a target for elimination by the tobacco industry. The experience from California demonstrates the need for continuing, aggressive intervention by nongovernmental organisations in order to maintain the quality of anti-tobacco media campaigns.

  9. Mine planning and emission control strategies using geostatistics

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

    Martino, F.; Kim, Y.C.

    1983-03-01

    This paper reviews the past four years' research efforts performed jointly by the University of Arizona and the Homer City Owners in which geostatistics were applied to solve various problems associated with coal characterization, mine planning, and development of emission control strategies. Because geostatistics is the only technique which can quantify the degree of confidence associated with a given estimate (or prediction), it played an important role throughout the research efforts. Through geostatistics, it was learned that there is an urgent need for closely spaced sample information, if short-term coal quality predictions are to be made for mine planning purposes.

  10. An Overview of Controls and Flying Qualities Technology on the F/A-18 High Alpha Research Vehicle

    NASA Technical Reports Server (NTRS)

    Pahle, Joseph W.; Wichman, Keith D.; Foster, John V.; Bundick, W. Thomas

    1996-01-01

    The NASA F/A-18 High Alpha Research Vehicle (HARV) has been the flight test bed of a focused technology effort to significantly increase maneuvering capability at high angles of attack. Development and flight test of control law design methodologies, handling qualities metrics, performance guidelines, and flight evaluation maneuvers are described. The HARV has been modified to include two research control effectors, thrust vectoring, and actuated forebody strakes in order to provide increased control power at high angles of attack. A research flight control system has been used to provide a flexible, easily modified capability for high-angle-of-attack research controls. Different control law design techniques have been implemented and flight-tested, including eigenstructure assignment, variable gain output feedback, pseudo controls, and model-following. Extensive piloted simulation has been used to develop nonlinear performance guide-lines and handling qualities criteria for high angles of attack. This paper reviews the development and evaluation of technologies useful for high-angle-of-attack control. Design, development, and flight test of the research flight control system, control laws, flying qualities specifications, and flight test maneuvers are described. Flight test results are used to illustrate some of the lessons learned during flight test and handling qualities evaluations.

  11. QCloud: A cloud-based quality control system for mass spectrometry-based proteomics laboratories

    PubMed Central

    Chiva, Cristina; Olivella, Roger; Borràs, Eva; Espadas, Guadalupe; Pastor, Olga; Solé, Amanda

    2018-01-01

    The increasing number of biomedical and translational applications in mass spectrometry-based proteomics poses new analytical challenges and raises the need for automated quality control systems. Despite previous efforts to set standard file formats, data processing workflows and key evaluation parameters for quality control, automated quality control systems are not yet widespread among proteomics laboratories, which limits the acquisition of high-quality results, inter-laboratory comparisons and the assessment of variability of instrumental platforms. Here we present QCloud, a cloud-based system to support proteomics laboratories in daily quality assessment using a user-friendly interface, easy setup, automated data processing and archiving, and unbiased instrument evaluation. QCloud supports the most common targeted and untargeted proteomics workflows, it accepts data formats from different vendors and it enables the annotation of acquired data and reporting incidences. A complete version of the QCloud system has successfully been developed and it is now open to the proteomics community (http://qcloud.crg.eu). QCloud system is an open source project, publicly available under a Creative Commons License Attribution-ShareAlike 4.0. PMID:29324744

  12. Early Parenting, Represented Family Relationships, and Externalizing Behavior Problems in Children Born Preterm

    PubMed Central

    Poehlmann, Julie; Burnson, Cynthia; Weymouth, Lindsay A.

    2015-01-01

    Through assessment of 173 preterm infants and their mothers at hospital discharge and at 9, 16, 24, 36, and 72 months, the study examined early parenting, attachment security, effortful control, and children’s representations of family relationships in relation to subsequent externalizing behavior problems. Less intrusive early parenting predicted more secure attachment, better effortful control skills, and fewer early behavior problems, although it did not directly relate to the structural or content characteristics of children’s represented family relationships. Children with higher effortful control scores at 24 months had more coherent family representations at 36 months. Moreover, children who exhibited less avoidance in their family representations at 36 months had fewer mother-reported externalizing behavior problems at 72 months. The study suggests that early parenting quality and avoidance in children’s represented relationships are important for the development of externalizing behavior problems in children born preterm. PMID:24580068

  13. Early parenting, represented family relationships, and externalizing behavior problems in children born preterm.

    PubMed

    Poehlmann, Julie; Burnson, Cynthia; Weymouth, Lindsay A

    2014-01-01

    Through assessment of 173 preterm infants and their mothers at hospital discharge and at 9, 16, 24, 36, and 72 months, the study examined early parenting, attachment security, effortful control, and children's representations of family relationships in relation to subsequent externalizing behavior problems. Less intrusive early parenting predicted more secure attachment, better effortful control skills, and fewer early behavior problems, although it did not directly relate to the structural or content characteristics of children's represented family relationships. Children with higher effortful control scores at 24 months had more coherent family representations at 36 months. Moreover, children who exhibited less avoidance in their family representations at 36 months had fewer mother-reported externalizing behavior problems at 72 months. The study suggests that early parenting quality and avoidance in children's represented relationships are important for the development of externalizing behavior problems in children born preterm.

  14. Depression, Control, and Climate: An Examination of Factors Impacting Teaching Quality in Preschool Classrooms

    PubMed Central

    Sandilos, Lia E.; Cycyk, Lauren M.; Hammer, Carol Scheffner; Sawyer, Brook E.; López, Lisa; Blair, Clancy

    2015-01-01

    Research Findings This study investigated the relationship of preschool teachers' self-reported depressive symptomatology, perception of classroom control, and perception of school climate to classroom quality as measured by the Classroom Assessment Scoring System Pre-K. The sample consisted of 59 urban preschool classrooms serving low-income and linguistically diverse students in the northeastern and southeastern United States. Results of hierarchical linear modeling revealed that teachers' individual reports of depressive symptomatology were significantly and negatively predictive of the observed quality of their instructional support and classroom organization. Practice or Policy The findings of this study have implications for increasing access to mental health supports for teachers in an effort to minimize depressive symptoms and potentially improve classroom quality. PMID:26924914

  15. 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.

  16. Benefits and Costs of Pulp and Paper Effluent Controls Under the Clean Water Act

    NASA Astrophysics Data System (ADS)

    Luken, Ralph A.; Johnson, F. Reed; Kibler, Virginia

    1992-03-01

    This study quantifies local improvements in environmental quality from controlling effluents in the pulp and paper industry. Although it is confined to a single industry, this study is the first effort to assess the actual net benefits of the Clean Water Act pollution control program. An assessment of water quality benefits requires linking regulatory policy, technical effects, and behavioral responses. Regulatory policies mandate specific controls that influence the quantity and nature of effluent discharges. We identify a subset of stream segments suitable for analysis, describe water quality simulations and control cost calculations under alternative regulatory scenarios, assign feasible water uses to each segment based on water quality, and determine probable upper bounds for the willingness of beneficiaries to pay. Because the act imposes uniform regulations that do not account for differences in compliance costs, existing stream quality, contributions of other effluent sources, and recreation potential, the relation between water quality benefits and costs varies widely across sites. This variation suggests that significant positive net benefits have probably been achieved in some cases, but we conclude that the costs of the Clean Water Act as a whole exceed likely benefits by a significant margin.

  17. Colwater fish in rivers

    EPA Science Inventory

    A standard sampling protocol to assess the fish assemblages and abundances in large, coldwater rivers is most accurate and precise if consistent gears and levels of effort are used at each site. This requires thorough crew training, quality control audits, and replicate sampling...

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

    PubMed

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

    2006-01-01

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

  19. (abstract) Mission Operations and Control Assurance: Flight Operations Quality Improvements

    NASA Technical Reports Server (NTRS)

    Welz, Linda L.; Bruno, Kristin J.; Kazz, Sheri L.; Witkowski, Mona M.

    1993-01-01

    Mission Operations and Command Assurance (MO&CA), a recent addition to flight operations teams at JPL. provides a system level function to instill quality in mission operations. MO&CA's primary goal at JPL is to help improve the operational reliability for projects during flight. MO&CA tasks include early detection and correction of process design and procedural deficiencies within projects. Early detection and correction are essential during development of operational procedures and training of operational teams. MO&CA's effort focuses directly on reducing the probability of radiating incorrect commands to a spacecraft. Over the last seven years at JPL, MO&CA has become a valuable asset to JPL flight projects. JPL flight projects have benefited significantly from MO&CA's efforts to contain risk and prevent rather than rework errors. MO&CA's ability to provide direct transfer of knowledge allows new projects to benefit directly from previous and ongoing experience. Since MO&CA, like Total Quality Management (TQM), focuses on continuous improvement of processes and elimination of rework, we recommend that this effort be continued on NASA flight projects.

  20. Roles for specialty societies and vascular surgeons in accountable care organizations.

    PubMed

    Goodney, Philip P; Fisher, Elliott S; Cambria, Richard P

    2012-03-01

    With the passage of the Affordable Care Act, accountable care organizations (ACOs) represent a new paradigm in healthcare payment reform. Designed to limit growth in spending while preserving quality, these organizations aim to incant physicians to lower costs by returning a portion of the savings realized by cost-effective, evidence-based care back to the ACO. In this review, first, we will explore the development of ACOs within the context of prior attempts to control Medicare spending, such as the sustainable growth rate and managed care organizations. Second, we describe the evolution of ACOs, the demonstration projects that established their feasibility, and their current organizational structure. Third, because quality metrics are central to the use and implementation of ACOs, we describe current efforts to design, collect, and interpret quality metrics in vascular surgery. And fourth, because a "seat at the table" will be an important key to success for vascular surgeons in these efforts, we discuss how vascular surgeons can participate and lead efforts within ACOs. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  1. Development and validation of measures to assess prevention and control of AMR in hospitals.

    PubMed

    Flanagan, Mindy; Ramanujam, Rangaraj; Sutherland, Jason; Vaughn, Thomas; Diekema, Daniel; Doebbeling, Bradley N

    2007-06-01

    The rapid spread of antimicrobial resistance (AMR) in the US hospitals poses serious quality and safety problems. Expert panels, identifying strategies for optimizing antibiotic use and preventing AMR spread, have recommended hospitals undertake efforts to implement specific evidence-based practices. To develop and validate a measurement scale for assessing hospitals' efforts to implement recommended AMR prevention and control measures. Surveys were mailed to infection control professionals in a national sample of 670 US hospitals stratified by geographic region, bedsize, teaching status, and VA affiliation. : Four hundred forty-eight infection control professionals participated (67% response rate). Survey items measured implementation of guideline recommendations, practices for AMR monitoring and feedback, AMR-related outcomes (methicillin-resistant Staphylococcus aureus prevalence and outbreaks [MRSA]), and organizational features. "Derivation" and "validation" samples were randomly selected. Exploratory factor analysis was performed to identify factors underlying AMR prevention and control efforts. Multiple methods were used for validation. We identified 4 empirically distinct factors in AMR prevention and control: (1) practices for antimicrobial prescription/use, (2) information/resources for AMR control, (3) practices for isolating infected patients, and (4) organizational support for infection control policies. The Prevention and Control of Antimicrobial Resistance scale was reliable and had content and construct validity. MRSA prevalence was significantly lower in hospitals with higher resource/information availability and broader organizational support. The Prevention and Control of Antimicrobial Resistance scale offers a simple yet discriminating assessment of AMR prevention and control efforts. Use should complement assessment methods based exclusively on AMR outcomes.

  2. Appendix A: Proposed statement of work, 1994

    NASA Technical Reports Server (NTRS)

    1993-01-01

    This NRA effort is devoted to developing new techniques and methodologies which utilize and/or provide support to Integrated Vehicle Health Management (IVHM) concepts and techniques, modern design processes, and open architectures to realize an avionics system architecture that relieves the flight control system (FCS) of the requirement of maintaining intimate knowledge and control of the vehicle subsystems (for instance, the reaction control system (RCS)). The benefit of this architecture is that future upgrades and enhancements to the system(s) or to individual components within the system(s) are greatly simplified. This approach also allows a much more straightforward treatment of failure analysis, system diagnosis, and the design of fault containment domains. This NRA effort is also devoted to realizing capabilities to provide an available avionics system (and subsystem(s)) at minimum operational cost. This thrust provides a direct benefit to NASA in that it seeks to accelerate the design cycle to allow state of the art components and designs to actually appear in the fielded system rather than merely in the initial design. To achieve this, this effort is intended to benefit from efforts already underway at Lockheed and other major contractors. For instance, Lockheed Sanders is currently engaged in a major DoD funded development program which has the goal of cutting design cycle time of high performance electronics by a factor of four while simultaneously improving quality also by a factor of four. The early work on this program was used to enable the rapid prototyping of the Reaction Jet Drive Controller which was accomplished in 1993. Similarly, maximum leverage will be derived from recent NASA and DoD efforts to increase the content of high quality commercial grade electronic components in systems for aerospace applications. Both of these goals result in a system with enhanced cost effectiveness, increased reliability, and greatly increased performance compared to a system developed using a more conventional approach.

  3. Appendix A: Proposed statement of work, 1994

    NASA Astrophysics Data System (ADS)

    1993-12-01

    This NRA effort is devoted to developing new techniques and methodologies which utilize and/or provide support to Integrated Vehicle Health Management (IVHM) concepts and techniques, modern design processes, and open architectures to realize an avionics system architecture that relieves the flight control system (FCS) of the requirement of maintaining intimate knowledge and control of the vehicle subsystems (for instance, the reaction control system (RCS)). The benefit of this architecture is that future upgrades and enhancements to the system(s) or to individual components within the system(s) are greatly simplified. This approach also allows a much more straightforward treatment of failure analysis, system diagnosis, and the design of fault containment domains. This NRA effort is also devoted to realizing capabilities to provide an available avionics system (and subsystem(s)) at minimum operational cost. This thrust provides a direct benefit to NASA in that it seeks to accelerate the design cycle to allow state of the art components and designs to actually appear in the fielded system rather than merely in the initial design. To achieve this, this effort is intended to benefit from efforts already underway at Lockheed and other major contractors. For instance, Lockheed Sanders is currently engaged in a major DoD funded development program which has the goal of cutting design cycle time of high performance electronics by a factor of four while simultaneously improving quality also by a factor of four. The early work on this program was used to enable the rapid prototyping of the Reaction Jet Drive Controller which was accomplished in 1993. Similarly, maximum leverage will be derived from recent NASA and DoD efforts to increase the content of high quality commercial grade electronic components in systems for aerospace applications. Both of these goals result in a system with enhanced cost effectiveness, increased reliability, and greatly increased performance compared to a system developed using a more conventional approach.

  4. Analysis of aircraft longitudinal handling qualities

    NASA Technical Reports Server (NTRS)

    Hess, R. A.

    1981-01-01

    The optimal control model (OCM) of the human pilot is applied to the study of aircraft handling qualities. Attention is focused primarily on longitudinal tasks. The modeling technique differs from previous applications of the OCM in that considerable effort is expended in simplifying the pilot/vehicle analysis. After briefly reviewing the OCM, a technique for modeling the pilot controlling higher order systems is introduced. Following this, a simple criterion for determining the susceptibility of an aircraft to pilot induced oscillations (PIO) is formulated. Finally, a model-based metric for pilot rating prediction is discussed. The resulting modeling procedure provides a relatively simple, yet unified approach to the study of a variety of handling qualities problems.

  5. Prediction of aircraft handling qualities using analytical models of the human pilot

    NASA Technical Reports Server (NTRS)

    Hess, R. A.

    1982-01-01

    The optimal control model (OCM) of the human pilot is applied to the study of aircraft handling qualities. Attention is focused primarily on longitudinal tasks. The modeling technique differs from previous applications of the OCM in that considerable effort is expended in simplifying the pilot/vehicle analysis. After briefly reviewing the OCM, a technique for modeling the pilot controlling higher order systems is introduced. Following this, a simple criterion for determining the susceptibility of an aircraft to pilot-induced oscillations (PIO) is formulated. Finally, a model-based metric for pilot rating prediction is discussed. The resulting modeling procedure provides a relatively simple, yet unified approach to the study of a variety of handling qualities problems.

  6. Prediction of aircraft handling qualities using analytical models of the human pilot

    NASA Technical Reports Server (NTRS)

    Hess, R. A.

    1982-01-01

    The optimal control model (OCM) of the human pilot is applied to the study of aircraft handling qualities. Attention is focused primarily on longitudinal tasks. The modeling technique differs from previous applications of the OCM in that considerable effort is expended in simplifying the pilot/vehicle analysis. After briefly reviewing the OCM, a technique for modeling the pilot controlling higher order systems is introduced. Following this, a simple criterion for determining the susceptibility of an aircraft to pilot induced oscillations is formulated. Finally, a model based metric for pilot rating prediction is discussed. The resulting modeling procedure provides a relatively simple, yet unified approach to the study of a variety of handling qualities problems.

  7. Tobacco control advocates must demand high-quality media campaigns: the California experience

    PubMed Central

    Balbach, E.; Glantz, S.

    1998-01-01

    OBJECTIVE—To document efforts on the part of public officials in California to soften the media campaign's attack on the tobacco industry and to analyse strategies to counter those efforts on the part of tobacco control advocates.
METHODS—Data were gathered from interviews with programme participants, direct observation, written materials, and media stories. In addition, internal documents were released by the state's Department of Health Services in response to requests made under the California Public Records Act by Americans for Nonsmokers' Rights. Finally, a draft of the paper was circulated to 11 key players for their comments.
RESULTS—In 1988 California voters enacted Proposition 99, an initiative that raised the tobacco tax by $0.25 and allocated 20% of the revenues to anti-tobacco education. A media campaign, which was part of the education programme, directly attacked the tobacco industry, exposing the media campaign to politically based efforts to shut it down or soften it. Through use of outsider strategies such as advertising, press conferences, and public meetings, programme advocates were able to counter the efforts to soften the campaign.
CONCLUSION—Anti-tobacco media campaigns that expose industry manipulation are a key component of an effective tobacco control programme. The effectiveness of these campaigns, however, makes them a target for elimination by the tobacco industry. The experience from California demonstrates the need for continuing, aggressive intervention by non-governmental organisations in order to maintain the quality of anti-tobacco media campaigns.


Keywords: media campaigns; anti-tobacco advocacy; California PMID:10093175

  8. Shuttle Mission STS-50: Orbital Processing of High-Quality CdTe Compound Semiconductors Experiment: Final Flight Sample Characterization Report

    NASA Technical Reports Server (NTRS)

    Larson, David J.; Casagrande, Luis G.; DiMarzio, Don; Alexander, J. Iwan D.; Carlson, Fred; Lee, Taipo; Dudley, Michael; Raghathamachar, Balaji

    1998-01-01

    The Orbital Processing of High-Quality Doped and Alloyed CdTe Compound Semiconductors program was initiated to investigate, quantitatively, the influences of gravitationally dependent phenomena on the growth and quality of bulk compound semiconductors. The objective was to improve crystal quality (both structural and compositional) and to better understand and control the variables within the crystal growth production process. The empirical effort entailed the development of a terrestrial (one-g) experiment baseline for quantitative comparison with microgravity (mu-g) results. This effort was supported by the development of high-fidelity process models of heat transfer, fluid flow and solute redistribution, and thermo-mechanical stress occurring in the furnace, safety cartridge, ampoule, and crystal throughout the melting, seeding, crystal growth, and post-solidification processing. In addition, the sensitivity of the orbital experiments was analyzed with respect to the residual microgravity (mu-g) environment, both steady state and g-jitter. CdZnTe crystals were grown in one-g and in mu-g. Crystals processed terrestrially were grown at the NASA Ground Control Experiments Laboratory (GCEL) and at Grumman Aerospace Corporation (now Northrop Grumman Corporation). Two mu-g crystals were grown in the Crystal Growth Furnace (CGF) during the First United States Microgravity Laboratory Mission (USML-1), STS-50, June 24 - July 9, 1992.

  9. Producing a Climate-Quality Database of Global Upper Ocean Profile Temperatures - The IQuOD (International Quality-controlled Ocean Database) Project.

    NASA Astrophysics Data System (ADS)

    Sprintall, J.; Cowley, R.; Palmer, M. D.; Domingues, C. M.; Suzuki, T.; Ishii, M.; Boyer, T.; Goni, G. J.; Gouretski, V. V.; Macdonald, A. M.; Thresher, A.; Good, S. A.; Diggs, S. C.

    2016-02-01

    Historical ocean temperature profile observations provide a critical element for a host of ocean and climate research activities. These include providing initial conditions for seasonal-to-decadal prediction systems, evaluating past variations in sea level and Earth's energy imbalance, ocean state estimation for studying variability and change, and climate model evaluation and development. The International Quality controlled Ocean Database (IQuOD) initiative represents a community effort to create the most globally complete temperature profile dataset, with (intelligent) metadata and assigned uncertainties. With an internationally coordinated effort organized by oceanographers, with data and ocean instrumentation expertise, and in close consultation with end users (e.g., climate modelers), the IQuOD initiative will assess and maximize the potential of an irreplaceable collection of ocean temperature observations (tens of millions of profiles collected at a cost of tens of billions of dollars, since 1772) to fulfil the demand for a climate-quality global database that can be used with greater confidence in a vast range of climate change related research and services of societal benefit. Progress towards version 1 of the IQuOD database, ongoing and future work will be presented. More information on IQuOD is available at www.iquod.org.

  10. Organizational readiness in specialty mental health care.

    PubMed

    Hamilton, Alison B; Cohen, Amy N; Young, Alexander S

    2010-01-01

    Implementing quality improvement efforts in clinics is challenging. Assessment of organizational "readiness" for change can set the stage for implementation by providing information regarding existing strengths and deficiencies, thereby increasing the chance of a successful improvement effort. This paper discusses organizational assessment in specialty mental health, in preparation for improving care for individuals with schizophrenia. To assess organizational readiness for change in specialty mental health in order to facilitate locally tailored implementation strategies. EQUIP-2 is a site-level controlled trial at nine VA medical centers (four intervention, five control). Providers at all sites completed an organizational readiness for change (ORC) measure, and key stakeholders at the intervention sites completed a semi-structured interview at baseline. At the four intervention sites, 16 administrators and 43 clinical staff completed the ORC, and 38 key stakeholders were interviewed. The readiness domains of training needs, communication, and change were the domains with lower mean scores (i.e., potential deficiencies) ranging from a low of 23.8 to a high of 36.2 on a scale of 10-50, while staff attributes of growth and adaptability had higher mean scores (i.e., potential strengths) ranging from a low of 35.4 to a high of 41.1. Semi-structured interviews revealed that staff perceptions and experiences of change and decision-making are affected by larger structural factors such as change mandates from VA headquarters. Motivation for change, organizational climate, staff perceptions and beliefs, and prior experience with change efforts contribute to readiness for change in specialty mental health. Sites with less readiness for change may require more flexibility in the implementation of a quality improvement intervention. We suggest that uptake of evidence-based practices can be enhanced by tailoring implementation efforts to the strengths and deficiencies of the organizations that are implementing quality improvement changes.

  11. Wing Shaping and Gust Load Controls of Flexible Aircraft: An LPV Approach

    NASA Technical Reports Server (NTRS)

    Hammerton, Jared R.; Su, Weihua; Zhu, Guoming; Swei, Sean Shan-Min

    2018-01-01

    In the proposed paper, the optimum wing shape of a highly flexible aircraft under varying flight conditions will be controlled by a linear parameter-varying approach. The optimum shape determined under multiple objectives, including flight performance, ride quality, and control effort, will be determined as well. This work is an extension of work done previously by the authors, and updates the existing optimization and utilizes the results to generate a robust flight controller.

  12. Air Pollution Surveillance Systems

    ERIC Educational Resources Information Center

    Morgan, George B.; And Others

    1970-01-01

    Describes atmospheric data monitoring as part of total airpollution control effort. Summarizes types of gaseous, liquid and solid pollutants and their sources; contrast between urban and rural environmental air quality; instrumentation to identify pollutants; and anticipated new non-wet chemical physical and physiochemical techniques tor cetection…

  13. The Mao Ethic and Environmental Quality

    ERIC Educational Resources Information Center

    Orleans, Leo A.; Suttmeier, Richard P.

    1970-01-01

    Reviews reports on efforts to improve the Communist Chinese natural environment. National campaigns for water and air pollution control, sanitation improvement, and industrial development are related to Mao Tse-tung's philosophy of frugality and comprehensive resource use. Concern is expressed regarding possible ecological consequences from…

  14. Evaluating Green/Gray Infrastructure for CSO/Stormwater Control

    EPA Science Inventory

    The NRMRL is conducting this project to evaluate the water quality and quantity benefits of a large-scale application of green infrastructure (low-impact development/best management practices) retrofits in an entire subcatchment. It will document ORD's effort to demonstrate the e...

  15. Lessions learned in WISE image quality

    NASA Astrophysics Data System (ADS)

    Kendall, Martha; Duval, Valerie G.; Larsen, Mark F.; Heinrichsen, Ingolf H.; Esplin, Roy W.; Shannon, Mark; Wright, Edward L.

    2010-08-01

    The Wide-Field Infrared Survey Explorer (WISE) mission launched in December of 2009 is a true success story. The mission is performing beyond expectations on-orbit and maintained cost and schedule throughout. How does such a thing happen? A team constantly focused on mission success is a key factor. Mission success is more than a program meeting its ultimate science goals; it is also meeting schedule and cost goals to avoid cancellation. The WISE program can attribute some of its success in achieving the image quality needed to meet science goals to lessons learned along the way. A requirement was missed in early decomposition, the absence of which would have adversely affected end-to-end system image quality. Fortunately, the ability of the cross-organizational team to focus on fixing the problem without pointing fingers or waiting for paperwork was crucial in achieving a timely solution. Asking layman questions early in the program could have revealed requirement flowdown misunderstandings between spacecraft control stability and image processing needs. Such is the lesson learned with the WISE spacecraft Attitude Determination & Control Subsystem (ADCS) jitter control and the image data reductions needs. Spacecraft motion can affect image quality in numerous ways. Something as seemingly benign as different terminology being used by teammates in separate groups working on data reduction, spacecraft ADCS, the instrument, mission operations, and the science proved to be a risk to system image quality. While the spacecraft was meeting the allocated jitter requirement , the drift rate variation need was not being met. This missing need was noticed about a year before launch and with a dedicated team effort, an adjustment was made to the spacecraft ADCS control. WISE is meeting all image quality requirements on-orbit thanks to a diligent team noticing something was missing before it was too late and applying their best effort to find a solution.

  16. Establishing a Quality Control System for Stem Cell-Based Medicinal Products in China

    PubMed Central

    2015-01-01

    Stem cell-based medicinal products (SCMPs) are emerging as novel therapeutic products. The success of its development depends on the existence of an effective quality control system, which is constituted by quality control technologies, standards, reference materials, guidelines, and the associated management system in accordance with regulatory requirements along product lifespan. However, a worldwide, effective quality control system specific for SCMPs is still far from established partially due to the limited understanding of stem cell sciences and lack of quality control technologies for accurately assessing the safety and biological effectiveness of SCMPs before clinical use. Even though, based on the existing regulations and current stem cell sciences and technologies, initial actions toward the goal of establishing such a system have been taken as exemplified by recent development of new “interim guidelines” for governing quality control along development of SCMPs and new development of the associated quality control technologies in China. In this review, we first briefly introduced the major institutions involved in the regulation of cell substrates and therapeutic cell products in China and the existing regulatory documents and technical guidelines used as critical references for developing the new interim guidelines. With focus only on nonhematopoietic stem cells, we then discussed the principal quality attributes of SCMPs as well as our thinking of proper testing approaches to be established with relevant evaluation technologies to ensure all quality requirements of SCMPs along different manufacturing processes and development stages. At the end, some regulatory and technical challenges were also discussed with the conclusion that combined efforts should be taken to promote stem cell regulatory sciences to establish the effective quality control system for SCMPs. PMID:25471126

  17. Quality Indicators in Radiation Oncology

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

    Albert, Jeffrey M.; Das, Prajnan, E-mail: prajdas@mdanderson.org

    Oncologic specialty societies and multidisciplinary collaborative groups have dedicated considerable effort to developing evidence-based quality indicators (QIs) to facilitate quality improvement, accreditation, benchmarking, reimbursement, maintenance of certification, and regulatory reporting. In particular, the field of radiation oncology has a long history of organized quality assessment efforts and continues to work toward developing consensus quality standards in the face of continually evolving technologies and standards of care. This report provides a comprehensive review of the current state of quality assessment in radiation oncology. Specifically, this report highlights implications of the healthcare quality movement for radiation oncology and reviews existing efforts tomore » define and measure quality in the field, with focus on dimensions of quality specific to radiation oncology within the “big picture” of oncologic quality assessment efforts.« less

  18. Song environment affects singing effort and vasotocin immunoreactivity in the forebrain of male Lincoln’s sparrows

    PubMed Central

    Sewall, Kendra B.; Dankoski, Elyse C.; Sockman, Keith W.

    2010-01-01

    Male songbirds often establish territories and attract mates by singing, and some song features can reflect the singer’s condition or quality. The quality of the song environment can change, so male songbirds should benefit from assessing the competitiveness of the song environment and appropriately adjusting their own singing behavior and the neural substrates by which song is controlled. In a wide range of taxa social modulation of behavior is partly mediated by the arginine vasopressin or vasotocin (AVP/AVT) systems. To examine the modulation of singing behavior in response to the quality of the song environment we compared the song output of laboratory-housed male Lincoln’s sparrows (Melospiza lincolnii) exposed to one week of chronic playback of songs categorized as either high or low quality, based on song length, complexity and trill performance. To explore the neural basis of any facultative shifts in behavior, we also quantified the subjects’ AVT immunoreactivity (AVT-IR) in three forebrain regions that regulate socio-sexual behavior: the medial bed nucleus of the stria terminalis (BSTm), the lateral septum (LS) and the preoptic area. We found that high quality songs increased singing effort and reduced AVT-IR in the BSTm and LS, relative to low quality songs. The effect of the quality of the song environment on both singing effort and forebrain AVT-IR raises the hypothesis that AVT within these brain regions plays a role in the modulation of behavior in response to competition that individual males may assess from the prevailing song environment. PMID:20399213

  19. Quality assurance in the surgical intensive care unit. Where it came from and where it's going.

    PubMed

    Osler, T; Horne, L

    1991-08-01

    The early history of QA is one of stunning achievements. Men and women led by a vision of what hospital health care should be brought about fundamental changes in the structure of hospitals and medical schools. These successes required lifetimes of work and enormous capital (Flexner's war chest would have amounted to billions of 1990 dollars). A second wave of reform included the creation of credentialing committees, tissue committees, and infection control efforts. Although less dramatic in their impact, these efforts have had measurable influence on the outcome of health care and, under the joint administration of local hospitals and the JCAHO, continue to guarantee excellence in health care. The most recent attempts at quality assurance, driven at least in part by a federal mandate to control costs, have been much more modest in their success. Committed groups working within a sound theoretical framework have had great difficulty monitoring and evaluating centrally a process as decentralized as health care. The regularity with which new fashions in QA have appeared underscores the frustration felt with this approach. If the quality of health care is to be monitored centrally, reliable measures of quality will be required. No one knows if such measures actually exist. The absence of objective evidence that quality has been improved by these efforts suggests that little has been accomplished, perhaps because all easily attainable improvements had already been implemented. The basic concept of a centrally monitored hospital structure within which provision is made for ongoing observation and innovation by those actually involved in the care of patients retains the advantages of central monitoring and local invention. It is a model that will be hard to improve on. We should persist in our efforts, but fundamental advances are unlikely. In the end, quality is only doing everything the best it can be done. The best quality assurance requires an excellent hospital in which a well-trained and committed staff has a central mandate and local purview to do the best possible job. Two thousand years after Hammurabi's minions busied themselves determining the appropriate punishment for various medical misadventures, the Greek Hippocrates advocated a less complex approach to the same problem. He suggested that the quality of health care could be best guaranteed by administering an oath to physicians, exhorting them simply to do what was best for their fellow men. This approach has seen us through two millennia and, however variable its results, may not be easily improved on.

  20. Health-related quality of life and working conditions among nursing providers.

    PubMed

    Silva, Amanda Aparecida; Souza, José Maria Pacheco de; Borges, Flávio Notarnicola da Silva; Fischer, Frida Marina

    2010-08-01

    To evaluate working conditions associated with health-related quality of life (HRQL) among nursing providers. Cross-sectional study conducted in a university hospital in the city of São Paulo, Southeastern Brazil, during 2004-2005. The study sample comprised 696 registered nurses, nurse technicians and nurse assistants, predominantly females (87.8%), who worked day and/or night shifts. Data on sociodemographic information, working and living conditions, lifestyles, and health symptoms were collected using self-administered questionnaires. The following questionnaires were also used: Job Stress Scale, Effort-Reward Imbalance (ERI) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Ordinal logistic regression analysis using proportional odds model was performed to evaluate each dimension of the SF-36. Around 22% of the sample was found to be have high strain and 8% showed an effort-reward imbalance at work. The dimensions with the lowest mean scores in the SF-36 were vitality, bodily pain and mental health. High-strain job, effort-reward imbalance (ERI>1.01), and being a registered nurse were independently associated with low scores on the role emotional dimension. Those dimensions associated to mental health were the ones most affected by psychosocial factors at work. Effort-reward imbalance was more associated with health than high-strain (high demand and low control). The study results suggest that the joint analysis of psychosocial factors at work such as effort-reward imbalance and demand-control can provide more insight to the discussion of professional roles, working conditions and HRQL of nursing providers.

  1. Guidelines for preparation of the 1996 state water quality assessments (305(b) reports)

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

    NONE

    1995-05-01

    The Federal Water Polluton Control Act (PL92-500, commonly known as the Clean Water Act), establishes a process for States to use to develop information on the quality of the Nation`s water resources and to report this information to the U.S. Environmental Protection Agency (EPA), the U.S. Congress, and the citizens of this country. Each State must develop a program to monitor the quality of its surface and ground waters and prepare a report every 2 years describing the status of its water quality. EPA compiles the data from the State reports, summarizes them, and transmits the summaries to Congress alongmore » with an analysis of the status of water quality nationwide. This process, referred to as the 305(b) process, is an essential aspect of the Nation`s water pollution control effort.« less

  2. Can We Control Contaminant Transport In Hydrologic Networks? Application Of Control Theory Concepts To Watershed Management

    NASA Astrophysics Data System (ADS)

    Yeghiazarian, L.; Riasi, M. S.

    2016-12-01

    Although controlling the level of contamination everywhere in the surface water network may not be feasible, it is vital to maintain safe water quality levels in specific areas, e.g. recreational waters. The question then is "what is the most efficient way to fully/partially control water quality in surface water networks?". This can be posed as a control problem where the goal is to efficiently drive the system to a desired state by manipulating few input variables. Such problems reduce to (1) finding the best control locations in the network to influence the state of the system; and (2) choosing the time-variant inputs at the control locations to achieve the desired state of the system with minimum effort. We demonstrate that the optimal solution to control the level of contamination in the network can be found through application of control theory concepts to transport in dendritic surface water networks.

  3. [Effect of occupational stress and effort-reward imbalance on sleep quality of people's policeman].

    PubMed

    Wu, Hui; Gu, Guizhen; Yu, Shanfa

    2014-04-01

    To explore the effect of occupational stress and effort-reward imbalance on sleep quality of people's police. A cluster sampling survey of sleep quality and occupational stress correlated factors was conducted on 287 police from a city public security bureau by questionnaires in May, 2011; the relationship between sleep quality and occupational stress correlated factors was analyzed by one-way ANOVA and multivariate non-conditional logistic regression using effort-reward imbalance model (ERI) and demand-control-support model (DCS). And the subjects were divided into high tension group and low tension group using the 1.0 of ERI and DCS coefficients as the boundary. The sleep quality score of shift work police was higher than day work police (11.95 ± 6.54 vs 9.52 ± 6.43, t = 2.77, P < 0.05).In ERI model, the sleep quality score in high tension group was higher than low tension group (14.50 ± 6.41 vs 8.60 ± 5.53, t = -5.32, P < 0.01), and in DCS model, the sleep quality score in high tension group was also higher than low tension group (13.71 ± 6.62 vs 9.46 ± 6.04, t = -3.71, P < 0.01).For the regression analysis of ERI model as an argument, sex (OR = 3.0, 95%CI:1.16-7.73) , age for 30-39 years (OR = 3.48, 95%CI:1.32-9.16) , intrinsic effort (OR = 2.30, 95%CI:1.10-4.81) and daily hassles (OR = 2.15, 95%CI:1.06-4.33) were risk factors of low sleep quality, and reward (OR = 0.26, 95%CI:0.12-0.52) was the protective factor.For the regression analysis of DCS model as an argument , age for 30-39 years (OR = 2.55, 95%CI:1.02-6.37) , depressive symptom (OR = 2.10, 95%CI:1.14-3.89) and daily hassles (OR = 3.25, 95%CI:1.70-6.19) were risk factors of low sleep quality.While the ERI model and the DCS model were analyzed simultaneously, sex (OR = 3.03, 95%CI:1.15-7.98) , age for 30-39 years (OR = 3.71, 95%CI:1.38-9.98) and daily hassles (OR = 2.09, 95%CI:1.01-4.30) were the risk factors of low sleep quality, and reward (OR = 0.22, 95%CI:0.10-0.48) was the protective factor. Occupational stress and effort-reward imbalance affected the sleep quality to people's policeman.

  4. Impact of variation in materials properties on asphalt pavement life : evaluation of a questionnaire.

    DOT National Transportation Integrated Search

    1981-05-01

    In an effort to collect information on the status of quality control procedures and the use of pay adjustment factors, a questionnaire was distributed to all state agencies, the District of Columbia, and the Federal Highway Administration. Each agenc...

  5. Combating poor-quality anti-malarial medicines: a call to action.

    PubMed

    Bassat, Quique; Tanner, Marcel; Guerin, Philippe J; Stricker, Kirstin; Hamed, Kamal

    2016-06-01

    The circulation of poor-quality medicines continues to undermine the fight against many life-threatening diseases. Anti-malarial medicines appear to have been particularly compromised and present a major public health threat in malaria-endemic countries, negatively affecting individuals and their communities. Concerted collaborative efforts are required from global, regional and national organizations, involving the public and private sectors, to address the problem. While many initiatives are underway, a number of unmet needs deserve urgent and increased multisector attention. At the global level, there is a need for an international public health legal framework or treaty on poor-quality medicines, with statutes suitable for integration into national laws. In addition, increased international efforts are required to strengthen the governance of global supply chains and enhance cooperation between national medicine regulation authorities and law enforcement bodies. Increased investment is needed in innovative technologies that will enable healthcare teams to detect poor-quality medicines at all levels of the supply chain. At the regional level, a number of initiatives would be beneficial-key areas are standardization, simplification, and reciprocal recognition of registration processes and development of quality control capacity in regional centres of excellence that are better aligned with public health needs; improved surveillance methods and creation of a framework for compulsory and transparent reporting of poor-quality medicines; additional support for national medicine regulation authorities and other national partner authorities; and an increase in support for regional laboratories to boost their capabilities in detecting poor-quality medicines. It is vital that all stakeholders involved in efforts against poor-quality anti-malarial medicines extend and strengthen their actions in these critical areas and thus effectively support global health development and malaria elimination programmes.

  6. Urban Stormwater Characterization, Control, and Treatment.

    PubMed

    Moore, Trisha L; Rodak, Carolyn M; Vogel, Jason R

    2017-10-01

    A summary of 246 studies published in 2016 on topics related to the characterization and management of urban stormwater runoff is presented in the following review. The review is structured along three major topical areas: (1) general characterization of stormwater quantity and quality; (2) engineered systems for stormwater control and treatment, including erosion and sediment control practices, constructed stormwater ponds and wetlands, bioretention, permeable pavement, greenroofs, and rainwater harvesting and (3) watershedscale application of stormwater treatment and control practices. Common research themes and needs highlighted throughout this review include efforts to better understand stormwater transport and treatment mechanisms and their representation in models, advancements to optimize the design of stormwater control measures to meet specific hydrologic and/or water quality targets, and increasing understanding of the biophysical and social factors that influence watershed-scale implementation of low impact development and other stormwater control measures.

  7. Neural and Molecular Mechanisms Involved in Controlling the Quality of Feeding Behavior: Diet Selection and Feeding Patterns

    PubMed Central

    2017-01-01

    We are what we eat. There are three aspects of feeding: what, when, and how much. These aspects represent the quantity (how much) and quality (what and when) of feeding. The quantitative aspect of feeding has been studied extensively, because weight is primarily determined by the balance between caloric intake and expenditure. In contrast, less is known about the mechanisms that regulate the qualitative aspects of feeding, although they also significantly impact the control of weight and health. However, two aspects of feeding quality relevant to weight loss and weight regain are discussed in this review: macronutrient-based diet selection (what) and feeding pattern (when). This review covers the importance of these two factors in controlling weight and health, and the central mechanisms that regulate them. The relatively limited and fragmented knowledge on these topics indicates that we lack an integrated understanding of the qualitative aspects of feeding behavior. To promote better understanding of weight control, research efforts must focus more on the mechanisms that control the quality and quantity of feeding behavior. This understanding will contribute to improving dietary interventions for achieving weight control and for preventing weight regain following weight loss. PMID:29053636

  8. Greening the Engineering and Technology Curriculum via Real Life Hands-on Projects

    USDA-ARS?s Scientific Manuscript database

    This paper aims at demonstrating how greening efforts can be embedded into science and engineering courses without major curricular changes. In this regard, examples of final projects assigned in a statistical quality control, a 500-level, graduate engineering course, focusing on campus sustainabili...

  9. EML pulse ionization chamber systems for /sup 222/Rn measurements

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

    Fisenne, I M; Keller, H W

    1985-03-01

    Radon measurements have been performed with pulse ionization chambers at the Environmental Measurements Laboratory (EML) for over 35 years. This report describes the evolution of radon measurement systems, with emphasis on the continuous quality control efforts at EML. 38 refs., 3 figs., 3 tabs.

  10. Quality Control for Ambient Sampling of PCDD/PCDF from Open Combustion Sources

    EPA Science Inventory

    Both long duration (> 6 h) and high temperature (up to 139o C) sampling efforts were conducted using ambient air sampling methods to determine if either high volume throughput or higher than ambient sampling temperatures resulted in loss of target polychlorinated dibenzodioxins/d...

  11. Evaluation of Post-Trial Reviews of Courts-Martial within the Department of the Navy

    DTIC Science & Technology

    2010-12-10

    subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE...Moreno case in an effort to take control of a situation the Navy and Marine Corps would not address. Over the years, the appellate courts repeatedly...inexperienced, first-tour lieutenants. Consequently, having senior, experienced counsel in supervisory positions is essential to controlling quality

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

    NASA Astrophysics Data System (ADS)

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

    2016-12-01

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

  13. Breaking Barriers to Low-Cost Modular Inverter Production & Use

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

    Bogdan Borowy; Leo Casey; Jerry Foshage

    2005-05-31

    The goal of this cost share contract is to advance key technologies to reduce size, weight and cost while enhancing performance and reliability of Modular Inverter Product for Distributed Energy Resources (DER). Efforts address technology development to meet technical needs of DER market protection, isolation, reliability, and quality. Program activities build on SatCon Technology Corporation inverter experience (e.g., AIPM, Starsine, PowerGate) for Photovoltaic, Fuel Cell, Energy Storage applications. Efforts focused four technical areas, Capacitors, Cooling, Voltage Sensing and Control of Parallel Inverters. Capacitor efforts developed a hybrid capacitor approach for conditioning SatCon's AIPM unit supply voltages by incorporating several typesmore » and sizes to store energy and filter at high, medium and low frequencies while minimizing parasitics (ESR and ESL). Cooling efforts converted the liquid cooled AIPM module to an air-cooled unit using augmented fin, impingement flow cooling. Voltage sensing efforts successfully modified the existing AIPM sensor board to allow several, application dependent configurations and enabling voltage sensor galvanic isolation. Parallel inverter control efforts realized a reliable technique to control individual inverters, connected in a parallel configuration, without a communication link. Individual inverter currents, AC and DC, were balanced in the paralleled modules by introducing a delay to the individual PWM gate pulses. The load current sharing is robust and independent of load types (i.e., linear and nonlinear, resistive and/or inductive). It is a simple yet powerful method for paralleling both individual devices dramatically improves reliability and fault tolerance of parallel inverter power systems. A patent application has been made based on this control technology.« less

  14. Effects of Hearing Impairment and Hearing Aid Amplification on Listening Effort: A Systematic Review.

    PubMed

    Ohlenforst, Barbara; Zekveld, Adriana A; Jansma, Elise P; Wang, Yang; Naylor, Graham; Lorens, Artur; Lunner, Thomas; Kramer, Sophia E

    To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension? English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects. The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort. In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings.

  15. Effects of Hearing Impairment and Hearing Aid Amplification on Listening Effort: A Systematic Review

    PubMed Central

    Ohlenforst, Barbara; Jansma, Elise P.; Wang, Yang; Naylor, Graham; Lorens, Artur; Lunner, Thomas; Kramer, Sophia E.

    2017-01-01

    Objectives: To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension? Design: English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects. Results: The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort. Conclusion: In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings. PMID:28234670

  16. Off-Line Quality Control In Integrated Circuit Fabrication Using Experimental Design

    NASA Astrophysics Data System (ADS)

    Phadke, M. S.; Kackar, R. N.; Speeney, D. V.; Grieco, M. J.

    1987-04-01

    Off-line quality control is a systematic method of optimizing production processes and product designs. It is widely used in Japan to produce high quality products at low cost. The method was introduced to us by Professor Genichi Taguchi who is a Deming-award winner and a former Director of the Japanese Academy of Quality. In this paper we will i) describe the off-line quality control method, and ii) document our efforts to optimize the process for forming contact windows in 3.5 Aim CMOS circuits fabricated in the Murray Hill Integrated Circuit Design Capability Laboratory. In the fabrication of integrated circuits it is critically important to produce contact windows of size very near the target dimension. Windows which are too small or too large lead to loss of yield. The off-line quality control method has improved both the process quality and productivity. The variance of the window size has been reduced by a factor of four. Also, processing time for window photolithography has been substantially reduced. The key steps of off-line quality control are: i) Identify important manipulatable process factors and their potential working levels. ii) Perform fractional factorial experiments on the process using orthogonal array designs. iii) Analyze the resulting data to determine the optimum operating levels of the factors. Both the process mean and the process variance are considered in this analysis. iv) Conduct an additional experiment to verify that the new factor levels indeed give an improvement.

  17. Possible environmental effects of increased coal use in California

    NASA Technical Reports Server (NTRS)

    Carey, D. L.

    1978-01-01

    If coal is to be utilized in California it must be made compatible with the state's drive toward restoring environmental quality. The impacts resulting from coal's mining and transportation, or from water consumption, water quality degradation and electric transmission line routing can probably be adequately mitigated through strong and early planning efforts, the use of improved control and process technologies, and sincere utility commitment. The socioeconomic impacts may prove somewhat more difficult to satisfactorily mitigate. Of greatest concern is adequate control of generated air pollutants and disposal of solid and liquid wastes since acceptable technologies or handling techniques have yet to be conclusively demonstrated.

  18. Using Clustering Strategies for Creating Authority Files.

    ERIC Educational Resources Information Center

    French, James C.; Powell, Allison L.; Schulman, Eric

    2000-01-01

    Discussion of quality control of data in online bibliographic databases focuses on authority files. Describes approximate string matching, introduces the concept of approximate word matching and clustering, and presents a case study using the Astrophysics Data System (ADS) that shows how to reduce human effort involved in authority work. (LRW)

  19. NAEYC Accreditation: The First Decade of NAEYC Accreditation: Growth and Impact on the Field.

    ERIC Educational Resources Information Center

    Bredekamp, Sue; Glowacki, Stephanie

    1996-01-01

    Describes development of NAEYC accreditation and offers a description of the process. Highlights the effects of accreditation and discusses its future. Notes that accreditation provides opportunities and motivation for valuable professional development, and that quality control is the greatest challenge faced by accreditation efforts. Notes…

  20. Environment and the Law. Legal Almanac Series.

    ERIC Educational Resources Information Center

    Sloan, Irving J.

    This survey is designed to provide the general reader with some basic background on the legal aspects of the effort to achieve environmental quality. The first chapter discusses the structure of federal environmental control in terms of newly established agencies and recently enacted legislation. Other chapters deal individually with air, water,…

  1. Integrating watershed- and farm-scale modeling framework for targeting critical source areas while maintaining farm economic viability

    USDA-ARS?s Scientific Manuscript database

    Quantitative risk assessments of pollution and data related to the effectiveness of mitigating best management practices (BMPs) are important aspects of nonpoint source (NPS) pollution control efforts, particularly those driven by specific water quality objectives and by measurable improvement goals...

  2. THE PASSIVE OZONE NETWORK IN DALLAS (POND CONCEPT) - A MODELING OPPORTUNITY WITH COMMUNITY INVOLVEMENT

    EPA Science Inventory

    Despite tremendous efforts towards regulating and controlling tropospheric ozone (O3) formation, over 70 million people currently live in U.S. counties which exceed the National Ambient Air Quality Standard (NAAQS) set for 03. These high 03 concentrations alone cost the U.S. ap...

  3. Bibliographic Control of Large Quantities of Research Material.

    ERIC Educational Resources Information Center

    Evans, Martha M.

    1983-01-01

    Guidelines for individual researcher describe bibliographic methods for achieving high standards of quality while maintaining maximum efficiency in each step of all necessary procedures involved in the construction of a bibliography ranging from several hundred to several thousand items. Ways to minimize waste motion and duplication of effort are…

  4. Identifying the Machine Translation Error Types with the Greatest Impact on Post-editing Effort

    PubMed Central

    Daems, Joke; Vandepitte, Sonia; Hartsuiker, Robert J.; Macken, Lieve

    2017-01-01

    Translation Environment Tools make translators’ work easier by providing them with term lists, translation memories and machine translation output. Ideally, such tools automatically predict whether it is more effortful to post-edit than to translate from scratch, and determine whether or not to provide translators with machine translation output. Current machine translation quality estimation systems heavily rely on automatic metrics, even though they do not accurately capture actual post-editing effort. In addition, these systems do not take translator experience into account, even though novices’ translation processes are different from those of professional translators. In this paper, we report on the impact of machine translation errors on various types of post-editing effort indicators, for professional translators as well as student translators. We compare the impact of MT quality on a product effort indicator (HTER) with that on various process effort indicators. The translation and post-editing process of student translators and professional translators was logged with a combination of keystroke logging and eye-tracking, and the MT output was analyzed with a fine-grained translation quality assessment approach. We find that most post-editing effort indicators (product as well as process) are influenced by machine translation quality, but that different error types affect different post-editing effort indicators, confirming that a more fine-grained MT quality analysis is needed to correctly estimate actual post-editing effort. Coherence, meaning shifts, and structural issues are shown to be good indicators of post-editing effort. The additional impact of experience on these interactions between MT quality and post-editing effort is smaller than expected. PMID:28824482

  5. Identifying the Machine Translation Error Types with the Greatest Impact on Post-editing Effort.

    PubMed

    Daems, Joke; Vandepitte, Sonia; Hartsuiker, Robert J; Macken, Lieve

    2017-01-01

    Translation Environment Tools make translators' work easier by providing them with term lists, translation memories and machine translation output. Ideally, such tools automatically predict whether it is more effortful to post-edit than to translate from scratch, and determine whether or not to provide translators with machine translation output. Current machine translation quality estimation systems heavily rely on automatic metrics, even though they do not accurately capture actual post-editing effort. In addition, these systems do not take translator experience into account, even though novices' translation processes are different from those of professional translators. In this paper, we report on the impact of machine translation errors on various types of post-editing effort indicators, for professional translators as well as student translators. We compare the impact of MT quality on a product effort indicator (HTER) with that on various process effort indicators. The translation and post-editing process of student translators and professional translators was logged with a combination of keystroke logging and eye-tracking, and the MT output was analyzed with a fine-grained translation quality assessment approach. We find that most post-editing effort indicators (product as well as process) are influenced by machine translation quality, but that different error types affect different post-editing effort indicators, confirming that a more fine-grained MT quality analysis is needed to correctly estimate actual post-editing effort. Coherence, meaning shifts, and structural issues are shown to be good indicators of post-editing effort. The additional impact of experience on these interactions between MT quality and post-editing effort is smaller than expected.

  6. Save medical personnel's time by improved user interfaces.

    PubMed

    Kindler, H

    1997-01-01

    Common objectives in the industrial countries are the improvement of quality of care, clinical effectiveness, and cost control. Cost control, in particular, has been addressed through the introduction of case mix systems for reimbursement by social-security institutions. More data is required to enable quality improvement, increases in clinical effectiveness and for juridical reasons. At first glance, this documentation effort is contradictory to cost reduction. However, integrated services for resource management based on better documentation should help to reduce costs. The clerical effort for documentation should be decreased by providing a co-operative working environment for healthcare professionals applying sophisticated human-computer interface technology. Additional services, e.g., automatic report generation, increase the efficiency of healthcare personnel. Modelling the medical work flow forms an essential prerequisite for integrated resource management services and for co-operative user interfaces. A user interface aware of the work flow provides intelligent assistance by offering the appropriate tools at the right moment. Nowadays there is a trend to client/server systems with relational databases or object-oriented databases as repository. The work flows used for controlling purposes and to steer the user interfaces must be represented in the repository.

  7. Wireless in-situ Sensor Network for Agriculture and Water Monitoring on a River Basin Scale in Southern Finland: Evaluation from a Data User’s Perspective

    PubMed Central

    Kotamäki, Niina; Thessler, Sirpa; Koskiaho, Jari; Hannukkala, Asko O.; Huitu, Hanna; Huttula, Timo; Havento, Jukka; Järvenpää, Markku

    2009-01-01

    Sensor networks are increasingly being implemented for environmental monitoring and agriculture to provide spatially accurate and continuous environmental information and (near) real-time applications. These networks provide a large amount of data which poses challenges for ensuring data quality and extracting relevant information. In the present paper we describe a river basin scale wireless sensor network for agriculture and water monitoring. The network, called SoilWeather, is unique and the first of this type in Finland. The performance of the network is assessed from the user and maintainer perspectives, concentrating on data quality, network maintenance and applications. The results showed that the SoilWeather network has been functioning in a relatively reliable way, but also that the maintenance and data quality assurance by automatic algorithms and calibration samples requires a lot of effort, especially in continuous water monitoring over large areas. We see great benefits on sensor networks enabling continuous, real-time monitoring, while data quality control and maintenance efforts highlight the need for tight collaboration between sensor and sensor network owners to decrease costs and increase the quality of the sensor data in large scale applications. PMID:22574050

  8. Ambient air quality programmes for health impact assessment in the WHO European region.

    PubMed

    Mücke, H G

    2000-06-01

    An important aim of air quality assessment is to provide information about population exposure and health impact assessment. Numerous epidemiological studies have already shown that exposure to excessive levels of ambient air pollutants are associated with either acute or chronic health effects. Until recently, the adequacy of monitoring population exposure in relation to quantitative assessment of health effects of air pollution was rarely considered in ambient air monitoring strategies. This made the formulation of health-related recommendations to risk management difficult and weakens preventive and other measures to reduce adverse health effects of air pollution. To improve local and national capacities for health impact assessment, the European Centre for Environment and Health of the World Health Organization has prepared methodology guidelines concerning selected aspects of air monitoring. The WHO Collaborating Centre for Air Quality Management and Air Pollution Control support efforts in line with international programmes on quality assurance and control for Europe.

  9. [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.

  10. Adverse effects of psychosocial work factors on blood pressure: systematic review of studies on demand-control-support and effort-reward imbalance models.

    PubMed

    Gilbert-Ouimet, Mahée; Trudel, Xavier; Brisson, Chantal; Milot, Alain; Vézina, Michel

    2014-03-01

    A growing body of research has investigated the adverse effects of psychosocial work factors on blood pressure (BP) elevation. There is now a clear need for an up-to-date, critical synthesis of reliable findings on this topic. This systematic review aimed to evaluate the adverse effects of psychosocial work factors of both the demand-control-support (DCS) and effort-reward imbalance (ERI) models on BP among men and women, according to the methodological quality of the studies. To be eligible, studies had to: (i) evaluate at least one psychosocial work factor, (ii) evaluate BP or hypertension, (iii) comprise ≥100 workers, (iv) be written in English or French, and (v) be published in a peer-reviewed journal. A total of 74 studies were included. Of these, 64 examined the DCS model, and 12 looked at the ERI model, with 2 studies considering both models. Approximately half the studies observed a significant adverse effect of psychosocial work factors on BP. A more consistent effect was observed, however, among men than women. For job strain, a more consistent effect was also observed in studies of higher methodological quality, ie, studies using a prospective design and ambulatory BP measures. A more consistent adverse effect of psychosocial work factors was observed among men than women and in studies of higher methodological quality. These findings contribute to the current effort of primary prevention of cardiovascular disease by documenting the psychosocial etiology of elevated BP, a major cardiovascular risk factor.

  11. Climate Change and Implications for Prevention. California's Efforts to Provide Leadership.

    PubMed

    Balmes, John R

    2018-04-01

    The atmospheric concentration of carbon dioxide (CO 2 ) and the temperature of the earth's surface have been rising in parallel for decades, with the former recently reaching 400 parts per million, consistent with a 1.5°C increase in global warming. Climate change models predict that a "business as usual" approach, that is, no effort to control CO 2 emissions from combustion of fossil fuels, will result in a more than 2°C increase in annual average surface temperature by approximately 2034. With atmospheric warming comes increased air pollution. The concept of a "climate gap" in air quality control captures the decreased effectiveness of regulatory policies to reduce pollution with a hotter climate. Sources of greenhouse gases and climate-forcing aerosols ("black carbon") are the same sources of air pollutants that harm health. California has adopted robust climate change mitigation policies that are also designed to achieve public health cobenefits by improving air quality. These policies include advanced clean car standards, renewable energy, a sustainable communities strategy to limit suburban sprawl, a low carbon fuel standard, and energy efficiency. A market-based mechanism to put a price on CO 2 emissions is the cap-and-trade program that allows capped facilities to trade state-issued greenhouse gas emissions allowances. The "cap" limits total greenhouse gas emissions from all covered sources, and declines over time to progressively reduce emissions. An alternative approach is a carbon tax. California's leadership on air quality and climate change mitigation is increasingly important, given the efforts to slow or even reverse implementation of such policies at the U.S. national level.

  12. Model Checking Verification and Validation at JPL and the NASA Fairmont IV and V Facility

    NASA Technical Reports Server (NTRS)

    Schneider, Frank; Easterbrook, Steve; Callahan, Jack; Montgomery, Todd

    1999-01-01

    We show how a technology transfer effort was carried out. The successful use of model checking on a pilot JPL flight project demonstrates the usefulness and the efficacy of the approach. The pilot project was used to model a complex spacecraft controller. Software design and implementation validation were carried out successfully. To suggest future applications we also show how the implementation validation step can be automated. The effort was followed by the formal introduction of the modeling technique as a part of the JPL Quality Assurance process.

  13. Data Quality Control: Challenges, Methods, and Solutions from an Eco-Hydrologic Instrumentation Network

    NASA Astrophysics Data System (ADS)

    Eiriksson, D.; Jones, A. S.; Horsburgh, J. S.; Cox, C.; Dastrup, D.

    2017-12-01

    Over the past few decades, advances in electronic dataloggers and in situ sensor technology have revolutionized our ability to monitor air, soil, and water to address questions in the environmental sciences. The increased spatial and temporal resolution of in situ data is alluring. However, an often overlooked aspect of these advances are the challenges data managers and technicians face in performing quality control on millions of data points collected every year. While there is general agreement that high quantities of data offer little value unless the data are of high quality, it is commonly understood that despite efforts toward quality assurance, environmental data collection occasionally goes wrong. After identifying erroneous data, data managers and technicians must determine whether to flag, delete, leave unaltered, or retroactively correct suspect data. While individual instrumentation networks often develop their own QA/QC procedures, there is a scarcity of consensus and literature regarding specific solutions and methods for correcting data. This may be because back correction efforts are time consuming, so suspect data are often simply abandoned. Correction techniques are also rarely reported in the literature, likely because corrections are often performed by technicians rather than the researchers who write the scientific papers. Details of correction procedures are often glossed over as a minor component of data collection and processing. To help address this disconnect, we present case studies of quality control challenges, solutions, and lessons learned from a large scale, multi-watershed environmental observatory in Northern Utah that monitors Gradients Along Mountain to Urban Transitions (GAMUT). The GAMUT network consists of over 40 individual climate, water quality, and storm drain monitoring stations that have collected more than 200 million unique data points in four years of operation. In all of our examples, we emphasize that scientists should remain skeptical and seek independent verification of sensor data, even for sensors purchased from trusted manufacturers.

  14. Quality effort decision in service supply chain with quality preference based on quantum game

    NASA Astrophysics Data System (ADS)

    Zhang, Cuihua; Xing, Peng; Wang, Jianwei

    2015-04-01

    Service quality preference behaviors of both members are considered in service supply chain (SSC) including a service integrator and a service provider with stochastic demand. Through analysis of service quality cost and revenue, the utility functions are established on service quality effort degree and service quality preference level in integrated and decentralized SSC. Nash equilibrium and quantum game are used to optimize the models. By comparing the different solutions, the optimal strategies are obtained in SSC with quality preference. Then some numerical examples are studied and the changing trend of service quality effort is further analyzed by the influence of the entanglement operator and quality preferences.

  15. Recent Local and State Action in Arizona to Maintain Sky Quality

    NASA Astrophysics Data System (ADS)

    Hall, Jeffrey C.; Shankland, P. D.; Green, R. F.; Jannuzi, B.

    2014-01-01

    The large number of observatories in Arizona has led to the development of a number of lighting control ordinances around the state, some quite strict. Several factors are now contributing to an increased need for active effort at the local, County, and State levels in maintaining the quality of these codes; these factors include an expansion of competing interests in the state, the increasing use of LED lighting, and the potential for major new investments through projects such as the Cherenkov Telescope Array (CTA) and enhancements to the Navy Precision Optical Interferometer. I will review recent strategies Arizona's observatories have used to effect maintenance of ordinances and preserve sky quality; cases include (1) a statewide effort in 2012 to curb a proliferation of electronic billboards and (2) engagement of a broad group of local, County, and State officials, as well as individuals from the private sector, in support of projects like CTA, including awareness of and support for dark-sky preservation.

  16. Research and demonstration to improve air quality for the U.S. animal feeding operations in the 21st century - a critical review.

    PubMed

    Ni, Ji-Qin

    2015-05-01

    There was an increasing interest in reducing production and emission of air pollutants to improve air quality for animal feeding operations (AFOs) in the U.S. in the 21st century. Research was focused on identification, quantification, characterization, and modeling of air pollutions; effects of emissions; and methodologies and technologies for scientific research and pollution control. Mitigation effects were on pre-excretion, pre-release, pre-emission, and post-emission. More emphasis was given on reducing pollutant emissions than improving indoor air quality. Research and demonstrations were generally continuation and improvement of previous efforts. Most demonstrated technologies were still in a limited scale of application. Future efforts are needed in many fundamental and applied research areas. Advancement in instrumentation, computer technology, and biological sciences and genetic engineering is critical to bring major changes in this area. Development in research and demonstration will depend on the actual political, economic, and environmental situations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Tobacco control in the 21st century: a critical issue for the nursing profession.

    PubMed

    Sarna, Linda; Bialous, Stella

    2005-01-01

    Tobacco control is central to reducing death and disability and improving quality of life worldwide and nursing action is imperative. This article addresses tobacco as a global health issue with implications for nursing practice, education, research, and policy development. The lack of knowledge and skills, lack of expectation for clinical intervention, limited research, an absence of professional policies, and minimal nursing leadership have diminished the critical role that nurses can play in confronting this epidemic. Swift action is needed to ensure that all nurses are prepared to effectively engage in activities to prevent tobacco use, provide evidence-based cessation interventions, and support efforts to prevent exposure to secondhand smoke. Increased opportunities are needed to support creative nursing research efforts that test interventions and strategies to reduce barriers to tobacco control within different cultures, subcultures, and countries.

  18. Quality Improvement Efforts among Early Childhood Education Programs Participating in Iowa's Quality Rating System. REL 2017-244

    ERIC Educational Resources Information Center

    Hawkinson, Laura E.; Faria, Ann-Marie; Bouacha, Nora; Lee, Dong Hoon; Metzger, Ivan

    2017-01-01

    This report describes the quality improvement efforts of early childhood education programs participating in Iowa's Quality Rating System (QRS). It identifies supports and barriers to quality improvement and examines how quality improvement supports and activities relate to changes in program quality ratings across time. The study team developed…

  19. A simple tool for neuroimaging data sharing

    PubMed Central

    Haselgrove, Christian; Poline, Jean-Baptiste; Kennedy, David N.

    2014-01-01

    Data sharing is becoming increasingly common, but despite encouragement and facilitation by funding agencies, journals, and some research efforts, most neuroimaging data acquired today is still not shared due to political, financial, social, and technical barriers to sharing data that remain. In particular, technical solutions are few for researchers that are not a part of larger efforts with dedicated sharing infrastructures, and social barriers such as the time commitment required to share can keep data from becoming publicly available. We present a system for sharing neuroimaging data, designed to be simple to use and to provide benefit to the data provider. The system consists of a server at the International Neuroinformatics Coordinating Facility (INCF) and user tools for uploading data to the server. The primary design principle for the user tools is ease of use: the user identifies a directory containing Digital Imaging and Communications in Medicine (DICOM) data, provides their INCF Portal authentication, and provides identifiers for the subject and imaging session. The user tool anonymizes the data and sends it to the server. The server then runs quality control routines on the data, and the data and the quality control reports are made public. The user retains control of the data and may change the sharing policy as they need. The result is that in a few minutes of the user’s time, DICOM data can be anonymized and made publicly available, and an initial quality control assessment can be performed on the data. The system is currently functional, and user tools and access to the public image database are available at http://xnat.incf.org/. PMID:24904398

  20. The GSN Data Quality Initiative

    NASA Astrophysics Data System (ADS)

    Davis, J. P.; Anderson, K. R.; Gee, L. S.

    2010-12-01

    The Global Seismographic Network (GSN) is undertaking a renewed effort to assess and assure data quality that builds upon completion of the major installation phase of the GSN and recent funding to recapitalize most of the network’s equipment including data acquisition systems, ancillary equipment and secondary sensors. We highlight here work by the network operators, the USGS’ Albuquerque Seismological Lab and UCSD’s Project IDA, to ensure that both the quality of the waveforms collected is maximized, that the published metadata accurately reflect the instrument response of the data acquisitions systems, and that data users are informed of the status of the GSN data quality. Procedures to evaluate waveform quality blend tools made available through the IRIS DMC’s Quality Analysis Control Kit (http://www.iris.washington.edu/QUACK/), analysis results provided by the Lamont Waveform Quality Center (www.ldeo.columbia.edu/~ekstrom/Projects/WQC.html), and custom software developed by each of the operators to identify and track known hardware failure modes. Each operator’s equipment upgrade schedule is updated periodically to address sensors identified as failing or problematic and for which replacements are available. Particular attention is also paid to monitoring the GPS clock signal to guarantee that the data are timed properly. Devices based on GPS technology unavailable when the GSN began 25 years ago are being integrated into operations to verify sensor orientations. Portable, broadband seismometers whose stable response can be verified in the laboratory are now co-located with GSN sensors during field visits to verify the existing GSN sensors’ sensitivity. Additional effort is being made to analyze past calibration signals and to check the system response functions of the secondary broadband sensors at GSN sites. The new generation of data acquisition systems will enable relative calibrations to be performed more frequently than was possible in the past. Additional details of this effort can be found at the GSN Quality webpage (www.iris.edu/hq/programs/gsn/quality).

  1. Externalizing symptoms, effortful control, and intrusive parenting: A test of bidirectional longitudinal relations during early childhood.

    PubMed

    Eisenberg, Nancy; Taylor, Zoe E; Widaman, Keith F; Spinrad, Tracy L

    2015-11-01

    At approximately 30, 42, and 54 months of age (N = 231), the relations among children's externalizing symptoms, intrusive maternal parenting, and children's effortful control (EC) were examined. Both intrusive parenting and low EC have been related to psychopathology, but children's externalizing problems and low EC might affect the quality of parenting and one another. Mothers' intrusive behavior with their children was assessed with observations, children's EC was measured with mothers' and caregivers' reports, and children's externalizing symptoms were assessed with mothers', fathers', and caregivers' reports. In a structural equation panel model, bidirectional relations between intrusive parenting and EC were found: EC at 30 and 42 months predicted low levels of intrusive parenting a year later, controlling for prior levels of parenting and vice versa. Moreover, high levels of children's externalizing problems at both 30 and 42 months negatively predicted EC a year later, controlling for prior levels of EC. Although externalizing problems positively predicted high EC over time, this appeared to be a suppression effect because these variables had a strong negative pattern in the zero-order correlations. Moreover, when controlling for the stability of intrusive parenting, EC, and externalizing (all exhibited significant stability across time) and the aforementioned cross-lagged predictive paths, EC and externalizing problems were still negatively related within the 54-month assessment. The findings are consistent with the view that children's externalizing behavior undermines their EC and contributes to intrusive mothering and that relations between intrusive parenting and EC are bidirectional across time. Thus, interventions that focus on modifying children's externalizing problems (as well as the quality of parenting) might affect the quality of parenting they receive and, hence, subsequent problems with adjustment.

  2. China's women leaders promote quality and equity in family planning.

    PubMed

    He, S

    1995-08-01

    In China, key policy-makers at the highest levels of government recognize that the success of the family planning (FP) program depends upon improving the status of Chinese women. The highest ranking female government official, Peng Peiyun, a State Councilor and the Minister of the State Family Planning (FP) Commission, has initiated a new policy of improving the quality of service in the FP program. She recognizes that women who are gainfully employed and control their income are less likely to desire large families. One aspect of the effort to improve quality involves training FP personnel in interpersonal communication and counseling skills. The results of a pilot training program show that clients are pleased with the new approach and that use of FP services has increased. The FP Commission is also experimenting with programs which integrate all the needs of women and their families (FP, credit availability, old age support) in rural areas. Traditionally, sons provided for their elderly parents, so families with only one daughter are concerned about old age provision. Thus, national efforts are underway to develop social security systems. In the meantime, women at all levels, from grassroots FP acceptors to FP staff members and researchers are the major contributors to the innovations which will allow China to control its population growth.

  3. Astronomical Instrumentation Systems Quality Management Planning: AISQMP

    NASA Astrophysics Data System (ADS)

    Goldbaum, Jesse

    2017-06-01

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

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

    NASA Astrophysics Data System (ADS)

    Goldbaum, J.

    2017-12-01

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

  5. Promise and problems with supply chain management approaches to health care purchasing.

    PubMed

    Ford, Eric W; Scanlon, Dennis P

    2007-01-01

    Double-digit health care inflation, coupled with widespread reports of poor care quality and deadly medical errors, has caused private sector employers to reevaluate their health benefits purchasing strategies, with a focus on supply chain management approaches. In other industries, this strategy has proven to be an effective method for simultaneously reducing costs and increasing quality. This article describes four current applications of supply chain management network methodologies to health care systems and identifies potential ways to improve purchasers' return on investment. In particular, information exchanges, purchase decision, and payment agreement components of integrated supply chains are described. First, visual depictions of the health care supply chain are developed from a purchaser's perspective. Next, five nationwide programs designed to realign incentives and rewards across the health care supply chain are described. Although several nationwide efforts are gaining traction in the marketplace, at this time, no cost reduction and quality improvement program initiative appears to systematically align the entire health care supply chain from providers to purchasers, raising doubt about the ability of supply chain management network techniques to significantly impact the health care marketplace in the short run. Current individual efforts to coordinate the health care supply chain do not act on all of the actors necessary to improve outcomes, promote safety, and control costs. Nevertheless, there are indications that several of the individual efforts are coming together. If national efforts touching on all critical elements can coordinate with purchasers, then the health care supply chain's performance may improve significantly.

  6. Sleep quality and temperament among university students: differential associations with nighttime sleep duration and sleep disruptions.

    PubMed

    Lukowski, Angela F; Milojevich, Helen M

    2015-01-01

    Sleep-temperament associations have not yet been examined among university students, despite awareness of the high incidence of sleep problems in this population. The present study was conducted (a) to examine whether sleep quality was associated with temperament among university-attending young adults and (b) to determine whether particular components of sleep quality were differentially associated with temperament. University students completed questionnaires designed to assess sleep quality and temperament. Poor sleep quality was associated with increased negative affect and orienting sensitivity as well as decreased effortful control; regression analyses revealed differential associations between components of nighttime sleep quality and temperament ratings. The presented study reveals conceptual continuity in sleep-temperament relations from infancy to young adulthood and highlights important avenues for future research.

  7. [Quality of health care for diabetic and hypertensive patients in primary care settings servicing Mexican Seguro Popular].

    PubMed

    Ortiz-Domínguez, Maki E; Garrido-Latorre, Francisco; Orozco, Ricardo; Pineda-Pérez, Dayana; Rodríguez-Salgado, Marlenne

    2011-01-01

    To assess health care quality provided to type-2 diabetic and hypertensive patients in primary care settings from the Mexican Ministry of Health and to evaluate whether accredited clinics providing services to the Mexican Seguro Popular performed better in terms of metabolic control of those patients compared to the non-accredited. Cross-sectional study performed on 2008. Previous year clinical measures were obtained from 5 444 diabetic and 5 827 hypertensive patient's clinical records. Adequate metabolic control (glucose <110 mg/dl for diabetes and blood pressure <140/90 mmHg for hypertension) associated factors were assessed by multiple-multilevel logistic regression methods. Patients attending accredited clinics were more likely to be controlled, however, metabolic control was not constant over time of accreditation. Additional efforts are required to monitor accredited clinics' performance in order to maintain both metabolic control and clinical assessment of patients.

  8. Implementing Pay-for-Performance in the Neonatal Intensive Care Unit

    PubMed Central

    Profit, Jochen; Zupancic, John A. F.; Gould, Jeffrey B.; Petersen, Laura A.

    2011-01-01

    Pay-for-performance initiatives in medicine are proliferating rapidly. Neonatal intensive care is a likely target for these efforts because of the high cost, available databases, and relative strength of evidence for at least some measures of quality. Pay-for-performance may improve patient care but requires valid measurements of quality to ensure that financial incentives truly support superior performance. Given the existing uncertainty with respect to both the effectiveness of pay-for-performance and the state of quality measurement science, experimentation with pay-for-performance initiatives should proceed with caution and in controlled settings. In this article, we describe approaches to measuring quality and implementing pay-for-performance in the NICU setting. PMID:17473099

  9. Data from exploratory sampling of groundwater in selected oil and gas areas of coastal Los Angeles County and Kern and Kings Counties in southern San Joaquin Valley, 2014–15: California oil, gas, and groundwater project

    USGS Publications Warehouse

    Dillon, David B.; Davis, Tracy A.; Landon, Matthew K.; Land, Michael T.; Wright, Michael T.; Kulongoski, Justin T.

    2016-12-09

    Exploratory sampling of groundwater in coastal Los Angeles County and Kern and Kings Counties of the southern San Joaquin Valley was done by the U.S. Geological Survey from September 2014 through January 2015 as part of the California State Water Resources Control Board’s Water Quality in Areas of Oil and Gas Production Regional Groundwater Monitoring Program. The Regional Groundwater Monitoring Program was established in response to the California Senate Bill 4 of 2013 mandating that the California State Water Resources Control Board design and implement a groundwater-monitoring program to assess potential effects of well-stimulation treatments on groundwater resources in California. The U.S. Geological Survey is in cooperation with the California State Water Resources Control Board to collaboratively implement the Regional Groundwater Monitoring Program through the California Oil, Gas, and Groundwater Project. Many researchers have documented the utility of different suites of chemical tracers for evaluating the effects of oil and gas development on groundwater quality. The purpose of this exploratory sampling effort was to determine whether tracers reported in the literature could be used effectively in California. This reconnaissance effort was not designed to assess the effects of oil and gas on groundwater quality in the sampled areas. A suite of water-quality indicators and geochemical tracers were sampled at groundwater sites in selected areas that have extensive oil and gas development. Groundwater samples were collected from a total of 51 wells, including 37 monitoring wells at 17 multiple-well monitoring sites in coastal Los Angeles County and 5 monitoring wells and 9 water-production wells in southern San Joaquin Valley, primarily in Kern and Kings Counties. Groundwater samples were analyzed for field waterquality indicators; organic constituents, including volatile and semi-volatile organic compounds and dissolved organic carbon indicators; naturally present inorganic constituents, including trace elements, nutrients, major and minor ions, and iron species; naturally present stable and radioactive isotopes; dissolved noble gases; dissolved standard and hydrocarbon gases, δ13C of methane, ethane, and δ2 H of methane. In total, 249 constituents and water-quality indicators were measured. Four types of quality-control samples (blanks, replicates, matrix spikes, and surrogates spiked in environmental and blank samples) were collected at approximately 10 percent of the wells. The quality-control data were used to determine whether the groundwater-sample data were of sufficient quality for the measured analytes to be used as potential indicators of oil and gas effects. The data from the 51 groundwater samples and from the quality-control samples are presented in this report.

  10. Donor support for quality assurance and pharmacovigilance of anti-malarials in malaria-endemic countries.

    PubMed

    Kovacs, Stephanie D; Mills, Brianna M; Stergachis, Andy

    2017-07-11

    Malaria control efforts have been strengthened by funding from donor groups and government agencies. The Global Fund to Fight AIDS, Tuberculosis and the Malaria (Global Fund), the US President's Malaria Initiative (PMI) account for the majority of donor support for malaria control and prevention efforts. Pharmacovigilance (PV), which encompasses all activities relating to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problem, is a necessary part of efforts to reduce drug resistance and improve treatment outcomes. This paper reports on an analysis of PV plans in the Global Fund and PMI and World Bank's grants for malaria prevention and control. All active malaria grants as of September 2015 funded by the Global Fund and World Bank, and fiscal year 2015 and 2016 PMI Malaria Operational Plans (MOP) were identified. The total amount awarded for PV-related activities and drug quality assurance was abstracted. A Key-Word-in-Context (KWIC) analysis was conducted for the content of each grant. Specific search terms consisted of pharmacovigilance, pregn*, registry, safety, adverse drug, mass drug administration, primaquine, counterfeit, sub-standard, and falsified. Grants that mentioned PV activities identified in the KWIC search, listed PV in their budgets, or included the keywords: counterfeit, sub-standard, falsified, mass drug administration, or adverse event were thematically coded using Dedoose software version 7.0. The search identified 159 active malaria grants including 107 Global Fund grants, 39 fiscal year 2015 and 2016 PMI grants and 13 World Bank grants. These grants were primarily awarded to low-income countries (57.2%) and in sub-Saharan Africa (SSA) (70.4%). Thirty-seven (23.3%) grants included a budget line for PV- or drug quality assurance-related activities, including 21 PMI grants and 16 Global Fund grants. Only 23 (14.5%) grants directly mentioned PV. The primary focus area was improving drug quality monitoring, especially among the PMI grants. The results of the analysis demonstrate that funding for PV has not been sufficiently prioritized by either the key malaria donor organizations or by the recipient countries, as reflected in their grant proposal submissions and MOPs.

  11. Endovascular aneurysm repair delivery redesign leads to quality improvement and cost reduction.

    PubMed

    Warner, Courtney J; Horvath, Alexander J; Powell, Richard J; Columbo, Jesse A; Walsh, Teri R; Goodney, Philip P; Walsh, Daniel B; Stone, David H

    2015-08-01

    Endovascular aneurysm repair (EVAR) is now a mainstay of therapy for abdominal aortic aneurysm, although it remains associated with significant expense. We performed a comprehensive analysis of EVAR delivery at an academic medical center to identify targets for quality improvement and cost reduction in light of impending health care reform. All infrarenal EVARs performed from April 2011 to March 2012 were identified (N = 127). Procedures were included if they met standard commercial instructions for use guidelines, used a single manufacturer, and were billed to Medicare diagnosis-related group 238 (n = 49). By use of DMAIC (define, measure, analyze, improve, and control) quality improvement methodology (define, measure, analyze, improve, control), targets for EVAR quality improvement were identified and high-yield changes were implemented. Procedure technical costs were calculated before and after process redesign. Perioperative services and clinic visits were identified as targets for quality improvement efforts and cost reduction. Mean technical costs before the intervention were $31,672, with endograft implants accounting for 52%. Pricing redesign in collaboration with hospital purchasing reduced mean EVAR technical costs to $28,607, a 10% reduction in overall cost, with endograft implants now accounting for 46%. Perioperative implementation of instrument tray redesign reduced instrument use by 32% (184 vs 132 instruments), saving $50,000 annually. Unnecessary clinic visits were reduced by 39% (1.6 vs 1.1 clinic visits per patient) through implementation of a preclinic imaging protocol. There was no difference in mean length of stay after the intervention. Comprehensive EVAR delivery redesign leads to cost reduction and waste elimination while preserving quality. Future efforts to achieve more competitive and transparent device pricing will make EVAR more cost neutral and enhance its financial sustainability for health care systems. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  12. Endovascular aneurysm repair delivery redesign leads to quality improvement and cost reduction

    PubMed Central

    Warner, Courtney J.; Horvath, Alexander J.; Powell, Richard J.; Columbo, Jesse A.; Walsh, Teri R.; Goodney, Philip P.; Walsh, Daniel B.; Stone, David H.

    2017-01-01

    Objective Endovascular aneurysm repair (EVAR) is now a mainstay of therapy for abdominal aortic aneurysm, although it remains associated with significant expense. We performed a comprehensive analysis of EVAR delivery at an academic medical center to identify targets for quality improvement and cost reduction in light of impending health care reform. Methods All infrarenal EVARs performed from April 2011 to March 2012 were identified (N = 127). Procedures were included if they met standard commercial instructions for use guidelines, used a single manufacturer, and were billed to Medicare diagnosis-related group 238 (n = 49). By use of DMAIC (define, measure, analyze, improve, and control) quality improvement methodology (define, measure, analyze, improve, control), targets for EVAR quality improvement were identified and high-yield changes were implemented. Procedure technical costs were calculated before and after process redesign. Results Perioperative services and clinic visits were identified as targets for quality improvement efforts and cost reduction. Mean technical costs before the intervention were $31,672, with endograft implants accounting for 52%. Pricing redesign in collaboration with hospital purchasing reduced mean EVAR technical costs to $28,607, a 10% reduction in overall cost, with endograft implants now accounting for 46%. Perioperative implementation of instrument tray redesign reduced instrument use by 32% (184 vs 132 instruments), saving $50,000 annually. Unnecessary clinic visits were reduced by 39% (1.6 vs 1.1 clinic visits per patient) through implementation of a preclinic imaging protocol. There was no difference in mean length of stay after the intervention. Conclusions Comprehensive EVAR delivery redesign leads to cost reduction and waste elimination while preserving quality. Future efforts to achieve more competitive and transparent device pricing will make EVAR more cost neutral and enhance its financial sustainability for health care systems. PMID:25935271

  13. Localizing College Retention Efforts: The Distance between Theoretical Orientation and Institution-Specific Needs

    ERIC Educational Resources Information Center

    Xu, Yonghong Jade

    2017-01-01

    The study used a theoretically guided questionnaire to examine student experience in college and to gain a better understanding about how college environment affects student persistence. Data were collected from a single four-year institution; the findings suggest that institutional control over academic quality is the most critical factor in…

  14. A Comprehensive Planning Model and Delivery System for Leadership Training Programs.

    ERIC Educational Resources Information Center

    Janosik, Steven M.; Sina, Julie A.

    1988-01-01

    Presents an eight-step planning model that operationally defines a comprehensive delivery systems approach to campuswide leadership training. Lists four goals of the model: to increase efficiency of leadership training through shared resources, to decrease costs, to provide quality control, and to increase impact of programming effort by creating…

  15. Physiology of host-pathogen interaction in wilt diseases of cotton in relation to pathogen management

    USDA-ARS?s Scientific Manuscript database

    Verticillium and Fusarium wilts are important vascular wilt diseases of cotton that significantly reduce cotton yields and negatively impact fiber quality. In spite of intense efforts to control these diseases, yield losses persist and in the US alone were estimated to be about 133 and 28 thousand b...

  16. Attaining Visual Literacy Using Simplified Graphics in Industry.

    ERIC Educational Resources Information Center

    Burton, Terry

    In the current milieu of ISO 9000 certification, just-in-time engineering (JIT), demand flow technology (DFT), and total quality management (TQM), industry is attempting to implement available technology for the creation, control, and delivery of documentation. In most cases, their efforts are in need of outside resources to analyze, develop,…

  17. Behavioral Assessment of Impulsivity: A Comparison of Children with and without Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Neef, Nancy A.; Marckel, Julie; Ferreri, Summer J.; Bicard, David F.; Endo, Sayaka; Aman, Michael G.; Miller, Kelly M.; Jung, Sunhwa; Nist, Lindsay; Armstrong, Nancy

    2005-01-01

    We conducted a brief computer-based assessment involving choices of concurrently presented arithmetic problems associated with competing reinforcer dimensions to assess impulsivity (choices controlled primarily by reinforcer immediacy) as well as the relative influence of other dimensions (reinforcer rate, quality, and response effort), with 58…

  18. Adaptive Video Streaming Using Bandwidth Estimation for 3.5G Mobile Network

    NASA Astrophysics Data System (ADS)

    Nam, Hyeong-Min; Park, Chun-Su; Jung, Seung-Won; Ko, Sung-Jea

    Currently deployed mobile networks including High Speed Downlink Packet Access (HSDPA) offer only best-effort Quality of Service (QoS). In wireless best effort networks, the bandwidth variation is a critical problem, especially, for mobile devices with small buffers. This is because the bandwidth variation leads to packet losses caused by buffer overflow as well as picture freezing due to high transmission delay or buffer underflow. In this paper, in order to provide seamless video streaming over HSDPA, we propose an efficient real-time video streaming method that consists of the available bandwidth (AB) estimation for the HSDPA network and the transmission rate control to prevent buffer overflows/underflows. In the proposed method, the client estimates the AB and the estimated AB is fed back to the server through real-time transport control protocol (RTCP) packets. Then, the server adaptively adjusts the transmission rate according to the estimated AB and the buffer state obtained from the RTCP feedback information. Experimental results show that the proposed method achieves seamless video streaming over the HSDPA network providing higher video quality and lower transmission delay.

  19. Evaluating barnyard Best Management Practices in Wisconsin using upstream-downstream monitoring

    USGS Publications Warehouse

    Stuntebeck, Todd D.

    1995-01-01

    The Nonpoint Source Water Pollution Abatement Program was created in 1978 by the Wisconsin Legislature. The goal of the program is to improve and protect the water quality of lakes, streams, wetlands, and ground water within selected priority watersheds by controlling sources of nonpoint pollution. For each selected watershed, the Wisconsin Department of Natural Resources drafts a management plan that guides the implementation of pollution-control strategies known as Best Management Practices (BMP's). This plan summarizes resource and land-use inventories, describes the results of pollution-source modeling, and suggests pollution reduction goals. The U.S. Geological Survey, through a cooperative effort with the Wisconsin Department of Natural Resources, is monitoring water-quality improvements that result from the implementation of BMP's. The data collected are then compared to the watershed plans to assess progress and determine whether goals are being realized. This fact sheet describes the data-collection efforts, preliminary results, and planned data-analysis techniques of monitoring projects for pre-BMP conditions at two barnyards, one each on Otter Creek and Halfway Prairie Creek.

  20. Physician-Pharmacist collaboration in a pay for performance healthcare environment.

    PubMed

    Farley, T M; Izakovic, M

    2015-01-01

    Healthcare is becoming more complex and costly in both European (Slovak) and American models. Healthcare in the United States (U.S.) is undergoing a particularly dramatic change. Physician and hospital reimbursement are becoming less procedure focused and increasingly outcome focused. Efforts at Mercy Hospital have shown promise in terms of collaborative team based care improving performance on glucose control outcome metrics, linked to reimbursement. Our performance on the Centers for Medicare and Medicaid Services (CMS) post-operative glucose control metric for cardiac surgery patients increased from a 63.6% pass rate to a 95.1% pass rate after implementing interventions involving physician-pharmacist team based care.Having a multidisciplinary team that is able to adapt quickly to changing expectations in the healthcare environment has aided our institution. As healthcare becomes increasingly saturated with technology, data and quality metrics, collaborative efforts resulting in increased quality and physician efficiency are desirable. Multidisciplinary collaboration (including physician-pharmacist collaboration) appears to be a viable route to improved performance in an outcome based healthcare system (Fig. 2, Ref. 12).

  1. Virtual environment assessment for laser-based vision surface profiling

    NASA Astrophysics Data System (ADS)

    ElSoussi, Adnane; Al Alami, Abed ElRahman; Abu-Nabah, Bassam A.

    2015-03-01

    Oil and gas businesses have been raising the demand from original equipment manufacturers (OEMs) to implement a reliable metrology method in assessing surface profiles of welds before and after grinding. This certainly mandates the deviation from the commonly used surface measurement gauges, which are not only operator dependent, but also limited to discrete measurements along the weld. Due to its potential accuracy and speed, the use of laser-based vision surface profiling systems have been progressively rising as part of manufacturing quality control. This effort presents a virtual environment that lends itself for developing and evaluating existing laser vision sensor (LVS) calibration and measurement techniques. A combination of two known calibration techniques is implemented to deliver a calibrated LVS system. System calibration is implemented virtually and experimentally to scan simulated and 3D printed features of known profiles, respectively. Scanned data is inverted and compared with the input profiles to validate the virtual environment capability for LVS surface profiling and preliminary assess the measurement technique for weld profiling applications. Moreover, this effort brings 3D scanning capability a step closer towards robust quality control applications in a manufacturing environment.

  2. [Pursuit of economic efficiency in the hospital laboratory--full automatic re-test system of clinical chemistry, hematology, immunology and cost control system].

    PubMed

    Chiba, M

    2000-10-01

    Further business improvement is requested due to finance-based fluctuation and the influence of the revision in the medical treatment law. Therefore, new laboratories are needed. To achieving this in our hospital, economic efficiency is being pursued. The first issue is the use of space, the second issue is labor-saving. The third issue is the simplification of business procedures. There is individual quality control by the zonal verification method that we developed, as well as the quality control of the batch method using controlled substances. The four issue is cost control. By controlling the delivery and use of reagents and materials including the term of validity control, we made an effort to abolition defective stock. The fifth issue is correspondence to circulation style society. The disposal of laboratory garbage is a major issue. We controlled garbage that occurs unnecessarily. Furthermore, we are improving the demand for reagents that exceeds the specification and use reagent containers.

  3. Trends in eutrophication research and control

    NASA Astrophysics Data System (ADS)

    Rast, Walter; Thornton, Jeffrey A.

    1996-02-01

    Eutrophication is the natural ageing process of lakes. It is characterized by a geologically slow shift from in-lake biological production driven by allochthonous (external to the water body) loading of nutrients, to production driven by autochthonous (in-lake) processes. This shift typically is accompanied by changes in species and biotic community composition, as an aquatic ecosystem is ultimately transformed into a terrestrial biome. However, this typically slow process can be greatly accelerated by human intervention in the natural biogeochemical cycling of nutrients within a watershed; the resulting cultural eutrophication can create conditions inimical to the continued use of the water body for human-driven economic purposes. Excessive algal and rooted plant growth, degraded water quality, extensive deoxygenation of the bottom water layers and increased fish biomass accompanied by decreased harvest quality, are some features of this process.Following the Second World War, concern with cultural eutrophication achieved an intensity that spurred a significant research effort, culminating in the identification of phosphorus as the single most significant, and controllable, element involved in driving the eutrophication process. During the late 1960s and throughout the 1970s, much effort was devoted to reducing phosphorus in wastewater effluents, primarily in the developed countries of the temperate zone. These efforts generally resulted in the control of eutrophication in these countries, albeit with varying degrees of success. The present effort in the temperature zone, comprising mostly developed nations, has now shifted to the control of diffuse sources of a broader spectrum of contaminants that impact human water use.In the developing countries of the inter-tropical zone, however, rapidly expanding populations, a growing industrial economy and extensive urbanization have only recently reached an intensity at which cultural eutrophication can no longer be ignored. Further, initial attempts at applying temperate zone control measures in this region have been largely unsuccessful. Modification of the temperate zone eutrophication paradigm will be needed, especially to address the differing climatic and hydrological conditions, if cultural eutrophication is to be contained in this region, where eutrophication-related diseases continue to be a primary cause of human distress.

  4. The Human Student: The Essentiality of the Teacher-Student Connection in Higher Education

    ERIC Educational Resources Information Center

    Torrisi-Steele, Geraldine

    2018-01-01

    Higher education institutions are investing significant effort into the improvement of student success, retention and satisfaction. Some effort is being expended in research seeking to understand influencing factors, but the majority of effort is directed towards improving teaching quality. Effort to improve teaching quality is characterised by…

  5. An analytical approach for predicting pilot induced oscillations

    NASA Technical Reports Server (NTRS)

    Hess, R. A.

    1981-01-01

    The optimal control model (OCM) of the human pilot is applied to the study of aircraft handling qualities. Attention is focused primarily on longitudinal tasks. The modeling technique differs from previous applications of the OCM in that considerable effort is expended in simplifying the pilot/vehicle analysis. After briefly reviewing the OCM, a technique for modeling the pilot controlling higher order systems is introduced. Following this, a simple criterion or determining the susceptability of an aircraft to pilot induced oscillations (PIO) is formulated. Finally, a model-based metric for pilot rating prediction is discussed. The resulting modeling procedure provides a relatively simple, yet unified approach to the study of a variety of handling qualities problems.

  6. The Value of clean water: The public's willingness to pay for boatable, fishable, and swimmable quality water

    NASA Astrophysics Data System (ADS)

    Carson, Richard T.; Mitchell, Robert Cameron

    1993-07-01

    This paper presents the findings of a study designed to determine the national benefits of freshwater pollution control. By using data from a national contingent valuation survey, we estimate the aggregate benefits of meeting the goals of the Clean Water Act. A valuation function is estimated which depicts willingness to pay as a function of water quality, income, and other variables. Several validation checks and tests for specific biases are performed, and the benefit estimates are corrected for missing and invalid responses. The two major policy implications from our work are that the benefits and costs of water pollution control efforts are roughly equal and that many of the new policy actions necessary to ensure that all water bodies reach at least a swimmable quality level will not have positive net benefits.

  7. [Rethinking clinical research in surgical oncology. From comic opera to quality control].

    PubMed

    Evrard, Serge

    2016-01-01

    The evidence base for the effectiveness of surgical interventions is relatively poor and data from large, randomized prospective studies are rare with often a poor quality. Many efforts have been made to increase the number of high quality randomized trials in surgery and theoretical proposals have been put forward to improve the situation, but practical implementation of these proposals is seriously lacking. The consequences of this policy are not trivial; with very few patients included in surgical oncology trials, this represents wasted opportunity for advances in cancer treatment. In this review, we cover the difficulties inherent to clinical research in surgical oncology, such as quality control, equipoise, accrual, and funding and promote alternative designs to the randomized controlled trial. Although the classic randomized controlled trial has a valid but limited place in surgical oncology, other prospective designs need to be promoted as a new deal. This new deal not only implicates surgeons but also journal editors, tender jury, as well as regulatory bodies to cover legal gaps currently surrounding surgical innovation. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  8. Scater: pre-processing, quality control, normalization and visualization of single-cell RNA-seq data in R.

    PubMed

    McCarthy, Davis J; Campbell, Kieran R; Lun, Aaron T L; Wills, Quin F

    2017-04-15

    Single-cell RNA sequencing (scRNA-seq) is increasingly used to study gene expression at the level of individual cells. However, preparing raw sequence data for further analysis is not a straightforward process. Biases, artifacts and other sources of unwanted variation are present in the data, requiring substantial time and effort to be spent on pre-processing, quality control (QC) and normalization. We have developed the R/Bioconductor package scater to facilitate rigorous pre-processing, quality control, normalization and visualization of scRNA-seq data. The package provides a convenient, flexible workflow to process raw sequencing reads into a high-quality expression dataset ready for downstream analysis. scater provides a rich suite of plotting tools for single-cell data and a flexible data structure that is compatible with existing tools and can be used as infrastructure for future software development. The open-source code, along with installation instructions, vignettes and case studies, is available through Bioconductor at http://bioconductor.org/packages/scater . davis@ebi.ac.uk. Supplementary data are available at Bioinformatics online. © The Author 2017. Published by Oxford University Press.

  9. Spatial Data Quality Control Procedure applied to the Okavango Basin Information System

    NASA Astrophysics Data System (ADS)

    Butchart-Kuhlmann, Daniel

    2014-05-01

    Spatial data is a powerful form of information, capable of providing information of great interest and tremendous use to a variety of users. However, much like other data representing the 'real world', precision and accuracy must be high for the results of data analysis to be deemed reliable and thus applicable to real world projects and undertakings. The spatial data quality control (QC) procedure presented here was developed as the topic of a Master's thesis, in the sphere of and using data from the Okavango Basin Information System (OBIS), itself a part of The Future Okavango (TFO) project. The aim of the QC procedure was to form the basis of a method through which to determine the quality of spatial data relevant for application to hydrological, solute, and erosion transport modelling using the Jena Adaptable Modelling System (JAMS). As such, the quality of all data present in OBIS classified under the topics of elevation, geoscientific information, or inland waters, was evaluated. Since the initial data quality has been evaluated, efforts are underway to correct the errors found, thus improving the quality of the dataset.

  10. Improving the Quality of Palliative Care Through National and Regional Collaboration Efforts.

    PubMed

    Kamal, Arif H; Harrison, Krista L; Bakitas, Marie; Dionne-Odom, J Nicholas; Zubkoff, Lisa; Akyar, Imatullah; Pantilat, Steven Z; O'Riordan, David L; Bragg, Ashley R; Bischoff, Kara E; Bull, Janet

    2015-10-01

    The measurement and reporting of the quality of care in the field of palliation has become a required task for many health care leaders and specialists in palliative care. Such efforts are aided when organizations collaborate together to share lessons learned. The authors reviewed examples of quality-improvement collaborations in palliative care to understand the similarities, differences, and future directions of quality measurement and improvement strategies in the discipline. Three examples were identified that showed areas of robust and growing quality-improvement collaboration in the field of palliative care: the Global Palliative Care Quality Alliance, Palliative Care Quality Network, and Project Educate, Nurture, Advise, Before Life Ends. These efforts exemplify how shared-improvement activities can inform improved practice for organizations participating in collaboration. National and regional collaboratives can be used to enhance the quality of palliative care and are important efforts to standardize and improve the delivery of palliative care for persons with serious illness, along with their friends, family, and caregivers.

  11. Advanced composite aileron for L-1011 transport aircraft: Aileron manufacture

    NASA Technical Reports Server (NTRS)

    Dunning, E. G.; Cobbs, W. L.; Legg, R. L.

    1981-01-01

    The fabrication activities of the Advanced Composite Aileron (ACA) program are discussed. These activities included detail fabrication, manufacturing development, assembly, repair and quality assurance. Five ship sets of ailerons were manufactured. The detail fabrication effort of ribs, spar and covers was accomplished on male tools to a common cure cycle. Graphite epoxy tape and fabric and syntactic epoxy materials were utilized in the fabrication. The ribs and spar were net cured and required no post cure trim. Material inconsistencies resulted in manufacturing development of the front spar during the production effort. The assembly effort was accomplished in subassembly and assembly fixtures. The manual drilling system utilized a dagger type drill in a hydraulic feed control hand drill. Coupon testing for each detail was done.

  12. Improving guideline adherence through intensive quality improvement and the use of a National Quality Register in Sweden for acute myocardial infarction.

    PubMed

    Peterson, Anette; Carlhed, Rickard; Lindahl, Bertil; Lindström, Gunilla; Aberg, Christina; Andersson-Gäre, Boel; Bojestig, Mats

    2007-01-01

    Data from the Swedish National Register in Cardiac Care have shown over the last 10 years an enduring gap between optimal treatment of acute myocardial infarction (AMI) according to current guidelines and the treatment actually given. We performed a controlled, prospective study in order to evaluate the effects of applying a multidisciplinary team-based improvement methodology to the use of evidence-based treatments in AMI, together with the use of a modified National Quality Register. The project engaged 25% of the Swedish hospitals. Multidisciplinary teams from 20 hospitals participating in the National Register in Cardiac Care, ranging from small to large hospitals, were trained in continuous quality improvement methodology. Twenty matched hospitals served as controls. Our efforts were focused on finding and applying tools and methods to increase adherence to the national guidelines for 5 different treatments for AMI. For measurement, specially designed quality control charts were made available in the National Register for Cardiac Care. To close the gap, an important issue for the teams was to get all 5 treatments in place. Ten of the hospitals in the study group reduced the gap in 5 of 5 treatments by 50%, while none of the control hospitals did so. This first, controlled prospective study of a registry supported by multidisciplinary team-based improvement methodology showed that this approach led to rapidly improved adherence to AMI guidelines in a broad spectrum of hospitals and that National Quality Registers can be helpful tools.

  13. Installation Restoration Program (IRP) Stage 7, Remedial Investigation/ Feasibility Study Comprehensive CERCLA Work PLan for McClellan AFB/EM, McClellan AFB, California

    DTIC Science & Technology

    1991-07-01

    Systems Audits ; Preventive Maintenance; Data Assessment Procedures; Corrective Action; Quality Assurance Reports; and Site Management. General Data Quality...for verification and quality control audits . A copy of the QAPP will be in the possession of field sampling teams for all sampling efforts...L cc- acca C wi w-C P-3-- C I- usu 2; - at C4~~2 Q (( c ccc c-c C- 0L U -C 3- au S - - C3 . - acu tr - -a CL.43 C LU -C2 -C ul 0it S w- -C u Ocw - z i

  14. STARS Proceedings (3-4 December 1991)

    DTIC Science & Technology

    1991-12-04

    PROJECT PROCESS OBJECTIVES & ASSOCIATED METRICS: Prioritize ECPs: complexity & error-history measures 0 Make vs Buy decisions: Effort & Quality (or...history measures, error- proneness and past histories of trouble with particular modules are very useful measures. Make vs Buy decisions: Does the...Effort offset the gain in Quality relative to buy ... Effort and Quality (or defect rate) histories give helpful indications of how to make this decision

  15. Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement.

    PubMed

    Dupont, Corinne; Occelli, Pauline; Deneux-Tharaux, Catherine; Touzet, Sandrine; Duclos, Antoine; Bouvier-Colle, Marie-Hélène; Rudigoz, René-Charles; Huissoud, Cyril

    2014-07-01

    Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (p<0.001). Since 2010, the quarterly rate of severe PPH has not exceeded the upper control limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Risk Allocation in Construction Contracting

    DTIC Science & Technology

    1992-01-01

    contractor’s control, contingency amounts will be at a minimum. For risks that are beyond the con - tractor’s control, contingency amounts can...ficing the quality of work in a concerted effort to recoup his or her losses. 2.3 Owner’s Risk A complete shift of all risk from the owner to a con ...circumstances, a shortsighted attempt to shift certain risks to the contractor can have disastrous conse - quences. An owner’s erroneous reliance on the

  17. Quality Controlling CMIP datasets at GFDL

    NASA Astrophysics Data System (ADS)

    Horowitz, L. W.; Radhakrishnan, A.; Balaji, V.; Adcroft, A.; Krasting, J. P.; Nikonov, S.; Mason, E. E.; Schweitzer, R.; Nadeau, D.

    2017-12-01

    As GFDL makes the switch from model development to production in light of the Climate Model Intercomparison Project (CMIP), GFDL's efforts are shifted to testing and more importantly establishing guidelines and protocols for Quality Controlling and semi-automated data publishing. Every CMIP cycle introduces key challenges and the upcoming CMIP6 is no exception. The new CMIP experimental design comprises of multiple MIPs facilitating research in different focus areas. This paradigm has implications not only for the groups that develop the models and conduct the runs, but also for the groups that monitor, analyze and quality control the datasets before data publishing, before their knowledge makes its way into reports like the IPCC (Intergovernmental Panel on Climate Change) Assessment Reports. In this talk, we discuss some of the paths taken at GFDL to quality control the CMIP-ready datasets including: Jupyter notebooks, PrePARE, LAMP (Linux, Apache, MySQL, PHP/Python/Perl): technology-driven tracker system to monitor the status of experiments qualitatively and quantitatively, provide additional metadata and analysis services along with some in-built controlled-vocabulary validations in the workflow. In addition to this, we also discuss the integration of community-based model evaluation software (ESMValTool, PCMDI Metrics Package, and ILAMB) as part of our CMIP6 workflow.

  18. Increasing Efficiency at the NTF by Optimizing Model AoA Positioning

    NASA Technical Reports Server (NTRS)

    Crawford, Bradley L.; Spells, Courtney

    2006-01-01

    The National Transonic Facility (NTF) at NASA Langley Research Center (LaRC) is a national resource for aeronautical research and development. The government, military and private industries rely on the capability of this facility for realistic flight data. Reducing the operation costs and keeping the NTF affordable is essential for aeronautics research. The NTF is undertaking an effort to reduce the time between data points during a pitch polar. This reduction is being driven by the operating costs of a cryogenic facility. If the time per data point can be reduced, a substantial cost savings can be realized from a reduction in liquid nitrogen (LN2) consumption. It is known that angle-of-attack (AoA) positioning is the longest lead-time item between points. In January 2005 a test was conducted at the NTF to determine the cause of the long lead-time so that an effort could be made to improve efficiency. The AoA signal at the NTF originates from onboard instrumentation then travels through a number of different systems including the signal conditioner, digital voltmeter, and the data system where the AoA angle is calculated. It is then fed into a closed loop control system that sets the model position. Each process along this path adds to the time per data point affecting the efficiency of the data taking process. Due to the nature of the closed loop feed back AoA control and the signal path, it takes approximately 18 seconds to take one pitch pause point with a typical AoA increment. Options are being investigated to reduce the time delay between points by modifying the signal path. These options include: reduced signal filtering, using analog channels instead of a digital volt meter (DVM), re-routing the signal directly to the AoA control computer and implementing new control algorithms. Each of these has potential to reduce the positioning time and together the savings could be significant. These timesaving efforts are essential but must be weighed against possible loss of data quality. For example, a reduction in filtering can introduce noise into the signal and using analog channels could result in some loss of accuracy. Data quality assessments need to be performed concurrently with timesaving techniques since data quality parameters are essential in maintaining facility integrity. This paper will highlight time saving efforts being undertaken or studied at the NTF. It will outline the instrumentation and computer systems involved in setting of the model pitch attitude then suggest changes to the process and discuss how these system changes would effect the time between data points. It also discusses the issue of data quality and how the potential efficiency changes in the system could affect it. Lastly, it will discuss the possibility of using an open loop control system and give some pros and cons of this method.

  19. Improved Advanced Actuated Hybrid Mirrors Final Report CRADA No. TC02130.0

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

    Barbee, T. W.; Ealey, M. A.

    2017-08-25

    This was a collaborative effort to develop and demonstrate an improved Advanced Actuated Hybrid Mirrors (AAHM) for commercial or Government purposes. The AAHM consists of a nanolaminate film replicating a precision optical surface bonded to a Silicon Carbide (SiC) substrate with active figure control capability. The goal of this project was to further the development of specific AAHM technologies. The intent of the CRADA was to combine the expertise of LLNL and NG Xinetics in the manufacture and test of a very high quality AAHM, incorporating lessons learned from earlier joint efforts.

  20. ICAM (Conceptual Design for Computer-Integrated Manufacturing. Volume 2. Part 6. Task B - Establishment of the Factory of the Future Conceptual Framework Conceptual Framework Document, (MMR)

    DTIC Science & Technology

    1984-06-29

    effort that requires hard copy documentation. As a result, there are generally numerous delays in providing current quality information. In the FoF...process have had fixed controls or were based on " hard -coded" information. A template, for example, is hard -coded information defining the shape of a...represents soft-coded control information. (Although manual handling of punch tapes still possess some of the limitations of " hard -coded" controls

  1. Two approaches to improving mental health care: positivist/quantitative versus skill-based/qualitative.

    PubMed

    Luchins, Daniel

    2012-01-01

    The quality improvement model currently used in medicine and mental health was adopted from industry, where it developed out of early 20th-century efforts to apply a positivist/quantitative agenda to improving manufacturing. This article questions the application of this model to mental health care. It argues that (1) developing "operational definitions" for something as value-laden as "quality" risks conflating two realms, what we measure with what we value; (2) when measurements that are tied to individuals are aggregated to establish benchmarks and goals, unwarranted mathematical assumptions are made; (3) choosing clinical outcomes is problematic; (4) there is little relationship between process measures and clinical outcomes; and (5) since changes in quality indices do not relate to improved clinical care, management's reliance on such indices provides an illusory sense of control. An alternative model is the older, skill-based/qualitative approach to knowing, which relies on "implicit/ expert" knowledge. These two approaches offer a series of contrasts: quality versus excellence, competence versus expertise, management versus leadership, extrinsic versus intrinsic rewards. The article concludes that we need not totally dispense with the current quality improvement model, but rather should balance quantitative efforts with the older qualitative approach in a mixed methods model.

  2. Managerialism and the Risky Business of Quality Assurance in Universities

    ERIC Educational Resources Information Center

    Davis, Annemarie

    2017-01-01

    Purpose: This paper aims to identify what is needed to enhance academic quality assurance in a university, with specific efforts to reduce the risks associated with ritualised quality assurance practices. Design/methodology/approach: The aspects to enhance academic quality assurance efforts in managerial universities are identified through a…

  3. Effects of cues in a binary categorization task on dual-task performance, mental workload, and effort.

    PubMed

    Botzer, Assaf; Meyer, Joachim; Parmet, Yisrael

    2016-09-01

    Binary cues help operators perform binary categorization tasks, such as monitoring for system failures. They may also allow them to attend to other tasks they concurrently perform. If the time saved by using cues is allocated to other concurrent tasks, users' overall effort may remain unchanged. In 2 experiments, participants performed a simulated quality control task, together with a tracking task. In half the experimental blocks cues were available, and participants could use them in their decisions about the quality of products (intact or faulty). In Experiment 1, the difficulty of tracking was constant, while in Experiment 2, tracking difficulty differed in the 2 halves of the experiment. In both experiments, participants reported on the NASA Task Load Index that cues improved their performance and reduced their frustration. Consequently, their overall score on mental workload (MWL) was lower with cues. They also reported, however, that cues did not reduce their effort. We conclude that cues and other forms of automation may support task performance and reduce overall MWL, but this will not necessarily mean that users will work less hard. Thus, effort and overall MWL should be evaluated separately, if one wants to obtain a full picture of the effects of automation. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. Control of Space-Based Electron Beam Free Form Fabrication

    NASA Technical Reports Server (NTRS)

    Seifzer. W. J.; Taminger, K. M.

    2007-01-01

    Engineering a closed-loop control system for an electron beam welder for space-based additive manufacturing is challenging. For earth and space based applications, components must work in a vacuum and optical components become occluded with metal vapor deposition. For extraterrestrial applications added components increase launch weight, increase complexity, and increase space flight certification efforts. Here we present a software tool that closely couples path planning and E-beam parameter controls into the build process to increase flexibility. In an environment where data collection hinders real-time control, another approach is considered that will still yield a high quality build.

  5. Highlights of contractor initiatives in quality enhancement and productivity improvement

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The NASA/Contractor Team efforts are presented as part of NASA's continuing effort to facilitate the sharing of quality and productivity improvement ideas among its contractors. This complilation is not meant to be a comprehensive review of contractor initiative nor does it necessarily express NASA's views. The submissions represent samples from a general survey, and were not edited by NASA. The efforts are examples of quality and productivity programs in private industry, and as such, highlight company efforts in individual areas. Topics range from modernization of equipment, hardware, and technology to management of human resources. Of particular interest are contractor initiatives which deal with measurement and evaluation data pertaining to quality and productivity performance.

  6. Developing regulatory programs for the control of acid precipitation

    Treesearch

    Michael A. Berry; John D. Bachmann

    1976-01-01

    The U.S. Clean Air Act provides mechanisms by which the public welfare may be protected from "any known or anticipated adverse effects associated with the presence of (an) air pollutant in the ambient air." The history of the U.S. Environment Protection Agency's (EPA) efforts to establish and defend a secondary ambient air quality standard for sulfur...

  7. Part-Time Faculty Evaluation: A Campus Case Study.

    ERIC Educational Resources Information Center

    Williams, James P.

    For the past 13 years, the Verde Valley Campus of Yavapai College, in Arizona, has used the same system to evaluate part-time faculty in an effort to both maintain quality control and provide feedback to part-time faculty and address their concerns. The system utilizes two instruments to gather evaluative data. The first is used to determine…

  8. Integration of visual and motion cues for simulator requirements and ride quality investigation

    NASA Technical Reports Server (NTRS)

    Young, L. R.

    1976-01-01

    Practical tools which can extend the state of the art of moving base flight simulation for research and training are developed. Main approaches to this research effort include: (1) application of the vestibular model for perception of orientation based on motion cues: optimum simulator motion controls; and (2) visual cues in landing.

  9. Controlling flooding and water pollution with upland and streamside vegetation systems

    Treesearch

    Michael Dosskey

    2003-01-01

    Substantial research and development effort in the U.S. is being spent on developing strategies that address flooding and water pollution problems in agricultural areas. Concerns have been raised about the costs of flood damage, degradation of productive farm land, and declining water quality that are now recognized as unintended consequences of intensive, high-yield...

  10. 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.…

  11. Electron tubes for industrial applications

    NASA Astrophysics Data System (ADS)

    Gellert, Bernd

    1994-05-01

    This report reviews research and development efforts within the last years for vacuum electron tubes, in particular power grid tubes for industrial applications. Physical and chemical effects are discussed that determine the performance of todays devices. Due to the progress made in the fundamental understanding of materials and newly developed processes the reliability and reproducibility of power grid tubes could be improved considerably. Modern computer controlled manufacturing methods ensure a high reproducibility of production and continuous quality certification according to ISO 9001 guarantees future high quality standards. Some typical applications of these tubes are given as an example.

  12. Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives.

    PubMed

    Chelico, John D; Wilcox, Adam B; Vawdrey, David K; Kuperman, Gilad J

    2016-01-01

    Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement.

  13. Designing a Clinical Data Warehouse Architecture to Support Quality Improvement Initiatives

    PubMed Central

    Chelico, John D.; Wilcox, Adam B.; Vawdrey, David K.; Kuperman, Gilad J.

    2016-01-01

    Clinical data warehouses, initially directed towards clinical research or financial analyses, are evolving to support quality improvement efforts, and must now address the quality improvement life cycle. In addition, data that are needed for quality improvement often do not reside in a single database, requiring easier methods to query data across multiple disparate sources. We created a virtual data warehouse at NewYork Presbyterian Hospital that allowed us to bring together data from several source systems throughout the organization. We also created a framework to match the maturity of a data request in the quality improvement life cycle to proper tools needed for each request. As projects progress in the Define, Measure, Analyze, Improve, Control stages of quality improvement, there is a proper matching of resources the data needs at each step. We describe the analysis and design creating a robust model for applying clinical data warehousing to quality improvement. PMID:28269833

  14. Toward a perceptual video-quality metric

    NASA Astrophysics Data System (ADS)

    Watson, Andrew B.

    1998-07-01

    The advent of widespread distribution of digital video creates a need for automated methods for evaluating the visual quality of digital video. This is particularly so since most digital video is compressed using lossy methods, which involve the controlled introduction of potentially visible artifacts. Compounding the problem is the bursty nature of digital video, which requires adaptive bit allocation based on visual quality metrics, and the economic need to reduce bit-rate to the lowest level that yields acceptable quality. In previous work, we have developed visual quality metrics for evaluating, controlling,a nd optimizing the quality of compressed still images. These metrics incorporate simplified models of human visual sensitivity to spatial and chromatic visual signals. Here I describe a new video quality metric that is an extension of these still image metrics into the time domain. Like the still image metrics, it is based on the Discrete Cosine Transform. An effort has been made to minimize the amount of memory and computation required by the metric, in order that might be applied in the widest range of applications. To calibrate the basic sensitivity of this metric to spatial and temporal signals we have made measurements of visual thresholds for temporally varying samples of DCT quantization noise.

  15. Work More, Then Feel More: The Influence of Effort on Affective Predictions

    PubMed Central

    Jiga-Boy, Gabriela M.; Toma, Claudia; Corneille, Olivier

    2014-01-01

    Two studies examined how effort invested in a task shapes the affective predictions related to potential success in that task, and the mechanism underlying this relationship. In Study 1, PhD students awaiting an editorial decision about a submitted manuscript estimated the effort they had invested in preparing that manuscript for submission and how happy they would feel if it were accepted. Subjective estimates of effort were positively related to participants' anticipated happiness, an effect mediated by the higher perceived quality of one's work. In other words, the more effort one though having invested, the happier one expected to feel if it were accepted, because one expected a higher quality manuscript. We replicated this effect and its underlying mediation in Study 2, this time using an experimental manipulation of effort in the context of creating an advertising slogan. Study 2 further showed that participants mistakenly thought their extra efforts invested in the task had improved the quality of their work, while independent judges had found no objective differences in quality between the outcomes of the high- and low-effort groups. We discuss the implications of the relationship between effort and anticipated emotions and the conditions under which such relationship might be functional. PMID:25028961

  16. Utah Cancer Survivors: A Comprehensive Comparison of Health-Related Outcomes Between Survivors and Individuals Without a History of Cancer.

    PubMed

    Fowler, Brynn; Ding, Qian; Pappas, Lisa; Wu, Yelena P; Linder, Lauri; Yancey, Jeff; Wright, Jennifer; Clayton, Margaret; Kepka, Deanna; Kirchhoff, Anne C

    2018-02-01

    Assessments of cancer survivors' health-related needs are often limited to national estimates. State-specific information is vital to inform state comprehensive cancer control efforts developed to support patients and providers. We investigated demographics, health status/quality of life, health behaviors, and health care characteristics of long-term Utah cancer survivors compared to Utahans without a history of cancer. Utah Behavioral Risk Factor Surveillance System (BRFSS) 2009 and 2010 data were used. Individuals diagnosed with cancer within the past 5 years were excluded. Multivariable survey weighted logistic regressions and computed predictive marginals were used to estimate age-adjusted percentages and 95 % confidence intervals (CI). A total of 11,320 eligible individuals (727 cancer survivors, 10,593 controls) were included. Respondents were primarily non-Hispanic White (95.3 % of survivors, 84.1 % of controls). Survivors were older (85 % of survivors ≥40 years of age vs. 47 % of controls). Survivors reported the majority of their cancer survivorship care was managed by primary care physicians or non-cancer specialists (93.5 %, 95 % CI = 87.9-99.1). Furthermore, 71.1 % (95 % CI = 59.2-82.9) of survivors reported that they did not receive a cancer treatment summary. In multivariable estimates, fair/poor general health was more common among survivors compared to controls (17.8 %, 95 % CI = 12.5-23.1 vs. 14.2 %, 95 % CI = 12.4-16.0). Few survivors in Utah receive follow-up care from a cancer specialist. Provider educational efforts are needed to promote knowledge of cancer survivor issues. Efforts should be made to improve continuity in follow-up care that addresses the known issues of long-term survivors that preclude optimal quality of life, resulting in a patient-centered approach to survivorship.

  17. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency.

    PubMed

    Hanna, Timothy P; Kangolle, Alfred C T

    2010-10-13

    Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) PROCESS: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) OUTCOME: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important.

  18. Development and expansion of high-quality control region databases to improve forensic mtDNA evidence interpretation.

    PubMed

    Irwin, Jodi A; Saunier, Jessica L; Strouss, Katharine M; Sturk, Kimberly A; Diegoli, Toni M; Just, Rebecca S; Coble, Michael D; Parson, Walther; Parsons, Thomas J

    2007-06-01

    In an effort to increase the quantity, breadth and availability of mtDNA databases suitable for forensic comparisons, we have developed a high-throughput process to generate approximately 5000 control region sequences per year from regional US populations, global populations from which the current US population is derived and global populations currently under-represented in available forensic databases. The system utilizes robotic instrumentation for all laboratory steps from pre-extraction through sequence detection, and a rigorous eight-step, multi-laboratory data review process with entirely electronic data transfer. Over the past 3 years, nearly 10,000 control region sequences have been generated using this approach. These data are being made publicly available and should further address the need for consistent, high-quality mtDNA databases for forensic testing.

  19. An Overview of Air Pollution Problem in Megacities and City Clusters in China

    NASA Astrophysics Data System (ADS)

    Tang, X.

    2007-05-01

    China has experienced the rapid economic growth in last twenty years. City clusters, which consist of one or several mega cities in close vicinity and many satellite cities and towns, are playing a leading role in Chinese economic growth, owing to their collective economic capacity and interdependency. However, accompanying with the economic boom, population growth and increased energy consumption, the air quality has been degrading in the past two decades. Air pollution in those areas is characterized by concurrent occurrence of high concentrations of multiple primary pollutants leading to form complex secondary pollution problem. After decades long efforts to control air pollution, both the government and scientific communities have realized that to control regional scale air pollution, regional efforts are needed. Field experiments covering the regions like Pearl River Delta region and Beijing City with surrounding areas are critical to understand the chemical and physical processes leading to the formation of regional scale air pollution. In order to formulate policy suggestions for air quality attainment during 2008 Beijing Olympic game and to propose objectives of air quality attainment in 2010 in Beijing, CAREBEIJING (Campaigns of Air Quality Research in Beijing and Surrounding Region) was organized by Peking University in 2006 to learn current air pollution situation of the region, and to identify the transport and transformation processes that lead to the impact of the surrounding area on air quality in Beijing. Same as the purpose for understanding the chemical and physical processes happened in regional scale, the fall and summer campaigns in 2004 and 2006 were carried out in Pearl River Delta. More than 16 domestic and foreign institutions were involved in these campaigns. The background, current status, problems, and some results of these campaigns will be introduced in this presentation.

  20. Impact of growth rate on graphene lattice-defect formation within a single crystalline domain.

    PubMed

    Chin, Hao-Ting; Lee, Jian-Jhang; Hofmann, Mario; Hsieh, Ya-Ping

    2018-03-06

    Chemical vapor deposition (CVD) is promising for the large scale production of graphene and other two-dimensional materials. Optimization of the CVD process for enhancing their quality is a focus of ongoing effort and significant progress has been made in decreasing the defectiveness associated with grain boundaries and nucleation spots. However, little is known about the quality and origin of structural defects in the outgrowing lattice which are present even in single-crystalline material and represent the limit of current optimization efforts. We here investigate the formation kinetics of such defects by controlling graphene's growth rate over a wide range using nanoscale confinements. Statistical analysis of Raman spectroscopic results shows a clear trend between growth rate and defectiveness that is in quantitative agreement with a model where defects are healed preferentially at the growth front. Our results suggest that low growth rates are required to avoid the freezing of lattice defects and form high quality material. This conclusion is confirmed by a fourfold enhancement in graphene's carrier mobility upon optimization of the growth rate.

  1. Dopamine, Effort-Based Choice, and Behavioral Economics: Basic and Translational Research

    PubMed Central

    Salamone, John D.; Correa, Merce; Yang, Jen-Hau; Rotolo, Renee; Presby, Rose

    2018-01-01

    Operant behavior is not only regulated by factors related to the quality or quantity of reinforcement, but also by the work requirements inherent in performing instrumental actions. Moreover, organisms often make effort-related decisions involving economic choices such as cost/benefit analyses. Effort-based decision making is studied using behavioral procedures that offer choices between high-effort options leading to relatively preferred reinforcers vs. low effort/low reward choices. Several neural systems, including the mesolimbic dopamine (DA) system and other brain circuits, are involved in regulating effort-related aspects of motivation. Considerable evidence indicates that mesolimbic DA transmission exerts a bi-directional control over exertion of effort on instrumental behavior tasks. Interference with DA transmission produces a low-effort bias in animals tested on effort-based choice tasks, while increasing DA transmission with drugs such as DA transport blockers tends to enhance selection of high-effort options. The results from these pharmacology studies are corroborated by the findings from recent articles using optogenetic, chemogenetic and physiological techniques. In addition to providing important information about the neural regulation of motivated behavior, effort-based choice tasks are useful for developing animal models of some of the motivational symptoms that are seen in people with various psychiatric and neurological disorders (e.g., depression, schizophrenia, Parkinson’s disease). Studies of effort-based decision making may ultimately contribute to the development of novel drug treatments for motivational dysfunction. PMID:29628879

  2. Dopamine, Effort-Based Choice, and Behavioral Economics: Basic and Translational Research.

    PubMed

    Salamone, John D; Correa, Merce; Yang, Jen-Hau; Rotolo, Renee; Presby, Rose

    2018-01-01

    Operant behavior is not only regulated by factors related to the quality or quantity of reinforcement, but also by the work requirements inherent in performing instrumental actions. Moreover, organisms often make effort-related decisions involving economic choices such as cost/benefit analyses. Effort-based decision making is studied using behavioral procedures that offer choices between high-effort options leading to relatively preferred reinforcers vs. low effort/low reward choices. Several neural systems, including the mesolimbic dopamine (DA) system and other brain circuits, are involved in regulating effort-related aspects of motivation. Considerable evidence indicates that mesolimbic DA transmission exerts a bi-directional control over exertion of effort on instrumental behavior tasks. Interference with DA transmission produces a low-effort bias in animals tested on effort-based choice tasks, while increasing DA transmission with drugs such as DA transport blockers tends to enhance selection of high-effort options. The results from these pharmacology studies are corroborated by the findings from recent articles using optogenetic, chemogenetic and physiological techniques. In addition to providing important information about the neural regulation of motivated behavior, effort-based choice tasks are useful for developing animal models of some of the motivational symptoms that are seen in people with various psychiatric and neurological disorders (e.g., depression, schizophrenia, Parkinson's disease). Studies of effort-based decision making may ultimately contribute to the development of novel drug treatments for motivational dysfunction.

  3. Noise Protection

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Environmental Health Systems puts forth an increasing effort in the U.S. to develop ways of controlling noise, particularly in industrial environments due to Federal and State laws, labor union insistence and new findings relative to noise pollution impact on human health. NASA's Apollo guidance control system aided in the development of a noise protection product, SMART. The basis of all SMART products is SMART compound a liquid plastic mixture with exceptional energy/sound absorbing qualities. The basic compound was later refined for noise protection use.

  4. [Advances in research on automatic exposure control of mammography system].

    PubMed

    Wang, Guoyi; Ye, Chengfu; Wu, Haiming; Wang, Tainfu; Zhang, Hong

    2014-12-01

    Mammography imaging is one of the most demanding imaging modalities from the point of view of the bal- ance between image quality (the visibility of small size and/or low contrast structures) and dose (screening of many asymptomatic people). Therefore, since the introduction of the first dedicated mammographic units, many efforts have been directed to seek the best possible image quality while minimizing patient dose. The performance of auto- matic exposure control (AEC) is the manifestation of this demand. The theory of AEC includes exposure detection and optimization and also involves some accomplished methodology. This review presents the development and present situa- tion of spectrum optimization, detector evolution, and the way how to accomplish and evaluate AEC methods.

  5. Transboundary movement of hazardous wastes into Lebanon: Part 2. Environmental impacts and the need for remedial actions.

    PubMed

    Jurdi, Mey

    2002-01-01

    This paper discusses the transboundary movement of hazardous wastes (the "silent trade") into Lebanon in terms of environmental impacts and remedial actions. It highlights the projected impacts on potable-water quality, the exposure of the groundwater aquifer, and the status of quality control programs. The public responses to these problems are presented and characterized in terms of mistrust and rejection. The constraints developing countries face in handling environmental impacts and undertaking remedial actions are emphasized. The vision derived from the decade covered (1990-2000) emphasizes the need for international collaboration, through Basel Convention efforts, to control the transboundary movement of hazardous wastes and the disposal of such wastes. The need for "global harmonization" should be given serious consideration.

  6. 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.

  7. A System That Works: Highlights of Effective Intervention Strategies in a Quality Improvement System

    ERIC Educational Resources Information Center

    Sinisterra, Diana; Baker, Stephen

    2010-01-01

    This paper describes one approach to quality improvement efforts: the Quality Improvement System (QIS) implemented by Prime Time Palm Beach County (Prime Time) in Palm Beach County, Florida. Prime Time's QIS is recognized as one promising systemic effort to improve quality in the afterschool field (Yohalem, Granger, & Pittman, 2009). As a…

  8. Publicly reported quality-of-care measures influenced Wisconsin physician groups to improve performance

    PubMed Central

    Lamb, Geoffrey C.; Smith, Maureen; Weeks, William B.; Queram, Christopher

    2014-01-01

    Public reporting of performance on quality measures is increasingly common but little is known about the impact, especially among physician groups. The Wisconsin Collaborative for Healthcare Quality (Collaborative) is a voluntary consortium of physician groups which has publicly reported quality measures since 2004, providing an opportunity to study the effect of this effort on participating groups. Analyses included member performance on 14 ambulatory measures from 2004–2009, a survey regarding reporting and its relationship to improvement efforts, and use of Medicare billing data to independently compare Collaborative members to the rest of Wisconsin, neighboring states and the rest of the United States. Faced with limited resources, groups prioritized their efforts based on the nature of the measure and their performance compared to others. The outcomes demonstrated that public reporting was associated with improvement in health quality and that large physician group practices will engage in improvement efforts in response. PMID:23459733

  9. Gaining Control and Predictability of Software-Intensive Systems Development and Sustainment

    DTIC Science & Technology

    2015-02-04

    implementation of the baselines, audits , and technical reviews within an overarching systems engineering process (SEP; Defense Acquisition University...warfighters’ needs. This management and metrics effort supplements and supports the system’s technical development through the baselines, audits and...other areas that could be researched and added into the nine-tier model. Areas including software metrics, quality assurance , software-oriented

  10. A Microfluidic Immunostaining System Enables Quality Assured and Standardized Immunohistochemical Biomarker Analysis

    NASA Astrophysics Data System (ADS)

    Kwon, Seyong; Cho, Chang Hyun; Kwon, Youngmee; Lee, Eun Sook; Park, Je-Kyun

    2017-04-01

    Immunohistochemistry (IHC) plays an important role in biomarker-driven cancer therapy. Although there has been a high demand for standardized and quality assured IHC, it has rarely been achieved due to the complexity of IHC testing and the subjective validation-based process flow of IHC quality control. We present here a microfluidic immunostaining system for the standardization of IHC by creating a microfluidic linearly graded antibody (Ab)-staining device and a reference cell microarray. Unlike conventional efforts, our system deals primarily with the screening of biomarker staining conditions for quantitative quality assurance testing in IHC. We characterized the microfluidic matching of Ab staining intensity using three HER2 Abs produced by different manufacturers. The quality of HER2 Ab was also validated using tissues of breast cancer patients, demonstrating that our system is an efficient and powerful tool for the standardization and quality assurance of IHC.

  11. Respiratory muscle training for cystic fibrosis.

    PubMed

    Hilton, Nathan; Solis-Moya, Arturo

    2018-05-24

    Cystic fibrosis is the most common autosomal recessive disease in white populations, and causes respiratory dysfunction in the majority of individuals. Numerous types of respiratory muscle training to improve respiratory function and health-related quality of life in people with cystic fibrosis have been reported in the literature. Hence a systematic review of the literature is needed to establish the effectiveness of respiratory muscle training (either inspiratory or expiratory muscle training) on clinical outcomes in cystic fibrosis. This is an update of a previously published review. To determine the effectiveness of respiratory muscle training on clinical outcomes in people with cystic fibrosis. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials register comprising of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Date of most recent search: 17 April 2018.A hand search of the Journal of Cystic Fibrosis and Pediatric Pulmonology was performed, along with an electronic search of online trial databases up until 07 May 2018. Randomised controlled studies comparing respiratory muscle training with a control group in people with cystic fibrosis. Review authors independently selected articles for inclusion, evaluated the methodological quality of the studies, and extracted data. Additional information was sought from trial authors where necessary. The quality of the evidence was assessed using the GRADE system MAIN RESULTS: Authors identified 19 studies, of which nine studies with 202 participants met the review's inclusion criteria. There was wide variation in the methodological and written quality of the included studies. Four of the nine included studies were published as abstracts only and lacking concise details, thus limiting the information available. Seven studies were parallel studies and two of a cross-over design. Respiratory muscle training interventions varied dramatically, with frequency, intensity and duration ranging from thrice weekly to twice daily, 20% to 80% of maximal effort, and 10 to 30 minutes, respectively. Participant numbers ranged from 11 to 39 participants in the included studies; five studies were in adults only and four in a combination of children and adults.No significant improvement was reported in the primary outcome of pulmonary function (forced expiratory volume in one second and forced vital capacity) (very low-quality evidence). Although no change was reported in exercise capacity as assessed by the maximum rate of oxygen use, a 10% improvement in exercise duration was found when working at 60% of maximal effort in one study (n = 20) (very low-quality evidence). In a further study (n = 18), when working at 80% of maximal effort, health-related quality of life improved in the mastery and emotion domains (very low-quality evidence). With regards to the review's secondary outcomes, one study (n = 11) found a significant change in intramural pressure, functional residual capacity and maximal inspiratory pressure following training (low-quality evidence). A further study (n = 22) reported that respiratory muscle endurance was significantly longer in the training group (P < 0.01). No studies reported on any other secondary outcomes. Meta-analyses could not be performed due to a lack of consistency and insufficient detail in reported outcome measures. There is insufficient evidence to suggest whether this intervention is beneficial or not. Healthcare practitioners should consider the use of respiratory muscle training on a case-by-case basis. Further research of reputable methodological quality is needed to determine the effectiveness of respiratory muscle training in people with cystic fibrosis. Researchers should consider the following clinical outcomes in future studies; respiratory muscle function, pulmonary function, exercise capacity, hospital admissions, and health-related quality of life. Sensory-perceptual changes, such as respiratory effort sensation (e.g. rating of perceived breathlessness) and peripheral effort sensation (e.g. rating of perceived exertion) may also help to elucidate mechanisms underpinning the effectiveness of respiratory muscle training.

  12. Implementation of Quality Management in Core Service Laboratories

    PubMed Central

    Creavalle, T.; Haque, K.; Raley, C.; Subleski, M.; Smith, M.W.; Hicks, B.

    2010-01-01

    CF-28 The Genetics and Genomics group of the Advanced Technology Program of SAIC-Frederick exists to bring innovative genomic expertise, tools and analysis to NCI and the scientific community. The Sequencing Facility (SF) provides next generation short read (Illumina) sequencing capacity to investigators using a streamlined production approach. The Laboratory of Molecular Technology (LMT) offers a wide range of genomics core services including microarray expression analysis, miRNA analysis, array comparative genome hybridization, long read (Roche) next generation sequencing, quantitative real time PCR, transgenic genotyping, Sanger sequencing, and clinical mutation detection services to investigators from across the NIH. As the technology supporting this genomic research becomes more complex, the need for basic quality processes within all aspects of the core service groups becomes critical. The Quality Management group works alongside members of these labs to establish or improve processes supporting operations control (equipment, reagent and materials management), process improvement (reengineering/optimization, automation, acceptance criteria for new technologies and tech transfer), and quality assurance and customer support (controlled documentation/SOPs, training, service deficiencies and continual improvement efforts). Implementation and expansion of quality programs within unregulated environments demonstrates SAIC-Frederick's dedication to providing the highest quality products and services to the NIH community.

  13. Public Health Opportunities for Promoting Health Equity in Cancer Prevention and Control in LGBT Populations.

    PubMed

    Massetti, Greta M; Ragan, Kathleen R; Thomas, Cheryll C; Ryerson, A Blythe

    2015-10-20

    Advances in cancer prevention, detection, and treatment have led to reductions in morbidity and premature mortality and improvements in quality of life. However, not all Americans have benefitted equally from these advances, and certain populations experience continued disparities in cancer care. Although research and public health efforts have highlighted the experiences of some groups, other populations have been relatively understudied, such as lesbian, gay, bisexual, and transgender (LGBT) individuals. Public health efforts in surveillance, research, programs, and partnerships can provide opportunities to advance health equity for LGBT at the population level and lead to better health outcomes for LGBT individuals with cancer.

  14. MAINTAINING DATA QUALITY IN THE PERFORMANCE OF A LARGE SCALE INTEGRATED MONITORING EFFORT

    EPA Science Inventory

    Macauley, John M. and Linda C. Harwell. In press. Maintaining Data Quality in the Performance of a Large Scale Integrated Monitoring Effort (Abstract). To be presented at EMAP Symposium 2004: Integrated Monitoring and Assessment for Effective Water Quality Management, 3-7 May 200...

  15. A new generation of tools for search, recovery and quality evaluation of World Wide Web medical resources.

    PubMed

    Aguillo, I

    2000-01-01

    Although the Internet is already a valuable information resource in medicine, there are important challenges to be faced before physicians and general users will have extensive access to this information. As a result of a research effort to compile a health-related Internet directory, new tools and strategies have been developed to solve key problems derived from the explosive growth of medical information on the Net and the great concern over the quality of such critical information. The current Internet search engines lack some important capabilities. We suggest using second generation tools (client-side based) able to deal with large quantities of data and to increase the usability of the records recovered. We tested the capabilities of these programs to solve health-related information problems, recognising six groups according to the kind of topics addressed: Z39.50 clients, downloaders, multisearchers, tracing agents, indexers and mappers. The evaluation of the quality of health information available on the Internet could require a large amount of human effort. A possible solution may be to use quantitative indicators based on the hypertext visibility of the Web sites. The cybermetric measures are valid for quality evaluation if they are derived from indirect peer review by experts with Web pages citing the site. The hypertext links acting as citations need to be extracted from a controlled sample of quality super-sites.

  16. Six Sigma arises from the ashes of TQM with a twist.

    PubMed

    Black, Ken; Revere, Lee

    2006-01-01

    This paper sets out to analyse the use of the Six Sigma methodology to improve quality in healthcare. It looks at how Six Sigma grew out of the concept of Total Quality Management (TQM). Six Sigma is a quality improvement methodology that has been widely adopted by companies since the early 1990s and has grown exponentially in the healthcare industry during the past five years. Some of the main tenets of Six Sigma have emerged from the principles of TQM, including the notion that the entire organization must support the quality effort; that there should be a vigorous education effort; and that a quality improvement process should emphasize root cause analysis. In spite of its early success, TQM "crashed and burned" for several reasons including the fact that financial benefits were difficult to assign to TQM efforts, root cause was not always determined resulting in recurring errors, there was no common metric to measure the level of quality attained, and quality efforts were sometimes aimed at processes or operations that were not critical to the customer. Six Sigma filled the vacuums created by these TQM failures in several ways. Under the Six Sigma methodology, quality improvement projects are carefully defined so that they can be successfully completed within a relatively short time frame. Financials are applied to each completed project so that management knows how much the project saves the institution. On each project, intense study is used to determine root cause analysis; and in the end, a metric known as "sigma level" can be assigned to signify the level of quality. Six Sigma has a "critical to quality" dimension that keeps the quality effort focused on improving only those things that really matter to the customer.

  17. Effects of stick dynamics on helicopter flying qualities

    NASA Technical Reports Server (NTRS)

    Watson, Douglas C.; Schroeder, Jeffery A.

    1990-01-01

    An experiment that investigated the influence of typical helicopter force-feel system dynamics on roll-axis handling qualities was conducted in concurrent ground and inflight simulations. Variations in lateral control natural frequency and damping ratio, effected by changes in inertia and damping, were evaluated in a disturbance-rejection task. Pilot ratings indicated a preference for low-inertia feel systems, although measured performance was relatively constant over the range of stick characteristics. Force-sensing was compared with position sensing as the input to the control system. Force-sensing improved performance but did not improve pilot ratings. Overall, the results indicated that control-stick dynamics, at least within a reasonable range, did not have a significant effect on pilot-vehicle performance. However, the physical effort required to maintain a desired pilot/manipulator bandwidth became objectionable as the stick inertia increased beyond 5-7 lbm, which was reflected in the pilot ratings and comments.

  18. Integrity management of offshore structures and its implication on computation of structural action effects and resistance

    NASA Astrophysics Data System (ADS)

    Moan, T.

    2017-12-01

    An overview of integrity management of offshore structures, with emphasis on the oil and gas energy sector, is given. Based on relevant accident experiences and means to control the associated risks, accidents are categorized from a technical-physical as well as human and organizational point of view. Structural risk relates to extreme actions as well as structural degradation. Risk mitigation measures, including adequate design criteria, inspection, repair and maintenance as well as quality assurance and control of engineering processes, are briefly outlined. The current status of risk and reliability methodology to aid decisions in the integrity management is briefly reviewed. Finally, the need to balance the uncertainties in data, methods and computational efforts and the cautious use and quality assurance and control in applying high fidelity methods to avoid human errors, is emphasized, and with a plea to develop both high fidelity as well as efficient, simplified methods for design.

  19. Development of a murre (Uria spp.) egg control material

    USGS Publications Warehouse

    Vander Pol, Stacy S.; Ellisor, M.B.; Pugh, Rebecca S.; Becker, P.R.; Poster, D.L.; Schantz, M.M.; Leigh, S.D.; Wakeford, B.J.; Roseneau, David G.; Simac, K.S.

    2007-01-01

    The Seabird Tissue Archival and Monitoring Project (STAMP) is a collaborative Alaska-wide effort by the US Fish and Wildlife Service's Alaska Maritime National Wildlife Refuge (USFWS/AMNWR), the US Geological Survey's Biological Resources Division (USGS/BRD), the Bureau of Indian Affairs Alaska Region Subsistence Branch (BIA/ARSB), and the National Institute of Standards and Technology (NIST) to monitor long-term (decadal) trends in environmental contaminants using seabird eggs. To support this effort, a matrix- (seabird egg) and concentration-specific control material was needed to ensure quality during analytical work. Although a herring gull egg quality assurance (HGQA) material is available from Environment Canada (EC), contaminant concentrations in this material tended to be higher than those observed in Alaskan murre (Uria spp.) eggs. Therefore, to prepare a more appropriate control material, a total of 12 common murre (U. aalge) and thick-billed murre (U. lomvia) eggs from four Bering Sea and Gulf of Alaska nesting locations were cryohomogenized to create 190 aliquots each containing approximately 6 g. This new control material was analyzed by different methods at NIST and EC facilities for the determination of concentrations and value assignment of 63 polychlorinated biphenyl (PCB) congeners, 20 organochlorine pesticides, and 11 polybrominated diphenyl ether (PBDE) congeners. The total PCB concentration is approximately 58 ng g -1 wet mass. Results obtained for analytes not listed on the certificates of analysis of the previously used control materials, HGQA and NIST's Standard Reference Material (SRM) 1946 Lake Superior Fish Tissue, are also presented. [Figure not available: see fulltext.]. ?? Springer-Verlag 2007.

  20. Failure to Control Hyperglycemia in NonCritically Ill Diabetes Patients Despite Standard Glycemic Management in a Hospital Setting

    PubMed Central

    Neubauer, Katharina Maria; Schaupp, Lukas; Plank, Johannes; Augustin, Thomas; Mautner, Selma Isabella; Tschapeller, Bernd; Pieber, Thomas Rudolf

    2013-01-01

    Background Successful control of hyperglycemia has been shown to improve outcomes for diabetes patients in a clinical setting. We assessed the quality of physician-based glycemic management in two general wards, considering the most recent recommendations for glycemic control for noncritically ill patients (<140 mg/dl for premeal glucose). Methods Quality of glycemic management of 50 patients in two wards (endocrinology, cardiology) was assessed retrospectively by analyzing blood glucose (BG) levels, the glycemic management effort, and the online questionnaire. Results Glycemic control was clearly above the recommended target (mean BG levels: endocrinology: 175 ± 62 mg/dl; cardiology: 186 ± 68 mg/dl). When comparing the first half with the second half of the hospital stay, we found no difference in glycemic control (endocrinology: 168 ± 32 vs 164 ± 42 mg/dl, P = .67; cardiology: 174 ± 36 mg/dl vs 170 ± 42 mg/dl, P =.51) and in insulin dose (endocrinology: 15 ± 14 IU vs 15 ± 13 IU per day, P = .87; cardiology: 27 ± 17 IU vs 27 ± 18 IU per day, P = .92), despite frequent BG measurements (endocrinology: 2.7 per day; cardiology: 3.2 per day). A lack of clearly defined BG targets was indicated in the questionnaire. Conclusions The recommended BG target range was not achieved in both wards. Analysis of routine glycemic management demonstrated considerable glycemic management effort, but also a lack of translation into adequate insulin therapy. Implementation of corrective measures, such as structured treatment protocols, is essential. PMID:23566999

  1. A new roadmap for biopharmaceutical drug product development: Integrating development, validation, and quality by design.

    PubMed

    Martin-Moe, Sheryl; Lim, Fredric J; Wong, Rita L; Sreedhara, Alavattam; Sundaram, Jagannathan; Sane, Samir U

    2011-08-01

    Quality by design (QbD) is a science- and risk-based approach to drug product development. Although pharmaceutical companies have historically used many of the same principles during development, this knowledge was not always formally captured or proactively submitted to regulators. In recent years, the US Food and Drug Administration has also recognized the need for more controls in the drug manufacturing processes, especially for biological therapeutics, and it has recently launched an initiative for Pharmaceutical Quality for the 21st Century to modernize pharmaceutical manufacturing and improve product quality. In the biopharmaceutical world, the QbD efforts have been mainly focused on active pharmaceutical ingredient processes with little emphasis on drug product development. We present a systematic approach to biopharmaceutical drug product development using a monoclonal antibody as an example. The approach presented herein leverages scientific understanding of products and processes, risk assessments, and rational experimental design to deliver processes that are consistent with QbD philosophy without excessive incremental effort. Data generated using these approaches will not only strengthen data packages to support specifications and manufacturing ranges but hopefully simplify implementation of postapproval changes. We anticipate that this approach will positively impact cost for companies, regulatory agencies, and patients, alike. Copyright © 2011 Wiley-Liss, Inc.

  2. Persistent Urban Impacts on Surface Water Quality Mediated by Stormwater Recharge

    NASA Astrophysics Data System (ADS)

    Gabor, R. S.; Brooks, P. D.; Neilson, B. T.; Bowen, G. J.; Jameel, M. Y.; Hall, S. J.; Eiriksson, D.; Millington, M. R.; Gelderloos, A.

    2016-12-01

    Growing population centers along mountain watersheds put added stress on sensitive hydrologic systems and create water quality impacts downstream. We examined the mountain-to-urban transition in watersheds on Utah's Wasatch Front to identify mechanisms by which urbanization impacts water resources. Rivers in the Wasatch flow from the mountains directly into an urban landscape, where they are subject to channelization, stormwater runoff systems, and urban inputs to water quality from sources such as road salt and fertilizer. As part of an interdisciplinary effort within the iUTAH project, multiple synoptic surveys were performed and a variety of measurements were made, including basic water chemistry along with discharge, water isotopes, and nutrients. Red Butte Creek, a stream in Salt Lake City, does not show significant urban impact to water quality until several kilometers after it enters the city where concentrations of solutes such as chloride and nitrate more than triple in a gaining reach. Groundwater springs discharging to this gaining section demonstrate urban-impacted water chemistry, suggesting that during baseflow a contaminated alluvial aquifer significantly controls stream chemistry. By combining hydrometric and hydrochemical observations we were able to estimate that these groundwater springs were 17-20% urban runoff. We were then able to predict the chemistry of urban runoff that feeds into the alluvial aquifer. Samples collected from storm culverts, roofs, and asphalt during storms had chemistry values within the range of those predicted by the mixing model. This evidence that urbanization affects the water quality of baseflow through impacted groundwater suggests that stormwater mitigation may not be sufficient for protecting urban watersheds, and quantifying these persistent groundwater mediated impacts is necessary to evaluate the success of restoration efforts. By comparing these results from Red Butte Creek with similar studies from other rivers in the Wasatch Front and other alluvial systems, we can quantify how characteristics such as discharge patterns and land-use determine alluvial recharge controls on surface water quality.

  3. Development and Characterization of Reference Materials for Genetic Testing: Focus on Public Partnerships.

    PubMed

    Kalman, Lisa V; Datta, Vivekananda; Williams, Mickey; Zook, Justin M; Salit, Marc L; Han, Jin Yeong

    2016-11-01

    Characterized reference materials (RMs) are needed for clinical laboratory test development and validation, quality control procedures, and proficiency testing to assure their quality. In this article, we review the development and characterization of RMs for clinical molecular genetic tests. We describe various types of RMs and how to access and utilize them, especially focusing on the Genetic Testing Reference Materials Coordination Program (Get-RM) and the Genome in a Bottle (GIAB) Consortium. This review also reinforces the need for collaborative efforts in the clinical genetic testing community to develop additional RMs.

  4. Collaboration and Commitment to Sealed Source Safety, Security, and Disposition - 13627

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

    Jennison, Meaghan; Martin, David W.

    2013-07-01

    EnergySolutions, the Division of Radiation Control at the Utah Department of Environmental Quality (UDEQ), the Conference of Radiation Control Program Directors (CRCPD), and the Department of Energy's Global Threat Reduction Initiative (GTRI) are collaborating on a truly innovative effort to expand opportunities for cost-effective sealed source disposal. These entities have developed a first-of-its-kind initiative to dispose of certain sealed sources at the EnergySolutions disposal facility near Clive, Utah, which normally cannot accept sealed sources of any type. This creative and collaborative effort to improve radiation health, safety, and security exemplifies the spirit and commitment represented by the Richard S. Hodes,more » M.D. Honor Lecture Award, which is presented annually at the Waste Management Symposia by the Southeast Compact Commission to encourage environmental professionals and political leaders to develop innovative approaches to waste management in the United States. The participants in the collaborative initiative are honored to receive special recognition for their efforts thus far. They also recognize that the hard work remains to be done. (authors)« less

  5. Consumer Involvement in Evaluation and Quality Assurance Efforts: Review of Current Efforts in the Field of Developmental Disabilities.

    ERIC Educational Resources Information Center

    Ashline, Melissa

    This review of the professional and programmatic literature in the field of developmental disabilities focuses on ways in which individuals with developmental disabilities and their families are becoming increasingly involved in program evaluation and quality assurance efforts. Three major movements are having an impact on this activity: state and…

  6. ASVCP quality assurance guidelines: control of general analytical factors in veterinary laboratories.

    PubMed

    Flatland, Bente; Freeman, Kathy P; Friedrichs, Kristen R; Vap, Linda M; Getzy, Karen M; Evans, Ellen W; Harr, Kendal E

    2010-09-01

    Owing to lack of governmental regulation of veterinary laboratory performance, veterinarians ideally should demonstrate a commitment to self-monitoring and regulation of laboratory performance from within the profession. In response to member concerns about quality management in veterinary laboratories, the American Society for Veterinary Clinical Pathology (ASVCP) formed a Quality Assurance and Laboratory Standards (QAS) committee in 1996. This committee recently published updated and peer-reviewed Quality Assurance Guidelines on the ASVCP website. The Quality Assurance Guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports on 1) general analytic factors for veterinary laboratory performance and comparisons, 2) hematology and hemostasis, and 3) clinical chemistry, endocrine assessment, and urinalysis. This report documents recommendations for control of general analytical factors within veterinary clinical laboratories and is based on section 2.1 (Analytical Factors Important In Veterinary Clinical Pathology, General) of the newly revised ASVCP QAS Guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimum guidelines for quality assurance and quality control for veterinary laboratory testing. It is hoped that these guidelines will provide a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. ©2010 American Society for Veterinary Clinical Pathology.

  7. Modeling ozone episodes in the Baltimore-Washington region

    NASA Technical Reports Server (NTRS)

    Ryan, William F.

    1994-01-01

    Surface ozone (O3) concentrations in excess of the National Ambient Air Quality Standard (NAAQS) continue to occur in metropolitan areas in the United States despite efforts to control emissions of O3 precursors. Future O3 control strategies will be based on results from modeling efforts that have just begun in many areas. Two initial questions that arise are model sensitivity to domain-specific conditions and the selection of episodes for model evaluation and control strategy development. For the Baltimore-Washington region (B-W), the presence of the Chesapeake Bay introduces a number of issues relevant to model sensitivity. In this paper, the specific questions of the determination of model volume (mixing height) for the Urban Airshed Model (UAM) is discussed and various alternative methods compared. For the latter question, several analytic approaches, Cluster Analysis and classification and Regression Tree (CART) analysis are undertaken to determine meteorological conditions associated with severe O3 events in the B-W domain.

  8. The effect of accountable care organizations on oncology practice.

    PubMed

    Shulman, Lawrence N

    2014-01-01

    Cancer care accounts for a significant portion of the rise in health care costs, and therefore, as national efforts escalate to control cost, cancer care will be a focus of concern. Cost increases in cancer care are related to many factors, including increasing cancer incidence in an aging population, the introduction of new high-cost therapeutics, and the high cost of end-of-life care. Accountable care organizations (ACOs) have been one of the major efforts directed at controlling health care costs. How cancer care will fit into the rubric of ACOs is not entirely clear but will certainly evolve over the coming years. The oncology profession has the opportunity to play a role in this evolution or could leave the evolution to others driving the process, such as the Centers for Medicare and Medicaid Services (CMS), private payers, and ACOs. Ideally all parties will work together to provide a construct for high-value, high-quality care for patients with cancer while contributing to cost control in overall health care.

  9. Quality improvement in hospitals: how much does it reduce healthcare costs?

    PubMed

    Jones, S B

    1995-01-01

    The philosophy of W.E. Deming suggests that continuous quality improvement efforts, when properly applied, ultimately will lead to financial dividends and will help ensure business longevity. Reducing hospital charges can be exciting for the participants and can provide an impetus for expanding quality improvement efforts. Americans, however, tend to demand almost instant gratification and have limited patience for longer-term results. This factor, coupled with minimal knowledge of actual operational costs and inaccurate charge accounting systems, may lead hospital managers to misinterpret the potential net long-term effects of their quality improvement efforts. In the approaching environment of capitated reimbursement, such mistakes may have serious consequences.

  10. An expert system/ion trap mass spectrometry approach for life support systems monitoring

    NASA Technical Reports Server (NTRS)

    Palmer, Peter T.; Wong, Carla M.; Yost, Richard A.; Johnson, Jodie V.; Yates, Nathan A.; Story, Michael

    1992-01-01

    Efforts to develop sensor and control system technology to monitor air quality for life support have resulted in the development and preliminary testing of a concept based on expert systems and ion trap mass spectrometry (ITMS). An ITMS instrument provides the capability to identify and quantitate a large number of suspected contaminants at trace levels through the use of a variety of multidimensional experiments. An expert system provides specialized knowledge for control, analysis, and decision making. The system is intended for real-time, on-line, autonomous monitoring of air quality. The key characteristics of the system, performance data and analytical capabilities of the ITMS instrument, the design and operation of the expert system, and results from preliminary testing of the system for trace contaminant monitoring are described.

  11. Reliability and Maintainability Analysis: A Conceptual Design Model

    DTIC Science & Technology

    1972-03-01

    Elements For a System I. Research ane Development A. Preliminary design and engineering B. Fabrication of test equipment C. Test operations D...reliability racquiro:wents, little, if any, modu larzation and auto- matic test features would be incorporated in the subsystem design, limited reliability...niaintaina~ility testing and monitoring would be conducted turing dev!qopmcnt, and little Quality Control effort, in the rell ability/’uaintainalility

  12. Quality and safety in medical care: what does the future hold?

    PubMed

    Liang, Bryan A; Mackey, Tim

    2011-11-01

    The rapid changes in health care policy, embracing quality and safety mandates, have culminated in programs and initiatives under the Patient Protection and Affordable Care Act. To review the context of, and anticipated quality and patient safety mandates for, delivery systems, incentives under health care reform, and models for future accountability for outcomes of care. Assessment of the provisions of Patient Protection and Affordable Care Act, other reform efforts, and reform initiatives focusing on future quality and safety provisions for health care providers. Health care reform and other efforts focus on consumerism in the context of price. Quality and safety efforts will be structured using financial incentives, best-practices research, and new delivery models that focus on reaching benchmarks while reducing costs. In addition, patient experience will be a key component of reimbursement, and a move toward "retail" approaches directed at the individual patient may supplant traditional "wholesale" efforts at attracting employers. Quality and safety have always been of prime importance in medicine. However, in the future, under health care reform and associated initiatives, a shift in the paradigm of medicine will integrate quality and safety measurement with financial incentives and a new emphasis on consumerism.

  13. Merging and Visualization of Archived Oceanographic Acoustic, Optical, and Sensor Data to Support Improved Access and Interpretation

    NASA Astrophysics Data System (ADS)

    Malik, M. A.; Cantwell, K. L.; Reser, B.; Gray, L. M.

    2016-02-01

    Marine researchers and managers routinely rely on interdisciplinary data sets collected using hull-mounted sonars, towed sensors, or submersible vehicles. These data sets can be broadly categorized into acoustic remote sensing, imagery-based observations, water property measurements, and physical samples. The resulting raw data sets are overwhelmingly large and complex, and often require specialized software and training to process. To address these challenges, NOAA's Office of Ocean Exploration and Research (OER) is developing tools to improve the discoverability of raw data sets and integration of quality-controlled processed data in order to facilitate re-use of archived oceanographic data. Majority of recently collected OER raw oceanographic data can be retrieved from national data archives (e.g. NCEI and NOAA central library). Merging of disperse data sets by scientists with diverse expertise, however remains problematic. Initial efforts at OER have focused on merging geospatial acoustic remote sensing data with imagery and water property measurements that typically lack direct geo-referencing. OER has developed `smart' ship and submersible tracks that can provide a synopsis of geospatial coverage of various data sets. Tools under development enable scientists to quickly assess the relevance of archived OER data to their respective research or management interests, and enable quick access to the desired raw and processed data sets. Pre-processing of the data and visualization to combine various data sets also offers benefits to streamline data quality assurance and quality control efforts.

  14. Overlapping neural systems represent cognitive effort and reward anticipation.

    PubMed

    Vassena, Eliana; Silvetti, Massimo; Boehler, Carsten N; Achten, Eric; Fias, Wim; Verguts, Tom

    2014-01-01

    Anticipating a potential benefit and how difficult it will be to obtain it are valuable skills in a constantly changing environment. In the human brain, the anticipation of reward is encoded by the Anterior Cingulate Cortex (ACC) and Striatum. Naturally, potential rewards have an incentive quality, resulting in a motivational effect improving performance. Recently it has been proposed that an upcoming task requiring effort induces a similar anticipation mechanism as reward, relying on the same cortico-limbic network. However, this overlapping anticipatory activity for reward and effort has only been investigated in a perceptual task. Whether this generalizes to high-level cognitive tasks remains to be investigated. To this end, an fMRI experiment was designed to investigate anticipation of reward and effort in cognitive tasks. A mental arithmetic task was implemented, manipulating effort (difficulty), reward, and delay in reward delivery to control for temporal confounds. The goal was to test for the motivational effect induced by the expectation of bigger reward and higher effort. The results showed that the activation elicited by an upcoming difficult task overlapped with higher reward prospect in the ACC and in the striatum, thus highlighting a pivotal role of this circuit in sustaining motivated behavior.

  15. Development of a standardized control module for dc-to-dc converters

    NASA Technical Reports Server (NTRS)

    Yu, Y.; Iwens, R. I.; Lee, F. C.; Inouye, L. Y.

    1977-01-01

    The electrical performance of a power processor depends on the quality of its control system. Most of the existing control circuits suffer one or more of the following imperfections that tend to restrict their respective utility: (1) inability to perform different modes of duty cycle control; (2) lack of immunity to output filter parameter changes, and (3) lack of capability to provide power component stress limiting on an instantaneous basis. The three lagging aspects of existing control circuits have been used to define the major objectives of the current Standardized Control Module (SCM) Program. Detailed information on the SCM functional block diagram, its universality, and performance features, circuit description, test results, and modeling and analysis efforts are presented.

  16. Going to Scale with High-Quality Early Education

    ERIC Educational Resources Information Center

    Christina, Rachel; Nicholson-Goodman, JoVictoria

    2005-01-01

    This report is an initial effort to describe efforts of a number of states that are seeking to create statewide systems of high-quality pre-kindergarten services, as well as some of the progress they have made in doing so. Focusing on the efforts of a sample of eight U.S. states, it examines the policy choices that states have made when…

  17. Microbiological surveillance and state of the art technological strategies for the prevention of dialysis water pollution.

    PubMed

    Bolasco, Piergiorgio; Contu, Antonio; Meloni, Patrizia; Vacca, Dorio; Galfrè, Andrea

    2012-08-01

    The present report attempts to illustrate the positive impact on the microbiological quality of dialysis patients over a 15-year period through the progressive implementation of state-of-the-art technological strategies and the optimization of microbiological surveillance procedures in five dialysis units in Sardinia. Following on better microbiological, quality controls of dialysis water and improvement of procedures and equipment, a drastic improvement of microbiological water quality was observed in a total of 945 samples. The main aim was to introduce the use of microbiological culture methods as recommended by the most important guidelines. The microbiological results obtained have led to a progressive refining of controls and introduction of new materials and equipment, including two-stage osmosis and piping distribution rings featuring a greater capacity to prevent biofilm adhesion. The actions undertaken have resulted in unexpected quality improvements. Dialysis water should be viewed by the nephrologist as a medicinal product exerting a demonstrable positive impact on microinflammation in dialysis patients. A synergic effort between nephrologists and microbiologists undoubtedly constitutes the most effective means of preventing dialysis infections.

  18. Quality assurance and quality control for thermal/optical analysis of aerosol samples for organic and elemental carbon.

    PubMed

    Chow, Judith C; Watson, John G; Robles, Jerome; Wang, Xiaoliang; Chen, L-W Antony; Trimble, Dana L; Kohl, Steven D; Tropp, Richard J; Fung, Kochy K

    2011-12-01

    Accurate, precise, and valid organic and elemental carbon (OC and EC, respectively) measurements require more effort than the routine analysis of ambient aerosol and source samples. This paper documents the quality assurance (QA) and quality control (QC) procedures that should be implemented to ensure consistency of OC and EC measurements. Prior to field sampling, the appropriate filter substrate must be selected and tested for sampling effectiveness. Unexposed filters are pre-fired to remove contaminants and acceptance tested. After sampling, filters must be stored in the laboratory in clean, labeled containers under refrigeration (<4 °C) to minimize loss of semi-volatile OC. QA activities include participation in laboratory accreditation programs, external system audits, and interlaboratory comparisons. For thermal/optical carbon analyses, periodic QC tests include calibration of the flame ionization detector with different types of carbon standards, thermogram inspection, replicate analyses, quantification of trace oxygen concentrations (<100 ppmv) in the helium atmosphere, and calibration of the sample temperature sensor. These established QA/QC procedures are applicable to aerosol sampling and analysis for carbon and other chemical components.

  19. Handling Qualities Prediction of an F-16XL-Based Reduced Sonic Boom Aircraft

    NASA Technical Reports Server (NTRS)

    Cogan, Bruce; Yoo, Seung

    2010-01-01

    A major goal of the Supersonics Project under NASA s Fundamental Aeronautics program is sonic boom reduction of supersonic aircraft. An important part of this effort is development and validation of sonic boom prediction tools used in aircraft design. NASA Dryden s F- 16XL was selected as a potential testbed aircraft to provide flight validation. Part of this task was predicting the handling qualities of the modified aircraft. Due to the high cost of modifying the existing F-16XL control laws, it was desirable to find modifications that reduced the aircraft sonic boom but did not degrade baseline aircraft handling qualities allowing for the potential of flight test without changing the current control laws. This was not a requirement for the initial modification design work, but an important consideration for proceeding to the flight test option. The primary objective of this work was to determine an aerodynamic and mass properties envelope of the F-16XL aircraft. The designers could use this envelope to determine the effect of proposed modifications on aircraft handling qualities.

  20. Microbiological Surveillance and State of the Art Technological Strategies for the Prevention of Dialysis Water Pollution

    PubMed Central

    Bolasco, Piergiorgio; Contu, Antonio; Meloni, Patrizia; Vacca, Dorio; Galfrè, Andrea

    2012-01-01

    Methods: The present report attempts to illustrate the positive impact on the microbiological quality of dialysis patients over a 15-year period through the progressive implementation of state-of-the-art technological strategies and the optimization of microbiological surveillance procedures in five dialysis units in Sardinia. Results: Following on better microbiological, quality controls of dialysis water and improvement of procedures and equipment, a drastic improvement of microbiological water quality was observed in a total of 945 samples. The main aim was to introduce the use of microbiological culture methods as recommended by the most important guidelines. The microbiological results obtained have led to a progressive refining of controls and introduction of new materials and equipment, including two-stage osmosis and piping distribution rings featuring a greater capacity to prevent biofilm adhesion. The actions undertaken have resulted in unexpected quality improvements. Conclusions: Dialysis water should be viewed by the nephrologist as a medicinal product exerting a demonstrable positive impact on microinflammation in dialysis patients. A synergic effort between nephrologists and microbiologists undoubtedly constitutes the most effective means of preventing dialysis infections. PMID:23066395

  1. [Methodology for the comprehensive evaluation of the quality of performance of activities of medical and social experts].

    PubMed

    Moskalenko, V F; Gorban', Ie M; Marunich, V V; Ipatov, A V; Sergiieni, O V

    2001-01-01

    The paper scientifically substantiates methodology, approaches, criteria, and control indices for assessment of activities of establishments of medical-and-social performance. Most indices for efficiency and certain indices for week points in the work of establishments of the service depend on interaction thereof with curative- and prophylactic institutions; the best results with the problem of prevention of disability and rehabilitation of invalids are supposed to be achieved through collaborative efforts. Other criteria and intermediate indices having an effect on the quality of activities reflect the resource- and trained personnel supplies of establishments of the service, amount of work, organizational measures designed to raise the quality of medical-and-social expert performance.

  2. Quality control: can compounding pharmacy learn from the automotive industry?

    PubMed

    Dillon, L Rad

    2014-01-01

    The healthcare system is vast in scope, with constant concerns of how the system's major changes will affect the quality of future patient care. This article concerns only one small corner of the healthcare system--pharmaceutical compounding. Despite our best efforts, we are not going to single-handedly change all of the grim statistics, no matter how many years we are given or how much assistance Americans obtain from their international colleagues. Yet, the "good" news is that although in my opinion the overall quality of America's healthcare system has declined, perhaps the modest niche of compounding pharmacy can become a role model of what actually works and can offer immense opportunities to improve the efficiency and effectiveness of health care.

  3. Quality of natural product clinical trials: a comparison of those published in alternative medicine versus conventional medicine journals.

    PubMed

    Cochrane, Zara Risoldi; Gregory, Philip; Wilson, Amy

    2011-06-01

    To compare the quality of natural product clinical trials published in alternative medicine journals versus those published in conventional medicine journals. Systematic search and review of the literature. Randomized controlled trials of natural products were included if they were published in English between 2003 and 2008. Articles were categorized by their journal of publication (alternative medicine versus conventional medicine). Two independent reviewers evaluated study quality using guidelines from the Cochrane Collaboration. The results with respect to the primary outcome (positive or negative) were also assessed. Thirty articles were evaluated, 15 published in alternative medicine journals and 15 in conventional medicine journals. Of articles published in alternative medicine journals, 33.33% (n = 5) were considered low quality, and none were considered high quality. Of articles published in conventional medicine journals, 26.67% (n = 4) were considered low quality and 6.67% (n = 1) were considered high quality. Two thirds of all trials reviewed were of unclear quality, due to inadequate reporting of information relating to the study's methodology. Similar proportions of positive and negative primary outcomes were found in alternative and conventional medicine journals, and low-quality articles were not more likely to report a positive primary outcome (Fisher's exact test, two-tailed p = .287). The quality of natural product randomized controlled trials was similar among alternative and conventional medicine journals. Efforts should be made to improve the reporting of natural product clinical trials for accurate determinations of study quality to be possible.

  4. Intelligent Manufacturing of Commercial Optics Final Report CRADA No. TC-0313-92

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

    Taylor, J. S.; Pollicove, H.

    The project combined the research and development efforts of LLNL and the University of Rochester Center for Manufacturing Optics (COM), to develop a new generation of flexible computer controlled optics· grinding machines. COM's principal near term development effort is to commercialize the OPTICAM-SM, a new prototype spherical grinding machine. A crucial requirement for commercializing the OPTICAM-SM is the development of a predictable and repeatable material removal process ( deterministic micro-grinding) that yields high quality surfaces that minimize non-deterministic polishing. OPTICAM machine tools and the fabrication process development studies are part of COM' s response to the DOD (ARPA) request tomore » implement a modernization strategy for revitalizing the U.S. optics manufacturing base. This project was entered into in order to develop a new generation of :flexible, computer-controlled optics grinding machines.« less

  5. An inter- laboratory proficiency testing exercise for rabies diagnosis in Latin America and the Caribbean

    PubMed Central

    Clavijo, Alfonso; Freire de Carvalho, Mary H.; Orciari, Lillian A.; Velasco-Villa, Andres; Ellison, James A.; Greenberg, Lauren; Yager, Pamela A.; Green, Douglas B.; Vigilato, Marco A.; Cosivi, Ottorino; Del Rio-Vilas, Victor J.

    2017-01-01

    The direct fluorescent antibody test (DFA), is performed in all rabies reference laboratories across Latin America and the Caribbean (LAC). Despite DFA being a critical capacity in the control of rabies, there is not a standardized protocol in the region. We describe the results of the first inter-laboratory proficiency exercise of national rabies laboratories in LAC countries as part of the regional efforts towards dog-maintained rabies elimination in the American region. Twenty three laboratories affiliated to the Ministries of Health and Ministries of Agriculture participated in this exercise. In addition, the laboratories completed an online questionnaire to assess laboratory practices. Answers to the online questionnaire indicated large variability in the laboratories throughput, equipment used, protocols availability, quality control standards and biosafety requirements. Our results will inform actions to improve and harmonize laboratory rabies capacities across LAC in support for the regional efforts towards elimination of dog-maintained rabies. PMID:28369139

  6. Evaluation of the impact of 2 years of a dosing intervention on canine echinococcosis in the Alay Valley, Kyrgyzstan.

    PubMed

    VAN Kesteren, F; Mastin, A; Torgerson, P R; Mytynova, Bermet; Craig, P S

    2017-09-01

    Echinococcosis is a re-emerging zoonotic disease in Kyrgyzstan. In 2012, an echinococcosis control scheme was started that included dosing owned dogs in the Alay Valley, Kyrgyzstan with praziquantel. Control programmes require large investments of money and resources; as such it is important to evaluate how well these are meeting their targets. However, problems associated with echinococcosis control schemes include remoteness and semi-nomadic customs of affected communities, and lack of resources. These same problems apply to control scheme evaluations, and quick and easy assessment tools are highly desirable. Lot quality assurance sampling was used to assess the impact of approximately 2 years of echinococcosis control in the Alay valley. A pre-intervention coproELISA prevalence was established, and a 75% threshold for dosing compliance was set based on previous studies. Ten communities were visited in 2013 and 2014, with 18-21 dogs sampled per community, and questionnaires administered to dog owners. After 21 months of control efforts, 8/10 communities showed evidence of reaching the 75% praziquantel dosing target, although only 3/10 showed evidence of a reduction in coproELISA prevalence. This is understandable, since years of sustained control are required to effectively control echinococcosis, and efforts in the Alay valley should be and are being continued.

  7. Feature selection with harmony search.

    PubMed

    Diao, Ren; Shen, Qiang

    2012-12-01

    Many search strategies have been exploited for the task of feature selection (FS), in an effort to identify more compact and better quality subsets. Such work typically involves the use of greedy hill climbing (HC), or nature-inspired heuristics, in order to discover the optimal solution without going through exhaustive search. In this paper, a novel FS approach based on harmony search (HS) is presented. It is a general approach that can be used in conjunction with many subset evaluation techniques. The simplicity of HS is exploited to reduce the overall complexity of the search process. The proposed approach is able to escape from local solutions and identify multiple solutions owing to the stochastic nature of HS. Additional parameter control schemes are introduced to reduce the effort and impact of parameter configuration. These can be further combined with the iterative refinement strategy, tailored to enforce the discovery of quality subsets. The resulting approach is compared with those that rely on HC, genetic algorithms, and particle swarm optimization, accompanied by in-depth studies of the suggested improvements.

  8. Preliminary remediation goals for use at the US Department of Energy Oak Ridge Operations Office. Revision 1

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

    NONE

    1996-05-01

    This technical memorandum presents Preliminary Remediation Goals (PRGs) for use in human health risk assessment efforts under the United States Department of Energy, Oak Ridge Operations Office Environmental Restoration (ER) Division. This document provides the ER Division with standardized PRGs which are integral to the Remedial Investigation/Feasibility Study process. They are used during project scooping (Data Quality Objectives development), in screening level risk assessments to support early action or No Further Investigation decisions, and in the baselines risk assessment where they are employed in the selection of chemicals of potential concern. The primary objective of this document is to standardizemore » these values and eliminate any duplication of effort by providing PRGs to all contractors involved in risk activities. In addition, by managing the assumptions and systems used in PRG derivation, the ER Risk Assessment Program will be able to control the level of quality assurance associated with these risk-based guideline values.« less

  9. Occupational stress in the ED: a systematic literature review.

    PubMed

    Basu, Subhashis; Qayyum, Hasan; Mason, Suzanne

    2017-07-01

    Occupational stress is a major modern health and safety challenges. While the ED is known to be a high-pressure environment, the specific organisational stressors which affect ED staff have not been established. We conducted a systematic review of literature examining the sources of organisational stress in the ED, their link to adverse health outcomes and interventions designed to address them. A narrative review of contextual factors that may contribute to occupational stress was also performed. All articles written in English, French or Spanish were eligible for conclusion. Study quality was graded using a modified version of the Newcastle-Ottawa Scale. Twenty-five full-text articles were eligible for inclusion in our systematic review. Most were of moderate quality, with two low-quality and two high-quality studies, respectively. While high demand and low job control were commonly featured, other studies demonstrated the role of insufficient support at work, effort-reward imbalance and organisational injustice in the development of adverse health and occupational outcomes. We found only one intervention in a peer-reviewed journal evaluating a stress reduction programme in ED staff. Our review provides a guide to developing interventions that target the origins of stress in the ED. It suggests that those which reduce demand and increase workers' control over their job, improve managerial support, establish better working relationships and make workers' feel more valued for their efforts could be beneficial. We have detailed examples of successful interventions from other fields which may be applicable to this setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Positioning Continuing Education: Boundaries and Intersections between the Domains Continuing Education, Knowledge Translation, Patient Safety and Quality Improvement

    ERIC Educational Resources Information Center

    Kitto, Simon; Bell, Mary; Peller, Jennifer; Sargeant, Joan; Etchells, Edward; Reeves, Scott; Silver, Ivan

    2013-01-01

    Public and professional concern about health care quality, safety and efficiency is growing. Continuing education, knowledge translation, patient safety and quality improvement have made concerted efforts to address these issues. However, a coordinated and integrated effort across these domains is lacking. This article explores and discusses the…

  11. The need for a formalised system of Quality Control for environmental policy-science.

    PubMed

    Larcombe, Piers; Ridd, Peter

    2018-01-01

    Research science used to inform public policy decisions, herein defined as "Policy-Science", is rarely subjected to rigorous checking, testing and replication. Studies of biomedical and other sciences indicate that a considerable fraction of published peer-reviewed scientific literature, perhaps half, has significant flaws. To demonstrate the potential failings of the present approaches to scientific Quality Control (QC), we describe examples of science associated with perceived threats to the Great Barrier Reef (GBR), Australia. There appears a serious risk of efforts to improve the health of the GBR being directed inefficiently and/or away from the more serious threats. We suggest the need for a new organisation to undertake quality reviews and audits of important scientific results that underpin government spending decisions on the environment. Logically, such a body could also examine policy science in other key areas where governments rely heavily upon scientific results, such as education, health and criminology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. 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.

  13. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

    PubMed Central

    2010-01-01

    Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political leadership. Horizontal integration with programs for other diseases will be important. PMID:20942937

  14. Reference H Cycle 3 Stability, Control, and Flying Qualities Batch Assessments

    NASA Technical Reports Server (NTRS)

    Henderson, Dennis K.

    1999-01-01

    This work is an update of the assessment completed in February of 1996, when a preliminary assessment report was issued for the Cycle 2B simulation model. The primary purpose of the final assessment was to re-evaluate each assessment against the flight control system (FCS) requirements document using the updated model. Only a limited number of final assessments were completed due to the close proximity of the release of the Langley model and the assessment deliverable date. The assessment used the nonlinear Cycle 3 simulation model because it combines nonlinear aeroelastic (quasi-static) aerodynamic with hinge moment and rate limited control surface deflections. Both Configuration Aerodynamics (Task 32) and Flight Controls (Task 36) were funded in 1996 to conduct the final stability and control assessments of the unaugmented Reference H configuration in FY96. Because the two tasks had similar output requirements, the work was divided such that Flight Controls would be responsible for the implementation and checkout of the simulation model and Configuration Aerodynamics for writing Madab "script' files, conducting the batch assessments and writing the assessment report. Additionally, Flight Controls was to investigate control surface allocations schemes different from the baseline Reference H in an effort to fulfill flying qualities criteria.

  15. Statistical Methods for Quality Control of Steel Coils Manufacturing Process using Generalized Linear Models

    NASA Astrophysics Data System (ADS)

    García-Díaz, J. Carlos

    2009-11-01

    Fault detection and diagnosis is an important problem in process engineering. Process equipments are subject to malfunctions during operation. Galvanized steel is a value added product, furnishing effective performance by combining the corrosion resistance of zinc with the strength and formability of steel. Fault detection and diagnosis is an important problem in continuous hot dip galvanizing and the increasingly stringent quality requirements in automotive industry has also demanded ongoing efforts in process control to make the process more robust. When faults occur, they change the relationship among these observed variables. This work compares different statistical regression models proposed in the literature for estimating the quality of galvanized steel coils on the basis of short time histories. Data for 26 batches were available. Five variables were selected for monitoring the process: the steel strip velocity, four bath temperatures and bath level. The entire data consisting of 48 galvanized steel coils was divided into sets. The first training data set was 25 conforming coils and the second data set was 23 nonconforming coils. Logistic regression is a modeling tool in which the dependent variable is categorical. In most applications, the dependent variable is binary. The results show that the logistic generalized linear models do provide good estimates of quality coils and can be useful for quality control in manufacturing process.

  16. ASVCP quality assurance guidelines: control of preanalytical, analytical, and postanalytical factors for urinalysis, cytology, and clinical chemistry in veterinary laboratories.

    PubMed

    Gunn-Christie, Rebekah G; Flatland, Bente; Friedrichs, Kristen R; Szladovits, Balazs; Harr, Kendal E; Ruotsalo, Kristiina; Knoll, Joyce S; Wamsley, Heather L; Freeman, Kathy P

    2012-03-01

    In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and documents recommendations for control of preanalytical, analytical, and postanalytical factors related to urinalysis, cytology, and clinical chemistry in veterinary laboratories and is adapted from sections 1.1 and 2.2 (clinical chemistry), 1.3 and 2.5 (urinalysis), 1.4 and 2.6 (cytology), and 3 (postanalytical factors important in veterinary clinical pathology) of these guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. © 2012 American Society for Veterinary Clinical Pathology.

  17. ASVCP quality assurance guidelines: control of preanalytical and analytical factors for hematology for mammalian and nonmammalian species, hemostasis, and crossmatching in veterinary laboratories.

    PubMed

    Vap, Linda M; Harr, Kendal E; Arnold, Jill E; Freeman, Kathleen P; Getzy, Karen; Lester, Sally; Friedrichs, Kristen R

    2012-03-01

    In December 2009, the American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards committee published the updated and peer-reviewed ASVCP Quality Assurance Guidelines on the Society's website. These guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports: (1) general analytical factors for veterinary laboratory performance and comparisons; (2) hematology, hemostasis, and crossmatching; and (3) clinical chemistry, cytology, and urinalysis. This particular report is one of 3 reports and provides recommendations for control of preanalytical and analytical factors related to hematology for mammalian and nonmammalian species, hemostasis testing, and crossmatching and is adapted from sections 1.1 and 2.3 (mammalian hematology), 1.2 and 2.4 (nonmammalian hematology), 1.5 and 2.7 (hemostasis testing), and 1.6 and 2.8 (crossmatching) of the complete guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimal guidelines for quality assurance and quality control for veterinary laboratory testing and a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. © 2012 American Society for Veterinary Clinical Pathology.

  18. Quality control in public participation assessments of water quality: the OPAL Water Survey.

    PubMed

    Rose, N L; Turner, S D; Goldsmith, B; Gosling, L; Davidson, T A

    2016-07-22

    Public participation in scientific data collection is a rapidly expanding field. In water quality surveys, the involvement of the public, usually as trained volunteers, generally includes the identification of aquatic invertebrates to a broad taxonomic level. However, quality assurance is often not addressed and remains a key concern for the acceptance of publicly-generated water quality data. The Open Air Laboratories (OPAL) Water Survey, launched in May 2010, aimed to encourage interest and participation in water science by developing a 'low-barrier-to-entry' water quality survey. During 2010, over 3000 participant-selected lakes and ponds were surveyed making this the largest public participation lake and pond survey undertaken to date in the UK. But the OPAL approach of using untrained volunteers and largely anonymous data submission exacerbates quality control concerns. A number of approaches were used in order to address data quality issues including: sensitivity analysis to determine differences due to operator, sampling effort and duration; direct comparisons of identification between participants and experienced scientists; the use of a self-assessment identification quiz; the use of multiple participant surveys to assess data variability at single sites over short periods of time; comparison of survey techniques with other measurement variables and with other metrics generally considered more accurate. These quality control approaches were then used to screen the OPAL Water Survey data to generate a more robust dataset. The OPAL Water Survey results provide a regional and national assessment of water quality as well as a first national picture of water clarity (as suspended solids concentrations). Less than 10 % of lakes and ponds surveyed were 'poor' quality while 26.8 % were in the highest water quality band. It is likely that there will always be a question mark over untrained volunteer generated data simply because quality assurance is uncertain, regardless of any post hoc data analyses. Quality control at all stages, from survey design, identification tests, data submission and interpretation can all increase confidence such that useful data can be generated by public participants.

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

    Reisman, D.J.

    A variety of issues must be addressed in development of software for information resources. One is accessibility and use of information. Another is that to properly design, abstract, index, and do quality control on a database requires the effort of well-trained and knowledgeable personnel as well as substantial financial resources. Transferring data to other locations has inherent difficulties, including those related to incompatibility. The main issue in developing health risk assessment databases is the needs of the user.

  20. Columbia/Willamette Skill Builders Consortium. Final Performance Report. Appendix 5B Anodizing Inc. (Aluminum Extrusion Manufacturing). Basic Measurement Math. Instructors' Reports and Sample Curriculum Materials.

    ERIC Educational Resources Information Center

    Taylor, Marjorie; And Others

    Anodizing, Inc., Teamsters Local 162, and Mt. Hood Community College (Oregon) developed a workplace literacy program for workers at Anodizing. These workers did not have the basic skill competencies to benefit from company training efforts in statistical process control and quality assurance and were not able to advance to lead and supervisory…

  1. Research and technology, 1983

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Highlights of major accomplishments and applications made during the past year illustrate the broad range of research and technology activities at the Langley Research Center. Advances are reported in the following areas: systems engineering and operation; aeronautics; electronics; space applications; aircraft and spacecraft structures; composite structures; laminar flow control; subsonic transport aircraft; and supersonic fighter concepts. Technology utilization efforts described cover a hyperthermia monitor, a lightweight composite wheelchair; and a vehicle ride quality meter.

  2. Watershed Sediment Losses to Lakes Accelerating Despite Agricultural Soil Conservation Efforts

    PubMed Central

    Heathcote, Adam J.; Filstrup, Christopher T.; Downing, John A.

    2013-01-01

    Agricultural soil loss and deposition in aquatic ecosystems is a problem that impairs water quality worldwide and is costly to agriculture and food supplies. In the US, for example, billions of dollars have subsidized soil and water conservation practices in agricultural landscapes over the past decades. We used paleolimnological methods to reconstruct trends in sedimentation related to human-induced landscape change in 32 lakes in the intensively agricultural region of the Midwestern United States. Despite erosion control efforts, we found accelerating increases in sediment deposition from erosion; median erosion loss since 1800 has been 15.4 tons ha−1. Sediment deposition from erosion increased >6-fold, from 149 g m−2 yr−1 in 1850 to 986 g m−2 yr−1 by 2010. Average time to accumulate one mm of sediment decreased from 631 days before European settlement (ca. 1850) to 59 days mm−1 at present. Most of this sediment was deposited in the last 50 years and is related to agricultural intensification rather than land clearance or predominance of agricultural lands. In the face of these intensive agricultural practices, traditional soil conservation programs have not decelerated downstream losses. Despite large erosion control subsidies, erosion and declining water quality continue, thus new approaches are needed to mitigate erosion and water degradation. PMID:23326454

  3. Watershed sediment losses to lakes accelerating despite agricultural soil conservation efforts.

    PubMed

    Heathcote, Adam J; Filstrup, Christopher T; Downing, John A

    2013-01-01

    Agricultural soil loss and deposition in aquatic ecosystems is a problem that impairs water quality worldwide and is costly to agriculture and food supplies. In the US, for example, billions of dollars have subsidized soil and water conservation practices in agricultural landscapes over the past decades. We used paleolimnological methods to reconstruct trends in sedimentation related to human-induced landscape change in 32 lakes in the intensively agricultural region of the Midwestern United States. Despite erosion control efforts, we found accelerating increases in sediment deposition from erosion; median erosion loss since 1800 has been 15.4 tons ha(-1). Sediment deposition from erosion increased >6-fold, from 149 g m(-2) yr(-1) in 1850 to 986 g m(-2) yr(-1) by 2010. Average time to accumulate one mm of sediment decreased from 631 days before European settlement (ca. 1850) to 59 days mm(-1) at present. Most of this sediment was deposited in the last 50 years and is related to agricultural intensification rather than land clearance or predominance of agricultural lands. In the face of these intensive agricultural practices, traditional soil conservation programs have not decelerated downstream losses. Despite large erosion control subsidies, erosion and declining water quality continue, thus new approaches are needed to mitigate erosion and water degradation.

  4. Motivators and hygiene factors among physicians responding to explicit incentives to improve the value of care.

    PubMed

    Waddimba, Anthony C; Burgess, James F; Young, Gary J; Beckman, Howard B; Meterko, Mark

    2013-01-01

    Physician's dissatisfaction is reported to be increasing, especially in primary care. The transition from fee-for-service to outcome-based reimbursements may make matters worse. To investigate influences of provider attitudes and practice settings on job satisfaction/dissatisfaction during transition to quality-based payment models, we assessed self-reported satisfaction/dissatisfaction with practice in a Rochester (New York)-area physician practice association in the process of implementing pay-for-performance. We linked cross-sectional data for 215 survey respondents on satisfaction ratings and behavioral attitudes with medical record data on their clinical behavior and practices, and census data on their catchment population. Factors associated with the odds of being satisfied or dissatisfied were determined via predictive multivariable logistic regression modeling. Dissatisfied physicians were more likely to have larger-than-average patient panels, lower autonomy and/or control, and beliefs that quality incentives were hindering patient care. Satisfied physicians were more likely to have a higher sense of autonomy and control, smaller patient volumes, and a less complex patient mix. Efforts to maintain or improve satisfaction among physicians should focus on encouraging professional autonomy during transitions from volume-based to quality/outcomes-based payment systems. An optimum balance between accountability and autonomy/control might maximize both health care quality and job satisfaction.

  5. An index approach to performance-based payments for water quality.

    PubMed

    Maille, Peter; Collins, Alan R

    2012-05-30

    In this paper we describe elements of a field research project that presented farmers with economic incentives to control nitrate runoff. The approach used is novel in that payments are based on ambient water quality and water quantity produced by a watershed rather than proxies for water quality conservation. Also, payments are made based on water quality relative to a control watershed, and therefore, account for stochastic fluctuations in background nitrate levels. Finally, the program pays farmers as a group to elicit team behavior. We present our approach to modeling that allowed us to estimate prices for water and resulting payment levels. We then compare these preliminary estimates to the actual values recorded over 33 months of fieldwork. We find that our actual payments were 29% less than our preliminary estimates, due in part to the failure of our ecological model to estimate discharge accurately. Despite this shortfall, the program attracted the participation of 53% of the farmers in the watershed, and resulted in substantial nitrate abatement activity. Given this favorable response, we propose that research efforts focus on implementing field trials of group-level performance-based payments. Ideally these programs would be low risk and control for naturally occurring contamination. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Effects on work ability, job strain and quality of life of monitoring depression using a self-assessment instrument in recurrent general practitioner consultations: A randomized controlled study.

    PubMed

    Petersson, E-L; Wikberg, C; Westman, J; Ariai, N; Nejati, S; Björkelund, C

    2018-05-01

    Depression reduces individuals' function and work ability and is associated with both frequent and long-term sickness absence. Investigate if monitoring of depression course using a self-assessment instrument in recurrent general practitioner (GP) consultations leads to improved work ability, decreased job strain, and quality of life among primary care patients. Primary care patients n = 183, who worked. In addition to regular treatment (control group), intervention patients received evaluation and monitoring and used the MADRS-S depression scale during GP visit at baseline and at visits 4, 8, and 12 weeks. Work ability, quality of life and job strain were outcome measures. Depression symptoms decreased in all patients. Significantly steeper increase of WAI at 3 months in the intervention group. Social support was perceived high in a significantly higher frequency in intervention group compared to control group. Monitoring of depression course using a self-assessment instrument in recurrent GP consultations seems to lead to improved self-assessed work ability and increased high social support, but not to reduced job strain or increased quality of life compared to TAU. Future studies concerning rehabilitative efforts that seek to influence work ability probably also should include more active interventions at the workplace.

  7. Do People with Schizophrenia Have Difficulty Anticipating Pleasure, Engaging in Effortful Behavior, or Both?

    PubMed Central

    Gard, David E.; Sanchez, Amy H.; Cooper, Kathryn; Fisher, Melissa; Garrett, Coleman; Vinogradov, Sophia

    2014-01-01

    Motivation deficits are common in schizophrenia, but little is known about underlying mechanisms, or the specific goals that people with schizophrenia set in daily life. Using neurobiological heuristics of pleasure anticipation and effort assessment, we examined the quality of activities and goals of 47 people with and 41 people without schizophrenia, utilizing Ecological Momentary Assessment. Participants were provided cell phones and called four times a day for seven days, and were asked about their current activities and anticipation of upcoming goals. Activities and goals were later coded by independent raters on pleasure and effort. In line with recent laboratory findings on effort computation deficits in schizophrenia, relative to healthy participants, people with schizophrenia reported engaging in less effortful activities and setting less effortful goals, which were related to patient functioning. In addition, patients showed some inaccuracy in estimating how difficult an effortful goal would be, which in turn was associated with lower neurocognition. In contrast to previous research, people with schizophrenia engaged in activities and set goals that were more pleasure-based, and anticipated goals as being more pleasurable than controls. Thus, this study provided evidence for difficulty with effortful behavior and not anticipation of pleasure. These findings may have psychosocial treatment implications, focusing on effort assessment/effort expenditure. For example, in order to help people with schizophrenia engage in more meaningful goal pursuits, treatment providers may leverage low-effort pleasurable goals by helping patients to break down larger, more complex goals into smaller, lower-effort steps that are associated with specific pleasurable rewards. PMID:25133986

  8. Evaluating the Economic and Social Benefits of Nutrient ...

    EPA Pesticide Factsheets

    New England’s coastal social-ecological systems are subject to chronic environmental problems, including water quality degradation. Researchers at EPA’s Office of Research and Development (ORD) Atlantic Ecology Division (AED) are piloting an effort to further understand how reduced water quality due to nutrient enrichment is affecting and may affect the economic prosperity, social capacity, and ecological integrity of coastal New England communities. This research is part of task 4.61 of ORD’s Sustainable and Healthy Communities Research Program (Integrated Solutions for Sustainable Communities: Social-Ecological Systems for Resilience and Adaptive Management in Communities - A Cape Cod Case Study). Concurrent with this effort, AED researchers are participating in EPA’s three-office effort (Office of Research and Development, Office of Policy, and Office of Water) to quantify and monetize the benefits of water quality improvements across the Nation. AED’s effort is a case study of changes in recreation demand and values due to changes in nutrients in Northeastern estuaries and freshwater ponds. This work is part of task 3.04A of the Safe and Sustainable Waters Research Program (National Water Quality Benefits: Economic Case Studies of Water Quality Benefits). Because of the complementarity between the two projects, this Supporting Statement describes and requests hours for focus groups and interviews for both of these research efforts. Our initial

  9. How motivation affects academic performance: a structural equation modelling analysis.

    PubMed

    Kusurkar, R A; Ten Cate, Th J; Vos, C M P; Westers, P; Croiset, G

    2013-03-01

    Few studies in medical education have studied effect of quality of motivation on performance. Self-Determination Theory based on quality of motivation differentiates between Autonomous Motivation (AM) that originates within an individual and Controlled Motivation (CM) that originates from external sources. To determine whether Relative Autonomous Motivation (RAM, a measure of the balance between AM and CM) affects academic performance through good study strategy and higher study effort and compare this model between subgroups: males and females; students selected via two different systems namely qualitative and weighted lottery selection. Data on motivation, study strategy and effort was collected from 383 medical students of VU University Medical Center Amsterdam and their academic performance results were obtained from the student administration. Structural Equation Modelling analysis technique was used to test a hypothesized model in which high RAM would positively affect Good Study Strategy (GSS) and study effort, which in turn would positively affect academic performance in the form of grade point averages. This model fit well with the data, Chi square = 1.095, df = 3, p = 0.778, RMSEA model fit = 0.000. This model also fitted well for all tested subgroups of students. Differences were found in the strength of relationships between the variables for the different subgroups as expected. In conclusion, RAM positively correlated with academic performance through deep strategy towards study and higher study effort. This model seems valid in medical education in subgroups such as males, females, students selected by qualitative and weighted lottery selection.

  10. QCL seeded, ns-pulse, multi-line, CO2 laser oscillator for laser-produced-plasma extreme-UV source

    NASA Astrophysics Data System (ADS)

    Nowak, Krzysztof Michał; Suganuma, Takashi; Kurosawa, Yoshiaki; Ohta, Takeshi; Kawasuji, Yasufumi; Nakarai, Hiroaki; Saitou, Takashi; Fujimoto, Junichi; Mizoguchi, Hakaru; Sumitani, Akira; Endo, Akira

    2017-01-01

    Successful merger of state-of-the-art, semiconductor quantum-cascade lasers (QCL), with the mature CO2 laser technology, resulted in a delivery of highly-desired qualities of CO2 laser output that were not available previously without much effort. These qualities, such as multi-line operation, excellent spectro-temporal stability and pulse waveform control, became available from a single device of moderate complexity. This paper describes the operation principle and the unique properties of the solid{state seeded CO2 laser, invented for an application in laser-produced-plasma (LPP), extreme-UV (EUV) light source.

  11. Governance matters: an ecological association between governance and child mortality

    PubMed Central

    Lin, Ro-Ting; Chien, Lung-Chang; Chen, Ya-Mei; Chan, Chang-Chuan

    2014-01-01

    Background Governance of a country may have widespread effects on the health of its population, yet little is known about the effect of governance on child mortality in a country that is undergoing urbanization, economic development, and disease control. Methods We obtained indicators of six dimensions of governance (perceptions of voice and accountability, political stability and absence of violence, government effectiveness, regulatory quality, rule of law, and control of corruption) and national under-5 mortality rates for 149 countries between 1996 and 2010. We applied a semi-parametric generalized additive mixed model to examine associations after controlling for the effects of development factors (urbanization level and economy), disease control factors (hygienic conditions and vaccination rates), health expenditures, air quality, and time. Results Governance, development, and disease control showed clear inverse relations with the under-5 mortality rate (p<0.001). Per unit increases in governance, development, and disease control factors, the child mortality rate had a 0.901-, 0.823-, and 0.922-fold decrease, respectively, at fixed levels of the other two factors. Conclusions In the effort to reduce the global under-5 mortality rate, addressing a country's need for better governance is as important as improvements in development and disease control. PMID:24711600

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

    PubMed

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

    2017-09-01

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

  13. 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

  14. Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients.

    PubMed

    Pitt, Henry A; Tsypenyuk, Ella; Freeman, Susan L; Carson, Steven R; Shinefeld, Jonathan A; Hinkle, Sally M; Powers, Benjamin D; Goldberg, Amy J; DiSesa, Verdi J; Kaiser, Larry R

    2016-04-01

    Patient value (V) is enhanced when quality (Q) is increased and cost (C) is diminished (V = Q/C). However, calculating value has been inhibited by a lack of risk-adjusted cost data. The aim of this analysis was to measure patient value before and after implementation of quality improvement and cost reduction programs. Multidisciplinary efforts to improve patient value were initiated at a safety-net hospital in 2012. Quality improvement focused on adoption of multiple best practices, and minimizing practice variation was the strategy to control cost. University HealthSystem Consortium (UHC) risk-adjusted quality (patient mortality + safety + satisfaction + effectiveness) and cost (length of stay + direct cost) data were used to calculate patient value over 3 fiscal years. Normalized ranks in the UHC Quality and Accountability Scorecard were used in the value equation. For all hospital patients, quality scores improved from 50.3 to 66.5, with most of the change occurring in decreased mortality. Similar trends were observed for all surgery patients (42.6 to 48.4) and for general surgery patients (30.9 to 64.6). For all hospital patients, cost scores improved from 71.0 to 2.9. Similar changes were noted for all surgical (71.6 to 27.1) and general surgery (85.7 to 23.0) patients. Therefore, value increased more than 30-fold for all patients, 3-fold for all surgical patients, and almost 8-fold for general surgery patients. Multidisciplinary quality and cost efforts resulted in significant improvements in value for all hospitalized patients as well as general surgery patients. Mortality improved the most in general surgery patients, and satisfaction was highest among surgical patients. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  15. The interplay between sleep and mood in predicting academic functioning, physical health and psychological health: a longitudinal study.

    PubMed

    Wong, Mark Lawrence; Lau, Esther Yuet Ying; Wan, Jacky Ho Yin; Cheung, Shu Fai; Hui, C Harry; Mok, Doris Shui Ying

    2013-04-01

    Existing studies on sleep and behavioral outcomes are mostly correlational. Longitudinal data is limited. The current longitudinal study assessed how sleep duration and sleep quality may be causally linked to daytime functions, including physical health (physical well-being and daytime sleepiness), psychological health (mood and self-esteem) and academic functioning (school grades and study effort). The mediation role of mood in the relationship between sleep quality, sleep duration and these daytime functions is also assessed. A sample of 930 Chinese students (aged 18-25) from Hong Kong/Macau completed self-reported questionnaires online across three academic semesters. Sleep behaviors are assessed by the sleep timing questionnaire (for sleep duration and weekday/weekend sleep discrepancy) and the Pittsburgh sleep quality index (sleep quality); physical health by the World Health Organization quality of life scale-brief version (physical well-being) and Epworth Sleepiness Scale (daytime sleepiness); psychological health by the depression anxiety stress scale (mood) and Rosenberg Self-esteem Scale (self-esteem) and academic functioning by grade-point-average and the college student expectation questionnaire (study effort). Structural equation modeling with a bootstrap resample of 5000 showed that after controlling for demographics and participants' daytime functions at baseline, academic functions, physical and psychological health were predicted by the duration and quality of sleep. While some sleep behaviors directly predicted daytime functions, others had an indirect effect on daytime functions through negative mood, such as anxiety. Sleep duration and quality have direct and indirect (via mood) effects on college students' academic function, physical and psychological health. Our findings underscore the importance of healthy sleep patterns for better adjustment in college years. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. The National Mastitis Council: A Global Organization for Mastitis Control and Milk Quality, 50 Years and Beyond.

    PubMed

    Middleton, John R; Saeman, Anne; Fox, Larry K; Lombard, Jason; Hogan, Joe S; Smith, K Larry

    2014-12-01

    The National Mastitis Council was founded in 1961 based on the desire of a forward-thinking group of individuals to bring together "all forces of organized agriculture in the United States to combat, through every practical device, the mastitis threat to the Nation's health and food safety". What started as a small organization focused on mastitis of dairy cattle in the United States has grown into a global organization for mastitis and milk quality. Over the last 50-plus years the concerted efforts of the membership have led to the synthesis and dissemination of a considerable body of knowledge regarding udder health, milk quality, and food safety which has improved dairy cattle health and well-being and farm productivity.

  17. [Establishing and operating a human biobank. Ethical aspects].

    PubMed

    Jahns, Roland

    2016-03-01

    Particularly in the past decade which has been marked by efforts to foster individualized/personalized medicine the need for well-characterized high-quality collections of human biological material has significantly increased. When establishing and operating a human biobank the interests and the "freedom" of biomedical research must always be weighed against the interests and rights of patients and/or donors; in this process ethical aspects should be considered systematically. In addition, the importance of quality control and quality assurance has largely increased in human biobanking, both from a scientific and even more from an ethical point of view, because donated biological materials are potentially stored for decades and (on request) might serve for currently not foreseeable biomedical research purposes. In addition, the compatibility of national human biobanks with international biobank networks becomes increasingly important.

  18. Quantification of histochemical stains using whole slide imaging: development of a method and demonstration of its usefulness in laboratory quality control.

    PubMed

    Gray, Allan; Wright, Alex; Jackson, Pete; Hale, Mike; Treanor, Darren

    2015-03-01

    Histochemical staining of tissue is a fundamental technique in tissue diagnosis and research, but it suffers from significant variability. Efforts to address this include laboratory quality controls and quality assurance schemes, but these rely on subjective interpretation of stain quality, are laborious and have low reproducibility. We aimed (1) to develop a method for histochemical stain quantification using whole slide imaging and image analysis and (2) to demonstrate its usefulness in measuring staining variation. A method to quantify the individual stain components of histochemical stains on virtual slides was developed. It was evaluated for repeatability and reproducibility, then applied to control sections of an appendix to quantify H&E staining (H/E intensities and H:E ratio) between automated staining machines and to measure differences between six regional diagnostic laboratories. The method was validated with <0.5% variation in H:E ratio measurement when using the same scanner for a batch of slides (ie, it was repeatable) but was not highly reproducible between scanners or over time, where variation of 7% was found. Application of the method showed H:E ratios between three staining machines varied from 0.69 to 0.93, H:E ratio variation over time was observed. Interlaboratory comparison demonstrated differences in H:E ratio between regional laboratories from 0.57 to 0.89. A simple method using whole slide imaging can be used to quantify and compare histochemical staining. This method could be deployed in routine quality assurance and quality control. Work is needed on whole slide imaging devices to improve reproducibility. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Indicators for the automated analysis of drug prescribing quality.

    PubMed

    Coste, J; Séné, B; Milstein, C; Bouée, S; Venot, A

    1998-01-01

    Irrational and inconsistent drug prescription has considerable impact on morbidity, mortality, health service utilization, and community burden. However, few studies have addressed the methodology of processing the information contained in these drug orders used to study the quality of drug prescriptions and prescriber behavior. We present a comprehensive set of quantitative indicators for the quality of drug prescriptions which can be derived from a drug order. These indicators were constructed using explicit a priori criteria which were previously validated on the basis of scientific data. Automatic computation is straightforward, using a relational database system, such that large sets of prescriptions can be processed with minimal human effort. We illustrate the feasibility and value of this approach by using a large set of 23,000 prescriptions for several diseases, selected from a nationally representative prescriptions database. Our study may result in direct and wide applications in the epidemiology of medical practice and in quality control procedures.

  20. Local and regional interactions between air quality and climate in New Delhi- A sector based analysis

    NASA Astrophysics Data System (ADS)

    Marrapu, Pallavi

    Deteriorating air quality is one of the major problems faced worldwide and in particular in Asia. The world's most polluted megacities are located in Asia highlighting the urgent need for efforts to improve the air quality. New Delhi (India), one of the world's most polluted cities, was the host of the Common Wealth Games during the period of 4-14 October 2010. This high profile event provided a good opportunity to accelerate efforts to improve air quality. Computational advances now allow air quality forecast models to fully couple the meteorology with chemical constituents within a unified modeling system that allows two-way interactions. The WRF-Chem model is used to simulate air quality in New Delhi. The thesis focuses on evaluating air quality and meteorology feedbacks. Four nested domains ranging from South Asia, Northern India, NCR Delhi and Delhi city at 45km, 15km, 5km and 1.67km resolution for a period of 20 day (26th Sep--15th Oct, 2010) are used in the study. The predicted mean surface concentrations of various pollutants show similar spatial distributions with peak values in the middle of the domain reflecting the traffic and population patterns in the city. Along with these activities, construction dust and industrial emissions contribute to high levels of criteria pollutants. The study evaluates the WRF-Chem capabilities using a new emission inventory developed over Delhi at a fine resolution of 1.67km and evaluating the results with observational data from 11 monitoring sties placed at various Game venues. The contribution of emission sectors including transportation, power, industry, and domestic to pollutant concentrations at targeted regions are studied and the results show that transportation and domestic sector are the major contributors to the pollution levels in Delhi, followed by industry. Apart from these sectors, emissions outside of Delhi contribute 20-50% to surface concentrations depending on the species. This indicates that pollution control efforts should take a regional perspective. Air quality projections in Delhi for 2030 are investigated. The Greenhouse Gas and Air Pollution I nteractions and Synergies (GAINS) model is used to generate a 2030 future emission scenario for Delhi using projections of air quality control measures and energy demands. Net reductions in CO concentrations by 50%, and increases of 140% and 40% in BC and NOx concentrations, respectively, are predicted. The net changes in concentration are associated with increases in transport and industry sectors. The domestic sector still has a significant contribution to air pollutant levels. The air quality levels show a profound effect under this scenario on the environment and human health. The increase in pollution from 2010 to 2030 is predicted to cause an increase in surface temperature by ˜0.65K. These increasing pollution levels also show effects on the radiative forcing. The high aerosols loading i.e. BC, PM2.5 and PM10 levels show strong influence on the short and longwave fluxes causing strong surface dimming and strong atmosphere heating due to BC. These results indicate transport and domestic sectors should be targeted for air quality and climate mitigations.

  1. Student laboratory reports: an approach to improving feedback and quality

    NASA Astrophysics Data System (ADS)

    Ellingsen, Pål Gunnar; Støvneng, Jon Andreas

    2018-05-01

    We present an ongoing effort in improving the quality of laboratory reports written by first and second year physics students. The effort involves a new approach where students are given the opportunity to submit reports at intermediate deadlines, receive feedback, and then resubmit for the final deadline. In combination with a differential grading system, instead of pass/fail, the improved feedback results in higher quality reports. Improvement in the quality of the reports is visible through the grade statistics.

  2. Effects of efforts to optimise morbidity and mortality rounds to serve contemporary quality improvement and educational goals: a systematic review.

    PubMed

    Smaggus, Andrew; Mrkobrada, Marko; Marson, Alanna; Appleton, Andrew

    2018-01-01

    The quality and safety movement has reinvigorated interest in optimising morbidity and mortality (M&M) rounds. We performed a systematic review to identify effective means of updating M&M rounds to (1) identify and address quality and safety issues, and (2) address contemporary educational goals. Relevant databases (Medline, Embase, PubMed, Education Resource Information Centre, Cumulative Index to Nursing and Allied Health Literature, Healthstar, and Global Health) were searched to identify primary sources. Studies were included if they (1) investigated an intervention applied to M&M rounds, (2) reported outcomes relevant to the identification of quality and safety issues, or educational outcomes relevant to quality improvement (QI), patient safety or general medical education and (3) included a control group. Study quality was assessed using the Medical Education Research Study Quality Instrument and Newcastle-Ottawa Scale-Education instruments. Given the heterogeneity of interventions and outcome measures, results were analysed thematically. The final analysis included 19 studies. We identified multiple effective strategies (updating objectives, standardising elements of rounds and attaching rounds to a formal quality committee) to optimise M&M rounds for a QI/safety purpose. These efforts were associated with successful integration of quality and safety content into rounds, and increased implementation of QI interventions. Consistent effects on educational outcomes were difficult to identify, likely due to the use of methodologies ill-fitted for educational research. These results are encouraging for those seeking to optimise the quality and safety mission of M&M rounds. However, the inability to identify consistent educational effects suggests the investigation of M&M rounds could benefit from additional methodologies (qualitative, mixed methods) in order to understand the complex mechanisms driving learning at M&M rounds. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Some Improvements in H-PDLCs

    NASA Technical Reports Server (NTRS)

    Crawford, Gregory P.; Li, Liuliu

    2005-01-01

    Some improvements have been made in the formulation of holographically formed polymer-dispersed liquid crystals (H-PDLCs) and in the fabrication of devices made from these materials, with resulting improvements in performance. H-PDLCs are essentially volume Bragg gratings. Devices made from H-PDLCs function as electrically switchable reflective filters. Heretofore, it has been necessary to apply undesirably high drive voltages in order to switch H-PDLC devices. Many scientific papers on H-PDLCs and on the potential utility of H-PDLC devices for display and telecommunication applications have been published. However, until now, little has been published about improving quality control in synthesis of H-PDLCs and fabrication of H-PDLC devices to minimize (1) spatial nonuniformities within individual devices, (2) nonuniformities among nominally identical devices, and (3) variations in performance among nominally identical devices. The improvements reported here are results of a research effort directed partly toward solving these quality-control problems and partly toward reducing switching voltages. The quality-control improvements include incorporation of a number of process controls to create a relatively robust process, such that the H-PDLC devices fabricated in this process are more nearly uniform than were those fabricated in a prior laboratory-type process. The improved process includes ultrasonic mixing, ultrasonic cleaning, the use of a micro dispensing technique, and the use of a bubble press.

  4. Air quality improvements using European environment policies: a case study of SO2 in a coastal region in Portugal.

    PubMed

    Pereira, M C; Santos, R C; Alvim-Ferraz, M C M

    2007-02-01

    The European Union (EU) has defined several efforts for preventing and controlling air pollution that have led to a generalized reduction of health risks and environmental effects. One example of these efforts was the establishment of legislation that imposed a reduction of sulfur content in fuels, switching to cleaner fuels for industry and motor vehicles (Auto-Oil Directives). The goal of this study was to evaluate the first trends in the air quality of Oporto Metropolitan Area (Oporto-MA) related to implementation of these directives in Portugal since 2000. Therefore, sulfur dioxide (SO2) concentration data from air quality monitoring sites were analyzed for the period 1999 through 2003. It was observed that daily SO2 concentrations in the industrial area are much higher than those of the urban and rural areas, reflecting the influence of the industrial sector. The annual SO2 concentrations for the consecutive years of analysis decreased considerably for all the monitoring sites. A considerable decrease in SO2 emissions was also observed for the same period. According to EU legislation, the exceedances of the SO2 recommended limit values decreased significantly. In conclusion, this analysis shows evidence that SO2 concentrations are decreasing, and that this is consistent with the implementation of the legislation and control of the sources of pollution. Nevertheless, the potential for human health risks still persists, particularly in industrialized areas. It is expected that SO2 concentration levels in ambient air of Oporto-MA will continue to decrease in the coming years, following the present European trends.

  5. [Overview of the US policies for health information technology and lessons learned for Israel].

    PubMed

    Topaz, Maxim; Ash, Nachman

    2013-05-01

    The heaLthcare system in the United States (U.S.) faces a number of significant changes aimed at improving the quality and availability of medical services and reducing costs. Implementation of health information technologies, especiaLly ELectronic Health Records (EHR), is central to achieving these goals. Several recent Legislative efforts in the U.S. aim at defining standards and promoting wide scale "Meaningful Use" of the novel technologies. In Israel, the majority of heaLthcare providers adopted EHR throughout the Last decade. Unlike the U.S., the process of EHR adoption occurred spontaneously, without governmental control or the definition of standards. In this article, we review the U.S. health information technology policies and standards and suggest potential lessons Learned for Israel. First, we present the three-staged Meaningful Use regulations that require eligible healthcare practitioners to use EHR in their practice. We also describe the standards for EHR certification and national efforts to create interoperable health information technology networks. Finally, we provide a brief overview of the IsraeLi regulation in the field of EHR. Although the adoption of health information technology is wider in Israel, the Lack of technology standards and governmental control has Led to Large technology gaps between providers. The example of the U.S. Legislation urges the adoption of several critical steps to further enhance the quality and efficiency of the Israeli healthcare system, in particular: strengthening health information technology regulation; developing Licensure criteria for health information technology; bridging the digital gap between healthcare organizations; defining quality measures; and improving the accessibility of health information for patients.

  6. Operational Processing of Ground Validation Data for the Tropical Rainfall Measuring Mission

    NASA Technical Reports Server (NTRS)

    Kulie, Mark S.; Robinson, Mike; Marks, David A.; Ferrier, Brad S.; Rosenfeld, Danny; Wolff, David B.

    1999-01-01

    The Tropical Rainfall Measuring Mission (TRMM) satellite was successfully launched in November 1997. A primary goal of TRMM is to sample tropical rainfall using the first active spaceborne precipitation radar. To validate TRMM satellite observations, a comprehensive Ground Validation (GV) Program has been implemented for this mission. A key component of GV is the analysis and quality control of meteorological ground-based radar data from four primary sites: Melbourne, FL; Houston, TX; Darwin, Australia; and Kwajalein Atoll, RMI. As part of the TRMM GV effort, the Joint Center for Earth Systems Technology (JCET) at the University of Maryland, Baltimore County, has been tasked with developing and implementing an operational system to quality control (QC), archive, and provide data for subsequent rainfall product generation from the four primary GV sites. This paper provides an overview of the JCET operational environment. A description of the QC algorithm and performance, in addition to the data flow procedure between JCET and the TRNM science and Data Information System (TSDIS), are presented. The impact of quality-controlled data on higher level rainfall and reflectivity products will also be addressed, Finally, a brief description of JCET's expanded role into producing reference rainfall products will be discussed.

  7. Point focusing using loudspeaker arrays from the perspective of optimal beamforming.

    PubMed

    Bai, Mingsian R; Hsieh, Yu-Hao

    2015-06-01

    Sound focusing is to create a concentrated acoustic field in the region surrounded by a loudspeaker array. This problem was tackled in the previous research via the Helmholtz integral approach, brightness control, acoustic contrast control, etc. In this paper, the same problem was revisited from the perspective of beamforming. A source array model is reformulated in terms of the steering matrix between the source and the field points, which lends itself to the use of beamforming algorithms such as minimum variance distortionless response (MVDR) and linearly constrained minimum variance (LCMV) originally intended for sensor arrays. The beamforming methods are compared with the conventional methods in terms of beam pattern, directional index, and control effort. Objective tests are conducted to assess the audio quality by using perceptual evaluation of audio quality (PEAQ). Experiments of produced sound field and listening tests are conducted in a listening room, with results processed using analysis of variance and regression analysis. In contrast to the conventional energy-based methods, the results have shown that the proposed methods are phase-sensitive in light of the distortionless constraint in formulating the array filters, which helps enhance audio quality and focusing performance.

  8. An efficient visualization method for analyzing biometric data

    NASA Astrophysics Data System (ADS)

    Rahmes, Mark; McGonagle, Mike; Yates, J. Harlan; Henning, Ronda; Hackett, Jay

    2013-05-01

    We introduce a novel application for biometric data analysis. This technology can be used as part of a unique and systematic approach designed to augment existing processing chains. Our system provides image quality control and analysis capabilities. We show how analysis and efficient visualization are used as part of an automated process. The goal of this system is to provide a unified platform for the analysis of biometric images that reduce manual effort and increase the likelihood of a match being brought to an examiner's attention from either a manual or lights-out application. We discuss the functionality of FeatureSCOPE™ which provides an efficient tool for feature analysis and quality control of biometric extracted features. Biometric databases must be checked for accuracy for a large volume of data attributes. Our solution accelerates review of features by a factor of up to 100 times. Review of qualitative results and cost reduction is shown by using efficient parallel visual review for quality control. Our process automatically sorts and filters features for examination, and packs these into a condensed view. An analyst can then rapidly page through screens of features and flag and annotate outliers as necessary.

  9. Can managed care plans control health care costs?

    PubMed

    Zwanziger, J; Melnick, G A

    1996-01-01

    The health insurance sector has been transformed in the past fifteen years, with managed care replacing indemnity insurance as the norm. This transformation was intended to change the nature of competition in the health care system so that market forces could be used to control costs. Empirical studies have shown that this objective has been met, as areas with high managed care penetration have tended to have much lower rates of increase in their costs. Creating a more efficient health care system will require additional efforts to produce useful measures of quality and to maintain competitive markets.

  10. Behavioral and physiological responses to male handicap in chick-rearing black-legged kittiwakes

    USGS Publications Warehouse

    Leclaire, S.; Bourret, V.; Wagner, R.H.; Hatch, Shyla A.; Helfenstein, F.; Chastel, O.; Danchin, E.

    2011-01-01

    Parental investment entails a trade-off between the benefits of effort in current offspring and the costs to future reproduction. Long-lived species are predicted to be reluctant to increase parental effort to avoid affecting their survival. We tested this hypothesis in black-legged kittiwakes Rissa tridactyla by clipping flight feathers of experimental males at the beginning of the chick-rearing period. We analyzed the consequences of this handicap on feeding and attendance behavior, body condition, integument coloration, and circulating levels of corticosterone and prolactin in handicapped males and their mates in comparison to unmanipulated controls. Chicks in both groups were compared in terms of aggressive behavior, growth, and mortality. Handicapped males lost more mass, had less bright integuments, and attended the nest less often than controls. Nevertheless, they fed their chicks at the same rate and had similar corticosterone and prolactin levels. Compared with control females, females mated with handicapped males showed a lower provisioning rate and higher nest attendance in the first days after manipulation. Their lower feeding rate probably triggered the increased sibling aggression and mortality observed in experimental broods. Our findings suggest that experimental females adaptively adjusted their effort to their mate's perceived quality or that their provisioning was constrained by their higher nest attendance. Overall, our results suggest that kittiwake males can decrease their condition for the sake of their chicks, which seems to contradict the hypothesis that kittiwakes should be reluctant to increase parental effort to avoid affecting their survival. ?? 2011 The Author. Published by Oxford University Press on behalf of the International Society for Behavioral Ecology. All rights reserved.

  11. Integrating Representation Learning and Skill Learning in a Human-Like Intelligent Agent

    DTIC Science & Technology

    2013-06-21

    of 10 full-year controlled studies [Koedinger and MacLaren, 1997]. Nevertheless, the quality of the personalized instructions depends largely on the...relation among its children . The value of the direction field can be d, h, or v. d is the default value set for grammar rules that have only one child ...nearly comparable performance while significantly reducing the amount of knowledge engineering effort needed. 6.3 Experimental Study on

  12. Tools for Local and Distributed Climate Data Access

    NASA Astrophysics Data System (ADS)

    Schweitzer, R.; O'Brien, K.; Burger, E. F.; Smith, K. M.; Manke, A. B.; Radhakrishnan, A.; Balaji, V.

    2017-12-01

    Last year we reported on our efforts to adapt existing tools to facilitate model development. During the lifecycle of a Climate Model Intercomparison Project (CMIP), data must be quality controlled before it can be published and studied. Like previous efforts, the next CMIP6 will produce an unprecedented volume of data. For an institution, modelling group or modeller the volume of data is unmanageable without tools that organize and automate as many processes as possible. Even if a modelling group has tools for data and metadata management, it often falls on individuals to do the initial quality assessment for a model run with bespoke tools. Using individually crafted tools can lead to interruptions when project personnel change and may result in inconsistencies and duplication of effort across groups. This talk will expand on our experiences using available tools (Ferret/PyFerret, the Live Access Server, the GFDL Curator, the GFDL Model Development Database Interface and the THREDDS Data Server) to seamlessly automate the data assembly process to give users "one-click" access to a rich suite of Web-based analysis and comparison tools. On the surface, it appears that this collection of tools is well suited to the task, but our experience of the last year taught us that the data volume and distributed storage adds a number of challenges in adapting the tools for this task. Quality control and initial evaluation add their own set of challenges. We will discuss how we addressed the needs of QC researchers by expanding standard tools to include specialized plots and leveraged the configurability of the tools to add specific user defined analysis operations so they are available to everyone using the system. We also report on our efforts to overcome some of the technical barriers for wide adoption of the tools by providing pre-built containers that are easily deployed in virtual machine and cloud environments. Finally, we will offer some suggestions for added features, configuration options and improved robustness that can make future implementation of similar systems operate faster and more reliably. Solving these challenges for data sets distributed narrowly across networks and storage systems of points the way to solving similar problems associated with sharing data distributed across institutions continents.

  13. NASA total quality management 1989 accomplishments report

    NASA Technical Reports Server (NTRS)

    Tai, Betty P. (Editor); Stewart, Lynne M. (Editor)

    1990-01-01

    NASA and contractor employees achieved many notable improvements in 1989. The highlights of those improvements, described in this seventh annual Accomplishments Report, demonstrate that the people who support NASA's activities are getting more involved in quality and continuous improvement efforts. Their gains solidly support NASA's and this Nation's goal to remain a leader in space exploration and in world-wide market competition, and, when communicated to others through avenues such as this report, foster improvement efforts across government and industry. The principles in practice which led to these process refinements are important cultural elements to any organization's productivity and quality efforts. The categories in this report reflect NASA principles set forth in the 1980's and are more commonly known today as Total Quality Management (TQM): top management leadership and support; strategic planning; focus on the customer; employee training and recognition; employee empowerment and teamwork; measurement and analysis; and quality assurance.

  14. Southeast Atmosphere Studies: learning from model-observation syntheses

    NASA Astrophysics Data System (ADS)

    Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; McNeill, V. Faye; Tsigaridis, Kostas; McDonald, Brian C.; Warneke, Carsten; Guenther, Alex; Alvarado, Matthew J.; de Gouw, Joost; Mickley, Loretta J.; Leibensperger, Eric M.; Mathur, Rohit; Nolte, Christopher G.; Portmann, Robert W.; Unger, Nadine; Tosca, Mika; Horowitz, Larry W.

    2018-02-01

    Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales.This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we address questions surrounding four key themes: gas-phase chemistry, aerosol chemistry, regional climate and chemistry interactions, and natural and anthropogenic emissions. We expect this review to serve as a guidance for future modeling efforts.

  15. Southeast Atmosphere Studies: learning from model-observation syntheses

    PubMed Central

    Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; McNeill, V. Faye; Tsigaridis, Kostas; McDonald, Brian C.; Warneke, Carsten; Guenther, Alex; Alvarado, Matthew J.; de Gouw, Joost; Mickley, Loretta J.; Leibensperger, Eric M.; Mathur, Rohit; Nolte, Christopher G.; Portmann, Robert W.; Unger, Nadine; Tosca, Mika; Horowitz, Larry W.

    2018-01-01

    Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales. This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we address questions surrounding four key themes: gas-phase chemistry, aerosol chemistry, regional climate and chemistry interactions, and natural and anthropogenic emissions. We expect this review to serve as a guidance for future modeling efforts.

  16. Southeast Atmosphere Studies: Learning from Model-Observation Syntheses

    NASA Technical Reports Server (NTRS)

    Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; hide

    2018-01-01

    Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales. This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we address questions surrounding four key themes: gas-phase chemistry, aerosol chemistry, regional climate and chemistry interactions, and natural and anthropogenic emissions. We expect this review to serve as a guidance for future modeling efforts.

  17. Beyond quality improvement: exploring why primary care teams engage in a voluntary audit and feedback program.

    PubMed

    Wagner, Daniel J; Durbin, Janet; Barnsley, Jan; Ivers, Noah M

    2017-12-02

    Despite its popularity, the effectiveness of audit and feedback in support quality improvement efforts is mixed. While audit and feedback-related research efforts have investigated issues relating to feedback design and delivery, little attention has been directed towards factors which motivate interest and engagement with feedback interventions. This study explored the motivating factors that drove primary care teams to participate in a voluntary audit and feedback initiative. Interviews were conducted with leaders of primary care teams who had participated in at least one iteration of the audit and feedback program. This intervention was developed by an organization which advocates for high-quality, team-based primary care in Ontario, Canada. Interview transcripts were coded using the Consolidated Framework for Implementation Research and the resulting framework was analyzed inductively to generate key themes. Interviews were completed with 25 individuals from 18 primary care teams across Ontario. The majority were Executive Directors (14), Physician leaders (3) and support staff for Quality Improvement (4). A range of motivations for participating in the audit and feedback program beyond quality improvement were emphasized. Primarily, informants believed that the program would eventually become a best-in-class audit and feedback initiative. This reflected concerns regarding existing initiatives in terms of the intervention components and intentions as well as the perception that an initiative by primary care, for primary care would better reflect their own goals and better support desired patient outcomes. Key enablers included perceived obligations to engage and provision of support for the work involved. No teams cited an evidence base for A&F as a motivating factor for participation. A range of motivating factors, beyond quality improvement, contributed to participation in the audit and feedback program. Findings from this study highlight that efforts to understand how and when the intervention works best cannot be limited to factors within developers' control. Clinical teams may more readily engage with initiatives with the potential to address their own long-term system goals. Aligning motivations for participation with the goals of the audit and feedback initiative may facilitate both engagement and impact.

  18. Biobanking of CSF: international standardization to optimize biomarker development.

    PubMed

    Teunissen, Charlotte E; Tumani, Hayrettin; Engelborghs, Sebastiaan; Mollenhauer, Brit

    2014-03-01

    Cerebrospinal fluid (CSF) reflects pathophysiological aspects of neurological diseases, where neuroprotective strategies and biomarkers are urgently needed. Therefore, biobanking is very relevant for biomarker discovery and evaluation of neurological diseases. Important and unique features of CSF biobanking are intensive collaboration in international networks and the tight application of standardized protocols. The current adoption of standardized protocols for CSF and blood collection as presented in this review enables biomarker studies in large cohorts of patients and controls. Another topic of this review is the selection of control groups, which influences the outcome of biomarker investigations. Control groups in CSF biobanks mainly consist of different disease controls. This is in part due to the fact that lumbar punctures are mostly performed for clinical indications and rarely for research purposes only, as it is a relatively invasive procedure. Moreover, there is a lack of homogenous criteria and definition of control groups. We therefore propose uniform consensus definitions for such control groups in biomarker research, i.e. Healthy controls (HC), Spinal anesthesia subjects (SAS), Symptomatic controls (SC), Inflammatory Neurological Disease Controls (CINDC), Peripheral Inflammatory Neurological Disease Controls (PINDC) and Non-inflammatory Neurological Disease Controls (NINDC). Another important aspect of CSF biobanking is quality control. Systematic studies to address effects of pre-analytical and storage variation on a broad range of CSF proteins are needed. In conclusion, biomarker research in neurodegenerative diseases has entered a new era due to the collaborative and multicenter efforts of many groups. The streamlining of biobanking procedures, including quality control, and the selection of optimal control groups for investigating biomarkers are important improvements to perform high quality biomarker studies. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  19. The Controlled Cortical Impact Model of Experimental Brain Trauma: Overview, Research Applications, and Protocol

    PubMed Central

    Osier, Nicole; Dixon, C. Edward

    2017-01-01

    Controlled cortical impact (CCI) is a commonly used and highly regarded model of brain trauma that uses a pneumatically or electromagnetically controlled piston to induce reproducible and well-controlled injury. The CCI model was originally used in ferrets and it has since been scaled for use in many other species. This chapter will describe the historical development of the CCI model, compare and contrast the pneumatic and electromagnetic models, and summarize key short- and long-term consequences of TBI that have been gleaned using this model. In accordance with the recent efforts to promote high-quality evidence through the reporting of common data elements (CDEs), relevant study details—that should be reported in CCI studies—will be noted. PMID:27604719

  20. The Controlled Cortical Impact Model of Experimental Brain Trauma: Overview, Research Applications, and Protocol.

    PubMed

    Osier, Nicole; Dixon, C Edward

    2016-01-01

    Controlled cortical impact (CCI) is a commonly used and highly regarded model of brain trauma that uses a pneumatically or electromagnetically controlled piston to induce reproducible and well-controlled injury. The CCI model was originally used in ferrets and it has since been scaled for use in many other species. This chapter will describe the historical development of the CCI model, compare and contrast the pneumatic and electromagnetic models, and summarize key short- and long-term consequences of TBI that have been gleaned using this model. In accordance with the recent efforts to promote high-quality evidence through the reporting of common data elements (CDEs), relevant study details-that should be reported in CCI studies-will be noted.

  1. Continuous Improvement through Baldridge in Education.

    ERIC Educational Resources Information Center

    Siri, Diane K.; Miller, Ruth

    2001-01-01

    Describes efforts of the Baldrige in Education Center and Quality Leadership Academy in Santa Cruz County, California, to support teacher and administrator efforts to improve student performance in selected schools through the use of continuous-improvement techniques adopted by many American corporations to improve product quality and increase…

  2. Job stress and mortality in older age.

    PubMed

    Tobiasz-Adamczyk, Beata; Brzyski, Piotr; Florek, Marzena; Brzyska, Monika

    2013-06-01

    This paper aims to assess the relationship between the determinants of the psychosocial work environment, as expressed in terms of JDC or ERI models, and all-cause mortality in older individuals. The baseline study was conducted on a cohort comprising a random sample of 65-year-old community-dwelling citizens of Kraków, Poland. All of the 727 participants (410 women, 317 men) were interviewed in their households in the period between 2001 and 2003; a structured questionnaire was used regarding their occupational activity history, which included indexes measuring particular dimensions of their psychosocial work environment based on Karasek's Job Demand-Control model and Siegrist's Effort-Reward Imbalance model, as well as health-related quality of life and demographic data. Mortality was ascertained by monitoring City Vital Records for 7 years. Analyses were conducted separately for men and women, with the multivariate Cox proportional hazard model. During a 7-year follow-up period, 59 participants (8.1%) died, including 21 women (5.1% of total women) and 38 men (12%) (p < 0.05). Significant differences in the number of deaths occurred regarding disproportion between physical demands and control in men: those with low physical demands and low control died three times more often than those with high control, regardless of the level of demands. The multivariate Cox proportional hazard model showed that significantly higher risk of death was observed only in men with low physical demands and low control, compared to those with low physical demands and high control (Exp(B) = 4.65, 95% CI: 1.64-13.2). Observed differences in mortality patterns are similar to the patterns of relationships observed in health-related quality of life (HRQoL) level at the beginning of old age; however, the relationship between efforts and rewards or demands and control and mortality was not fully confirmed.

  3. George M. Low Trophy: NASA's quality and excellence award

    NASA Technical Reports Server (NTRS)

    1991-01-01

    NASA's major goal is the preservation of America's position as a leader in the aerospace industry. To maintain that status, it is crucial that the products and services we depend upon from NASA contractors, subcontractors, and suppliers meet the highest quality standards to ensure the space program's success. The George M. Low Trophy: NASA's Quality and Excellence Award is the result of NASA's desire to encourage continuous improvement and Total Quality Management (TQM) in the aerospace industry and is awarded to members of NASA's contractor community that have demonstrated sustained excellence, customer orientation, and outstanding achievements in a Total Quality Management (TQM) environment. The purpose in presenting this award is to increase public awareness of the importance of quality and productivity to the nation's aerospace industry and the nation's leadership position overall; encourage domestic business to continuously pursue efforts that enhance quality and increase productivity which will strengthen the nation's competitiveness in the international arena; and provide a forum for sharing the successful techniques and strategies used by applicants with other American organizations. Awards to Rockwell International and Marotta Scientific Controls, Inc. are announced and discussed.

  4. Data quality through a web-based QA/QC system: implementation for atmospheric mercury data from the global mercury observation system.

    PubMed

    D'Amore, Francesco; Bencardino, Mariantonia; Cinnirella, Sergio; Sprovieri, Francesca; Pirrone, Nicola

    2015-08-01

    The overall goal of the on-going Global Mercury Observation System (GMOS) project is to develop a coordinated global monitoring network for mercury, including ground-based, high altitude and sea level stations. In order to ensure data reliability and comparability, a significant effort has been made to implement a centralized system, which is designed to quality assure and quality control atmospheric mercury datasets. This system, GMOS-Data Quality Management (G-DQM), uses a web-based approach with real-time adaptive monitoring procedures aimed at preventing the production of poor-quality data. G-DQM is plugged on a cyberinfrastructure and deployed as a service. Atmospheric mercury datasets, produced during the first-three years of the GMOS project, are used as the input to demonstrate the application of the G-DQM and how it identifies a number of key issues concerning data quality. The major issues influencing data quality are presented and discussed for the GMOS stations under study. Atmospheric mercury data collected at the Longobucco (Italy) station is used as a detailed case study.

  5. Research and evaluation in the transformation of primary care.

    PubMed

    Peek, C J; Cohen, Deborah J; deGruy, Frank V

    2014-01-01

    Across the United States, primary care practices are engaged in demonstration projects and quality improvement efforts aimed at integrating behavioral health and primary care. Efforts to make sustainable changes at the frontline of care have identified new research and evaluation needs. These efforts enable clinics and larger health care communities to learn from demonstration projects regarding what works and what does not when integrating mental health, substance use, and primary care under realistic circumstances. To do this, implementers need to measure their successes and failures to inform local improvement processes, including the efforts of those working on integration in separate but similar settings. We review how new research approaches, beyond the contributions of traditional controlled trials, are needed to inform integrated behavioral health. Illustrating with research examples from the field, we describe how research traditions can be extended to meet these new research and learning needs of frontline implementers. We further suggest that a shared language and set of definitions for the field (not just for a particular study) are critical for the aggregation of knowledge and learning across practices and for policymaking and business modeling.

  6. Defining a Safe Operating Space for inland recreational fisheries

    USGS Publications Warehouse

    Carpenter, Stephen R.; Brock, William A.; Hansen, Gretchen J. A.; Hansen, Jonathan F.; Hennessy, Joseph M.; Isermann, Daniel A.; Pedersen, Eric J.; Perales, K. Martin; Rypel, Andrew L.; Sass, Greg G.; Tunney, Tyler D.; Vander Zanden, M. Jake

    2017-01-01

    The Safe Operating Space (SOS) of a recreational fishery is the multidimensional region defined by levels of harvest, angler effort, habitat, predation and other factors in which the fishery is sustainable into the future. SOS boundaries exhibit trade-offs such that decreases in harvest can compensate to some degree for losses of habitat, increases in predation and increasing value of fishing time to anglers. Conversely, high levels of harvest can be sustained if habitat is intact, predation is low, and value of fishing effort is moderate. The SOS approach recognizes limits in several dimensions: at overly high levels of harvest, habitat loss, predation, or value of fishing effort, the stock falls to a low equilibrium biomass. Recreational fisheries managers can influence harvest and perhaps predation, but they must cope with trends that are beyond their control such as changes in climate, loss of aquatic habitat or social factors that affect the value of fishing effort for anglers. The SOS illustrates opportunities to manage harvest or predation to maintain quality fisheries in the presence of trends in climate, social preferences or other factors that are not manageable.

  7. An Integrated Framework for Multipollutant Air Quality Management and Its Application in Georgia

    NASA Astrophysics Data System (ADS)

    Cohan, Daniel S.; Boylan, James W.; Marmur, Amit; Khan, Maudood N.

    2007-10-01

    Air protection agencies in the United States increasingly confront non-attainment of air quality standards for multiple pollutants sharing interrelated emission origins. Traditional approaches to attainment planning face important limitations that are magnified in the multipollutant context. Recognizing those limitations, the Georgia Environmental Protection Division has adopted an integrated framework to address ozone, fine particulate matter, and regional haze in the state. Rather than applying atmospheric modeling merely as a final check of an overall strategy, photochemical sensitivity analysis is conducted upfront to compare the effectiveness of controlling various precursor emission species and source regions. Emerging software enables the modeling of health benefits and associated economic valuations resulting from air pollution control. Photochemical sensitivity and health benefits analyses, applied together with traditional cost and feasibility assessments, provide a more comprehensive characterization of the implications of various control options. The fuller characterization both informs the selection of control options and facilitates the communication of impacts to affected stakeholders and the public. Although the integrated framework represents a clear improvement over previous attainment-planning efforts, key remaining shortcomings are also discussed.

  8. Epi-fingerprinting and epi-interventions for improved crop production and food quality

    PubMed Central

    Rodríguez López, Carlos M.; Wilkinson, Mike J.

    2015-01-01

    Increasing crop production at a time of rapid climate change represents the greatest challenge facing contemporary agricultural research. Our understanding of the genetic control of yield derives from controlled field experiments designed to minimize environmental variance. In spite of these efforts there is substantial residual variability among plants attributable to Genotype × Environment interactions. Recent advances in the field of epigenetics have revealed a plethora of gene control mechanisms that could account for much of this unassigned variation. These systems act as a regulatory interface between the perception of the environment and associated alterations in gene expression. Direct intervention of epigenetic control systems hold the enticing promise of creating new sources of variability that could enhance crop performance. Equally, understanding the relationship between various epigenetic states and responses of the crop to specific aspects of the growing environment (epigenetic fingerprinting) could allow for a more tailored approach to plant agronomy. In this review, we explore the many ways in which epigenetic interventions and epigenetic fingerprinting can be deployed for the improvement of crop production and quality. PMID:26097484

  9. An integrated framework for multipollutant air quality management and its application in Georgia.

    PubMed

    Cohan, Daniel S; Boylan, James W; Marmur, Amit; Khan, Maudood N

    2007-10-01

    Air protection agencies in the United States increasingly confront non-attainment of air quality standards for multiple pollutants sharing interrelated emission origins. Traditional approaches to attainment planning face important limitations that are magnified in the multipollutant context. Recognizing those limitations, the Georgia Environmental Protection Division has adopted an integrated framework to address ozone, fine particulate matter, and regional haze in the state. Rather than applying atmospheric modeling merely as a final check of an overall strategy, photochemical sensitivity analysis is conducted upfront to compare the effectiveness of controlling various precursor emission species and source regions. Emerging software enables the modeling of health benefits and associated economic valuations resulting from air pollution control. Photochemical sensitivity and health benefits analyses, applied together with traditional cost and feasibility assessments, provide a more comprehensive characterization of the implications of various control options. The fuller characterization both informs the selection of control options and facilitates the communication of impacts to affected stakeholders and the public. Although the integrated framework represents a clear improvement over previous attainment-planning efforts, key remaining shortcomings are also discussed.

  10. Use of multiple sensor technologies for quality control of in situ biogeochemical measurements: A SeaCycler case study

    NASA Astrophysics Data System (ADS)

    Atamanchuk, Dariia; Koelling, Jannes; Lai, Jeremy; Send, Uwe; Wallace, Douglas

    2017-04-01

    Over the last two decades observing capacity for the global ocean has increased dramatically. Emerging sensor technologies for dissolved gases, nutrients and bio-optical properties in seawater are allowing extension of in situ observations beyond the traditionally measured salinity, temperature and pressure (CTD). However the effort to extend observations using autonomous instruments and platforms carries the risk of losing the level of data quality achievable through conventional water sampling techniques. We will present results from a case study with the SeaCycler profiling winch focusing on quality control of the in-situ measurements. A total of 13 sensors were deployed from May 2016 to early 2017 on SeaCycler's profiling sensor float, including CTD, dissolved oxygen (O2, 3 sensors), carbon dioxide (pCO2, 2 sensors), nutrients, velocity sensors, fluorometer, transmissometer, single channel PAR sensor, and others. We will highlight how multiple measurement technologies (e.g. for O2 and CO2) complement each other and result in a high quality data product. We will also present an initial assessment of the bio-optical data, their implications for seasonal phytoplankton dynamics and comparisons to climatologies and ocean-color data products obtained from the MODIS satellite.

  11. Therapeutic Inertia and Treatment Intensification.

    PubMed

    Josiah Willock, Robina; Miller, Joseph B; Mohyi, Michelle; Abuzaanona, Ahmed; Muminovic, Meri; Levy, Phillip D

    2018-01-29

    This review aims to emphasize how therapeutic inertia, the failure of clinicians to intensify treatment when blood pressure rises or remains above therapeutic goals, contributes to suboptimal blood pressure control in hypertensive populations. Studies reveal that the therapeutic inertia is quite common and contributes to suboptimal blood pressure control. Quality improvement programs and standardized approaches to support antihypertensive treatment intensification are ways to combat therapeutic inertia. Furthermore, programs that utilize non-physician medical professionals such as pharmacists and nurses demonstrate promise in mitigating the effects of this important problem. Therapeutic inertia impedes antihypertensive management and requires a broad effort to reduce its effects. There is an ongoing need for renewed focus and research in this area to improve hypertension control.

  12. PINK1, Parkin, and Mitochondrial Quality Control: What can we Learn about Parkinson's Disease Pathobiology?

    PubMed

    Truban, Dominika; Hou, Xu; Caulfield, Thomas R; Fiesel, Fabienne C; Springer, Wolfdieter

    2017-01-01

    The first clinical description of Parkinson's disease (PD) will embrace its two century anniversary in 2017. For the past 30 years, mitochondrial dysfunction has been hypothesized to play a central role in the pathobiology of this devastating neurodegenerative disease. The identifications of mutations in genes encoding PINK1 (PTEN-induced kinase 1) and Parkin (E3 ubiquitin ligase) in familial PD and their functional association with mitochondrial quality control provided further support to this hypothesis. Recent research focused mainly on their key involvement in the clearance of damaged mitochondria, a process known as mitophagy. It has become evident that there are many other aspects of this complex regulated, multifaceted pathway that provides neuroprotection. As such, numerous additional factors that impact PINK1/Parkin have already been identified including genes involved in other forms of PD. A great pathogenic overlap amongst different forms of familial, environmental and even sporadic disease is emerging that potentially converges at the level of mitochondrial quality control. Tremendous efforts now seek to further detail the roles and exploit PINK1 and Parkin, their upstream regulators and downstream signaling pathways for future translation. This review summarizes the latest findings on PINK1/Parkin-directed mitochondrial quality control, its integration and cross-talk with other disease factors and pathways as well as the implications for idiopathic PD. In addition, we highlight novel avenues for the development of biomarkers and disease-modifying therapies that are based on a detailed understanding of the PINK1/Parkin pathway.

  13. Preventing Harm in the ICU-Building a Culture of Safety and Engaging Patients and Families.

    PubMed

    Thornton, Kevin C; Schwarz, Jennifer J; Gross, A Kendall; Anderson, Wendy G; Liu, Kathleen D; Romig, Mark C; Schell-Chaple, Hildy; Pronovost, Peter J; Sapirstein, Adam; Gropper, Michael A; Lipshutz, Angela K M

    2017-09-01

    Preventing harm remains a persistent challenge in the ICU despite evidence-based practices known to reduce the prevalence of adverse events. This review seeks to describe the critical role of safety culture and patient and family engagement in successful quality improvement initiatives in the ICU. We review the evidence supporting the impact of safety culture and provide practical guidance for those wishing to implement initiatives aimed at improving safety culture and more effectively integrate patients and families in such efforts. Literature review using PubMed including evaluation of key studies assessing large-scale quality improvement efforts in the ICU, impact of safety culture on patient outcomes, methodologies for quality improvement commonly used in healthcare, and patient and family engagement. Print and web-based resources from leading patient safety organizations were also searched. Our group completed a review of original studies, review articles, book chapters, and recommendations from leading patient safety organizations. Our group determined by consensus which resources would best inform this review. A strong safety culture is associated with reduced adverse events, lower mortality rates, and lower costs. Quality improvement efforts have been shown to be more effective and sustainable when paired with a strong safety culture. Different methodologies exist for quality improvement in the ICU; a thoughtful approach to implementation that engages frontline providers and administrative leadership is essential for success. Efforts to substantively include patients and families in the processes of quality improvement work in the ICU should be expanded. Efforts to establish a culture of safety and meaningfully engage patients and families should form the foundation for all safety interventions in the ICU. This review describes an approach that integrates components of several proven quality improvement methodologies to enhance safety culture in the ICU and highlights opportunities to include patients and families.

  14. Air quality benefits of universal particle filter and NOx controls on diesel trucks

    NASA Astrophysics Data System (ADS)

    Tao, L.; Mcdonald, B. C.; Harley, R.

    2015-12-01

    Heavy-duty diesel trucks are a major source of black carbon/particulate matter and nitrogen oxide emissions on urban and regional scales. These emissions are relevant to both air quality and climate change. Since 2010 in the US, new engines are required to be equipped with emission control systems that greatly reduce both PM and NOx emissions, by ~98% relative to 1988 levels. To reduce emissions from the legacy fleet of older trucks that still remain on the road, regulations have been adopted in Califonia to accelerate the replacement of older trucks and thereby reduce associated emissions of PM and NOx. Use of diesel particle filters will be widespread by 2016, and universal use of catalytic converters for NOx control is required by 2023. We assess the air quality consequences of this clean-up effort in Southern California, using the Community Multiscale Air Quality model (CMAQ), and comparing three scenarios: historical (2005), present day (2016), and future year (2023). Emissions from the motor vehicle sector are mapped at high spatial resolution based on traffic count and fuel sales data. NOx emissions from diesel engines in 2023 are expected to decrease by ~80% compared to 2005, while the fraction of NOx emitted as NO2 is expected to increase from 5 to 18%. Air quality model simulations will be analyzed to quantify changes in NO2, black carbon, particulate matter, and ozone, both basin-wide and near hot spots such as ports and major highways.

  15. Roles of laboratories and laboratory systems in effective tuberculosis programmes.

    PubMed

    Ridderhof, John C; van Deun, Armand; Kam, Kai Man; Narayanan, P R; Aziz, Mohamed Abdul

    2007-05-01

    Laboratories and laboratory networks are a fundamental component of tuberculosis (TB) control, providing testing for diagnosis, surveillance and treatment monitoring at every level of the health-care system. New initiatives and resources to strengthen laboratory capacity and implement rapid and new diagnostic tests for TB will require recognition that laboratories are systems that require quality standards, appropriate human resources, and attention to safety in addition to supplies and equipment. To prepare the laboratory networks for new diagnostics and expanded capacity, we need to focus efforts on strengthening quality management systems (QMS) through additional resources for external quality assessment programmes for microscopy, culture, drug susceptibility testing (DST) and molecular diagnostics. QMS should also promote development of accreditation programmes to ensure adherence to standards to improve both the quality and credibility of the laboratory system within TB programmes. Corresponding attention must be given to addressing human resources at every level of the laboratory, with special consideration being given to new programmes for laboratory management and leadership skills. Strengthening laboratory networks will also involve setting up partnerships between TB programmes and those seeking to control other diseases in order to pool resources and to promote advocacy for quality standards, to develop strategies to integrate laboratories functions and to extend control programme activities to the private sector. Improving the laboratory system will assure that increased resources, in the form of supplies, equipment and facilities, will be invested in networks that are capable of providing effective testing to meet the goals of the Global Plan to Stop TB.

  16. Advancing Equity in Illinois's ESSA Plan

    ERIC Educational Resources Information Center

    Ostro, Ginger

    2017-01-01

    Advance Illinois is an independent, objective voice for a healthy public education system that prepares all students in Illinois for success in college, careers, and civic life. Advocacy efforts have focused on securing equitable funding for schools, Common Core State Standards, high-quality assessments, and teacher quality efforts. As advocates…

  17. Online Error Reporting for Managing Quality Control Within Radiology.

    PubMed

    Golnari, Pedram; Forsberg, Daniel; Rosipko, Beverly; Sunshine, Jeffrey L

    2016-06-01

    Information technology systems within health care, such as picture archiving and communication system (PACS) in radiology, can have a positive impact on production but can also risk compromising quality. The widespread use of PACS has removed the previous feedback loop between radiologists and technologists. Instead of direct communication of quality discrepancies found for an examination, the radiologist submitted a paper-based quality-control report. A web-based issue-reporting tool can help restore some of the feedback loop and also provide possibilities for more detailed analysis of submitted errors. The purpose of this study was to evaluate the hypothesis that data from use of an online error reporting software for quality control can focus our efforts within our department. For the 372,258 radiologic examinations conducted during the 6-month period study, 930 errors (390 exam protocol, 390 exam validation, and 150 exam technique) were submitted, corresponding to an error rate of 0.25 %. Within the category exam protocol, technologist documentation had the highest number of submitted errors in ultrasonography (77 errors [44 %]), while imaging protocol errors were the highest subtype error for computed tomography modality (35 errors [18 %]). Positioning and incorrect accession had the highest errors in the exam technique and exam validation error category, respectively, for nearly all of the modalities. An error rate less than 1 % could signify a system with a very high quality; however, a more likely explanation is that not all errors were detected or reported. Furthermore, staff reception of the error reporting system could also affect the reporting rate.

  18. Quality improvement: the nurse's role.

    PubMed

    Moran, M J; Johnson, J E

    1992-06-01

    Continuous quality improvement is a concept which includes: Quality assurance--the provision of services that meet an appropriate standard. Problem resolution--including all departments involved in the issue at hand. Quality improvement--a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients. Deming (1982b) and others have espoused total system reform to achieve quality improvement--not merely altering the current system, but radically changing it. It must be assumed that those who provide services at the staff level are acting in good faith and are not willfully failing to do what is correct (Berwick, 1991). Those who perform direct services are in an excellent position to identify the need for change in service delivery processes. Based on this premise, the staff nurse--who is at the heart of the system--is the best person to assess the status of health care services and to work toward improving the processes by which these services are provided to clients in the health care setting. The nurse manager must structure the work setting to facilitate the staff nurse's ability to undertake constructive action for improving care. The use of quality circles, quality councils, or quality improvement forums to facilitate the coordination of quality improvement efforts is an effective way to achieve success. The QA coordinator assists departments in documenting that the quality improvement efforts are effective across all departments of the organization, and aggregates data to demonstrate that they meet the requirements of external regulatory agencies, insurers, and professional standards. The nurse executive provides the vision and secures the necessary resources to ensure that the organization's quality improvement efforts are successful. By inspiring and empowering the staff in their efforts to improve the process by which health care is provided, nurse managers participate in reshaping the health care environment. The professional nurse plays a vital role in the quality improvement of health care services. However, nurses cannot make these improvements in a vacuum; they must include other professionals and ancillary personnel in their efforts. Total quality commitment must include all levels of an organization's structure. Quality patient care services will be achieved as the result of positive interactions among departments working together to build a dynamic mechanism that continuously improves the processes and outcomes of health care services.

  19. Social cognitive theory: an agentic perspective.

    PubMed

    Bandura, A

    2001-01-01

    The capacity to exercise control over the nature and quality of one's life is the essence of humanness. Human agency is characterized by a number of core features that operate through phenomenal and functional consciousness. These include the temporal extension of agency through intentionality and forethought, self-regulation by self-reactive influence, and self-reflectiveness about one's capabilities, quality of functioning, and the meaning and purpose of one's life pursuits. Personal agency operates within a broad network of sociostructural influences. In these agentic transactions, people are producers as well as products of social systems. Social cognitive theory distinguishes among three modes of agency: direct personal agency, proxy agency that relies on others to act on one's behest to secure desired outcomes, and collective agency exercised through socially coordinative and interdependent effort. Growing transnational embeddedness and interdependence are placing a premium on collective efficacy to exercise control over personal destinies and national life.

  20. CDC's strategic plan for bioterrorism preparedness and response.

    PubMed

    Koplan, J

    2001-01-01

    The Department of Health and Human Services (DHHS) has played a critical lead role over the past two years in fostering activities associated with the medical and public health response to bioterrorism. Based on a charge from Secretary Donna Shalala in 1998, the Centers for Disease Control and Prevention (CDC) is leading public health efforts to strengthen the nation's capacity to detect and respond to a bioterrorist event. As a result of our efforts, federal, state, and local communities are improving their public health capacities to respond to these types of emergencies. For many of us in public health, developing plans and capacities to respond to acts of bioterrorism is an extension of our long-standing roles and responsibilities. These are stated in the CDC Mission Statement: to promote health and quality of life by preventing and controlling disease, injury, and disability, and the Bioterrorism Mission: to lead the public health effort in enhancing readiness to detect and respond to bioterrorism. CDC's infectious diseases control efforts are summarized below: --Initially formed to address malaria control in 1946; --Established the epidemic Intelligence Service in 1951; --Participated in global smallpox eradication and other immunization programs; --Estimated 800-1,000 + field investigations/year since late 1990s; --New diseases: Legionnaire's Disease, toxic shock syndrome, Lyme disease, HIV, hantavirus pulmonary syndrome, West Nile, etc. -- Today: focus on emerging infections and bioterrorism. Over the past 50 years, CDC has seen a decline in the incidence of some infectious diseases and an increase in some, whereas others continue to present on a more unpredictable basis (i.e., hantavirus). Outbreak identification, investigation, and control have been an integral part of what we do for more than 50 years. We estimate that 800 to 1,000 field investigations have occurred every year since the late 1990s. Today, however, we have a new focus on emerging infectious diseases and bioterrorism.

  1. CDC's strategic plan for bioterrorism preparedness and response.

    PubMed Central

    Koplan, J

    2001-01-01

    The Department of Health and Human Services (DHHS) has played a critical lead role over the past two years in fostering activities associated with the medical and public health response to bioterrorism. Based on a charge from Secretary Donna Shalala in 1998, the Centers for Disease Control and Prevention (CDC) is leading public health efforts to strengthen the nation's capacity to detect and respond to a bioterrorist event. As a result of our efforts, federal, state, and local communities are improving their public health capacities to respond to these types of emergencies. For many of us in public health, developing plans and capacities to respond to acts of bioterrorism is an extension of our long-standing roles and responsibilities. These are stated in the CDC Mission Statement: to promote health and quality of life by preventing and controlling disease, injury, and disability, and the Bioterrorism Mission: to lead the public health effort in enhancing readiness to detect and respond to bioterrorism. CDC's infectious diseases control efforts are summarized below: --Initially formed to address malaria control in 1946; --Established the epidemic Intelligence Service in 1951; --Participated in global smallpox eradication and other immunization programs; --Estimated 800-1,000 + field investigations/year since late 1990s; --New diseases: Legionnaire's Disease, toxic shock syndrome, Lyme disease, HIV, hantavirus pulmonary syndrome, West Nile, etc. -- Today: focus on emerging infections and bioterrorism. Over the past 50 years, CDC has seen a decline in the incidence of some infectious diseases and an increase in some, whereas others continue to present on a more unpredictable basis (i.e., hantavirus). Outbreak identification, investigation, and control have been an integral part of what we do for more than 50 years. We estimate that 800 to 1,000 field investigations have occurred every year since the late 1990s. Today, however, we have a new focus on emerging infectious diseases and bioterrorism. PMID:11880662

  2. A multi-factor designation method for mapping particulate-pollution control zones in China.

    PubMed

    Qin, Y; Xie, S D

    2011-09-01

    A multi-factor designation method for mapping particulate-pollution control zones was brought out through synthetically considering PM(10) pollution status, PM(10) anthropogenic emissions, fine particle pollution, long-range transport and economic situation. According to this method, China was divided into four different particulate-pollution control regions: PM Suspended Control Region, PM(10) Pollution Control Region, PM(2.5) Pollution Control Region and PM(10) and PM(2.5) Common Control Region, which accounted for 69.55%, 9.66%, 4.67% and 16.13% of China's territory, respectively. The PM(10) and PM(2.5) Common Control Region was mainly distributed in Bohai Region, Yangtze River Delta, Pearl River Delta, eastern of Sichuan province and Chongqing municipality, calling for immediate control of both PM(10) and PM(2.5). Cost-effective control effects can be achieved through concentrating efforts on PM(10) and PM(2.5) Common Control Region to address 60.32% of national PM(10) anthropogenic emissions. Air quality in districts belonging to PM(2.5) Pollution Control Region suggested that Chinese national ambient air quality standard for PM(10) was not strict enough. The result derived from application to China proved that this approach was feasible for mapping pollution control regions for a country with vast territory, complicated pollution characteristics and limited available monitoring data. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. The role of quality improvement in disease management: a statewide tuberculosis control success story.

    PubMed

    Fos, Peter J; Lee, Jae Eun; Sung, Jung Hye; Zuniga, Miguel A; Amy, Brian W

    2005-01-01

    This study describes Mississippi's statewide latent tuberculosis infection (LTBI) control management efforts to improve treatment outcomes using scientific quality improvement tools. LTBI medication completion rates were observed by month and by nine administrative health districts for a 12-month period. Analysis of variance (ANOVA) was conducted to see if there was any significant change between preintervention and postintervention in medication completion rates. Regression analysis was performed to test the linearity of change across the monthly rates. A change from a rate of 79.7 percent to 90.5 percent completion of the LTBI medication regimen was observed after the quality improvement intervention was instituted. During the quality improvement intervention, the mean reached 96.5 percent completion, followed by a slight decline at the end of the intervention to 90.5 percent. The analysis revealed that the mean LTBI medication completion rate across the nine administrative health districts was significantly increased and variability was decreased across all administrative health districts, with minor exceptions. A quality improvement team approach was shown to be effective in disease management by increasing LTBI medication completion. New baseline expectations can be established when quality improvement initiatives are implemented. This success can be linked, in part, to the use of scientific methods, precise and valid data, persuasive and clear goal setting, appropriate feedback, and ongoing monitoring.

  4. Association between health worker motivation and healthcare quality efforts in Ghana.

    PubMed

    Alhassan, Robert Kaba; Spieker, Nicole; van Ostenberg, Paul; Ogink, Alice; Nketiah-Amponsah, Edward; de Wit, Tobias F Rinke

    2013-08-14

    Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P <0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic's effort towards quality improvement and patient safety (P <0.05). As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst.

  5. Diabetes Care in Iran: Where We Stand and Where We Are Headed.

    PubMed

    Noshad, Sina; Afarideh, Mohsen; Heidari, Behnam; Mechanick, Jeffrey I; Esteghamati, Alireza

    2015-01-01

    The prevalence of diabetes has steadily increased in Iran from the time of the first published nationally representative survey in 1999 and despite efforts and strategies to reduce disease burden. The aim of the present review was to describe the current status of diabetes care in Iran. A selective review of the relevant literature, focusing on properly conducted studies, describing past and present diabetes care strategies, policies, and outcomes in Iran was performed. The quality of diabetes care has gradually improved as suggested by a reduction in the proportion of undiagnosed patients and an increase in affordability of diabetes medications. The National Program for Prevention and Control of Diabetes has proven successful at identifying high-risk individuals, particularly in rural and remote-access areas. Unfortunately, the rising tide of diabetes is outpacing these efforts by a considerable margin. Substantial opportunities and challenges in the areas of prevention, diagnosis, and management of diabetes exist in Iran that need to be addressed to further improve the quality of care and clinical outcomes. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Impact of peer-led quality improvement networks on quality of inpatient mental health care: study protocol for a cluster randomized controlled trial.

    PubMed

    Aimola, Lina; Jasim, Sarah; Tripathi, Neeraj; Tucker, Sarah; Worrall, Adrian; Quirk, Alan; Crawford, Mike J

    2016-09-21

    Quality improvement networks are peer-led programmes in which members of the network assess the quality of care colleagues provide according to agreed standards of practice. These networks aim to help members identify areas of service provision that could be improved and share good practice. Despite the widespread use of peer-led quality improvement networks, there is very little information about their impact. We are conducting a cluster randomized controlled trial of a quality improvement network for low-secure mental health wards to examine the impact of membership on the process and outcomes of care over a 12 month period. Standalone low secure units in England and Wales that expressed an interest in joining the quality improvement network were recruited for the study from 2012 to 2014. Thirty-eight units were randomly allocated to either the active intervention (participation in the network n = 18) or a control arm (delayed participation in the network n = 20). Using a 5 % significance level and 90 % power, it was calculated that a sample size of 60 wards was required taking into account a 10 % drop out. A total of 75 wards were assessed at baseline and 8 wards dropped out the study before the data collection at follow up. Researchers masked to the allocation status of the units assessed all study outcomes at baseline and follow-up 12 months later. The primary outcome is the quality of the physical environment and facilities on the wards. The secondary outcomes are: safety of the ward, patient-rated satisfaction with care and mental well-being, staff burnout, training and supervision. Relative to control wards, it is hypothesized that the quality of the physical environment and facilities will be higher on wards in the active arm of the trial 12 months after randomization. To our knowledge, this is the first randomized evaluation of a peer-led quality improvement network that has examined the impact of participation on both patient-level and service-level outcomes. The study has the potential to help shape future efforts to improve the quality of inpatient care. Current Controlled Trials ISRCTN79614916 . Retrospectively registered 28 March 2014].

  7. Chinese children's effortful control and dispositional anger/frustration: relations to parenting styles and children's social functioning.

    PubMed

    Zhou, Qing; Eisenberg, Nancy; Wang, Yun; Reiser, Mark

    2004-05-01

    Relations among authoritative and authoritarian parenting styles, children's effortful control and dispositional anger/frustration, and children's social functioning were examined for 425 first and second graders (7-10 years old) in Beijing, China. Parents reported on parenting styles; parents and teachers rated children's effortful control, anger/frustration, externalizing problems, and socially appropriate behaviors: and peers rated aggression and leadership/sociability. High effortful control and low dispositional anger/frustration uniquely predicted Chinese children's high social functioning, and the relation of anger/frustration to social functioning was moderated by effortful control. Authoritarian parenting was associated with children's low effortful control and high dispositional anger/frustration, which (especially effortful control) mediated the negative relation between authoritarian parenting and children's social functioning. Effortful control weakly mediated the positive relation of authoritative parenting to social functioning.

  8. Bioethics for clinicians: 15. Quality end-of-life care

    PubMed Central

    Singer, P A; MacDonald, N

    1998-01-01

    A physician who receives a call from the emergency department to see a patient with heart failure will have a clear framework within which to approach this problem. The thesis of this article is that physicians do not have an analogous conceptual framework for approaching end-of-life care. The authors present and describe a framework for end-of-life care with 3 main elements: control of pain and other symptoms, the use of life-sustaining treatments and support of those who are dying and their families. This 3-part framework can be used by clinicians at the bedside to focus their effort in improving the quality of end-of-life care. PMID:9700330

  9. [Evaluation of social medicine expert assessment].

    PubMed

    Piechowiak, H

    1989-10-01

    There are only few scientific publications in literature on medical expertising in social medicine. Although this deficit may be explained by several facts, it cannot be justified. Evaluation is a systematic set of data collection and analysis activities undertaken to place social practice on a more rational basis, i.e. greater efficiency and justice. These aims also hold good for social medicine. Evaluation, however, is only the first step within a broader research programme for quality control and quality improvement efforts, which can be successfully performed only in cooperation with the social insurance institutions. Within their medical services these institutions should provide the organisational prerequisites to enable qualified scientific research in practical social medicine.

  10. CT Dose Optimization in Pediatric Radiology: A Multiyear Effort to Preserve the Benefits of Imaging While Reducing the Risks.

    PubMed

    Greenwood, Taylor J; Lopez-Costa, Rodrigo I; Rhoades, Patrick D; Ramírez-Giraldo, Juan C; Starr, Matthew; Street, Mandie; Duncan, James; McKinstry, Robert C

    2015-01-01

    The marked increase in radiation exposure from medical imaging, especially in children, has caused considerable alarm and spurred efforts to preserve the benefits but reduce the risks of imaging. Applying the principles of the Image Gently campaign, data-driven process and quality improvement techniques such as process mapping and flowcharting, cause-and-effect diagrams, Pareto analysis, statistical process control (control charts), failure mode and effects analysis, "lean" or Six Sigma methodology, and closed feedback loops led to a multiyear program that has reduced overall computed tomographic (CT) examination volume by more than fourfold and concurrently decreased radiation exposure per CT study without compromising diagnostic utility. This systematic approach involving education, streamlining access to magnetic resonance imaging and ultrasonography, auditing with comparison with benchmarks, applying modern CT technology, and revising CT protocols has led to a more than twofold reduction in CT radiation exposure between 2005 and 2012 for patients at the authors' institution while maintaining diagnostic utility. (©)RSNA, 2015.

  11. Assessing the efficacy of rescue equipment in lifeguard resuscitation efforts for drowning.

    PubMed

    Barcala-Furelos, Roberto; Szpilman, David; Palacios-Aguilar, Jose; Costas-Veiga, Javier; Abelairas-Gomez, Cristian; Bores-Cerezal, Antonio; López-García, Sergio; Rodríguez-Nuñez, Antonio

    2016-03-01

    The whole drowning process usually occurs within seconds to a few minutes. An early rescue may stop and/or prevent most medical complications. Fins, rescue tube, and rescue board (RB) are the equipment most frequently used by lifeguards. Our objective was to compare, in a water rescue quasiexperimental trial, these different pieces of rescue equipment to define the safest and with the lower rescue time as well as to assess their effects on the lifeguards' physiological state and cardiopulmonary resuscitation (CPR) performance. A controlled trial was conducted to study the time effect of 4 different rescue techniques and assess CPR quality, along with the physiological effects of each rescue technique (blood lactate and subjective Borg's scale effort perception) on 35 lifeguards. Among the final sample subjects (n = 23), a total of 92 rescues were completed. Total water rescue time was longer without equipment (NE). The total rescue time was significantly lower using RB (P < .001). Similar good quality of CPR before and after water rescue was observed in all trials (P > .05), although correct ventilations represented less than 50% of total in all trials. Blood lactate increased after all rescues. The subjective effort Borg's scale showed significantly less effort using RB vs without equipment, fins, and fins and rescue tube. The use of propelling and/or floating equipment saves precious time with repercussions in the reduction of drowning mortality and morbidity. The RB offers a significant advantage. Lifeguards need more CPR training, especially considering the importance of efficient ventilations for drowning victims. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Sporadic sampling, not climatic forcing, drives observed early hominin diversity.

    PubMed

    Maxwell, Simon J; Hopley, Philip J; Upchurch, Paul; Soligo, Christophe

    2018-05-08

    The role of climate change in the origin and diversification of early hominins is hotly debated. Most accounts of early hominin evolution link observed fluctuations in species diversity to directional shifts in climate or periods of intense climatic instability. None of these hypotheses, however, have tested whether observed diversity patterns are distorted by variation in the quality of the hominin fossil record. Here, we present a detailed examination of early hominin diversity dynamics, including both taxic and phylogenetically corrected diversity estimates. Unlike past studies, we compare these estimates to sampling metrics for rock availability (hominin-, primate-, and mammal-bearing formations) and collection effort, to assess the geological and anthropogenic controls on the sampling of the early hominin fossil record. Taxic diversity, primate-bearing formations, and collection effort show strong positive correlations, demonstrating that observed patterns of early hominin taxic diversity can be explained by temporal heterogeneity in fossil sampling rather than genuine evolutionary processes. Peak taxic diversity at 1.9 million years ago (Ma) is a sampling artifact, reflecting merely maximal rock availability and collection effort. In contrast, phylogenetic diversity estimates imply peak diversity at 2.4 Ma and show little relation to sampling metrics. We find that apparent relationships between early hominin diversity and indicators of climatic instability are, in fact, driven largely by variation in suitable rock exposure and collection effort. Our results suggest that significant improvements in the quality of the fossil record are required before the role of climate in hominin evolution can be reliably determined. Copyright © 2018 the Author(s). Published by PNAS.

  13. Quality of anti-malarials collected in the private and informal sectors in Guyana and Suriname

    PubMed Central

    2012-01-01

    Background Despite a significant reduction in the number of malaria cases in Guyana and Suriname, this disease remains a major problem in the interior of both countries, especially in areas with gold mining and logging operations, where malaria is endemic. National malaria control programmes in these countries provide treatment to patients with medicines that are procured and distributed through regulated processes in the public sector. However, availability to medicines in licensed facilities (private sector) and unlicensed facilities (informal sector) is common, posing the risk of access to and use of non-recommended treatments and/or poor quality products. Methods To assess the quality of circulating anti-malarial medicines, samples were purchased in the private and informal sectors of Guyana and Suriname in 2009. The sampling sites were selected based on epidemiological data and/or distance from health facilities. Samples were analysed for identity, content, dissolution or disintegration, impurities, and uniformity of dosage units or weight variation according to manufacturer, pharmacopeial, or other validated method. Results Quality issues were observed in 45 of 77 (58%) anti-malarial medicines sampled in Guyana of which 30 failed visual & physical inspection and 18 failed quality control tests. The proportion of monotherapy and ACT medicines failing quality control tests was 43% (13/30) and 11% (5/47) respectively. A higher proportion of medicines sampled from the private sector 34% (11/32) failed quality control tests versus 16% (7/45) in the informal sector. In Suriname, 58 medicines were sampled, of which 50 (86%) were Artecom®, the fixed-dose combination of piperaquine-dihydroartemisinin-trimethoprim co-blistered with a primaquine phosphate tablet. All Artecom samples were found to lack a label claim for primaquine, thus failing visual and physical inspection. Conclusions The findings of the studies in both countries point to significant problems with the quality of anti-malarial medicines available in private and informal sector facilities as well as the availability of therapy not compliant with national treatment guidelines. They also stress the need to strengthen regulatory control efforts on the availability of anti-malarial medicines in these sectors and in endemic areas. PMID:22704709

  14. The quality improvement attitude survey: Development and preliminary psychometric characteristics.

    PubMed

    Dunagan, Pamela B

    2017-12-01

    To report the development of a tool to measure nurse's attitudes about quality improvement in their practice setting and to examine preliminary psychometric characteristics of the Quality Improvement Nursing Attitude Scale. Human factors such as nursing attitudes of complacency have been identified as root causes of sentinel events. Attitudes of nurses concerning use of Quality and Safety Education for nurse's competencies can be most challenging to teach and to change. No tool has been developed measuring attitudes of nurses concerning their role in quality improvement. A descriptive study design with preliminary psychometric evaluation was used to examine the preliminary psychometric characteristics of the Quality Improvement Nursing Attitude Scale. Registered bedside clinical nurses comprised the sample for the study (n = 57). Quantitative data were analysed using descriptive statistics and Cronbach's alpha reliability. Total score and individual item statistics were evaluated. Two open-ended items were used to collect statements about nurses' feelings regarding their experience in quality improvement efforts. Strong support for the internal consistency reliability and face validity of the Quality Improvement Nursing Attitude Scale was found. Total scale scores were high indicating nurse participants valued Quality and Safety Education for Nurse competencies in practice. However, item-level statistics indicated nurses felt powerless when other nurses deviate from care standards. Additionally, the sample indicated they did not consistently report patient safety issues and did not have a feeling of value in efforts to improve care. Findings suggested organisational culture fosters nurses' reporting safety issues and feeling valued in efforts to improve care. Participants' narrative comments and item analysis revealed the need to generate new items for the Quality Improvement Nursing Attitude Scale focused on nurses' perception of their importance in quality and safety and their power to enact principles. The Quality Improvement Nursing Attitude Scale-Revised edition was designed to help in understanding nurses' attitudes and values. It can be used to further explore broad concepts of quality improvement efforts. © 2017 John Wiley & Sons Ltd.

  15. A Transparent and Transferable Framework for Tracking Quality Information in Large Datasets

    PubMed Central

    Smith, Derek E.; Metzger, Stefan; Taylor, Jeffrey R.

    2014-01-01

    The ability to evaluate the validity of data is essential to any investigation, and manual “eyes on” assessments of data quality have dominated in the past. Yet, as the size of collected data continues to increase, so does the effort required to assess their quality. This challenge is of particular concern for networks that automate their data collection, and has resulted in the automation of many quality assurance and quality control analyses. Unfortunately, the interpretation of the resulting data quality flags can become quite challenging with large data sets. We have developed a framework to summarize data quality information and facilitate interpretation by the user. Our framework consists of first compiling data quality information and then presenting it through 2 separate mechanisms; a quality report and a quality summary. The quality report presents the results of specific quality analyses as they relate to individual observations, while the quality summary takes a spatial or temporal aggregate of each quality analysis and provides a summary of the results. Included in the quality summary is a final quality flag, which further condenses data quality information to assess whether a data product is valid or not. This framework has the added flexibility to allow “eyes on” information on data quality to be incorporated for many data types. Furthermore, this framework can aid problem tracking and resolution, should sensor or system malfunctions arise. PMID:25379884

  16. Software archeology: a case study in software quality assurance and design

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

    Macdonald, John M; Lloyd, Jane A; Turner, Cameron J

    2009-01-01

    Ideally, quality is designed into software, just as quality is designed into hardware. However, when dealing with legacy systems, demonstrating that the software meets required quality standards may be difficult to achieve. As the need to demonstrate the quality of existing software was recognized at Los Alamos National Laboratory (LANL), an effort was initiated to uncover and demonstrate that legacy software met the required quality standards. This effort led to the development of a reverse engineering approach referred to as software archaeology. This paper documents the software archaeology approaches used at LANL to document legacy software systems. A case studymore » for the Robotic Integrated Packaging System (RIPS) software is included.« less

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

    Johnson, Gary E.; Diefenderfer, Heida L.; Ebberts, Blaine D.

    The purpose ofthis document is to describe research, monitoring, and evaluation (RME) for the Federal Columbia River Estuary Program. The intent of this RME effort is to provide data and information to evaluate progress toward meeting program goals and objectives and support decision-making in the Estuary Program. The goal of the Estuary Program is to understand, conserve, and restore the estuary ecosystem to improve the performance of listed salmonid populations. The Estuary Program has five general objectives, designed to fulfill the program goal, as follows. 1. Understand the primary stressors affecting ecosystem controlling factors, such as ocean conditions and invasivemore » species. 2. Conserve and restore factors controlling ecosystem structures and processes, such as hydrodynamics and water quality. 3. Increase the quantity and quality of ecosystem structures, i.e., habitats, juvenile salmonids use during migration through the estuary. 4. Maintain the food web to benefit salmonid performance. 5. Improve salmonid performance in terms of life history diversity, foraging success, growth, and survival. The goal of estuary RME is to provide pertinent and timely research and monitoring information to planners, implementers, and managers of the Estuary Program. In conclusion, the estuary RME effort is designed to meet the research and monitoring needs of the estuary Program using an adaptive management process. Estuary RME's success and usefulness will depend on the actual conduct of adaptive management, as embodied in the objectives, implrementation, data, reporting, and synthesis, evaluation, and decision-making described herein.« less

  18. High and low neurobehavior disinhibition clusters within locales: implications for community efforts to prevent substance use disorder.

    PubMed

    Ridenour, Ty A; Reynolds, Maureen; Ahlqvist, Ola; Zhai, Zu Wei; Kirisci, Levent; Vanyukov, Michael M; Tarter, Ralph E

    2013-05-01

    Knowledge of where substance use and other such behavioral problems frequently occur has aided policing, public health, and urban planning strategies to reduce such behaviors. Identifying locales characterized by high childhood neurobehavioral disinhibition (ND), a strong predictor of substance use and consequent disorder (SUD), may likewise improve prevention efforts. The distribution of ND in 10-12-year olds was mapped to metropolitan Pittsburgh, PA, and tested for clustering within locales. The 738 participating families represented the population in terms of economic status, race, and population distribution. ND was measured using indicators of executive cognitive function, emotion regulation, and behavior control. Innovative geospatial analyzes statistically tested clustering of ND within locales while accounting for geographic barriers (large rivers, major highways), parental SUD severity, and neighborhood quality. Clustering of youth with high and low ND occurred in specific locales. Accounting for geographic barriers better delineated where high ND is concentrated, areas which also tended to be characterized by greater parental SUD severity and poorer neighborhood quality. Offering programs that have been demonstrated to improve inhibitory control in locales where youth have high ND on average may reduce youth risk for SUD and other problem behaviors. As demonstrated by the present results, geospatial analysis of youth risk factors, frequently used in community coalition strategies, may be improved with greater statistical and measurement rigor.

  19. Summary Report for the Evaluation of Current QA Processes Within the FRMAC FAL and EPA MERL.

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

    Shanks, Sonoya T.; Redding, Ted; Jaussi, Lynn

    The Federal Radiological Monitoring and Assessment Center (FRMAC) relies on accurate and defensible analytical laboratory data to support its mission. Therefore, FRMAC must ensure that the environmental analytical laboratories providing analytical services maintain an ongoing capability to provide accurate analytical results to DOE. It is undeniable that the more Quality Assurance (QA) and Quality Control (QC) measures required of the laboratory, the less resources that are available for analysis of response samples. Being that QA and QC measures in general are understood to comprise a major effort related to a laboratory’s operations, requirements should only be considered if they aremore » deemed “value-added” for the FRMAC mission. This report provides observations of areas for improvement and potential interoperability opportunities in the areas of Batch Quality Control Requirements, Written Communications, Data Review Processes, Data Reporting Processes, along with the lessons learned as they apply to items in the early phase of a response that will be critical for developing a more efficient, integrated response for future interactions between the FRMAC and EPA assets.« less

  20. 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.

  1. Cooperative water-resources monitoring in the St. Clair River/Lake St. Clair Basin, Michigan

    USGS Publications Warehouse

    Rheaume, Stephen J.; Neff, Brian P.; Blumer, Stephen P.

    2007-01-01

    As part of the Lake St. Clair Regional Monitoring Project, this report describes numerous cooperative water-resources monitoring efforts conducted in the St. Clair River/Lake St. Clair Basin over the last 100 years. Cooperative monitoring is a tool used to observe and record changes in water quantity and quality over time. This report describes cooperative efforts for monitoring streamflows and flood magnitudes, past and present water-quality conditions, significant human-health threats, and flow-regime changes that are the result of changing land use. Water-resources monitoring is a long-term effort that can be made cost-effective by leveraging funds, sharing data, and avoiding duplication of effort. Without long-term cooperative monitoring, future water-resources managers and planners may find it difficult to establish and maintain public supply, recreational, ecological, and esthetic water-quality goals for the St. Clair River/Lake St. Clair Basin.

  2. Effortful control and school adjustment: The moderating role of classroom chaos.

    PubMed

    Berger, Rebecca H; Valiente, Carlos; Eisenberg, Nancy; Hernandez, Maciel M; Thompson, Marilyn; Spinrad, Tracy; VanSchyndel, Sarah; Silva, Kassondra; Southworth, Jody

    2017-11-01

    Guided by the person by environment framework, the primary goal of this study was to determine whether classroom chaos moderated the relation between effortful control and kindergarteners' school adjustment. Classroom observers reported on children's ( N = 301) effortful control in the fall. In the spring, teachers reported on classroom chaos and school adjustment outcomes (teacher-student relationship closeness and conflict, and school liking and avoidance). Cross-level interactions between effortful control and classroom chaos predicting school adjustment outcomes were assessed. A consistent pattern of interactions between effortful control and classroom chaos indicated that the relations between effortful control and the school adjustment outcomes were strongest in high chaos classrooms. Post-hoc analyses indicated that classroom chaos was associated with poor school adjustment when effortful control was low, suggesting that the combination of high chaos and low effortful control was associated with the poorest school outcomes.

  3. Identification of long-term trends and seasonality in high-frequency water quality data from the Yangtze River basin, China.

    PubMed

    Duan, Weili; He, Bin; Chen, Yaning; Zou, Shan; Wang, Yi; Nover, Daniel; Chen, Wen; Yang, Guishan

    2018-01-01

    Comprehensive understanding of the long-term trends and seasonality of water quality is important for controlling water pollution. This study focuses on spatio-temporal distributions, long-term trends, and seasonality of water quality in the Yangtze River basin using a combination of the seasonal Mann-Kendall test and time-series decomposition. The used weekly water quality data were from 17 environmental stations for the period January 2004 to December 2015. Results show gradual improvement in water quality during this period in the Yangtze River basin and greater improvement in the Uppermost Yangtze River basin. The larger cities, with high GDP and population density, experienced relatively higher pollution levels due to discharge of industrial and household wastewater. There are higher pollution levels in Xiang and Gan River basins, as indicated by higher NH4-N and CODMn concentrations measured at the stations within these basins. Significant trends in water quality were identified for the 2004-2015 period. Operations of the three Gorges Reservoir (TGR) enhanced pH fluctuations and possibly attenuated CODMn, and NH4-N transportation. Finally, seasonal cycles of varying strength were detected for time-series of pollutants in river discharge. Seasonal patterns in pH indicate that maxima appear in winter, and minima in summer, with the opposite true for CODMn. Accurate understanding of long-term trends and seasonality are necessary goals of water quality monitoring system efforts and the analysis methods described here provide essential information for effectively controlling water pollution.

  4. Optimising UAV topographic surveys processed with structure-from-motion: Ground control quality, quantity and bundle adjustment

    NASA Astrophysics Data System (ADS)

    James, M. R.; Robson, S.; d'Oleire-Oltmanns, S.; Niethammer, U.

    2017-03-01

    Structure-from-motion (SfM) algorithms greatly facilitate the production of detailed topographic models from photographs collected using unmanned aerial vehicles (UAVs). However, the survey quality achieved in published geomorphological studies is highly variable, and sufficient processing details are never provided to understand fully the causes of variability. To address this, we show how survey quality and consistency can be improved through a deeper consideration of the underlying photogrammetric methods. We demonstrate the sensitivity of digital elevation models (DEMs) to processing settings that have not been discussed in the geomorphological literature, yet are a critical part of survey georeferencing, and are responsible for balancing the contributions of tie and control points. We provide a Monte Carlo approach to enable geomorphologists to (1) carefully consider sources of survey error and hence increase the accuracy of SfM-based DEMs and (2) minimise the associated field effort by robust determination of suitable lower-density deployments of ground control. By identifying appropriate processing settings and highlighting photogrammetric issues such as over-parameterisation during camera self-calibration, processing artefacts are reduced and the spatial variability of error minimised. We demonstrate such DEM improvements with a commonly-used SfM-based software (PhotoScan), which we augment with semi-automated and automated identification of ground control points (GCPs) in images, and apply to two contrasting case studies - an erosion gully survey (Taroudant, Morocco) and an active landslide survey (Super-Sauze, France). In the gully survey, refined processing settings eliminated step-like artefacts of up to 50 mm in amplitude, and overall DEM variability with GCP selection improved from 37 to 16 mm. In the much more challenging landslide case study, our processing halved planimetric error to 0.1 m, effectively doubling the frequency at which changes in landslide velocity could be detected. In both case studies, the Monte Carlo approach provided a robust demonstration that field effort could by substantially reduced by only deploying approximately half the number of GCPs, with minimal effect on the survey quality. To reduce processing artefacts and promote confidence in SfM-based geomorphological surveys, published results should include processing details which include the image residuals for both tie points and GCPs, and ensure that these are considered appropriately within the workflow.

  5. Print quality analysis for ink-saving algorithms

    NASA Astrophysics Data System (ADS)

    Ortiz Segovia, Maria V.; Bonnier, Nicolas; Allebach, Jan P.

    2012-01-01

    Ink-saving strategies for CMYK printers have evolved from their earlier stages where the 'draft' print mode was the main option available to control ink usage. The savings were achieved by printing alternate dots in an image at the expense of reducing print quality considerably. Nowadays, customers are not only unwilling to compromise quality but have higher expectations regarding both visual print quality and ink reduction solutions. Therefore, the need for more intricate ink-saving solutions with lower impact on print quality is evident. Printing-related factors such as the way the printer places the dots on the paper and the ink-substrate interaction play important and complex roles in the characterization and modeling of the printing process that make the ink reduction topic a challenging problem. In our study, we are interested in benchmarking ink-saving algorithms to find the connections between different ink reduction levels of a given ink-saving method and a set of print quality attributes. This study is mostly related to CMYK printers that use dispersed dot halftoning algorithms. The results of our efforts to develop such an evaluation scheme are presented in this paper.

  6. Governance matters: an ecological association between governance and child mortality.

    PubMed

    Lin, Ro-Ting; Chien, Lung-Chang; Chen, Ya-Mei; Chan, Chang-Chuan

    2014-09-01

    Governance of a country may have widespread effects on the health of its population, yet little is known about the effect of governance on child mortality in a country that is undergoing urbanization, economic development, and disease control. We obtained indicators of six dimensions of governance (perceptions of voice and accountability, political stability and absence of violence, government effectiveness, regulatory quality, rule of law, and control of corruption) and national under-5 mortality rates for 149 countries between 1996 and 2010. We applied a semi-parametric generalized additive mixed model to examine associations after controlling for the effects of development factors (urbanization level and economy), disease control factors (hygienic conditions and vaccination rates), health expenditures, air quality, and time. Governance, development, and disease control showed clear inverse relations with the under-5 mortality rate (p<0.001). Per unit increases in governance, development, and disease control factors, the child mortality rate had a 0.901-, 0.823-, and 0.922-fold decrease, respectively, at fixed levels of the other two factors. In the effort to reduce the global under-5 mortality rate, addressing a country's need for better governance is as important as improvements in development and disease control. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  7. Evaluation of Various Radar Data Quality Control Algorithms Based on Accumulated Radar Rainfall Statistics

    NASA Technical Reports Server (NTRS)

    Robinson, Michael; Steiner, Matthias; Wolff, David B.; Ferrier, Brad S.; Kessinger, Cathy; Einaudi, Franco (Technical Monitor)

    2000-01-01

    The primary function of the TRMM Ground Validation (GV) Program is to create GV rainfall products that provide basic validation of satellite-derived precipitation measurements for select primary sites. A fundamental and extremely important step in creating high-quality GV products is radar data quality control. Quality control (QC) processing of TRMM GV radar data is based on some automated procedures, but the current QC algorithm is not fully operational and requires significant human interaction to assure satisfactory results. Moreover, the TRMM GV QC algorithm, even with continuous manual tuning, still can not completely remove all types of spurious echoes. In an attempt to improve the current operational radar data QC procedures of the TRMM GV effort, an intercomparison of several QC algorithms has been conducted. This presentation will demonstrate how various radar data QC algorithms affect accumulated radar rainfall products. In all, six different QC algorithms will be applied to two months of WSR-88D radar data from Melbourne, Florida. Daily, five-day, and monthly accumulated radar rainfall maps will be produced for each quality-controlled data set. The QC algorithms will be evaluated and compared based on their ability to remove spurious echoes without removing significant precipitation. Strengths and weaknesses of each algorithm will be assessed based on, their abilit to mitigate both erroneous additions and reductions in rainfall accumulation from spurious echo contamination and true precipitation removal, respectively. Contamination from individual spurious echo categories will be quantified to further diagnose the abilities of each radar QC algorithm. Finally, a cost-benefit analysis will be conducted to determine if a more automated QC algorithm is a viable alternative to the current, labor-intensive QC algorithm employed by TRMM GV.

  8. Health care quality: from data to accountability.

    PubMed

    Darby, M

    1998-08-01

    The many audiences for information about the quality of health care have different and sometimes conflicting interests and priorities. This is reflected in the diversity of current efforts to use health care data to identify, measure, and demonstrate quality. The author surveys three of these approaches in depth: (1) the professional approach, which relies on the actions of private-sector accreditation groups, trade associations and health plans, hospitals, and other providers to assure quality; (2) the market-driven approach, which relies on the use of quality data by health care purchasers and consumers in choosing plans and providers; and (3) the public-sector approach, which relies on the regulatory, oversight, and purchasing actions of government at the federal, state, and local levels to assure quality. The author concludes that efforts to measure and report the quality of health care invariably confront a variety of technical and political issues. Several observers maintain that it is more important for participants in quality issues to reach consensus on the issues than to reach technical perfection in the way the data are handled. Important obstacles in the technical realm include inadequate investment in sufficiently sophisticated and compatible information systems and the fact that where such systems are in place, they generally cannot be linked. But efforts, both technical and legal, are under way to overcome these obstacles. Even so, some of the issues of health care quality will remain moving targets because of constant changes in the health care environment and in technology. The author closes with the hope that the various actors within the health care industry may coordinate their efforts in dealing with these issues.

  9. Integrating High-Resolution Datasets to Target Mitigation Efforts for Improving Air Quality and Public Health in Urban Neighborhoods

    PubMed Central

    Shandas, Vivek; Voelkel, Jackson; Rao, Meenakshi; George, Linda

    2016-01-01

    Reducing exposure to degraded air quality is essential for building healthy cities. Although air quality and population vary at fine spatial scales, current regulatory and public health frameworks assess human exposures using county- or city-scales. We build on a spatial analysis technique, dasymetric mapping, for allocating urban populations that, together with emerging fine-scale measurements of air pollution, addresses three objectives: (1) evaluate the role of spatial scale in estimating exposure; (2) identify urban communities that are disproportionately burdened by poor air quality; and (3) estimate reduction in mobile sources of pollutants due to local tree-planting efforts using nitrogen dioxide. Our results show a maximum value of 197% difference between cadastrally-informed dasymetric system (CIDS) and standard estimations of population exposure to degraded air quality for small spatial extent analyses, and a lack of substantial difference for large spatial extent analyses. These results provide the foundation for improving policies for managing air quality, and targeting mitigation efforts to address challenges of environmental justice. PMID:27527205

  10. Coping Mediates the Association Between Marital Instability and Depression, but Not Marital Satisfaction and Depression

    PubMed Central

    Fink, Brandi C.; Shapiro, Alyson F.

    2014-01-01

    The association between marital discord and depression is well established. Marital discord is hypothesized to be a stressful life event that would evoke one’s efforts to cope with it. In an effort to further understand the nature of this association, the current study investigated coping as a mediating variable between marital dissatisfaction and depression and between marital instability and depression. Both marital dissatisfaction and instability, reflecting orthogonal dimensions of marital discord, were included in the model examined to elucidate a more complete picture of marital functioning. Structural Equation Modeling analyses revealed that coping mediated the association between marital instability and depression, but not marital dissatisfaction and depression, suggesting that coping traditionally considered adaptive for individuals in the context of controllable stressors may not be adaptive in the context of couple relationship instability. The findings also have implications for interventions focusing on decreasing maladaptive coping strategies in couples presenting for marital therapy or depression in addition to efforts directed at improving marital quality. PMID:25032063

  11. Aircrew-aircraft integration: A summary of US Army research programs and plans

    NASA Technical Reports Server (NTRS)

    Key, D. L.; Aiken, E. W.

    1984-01-01

    A review of selected programs which illustrate the research efforts of the U.S. Army Aeromechanics Laboratory in the area of aircrew-aircraft integration is presented. Plans for research programs to support the development of future military rotorcraft are also described. The crew of a combat helicopter must, in general, perform two major functions during the conduct of a particular mission: flightpath control and mission management. Accordingly, the research programs described are being conducted in the same two major categories: (1) flightpath control, which encompasses the areas of handling qualities, stability and control, and displays for the pilot's control of the rotorcraft's flightpath, and (2) mission management, which includes human factors and cockpit integration research topics related to performance of navigation, communication, and aircraft systems management tasks.

  12. Testing and checkout experiences in the National Transonic Facility since becoming operational

    NASA Technical Reports Server (NTRS)

    Bruce, W. E., Jr.; Gloss, B. B.; Mckinney, L. W.

    1988-01-01

    The U.S. National Transonic Facility, constructed by NASA to meet the national needs for High Reynolds Number Testing, has been operational in a checkout and test mode since the operational readiness review (ORR) in late 1984. During this time, there have been problems centered around the effect of large temperature excursions on the mechanical movement of large components, the reliable performance of instrumentation systems, and an unexpected moisture problem with dry insulation. The more significant efforts since the ORR are reviewed and NTF status concerning hardware, instrumentation and process controls systems, operating constraints imposed by the cryogenic environment, and data quality and process controls is summarized.

  13. Indiana Air Pollution Control Board Approves a Modification on a PSD Permit for General Motors in which Two Coal-Fired Boilers are Forgiven a SO2 Control Requirement

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  14. Conversation with traumatically brain-injured individuals: a controlled study of behavioural changes and their impact.

    PubMed

    Bond, F; Godfrey, H P

    1997-05-01

    The conversations of 62 traumatically brain-injured (TBI) patients, assessed between 6 months and 3 years post-injury, were compared with those of an orthopaedic control (OC) group (n = 25). Conversations involving TBI subjects were rated as significantly less interesting, less appropriate, less rewarding and more effortful than interactions involving OC subjects, and were characterized by differences in the frequency of prompt usage and turn duration. Furthermore, measures of turn duration and prompt frequency were significantly associated with the perceived quality of conversation. These findings provide a microbehavioural description of the social process through which TBI individuals fail to adequately reinforce others.

  15. Quality of care for patients with type 2 diabetes mellitus in the Netherlands and the United States: a comparison of two quality improvement programs.

    PubMed

    Valk, Gerlof D; Renders, Carry M; Kriegsman, Didi M W; Newton, Katherine M; Twisk, Jos W R; van Eijk, Jacques Th M; van der Wal, Gerrit; Wagner, Edward H

    2004-08-01

    To assess differences in diabetes care and patient outcomes by comparing two multifaceted quality improvement programs in two different countries, and to increase knowledge of effective elements of such programs. Primary care in the ExtraMural Clinic (EMC) of the Department of General Practice of the Vrije Universiteit in Amsterdam, the Netherlands, and the Group Health Cooperative (GHC), a group-model health maintenance organization (HMO) in western Washington State in the United States. Data were collected from 1992 to 1997. In this observational study two diabetes cohorts in which a quality improvement program was implemented were compared. Both programs included a medical record system, clinical practice guidelines, physician educational meetings, audit, and feedback. Only the Dutch program (EMC) included guidelines on the structure of diabetes care and a recall system. Only the GHC program included educational outreach visits, formation of multidisciplinary teams, and patient self-management support. Included were 379 EMC patients, and 2,119 GHC patients with type 2 diabetes mellitus. Main process outcomes were: annual number of diabetes visits, and number of HbA1c and blood lipid measurements. Main patient outcomes were HbA1c and blood lipid levels. Multilevel analysis was used to adjust for dependency between repeated observations within one patient and for clustering of patients within general practices. In the EMC process outcomes and glycemic control improved more than at GHC, however, GHC had better baseline measures. There were no differences between programs on blood lipid control. During follow-up, intensification of pharmacotherapy was noted at both sites. Differences noted between programs were in line with differences in diabetes guidelines. Following implementation of guidelines and organizational improvement efforts, change occurred primarily in the process outcomes, rather than in the patient outcomes. Although much effort was put into improving process and patient outcomes, both complex programs still showed only moderate effects.

  16. Inception of a national multidisciplinary registry for stereotactic radiosurgery.

    PubMed

    Sheehan, Jason P; Kavanagh, Brian D; Asher, Anthony; Harbaugh, Robert E

    2016-01-01

    Stereotactic radiosurgery (SRS) represents a multidisciplinary approach to the delivery of ionizing high-dose radiation to treat a wide variety of disorders. Much of the radiosurgical literature is based upon retrospective single-center studies along with a few randomized controlled clinical trials. More timely and effective evidence is needed to enhance the consistency and quality of and clinical outcomes achieved with SRS. The authors summarize the creation and implementation of a national SRS registry. The American Association of Neurological Surgeons (AANS) through NeuroPoint Alliance, Inc., started a successful registry effort with its lumbar spine initiative. Following a similar approach, the AANS and NeuroPoint Alliance collaborated with corporate partners and the American Society for Radiation Oncology to devise a data dictionary for an SRS registry. Through administrative and financial support from professional societies and corporate partners, a framework for implementation of the registry was created. Initial plans were devised for a 3-year effort encompassing 30 high-volume SRS centers across the country. Device-specific web-based data-extraction platforms were built by the corporate partners. Data uploaders were then used to port the data to a common repository managed by Quintiles, a national and international health care trials company. Audits of the data for completeness and veracity will be undertaken by Quintiles to ensure data fidelity. Data governance and analysis are overseen by an SRS board comprising equal numbers of representatives from the AANS and NeuroPoint Alliance. Over time, quality outcome assessments and post hoc research can be performed to advance the field of SRS. Stereotactic radiosurgery offers a high-technology approach to treating complex intracranial disorders. Improvements in the consistency and quality of care delivered to patients who undergo SRS should be afforded by the national registry effort that is underway.

  17. 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.

  18. Real-World Vehicle Emissions: A Summary of the 18th Coordinating Research Council On-Road Vehicle Emissions Workshop

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

    Cadle, S. H.; Ayala, A.; Black, K. N.

    2009-02-01

    The Coordinating Research Council (CRC) convened its 18th On-Road Vehicle Emissions Workshop March 31-April 2, 2008, with 104 presentations describing the most recent mobile source-related emissions research. In this paper we summarize the presentations from researchers whose efforts are improving our understanding of the contribution of mobile sources to air quality. Participants in the workshop discussed emission models and emissions inventories, results from gas- and particle-phase emissions studies from spark-ignition and diesel-powered vehicles (with an emphasis in this workshop on particle emissions), effects of fuels on emissions, evaluation of in-use emission-control programs, and efforts to improve our capabilities in performingmore » on-board emissions measurements, as well as topics for future research.« less

  19. Control of Fine Particulate (PM2.5) Emissions from Restaurant Operations.

    PubMed

    Whynot, Jill; Quinn, Gary; Perryman, Pamela; Votlucka, Peter

    1999-09-01

    This paper describes efforts to reduce particulate matter (PM) emissions from restaurant operations, including application of an existing control method to a new equipment type. Commercial charbroiling in the South Coast Air Basin results in emissions of approximately 10 tons/day of fine particulate matter ( PM 2.5) and 1.3 tons/day of volatile organic compounds (VOCs). Over a seven-year period, the South Coast Air Quality Management District worked with industry to develop test methods for measuring emissions from various cooking operations, evaluate control technologies, and develop a rule to reduce these emissions. Of the two basic types of charbroilers-chain-driven and underfired-underfired produce four times the emissions when equivalent amounts of product are cooked. Cost-effective control technology is currently available only for chain-driven charbroilers. The application of flameless catalytic oxidizers to chain-driven charbroilers was found to effectively reduce emissions by at least 83% and is cost-effective. The catalysts have been used worldwide at restaurants for several years. Research efforts are underway to identify control options for underfired charbroilers. Implementation of Rule 1138, Control of Emissions from Restaurant Operations, adopted November 14, 1997, will result in reductions of 0.5 tons/day of PM 2.5 and 0.2 tons/day of VOCs. Future rules will result in reductions from underfired charbroilers and possibly other restaurant equipment when cost-effective solutions are available.

  20. Control of fine particulate (PM2.5) emissions from restaurant operations.

    PubMed

    Whynot, J; Quinn, G; Perryman, P; Votlucka, P

    1999-09-01

    This paper describes efforts to reduce particulate matter (PM) emissions from restaurant operations, including application of an existing control method to a new equipment type. Commercial charbroiling in the South Coast Air Basin results in emissions of approximately 10 tons/day of fine particulate matter (PM2.5) and 1.3 tons/day of volatile organic compounds (VOCs). Over a seven-year period, the South Coast Air Quality Management District worked with industry to develop test methods for measuring emissions from various cooking operations, evaluate control technologies, and develop a rule to reduce these emissions. Of the two basic types of charbroilers--chain-driven and underfired--underfired produce four times the emissions when equivalent amounts of product are cooked. Cost-effective control technology is currently available only for chain-driven charbroilers. The application of flameless catalytic oxidizers to chain-driven charbroilers was found to effectively reduce emissions by at least 83% and is cost-effective. The catalysts have been used worldwide at restaurants for several years. Research efforts are underway to identify control options for underfired charbroilers. Implementation of Rule 1138, Control of Emissions from Restaurant Operations, adopted November 14, 1997, will result in reductions of 0.5 tons/day of PM2.5 and 0.2 tons/day of VOCs. Future rules will result in reductions from underfired charbroilers and possibly other restaurant equipment when cost-effective solutions are available.

  1. Environmental Public Health Survelliance for Exposure to Respiratory Health Hazards: A Joint NASA/CDC Project to Use Remote Sensing Data for Estimating Airborne Particulate Matter Over the Atlanta, Georgia Metropolitan Area

    NASA Technical Reports Server (NTRS)

    Quattrochi, Dale A.; Rickman, Douglas; Mohammad, Al-Hamdan; Crosson, William; Estes, Maurice, Jr.; Limaye, Ashutosh; Qualters, Judith

    2008-01-01

    Describes the public health surveillance efforts of NASA, in a joint effort with the Center for Disease Control (CDC). NASA/MSFC and the CDC are partners in linking nvironmental and health data to enhance public health surveillance. The use of NASA technology creates value - added geospatial products from existing environmental data sources to facilitate public health linkages. The venture sought to provide remote sensing data for the 5-country Metro-Atlanta area and to integrate this environmental data with public health data into a local network, in an effort to prevent and control environmentally related health effects. Remote sensing data used environmental data (Environmental Protection Agency [EPA] Air Quality System [AQS] ground measurements and MODIS Aerosol Optical Depth [AOD]) to estimate airborne particulate matter over Atlanta, and linked this data with health data related to asthma. The study proved the feasibility of linking environmental data (MODIS particular matter estimates and AQS) with health data (asthma). Algorithms were developed for QC, bias removal, merging MODIS and AQS particulate matter data, as well as for other applications. Additionally, a Business Associate Agreement was negotiated for a health care provider to enable sharing of Protected Health Information.

  2. Assessing the Long-Term Impacts of Water Quality Outreach and Education Efforts on Agricultural Landowners

    ERIC Educational Resources Information Center

    Jackson-Smith, Douglas B.; McEvoy, Jamie P.

    2011-01-01

    We assess the long-term effectiveness of outreach and education efforts associated with a water quality improvement project in a watershed located in northern Utah, USA. Conducted 15 years after the original project began, our research examines the lasting impacts of different extension activities on landowners' motivations to participate and…

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

    ERIC Educational Resources Information Center

    Aliff, John Vincent

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

  4. Incorporating discrete event simulation into quality improvement efforts in health care systems.

    PubMed

    Rutberg, Matthew Harris; Wenczel, Sharon; Devaney, John; Goldlust, Eric Jonathan; Day, Theodore Eugene

    2015-01-01

    Quality improvement (QI) efforts are an indispensable aspect of health care delivery, particularly in an environment of increasing financial and regulatory pressures. The ability to test predictions of proposed changes to flow, policy, staffing, and other process-level changes using discrete event simulation (DES) has shown significant promise and is well reported in the literature. This article describes how to incorporate DES into QI departments and programs in order to support QI efforts, develop high-fidelity simulation models, conduct experiments, make recommendations, and support adoption of results. The authors describe how DES-enabled QI teams can partner with clinical services and administration to plan, conduct, and sustain QI investigations. © 2013 by the American College of Medical Quality.

  5. Lessons Learned on Quality (of) Standards

    NASA Astrophysics Data System (ADS)

    Gerlich, Rainer; Gerlich, Ralf

    2011-08-01

    Standards are used to describe and ensure the quality of products, services and processes throughout almost all branches of industry, including the field of software engineering. Contractors and suppliers are obligated by their customers and certification authorities to follow a certain set of standards during development. For example, a customer can easier actively participate in and control the contractor's process when enforcing a standard process..However, as with any requirement, a standard may also impede the contractor or supplier in assuring actual quality of the product in the sense of fitness for the purpose intended by the customer.This is the case when a standard defines specific quality assurance activities requiring a considerable amount of effort while other more efficient but equivalent or even superior approaches are blocked. Then improvement of the ratio between cost and quality exceeding miniscule advances is heavily impeded.While in some parts being too specific in defining the mechanisms of the enforced process, standards are sometimes too weak in defining the principles or goals on control of product quality.Therefore this paper addresses the following issues: (1) Which conclusions can be drawn on the quality and efficiency of a standard? (2) If and how is it possible to improve or evolve a standard? (3) How well does a standard guide a user towards high quality of the end product?One conclusion is that the analyzed standards do interfere with technological innovation, though the standards leave a lot of freedom for concretization and are understood as technology-independent.Another conclusion is that standards are not only a matter of quality but also a matter of competitiveness of the industry depending on resulting costs and time-to- market. When the costs induced by a standard are not adequate to the achievable quality, industry encounters a significant disadvantage.

  6. Generic Ada code in the NASA space station command, control and communications environment

    NASA Technical Reports Server (NTRS)

    Mcdougall, D. P.; Vollman, T. E.

    1986-01-01

    The results of efforts to apply powerful Ada constructs to the formatted message handling process are described. The goal of these efforts was to extend the state-of-technology in message handling while at the same time producing production-quality, reusable code. The first effort was initiated in September, 1984 and delivered in April, 1985. That product, the Generic Message Handling Facility, met initial goals, was reused, and is available in the Ada Repository on ARPANET. However, it became apparent during its development that the initial approach to building a message handler template was not optimal. As a result of this initial effort, several alternate approaches were identified, and research is now on-going to identify an improved product. The ultimate goal is to be able to instantly build a message handling system for any message format given a specification of that message format. The problem lies in how to specify the message format, and one that is done, how to use that information to build the message handler. Message handling systems and message types are described. The initial efforts, its results and its shortcomings are detailed. The approach now being taken to build a system which will be significantly easier to implement, and once implemented, easier to use, is described. Finally, conclusions are offered.

  7. [Publication of healthcare quality data to citizens--status and perspectives].

    PubMed

    Utzon, Jan; Kaergaard, Johan

    2009-05-11

    Public quality reports are intended to stimulate active consumer participation by enabling consumers to make informed choices about their healthcare providers. Despite all efforts, public reporting has been shown not to be effective in stimulating consumers to choose their healthcare provider based on performance information in Denmark and other countries. Numerous barriers are identified. In an effort to move towards an effective public reporting system in Denmark, the present article discusses how quality information can be made accessible and meaningful to wider groups of consumers.

  8. [Sleep quality and occupational stress relationship analysis of 1413 train drivers in a railway bureau].

    PubMed

    Gu, G Z; Yu, S F; Zhou, W H; Wu, H; Kang, L; Chen, R

    2017-07-20

    Objective: To investigate sleep quality status of train drivers. Methods: By using cluster sampling method, a cross-sectional study was conducted in 1413 train drivers (including passenger train drivers 301, freight train drivers 683, passenger shunting train drivers 350, and high speed train drivers 79) from a railway bureau. The occupational stressors, strains, personalities and sleep quality were measured using occupational stress instruments and effort-reward imbalance questionnaire. Results: The train drivers of poor sleep quality was 48.34%. Sleep quality scores among different among different job category (job title) , exercise, smoking and drinking were statistical significance ( P <0.01) . Differences of sleep quality among different educational level, marry status, age, length of service groups weren't statistical significance ( P >0.05) . Correlation: analysis revealed that sleep quality score was related negatively to job satisfaction, reward, working stability, promotion opportunities, positive affectivity, esteem and self-esteem scores ( r : -0.454, -0.207, -0.329,-0.170, -0.291, -0.103, -0.139, P <0.01 or P <0.05) , positively to social support, effort, role conflict, conflict between groups, conflict in groups, responsibility for person, responsibility for thing, psychological needs, physiological needs, daily stress, negative affectivity, depressive symptoms scores ( r : 0.338, 0.524, 0.226, 0.094, 0.182, 0.210, 0.247, 0.190, 0.615, 0.550, 0.345, 0.570, P <0.01) . Nonparametric test found that train drivers of group with high sleep quality score reported higher scores for physiological need, psychological need, effort, role conflict, conflict between groups, social support, daily stress, depressive symptoms, responsibility for person, responsibility for thing, negative affectivity and coping scores than the group of lower sleep quality score ( P <0.01) . But reword, job satisfaction, positive affectivity, self-esteem working stability and Promotion opportunities scores were lower than the group of lower sleep quality score (P<0.01) . Multivariate logistic regression analysis revealed the risk for more physiological needs, more effort, more depressive symptoms and more daily stress for drivers occured the risk of poor sleep quality were more than two times as high as that of drivers with less physiological needs, less effort, less depressive symptoms and less daily stress ( OR =2.905~2.005) . Conclusions Different types of locomotive drivers get different level of sleep quality. Sleep quality was affected by occupational stress largely. Reducing the occupational stress may contribute to improve the sleep quality of train drivers.

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

    PubMed

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

    2014-05-15

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

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

    PubMed Central

    2014-01-01

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

  11. Doctors or technicians: assessing quality of medical education

    PubMed Central

    Hasan, Tayyab

    2010-01-01

    Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products. PMID:23745059

  12. Doctors or technicians: assessing quality of medical education.

    PubMed

    Hasan, Tayyab

    2010-01-01

    Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products.

  13. The Project Protect Infection Prevention Fellowship: A model for advancing infection prevention competency, quality improvement, and patient safety.

    PubMed

    Reisinger, Janine D; Wojcik, Anna; Jenkins, Ian; Edson, Barbara; Pegues, David A; Greene, Linda

    2017-08-01

    The Centers for Disease Control and Prevention 2016 Healthcare-Associated Infections (HAI) Progress Report documented no change in catheter-associated urinary tract infections (CAUTIs) between 2009 and 2014. There is a need for investment in additional efforts to reduce HAIs, specifically CAUTI. Quality improvement fellowships are 1 approach to expand the capacity of dedicated leaders and infection prevention champions. The fellowship used a model that expanded collaboration among disciplines and focused on partnership by recruiting a diverse cohort of fellows and by providing 1-on-1 mentoring to enhance leadership development. The curriculum supported the Association for Professionals in Infection Control and Prevention Competency Model in 2 domains: leadership and performance improvement and implementation science. The fellowship was successful. The fellows and mentors had self-reported high level of satisfaction, fellows' knowledge increased, and they demonstrated leadership, quality improvement, and implementation science competency within the completed capstone projects. A model encompassing diverse educational topics, discussions, workshops, and mentorship can serve as a template for developing infection prevention champions. Although this project focused on CAUTI, this template can be used in a variety of settings and applied to a range of other HAIs and performance improvement projects. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  14. Inherent Control - Hot-Mix Asphalt Industry

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  15. Application for a Pollution Control Project Exemption - Potlatch Corporation, Lewiston

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  16. Operational Guidance on Control Technology for New and Modified MWC's

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  17. Tennessee Gas Pipeline Pollution Control Project

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  18. Technical Document on Control of Nitrogen Oxides From Municipal Waste Combustors

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  19. Calculation of Cost Effectiveness of Emission Control Systems

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  20. General Electric (GE ) Silicones, Request for Pollution Control Project Exclusion

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  1. Pollution Control Technical Manual

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  2. NOx Controls For Existing Utility Boilers

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  3. Pollution Control Projects and New Source Review (NSR) Applicability

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  4. Common Control, September 18, 1995 Letter to Peter Hamlin

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  5. Common Control for Maplewood Landfill and Industrial Power Generating Corporation

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  6. Inherent Controls on Ready Mix Cement Silos

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  7. PSD Question Concerning Common Control, Alliant Energy and Climax Molybdenum

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  8. PowerSecure Common Control Determination

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  9. Kamine Development Corporation Request for a PSD Innovative Control Technology Waiver

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  10. Transmittal of OAQPS Interim Control Policy Statement

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  11. Design of optimal buffer layers for CuInGaSe2 thin-film solar cells(Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Lordi, Vincenzo; Varley, Joel B.; He, Xiaoqing; Rockett, Angus A.; Bailey, Jeff; Zapalac, Geordie H.; Mackie, Neil; Poplavskyy, Dmitry; Bayman, Atiye

    2016-09-01

    Optimizing the buffer layer in manufactured thin-film PV is essential to maximize device efficiency. Here, we describe a combined synthesis, characterization, and theory effort to design optimal buffers based on the (Cd,Zn)(O,S) alloy system for CIGS devices. Optimization of buffer composition and absorber/buffer interface properties in light of several competing requirements for maximum device efficiency were performed, along with process variations to control the film and interface quality. The most relevant buffer properties controlling performance include band gap, conduction band offset with absorber, dopability, interface quality, and film crystallinity. Control of an all-PVD deposition process enabled variation of buffer composition, crystallinity, doping, and quality of the absorber/buffer interface. Analytical electron microscopy was used to characterize the film composition and morphology, while hybrid density functional theory was used to predict optimal compositions and growth parameters based on computed material properties. Process variations were developed to produce layers with controlled crystallinity, varying from amorphous to fully epitaxial, depending primarily on oxygen content. Elemental intermixing between buffer and absorber, particularly involving Cd and Cu, also is controlled and significantly affects device performance. Secondary phase formation at the interface is observed for some conditions and may be detrimental depending on the morphology. Theoretical calculations suggest optimal composition ranges for the buffer based on a suite of computed properties and drive process optimizations connected with observed film properties. Prepared by LLNL under Contract DE-AC52-07NA27344.

  12. The effect of voice quality and competing speakers in a passage comprehension task: perceived effort in relation to cognitive functioning and performance in children with normal hearing.

    PubMed

    von Lochow, Heike; Lyberg-Åhlander, Viveka; Sahlén, Birgitta; Kastberg, Tobias; Brännström, K Jonas

    2018-04-01

    The study investigates the effect of voice quality and competing speakers on perceived effort in a passage comprehension task in relation to cognitive functioning. In addition, it explores if perceived effort was related to performance. A total of 49 children (aged 7:03 to 12:02 years) with normal hearing participated. The children performed an auditory passage comprehension task presented with six different listening conditions consisting of a typical voice or a dysphonic voice presented in quiet, with one competing speaker, and with four competing speakers. After completing the task, they rated their perceived effort on a five-grade scale. The children also performed tasks measuring working memory capacity (WMC) and executive functioning. The results show that voice quality had no direct effect on perceived effort but the children's ratings of perceived effort were related to their executive functioning. A significant effect was seen for background listening condition indicating higher perceived effort for background listening conditions with competing speakers. The effects of background listening condition were mainly related to the children's WMC but also their executive functioning. It can be concluded that the individual susceptibility to the effect of the dysphonic voice is related to the child's executive functioning. The individual susceptibility to the presence of competing speakers is related to the child's WMC and executive functioning.

  13. A modeling study of coarse particulate matter pollution in Beijing: regional source contributions and control implications for the 2008 summer Olympics

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

    Litao Wang; Jiming Hao; Kebin He

    In the last 10 yr, Beijing has made a great effort to improve its air quality. However, it is still suffering from regional coarse particulate matter (PM10) pollution that could be a challenge to the promise of clean air during the 2008 Olympics. To provide scientific guidance on regional air pollution control, the Mesoscale Modeling System Generation 5 (MM5) and the Models-3/Community Multiscale Air Quality Model (CMAQ) air quality modeling system was used to investigate the contributions of emission sources outside the Beijing area to pollution levels in Beijing. The contributions to the PM10 concentrations in Beijing were assessed formore » the following sources: power plants, industry, domestic sources, transportation, agriculture, and biomass open burning. In January, it is estimated that on average 22% of the PM10 concentrations can be attributed to outside sources, of which domestic and industrial sources contributed 37 and 31%, respectively. In August, as much as 40% of the PM10 concentrations came from regional sources, of which approximately 41% came from industry and 31% from power plants. However, the synchronous analysis of the hourly concentrations, regional contributions, and wind vectors indicates that in the heaviest pollution periods the local emission sources play a more important role. The implications are that long-term control strategies should be based on regional-scale collaborations, and that emission abatement of local sources may be more effective in lowering the PM10 concentration levels on the heavy pollution days. Better air quality can be attained during the Olympics by placing effective emission controls on the local sources in Beijing and by controlling emissions from industry and power plants in the surrounding regions. 44 refs., 6 figs., 3 tabs.« less

  14. Prevention and control of food safety risks: the role of governments, food producers, marketers, and academia.

    PubMed

    Lupien, John R

    2007-01-01

    Food systems are rapidly changing as world population grows, increasing urbanization occurs, consumer tastes and preferences change and differ in various countries and cultures, large scale food production increases, and food imports and exports grow in volume and value. Consumers in all countries have become more insistent that foods available in the marketplace are of good quality and safe, and do not pose risks to them and their families. Publicity about food risk problems and related risks, including chemical and microbiological contamination of foods, mad-cow disease, avian flu, industrial chemical contamination all have made consumers and policy makers more aware of the need of the control of food safety risk factors in all countries. To discuss changes in food systems, and in consumer expectations, that have placed additional stress on the need for better control of food safety risks. Food producers, processors, and marketers have additional food law and regulations to meet; government agencies must increase monitoring and enforcement of adequate food quality and safety legislation and coordinate efforts between agriculture, health, trade, justice and customs agencies; and academia must take action to strengthen the education of competent food legislation administrators, inspectorate, and laboratory personnel for work in government and industry, including related food and food safety research . Both Government and the food industry must assure that adequate control programs are in place to control the quality and safety of all foods, raw or processed, throughout the food chain from production to final consumption. This includes appropriate laboratory facilities to perform necessary analysis of foods for risk and quality factors, and to carry out a wide range of food science, toxicological and related research.

  15. Effortful Control, Behavior Problems and Peer Relations: What Predicts Academic Adjustment in Kindergarteners from Low-income Families?

    PubMed Central

    Morris, Amanda Sheffield; John, Aesha; Halliburton, Amy L.; Morris, Michael D. S.; Robinson, Lara R.; Myers, Sonya S.; Aucoin, Katherine J.; Keyes, Angela W.; Terranova, Andrew

    2013-01-01

    This study examined the role of effortful control, behavior problems, and peer relations in the academic adjustment of 74 kindergarten children from primarily low-income families using a short-term longitudinal design. Teachers completed standardized measures of children’s effortful control, internalizing and externalizing problems, school readiness, and academic skills. Children participated in a sociometric interview to assess peer relations. Research Findings: Correlational analyses indicate that children’s effortful control, behavior problems in school, and peer relations are associated with academic adjustment variables at the end of the school year, including school readiness, reading skills, and math skills. Results of regression analyses indicate that household income and children’s effortful control primarily account for variation in children’s academic adjustment. The associations between children’s effortful control and academic adjustment did not vary across sex of the child or ethnicity. Mediational analyses indicate an indirect effect of effortful control on school readiness, through children’s internalizing problems. Practice or Policy: Effortful control emerged as a strong predictor of academic adjustment among kindergarten children from low-income families. Strategies for enhancing effortful control and school readiness among low-income children are discussed. PMID:24163572

  16. PINK1, Parkin, and Mitochondrial Quality Control: What can we Learn about Parkinson’s Disease Pathobiology?

    PubMed Central

    Truban, Dominika; Hou, Xu; Caulfield, Thomas R.; Fiesel, Fabienne C.; Springer, Wolfdieter

    2016-01-01

    The first clinical description of Parkinson’s disease (PD) will embrace its two century anniversary in 2017. For the past 30 years, mitochondrial dysfunction has been hypothesized to play a central role in the pathobiology of this devastating neurodegenerative disease. The identifications of mutations in genes encoding PINK1 (PTEN-induced kinase 1) and Parkin (E3 ubiquitin ligase) in familial PD and their functional association with mitochondrial quality control provided further support to this hypothesis. Recent research focused mainly on their key involvement in the clearance of damaged mitochondria, a process known as mitophagy. It has become evident that there are many other aspects of this complex regulated, multifaceted pathway that provides neuroprotection. As such, numerous additional factors that impact PINK1/Parkin have already been identified including genes involved in other forms of PD. A great pathogenic overlap amongst different forms of familial, environmental and even sporadic disease is emerging that potentially converges at the level of mitochondrial quality control. Tremendous efforts now seek to further detail the roles and exploit PINK1 and Parkin, their upstream regulators and downstream signaling pathways for future translation. This review summarizes the latest findings on PINK1/Parkin-directed mitochondrial quality control, its integration and cross-talk with other disease factors and pathways as well as the implications for idiopathic PD. In addition, we highlight novel avenues for the development of biomarkers and disease-modifying therapies that are based on a detailed understanding of the PINK1/Parkin pathway. PMID:27911343

  17. Concurrent and longitudinal associations of peers' acceptance with emotion and effortful control in kindergarten

    PubMed Central

    Hernández, Maciel M.; Eisenberg, Nancy; Valiente, Carlos; Diaz, Anjolii; VanSchyndel, Sarah K.; Berger, Rebecca H.; Terrell, Nathan; Silva, Kassondra M.; Spinrad, Tracy L.; Southworth, Jody

    2015-01-01

    The purpose of the study was to evaluate bidirectional associations between peer acceptance and both emotion and effortful control during kindergarten (N = 301). In both the fall and spring semesters, we obtained peer nominations of acceptance, measures of positive and negative emotion based on naturalistic observations in school (i.e., classroom, lunch/recess), and observers’ reports of effortful control (i.e., inhibitory control, attention focusing) and emotions (i.e., positive, negative). In structural equation panel models, peer acceptance in fall predicted higher effortful control in spring. Effortful control in fall did not predict peer acceptance in spring. Negative emotion predicted lower peer acceptance across time for girls but not for boys. Peer acceptance did not predict negative or positive emotion over time. In addition, we tested interactions between positive or negative emotion and effortful control predicting peer acceptance. Positive emotion predicted higher peer acceptance for children low in effortful control. PMID:28348445

  18. Systematic Review of Knowledge Translation Strategies to Promote Research Uptake in Child Health Settings.

    PubMed

    Albrecht, Lauren; Archibald, Mandy; Snelgrove-Clarke, Erna; Scott, Shannon D

    2016-01-01

    Strategies to assist evidence-based decision-making for healthcare professionals are crucial to ensure high quality patient care and outcomes. The goal of this systematic review was to identify and synthesize the evidence on knowledge translation interventions aimed at putting explicit research evidence into child health practice. A comprehensive search of thirteen electronic databases was conducted, restricted by date (1985-2011) and language (English). Articles were included if: 1) studies were randomized controlled trials (RCT), controlled clinical trials (CCT), or controlled before-and-after (CBA) studies; 2) target population was child health professionals; 3) interventions implemented research in child health practice; and 4) outcomes were measured at the professional/process, patient, or economic level. Two reviewers independently extracted data and assessed methodological quality. Study data were aggregated and analyzed using evidence tables. Twenty-one studies (13 RCT, 2 CCT, 6 CBA) were included. The studies employed single (n=9) and multiple interventions (n=12). The methodological quality of the included studies was largely moderate (n=8) or weak (n=11). Of the studies with moderate to strong methodological quality ratings, three demonstrated consistent, positive effect(s) on the primary outcome(s); effective knowledge translation interventions were two single, non-educational interventions and one multiple, educational intervention. This multidisciplinary systematic review in child health setting identified effective knowledge translation strategies assessed by the most rigorous research designs. Given the overall poor quality of the research literature, specific recommendations were made to improve knowledge translation efforts in child health. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Roles of laboratories and laboratory systems in effective tuberculosis programmes

    PubMed Central

    van Deun, Armand; Kam, Kai Man; Narayanan, PR; Aziz, Mohamed Abdul

    2007-01-01

    Abstract Laboratories and laboratory networks are a fundamental component of tuberculosis (TB) control, providing testing for diagnosis, surveillance and treatment monitoring at every level of the health-care system. New initiatives and resources to strengthen laboratory capacity and implement rapid and new diagnostic tests for TB will require recognition that laboratories are systems that require quality standards, appropriate human resources, and attention to safety in addition to supplies and equipment. To prepare the laboratory networks for new diagnostics and expanded capacity, we need to focus efforts on strengthening quality management systems (QMS) through additional resources for external quality assessment programmes for microscopy, culture, drug susceptibility testing (DST) and molecular diagnostics. QMS should also promote development of accreditation programmes to ensure adherence to standards to improve both the quality and credibility of the laboratory system within TB programmes. Corresponding attention must be given to addressing human resources at every level of the laboratory, with special consideration being given to new programmes for laboratory management and leadership skills. Strengthening laboratory networks will also involve setting up partnerships between TB programmes and those seeking to control other diseases in order to pool resources and to promote advocacy for quality standards, to develop strategies to integrate laboratories’ functions and to extend control programme activities to the private sector. Improving the laboratory system will assure that increased resources, in the form of supplies, equipment and facilities, will be invested in networks that are capable of providing effective testing to meet the goals of the Global Plan to Stop TB. PMID:17639219

  20. Impact of emission control on regional air quality in the Pearl Delta River region, southern China

    NASA Astrophysics Data System (ADS)

    Wang, N.; Xuejiao, D.

    2017-12-01

    The Pearl River Delta (PRD) in China has been suffering from air quality issues and the government has implemented a series of strategies in controlling emissions. In an attempt to provide scientific support for improving air quality, the paper investigates the concerning past-to-present air quality data and assesses air quality resulting from emission control. Statistical data revealed that energy consumption doubled from 2004 to 20014 and vehicle usage increased significantly from 2006 to 2014. Due to the effect of control efforts, primary emission of SO2, NOx and PM2.5 decreased resulting in ambient concentrations of SO2, NO2 and PM10 decreased by 66%, 20% and 24%, respectively. However, O3 increased 19% because of the increase of VOC emission. A chemical transport model, the Community Multi-scale Air Quality, was employed to evaluate the responses of nitrate, ammonium, SOA, PM2.5 and O3 to changes in NOx, VOC and NH3 emissions. Three scenarios, a baseline scenario, a CAP scenario (control strength followed as past tendency), and a REF scenario (strict control referred to latest policy and plans), were conducted to investigate the responses and mechanisms. NOx controlling scenarios showed that NOx, nitrate and PM2.5 reduced by 1.8%, 0.7% and 0.2% under CAP and reduced by 7.2%, 1.8% and 0.3% under REF, respectively. The results indicated that reducing NOx emission caused the increase of atmospheric oxidizability, which might result in a compensation of PM2.5 due to the increase of nitrate or sulfate. NH3 controlling scenarios showed that nitrate was sensitive to NH3 emission in PRD, with nitrate decreased by 0 - 10.6% and 0 - 48% under CAP and REF, respectively. Since controlling NH3 emissions not only reduced ammonium but also significantly reduced nitrate, the implement of NH3 controlling strategy was highly suggested. The VOC scenarios revealed that though SOA was not the major component of PM2.5, controlling VOC emission might take effect in southwestern PRD where photochemical pollution usually occurred. Last but not least, the responses of O3 indicated that the PRD was generally VOC-sensitive, while the regime turned to NOx-sensitive in the afternoon, therefore controlling VOC emission could reduce the overall O3 and controlling NOx emission in the afternoon could reduce peak O3.

  1. Category 1 external quality assessment program for serum creatinine.

    PubMed

    González-Lao, Elisabet; Díaz-Garzón, Jorge; Corte, Zoraida; Ricós, Carmen; Perich, Carmen; Álvarez, Virtudes; Simón, Margarita; Minchinela, Joana; García-Lario, José Vicente; Boned, Beatriz; Biosca, Carmen; Cava, Fernando; Fernández-Fernández, Pilar; Fernández-Calle, Pilar

    2017-03-01

    The Commission of Analytical Quality and the Committee of External Quality Programs of Spanish Society of Laboratory Medicine (SEQC) in collaboration with the Dutch Foundation for the Quality organized the first national category 1 External Quality Assessment Programs (EQAP) pilot study. The aim is to evaluate the standardization of serum creatinine measurements in the Spanish laboratories through a category 1 external quality assurance program with commutable material and reference method assigned values. A total of 87 Spanish laboratories were involved in this program in 2015. Each day a sample control was measured by duplicate during 6 consecutive days. Percentage deviations and coefficients of variation obtained were compared with quality specifications derived from biological variation. A total of 1044 creatinine results were obtained. Laboratories were coded in 11 different method-traceability combinations. Only enzymatic methods get all results within the acceptability limits. To participate in a category 1 EQAP is a valuable tool to assess the standardization degree in our country; a big effort should be made to promote laboratories to change their procedures and to use enzymatic creatinine methods, in order to achieve a satisfactory standardization degree for this important analyte.

  2. Academic goals and learning quality in higher education students.

    PubMed

    Valle, Antonio; Núñez, José C; Cabanach, Ramón G; González-Pienda, Julio A; Rodríguez, Susana; Rosário, Pedro; Muñoz-Cadavid, María A; Cerezo, Rebeca

    2009-05-01

    In this paper, the relations between academic goals and various indicators that define the quality of the learning process are analyzed. The purpose was to determine to what extent high, moderate, or low levels of academic goals were positively or negatively related to effort regulation, the value assigned to academic tasks, meta-cognitive self-regulation, self-efficacy, beliefs about learning control, and management of time and study environment. The investigation was carried out with a sample of 632 university students (70% female and 30% male) and mean age of 21.22 (SD=2.2).The results show that learning goals, or task orientation, are positively related to all the indictors of learning quality considered herein. Although for other kinds of goals-work-avoidance goals, performance-approach goals, and performance-avoidance goals-significant relations were not found with all the indicators, there was a similar tendency of significant results in all cases; the higher the levels of these goals, the lower the levels of the indicators of learning quality.

  3. Investigating the relationship between costs and outcomes for English mental health providers: a bi-variate multi-level regression analysis.

    PubMed

    Moran, Valerie; Jacobs, Rowena

    2018-06-01

    Provider payment systems for mental health care that incentivize cost control and quality improvement have been a policy focus in a number of countries. In England, a new prospective provider payment system is being introduced to mental health that should encourage providers to control costs and improve outcomes. The aim of this research is to investigate the relationship between costs and outcomes to ascertain whether there is a trade-off between controlling costs and improving outcomes. The main data source is the Mental Health Minimum Data Set (MHMDS) for the years 2011/12 and 2012/13. Costs are calculated using NHS reference cost data while outcomes are measured using the Health of the Nation Outcome Scales (HoNOS). We estimate a bivariate multi-level model with costs and outcomes simultaneously. We calculate the correlation and plot the pairwise relationship between residual costs and outcomes at the provider level. After controlling for a range of demographic, need, social, and treatment variables, residual variation in costs and outcomes remains at the provider level. The correlation between residual costs and outcomes is negative, but very small, suggesting that cost-containment efforts by providers should not undermine outcome-improving efforts under the new payment system.

  4. A pilot study of routine immunization data quality in Bunza Local Government area: causes and possible remedies.

    PubMed

    Omoleke, Semeeh Akinwale; Tadesse, Menberu Getachew

    2017-01-01

    As a result of poor quality administrative data for routine immunisation (RI) in Nigeria, the real coverage of RI remains unknown, constituting a setback in curtailing vaccine preventable diseases (VPDs). Consequently, the purpose of this pilot study is to identify source(s) and evaluate the magnitude of poor data quality as well as propose recommendations to address the problem. The authors conducted a cross-sectional study in which 5 out of the 22 health facilities providing routine immunization services in Bunza Local Government Area (LGA), Kebbi State, Nigeria, were selected for data quality assessment. The reported coverage of RI in August and September, 2016 was the primary element of evaluation in the selected Health Facilities (HFs). Administered questionnaires were adapted from WHO Data Quality Assurance and RI monitoring tools to generate data from the HFs, as well as standardised community survey tool for household surveys. Data inconsistency was detected in 100% of the selected HFs. Maximum difference between HF monthly summary and RI registration book for penta 3 data quality report analysis was 820% and 767% in MCH Bunza and PHC Balu respectively. However, a minimum difference of 3% was observed at Loko Dispensary. Maximum difference between HF summary and RI registration for measles was 614% at MCH Bunza and 43% minimum difference at Loko. In contrast to the administrative coverage, 60-80% of the children sampled from households were either not immunised or partially immunised. Further, the main sources of poor data quality include heavy workload on RI providers, over-reliance on administrative coverage report, and lack of understanding of the significance of high data quality by RI providers. Substantial data discrepancies were observed in RI reports from all the Health Facilities which is indicative of poor data quality at the LGA level. Community surveys also revealed an over-reporting from administrative coverage data. Consequently, efforts should be geared towards achieving good data quality by immunisation stakeholders as it has implication on disease prevention and control efforts.

  5. A pilot study of routine immunization data quality in Bunza Local Government area: causes and possible remedies

    PubMed Central

    Omoleke, Semeeh Akinwale; Tadesse, Menberu Getachew

    2017-01-01

    Introduction As a result of poor quality administrative data for routine immunisation (RI) in Nigeria, the real coverage of RI remains unknown, constituting a setback in curtailing vaccine preventable diseases (VPDs). Consequently, the purpose of this pilot study is to identify source(s) and evaluate the magnitude of poor data quality as well as propose recommendations to address the problem. Methods The authors conducted a cross-sectional study in which 5 out of the 22 health facilities providing routine immunization services in Bunza Local Government Area (LGA), Kebbi State, Nigeria, were selected for data quality assessment. The reported coverage of RI in August and September, 2016 was the primary element of evaluation in the selected Health Facilities (HFs). Administered questionnaires were adapted from WHO Data Quality Assurance and RI monitoring tools to generate data from the HFs, as well as standardised community survey tool for household surveys. Results Data inconsistency was detected in 100% of the selected HFs. Maximum difference between HF monthly summary and RI registration book for penta 3 data quality report analysis was 820% and 767% in MCH Bunza and PHC Balu respectively. However, a minimum difference of 3% was observed at Loko Dispensary. Maximum difference between HF summary and RI registration for measles was 614% at MCH Bunza and 43% minimum difference at Loko. In contrast to the administrative coverage, 60-80% of the children sampled from households were either not immunised or partially immunised. Further, the main sources of poor data quality include heavy workload on RI providers, over-reliance on administrative coverage report, and lack of understanding of the significance of high data quality by RI providers. Conclusion Substantial data discrepancies were observed in RI reports from all the Health Facilities which is indicative of poor data quality at the LGA level. Community surveys also revealed an over-reporting from administrative coverage data. Consequently, efforts should be geared towards achieving good data quality by immunisation stakeholders as it has implication on disease prevention and control efforts. PMID:28979641

  6. Challenges in Development of Sperm Repositories for Biomedical Fishes: Quality Control in Small-Bodied Species.

    PubMed

    Torres, Leticia; Liu, Yue; Guitreau, Amy; Yang, Huiping; Tiersch, Terrence R

    2017-12-01

    Quality control (QC) is essential for reproducible and efficient functioning of germplasm repositories. However, many biomedical fish models present significant QC challenges due to small body sizes (<5 cm) and miniscule sperm volumes (<5 μL). Using minimal volumes of sperm, we used Zebrafish to evaluate common QC endpoints as surrogates for fertilization success along sequential steps of cryopreservation. First, concentrations of calibration bead suspensions were evaluated with a Makler ® counting chamber by using different sample volumes and mixing methods. For sperm analysis, samples were initially diluted at a 1:30 ratio with Hanks' balanced salt solution (HBSS). Motility was evaluated by using different ratios of sperm and activation medium, and membrane integrity was analyzed with flow cytometry at different concentrations. Concentration and sperm motility could be confidently estimated by using volumes as small as 1 μL, whereas membrane integrity required a minimum of 2 μL (at 1 × 10 6 cells/mL). Thus, <5 μL of sperm suspension (after dilution to 30-150 μL with HBSS) was required to evaluate sperm quality by using three endpoints. Sperm quality assessment using a combination of complementary endpoints enhances QC efforts during cryopreservation, increasing reliability and reproducibility, and reducing waste of time and resources.

  7. Parts Quality Management: Direct Part Marking via Data Matrix Symbols for Mission Assurance

    NASA Technical Reports Server (NTRS)

    Moss, Chantrice

    2013-01-01

    A United States Government Accountability Office (GAO) review of twelve NASA programs found widespread parts quality problems contributing to significant cost overruns, schedule delays, and reduced system reliability. Direct part-marking with Data Matrix symbols could significantly improve the quality of inventory control and parts lifecycle management. This paper examines the feasibility of using 15 marking technologies for use in future NASA programs. A structural analysis is based on marked material type, operational environment (e.g., ground, suborbital, orbital), durability of marks, ease of operation, reliability, and affordability. A cost-benefits analysis considers marking technology (data plates, label printing, direct part marking) and marking types (two-dimensional machine-readable, human-readable). Previous NASA parts marking efforts and historical cost data are accounted for, including in-house vs. outsourced marking. Some marking methods are still under development. While this paper focuses on NASA programs, results may be applicable to a variety of industrial environments.

  8. Fishes of the White River basin, Indiana

    USGS Publications Warehouse

    Crawford, Charles G.; Lydy, Michael J.; Frey, Jeffrey W.

    1996-01-01

    Since 1875, researchers have reported 158 species of fish belonging to 25 families in the White River Basin. Of these species, 6 have not been reported since 1900 and 10 have not been reported since 1943. Since the 1820's, fish communities in the White River Basin have been affected by the alteration of stream habitat, overfishing, the introduction of non-native species, agriculture, and urbanization. Erosion resulting from conversion of forest land to cropland in the 1800's led to siltation of streambeds and resulted in the loss of some silt-sensitive species. In the early 1900's, the water quality of the White River was seriously degraded for 100 miles by untreated sewage from the City of Indianapolis. During the last 25 years, water quality in the basin has improved because of efforts to control water pollution. Fish communities in the basin have responded favorably to the improved water quality.

  9. Family Relationships and Adolescents’ Health Attitudes and Weight: The Understudied Role of Sibling Relationships

    PubMed Central

    Senguttuvan, Umadevi; Whiteman, Shawn D.; Jensen, Alexander C.

    2014-01-01

    Family relationships are important predictors of adolescents’ diet, physical activity, and health issues including obesity. Despite their prominence in the family, siblings have received little attention on how they may influence these health-related behaviors. Addressing this gap, the present study examined associations between sibling relationship qualities and adolescents’ health attitudes, exercise behaviors, and weight controlling for other family relationship qualities. Participants included one parent and two adolescent siblings (ages 12 to 19) from 326 families. Multilevel models indicated that net of parent-adolescent relationship qualities and adolescents’ personal characteristics, sibling intimacy was related to healthy attitudes and greater exercise behaviors, whereas sibling conflict was associated with increased risk of being overweight. Links between sibling conflict and weight status, however, were further qualified by gender composition of the sibling dyad. Results highlight the significance of sibling relationships in adolescents’ everyday health attitudes and behaviors and implications for intervention efforts are discussed. PMID:24954967

  10. Quality of vaccination services and social demand for vaccinations in Africa and Asia.

    PubMed Central

    Streefland, P. H.; Chowdhury, A. M.; Ramos-Jimenez, P.

    1999-01-01

    For immunization to be effective in the long run as a major global disease control intervention it is important to provide good quality vaccination services. Studies carried out in three countries in Asia (Bangladesh, India, and the Philippines) and two countries in Africa (Ethiopia and Malawi), and reported on in this article, document the fact that parents are willing to invest considerable effort in having their children vaccinated; however, there are a number of serious shortcomings in the quality of the routine vaccination services and strains are apparent at the interface between the vaccination providers and the users. These shortcomings are detracting from the sustainability of routine vaccination programmes and are promoting the growth of pools of nonimmunized and partially immunized children. To safeguard the continued operation and to enhance the coverage of routine vaccination programmes it is crucial that these difficulties be addressed. PMID:10534895

  11. Engaging multilevel stakeholders in an implementation trial of evidence-based quality improvement in VA women's health primary care.

    PubMed

    Hamilton, Alison B; Brunner, Julian; Cain, Cindy; Chuang, Emmeline; Luger, Tana M; Canelo, Ismelda; Rubenstein, Lisa; Yano, Elizabeth M

    2017-09-01

    The Veterans Health Administration (VHA) has undertaken primary care transformation based on patient-centered medical home (PCMH) tenets. VHA PCMH models are designed for the predominantly male Veteran population, and require tailoring to meet women Veterans' needs. We used evidence-based quality improvement (EBQI), a stakeholder-driven implementation strategy, in a cluster randomized controlled trial across 12 sites (eight EBQI, four control) that are members of a Practice-Based Research Network. EBQI involves engaging multilevel, inter-professional leaders and staff as stakeholders in reviewing evidence and setting QI priorities. The goal of this analysis was to examine processes of engaging stakeholders in early implementation of EBQI to tailor VHA's medical home for women. Four inter-professional regional stakeholder planning meetings were conducted; these meetings engaged stakeholders by providing regional data about gender disparities in Veterans' care experiences. Subsequent to each meeting, qualitative interviews were conducted with 87 key stakeholders (leaders and staff). Stakeholders were asked to describe QI efforts and the use of data to change aspects of care, including women's health care. Interview transcripts were summarized and coded using a hybrid deductive/inductive analytic approach. The presentation of regional-level data about gender disparities resulted in heightened awareness and stakeholder buy-in and decision-making related to women's health-focused QI. Interviews revealed that stakeholders were familiar with QI, with regional and facility leaders aware of inter-disciplinary committees and efforts to foster organizational change, including PCMH transformation. These efforts did not typically focus on women's health, though some informal efforts had been undertaken. Barriers to engaging in QI included lack of communication across clinical service lines, fluidity in staffing, and lack of protected time. Inter-professional, multilevel stakeholders need to be engaged in implementation early, with data and discussion that convey the importance and relevance of a new initiative. Stakeholder perspectives on institutional norms (e.g., gender norms) and readiness for population-specific QI are useful drivers of clinical initiatives designed to transform care for clinical subpopulations.

  12. Adapting water treatment design and operations to the impacts of global climate change

    NASA Astrophysics Data System (ADS)

    Clark, Robert M.; Li, Zhiwei; Buchberger, Steven G.

    2011-12-01

    It is anticipated that global climate change will adversely impact source water quality in many areas of the United States and will therefore, potentially, impact the design and operation of current and future water treatment systems. The USEPA has initiated an effort called the Water Resources Adaptation Program (WRAP) which is intended to develop tools and techniques that can assess the impact of global climate change on urban drinking water and wastewater infrastructure. A three step approach for assessing climate change impacts on water treatment operation and design is being persude in this effort. The first step is the stochastic characterization of source water quality, the second step is the application of the USEPA Water Treatment Plant model and the third step is the application of cost algorithms to provide a metric that can be used to assess the coat impact of climate change. A model has been validated using data collected from Cincinnati's Richard Miller Water Treatment Plant for the USEPA Information Collection Rule (ICR) database. An analysis of the water treatment processes in response to assumed perturbations in raw water quality identified TOC, pH, and bromide as the three most important parameters affecting performance of the Miller WTP. The Miller Plant was simulated using the EPA WTP model to examine the impact of these parameters on selected regulated water quality parameters. Uncertainty in influent water quality was analyzed to estimate the risk of violating drinking water maximum contaminant levels (MCLs).Water quality changes in the Ohio River were projected for 2050 using Monte Carlo simulation and the WTP model was used to evaluate the effects of water quality changes on design and operation. Results indicate that the existing Miller WTP might not meet Safe Drinking Water Act MCL requirements for certain extreme future conditions. However, it was found that the risk of MCL violations under future conditions could be controlled by enhancing existing WTP design and operation or by process retrofitting and modification.

  13. How Safe? The Status of State Efforts To Protect Children in Child Care.

    ERIC Educational Resources Information Center

    Adams, Gina

    Based on the view that strong state child care licensing policies can influence the quality of child care and thereby enhance children's health and development, this report examines the status of state efforts to improve the quality of child care programs. Almost all data were collected for a 1993 Parenting Magazine survey, and were verified by…

  14. Adverse psychosocial working conditions and poor quality of life among financial service employees in Brazil.

    PubMed

    Silva, Luiz Sergio; Barreto, Sandhi Maria

    2012-01-01

    Workers in the financial services sector are exposed to great stress at work. This study investigates whether exposure to adverse psychosocial work conditions is independently associated with poor health-related physical and mental quality of life among financial services workers. We studied a nationwide representative sample of 2,054 workers of a large Brazilian state bank in 2008. Adverse psychosocial work conditions were investigated by the Effort-reward imbalance (ERI) scale and the Job content questionnaire (JCQ). Health-related quality of life (HRQL) was assessed using the Medical Outcomes Study Short-Form General Health Survey (SF-12). Poor mental and physical HRQL was defined by the lowest quartiles of the SF-12 final score distributions. Associations were investigated using multiple logistic regression analysis. In the multivariate analysis, exposures to low control and lack of social support at work (JCQ) were associated with poor HRQL in the physical domain. Increasing effort-reward imbalance and overcommitment (ERI), on the other hand, were associated with poor HRQL in the mental domain, with a significant statistical trend. Overcommitment was also associated with poor physical HRQL. The results suggest that exposure to adverse psychosocial work conditions has a negative impact on both domains of HRQL among financial service workers. They also indicate that ERI and DC models capture different aspects of job strain.

  15. Quality of Voluntary Medical Male Circumcision Services during Scale-Up: A Comparative Process Evaluation in Kenya, South Africa, Tanzania and Zimbabwe

    PubMed Central

    Jennings, Larissa; Bertrand, Jane; Rech, Dino; Harvey, Steven A.; Hatzold, Karin; Samkange, Christopher A.; Omondi Aduda, Dickens S.; Fimbo, Bennett; Cherutich, Peter; Perry, Linnea; Castor, Delivette; Njeuhmeli, Emmanuel

    2014-01-01

    Background The rapid expansion of voluntary medical male circumcision (VMMC) has raised concerns whether health systems can deliver and sustain VMMC according to minimum quality criteria. Methods and Findings A comparative process evaluation was used to examine data from SYMMACS, the Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-Up, among health facilities providing VMMC across two years of program scale-up. Site-level assessments examined the availability of guidelines, supplies and equipment, infection control, and continuity of care services. Direct observation of VMMC surgeries were used to assess care quality. Two sample tests of proportions and t-tests were used to examine differences in the percent of facilities meeting requisite preparedness standards and the mean number of directly-observed surgical tasks performed correctly. Results showed that safe, high quality VMMC can be implemented and sustained at-scale, although substantial variability was observed over time. In some settings, facility preparedness and VMMC service quality improved as the number of VMMC facilities increased. Yet, lapses in high performance and expansion of considerably deficient services were also observed. Surgical tasks had the highest quality scores, with lower performance levels in infection control, pre-operative examinations, and post-operative patient monitoring and counseling. The range of scale-up models used across countries additionally underscored the complexity of delivering high quality VMMC. Conclusions Greater efforts are needed to integrate VMMC scale-up and quality improvement processes in sub-Saharan African settings. Monitoring of service quality, not just adverse events reporting, will be essential in realizing the full health impact of VMMC for HIV prevention. PMID:24801073

  16. Association between health worker motivation and healthcare quality efforts in Ghana

    PubMed Central

    2013-01-01

    Background Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. Purpose This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. Methods The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. Results The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P <0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic’s effort towards quality improvement and patient safety (P <0.05). Conclusion As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst. PMID:23945073

  17. Florida Initiative for Quality Cancer Care: improvements on colorectal cancer quality of care indicators during a 3-year interval.

    PubMed

    Siegel, Erin M; Jacobsen, Paul B; Lee, Ji-Hyun; Malafa, Mokenge; Fulp, William; Fletcher, Michelle; Smith, Jesusa Corazon R; Brown, Richard; Levine, Richard; Cartwright, Thomas; Abesada-Terk, Guillermo; Kim, George; Alemany, Carlos; Faig, Douglas; Sharp, Philip; Markham, Merry-Jennifer; Shibata, David

    2014-01-01

    The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥ 12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for Quality Cancer Care are useful for evaluating and improving the quality of cancer care at a regional level. Copyright © 2014. Published by Elsevier Inc.

  18. Geodetic Seamless Archive Centers Modernization - Information Technology for Exploiting the Data Explosion

    NASA Astrophysics Data System (ADS)

    Boler, F. M.; Blewitt, G.; Kreemer, C. W.; Bock, Y.; Noll, C. E.; McWhirter, J.; Jamason, P.; Squibb, M. B.

    2010-12-01

    Space geodetic science and other disciplines using geodetic products have benefited immensely from open sharing of data and metadata from global and regional archives Ten years ago Scripps Orbit and Permanent Array Center (SOPAC), the NASA Crustal Dynamics Data Information System (CDDIS), UNAVCO and other archives collaborated to create the GPS Seamless Archive Centers (GSAC) in an effort to further enable research with the expanding collections of GPS data then becoming available. The GSAC partners share metadata to facilitate data discovery and mining across participating archives and distribution of data to users. This effort was pioneering, but was built on technology that has now been rendered obsolete. As the number of geodetic observing technologies has expanded, the variety of data and data products has grown dramatically, exposing limitations in data product sharing. Through a NASA ROSES project, the three archives (CDDIS, SOPAC and UNAVCO) have been funded to expand the original GSAC capability for multiple geodetic observation types and to simultaneously modernize the underlying technology by implementing web services. The University of Nevada, Reno (UNR) will test the web services implementation by incorporating them into their daily GNSS data processing scheme. The effort will include new methods for quality control of current and legacy data that will be a product of the analysis/testing phase performed by UNR. The quality analysis by UNR will include a report of the stability of the stations coordinates over time that will enable data users to select sites suitable for their application, for example identifying stations with large seasonal effects. This effort will contribute to enhanced ability for very large networks to obtain complete data sets for processing.

  19. Digitalizing historical high resolution water level data: Challenges and opportunities

    NASA Astrophysics Data System (ADS)

    Holinde, Lars; Hein, Hartmut; Barjenbruch, Ulrich

    2017-04-01

    Historical tide-gauge data offer the opportunities for determining variations in key characteristics for water level data and the analyses of past extreme events (storm surges). These information are important for calculating future trends and scenarios. But there are challenges involved due to the extensive effort needed to digitalize gauge sheets and quality control the resulting historical data. Based on these conditions, two main sources for inaccuracies in historical time series can be identified. First are several challenges due to the digitalization of the historical data, e.g. general quality of the sheets, multiple crossing lines of the observed water levels and additional comments on the sheet describing problems or additional information during the measurements. Second are problems during the measurements themselves. These can include the incorrect positioning of the sheets, trouble with the tide-gauge and maintenance. Errors resulting from these problems can be e.g. flat lines, discontinuities and outlier. Especially, the characterization of outliers has to be conducted carefully, to distinguish between real outliers and the appearance of extreme events. Methods for the quality control process involve the use of statistics, machine learning and neural networks. These will be described and applied to three different time series from tide gauge stations at the cost of Lower Saxony, Germany. Resulting difficulties and outcomes of the quality control process will be presented and explained. Furthermore, we will present a first glance at analyses for these time series.

  20. Guilt and Effortful Control: Two Mechanisms that Prevent Disruptive Developmental Trajectories

    PubMed Central

    Kochanska, Grazyna; Barry, Robin A.; Jimenez, Natasha B.; Hollatz, Amanda L.; Woodard, Jarilyn

    2009-01-01

    Children's guilt associated with transgressions and their capacity for effortful control are both powerful forces that inhibit disruptive conduct. We examined how guilt and effortful control, repeatedly observed from toddler to preschool age, jointly predict children's disruptive outcomes in two multi-method multi-trait longitudinal studies (N's 57 and 99). Disruptive outcomes were rated by mothers at 73 months (Study 1) and mothers, fathers, and teachers at 52 and 67 months (Study 2). In both studies, guilt moderated effects of effortful control: For highly guilt-prone children, variations in effortful control were unrelated to future disruptive outcomes, but for children who were less guilt prone, effortful control predicted such outcomes. Guilt may inhibit transgressions through an automatic response due to negative arousal triggered by memories of past wrongdoing, regardless of child capacity for deliberate inhibition. Effortful control that engages a deliberate restraint may offset risk for disruptive conduct conferred by low guilt. PMID:19634978

  1. Grade pending: lessons for hospital quality reporting from the New York City restaurant sanitation inspection program.

    PubMed

    Ryan, Andrew M; Detsky, Allan S

    2015-02-01

    Public quality reporting programs have been widely implemented in hospitals in an effort to improve quality and safety. One such program is Hospital Compare, Medicare's national quality reporting program for US hospitals. The New York City sanitary grade inspection program is a parallel effort for restaurants. The aims of Hospital Compare and the New York City sanitary inspection program are fundamentally similar: to address a common market failure resulting from consumers' lack of information on quality and safety. However, by displaying easily understandable information at the point of service, the New York City sanitary inspection program is better designed to encourage informed consumer decision making. We argue that this program holds important lessons for public quality reporting of US hospitals. © 2014 Society of Hospital Medicine.

  2. Quality of Diabetes Care in Germany Improved from 2000 to 2007 to 2014, but Improvements Diminished since 2007. Evidence from the Population-Based KORA Studies

    PubMed Central

    Knoll, Gabriella; Schunk, Michaela; Meisinger, Christa; Huth, Cornelia; Holle, Rolf

    2016-01-01

    Objective Little is known about the development of the quality of diabetes care in Germany. The aim of this study is to analyze time trends in patient self-management, physician-delivered care, medication, risk factor control, complications and quality of life from 2000 to 2014. Methods Analyses are based on data from individuals with type 2 diabetes of the population-based KORA S4 (1999–2001, n = 150), F4 (2006–2008, n = 203), FF4 (2013/14, n = 212) cohort study. Information on patient self-management, physician-delivered care, medication, risk factor control and quality of life were assessed in standardized questionnaires and examinations. The 10-year coronary heart disease (CHD) risk was calculated using the UKPDS risk engine. Time trends were analyzed using multivariable linear and logistic regression models adjusted for age, sex, education, diabetes duration, and history of cardiovascular disease. Results From 2000 to 2014 the proportion of participants with type 2 diabetes receiving oral antidiabetic/cardio-protective medication and of those reaching treatment goals for glycemic control (HbA1c<7%, 60% to 71%, p = 0.09), blood pressure (<140/80 mmHg, 25% to 69%, p<0.001) and LDL cholesterol (<2.6 mmol/l, 13% to 27%, p<0.001) increased significantly. However, improvements were generally smaller from 2007 to 2014 than from 2000 to 2007. Modeled 10-year CHD risk decreased from 30% in 2000 to 24% in 2007 to 19% in 2014 (p<0.01). From 2007 to 2014, the prevalence of microvascular complications decreased and quality of life increased, but no improvements were observed for the majority of indicators of self-management. Conclusion Despite improvements, medication and risk factor control has remained suboptimal. The flattening of improvements and deteriorations in quality of (self-) care since 2007 indicate that more effort is needed to improve quality of care and patient self-management. Due to selection or lead time bias an overestimation of quality of care improvements cannot be ruled out. PMID:27749939

  3. Evaluation of Knowledge Development in a Healthcare Setting

    NASA Astrophysics Data System (ADS)

    Schaffer, Scott P.

    Healthcare organizations worldwide have recently increased efforts to improve performance, quality, and knowledge transfer using information and communication technologies. Evaluation of the effectiveness and quality of such efforts is challenging. A macro and micro-level system evaluation conducted with a 14000 member US hospital administrative services organization examined the appropriateness of a blended face-to-face and technology-enabled performance improvement and knowledge development system. Furthermore, a successful team or microsystem in a high performing hospital was studied in-depth. Several types of data methods including interview, observation, and questionnaire were used to address evaluation questions within a knowledge development framework created for the study. Results of this preliminary study focus on how this organization attempted to organize clinical improvement efforts around quality and performance improvement processes supported by networked technologies.

  4. Effort-Reward Imbalance for Learning Is Associated with Fatigue in School Children

    ERIC Educational Resources Information Center

    Fukuda, Sanae; Yamano, Emi; Joudoi, Takako; Mizuno, Kei; Tanaka, Masaaki; Kawatani, Junko; Takano, Miyuki; Tomoda, Akemi; Imai-Matsumura, Kyoko; Miike, Teruhisa; Watanabe, Yasuyoshi

    2010-01-01

    We examined relationships among fatigue, sleep quality, and effort-reward imbalance for learning in school children. We developed an effort-reward for learning scale in school students and examined its reliability and validity. Self-administered surveys, including the effort reward for leaning scale and fatigue scale, were completed by 1,023…

  5. Interventions to Improve Parental Communication About Sex: A Systematic Review

    PubMed Central

    Holland, Cynthia L.; Bost, James

    2011-01-01

    CONTEXT: The relative effectiveness of interventions to improve parental communication with adolescents about sex is not known. OBJECTIVE: To compare the effectiveness and methodologic quality of interventions for improving parental communication with adolescents about sex. METHODS: We searched 6 databases: OVID/Medline, PsychInfo, ERIC, Cochrane Review, Communication and Mass Media, and the Cumulative Index to Nursing and Allied Health Literature. We included studies published between 1980 and July 2010 in peer-reviewed English-language journals that targeted US parents of adolescents aged 11 to 18 years, used an experimental or quasi-experimental design, included a control group, and had a pretest/posttest design. We abstracted data on multiple communication outcomes defined by the integrative conceptual model (communication frequency, content, skills, intentions, self-efficacy, perceived environmental barriers/facilitators, perceived social norms, attitudes, outcome expectations, knowledge, and beliefs). Methodologic quality was assessed using the 11-item methodologic quality score. RESULTS: Twelve studies met inclusion criteria. Compared with controls, parents who participated in these interventions experienced improvements in multiple communication domains including the frequency, quality, intentions, comfort, and self-efficacy for communicating. We noted no effects on parental attitudes toward communicating or the outcomes they expected to occur as a result of communicating. Four studies were of high quality, 7 were of medium quality, and 1 was of lower quality. CONCLUSIONS: Our review was limited by the lack of standardized measures for assessing parental communication. Still, interventions for improving parent-adolescent sex communication are well designed and have some targeted effects. Wider dissemination could augment efforts by schools, clinicians, and health educators. PMID:21321027

  6. Interventions to improve parental communication about sex: a systematic review.

    PubMed

    Akers, Aletha Y; Holland, Cynthia L; Bost, James

    2011-03-01

    The relative effectiveness of interventions to improve parental communication with adolescents about sex is not known. To compare the effectiveness and methodologic quality of interventions for improving parental communication with adolescents about sex. We searched 6 databases: OVID/Medline, PsychInfo, ERIC, Cochrane Review, Communication and Mass Media, and the Cumulative Index to Nursing and Allied Health Literature. We included studies published between 1980 and July 2010 in peer-reviewed English-language journals that targeted US parents of adolescents aged 11 to 18 years, used an experimental or quasi-experimental design, included a control group, and had a pretest/posttest design. We abstracted data on multiple communication outcomes defined by the integrative conceptual model (communication frequency, content, skills, intentions, self-efficacy, perceived environmental barriers/facilitators, perceived social norms, attitudes, outcome expectations, knowledge, and beliefs). Methodologic quality was assessed using the 11-item methodologic quality score. Twelve studies met inclusion criteria. Compared with controls, parents who participated in these interventions experienced improvements in multiple communication domains including the frequency, quality, intentions, comfort, and self-efficacy for communicating. We noted no effects on parental attitudes toward communicating or the outcomes they expected to occur as a result of communicating. Four studies were of high quality, 7 were of medium quality, and 1 was of lower quality. Our review was limited by the lack of standardized measures for assessing parental communication. Still, interventions for improving parent-adolescent sex communication are well designed and have some targeted effects. Wider dissemination could augment efforts by schools, clinicians, and health educators.

  7. Identification of long-term trends and seasonality in high-frequency water quality data from the Yangtze River basin, China

    PubMed Central

    He, Bin; Chen, Yaning; Zou, Shan; Wang, Yi; Nover, Daniel; Chen, Wen; Yang, Guishan

    2018-01-01

    Comprehensive understanding of the long-term trends and seasonality of water quality is important for controlling water pollution. This study focuses on spatio-temporal distributions, long-term trends, and seasonality of water quality in the Yangtze River basin using a combination of the seasonal Mann-Kendall test and time-series decomposition. The used weekly water quality data were from 17 environmental stations for the period January 2004 to December 2015. Results show gradual improvement in water quality during this period in the Yangtze River basin and greater improvement in the Uppermost Yangtze River basin. The larger cities, with high GDP and population density, experienced relatively higher pollution levels due to discharge of industrial and household wastewater. There are higher pollution levels in Xiang and Gan River basins, as indicated by higher NH4-N and CODMn concentrations measured at the stations within these basins. Significant trends in water quality were identified for the 2004–2015 period. Operations of the three Gorges Reservoir (TGR) enhanced pH fluctuations and possibly attenuated CODMn, and NH4-N transportation. Finally, seasonal cycles of varying strength were detected for time-series of pollutants in river discharge. Seasonal patterns in pH indicate that maxima appear in winter, and minima in summer, with the opposite true for CODMn. Accurate understanding of long-term trends and seasonality are necessary goals of water quality monitoring system efforts and the analysis methods described here provide essential information for effectively controlling water pollution. PMID:29466354

  8. Quality control management and communication between radiologists and technologists.

    PubMed

    Nagy, Paul G; Pierce, Benjamin; Otto, Misty; Safdar, Nabile M

    2008-06-01

    The greatest barrier to quality control (QC) in the digital imaging environment is the lack of communication and documentation between those who interpret images and those who acquire them. Paper-based QC methods are insufficient in a digital image management system. Problem work flow must be incorporated into reengineering efforts when migrating to a digital practice. The authors implemented a Web-based QC feedback tool to document and facilitate the communication of issues identified by radiologists. The goal was to promote a responsive and constructive tool that contributes to a culture of quality. The hypothesis was that by making it easier for radiologists to submit quality issues, the number of QC issues submitted would increase. The authors integrated their Web-based quality tracking system with a clinical picture archiving and communication system so that radiologists could report quality issues without disrupting clinical work flow. Graphical dashboarding techniques aid supervisors in using this database to identify the root causes of different types of issues. Over the initial 12-month rollout period, starting in the general section, the authors recorded 20 times more QC issues submitted by radiologists, accompanied by a rise in technologists' responsiveness to QC issues. For technologists with high numbers of QC issues, the incorporation of data from this tracking system proved useful in performance appraisals and in driving individual improvement. This tool is an example of the types of information technology innovations that can be leveraged to support QC in the digital imaging environment. Initial data suggest that the result is not only an improvement in quality but higher levels of satisfaction for both radiologists and technologists.

  9. Quality Tools and TRIZ Based Quality Improvement Case Study at PT ‘X’ A Plastic Moulding Manufacturing Industry

    NASA Astrophysics Data System (ADS)

    Wirawan, Christina; Chandra, Fory

    2016-02-01

    Theory of Inventive Problem Solving (TRIZ) is a creative encouraging problem solving method. TRIZ is prepared by Altshuller for product design. Altshuller prepared contradiction matrix and suggestion to solve contradictions usually occur in product design. This paper try to combine TRIZ with quality tools such as Pareto and Fault Tree Analysis (FTA) to solve contradiction in quality improvement problem, neither than product design problem. Pareto used to identify defect priority, FTA used to analysis and identify root cause of defect. When there is contradiction in solving defect causes, TRIZ used to find creative problem solving. As a case study, PT ’X’, a plastic molding manufacturing industry was taken. PT ‘X’ using traditional press machine to produce plastic thread cone. There are 5 defect types that might occur in plastic thread cone production, incomplete form, dirty, mottle, excessive form, rugged. Research about quality improvement effort using DMAIC at PT ‘X’ have been done by Fory Candra. From this research, defect types, priority, root cause from FTA, recommendation from FMEA. In this research, from FTA reviewed, contradictions found among causes troublesome quality improvement efforts. TRIZ used to solve the contradictions and quality improvement effort can be made effectively.

  10. [Blood-sugar self control. A means for the diabetic of controlling his metabolic management. Quality control of a battery-run pocket size reflectometer (glucose-meter)].

    PubMed

    Leidinger, F; Jörgens, V; Chantelau, E; Berchtold, P; Berger, M

    1980-07-26

    Home blood glucose monitoring by diabetic patients has recently been advocated as an effective means to improve metabolic control. The Glucocheck apparatus, a pocket-size battery-driven reflectance-meter (in Germany commercially available under the name Glucose-meter), has been evaluated for accuracy and practicability. In 450 blood glucose measurements, the variance between the values obtained using the Glucocheck apparatus and routine clinical laboratory procedures was +/- 11.7%. Especially in the low range of blood glucose concentrations, the Glucocheck method was very reliable. The quantitative precision of the Glucocheck method depends, however, quite considerably on the ability of the patient to use the apparatus correctly. In order to profit from Glucocheck in clinical practice, particular efforts to educate the patients in its use are necessary.

  11. Cryopreservation: Evolution of Molecular Based Strategies.

    PubMed

    Baust, John M; Corwin, William; Snyder, Kristi K; Van Buskirk, Robert; Baust, John G

    2016-01-01

    Cryopreservation (CP) is an enabling process providing for on-demand access to biological material (cells and tissues) which serve as a starting, intermediate or even final product. While a critical tool, CP protocols, approaches and technologies have evolved little over the last several decades. A lack of conversion of discoveries from the CP sciences into mainstream utilization has resulted in a bottleneck in technological progression in areas such as stem cell research and cell therapy. While the adoption has been slow, discoveries including molecular control and buffering of cell stress response to CP as well as the development of new devices for improved sample freezing and thawing are providing for improved CP from both the processing and sample quality perspectives. Numerous studies have described the impact, mechanisms and points of control of cryopreservation-induced delayed-onset cell death (CIDOCD). In an effort to limit CIDOCD, efforts have focused on CP agent and freeze media formulation to provide a solution path and have yielded improvements in survival over traditional approaches. Importantly, each of these areas, new technologies and cell stress modulation, both individually and in combination, are now providing a new foundation to accelerate new research, technology and product development for which CP serves as an integral component. This chapter provides an overview of the molecular stress responses of cells to cryopreservation, the impact of the hypothermic and cell death continuums and the targeted modulation of common and/or cell specific responses to CP in providing a path to improving cell quality.

  12. Contribution au developpement d'une methode de controle des procedes dans une usine de bouletage

    NASA Astrophysics Data System (ADS)

    Gosselin, Claude

    This thesis, a collaborative effort between Ecole de technologie superieure and ArcelorMittal Company, presents the development of a methodology for monitoring and quality control of multivariable industrial production processes. This innovation research mandate was developed at ArcelorMittal Exploitation Miniere (AMEM) pellet plant in Port-Cartier (Quebec, Canada). With this undertaking, ArcelorMittal is striving to maintain its world class level of excellence and continues to pursue initiatives that can augment its competitive advantage worldwide. The plant's gravimetric classification process was retained as a prototype and development laboratory due to its effect on the company's competitiveness and its impact on subsequent steps leading to final production of iron oxide pellets. Concretely, the development of this expertise in process control and in situ monitoring will establish a firm basic knowledge in the fields of complex system physical modeling, data reconciliation, statistical observers, multivariate command and quality control using real-time monitoring of the desirability function. The hydraulic classifier is mathematically modeled. Using planned disturbances on the production line, an identification procedure was established to provide empirical estimations of the model's structural parameters. A new sampling campaign and a previously unpublished data collection and consolidation policy were implemented plant-wide. Access to these invaluable data sources has enabled the establishment of new thresholds that govern the production process and its control. Finally, as a substitute for the traditional quality control process, we have implemented a new strategy based on the use of the desirability function. Our innovation is not in using this Finally, as a substitute for the traditional quality control process, we have implemented a new strategy based on the use of the desirability function. Our innovation is not in using this function as an indicator of overall (economic) satisfaction in the production process, but rather in proposing it as an "observer" of the system's state. The first implementation steps have already demonstrated the method's feasibility as well as other numerous industrial impacts on production processes within the company. Namely, the emergence of the economical aspect as a strategic variable that assures better governance of production processes where quality variables present strategic issues.

  13. Comparing and contrasting 'innovation platforms' with other forms of professional networks for strengthening primary healthcare systems for Indigenous Australians.

    PubMed

    Bailie, Jodie; Cunningham, Frances Clare; Bainbridge, Roxanne Gwendalyn; Passey, Megan E; Laycock, Alison Frances; Bailie, Ross Stewart; Larkins, Sarah L; Brands, Jenny S M; Ramanathan, Shanthi; Abimbola, Seye; Peiris, David

    2018-01-01

    Efforts to strengthen health systems require the engagement of diverse, multidisciplinary stakeholder networks. Networks provide a forum for experimentation and knowledge creation, information exchange and the spread of good ideas and practice. They might be useful in addressing complex issues or 'wicked' problems, the solutions to which go beyond the control and scope of any one agency. Innovation platforms are proposed as a novel type of network because of their diverse stakeholder composition and focus on problem solving within complex systems. Thus, they have potential applicability to health systems strengthening initiatives, even though they have been predominantly applied in the international agricultural development sector. In this paper, we compare and contrast the concept of innovation platforms with other types of networks that can be used in efforts to strengthen primary healthcare systems, such as communities of practice, practice-based research networks and quality improvement collaboratives. We reflect on our ongoing research programme that applies innovation platform concepts to drive large-scale quality improvement in primary healthcare for Aboriginal and Torres Strait Islander Australians and outline our plans for evaluation. Lessons from our experience will find resonance with others working on similar initiatives in global health.

  14. Improving Employees' Safety Awareness in Healthcare Organizations Using the DMAIC Quality Improvement Approach.

    PubMed

    Momani, Amer; Hirzallah, Muʼath; Mumani, Ahmad

    Occupational injuries and illnesses in healthcare can cause great human suffering, incur high cost, and have an adverse impact on the quality of patient care. One of the most effective solutions for addressing health and safety issues and improving decisions at the point of care rests in raising employees' safety awareness to recognize, avoid, or respond to potential problems before they arise. In this article, the DMAIC Six Sigma model (Define, Measure, Analyze, Improve, Control) is used as a systematic program to measure, improve, and sustain employees' safety awareness in healthcare organizations. We report on a case study using the model, which was implemented and validated at a local hospital. First, the occupational health and safety knowledge that each job requires was identified. Next, the degree of competence of jobholders to meet these requirements was assessed. Based on the assessment, different awareness-raising efforts were proposed and implemented. The results showed significant improvement in the overall safety awareness compliance assessed: from 74.2% to 84.4% (p < .001) after the intervention. The proposed model ensures that the organization's awareness-raising efforts serve its actual needs and produce optimized and sustained results that eventually lead to safer healthcare service.

  15. The Other Side of Accountability: Measuring Students' Use of Facilities and Opportunities. AIR Forum 1979 Paper.

    ERIC Educational Resources Information Center

    Pace, C. Robert

    A set of measures was developed to assess the quality of student effort in the utilization of the facilities and opportunities available in the college setting. The measures are based on the assumption that students are accountable for the amount, scope, and quality of effort they invest in using the available resources for their learning and…

  16. Hospital nurse productivity enhancement.

    PubMed

    Eastaugh, Steven R

    2007-01-01

    Nurse staffing patterns have come under increased scrutiny as hospital managers attempt to control costs without harming service quality or staff morale. This study presents production function results from a study of nurse output from 2002 to 2005. The results suggest that productivity varies widely among the 39 hospitals as a function of staffing patterns, methods of organization, and the degree of reliance on nurse extender technicians. Nurse extenders can enhance the marginal value product of the most educated nurses as the RNs concentrate their workday around patient care activities. The results suggest that nurse extenders free RNs from the burden of nonnursing tasks. Incentive pay for nurses based on productivity gains is associated with enhanced productivity. One should get the greatest output for the least input effort, better balancing all factors of service delivery to achieve the most with the smallest resource effort.

  17. Fluid Flow Technology that Measures Up

    NASA Technical Reports Server (NTRS)

    2004-01-01

    From 1994 to 1996, NASA s Marshall Space Flight Center conducted a Center Director's Discretionary Fund research effort to apply artificial intelligence technologies to the health management of plant equipment and space propulsion systems. Through this effort, NASA established a business relationship with Quality Monitoring and Control (QMC), of Kingwood, Texas, to provide hardware modeling and artificial intelligence tools. Very detailed and accurate Space Shuttle Main Engine (SSME) analysis and algorithms were jointly created, which identified several missing, critical instrumentation needs for adequately evaluating the engine health status. One of the missing instruments was a liquid oxygen (LOX) flow measurement. This instrument was missing since the original SSME included a LOX turbine flow meter that failed during a ground test, resulting in considerable damage for NASA. New balanced flow meter technology addresses this need with robust, safe, and accurate flow metering hardware.

  18. Combining traditional dietary assessment methods with novel metabolomics techniques: present efforts by the Food Biomarker Alliance.

    PubMed

    Brouwer-Brolsma, Elske M; Brennan, Lorraine; Drevon, Christian A; van Kranen, Henk; Manach, Claudine; Dragsted, Lars Ove; Roche, Helen M; Andres-Lacueva, Cristina; Bakker, Stephan J L; Bouwman, Jildau; Capozzi, Francesco; De Saeger, Sarah; Gundersen, Thomas E; Kolehmainen, Marjukka; Kulling, Sabine E; Landberg, Rikard; Linseisen, Jakob; Mattivi, Fulvio; Mensink, Ronald P; Scaccini, Cristina; Skurk, Thomas; Tetens, Inge; Vergeres, Guy; Wishart, David S; Scalbert, Augustin; Feskens, Edith J M

    2017-11-01

    FFQ, food diaries and 24 h recall methods represent the most commonly used dietary assessment tools in human studies on nutrition and health, but food intake biomarkers are assumed to provide a more objective reflection of intake. Unfortunately, very few of these biomarkers are sufficiently validated. This review provides an overview of food intake biomarker research and highlights present research efforts of the Joint Programming Initiative 'A Healthy Diet for a Healthy Life' (JPI-HDHL) Food Biomarkers Alliance (FoodBAll). In order to identify novel food intake biomarkers, the focus is on new food metabolomics techniques that allow the quantification of up to thousands of metabolites simultaneously, which may be applied in intervention and observational studies. As biomarkers are often influenced by various other factors than the food under investigation, FoodBAll developed a food intake biomarker quality and validity score aiming to assist the systematic evaluation of novel biomarkers. Moreover, to evaluate the applicability of nutritional biomarkers, studies are presently also focusing on associations between food intake biomarkers and diet-related disease risk. In order to be successful in these metabolomics studies, knowledge about available electronic metabolomics resources is necessary and further developments of these resources are essential. Ultimately, present efforts in this research area aim to advance quality control of traditional dietary assessment methods, advance compliance evaluation in nutritional intervention studies, and increase the significance of observational studies by investigating associations between nutrition and health.

  19. The US National Transonic Facility, NTF

    NASA Technical Reports Server (NTRS)

    Bruce, Walter E., Jr.; Gloss, Blair B.

    1989-01-01

    The construction of the National Transonic Facility was completed in September 1982 and the start-up and checkout of tunnel systems were performed over the next two years. In August 1984, the Operational Readiness Review (ORR) was conducted and the facility was declared operational for final checkout of cryogenic instrumentation and control systems, and for the aerodynamic calibration and testing to commence. Also, the model access system for the cryogenic mode of operation would be placed into operation along with tunnel testing. Since the ORR, a host of operating problems resulting from the cryogenic environment were identified and solved. These range from making mechanical and electrical systems functional to eliminating temperature induced model vibration to coping with the outgassing of moisture from the thermal insulation. Additionally, a series of aerodynamic tests have demonstrated data quality and provided research data on several configurations. Some of the more significant efforts are reviewed since the ORR and the NTF status concerning hardware, instrumentation and process controls systems, operating constraints imposed by the cryogenic environment, and data quality are summarized.

  20. Analysis of the Ability of United States and Russian Trace Contaminant Control Systems to Meet U.S. 180-Day and Russian 360-Day Spacecraft Maximum Allowable Concentrations

    NASA Technical Reports Server (NTRS)

    Perry, J. L.

    2016-01-01

    As the Space Station Freedom program transitioned to become the International Space Station (ISS), uncertainty existed concerning the performance capabilities for U.S.- and Russian-provided trace contaminant control (TCC) equipment. In preparation for the first dialogue between NASA and Russian Space Agency personnel in Moscow, Russia, in late April 1994, an engineering analysis was conducted to serve as a basis for discussing TCC equipment engineering assumptions as well as relevant assumptions on equipment offgassing and cabin air quality standards. The analysis presented was conducted as part of the efforts to integrate Russia into the ISS program via the early ISS Multilateral Medical Operations Panel's Air Quality Subgroup deliberations. This analysis, served as a basis for technical deliberations that established a framework for TCC system design and operations among the ISS program's international partners that has been instrumental in successfully managing the ISS common cabin environment.

  1. Prevention and Management of Type 2 Diabetes: Dietary Components and Nutritional Strategies

    PubMed Central

    Ley, Sylvia H.; Hamdy, Osama; Mohan, V.; Hu, Frank B.

    2016-01-01

    Summary In the past couple of decades, evidence from prospective observational studies and clinical trials has converged to support the importance of individual nutrients, foods, and dietary patterns in the prevention and management of type 2 diabetes. The quality of dietary fats and carbohydrates consumed is more crucial than the quantity of these macronutrients. Diets rich in whole grains, fruits, vegetables, legumes, nuts, moderate in alcohol consumption, and lower in refined grains, red/processed meats, and sugar-sweetened beverages have demonstrated to reduce diabetes risk and improve glycemic control and blood lipids in patients with diabetes. Several healthful dietary patterns emphasizing the overall diet quality can be adapted to appropriate personal and cultural food preferences and calorie needs for weight control and diabetes prevention and management. Although considerable progress has been made in developing and implementing evidence-based nutrition recommendations in developed countries, concerted global efforts and policies are warranted to alleviate regional disparities. PMID:24910231

  2. The MicroArray Quality Control (MAQC) project shows inter- and intraplatform reproducibility of gene expression measurements

    PubMed Central

    2012-01-01

    Over the last decade, the introduction of microarray technology has had a profound impact on gene expression research. The publication of studies with dissimilar or altogether contradictory results, obtained using different microarray platforms to analyze identical RNA samples, has raised concerns about the reliability of this technology. The MicroArray Quality Control (MAQC) project was initiated to address these concerns, as well as other performance and data analysis issues. Expression data on four titration pools from two distinct reference RNA samples were generated at multiple test sites using a variety of microarray-based and alternative technology platforms. Here we describe the experimental design and probe mapping efforts behind the MAQC project. We show intraplatform consistency across test sites as well as a high level of interplatform concordance in terms of genes identified as differentially expressed. This study provides a resource that represents an important first step toward establishing a framework for the use of microarrays in clinical and regulatory settings. PMID:16964229

  3. HDBStat!: a platform-independent software suite for statistical analysis of high dimensional biology data.

    PubMed

    Trivedi, Prinal; Edwards, Jode W; Wang, Jelai; Gadbury, Gary L; Srinivasasainagendra, Vinodh; Zakharkin, Stanislav O; Kim, Kyoungmi; Mehta, Tapan; Brand, Jacob P L; Patki, Amit; Page, Grier P; Allison, David B

    2005-04-06

    Many efforts in microarray data analysis are focused on providing tools and methods for the qualitative analysis of microarray data. HDBStat! (High-Dimensional Biology-Statistics) is a software package designed for analysis of high dimensional biology data such as microarray data. It was initially developed for the analysis of microarray gene expression data, but it can also be used for some applications in proteomics and other aspects of genomics. HDBStat! provides statisticians and biologists a flexible and easy-to-use interface to analyze complex microarray data using a variety of methods for data preprocessing, quality control analysis and hypothesis testing. Results generated from data preprocessing methods, quality control analysis and hypothesis testing methods are output in the form of Excel CSV tables, graphs and an Html report summarizing data analysis. HDBStat! is a platform-independent software that is freely available to academic institutions and non-profit organizations. It can be downloaded from our website http://www.soph.uab.edu/ssg_content.asp?id=1164.

  4. Progress and lessons learned from water-quality monitoring networks

    USGS Publications Warehouse

    Myers, Donna N.; Ludtke, Amy S.

    2017-01-01

    Stream-quality monitoring networks in the United States were initiated and expanded after passage of successive federal water-pollution control laws from 1948 to 1972. The first networks addressed information gaps on the extent and severity of stream pollution and served as early warning systems for spills. From 1965 to 1972, monitoring networks expanded to evaluate compliance with stream standards, track emerging issues, and assess water-quality status and trends. After 1972, concerns arose regarding the ability of monitoring networks to determine if water quality was getting better or worse and why. As a result, monitoring networks adopted a hydrologic systems approach targeted to key water-quality issues, accounted for human and natural factors affecting water quality, innovated new statistical methods, and introduced geographic information systems and models that predict water quality at unmeasured locations. Despite improvements, national-scale monitoring networks have declined over time. Only about 1%, or 217, of more than 36,000 US Geological Survey monitoring sites sampled from 1975 to 2014 have been operated throughout the four decades since passage of the 1972 Clean Water Act. Efforts to sustain monitoring networks are important because these networks have collected information crucial to the description of water-quality trends over time and are providing information against which to evaluate future trends.

  5. Describing methods and interventions: a protocol for the systematic analysis of the perioperative quality improvement literature.

    PubMed

    Jones, Emma; Lees, Nicholas; Martin, Graham; Dixon-Woods, Mary

    2014-09-05

    Quality improvement (QI) methods are widely used in surgery in an effort to improve care, often using techniques such as Plan-Do-Study-Act cycles to implement specific interventions. Explicit definition of both the QI method and quality intervention is necessary to enable the accurate replication of effective interventions in practice, facilitate cumulative learning, reduce research waste and optimise benefits to patients. This systematic review aims to assess quality of reporting of QI methods and quality interventions in perioperative care. Studies reporting on quality interventions implemented in perioperative care settings will be identified. Searches will be conducted in the Ovid SP version of Medline, Scopus, the Cochrane Central Register of Controlled Trials, the Cochrane Effective Practice and Organisation of Care database and the related articles function of PubMed. The journal BMJ Quality will be searched separately. Search strategy terms will relate to (i) surgery, (ii) QI and (iii) evaluation methods. Explicit exclusion and inclusion criteria will be applied. Data from studies will be extracted using a data extraction form. The Template for Intervention Description and Replication (TIDieR) checklist will be used to evaluate quality of reporting, together with additional items aimed at assessing QI methods specifically. PROSPERO http://CRD42014012845.

  6. Does physician communication style impact patient report of decision quality for breast cancer treatment?

    PubMed

    Martinez, Kathryn A; Resnicow, Ken; Williams, Geoffrey C; Silva, Marlene; Abrahamse, Paul; Shumway, Dean A; Wallner, Lauren P; Katz, Steven J; Hawley, Sarah T

    2016-12-01

    Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). Among the 1690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. Autonomy-supportive communication by cancer doctors can improve patients' perceived decision quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Does physician communication style impact patient report of decision quality for breast cancer treatment?

    PubMed Central

    Resnicow, Ken; Williams, Geoffrey C.; Silva, Marlene; Abrahamse, Paul; Shumway, Dean; Wallner, Lauren; Katz, Steven; Hawley, Sarah

    2016-01-01

    Objective Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. Methods Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). Results Among the 1,690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. Conclusion Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. Practice Implications Autonomy-supportive communication by cancer doctors can improve patients’ perceived decision quality. PMID:27395750

  8. Dyshomeostasis, obesity, addiction and chronic stress

    PubMed Central

    Marks, David F

    2016-01-01

    When eating control is overridden by hedonic reward, a condition of obesity dyshomeostasis occurs. Appetitive hedonic reward is a natural response to an obesogenic environment containing endemic stress and easily accessible and palatable high-energy foods and beverages. Obesity dyshomeostasis is mediated by the prefrontal cortex, amygdala and hypothalamic–pituitary–adrenal axis. The ghrelin axis provides the perfect signalling system for feeding dyshomeostasis, affect control and hedonic reward. Dyshomeostasis plays a central role in obesity causation, the addictions and chronic conditions and in persons with diverse bodies. Prevention and treatment efforts that target sources of dyshomeostasis provide ways of reducing adiposity, ameliorating the health impacts of addiction and raising the quality of life in people suffering from chronic stress. PMID:28070396

  9. External Quality Assessment for Rubella Virus RNA Detection Using Armored RNA in China.

    PubMed

    Zhang, D; Lin, G; Yi, L; Hao, M; Fan, G; Yang, X; Peng, R; Ding, J; Zhang, K; Zhang, R; Li, J

    2017-02-01

    Although tremendous efforts have been made to reduce rubella incidence, there are still 300 new cases of congenital rubella syndrome daily; thus, rubella infections remain one of the leading causes of preventable congenital birth defects. An effective surveillance system, which could be achieved and maintained by using an external quality assessment program, is critical for prevention and control of this disease. Armored RNAs, which are noninfectious and RNase-resistant, were used for encapsulation of the E1 gene of rubella virus and for preparation of a 10-specimen panel for external quality assessment. Thirty-two laboratories across mainland China that used nucleic acid tests for rubella virus RNA detection were included in the external quality assessment program organized by the National Center for Clinical Laboratories of China. Different kinds of commercial kits were used by the laboratories for nucleic acid extraction and TaqMan real-time reverse-transcription PCR for rubella virus RNA detection; 99.2% sensitivity and 100% specificity were achieved in this external quality assessment program. Most of the participating laboratories obtained accurate results for rubella nucleic acid tests, thereby achieving the quality required for regional rubella and congenital rubella syndrome elimination.

  10. ATMOSPHERIC MODEL DEVELOPMENT

    EPA Science Inventory

    This task provides credible state of the art air quality models and guidance for use in implementation of National Ambient Air Quality Standards for ozone and PM. This research effort is to develop and improve air quality models, such as the Community Multiscale Air Quality (CMA...

  11. 32 CFR 206.3 - Overall program emphasis.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... curriculum development efforts. Such efforts may involve intensive language study designed for different... comparative terms. Students in these areas also need quality opportunities in international education. (3...

  12. 32 CFR 206.3 - Overall program emphasis.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... curriculum development efforts. Such efforts may involve intensive language study designed for different... comparative terms. Students in these areas also need quality opportunities in international education. (3...

  13. 32 CFR 206.3 - Overall program emphasis.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... curriculum development efforts. Such efforts may involve intensive language study designed for different... comparative terms. Students in these areas also need quality opportunities in international education. (3...

  14. 32 CFR 206.3 - Overall program emphasis.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... curriculum development efforts. Such efforts may involve intensive language study designed for different... comparative terms. Students in these areas also need quality opportunities in international education. (3...

  15. 32 CFR 206.3 - Overall program emphasis.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... curriculum development efforts. Such efforts may involve intensive language study designed for different... comparative terms. Students in these areas also need quality opportunities in international education. (3...

  16. Artificial intelligence-based computer modeling tools for controlling slag foaming in electric arc furnaces

    NASA Astrophysics Data System (ADS)

    Wilson, Eric Lee

    Due to increased competition in a world economy, steel companies are currently interested in developing techniques that will allow for the improvement of the steelmaking process, either by increasing output efficiency or by improving the quality of their product, or both. Slag foaming is one practice that has been shown to contribute to both these goals. However, slag foaming is highly dynamic and difficult to model or control. This dissertation describes an effort to use artificial intelligence-based tools (genetic algorithms, fuzzy logic, and neural networks) to both model and control the slag foaming process. Specifically, a neural network is trained and tested on slag foaming data provided by a steel plant. This neural network model is then controlled by a fuzzy logic controller, which in turn is optimized by a genetic algorithm. This tuned controller is then installed at a steel plant and given control be a more efficient slag foaming controller than what was previously used by the steel plant.

  17. Results of Survey Regarding Prevalence of Adventitial Infections in Mice and Rats at Biomedical Research Facilities.

    PubMed

    Marx, James O; Gaertner, Diane J; Smith, Abigail L

    2017-09-01

    Control of rodent adventitial infections in biomedical research facilities is of extreme importance in assuring both animal welfare and high-quality research results. Sixty-three U.S. institutions participated in a survey reporting the methods used to detect and control these infections and the prevalence of outbreaks from 1 January 2014 through 31 December 2015. These results were then compared with the results of 2 similar surveys published in 1998 and 2008. The results of the current survey demonstrated that the rate of viral outbreaks in mouse colonies was decreasing, particularly in barrier facilities, whereas the prevalence of parasitic outbreaks has remained constant. These results will help our profession focus its efforts in the control of adventitial rodent disease outbreaks to the areas of the greatest needs.

  18. Impacts of emission reduction and meteorological conditions on air quality improvement during the 2014 Youth Olympic Games in Nanjing, China

    NASA Astrophysics Data System (ADS)

    Huang, Qian; Wang, Tijian; Chen, Pulong; Huang, Xiaoxian; Zhu, Jialei; Zhuang, Bingliang

    2017-11-01

    As the holding city of the 2nd Youth Olympic Games (YOG), Nanjing is highly industrialized and urbanized, and faces several air pollution issues. In order to ensure better air quality during the event, the local government took great efforts to control the emissions from pollutant sources. However, air quality can still be affected by synoptic weather, not only emission. In this paper, the influences of meteorological factors and emission reductions were investigated using observational data and numerical simulations with WRF-CMAQ (Weather Research and Forecasting - Community Multiscale Air Quality). During the month in which the YOG were held (August 2014), the observed hourly mean concentrations of SO2, NO2, PM10, PM2.5, CO and O3 were 11.6 µg m-3, 34.0 µg m-3, 57.8 µg m-3, 39.4 µg m-3, 0.9 mg m-3 and 38.8 µg m-3, respectively, which were below China National Ambient Air Quality Standard (level 2). However, model simulation showed that the weather conditions, such as weaker winds during the YOG, were adverse for better air quality and could increase SO2, NO2, PM10, PM2.5 and CO by 17.5, 16.9, 18.5, 18.8, 7.8 and 0.8 %. Taking account of local emission abatement only, the simulated SO2, NO2, PM10, PM2.5 and CO decreased by 24.6, 12.1, 15.1, 8.1 and 7.2 %. Consequently, stringent emission control measures can reduce the concentrations of air pollutants in the short term, and emission reduction is very important for air quality improvement during the YOG. A good example has been set for air quality protection for important social events.

  19. Parenting and the development of effortful control from early childhood to early adolescence: A transactional developmental model.

    PubMed

    Tiberio, Stacey S; Capaldi, Deborah M; Kerr, David C R; Bertrand, Maria; Pears, Katherine C; Owen, Lee

    2016-08-01

    Poor effortful control is a key temperamental factor underlying behavioral problems. The bidirectional association of child effortful control with both positive parenting and negative discipline was examined from ages approximately 3 to 13-14 years, involving five time points, and using data from parents and children in the Oregon Youth Study-Three Generational Study (N = 318 children from 150 families). Based on a dynamic developmental systems approach, it was hypothesized that there would be concurrent associations between parenting and child effortful control and bidirectional effects across time from each aspect of parenting to effortful control and from effortful control to each aspect of parenting. It was also hypothesized that associations would be more robust in early childhood, from ages 3 to 7 years, and would diminish as indicated by significantly weaker effects at the older ages, 11-12 to 13-14 years. Longitudinal feedback or mediated effects were also tested. The findings supported (a) stability in each construct over multiple developmental periods; (b) concurrent associations, which were significantly weaker at the older ages; (c) bidirectional effects, consistent with the interpretation that at younger ages children's effortful control influenced parenting, whereas at older child ages, parenting influenced effortful control; and (d) a transactional effect, such that maternal parenting in late childhood was a mechanism explaining children's development of effortful control from middle childhood to early adolescence.

  20. Parenting and the Development of Effortful Control from Early Childhood to Early Adolescence: A Transactional Developmental Model

    PubMed Central

    Capaldi, Deborah M.; Kerr, David C. R.; Bertrand, Maria; Pears, Katherine C.; Owen, Lee

    2016-01-01

    Poor effortful control is a key temperamental factor underlying behavioral problems. The bidirectional association of child effortful control with both positive parenting and negative discipline was examined from ages approximately 3 to 13–14 years, involving 5 time points, and using data from parents and children in the Oregon Youth Study-Three Generational Study (N = 318 children from 150 families). Based on a dynamic developmental systems approach, it was hypothesized that there would be concurrent associations between parenting and child effortful control and bidirectional effects across time from each aspect of parenting to effortful control and from effortful control to each aspect of parenting. It was also hypothesized that associations would be more robust in early childhood, from ages 3 to 7 years, and would diminish as indicated by significantly weaker effects at the older ages, 11–12 to 13–14 years. Longitudinal feedback or mediated effects were also tested. Findings supported (a) stability in each construct over multiple developmental periods; (b) concurrent associations, which were significantly weaker at the older ages; (c) bidirectional effects, consistent with the interpretation that at younger ages children’s effortful control influenced parenting, whereas at older child ages, parenting influenced effortful control; and (d) a transactional effect, such that maternal parenting in late childhood was a mechanism explaining children’s development of effortful control from midchildhood to early adolescence. PMID:27427809

  1. Publicly disclosed information about the quality of health care: response of the US public

    PubMed Central

    Schneider, E; Lieberman, T

    2001-01-01

    Public disclosure of information about the quality of health plans, hospitals, and doctors continues to be controversial. The US experience of the past decade suggests that sophisticated quality measures and reporting systems that disclose information on quality have improved the process and outcomes of care in limited ways in some settings, but these efforts have not led to the "consumer choice" market envisaged. Important reasons for this failure include limited salience of objective measures to consumers, the complexity of the task of interpretation, and insufficient use of quality results by organised purchasers and insurers to inform contracting and pricing decisions. Nevertheless, public disclosure may motivate quality managers and providers to undertake changes that improve the delivery of care. Efforts to measure and report information about quality should remain public, but may be most effective if they are targeted to the needs of institutional and individual providers of care. Key Words: public disclosure; quality of health care; quality improvement PMID:11389318

  2. The doctor-patient relationship as the business case for quality: doing well by doing right.

    PubMed

    Gosfield, Alice G

    2004-01-01

    The idea that healthcare quality in America has lagged behind optimal levels has been a central national policy issue since at least 1998. Reform efforts, however, have failed to acknowledge the critical and unique role physicians play in making quality initiatives real. This Article argues physicians are at the core of any effort to propel quality forward in a significant way and, therefore, must be taken into account directly and without apology. The Article examines the quality-accountability context present in this country. It addresses why the physician nexus on these issues is vital for real change to take place and sets forth a clear statement of what is essential to support the doctor-patient relationship in any quality agenda. Finally, it reiterates the author's previously proposed five principles for quality, as well as her unified field theory of quality, all of which are designed to advance quality in a very different way.

  3. Contract management techniques for improving construction quality

    DOT National Transportation Integrated Search

    1997-07-01

    Efforts to improve quality in highway construction embrace many aspects of the construction process. Quality goals include enhanced efficiency and productivity, optimal cost and delivery time, improved performance, and changes in attitude-promoting a...

  4. Data quality can make or break a research infrastructure

    NASA Astrophysics Data System (ADS)

    Pastorello, G.; Gunter, D.; Chu, H.; Christianson, D. S.; Trotta, C.; Canfora, E.; Faybishenko, B.; Cheah, Y. W.; Beekwilder, N.; Chan, S.; Dengel, S.; Keenan, T. F.; O'Brien, F.; Elbashandy, A.; Poindexter, C.; Humphrey, M.; Papale, D.; Agarwal, D.

    2017-12-01

    Research infrastructures (RIs) commonly support observational data provided by multiple, independent sources. Uniformity in the data distributed by such RIs is important in most applications, e.g., in comparative studies using data from two or more sources. Achieving uniformity in terms of data quality is challenging, especially considering that many data issues are unpredictable and cannot be detected until a first occurrence of the issue. With that, many data quality control activities within RIs require a manual, human-in-the-loop element, making it an expensive activity. Our motivating example is the FLUXNET2015 dataset - a collection of ecosystem-level carbon, water, and energy fluxes between land and atmosphere from over 200 sites around the world, some sites with over 20 years of data. About 90% of the human effort to create the dataset was spent in data quality related activities. Based on this experience, we have been working on solutions to increase the automation of data quality control procedures. Since it is nearly impossible to fully automate all quality related checks, we have been drawing from the experience with techniques used in software development, which shares a few common constraints. In both managing scientific data and writing software, human time is a precious resource; code bases, as Science datasets, can be large, complex, and full of errors; both scientific and software endeavors can be pursued by individuals, but collaborative teams can accomplish a lot more. The lucrative and fast-paced nature of the software industry fueled the creation of methods and tools to increase automation and productivity within these constraints. Issue tracking systems, methods for translating problems into automated tests, powerful version control tools are a few examples. Terrestrial and aquatic ecosystems research relies heavily on many types of observational data. As volumes of data collection increases, ensuring data quality is becoming an unwieldy challenge for RIs. Business as usual approaches to data quality do not work with larger data volumes. We believe RIs can benefit greatly from adapting and imitating this body of theory and practice from software quality into data quality, enabling systematic and reproducible safeguards against errors and mistakes in datasets as much as in software.

  5. The Surface Ocean CO2 Atlas: Stewarding Underway Carbon Data from Collection to Archival

    NASA Astrophysics Data System (ADS)

    O'Brien, K.; Smith, K. M.; Pfeil, B.; Landa, C.; Bakker, D. C. E.; Olsen, A.; Jones, S.; Shrestha, B.; Kozyr, A.; Manke, A. B.; Schweitzer, R.; Burger, E. F.

    2016-02-01

    The Surface Ocean CO2 Atlas (SOCAT, www.socat.info) is a quality controlled, global surface ocean carbon dioxide (CO2) data set gathered on research vessels, SOOP and buoys. To the degree feasible SOCAT is comprehensive; it draws together and applies uniform QC procedures to all such observations made across the international community. The first version of SOCAT (version 1.5) was publicly released September 2011(Bakker et al., 2011) with 6.3 million observations. This was followed by the release of SOCAT version 2, expanded to over 10 million observations, in June 2013 (Bakker et al., 2013). Most recently, in September 2015 SOCAT version 3 was released containing over 14 millions observations spanning almost 60 years! The process of assembling, QC'ing and publishing V1.5 and V2 of SOCAT required an unsustainable level of manual effort. To ease the burden on data managers and data providers, the SOCAT community agreed to embark an automated data ingestion process which would create a streamlined workflow to improve data stewardship from ingestion to quality control and from publishing to archival. To that end, for version 3 and beyond, the SOCAT automation team created a framework which was based upon standards and conventions, yet at the same time allows scientists to work in the data formats they felt most comfortable with (ie, csv files). This automated workflow provides several advantages: 1) data ingestion into uniform and standards-based file formats; 2) ease of data integration into standard quality control system; 3) data ingestion and quality control can be performed in parallel; 4) provides uniform method of archiving carbon data and generation of digital object identifiers (DOI).In this presentation, we will discuss and demonstrate the SOCAT data ingestion dashboard and the quality control system. We will also discuss the standards, conventions, and tools that were leveraged to create a workflow that allows scientists to work in their own formats, yet provides a framework for creating high quality data products on an annual basis, while meeting or exceeding data requirements for access, documentation and archival.

  6. Hypertension and hyperlipidemia management in patients treated at community health centers.

    PubMed

    Kirchhoff, Anne C; Drum, Melinda L; Zhang, James X; Schlichting, Jennifer; Levie, Jessica; Harrison, James F; Lippold, Susan A; Schaefer, Cynthia T; Chin, Marshall H

    2008-01-01

    OBJECTIVE: Community health centers (HCs) provide care for millions of medically underserved Americans with disproportionate burdens of hypertension and hyperlipidemia. For both conditions, treatment guidelines recently became more stringent and quality improvement (QI) efforts have intensified. We assessed hypertension and hyperlipidemia management in HCs during this time of guideline revision and increased QI efforts. DESIGN: Cross-sectional chart review. SETTING AND PARTICIPANTS: Eleven Midwestern HCs for 2000 and 9 for 2002 provided audit data from 2,976 randomly chosen patients with hypertension and/or hyperlipidemia. MEASUREMENT: Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI/VII) and National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III) guidelines were used to assess management of these conditions. RESULTS: Hypertension (2000, N=808; 2002, N=692) and hyperlipidemia (2000, N=774; 2002, N=702) outcomes improved for specific clinical subgroups. Hypertensive patients with 1 or more cardiovascular risk factors demonstrated significant improvement (34% vs. 45% controlled at <140/90 mm Hg, p=0.02). Hypertension control for persons with diabetes, renal failure and heart failure increased (16% vs. 28% controlled at <130/85 mm Hg, p=0.006). LDL control increased significantly for patients with 2 or more risk factors (39% vs. 58% controlled at <130 mg/dl, p=0.008). Other clinical subgroups showed trends toward better control, although there was insufficient power to detect significant differences for these groups. CONCLUSION: Hypertension and hyperlipidemia outcomes improved for some risk groups; however, ongoing QI is necessary.

  7. Acoustical analysis of trained and untrained singers onsite before and after prolonged voice use

    NASA Astrophysics Data System (ADS)

    Jackson, Christophe E.

    Controlled acoustic environments are important in voice research. Recording environment affects the quality of voice recordings. While sound booths and anechoic chambers are examples of controlled acoustic environments widely used in research, they are both costly and not portable. The long-term goal of this project is to compare the voice usage and efficiency of trained and untrained singers onsite immediately before and after vocal performance. The specific goal of this project is the further of development a Portable Sound Booth (PSB) and standardization of onsite voice recording procedures under controlled conditions. We hypothesized that the simple and controlled acoustic environment provided by the PSB would enable consistent reliable onsite voice recordings and the immediate differences as a consequence of voice usage were measurable. Research has suggested that it would be possible to conduct onsite voice recordings. Proof of concept research titled "Construction and Characterization of a Portable Sound Booth for Onsite Measurement" was conducted before initiating the full research effort. Preliminary findings revealed that: (1) it was possible to make high-quality voice recordings onsite, (2) the use of a Portable Sound Booth (PSB) required further acoustic characterization of its inherent acoustic properties, and (3) testable differences before and after performance were evident. The specific aims were to (1) develop and refine onsite objective voice measurements in the PSB and (2) evaluate use of the PSB to measure voice quality changes before and after voice usage.

  8. The Role of Socialization, Effortful Control, and Ego Resiliency in French Adolescents’ Social Functioning

    PubMed Central

    Hofer, Claire; Eisenberg, Nancy; Reiser, Mark

    2010-01-01

    The relations among effortful control, ego resiliency, socialization, and social functioning were examined with a sample of 182 French adolescents (14–20 years old). Adolescents, their parents, and/or teachers completed questionnaires on these constructs. Effortful control and ego resiliency were correlated with adolescents’ social functioning, especially with low externalizing and internalizing behaviors and sometimes with high peer competence. Furthermore, aspects of socialization (parenting practices more than family expressiveness) were associated with adolescents’ effortful control, ego resiliency, and social functioning. Effortful control and ego resiliency mediated the relations between parental socialization and adolescents’ peer competence and internalizing problems. Furthermore, effortful control mediated the relations between socialization and adolescents’ externalizing behavior. Findings are discussed in terms of cultural and developmental variation. PMID:21228912

  9. 77 FR 70786 - Request for Information Regarding Health Care Quality for Exchanges

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ...] Request for Information Regarding Health Care Quality for Exchanges AGENCY: Centers for Medicare... Quality Improvement in Health Care (National Quality Strategy) to create national aims and priorities that would guide local, state, and national efforts to improve the quality of health care in the United...

  10. What Determines Alumni Generosity?

    ERIC Educational Resources Information Center

    Baade, Robert A.; Sundberg, Jeffrey O.

    1996-01-01

    College alumni giving is correlated with institutional characteristics (quality and development efforts) and student characteristics (quality and wealth). This paper uses a two-step least-squares approach with data and quality/wealth variables to explore the "rich-student, quality-school" alumni generosity phenomenon. Alumni giving is…

  11. Using clinical indicators to facilitate quality improvement via the accreditation process: an adaptive study into the control relationship.

    PubMed

    Chuang, Sheuwen; Howley, Peter P; Hancock, Stephen

    2013-07-01

    The aim of the study was to determine accreditation surveyors' and hospitals' use and perceived usefulness of clinical indicator reports and the potential to establish the control relationship between the accreditation and reporting systems. The control relationship refers to instructional directives, arising from appropriately designed methods and efforts towards using clinical indicators, which provide a directed moderating, balancing and best outcome for the connected systems. Web-based questionnaire survey. Australian Council on Healthcare Standards' (ACHS) accreditation and clinical indicator programmes. Seventy-three of 306 surveyors responded. Half used the reports always/most of the time. Five key messages were revealed: (i) report use was related to availability before on-site investigation; (ii) report use was associated with the use of non-ACHS reports; (iii) a clinical indicator set's perceived usefulness was associated with its reporting volume across hospitals; (iv) simpler measures and visual summaries in reports were rated the most useful; (v) reports were deemed to be suitable for the quality and safety objectives of the key groups of interested parties (hospitals' senior executive and management officers, clinicians, quality managers and surveyors). Implementing the control relationship between the reporting and accreditation systems is a promising expectation. Redesigning processes to ensure reports are available in pre-survey packages and refined education of surveyors and hospitals on how to better utilize the reports will support the relationship. Additional studies on the systems' theory-based model of the accreditation and reporting system are warranted to establish the control relationship, building integrated system-wide relationships with sustainable and improved outcomes.

  12. 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?

  13. Productivity improvement and quality enhancement at NASA

    NASA Technical Reports Server (NTRS)

    Braunstein, D. R.

    1985-01-01

    NASA's Productivity Improvement and Quality Enhancement (PIQE) effort has as its objectives the encouragement of greater employee participation in management decision-making and the identification of impediments as well as opportunities for high productivity. Attempts are also made to try out novel management practices, and to evolve productivity trend analysis techniques. Every effort is made to note, reward, and diffuse successfully instituted PIQE approaches throughout the NASA-contractor organization.

  14. Improvement of Human Resources Quality through Vocational Training in Tourism in Karimunjawa Islands (Central Java, Indonesia): A Pro-Economical Tourism Approach

    ERIC Educational Resources Information Center

    Putro, S. Eko; Sukirno; Budi, S.; Didik, W.

    2016-01-01

    The effort to improve human resource quality is not easy to be implemented. This effort becomes more complicated to do when implemented to the group of poor community, especially in this case marginal community of small island. This research analyzes the characteristic of poor household in small island as well as the strategy of poverty…

  15. Intelligent Control for the BEES Flyer

    NASA Technical Reports Server (NTRS)

    Krishnakumar, K.; Gundy-Burlet, Karen; Aftosmis, Mike; Nemec, Marian; Limes, Greg; Berry, Misty; Logan, Michael

    2004-01-01

    This paper describes the effort to provide a preliminary capability analysis and a neural network based adaptive flight control system for the JPL-led BEES aircraft project. The BEES flyer was envisioned to be a small, autonomous platform with sensing and control systems mimicking those of biological systems for the purpose of scientific exploration on the surface of Mars. The platform is physically tightly constrained by the necessity of efficient packing within rockets for the trip to Mars. Given the physical constraints, the system is not an ideal configuration for aerodynamics or stability and control. The objectives of this effort are to evaluate the aerodynamics characteristics of the existing design, to make recommendaaons as to potential improvements and to provide a control system that stabilizes the existing aircraft for nominal flight and damaged conditions. Towards this several questions are raised and analyses are presented to arrive at answers to some of the questions raised. CART3D, a high-fidelity inviscid analysis package for conceptual and preliminary aerodynamic design, was used to compute a parametric set of solutions over the expected flight domain. Stability and control derivatives were extracted from the database and integrated with the neural flight control system. The Integrated Vehicle Modeling Environment (IVME) was also used for estimating aircraft geometric, inertial, and aerodynamic characteristics. A generic neural flight control system is used to provide adaptive control without the requirement for extensive gain scheduling or explicit system identification. The neural flight control system uses reference models to specify desired handling qualities in the roll, pitch, and yaw axes, and incorporates both pre-trained and on-line learning neural networks in the inverse model portion of the controller. Results are presented for the BEES aircraft in the subsonic regime for terrestrial and Martian environments.

  16. The Effect of the Demand Control and Effort Reward Imbalance Models on the Academic Burnout of Korean Adolescents

    ERIC Educational Resources Information Center

    Lee, Jayoung; Puig, Ana; Lee, Sang Min

    2012-01-01

    The purpose of this study was to examine the effects of the Demand Control Model (DCM) and the Effort Reward Imbalance Model (ERIM) on academic burnout for Korean students. Specifically, this study identified the effects of the predictor variables based on DCM and ERIM (i.e., demand, control, effort, reward, Demand Control Ratio, Effort Reward…

  17. Phonation interval modification and speech performance quality during fluency-inducing conditions by adults who stutter

    PubMed Central

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

    2012-01-01

    Purpose To relate changes in four variables previously defined as characteristic of normally fluent speech to changes in phonatory behavior during oral reading by persons who stutter (PWS) and normally fluent controls under multiple fluency-inducing (FI) conditions. Method Twelve PWS and 12 controls each completed 4 ABA experiments. During A phases, participants read normally. B phases were 4 different FI conditions: auditory masking, chorus reading, whispering, and rhythmic stimulation. Dependent variables were the durations of accelerometer-recorded phonated intervals; self-judged speech effort; and observer-judged stuttering frequency, speech rate, and speech naturalness. The method enabled a systematic replication of Ingham et al. (2009). Results All FI conditions resulted in decreased stuttering and decreases in the number of short phonated intervals, as compared with baseline conditions, but the only FI condition that satisfied all four characteristics of normally fluent speech was chorus reading. Increases in longer phonated intervals were associated with decreased stuttering but also with poorer naturalness and/or increased speech effort. Previous findings concerning the effects of FI conditions on speech naturalness and effort were replicated. Conclusions Measuring all relevant characteristics of normally fluent speech, in the context of treatments that aim to reduce the occurrence of short-duration PIs, may aid the search for an explanation of the nature of stuttering and may also maximize treatment outcomes for adults who stutter. PMID:22365886

  18. WELDSMART: A vision-based expert system for quality control

    NASA Technical Reports Server (NTRS)

    Andersen, Kristinn; Barnett, Robert Joel; Springfield, James F.; Cook, George E.

    1992-01-01

    This work was aimed at exploring means for utilizing computer technology in quality inspection and evaluation. Inspection of metallic welds was selected as the main application for this development and primary emphasis was placed on visual inspection, as opposed to other inspection methods, such as radiographic techniques. Emphasis was placed on methodologies with the potential for use in real-time quality control systems. Because quality evaluation is somewhat subjective, despite various efforts to classify discontinuities and standardize inspection methods, the task of using a computer for both inspection and evaluation was not trivial. The work started out with a review of the various inspection techniques that are used for quality control in welding. Among other observations from this review was the finding that most weld defects result in abnormalities that may be seen by visual inspection. This supports the approach of emphasizing visual inspection for this work. Quality control consists of two phases: (1) identification of weld discontinuities (some of which may be severe enough to be classified as defects), and (2) assessment or evaluation of the weld based on the observed discontinuities. Usually the latter phase results in a pass/fail judgement for the inspected piece. It is the conclusion of this work that the first of the above tasks, identification of discontinuities, is the most challenging one. It calls for sophisticated image processing and image analysis techniques, and frequently ad hoc methods have to be developed to identify specific features in the weld image. The difficulty of this task is generally not due to limited computing power. In most cases it was found that a modest personal computer or workstation could carry out most computations in a reasonably short time period. Rather, the algorithms and methods necessary for identifying weld discontinuities were in some cases limited. The fact that specific techniques were finally developed and successfully demosntrated to work illustrates that the general approach taken here appears to be promising for commercial development of computerized quality inspection systems. Inspection based on these techniques may be used to supplement or substitute more elaborate inspection methods, such as x-ray inspections.

  19. A fuzzy-logic based decision-making approach for identification of groundwater quality based on groundwater quality indices.

    PubMed

    Vadiati, M; Asghari-Moghaddam, A; Nakhaei, M; Adamowski, J; Akbarzadeh, A H

    2016-12-15

    Due to inherent uncertainties in measurement and analysis, groundwater quality assessment is a difficult task. Artificial intelligence techniques, specifically fuzzy inference systems, have proven useful in evaluating groundwater quality in uncertain and complex hydrogeological systems. In the present study, a Mamdani fuzzy-logic-based decision-making approach was developed to assess groundwater quality based on relevant indices. In an effort to develop a set of new hybrid fuzzy indices for groundwater quality assessment, a Mamdani fuzzy inference model was developed with widely-accepted groundwater quality indices: the Groundwater Quality Index (GQI), the Water Quality Index (WQI), and the Ground Water Quality Index (GWQI). In an effort to present generalized hybrid fuzzy indices a significant effort was made to employ well-known groundwater quality index acceptability ranges as fuzzy model output ranges rather than employing expert knowledge in the fuzzification of output parameters. The proposed approach was evaluated for its ability to assess the drinking water quality of 49 samples collected seasonally from groundwater resources in Iran's Sarab Plain during 2013-2014. Input membership functions were defined as "desirable", "acceptable" and "unacceptable" based on expert knowledge and the standard and permissible limits prescribed by the World Health Organization. Output data were categorized into multiple categories based on the GQI (5 categories), WQI (5 categories), and GWQI (3 categories). Given the potential of fuzzy models to minimize uncertainties, hybrid fuzzy-based indices produce significantly more accurate assessments of groundwater quality than traditional indices. The developed models' accuracy was assessed and a comparison of the performance indices demonstrated the Fuzzy Groundwater Quality Index model to be more accurate than both the Fuzzy Water Quality Index and Fuzzy Ground Water Quality Index models. This suggests that the new hybrid fuzzy indices developed in this research are reliable and flexible when used in groundwater quality assessment for drinking purposes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. The Armstrong Institute: An Academic Institute for Patient Safety and Quality Improvement, Research, Training, and Practice.

    PubMed

    Pronovost, Peter J; Holzmueller, Christine G; Molello, Nancy E; Paine, Lori; Winner, Laura; Marsteller, Jill A; Berenholtz, Sean M; Aboumatar, Hanan J; Demski, Renee; Armstrong, C Michael

    2015-10-01

    Academic medical centers (AMCs) could advance the science of health care delivery, improve patient safety and quality improvement, and enhance value, but many centers have fragmented efforts with little accountability. Johns Hopkins Medicine, the AMC under which the Johns Hopkins University School of Medicine and the Johns Hopkins Health System are organized, experienced similar challenges, with operational patient safety and quality leadership separate from safety and quality-related research efforts. To unite efforts and establish accountability, the Armstrong Institute for Patient Safety and Quality was created in 2011.The authors describe the development, purpose, governance, function, and challenges of the institute to help other AMCs replicate it and accelerate safety and quality improvement. The purpose is to partner with patients, their loved ones, and all interested parties to end preventable harm, continuously improve patient outcomes and experience, and eliminate waste in health care. A governance structure was created, with care mapped into seven categories, to oversee the quality and safety of all patients treated at a Johns Hopkins Medicine entity. The governance has a Patient Safety and Quality Board Committee that sets strategic goals, and the institute communicates these goals throughout the health system and supports personnel in meeting these goals. The institute is organized into 13 functional councils reflecting their behaviors and purpose. The institute works daily to build the capacity of clinicians trained in safety and quality through established programs, advance improvement science, and implement and evaluate interventions to improve the quality of care and safety of patients.

  1. An analysis of the diffusion of new antidepressants: variety, quality, and marketing efforts.

    PubMed

    Berndt, Ernst R; Bhattacharjya, Ashoke; Mishol, David N; Arcelus, Almudena; Lasky, Thomas

    2002-03-01

    We are not aware of any published research that quantifies and compares the importance of effectiveness and side effects for pharmaceutical sales, and that simultaneously incorporates the impacts of marketing efforts on the diffusion of new pharmaceutical agents in the U.S. The overall level and market share success of the various selective serotonin reuptake inhibitors ( SSRIs ) relative to a representative older generation tricyclic (such as amitriptyline) provides a useful focus for studying such issues. To model jointly the marketing and sales relationships of the SSRIs in the U.S., to quantify the extent to which marketing efforts are responsive to the availability of new scientific information accompanying changes in quality and increases in product variety, and in turn to assess how the new FDA indication approvals and the enhanced marketing initiatives involving product quality and variety affect sales of the SSRI and other novel antidepressants. Quarterly US sales, price, quantity and marketing data 1988Q1-1997Q4 are taken from IMS Health for the eight new antidepressants introduced into the US during this time period. Measures of physician-perceived quality attributes of the antidepressants are drawn from Market Measures, Inc., a medical survey research firm. These data are used to construct measures of product quality (effectiveness and side effect profile), and attribute variety across all antidepressants. Multivariate regression methods are used in estimating parameters of a marketing efforts model, a sales demand model encompassing the aggregate of the newer antidepressants, and a product share model. Simulation methods are employed to quantify elasticities. Since 1988, and relative to amitriptyline, there has been only a rather modest increase in the perceived average effectiveness of the SSRIs and related products, but the side effect profiles have improved substantially. Variety measures for effectiveness show greater increases over time than do those for side effects. Marketing efforts respond to science-based events, such as new FDA indication approvals, and to effectiveness and side-effect quality improvements. Total antidepressant sales are positively and significantly related to price reductions, increased marketing efforts, and the level and variety of side effect profiles involving antidepressants. The level and variety of effectiveness does not significantly affect total antidepressant sales. Order of entry effects are important in affecting product market shares, while marketing efforts and relative quality attributes (particularly a more favorable side effect profile) have positive and significant impacts on relative market shares. Since patient response to SSRIs and related products is idiosyncratic, greater product variety facilitates better matching of antidepressant with patient. Much of the growth of the SSRIs and related antidepressants since 1988 can be attributed to increased product attribute variety, to improved changes in side effect quality relative to that of the tricyclics, and to the marketing of those improvements. Marketing efforts play an important role in diffusing product information. Marketing efforts increase considerably following FDA approval for indications other than depression, and also increase with the average effectiveness and the average side effect rating of the products. Whether the relatively minor role that perceived effectiveness has in affecting sales relative to perceived side effect profile is unique to antidepressants, or generalizes to other therapeutic classes, merits further examination.

  2. Case history of Yakin field: its development and sand control

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

    Sawolo, N.; Krueger, R.F.; Maly, G.P.

    1983-01-01

    This paper deals with the development of the Yakin field in East Kalimantan, Indonesia, with emphasis on the sand control methods used. Implementation of an effective sand control program ensured the successful development of this field. Gravel-packed wells had substantially lower production decline rates than the initial completions without gravel packs. Control of sand production also has been demonstrated by the lack of sand problems during the 4 1/2 years since the sand control program was initiated. During this time there have been no submersible pump failures associated with sand production. The successful sand control program was achieved by amore » well-coordinated and cooperative effort of drilling, reservoir engineering, production research, and service company personnel. Establishment of communication among all people involved, starting early in the planning process and continuing through the rig operations to the final production phase, coupled with intensive training at all levels of responsibility, on-site supervision, and quality control were important factors in the success of the development program.« less

  3. Modern banking, collection, compatibility testing and storage of blood and blood components.

    PubMed

    Green, L; Allard, S; Cardigan, R

    2015-01-01

    The clinical practice of blood transfusion has changed considerably over the last few decades. The potential risk of transfusion transmissible diseases has directed efforts towards the production of safe and high quality blood. All transfusion services now operate in an environment of ever-increasing regulatory controls encompassing all aspects of blood collection, processing and storage. Stringent donor selection, identification of pathogens that can be transmitted through blood, and development of technologies that can enhance the quality of blood, have all led to a substantial reduction in potential risks and complications associated with blood transfusion. In this article, we will discuss the current standards required for the manufacture of blood, starting from blood collection, through processing and on to storage. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

  4. Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

    PubMed Central

    Nawaz, Saira; Thomas, Craig; Young, Andrea

    2015-01-01

    We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI’s impact on the practice of public health. PMID:25689185

  5. Improving Direct-Care Compensation in Nursing Homes: Medicaid Wage Pass-through Adoption, 1999 – 2004

    PubMed Central

    Miller, Edward Alan; Wang, Lili; Feng, Zhanlian; Mor, Vincent

    2013-01-01

    Because states play such a prominent role in the U.S. health care system, they have long grappled with how to best control health care costs while maintaining high quality of care. There are many policy tools available to address efficiency and quality concerns — from pure state regulation to market-oriented competition designs. Given public discourse and official party platforms, one would assume that states controlled by Democrats would be more likely to adopt regulatory reforms. This study examines whether party control, as well as other economic and political factors, is associated with adopting wage pass-through (WPT) policies, which direct a portion of Medicaid reimbursement or its increase toward nursing home staff in an effort to reduce staff turnover, thereby increasing efficiency and the quality of care provided. Contrary to expectations, results indicate that states with Republican governors were against WPT adoption only when for-profit industry pressure increased; otherwise, they were more likely to favor adoption than their Democratic counterparts. This suggests a more complex relationship between partisanship and state-level policy adoption than is typically assumed. Results also indicate that state officials reacted predictably to prevailing political and economic conditions affecting state fiscal-year decisions but required sufficient governing capacity to successfully integrate WPTs into existing reimbursement system arrangements. This suggests that WPTs represent a hybrid between comprehensive and incremental policy change. PMID:22323236

  6. Psychosocial and emotional adjustment for children with pediatric cancer and their primary caregivers and the impact on their health-related quality of life during the first 6 months.

    PubMed

    Tsai, Ming-Horng; Hsu, Jen-Fu; Chou, Wen-Jiun; Yang, Chao-Ping; Jaing, Tang-Her; Hung, Iou-Jih; Liang, Hwey-Fang; Huang, Hsuan-Rong; Huang, Yu-Shu

    2013-04-01

    To evaluate caregiver-reported psychosocial adjustment and health-related quality of life (HrQoL) of Taiwanese children with newly diagnosed cancer and their caregivers during the first 6 months of treatment. Caregivers of 89 newly diagnosed children completed the child behavior checklist, the pediatric quality of life inventory (PedsQL(™) 4.0), the Parenting Stress Index, and the SF-36 questionnaire at diagnosis, and again 3 and 6 months into treatment. They were compared with a group of age- and sex-matched controls from general community. Significantly worse HrQoL in both children and their caregivers and greater parenting stress were noted in the cancer group than the controls during the first 6 months. Children with cancer were found to have significantly more internalizing behavioral problems and somatic complaints, especially those younger than 12 years old. After starting chemotherapy, significant decrease in parenting stress and improvements of both caregivers and children's HrQoL were noted within the first 6 months, although not to the level comparable with normal controls. Although children and their caregivers can adjust themselves gradually during the first 6 months after diagnosis of cancer, intervention and efforts aimed at reducing their distress and promoting adjustments are still required during this period.

  7. Commercialization of veterinary viral vaccines.

    PubMed

    Flore, P H

    2004-12-01

    If vaccines are to reliably prevent disease, they must be developed, produced and quality-controlled according to very strict regulations and procedures. Veterinary viral vaccine registrations are governed by different rules in different countries, but these rules all emphasize that the quality of the raw materials--the cells, eggs, animals or plants that are used in production--need to be carefully controlled. The veterinary vaccine business is also very cost-conscious. Emphasis over the last 5-10 years has therefore been to develop culture systems that minimize labor and sterility problems and thus provide for reliable and cost-effective production. Implementing these often more complex systems in a production environment takes considerable effort, first in scale-up trials and further down the line in convincing production personnel to change their familiar system for something new and possibly untried. To complete scale-up trials successfully, it is absolutely necessary to understand the biochemistry of the cells and the influence of the virus on the cells under scale-up and later production conditions. Once a viral product can be produced on a large scale, it is imperative that the quality of the end-product is controlled in an intelligent way. One needs to know whether the end-product performs in the animal as was intended during its conception in the research and development department. The development of the appropriate tests to demonstrate this plays an important role in the successful development of a vaccine.

  8. One fish, two fish, we QC fish: controlling data quality among more than 50 organizations over a four-year period.

    PubMed

    Riddick, L; Simbanin, C

    2001-01-01

    EPA is conducting a National Study of Chemical Residues in Lake Fish Tissue. The study involves five analytical laboratories, multiple sampling teams from each of the 47 participating states, several tribes, all 10 EPA Regions and several EPA program offices, with input from other federal agencies. To fulfill study objectives, state and tribal sampling teams are voluntarily collecting predator and bottom-dwelling fish from approximately 500 randomly selected lakes over a 4-year period. The fish will be analyzed for more than 300 pollutants. The long-term nature of the study, combined with the large number of participants, created several QA challenges: (1) controlling variability among sampling activities performed by different sampling teams from more than 50 organizations over a 4-year period; (2) controlling variability in lab processes over a 4-year period; (3) generating results that will meet the primary study objectives for use by OW statisticians; (4) generating results that will meet the undefined needs of more than 50 participating organizations; and (5) devising a system for evaluating and defining data quality and for reporting data quality assessments concurrently with the data to ensure that assessment efforts are streamlined and that assessments are consistent among organizations. This paper describes the QA program employed for the study and presents an interim assessment of the program's effectiveness.

  9. Texas Air Control Board Inquiry Regarding Allowable Emissions in PSD NAAQS Analyses

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  10. Safety issues with herbal products.

    PubMed

    Marrone, C M

    1999-12-01

    To review safety issues associated with the use of herbal products. Literature accessed through MEDLINE and other Internet search engines. Key search terms included herbs, dietary supplements, and safety. A misconception exists among consumers that herbal remedies are safe because they are natural. In an effort to provide healthcare practitioners with information necessary for a patient discussion, a review of safety concerns with herbal products was conducted. Several safety concerns exist with herbal products including lack of safety data, absence of quality-control requirements for potency and purity, and lenient labeling standards.

  11. Common Control Determination for Ocean County Landfill and Manchester Renewable Power Corp./LES

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  12. Ozone Control Strategy - Regional Office Review of Potential in Improvements In New Source Review (NSR) Regulations

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  13. Altered States of Consciousness Profile: An Afro-Centric Intrapsychic Evaluation Tool

    PubMed Central

    Bell, Carl C.; Thompson, Belinda; Shorter-Gooden, Kumea; Mays, Raymond; Shakoor, Bambade

    1985-01-01

    In an effort to develop an Afro-centric intrapsychic evaluation tool, the Community Mental Health Council, Inc., Altered States of Consciousness Research Team, developed a structured interview used to quantify and qualify the 17 states of consciousness1 that occurred in black control, precare, and aftercare subjects. Differences were noted in the three groups as to the incidence, prevalence, and quality of the various states of consciousness. It was also noted that the profile obtained from the interviews yielded a sharp clinical picture of the subjects' total intrapsychic propensities. PMID:4057274

  14. Assessing the role of conspecific attraction in habitat restoration for Henslow's sparrows in Iowa

    USGS Publications Warehouse

    Vogel, Jennifer A.; Koford, Rolf R.; Otis, David L.

    2011-01-01

    The presence of conspecific individuals may provide important cues about habitat quality for territorial songbirds. We tested the ability of a conspecific song playback system to attract Henslow’s sparrows to previously unoccupied restored habitat. We successfully attracted Heslow’s sparrows to 3 of 7 treatment plots using conspecific song playbacks and we found no Henslow’s sparrows in control plots. The addition of social cues using playback systems in restored grassland habitats may aid conservation efforts of Henslow’s sparrows to available habitat.

  15. Criteria for Determining whether Equipment is Air Pollution Control Equipment or Process Equipment

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  16. PowerSecure Common Control Determination

    EPA Pesticide Factsheets

    This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  17. PSD Analysis for SIP Relaxation in Metropolitan Boston Air Pollution Control District - Eastman Gelatin

    EPA Pesticide Factsheets

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  18. Leprosy: ancient disease remains a public health problem nowadays.

    PubMed

    Noriega, Leandro Fonseca; Chiacchio, Nilton Di; Noriega, Angélica Fonseca; Pereira, Gilmayara Alves Abreu Maciel; Vieira, Marina Lino

    2016-01-01

    Despite being an ancient disease, leprosy remains a public health problem in several countries -particularly in India, Brazil and Indonesia. The current operational guidelines emphasize the evaluation of disability from the time of diagnosis and stipulate as fundamental principles for disease control: early detection and proper treatment. Continued efforts are needed to establish and improve quality leprosy services. A qualified primary care network that is integrated into specialized service and the development of educational activities are part of the arsenal in the fight against the disease, considered neglected and stigmatizing.

  19. A climate trend analysis of Uganda

    USGS Publications Warehouse

    Funk, Christopher C.; Rowland, Jim; Eilerts, Gary; White, Libby

    2012-01-01

    This brief report, drawing from a multi-year effort by the U.S. Agency for International Development (USAID) Famine Early Warning Systems Network (FEWS NET), identifies observed changes in rainfall and temperature in Uganda, based on an analysis of a quality-controlled, long time series of station observations throughout Uganda. Extending recent trends forward, it also provides a current and near-future context for understanding the actual nature of climate change impacts in the country, and a basis for identifying climate adaptations that may protect and improve the country's food security.

  20. The medical communications officer. A resource for data collection, quality management and medical control.

    PubMed

    Gunderson, Michael; Barnard, Jeff; McPherson, John; Kearns, Conrad T

    2002-08-01

    Pinellas County EMS' Medical Communications Officers provide a wide variety of services to patients, field clinicians, managers and their medical director. The concurrent data collection processes used in the MCO program for performance measurement of resuscitation efforts, intubations, submersion incidents and aeromedical transports for trauma cases have been very effective in the integration of data from multiple computer databases and telephone follow-ups with field crews and receiving emergency department staffs. This has facilitated significant improvements in the performance of these and many other aspects of our EMS system.

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