78 FR 40086 - Approval and Promulgation of Air Quality Implementation Plans; Illinois

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection Agency (EPA...) 692-2450. 4. Mail: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U... Delivery: Pamela Blakley, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U.S...

Development of risk-based air quality management strategies under impacts of climate change.

PubMed

Liao, Kuo-Jen; Amar, Praveen; Tagaris, Efthimios; Russell, Armistead G

2012-05-01

Climate change is forecast to adversely affect air quality through perturbations in meteorological conditions, photochemical reactions, and precursor emissions. To protect the environment and human health from air pollution, there is an increasing recognition of the necessity of developing effective air quality management strategies under the impacts of climate change. This paper presents a framework for developing risk-based air quality management strategies that can help policy makers improve their decision-making processes in response to current and future climate change about 30-50 years from now. Development of air quality management strategies under the impacts of climate change is fundamentally a risk assessment and risk management process involving four steps: (1) assessment of the impacts of climate change and associated uncertainties; (2) determination of air quality targets; (3) selections of potential air quality management options; and (4) identification of preferred air quality management strategies that minimize control costs, maximize benefits, or limit the adverse effects of climate change on air quality when considering the scarcity of resources. The main challenge relates to the level of uncertainties associated with climate change forecasts and advancements in future control measures, since they will significantly affect the risk assessment results and development of effective air quality management plans. The concept presented in this paper can help decision makers make appropriate responses to climate change, since it provides an integrated approach for climate risk assessment and management when developing air quality management strategies. Development of climate-responsive air quality management strategies is fundamentally a risk assessment and risk management process. The risk assessment process includes quantification of climate change impacts on air quality and associated uncertainties. Risk management for air quality under the impacts of climate change includes determination of air quality targets, selections of potential management options, and identification of effective air quality management strategies through decision-making models. The risk-based decision-making framework can also be applied to develop climate-responsive management strategies for the other environmental dimensions and assess costs and benefits of future environmental management policies.

75 FR 18061 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Control of Air Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... Promulgation of Air Quality Implementation Plans; Texas; Control of Air Pollution From Motor Vehicles AGENCY... Chapter 114, Control of Air Pollution from Motor Vehicles. These revisions consist of the new Rebate Grant... air pollution regulations and control strategies to ensure that air quality meets the National Ambient...

Managing Air Quality - Multi-Pollutant Planning and Control

EPA Pesticide Factsheets

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

Multi-criteria decision making approaches for quality control of genome-wide association studies.

PubMed

Malovini, Alberto; Rognoni, Carla; Puca, Annibale; Bellazzi, Riccardo

2009-03-01

Experimental errors in the genotyping phases of a Genome-Wide Association Study (GWAS) can lead to false positive findings and to spurious associations. An appropriate quality control phase could minimize the effects of this kind of errors. Several filtering criteria can be used to perform quality control. Currently, no formal methods have been proposed for taking into account at the same time these criteria and the experimenter's preferences. In this paper we propose two strategies for setting appropriate genotyping rate thresholds for GWAS quality control. These two approaches are based on the Multi-Criteria Decision Making theory. We have applied our method on a real dataset composed by 734 individuals affected by Arterial Hypertension (AH) and 486 nonagenarians without history of AH. The proposed strategies appear to deal with GWAS quality control in a sound way, as they lead to rationalize and make explicit the experimenter's choices thus providing more reproducible results.

Sustainable improvement of animal health care by systematic quality risk management according to the HACCP concept.

PubMed

Noordhuizen, J P; Welpelo, H J

1996-12-01

This paper addresses the principles of the Hazard Analysis Critical Control Point (HACCP) concept as applied to animal health management strategy. Characteristics of the concept were analysed and compared with those of current animal health care strategies for disease risk identification and herd health management, insurance, and certification. HACCP is a hybrid strategy of quality control at both production process and product level. Animal health is considered a particular quality feature. We show that process control (expressed in terms of controlling both general and specific disease risk factors) and product control (expressed in terms of testing animals or animal products for specific disease agents) could form the basis for improving animal health. We conclude that HACCP provides ample opportunity for preventive health action and risk management at a relatively low cost in terms of labour, finance and documentation expenditure, at both the farm and sector level. Epidemiological field studies are currently needed to identify critical control points and to design HACCP procedures for livestock producers. In the long run, HACCP based animal health care can be further developed into a quality control systems approach to cover all aspects that are related, either directly or indirectly, to animal health.

Drop-on-Demand System for Manufacturing of Melt-based Solid Oral Dosage: Effect of Critical Process Parameters on Product Quality.

PubMed

Içten, Elçin; Giridhar, Arun; Nagy, Zoltan K; Reklaitis, Gintaras V

2016-04-01

The features of a drop-on-demand-based system developed for the manufacture of melt-based pharmaceuticals have been previously reported. In this paper, a supervisory control system, which is designed to ensure reproducible production of high quality of melt-based solid oral dosages, is presented. This control system enables the production of individual dosage forms with the desired critical quality attributes: amount of active ingredient and drug morphology by monitoring and controlling critical process parameters, such as drop size and product and process temperatures. The effects of these process parameters on the final product quality are investigated, and the properties of the produced dosage forms characterized using various techniques, such as Raman spectroscopy, optical microscopy, and dissolution testing. A crystallization temperature control strategy, including controlled temperature cycles, is presented to tailor the crystallization behavior of drug deposits and to achieve consistent drug morphology. This control strategy can be used to achieve the desired bioavailability of the drug by mitigating variations in the dissolution profiles. The supervisor control strategy enables the application of the drop-on-demand system to the production of individualized dosage required for personalized drug regimens.

Musical Sound Quality in Cochlear Implant Users: A Comparison in Bass Frequency Perception Between Fine Structure Processing and High-Definition Continuous Interleaved Sampling Strategies.

PubMed

Roy, Alexis T; Carver, Courtney; Jiradejvong, Patpong; Limb, Charles J

2015-01-01

Med-El cochlear implant (CI) patients are typically programmed with either the fine structure processing (FSP) or high-definition continuous interleaved sampling (HDCIS) strategy. FSP is the newer-generation strategy and aims to provide more direct encoding of fine structure information compared with HDCIS. Since fine structure information is extremely important in music listening, FSP may offer improvements in musical sound quality for CI users. Despite widespread clinical use of both strategies, few studies have assessed the possible benefits in music perception for the FSP strategy. The objective of this study is to measure the differences in musical sound quality discrimination between the FSP and HDCIS strategies. Musical sound quality discrimination was measured using a previously designed evaluation, called Cochlear Implant-MUltiple Stimulus with Hidden Reference and Anchor (CI-MUSHRA). In this evaluation, participants were required to detect sound quality differences between an unaltered real-world musical stimulus and versions of the stimulus in which various amount of bass (low) frequency information was removed via a high-pass filer. Eight CI users, currently using the FSP strategy, were enrolled in this study. In the first session, participants completed the CI-MUSHRA evaluation with their FSP strategy. Patients were then programmed with the clinical-default HDCIS strategy, which they used for 2 months to allow for acclimatization. After acclimatization, each participant returned for the second session, during which they were retested with HDCIS, and then switched back to their original FSP strategy and tested acutely. Sixteen normal-hearing (NH) controls completed a CI-MUSHRA evaluation for comparison, in which NH controls listened to music samples under normal acoustic conditions, without CI stimulation. Sensitivity to high-pass filtering more closely resembled that of NH controls when CI users were programmed with the clinical-default FSP strategy compared with performance when programmed with HDCIS (mixed-design analysis of variance, p < 0.05). The clinical-default FSP strategy offers improvements in musical sound quality discrimination for CI users with respect to bass frequency perception. This improved bass frequency discrimination may in turn support enhanced musical sound quality. This is the first study that has demonstrated objective improvements in musical sound quality discrimination with the newer-generation FSP strategy. These positive results may help guide the selection of processing strategies for Med-El CI patients. In addition, CI-MUSHRA may also provide a novel method for assessing the benefits of newer processing strategies in the future.

Optimal shifting control strategy in inertia phase of an automatic transmission for automotive applications

NASA Astrophysics Data System (ADS)

Meng, Fei; Tao, Gang; Zhang, Tao; Hu, Yihuai; Geng, Peng

2015-08-01

Shifting quality is a crucial factor in all parts of the automobile industry. To ensure an optimal gear shifting strategy with best fuel economy for a stepped automatic transmission, the controller should be designed to meet the challenge of lacking of a feedback sensor to measure the relevant variables. This paper focuses on a new kind of automatic transmission using proportional solenoid valve to control the clutch pressure, a speed difference of the clutch based control strategy is designed for the shift control during the inertia phase. First, the mechanical system is shown and the system dynamic model is built. Second, the control strategy is designed based on the characterization analysis of models which are derived from dynamics of the drive line and electro-hydraulic actuator. Then, the controller uses conventional Proportional-Integral-Derivative control theory, and a robust two-degree-of-freedom controller is also carried out to determine the optimal control parameters to further improve the system performance. Finally, the designed control strategy with different controller is implemented on a simulation model. The compared results show that the speed difference of clutch can track the desired trajectory well and improve the shift quality effectively.

Air Quality Strategies on Public Health and Health Equity in Europe-A Systematic Review.

PubMed

Wang, Li; Zhong, Buqing; Vardoulakis, Sotiris; Zhang, Fengying; Pilot, Eva; Li, Yonghua; Yang, Linsheng; Wang, Wuyi; Krafft, Thomas

2016-12-02

Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO₂) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO₂ were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no consistent impact on health equity from the strategies was found. The strategy types aiming to control air pollution in Europe and the health impact assessment methodology were also discussed in this review.

Air Quality Strategies on Public Health and Health Equity in Europe—A Systematic Review

PubMed Central

Wang, Li; Zhong, Buqing; Vardoulakis, Sotiris; Zhang, Fengying; Pilot, Eva; Li, Yonghua; Yang, Linsheng; Wang, Wuyi; Krafft, Thomas

2016-01-01

Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO2) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO2 were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no consistent impact on health equity from the strategies was found. The strategy types aiming to control air pollution in Europe and the health impact assessment methodology were also discussed in this review. PMID:27918457

Integrated Application of Quality-by-Design Principles to Drug Product Development: A Case Study of Brivanib Alaninate Film-Coated Tablets.

PubMed

Badawy, Sherif I F; Narang, Ajit S; LaMarche, Keirnan R; Subramanian, Ganeshkumar A; Varia, Sailesh A; Lin, Judy; Stevens, Tim; Shah, Pankaj A

2016-01-01

Modern drug product development is expected to follow quality-by-design (QbD) paradigm. At the same time, although there are several issue-specific examples in the literature that demonstrate the application of QbD principles, a holistic demonstration of the application of QbD principles to drug product development and control strategy, is lacking. This article provides an integrated case study on the systematic application of QbD to product development and demonstrates the implementation of QbD concepts in the different aspects of product and process design for brivanib alaninate film-coated tablets. Using a risk-based approach, the strategy for development entailed identification of product critical quality attributes (CQAs), assessment of risks to the CQAs, and performing experiments to understand and mitigate identified risks. Quality risk assessments and design of experiments were performed to understand the quality of the input raw materials required for a robust formulation and the impact of manufacturing process parameters on CQAs. In addition to the material property and process parameter controls, the proposed control strategy includes use of process analytical technology and conventional analytical tests to control in-process material attributes and ensure quality of the final product. Copyright © 2016. Published by Elsevier Inc.

Control Strategy of Active Power Filter Based on Modular Multilevel Converter

NASA Astrophysics Data System (ADS)

Xie, Xifeng

2018-03-01

To improve the capacity, pressure resistance and the equivalent switching frequency of active power filter (APF), a control strategy of APF based on Modular Multilevel Converter (MMC) is presented. In this Control Strategy, the indirect current control method is used to achieve active current and reactive current decoupling control; Voltage Balance Control Strategy is to stabilize sub-module capacitor voltage, the predictive current control method is used to Track and control of harmonic currents. As a result, the harmonic current is restrained, and power quality is improved. Finally, the simulation model of active power filter controller based on MMC is established in Matlab/Simulink, the simulation proves that the proposed strategy is feasible and correct.

Multi-Criteria Decision Making Approaches for Quality Control of Genome-Wide Association Studies

PubMed Central

Malovini, Alberto; Rognoni, Carla; Puca, Annibale; Bellazzi, Riccardo

2009-01-01

Experimental errors in the genotyping phases of a Genome-Wide Association Study (GWAS) can lead to false positive findings and to spurious associations. An appropriate quality control phase could minimize the effects of this kind of errors. Several filtering criteria can be used to perform quality control. Currently, no formal methods have been proposed for taking into account at the same time these criteria and the experimenter’s preferences. In this paper we propose two strategies for setting appropriate genotyping rate thresholds for GWAS quality control. These two approaches are based on the Multi-Criteria Decision Making theory. We have applied our method on a real dataset composed by 734 individuals affected by Arterial Hypertension (AH) and 486 nonagenarians without history of AH. The proposed strategies appear to deal with GWAS quality control in a sound way, as they lead to rationalize and make explicit the experimenter’s choices thus providing more reproducible results. PMID:21347174

A novel strategy with standardized reference extract qualification and single compound quantitative evaluation for quality control of Panax notoginseng used as a functional food.

PubMed

Li, S P; Qiao, C F; Chen, Y W; Zhao, J; Cui, X M; Zhang, Q W; Liu, X M; Hu, D J

2013-10-25

Root of Panax notoginseng (Burk.) F.H. Chen (Sanqi in Chinese) is one of traditional Chinese medicines (TCMs) based functional food. Saponins are the major bioactive components. The shortage of reference compounds or chemical standards is one of the main bottlenecks for quality control of TCMs. A novel strategy, i.e. standardized reference extract based qualification and single calibrated components directly quantitative estimation of multiple analytes, was proposed to easily and effectively control the quality of natural functional foods such as Sanqi. The feasibility and credibility of this methodology were also assessed with a developed fast HPLC method. Five saponins, including ginsenoside Rg1, Re, Rb1, Rd and notoginsenoside R1 were rapidly separated using a conventional HPLC in 20 min. The quantification method was also compared with individual calibration curve method. The strategy is feasible and credible, which is easily and effectively adapted for improving the quality control of natural functional foods such as Sanqi. Copyright © 2013 Elsevier B.V. All rights reserved.

Environmental Law Deskbook

DTIC Science & Technology

1998-06-12

public health threats posed by water pollution. (b) More effective control of polluted runoff (including a strategy for achieving a net gain of... Control Strategies for Toxic Pollutants. a. The CWA requires states to identify "impaired" water bodies within their boundaries. For water...standards. Thereafter, states must develop "individual control strategies " (ICSs) to regulate such pollutants and achieve water quality standards

[Quality by design approaches for pharmaceutical development and manufacturing of Chinese medicine].

PubMed

Xu, Bing; Shi, Xin-Yuan; Wu, Zhi-Sheng; Zhang, Yan-Ling; Wang, Yun; Qiao, Yan-Jiang

2017-03-01

The pharmaceutical quality was built by design, formed in the manufacturing process and improved during the product's lifecycle. Based on the comprehensive literature review of pharmaceutical quality by design (QbD), the essential ideas and implementation strategies of pharmaceutical QbD were interpreted. Considering the complex nature of Chinese medicine, the "4H" model was innovated and proposed for implementing QbD in pharmaceutical development and industrial manufacture of Chinese medicine product. "4H" corresponds to the acronym of holistic design, holistic information analysis, holistic quality control, and holistic process optimization, which is consistent with the holistic concept of Chinese medicine theory. The holistic design aims at constructing both the quality problem space from the patient requirement and the quality solution space from multidisciplinary knowledge. Holistic information analysis emphasizes understanding the quality pattern of Chinese medicine by integrating and mining multisource data and information at a relatively high level. The batch-to-batch quality consistence and manufacturing system reliability can be realized by comprehensive application of inspective quality control, statistical quality control, predictive quality control and intelligent quality control strategies. Holistic process optimization is to improve the product quality and process capability during the product lifecycle management. The implementation of QbD is useful to eliminate the ecosystem contradictions lying in the pharmaceutical development and manufacturing process of Chinese medicine product, and helps guarantee the cost effectiveness. Copyright© by the Chinese Pharmaceutical Association.

Measuring management's perspective of data quality in Pakistan's Tuberculosis control programme: a test-based approach to identify data quality dimensions.

PubMed

Ali, Syed Mustafa; Anjum, Naveed; Kamel Boulos, Maged N; Ishaq, Muhammad; Aamir, Javariya; Haider, Ghulam Rasool

2018-01-16

Data quality is core theme of programme's performance assessment and many organizations do not have any data quality improvement strategy, wherein data quality dimensions and data quality assessment framework are important constituents. As there is limited published research about the data quality specifics that are relevant to the context of Pakistan's Tuberculosis control programme, this study aims at identifying the applicable data quality dimensions by using the 'fitness-for-purpose' perspective. Forty-two respondents pooled a total of 473 years of professional experience, out of which 223 years (47%) were in TB control related programmes. Based on the responses against 11 practical cases, adopted from the routine recording and reporting system of Pakistan's TB control programme (real identities of patient were masked), completeness, accuracy, consistency, vagueness, uniqueness and timeliness are the applicable data quality dimensions relevant to the programme's context, i.e. work settings and field of practice. Based on a 'fitness-for-purpose' approach to data quality, this study used a test-based approach to measure management's perspective and identified data quality dimensions pertinent to the programme and country specific requirements. Implementation of a data quality improvement strategy and achieving enhanced data quality would greatly help organizations in promoting data use for informed decision making.

The impact of translucent fabric shades and control strategies on energy savings and visual quality

NASA Astrophysics Data System (ADS)

Wankanapon, Pimonmart

Translucent fabric shades provide opportunities for building occupants to control sunlight penetration for heat reduction, thermal comfort, and visual quality. Regulating shades affects building energy and can potentially reduce the size of mechanical cooling systems. Shades are not normally included in energy model studies during the design process, even though shades potential impact energy use. This is because the occupants normally leave shades closed a large fraction of the time, but models are generally performed with no shades. Automatic shade control is now available, so it is necessary to understand the impact of shades on visual quality and their energy saving potential in order to optimize their overall performance. There are very limited studies that have address shades and their integrated performance on energy consumption and visual quality. Most of these do not reflected modern shade types and their application. The goals of this study are: First, to determine the impact of shades on total, heating, cooling and lighting energy savings with different design and operation parameters. Second, to study and develop different automatic shade control strategies to promote and optimize energy savings and visual quality. A simulation-based approach using EnergyPlus in a parametric study provide better understanding energy savings under different shade conditions. The parametric runs addressed various building parameters such as geometry, orientation, site climate, glazing/shade properties, and shade control strategies with integrated lighting control. The impact of shades was determined for total building and space heating, cooling and lighting energy savings. The effect of shades on visual quality was studied using EnergyPlus, AGI32 and DAYSIM for several indices such as daylight glare index (DGI), work plane illuminance, luminance ratios and view. Different shade control strategies and integrated lighting control were considered with two translucent fabric shade colors. The results clearly show the benefit of automatic shade control strategies with integrated lighting control over a condition when shades are closed all day. The main contributor to the total energy savings is from lighting energy savings, followed by cooling energy savings. Shades provide greater benefit in a hot climate and in a moderate climate than in a cold climate. Different control strategies provide savings in the range of 7-35% for annual total space energy with higher savings with light colored shades. Control strategies of shades should be selected and optimized based on climate, orientation, window area, and window/shade properties. High performance glazings, when equipped with shades, show lower energy savings when compared to standard glazings. High transmittance/reflectance shades, such as white shades, perform better than dark shades in most of the cases due to higher lighting energy savings obtained with the automatic electric lighting control and the resulting cooling energy savings from rejection of some solar energy and a reduction in the heat from lights. A South orientation showed the least benefit of automatic control of shades when compare to other orientations due to the large fraction of time shades are required to provide visual comfort. Under automatic shade control, energy savings are higher the more often the shades can be raised. The different automatic control strategies present tradeoffs between energy savings and comfort. With regard to visual quality, daylight quality assessments on view, glare, luminance ratios, and UDI can be used to assess shade control strategies. Automatic shade control can increase the number of view hours while controlling sunlight penetration. With automatic shade control, more daylight hours can be provided within the beneficial range of 100-2000 lux compared to shades that are closed all day. For a person facing the window, discomfort glare is likely to increase the more often the shades are raised. Keeping the shades down ensures an acceptable glare condition, but limits energy savings. Luminance ratios are another metric that can be used to assess shade performance. With white shades, the luminance ratios between the task and proximate surfaces are improved. Dark shades help improve the luminance ratios between the task and distant surfaces. When the shades are left open, even with no direct sunlight in the space, task to window luminance ratios will often exceed 1:10.

Environmental Law

DTIC Science & Technology

2001-12-04

criteria for water bodies within the state. 4. Individual Control Strategies for Toxic Pollutants. a. The CWA requires states to identify...preventing or impeding the achievement of water quality standards. Thereafter, states must develop “individual control strategies ” (ICSs) to regulate...standards will be met not later than three years after the individual control strategy is established.” 40 C.F.R. § 123.46(c). (1) As a result

Organizational Culture in Community Colleges: Connecting Market Orientation, Quality, and Student Engagement

ERIC Educational Resources Information Center

McManimon, Debra J.

2012-01-01

To enhance their competitive advantage in the marketplace, many business leaders develop market orientation strategies designed to increase customer engagement. These market orientation strategies include improvement in service delivery, relationship management, customer satisfaction, and quality control methods. There is a lack of understanding…

Quality of life, psychological characteristics, and adjustment in parents of children with Attention-Deficit/Hyperactivity Disorder.

PubMed

Cappe, Emilie; Bolduc, Mélanie; Rougé, Marie-Caroline; Saiag, Marie-Claude; Delorme, Richard

2017-05-01

This study investigated quality of life and adjustment mechanisms in parents of children with Attention-Deficit/Hyperactivity Disorder (ADHD). Ninety parents of children with ADHD completed a sociodemographic questionnaire and self-assessment scales to measure their perceived stress, social support, sense of control, coping strategies and quality of life. ADHD in children negatively affected parents' quality of life, especially their psychological well-being and personal fulfillment. Family and couple relationships, as well as daily life activities, were also affected. The severity of the disorder, perceiving the situation as a threat or a loss, feeling guilty and holding on to irrational beliefs were related to emotion-focused coping strategies and to a poorer quality of life. Furthermore, hyperactivity index and stress ratings relative to perceiving the situation as a threat or a loss, and adopting emotion-focused coping strategies, predicted poorer quality of life. In contrast, perceiving the situation as challenging was related to a greater sense of control and personal fulfillment. Moreover, perceiving the situation as challenging and adopting problem-focused coping strategies predicted better quality of life. The findings highlight the negative effects of ADHD on parent psychological adjustment and underline the need to recommend training programs that improve parenting skills, parents' perceptions concerning their child's behavior disorder and parental functioning.

Data quality assurance and control in cognitive research: Lessons learned from the PREDICT-HD study.

PubMed

Westervelt, Holly James; Bernier, Rachel A; Faust, Melanie; Gover, Mary; Bockholt, H Jeremy; Zschiegner, Roland; Long, Jeffrey D; Paulsen, Jane S

2017-09-01

We discuss the strategies employed in data quality control and quality assurance for the cognitive core of Neurobiological Predictors of Huntington's Disease (PREDICT-HD), a long-term observational study of over 1,000 participants with prodromal Huntington disease. In particular, we provide details regarding the training and continual evaluation of cognitive examiners, methods for error corrections, and strategies to minimize errors in the data. We present five important lessons learned to help other researchers avoid certain assumptions that could potentially lead to inaccuracies in their cognitive data. Copyright © 2017 John Wiley & Sons, Ltd.

Research on control strategy based on fuzzy PR for grid-connected inverter

NASA Astrophysics Data System (ADS)

Zhang, Qian; Guan, Weiguo; Miao, Wen

2018-04-01

In the traditional PI controller, there is static error in tracking ac signals. To solve the problem, the control strategy of a fuzzy PR and the grid voltage feed-forward is proposed. The fuzzy PR controller is to eliminate the static error of the system. It also adjusts parameters of PR controller in real time, which avoids the defect of fixed parameter fixed. The grid voltage feed-forward control can ensure the quality of current and improve the system's anti-interference ability when the grid voltage is distorted. Finally, the simulation results show that the system can output grid current with good quality and also has good dynamic and steady state performance.

Design and implementation of a control structure for quality products in a crude oil atmospheric distillation column.

PubMed

Sotelo, David; Favela-Contreras, Antonio; Sotelo, Carlos; Jiménez, Guillermo; Gallegos-Canales, Luis

2017-11-01

In recent years, interest for petrochemical processes has been increasing, especially in refinement area. However, the high variability in the dynamic characteristics present in the atmospheric distillation column poses a challenge to obtain quality products. To improve distillates quality in spite of the changes in the input crude oil composition, this paper details a new design of a control strategy in a conventional crude oil distillation plant defined using formal interaction analysis tools. The process dynamic and its control are simulated on Aspen HYSYS ® dynamic environment under real operating conditions. The simulation results are compared against a typical control strategy commonly used in crude oil atmospheric distillation columns. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

40 CFR 52.2780 - Control strategy for sulfur oxides.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Control strategy for sulfur oxides. 52... strategy for sulfur oxides. (a) The requirements of subpart G of this chapter are not met since there has... maintenance of the national ambient air quality standards for sulfur oxides on the island of St. Croix. (b...

40 CFR 52.2780 - Control strategy for sulfur oxides.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 5 2014-07-01 2014-07-01 false Control strategy for sulfur oxides. 52... strategy for sulfur oxides. (a) The requirements of subpart G of this chapter are not met since there has... maintenance of the national ambient air quality standards for sulfur oxides on the island of St. Croix. (b...

40 CFR 52.2780 - Control strategy for sulfur oxides.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 5 2013-07-01 2013-07-01 false Control strategy for sulfur oxides. 52... strategy for sulfur oxides. (a) The requirements of subpart G of this chapter are not met since there has... maintenance of the national ambient air quality standards for sulfur oxides on the island of St. Croix. (b...

40 CFR 52.2780 - Control strategy for sulfur oxides.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 5 2012-07-01 2012-07-01 false Control strategy for sulfur oxides. 52... strategy for sulfur oxides. (a) The requirements of subpart G of this chapter are not met since there has... maintenance of the national ambient air quality standards for sulfur oxides on the island of St. Croix. (b...

Likelihood of achieving air quality targets under model uncertainties.

PubMed

Digar, Antara; Cohan, Daniel S; Cox, Dennis D; Kim, Byeong-Uk; Boylan, James W

2011-01-01

Regulatory attainment demonstrations in the United States typically apply a bright-line test to predict whether a control strategy is sufficient to attain an air quality standard. Photochemical models are the best tools available to project future pollutant levels and are a critical part of regulatory attainment demonstrations. However, because photochemical models are uncertain and future meteorology is unknowable, future pollutant levels cannot be predicted perfectly and attainment cannot be guaranteed. This paper introduces a computationally efficient methodology for estimating the likelihood that an emission control strategy will achieve an air quality objective in light of uncertainties in photochemical model input parameters (e.g., uncertain emission and reaction rates, deposition velocities, and boundary conditions). The method incorporates Monte Carlo simulations of a reduced form model representing pollutant-precursor response under parametric uncertainty to probabilistically predict the improvement in air quality due to emission control. The method is applied to recent 8-h ozone attainment modeling for Atlanta, Georgia, to assess the likelihood that additional controls would achieve fixed (well-defined) or flexible (due to meteorological variability and uncertain emission trends) targets of air pollution reduction. The results show that in certain instances ranking of the predicted effectiveness of control strategies may differ between probabilistic and deterministic analyses.

HISTORICAL DEVELOPMENT OF WET-WEATHER FLOW MANAGEMENT

EPA Science Inventory

The management of wet-weather flow (WWF) is necessary to maintain the quality of urban water resources. Throughout history strategies were implemented to control WWF for reasons, e.g., flood and water quality control, aesthetic improvement, waste removal and others. A comprehen...

40 CFR 52.675 - Control strategy: Sulfur oxides-Eastern Idaho Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of Sulfur Oxide Emissions from Sulfuric Acid Plants) of the “Rules and Regulations for the Control of... have previously been established for certain existing acid plants in this Air Quality Control Region... apply to existing acid plants with approved or promulgated emission limits that are more stringent than...

40 CFR 52.675 - Control strategy: Sulfur oxides-Eastern Idaho Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of Sulfur Oxide Emissions from Sulfuric Acid Plants) of the “Rules and Regulations for the Control of... have previously been established for certain existing acid plants in this Air Quality Control Region... apply to existing acid plants with approved or promulgated emission limits that are more stringent than...

40 CFR 52.675 - Control strategy: Sulfur oxides-Eastern Idaho Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of Sulfur Oxide Emissions from Sulfuric Acid Plants) of the “Rules and Regulations for the Control of... have previously been established for certain existing acid plants in this Air Quality Control Region... apply to existing acid plants with approved or promulgated emission limits that are more stringent than...

40 CFR 52.675 - Control strategy: Sulfur oxides-Eastern Idaho Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of Sulfur Oxide Emissions from Sulfuric Acid Plants) of the “Rules and Regulations for the Control of... have previously been established for certain existing acid plants in this Air Quality Control Region... apply to existing acid plants with approved or promulgated emission limits that are more stringent than...

40 CFR 52.675 - Control strategy: Sulfur oxides-Eastern Idaho Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of Sulfur Oxide Emissions from Sulfuric Acid Plants) of the “Rules and Regulations for the Control of... have previously been established for certain existing acid plants in this Air Quality Control Region... apply to existing acid plants with approved or promulgated emission limits that are more stringent than...

Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review.

PubMed

Munce, Sarah E P; Perrier, Laure; Shin, Saeha; Adhihetty, Chamila; Pitzul, Kristen; Nelson, Michelle L A; Bayley, Mark T

2017-09-07

While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal. Only randomized controlled trials that report on the impact of quality improvement strategies on quality of life outcomes in people with stroke will be included. The secondary outcomes will be physical and psychological well-being. Quality improvement strategies include audit and feedback, case management, team changes, electronic patient registries, clinician education, clinical reminders, facilitated relay of clinical information to clinicians, patient education, (promotion of) self-management, patient reminder systems, and continuous quality improvement. Studies published since 2000 will be included to increase the relevancy of findings. Results will be grouped according to the target group of the varying quality improvement strategies (i.e., health system, health care professionals, or patients) and/or by any other noteworthy grouping variables, such as etiology of stroke or by sex. This systematic review will identify those quality improvement strategies aimed at the health system, health care professionals, and patients that impact the quality of life of individuals with stroke. Improving awareness and utilization of such strategies may enhance uptake of stroke best practices and reduce inappropriate health care utilization costs. PROSPERO, CRD42017064141.

A Systematic Review of Relaxation, Meditation, and Guided Imagery Strategies for Symptom Management in Heart Failure.

PubMed

Kwekkeboom, Kristine L; Bratzke, Lisa C

2016-01-01

Pain, dyspnea, fatigue, and sleep disturbance are prevalent and distressing symptoms in persons with advanced heart failure. Although many lifestyle and self-care interventions have been developed to control heart failure progression, very few studies have explored treatments exclusively for symptom palliation. Cognitive-behavioral strategies may be effective treatment for these symptoms in advanced heart failure. A systemic review was conducted to describe the effect of cognitive-behavioral strategies on pain, dyspnea, fatigue, and sleep disturbance in patients with heart failure. CINAHL, Medline, and PsychINFO were searched from inception through December 2014. Articles were selected for inclusion if they tested a cognitive-behavioral strategy using a quasi-experimental or experimental design, involved a sample of adults with heart failure, and measured pain, dyspnea, fatigue, sleep disturbance, or symptom-related quality of life. The 2 authors evaluated study quality, abstracted data elements from each study, and synthesized findings. Thirteen articles describing 9 unique studies met criteria and were included in the review. Five studies tested relaxation strategies, 3 tested meditation strategies, and 1 tested a guided imagery strategy. Of the 9 studies, 7 demonstrated some improvement in symptom outcomes. Relaxation, meditation, guided imagery, or combinations of these strategies resulted in less dyspnea and better sleep compared with attention control or usual care conditions and reduced pain, dyspnea, fatigue, and sleep disturbance within treatment groups (pretreatment to posttreatment). Symptom-related quality of life was improved with meditation compared with attention control and usual care conditions and improved pre- to post-guided imagery. Studies exploring cognitive-behavioral symptom management strategies in heart failure vary in quality and report mixed findings but indicate potential beneficial effects of relaxation, meditation, and guided imagery on heart failure-related symptoms. Future research should test cognitive-behavioral strategies in rigorously designed efficacy trials, using samples selected for their symptom experience, and measure pain, dyspnea, fatigue, and sleep disturbance outcomes with targeted symptom measures.

Approaches to Quality Risk Management When Using Single-Use Systems in the Manufacture of Biologics.

PubMed

Ishii-Watabe, Akiko; Hirose, Akihiko; Katori, Noriko; Hashii, Norikata; Arai, Susumu; Awatsu, Hirotoshi; Eiza, Akira; Hara, Yoshiaki; Hattori, Hideshi; Inoue, Tomomi; Isono, Tetsuya; Iwakura, Masahiro; Kajihara, Daisuke; Kasahara, Nobuo; Matsuda, Hiroyuki; Murakami, Sei; Nakagawa, Taishiro; Okumura, Takehiro; Omasa, Takeshi; Takuma, Shinya; Terashima, Iyo; Tsukahara, Masayoshi; Tsutsui, Maiko; Yano, Takahiro; Kawasaki, Nana

2015-10-01

Biologics manufacturing technology has made great progress in the last decade. One of the most promising new technologies is the single-use system, which has improved the efficiency of biologics manufacturing processes. To ensure safety of biologics when employing such single-use systems in the manufacturing process, various issues need to be considered including possible extractables/leachables and particles arising from the components used in single-use systems. Japanese pharmaceutical manufacturers, together with single-use suppliers, members of the academia and regulatory authorities have discussed the risks of using single-use systems and established control strategies for the quality assurance of biologics. In this study, we describe approaches for quality risk management when employing single-use systems in the manufacturing of biologics. We consider the potential impact of impurities related to single-use components on drug safety and the potential impact of the single-use system on other critical quality attributes as well as the stable supply of biologics. We also suggest a risk-mitigating strategy combining multiple control methods which includes the selection of appropriate single-use components, their inspections upon receipt and before releasing for use and qualification of single-use systems. Communication between suppliers of single-use systems and the users, as well as change controls in the facilities both of suppliers and users, are also important in risk-mitigating strategies. Implementing these control strategies can mitigate the risks attributed to the use of single-use systems. This study will be useful in promoting the development of biologics as well as in ensuring their safety, quality and stable supply.

40 CFR 52.1179 - Control strategy: Carbon monoxide.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Carbon monoxide. 52.1179 Section 52.1179 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS...: Carbon monoxide. (a) Approval—On March 18, 1999, the Michigan Department of Environmental Quality...

FIELD QUALITY CONTROL STRATEGIES ASSESSING SOLIDIFICATION/STABILIZATION

EPA Science Inventory

Existing regulatory mobility reduction (leaching) tests are not amenable to real time quality control because of the time required to perform sample extraction and chemical analysis. This is of conccern because the leaching test is the most important parameter used to relate trea...

INTERDEPENDENCIES OF MULTI-POLLUTANT CONTROL SIMULATIONS IN AN AIR QUALITY MODEL

EPA Science Inventory

In this work, we use the Community Multi-Scale Air Quality (CMAQ) modeling system to examine the effect of several control strategies on simultaneous concentrations of ozone, PM_2.5, and three important HAPs: formaldehyde, acetaldehyde and benzene.

[Discussion on research thinking of traditional Chinese medicine standardization system based on whole process quality control].

PubMed

Dong, Ling; Sun, Yu; Pei, Wen-Xuan; Dai, Jun-Dong; Wang, Zi-Yu; Pan, Meng; Chen, Jiang-Peng; Wang, Yun

2017-12-01

The concept of "Quality by design" indicates that good design for the whole life cycle of pharmaceutical production enables the drug to meet the expected quality requirements. Aiming at the existing problems of the traditional Chinese medicine (TCM) industry, the TCM standardization system was put forward in this paper from the national strategic level, under the guidance by the idea of quality control in international manufacturing industry and with considerations of TCM industry's own characteristics and development status. The connotation of this strategy was to establish five interrelated systems: multi-indicators system based on tri-indicators system, quality standard and specification system of TCM herbal materials and decoction pieces, quality traceability system, data monitoring system based on whole-process quality control, and whole-process quality management system of TCM, and achieve the whole process systematic and scientific study in TCM industry through "top-level design-implement in steps-system integration" workflow. This article analyzed the correlation between the quality standards of all links, established standard operating procedures of each link and whole process, and constructed a high standard overall quality management system for TCM industry chains, in order to provide a demonstration for the establishment of TCM whole-process quality control system and provide systematic reference and basis for standardization strategy in TCM industry. Copyright© by the Chinese Pharmaceutical Association.

Guidelines for Controlling Indoor Air Quality Problems Associated with Kilns, Copiers, and Welding in Schools. Technical Bulletin.

ERIC Educational Resources Information Center

Turner, Ronald W.; And Others

Guidelines for controlling indoor air quality problems associated with kilns, copiers, and welding in schools are provided in this document. Individual sections on kilns, duplicating equipment, and welding operations contain information on the following: sources of contaminants; health effects; methods of control; ventilation strategies; and…

75 FR 15348 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Revision To Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

.... What Is a SIP? Section 110 of the CAA requires states to develop air pollution regulations and control... air pollution regulations, control strategies, other means or techniques, and technical analyses... provisions of the CAA. A SIP protects air quality primarily by addressing air pollution at its point of...

Coping strategies and quality of life in caregivers of dependent elderly relatives.

PubMed

Rodríguez-Pérez, Margarita; Abreu-Sánchez, Ana; Rojas-Ocaña, María Jesús; Del-Pino-Casado, Rafael

2017-04-14

Despite the importance of coping in caregiving, there are few studies on the relationship between coping and quality of life in caregivers of the frail dependent elderly. Thus, this study aims to analyze the relationship between coping strategies and quality of life dimensions in primary caregivers of dependent elderly relatives. A cross-sectional study was conducted from 86 caregivers. Predictive variables were coping strategies (problem-focused, emotion-focused, socially-supported, and dysfunctional); dependent variables were quality of life dimensions (psychological, physical, relational, and environmental); and potential confounding variables were age, gender, perceived health and burden of caregiver, and functional capacity of care receiver. Correlation coefficients were calculated and multiple linear regression analysis was performed. After controlling for potential confounders, dysfunctional coping was related to worse quality of life in the psychological dimension, while emotion-focused and socially-supported coping were related to superior psychological and environmental dimensions of quality of life. The physical and relational dimensions of quality of life were not related to coping strategies. 1) it is important to consider coping strategies in the assessment of primary caregivers of dependent elderly relatives; 2) the quality of life of caregivers is related to their coping strategies, 3) their quality of life can be worsened by avoidance-type coping, and 4) their quality of life can be improved by active emotion-focused coping and socially-supported coping.

Application of Sigma Metrics Analysis for the Assessment and Modification of Quality Control Program in the Clinical Chemistry Laboratory of a Tertiary Care Hospital.

PubMed

Iqbal, Sahar; Mustansar, Tazeen

2017-03-01

Sigma is a metric that quantifies the performance of a process as a rate of Defects-Per-Million opportunities. In clinical laboratories, sigma metric analysis is used to assess the performance of laboratory process system. Sigma metric is also used as a quality management strategy for a laboratory process to improve the quality by addressing the errors after identification. The aim of this study is to evaluate the errors in quality control of analytical phase of laboratory system by sigma metric. For this purpose sigma metric analysis was done for analytes using the internal and external quality control as quality indicators. Results of sigma metric analysis were used to identify the gaps and need for modification in the strategy of laboratory quality control procedure. Sigma metric was calculated for quality control program of ten clinical chemistry analytes including glucose, chloride, cholesterol, triglyceride, HDL, albumin, direct bilirubin, total bilirubin, protein and creatinine, at two control levels. To calculate the sigma metric imprecision and bias was calculated with internal and external quality control data, respectively. The minimum acceptable performance was considered as 3 sigma. Westgard sigma rules were applied to customize the quality control procedure. Sigma level was found acceptable (≥3) for glucose (L2), cholesterol, triglyceride, HDL, direct bilirubin and creatinine at both levels of control. For rest of the analytes sigma metric was found <3. The lowest value for sigma was found for chloride (1.1) at L2. The highest value of sigma was found for creatinine (10.1) at L3. HDL was found with the highest sigma values at both control levels (8.8 and 8.0 at L2 and L3, respectively). We conclude that analytes with the sigma value <3 are required strict monitoring and modification in quality control procedure. In this study application of sigma rules provided us the practical solution for improved and focused design of QC procedure.

Environmental Law Deskbook.

DTIC Science & Technology

1995-11-01

jurisdiction of the Department of the Interior’s Bureau of Land Management (BLM). Flue - Gas Desulfurization (FGD). Post-combustion sulfur dioxide control ...National Pollution Discharge Elimination System Permits .......... 11 VIII Individual Control Strategies for Toxic Pollutants (ICS) ........... 14 IX Storm...individual control strategies be integrated into the sources’ NPDES permits. EPA has established water quality standards for a number of toxic

40 CFR 52.2353 - Control strategy: Carbon monoxide.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Carbon monoxide. 52...: Carbon monoxide. Determination. EPA has determined that the Provo carbon monoxide “moderate” nonattainment area attained the carbon monoxide national ambient air quality standard by December 31, 1995. This...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

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

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

PubMed

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

2018-06-01

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

[Colonoscopy quality control as a requirement of colorectal cancer screening].

PubMed

Quintero, Enrique; Alarcón-Fernández, Onofre; Jover, Rodrigo

2013-11-01

The strategies used in population-based colorectal screening strategies culminate in colonoscopy and consequently the success of these programs largely depends on the quality of this diagnostic test. The main factors to consider when evaluating quality are scientific-technical quality, safety, patient satisfaction, and accessibility. Quality indicators allow variability among hospitals, endoscopy units and endoscopists to be determined and can identify those not achieving recommended standards. In Spain, the working group for colonoscopy quality of the Spanish Society of Gastroenterology and the Spanish Society of Gastrointestinal Endoscopy have recently drawn up a Clinical Practice Guideline that contains the available evidence on the quality of screening colonoscopy, as well as the basic requirements that must be met by endoscopy units and endoscopists carrying out this procedure. The implementation of training programs and screening colonoscopy quality controls are strongly recommended to guarantee the success of population-based colorectal cancer screening. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

A Review of Control Strategy of the Large-scale of Electric Vehicles Charging and Discharging Behavior

NASA Astrophysics Data System (ADS)

Kong, Lingyu; Han, Jiming; Xiong, Wenting; Wang, Hao; Shen, Yaqi; Li, Ying

2017-05-01

Large scale access of electric vehicles will bring huge challenges to the safe operation of the power grid, and it’s important to control the charging and discharging of the electric vehicle. First of all, from the electric quality and network loss, this paper points out the influence on the grid caused by electric vehicle charging behaviour. Besides, control strategy of electric vehicle charging and discharging has carried on the induction and the summary from the direct and indirect control. Direct control strategy means control the electric charging behaviour by controlling its electric vehicle charging and discharging power while the indirect control strategy by means of controlling the price of charging and discharging. Finally, for the convenience of the reader, this paper also proposed a complete idea of the research methods about how to study the control strategy, taking the adaptability and possibility of failure of electric vehicle control strategy into consideration. Finally, suggestions on the key areas for future research are put up.

Strategies of performance self-monitoring in automotive production.

PubMed

Faye, Hélène; Falzon, Pierre

2009-09-01

Production in the automotive industry, based on assembly line work, is now characterized by lean manufacturing and customization. This results in greater flexibility and increased quality demands, including worker performance self-monitoring. The objectives of this study are to refine the concept of performance self-monitoring and to characterize the strategies developed by operators to achieve it. Data were collected based on the method of individual auto-confrontation, consisting of two steps: eleven assembly-line operators of a French automotive company were individually observed and video-taped while they were working; an interview then allowed each operator to discuss his/her activity based on the video-tape. This study expands the concept of performance self-monitoring by highlighting three types of strategies directly oriented toward quality: prevention, feedback control and control action strategies.

40 CFR 52.2332 - Control Strategy: Ozone.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 5 2014-07-01 2014-07-01 false Control Strategy: Ozone. 52.2332...: Ozone. Determinations—EPA is determining that, as of July 18, 1995, the Salt Lake and Davis Counties ozone nonattainment area has attained the ozone standard based on air quality monitoring data from 1992...

40 CFR 52.977 - Control strategy and regulations: Ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy and regulations: Ozone... and regulations: Ozone. Determination of Attainment. Effective March 12, 2010 EPA has determined the Baton Rouge 1-hour ozone nonattainment area has attained the 1-hour ozone National Ambient Air Quality...

40 CFR 52.2332 - Control Strategy: Ozone.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 5 2012-07-01 2012-07-01 false Control Strategy: Ozone. 52.2332...: Ozone. Determinations—EPA is determining that, as of July 18, 1995, the Salt Lake and Davis Counties ozone nonattainment area has attained the ozone standard based on air quality monitoring data from 1992...

40 CFR 52.2332 - Control Strategy: Ozone.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 5 2013-07-01 2013-07-01 false Control Strategy: Ozone. 52.2332...: Ozone. Determinations—EPA is determining that, as of July 18, 1995, the Salt Lake and Davis Counties ozone nonattainment area has attained the ozone standard based on air quality monitoring data from 1992...

40 CFR 52.2332 - Control Strategy: Ozone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control Strategy: Ozone. 52.2332...: Ozone. Determinations—EPA is determining that, as of July 18, 1995, the Salt Lake and Davis Counties ozone nonattainment area has attained the ozone standard based on air quality monitoring data from 1992...

40 CFR 52.2332 - Control Strategy: Ozone.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Control Strategy: Ozone. 52.2332...: Ozone. Determinations—EPA is determining that, as of July 18, 1995, the Salt Lake and Davis Counties ozone nonattainment area has attained the ozone standard based on air quality monitoring data from 1992...

40 CFR 52.1475 - Control strategy and regulations: Sulfur oxides.

Code of Federal Regulations, 2012 CFR

2012-07-01

...: Sulfur oxides. 52.1475 Section 52.1475 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.1475 Control strategy and regulations: Sulfur oxides. (a) The requirements of subpart G of this... National Ambient Air Quality Standards for sulfur oxides in the Nevada Intrastate Region. (b) Article 8.1.3...

40 CFR 52.1475 - Control strategy and regulations: Sulfur oxides.

Code of Federal Regulations, 2013 CFR

2013-07-01

...: Sulfur oxides. 52.1475 Section 52.1475 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.1475 Control strategy and regulations: Sulfur oxides. (a) The requirements of subpart G of this... National Ambient Air Quality Standards for sulfur oxides in the Nevada Intrastate Region. (b) Article 8.1.3...

40 CFR 52.1475 - Control strategy and regulations: Sulfur oxides.

Code of Federal Regulations, 2011 CFR

2011-07-01

...: Sulfur oxides. 52.1475 Section 52.1475 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.1475 Control strategy and regulations: Sulfur oxides. (a) The requirements of subpart G of this... National Ambient Air Quality Standards for sulfur oxides in the Nevada Intrastate Region. (b) Article 8.1.3...

40 CFR 52.1475 - Control strategy and regulations: Sulfur oxides.

Code of Federal Regulations, 2014 CFR

2014-07-01

...: Sulfur oxides. 52.1475 Section 52.1475 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.1475 Control strategy and regulations: Sulfur oxides. (a) The requirements of subpart G of this... National Ambient Air Quality Standards for sulfur oxides in the Nevada Intrastate Region. (b) Article 8.1.3...

40 CFR 52.1475 - Control strategy and regulations: Sulfur oxides.

Code of Federal Regulations, 2010 CFR

2010-07-01

...: Sulfur oxides. 52.1475 Section 52.1475 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 52.1475 Control strategy and regulations: Sulfur oxides. (a) The requirements of subpart G of this... National Ambient Air Quality Standards for sulfur oxides in the Nevada Intrastate Region. (b) Article 8.1.3...

Development of a Premium Quality Plasma-derived IVIg (IQYMUNE®) Utilizing the Principles of Quality by Design-A Worked-through Case Study.

PubMed

Paolantonacci, Philippe; Appourchaux, Philippe; Claudel, Béatrice; Ollivier, Monique; Dennett, Richard; Siret, Laurent

2018-01-01

Polyvalent human normal immunoglobulins for intravenous use (IVIg), indicated for rare and often severe diseases, are complex plasma-derived protein preparations. A quality by design approach has been used to develop the Laboratoire Français du Fractionnement et des Biotechnologies new-generation IVIg, targeting a high level of purity to generate an enhanced safety profile while maintaining a high level of efficacy. A modular approach of quality by design was implemented consisting of five consecutive steps to cover all the stages from the product design to the final product control strategy.A well-defined target product profile was translated into 27 product quality attributes that formed the basis of the process design. In parallel, a product risk analysis was conducted and identified 19 critical quality attributes among the product quality attributes. Process risk analysis was carried out to establish the links between process parameters and critical quality attributes. Twelve critical steps were identified, and for each of these steps a risk mitigation plan was established.Among the different process risk mitigation exercises, five process robustness studies were conducted at qualified small scale with a design of experiment approach. For each process step, critical process parameters were identified and, for each critical process parameter, proven acceptable ranges were established. The quality risk management and risk mitigation outputs, including verification of proven acceptable ranges, were used to design the process verification exercise at industrial scale.Finally, the control strategy was established using a mix, or hybrid, of the traditional approach plus elements of the quality by design enhanced approach, as illustrated, to more robustly assign material and process controls and in order to securely meet product specifications.The advantages of this quality by design approach were improved process knowledge for industrial design and process validation and a clear justification of the process and product specifications as a basis for control strategy and future comparability exercises. © PDA, Inc. 2018.

The Impact of Transformer Winding Connections of A Grid-Connected PV on Voltage Quality Improvement

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

Muljadi, Eduard; Tumbelaka, Hanny H.; Gao, Wenzhong

In this paper, the high-power PV plant is connected to the weak grid by means of a three-phase power transformer. The selection of transformer winding connection is critical especially when the PV inverter has a reactive power controller. In general, transformer winding connection can be arranged in star-star (with neutral earthed) or star-delta. The reactive power controller supports voltage regulation of the power system particularly under transient faults. Its control strategy is based on utilizing the grid currents to make a three-phase reactive unbalanced current with a small gain. The gain is determined by the system impedance. Simulation results exhibitmore » that the control strategy works very well particularly under disturbance conditions when the transformer winding connection is star-star with both neutrals grounded. The power quality in terms of the voltage quality is improved.« less

Quality Assurance and School Monitoring in Hong Kong

ERIC Educational Resources Information Center

Mok, Magdalena Mo Ching

2007-01-01

This study reports on the Hong Kong education quality assurance and school monitoring system. Three research questions were addressed: (1) Who controls the quality of school education in Hong Kong? (2) What strategies are used in the Hong Kong school education quality assurance process? (3) Agenda for Future Research on quality assurance and…

Model of refrigerated display-space allocation for multi agro-perishable products considering markdown policy

NASA Astrophysics Data System (ADS)

Satiti, D.; Rusdiansyah, A.

2018-04-01

Problems that need more attention in the agri-food supply chain are loss and waste as consequences from improper quality control and excessive inventories. The use of cold storage is still being one of favourite technologies in controlling product quality by majority of retailers. We considerate the temperature of cold storage in determining the inventory and pricing strategies based on identified product quality. This study aims to minimize the agri-food waste, utility of cold storage facilities and maximize retailer’s profit through determining the refrigerated display-space allocation and markdown policy based on identified food shelf life. The proposed model evaluated with several different scenarios to find out the right strategy.

Quality of life, coping strategies, social support and self-efficacy in women after acute myocardial infarction: a mixed methods approach.

PubMed

Fuochi, G; Foà, C

2018-03-01

Quality of life, coping strategies, social support and self-efficacy are important psychosocial variables strongly affecting the experience of acute myocardial infarction (AMI) in women. To gain a more in-depth understanding of how coping strategies, self-efficacy, quality of life and social support shape women's adjustment to AMI. Mixed methods study. Quantitative data were collected through a standardised questionnaire on coping strategies, self-efficacy, quality of life and social support. Qualitative data stemmed from 57 semistructured interviews conducted with post-AMI female patients on related topics. Quantitative data were analysed with unpaired two-sample t-tests on the means, comparing women who experienced AMI (N = 77) with a control group of women who did not have AMI (N = 173), and pairwise correlations on the AMI sample. Qualitative data were grouped into coding families and analysed through thematic content analysis. Qualitative and quantitative results were then integrated, for different age groups. Quantitative results indicated statistically significant differences between women who experienced AMI and the control group: the former showed lower self-perceived health, perceived social support and social support coping, but greater self-efficacy, use of acceptance, avoidance and religious coping. Pairwise correlations showed that avoidance coping strategy was negatively correlated with quality of life, while the opposite was true for problem-oriented coping, perceived social support and self-efficacy. Qualitative results extended and confirmed quantitative results, except for coping strategies: avoidance coping seemed more present than reported in the standardised measures. Mixed methods provide understanding of the importance of social support, self-efficacy and less avoidant coping strategies to women's adjustment to AMI. Women need support from health professionals with knowledge of these topics, to facilitate their adaptation to AMI. © 2017 Nordic College of Caring Science.

Social Welfare Control in Mobile Crowdsensing Using Zero-Determinant Strategy.

PubMed

Hu, Qin; Wang, Shengling; Bie, Rongfang; Cheng, Xiuzhen

2017-05-03

As a promising paradigm, mobile crowdsensing exerts the potential of widespread sensors embedded in mobile devices. The greedy nature of workers brings the problem of low-quality sensing data, which poses threats to the overall performance of a crowdsensing system. Existing works often tackle this problem with additional function components. In this paper, we systematically formulate the problem into a crowdsensing interaction process between a requestor and a worker, which can be modeled by two types of iterated games with different strategy spaces. Considering that the low-quality data submitted by the workers can reduce the requestor's payoff and further decrease the global income, we turn to controlling the social welfare in the games. To that aim, we take advantage of zero-determinant strategy, based on which we propose two social welfare control mechanisms under both game models. Specifically, we consider the requestor as the controller of the games and, with proper parameter settings for the to-be-adopted zero-determinant strategy, social welfare can be optimized to the desired level no matter what strategy the worker adopts. Simulation results demonstrate that the requestor can achieve the maximized social welfare and keep it stable by using our proposed mechanisms.

Social Welfare Control in Mobile Crowdsensing Using Zero-Determinant Strategy

PubMed Central

Hu, Qin; Wang, Shengling; Bie, Rongfang; Cheng, Xiuzhen

2017-01-01

As a promising paradigm, mobile crowdsensing exerts the potential of widespread sensors embedded in mobile devices. The greedy nature of workers brings the problem of low-quality sensing data, which poses threats to the overall performance of a crowdsensing system. Existing works often tackle this problem with additional function components. In this paper, we systematically formulate the problem into a crowdsensing interaction process between a requestor and a worker, which can be modeled by two types of iterated games with different strategy spaces. Considering that the low-quality data submitted by the workers can reduce the requestor’s payoff and further decrease the global income, we turn to controlling the social welfare in the games. To that aim, we take advantage of zero-determinant strategy, based on which we propose two social welfare control mechanisms under both game models. Specifically, we consider the requestor as the controller of the games and, with proper parameter settings for the to-be-adopted zero-determinant strategy, social welfare can be optimized to the desired level no matter what strategy the worker adopts. Simulation results demonstrate that the requestor can achieve the maximized social welfare and keep it stable by using our proposed mechanisms. PMID:28467370

Quality by design for herbal drugs: a feedforward control strategy and an approach to define the acceptable ranges of critical quality attributes.

PubMed

Yan, Binjun; Li, Yao; Guo, Zhengtai; Qu, Haibin

2014-01-01

The concept of quality by design (QbD) has been widely accepted and applied in the pharmaceutical manufacturing industry. There are still two key issues to be addressed in the implementation of QbD for herbal drugs. The first issue is the quality variation of herbal raw materials and the second issue is the difficulty in defining the acceptable ranges of critical quality attributes (CQAs). To propose a feedforward control strategy and a method for defining the acceptable ranges of CQAs for the two issues. In the case study of the ethanol precipitation process of Danshen (Radix Salvia miltiorrhiza) injection, regression models linking input material attributes and process parameters to CQAs were built first and an optimisation model for calculating the best process parameters according to the input materials was established. Then, the feasible material space was defined and the acceptable ranges of CQAs for the previous process were determined. In the case study, satisfactory regression models were built with cross-validated regression coefficients (Q(2) ) all above 91 %. The feedforward control strategy was applied successfully to compensate the quality variation of the input materials, which was able to control the CQAs in the 90-110 % ranges of the desired values. In addition, the feasible material space for the ethanol precipitation process was built successfully, which showed the acceptable ranges of the CQAs for the concentration process. The proposed methodology can help to promote the implementation of QbD for herbal drugs. Copyright © 2013 John Wiley & Sons, Ltd.

The Quality Movements in Higher Education in the United States.

ERIC Educational Resources Information Center

Miller, Richard I.

1996-01-01

Discussion of various quality control strategies in American higher education looks at and compares Total Quality Management (TQM), outcomes assessment, Deming's 14 points, the Malcolm Baldrige National Quality Award, the ISO 9000 series, restructuring, reengineering, and performance indicators. It is suggested that colleges and universities will…

Strategies for coping with pain presented by adolescents with hematopoietic malignancies.

PubMed

Cepuch, Grazyna; Wojnar-Gruszka, Katarzyna; Kowalczyk, Marta

2012-01-01

Leukaemias and lymphomas are the most common malignant diseases diagnosed among adolescents and they are associated with pain and anxiety. As a result they may affect the way patients accept their disease and determine subjective assessment of quality of life. The objective of this study was to recognise strategies for coping with pain, evaluate the process of accepting the disease and assess quality of life among adolescents diagnosed with hematopoietic malignancies. The study group comprised 66 patients aged between 14 and 21 and diagnosed with leukaemia or lymphoma. The following measuring tools were used: the Pain Coping Strategies Questionnaire (CSQ), Zung Self-Rating Anxiety Scale (SAS), Acceptance of Illness Scale (AIS), and WHOQOL-BREF for quality of life evaluation. Coping self-statements and praying or hoping were the two most common strategies used by our respondents when coping with pain. In the study group the level of anxiety had no influence on pain control and the ability to reduce it. A statistically significant relation was found between the level of catastrophizing as a method of coping with pain and quality of life in the physical domain. An additional correlation was observed between quality of life in the psychological domain and the level of pain control. The ability of coping with pain promotes the acceptance of illness and improves patient's quality of life. The age and duration of the disease were factors affecting strategies for coping with pain. A small percentage of respondents who experienced anxiety suggests that further and deeper research is needed in this field.

Towards an integrated quality control procedure for eddy-covariance data

NASA Astrophysics Data System (ADS)

Vitale, Domenico; Papale, Dario

2017-04-01

The eddy-covariance technique is nowadays the most reliable and direct way, allowing to calculate the main fluxes of Sensible and Latent Heat and of Net Ecosystem Exchange, this last being the result of the difference between the CO2 assimilated by photosynthetic activities and those released to the atmosphere through the ecosystem respiration processes. Despite the improvements in accuracy of measurement instruments and software development, the eddy-covariance technique is not suitable under non-ideal conditions respect to the instruments characteristics and the physical assumption behind the technique mainly related to the well-developed and stationary turbulence conditions. Under these conditions the calculated fluxes are not reliable and need to be flagged and discarded. In order to discover these unavoidable "bad" fluxes and build dataset with the highest quality, several tests applied both on high-frequency (10-20 Hz) raw data and on half-hourly times series have been developed in the past years. Nevertheless, there is an increasing need to develop a standardized quality control procedure suitable not only for the analysis of long-term data, but also for the near-real time data processing. In this paper, we review established quality assessment procedures and present an innovative quality control strategy with the purpose of integrating the existing consolidated procedures with robust and advanced statistical tests more suitable for the analysis of time series data. The performance of the proposed quality control strategy is evaluated both on simulated and EC data distributed by the ICOS research infrastructure. It is concluded that the proposed strategy is able to flag and exclude unrealistic fluxes while being reproducible and retaining the largest possible amount of high quality data.

[Influence of Moxa Smoke on Indoor Air Quality and Strategies for Its Control].

PubMed

Yu, Chang; Wu, Qiao-Feng; Tang, Yong; Yu, Shu-Guang

2018-02-25

Moxibustion is an effective therapy for treatment of a lot of clinical problems, but the ignited moxa-induced smoke containing harmful substances may bring about indoor air pollution to affect both patients' and medical workers' health. However, there is no standards about controlling indoor air quality (IAQ) for moxibustion rooms in China. In the present study, the authors reviewed newly-published articles about some substances released from moxa smoke as inhalable particles (PM 10 and PM 2.5), formaldehyde, benzene, methylbenzene, xylene, bene[α]pyrene, total volatile organic compounds, CO, CO 2 , NO, SO 2 , NH 3 , O 3 , etc. some of which affect IAQ. On this account, the authors put forward some strategies for controlling IAQ in moxibustion clinics including setting united safe standards, enhancing ventilation, controlling moxibustion material quality and strengthening scientific research on the safety of moxa smoke control, fully playing the superiority of moxibustion therapy and reducing its unfavorable aspects in clinical practice in the future.

ATAD control goals through the analysis of process variables and evaluation of quality, production and cost.

PubMed

Nájera, S; Gil-Martínez, M; Zambrano, J A

2015-01-01

The aim of this paper is to establish and quantify different operational goals and control strategies in autothermal thermophilic aerobic digestion (ATAD). This technology appears as an alternative to conventional sludge digestion systems. During the batch-mode reaction, high temperatures promote sludge stabilization and pasteurization. The digester temperature is usually the only online, robust, measurable variable. The average temperature can be regulated by manipulating both the air injection and the sludge retention time. An improved performance of diverse biochemical variables can be achieved through proper manipulation of these inputs. However, a better quality of treated sludge usually implies major operating costs or a lower production rate. Thus, quality, production and cost indices are defined to quantify the outcomes of the treatment. Based on these, tradeoff control strategies are proposed and illustrated through some examples. This paper's results are relevant to guide plant operators, to design automatic control systems and to compare or evaluate the control performance on ATAD systems.

Enhanced Attitude Control Experiment for SSTI Lewis Spacecraft

NASA Technical Reports Server (NTRS)

Maghami, Peoman G.

1997-01-01

The enhanced attitude control system experiment is a technology demonstration experiment on the NASA's small spacecraft technology initiative program's Lewis spacecraft to evaluate advanced attitude control strategies. The purpose of the enhanced attitude control system experiment is to evaluate the feasibility of designing and implementing robust multi-input/multi-output attitude control strategies for enhanced pointing performance of spacecraft to improve the quality of the measurements of the science instruments. Different control design strategies based on modern and robust control theories are being considered for the enhanced attitude control system experiment. This paper describes the experiment as well as the design and synthesis of a mixed H(sub 2)/H(sub infinity) controller for attitude control. The control synthesis uses a nonlinear programming technique to tune the controller parameters and impose robustness and performance constraints. Simulations are carried out to demonstrate the feasibility of the proposed attitude control design strategy. Introduction

A YEAR-LONG MM5 EVALUATION USING A MODEL EVALUATION TOOLKIT

EPA Science Inventory

Air quality modeling has expanded in both sophistication and application over the past decade. Meteorological and air quality modeling tools are being used for research, forecasting, and regulatory related emission control strategies. Results from air quality simulations have far...

Drying based on temperature-detection-assisted control in microwave-assisted pulse-spouted vacuum drying.

PubMed

Cao, Xiaohuang; Zhang, Min; Qian, He; Mujumdar, Arun S

2017-06-01

An online temperature-detection-assisted control system of microwave-assisted pulse-spouted vacuum drying was newly developed. By using this system, temperature control can be automatically and continuously adjusted based on the detection of drying temperature and preset temperature. Various strategies for constant temperature control, linear temperature control and three-step temperature control were applied to drying carrot cubes. Drying kinetics and the quality of various temperature-controlled strategies online are evaluated for the new drying technology as well as its suitability as an alternative drying method. Drying time in 70 °C mode 1 had the shortest drying time and lowest energy consumption in all modes. A suitable colour, highest re-hydration ratio and fracture-hardness, and longest drying time occurred in 30-40-50 °C mode 3. The number of hot spots was reduced in 40-50-60 °C mode 3. Acceptable carrot snacks were obtained in 50-60-70 °C mode 3 and 70 °C mode 2. All temperature curves showed that the actual temperatures followed the preset temperatures appropriately. With this system, a linear temperature-controlled strategy and a three-step temperature-controlled strategy can improve product quality and heating non-uniformity compared to constant temperature control, but need greater energy consumption and longer drying time. A temperature-detection-assisted control system was developed for providing various drying strategies as a suitable alternative in making a snack product. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

EVALUATING AND USING AIR QUALITY MODELS

EPA Science Inventory

Grid-based models are being used to assess the magnitude of the pollution problem and to design emission control strategies to achieve compliance with the relevant air quality standards in the United States.

Evaluation of emission control strategies to reduce ozone pollution in the Paso del Norte region using a photochemical air quality modeling system

NASA Astrophysics Data System (ADS)

Valenzuela, Victor Hugo

Air pollution emissions control strategies to reduce ozone precursor pollutants are analyzed by applying a photochemical modeling system. Simulations of air quality conditions during an ozone episode which occurred in June, 2006 are undertaken by increasing or reducing area source emissions in Ciudad Juarez, Chihuahua, Mexico. Two air pollutants are primary drivers in the formation of tropospheric ozone. Oxides of nitrogen (NOx) and volatile organic compounds (VOC) undergo multiple chemical reactions under favorable meteorological conditions to form ozone, which is a secondary pollutant that irritates respiratory systems in sensitive individuals especially the elderly and young children. The U.S. Environmental Protection Agency established National Ambient Air Quality Standards (NAAQS) to limit ambient air pollutants such as ozone by establishing an 8-hour average concentration of 0.075 ppm as the threshold at which a violation of the standard occurs. Ozone forms primarily due reactions in the troposphere of NOx and VOC emissions generated primarily by anthropogenic sources in urban regions. Data from emissions inventories indicate area sources account for ˜15 of NOx and ˜45% of regional VOC emissions. Area sources include gasoline stations, automotive paint bodyshops and nonroad mobile sources. Multiplicity of air pollution emissions sources provides an opportunity to investigate and potentially implement air quality improvement strategies to reduce emissions which contribute to elevated ozone concentrations. A baseline modeling scenario was established using the CAMx photochemical air quality model from which a series of sensitivity analyses for evaluating air quality control strategies were conducted. Modifications to area source emissions were made by varying NOx and / or VOC emissions in the areas of particular interest. Model performance was assessed for each sensitivity analysis. Normalized bias (NB) and normalized error (NE) were used to identify variability of the PREDICTED to OBSERVED ozone concentrations of both BASELINE model and simulations with modified emissions assessed by the sensitivity analysis. All simulations were found to vary within acceptable ranges of these two criteria variables. Simulation results indicate ozone formation in the PdN region is VOC-limited. Under VOC-limited conditions, modifications to NOx emissions do not produce a marked increase or decrease in ozone concentrations. Modifications to VOC emissions generated the highest variability in ozone concentrations. Increasing VOC emissions by 75% produced results which minimized model bias and error when comparing PREDICTED and OBSERVED ozone concentrations. Increasing VOC emissions by 75% either alone or in combination with a 75% increase in NOx emissions generated PREDICTED ozone concentrations very near to OBSERVED ozone. By evaluating the changes in ambient ozone concentrations through photochemical modeling, air quality planners may identify the most efficient or effective VOC emissions control strategies for area sources. Among the strategies to achieve emissions reductions are installation of gasoline vapor recovery systems, replacing high-pressure low-volume surface coating paint spray guns with high-volume low-pressure spray paint guns, requiring emissions control booths for surface coating operations as well as undertaking solvent management practices, requiring the sale of low VOC paint solvents in the surface-coating industry, and requiring low-VOC solvents in the dry cleaning industry. Other strategies to reduce VOC emissions include initiating Eco-Driving strategies to reduce fuel consumption from mobile sources and minimize vehicle idling at the international ports of entry by reducing bridge wait times. This dissertation depicts a tool for evaluating impacts of emissions on regional air quality by addressing the highly unresolved fugitive emissions in the Paso del Norte region. It provides a protocol for decision makers to assess the effects of various emission control strategies in the region. Impacts of specific source categories such as the international ports of entry, gasoline stations, paint body shops, truck stops, and military installations on the regional air quality can be easily and systematically addressed in a timely manner in the future.

New approach for quality control in manufacturing process

NASA Astrophysics Data System (ADS)

Hanzah, Muhammad Radhi bin; Rahim, Wan Mohd Faizal Wan Abd; Khor, C. Y.; Ishak, Muhammad Ikman; Rosli, M. U.; Jamalludin, Mohd Riduan; Zakaria, M. S.; Nawi, M. A. M.

2017-09-01

This study was regulated exclusively in view of theoretical aspect and further research should be done to demonstrate it in the genuine circumstance. The structure of this investigation including two industrial visits, i.e. interviews and meeting with approved staff from each organization agents. This review is cut up into two sections. Aside from the perception, little gatherings with the staffs from both organizations are held. With the subtle elements, the review is begun up. The aim of the study is characterized as to enhance the assessment strategy at quality control station to minimize defect outflow to the following client. This is to investigate the underlying factor in ebb and flow quality control framework so that another strategy to enhance quality control framework can implemented. Quality is a basic characteristic to be instated so that the end goal to fulfill clients' need is achieved. After a long hypothetical review is made, the best answer for be actualized at QG station to beat defects outflow to the following customer is by photoelectric sensor. It is reasonable, simple to keep up and has a high affectability to identify the defective items at the QG station.

Quality control in gastrointestinal surgery.

PubMed

Ramírez-Barba, Ector Jaime; Arenas-Moya, Diego; Vázquez-Guerrero, Arturo

2011-01-01

We analyzed the Mexican legal framework, identifying the vectors that characterize quality and control in gastrointestinal surgery. Quality is contemplated in the health protection rights determined according to the Mexican Constitution, established in the general health law and included as a specific goal in the actual National Development Plan and Health Sector Plan. Quality control implies planning, verification and application of corrective measures. Mexico has implemented several quality strategies such as certification of hospitals and regulatory agreements by the General Salubrity Council, creation of the National Health Quality Committee, generation of Clinical Practice Guidelines and the Certification of Medical Specialties, among others. Quality control in gastrointestinal surgery must begin at the time of medical education and continue during professional activities of surgeons, encouraging multidisciplinary teamwork, knowledge, abilities, attitudes, values and skills that promote homogeneous, safe and quality health services for the Mexican population.

Modeling in the quality by design environment: Regulatory requirements and recommendations for design space and control strategy appointment.

PubMed

Djuris, Jelena; Djuric, Zorica

2017-11-30

Mathematical models can be used as an integral part of the quality by design (QbD) concept throughout the product lifecycle for variety of purposes, including appointment of the design space and control strategy, continual improvement and risk assessment. Examples of different mathematical modeling techniques (mechanistic, empirical and hybrid) in the pharmaceutical development and process monitoring or control are provided in the presented review. In the QbD context, mathematical models are predominantly used to support design space and/or control strategies. Considering their impact to the final product quality, models can be divided into the following categories: high, medium and low impact models. Although there are regulatory guidelines on the topic of modeling applications, review of QbD-based submission containing modeling elements revealed concerns regarding the scale-dependency of design spaces and verification of models predictions at commercial scale of manufacturing, especially regarding real-time release (RTR) models. Authors provide critical overview on the good modeling practices and introduce concepts of multiple-unit, adaptive and dynamic design space, multivariate specifications and methods for process uncertainty analysis. RTR specification with mathematical model and different approaches to multivariate statistical process control supporting process analytical technologies are also presented. Copyright © 2017 Elsevier B.V. All rights reserved.

Protein quality control system in neurodegeneration: a healing company hard to beat but failure is fatal.

PubMed

Chhangani, Deepak; Mishra, Amit

2013-08-01

A common feature in most neurodegenerative diseases and aging is the progressive accumulation of damaged proteins. Proteins are essential for all crucial biological functions. Under some notorious conditions, proteins loss their three dimensional native conformations and are converted into disordered aggregated structures. Such changes rise into pathological conditions and eventually cause serious protein conformation disorders. Protein aggregation and inclusion bodies formation mediated multifactorial proteotoxic stress has been reported in the progression of Parkinson's disease (PD), Huntington's disease (HD), Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS) and Prion disease. Ongoing studies have been remarkably informative in providing a systematic outlook for better understanding the concept and fundamentals of protein misfolding and aggregations. However, the precise role of protein quality control system and precursors of this mechanism remains elusive. In this review, we highlight recent insights and discuss emerging cytoprotective strategies of cellular protein quality control system implicated in protein deposition diseases. Our current review provides a clear, understandable framework of protein quality control system that may offer the more suitable therapeutic strategies for protein-associated diseases.

Image quality prediction - An aid to the Viking lander imaging investigation on Mars

NASA Technical Reports Server (NTRS)

Huck, F. O.; Wall, S. D.

1976-01-01

Image quality criteria and image quality predictions are formulated for the multispectral panoramic cameras carried by the Viking Mars landers. Image quality predictions are based on expected camera performance, Mars surface radiance, and lighting and viewing geometry (fields of view, Mars lander shadows, solar day-night alternation), and are needed in diagnosis of camera performance, in arriving at a preflight imaging strategy, and revision of that strategy should the need arise. Landing considerations, camera control instructions, camera control logic, aspects of the imaging process (spectral response, spatial response, sensitivity), and likely problems are discussed. Major concerns include: degradation of camera response by isotope radiation, uncertainties in lighting and viewing geometry and in landing site local topography, contamination of camera window by dust abrasion, and initial errors in assigning camera dynamic ranges (gains and offsets).

A randomized controlled trial of movement strategies compared with exercise for people with Parkinson's disease.

PubMed

Morris, Meg E; Iansek, Robert; Kirkwood, Beth

2009-01-15

This randomized controlled clinical trial was conducted to compare the effects of movement rehabilitation strategies and exercise therapy in hospitalized patients with idiopathic Parkinson's disease. Participants were randomly assigned to a group that received movement strategy training or musculoskeletal exercises during 2 consecutive weeks of hospitalization. The primary outcome was disability as measured by the Unified Parkinson's Disease Rating Scale, UPDRS (motor and ADL components). Secondary outcomes were balance, walking speed, endurance, and quality of life. Assessments were carried out by blinded testers at baseline, after the 2 weeks of treatment and 3 months after discharge. The movement strategy group showed improvements on several outcome measures from admission to discharge, including the UPDRS, 10 m walk, 2 minute walk, balance, and PDQ39. However, from discharge to follow up there was significant regression in performance on the 2 minute walk and PDQ39. For the exercise group, quality of life improved significantly during inpatient hospitalization and this was retained at follow-up. Inpatient rehabilitation produces short term reductions in disability and improvements in quality of life in people with Parkinson's disease.

Temporal and spatial changes of water quality and management strategies of Dianchi Lake in southwest China

NASA Astrophysics Data System (ADS)

Zhang, T.; Zeng, W. H.; Wang, S. R.; Ni, Z. K.

2013-12-01

Temporal and spatial changes to the water quality of Dianchi Lake in Southwest China were investigated using monthly monitoring data from 2005 to 2012. Based on the analysis of total phosphorus (TP), total nitrogen (TN), and chlorophyll a (Chl a) concentrations, it was determined that, in Caohai Lake, the annual concentrations of these variables ranged from 0.19-1.46, 6.11-16.79, 0.06-0.14 mg L-1, respectively. In addition, the annual concentrations of TP, TN and Chl a in Waihai Lake ranged between 0.13-0.20, 1.82-3.01, 0.04-0.09 mg L-1, respectively. Cluster Analysis (CA) classified the 10 monitoring sites into two groups (group A and group B) based on similarities of water quality characteristics. Our data revealed that the current status of water quality within Caohai Lake was much worse than that of Waihai Lake. Water quality was seriously degraded during the economic boom near the period of the "Eleventh Five-Year Plan" (2005-2010), and gradually improved from 2010 to 2012 because of the "standard emission directive to industry". The main factors that influenced the spatial and temporal changes to water quality were natural factors including lake evolution and regional characteristic as well as human factors such as pollution load into the lake and management strategies that were already adopted. Some activities and regulations were implemented to enhance the lake environment by controlling wastewater emissions and establishing regulations to protect the lakes in the Yunnan Province. However, problems with institutional fragmentation (horizontal and vertical), simple treatment methods, low-intensity investment in pollution control, and lack of meaningful endogenous pollution control strategies were still present in the lake management strategy. To solve these problems, suitable control measures are needed, especially considering the current old-age status of Dianchi Lake. The fundamental improvement of the water quality within Caohai Lake was dependent on the measures taken in the upper reaches of the Caohai Watershed, including further recovery of submerged plants, resource utilization by floating plants and the reinforcement of sediment disposal. Management strategies for endogenous pollution in Waihai Lake were mainly dependent on restocking algae-eating fish and the ecological restoration of macrophytes. In this way, the swamping trend and the ageing process that is occurring in Dianchi Lake can be stunted.

An experimental search strategy retrieves more precise results than PubMed and Google for questions about medical interventions

PubMed Central

Dylla, Daniel P.; Megison, Susan D.

2015-01-01

Objective. We compared the precision of a search strategy designed specifically to retrieve randomized controlled trials (RCTs) and systematic reviews of RCTs with search strategies designed for broader purposes. Methods. We designed an experimental search strategy that automatically revised searches up to five times by using increasingly restrictive queries as long at least 50 citations were retrieved. We compared the ability of the experimental and alternative strategies to retrieve studies relevant to 312 test questions. The primary outcome, search precision, was defined for each strategy as the proportion of relevant, high quality citations among the first 50 citations retrieved. Results. The experimental strategy had the highest median precision (5.5%; interquartile range [IQR]: 0%–12%) followed by the narrow strategy of the PubMed Clinical Queries (4.0%; IQR: 0%–10%). The experimental strategy found the most high quality citations (median 2; IQR: 0–6) and was the strategy most likely to find at least one high quality citation (73% of searches; 95% confidence interval 68%–78%). All comparisons were statistically significant. Conclusions. The experimental strategy performed the best in all outcomes although all strategies had low precision. PMID:25922798

Role of photoexcited nitrogen dioxide chemistry on ozone formation and emission control strategy over the Pearl River Delta, China

EPA Science Inventory

A new hydroxyl radical formation pathway via photo-excited nitrogen dioxide chemistry is incorporated into a chemistry-only box model as well as a 3D air quality model to examine its potential role on ozone formation and emission control strategy over the Pearl River Delta region...

Master Pump Shutdown MPS Software Quality Assurance Plan (SQAP)

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

BEVINS, R.R.

2000-09-20

The MPSS Software Quality Assurance (SQAP) describes the tools and strategy used in the development of the MPSS software. The document also describes the methodology for controlling and managing changes to the software.

Managing Air Quality - Program Implementation

EPA Pesticide Factsheets

Describes elements for the set of activities to ensure that control strategies are put into effect and that air quality goals and standards are fulfilled, permitting programs, and additional resources related to implementation under the Clean Air Act.

Discrimination and identification of Q-markers based on 'Spider-web' mode for quality control of traditional Chinese medicine.

PubMed

Jiang, Zhenzuo; Yang, Jing; Wang, Yuefei

2017-12-28

The safety and effectiveness of traditional Chinese medicine (TCM) in clinical practice is directly related to the quality of TCM. And, the quality control of TCM is a pivotal issue to the quality of TCM, but also an obstacle impeding the modernization of TCM. The purpose of this work is to compile and develop a strategy based on discrimination and identification of quality markers (Q-markers) for quality control of TCM. Mainly established by seven variables derived from four dimensions including content, stability, pharmacokinetics and pharmacology, the 'Spider-web' mode was undertaken to assess the Q-marker property of candidate compounds originated from TCM by taking regression area (A) and coefficient variation (CV) of the tested compounds into account. The importance index (ImI), ImI = A × 1/CV, was suggested to focus Q-markers. The compounds with larger regression area (A) and less coefficient variation (CV) are preferentially adopted as Q-markers, which should possess the satisfactory properties of content, stability, pharmacokinetics and pharmacological activity. To the contrary, the compounds are excluded on the grounds of the unsatisfactory Q-markers' property, less regression area (A) and larger coefficient variation (CV), which cannot represent the quality of TCM. The 'Spider-web' mode can filter out the redundant constituents and focus on the key indexes of quality control - Q-markers. The screened Q-markers possess the optimal integrated properties of content, stability, pharmacokinetics and pharmacology among the numerous and complicated ingredients of TCM, which can comprehensively characterize inherent quality of TCM. In summary, the novel strategy established in this work provides a valuable perspective for the quality control of TCM. Copyright © 2017 Elsevier GmbH. All rights reserved.

Viral Evasion and Manipulation of Host RNA Quality Control Pathways

PubMed Central

2016-01-01

Viruses have evolved diverse strategies to maximize the functional and coding capacities of their genetic material. Individual viral RNAs are often used as substrates for both replication and translation and can contain multiple, sometimes overlapping open reading frames. Further, viral RNAs engage in a wide variety of interactions with both host and viral proteins to modify the activities of important cellular factors and direct their own trafficking, packaging, localization, stability, and translation. However, adaptations increasing the information density of small viral genomes can have unintended consequences. In particular, viral RNAs have developed features that mark them as potential targets of host RNA quality control pathways. This minireview focuses on ways in which viral RNAs run afoul of the cellular mRNA quality control and decay machinery, as well as on strategies developed by viruses to circumvent or exploit cellular mRNA surveillance. PMID:27226372

Viral Evasion and Manipulation of Host RNA Quality Control Pathways.

PubMed

Hogg, J Robert

2016-08-15

Viruses have evolved diverse strategies to maximize the functional and coding capacities of their genetic material. Individual viral RNAs are often used as substrates for both replication and translation and can contain multiple, sometimes overlapping open reading frames. Further, viral RNAs engage in a wide variety of interactions with both host and viral proteins to modify the activities of important cellular factors and direct their own trafficking, packaging, localization, stability, and translation. However, adaptations increasing the information density of small viral genomes can have unintended consequences. In particular, viral RNAs have developed features that mark them as potential targets of host RNA quality control pathways. This minireview focuses on ways in which viral RNAs run afoul of the cellular mRNA quality control and decay machinery, as well as on strategies developed by viruses to circumvent or exploit cellular mRNA surveillance. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

A Systematic Review of Relaxation, Meditation, and Guided Imagery Strategies for Symptom Management in Heart Failure

PubMed Central

Kwekkeboom, Kristine L.; Bratzke, Lisa C.

2015-01-01

Background Pain, dyspnea, fatigue, and sleep disturbance are prevalent and distressing symptoms in persons with advanced heart failure. Although many lifestyle and self-care interventions have been developed to control heart failure progression, very few studies have explored treatments exclusively for symptom palliation. Cognitive-behavioral strategies may be effective treatment for these symptoms in advanced heart failure. Objective A systemic review was conducted to describe the effect of cognitive-behavioral strategies on pain, dyspnea, fatigue, and sleep disturbance in patients with heart failure. Methods CINAHL, Medline, and PsychINFO were searched from inception through December 2014. Articles were selected for inclusion if they tested a cognitive-behavioral strategy using a quasi-experimental or experimental design, involved a sample of adults with heart failure, and measured pain, dyspnea, fatigue, sleep disturbance, or symptom-related quality of life (QoL). The two authors evaluated study quality, abstracted data elements from each study, and synthesized findings. Results Thirteen articles describing nine unique studies met criteria and were included in the review. Five studies tested relaxation strategies, three tested meditation strategies, and one tested a guided imagery strategy. Seven of the nine studies demonstrated some improvement in symptom outcomes. Relaxation, meditation, guided imagery, or combinations of these strategies resulted in less dyspnea and better sleep compared to attention control or usual care conditions, and reduced pain, dyspnea, fatigue and sleep disturbance within treatment groups (pre- to post-treatment). Symptom-related QoL was improved with meditation compared to attention control and usual care conditions, and improved pre- to post-guided imagery. Conclusions Studies exploring cognitive-behavioral symptom management strategies in heart failure vary in quality and report mixed findings, but indicate potential beneficial effects of relaxation, meditation, and guided imagery on heart failure-related symptoms. Future research should test cognitive-behavioral strategies in rigorously designed efficacy trials, using samples selected for their symptom experience, and measure pain, dyspnea, fatigue, and sleep disturbance outcomes with targeted symptom measures. PMID:26065388

Flexible NO(x) abatement from power plants in the eastern United States.

PubMed

Sun, Lin; Webster, Mort; McGaughey, Gary; McDonald-Buller, Elena C; Thompson, Tammy; Prinn, Ronald; Ellerman, A Denny; Allen, David T

2012-05-15

Emission controls that provide incentives for maximizing reductions in emissions of ozone precursors on days when ozone concentrations are highest have the potential to be cost-effective ozone management strategies. Conventional prescriptive emissions controls or cap-and-trade programs consider all emissions similarly regardless of when they occur, despite the fact that contributions to ozone formation may vary. In contrast, a time-differentiated approach targets emissions reductions on forecasted high ozone days without imposition of additional costs on lower ozone days. This work examines simulations of such dynamic air quality management strategies for NO(x) emissions from electric generating units. Results from a model of day-specific NO(x) pricing applied to the Pennsylvania-New Jersey-Maryland (PJM) portion of the northeastern U.S. electrical grid demonstrate (i) that sufficient flexibility in electricity generation is available to allow power production to be switched from high to low NO(x) emitting facilities, (ii) that the emission price required to induce EGUs to change their strategies for power generation are competitive with other control costs, (iii) that dispatching strategies, which can change the spatial and temporal distribution of emissions, lead to ozone concentration reductions comparable to other control technologies, and (iv) that air quality forecasting is sufficiently accurate to allow EGUs to adapt their power generation strategies.

78 FR 28221 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Healthcare... Healthcare Quality Promotion, the Director, National Center for Emerging and Zoonotic Infectious Diseases... healthcare infection prevention and control; (2) strategies for surveillance, prevention, and control of...

Why is quality estimation judgment fast? Comparison of gaze control strategies in quality and difference estimation tasks

NASA Astrophysics Data System (ADS)

Radun, Jenni; Leisti, Tuomas; Virtanen, Toni; Nyman, Göte; Häkkinen, Jukka

2014-11-01

To understand the viewing strategies employed in a quality estimation task, we compared two visual tasks-quality estimation and difference estimation. The estimation was done for a pair of natural images having small global changes in quality. Two groups of observers estimated the same set of images, but with different instructions. One group estimated the difference in quality and the other the difference between image pairs. The results demonstrated the use of different visual strategies in the tasks. The quality estimation was found to include more visual planning during the first fixation than the difference estimation, but afterward needed only a few long fixations on the semantically important areas of the image. The difference estimation used many short fixations. Salient image areas were mainly attended to when these areas were also semantically important. The results support the hypothesis that these tasks' general characteristics (evaluation time, number of fixations, area fixated on) show differences in processing, but also suggest that examining only single fixations when comparing tasks is too narrow a view. When planning a subjective experiment, one must remember that a small change in the instructions might lead to a noticeable change in viewing strategy.

Public Health Interventions for Aedes Control in the Time of Zikavirus– A Meta-Review on Effectiveness of Vector Control Strategies

PubMed Central

Bouzid, Maha; Brainard, Julii; Hooper, Lee; Hunter, Paul R.

2016-01-01

Background There is renewed interest in effective measures to control Zika and dengue vectors. A synthesis of published literature with a focus on the quality of evidence is warranted to determine the effectiveness of vector control strategies. Methodology We conducted a meta-review assessing the effectiveness of any Aedes control measure. We searched Scopus and Medline for relevant reviews through to May 2016. Titles, abstracts and full texts were assessed independently for inclusion by two authors. Data extraction was performed in duplicate and validity of the evidence was assessed using GRADE criteria. Findings 13 systematic reviews that investigated the effect of control measures on entomological parameters or disease incidence were included. Biological controls seem to achieve better reduction of entomological indices than chemical controls, while educational campaigns can reduce breeding habitats. Integrated vector control strategies may not always increase effectiveness. The efficacy of any control programme is dependent on local settings, intervention type, resources and study duration, which may partly explain the varying degree of success between studies. Nevertheless, the quality of evidence was mostly low to very low due to poor reporting of study design, observational methodologies, heterogeneity, and indirect outcomes, thus hindering an evidence-based recommendation. Conclusions The evidence for the effectiveness of Aedes control measures is mixed. Chemical control, which is commonly used, does not appear to be associated with sustainable reductions of mosquito populations over time. Indeed, by contributing to a false sense of security, chemical control may reduce the effectiveness of educational interventions aimed at encouraging local people to remove mosquito breeding sites. Better quality studies of the impact of vector control interventions on the incidence of human infections with Dengue or Zika are still needed. PMID:27926934

Fault-Tolerant Control of ANPC Three-Level Inverter Based on Order-Reduction Optimal Control Strategy under Multi-Device Open-Circuit Fault.

PubMed

Xu, Shi-Zhou; Wang, Chun-Jie; Lin, Fang-Li; Li, Shi-Xiang

2017-10-31

The multi-device open-circuit fault is a common fault of ANPC (Active Neutral-Point Clamped) three-level inverter and effect the operation stability of the whole system. To improve the operation stability, this paper summarized the main solutions currently firstly and analyzed all the possible states of multi-device open-circuit fault. Secondly, an order-reduction optimal control strategy was proposed under multi-device open-circuit fault to realize fault-tolerant control based on the topology and control requirement of ANPC three-level inverter and operation stability. This control strategy can solve the faults with different operation states, and can works in order-reduction state under specific open-circuit faults with specific combined devices, which sacrifices the control quality to obtain the stability priority control. Finally, the simulation and experiment proved the effectiveness of the proposed strategy.

Conflict Resolution in Mexican-Origin Couples: Culture, Gender, and Marital Quality

ERIC Educational Resources Information Center

Wheeler, Lorey A.; Updegraff, Kimberly A.; Thayer, Shawna M.

2010-01-01

This study examined associations between Mexican-origin spouses' conflict resolution strategies (i.e., nonconfrontation, solution orientation, and control) and (a) gender-typed qualities and attitudes, (b) cultural orientations, and (c) marital quality in a sample of 227 couples. Results of multilevel modeling revealed that Mexican cultural…

78 FR 70497 - Approval and Promulgation of Air Quality Implementation Plans; Illinois

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

...] Approval and Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection... VOC for purposes of preparing SIPs to attain the national ambient air quality standard for ozone [email protected] . 3. Fax: (312) 692-2450. 4. Mail: Pamela Blakley, Chief, Control Strategies Section, Air...

40 CFR 52.1126 - Control strategy: Sulfur oxides.

Code of Federal Regulations, 2012 CFR

2012-07-01

... granted by the Massachusetts Department of Environmental Quality Engineering.) Massachusetts Mutual Life... stack). Central Massachusetts APCD Borden, Inc., Chemical Division, Leominster (conditioned upon first... Department of Environmental Quality Engineering.). Gardner State Hospital, Gardner. Grafton State Hospital...

40 CFR 52.1126 - Control strategy: Sulfur oxides.

Code of Federal Regulations, 2010 CFR

2010-07-01

... granted by the Massachusetts Department of Environmental Quality Engineering.) Massachusetts Mutual Life... stack). Central Massachusetts APCD Borden, Inc., Chemical Division, Leominster (conditioned upon first... Department of Environmental Quality Engineering.). Gardner State Hospital, Gardner. Grafton State Hospital...

40 CFR 52.1126 - Control strategy: Sulfur oxides.

Code of Federal Regulations, 2011 CFR

2011-07-01

... granted by the Massachusetts Department of Environmental Quality Engineering.) Massachusetts Mutual Life... stack). Central Massachusetts APCD Borden, Inc., Chemical Division, Leominster (conditioned upon first... Department of Environmental Quality Engineering.). Gardner State Hospital, Gardner. Grafton State Hospital...

Protein Quality Control and the Amyotrophic Lateral Sclerosis/Frontotemporal Dementia Continuum

PubMed Central

Shahheydari, Hamideh; Ragagnin, Audrey; Walker, Adam K.; Toth, Reka P.; Vidal, Marta; Jagaraj, Cyril J.; Perri, Emma R.; Konopka, Anna; Sultana, Jessica M.; Atkin, Julie D.

2017-01-01

Protein homeostasis, or proteostasis, has an important regulatory role in cellular function. Protein quality control mechanisms, including protein folding and protein degradation processes, have a crucial function in post-mitotic neurons. Cellular protein quality control relies on multiple strategies, including molecular chaperones, autophagy, the ubiquitin proteasome system, endoplasmic reticulum (ER)-associated degradation (ERAD) and the formation of stress granules (SGs), to regulate proteostasis. Neurodegenerative diseases are characterized by the presence of misfolded protein aggregates, implying that protein quality control mechanisms are dysfunctional in these conditions. Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are neurodegenerative diseases that are now recognized to overlap clinically and pathologically, forming a continuous disease spectrum. In this review article, we detail the evidence for dysregulation of protein quality control mechanisms across the whole ALS-FTD continuum, by discussing the major proteins implicated in ALS and/or FTD. We also discuss possible ways in which protein quality mechanisms could be targeted therapeutically in these disorders and highlight promising protein quality control-based therapeutics for clinical trials. PMID:28539871

Sibling relationship quality moderates the associations between parental interventions and siblings' independent conflict strategies and outcomes.

PubMed

Recchia, Holly E; Howe, Nina

2009-08-01

This study extends research on sibling conflict strategies and outcomes by examining unique and interactive associations with age, relative birth order, sibling relationship quality, and caregivers' interventions into conflict. Each of 62 sibling dyads (older sibling mean age = 8.39 years; younger sibling mean age = 6.06 years) discussed 1 recurring conflict alone (dyadic negotiation) and a 2nd conflict with their primary parental caregiver (triadic negotiation). Negotiations were coded for children's conflict strategies, outcomes, and caregiver interventions; each family member provided ratings of sibling relationship quality. Results revealed that age was associated with siblings' constructive strategies, particularly in the dyadic negotiation. With age controlled, younger siblings referred more frequently to their own perspective. Caregivers' future orientation in the triadic negotiation was associated with children's future orientation in the dyadic negotiation; however, this association was most evident when sibling relationship quality was high. Similarly, caregivers' past orientation was positively associated with dyadic compromise, especially when relationship quality was high. Results reveal the value of simultaneously considering associations among parental, affective, and developmental correlates of sibling conflict strategies. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Evaluating the Effectiveness of Two Teaching Strategies to Improve Nursing Students' Knowledge, Skills, and Attitudes About Quality Improvement and Patient Safety.

PubMed

Maxwell, Karen L; Wright, Vivian H

The purpose of this study was to evaluate two teaching strategies with regard to quality and safety education for nurses content on quality improvement and safety. Two groups (total of 64 students) participated in online learning or online learning in conjunction with a flipped classroom. A pretest/posttest control group design was used. The use of online modules in conjunction with the flipped classroom had a greater effect on increasing nursing students' knowledge of quality improvement than the use of online modules only. There was no statistically significant difference between the groups for safety.

Development, optimization and validation of gas chromatographic fingerprinting of Brazilian commercial diesel fuel for quality control.

PubMed

dos Santos, Bruno César Diniz Brito; Flumignan, Danilo Luiz; de Oliveira, José Eduardo

2012-10-01

A three-step development, optimization and validation strategy is described for gas chromatography (GC) fingerprints of Brazilian commercial diesel fuel. A suitable GC-flame ionization detection (FID) system was selected to assay a complex matrix such as diesel. The next step was to improve acceptable chromatographic resolution with reduced analysis time, which is recommended for routine applications. Full three-level factorial designs were performed to improve flow rate, oven ramps, injection volume and split ratio in the GC system. Finally, several validation parameters were performed. The GC fingerprinting can be coupled with pattern recognition and multivariate regressions analyses to determine fuel quality and fuel physicochemical parameters. This strategy can also be applied to develop fingerprints for quality control of other fuel types.

Functional specialization in regulation and quality control in thermal adaptive evolution.

PubMed

Yama, Kazuma; Matsumoto, Yuki; Murakami, Yoshie; Seno, Shigeto; Matsuda, Hideo; Gotoh, Kazuyoshi; Motooka, Daisuke; Nakamura, Shota; Ying, Bei-Wen; Yomo, Tetsuya

2015-11-01

Distinctive survival strategies, specialized in regulation and in quality control, were observed in thermal adaptive evolution with a laboratory Escherichia coli strain. The two specialists carried a single mutation either within rpoH or upstream of groESL, which led to the activated global regulation by sigma factor 32 or an increased amount of GroEL/ES chaperonins, respectively. Although both specialists succeeded in thermal adaptation, the common winner of the evolution was the specialist in quality control, that is, the strategy of chaperonin-mediated protein folding. To understand this evolutionary consequence, multilevel analyses of cellular status, for example, transcriptome, protein and growth fitness, were carried out. The specialist in quality control showed less change in transcriptional reorganization responding to temperature increase, which was consistent with the finding of that the two specialists showed the biased expression of molecular chaperones. Such repressed changes in gene expression seemed to be advantageous for long-term sustainability because a specific increase in chaperonins not only facilitated the folding of essential gene products but also saved cost in gene expression compared with the overall transcriptional increase induced by rpoH regulation. Functional specialization offered two strategies for successful thermal adaptation, whereas the evolutionary advantageous was more at the points of cost-saving in gene expression and the essentiality in protein folding. © 2015 The Authors. Genes to Cells published by Molecular Biology Society of Japan and Wiley Publishing Asia Pty Ltd.

Developing a consumer evaluation tool of weight control strategy advertisements on the Internet.

PubMed

Luevorasirikul, Kanokrat; Gray, Nicola J; Anderson, Claire W

2008-06-01

To develop two evaluation tools for weight loss and weight gain advertisements on the Internet in order to help consumers to evaluate the quality of information within these advertisements. One hundred websites identified by Internet search engines for weight loss and weight gain strategies (50 websites each) were evaluated using two specific scoring instruments, developed by adapting questions from the 'DISCERN' tool and reviewing all related weight control guidelines and advertising regulations. The validity and reliability of the adapted tools were tested. Our evaluation tools rated the information from most websites as poor quality (70%). In the case of weight loss strategies, statements about rapid (18%) and permanent (28%) weight loss caused concern as well as lack of sensible advice about dieting and a lack of product warnings (84%). Safety concerns relating to weight gain products were the lack of warnings about side effects in products containing steroids and creatine (92%). The adapted tools exhibited acceptable validity and reliability. Quality of information within weight control advertisements on the Internet was generally poor. Problems of false claims, little advice on healthy ways to modify weight and few warnings on side effects have been highlighted in this study.

Quality of mass-reared codling moth (Lepidoptera: Tortricidae) after long distance transportation 1. Logistics of shipping procedures and quality parameters as measured in the laboratory.

USDA-ARS?s Scientific Manuscript database

The sterile insect technique is a proven effective control tactic against lepidopteran pests when applied in an area-wide integrated pest management programme. The construction of insect mass-rearing facilities requires considerable investment and moth control strategies that include the use of ster...

Feedback on end-of-life care in dementia: the study protocol of the FOLlow-up project.

PubMed

Boogaard, Jannie A; van Soest-Poortvliet, Mirjam C; Anema, Johannes R; Achterberg, Wilco P; Hertogh, Cees M P M; de Vet, Henrica C W; van der Steen, Jenny T

2013-08-07

End-of-life care in dementia in nursing homes is often found to be suboptimal. The Feedback on End-of-Life care in dementia (FOLlow-up) project tests the effectiveness of audit- and feedback to improve the quality of end-of-life care in dementia. Nursing homes systematically invite the family after death of a resident with dementia to provide feedback using the End-of-Life in Dementia (EOLD) - instruments. Two audit- and feedback strategies are designed and tested in a three-armed Randomized Controlled Trial (RCT): a generic feedback strategy using cumulative EOLD-scores of a group of patients and a patient specific feedback strategy using EOLD-scores on a patient level. A total of 18 nursing homes, three groups of six homes matched on size, geographic location, religious affiliation and availability of a palliative care unit were randomly assigned to an intervention group or the control group. The effect on quality of care and quality of dying and the barriers and facilitators of audit- and feedback in the nursing home setting are evaluated using mixed-method analyses. The FOLlow-up project is the first study to assess and compare the effect of two audit- and feedback strategies to improve quality of care and quality of dying in dementia. The results contribute to the development of practice guidelines for nursing homes to monitor and improve care outcomes in the realm of end-of-life care in dementia. The Netherlands National Trial Register (NTR). NTR3942.

Comparison of Image Quality and Radiation Dose of Coronary Computed Tomography Angiography Between Conventional Helical Scanning and a Strategy Incorporating Sequential Scanning

PubMed Central

Einstein, Andrew J.; Wolff, Steven D.; Manheimer, Eric D.; Thompson, James; Terry, Sylvia; Uretsky, Seth; Pilip, Adalbert; Peters, M. Robert

2009-01-01

Radiation dose from coronary computed tomography angiography may be reduced using a sequential scanning protocol rather than a conventional helical scanning protocol. Here we compare radiation dose and image quality from coronary computed tomography angiography in a single center between an initial period during which helical scanning with electrocardiographically-controlled tube current modulation was used for all patients (n=138) and after adoption of a strategy incorporating sequential scanning whenever appropriate (n=261). Using the sequential-if-appropriate strategy, sequential scanning was employed in 86.2% of patients. Compared to the helical-only strategy, this strategy was associated with a 65.1% dose reduction (mean dose-length product of 305.2 vs. 875.1 and mean effective dose of 14.9 mSv vs. 5.2 mSv, respectively), with no significant change in overall image quality, step artifacts, motion artifacts, or perceived image noise. For the 225 patients undergoing sequential scanning, the dose-length product was 201.9 ± 90.0 mGy·cm, while for patients undergoing helical scanning under either strategy, the dose-length product was 890.9 ± 293.3 mGy·cm (p<0.0001), corresponding to mean effective doses of 3.4 mSv and 15.1 mSv, respectively, a 77.5% reduction. Image quality was significantly greater for the sequential studies, reflecting the poorer image quality in patients undergoing helical scanning in the sequential-if-appropriate strategy. In conclusion, a sequential-if-appropriate diagnostic strategy reduces dose markedly compared to a helical-only strategy, with no significant difference in image quality. PMID:19892048

Predicting Future-Year Ozone Concentrations: Integrated Observational-Modeling Approach for Probabilistic Evaluation of the Efficacy of Emission Control strategies

EPA Science Inventory

Regional-scale air quality models are being used to demonstrate attainment of the ozone air quality standard. In current regulatory applications, a regional-scale air quality model is applied for a base year and a future year with reduced emissions using the same meteorological ...

Scale Issues in Air Quality Modeling Policy Support

EPA Science Inventory

This study examines the issues relating to the use of regional photochemical air quality models for evaluating their performance in reproducing the spatio-temporal features embedded in the observations and for designing emission control strategies needed to achieve compliance wit...

40 CFR 52.1678 - Control strategy and regulations: Particulate matter.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-CT fine particle (PM2.5) nonattainment area has attained the 1997 PM2.5 National Ambient Air Quality... particle (PM2.5) nonattainment area has attained the 2006 PM2.5 National Ambient Air Quality Standard. This...

Bayesian Analysis of a Reduced-Form Air Quality Model

EPA Science Inventory

Numerical air quality models are being used for assessing emission control strategies for improving ambient pollution levels across the globe. This paper applies probabilistic modeling to evaluate the effectiveness of emission reduction scenarios aimed at lowering ground-level oz...

Water pollution control technology and strategy for river-lake systems: a case study in Gehu Lake and Taige Canal.

PubMed

Zhang, Yimin; Zhang, Yongchun; Gao, Yuexiang; Zhang, Houhu; Cao, Jianying; Cai, Jinbang; Kong, Xiangji

2011-07-01

The Taoge water system is located in the upstream of Taihu Lake basin and is characterized by its multi-connected rivers and lakes. In this paper, current analyses of hydrology, hydrodynamics and water pollution of Gehu Lake and Taige Canal are presented. Several technologies are proposed for pollution prevention and control, and water environmental protection in the Taihu Lake basin. These included water pollution control integration technology for the water systems of Gehu Lake, Taige Canal and Caoqiao River. Additionally, river-lake water quality and quantity regulation technology, ecological restoration technology for polluted and degraded water bodies, and water environmental integration management and optimization strategies were also examined. The main objectives of these strategies are to: (a) improve environmental quality of relative water bodies, prevent pollutants from entering Gehu Lake and Taige Canal, and ensure that the clean water after the pre-treatment through Gehu Lake is not polluted before entering the Taihu Lake through Taige Canal; (b) stably and efficiently intercept and decrease the pollution load entering the lake through enhancing the river outlet ecological system structure function and water self-purifying capacity, and (c) designate Gehu Lake as a regulation system for water quality and water quantity in the Taoge water system and thus guarantee the improvement of the water quality of the inflow into Taihu Lake.

Case study of odor and indoor air quality assessment in the dewatering building at the Stickney Water Reclamation Plant.

PubMed

Sharma, Manju; O'Connell, Susan; Garelli, Brett; Sattayatewa, Chakkrid; Moschandreas, Demetrios; Pagilla, Krishna

2012-01-01

Indoor air quality (IAQ) and odors were determined using sampling/monitoring, measurement, and modeling methods in a large dewatering building at a very large water reclamation plant. The ultimate goal was to determine control strategies to reduce the sensory impacts on the workforce and achieve odor reduction within the building. Study approaches included: (1) investigation of air mixing by using CO(2) as an indicator, (2) measurement of airflow capacity of ventilation fans, (3) measurement of odors and odorants, (4) development of statistical and IAQ models, and (5) recommendation of control strategies. The results showed that air quality in the building complies with occupational safety and health guidelines; however, nuisance odors that can increase stress and productivity loss still persist. Excess roof fan capacity induced odor dispersion to the upper levels. Lack of a local air exhaust system of sufficient capacity and optimum design was found to be the contributor to occasional less than adequate indoor air quality and odors. Overall, air ventilation rate in the building has less effect on persistence of odors in the building. Odor/odorant emission rates from centrifuge drops were approximately 100 times higher than those from the open conveyors. Based on measurements and modeling, the key control strategies recommended include increasing local air exhaust system capacity and relocation of exhaust hoods closer to the centrifuge drops.

Measurement and Control Strategies for Sterol Glucosides to Improve Biodiesel Quality - Year 2

DOT National Transportation Integrated Search

2011-02-01

This project had the objective of measuring trace compounds in biodiesel called sterol glucosides (SG) so strategies to reduce their concentration could be investigated. A MALDI-TOF-MS (matrix assisted laser desorption ionization time of flight mass ...

Quality of life of coronary artery disease patients after the implementation of planning strategies for medication adherence 1

PubMed Central

Lourenço, Laura Bacelar de Araujo; Rodrigues, Roberta Cunha Matheus; São-João, Thaís Moreira; Gallani, Maria Cecilia; Cornélio, Marilia Estevam

2015-01-01

OBJECTIVE: to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL. METHOD: this was a controlled and randomized study. RESULTS: the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring. CONCLUSION: the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring. PMID:25806626

Fuzzy logic for plant-wide control of biological wastewater treatment process including greenhouse gas emissions.

PubMed

Santín, I; Barbu, M; Pedret, C; Vilanova, R

2018-06-01

The application of control strategies is increasingly used in wastewater treatment plants with the aim of improving effluent quality and reducing operating costs. Due to concerns about the progressive growth of greenhouse gas emissions (GHG), these are also currently being evaluated in wastewater treatment plants. The present article proposes a fuzzy controller for plant-wide control of the biological wastewater treatment process. Its design is based on 14 inputs and 6 outputs in order to reduce GHG emissions, nutrient concentration in the effluent and operational costs. The article explains and shows the effect of each one of the inputs and outputs of the fuzzy controller, as well as the relationship between them. Benchmark Simulation Model no 2 Gas is used for testing the proposed control strategy. The results of simulation results show that the fuzzy controller is able to reduce GHG emissions while improving, at the same time, the common criteria of effluent quality and operational costs. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

Maximum entropy approach to fuzzy control

NASA Technical Reports Server (NTRS)

Ramer, Arthur; Kreinovich, Vladik YA.

1992-01-01

For the same expert knowledge, if one uses different &- and V-operations in a fuzzy control methodology, one ends up with different control strategies. Each choice of these operations restricts the set of possible control strategies. Since a wrong choice can lead to a low quality control, it is reasonable to try to loose as few possibilities as possible. This idea is formalized and it is shown that it leads to the choice of min(a + b,1) for V and min(a,b) for &. This choice was tried on NASA Shuttle simulator; it leads to a maximally stable control.

[Strategies and development of quality assurance and control in the ELSA-Brasil].

PubMed

Schmidt, Maria Inês; Griep, Rosane Härter; Passos, Valéria Maria; Luft, Vivian Cristine; Goulart, Alessandra Carvalho; Menezes, Greice Maria de Souza; Molina, Maria del Carmen Bisi; Vigo, Alvaro; Nunes, Maria Angélica

2013-06-01

The ELSA-Brasil (Estudo Longitudinal de Saúde do Adulto - Brazilian Longitudinal Study for Adult Health) is a cohort study composed of 15,105 adults followed up in order to assess the development of chronic diseases, especially diabetes and cardiovascular disease. Its size, multicenter nature and the diversity of measurements required effective and efficient mechanisms of quality assurance and control. The main quality assurance activities (those developed before data collection) were: careful selection of research instruments, centralized training and certification, pretesting and pilot studies, and preparation of operation manuals for the procedures. Quality control activities (developed during data collection and processing) were performed more intensively at the beginning, when routines had not been established yet. The main quality control activities were: periodic observation of technicians, test-retest studies, data monitoring, network of supervisors, and cross visits. Data that estimate the reliability of the obtained information attest that the quality goals have been achieved.

Interactions between neurons in the frontal cortex and hippocampus in cats trained to select reinforcements of different value in conditions of cholinergic deficiency.

PubMed

Dolbakyan, E E; Merzhanova, G Kh

2007-09-01

An operant food-related conditioned reflex was developed in six cats by the "active choice" protocol: short-latency pedal presses were followed by presentation of low-quality reinforcement (bread-meat mix), while long-latency pedal presses were followed by presentation of high-quality reinforcement (meat). Animals differed in terms of their food-procuring strategies, displaying "self-control," "ambivalence," or "impulsivity." Multineuron activity was recorded from the frontal cortex and hippocampus (field CA3). Cross-correlation analysis of interneuronal interactions within (local networks) and between (distributed networks) study structures showed that the numbers of interneuronal interactions in both local and distributed networks were maximal in animals with "self-control." On the background of systemic administration of the muscarinic cholinoreceptor blockers scopolamine and trihexyphenidyl, the numbers of interneuronal interactions decreased, while "common source" influences increased. This correlated with impairment of the reproduction of the selected strategy, primarily affecting the animals' self-controlled behavior. These results show that the "self-control" strategy is determined by the organization of local and distributed networks in the frontal cortex and hippocampus.

Safety in the preparation of cytotoxic drugs: How to integrate gravimetric control in the quality assurance policy?

PubMed

Lecordier, J; Heluin, Y; Plivard, C; Bureau, A; Mouawad, C; Chaillot, B; Lahet, J-J

2011-02-01

We present the way to integrate gravimetric control (GC) in a centralized preparation of cytotoxic drugs unit. Two different modalities are described. In the first strategy, the balance is located inside the isolator, whereas in the second, it is located outside in order to remove many technical and ergonomic constraints. These two modalities are compared in terms of benefits and limits. GC consists in comparing the observed weight variation with the expected weight variation using a precision balance. According to the B-in strategy, this variation is directly attributable to the weight of the cytotoxic solution injected, whereas with the B-out strategy, the weight of various additional components must be taken into account. Five hundred and seventy-seven preparations have been weighed. For "B-in" strategy, the 95% confidence interval is [1.02-1.14%] and every preparation is below the threshold of 5%. For "B-out" strategy, the 95% confidence interval is [2.34-2.63%] and 94% of preparations are below the threshold of 5%. B-in strategy is distinctly more precise than B-out strategy and can be applied to all preparations. However, B-out strategy is a feasible option in practice and enables the detection of an important mistake. All in all, results obtained from B-out strategy can be considered as a quality indicator in the production line. Results of GC are helpful in the final step of release, which the pharmacist is responsible for. Many contributions in the quality assurance policy could justify using of GC in every unit. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

The Effects of Quality Books for Children and the Metacognitive Strategy on Students' Self-Esteem Levels

ERIC Educational Resources Information Center

Cer, Erkan; Sahin, Ertugrul

2017-01-01

Using a quasi-experimental design with pre-test and post-test control groups, 93 eighth grade students were randomly assigned either to the experimental or to the control group and responded to the Rosenberg Self-Esteem Scale two weeks before and after the intervention. While the students in the experimental group were instructed in quality books…

A spectral method for spatial downscaling

EPA Science Inventory

Complex computer models play a crucial role in air quality research. These models are used to evaluate potential regulatory impacts of emission control strategies and to estimate air quality in areas without monitoring data. For both of these purposes, it is important to calibrat...

[Research advances in secondary development of Chinese patent medicines based on quality by design concept].

PubMed

Gong, Xing-Chu; Chen, Teng; Qu, Hai-Bin

2017-03-01

Quality by design (QbD) concept is an advanced pharmaceutical quality control concept. The application of QbD concept in the research and development of pharmaceutical processes of traditional Chinese medicines (TCM) mainly contains five parts, including the definition of critical processes and their evaluation criteria, the determination of critical process parameters and critical material attributes, the establishment of quantitative models, the development of design space, as well as the application and continuous improvement of control strategy. In this work, recent research advances in QbD concept implementation methods in the secondary development of Chinese patent medicines were reviewed, and five promising fields of the implementation of QbD concept were pointed out, including the research and development of TCM new drugs and Chinese medicine granules for formulation, modeling of pharmaceutical processes, development of control strategy based on industrial big data, strengthening the research of process amplification rules, and the development of new pharmaceutical equipment.. Copyright© by the Chinese Pharmaceutical Association.

Multi-component determination and chemometric analysis of Paris polyphylla by ultra high performance liquid chromatography with photodiode array detection.

PubMed

Chen, Pei; Jin, Hong-Yu; Sun, Lei; Ma, Shuang-Cheng

2016-09-01

Multi-source analysis of traditional Chinese medicine is key to ensuring its safety and efficacy. Compared with traditional experimental differentiation, chemometric analysis is a simpler strategy to identify traditional Chinese medicines. Multi-component analysis plays an increasingly vital role in the quality control of traditional Chinese medicines. A novel strategy, based on chemometric analysis and quantitative analysis of multiple components, was proposed to easily and effectively control the quality of traditional Chinese medicines such as Chonglou. Ultra high performance liquid chromatography was more convenient and efficient. Five species of Chonglou were distinguished by chemometric analysis and nine saponins, including Chonglou saponins I, II, V, VI, VII, D, and H, as well as dioscin and gracillin, were determined in 18 min. The method is feasible and credible, and enables to improve quality control of traditional Chinese medicines and natural products. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

78 FR 34177 - Implementation of the 2008 National Ambient Air Quality Standards for Ozone: State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-06

... evaluating control strategies. This better understanding allows for more strategic approaches in which public..., we lay out our proposed approaches, but here are a few examples: 1. Federal control measures: States...), reasonably available control technology (RACT), reasonably available control measures (RACM), new source...

Control Strategies for Drug Product Continuous Direct Compression-State of Control, Product Collection Strategies, and Startup/Shutdown Operations for the Production of Clinical Trial Materials and Commercial Products.

PubMed

Almaya, Ahmad; De Belder, Lawrence; Meyer, Robert; Nagapudi, Karthik; Lin, Hung-Ren Homer; Leavesley, Ian; Jayanth, Jayanthy; Bajwa, Gurjit; DiNunzio, James; Tantuccio, Anthony; Blackwood, Dan; Abebe, Admassu

2017-04-01

Continuous manufacturing (CM) has emerged in the pharmaceutical industry as a paradigm shift with significant advantages related to cost, efficiency, flexibility, and higher assurance of quality. The inherent differences from batch processes justify examining the CM control strategy more holistically. This article describes the current thinking for the control and implementation of CM, using the example of a direct compression process and taking into consideration the ICH Q10 definition of "state of control" and process validation requirements. Statistical process control using control charts, sources of variation, process capability, and process performance is explained as a useful concept that can help assess the impact of variation within a batch and indicates if a process is in state of control. The potential for time-variant nature of startup and shutdown with CM is discussed to assure product quality while minimizing waste as well as different options for detection and isolation of non-conforming materials due to process upsets. While different levels of control are possible with CM, an appropriate balance between process control and end product testing is needed depending on the level of process understanding at the different stages of development from the production of clinical supplies through commercialization. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Reactive power and voltage control strategy based on dynamic and adaptive segment for DG inverter

NASA Astrophysics Data System (ADS)

Zhai, Jianwei; Lin, Xiaoming; Zhang, Yongjun

2018-03-01

The inverter of distributed generation (DG) can support reactive power to help solve the problem of out-of-limit voltage in active distribution network (ADN). Therefore, a reactive voltage control strategy based on dynamic and adaptive segment for DG inverter is put forward to actively control voltage in this paper. The proposed strategy adjusts the segmented voltage threshold of Q(U) droop curve dynamically and adaptively according to the voltage of grid-connected point and the power direction of adjacent downstream line. And then the reactive power reference of DG inverter can be got through modified Q(U) control strategy. The reactive power of inverter is controlled to trace the reference value. The proposed control strategy can not only control the local voltage of grid-connected point but also help to maintain voltage within qualified range considering the terminal voltage of distribution feeder and the reactive support for adjacent downstream DG. The scheme using the proposed strategy is compared with the scheme without the reactive support of DG inverter and the scheme using the Q(U) control strategy with constant segmented voltage threshold. The simulation results suggest that the proposed method has a significant improvement on solving the problem of out-of-limit voltage, restraining voltage variation and improving voltage quality.

Thermal Comfort Strategies: A Report on Cellulose Insulation.

DTIC Science & Technology

1996-12-01

comfort, saves energy, controls moisture, increases indoor air quality, and, in general, increases user satisfaction. Thermal comfort is an important...productivity could mean an annual savings of $1 billion. This report presents thermal comfort strategies relating to the use of cellulose insulation...insulation are described. The report also discusses technical issues involved in general thermal comfort strategies, including: (1) infiltration, (2

Use of a Motivational Interviewing-Informed Strategy in Group Orientations to Improve Retention and Intervention Attendance in a Randomized Controlled Trial

ERIC Educational Resources Information Center

Xiao, Lan; Lv, Nan; Rosas, Lisa G.; Karve, Shweta; Luna, Veronica; Jameiro, Elizabeth; Wittels, Nancy; Ma, Jun

2016-01-01

High retention and treatment adherence are essential to ensure the quality of evidence from clinical trials. Strategies for improving these have been explored but actual rates in lifestyle intervention trials indicate challenges. This study examined the use of a motivational interviewing-informed strategy during interactive group orientations…

The effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter: A systematic review with meta-analysis and Trial Sequential Analysis

PubMed Central

Gluud, Christian; Jakobsen, Janus C.

2017-01-01

Background Atrial fibrillation and atrial flutter may be managed by either a rhythm control strategy or a rate control strategy but the evidence on the clinical effects of these two intervention strategies is unclear. Our objective was to assess the beneficial and harmful effects of rhythm control strategies versus rate control strategies for atrial fibrillation and atrial flutter. Methods We searched CENTRAL, MEDLINE, Embase, LILACS, Web of Science, BIOSIS, Google Scholar, clinicaltrials.gov, TRIP, EU-CTR, Chi-CTR, and ICTRP for eligible trials comparing any rhythm control strategy with any rate control strategy in patients with atrial fibrillation or atrial flutter published before November 2016. Our primary outcomes were all-cause mortality, serious adverse events, and quality of life. Our secondary outcomes were stroke and ejection fraction. We performed both random-effects and fixed-effect meta-analysis and chose the most conservative result as our primary result. We used Trial Sequential Analysis (TSA) to control for random errors. Statistical heterogeneity was assessed by visual inspection of forest plots and by calculating inconsistency (I2) for traditional meta-analyses and diversity (D2) for TSA. Sensitivity analyses and subgroup analyses were conducted to explore the reasons for substantial statistical heterogeneity. We assessed the risk of publication bias in meta-analyses consisting of 10 trials or more with tests for funnel plot asymmetry. We used GRADE to assess the quality of the body of evidence. Results 25 randomized clinical trials (n = 9354 participants) were included, all of which were at high risk of bias. Meta-analysis showed that rhythm control strategies versus rate control strategies significantly increased the risk of a serious adverse event (risk ratio (RR), 1.10; 95% confidence interval (CI), 1.02 to 1.18; P = 0.02; I2 = 12% (95% CI 0.00 to 0.32); 21 trials), but TSA did not confirm this result (TSA-adjusted CI 0.99 to 1.22). The increased risk of a serious adverse event did not seem to be caused by any single component of the composite outcome. Meta-analysis showed that rhythm control strategies versus rate control strategies were associated with better SF-36 physical component score (mean difference (MD), 6.93 points; 95% CI, 2.25 to 11.61; P = 0.004; I2 = 95% (95% CI 0.94 to 0.96); 8 trials) and ejection fraction (MD, 4.20%; 95% CI, 0.54 to 7.87; P = 0.02; I2 = 79% (95% CI 0.69 to 0.85); 7 trials), but TSA did not confirm these results. Both meta-analysis and TSA showed no significant differences on all-cause mortality, SF-36 mental component score, Minnesota Living with Heart Failure Questionnaire, and stroke. Conclusions Rhythm control strategies compared with rate control strategies seem to significantly increase the risk of a serious adverse event in patients with atrial fibrillation. Based on current evidence, it seems that most patients with atrial fibrillation should be treated with a rate control strategy unless there are specific reasons (e.g., patients with unbearable symptoms due to atrial fibrillation or patients who are hemodynamically unstable due to atrial fibrillation) justifying a rhythm control strategy. More randomized trials at low risk of bias and low risk of random errors are needed. Trial registration PROSPERO CRD42016051433 PMID:29073191

Interventions to aid patient adherence to physiotherapist prescribed self-management strategies: a systematic review.

PubMed

Peek, Kerry; Sanson-Fisher, Robert; Mackenzie, Lisa; Carey, Mariko

2016-06-01

Physiotherapist prescribed self-management strategies are an important adjunct to 'hands on' treatment. However, treatment outcomes are likely to be related to whether patients adhere to the prescribed strategy. Therefore, physiotherapists should be aware of adherence aiding interventions designed to maximise patient outcomes underpinned by quality research studies. To conduct a systematic review of the interventions used to aid patient adherence to all physiotherapist prescribed self-management strategies. The search included the databases CINAHL, EMBASE, MEDLINE, PUBMED, PSYCINFO, SPORTSDiscus, the Cochrane Central Register of Controlled Trials, PEDro and Mednar for randomised controlled trials (RCTs) published in a peer reviewed journal from inception to November 2014. Data were extracted using a standardised form from twelve included RCTs for patient adherence rates to self-management strategies for interventions used to aid patient adherence and usual care. Two independent reviewers conducted methodological quality assessment. Twelve different interventions to aid patient adherence to exercise were recorded from twelve fair to high quality RCTs. Potential adherence aiding interventions include an activity monitor and feedback system, written exercise instructions, behavioural exercise programme with booster sessions and goal setting. Despite a number of studies demonstrating interventions to positively influence patient adherence to exercise, there is insufficient data to endorse their use in clinical practice. No RCTs examining adherence aiding interventions to self-management strategies other than exercise were identified, indicating a significant gap in the literature. PROSPERO CRD42015014516. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Diarrhoea prevention in Bolivia through point-of-use water treatment and safe storage: a promising new strategy.

PubMed Central

Quick, R. E.; Venczel, L. V.; Mintz, E. D.; Soleto, L.; Aparicio, J.; Gironaz, M.; Hutwagner, L.; Greene, K.; Bopp, C.; Maloney, K.; Chavez, D.; Sobsey, M.; Tauxe, R. V.

1999-01-01

A novel water quality intervention that consists of point-of-use water disinfection, safe storage and community education was field tested in Bolivia. A total of 127 households in two periurban communities were randomized into intervention and control groups, surveyed and the intervention was distributed. Monthly water quality testing and weekly diarrhoea surveillance were conducted. Over a 5-month period, intervention households had 44% fewer diarrhoea episodes than control households (P = 0.002). Infants < 1 year old (P = 0.05) and children 5-14 years old (P = 0.01) in intervention households had significantly less diarrhoea than control children. Campylobacter was less commonly isolated from intervention than control patients (P = 0.02). Stored water in intervention households was less contaminated with Escherichia coli than stored water in control households (P < 0.0001). Intervention households exhibited less E. coli contamination of stored water and less diarrhoea than control households. This promising new strategy may have broad applicability for waterborne disease prevention. PMID:10098789

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.

12 CFR 652.60 - Corporation board guidelines.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... (a) Your board of directors is responsible for ensuring that you maintain total capital at a level... developing the capital adequacy plan: (1) Capability of management; (2) Strategies and objectives in your business plan; (3) Quality of operating policies, procedures, and internal controls; (4) Quality and...

12 CFR 652.60 - Corporation board guidelines.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... (a) Your board of directors is responsible for ensuring that you maintain total capital at a level... developing the capital adequacy plan: (1) Capability of management; (2) Strategies and objectives in your business plan; (3) Quality of operating policies, procedures, and internal controls; (4) Quality and...

76 FR 24846 - Approval and Promulgation of Air Quality Implementation Plans; Illinois

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

... Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection Agency (EPA... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Douglas Aburano, Chief, Control Strategies Section, Air...

Writing Expertise and Second-Language Proficiency.

ERIC Educational Resources Information Center

Cumming, Alister

1989-01-01

Assessment of the English writing proficiency of 23 native French speaking students on 3 composition tasks found variance in the qualities of written texts and problem-solving behaviors. Writing expertise was found to affect discourse organization and content, writing complexity, heuristic strategies, and control strategies, while second-language…

Control Strategies and Noncompliance in Abusive Mother-Child Dyads: An Observational Study.

ERIC Educational Resources Information Center

Oldershaw, Lynn; And Others

1986-01-01

Explores the hypothesis that parenting practices of abusive mothers are characterized by (1) greater use of power-assertive strategies, (2) less flexible behavior with respect to child compliance attempts, (3) more inconsistent use of parenting techniques, and (4) diminished affective quality. (HOD)

Quality of life of French Canadian parents raising a child with autism spectrum disorder and effects of psychosocial factors.

PubMed

Cappe, Émilie; Poirier, Nathalie; Sankey, Carol; Belzil, Andréa; Dionne, Carmen

2018-04-01

This study aimed to investigate the quality of life of parents of a child with autism spectrum disorder in Quebec. Seventy-seven participants completed a questionnaire with socio-biographic information and five self-assessed scales, to measure perceived stress, social support and control, coping strategies, and quality of life. Perception of their child's autonomy level, of the severity of the disorder, of the family's income, as well as changes in their professional or familial organization influenced parents' quality of life. Perceiving their situation as a threat predicted poor quality of life, whereas satisfaction of social support predicted good quality of life. In addition, parents who used problem solving and support-seeking coping strategies had a better relationship with their child, whereas those who used more emotion-centered coping strategies struggled. Lastly, parents who felt they had the power to contribute to their child's development were more satisfied and less disturbed. Beyond the parents' actual situation, our results underscore the importance of paying attention to their own perception of the situation in order to provide them with appropriate support.

[A new strategy for Chinese medicine processing technologies: coupled with individuation processed and cybernetics].

PubMed

Zhang, Ding-kun; Yang, Ming; Han, Xue; Lin, Jun-zhi; Wang, Jia-bo; Xiao, Xiao-he

2015-08-01

The stable and controllable quality of decoction pieces is an important factor to ensure the efficacy of clinical medicine. Considering the dilemma that the existing standardization of processing mode cannot effectively eliminate the variability of quality raw ingredients, and ensure the stability between different batches, we first propose a new strategy for Chinese medicine processing technologies that coupled with individuation processed and cybernetics. In order to explain this thinking, an individual study case about different grades aconite is provided. We hope this strategy could better serve for clinical medicine, and promote the inheritance and innovation of Chinese medicine processing skills and theories.

Accreditation of Individualized Quality Control Plans by the College of American Pathologists.

PubMed

Hoeltge, Gerald A

2017-03-01

The Laboratory Accreditation Program of the College of American Pathologists (CAP) began in 2015 to allow accredited laboratories to devise their own strategies for quality control of laboratory testing. Participants now have the option to implement individualized quality control plans (IQCPs). Only nonwaived testing that features an internal control (built-in, electronic, or procedural) is eligible for IQCP accreditation. The accreditation checklists that detail the requirements have been peer-reviewed by content experts on CAP's scientific resource committees and by a panel of accreditation participants. Training and communication have been key to the successful introduction of the new IQCP requirements. Copyright © 2016 Elsevier Inc. All rights reserved.

Living with life-saving technology - coping strategies in implantable cardioverter defibrillators recipients.

PubMed

Flemme, Inger; Johansson, Ingela; Strömberg, Anna

2012-02-01

To describe coping strategies and coping effectiveness in recipients with an implantable cardioverter defibrillator and to explore factors influencing coping. Implantable cardioverter defibrillators are documented as saving lives and are used to treat ventricular tachycardia and ventricular fibrillation. Despite the implantable cardioverter defibrillator not evidently interfering with everyday life, there is conflicting evidence regarding the psychosocial impact of an implantable cardioverter defibrillator implantation such as anxiety, depression, perceived control and quality of life and how these concerns may relate to coping. Cross-sectional multicentre design. Individuals (n = 147, mean age 63 years, 121 men) who had lived with an implantable cardioverter defibrillator between 6-24 months completed the Jalowiec Coping Scale-60, Hospital Anxiety and Depression Scale, Control Attitude Scale and Quality of Life Index-Cardiac version. Implantable cardioverter defibrillators recipients seldom used coping strategies, and the coping strategies used were perceived as fairly helpful. Optimism was found to be the most frequently used (1·8 SD 0·68) and most effective (2·1 SD 0·48) coping strategy, and recipients perceived moderate control in life. Anxiety (β = 3·5, p ≤ 0·001) and gender (β = 12·3, p = 0·046) accounted for 26% of the variance in the total use of coping strategies, suggesting that the more symptoms of anxiety and being women the greater use of coping strategies. Most recipients with an implantable cardioverter defibrillator did not appraise daily concerns as stressors in need of coping and seem to have made a successful transition in getting on with their lives 6-24 months after implantation. Relevance to clinical practice.  Nurses working with recipients with an implantable cardioverter defibrillator should have a supportive communication so that positive outcomes such as decreased anxiety and increased perceived control and quality of life can be obtained. Through screening for anxiety at follow-up in the outpatient clinic, these recipients perceiving mental strain in their daily life can be identified. © 2011 Blackwell Publishing Ltd.

Strategy of Water Pollution Control Base On Social Economic Activitiy, in Karang Mumus River, Samarinda East Kalimantan, Indonesia

NASA Astrophysics Data System (ADS)

Pramaningsih, Vita; Suprayogi, Slamet; Purnama, Setyawan

2018-02-01

Water Pollution in Karang Mumus River caused society behavior along the river. Daily activity such as bath, washing and defecate at the river. Garbage, sediment, domestic waste and flood are river problems should be solved. Purpose this research is make strategy of water pollution control in the Karang Mumus River. Method used observation in the field, interview to the society, industry, public activity along the river and government of environment department. Further create data using tool of Analysis Hierarchy Process (AHP) to get the strategy to control water pollution in the river. Actors have contribute pollution control are government, industry and society. Criteria to pollution control are society participation, low, human resources and sustainable. Alternative of pollution control are unit garbage storage; license loyalty for industry and waste; communal waste water installation; monitoring of water quality. Result for actor priority are government (0.4); Industry (0.4); Society (0.2). Result for priority criteria are society participation (0.338), low (0.288), human resources (0.205) and sustainable (0.169). Result for priority alternative are unit garbage storage (0.433); license loyalty for industry and waste (0.238); communal waste water installation (0.169); monitoring of water quality (0.161).

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

PubMed

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

2017-01-01

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

Air Pollution in the World's Megacities.

ERIC Educational Resources Information Center

Richman, Barbara T., Ed.

1994-01-01

Reports findings of the Global Environment Monitoring System study concerning air pollution in the world's megacities. Discusses sources of air pollution, air pollution impacts, air quality monitoring, air quality trends, and control strategies. Provides profiles of the problem in Beijing, Los Angeles, Mexico City, India, Cairo, Sao Paulo, and…

78 FR 70516 - Approval and Promulgation of Air Quality Implementation Plans; Illinois

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

...] Approval and Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Pamela Blakley, Chief, Control Strategies Section, Air Programs...

78 FR 40013 - Approval and Promulgation of Air Quality Implementation Plans; Illinois

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... Promulgation of Air Quality Implementation Plans; Illinois AGENCY: Environmental Protection Agency (EPA... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Pamela Blakley, Chief, Control Strategies Section, Air Programs...

78 FR 63148 - Approval and Promulgation of Air Quality Implementation Plans; Indiana

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-23

...] Approval and Promulgation of Air Quality Implementation Plans; Indiana AGENCY: Environmental Protection... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard, Chicago, Illinois 60604. 5. Hand Delivery: Pamela Blakley, Chief, Control Strategies Section, Air Programs...

Quality of life and personality traits in patients with colorectal cancer.

PubMed

Glavić, Zeljko; Galić, Slavka; Krip, Marija

2014-06-01

The aim of this study was to determine whether it is possible to predict quality of life in patients with colorectal cancer on the basis of personality dimensions from the Five-factor model. The study included 56 patients with colorectal cancer (40 men and 16 women), aged 48-87. The following instruments were used: the Questionnaire on General Information and Lifestyle Habits, the Quality of Life Scale, and the Neo Five-Factor Inventory. The results of overall quality of life estimations of colorectal cancer patients were comparable to those of healthy people. Contrary to expectations, extraversion was not a significant quality of life predictor. Neuroticism as a personality trait was the only variable which consistently proved to be highly significant across analyses in the prediction of total quality of life, satisfaction with past life, future expectations, and comparison with others. Key determinants of neuroticism are a proneness to experiencing negative affects which makes adaptation difficult, a proneness to irrational ideas, reduced impulse control, ineffective coping strategies, the perception of poor control over oneself and others, and deeming one's own resources to be insufficient to adequately cope with stress, thus resulting in a more negative quality of life estimation. These results support the conclusion that cognitive-behavioral interventions aimed at changing negative attributions, reducing tension and negative affects, acquiring more effective coping strategies, strengthening perceived personal control, redefining and re-conceptualizing quality of life, and seeking/receiving more adequate social support could lead to an improved quality of life in patients with colorectal cancer.

Eutrophication of lakes and reservoirs: A framework for making management decisions

USGS Publications Warehouse

Rast, W.; Holland, M.

1988-01-01

The development of management strategies for the protection of environmental quality usually involves consideration both of technical and nontechnical issues. A logical, step-by-step framework for development of such strategies is provided. Its application to the control of cultured eutrophication of lakes and reservoirs illustrates its potential usefulness. From the perspective of the policymaker, the main consideration is that the eutrophication-related water quality of a lake or reservoir can be managed for given water uses. The approach presented here allows the rational assessment of relevant water-quality parameters and establishment of water-quality goals, consideration of social and other nontechnical issues, the possibilities of public involvement in the decision-making process, and a reasonable economic analysis within a management framework.

Opportunities and challenges of real-time release testing in biopharmaceutical manufacturing.

PubMed

Jiang, Mo; Severson, Kristen A; Love, John Christopher; Madden, Helena; Swann, Patrick; Zang, Li; Braatz, Richard D

2017-11-01

Real-time release testing (RTRT) is defined as "the ability to evaluate and ensure the quality of in-process and/or final drug product based on process data, which typically includes a valid combination of measured material attributes and process controls" (ICH Q8[R2]). This article discusses sensors (process analytical technology, PAT) and control strategies that enable RTRT for the spectrum of critical quality attributes (CQAs) in biopharmaceutical manufacturing. Case studies from the small-molecule and biologic pharmaceutical industry are described to demonstrate how RTRT can be facilitated by integrated manufacturing and multivariable control strategies to ensure the quality of products. RTRT can enable increased assurance of product safety, efficacy, and quality-with improved productivity including faster release and potentially decreased costs-all of which improve the value to patients. To implement a complete RTRT solution, biologic drug manufacturers need to consider the special attributes of their industry, particularly sterility and the measurement of viral and microbial contamination. Continued advances in on-line and in-line sensor technologies are key for the biopharmaceutical manufacturing industry to achieve the potential of RTRT. Related article: http://onlinelibrary.wiley.com/doi/10.1002/bit.26378/full. © 2017 Wiley Periodicals, Inc.

Integrating air quality, water and climate concerns into China's energy strategy

NASA Astrophysics Data System (ADS)

Peng, Wei

As the world's top carbon emitter, China also suffers from serious air pollution and increasingly severe water stress. My dissertation focuses on a variety of energy strategies in China and examines potential synergies and tradeoffs between air quality, water conservation and carbon mitigation objectives. It includes four analytical chapters. Chapter 2 and 3 examines the air quality and climate implications of a variety policy options in the near term and at the 2030 time horizon, respectively. Based on an integrated assessment using regional air pollution model and epidemiological evidence, I find that improving industrial energy efficiency is the most effective near-term strategy to curb air pollution and carbon emissions, while electrifying end-use sectors (e.g. vehicles and residential stoves) with decarbonized electricity will likely become the favorable co-control strategy in 2030. These two chapters hence provide a scientific basis for policymakers in China to coordinate air pollution and carbon mitigation strategies. Chapter 4 and 5 then examines the role of electricity transmission, as a critical element of the electrification strategy, in the nexus of air pollution, water stress and carbon emissions. Chapter 4 evaluates the potential air quality and climate benefits of long-distance electricity transmission in China in the near term. I find that transmitting a hybrid mix of renewable and coal power can be a cost-effective energy transfer strategy to curb air pollution impacts and carbon emissions, because it not only utilizes zero-carbon renewable resources in the west, but also displaces coal power generation and associated air pollution impacts in highly populated eastern regions. Chapter 5 studies the potential tradeoffs in the transmission system designs to achieve air quality or water conservation benefits from a decarbonized generation system. Since air pollution and water stress are severe in eastern and northern China respectively, I find that an increasing priority on air pollution control would favor a larger amount of electricity transmission into eastern population centers, while an increasing priority on water conservation would favor using locally produced renewable power or imported electricity to displace fossil generation in northern water-stressed regions.

Temporal and spatial changes of water quality and management strategies of Dianchi Lake in southwest China

NASA Astrophysics Data System (ADS)

Zhang, T.; Zeng, W. H.; Wang, S. R.; Ni, Z. K.

2014-04-01

Temporal and spatial changes to the water quality of Dianchi Lake in southwest China were investigated using monthly monitoring data from 2005 to 2012. Dianchi Lake is divided into two parts, Caohai Lake and Waihai Lake, by a man-made dike. Caohai Lake lies at the north of Dianchi Lake, while Waihai Lake is the main water body of Dianchi Lake and accounts for 96.7% of the whole area of the lake. Based on the analysis of total phosphorus (TP), total nitrogen (TN), and chlorophyll a (Chl a) concentrations, it was determined that, in Caohai Lake, the annual concentrations of these variables ranged from 0.19-1.46 mg L-1, 6.11-16.79 mg L-1, 0.06-0.14 mg L-1, respectively. In addition, the annual concentrations of TP, TN and Chl a in Waihai Lake ranged between 0.13 and 0.20 mg L-1, 1.82 and 3.01 mg L-1, and 0.04 and 0.09 mg L-1, respectively. Cluster analysis (CA) classified the 10 monitoring sites into two clusters (cluster A and cluster B) based on similarities of water quality characteristics. Our data revealed that the current status of water quality within Caohai Lake was much worse than that of Waihai Lake. Water quality was seriously degraded during the economic boom near the period of the "Eleventh Five-Year Plan" (2005-2010), and gradually improved from 2010 to 2012 because of the "standard emission directive to industry". The main factors that influenced the spatial and temporal changes to water quality were natural factors including lake evolution and regional characteristic as well as human factors such as pollution load into the lake and management strategies that were already adopted. Some activities and regulations were implemented to enhance the lake environment by controlling wastewater emissions and establishing regulations to protect the lakes in the Yunnan Province. However, problems with institutional fragmentation (horizontal and vertical), simple treatment methods, low-intensity investment in pollution control, and lack of meaningful endogenous pollution control strategies were still present in the lake management strategy. To solve these problems, suitable control measures are needed, especially considering the current old-age status of Dianchi Lake. The fundamental improvement of the water quality within Caohai Lake was dependent on the measures taken in the upper reaches of the Caohai Watershed, including further recovery of submerged plants, resource utilization by floating plants and the reinforcement of sediment disposal. Management strategies for endogenous pollution in Waihai Lake were mainly dependent on restocking algae-eating fish and the ecological restoration of macrophytes. In this way, the swamping trend and the ageing process that is occurring in Dianchi Lake can be stunted. And the management strategies would be a contribution to the management of water conflicts between mankind and ecosystems in similar lakes.

40 CFR 52.1960 - Original Identification of plan section.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., 1972. (Non-regulatory) (7) Sections 16.1, 16.3, and 16.5 of Regulation No. 16, “Control of Emissions of... plan revision designed to achieve the ozone standard in Tulsa County, including control strategy... Quality Control Implementation Plan” and all revisions submitted by Oklahoma that were federally approved...

40 CFR 52.1960 - Original Identification of plan section.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., 1972. (Non-regulatory) (7) Sections 16.1, 16.3, and 16.5 of Regulation No. 16, “Control of Emissions of... plan revision designed to achieve the ozone standard in Tulsa County, including control strategy... Quality Control Implementation Plan” and all revisions submitted by Oklahoma that were federally approved...

40 CFR 52.1960 - Original Identification of plan section.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., 1972. (Non-regulatory) (7) Sections 16.1, 16.3, and 16.5 of Regulation No. 16, “Control of Emissions of... plan revision designed to achieve the ozone standard in Tulsa County, including control strategy... Quality Control Implementation Plan” and all revisions submitted by Oklahoma that were federally approved...

40 CFR 52.1960 - Original Identification of plan section.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., 1972. (Non-regulatory) (7) Sections 16.1, 16.3, and 16.5 of Regulation No. 16, “Control of Emissions of... plan revision designed to achieve the ozone standard in Tulsa County, including control strategy... Quality Control Implementation Plan” and all revisions submitted by Oklahoma that were federally approved...

Goals and strategies in the global control design of the OAJ Robotic Observatory

NASA Astrophysics Data System (ADS)

Yanes-Díaz, A.; Rueda-Teruel, S.; Antón, J. L.; Rueda-Teruel, F.; Moles, M.; Cenarro, A. J.; Marín-Franch, A.; Ederoclite, A.; Gruel, N.; Varela, J.; Cristóbal-Hornillos, D.; Chueca, S.; Díaz-Martín, M. C.; Guillén, L.; Luis-Simoes, R.; Maícas, N.; Lamadrid, J. L.; López-Sainz, A.; Hernández-Fuertes, J.; Valdivielso, L.; Mendes de Oliveira, C.; Penteado, P.; Schoenell, W.; Kanaan, A.

2012-09-01

There are many ways to solve the challenging problem of making a high performance robotic observatory from scratch. The Observatorio Astrofísico de Javalambre (OAJ) is a new astronomical facility located in the Sierra de Javalambre (Teruel, Spain) whose primary role will be to conduct all-sky astronomical surveys. The OAJ control system has been designed from a global point of view including astronomical subsystems as well as infrastructures and other facilities. Three main factors have been considered in the design of a global control system for the robotic OAJ: quality, reliability and efficiency. We propose CIA (Control Integrated Architecture) design and OEE (Overall Equipment Effectiveness) as a key performance indicator in order to improve operation processes, minimizing resources and obtaining high cost reduction whilst maintaining quality requirements. The OAJ subsystems considered for the control integrated architecture are the following: two wide-field telescopes and their instrumentation, active optics subsystems, facilities for sky quality monitoring (seeing, extinction, sky background, sky brightness, cloud distribution, meteorological station), domes and several infrastructure facilities such as water supply, glycol water, water treatment plant, air conditioning, compressed air, LN2 plant, illumination, surveillance, access control, fire suppression, electrical generators, electrical distribution, electrical consumption, communication network, Uninterruptible Power Supply and two main control rooms, one at the OAJ and the other remotely located in Teruel, 40km from the observatory, connected through a microwave radio-link. This paper presents the OAJ strategy in control design to achieve maximum quality efficiency for the observatory processes and operations, giving practical examples of our approach.

A QRM Discussion of Microbial Contamination of Non-sterile Drug Products, Using FDA and EMA Warning Letters Recorded between 2008 and 2016.

PubMed

Santos, Ana M C; Doria, Mara S; Meirinhos-Soares, Luís; Almeida, António J; Menezes, José C

2018-01-01

Microbial quality control of non-sterile drug products has been a concern to regulatory agencies and the pharmaceutical industry since the 1960s. Despite being an old challenge to companies, microbial contamination still affects a high number of manufacturers of non-sterile products. Consequences go well beyond the obvious direct costs related to batch rejections or product recalls, as human lives and a company's reputation are significantly impacted if such events occur. To better manage risk and establish effective mitigation strategies, it is necessary to understand the microbial hazards involved in non-sterile drug products manufacturing, be able to evaluate their potential impact on final product quality, and apply mitigation actions. Herein we discuss the most likely root causes involved in microbial contaminations referenced in warning letters issued by US health authorities and non-compliance reports issued by European health authorities over a period of several years. The quality risk management tools proposed were applied to the data gathered from those databases, and a generic risk ranking was provided based on a panel of non-sterile drug product manufacturers that was assembled and given the opportunity to perform the risk assessments. That panel identified gaps and defined potential mitigation actions, based on their own experience of potential risks expected for their processes. Major findings clearly indicate that the manufacturers affected by the warning letters should focus their attention on process improvements and microbial control strategies, especially those related to microbial analysis and raw material quality control. Additionally, the WLs considered frequently referred to failures in quality-related issues, which indicates that the quality commitment should be reinforced at most companies to avoid microbiological contaminations. LAY ABSTRACT: Microbial contamination of drug products affects the quality of non-sterile drug products produced by numerous manufacturers, representing a major risk to patients. It is necessary to understand the microbial hazards involved in the manufacturing process and evaluate their impact on final product quality so that effective prevention strategies can be implemented. A risk-based classification of most likely root causes for microbial contamination found in the warning letters issued by the US Food and Drug Administration and the European Medicines Agency is proposed. To validate the likely root causes extracted from the warning letters, a subject matter expert panel made of several manufacturers was formed and consulted. A quality risk management approach to assess microbiological contamination of non-sterile drug products is proposed for the identification of microbial hazards involved in the manufacturing process. To enable ranking of microbial contamination risks, quality risk management metrics related to criticality and overall risk were applied. The results showed that manufacturers of non-sterile drug products should improve their microbial control strategy, with special attention to quality controls of raw materials, primary containers, and closures. Besides that, they should invest in a more robust quality system and culture. As a start, manufacturers may consider investigating their specific microbiological risks, adressing their sites' own microbial ecology, type of manufacturing processes, and dosage form characteristics, as these may lead to increased contamination risks. Authorities should allow and enforce innovative, more comprehensive, and more effective approaches to in-process contamination monitoring and controls. © PDA, Inc. 2018.

40 CFR 52.933 - Control Strategy: Sulfur oxides and particulate matter.

Code of Federal Regulations, 2013 CFR

2013-07-01

... certification does not apply to: Big Rivers-Green #1 & 2, Kentucky Utilities-Ghent #3 & 4, and Ashland Oil, Inc... based upon 2007-2009 air quality data, the Huntington-Ashland, West Virginia-Kentucky-Ohio... based upon 2007-2009 air quality data, the Cincinnati-Hamilton, Ohio-Kentucky-Indiana nonattainment Area...

40 CFR 52.933 - Control Strategy: Sulfur oxides and particulate matter.

Code of Federal Regulations, 2012 CFR

2012-07-01

... certification does not apply to: Big Rivers-Green #1 & 2, Kentucky Utilities-Ghent #3 & 4, and Ashland Oil, Inc... based upon 2007-2009 air quality data, the Huntington-Ashland, West Virginia-Kentucky-Ohio... based upon 2007-2009 air quality data, the Cincinnati-Hamilton, Ohio-Kentucky-Indiana nonattainment Area...

40 CFR 52.933 - Control Strategy: Sulfur oxides and particulate matter.

Code of Federal Regulations, 2014 CFR

2014-07-01

... certification does not apply to: Big Rivers-Green #1 & 2, Kentucky Utilities-Ghent #3 & 4, and Ashland Oil, Inc... based upon 2007-2009 air quality data, the Huntington-Ashland, West Virginia-Kentucky-Ohio... based upon 2007-2009 air quality data, the Cincinnati-Hamilton, Ohio-Kentucky-Indiana nonattainment Area...

76 FR 27973 - Approval and Promulgation of Air Quality Implementation Plans; Indiana

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-13

... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA-R05-OAR-2010-0999; FRL-9304-9] Approval and Promulgation of Air Quality Implementation Plans; Indiana AGENCY: Environmental Protection Agency (EPA). ACTION..., Control Strategies Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, Region 5...

76 FR 20906 - Approval and Promulgation of Air Quality Implementation Plans; Indiana

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-14

... Promulgation of Air Quality Implementation Plans; Indiana AGENCY: Environmental Protection Agency (EPA). ACTION... Clean Air Act. Indiana submitted revisions to the particulate matter (PM) and sulfur dioxide (SO 2...: Douglas Aburano, Chief, Control Strategies Section, Air Programs Branch (AR-18J), U.S. Environmental...

77 FR 41914 - Approval and Promulgation of Air Quality Implementation Plans; Indiana

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-17

... Promulgation of Air Quality Implementation Plans; Indiana AGENCY: Environmental Protection Agency (EPA). ACTION..., Control Strategies Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West... Section, Air Programs Branch (AR-18J), U.S. Environmental Protection Agency, 77 West Jackson Boulevard...

Discovery and identification of quality markers of Chinese medicine based on pharmacokinetic analysis.

PubMed

He, Jun; Feng, Xinchi; Wang, Kai; Liu, Changxiao; Qiu, Feng

2018-02-28

Quality control of Chinese medicine (CM) is an effective measure to ensure the safety and efficacy of CM in clinical practice, which is also a key factor to restrict the modernization process of CM. Various chemical components exist in CM and the determination of several chemical components is the main approach for quality control of vast majority of CM in the present. However, many components determined lack not only specificity, but also biological activities. This is bound to greatly reduce the actual value of quality standard of CM. Professor Changxiao Liu proposed the "quality marker" (Q-marker) concept to ensure the standardization and rationalization for the quality control of CM. As we all know, CMs are taken orally in most cases and could be extensively metabolized in vivo. Both prototype components and the metabolites could be the actual therapeutic material basis. Pharmacokinetic studies could benefit the elucidation of actual therapeutic material basis which is closely related to the identification of Q-markers. Therefore, a new strategy about Q-marker was proposed based on the pharmacokinetic analysis of CM, hoping to provide some ideas for the discovery and identification of Q-marker. The relationship between pharmacokinetic studies and the identification of Q-markers was demonstrated in this review and a new strategy was proposed. Starting from the pharmacokinetic analysis, reverse tracing of the prototype active components and the potential prodrugs in CM were conducted first and the therapeutic material basis were identified as Q-markers. Then, modern analytical techniques and methods were applied to obtain comprehensive quality control for these constituents. Several CMs including gingko biloba, ginseng, Periplocae Cortex, Mori Cortex, Bupleuri Radix and Scutellariae Radix were listed as examples to clarify how the new strategy could be applied. Pharmacokinetic studies play an important role for the elucidation of therapeutic material basis of CM and the identification of Q-markers and it should be taken into account during the process of the investigation of Q-marker. Copyright © 2018 Elsevier GmbH. All rights reserved.

Network-based production quality control

NASA Astrophysics Data System (ADS)

Kwon, Yongjin; Tseng, Bill; Chiou, Richard

2007-09-01

This study investigates the feasibility of remote quality control using a host of advanced automation equipment with Internet accessibility. Recent emphasis on product quality and reduction of waste stems from the dynamic, globalized and customer-driven market, which brings opportunities and threats to companies, depending on the response speed and production strategies. The current trends in industry also include a wide spread of distributed manufacturing systems, where design, production, and management facilities are geographically dispersed. This situation mandates not only the accessibility to remotely located production equipment for monitoring and control, but efficient means of responding to changing environment to counter process variations and diverse customer demands. To compete under such an environment, companies are striving to achieve 100%, sensor-based, automated inspection for zero-defect manufacturing. In this study, the Internet-based quality control scheme is referred to as "E-Quality for Manufacturing" or "EQM" for short. By its definition, EQM refers to a holistic approach to design and to embed efficient quality control functions in the context of network integrated manufacturing systems. Such system let designers located far away from the production facility to monitor, control and adjust the quality inspection processes as production design evolves.

[Investigation on production process quality control of traditional Chinese medicine--Banlangen granule as an example].

PubMed

Tan, Manrong; Yan, Dan; Qiu, Lingling; Chen, Longhu; Yan, Yan; Jin, Cheng; Li, Hanbing; Xiao, Xiaohe

2012-04-01

For the quality management system of herbal medicines, intermediate and finished products it exists the " short board" effect of methodologies. Based on the concept of process control, new strategies and new methods of the production process quality control had been established with the consideration of the actual production of traditional Chinese medicine an the characteristics of Chinese medicine. Taking Banlangen granule as a practice example, which was effective and widespread application, character identification, determination of index components, chemical fingerprint and biometrics technology were sequentially used respectively to assess the quality of Banlangen herbal medicines, intermediate (water extraction and alcohol precipitation) and finished product. With the transfer rate of chemical information and biological potency as indicators, the effectiveness and transmission of the above different assessments and control methods had been researched. And ultimately, the process quality control methods of Banlangen granule, which were based on chemical composition analysis-biometric analysis, had been set up. It can not only validly solute the current status that there were many manufacturers varying quality of Banlangen granule, but also ensure and enhance its clinical efficacy. Furthermore it provided a foundation for the construction of the quality control of traditional Chinese medicine production process.

Novel mechatronic solutions incorporating inerters for railway vehicle vertical secondary suspensions

NASA Astrophysics Data System (ADS)

Matamoros-Sanchez, Alejandra Z.; Goodall, Roger M.

2015-02-01

This paper discusses the effects of inerter-based passive networks in the design of novel mechatronic solutions for improving the vertical performance of a bogied railway vehicle. Combinations of inerter-based structures and active suspensions comprise distinct novel mechatronic solutions for the vertical secondary suspension of the vehicle. The parameters of the active and passive parts of the overall configuration are optimised so that a synergy arises to enhance the vehicle vertical performance and simplify common mechatronic suspension design conflicts. The study is performed by combining inerter-based suspensions with well-established active control (output-based and model-based) strategies for ride quality enhancement. Also, a novel nonlinear control strategy, here called 'Adaptive Stiffness', is incorporated for suspension deflection regulation to complement the well-known local implementation of skyhook damping. This would complete a significant set of control strategies to produce general conclusions. The vehicle performance is assessed through the vertical accelerations of the vehicle body as an initial investigation. Attained results show the potential of the inerter concept for innovating mechatronic technologies to achieve substantial improvements in railway vehicle vertical ride quality with reduced actuator force.

SELF-STIGMA AND COMING OUT ABOUT ONE’S MENTAL ILLNESS

PubMed Central

Corrigan, Patrick W.; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rüsch, Nicolas

2013-01-01

Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with serious mental illness completed measures of coming out (called the Coming Out with Mental Illness Scale, COMIS), self-stigma, quality of life, and strategies for managing self-stigma. An exploratory factor analysis of the COMIS uncovered two constructs: benefits of being out (BBO) and reasons for staying in. A mediational analysis showed BBO diminished self-stigma effects on quality of life. A factor analysis of measures of managing self-stigma yielded three factors. Benefits of being out was associated with two of these: affirming strategies and becoming aloof, not with strategies of shame. Implications for how coming out enhances the person’s quality of life are discussed. PMID:23970807

SELF-STIGMA AND COMING OUT ABOUT ONE'S MENTAL ILLNESS.

PubMed

Corrigan, Patrick W; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rüsch, Nicolas

2010-04-01

Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with serious mental illness completed measures of coming out (called the Coming Out with Mental Illness Scale, COMIS), self-stigma, quality of life, and strategies for managing self-stigma. An exploratory factor analysis of the COMIS uncovered two constructs: benefits of being out (BBO) and reasons for staying in. A mediational analysis showed BBO diminished self-stigma effects on quality of life. A factor analysis of measures of managing self-stigma yielded three factors. Benefits of being out was associated with two of these: affirming strategies and becoming aloof, not with strategies of shame. Implications for how coming out enhances the person's quality of life are discussed.

Ozone Control Strategies | Ground-level Ozone | New ...

EPA Pesticide Factsheets

2017-09-05

The Air Quality Planning Unit's primary goal is to protect your right to breathe clean air. Guided by the Clean Air Act, we work collaboratively with states, communities, and businesses to develop and implement strategies to reduce air pollution from a variety of sources that contribute to the ground-level ozone or smog problem.

Searching for disability in electronic databases of published literature.

PubMed

Walsh, Emily S; Peterson, Jana J; Judkins, Dolores Z

2014-01-01

As researchers in disability and health conduct systematic reviews with greater frequency, the definition of disability used in these reviews gains importance. Translating a comprehensive conceptual definition of "disability" into an operational definition that utilizes electronic databases in the health sciences is a difficult step necessary for performing systematic literature reviews in the field. Consistency of definition across studies will help build a body of evidence that is comparable and amenable to synthesis. To illustrate a process for operationalizing the World Health Organization's International Classification of Disability, Functioning, and Health concept of disability for MEDLINE, PsycINFO, and CINAHL databases. We created an electronic search strategy in conjunction with a reference librarian and an expert panel. Quality control steps included comparison of search results to results of a search for a specific disabling condition and to articles nominated by the expert panel. The complete search strategy is presented. Results of the quality control steps indicated that our strategy was sufficiently sensitive and specific. Our search strategy will be valuable to researchers conducting literature reviews on broad populations with disabilities. Copyright © 2014 Elsevier Inc. All rights reserved.

Effectiveness of transportation control measures : overview of the state of the practice.

DOT National Transportation Integrated Search

1996-01-01

Transportation control measures, or TCMs, are transportation measures or strategies intended both to reduce vehicle miles of travel (VMT) and to make those traveled more efficient. Although the term TCM has its origins in air quality and emissions re...

Placement and promotion strategies to increase sales of healthier products in supermarkets in low-income, ethnically diverse neighborhoods: a randomized controlled trial.

PubMed

Foster, Gary D; Karpyn, Allison; Wojtanowski, Alexis C; Davis, Erica; Weiss, Stephanie; Brensinger, Colleen; Tierney, Ann; Guo, Wensheng; Brown, Jeffery; Spross, Carly; Leuchten, Donna; Burns, Patrick J; Glanz, Karen

2014-06-01

The greater presence of supermarkets in low-income, high-minority neighborhoods has the potential to positively affect diet quality among those at greatest risk of obesity. In-store marketing strategies that draw attention to healthier products may be effective, sustainable, and scalable for improving diet quality and health. Few controlled studies of in-store marketing strategies to promote sales of healthier items in low-income, high-minority neighborhoods have been conducted. The objective of this study was to evaluate the effects of in-store marketing strategies to promote the purchase of specific healthier items in 5 product categories: milk, ready-to-eat cereal, frozen meals, in-aisle beverages, and checkout cooler beverages. The design was a cluster-randomized controlled trial conducted from 2011 to 2012. Eight urban supermarkets in low-income, high-minority neighborhoods were the unit of randomization, intervention, and analysis. Stores were matched on the percentage of sales from government food-assistance programs and store size and randomly assigned to an intervention or control group. The 4 intervention stores received a 6-mo, in-store marketing intervention that promoted the sales of healthier products through placement, signage, and product availability strategies. The 4 control stores received no intervention and were assessment-only controls. The main outcome measure was weekly sales of the targeted products, which was assessed on the basis of the stores' sales data. Intervention stores showed significantly greater sales of skim and 1% milk, water (in aisle and at checkout), and 2 of 3 types of frozen meals compared with control store sales during the same time period. No differences were found between the stores in sales of cereal, whole or 2% milk, beverages, or diet beverages. These data indicate that straightforward placement strategies can significantly enhance the sales of healthier items in several food and beverage categories. Such strategies show promise for significant public health effects in communities with the greatest risk of obesity. © 2014 American Society for Nutrition.

Control strategies for nitrous oxide emissions reduction on wastewater treatment plants operation.

PubMed

Santín, I; Barbu, M; Pedret, C; Vilanova, R

2017-11-15

The present paper focused on reducing greenhouse gases emissions in wastewater treatment plants operation by application of suitable control strategies. Specifically, the objective is to reduce nitrous oxide emissions during the nitrification process. Incomplete nitrification in the aerobic tanks can lead to an accumulation of nitrite that triggers the nitrous oxide emissions. In order to avoid the peaks of nitrous oxide emissions, this paper proposes a cascade control configuration by manipulating the dissolved oxygen set-points in the aerobic tanks. This control strategy is combined with ammonia cascade control already applied in the literature. This is performed with the objective to take also into account effluent pollutants and operational costs. In addition, other greenhouse gases emissions sources are also evaluated. Results have been obtained by simulation, using a modified version of Benchmark Simulation Model no. 2, which takes into account greenhouse gases emissions. This is called Benchmark Simulation Model no. 2 Gas. The results show that the proposed control strategies are able to reduce by 29.86% of nitrous oxide emissions compared to the default control strategy, while maintaining a satisfactory trade-off between water quality and costs. Copyright © 2017 Elsevier Ltd. All rights reserved.

El Nino impacts on seasonal high ozone levels in the lower troposphere

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

Linse, E.W. Jr.

The purpose of this paper is to clarify one difficulty in evaluating the control strategies for ozone concentrations. El Nino years may be mistakenly interpreted as periods having improved air quality because of those control programs. In fact, the differences in atmospheric stability and mixing have made some years especially benign for air quality. Improvements or the effectiveness of control programs can only be effectively reviewed if the meteorological signature is removed. It may not be generally known how large the impacts of the El Nino conditions can be.

Fugitive dust emission source profiles and assessment of selected control strategies for particulate matter at gravel processing sites in Taiwan.

PubMed

Chang, Chang-Tang; Chang, Yu-Min; Lin, Wen-Yinn; Wu, Ming-Ching

2010-10-01

Particles emitted from gravel processing sites are one contributor to worsening air quality in Taiwan. Major pollution sources at gravel processing sites include gravel and sand piles, unpaved roads, material crushers, and bare ground. This study analyzed fugitive dust emission characteristics at each pollution source using several types of particle samplers, including total suspended particulates (TSP), suspended particulate (PM10), fine suspended particulate (PM2.5), particulate sizer, and dust-fall collectors. Furthermore, silt content and moisture in the gravel were measured to develop particulate emission factors. The results showed that TSP (< 100 microm) concentrations at the boundary of gravel sites ranged from 280 to 1290 microg/m3, which clearly exceeds the Taiwan hourly air quality standard of 500 microg/m3. Moreover, PM10 concentrations, ranging from 135 to 550 microg/m3, were also above the daily air quality standard of 125 microg/m3 and approximately 1.2 and 1.5 times the PM2.5 concentrations, ranging from 105 to 470 microg/m3. The size distribution analysis reveals that mass mean diameter and geometric standard deviation ranged from 3.2 to 5.7 microm and from 2.82 to 5.51, respectively. In this study, spraying surfactant was the most effective control strategy to abate windblown dust from unpaved roads, having a control efficiency of approximately 93%, which is significantly higher than using paved road strategies with a control efficiency of approximately 45%. For paved roads, wet suppression provided the best dust control efficiencies ranging from 50 to 83%. Re-vegetation of disturbed ground had dust control efficiencies ranging from 48 to 64%.

Marketing to Develop the Premier Medical Brand in the Huaihai Economic Zone.

PubMed

Zhang, Peiying; Meng, Qingchao

2015-06-01

Based on the practices at Xuzhou Central Hospital, the authors analyzed the improvements in the healthcare quality and economic efficiency after implementing a brand marketing strategy. Using methods including questionnaires and business controlling means, we summarized that the improvements to the healthcare quality and economic efficiency after strategies were implemented in the areas of network, reputation, academic research, and public welfare. After the implementation of a brand marketing campaign, the medical service quality and brand reputation have been greatly improved. Meanwhile, a central hospital group was formed and gradually became the central healthcare provider in the Huaihai Economic Zone. The new marketing facilitated the drastic increase of medical service and brand reputation.

Iranian nurses' experiences of aggression in psychiatric wards: a qualitative study.

PubMed

Moghadam, Malek Fereidooni; Pazargadi, Mehrnoosh; Khoshknab, Masoud Fallahi

2013-10-01

Aggression from psychiatric patients is a constant problem for care providers that causes major problems in the therapeutic environment, and may have negative effects on the quality of care. Since recognition of aggression with regard to cultural background leads to better control of aggression in the psychiatric wards, this study has been done to clarify Iranian nurses' experiences of aggression in psychiatric wards. A qualitative content analysis study was conducted to explore experiences of nurses. Data analysis revealed four themes: (1) Damage resulting from aggression, (2) Aggression catalysts, (3) Contagious nature of aggression, and (4) Various control strategies. There are various causes for in-patients' aggression, and nurses use various approaches to control it. These approaches are influenced by personnel, facilities, and ward environment. Identifying these factors and strategies can contribute to better management of aggression and, thus, better quality of care in psychiatric wards.

Acquisition Strategies for Purchasing Bulk Petroleum in DoD.

DTIC Science & Technology

1980-12-01

Oligopoly . . . . . . . . 41 2. Pricing Policy . . . . . . . . . . . . . . 42 a. Crude Oil Price Controls . . . . . . 43 b...Petroleum Product Price Controls 4. . . c. OPEC Price Controls . . .. . 4 6l 3. Product Policy ...... ....... 45 4. Policy Toward Rivals...Market conduct in the petroleum industry will be divided into three areas: pricing policies , product quality policies , and policies toward

Enhanced power quality based single phase photovoltaic distributed generation system

NASA Astrophysics Data System (ADS)

Panda, Aurobinda; Pathak, M. K.; Srivastava, S. P.

2016-08-01

This article presents a novel control strategy for a 1-ϕ 2-level grid-tie photovoltaic (PV) inverter to enhance the power quality (PQ) of a PV distributed generation (PVDG) system. The objective is to obtain the maximum benefits from the grid-tie PV inverter by introducing current harmonics as well as reactive power compensation schemes in its control strategy, thereby controlling the PV inverter to achieve multiple functions in the PVDG system such as: (1) active power flow control between the PV inverter and the grid, (2) reactive power compensation, and (3) grid current harmonics compensation. A PQ enhancement controller (PQEC) has been designed to achieve the aforementioned objectives. The issue of underutilisation of the PV inverter in nighttime has also been addressed in this article and for the optimal use of the system; the PV inverter is used as a shunt active power filter in nighttime. A prototype model of the proposed system is developed in the laboratory, to validate the effectiveness of the control scheme, and is tested with the help of the dSPACE DS1104 platform.

The Role of Liposomal Bupivacaine in Value-Based Care.

PubMed

Iorio, Richard

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

The effect of nutrition training for health care staff on learner and patient outcomes in adults: a systematic review and meta-analysis.

PubMed

Marples, Owen; Baldwin, Christine; Weekes, C Elizabeth

2017-07-01

Background: Nutrition training for health care staff has been prioritized internationally as a key means of tackling malnutrition; however, there is a lack of clear evidence to support its implementation. Systematic reviews in other fields of training for health care staff indicate that training strategies may have a beneficial impact on learner and patient outcomes. Objectives: We assessed whether nutrition training for health care staff caring for nutritionally vulnerable adults resulted in improved learner and patient outcomes and evaluated the effectiveness of different training strategies. Design: A systematic review of trials of nutrition training for health care staff was conducted. Six databases were searched with key terms relating to malnutrition and nutrition training. Studies were categorized according to cognitive (didactic teaching), behavioral (practical implementation of skills), and psychological (individualized or group feedback and reflection) training strategies. Where sufficient data were available, meta-analysis was performed according to study design and training strategy. All study designs were eligible. The risk of bias was evaluated in accordance with Cochrane guidance. Results: Twenty-four studies met the eligibility criteria: 1 randomized controlled trial, 4 nonrandomized controlled trials, 3 quasi-experimental trials, 13 longitudinal pre-post trials, 2 qualitative studies, and 1 cross-sectional survey. Results from a number of low-quality studies suggest that nutrition training for health care staff may have a beneficial effect on staff nutrition knowledge, practice, and attitude as well as patient nutritional intake. There were insufficient data to determine whether any particular training strategy was more effective than the others. Conclusions: In the absence of high-quality evidence, low-quality studies suggest that nutrition training for health care staff has some positive effects. However, further randomized controlled trials are required to confirm overall efficacy and to explore the impact of training strategies on learner and patient outcomes. © 2017 American Society for Nutrition.

Measurement and Control Strategies for Sterol Glucosides to Improve Biodiesel Quality: Isolation and Characterization of Acylated Steryl Glucosides in Oilseed Crops of the Pacific Northwest

DOT National Transportation Integrated Search

2010-01-01

Acylated steryl glucosides (ASG), a form of phytosterols, have been identified in a variety of agricultural products, including the oilseeds of soybean and rapeseed. Currently, there are limited data available on the quality and quantity of phytoster...

Assuring Quality Control of Clinical Education in Multiple Clinical Affiliates.

ERIC Educational Resources Information Center

Davis, Judith A.

A plan was developed to assure equivalency of clinical education among the medical laboratory technician (MLT) programs affiliated with Sandhills Community College. The plan was designed by faculty to monitor the quality of clinical courses offered by the clinical affiliates. The major strategies were to develop competencies, slide/tape modules, a…

DYNAMIC EVALUATION OF REGIONAL AIR QUALITY MODELS: ASSESSING CHANGES TO O 3 STEMMING FROM CHANGES IN EMISSIONS AND METEOROLOGY

EPA Science Inventory

Regional-scale air quality models are used to estimate the response of air pollutants to potential emission control strategies as part of the decision-making process. Traditionally, the model predicted pollutant concentrations are evaluated for the “base case” to assess a model’s...

Water quality ramifications of manure storage and daily haul during winter and early spring

USDA-ARS?s Scientific Manuscript database

Manure storage is supported by the United States Natural Resources Conservation Service (NRCS) as a nutrient management strategy for controlling air and water quality. Daily haul is still a popular practice on the small farms in northeastern USA but receives criticism over the impact of spreading du...

Maintaining Acceptable Indoor Air Quality during the Renovation of a School. Technical Bulletin.

ERIC Educational Resources Information Center

Jacobs, Bruce W.

Information that school facility personnel can use concerning the potential impacts of renovation projects on indoor air quality (IAQ), along with details of some effective control strategies, are presented. Various kinds of contaminants may be generated by renovations, including volatile and semivolatile organic compounds, dusts and fibers (e.g.,…

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.

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

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

PubMed

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

2016-01-01

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

Randomized Trial of Hypnosis as a Pain and Symptom Management Strategy in Adults with Sickle Cell Disease

PubMed Central

Wallen, Gwenyth R; Middleton, Kimberly R; Ames, Nancy; Brooks, Alyssa T; Handel, Daniel

2014-01-01

Sickle cell disease (SCD) is the most common genetic disease in African-Americans, characterized by recurrent painful vaso-occlusive crises. Medical therapies for controlling or preventing crises are limited because of efficacy and/or toxicity. This is a randomized, controlled, single-crossover protocol of hypnosis for managing pain in SCD patients. Participants receive hypnosis from a trained hypnosis therapist followed by six weeks of self-hypnosis using digital media. Those in the control arm receive SCD education followed by a six-week waiting period before crossing over to the hypnosis arm of the study. Outcome measures include assessments of pain (frequency, intensity and quality), anxiety, coping strategies, sleep, depression, and health care utilization. To date, there are no published randomized, controlled trials evaluating the efficacy of hypnosis on SCD pain modulation in adults. Self-hypnosis for pain management may be helpful in modulating chronic pain, improving sleep quality, and decreasing use of narcotics in patients with SCD. TRIAL REGISTRATION ClinicalTrials.gov: NCT00393250 PMID:25520557

Osteocyte-Intrinsic TGF-β Signaling Regulates Bone Quality through Perilacunar/Canalicular Remodeling

DOE PAGES

Dole, Neha S.; Mazur, Courtney M.; Acevedo, Claire; ...

2017-11-28

Poor bone quality contributes to bone fragility in diabetes, aging, and osteogenesis imperfecta. However, the mechanisms controlling bone quality are not well understood, contributing to the current lack of strategies to diagnose or treat bone quality deficits. Transforming growth factor beta (TGF-β) signaling is a crucial mechanism known to regulate the material quality of bone, but its cellular target in this regulation is unknown. Studies showing that osteocytes directly remodel their perilacunar/canalicular matrix led us to hypothesize that TGF-β controls bone quality through perilacunar/canalicular remodeling (PLR). Using inhibitors and mice with an osteocyte-intrinsic defect in TGF-β signaling (TβRII ocy-/-), wemore » show that TGF-β regulates PLR in a cell-intrinsic manner to control bone quality. Altogether, this study emphasizes that osteocytes are key in executing the biological control of bone quality through PLR, thereby highlighting the fundamental role of osteocyte-mediated PLR in bone homeostasis and fragility. Resistance to fracture requires healthy bone mass and quality. However, the cellular mechanisms regulating bone quality are unclear. Dole et al. show that osteocyte-intrinsic TGF-β signaling maintains bone quality through perilacunar/canalicular remodeling. Thus, osteocytes mediate perilacunar/canalicular remodeling and osteoclast-directed remodeling to cooperatively maintain bone quality and mass and prevent fragility.« less

Osteocyte-Intrinsic TGF-β Signaling Regulates Bone Quality through Perilacunar/Canalicular Remodeling

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

Dole, Neha S.; Mazur, Courtney M.; Acevedo, Claire

Poor bone quality contributes to bone fragility in diabetes, aging, and osteogenesis imperfecta. However, the mechanisms controlling bone quality are not well understood, contributing to the current lack of strategies to diagnose or treat bone quality deficits. Transforming growth factor beta (TGF-β) signaling is a crucial mechanism known to regulate the material quality of bone, but its cellular target in this regulation is unknown. Studies showing that osteocytes directly remodel their perilacunar/canalicular matrix led us to hypothesize that TGF-β controls bone quality through perilacunar/canalicular remodeling (PLR). Using inhibitors and mice with an osteocyte-intrinsic defect in TGF-β signaling (TβRII ocy-/-), wemore » show that TGF-β regulates PLR in a cell-intrinsic manner to control bone quality. Altogether, this study emphasizes that osteocytes are key in executing the biological control of bone quality through PLR, thereby highlighting the fundamental role of osteocyte-mediated PLR in bone homeostasis and fragility. Resistance to fracture requires healthy bone mass and quality. However, the cellular mechanisms regulating bone quality are unclear. Dole et al. show that osteocyte-intrinsic TGF-β signaling maintains bone quality through perilacunar/canalicular remodeling. Thus, osteocytes mediate perilacunar/canalicular remodeling and osteoclast-directed remodeling to cooperatively maintain bone quality and mass and prevent fragility.« less

The association between fear of falling and quality of life for balance impairments based on hip and ankle strategies in the drug On- and Off-phase of patients with idiopathic Parkinson' disease.

PubMed

Mehdizadeh, Maryam; Lajevardi, Laleh; Habibi, Seyed Amir Hassan; ArabBaniasad, Mina; Baghoori, Delaram; Daneshjoo, Fatemeh; Taghizadeh, Ghorban

2016-01-01

Background: Despite the negative effect of fear of falling during functioning and social participation of patients with Parkinson' disease, so far, only few studies have investigated its effect on the quality of life in these patients. We aimed to investigate the association between fear of falling and quality of life controlling for balance impairments based on hip and ankle strategy in drug On- and Off-phase of patients with idiopathic Parkinson' disease. Methods: In this non-experimental cross-sectional study, 139 patients with idiopathic Parkinson' disease (100 male, 39 female) by mean± SD age of 60.2±12.27 years, mean±SD time since diagnosis of 6.7±5.53 years and mean±SD Hoehn and Yahr stage of 2.8±1.49 were selected by a simple non-probability method. Balance function was measured by a functional reach test with hip and ankle strategy. The Persian version of the selfcompleted Fall Efficacy Scale-International and Parkinson's disease quality of life questionnaire was used to evaluate fear of falling and quality of life, respectively. Results: The results showed that the score of all dimensions of quality of life (i.e., mobility, activities of daily living, emotional wellbeing, stigma, social support, cognition, communication and bodily discomfort) were significantly affected by the intensity of fear of falling. Multiple regression analysis indicated a significant association between fear of falling and quality of life in a way that fear of falling explained 11% to 47% and 12% to 43% of variance in drug On-phase, as well as 8% to 45% and 9% to 48% of variance in the drug Off-phase in dimensions of quality of life after controlling for balance function based on hip and ankle strategy, respectively. In the drug On-phase, the strongest association (R=0.85, p<0.001) was found between fear of falling and mobility dimension of quality of life. In the drug Off-phase, the strongest relation was observed between fear of falling and mobility (R=0.82, p<0.001) as well as activities of daily living (R=0.78-0.79, p<0.001) dimensions. Conclusion: This study found that fear of falling affects the quality of life of patients with Parkinson' disease beyond its relationship with balance impairments based on the hip and ankle strategy in both drug On- and Off-phase.

Comparison of Radiation Dose and Image Quality of Triple-Rule-Out Computed Tomography Angiography Between Conventional Helical Scanning and a Strategy Incorporating Sequential Scanning

PubMed Central

Manheimer, Eric D.; Peters, M. Robert; Wolff, Steven D.; Qureshi, Mehreen A.; Atluri, Prashanth; Pearson, Gregory D.N.; Einstein, Andrew J.

2011-01-01

Triple-rule-out computed tomography angiography (TRO CTA), performed to evaluate the coronary arteries, pulmonary arteries, and thoracic aorta, has been associated with high radiation exposure. Utilization of sequential scanning for coronary computed tomography angiography (CCTA) reduces radiation dose. The application of sequential scanning to TRO CTA is much less well defined. We analyzed radiation dose and image quality from TRO CTA performed in a single outpatient center, comparing scans from a period during which helical scanning with electrocardiographically controlled tube current modulation was used for all patients (n=35) and after adoption of a strategy incorporating sequential scanning whenever appropriate (n=35). Sequential scanning was able to be employed in 86% of cases. The sequential-if-appropriate strategy, compared to the helical-only strategy, was associated with a 61.6% dose decrease (mean dose-length product [DLP] of 439 mGy×cm vs 1144 mGy×cm and mean effective dose of 7.5 mSv vs 19.4 mSv, respectively, p<0.0001). Similarly, there was a 71.5% dose reduction among 30 patients scanned with the sequential protocol compared to 40 patients scanned with the helical protocol under either strategy (326 mGy×cm vs 1141 mGy×cm and 5.5 mSv vs 19.4 mSv, respectively, p<0.0001). Although image quality did not differ between strategies, there was a non-statistically significant trend towards better quality in the sequential protocol compared to the helical protocol. In conclusion, approaching TRO CTA with a diagnostic strategy of sequential scanning as appropriate offers a marked reduction in radiation dose while maintaining image quality. PMID:21306693

Proteostasis in cardiac health and disease.

PubMed

Henning, Robert H; Brundel, Bianca J J M

2017-11-01

The incidence and prevalence of cardiac diseases, which are the main cause of death worldwide, are likely to increase because of population ageing. Prevailing theories about the mechanisms of ageing feature the gradual derailment of cellular protein homeostasis (proteostasis) and loss of protein quality control as central factors. In the heart, loss of protein patency, owing to flaws in genetically-determined design or because of environmentally-induced 'wear and tear', can overwhelm protein quality control, thereby triggering derailment of proteostasis and contributing to cardiac ageing. Failure of protein quality control involves impairment of chaperones, ubiquitin-proteosomal systems, autophagy, and loss of sarcomeric and cytoskeletal proteins, all of which relate to induction of cardiomyocyte senescence. Targeting protein quality control to maintain cardiac proteostasis offers a novel therapeutic strategy to promote cardiac health and combat cardiac disease. Currently marketed drugs are available to explore this concept in the clinical setting.

Integrated application of river water quality modelling and cost-benefit analysis to optimize the environmental economical value based on various aquatic waste load reduction strategies

NASA Astrophysics Data System (ADS)

Wu, Chen-Yu; Fan, Chihhao

2017-04-01

To assure the river water quality, the Taiwan government establishes many pollution control strategies and expends huge monetary investment. Despite all these efforts, many rivers still suffer from severe pollution because of massive discharges of domestic and industrial wastewater without proper treatment. A comprehensive evaluation tool seems required to assess the suitability of water pollution control strategies. Therefore, the purpose of this study is to quantify the potential strategic benefits by applying the water quality modelling integrated with cost-benefit analysis to simulating scenarios based on regional development planning. The Erhjen Creek is selected as the study example because it is a major river in southern Taiwan, and its riverine environment impacts a great deal to the neighboring people. For strategy assessment, we established QUAL2k model of Erhjen Creek and conducted the cost-benefit analyses according the proposed strategies. In the water quality simulation, HEC-RAS was employed to calculate the hydraulic parameters and dilution impact of tidal effect in the downstream section. Daily pollution loadings were obtained from the Water Pollution Control Information System maintained by Taiwan EPA, and the wastewater delivery ratios were calculated by comparing the occurrence of pollution loadings with the monitoring data. In the cost-benefit analysis, we adopted the market valuation method, setting a period of 65 years for analysis and discount rate at 2.59%. Capital investments were the costs of design, construction, operation and maintenance for each project in Erhjen Creek catchment. In model calibration and model verification, the mean absolute percentage errors (MAPEs) were calculated to be 21.4% and 25.5%, respectively, which met the prescribed acceptable criteria of 50%. This model was applied to simulating water quality based on implementing various pollution control policies and engineering projects in the Erhjen Creek. The overall improvements in BOD, SS and NH3-N were estimated as 36.2%, 27.7% and 29.2%, respectively. The net present value (i.e., economical-based environmental impact) becomes positive in the sixtieth year following the original government planning. We designed two scenarios for further comparison: (i) treatment efficiency improvement of pollution control facilities, and (ii) biogas-based power generation using livestock manure. If government budget is not a limiting factor, improving the efficiency of sewage treatment plants can make the occurrence of balance between payments and revenues (i.e., net present value in this study) three years earlier. For the biogas-based power generation scenario, if all pig farms with livestock number >2000 install the on-site power generation equipment, BOD will further improve by 9% and the time span of payback period will be shortened by 1 year. If all the manure waste from pig-farms is collected for subsequent electricity generation, the BOD river pollution index is estimated to improve to lightly-polluted category for more than half the length of Erhjen Creek. In short, water quality modelling technique not only can assess the contributions of related projects, but establish a practical pollution reduction strategy using cost-benefit analysis, which allows decision-maker to find a suitable pollution reduction plan to exhibit most benefits in river water quality.

The vaccines consistency approach project: an EPAA initiative.

PubMed

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

2015-01-01

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

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.

The Effects of Different Pre-Writing Strategies on Iranian EFL Writing Achievement

ERIC Educational Resources Information Center

Mahnam, Lily; Nejadansari, Dariush

2012-01-01

This study aimed at investigating whether applying pre-writing strategies would affect the quality of L2 learners' compositions. Twenty three adult EFL students from Jahad-e-Daneshgahi English centre in Iran participated in this study. They were randomly assigned to control and experimental groups, including 11 and 12 participants in each. They…

Emission controls and changes in air quality in Guangzhou during the Asian Games

NASA Astrophysics Data System (ADS)

Liu, Huan; Wang, Xuemei; Zhang, Jinpu; He, Kebin; Wu, Ye; Xu, Jiayu

2013-09-01

With the new air quality standards forthcoming in China, the Pearl River Delta region is facing new challenges to achieve its air quality goal. The success of the emission reduction measures introduced by local authorities in the run-up to the Guangzhou Asian Games demonstrated that the Pearl River Delta air quality can be improved by introducing integrated emission reduction measures. This paper combines observation data, emission reduction measures, and air quality simulations that were applied during the Asian Games (12-27 November 2010) to analyze the relationship between emissions and concentrations of pollutants in Guangzhou. The Asian Games abatement strategy totally reduced emissions of 41.1% SO2, 41.9% NOx, 26.5% PM10, 25.8% PM2.5 and 39.7% VOC. The concentrations of SO2, NO2, PM10 and PM2.5 were reduced by 66.8%, 51.3%, 21.5% and 17.1%, respectively. In Guangzhou, the main challenge to be overcome with the new air quality daily requirements is mostly for NO2, PM2.5, and hourly ozone maxima. If pollutants maintain the same concentrations before and after the Asian Games, there will be 47.4% and 31.6% non-attainment days for NO2 and PM2.5 respectively as a period average. Although PM10 concentration can meet the daily limits (150 μg m-3), it is quite difficult to meet the annual limit value (70 μg m-3). One important implication is that the long-term, step-by-step integrated measures of the past six years work better than the strict, intensive, short-term measures on SO2, NO2 and VOC control. Dust control by limiting construction sites and watering the roads can further reduce 12.8% of the PM10 concentration. However, to reduce ambient PM2.5, the abatement strategy should be more complex and extensive. On the contrary, ozone pollution was not improved during the Asian Games, indicating that alleviation strategies should be improved by scientific studies to determine the appropriate control ratio of NO2 and VOC in the Pearl River Delta region.

System-wide hybrid MPC-PID control of a continuous pharmaceutical tablet manufacturing process via direct compaction.

PubMed

Singh, Ravendra; Ierapetritou, Marianthi; Ramachandran, Rohit

2013-11-01

The next generation of QbD based pharmaceutical products will be manufactured through continuous processing. This will allow the integration of online/inline monitoring tools, coupled with an efficient advanced model-based feedback control systems, to achieve precise control of process variables, so that the predefined product quality can be achieved consistently. The direct compaction process considered in this study is highly interactive and involves time delays for a number of process variables due to sensor placements, process equipment dimensions, and the flow characteristics of the solid material. A simple feedback regulatory control system (e.g., PI(D)) by itself may not be sufficient to achieve the tight process control that is mandated by regulatory authorities. The process presented herein comprises of coupled dynamics involving slow and fast responses, indicating the requirement of a hybrid control scheme such as a combined MPC-PID control scheme. In this manuscript, an efficient system-wide hybrid control strategy for an integrated continuous pharmaceutical tablet manufacturing process via direct compaction has been designed. The designed control system is a hybrid scheme of MPC-PID control. An effective controller parameter tuning strategy involving an ITAE method coupled with an optimization strategy has been used for tuning of both MPC and PID parameters. The designed hybrid control system has been implemented in a first-principles model-based flowsheet that was simulated in gPROMS (Process System Enterprise). Results demonstrate enhanced performance of critical quality attributes (CQAs) under the hybrid control scheme compared to only PID or MPC control schemes, illustrating the potential of a hybrid control scheme in improving pharmaceutical manufacturing operations. Copyright © 2013 Elsevier B.V. All rights reserved.

Study protocol for a cluster randomized controlled trial to evaluate a referral strategy for axial spondyloarthritis in young primary care patients with chronic low back pain; an impact study.

PubMed

van Hoeven, Lonneke; Vergouwe, Yvonne; Koes, Bart W; Hazes, Johanna M W; Weel, Angelique E A M

2016-07-12

Axial spondyloarthritis (axSpA) is a disabling inflammatory joint disease with chronic low back pain (CLBP) as leading symptom. Recognizing axSpA in the large amount of CLBP patients is difficult for general practioners (GP). This evaluation aims to assess the effect of a referral strategy for axSpA in young primary care patients with CLBP by comparing the use of the strategy with usual care. The effect is measured at three different levels; by patient reported outcomes (the clinical effect), process and costs evaluation. This study design is a cluster randomized controlled trial with GP as clusters. GPs throughout the Netherlands are invited to participate and randomized to either the intervention or the control group. Patients from participating GPs are invited to participate if they have ever been registered with low back pain, without radiation (ICPC L03) and aged 18-45 years. To be included in the study, patients need to have current low back pain and chronic low back pain (>12 weeks). In the intervention arm a referral strategy for axSpA will be applied in CLBP patients, in the control arm care as usual will be provided for CLBP patients. The referral strategy consists of four easy to use variables. All are questions about the back pain complaints of the patients. Data is prospectively collected in an online database at baseline (T0), 4 months (T1), 12 months (T2) and 24 months (T3). After time point T1 (4 months) patients from the control group will also receive the intervention i.e. the application of a referral strategy for axSpA. The effect of the referral strategy is measured at three different levels, by patient outcomes (e.g. pain scores, quality of life), process measures (e.g. number of axSpA diagnoses by rheumatologists) and by costs (work productivity and health care resources use). Our primary outcome is the Roland Morris Disability Questionnaire after 4 months, secondary outcomes are pain and quality of life. Costs will be assessed before and after the use of the referral strategy, to estimate if the use of the strategy will lead to a reduction in health care costs and improvement in work participation. It is anticipated that using the axSpA referral strategy for primary care CLBP patients will increase the quality of life of CLBP patients, will result in more (correct) diagnoses of axSpA by the rheumatologists, and will be cost-effective. Ultimately, the results of this study may contribute to the startup of a national implementation of the axSpA referral strategy to identify timely CLBP patients with axSpA. NCT01944163 , date of registration; September 6, 2013 (Clinicaltrials.gov).

76 FR 10249 - Approval and Promulgation of Air Quality Implementation Plans; Texas; Revisions To Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-24

... Container rule as an ozone control strategy from the Texas SIP for the Control of Ozone Air Pollution. In the submittal, Texas demonstrates that Federal portable fuel container standards promulgated by EPA in... Portable Fuel Container Regulations IV. What is the effect of this action? V. Final Action VI. Statutory...

Nonlinear Multiobjective MPC-Based Optimal Operation of a High Consistency Refining System in Papermaking

DOE PAGES

Li, Mingjie; Zhou, Ping; Wang, Hong; ...

2017-09-19

As one of the most important unit in the papermaking industry, the high consistency (HC) refining system is confronted with challenges such as improving pulp quality, energy saving, and emissions reduction in its operation processes. Here in this correspondence, an optimal operation of HC refining system is presented using nonlinear multiobjective model predictive control strategies that aim at set-point tracking objective of pulp quality, economic objective, and specific energy (SE) consumption objective, respectively. First, a set of input and output data at different times are employed to construct the subprocess model of the state process model for the HC refiningmore » system, and then the Wiener-type model can be obtained through combining the mechanism model of Canadian Standard Freeness and the state process model that determines their structures based on Akaike information criterion. Second, the multiobjective optimization strategy that optimizes both the set-point tracking objective of pulp quality and SE consumption is proposed simultaneously, which uses NSGA-II approach to obtain the Pareto optimal set. Furthermore, targeting at the set-point tracking objective of pulp quality, economic objective, and SE consumption objective, the sequential quadratic programming method is utilized to produce the optimal predictive controllers. In conclusion, the simulation results demonstrate that the proposed methods can make the HC refining system provide a better performance of set-point tracking of pulp quality when these predictive controllers are employed. In addition, while the optimal predictive controllers orienting with comprehensive economic objective and SE consumption objective, it has been shown that they have significantly reduced the energy consumption.« less

Nonlinear Multiobjective MPC-Based Optimal Operation of a High Consistency Refining System in Papermaking

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

Li, Mingjie; Zhou, Ping; Wang, Hong

As one of the most important unit in the papermaking industry, the high consistency (HC) refining system is confronted with challenges such as improving pulp quality, energy saving, and emissions reduction in its operation processes. Here in this correspondence, an optimal operation of HC refining system is presented using nonlinear multiobjective model predictive control strategies that aim at set-point tracking objective of pulp quality, economic objective, and specific energy (SE) consumption objective, respectively. First, a set of input and output data at different times are employed to construct the subprocess model of the state process model for the HC refiningmore » system, and then the Wiener-type model can be obtained through combining the mechanism model of Canadian Standard Freeness and the state process model that determines their structures based on Akaike information criterion. Second, the multiobjective optimization strategy that optimizes both the set-point tracking objective of pulp quality and SE consumption is proposed simultaneously, which uses NSGA-II approach to obtain the Pareto optimal set. Furthermore, targeting at the set-point tracking objective of pulp quality, economic objective, and SE consumption objective, the sequential quadratic programming method is utilized to produce the optimal predictive controllers. In conclusion, the simulation results demonstrate that the proposed methods can make the HC refining system provide a better performance of set-point tracking of pulp quality when these predictive controllers are employed. In addition, while the optimal predictive controllers orienting with comprehensive economic objective and SE consumption objective, it has been shown that they have significantly reduced the energy consumption.« less

Implementing guidelines in nursing homes: a systematic review.

PubMed

Diehl, Heinz; Graverholt, Birgitte; Espehaug, Birgitte; Lund, Hans

2016-07-25

Research on guideline implementation strategies has mostly been conducted in settings which differ significantly from a nursing home setting and its transferability to the nursing home setting is therefore limited. The objective of this study was to systematically review the effects of interventions to improve the implementation of guidelines in nursing homes. A systematic literature search was conducted in the Cochrane Library, CINAHL, Embase, MEDLINE, DARE, HTA, CENTRAL, SveMed + and ISI Web of Science from their inception until August 2015. Reference screening and a citation search were performed. Studies were eligible if they evaluated any type of guideline implementation strategy in a nursing home setting. Eligible study designs were systematic reviews, randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted-time-series studies. The EPOC risk of bias tool was used to evaluate the risk of bias in the included studies. The overall quality of the evidence was rated using GRADE. Five cluster-randomised controlled trials met the inclusion criteria, evaluating a total of six different multifaceted implementation strategies. One study reported a small statistically significant effect on professional practice, and two studies demonstrated small to moderate statistically significant effects on patient outcome. The overall quality of the evidence for all comparisons was low or very low using GRADE. Little is known about how to improve the implementation of guidelines in nursing homes, and the evidence to support or discourage particular interventions is inconclusive. More implementation research is needed to ensure high quality of care in nursing homes. PROSPERO 2014: CRD42014007664.

Mood regulation and quality of life in social anxiety disorder: An examination of generalized expectancies for negative mood regulation

PubMed Central

Sung, Sharon C.; Porter, Eliora; Robinaugh, Donald J.; Marks, Elizabeth H.; Marques, Luana M.; Otto, Michael W.; Pollack, Mark H.; Simon, Naomi M.

2014-01-01

The present study examined negative mood regulation expectancies, anxiety symptom severity, and quality of life in a sample of 167 patients with social anxiety disorder (SAD) and 165 healthy controls with no DSM-IV Axis I disorders. Participants completed the Generalized Expectancies for Negative Mood Regulation Scale (NMR), the Beck Anxiety Inventory, and the Quality of Life Enjoyment and Satisfaction Questionnaire. SAD symptom severity was assessed using the Liebowitz Social Anxiety Scale. Individuals with SAD scored significantly lower than controls on the NMR. Among SAD participants, NMR scores were negatively correlated with anxiety symptoms and SAD severity, and positively correlated with quality of life. NMR expectancies positively predicted quality of life even after controlling for demographic variables, comorbid diagnoses, anxiety symptoms, and SAD severity. Individuals with SAD may be less likely to engage in emotion regulating strategies due to negative beliefs regarding their effectiveness, thereby contributing to poorer quality of life. PMID:22343166

A qualitative investigation of the impact of asthma and self-management strategies among older adults.

PubMed

O'Conor, Rachel; Martynenko, Melissa; Gagnon, Monica; Hauser, Diane; Young, Edwin; Lurio, Joseph; Wisnivesky, Juan P; Wolf, Michael S; Federman, Alex D

2017-01-02

 We sought feedback from elderly patients living with asthma to understand their experience with assuming self-management roles for their asthma in order to inform the design and implementation of a primary care-based strategy that could best support their asthma control. We held six focus groups with a total of 31 English- and Spanish-speaking older adults with a current diagnosis of asthma. Focus groups addressed the effect of asthma on patients' lives and self-management strategies. Transcripts were analyzed using constant comparative techniques. Asthma exerted a consistent effect on patients' physical and psychological well-being. Common barriers to self-care included misuse of controller medications and uncertainty whether shortness of breath, fatigue, and cough were due to their asthma or some other chronic illness. Patients developed coping strategies to continue with daily activities even when experiencing symptoms, but did not recognize attainable asthma quality of life. Asthma had a distinct impact on elderly adults' quality of life; due to their longstanding history with this condition, many patients had accepted these symptoms as a "new normal." Developing strategies to reorient patients' perceptions of the possibilities for managing their illness will be critical to the success of asthma self-management support programs specific to older adults.

Hospital implementation of health information technology and quality of care: are they related?

PubMed

Restuccia, Joseph D; Cohen, Alan B; Horwitt, Jedediah N; Shwartz, Michael

2012-09-27

Recently, there has been considerable effort to promote the use of health information technology (HIT) in order to improve health care quality. However, relatively little is known about the extent to which HIT implementation is associated with hospital patient care quality. We undertook this study to determine the association of various HITs with: hospital quality improvement (QI) practices and strategies; adherence to process of care measures; risk-adjusted inpatient mortality; patient satisfaction; and assessment of patient care quality by hospital quality managers and front-line clinicians. We conducted surveys of quality managers and front-line clinicians (physicians and nurses) in 470 short-term, general hospitals to obtain data on hospitals' extent of HIT implementation, QI practices and strategies, assessments of quality performance, commitment to quality, and sufficiency of resources for QI. Of the 470 hospitals, 401 submitted complete data necessary for analysis. We also developed measures of hospital performance from several publicly data available sources: Hospital Compare adherence to process of care measures; Medicare Provider Analysis and Review (MEDPAR) file; and Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS® survey. We used Poisson regression analysis to examine the association between HIT implementation and QI practices and strategies, and general linear models to examine the relationship between HIT implementation and hospital performance measures. Controlling for potential confounders, we found that hospitals with high levels of HIT implementation engaged in a statistically significant greater number of QI practices and strategies, and had significantly better performance on mortality rates, patient satisfaction measures, and assessments of patient care quality by hospital quality managers; there was weaker evidence of higher assessments of patient care quality by front-line clinicians. Hospital implementation of HIT was positively associated with activities intended to improve patient care quality and with higher performance on four of six performance measures.

77 FR 9529 - Approval and Promulgation of Implementation Plans; State of Missouri

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-17

... pollution control, Environmental protection, Incorporation by reference, Lead, Reporting and recordkeeping... Implementation Plan (SIP) and control strategy for the lead National Ambient Air Quality Standard (NAAQS... in this action is the lead NAAQS promulgated by EPA in 1978. EPA has determined that both SIP...

Eight Truths for Middle Managers in Lean Times.

ERIC Educational Resources Information Center

Lewis, David W.

1991-01-01

Suggests strategies to help middle managers in libraries cope with difficult financial times. Highlights include resource allocations; the importance of change to prevent a decline in quality and to demonstrate some degree of control; the need to control both financial and staff resources; and providing vision for the future. (LRW)

An effective immunization strategy for airborne epidemics in modular and hierarchical social contact network

NASA Astrophysics Data System (ADS)

Song, Zhichao; Ge, Yuanzheng; Luo, Lei; Duan, Hong; Qiu, Xiaogang

2015-12-01

Social contact between individuals is the chief factor for airborne epidemic transmission among the crowd. Social contact networks, which describe the contact relationships among individuals, always exhibit overlapping qualities of communities, hierarchical structure and spatial-correlated. We find that traditional global targeted immunization strategy would lose its superiority in controlling the epidemic propagation in the social contact networks with modular and hierarchical structure. Therefore, we propose a hierarchical targeted immunization strategy to settle this problem. In this novel strategy, importance of the hierarchical structure is considered. Transmission control experiments of influenza H1N1 are carried out based on a modular and hierarchical network model. Results obtained indicate that hierarchical structure of the network is more critical than the degrees of the immunized targets and the modular network layer is the most important for the epidemic propagation control. Finally, the efficacy and stability of this novel immunization strategy have been validated as well.

Single-Family Quality Control Inspector Job Task Analysis

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

Head, Heather R; Kurnik, Charles W

The National Renewable Energy Laboratory (NREL) is contracted by the U.S. Department of Energy (DOE) Weatherization Assistance Program (WAP) to develop and maintain the resources under the Guidelines for Home Energy Professionals (GHEP) project. As part of the GHEP strategy to increase the quality of work conducted for single-family, residential energy-efficiency retrofits, the Home Energy Professionals Job Task Analysis are used as the foundation for quality training programs and trainers.

Air Emissions Factors and Quantification

EPA Pesticide Factsheets

Emissions factors are used in developing air emissions inventories for air quality management decisions and in developing emissions control strategies. This area provides technical information on and support for the use of emissions factors.

Support Center for Regulatory Atmospheric Modeling (SCRAM)

EPA Pesticide Factsheets

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

Quality management in in vivo proton MRS.

PubMed

Pedrosa de Barros, Nuno; Slotboom, Johannes

2017-07-15

The quality of MR-Spectroscopy data can easily be affected in in vivo applications. Several factors may produce signal artefacts, and often these are not easily detected, not even by experienced spectroscopists. Reliable and reproducible in vivo MRS-data requires the definition of quality requirements and goals, implementation of measures to guarantee quality standards, regular control of data quality, and a continuous search for quality improvement. The first part of this review includes a general introduction to different aspects of quality management in MRS. It is followed by the description of a series of tests and phantoms that can be used to assure the quality of the MR system. In the third part, several methods and strategies used for quality control of the spectroscopy data are presented. This review concludes with a reference to a few interesting techniques and aspects that may help to further improve the quality of in vivo MR-spectra. Copyright © 2017 Elsevier Inc. All rights reserved.

Problem-based learning in dental education: a systematic review of the literature.

PubMed

Bassir, Seyed Hossein; Sadr-Eshkevari, Pooyan; Amirikhorheh, Shaden; Karimbux, Nadeem Y

2014-01-01

The purpose of this systematic review was to compare the effectiveness of problem-based learning (PBL) with that of traditional (non-PBL) approaches in dental education. The search strategy included electronic and manual searches of studies published up to October 2012. The PICO (Population, Intervention, Comparator, and Outcome) framework was utilized to guide the inclusion or exclusion of studies. The search strategy identified 436 articles, seventeen of which met the inclusion criteria. No randomized controlled trial was found comparing the effectiveness of PBL with that of lecture-based approach at the level of an entire curriculum. Three randomized controlled trials had evaluated the effectiveness of PBL at a single course level. The quality assessment rated four studies as being of moderate quality, while the other studies were assessed as being of weak quality. This review concludes that there are a very limited number of well-designed controlled studies evaluating the effectiveness of PBL in dental education. The data in those studies reveal that PBL does not negatively influence the acquisition of factual knowledge in dental students and PBL enhances the ability of students in applying their knowledge to clinical situations. In addition, PBL positively affects students' perceived preparedness.

From quality markers to data mining and intelligence assessment: A smart quality-evaluation strategy for traditional Chinese medicine based on quality markers.

PubMed

Bai, Gang; Zhang, Tiejun; Hou, Yuanyuan; Ding, Guoyu; Jiang, Min; Luo, Guoan

2018-05-15

The quality of traditional Chinese medicine (TCM) forms the foundation of its clinical efficacy. The standardization of TCM is the most important task of TCM modernization. In recent years, there has been great progress in the quality control of TCM. However, there are still many issues related to the current quality standards, and it is difficult to objectively evaluate and effectively control the quality of TCM. To face these challenge, we summarized the current quality marker (Q-marker) research based on its characteristics and benefits, and proposed a reasonable and intelligentized quality evaluation strategy for the development and application of Q-markers. Ultra-performance liquid chromatography-quadrupole/time-of-flight with partial least squares-discriminant analysis was suggested to screen the chemical markers from Chinese medicinal materials (CMM), and a bioactive-guided evaluation method was used to select the Q-markers. Near-infrared spectroscopy (NIRS), based on the distinctive wavenumber zones or points from the Q-markers, was developed for its determination. Then, artificial intelligence algorithms were used to clarify the complex relationship between the Q-markers and their integral functions. Internet and mobile communication technology helped us to perform remote analysis and determine the information feedback of test samples. The quality control research, evaluation, standard establishment and quality control of TCM must be based on the systematic analysis of Q-markers to study and describe the material basis of TCM efficacy, define the chemical markers in the plant body, and understand the process of herb drug acquisition, change and transmission laws affecting metabolism and exposure. Based on the advantages of chemometrics, new sensor technologies, including infrared spectroscopy, hyperspectral imaging, chemical imaging, electronic nose and electronic tongue, have become increasingly important in the quality evaluation of CMM. Inspired by the concept of Q-marker, the quantitation can be achieved with the help of artificial intelligence, and these subtle differences can be discovered, allowing the quantitative analysis by NIRS and providing a quick and easy detection method for CMM quality evaluations. The concept of Q-markers focused on unique CMM differences, dynamic changes and their transmission and traceability to establish an overall quality control and traceability system. Based on the basic attributes, an integration model and artificial intelligence research path was proposed, with the hope of providing new ideas and perspectives for the TCM quality management. Copyright © 2018 Elsevier GmbH. All rights reserved.

Simulation-based training for nurses: Systematic review and meta-analysis.

PubMed

Hegland, Pål A; Aarlie, Hege; Strømme, Hilde; Jamtvedt, Gro

2017-07-01

Simulation-based training is a widespread strategy to improve health-care quality. However, its effect on registered nurses has previously not been established in systematic reviews. The aim of this systematic review is to evaluate effect of simulation-based training on nurses' skills and knowledge. We searched CDSR, DARE, HTA, CENTRAL, CINAHL, MEDLINE, Embase, ERIC, and SveMed+ for randomised controlled trials (RCT) evaluating effect of simulation-based training among nurses. Searches were completed in December 2016. Two reviewers independently screened abstracts and full-text, extracted data, and assessed risk of bias. We compared simulation-based training to other learning strategies, high-fidelity simulation to other simulation strategies, and different organisation of simulation training. Data were analysed through meta-analysis and narrative syntheses. GRADE was used to assess the quality of evidence. Fifteen RCTs met the inclusion criteria. For the comparison of simulation-based training to other learning strategies on nurses' skills, six studies in the meta-analysis showed a significant, but small effect in favour of simulation (SMD -1.09, CI -1.72 to -0.47). There was large heterogeneity (I 2 85%). For the other comparisons, there was large between-study variation in results. The quality of evidence for all comparisons was graded as low. The effect of simulation-based training varies substantially between studies. Our meta-analysis showed a significant effect of simulation training compared to other learning strategies, but the quality of evidence was low indicating uncertainty. Other comparisons showed inconsistency in results. Based on our findings simulation training appears to be an effective strategy to improve nurses' skills, but further good-quality RCTs with adequate sample sizes are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Application of quality by design in granulation process for Ginkgo leaf tablet (Ⅲ)： process control strategy based on design space].

PubMed

Cui, Xiang-Long; Xu, Bing; Sun, Fei; Dai, Sheng-Yun; Shi, Xin-Yuan; Qiao, Yan-Jiang

2017-03-01

In this paper, under the guidance of quality by design (QbD) concept, the control strategy of the high shear wet granulation process of the ginkgo leaf tablet based on the design space was established to improve the process controllability and product quality consistency. The median granule size (D50) and bulk density (Da) of granules were identified as critical quality attributes (CQAs) and potential critical process parameters (pCPPs) were determined by the failure modes and effect analysis (FMEA). The Plackeet-Burmann experimental design was used to screen pCPPs and the results demonstrated that the binder amount, the wet massing time and the wet mixing impeller speed were critical process parameters (CPPs). The design space of the high shear wet granulation process was developed within pCPPs range based on the Box-Behnken design and quadratic polynomial regression models. ANOVA analysis showed that the P-values of model were less than 0.05 and the values of lack of fit test were more than 0.1, indicating that the relationship between CQAs and CPPs could be well described by the mathematical models. D₅₀ could be controlled within 170 to 500 μm, and the bulk density could be controlled within 0.30 to 0.44 g•cm⁻³ by using any CPPs combination within the scope of design space. Besides, granules produced by process parameters within the design space region could also meet the requirement of tensile strength of the ginkgo leaf tablet.. Copyright© by the Chinese Pharmaceutical Association.

Evidence for the impact of quality improvement collaboratives: systematic review

PubMed Central

2008-01-01

Objective To evaluate the effectiveness of quality improvement collaboratives in improving the quality of care. Data sources Relevant studies through Medline, Embase, PsycINFO, CINAHL, and Cochrane databases. Study selection Two reviewers independently extracted data on topics, participants, setting, study design, and outcomes. Data synthesis Of 1104 articles identified, 72 were included in the study. Twelve reports representing nine studies (including two randomised controlled trials) used a controlled design to measure the effects of the quality improvement collaborative intervention on care processes or outcomes of care. Systematic review of these nine studies showed moderate positive results. Seven studies (including one randomised controlled trial) reported an effect on some of the selected outcome measures. Two studies (including one randomised controlled trial) did not show any significant effect. Conclusions The evidence underlying quality improvement collaboratives is positive but limited and the effects cannot be predicted with great certainty. Considering that quality improvement collaboratives seem to play a key part in current strategies focused on accelerating improvement, but may have only modest effects on outcomes at best, further knowledge of the basic components effectiveness, cost effectiveness, and success factors is crucial to determine the value of quality improvement collaboratives. PMID:18577559

Modeling U.S. air pollutant emissions and controls in GCAM-USA

EPA Science Inventory

We describe extensions to the GCAM-USA modeling framework that facilitate exploration of the co-benefits, tradeoffs and synergies among strategies for addressing climate, air quality, and other environmental goals.

Biocontrol strategies for Mediterranean-style fermented sausages.

PubMed

Oliveira, Márcia; Ferreira, Vânia; Magalhães, Rui; Teixeira, Paula

2018-01-01

Naturally fermented meat sausages have a long tradition in Mediterranean countries and are one of the most important groups of traditional foods consumed throughout Europe. Despite all the advances in food science and technology and increased regulatory requirements and concerns for safety and quality during the last decades, the challenge to control important foodborne pathogens in this type of meat products still persists. Simultaneously, growing consumer interest in safe, high quality and minimal processed products, with less additives/preservatives have driven the food industry and scientists in a crusade for innovative technologies to maintain the safety of these products by natural means. Biological control (biocontrol) fits well within this tendency. This review summarizes the latest achievements on biocontrol strategies applied to Mediterranean-style fermented sausages, namely: (i) bioprotective cultures; (ii) bacteriocins; and, (iii) essential oils (EOs). Copyright © 2017 Elsevier Ltd. All rights reserved.

Transforming nanomedicine manufacturing toward Quality by Design and microfluidics.

PubMed

Colombo, Stefano; Beck-Broichsitter, Moritz; Bøtker, Johan Peter; Malmsten, Martin; Rantanen, Jukka; Bohr, Adam

2018-04-05

Nanopharmaceuticals aim at translating the unique features of nano-scale materials into therapeutic products and consequently their development relies critically on the progression in manufacturing technology to allow scalable processes complying with process economy and quality assurance. The relatively high failure rate in translational nanopharmaceutical research and development, with respect to new products on the market, is at least partly due to immature bottom-up manufacturing development and resulting sub-optimal control of quality attributes in nanopharmaceuticals. Recently, quality-oriented manufacturing of pharmaceuticals has undergone an unprecedented change toward process and product development interaction. In this context, Quality by Design (QbD) aims to integrate product and process development resulting in an increased number of product applications to regulatory agencies and stronger proprietary defense strategies of process-based products. Although QbD can be applied to essentially any production approach, microfluidic production offers particular opportunities for QbD-based manufacturing of nanopharmaceuticals. Microfluidics provides unique design flexibility, process control and parameter predictability, and also offers ample opportunities for modular production setups, allowing process feedback for continuously operating production and process control. The present review aims at outlining emerging opportunities in the synergistic implementation of QbD strategies and microfluidic production in contemporary development and manufacturing of nanopharmaceuticals. In doing so, aspects of design and development, but also technology management, are reviewed, as is the strategic role of these tools for aligning nanopharmaceutical innovation, development, and advanced industrialization in the broader pharmaceutical field. Copyright © 2018 Elsevier B.V. All rights reserved.

Association between drug insurance cost sharing strategies and outcomes in patients with chronic diseases: a systematic review.

PubMed

Mann, Bikaramjit S; Barnieh, Lianne; Tang, Karen; Campbell, David J T; Clement, Fiona; Hemmelgarn, Brenda; Tonelli, Marcello; Lorenzetti, Diane; Manns, Braden J

2014-01-01

Prescription drugs are used in people with hypertension, diabetes, and cardiovascular disease to manage their illness. Patient cost sharing strategies such as copayments and deductibles are often employed to lower expenditures for prescription drug insurance plans, but the impact on health outcomes in these patients is unclear. To determine the association between drug insurance and patient cost sharing strategies on medication adherence, clinical and economic outcomes in those with chronic diseases (defined herein as diabetes, hypertension, hypercholesterolemia, coronary artery disease, and cerebrovascular disease). Studies were included if they examined various cost sharing strategies including copayments, coinsurance, fixed copayments, deductibles and maximum out-of-pocket expenditures. Value-based insurance design and reference based pricing studies were excluded. Two reviewers independently identified original intervention studies (randomized controlled trials, interrupted time series, and controlled before-after designs). MEDLINE, EMBASE, Cochrane Library, CINAHL, and relevant reference lists were searched until March 2013. Two reviewers independently assessed studies for inclusion, quality, and extracted data. Eleven studies, assessing the impact of seven policy changes, were included: 2 separate reports of one randomized controlled trial, 4 interrupted time series, and 5 controlled before-after studies. Outcomes included medication adherence, clinical events (myocardial infarction, stroke, death), quality of life, healthcare utilization, or cost. The heterogeneity among the studies precluded meta-analysis. Few studies reported the impact of cost sharing strategies on mortality, clinical and economic outcomes. The association between patient copayments and medication adherence varied across studies, ranging from no difference to significantly lower adherence, depending on the amount of the copayment. Lowering cost sharing in patients with chronic diseases may improve adherence, but the impact on clinical and economic outcomes is uncertain.

Appearance Investment, Quality of Life, and Metabolic Control Among Women with Type 1 Diabetes.

PubMed

Gawlik, Nicola R; Elias, Anna J; Bond, Malcolm J

2016-06-01

Concomitants of Type 1 diabetes management include weight gain and dietary restraint. Body image concerns, particularly among women, are therefore common. The study evaluated associations between the appearance investment component of body image, age, quality of life and self-reported metabolic control were examined, along with the practice of insulin restriction as a weight control strategy. A questionnaire comprising demographic and diabetes-related information, the Appearance Schemas Inventory, and Diabetes Quality of Life Brief Clinical Inventory was completed by Australian women diagnosed with type 1 diabetes (N = 177). Self-evaluative salience was higher among younger participants, those with a lower quality of life, and those with better metabolic control of their diabetes, with the relationships between metabolic control and all of age, quality of life, and self-evaluative salience noted to be non-linear. Among participants who reported restricting insulin for weight control, self-evaluative salience was particularly relevant. Motivational salience was not related to other study variables. Clinically, the provision of information regarding appearance changes that might arise in order to mitigate later body image difficulties is a potentially beneficial adjunct to standard diabetes management protocols that may lead to more successful disease adjustment.

The Utility of the OMI HCHO/NO2 in Air Quality Decision-Making Activities

NASA Technical Reports Server (NTRS)

Duncan, Bryan

2010-01-01

I will discuss a novel and practical application of the OMI HCHU and NO2 data products to the "weight of evidence" in the air quality decision-making process (e.g., State Implementation Plan (SIP)) for a city, region, or state to demonstrate that it is making progress toward attainment of the National Ambient Air Quality Standard (NAAQS) for ozone. Any trend, or lack thereof, in the observed OMI HCHO/NO2 may support that an emission control strategy implemented to reduce ozone is or is not occurring for a metropolitan area. In addition, the observed OMI HCHO/NO2 may be used to define new emission control strategies as the photochemical environments of urban areas evolve over time. I will demonstrate the utility of the OMI HCHO/NO2 over the U.S. for air quality applications with support from simulations with both a regional model and a photochemical box model. These results support mission planning of an OMI-like instrument for the proposed GEO-CAPE satellite that has as one of its objectives to study air quality from space. However, I'm attending the meeting as the Aura Deputy Project Scientist, so I don't technically need to present anything to justify the travel.

Educational games for health professionals.

PubMed

Akl, E A; Sackett, K; Pretorius, R; Erdley, S; Bhoopathi, P S; Mustafa, R; Schünemann, H J

2008-01-23

The use of games as an educational strategy has the potential to improve health professionals' performance (e.g. adherence to standards of care) through improving their knowledge, skills and attitudes. The objective was to assess the effect of educational games on health professionals' performance, knowledge, skills, attitude and satisfaction, and on patient outcomes. We used a comprehensive search strategy including an electronic search of the following databases: DARE, EPOC register, CENTRAL, MEDLINE, EMBASE, CINAHL, AMED, ERIC, and Dissertation Abstracts Online (search date: January 2007). We also screened the reference list of included studies and relevant reviews, contact authors of relevant papers and reviews, and searched ISI Web of Science for papers citing studies included in the review We included randomized controlled trials (RCT), controlled clinical trials (CCT), controlled before and after (CBA) and interrupted time-series analysis (ITS). Study participants were qualified health professionals or in postgraduate training. The intervention was an educational game with "a form of competitive activity or sport played according to rules". Using a standardized data form we extracted data on methodological quality, participants, interventions and outcomes of interest that included patient outcomes, professional behaviour (process of care outcomes), and professional's knowledge, skills, attitude and satisfaction. The search strategy identified 1156 citations. Out of 55 potentially eligible citations, we included one RCT. The methodological quality was fair. The game, used as a reinforcement technique, was based on the television game show "Family Feud" and focused on infection control. The study did not assess any patient or process of care outcomes. The group that was randomized to the game had statistically higher scores on the knowledge test (P = 0.02). The findings of this systematic review do not confirm nor refute the utility of games as a teaching strategy for health professionals. There is a need for additional high-quality research to explore the impact of educational games on patient and performance outcomes.

Innovative Quality-Assurance Strategies for Tuberculosis Surveillance in the United States

PubMed Central

Manangan, Lilia Ponce; Tryon, Cheryl; Magee, Elvin; Miramontes, Roque

2012-01-01

Introduction. The Centers for Disease Control and Prevention (CDC)'s National Tuberculosis Surveillance System (NTSS) is the national repository of tuberculosis (TB) data in the United States. Jurisdictions report to NTSS through the Report of Verified Case of Tuberculosis (RVCT) form that transitioned to a web-based system in 2009. Materials and Methods. To improve RVCT data quality, CDC conducted a quality assurance (QA) needs assessment to develop QA strategies. These include QA components (case detection, data accuracy, completeness, timeliness, data security, and confidentiality); sample tools such as National TB Indicators Project (NTIP) to identify TB case reporting discrepancies; comprehensive training course; resource guide and toolkit. Results and Discussion. During July–September 2011, 73 staff from 34 (57%) of 60 reporting jurisdictions participated in QA training. Participants stated usefulness of sharing jurisdictions' QA methods; 66 (93%) wrote that the QA tools will be effective for their activities. Several jurisdictions reported implementation of QA tools pertinent to their programs. Data showed >8% increase in NTSS and NTIP enrollment through Secure Access Management Services, which monitors system usage, from August 2011–February 2012. Conclusions. Despite challenges imposed by web-based surveillance systems, QA strategies can be developed with innovation and collaboration. These strategies can also be used by other disease programs to ensure high data quality. PMID:22685648

National plan for prevention, early detection, and cancer control in Peru.

PubMed

Vallejos, Carlos

2013-01-01

Peru currently is executing an ambitious plan for cancer control: its first nationwide program of cancer prevention and cancer control, and the first such program launched in Latin America. The adequate strategies were identified from previous experience developing smaller initiatives and from knowledge of our epidemiology and priorities. The geographic landscape and sociocultural differences, in which inequalities play a significant role in access to quality education and specialized cancer care, are the main challenges to elaborate strategies to diminish our burden of advanced disease. Challenges were not only identified for the poorest people, but for other sectors of the population. With a growing Peruvian economy in a globalized market context, emerging sectors are being exposed to new risk factors for cancer and educational strategies were implemented. The development of the National Plan for Cancer Control was launched involving not only technical efforts by a multidisciplinary team, but also political concertation.

Design and Implementation of Total Quality Management in a Civil Engineering Squadron

DTIC Science & Technology

1989-09-01

instruct employees and seek new ways to integrate quality into all functions, such as planning, marketing , and controlling. The second strategy is for...implement a TQM plan that contributes to the overall DOD TQM process. 7 2. Managers at all levels will provide leadership and integrate TQM principles... integral part of our daily activities. 8 3. Quality improvement is the key to productivity improvement and must be pursued with the necessary resources to

Management of impulse control disorders in Parkinson's disease: Controversies and future approaches.

PubMed

Samuel, Michael; Rodriguez-Oroz, Maria; Antonini, Angelo; Brotchie, Jonathan M; Ray Chaudhuri, Kallol; Brown, Richard G; Galpern, Wendy R; Nirenberg, Melissa J; Okun, Michael S; Lang, Anthony E

2015-02-01

Impulse control disorders in Parkinson's disease are a group of impulsive behaviors most often associated with dopaminergic treatment. Presently, there is a lack of high quality evidence available to guide their management. This manuscript reviews current management strategies, before concentrating on the concept of dopamine agonist withdrawal syndrome and its implications for the management of impulse control disorders. Further, we focus on controversies, including the role of more recently available anti-parkinsonian drugs, and potential future approaches involving routes of drug delivery, nonpharmacological treatments (such as cognitive behavioral therapy and deep brain stimulation), and other as yet experimental strategies. © 2015 International Parkinson and Movement Disorder Society.

Impulse Control Disorders in Parkinson’s Disease:Management, Controversies, and Potential Approaches

PubMed Central

Samuel, M; Rodriguez-Oroz, M; Antonini, A; Brotchie, JM; Ray Chaudhuri, K; Brown, RG; Galpern, WR; Nirenberg, MJ; Okun, MS; Lang, AE

2016-01-01

Impulse control disorders in Parkinson’s disease are a group of impulsive behaviors most often associated with dopaminergic treatment. Presently, there is a lack of high quality evidence available to guide their management. This manuscript reviews current management strategies, before concentrating on the concept of dopamine agonist withdrawal syndrome and its implications for the management of impulse control disorders. Further, we focus on controversies including the role of more recently available anti-parkinsonian drugs, and potential future approaches involving routes of drug delivery, non-pharmacological treatments (such as cognitive behaviour therapy and deep brain stimulation), and other as yet experimental strategies. PMID:25607799

Health benefit modelling and optimization of vehicular pollution control strategies

NASA Astrophysics Data System (ADS)

Sonawane, Nayan V.; Patil, Rashmi S.; Sethi, Virendra

2012-12-01

This study asserts that the evaluation of pollution reduction strategies should be approached on the basis of health benefits. The framework presented could be used for decision making on the basis of cost effectiveness when the strategies are applied concurrently. Several vehicular pollution control strategies have been proposed in literature for effective management of urban air pollution. The effectiveness of these strategies has been mostly studied as a one at a time approach on the basis of change in pollution concentration. The adequacy and practicality of such an approach is studied in the present work. Also, the assessment of respective benefits of these strategies has been carried out when they are implemented simultaneously. An integrated model has been developed which can be used as a tool for optimal prioritization of various pollution management strategies. The model estimates health benefits associated with specific control strategies. ISC-AERMOD View has been used to provide the cause-effect relation between control options and change in ambient air quality. BenMAP, developed by U.S. EPA, has been applied for estimation of health and economic benefits associated with various management strategies. Valuation of health benefits has been done for impact indicators of premature mortality, hospital admissions and respiratory syndrome. An optimization model has been developed to maximize overall social benefits with determination of optimized percentage implementations for multiple strategies. The model has been applied for sub-urban region of Mumbai city for vehicular sector. Several control scenarios have been considered like revised emission standards, electric, CNG, LPG and hybrid vehicles. Reduction in concentration and resultant health benefits for the pollutants CO, NOx and particulate matter are estimated for different control scenarios. Finally, an optimization model has been applied to determine optimized percentage implementation of specific control strategies with maximization of social benefits, when these strategies are applied simultaneously.

77 FR 39177 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Regional Haze

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-02

... of SO 2 from each of 167 stacks in 19 states, 28 percent control of non-EGU SO 2 emissions, and... INFORMATION CONTACT: Charles Hatten, Environmental Engineer, Control Strategies Section, Air Programs Branch... Directors Consortium (LADCO), Ohio identified one non-electric generating unit (non-EGU) source, P.H...

Adaptive super-twisting sliding mode control for a three-phase single-stage grid-connected differential boost inverter based photovoltaic system.

PubMed

Pati, Akshaya K; Sahoo, N C

2017-07-01

This paper presents an adaptive super-twisting sliding mode control (STC) along with double-loop control for voltage tracking performance of three-phase differential boost inverter and DC-link capacitor voltage regulation in grid-connected PV system. The effectiveness of the proposed control strategies are demonstrated under realistic scenarios such as variations in solar insolation, load power demand, grid voltage, and transition from grid-connected to standalone mode etc. Additional supplementary power quality control functions such as harmonic compensation, and reactive power management are also investigated with the proposed control strategy. The results are compared with conventional proportional-integral controller, and PWM sliding mode controller. The system performance is evaluated in simulation and in real-time. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

[Quality assurance in interventional cardiology].

PubMed

Gülker, H

2009-10-01

Quality assurance in clinical studies aiming at approval of pharmaceutical products is submitted to strict rules, controls and auditing regulations. Comparative instruments to ensure quality in diagnostic and therapeutic procedures are not available in interventional cardiology, likewise in other fields of cardiovascular medicine. Quality assurance simply consists of "quality registers" with basic data not externally controlled. Based on the experiences of clinical studies and their long history of standardization it is assumed that these data may be severely flawed thus being inappropriate to set standards for diagnostic and therapeutic strategies. The precondition for quality assurance are quality data. In invasive coronary angiography and intervention medical indications, the decision making process interventional versus surgical revascularization, technical performance and after - care are essential aspects affecting quality of diagnostics and therapy. Quality data are externally controlled data. To collect quality data an appropriate infrastructure is a necessary precondition which is not existent. For an appropriate infrastructure investments have to be done both to build up as well as to sustain the necessary preconditions. As long as there are no infrastructure and no investments there will be no "quality data". There exist simply registers of data which are not proved to be a basis for significant assurance and enhancement in quality in interventional coronary cardiology. Georg Thieme Verlag KG Stuttgart, New York.

Structural and process factors affecting the implementation of antimicrobial resistance prevention and control strategies in U.S. hospitals.

PubMed

Chou, Ann F; Yano, Elizabeth M; McCoy, Kimberly D; Willis, Deanna R; Doebbeling, Bradley N

2008-01-01

To address increases in the incidence of infection with antimicrobial-resistant pathogens, the National Foundation for Infectious Diseases and Centers for Disease Control and Prevention proposed two sets of strategies to (a) optimize antibiotic use and (b) prevent the spread of antimicrobial resistance and control transmission. However, little is known about the implementation of these strategies. Our objective is to explore organizational structural and process factors that facilitate the implementation of National Foundation for Infectious Diseases/Centers for Disease Control and Prevention strategies in U.S. hospitals. We surveyed 448 infection control professionals from a national sample of hospitals. Clinically anchored in the Donabedian model that defines quality in terms of structural and process factors, with the structural domain further informed by a contingency approach, we modeled the degree to which National Foundation for Infectious Diseases and Centers for Disease Control and Prevention strategies were implemented as a function of formalization and standardization of protocols, centralization of decision-making hierarchy, information technology capabilities, culture, communication mechanisms, and interdepartmental coordination, controlling for hospital characteristics. Formalization, standardization, centralization, institutional culture, provider-management communication, and information technology use were associated with optimal antibiotic use and enhanced implementation of strategies that prevent and control antimicrobial resistance spread (all p < .001). However, interdepartmental coordination for patient care was inversely related with antibiotic use in contrast to antimicrobial resistance spread prevention and control (p < .0001). Formalization and standardization may eliminate staff role conflict, whereas centralized authority may minimize ambiguity. Culture and communication likely promote internal trust, whereas information technology use helps integrate and support these organizational processes. These findings suggest concrete strategies for evaluating current capabilities to implement effective practices and foster and sustain a culture of patient safety.

The Microgravity Isolation Mount (MGIM): A Columbus facility for improving the microgravity quality of payloads

NASA Technical Reports Server (NTRS)

Owen, R. G.; Jones, D. I.; Owens, A. R.; Roberts, G.; Hadfield, P.

1992-01-01

The Microgravity Isolation Mount (MGIM) is a facility for providing active vibration isolation for sensitive experiments on the Columbus Attached Laboratory and the Columbus Free-Flying Laboratory. The facility is designed to be accommodated in a standard Columbus rack, and it iterfaces with existing rack utility services. The design is based on a non-contact strategy, whereby the payload 'floats' inside the rack, and its position is controlled by a number of magnetic actuators. The main advantage of using this non-contact strategy is the improved microgravity quality available. The overall design of the facility and a description of its elements are given.

Improving health related quality of life among rural hypertensive patients through the integrative strategy of health services delivery: a quasi-experimental trial from Chongqing, China.

PubMed

Miao, Yudong; Zhang, Liang; Sparring, Vibeke; Sandeep, Sandeep; Tang, Wenxi; Sun, Xiaowei; Feng, Da; Ye, Ting

2016-08-23

Integrative strategy of health services delivery has been proven to be effective in economically developed countries, where the healthcare systems have enough qualified primary care providers. However rural China lacks such providers to act as gatekeeper, besides, Chinese rural hypertensive patients are usually of old age, more likely to be exposed to health risk factors and they experience a greater socio-economic burden. All these Chinese rural setting specific features make the effectiveness of integrative strategy of health services in improving health related quality of life among Chinese rural hypertensive patients uncertain. In order to assess the impact of integrative strategy of health services delivery on health related quality of life among Chinese rural hypertensive patients, a two-year quasi-experimental trial was conducted in Chongqing, China. At baseline the sample enrolled 1006 hypertensive patients into intervention group and 420 hypertensive patients into control group. Physicians from village clinics, town hospitals and county hospitals worked collaboratively to deliver multidisciplinary health services for the intervention group, while physicians in the control group provided services without cooperation. The quality of life was studied by SF-36 Scale. Blood pressures were reported by town hospitals. The Difference-in-Differences model was used to estimate the differences in SF-36 score and blood pressure of both groups to assess the impact. The study showed that at baseline there was no statistical difference in SF-36 scores between both groups. While at follow-up the intervention group scored higher in overall SF-36, Role Physical, Body Pain, Social Functioning and Role Emotional than the control group. The Difference-in-Differences result demonstrated that there were statistical differences in SF-36 total score (p = 0.011), Role Physical (p = 0.027), Social Functioning (p = 0.000), Role Emotional (p = 0.002) between both groups. Integrative services delivery improved the score of SF-36 by 4.591 ± 1.794, and also improved the score in domains of Role Physical, Social Functioning and Role Emotional by 8.289 ± 3.753, 9.762 ± 2.019 and 12.534 ± 4.083, respectively. Patients in the intervention group obtained lower systolic blood pressure and diastolic blood pressure. Integrative strategy of health services delivery improved health related quality of life and blood pressure control among rural Chinese hypertensive patients. The Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology, ChiCTR-OOR-14005563, Registered on 7 June 2011.

Smell of Stress: Identification of Induced Biochemical Pathways Affecting the Volatile Composition and Flavor Quality of Crops.

PubMed

Wüst, Matthias

2018-04-11

Recent research has shown that the biosynthesis of several key odorants is controlled by genes whose expression is altered or even induced by biotic or abiotic stress. These new findings provide a roadmap for improvement of flavor quality by the application of moderate, well-controlled stress. This strategy aims at reducing the flavor deficiencies in modern commercial varieties as a "green" alternative to genetic engineering. The workflow for a successful implementation of this approach, from the identification of key odorants by molecular science techniques to the investigation of mechanisms controlling their biosynthesis, is complex and calls for interdisciplinary research.

Probe into Gaseous Pollution and Assessment of Air Quality Benefit under Sector Dependent Emission Control Strategies over Megacities in Yangtze River Delta, China

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

Dong, Xinyi; Gao, Yang; Fu, Joshua S.

On February 29th 2012, China published its new National Ambient Air Quality Standard (CH-NAAQS) aiming at revising the standards and measurements for both gaseous pollutants including ozone (O3), nitrogen dioxide (NO2), and sulfur dioxide (SO2), and also particle pollutants including PM10 and PM2.5. In order to understand the air pollution status regarding this new standard, the integrated MM5/CMAQ modeling system was applied over Yangtze River Delta (YRD) within this study to examine the criteria gaseous pollutants listed in the new CH-NAAQS. Sensitivity simulations were also conducted to assess the responses of gaseous pollutants under 8 different sector-dependent emission reduction scenariosmore » in order to evaluate the potential control strategies. 2006 was selected as the simulation year in order to review the air quality condition at the beginning of China’s 11th Five-Year-Plan (FYP, from 2006 to 2010), and also compared with air quality status in 2010 as the end of 11th FYP to probe into the effectiveness of the national emission control efforts. Base case simulation showed distinct seasonal variation for gaseous pollutants: SO2, and NO2 were found to have higher surface concentrations in winter while O3 was found to have higher concentrations in spring and summer than other seasons. According to the analyses focused on 3 megacities within YRD, Shanghai, Nanjing, and Hangzhou, we found different air quality conditions among the cities: NO2 was the primary pollutant that having the largest number of days exceeding the CH-NAAQS daily standard (80 μg/m3) in Shanghai (59 days) and Nanjing (27 days); SO2 was the primary pollutant with maximum number of days exceeding daily air quality standard (150 μg/m3) in Hangzhou (28 days), while O3 exceeding the daily maximum 8-hour standard (160 μg/m3) for relatively fewer days in all the three cities (9 days in Shanghai, 14 days in Nanjing, and 11 days in Hangzhou). Simulation results from predefined potential applicable emission control scenarios suggested significant air quality improvements from emission reduction: 90% of SO2 emission removed from power plant in YRD would be able to reduce more than 85% of SO2 pollution, 85% NOx emission reduction from power plant would reduce more than 60% of NO2 pollution, in terms of reducing the number of days exceeding daily air quality standard. NOx emission reduction from transportation and industry were also found to effectively reduce NO2 pollution but less efficient than emission control from power plants. We also found that multi-pollutants emission control including both NOx and VOC would be a better strategy than independent NOx control over YRD which is China’s 12th Five-Year-Plan (from 2011 to 2015), because O3 pollution would be increased as a side effect of NOx control and counteract NO2 pollution reduction benefit.« less

A cost-constrained model of strategic service quality emphasis in nursing homes.

PubMed

Davis, M A; Provan, K G

1996-02-01

This study employed structural equation modeling to test the relationship between three aspects of the environmental context of nursing homes; Medicaid dependence, ownership status, and market demand, and two basic strategic orientations: low cost and differentiation based on service quality emphasis. Hypotheses were proposed and tested against data collected from a sample of nursing homes operating in a single state. Because of the overwhelming importance of cost control in the nursing home industry, a cost constrained strategy perspective was supported. Specifically, while the three contextual variables had no direct effect on service quality emphasis, the entire model was supported when cost control orientation was introduced as a mediating variable.

Recommendations for accreditation of laboratories in molecular biology of hematologic malignancies.

PubMed

Flandrin-Gresta, Pascale; Cornillet, Pascale; Hayette, Sandrine; Gachard, Nathalie; Tondeur, Sylvie; Mauté, Carole; Cayuela, Jean-Michel

2015-01-01

Over recent years, the development of molecular biology techniques has improved the hematological diseases diagnostic and follow-up. Consequently, these techniques are largely used in the biological screening of these diseases; therefore the Hemato-oncology molecular diagnostics laboratories must be actively involved in the accreditation process according the ISO 15189 standard. The French group of molecular biologists (GBMHM) provides requirements for the implementation of quality assurance for the medical molecular laboratories. This guideline states the recommendations for the pre-analytical, analytical (methods validation procedures, quality controls, reagents), and post-analytical conditions. In addition, herein we state a strategy for the internal quality control management. These recommendations will be regularly updated.

Diffusion and dissemination of evidence-based dietary strategies for the prevention of cancer.

PubMed

Ciliska, Donna; Robinson, Paula; Armour, Tanya; Ellis, Peter; Brouwers, Melissa; Gauld, Mary; Baldassarre, Fulvia; Raina, Parminder

2005-04-08

The purpose was to determine what strategies have been evaluated to disseminate cancer control interventions that promote the uptake of adult healthy diet? A systematic review was conducted. Studies were identified by searching MEDLINE, PREMEDLINE, Cancer LIT, EMBASE/Excerpta Medica, PsycINFO, CINAHL, the Cochrane Database of Systematic Reviews, and reference lists and by contacting technical experts. English-language primary studies were selected if they evaluated the dissemination of healthy diet interventions in individuals, healthcare providers, or institutions. Studies of children or adolescents only were excluded. One hundred one articles were retrieved for full text screening. Nine reports of seven distinct studies were included; four were randomized trials, one was a cohort design and three were descriptive studies. Six studies were rated as methodologically weak, and one was rated as moderate. Studies were not meta-analyzed because of heterogeneity, low methodological quality, and incomplete data reporting. No beneficial dissemination strategies were found except one that looks promising, the use of peer educators in the worksite, which led to a short-term increase in fruit and vegetable intake. Overall, the quality of the evidence is not strong and is primarily descriptive rather than evaluative. No clear conclusions can be drawn from these data. Controlled studies are needed to evaluate dissemination strategies, and to compare dissemination and diffusion strategies with different messages and different target audiences.

[Audit and feedback, and continuous quality improvement strategies to improve the quality of care for type 2 diabetes: a systematic review of literature].

PubMed

Vecchi, Simona; Agabiti, Nera; Mitrova, Susanna; Cacciani, Laura; Amato, Laura; Davoli, Marina; Bargagli, Anna Maria

2016-01-01

we analysed evidence on effective interventions to improve the quality of care and management in patients with diabetes type 2. This review focuses particularly on audit and feedback intervention, targeted to healthcare providers, and continuous quality improvement (CQI) involving health professionals and health care systems, respectively. we searched The Cochrane Library, PubMed, and EMBASE (search period: January 2005-December 2015) to identify systematic reviews (SR) and randomized controlled trials (RCTs) considering patients' outcomes and process measures as quality indicators in diabetes care. Selection of studies and data extraction were carried out independently by two reviewers. Methodological quality of individual studies was assessed using the checklist «Assessment of methodological quality of systematic review» (AMSTAR) and the Cochrane's tool, respectively. We produced summaries of results for each study design. the search process resulted in 810 citations. One SR and 7 RCTs that compared any intervention in which audit and feedback and CQI was a component vs. other interventions were selected. The SR found that audit and feedback activity was associated with improvements of glycaemic (mean difference: 0.26; 95%CI 0.08;0.44) and cholesterol control (mean difference: 0.03; 95%CI -0.04;0.10). CQI interventions were not associated with an improvement of quality of diabetes care. The RCTs considered in this review compared a broad range of interventions including feedback as unique activity or as part of more complex strategies. The methodological quality was generally poor in all the included trials. the available evidence suggests that audit and feedback and CQI improve quality of care in diabetic patients, although the effect is small and heterogeneous among process and outcomes indicators.

Controlled Fission: Teaching Supercharged Subjects.

ERIC Educational Resources Information Center

Pace, David

2003-01-01

Shaping classroom experiences before controversial material is encountered in a class increases the likelihood that students will maintain higher mental function while examining that material. Presents 10 strategies for planning a course that facilitates quality discussion and thoughtful debate. (SLD)

40 CFR 52.1601 - Control strategy and regulations: Sulfur oxides.

Code of Federal Regulations, 2014 CFR

2014-07-01

... not be the cause for any Prevention of Significant Deterioration (PSD) increment to be exceeded, then... quality standards or cause any PSD increment to be exceeded, then EPA shall so inform the State of its...

40 CFR 52.1601 - Control strategy and regulations: Sulfur oxides.

Code of Federal Regulations, 2010 CFR

2010-07-01

... not be the cause for any Prevention of Significant Deterioration (PSD) increment to be exceeded, then... quality standards or cause any PSD increment to be exceeded, then EPA shall so inform the State of its...

40 CFR 52.1601 - Control strategy and regulations: Sulfur oxides.

Code of Federal Regulations, 2013 CFR

2013-07-01

... not be the cause for any Prevention of Significant Deterioration (PSD) increment to be exceeded, then... quality standards or cause any PSD increment to be exceeded, then EPA shall so inform the State of its...

40 CFR 52.1601 - Control strategy and regulations: Sulfur oxides.

Code of Federal Regulations, 2011 CFR

2011-07-01

... not be the cause for any Prevention of Significant Deterioration (PSD) increment to be exceeded, then... quality standards or cause any PSD increment to be exceeded, then EPA shall so inform the State of its...

40 CFR 52.1601 - Control strategy and regulations: Sulfur oxides.

Code of Federal Regulations, 2012 CFR

2012-07-01

... not be the cause for any Prevention of Significant Deterioration (PSD) increment to be exceeded, then... quality standards or cause any PSD increment to be exceeded, then EPA shall so inform the State of its...

MERCURY MEASUREMENTS USING DIRECT-ANALYZER METHODOLOGY

EPA Science Inventory

Under EPA's Water Quality Research Program, exposure studies are needed to determine how well control strategies and guidance are working. Consequently, reliable and convenient techniques that minimize waste production are of special interest. While traditional methods for determ...

Amoeba-related health risk in drinking water systems: could monitoring of amoebae be a complementary approach to current quality control strategies?

PubMed

Codony, Francesc; Pérez, Leonardo Martín; Adrados, Bárbara; Agustí, Gemma; Fittipaldi, Mariana; Morató, Jordi

2012-01-01

Culture-based methods for fecal indicator microorganisms are the standard protocol to assess potential health risk from drinking water systems. However, these traditional fecal indicators are inappropriate surrogates for disinfection-resistant fecal pathogens and the indigenous pathogens that grow in drinking water systems. There is now a range of molecular-based methods, such as quantitative PCR, which allow detection of a variety of pathogens and alternative indicators. Hence, in addition to targeting total Escherichia coli (i.e., dead and alive) for the detection of fecal pollution, various amoebae may be suitable to indicate the potential presence of pathogenic amoeba-resisting microorganisms, such as Legionellae. Therefore, monitoring amoeba levels by quantitative PCR could be a useful tool for directly and indirectly evaluating health risk and could also be a complementary approach to current microbial quality control strategies for drinking water systems.

[Quality of life in children with cancer history and parental adaptation].

PubMed

Tilkin, C; Touchèque, M; Missotten, P; Etienne, A M

2014-11-01

This study assesses quality of life (Qol) in children with cancer history as well as Qol of their parents and examines the relationship between parental adjustment and children Qol. Two groups were formed: an experimental group composed by children with cancer antecedents and their parents and a control group with healthy children and their parents. Children have filled a questionnaire about their Qol. Parents have completed questionnaires about their coping, their illness perceptions, their parenting stress and their Qol. The results show that Qol was satisfactory and similar in both groups. Significant correlations were found between parental illness representations (threat and personal control) and children Qol as well as between coping strategies based on maintaining family cohesion and children Qol. This study highlights the need to assess the adjustment of parents after child cancer and to develop interventions targeting parental representations and coping strategies.

Heat shock proteins as potential targets for protective strategies in neurodegeneration.

PubMed

Kampinga, Harm H; Bergink, Steven

2016-06-01

Protein aggregates are hallmarks of nearly all age-related neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, and several polyglutamine diseases such as Huntington's disease and different forms of spinocerebellar ataxias (SCA; SCA1-3, SCA6, and SCA7). The collapse of cellular protein homoeostasis can be both a cause and a consequence of this protein aggregation. Boosting components of the cellular protein quality control system has been widely investigated as a strategy to counteract protein aggregates or their toxic consequences. Heat shock proteins (HSPs) play a central part in regulating protein quality control and contribute to protein aggregation and disaggregation. Therefore, HSPs are viable targets for the development of drugs aimed at reducing pathogenic protein aggregates that are thought to contribute to the development of so many neurodegenerative disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

Teaching adolescents with learning disabilities to generate and use task-specific strategies.

PubMed

Ellis, E S; Deshler, D D; Schumaker, J B

1989-02-01

The effects of an intervention designed to enhance students' roles as control agents for strategic functioning were investigated. The goal was to increase the ability of students labeled learning disabled to generate new strategies or adapt existing task-specific strategies for meeting varying demands of the regular classroom. Measures were taken in three areas: (a) metacognitive knowledge related to generating or adapting strategies, (b) ability to generate problem-solving strategies for novel problems, and (c) the effects of the intervention on students' regular classroom grades and teachers' perceptions of the students' self-reliance and work quality. A multiple baseline across subjects design was used. The intervention resulted in dramatic increases in the subjects' verbal expression of metacognitive knowledge and ability to generate task-specific strategies. Students' regular class grades increased; for those students who did not spontaneously generalize use of the strategy to problems encountered in these classes, providing instruction to target specific classes resulted in improved grades. Teacher perceptions of students' self-reliance and work quality did not change, probably because baseline measures were already high in both areas. Implications for instruction and future research are discussed.

Benchmarking Strategies for Measuring the Quality of Healthcare: Problems and Prospects

PubMed Central

Lovaglio, Pietro Giorgio

2012-01-01

Over the last few years, increasing attention has been directed toward the problems inherent to measuring the quality of healthcare and implementing benchmarking strategies. Besides offering accreditation and certification processes, recent approaches measure the performance of healthcare institutions in order to evaluate their effectiveness, defined as the capacity to provide treatment that modifies and improves the patient's state of health. This paper, dealing with hospital effectiveness, focuses on research methods for effectiveness analyses within a strategy comparing different healthcare institutions. The paper, after having introduced readers to the principle debates on benchmarking strategies, which depend on the perspective and type of indicators used, focuses on the methodological problems related to performing consistent benchmarking analyses. Particularly, statistical methods suitable for controlling case-mix, analyzing aggregate data, rare events, and continuous outcomes measured with error are examined. Specific challenges of benchmarking strategies, such as the risk of risk adjustment (case-mix fallacy, underreporting, risk of comparing noncomparable hospitals), selection bias, and possible strategies for the development of consistent benchmarking analyses, are discussed. Finally, to demonstrate the feasibility of the illustrated benchmarking strategies, an application focused on determining regional benchmarks for patient satisfaction (using 2009 Lombardy Region Patient Satisfaction Questionnaire) is proposed. PMID:22666140

Benchmarking strategies for measuring the quality of healthcare: problems and prospects.

PubMed

Lovaglio, Pietro Giorgio

2012-01-01

Over the last few years, increasing attention has been directed toward the problems inherent to measuring the quality of healthcare and implementing benchmarking strategies. Besides offering accreditation and certification processes, recent approaches measure the performance of healthcare institutions in order to evaluate their effectiveness, defined as the capacity to provide treatment that modifies and improves the patient's state of health. This paper, dealing with hospital effectiveness, focuses on research methods for effectiveness analyses within a strategy comparing different healthcare institutions. The paper, after having introduced readers to the principle debates on benchmarking strategies, which depend on the perspective and type of indicators used, focuses on the methodological problems related to performing consistent benchmarking analyses. Particularly, statistical methods suitable for controlling case-mix, analyzing aggregate data, rare events, and continuous outcomes measured with error are examined. Specific challenges of benchmarking strategies, such as the risk of risk adjustment (case-mix fallacy, underreporting, risk of comparing noncomparable hospitals), selection bias, and possible strategies for the development of consistent benchmarking analyses, are discussed. Finally, to demonstrate the feasibility of the illustrated benchmarking strategies, an application focused on determining regional benchmarks for patient satisfaction (using 2009 Lombardy Region Patient Satisfaction Questionnaire) is proposed.

Economic evaluation of an implementation strategy for the management of low back pain in general practice.

PubMed

Jensen, Cathrine Elgaard; Riis, Allan; Petersen, Karin Dam; Jensen, Martin Bach; Pedersen, Kjeld Møller

2017-05-01

In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy. The economic evaluation was conducted as a cost-utility analysis where cost collected from a societal perspective and quality-adjusted life years were used as outcome measures. The analysis was conducted as a within-trial analysis with a 12-month time horizon consistent with the follow-up period of the clinical trial. To adjust for a priori selected covariates, generalised linear models with a gamma family were used to estimate incremental costs and quality-adjusted life years. Furthermore, both deterministic and probabilistic sensitivity analyses were conducted. Results showed that costs associated with primary health care were higher, whereas secondary health care costs were lower for the intervention group when compared with the control group. When adjusting for covariates, the intervention was less costly, and there was no significant difference in effect between the 2 groups. Sensitivity analyses showed that results were sensitive to uncertainty. In conclusion, the multifaceted implementation strategy was cost saving when compared with the usual strategy for implementing LBP clinical practice guidelines in general practice. Furthermore, there was no significant difference in effect, and the estimate was sensitive to uncertainty.

Issues regarding the usage of MPPT techniques in micro grid systems

NASA Astrophysics Data System (ADS)

Szeidert, I.; Filip, I.; Dragan, F.; Gal, A.

2018-01-01

The main objective of the control strategies applied at hybrid micro grid systems (wind/hydro/solar), that function based on maximum power point tracking (MPPT) techniques is to improve the conversion system’s efficiency and to preserve the quality of the generated electrical energy (voltage and power factor). One of the main goals of maximum power point tracking strategy is to achieve the harvesting of the maximal possible energy within a certain time period. In order to implement the control strategies for micro grid, there are typically required specific transducers (sensor for wind speed, optical rotational transducers, etc.). In the technical literature, several variants of the MPPT techniques are presented and particularized at some applications (wind energy conversion systems, solar systems, hydro plants, micro grid hybrid systems). The maximum power point tracking implementations are mainly based on two-level architecture. The lower level controls the main variable and the superior level represents the MPPT control structure. The paper presents micro grid structures developed at Politehnica University Timisoara (PUT) within the frame of a research grant. The paper is focused on the application of MPPT strategies on hybrid micro grid systems. There are presented several structures and control strategies and are highlighted their advantages and disadvantages, together with practical implementation guidelines.

Integrated Pest Management of Coffee Berry Borer: Strategies from Latin America that Could Be Useful for Coffee Farmers in Hawaii.

PubMed

Aristizábal, Luis F; Bustillo, Alex E; Arthurs, Steven P

2016-02-03

The coffee berry borer (CBB), Hypothenemus hampei Ferrari (Coleoptera: Curculionidae: Scolytinae) is the primary arthropod pest of coffee plantations worldwide. Since its detection in Hawaii (September 2010), coffee growers are facing financial losses due to reduced quality of coffee yields. Several control strategies that include cultural practices, biological control agents (parasitoids), chemical and microbial insecticides (entomopathogenic fungi), and a range of post-harvest sanitation practices have been conducted to manage CBB around the world. In addition, sampling methods including the use of alcohol based traps for monitoring CBB populations have been implemented in some coffee producing countries in Latin America. It is currently unclear which combination of CBB control strategies is optimal under economical, environmental, and sociocultural conditions of Hawaii. This review discusses components of an integrated pest management program for CBB. We focus on practical approaches to provide guidance to coffee farmers in Hawaii. Experiences of integrated pest management (IPM) of CBB learned from Latin America over the past 25 years may be relevant for establishing strategies of control that may fit under Hawaiian coffee farmers' conditions.

Planning schistosomiasis control: investigation of alternative sampling strategies for Schistosoma mansoni to target mass drug administration of praziquantel in East Africa.

PubMed

Sturrock, Hugh J W; Gething, Pete W; Ashton, Ruth A; Kolaczinski, Jan H; Kabatereine, Narcis B; Brooker, Simon

2011-09-01

In schistosomiasis control, there is a need to geographically target treatment to populations at high risk of morbidity. This paper evaluates alternative sampling strategies for surveys of Schistosoma mansoni to target mass drug administration in Kenya and Ethiopia. Two main designs are considered: lot quality assurance sampling (LQAS) of children from all schools; and a geostatistical design that samples a subset of schools and uses semi-variogram analysis and spatial interpolation to predict prevalence in the remaining unsurveyed schools. Computerized simulations are used to investigate the performance of sampling strategies in correctly classifying schools according to treatment needs and their cost-effectiveness in identifying high prevalence schools. LQAS performs better than geostatistical sampling in correctly classifying schools, but at a cost with a higher cost per high prevalence school correctly classified. It is suggested that the optimal surveying strategy for S. mansoni needs to take into account the goals of the control programme and the financial and drug resources available.

Pain affecting procedures in non-resectable pancreatic carcinoma.

PubMed

Plachkov, I; Chernopolski, P; Bozhkov, V; Madjov, R

2013-01-01

Pancreatic cancer is third most common cancer of the gastrointestinal tract in Bulgaria, accouting for 11, 6% in 2008. The leading symptom in patients with pancreatic cancer is the pain. The pain can be related with neoplasms and their metastasis. We should use all kind of resourses for pain relief: conventional drugs (according to the three steps strategy of WHO), interventional or surgical procedures. To present the interventional and surgical techniques in our practice and to share our experience for pain control in patients with nonresectable pancreatic cancer to improve their quality of life. In a seven year period (2004-2011) we performed 59 thoracoscopic splanhnicectomies/30--bilateral/ 4 intraoperative resections of celiac ganglion, 25 CT--control celiac plexus neurolysis and 90 cases pain relief with epidural analgesia. Concerning the quality of life we applied a questionnaire of a spannish medical center " City of Hope" adapted for patients with cancer and the level of pain with visual analogue scale VAS. The long-term duration of the pain relief technique depends on applied technic, of cancer invasion and of the technic itself. The technique with the longest effect are the intraoperative celiac ganglion removal and the bilateral thoracoscopic splanhnicectomy. On the other hand the shortest effect we report the celiac plexus neurolysis, and the epudural analgesia. These data are in correlation with the reduction of the pain shown using VAS thus improving the quality of life. The surgical and interventional methods for control of cancer pain have their own collocation improving the quality of life of these patients. New strategies for the pain control are need in the future.

Expanding integrated vector management to promote healthy environments

PubMed Central

Lizzi, Karina M.; Qualls, Whitney A.; Brown, Scott C.; Beier, John C.

2014-01-01

Integrated Vector Management (IVM) strategies are intended to protect communities from pathogen transmission by arthropods. These strategies target multiple vectors and different ecological and socioeconomic settings, but the aggregate benefits of IVM are limited by the narrow focus of its approach; IVM strategies only aim to control arthropod vectors. We argue that IVM should encompass environmental modifications at early stages, for instance, infrastructural development and sanitation services, to regulate not only vectors but also nuisance-biting arthropods. An additional focus on nuisance-biting arthropods will improve public health, quality of life, and minimize social disparity issues fostered by pests. Optimally, IVM could incorporate environmental awareness and promotion of control methods in order to proactively reduce threats of serious pest situations. PMID:25028090

Effect of the treatment of Type 2 diabetes mellitus on the development of cognitive impairment and dementia.

PubMed

Areosa Sastre, Almudena; Vernooij, Robin Wm; González-Colaço Harmand, Magali; Martínez, Gabriel

2017-06-15

Prevention of cognitive impairment and dementia is an important public health goal. Epidemiological evidence shows a relationship between cognitive impairment and Type 2 diabetes mellitus. The risk of dementia increases with duration of disease. This updated systematic review investigated the effect on cognitive function of the type of treatment and level of metabolic control in people with Type 2 diabetes. To assess the effects of different strategies for managing Type 2 diabetes mellitus on cognitive function and the incidence of dementia. We searched ALOIS (the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG)), the Cochrane Library, MEDLINE, Embase, PsycINFO, CINAHL and LILACS on 15 October 2016. ALOIS contains records from all major health care databases, (CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, LILACS), as well as from many trials' registers and grey literature sources. We included randomised controlled trials (RCTs) which compared two or more different treatments for Type 2 diabetes mellitus and in which cognitive function was measured at baseline and after treatment. Two review authors independently extracted data and assessed the quality of the included RCTs. We pooled data for comparable trials and estimated the effects of treatment by using risk ratios (RRs) and mean differences (MDs), according to the nature of the outcome. We assessed the quality of the evidence using GRADE methods. We identified seven eligible studies but only four provided data we could include in efficacy analyses. Two of these studies compared intensive versus standard glycaemic control and two compared different pharmacological treatments. All studies were at unclear risk of bias in at least two domains and one large study was at high risk of performance and detection bias.(a) Two studies with 13,934 participants at high cardiovascular risk provided efficacy data on intensive versus standard glycaemic control. A third study with 1791 participants provided additional data on hypoglycaemic episodes and mortality. There is probably no difference between treatment groups in the number of participants who decline by at least 3 points on the Mini-Mental State Examination (MMSE) over five years (RR 0.98, 95% CI 0.88 to 1.08; 1 study; n = 11,140; moderate-quality evidence); and there may also be little or no difference in the incidence of dementia (RR 1.27, 95% CI 0.87 to 1.85; 1 study; n = 11,140; low-quality evidence). From another study, there was probably little or no difference in MMSE score after 40 months (MD -0.01, 95% CI -0.18 to 0.16; 1 study; n = 2794; moderate quality evidence). Participants exposed to the intensive glycaemic control strategy probably experience more episodes of severe hypoglycaemia than those who have standard treatment (RR 2.18, 95% CI 1.52 to 3.14; 2 studies; n = 12,827; moderate-quality evidence). The evidence from these trials suggests that the intensity of glycaemic control may have little or no effect on all-cause mortality (RR 0.99, 95% CI 0.87 to 1.13; 3 studies; n = 15,888; low-quality evidence).(b) One study with 156 participants compared glibenclamide (glyburide) with repaglinide. There may be a small advantage of glibenclamide on global cognitive function measured with the MMSE after 12 months (MD -0.90, 95% CI -1.68 to -0.12; low-quality evidence). No data were reported on the incidence of dementia, hypoglycaemic events or all-cause mortality.(c) One study with 145 participants compared rosiglitazone plus metformin to glibenclamide (glyburide) plus metformin over 24 weeks. It reported only on cognitive subdomains and not on global cognitive function, incidence of MCI or dementia, hypoglycaemic events or all causes of mortality. We found no good evidence that any specific treatment or treatment strategy for Type 2 diabetes can prevent or delay cognitive impairment. The best available evidence related to the comparison of intensive with standard glycaemic control strategies. Here there was moderate-quality evidence that the strategies do not differ in their effect on global cognitive functioning over 40 to 60 months.

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.

High-efficiency holograms fixed in lithium niobate after recording using a digital fringe stabilization system.

PubMed

Arizmendi, Luis; Ambite, Emilio J

2012-02-20

We used a digital feedback control loop system to produce reproducible fixed volume transmission holograms of high diffraction efficiency. Different strategies were investigated to obtain holograms of good quality and the highest refractive index modulation depth. Using this control system, we were able to record holograms with stationary fringes. Additionally to using the stationary fringe recording, a double recording-fixing schedule resulted in being the most appropriate one to produce reproducible holograms of better characteristics. This strategy is discussed and compared with other already established ones. © 2012 Optical Society of America

Assessing Concentrations and Health Impacts of Air Quality Management Strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST)

PubMed Central

Milando, Chad W.; Martenies, Sheena E.; Batterman, Stuart A.

2017-01-01

In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest the potential for FRESH-EST to identify pollution control alternatives for air quality management planning. PMID:27318620

Research on charging and discharging control strategy for electric vehicles as distributed energy storage devices

NASA Astrophysics Data System (ADS)

Zhang, Min; Yang, Feng; Zhang, Dongqing; Tang, Pengcheng

2018-02-01

A large number of electric vehicles are connected to the family micro grid will affect the operation safety of the power grid and the quality of power. Considering the factors of family micro grid price and electric vehicle as a distributed energy storage device, a two stage optimization model is established, and the improved discrete binary particle swarm optimization algorithm is used to optimize the parameters in the model. The proposed control strategy of electric vehicle charging and discharging is of practical significance for the rational control of electric vehicle as a distributed energy storage device and electric vehicle participating in the peak load regulation of power consumption.

40 CFR 52.229 - Control strategy and regulations: Photochemical oxidants (hydrocarbons), Metropolitan Los Angeles...

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Rule 465 Vacuum Producing Devices or Systems, submitted on August 2, 1976. (2) South Coast Air Quality Management District. (i) Regulation IV, Rule 461 Gasoline Transfer and Dispensing, submitted on June 6, 1977...

78 FR 46931 - Intent To Hold North Dakota Task Force Meeting as Established by the Missouri River Protection...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-02

... a long-term strategy to improve conservation, protect recreation from sedimentation, improve water quality, improve erosion control, and protect historic and cultural sites along the Missouri River in...

The Use of Regulatory Air Quality Models to Develop Successful Ozone Attainment Strategies

NASA Astrophysics Data System (ADS)

Canty, T. P.; Salawitch, R. J.; Dickerson, R. R.; Ring, A.; Goldberg, D. L.; He, H.; Anderson, D. C.; Vinciguerra, T.

2015-12-01

The Environmental Protection Agency (EPA) recently proposed lowering the 8-hr ozone standard to between 65-70 ppb. Not all regions of the U.S. are in attainment of the current 75 ppb standard and it is expected that many regions currently in attainment will not meet the future, lower surface ozone standard. Ozone production is a nonlinear function of emissions, biological processes, and weather. Federal and state agencies rely on regulatory air quality models such as the Community Multi-Scale Air Quality (CMAQ) model and Comprehensive Air Quality Model with Extensions (CAMx) to test ozone precursor emission reduction strategies that will bring states into compliance with the National Ambient Air Quality Standards (NAAQS). We will describe various model scenarios that simulate how future limits on emission of ozone precursors (i.e. NOx and VOCs) from sources such as power plants and vehicles will affect air quality. These scenarios are currently being developed by states required to submit a State Implementation Plan to the EPA. Projections from these future case scenarios suggest that strategies intended to control local ozone may also bring upwind states into attainment of the new NAAQS. Ground based, aircraft, and satellite observations are used to ensure that air quality models accurately represent photochemical processes within the troposphere. We will highlight some of the improvements made to the CMAQ and CAMx model framework based on our analysis of NASA observations obtained by the OMI instrument on the Aura satellite and by the DISCOVER-AQ field campaign.

Strategies for addressing barriers to publishing pediatric quality improvement research.

PubMed

Van Cleave, Jeanne; Dougherty, Denise; Perrin, James M

2011-09-01

Advancing the science of quality improvement (QI) requires dissemination of the results of QI. However, the results of few QI interventions reach publication. To identify barriers to publishing results of pediatric QI research and provide practical strategies that QI researchers can use to enhance publishability of their work. We reviewed and summarized a workshop conducted at the Pediatric Academic Societies 2007 meeting in Toronto, Ontario, Canada, on conducting and publishing QI research. We also interviewed 7 experts (QI researchers, administrators, journal editors, and health services researchers who have reviewed QI manuscripts) about common reasons that QI research fails to reach publication. We also reviewed recently published pediatric QI articles to find specific examples of tactics to enhance publishability, as identified in interviews and the workshop. We found barriers at all stages of the QI process, from identifying an appropriate quality issue to address to drafting the manuscript. Strategies for overcoming these barriers included collaborating with research methodologists, creating incentives to publish, choosing a study design to include a control group, increasing sample size through research networks, and choosing appropriate process and clinical quality measures. Several well-conducted, successfully published QI studies in pediatrics offer guidance to other researchers in implementing these strategies in their own work. Specific, feasible approaches can be used to improve opportunities for publication in pediatric, QI, and general medical journals.

WE-G-BRF-09: Force- and Image-Adaptive Strategies for Robotised Placement of 4D Ultrasound Probes

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

Kuhlemann, I; Graduate School for Computing in Life Science, University of Luebeck, Luebeck; Bruder, R

2014-06-15

Purpose: To allow continuous acquisition of high quality 4D ultrasound images for non-invasive live tracking of tumours for IGRT, image- and force-adaptive strategies for robotised placement of 4D ultrasound probes are developed and evaluated. Methods: The developed robotised ultrasound system is based on a 6-axes industrial robot (adept Viper s850) carrying a 4D ultrasound transducer with a mounted force-torque sensor. The force-adaptive placement strategies include probe position control using artificial potential fields and contact pressure regulation by a PD controller strategy. The basis for live target tracking is a continuous minimum contact pressure to ensure good image quality and highmore » patient comfort. This contact pressure can be significantly disturbed by respiratory movements and has to be compensated. All measurements were performed on human subjects under realistic conditions. When performing cardiac ultrasound, rib- and lung shadows are a common source of interference and can disrupt the tracking. To ensure continuous tracking, these artefacts had to be detected to automatically realign the probe. The detection is realised by multiple algorithms based on entropy calculations as well as a determination of the image quality. Results: Through active contact pressure regulation it was possible to reduce the variance of the contact pressure by 89.79% despite respiratory motion of the chest. The results regarding the image processing clearly demonstrate the feasibility to detect image artefacts like rib shadows in real-time. Conclusion: In all cases, it was possible to stabilise the image quality by active contact pressure control and automatically detected image artefacts. This fact enables the possibility to compensate for such interferences by realigning the probe and thus continuously optimising the ultrasound images. This is a huge step towards fully automated transducer positioning and opens the possibility for stable target tracking in ultrasoundguided radiation therapy requiring contact pressure of 5–10 N. This work was supported by the Graduate School for Computing in Medicine and Life Sciences funded by Germany's Excellence Initiative [DFG GSC 235/1].« less

PI and repetitive control for single phase inverter based on virtual rotating coordinate system

NASA Astrophysics Data System (ADS)

Li, Mengqi; Tong, Yibin; Jiang, Jiuchun; Liang, Jiangang

2018-03-01

Microgrid technology developed rapidly and nonlinear loads were connected increasingly. A new control strategy was proposed for single phase inverter when connected nonlinear loads under island condition. PI and repetitive compound controller was realized under synchronous rotating coordinate system and acquired high quality sinusoidal voltage output without voltage spike when loads step changed. Validity and correctness were verified by simulation using MATLAB/Simulink.

Impact of Aging and Exercise on Mitochondrial Quality Control in Skeletal Muscle

PubMed Central

Kim, Yuho; Triolo, Matthew

2017-01-01

Mitochondria are characterized by its pivotal roles in managing energy production, reactive oxygen species, and calcium, whose aging-related structural and functional deteriorations are observed in aging muscle. Although it is still unclear how aging alters mitochondrial quality and quantity in skeletal muscle, dysregulation of mitochondrial biogenesis and dynamic controls has been suggested as key players for that. In this paper, we summarize current understandings on how aging regulates muscle mitochondrial biogenesis, while focusing on transcriptional regulations including PGC-1α, AMPK, p53, mtDNA, and Tfam. Further, we review current findings on the muscle mitochondrial dynamic systems in aging muscle: fusion/fission, autophagy/mitophagy, and protein import. Next, we also discuss how endurance and resistance exercises impact on the mitochondrial quality controls in aging muscle, suggesting possible effective exercise strategies to improve/maintain mitochondrial health. PMID:28656072

Disease activity-guided dose optimisation of adalimumab and etanercept is a cost-effective strategy compared with non-tapering tight control rheumatoid arthritis care: analyses of the DRESS study.

PubMed

Kievit, Wietske; van Herwaarden, Noortje; van den Hoogen, Frank Hj; van Vollenhoven, Ronald F; Bijlsma, Johannes Wj; van den Bemt, Bart Jf; van der Maas, Aatke; den Broeder, Alfons A

2016-11-01

A disease activity-guided dose optimisation strategy of adalimumab or etanercept (TNFi (tumour necrosis factor inhibitors)) has shown to be non-inferior in maintaining disease control in patients with rheumatoid arthritis (RA) compared with usual care. However, the cost-effectiveness of this strategy is still unknown. This is a preplanned cost-effectiveness analysis of the Dose REduction Strategy of Subcutaneous TNF inhibitors (DRESS) study, a randomised controlled, open-label, non-inferiority trial performed in two Dutch rheumatology outpatient clinics. Patients with low disease activity using TNF inhibitors were included. Total healthcare costs were measured and quality adjusted life years (QALY) were based on EQ5D utility scores. Decremental cost-effectiveness analyses were performed using bootstrap analyses; incremental net monetary benefit (iNMB) was used to express cost-effectiveness. 180 patients were included, and 121 were allocated to the dose optimisation strategy and 59 to control. The dose optimisation strategy resulted in a mean cost saving of -€12 280 (95 percentile -€10 502; -€14 104) per patient per 18 months. There is an 84% chance that the dose optimisation strategy results in a QALY loss with a mean QALY loss of -0.02 (-0.07 to 0.02). The decremental cost-effectiveness ratio (DCER) was €390 493 (€5 085 184; dominant) of savings per QALY lost. The mean iNMB was €10 467 (€6553-€14 037). Sensitivity analyses using 30% and 50% lower prices for TNFi remained cost-effective. Disease activity-guided dose optimisation of TNFi results in considerable cost savings while no relevant loss of quality of life was observed. When the minimal QALY loss is compensated with the upper limit of what society is willing to pay or accept in the Netherlands, the net savings are still high. NTR3216; Post-results. 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/.

Quality and rural-urban comparison of tuberculosis care in Rivers State, Nigeria.

PubMed

Tobin-West, Charles Ibiene; Isodje, Anastasia

2016-01-01

Nigeria ranks among countries with the highest burden of tuberculosis. Yet evidence continues to indicate poor treatment outcomes which have been attributed to poor quality of care. This study aims to identify some of the systemic problems in order to inform policy decisions for improved quality of services and treatment outcomes in Nigeria. A comparative assessment of the quality of TB care in rural and urban health facilities was carried out between May and June 2013, employing the Donabedian model of quality assessment. Data was analysed using the SPSS software package version 20.0. The level of significance was set at p < 0.05. Health facility infrastructures were more constrained in the urban than rural settings. Both the urban and rural facilities lacked adequate facilities for infection control such as, running water, air filter respirators, hand gloves and extractor fans. Health education and HIV counselling and testing (HCT) were limited in rural facilities compared to urban facilities. Although anti-TB drugs were generally available in both settings, the DOTS strategy in patient care was completely ignored. Finally, laboratory support for diagnosis and patient monitoring was limited in the rural facilities. The study highlights suboptimal quality of TB care in Rivers State with limitations in health education and HCT of patients for HIV as well as laboratory support for TB care in rural health facilities. We, therefore, recommend that adequate infection control measures, strict observance of the DOTS strategy and sufficient laboratory support be provided to TB clinics in the State.

Managing population health to prevent and detect cancer and non-communicable diseases.

PubMed

Bryant, Heather; Shin, Hai Rim; Forman, David; Stevanovic, Vladimir; Park, Sohee; Burton, Robert; Varghese, Cherian; Ullrich, Andreas; Sutcliffe, Catherine; Sutcliffe, Simon

2012-01-01

The goals of cancer control strategies are generally uniform across all constituencies and are to reduce cancer incidence, reduce cancer mortality, and improve quality of life for those affected by cancer. A well-constructed strategy will ensure that all of its elements can ultimately be connected to one of these goals. When a cancer control strategy is being implemented, it is essential to map progress towards these goals; without mapping progress, it is impossible to assess which components of the strategy require more attention or resources and which are not having the desired effect and need to be re-evaluated. In order to monitor and evaluate these strategies, systems need to be put in place to collect data and the appropriate indicators of performance need to be identified. Session 2 of the 4th International Cancer Control Congress (ICCC-4) focused on how to manage population health to prevent and detect cancers and non-communicable diseases through two plenary presentations and four interactive workshop discussions: 1) registries, measurement, and management in cancer control; 2) use of information for planning and evaluating screening and early detection programs; 3) alternative models for promoting community health, integrated care and illness management; and 4) control of non-communicable diseases. Workshop discussions highlighted that population based cancer registries are fundamental to understanding the cancer burden within a country. However, many countries in Africa, Asia, and South/ Central America do not have them in place. A new global initiative is underway, which brings together several international agencies, and aims to establish six IARC regional registration resource centres over the next five years. These will provide training, support, infrastructure and advocacy to local networks of cancer registries, and, it is hoped, improve the host countries' ability to assess and act on cancer issues within their jurisdictions. Multiple methods of programme evaluation were presented across workshops, but all were attuned to both the resource base and the specific questions to be addressed. Where innovative strategies were being tested, customized evaluation strategies should be undertaken. Where programmes are well-developed and data is being collected for evaluation, there is the opportunity for sophisticated analytical methods to be used to pinpoint specific areas or delivery sites for future quality improvement. Finally, unique opportunities now exist to integrate the strategies developed in cancer control and evaluation with those under development for other non-communicable diseases. This area will likely be one for future development.

Learning from death: a hospital mortality reduction programme

PubMed Central

Wright, John; Dugdale, Bob; Hammond, Ian; Jarman, Brian; Neary, Maria; Newton, Duncan; Patterson, Chris; Russon, Lynne; Stanley, Philip; Stephens, Rose; Warren, Erica

2006-01-01

Problem: There are wide variations in hospital mortality. Much of this variation remains unexplained and may reflect quality of care. Setting: A large acute hospital in an urban district in the North of England. Design: Before and after evaluation of a hospital mortality reduction programme. Strategies for change: Audit of hospital deaths to inform an evidence-based approach to identify processes of care to target for the hospital strategy. Establishment of a hospital mortality reduction group with senior leadership and support to ensure the alignment of the hospital departments to achieve a common goal. Robust measurement and regular feedback of hospital deaths using statistical process control charts and summaries of death certificates and routine hospital data. Whole system working across a health community to provide appropriate end of life care. Training and awareness in processes of high quality care such as clinical observation, medication safety and infection control. Effects: Hospital standardized mortality ratios fell significantly in the 3 years following the start of the programme from 94.6 (95% confidence interval 89.4, 99.9) in 2001 to 77.5 (95% CI 73.1, 82.1) in 2005. This translates as 905 fewer hospital deaths than expected during the period 2002-2005. Lessons learnt: Improving the safety of hospital care and reducing hospital deaths provides a clear and well supported goal from clinicians, managers and patients. Good leadership, good information, a quality improvement strategy based on good local evidence and a community-wide approach may be effective in improving the quality of processes of care sufficiently to reduce hospital mortality. PMID:16738373

Deficit irrigation strategies combined with controlled atmosphere preserve quality in early peaches.

PubMed

Falagán, Natalia; Artés, Francisco; Gómez, Perla A; Artés-Hernández, Francisco; Conejero, Wenceslao; Aguayo, Encarna

2015-10-01

Due to the water scarcity in the Mediterranean countries, irrigation must be optimized while keeping fruit quality. The effect of deficit irrigation strategies on changes in quality parameters of the early "Flordastar" peaches was studied. The deficit irrigation was programmed according to signal intensity of the maximum daily trunk shrinkage; deficit irrigation plants were irrigated to maintain maximum daily trunk shrinkage signal intensity values close to 1.4 or 1.3 in the case of DI1 or DI2 plants, respectively. Results were compared to a control watered at 150% crop evapotranspiration. Fruits were stored up to 14 days at 0 ℃ and 95% Relative Humidity (RH) in air or in controlled atmosphere (controlled atmosphere; 3-4 kPa O2 and 12-14 kPa CO2), followed by a retail sale period of 4 days at 15 ℃ and 90-95% Relative Humidity in air. Weight losses were lower in controlled atmosphere stored peaches from deficit irrigation. Air-stored fruits developed a more intense red color due to a faster ripening, which was not affected by the type of watering. At harvest, deficit irrigation peaches showed higher soluble solids content, which provided a better sensory evaluation. The soluble phenolic content was initially higher (55.26 ± 0.18 mg gallic acid equivalents/100 g fresh weight) and more stable throughout postharvest life in DI1 fruits than in those from the other irrigation treatments. Concerning vitamin C, control fruits at harvest showed higher ascorbic acid than dehydroascorbic acid content (5.43 versus 2.43 mg/100 g fresh weight, respectively), while water stressed peaches showed the opposite results. The combination of DI2 and controlled atmosphere storage allowed saving a significant amount of water and provided peaches with good overall quality, maintaining the bioactive compounds analyzed. © The Author(s) 2014.

Automatic control of the NMB level in general anaesthesia with a switching total system mass control strategy.

PubMed

Teixeira, Miguel; Mendonça, Teresa; Rocha, Paula; Rabiço, Rui

2014-12-01

This paper presents a model based switching control strategy to drive the neuromuscular blockade (NMB) level of patients undergoing general anesthesia to a predefined reference. A single-input single-output Wiener system with only two parameters is used to model the effect of two different muscle relaxants, atracurium and rocuronium, and a switching controller is designed based on a bank of total system mass control laws. Each of such laws is tuned for an individual model from a bank chosen to represent the behavior of the whole population. The control law to be applied at each instant corresponds to the model whose NMB response is closer to the patient's response. Moreover a scheme to improve the reference tracking quality based on the analysis of the patient's response, as well as, a comparison between the switching strategy and the Extended Kalman Kilter (EKF) technique are presented. The results are illustrated by means of several simulations, where switching shows to provide good results, both in theory and in practice, with a desirable reference tracking. The reference tracking improvement technique is able to produce a better reference tracking. Also, this technique showed a better performance than the (EKF). Based on these results, the switching control strategy with a bank of total system mass control laws proved to be robust enough to be used as an automatic control system for the NMB level.

Selection of sustainable seaweed and grouper aquaculture development strategy: a case of Pulau Panjang, Serang Regency Banten Province

NASA Astrophysics Data System (ADS)

Soejarwo, P. A.; Fitriyanny, W. P.; Heriati, A.; Hakim, A. R.

2018-03-01

Due to their high-income contribution, seaweed and grouper aquacultures are important activities in Pulau Panjang community. Determining alternative strategies in developing sustainable aquaculture for seaweed and grouper and their priority factors from theses aquaculture activities are done using TOPSIS and AHP analysis. It was found that the development strategy that must be taken is the option to maintain aquaculture activities, while, environment factor is the highest priority to maintain seaweed and grouper aquaculture in Pulau Panjang. Then three priorities are obtained from environment factor. The first is to maintain the water quality by the growth requirements of seaweed and grouper by encouraging the formation of “Environmental Community Awareness” that involved the active participation of the community to maintain quality and carrying capacity of the environment. Second is to use of natural or artificial coastal protectors (soft structure). The third priority strategy is integration and real implementation of heavy metal pollution control between government, industry sector and society.

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.

Practical UXO Classification: Enhanced Data Processing Strategies for Technology Transition - Fort Ord: Dynamic and Cued Metalmapper Processing and Classification

DTIC Science & Technology

2017-06-06

OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for...Geophysical Mapping, Electromagnetic Induction, Instrument Verification Strip, Time Domain Electromagnetic, Unexploded Ordnance 16. SECURITY...Munitions Response QA Quality Assurance QC Quality Control ROC Receiver Operating Characteristic RTK Real- time Kinematic s Second SNR

Watershed safety and quality control by safety threshold method

NASA Astrophysics Data System (ADS)

Da-Wei Tsai, David; Mengjung Chou, Caroline; Ramaraj, Rameshprabu; Liu, Wen-Cheng; Honglay Chen, Paris

2014-05-01

Taiwan was warned as one of the most dangerous countries by IPCC and the World Bank. In such an exceptional and perilous island, we would like to launch the strategic research of land-use management on the catastrophe prevention and environmental protection. This study used the watershed management by "Safety Threshold Method" to restore and to prevent the disasters and pollution on island. For the deluge prevention, this study applied the restoration strategy to reduce total runoff which was equilibrium to 59.4% of the infiltration each year. For the sediment management, safety threshold management could reduce the sediment below the equilibrium of the natural sediment cycle. In the water quality issues, the best strategies exhibited the significant total load reductions of 10% in carbon (BOD5), 15% in nitrogen (nitrate) and 9% in phosphorus (TP). We found out the water quality could meet the BOD target by the 50% peak reduction with management. All the simulations demonstrated the safety threshold method was helpful to control the loadings within the safe range of disasters and environmental quality. Moreover, from the historical data of whole island, the past deforestation policy and the mistake economic projects were the prime culprits. Consequently, this study showed a practical method to manage both the disasters and pollution in a watershed scale by the land-use management.

76 FR 41561 - Approval and Promulgation of Implementation Plans; California; 2007 South Coast PM2.5

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-14

...EPA is proposing to approve in part and disapprove in part state implementation plan (SIP) revisions submitted by California to provide for attainment of the 1997 fine particulate matter (PM2.5) national ambient air quality standards in the Los Angeles-South Coast area (South Coast). These SIP revisions are the South Coast 2007 Air Quality Management Plan (South Coast 2007 AQMP) (revised 2011) and South Coast-related provisions of the 2007 State Strategy (revised 2009 and 2011). EPA is proposing to approve the emissions inventories; air quality modeling; reasonably available control measures/reasonably available control technology demonstration; the reasonable further progress and attainment demonstrations; and the transportation conformity motor vehicle emissions budgets. EPA is also proposing to grant California's request to extend the attainment deadline for the South Coast to April 5, 2015 and to approve commitments to measures and reductions by the South Coast Air Quality Management District and the California Air Resources Board. Finally, we are proposing to disapprove the SIP's contingency measures and to reject the assignment of 10 tpd of NOX reductions to the federal government. This proposed rule amends EPA's November 22, 2010 proposed rule (75 FR 91294) on the South Coast PM2.5 plan and 2007 State strategy.

The impact of learned resourcefulness on quality of life in type II diabetic patients: a cross-sectional correlational study.

PubMed

Huang, Chiung-Yu; Perng, Shoa-Jen; Chen, Hisu-Fung; Lai, Chien-Yu

2008-12-01

It is well recognized that patients with diabetes encounter a host of daily self-care issues, including controlling blood sugar and preventing and managing complications, which impact significantly upon quality of life. Studies have indicated that learned resourcefulness has a potentially positive effect in dealing with psychosocial and health problems. The purpose of this study was to test the relationship between learned resourcefulness and quality of life in type II diabetic patients. The mediating and moderating effects of learned resourcefulness on the relationship between metabolic control and quality of life of diabetic patients was also examined. This cross-sectional and correlational study included a convenience sample of 131 type II diabetic patients recruited from three hospitals in southern Taiwan. Data were collected through questionnaires, which included the Rosenbaum's Self Control Schedule and World Health Organization's Quality of Life (Short Version). Multiple regression techniques were used to analyze outcome predictors. Study findings include identification of a mediating effect of learned resourcefulness between metabolic control and quality of life. While most DM patients were not satisfied with their health, we found that those with greater learned resourcefulness enjoyed a better quality of life. Learned resourcefulness, gender, and HbA1C explained 35.2% of variance in DM patient quality of life. Male diabetic patients enjoyed a better quality of life than females, even though levels of learned resourcefulness between the two groups were not significantly different. Results indicate that poor metabolic control of diabetic patients has a detrimental effect on quality of life, and when diabetic patients use more self-control skills, they may achieve better quality of life. Results suggest that nurses who use cognitive behavior coping strategies (resourcefulness) may help diabetic patients achieve better metabolic control and promote better quality of life.

V/STOL Dynamics, Control, and Flying Qualities

NASA Technical Reports Server (NTRS)

Franklin, James A.

2000-01-01

This publication presents material that constituted the lectures presented by the author as part of Course AA 234, Dynamics, Control, and Flying Qualities of Vertical/Short Takeoff and Landing (V/STOL) Aircraft that was taught in the Department of Aeronautics and Astronautics at Stanford University. It covers representative operations of vertical and short takeoff and landing (V/STOL) aircraft, a discussion of the pilot's strategy in controlling these aircraft, the equations of motion pertinent to V/STOL tasks, and their application in the analysis of longitudinal and lateral-directional control in hover and forward flight. Following that development, which applies to the characteristics of the basic airframe and propulsion system, the text concludes with a discussion of the contributions of control augmentation in specific flight tasks and of the integration of modern electronic displays with these controls.

General Guidance on Innovative and Voluntary Air Pollution Control Strategies

EPA Pesticide Factsheets

State and Local Transporation Resources is an EPA/OTAQ web page for state and local air quality regulators and transportation planners that offers guidance on how to reduce air pollution from cars, diesel trucks, city and school buses.

An integrated computer system for analysis, selection, and evaluation of unconventional intersections.

DOT National Transportation Integrated Search

2011-03-01

The emergence of unconventional intersections in the traffic community has been motivated by the notion : of improving service quality with innovative control strategies, such as rerouting the turning movements : or flipping the paths of two traffic ...

A cost-effectiveness modelling study of strategies to reduce risk of infection following primary hip replacement based on a systematic review.

PubMed

Graves, Nicholas; Wloch, Catherine; Wilson, Jennie; Barnett, Adrian; Sutton, Alex; Cooper, Nicola; Merollini, Katharina; McCreanor, Victoria; Cheng, Qinglu; Burn, Edward; Lamagni, Theresa; Charlett, Andre

2016-07-01

A deep infection of the surgical site is reported in 0.7% of all cases of total hip arthroplasty (THA). This often leads to revision surgery that is invasive, painful and costly. A range of strategies is employed in NHS hospitals to reduce risk, yet no economic analysis has been undertaken to compare the value for money of competing prevention strategies. To compare the costs and health benefits of strategies that reduce the risk of deep infection following THA in NHS hospitals. To make recommendations to decision-makers about the cost-effectiveness of the alternatives. The study comprised a systematic review and cost-effectiveness decision analysis. 77,321 patients who had a primary hip arthroplasty in NHS hospitals in 2012. Nine different treatment strategies including antibiotic prophylaxis, antibiotic-impregnated cement and ventilation systems used in the operating theatre. Change in the number of deep infections, change in the total costs and change in the total health benefits in quality-adjusted life-years (QALYs). Literature searches using MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trials were undertaken to cover the period 1966-2012 to identify infection prevention strategies. Relevant journals, conference proceedings and bibliographies of retrieved papers were hand-searched. Orthopaedic surgeons and infection prevention experts were also consulted. English-language papers only. The selection of evidence was by two independent reviewers. Studies were included if they were interventions that reported THA-related deep surgical site infection (SSI) as an outcome. Mixed-treatment comparisons were made to produce estimates of the relative effects of competing infection control strategies. Twelve studies, six randomised controlled trials and six observational studies, involving 123,788 total hip replacements (THRs) and nine infection control strategies, were identified. The quality of the evidence was judged against four categories developed by the National Institute for Health and Care Excellence Methods for Development of NICE Public Health Guidance ( http://publications.nice.org.uk/methods-for-the-development-of-nice-public-health-guidance-third-edition-pmg4 ), accessed March 2012. All evidence was found to fit the two highest categories of 1 and 2. Nine competing infection control interventions [treatments (Ts) 1-9] were used in a cohort simulation model of 77,321 patients who had a primary THR in 2012. Predictions were made for cases of deep infection and total costs, and QALY outcomes. Compared with a baseline of T1 (no systemic antibiotics, plain cement and conventional ventilation) all other treatment strategies reduced risk. T6 was the most effective (systemic antibiotics, antibiotic-impregnated cement and conventional ventilation) and prevented a further 1481 cases of deep infection, and led to the largest annual cost savings and the greatest gains to QALYs. The additional uses of laminar airflow and body exhaust suits indicate higher costs and worse health outcomes. T6 is an optimal strategy for reducing the risk of SSI following THA. The other strategies that are commonly used among NHS hospitals lead to higher cost and worse QALY outcomes. Policy-makers, therefore, have an opportunity to save resources and improve health outcomes. The effects of laminar air flow and body exhaust suits might be further studied if policy-makers are to consider disinvesting in these technologies. A wide range of evidence sources was synthesised and there is large uncertainty in the conclusions. The National Institute for Health Research Health Technology Assessment programme and the Queensland Health Quality Improvement and Enhancement Programme (grant number 2008001769).

Nanomedicine strategies for sustained, controlled and targeted treatment of cancer stem cells.

PubMed

Gao, Jie; Li, Wei; Guo, Yajun; Feng, Si-Shen

2016-12-01

Cancer stem cells (CSCs) are original cancer cells that are of characteristics associated with normal stem cells. CSCs are toughest against various treatments and thus responsible for cancer metastasis and recurrence. Therefore, development of specific and effective treatment of CSCs plays a key role in improving survival and life quality of cancer patients, especially those in the metastatic stage. Nanomedicine strategies, which include prodrugs, micelles, liposomes and nanoparticles of biodegradable polymers, could substantially improve the therapeutic index of conventional therapeutics due to its manner of sustained, controlled and targeted delivery of high transportation efficiency across the cell membrane and low elimination by intracellular autophagy, and thus provide a practical solution to solve the problem encountered in CSCs treatment. This review gives briefly the latest information to summarize the concept, strategies, mechanisms and current status as well as future promises of nanomedicine strategies for treatment of CSCs.

Effectiveness of guideline dissemination and implementation strategies on health care professionals' behaviour and patient outcomes in the cancer care context: a systematic review protocol.

PubMed

Tomasone, Jennifer R; Chaudhary, Rushil; Brouwers, Melissa C

2015-08-25

Health care professionals (HCPs) are able to make effective decisions regarding patient care through the use of systematically developed clinical practice guidelines (CPGs). These recommendations are especially important in a cancer health care context as patients are exposed to a multitude of interdisciplinary HCPs offering high-quality care throughout diagnosis, treatment, survivorship and palliative care. Although a large number of CPGs targeted towards cancer are widely disseminated, it is unknown whether implementation strategies targeting the use of these guidelines are effective in effecting HCP behaviour and patient outcomes in the cancer care context. The purpose of this systematic review will be to determine the effectiveness of different CPG dissemination and implementation interventions on HCPs' behaviour and patient outcomes in the cancer health care context. Five electronic databases (CINAHL, the Cochrane Controlled Trials Register, MEDLINE via Ovid, EMBASE via Ovid and PsycINFO via Ovid) will be searched to include all studies examining the dissemination and/or implementation of CPGs in a cancer care setting targeting all HCPs. CPG implementation strategies will be included if the CPGs were systematically developed (e.g. literature review/evidence-informed, expert panel, evidence appraisal). The studies will be limited to randomized controlled trials, controlled clinical trials and quasi-experimental (interrupted time series, controlled before-and-after designs) studies. Two independent reviewers will assess articles for eligibility, data extraction and quality appraisal. The aim of this review is to inform cancer care health care professionals and policymakers about evidence-based implementation strategies that will allow for effective use of CPGs. PROSPERO CRD42015019331.

ProSens: integrated production control by automated inspection planning and efficient multisensor metrology

NASA Astrophysics Data System (ADS)

Glaser, Ulf; Li, Zhichao; Bichmann, Stephan, II; Pfeifer, Tilo

2003-05-01

By China's entry into the WTO, Chinese as well as German companies are facing the question, how to minimize the risk of unfamiliar cooperation partners when developing products. The rise of customer demands concerning quality, product diversity and the reduction of expenses require flexibility and efficiency with reliable component suppliers. In order to build and strengthen sino-german cooperations, a manufacturing control using homogenized and efficient measures to assure high quality is of vital importance. Lack of unifications may cause identical measurements conducted at subcontractors or customers to be carried out with different measurement processes which leads to incomparable results. Rapidly growing company cooperations and simultaneously decreasing of manufacturing scope cause substantial difficulties when coordinating joint quality control activities. "ProSens," a sino-german project consortium consisting of industrial users, technology producers and research institutes, aims at improving selected production processes by: Creation of a homogeneous quality awareness in sino-german cooperations. Sensitization for process accompanying metrology at an early stage of product development. Increase of the process performance by the use of integrated metrology. Reduction of production time and cost. Unification of quality control of complex products by means of efficient measurement strategies and CAD-based inspection planning.

Uncertainty and sensitivity analysis of control strategies using the benchmark simulation model No1 (BSM1).

PubMed

Flores-Alsina, Xavier; Rodriguez-Roda, Ignasi; Sin, Gürkan; Gernaey, Krist V

2009-01-01

The objective of this paper is to perform an uncertainty and sensitivity analysis of the predictions of the Benchmark Simulation Model (BSM) No. 1, when comparing four activated sludge control strategies. The Monte Carlo simulation technique is used to evaluate the uncertainty in the BSM1 predictions, considering the ASM1 bio-kinetic parameters and influent fractions as input uncertainties while the Effluent Quality Index (EQI) and the Operating Cost Index (OCI) are focused on as model outputs. The resulting Monte Carlo simulations are presented using descriptive statistics indicating the degree of uncertainty in the predicted EQI and OCI. Next, the Standard Regression Coefficients (SRC) method is used for sensitivity analysis to identify which input parameters influence the uncertainty in the EQI predictions the most. The results show that control strategies including an ammonium (S(NH)) controller reduce uncertainty in both overall pollution removal and effluent total Kjeldahl nitrogen. Also, control strategies with an external carbon source reduce the effluent nitrate (S(NO)) uncertainty increasing both their economical cost and variability as a trade-off. Finally, the maximum specific autotrophic growth rate (micro(A)) causes most of the variance in the effluent for all the evaluated control strategies. The influence of denitrification related parameters, e.g. eta(g) (anoxic growth rate correction factor) and eta(h) (anoxic hydrolysis rate correction factor), becomes less important when a S(NO) controller manipulating an external carbon source addition is implemented.

76 FR 41337 - Approval and Promulgation of Implementation Plans; California; 2008 San Joaquin Valley PM2.5

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

...EPA is proposing to approve in part and disapprove in part state implementation plan (SIP) revisions submitted by California to provide for attainment of the 1997 fine particulate matter (PM2.5) national ambient air quality standards in the San Joaquin Valley (SJV). These SIP revisions are the SJV 2008 PM2.5 Plan (revised 2010 and 2011) and SJV-related provisions of the 2007 State Strategy (revised 2009 and 2011). EPA is proposing to approve the emissions inventories; air quality modeling; the reasonably available control measures/reasonably available control technology, reasonable further progress, and attainment demonstrations; and the transportation conformity motor vehicle emissions budgets. EPA is also proposing to grant California's request to extend the attainment deadline for the SJV to April 5, 2015 and to approve commitments to measures and reductions by the SJV Air Pollution Control District and the California Air Resources Board. Finally, it is proposing to disapprove the SIP's contingency measures. This proposed rule amends EPA's November 30, 2010 proposed rule (75 FR 74518) on the SJV 2008 PM2.5 Plan and 2007 State Strategy.

Supervising community health workers in low-income countries – a review of impact and implementation issues

PubMed Central

Hill, Zelee; Dumbaugh, Mari; Benton, Lorna; Källander, Karin; Strachan, Daniel; Asbroek, Augustinus ten; Tibenderana, James; Kirkwood, Betty; Meek, Sylvia

2014-01-01

Background Community health workers (CHWs) are an increasingly important component of health systems and programs. Despite the recognized role of supervision in ensuring CHWs are effective, supervision is often weak and under-supported. Little is known about what constitutes adequate supervision and how different supervision strategies influence performance, motivation, and retention. Objective To determine the impact of supervision strategies used in low- and middle-income countries and discuss implementation and feasibility issues with a focus on CHWs. Design A search of peer-reviewed, English language articles evaluating health provider supervision strategies was conducted through November 2013. Included articles evaluated the impact of supervision in low- or middle-income countries using a controlled, pre-/post- or observational design. Implementation and feasibility literature included both peer-reviewed and gray literature. Results A total of 22 impact papers were identified. Papers were from a range of low- and middle-income countries addressing the supervision of a variety of health care providers. We classified interventions as testing supervision frequency, the supportive/facilitative supervision package, supervision mode (peer, group, and community), tools (self-assessment and checklists), focus (quality assurance/problem solving), and training. Outcomes included coverage, performance, and perception of quality but were not uniform across studies. Evidence suggests that improving supervision quality has a greater impact than increasing frequency of supervision alone. Supportive supervision packages, community monitoring, and quality improvement/problem-solving approaches show the most promise; however, evaluation of all strategies was weak. Conclusion Few supervision strategies have been rigorously tested and data on CHW supervision is particularly sparse. This review highlights the diversity of supervision approaches that policy makers have to choose from and, while choices should be context specific, our findings suggest that high-quality supervision that focuses on supportive approaches, community monitoring, and/or quality assurance/problem solving may be most effective. PMID:24815075

Improvement in vehicle agility and stability by G-Vectoring control

NASA Astrophysics Data System (ADS)

Yamakado, Makoto; Takahashi, Jyunya; Saito, Shinjiro; Yokoyama, Atsushi; Abe, Masato

2010-12-01

We extracted a trade-off strategy between longitudinal traction/braking force and cornering force by using jerk information through observing an expert driver's voluntary braking and turning action. Using the expert driver's strategy, we developed a new control concept, called 'G-Vectoring control', which is an automatic longitudinal acceleration control (No DYC) in accordance with the vehicle's lateral jerk caused by the driver's steering manoeuvres. With the control, the direction of synthetic acceleration (G) changes seamlessly (i.e. vectoring). The improvements in vehicle agility and stability were evaluated by theoretical analysis and through computer simulation. We then introduced a 'G-Vectoring' equipped test vehicle realised by brake-by-wire technology and executed a detailed examination on a test track. We have confirmed that the vehicle motion in view of both handling and ride quality has improved dramatically.

New strategy to improve quality control of Montenegro skin test at the production level.

PubMed

Guedes, Deborah Carbonera; Minozzo, João Carlos; Pasquali, Aline Kuhn Sbruzzi; Faulds, Craig; Soccol, Carlos Ricardo; Thomaz-Soccol, Vanete

2017-01-01

The production of the Montenegro antigen for skin test poses difficulties regarding quality control. Here, we propose that certain animal models reproducing a similar immune response to humans may be used in the quality control of Montenegro antigen production. Fifteen Cavia porcellus (guinea pigs) were immunized with Leishmania amazonensis or Leishmania braziliensis , and, after 30 days, they were skin tested with standard Montenegro antigen. To validate C. porcellus as an animal model for skin tests, eighteen Mesocricetus auratus (hamsters) were infected with L. amazonensis or L. braziliensis , and, after 45 days, they were skin tested with standard Montenegro antigen. Cavia porcellus immunized with L. amazonensis or L. braziliensis , and hamsters infected with the same species presented induration reactions when skin tested with standard Montenegro antigen 48-72h after the test. The comparison between immunization methods and immune response from the two animal species validated C. porcellus as a good model for Montenegro skin test, and the model showed strong potential as an in vivo model in the quality control of the production of Montenegro antigen.

Early versus late initiation of rehabilitation after lumbar spinal fusion: economic evaluation alongside a randomized controlled trial.

PubMed

Oestergaard, Lisa G; Christensen, Finn B; Nielsen, Claus V; Bünger, Cody E; Fruensgaard, Soeren; Sogaard, Rikke

2013-11-01

Economic evaluation conducted alongside a randomized controlled trial with 1-year follow-up. To examine the cost-effectiveness of initiating rehabilitation 6 weeks after surgery as opposed to 12 weeks after surgery. In a previously reported randomized controlled trial, we assessed the impact of timing of rehabilitation after a lumbar spinal fusion and found that a fast-track strategy led to poorer functional ability. Before making recommendations, it seems relevant to address the societal perspective including return to work, quality of life, and costs. A cost-effectiveness analysis and a cost-utility analysis were conducted. Eighty-two patients undergoing instrumented lumbar spinal fusion due to degenerative disc disease or spondylolisthesis (grade I or II) were randomized to an identical protocol of 4 sessions of group-based rehabilitation and were instructed in home exercises focusing on active stability training. Outcome parameters included functional disability (Oswestry Disability Index) and quality-adjusted life years. Health care and productivity costs were estimated from national registries and reported in euros. Costs and effects were transformed into net benefit. Bootstrapping was used to estimate 95% confidence intervals (95% CI). The fast-track strategy tended to be costlier by €6869 (95% CI, -4640 to 18,378) while at the same time leading to significantly poorer outcomes of functional disability by -9 points (95% CI, -18 to -3) and a tendency for a reduced gain in quality-adjusted life years by -0.04 (95% CI, -0.13 to 0.01). The overall probability for the fast-track strategy being cost-effective does not reach 10% at conventional thresholds for cost-effectiveness. Initiating rehabilitation at 6 weeks as opposed to 12 weeks after surgery is on average more costly and less effective. The uncertainty of this result did not seem to be sensitive to methodological issues, and clinical managements who have already adapted fast-track rehabilitation strategies have reason to reconsider their choice. .

Improving prospective memory in persons with Parkinson disease: A randomized controlled trial

PubMed Central

Foster, Erin R.; McDaniel, Mark A.; Rendell, Peter G.

2017-01-01

Background Prospective memory is essential for productive and independent living and necessary for compliance with prescribed health behaviors. Parkinson disease (PD) can cause prospective memory deficits that are associated with activity limitations and reduced quality of life. Forming implementation intentions is an encoding strategy that may improve prospective memory in this population. Objective To determine the effect of implementation intentions on prospective memory performance in PD. Methods This was a laboratory-based randomized controlled trial. Participants with mild to moderate PD without dementia (N = 62) performed a computerized prospective memory test (Virtual Week) under standard instructions. One week later they were randomly allocated to perform it again while using either implementation intentions or a rehearsal encoding strategy. Results Prospective memory performance was better with the use of both strategies relative to standard instructions. This effect was larger for tasks with event-based compared to time-based cues. In addition, implementation intentions resulted in a larger effect than rehearsal for the non-repeated tasks. Conclusions Strategies that support full encoding of prospective memory cues and actions can improve prospective memory performance among people with PD, particularly for tasks with cues that are readily available in the environment. Implementation intentions may be more effective than rehearsal for non-repeated tasks, but this finding warrants verification. Future work should address transfer of strategy use from the laboratory to everyday life. Targeted strategies to manage prospective memory impairment could improve function and quality of life and significantly impact clinical care for people with PD. (NCT01469741) PMID:28176547

Testing the hospital value proposition: an empirical analysis of efficiency and quality.

PubMed

Huerta, Timothy R; Ford, Eric W; Peterson, Lori T; Brigham, Keith H

2008-01-01

To assess the relationship between hospitals' X-inefficiency levels and overall care quality based on the National Quality Forum's 27 safe practices score and to improve the analytic strategy for assessing X-inefficiency. The 2005 versions of the American Hospital Association and Leapfrog Group's annual surveys were the basis of the study. Additional case mix indices and market variables were drawn from the Centers for Medicare and Medicaid Services data sources and the Area Resource File. Data envelopment analysis was used to determine hospitals' X-inefficiency scores relative to their market-level competitors. Regression was used to assess the relationship between X-inefficiency and quality, controlling for organizational and market characteristics. Expenses (total and labor expenditures), case-mix-adjusted admissions, length of stay, and licensed beds defined the X-inefficiency function. The overall National Quality Forum's safe practice score, health maintenance organization penetration, market share, and teaching status served as independent control variables in the regression. The National Quality Forum's safe practice scores are significantly and positively correlated to hospital X-inefficiency levels (beta = .105, p < or = .05). The analysis of the value proposition had very good explanatory power (adjusted R(2) = .414; p < or = .001; df = 7, 265). Contrary to earlier findings, health maintenance organization penetration and being a teaching hospital were positively related to X-inefficiency. Similar with others' findings, greater market share and for-profit ownership were negatively associated with X-inefficiency. Measurement of overall hospital quality is improving but can still be made better. Nevertheless, the National Quality Forum's measure is significantly related to efficiency and could be used to create differential pay-for-performance programs. A market-segmented analytic strategy for studying hospitals' efficiency yields results with a high degree of explanatory power.

Unique contributions of emotion regulation and executive functions in predicting the quality of parent-child interaction behaviors.

PubMed

Shaffer, Anne; Obradović, Jelena

2017-03-01

Parenting is a cognitive, emotional, and behavioral endeavor, yet limited research investigates parents' executive functions and emotion regulation as predictors of how parents interact with their children. The current study is a multimethod investigation of parental self-regulation in relation to the quality of parenting behavior and parent-child interactions in a diverse sample of parents and kindergarten-age children. Using path analyses, we tested how parent executive functions (inhibitory control) and lack of emotion regulation strategies uniquely relate to both sensitive/responsive behaviors and positive/collaborative behaviors during observed interaction tasks. In our analyses, we accounted for parent education, financial stress, and social support as socioeconomic factors that likely relate to parent executive function and emotion regulation skills. In a diverse sample of primary caregivers (N = 102), we found that direct assessment of parent inhibitory control was positively associated with sensitive/responsive behaviors, whereas parent self-reported difficulties in using emotion regulation strategies were associated with lower levels of positive and collaborative dyadic behaviors. Parent education and financial stress predicted inhibitory control, and social support predicted emotion regulation difficulties; parent education was also a significant predictor of sensitive/responsive behaviors. Greater inhibitory control skills and fewer difficulties identifying effective emotion regulation strategies were not significantly related in our final path model. We discuss our findings in the context of current and emerging parenting interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Approaches to quality management and accreditation in a genetic testing laboratory

PubMed Central

Berwouts, Sarah; Morris, Michael A; Dequeker, Elisabeth

2010-01-01

Medical laboratories, and specifically genetic testing laboratories, provide vital medical services to different clients: clinicians requesting a test, patients from whom the sample was collected, public health and medical-legal instances, referral laboratories and authoritative bodies. All expect results that are accurate and obtained in an efficient and effective manner, within a suitable time frame and at acceptable cost. There are different ways of achieving the end results, but compliance with International Organization for Standardization (ISO) 15189, the international standard for the accreditation of medical laboratories, is becoming progressively accepted as the optimal approach to assuring quality in medical testing. We present recommendations and strategies designed to aid genetic testing laboratories with the implementation of a quality management system, including key aspects such as document control, external quality assessment, internal quality control, internal audit, management review, validation, as well as managing the human side of change. The focus is on pragmatic approaches to attain the levels of quality management and quality assurance required for accreditation according to ISO 15189, within the context of genetic testing. Attention is also given to implementing efficient and effective quality improvement. PMID:20720559

Read Code Quality Assurance

PubMed Central

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

1998-01-01

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

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

PubMed

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

1998-01-01

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

[Thoughts on optimizing the breast cancer screening strategies and implementation effects].

PubMed

Wu, K J

2018-02-01

Reasonable and effective breast cancer screening can make early diagnosis of breast cancer, improve the cure rate, prolong survival and improve the patients' quality of life. China has made preliminary exploration and attempt in breast cancer screening, however, there are still some problems that have not been solved in terms of the proportion of opportunistic screening, the selection of screening targets, methods and frequency, and the judgment of screening results. Therefore, this article analyzes the above problems in details, and presents some thoughts and recommendations on how to optimize the breast cancer screening strategies and implementation effects in China, from the experience of clinical practice, under the background of constantly emerging new research results and techniques and the rapid development of artificial intelligence, that is, to adjust measures to local conditions, provide personalized strategies, achieve precise screening, preach and educate, ensure health insurance coverage, improve quality control, offer technical support and employ artificial intelligence.

A fuzzy gear shifting strategy for manual transmissions

NASA Astrophysics Data System (ADS)

Mashadi, B.; Kazemkhani, A.

2005-12-01

Governing parameters in decision making for gear changing of an automated manual transmission are discussed based on two different criteria, namely engine working conditions and driver's intention. By taking into consideration the effects of these parameters, gear shifting strategy is designed with the application of Fuzzy control method. The controller structure is formed in two layers. In the first layer two fuzzy inference modules are used to determine necessary outputs. In second layer a fuzzy inference module makes the decision of shifting by up-shift, downshift or maintain commands. The quality of Fuzzy controller behavior is examined by making use of ADVISOR software. It is shown that at different driving conditions the controller makes correct decisions for gear shifting accounting for dynamical requirements of vehicle. It is also shown that the controller based on both engine state and driver's intention eliminates unnecessary shiftings that are present when the intention is ignored. A micro-trip is designed in which a required speed in the form of a step function is demanded for the vehicle. Starting from rest both strategies change the gear to reach maximum speed more or less in a similar fashion. In deceleration phase, however, large differences are observed between the two strategies. The engine-state strategy is less sensitive to downshift, taking even unnecessary up shift decisions. The state-intention strategy, however, correctly interprets the driver's intention for decreasing speed and utilizes engine brake torque to reduce vehicle speed in a shorter time.

Quantifying the sources of ozone, fine particulate matter, and regional haze in the Southeastern United States.

PubMed

Odman, M Talat; Hu, Yongtao; Russell, Armistead G; Hanedar, Asude; Boylan, James W; Brewer, Patricia F

2009-07-01

A detailed sensitivity analysis was conducted to quantify the contributions of various emission sources to ozone (O3), fine particulate matter (PM2.5), and regional haze in the Southeastern United States. O3 and particulate matter (PM) levels were estimated using the Community Multiscale Air Quality (CMAQ) modeling system and light extinction values were calculated from modeled PM concentrations. First, the base case was established using the emission projections for the year 2009. Then, in each model run, SO2, primary carbon (PC), NH3, NO(x) or VOC emissions from a particular source category in a certain geographic area were reduced by 30% and the responses were determined by calculating the difference between the results of the reduced emission case and the base case. The sensitivity of summertime O3 to VOC emissions is small in the Southeast and ground-level NO(x) controls are generally more beneficial than elevated NO(x) controls (per unit mass of emissions reduced). SO2 emission reduction is the most beneficial control strategy in reducing summertime PM2.5 levels and improving visibility in the Southeast and electric generating utilities are the single largest source of SO2. Controlling PC emissions can be very effective locally, especially in winter. Reducing NH3 emissions is an effective strategy to reduce wintertime ammonium nitrate (NO3NH4) levels and improve visibility; NO(x) emissions reductions are not as effective. The results presented here will help the development of specific emission control strategies for future attainment of the National Ambient Air Quality Standards in the region.

Balancing effluent quality, economic cost and greenhouse gas emissions during the evaluation of (plant-wide) control/operational strategies in WWTPs.

PubMed

Flores-Alsina, Xavier; Arnell, Magnus; Amerlinck, Youri; Corominas, Lluís; Gernaey, Krist V; Guo, Lisha; Lindblom, Erik; Nopens, Ingmar; Porro, Jose; Shaw, Andy; Snip, Laura; Vanrolleghem, Peter A; Jeppsson, Ulf

2014-01-01

The objective of this paper was to show the potential additional insight that result from adding greenhouse gas (GHG) emissions to plant performance evaluation criteria, such as effluent quality (EQI) and operational cost (OCI) indices, when evaluating (plant-wide) control/operational strategies in wastewater treatment plants (WWTPs). The proposed GHG evaluation is based on a set of comprehensive dynamic models that estimate the most significant potential on-site and off-site sources of CO₂, CH₄ and N₂O. The study calculates and discusses the changes in EQI, OCI and the emission of GHGs as a consequence of varying the following four process variables: (i) the set point of aeration control in the activated sludge section; (ii) the removal efficiency of total suspended solids (TSS) in the primary clarifier; (iii) the temperature in the anaerobic digester; and (iv) the control of the flow of anaerobic digester supernatants coming from sludge treatment. Based upon the assumptions built into the model structures, simulation results highlight the potential undesirable effects of increased GHG production when carrying out local energy optimization of the aeration system in the activated sludge section and energy recovery from the AD. Although off-site CO₂ emissions may decrease, the effect is counterbalanced by increased N₂O emissions, especially since N₂O has a 300-fold stronger greenhouse effect than CO₂. The reported results emphasize the importance and usefulness of using multiple evaluation criteria to compare and evaluate (plant-wide) control strategies in a WWTP for more informed operational decision making. © 2013.

From self-assessment to frustration, a small step toward autonomy in robotic navigation

PubMed Central

Jauffret, Adrien; Cuperlier, Nicolas; Tarroux, Philippe; Gaussier, Philippe

2013-01-01

Autonomy and self-improvement capabilities are still challenging in the fields of robotics and machine learning. Allowing a robot to autonomously navigate in wide and unknown environments not only requires a repertoire of robust strategies to cope with miscellaneous situations, but also needs mechanisms of self-assessment for guiding learning and for monitoring strategies. Monitoring strategies requires feedbacks on the behavior's quality, from a given fitness system in order to take correct decisions. In this work, we focus on how a second-order controller can be used to (1) manage behaviors according to the situation and (2) seek for human interactions to improve skills. Following an incremental and constructivist approach, we present a generic neural architecture, based on an on-line novelty detection algorithm that may be able to self-evaluate any sensory-motor strategies. This architecture learns contingencies between sensations and actions, giving the expected sensation from the previous perception. Prediction error, coming from surprising events, provides a measure of the quality of the underlying sensory-motor contingencies. We show how a simple second-order controller (emotional system) based on the prediction progress allows the system to regulate its behavior to solve complex navigation tasks and also succeeds in asking for help if it detects dead-lock situations. We propose that this model could be a key structure toward self-assessment and autonomy. We made several experiments that can account for such properties for two different strategies (road following and place cells based navigation) in different situations. PMID:24115931

Strengthening public health pesticide management in countries endemic with malaria or other major vector-borne diseases: an evaluation of three strategies.

PubMed

van den Berg, Henk; Yadav, Rajpal S; Zaim, Morteza

2014-09-18

Public health pesticides has been the mainstay control of vectors of malaria and other diseases, and public health pests, but there is increasing concern over how these pesticides are being managed. Poor pesticide management could lead to risks to human health and the environment, or diminish the effectiveness of interventions. Strategies for strengthening the management of public health pesticides, from manufacture to disposal, should be evaluated to propose future directions. The process and outcomes of three strategies were studied in five regions of the WHO (African Region, Eastern Mediterranean Region, South-East Asia Region, Western Pacific Region, and American Region) and 13 selected countries. These strategies are: regional policy development, in-depth country support and thematic support across countries. Consensus, frameworks and action plans on public health pesticide management were developed at regional level. Country support for situation analysis and national action planning highlighted weaknesses over the entire spectrum of pesticide management practices, mainly related to malaria control. The thematic support on pesticide quality control contributed to structural improvements on a priority issue for malaria control across countries. The three strategies showed promising and complementary results, but guidelines and tools for implementation of the strategies should be further improved. Increased national and international priority should be given to support the development of policy, legislation and capacity that are necessary for sound management of public health pesticides.

Implementing a Data Quality Strategy to Simplify Access to Data

NASA Astrophysics Data System (ADS)

Druken, K. A.; Trenham, C. E.; Evans, B. J. K.; Richards, C. J.; Wang, J.; Wyborn, L. A.

2016-12-01

To ensure seamless programmatic access for data analysis (including machine learning), standardization of both data and services is vital. At the Australian National Computational Infrastructure (NCI) we have developed a Data Quality Strategy (DQS) that currently provides processes for: (1) the consistency of data structures in the underlying High Performance Data (HPD) platform; (2) quality control through compliance with recognized community standards; and (3) data quality assurance through demonstrated functionality across common platforms, tools and services. NCI hosts one of Australia's largest repositories (10+ PBytes) of research data collections spanning datasets from climate, coasts, oceans and geophysics through to astronomy, bioinformatics and the social sciences. A key challenge is the application of community-agreed data standards to the broad set of Earth systems and environmental data that are being used. Within these disciplines, data span a wide range of gridded, ungridded (i.e., line surveys, point clouds), and raster image types, as well as diverse coordinate reference projections and resolutions. By implementing our DQS we have seen progressive improvement in the quality of the datasets across the different subject domains, and through this, the ease by which the users can programmatically access the data, either in situ or via web services. As part of its quality control procedures, NCI has developed a compliance checker based upon existing domain standards. The DQS also includes extensive Functionality Testing which include readability by commonly used libraries (e.g., netCDF, HDF, GDAL, etc.); accessibility by data servers (e.g., THREDDS, Hyrax, GeoServer), validation against scientific analysis and programming platforms (e.g., Python, Matlab, QGIS); and visualization tools (e.g., ParaView, NASA Web World Wind). These tests ensure smooth interoperability between products and services as well as exposing unforeseen requirements and dependencies. The results provide an important component of quality control within the DQS as well as clarifying the requirement for any extensions to the relevant standards that help support the uptake of data by broader international communities.

National quality improvement policies and strategies in European healthcare systems.

PubMed

Spencer, E; Walshe, K

2009-02-01

This survey provides an overview of the development of policies and strategies for quality improvement in European healthcare systems, by mapping quality improvement policies and strategies, progress in their implementation, and early indications of their impact. A survey of quality improvement policies and strategies in healthcare systems of the European Union was conducted in 2005 for the first phase of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The survey, completed by 68 key experts in quality improvement from 24 European Union member states, represents their views and accounts of quality improvement policies and strategies in their healthcare systems. There are substantial international and intra-national variations in the development of healthcare quality improvement. Legal requirements for quality improvement strategies are an important driver of progress, along with the activities of national governments and professional associations and societies. Patient and service user organisations appear to have less influence on quality improvement. Wide variation in voluntary and mandatory coverage of quality improvement policies and strategies across sectors can potentially lead to varying levels of progress in implementation. Many healthcare organisations lack basic infrastructure for quality improvement. Some convergence can be observed in policies on quality improvement in healthcare. Nevertheless, the growth of patient mobility across borders, along with the implications of free market provisions for the organisation and funding of healthcare systems in European Union member states, require policies for cooperation and learning transfer.

Effectiveness of the HuCare Quality Improvement Strategy on health-related quality of life in patients with cancer: study protocol of a stepped-wedge cluster randomised controlled trial (HuCare2 study).

PubMed

Caminiti, Caterina; Iezzi, Elisa; Passalacqua, Rodolfo

2017-10-06

Our group previously demonstrated the feasibility of the HuCare Quality Improvement Strategy (HQIS), aimed at integrating into practice six psychosocial interventions recommended by international guidelines. This trial will assess whether the introduction of the strategy in oncology wards improves patient's health-related quality of life (HRQoL). Multicentre, incomplete stepped-wedge cluster randomised controlled trial, conducted in three clusters of five centres each, in three equally spaced time epochs. The study also includes an initial epoch when none of the centres are exposed to the intervention, and a final epoch when all centres will have implemented the strategy. The intervention is applied at a cluster level, and assessed at an individual level with cross-sectional model. A total of 720 patients who received a cancer diagnosis in the previous 2 months and about to start medical treatment will be enrolled. The primary aim is to evaluate the effectiveness of the HQIS versus standard care in terms of improvement of at least one of two domains (emotional and social functions) of HRQoL using the EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 items) questionnaire, at baseline and at 3 months. This outcome was chosen because patients with cancer generally exhibit low HRQoL, particularly at certain stages of care, and because it allows to assess the strategy's impact as perceived by patients themselves. The HQIS comprises three phases: (1) clinician training-to improve communication-relational skills and instruct on the project; (2) centre support-four on-site visits by experts of the project team, aimed to boost motivation, help with context analysis and identification of solutions; (3) implementation of Evidence-Based Medicine (EBM) recommendations at the centre. Ethics committee review approval has been obtained from the Ethics Committee of Parma. Results will be disseminated at conferences, and in peer-reviewed and professional journals intended for policymakers and managers. NCT03008993; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

IMPROVE AND APPLY CHEMICAL MECHANISMS FOR DEVELOPING OZONE CONTROL STRATEGIES

EPA Science Inventory

Air quality models that realistically describe the formation of ozone, air toxics, and other pollutants are needed by EPA and state agencies to predict current and future concentrations of these pollutants and develop ways to decrease their concentrations below harmful levels. ...

The '333' integrated strategy for effective pollution control and its application to the heavily polluted Jialu River in north China.

PubMed

Huang, Yu; Sun, Jie; Li, Aimin; Xie, Xianchuan

2018-05-01

In this study, an integrated approach named the '333' strategy was applied to pollution control in the Jialu River, in northern China, which is heavily burdened with anthropogenic pollution. Due to a deficiency of the natural ecological inflow, the Jialu River receives predominantly industrial and municipal effluent. The '333' strategy is composed of three steps of pollution control including industrial point-source pollution control, advanced treatment of municipal wastewater, and ecological restoration; three increased stringency emission standards; and three stages of reclamation. Phase 1 of the '333' strategy focuses on industrial point-source pollution control; phase 2 aims to harness municipal wastewater and minimize sewage effluents using novel techniques for advanced water purification; phase 3 of the '333' strategy focuses on the further purification of effluents flowing into Jialu River with the employment of an engineering-based ecological restoration project. The application of the '333' strategy resulted in the development of novel techniques for water purification including modified magnetic resins (NDMP resin), a two-stage internal circulation anaerobic reactor (IC reactor) and an ecological restoration system. The results indicate that water quality in the river was significantly improved, with increased concentrations of dissolved oxygen (DO), as well as reduction of COD by 42.8% and NH 3 -N by 61.4%. In addition, it was observed that the total population of phytoplankton in treated river water notably increased from only one prior to restoration to 8 following restoration. This system also provides a tool for pollution control of other similar industrial and anthropogenic source polluted rivers.

The effectiveness of strategies to change organisational culture to improve healthcare performance.

PubMed

Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P

2011-01-19

Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. Great emphasis has been placed during the last years on the need to change organisational culture in order to pursue effective improvement of healthcare performance. However, the precise nature of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted has been called into question. To determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance.To examine the effectiveness of these strategies according to different patterns of organisational culture. We searched the following electronic databases for primary studies: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies, controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series analyses (ITS) meeting the quality criteria used by the Cochrane Effective Practice and Organisation of Care Group (EPOC). Studies should be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. At least two review authors independently applied the criteria for inclusion and exclusion criteria to scan titles and abstracts and then to screen the full reports of selected citations. At each stage results were compared and discrepancies solved through discussion. The search strategy yielded 4239 records. After the full text assessment, no studies met the quality criteria used by the EPOC Group and evaluated the effectiveness of strategies to change organisational culture to improve healthcare performance. It is not possible to draw any conclusions about the effectiveness of strategies to change organisational culture because we found no studies that fulfilled the methodological criteria for this review. Research efforts should focus on strengthening the evidence about the effectiveness of methods to change organisational culture to improve health care performance.

Assessment of the iodine concentration in table salt at the production stage in South Africa.

PubMed Central

Jooste, Pieter L.

2003-01-01

OBJECTIVE: To determine the iodine content of iodized salt at the production stage, to assess the perceptions and knowledge of salt producers about the prevention and control of iodine deficiency, and to examine the internal quality control procedures used during iodization in South Africa. METHOD: Salt samples were collected for iodine analysis by titration from the 12 producers iodizing salt in South Africa. Information on the producers' knowledge of iodine deficiency disorders and on internal quality control was obtained by means of questionnaires. FINDINGS: The legal requirement of 40-60 ppm iodine was met in 30.9% of salt samples; 57.9% contained more than 30 ppm iodine; 34.8% contained under 20 ppm iodine. There were shortcomings in perceptions and knowledge about iodine deficiency disorders and in the internal quality control procedures of a substantial proportion of the producers. CONCLUSION: In order to encourage and support salt producers to achieve optimal iodization there should be an information, education and communication strategy aimed at improving knowledge of iodine deficiency disorders and at raising the standard of internal quality control procedures. External monitoring should continue. PMID:12973644

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

DTIC Science & Technology

2011-03-21

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

Relationship between influence function accuracy and polishing quality in magnetorheological finishing

NASA Astrophysics Data System (ADS)

Schinhaerl, Markus; Schneider, Florian; Rascher, Rolf; Vogt, Christian; Sperber, Peter

2010-10-01

Magnetorheological finishing is a typical commercial application of a computer-controlled polishing process in the manufacturing of precision optical surfaces. Precise knowledge of the material removal characteristic of the polishing tool (influence function) is essential for controlling the material removal on the workpiece surface by the dwell time method. Results from the testing series with magnetorheological finishing have shown that a deviation of only 5% between the actual material removal characteristic of the polishing tool and that represented by the influence function caused a considerable reduction in the polishing quality. The paper discusses reasons for inaccuracies in the influence function and the effects on the polishing quality. The generic results of this research serve for the development of improved polishing strategies, and may be used in alternative applications of computer-controlled polishing processes that quantify the material removal characteristic by influence functions.

[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.

Near infrared spectroscopy based monitoring of extraction processes of raw material with the help of dynamic predictive modeling

NASA Astrophysics Data System (ADS)

Wang, Haixia; Suo, Tongchuan; Wu, Xiaolin; Zhang, Yue; Wang, Chunhua; Yu, Heshui; Li, Zheng

2018-03-01

The control of batch-to-batch quality variations remains a challenging task for pharmaceutical industries, e.g., traditional Chinese medicine (TCM) manufacturing. One difficult problem is to produce pharmaceutical products with consistent quality from raw material of large quality variations. In this paper, an integrated methodology combining the near infrared spectroscopy (NIRS) and dynamic predictive modeling is developed for the monitoring and control of the batch extraction process of licorice. With the spectra data in hand, the initial state of the process is firstly estimated with a state-space model to construct a process monitoring strategy for the early detection of variations induced by the initial process inputs such as raw materials. Secondly, the quality property of the end product is predicted at the mid-course during the extraction process with a partial least squares (PLS) model. The batch-end-time (BET) is then adjusted accordingly to minimize the quality variations. In conclusion, our study shows that with the help of the dynamic predictive modeling, NIRS can offer the past and future information of the process, which enables more accurate monitoring and control of process performance and product quality.

Effectiveness of the HuCare Quality Improvement Strategy on health-related quality of life in patients with cancer: study protocol of a stepped-wedge cluster randomised controlled trial (HuCare2 study)

PubMed Central

Caminiti, Caterina; Iezzi, Elisa; Passalacqua, Rodolfo

2017-01-01

Introduction Our group previously demonstrated the feasibility of the HuCare Quality Improvement Strategy (HQIS), aimed at integrating into practice six psychosocial interventions recommended by international guidelines. This trial will assess whether the introduction of the strategy in oncology wards improves patient’s health-related quality of life (HRQoL). Methods and analysis Multicentre, incomplete stepped-wedge cluster randomised controlled trial, conducted in three clusters of five centres each, in three equally spaced time epochs. The study also includes an initial epoch when none of the centres are exposed to the intervention, and a final epoch when all centres will have implemented the strategy. The intervention is applied at a cluster level, and assessed at an individual level with cross-sectional model. A total of 720 patients who received a cancer diagnosis in the previous 2 months and about to start medical treatment will be enrolled. The primary aim is to evaluate the effectiveness of the HQIS versus standard care in terms of improvement of at least one of two domains (emotional and social functions) of HRQoL using the EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 items) questionnaire, at baseline and at 3 months. This outcome was chosen because patients with cancer generally exhibit low HRQoL, particularly at certain stages of care, and because it allows to assess the strategy’s impact as perceived by patients themselves. The HQIS comprises three phases: (1) clinician training—to improve communication-relational skills and instruct on the project; (2) centre support—four on-site visits by experts of the project team, aimed to boost motivation, help with context analysis and identification of solutions; (3) implementation of Evidence-Based Medicine (EBM) recommendations at the centre. Ethics and dissemination Ethics committee review approval has been obtained from the Ethics Committee of Parma. Results will be disseminated at conferences, and in peer-reviewed and professional journals intended for policymakers and managers. Trial registration number NCT03008993; Pre-results. PMID:28988170

Development of at-line assay to monitor charge variants of MAbs during production.

PubMed

St Amand, M M; Ogunnaike, B A; Robinson, A S

2014-01-01

One major challenge currently facing the biopharmaceutical industry is to understand how MAb microheterogeneity affects therapeutic efficacy, potency, immunogenicity, and clearance. MAb micro-heterogeneity can result from post-translational modifications such as sialylation, galactosylation, C-terminal lysine cleavage, glycine amidation, and tryptophan oxidation, each of which can generate MAb charge variants; such heterogeneity can affect pharmacokinetics (PK) considerably. Implementation of appropriate on-line quality control strategies may help to regulate bioprocesses, thus enabling more homogenous material with desired post-translational modifications and PK behavior. However, one major restriction to implementation of quality control strategies is the availability of techniques for obtaining on-line or at-line measurements of these attributes. In this work, we describe the development of an at-line assay to separate MAb charge variants in near real-time, which could ultimately be used to implement on-line quality control strategies for MAb production. The assay consists of a 2D-HPLC method with sequential in-line Protein A and WCX-10 HPLC column steps. To perform the 2D-HPLC assay at-line, the two columns steps were integrated into a single method using a novel system configuration that allowed parallel flow over column 1 or column 2 or sequential flow from column 1 to column 2. A bioreactor system was also developed such that media samples could be removed automatically from bioreactor vessels during production and delivered to the 2D-HPLC for analysis. With this at-line HPLC assay, we have demonstrated that MAb microheterogeneity occurs throughout the cell cycle whether the host cell line is grown under different or the same nominal culture conditions. © 2013 American Institute of Chemical Engineers.

Overview on the Air Pollution Issues of the City Clusters in China and its Control Strategies

NASA Astrophysics Data System (ADS)

Tang, X.

2007-12-01

Mega-cities in China, such as Beijing, Guangzhou, Shenzhen, and Shanghai are located in three large city clusters, Bo-Hai Bay surrounding area, Pearl River Delta (PRD) and Yangtze River Delta. Like the rest of the coastal regions in China, these mega-cities have been experiencing fast economic developments and consequently serious environmental pollution. Air pollution in those areas is characterized by concurrent occurrence of high concentrations of multiple primary pollutants and secondary pollutants, which lead to the development of "air pollution complex" (perhaps typically Chinese) problem. Several campaigns of field experiments covering the regions such as PRD and Beijing City with surrounding areas have been conducted critically to understand the chemical and physical processes leading to the formation of regional scale air pollution since 2004. Some policy-relevant suggestions for air quality attainment have been made after these campaigns, specially the attainment of air quality during 2008 Beijing Olympic game, which has been attracted as an important concern worldwide. A scientific field campaign was conducted during August of 2007 for testing the control strategies suggested for air quality attainment in 2008-Olympic. An overview of the results of PRD and Beijing Campaigns will be presented.

Integrated Pest Management of Coffee Berry Borer: Strategies from Latin America that Could Be Useful for Coffee Farmers in Hawaii

PubMed Central

Aristizábal, Luis F.; Bustillo, Alex E.; Arthurs, Steven P.

2016-01-01

The coffee berry borer (CBB), Hypothenemus hampei Ferrari (Coleoptera: Curculionidae: Scolytinae) is the primary arthropod pest of coffee plantations worldwide. Since its detection in Hawaii (September 2010), coffee growers are facing financial losses due to reduced quality of coffee yields. Several control strategies that include cultural practices, biological control agents (parasitoids), chemical and microbial insecticides (entomopathogenic fungi), and a range of post-harvest sanitation practices have been conducted to manage CBB around the world. In addition, sampling methods including the use of alcohol based traps for monitoring CBB populations have been implemented in some coffee producing countries in Latin America. It is currently unclear which combination of CBB control strategies is optimal under economical, environmental, and sociocultural conditions of Hawaii. This review discusses components of an integrated pest management program for CBB. We focus on practical approaches to provide guidance to coffee farmers in Hawaii. Experiences of integrated pest management (IPM) of CBB learned from Latin America over the past 25 years may be relevant for establishing strategies of control that may fit under Hawaiian coffee farmers’ conditions. PMID:26848690

On-Line Control of Glucose Concentration in High-Yielding Mammalian Cell Cultures Enabled Through Oxygen Transfer Rate Measurements.

PubMed

Goldrick, Stephen; Lee, Kenneth; Spencer, Christopher; Holmes, William; Kuiper, Marcel; Turner, Richard; Farid, Suzanne S

2018-04-01

Glucose control is vital to ensure consistent growth and protein production in mammalian cell cultures. The typical fed-batch glucose control strategy involving bolus glucose additions based on infrequent off-line daily samples results in cells experiencing significant glucose concentration fluctuations that can influence product quality and growth. This study proposes an on-line method to control and manipulate glucose utilizing readily available process measurements. The method generates a correlation between the cumulative oxygen transfer rate and the cumulative glucose consumed. This correlation generates an on-line prediction of glucose that has been successfully incorporated into a control algorithm manipulating the glucose feed-rate. This advanced process control (APC) strategy enables the glucose concentration to be maintained at an adjustable set-point and has been found to significantly reduce the deviation in glucose concentration in comparison to conventional operation. This method has been validated to produce various therapeutic proteins across cell lines with different glucose consumption demands and is successfully demonstrated on micro (15 mL), laboratory (7 L), and pilot (50 L) scale systems. This novel APC strategy is simple to implement and offers the potential to significantly enhance the glucose control strategy for scales spanning micro-scale systems through to full scale industrial bioreactors. © 2018 The Authors. Biotechnology Journal Published by Wiley-VCH Verlag GmbH & Co. KGaA.

Diffusion and dissemination of evidence-based dietary srategies for the prevention of cancer

PubMed Central

Ciliska, Donna; Robinson, Paula; Armour, Tanya; Ellis, Peter; Brouwers, Melissa; Gauld, Mary; Baldassarre, Fulvia; Raina, Parminder

2005-01-01

Objective The purpose was to determine what strategies have been evaluated to disseminate cancer control interventions that promote the uptake of adult healthy diet? Methods A systematic review was conducted. Studies were identified by searching MEDLINE, PREMEDLINE, Cancer LIT, EMBASE/Excerpta Medica, PsycINFO, CINAHL, the Cochrane Database of Systematic Reviews, and reference lists and by contacting technical experts. English-language primary studies were selected if they evaluated the dissemination of healthy diet interventions in individuals, healthcare providers, or institutions. Studies of children or adolescents only were excluded. Results One hundred one articles were retrieved for full text screening. Nine reports of seven distinct studies were included; four were randomized trials, one was a cohort design and three were descriptive studies. Six studies were rated as methodologically weak, and one was rated as moderate. Studies were not meta-analyzed because of heterogeneity, low methodological quality, and incomplete data reporting. No beneficial dissemination strategies were found except one that looks promising, the use of peer educators in the worksite, which led to a short-term increase in fruit and vegetable intake. Conclusions and Implications Overall, the quality of the evidence is not strong and is primarily descriptive rather than evaluative. No clear conclusions can be drawn from these data. Controlled studies are needed to evaluate dissemination strategies, and to compare dissemination and diffusion strategies with different messages and different target audiences. PMID:15819991

Control Reallocation Strategies for Damage Adaptation in Transport Class Aircraft

NASA Technical Reports Server (NTRS)

Gundy-Burlet, Karen; Krishnakumar, K.; Limes, Greg; Bryant, Don

2003-01-01

This paper examines the feasibility, potential benefits and implementation issues associated with retrofitting a neural-adaptive flight control system (NFCS) to existing transport aircraft, including both cable/hydraulic and fly-by-wire configurations. NFCS uses a neural network based direct adaptive control approach for applying alternate sources of control authority in the presence of damage or failures in order to achieve desired flight control performance. Neural networks are used to provide consistent handling qualities across flight conditions, adapt to changes in aircraft dynamics and to make the controller easy to apply when implemented on different aircraft. Full-motion piloted simulation studies were performed on two different transport models: the Boeing 747-400 and the Boeing C-17. Subjects included NASA, Air Force and commercial airline pilots. Results demonstrate the potential for improving handing qualities and significantly increased survivability rates under various simulated failure conditions.

Quality, equipment hold keys to infection control.

PubMed

2006-02-01

EDs that are the most successful at infection control are the ones that look for new ways to improve on proven strategies and techniques. Follow and observe staff during hand-washing, and make them repeat steps that were omitted or performed improperly. Increase the percentage of isolation rooms in your department to help improve surge capacity. Have all cleaning supplies readily at hand to improve flow.

An urban-forest control measure for ozone in the Sacramento, CA federal non-attainment area (SFNA) Sustainable Cities and Society

Treesearch

Haider Taha; James Wilkinson; Robert Bornstein; Qingfu Xiao; E. Gregory McPherson; Jim Simpson; Charles Anderson; Steven Lau; Janice Lam; Cindy Blain

2015-01-01

Urban forest strategies of gradually replacing high emitters of biogenic volatile organic compounds (BVOC) with low-emitting species are being considered as voluntary or emerging control measures for maintenance of the 8-h ozone standard in the Sacramento Federal Non-Attainment Area (SFNA). We describe a regulatory modeling study demonstrating the air-quality impacts...

InternationaL cross-sectIonAl and longItudinal assessment on aSthma cONtrol in European adult patients - the LIAISON study protocol

PubMed Central

2013-01-01

Background According to international guidelines, the goal of asthma management is to achieve and maintain control of the disease, which can be assessed using composite measures. Prospective studies are required to determine how these measures are associated with asthma outcomes and/or future risk. The ‘InternationaL cross-sectIonAl and longItudinal assessment on aSthma cONtrol (LIAISON)’ observational study has been designed to evaluate asthma control and its determinants, including components of asthma management. Methods/design The LIAISON study will be conducted in 12 European countries and comprises a cross-sectional phase and a 12-month prospective phase. Both phases will aim at assessing asthma control (six-item Asthma Control Questionnaire, ACQ), asthma-related quality of life (Mini Asthma Quality of Life Questionnaire, Mini-AQLQ), risk of non-adherence to treatment (four-item Morisky Medication Adherence Scale, MMAS-4), potential reasons for poor control, treatment strategies and associated healthcare costs. The cross-sectional phase will recruit > 8,000 adult patients diagnosed with asthma for at least 6 months and receiving the same asthma treatment in the 4 weeks before enrolment. The prospective phase will include all patients with uncontrolled/poorly controlled asthma at the initial visit to assess the proportion reaching control during follow-up and to examine predictors of future risk. Visits will take place after 3, 6 and 12 months. Discussion The LIAISON study will provide important information on the prevalence of asthma control and on the quality of life in a broad spectrum of real-life patient populations from different European countries and will also contribute to evaluate differences in management strategies and their impact on healthcare costs over 12 months of observation. Trial registration ClinicalTrials.gov identifier, NCT01567280. PMID:23530817

Quality risk management of top spray fluidized bed process for antihypertensive drug formulation with control strategy engendered by Box-behnken experimental design space.

PubMed

Mukharya, Amit; Patel, Paresh U; Shenoy, Dinesh; Chaudhary, Shivang

2013-01-01

Lacidipine (LCDP) is a very low soluble and highly biovariable calcium channel blocker used in the treatment of hypertension. To increase its apparent solubility and to reduce its biovariability, solid dispersion fluid bed processing technology was explored, as it produces highly dispersible granules with a characteristic porous structure that enhances dispersibility, wettability, blend uniformity (by dissolving and spraying a solution of actives), flow ability and compressibility of granules for tableting and reducing variability by uniform drug-binder solution distribution on carrier molecules. Main object of this quality risk management (QRM) study is to provide a sophisticated "robust and rugged" Fluidized Bed Process (FBP) for the preparation of LCDP tablets with desired quality (stability) and performance (dissolution) by quality by design (QbD) concept. THIS STUDY IS PRINCIPALLY FOCUSING ON THOROUGH MECHANISTIC UNDERSTANDING OF THE FBP BY WHICH IT IS DEVELOPED AND SCALED UP WITH A KNOWLEDGE OF THE CRITICAL RISKS INVOLVED IN MANUFACTURING PROCESS ANALYZED BY RISK ASSESSMENT TOOLS LIKE: Qualitative Initial Risk-based Matrix Analysis (IRMA) and Quantitative Failure Mode Effective Analysis (FMEA) to identify and rank parameters with potential to have an impact on In Process/Finished Product Critical Quality Attributes (IP/FP CQAs). These Critical Process Parameters (CPPs) were further refined by DoE and MVDA to develop design space with Real Time Release Testing (RTRT) that leads to implementation of a control strategy to achieve consistent finished product quality at lab scale itself to prevent possible product failure at larger manufacturing scale.

Quality risk management of top spray fluidized bed process for antihypertensive drug formulation with control strategy engendered by Box-behnken experimental design space

PubMed Central

Mukharya, Amit; Patel, Paresh U; Shenoy, Dinesh; Chaudhary, Shivang

2013-01-01

Introduction: Lacidipine (LCDP) is a very low soluble and highly biovariable calcium channel blocker used in the treatment of hypertension. To increase its apparent solubility and to reduce its biovariability, solid dispersion fluid bed processing technology was explored, as it produces highly dispersible granules with a characteristic porous structure that enhances dispersibility, wettability, blend uniformity (by dissolving and spraying a solution of actives), flow ability and compressibility of granules for tableting and reducing variability by uniform drug-binder solution distribution on carrier molecules. Materials and Methods: Main object of this quality risk management (QRM) study is to provide a sophisticated “robust and rugged” Fluidized Bed Process (FBP) for the preparation of LCDP tablets with desired quality (stability) and performance (dissolution) by quality by design (QbD) concept. Results and Conclusion: This study is principally focusing on thorough mechanistic understanding of the FBP by which it is developed and scaled up with a knowledge of the critical risks involved in manufacturing process analyzed by risk assessment tools like: Qualitative Initial Risk-based Matrix Analysis (IRMA) and Quantitative Failure Mode Effective Analysis (FMEA) to identify and rank parameters with potential to have an impact on In Process/Finished Product Critical Quality Attributes (IP/FP CQAs). These Critical Process Parameters (CPPs) were further refined by DoE and MVDA to develop design space with Real Time Release Testing (RTRT) that leads to implementation of a control strategy to achieve consistent finished product quality at lab scale itself to prevent possible product failure at larger manufacturing scale. PMID:23799202

Quality and rural-urban comparison of tuberculosis care in Rivers State, Nigeria

PubMed Central

Tobin-West, Charles Ibiene; Isodje, Anastasia

2016-01-01

Introduction Nigeria ranks among countries with the highest burden of tuberculosis. Yet evidence continues to indicate poor treatment outcomes which have been attributed to poor quality of care. This study aims to identify some of the systemic problems in order to inform policy decisions for improved quality of services and treatment outcomes in Nigeria. Methods A comparative assessment of the quality of TB care in rural and urban health facilities was carried out between May and June 2013, employing the Donabedian model of quality assessment. Data was analysed using the SPSS software package version 20.0. The level of significance was set at p < 0.05. Results Health facility infrastructures were more constrained in the urban than rural settings. Both the urban and rural facilities lacked adequate facilities for infection control such as, running water, air filter respirators, hand gloves and extractor fans. Health education and HIV counselling and testing (HCT) were limited in rural facilities compared to urban facilities. Although anti-TB drugs were generally available in both settings, the DOTS strategy in patient care was completely ignored. Finally, laboratory support for diagnosis and patient monitoring was limited in the rural facilities. Conclusion The study highlights suboptimal quality of TB care in Rivers State with limitations in health education and HCT of patients for HIV as well as laboratory support for TB care in rural health facilities. We, therefore, recommend that adequate infection control measures, strict observance of the DOTS strategy and sufficient laboratory support be provided to TB clinics in the State. PMID:27642401

The effect of the emotional intelligence education programme on quality of life in haemodialysis patients.

PubMed

Shahnavazi, Masoome; Parsa-Yekta, Zohreh; Yekaninejad, Mir-Saeed; Amaniyan, Sara; Griffiths, Pauline; Vaismoradi, Mojtaba

2018-02-01

This study investigated the effect of the emotional intelligence education programme on quality of life of haemodialysis patients. Nurses need knowledge development regarding the impact of educational strategies on patients' quality of life suffering from chronic diseases. A pragmatic quasi-randomized controlled trial was conducted with 47 haemodialysis patients attending a university hospital in an urban area of Iran. The patients were randomly assigned to intervention (n=23) and control (n=24) groups. A socio-demographic questionnaire, the Cyberia-Shrink Emotional Intelligence Questionnaire, and the Kidney Disease Quality of Life-Short Form were used to gather data. The intervention group attended an educational programme on emotional intelligence that consisted of six-group discussion sessions. To ensure the continuity of learning and to measure the subsequent expected behavioural changes, the patients filled out the data collection tools six and 12weeks after the completion of the education programme. The mean score of quality of life in the intervention group was 39.94±15.88 in pre-test, 44.87±16.04 six weeks and 52.47±16.07 at the 12weeks after the intervention (p=0.032). The consideration of emotional intelligence educational strategies by nurses requires its incorporation into pre-qualifying nursing degrees and professional development programmes. Nurse managers need to lead nurses for applying emotional intelligence in daily practice with the aim of providing an holistic patient care. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Interventions to Promote Physical Activity in Older People with Type 2 Diabetes Mellitus: A Systematic Review

PubMed Central

Sazlina, Shariff-Ghazali; Browning, Colette; Yasin, Shajahan

2013-01-01

Introduction: Type 2 diabetes mellitus (T2DM) among people aged 60 years and above is a growing public health problem. Regular physical activity is one of the key elements in the management of T2DM. Recommendations suggest that older people with T2DM will benefit from regular physical activity for better disease control and delaying complications. Despite the known benefits, many remain sedentary. Hence, this review assessed interventions for promoting physical activity in persons aged 65 years and older with T2DM. Methods: A literature search was conducted using Ovid MEDLINE, PubMed, EMBASE, SPORTDiscus, and CINAHL databases to retrieve articles published between January 2000 and December 2012. Randomized controlled trials and quasi-experimental designs comparing different strategies to increase physical activity level in persons aged 65 years and older with T2DM were included. The methodological quality of studies was assessed. Results: Twenty-one eligible studies were reviewed, only six studies were rated as good quality and only one study specifically targeted persons aged 65 years and older. Personalized coaching, goal setting, peer support groups, use of technology, and physical activity monitors were proven to increase the level of physical activity. Incorporation of health behavior theories and follow-up supports also were successful strategies. However, the methodological quality and type of interventions promoting physical activity of the included studies in this review varied widely across the eligible studies. Conclusion: Strategies that increased level of physical activity in persons with T2DM are evident but most studies focused on middle-aged persons and there was a lack of well-designed trials. Hence, more studies of satisfactory methodological quality with interventions promoting physical activity in older people are required. PMID:24392445

Substantial air quality and climate co-benefits achievable now with sectoral mitigation strategies in China.

PubMed

Peng, Wei; Yang, Junnan; Wagner, Fabian; Mauzerall, Denise L

2017-11-15

China is the world's top carbon emitter and suffers from severe air pollution. We examine near-term air quality and CO 2 co-benefits of various current sector-based policies in China. Using a 2015 base case, we evaluate the potential benefits of four sectoral mitigation strategies. All scenarios include a 20% increase in conventional air pollution controls as well as the following sector-specific fuel switching or technology upgrade strategies. Power sector (POW): 80% replacement of small coal power plants with larger more efficient ones; Industry sector (IND): 10% improvement in energy efficiency; Transport sector (TRA): replacement of high emitters with average vehicle fleet emissions; and Residential sector (RES): replacement of 20% of coal-based stoves with stoves using liquefied petroleum gas (LPG). Conducting an integrated assessment using the regional air pollution model WRF-Chem, we find that the IND scenario reduces national air-pollution-related deaths the most of the four scenarios examined (27,000, 24,000, 13,000 and 23,000 deaths reduced annually in IND, POW, TRA and RES, respectively). In addition, the IND scenario reduces CO 2 emissions more than 8times as much as any other scenario (440, 53, 0 and 52Mt CO 2 reduced in IND, POW, TRA and RES, respectively). We also examine the benefits of an industrial efficiency improvement of just 5%. We find the resulting air quality and health benefits are still among the largest of the sectoral scenarios, while the carbon mitigation benefits remain more than 3 times larger than any other scenario. Our analysis hence highlights the importance of even modest industrial energy efficiency improvements and air pollution control technology upgrades for air quality, health and climate benefits in China. Copyright © 2017 Elsevier B.V. All rights reserved.

Impact of telemonitoring approaches on integrated HIV and TB diagnosis and treatment interventions in sub-Saharan Africa: a scoping review.

PubMed

Yah, Clarence S; Tambo, Ernest; Khayeka-Wandabwa, Christopher; Ngogang, Jeanne Y

2017-01-01

Background: This paper explores telemonitoring/mhealth approaches as a promising real time and contextual strategy in overhauling HIV and TB interventions quality access and uptake, retention,adherence and coverage impact in endemic and prone-epidemic prevention and control in sub-Sahara Africa. Methods: The scoping review method was applied in acknowledged journals indexing platforms including Medline, Embase, Global Health, PubMed, MeSH PsycInfo, Scopus and Google Scholar to identify relevant articles pertaining to telemonitoring as a proxy surrogate method in reinforcing sustainability of HIV/TB prevention/treatment interventions in sub-Saharan Africa. Full papers were assessed and those selected that fosters evidence on telemonitoring/mhealth diagnosis, treatment approaches and strategies in HIV and TB prevention and control were synthesized and analyzed. Results: We found telemonitoring/mhealth approach as a more efficient and sustained proxy in HIV and TB risk reduction strategies for early diagnosis and prompt quality clinical outcomes. It can significantly contribute to decreasing health systems/patients cost, long waiting time in clinics, hospital visits, travels and time off/on from work. Improved integrated HIV and TB telemonitoring systems sustainability hold great promise in health systems strengthening including patient centered early diagnosis and care delivery systems, uptake and retention to medications/services and improving patients' survival and quality of life. Conclusion: Telemonitoring/mhealth (electronic phone text/video/materials messaging)acceptability, access and uptake are crucial in monitoring and improving uptake, retention,adherence and coverage in both local and national integrated HIV and TB programs and interventions. Moreover, telemonitoring is crucial in patient-providers-health professional partnership, real-time quality care and service delivery, antiretroviral and anti-tuberculous drugs improvement, susceptibility monitoring and prescription choice, reinforcing cost effective HIV and TB integrated therapy model and survival rate.

Exploring Fusarium head blight disease control by RNA interference

USDA-ARS?s Scientific Manuscript database

RNA interference (RNAi) technology provides a novel tool to study gene function and plant protection strategies. Fusarium graminearum is the causal agent of Fusarium head blight (FHB), which reduces crop yield and quality by producing trichothecene mycotoxins including 3-acetyl deoxynivalenol (3-ADO...

Highway Safety Data : costs, quality, and strategies for improvement : final report

DOT National Transportation Integrated Search

1978-05-01

The objective of the experiment is to establish the influence of various types of trucks, buses and recreational vehicles on traffic flow on rural non-controlled access highways. This influence is due primarily to the low speeds which are common for ...

AIR QUALITY MODELING AT COARSE-TO-FINE SCALES IN URBAN AREAS

EPA Science Inventory

Urban air toxics control strategies are moving towards a community based modeling approach, with an emphasis on assessing those areas that experience high air toxic concentration levels, the so-called "hot spots". This approach will require information that accurately maps and...

PREFACE TO SPECIAL SECTION ON PARTICULATE MATTER SUPERSITES

EPA Science Inventory

An improved understanding of the key sources, development of the most cost/effective control strategies, and health risks associated with PM2.5 requires high-quality measurements of PM2.5 composition, size and, concentration over a variety of spatial and temporal scales. However...

Applications of aerospace technology in the electric power industry

NASA Technical Reports Server (NTRS)

Johnson, F. D.; Heins, C. F.

1974-01-01

Existing applications of NASA contributions to disciplines such as combustion engineering, mechanical engineering, materials science, quality assurance and computer control are outlined to illustrate how space technology is used in the electric power industry. Corporate strategies to acquire relevant space technology are described.

The categorisation of brands: The case of P&G™ branding strategy.

PubMed

Puente-Díaz, Rogelio; Cavazos-Arroyo, Judith

2017-06-01

In 2 studies, we tested what we considered to be the core of Procter and Gamble™ (P&G™) latest branding strategy: making the association between its corporate brand and its product brands explicit. Participants were randomly assigned to one of the conditions: explicit association between P&G™ and one of its product brands and a control condition. Results from Study 1 showed a positive influence of the corporate brand on judgements of brand quality for Crest™. Similarly, results from Study 2 showed a positive influence of the corporate brand on judgements of brand quality and trust for Oral-B™. From a multidisciplinary perspective, we discussed the theoretical and applied implications of our results. © 2015 International Union of Psychological Science.

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.

Phytoplankton dynamics of a subtropical reservoir controlled by the complex interplay among hydrological, abiotic, and biotic variables.

PubMed

Kuo, Yi-Ming; Wu, Jiunn-Tzong

2016-12-01

This study was conducted to identify the key factors related to the spatiotemporal variations in phytoplankton abundance in a subtropical reservoir from 2006 to 2010 and to assist in developing strategies for water quality management. Dynamic factor analysis (DFA), a dimension-reduction technique, was used to identify interactions between explanatory variables (i.e., environmental variables) and abundance (biovolume) of predominant phytoplankton classes. The optimal DFA model significantly described the dynamic changes in abundances of predominant phytoplankton groups (including dinoflagellates, diatoms, and green algae) at five monitoring sites. Water temperature, electrical conductivity, water level, nutrients (total phosphorus, NO 3 -N, and NH 3 -N), macro-zooplankton, and zooplankton were the key factors affecting the dynamics of aforementioned phytoplankton. Therefore, transformations of nutrients and reactions between water quality variables and aforementioned processes altered by hydrological conditions may also control the abundance dynamics of phytoplankton, which may represent common trends in the DFA model. The meandering shape of Shihmen Reservoir and its surrounding rivers caused a complex interplay between hydrological conditions and abiotic and biotic variables, resulting in phytoplankton abundance that could not be estimated using certain variables. Additional water quality and hydrological variables at surrounding rivers and monitoring plans should be executed a few days before and after reservoir operations and heavy storm, which would assist in developing site-specific preventive strategies to control phytoplankton abundance.

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

PubMed

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

2017-08-01

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

Improving lactate metabolism in an intensified CHO culture process: productivity and product quality considerations.

PubMed

Xu, Sen; Hoshan, Linda; Chen, Hao

2016-11-01

In this study, we discussed the development and optimization of an intensified CHO culture process, highlighting medium and control strategies to improve lactate metabolism. A few strategies, including supplementing glucose with other sugars (fructose, maltose, and galactose), controlling glucose level at <0.2 mM, and supplementing medium with copper sulfate, were found to be effective in reducing lactate accumulation. Among them, copper sulfate supplementation was found to be critical for process optimization when glucose was in excess. When copper sulfate was supplemented in the new process, two-fold increase in cell density (66.5 ± 8.4 × 10(6) cells/mL) and titer (11.9 ± 0.6 g/L) was achieved. Productivity and product quality attributes differences between batch, fed-batch, and concentrated fed-batch cultures were discussed. The importance of process and cell metabolism understanding when adapting the existing process to a new operational mode was demonstrated in the study.

Hall-Effect Based Semi-Fast AC On-Board Charging Equipment for Electric Vehicles

PubMed Central

Milanés-Montero, María Isabel; Gallardo-Lozano, Javier; Romero-Cadaval, Enrique; González-Romera, Eva

2011-01-01

The expected increase in the penetration of electric vehicles (EV) and plug-in hybrid electric vehicles (PHEV) will produce unbalanced conditions, reactive power consumption and current harmonics drawn by the battery charging equipment, causing a great impact on the power quality of the future smart grid. A single-phase semi-fast electric vehicle battery charger is proposed in this paper. This ac on-board charging equipment can operate in grid-to-vehicle (G2V) mode, and also in vehicle-to-grid (V2G) mode, transferring the battery energy to the grid when the vehicle is parked. The charger is controlled with a Perfect Harmonic Cancellation (PHC) strategy, contributing to improve the grid power quality, since the current demanded or injected has no harmonic content and a high power factor. Hall-effect current and voltage transducers have been used in the sensor stage to carry out this control strategy. Experimental results with a laboratory prototype are presented. PMID:22163697

Hall-effect based semi-fast AC on-board charging equipment for electric vehicles.

PubMed

Milanés-Montero, María Isabel; Gallardo-Lozano, Javier; Romero-Cadaval, Enrique; González-Romera, Eva

2011-01-01

The expected increase in the penetration of electric vehicles (EV) and plug-in hybrid electric vehicles (PHEV) will produce unbalanced conditions, reactive power consumption and current harmonics drawn by the battery charging equipment, causing a great impact on the power quality of the future smart grid. A single-phase semi-fast electric vehicle battery charger is proposed in this paper. This ac on-board charging equipment can operate in grid-to-vehicle (G2V) mode, and also in vehicle-to-grid (V2G) mode, transferring the battery energy to the grid when the vehicle is parked. The charger is controlled with a Perfect Harmonic Cancellation (PHC) strategy, contributing to improve the grid power quality, since the current demanded or injected has no harmonic content and a high power factor. Hall-effect current and voltage transducers have been used in the sensor stage to carry out this control strategy. Experimental results with a laboratory prototype are presented.

Meeting the challenge of the 80's cost reduction measures at the Iron Ore Company of Canada's Carol Project 1980-85

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

Tinto, I.A.

1985-01-01

The mining facilities, crushing plant, and concentrator of the Iron Ore Company of Canada were in operation by 1962. Today, the Carol Project has the capacity to produce 20 million tonnes of concentrate from which 10.5 million tonnes of pellets can be produced. The period 1980-85 spans a period of energy crisis, world-wide recession, and a consequent re-structuring of the North American steel industry as it struggles to survive in an arena of excess world stell making capacity, government subsidized industries, and the increasing competition from overseas and from developing countries. This paper reviews cost reduction programs implemented by themore » Iron Ore Company of Canada at its 'Carol Project' and emphasizes improvements made in labour productivity, energy conservation, mining strategy, quality control, and reduced cost through technical innovations over this difficult period. The cost reduction program is reviewed under the headings of labor productivity, energy conservation, mining strategy, technical innovations and quality control.« less

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.

Sampling the food processing environment: taking up the cudgel for preventive quality management in food processing environments.

PubMed

Wagner, Martin; Stessl, Beatrix

2014-01-01

The Listeria monitoring program for Austrian cheese factories was established in 1988. The basic idea is to control the introduction of L. monocytogenes into the food processing environment, preventing the pathogen from contaminating the food under processing. The Austrian Listeria monitoring program comprises four levels of investigation, dealing with routine monitoring of samples and consequences of finding a positive sample. Preventive quality control concepts attempt to detect a foodborne hazard along the food processing chain, prior to food delivery, retailing, and consumption. The implementation of a preventive food safety concept provokes a deepened insight by the manufacturers into problems concerning food safety. The development of preventive quality assurance strategies contributes to the national food safety status and protects public health.

Offset Printing Plate Quality Sensor on a Low-Cost Processor

PubMed Central

Poljak, Jelena; Botella, Guillermo; García, Carlos; Poljaček, Sanja Mahović; Prieto-Matías, Manuel; Tirado, Francisco

2013-01-01

The aim of this work is to develop a microprocessor-based sensor that measures the quality of the offset printing plate through the introduction of different image analysis applications. The main features of the presented system are the low cost, the low amount of power consumption, its modularity and easy integration with other industrial modules for printing plates, and its robustness against noise environments. For the sake of clarity, a viability analysis of previous software is presented through different strategies, based on dynamic histogram and Hough transform. This paper provides performance and scalability data compared with existing costly commercial devices. Furthermore, a general overview of quality control possibilities for printing plates is presented and could be useful to a system where such controls are regularly conducted. PMID:24284766

Quality of Life in Atrial Fibrillation: Measurement Tools and Impact of Interventions

PubMed Central

REYNOLDS, MATTHEW R.; ELLIS, ETHAN; ZIMETBAUM, PETER

2008-01-01

QoL in AF. Quality of life (QoL) is of central importance in atrial fibrillation as both a treatment goal and an endpoint in the evaluation of new therapies. QoL appears to be impaired in the majority of patients with AF. A number of interventions for AF have been shown to improve QoL, including pharmacologic and nonpharmacologic rate control, antiarrhythmic drugs, and nonpharmacologic rhythm control strategies. This paper will review the rationale, design, strengths, and limitations of the questionnaires most commonly used to assess QoL in AF studies, and present QoL outcomes from major studies of AF interventions. PMID:18266667

An effective and optimal quality control approach for green energy manufacturing using design of experiments framework and evolutionary algorithm

NASA Astrophysics Data System (ADS)

Saavedra, Juan Alejandro

Quality Control (QC) and Quality Assurance (QA) strategies vary significantly across industries in the manufacturing sector depending on the product being built. Such strategies range from simple statistical analysis and process controls, decision-making process of reworking, repairing, or scraping defective product. This study proposes an optimal QC methodology in order to include rework stations during the manufacturing process by identifying the amount and location of these workstations. The factors that are considered to optimize these stations are cost, cycle time, reworkability and rework benefit. The goal is to minimize the cost and cycle time of the process, but increase the reworkability and rework benefit. The specific objectives of this study are: (1) to propose a cost estimation model that includes energy consumption, and (2) to propose an optimal QC methodology to identify quantity and location of rework workstations. The cost estimation model includes energy consumption as part of the product direct cost. The cost estimation model developed allows the user to calculate product direct cost as the quality sigma level of the process changes. This provides a benefit because a complete cost estimation calculation does not need to be performed every time the processes yield changes. This cost estimation model is then used for the QC strategy optimization process. In order to propose a methodology that provides an optimal QC strategy, the possible factors that affect QC were evaluated. A screening Design of Experiments (DOE) was performed on seven initial factors and identified 3 significant factors. It reflected that one response variable was not required for the optimization process. A full factorial DOE was estimated in order to verify the significant factors obtained previously. The QC strategy optimization is performed through a Genetic Algorithm (GA) which allows the evaluation of several solutions in order to obtain feasible optimal solutions. The GA evaluates possible solutions based on cost, cycle time, reworkability and rework benefit. Finally it provides several possible solutions because this is a multi-objective optimization problem. The solutions are presented as chromosomes that clearly state the amount and location of the rework stations. The user analyzes these solutions in order to select one by deciding which of the four factors considered is most important depending on the product being manufactured or the company's objective. The major contribution of this study is to provide the user with a methodology used to identify an effective and optimal QC strategy that incorporates the number and location of rework substations in order to minimize direct product cost, and cycle time, and maximize reworkability, and rework benefit.

Advanced qualification of pharmaceutical excipient suppliers by multiple analytics and multivariate analysis combined.

PubMed

Hertrampf, A; Müller, H; Menezes, J C; Herdling, T

2015-11-10

Pharmaceutical excipients have different functions within a drug formulation, consequently they can influence the manufacturability and/or performance of medicinal products. Therefore, critical to quality attributes should be kept constant. Sometimes it may be necessary to qualify a second supplier, but its product will not be completely equal to the first supplier product. To minimize risks of not detecting small non-similarities between suppliers and to detect lot-to-lot variability for each supplier, multivariate data analysis (MVA) can be used as a more powerful alternative to classical quality control that uses one-parameter-at-a-time monitoring. Such approach is capable of supporting the requirements of a new guideline by the European Parliament and Council (2015/C-95/02) demanding appropriate quality control strategies for excipients based on their criticality and supplier risks in ensuring quality, safety and function. This study compares calcium hydrogen phosphate from two suppliers. It can be assumed that both suppliers use different manufacturing processes. Therefore, possible chemical and physical differences were investigated by using Raman spectroscopy, laser diffraction and X-ray powder diffraction. Afterwards MVA was used to extract relevant information from each analytical technique. Both CaHPO4 could be discriminated by their supplier. The gained knowledge allowed to specify an enhanced strategy for second supplier qualification. Copyright © 2015 Elsevier B.V. All rights reserved.

Quality of Life and Coping Strategies in Coronary Heart Disease Patients

NASA Astrophysics Data System (ADS)

Yazdi, Seyedeh-Monavar; Hosseinian, Simin; Eslami, Mansoure; Fathi-Ashtiani, Ali

This study aims to find the relationship between quality of life and coping strategies in coronary heart disease patients. Two hundred coronary heart disease patients at Tehran Heart Center, who had been diagnosed with the disease 3 months before, were selected and filled out The Coping Inventory for Stressful Situations (CISS) and Quality of Life-SF36. Results showed a discrepancy between quality of life indices and coping strategies. Task-oriented strategy had a positive and significant relationship with total quality of life and PF indices while it had a negative and significant relationship with MH, RE and RP indices. Emotional-oriented strategy had a positive and significant relationship with RP and RE indices while it had a negative and significant relationship with PF, GH, PH, total psychological health and total quality of life indices. Avoidance-oriented strategy had a negative and significant relationship only with MH index. Furthermore, quality of life aspects (physical and psychological) had a positive and significant relationship with emotional-oriented strategy, but it did not have a significant relationship with task-oriented and avoidance-oriented strategies. Also, the social aspect of quality of life did not have a significant relationship with any of the strategies. Considering the effect of stress on decreasing the quality of life, we recommend a psychologist train coping strategies to coronary heart disease patients along with medical treatments in order to improve recovery, maintain health and reduce recurrence.

Implementation of Departmental Quality Strategies Is Positively Associated with Clinical Practice: Results of a Multicenter Study in 73 Hospitals in 7 European Countries

PubMed Central

2015-01-01

Background Given the amount of time and resources invested in implementing quality programs in hospitals, few studies have investigated their clinical impact and what strategies could be recommended to enhance its effectiveness. Objective To assess variations in clinical practice and explore associations with hospital- and department-level quality management systems. Design Multicenter, multilevel cross-sectional study. Setting and Participants Seventy-three acute care hospitals with 276 departments managing acute myocardial infarction, deliveries, hip fracture, and stroke in seven countries. Intervention None. Measures Predictor variables included 3 hospital- and 4 department-level quality measures. Six measures were collected through direct observation by an external surveyor and one was assessed through a questionnaire completed by hospital quality managers. Dependent variables included 24 clinical practice indicators based on case note reviews covering the 4 conditions (acute myocardial infarction, deliveries, hip fracture and stroke). A directed acyclic graph was used to encode relationships between predictors, outcomes, and covariates and to guide the choice of covariates to control for confounding. Results and Limitations Data were provided on 9021 clinical records by 276 departments in 73 hospitals. There were substantial variations in compliance with the 24 clinical practice indicators. Weak associations were observed between hospital quality systems and 4 of the 24 indicators, but on analyzing department-level quality systems, strong associations were observed for 8 of the 11 indicators for acute myocardial infarction and stroke. Clinical indicators supported by higher levels of evidence were more frequently associated with quality systems and activities. Conclusions There are significant gaps between recommended standards of care and clinical practice in a large sample of hospitals. Implementation of department-level quality strategies was significantly associated with good clinical practice. Further research should aim to develop clinically relevant quality standards for hospital departments, which appear to be more effective than generic hospital-wide quality systems. PMID:26588842

Implementation of Departmental Quality Strategies Is Positively Associated with Clinical Practice: Results of a Multicenter Study in 73 Hospitals in 7 European Countries.

PubMed

Sunol, Rosa; Wagner, Cordula; Arah, Onyebuchi A; Kristensen, Solvejg; Pfaff, Holger; Klazinga, Niek; Thompson, Caroline A; Wang, Aolin; DerSarkissian, Maral; Bartels, Paul; Michel, Philippe; Groene, Oliver

2015-01-01

Given the amount of time and resources invested in implementing quality programs in hospitals, few studies have investigated their clinical impact and what strategies could be recommended to enhance its effectiveness. To assess variations in clinical practice and explore associations with hospital- and department-level quality management systems. Multicenter, multilevel cross-sectional study. Seventy-three acute care hospitals with 276 departments managing acute myocardial infarction, deliveries, hip fracture, and stroke in seven countries. None. Predictor variables included 3 hospital- and 4 department-level quality measures. Six measures were collected through direct observation by an external surveyor and one was assessed through a questionnaire completed by hospital quality managers. Dependent variables included 24 clinical practice indicators based on case note reviews covering the 4 conditions (acute myocardial infarction, deliveries, hip fracture and stroke). A directed acyclic graph was used to encode relationships between predictors, outcomes, and covariates and to guide the choice of covariates to control for confounding. Data were provided on 9021 clinical records by 276 departments in 73 hospitals. There were substantial variations in compliance with the 24 clinical practice indicators. Weak associations were observed between hospital quality systems and 4 of the 24 indicators, but on analyzing department-level quality systems, strong associations were observed for 8 of the 11 indicators for acute myocardial infarction and stroke. Clinical indicators supported by higher levels of evidence were more frequently associated with quality systems and activities. There are significant gaps between recommended standards of care and clinical practice in a large sample of hospitals. Implementation of department-level quality strategies was significantly associated with good clinical practice. Further research should aim to develop clinically relevant quality standards for hospital departments, which appear to be more effective than generic hospital-wide quality systems.

Robotic operation of the Observatorio Astrofísico de Javalambre

NASA Astrophysics Data System (ADS)

Yanes-Díaz, A.; Antón, J. L.; Rueda-Teruel, S.; Guillén-Civera, L.; Bello, R.; Jiménez-Mejías, D.; Chueca, S.; Lasso-Cabrera, N. M.; Suárez, O.; Rueda-Teruel, F.; Cenarro, A. J.; Cristóbal-Hornillos, D.; Marín-Franch, A.; Luis-Simoes, R.; López-Alegre, G.; Rodríguez-Hernández, M. A. C.; Moles, M.; Ederoclite, A.; Varela, J.; Vázquez Ramió, H.; Díaz-Martí, M. C.; Iglesias-Marzoa, R.; Maicas, N.; Lamadrid, J. L.; López-Sainz, A.; Hernández-Fuertes, J.; Valdivielso, L.

2015-05-01

The Observatorio Astrofísico de Javalambre (OAJ) is a new astronomical facility located at the Sierra de Javalambre (Teruel, Spain) whose primary role will be to conduct all-sky astronomical surveys with two unprecedented telescopes of unusually large fields of view: the JST/T250, a 2.55 m telescope of 3 deg field of view, and the JAST/T80, an 83 cm telescope of 2 deg field of view. CEFCA engineering team has been designing the OAJ control system as a global concept to manage, monitor, control and maintain all the observatory systems including not only astronomical subsystems but also infrastructure and other facilities. Three main factors have been considered in the design of a global control system for the robotic OAJ: quality, reliability and efficiency. We propose CIA (Control Integrated Architecture) design and OEE (Overall Equipment Effectiveness) as a key performance indicator in order to improve operation processes, minimizing resources and obtain high cost reduction maintaining quality requirements. Here we present the OAJ robotic control strategy to achieve maximum quality efficiency for the observatory surveys, processes and operations, giving practical examples of our approach.

Multi-objective optimisation of wastewater treatment plant control to reduce greenhouse gas emissions.

PubMed

Sweetapple, Christine; Fu, Guangtao; Butler, David

2014-05-15

This study investigates the potential of control strategy optimisation for the reduction of operational greenhouse gas emissions from wastewater treatment in a cost-effective manner, and demonstrates that significant improvements can be realised. A multi-objective evolutionary algorithm, NSGA-II, is used to derive sets of Pareto optimal operational and control parameter values for an activated sludge wastewater treatment plant, with objectives including minimisation of greenhouse gas emissions, operational costs and effluent pollutant concentrations, subject to legislative compliance. Different problem formulations are explored, to identify the most effective approach to emissions reduction, and the sets of optimal solutions enable identification of trade-offs between conflicting objectives. It is found that multi-objective optimisation can facilitate a significant reduction in greenhouse gas emissions without the need for plant redesign or modification of the control strategy layout, but there are trade-offs to consider: most importantly, if operational costs are not to be increased, reduction of greenhouse gas emissions is likely to incur an increase in effluent ammonia and total nitrogen concentrations. Design of control strategies for a high effluent quality and low costs alone is likely to result in an inadvertent increase in greenhouse gas emissions, so it is of key importance that effects on emissions are considered in control strategy development and optimisation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Home-based, Online Mindfulness and Cognitive Training for Soldiers and Veterans with TBI

DTIC Science & Technology

2017-10-01

evaluated as a Quality of Life (QOL) enhancing strategy by comparing it to an active control condition (casual video games + online TBI information...Contribution to Project: Dr. Jackson has developed study website. Funding Support: Name: Jose Gallegos Project Role: Game Programmer Researcher

A SIMPLE APPROACH TO ASSESSING COPPER PITTING CORROSION TENDENCIES AND DEVELOPING CONTROL STRATEGIES

EPA Science Inventory

Localized corrosion of copper premise plumbing in drinking water distribution systems can lead to pinhole leaks, which are a growing problem for many homeowners. Despite the fact that water quality is an important factor associated with localized copper corrosion, definitive appr...

A Clean Bill of Health.

ERIC Educational Resources Information Center

American School & University, 1998

1998-01-01

Explores the steps to take to reduce the likelihood that indoor-air-quality (IAQ) problems will develop in educational facilities. Highlights sources and hazards of IAQ when renovating buildings; control strategies and the establishment of IAQ close-out criteria for all renovation projects; heating, ventilation, and air-conditioning system…

Agent-based station for on-line diagnostics by self-adaptive laser Doppler vibrometry

NASA Astrophysics Data System (ADS)

Serafini, S.; Paone, N.; Castellini, P.

2013-12-01

A self-adaptive diagnostic system based on laser vibrometry is proposed for quality control of mechanical defects by vibration testing; it is developed for appliances at the end of an assembly line, but its characteristics are generally suited for testing most types of electromechanical products. It consists of a laser Doppler vibrometer, equipped with scanning mirrors and a camera, which implements self-adaptive bahaviour for optimizing the measurement. The system is conceived as a Quality Control Agent (QCA) and it is part of a Multi Agent System that supervises all the production line. The QCA behaviour is defined so to minimize measurement uncertainty during the on-line tests and to compensate target mis-positioning under guidance of a vision system. Best measurement conditions are reached by maximizing the amplitude of the optical Doppler beat signal (signal quality) and consequently minimize uncertainty. In this paper, the optimization strategy for measurement enhancement achieved by the down-hill algorithm (Nelder-Mead algorithm) and its effect on signal quality improvement is discussed. Tests on a washing machine in controlled operating conditions allow to evaluate the efficacy of the method; significant reduction of noise on vibration velocity spectra is observed. Results from on-line tests are presented, which demonstrate the potential of the system for industrial quality control.

An introduction to statistical process control in research proteomics.

PubMed

Bramwell, David

2013-12-16

Statistical process control is a well-established and respected method which provides a general purpose, and consistent framework for monitoring and improving the quality of a process. It is routinely used in many industries where the quality of final products is critical and is often required in clinical diagnostic laboratories [1,2]. To date, the methodology has been little utilised in research proteomics. It has been shown to be capable of delivering quantitative QC procedures for qualitative clinical assays [3] making it an ideal methodology to apply to this area of biological research. To introduce statistical process control as an objective strategy for quality control and show how it could be used to benefit proteomics researchers and enhance the quality of the results they generate. We demonstrate that rules which provide basic quality control are easy to derive and implement and could have a major impact on data quality for many studies. Statistical process control is a powerful tool for investigating and improving proteomics research work-flows. The process of characterising measurement systems and defining control rules forces the exploration of key questions that can lead to significant improvements in performance. This work asserts that QC is essential to proteomics discovery experiments. Every experimenter must know the current capabilities of their measurement system and have an objective means for tracking and ensuring that performance. Proteomic analysis work-flows are complicated and multi-variate. QC is critical for clinical chemistry measurements and huge strides have been made in ensuring the quality and validity of results in clinical biochemistry labs. This work introduces some of these QC concepts and works to bridge their use from single analyte QC to applications in multi-analyte systems. This article is part of a Special Issue entitled: Standardization and Quality Control in Proteomics. Copyright © 2013 The Author. Published by Elsevier B.V. All rights reserved.

Effects of organic carbon sequestration strategies on soil enzymatic activities

NASA Astrophysics Data System (ADS)

Puglisi, E.; Suciu, N.; Botteri, L.; Ferrari, T.; Coppolecchia, D.; Trevisan, M.; Piccolo, A.

2009-04-01

Greenhouse gases emissions can be counterbalanced with proper agronomical strategies aimed at sequestering carbon in soils. These strategies must be tested not only for their ability in reducing carbon dioxide emissions, but also for their impact on soil quality: enzymatic activities are related to main soil ecological quality, and can be used as early and sensitive indicators of alteration events. Three different strategies for soil carbon sequestration were studied: minimum tillage, protection of biodegradable organic fraction by compost amendment and oxidative polimerization of soil organic matter catalyzed by biometic porfirins. All strategies were compared with a traditional agricultural management based on tillage and mineral fertilization. Experiments were carried out in three Italian soils from different pedo-climatic regions located respectively in Piacenza, Turin and Naples and cultivated with maize or wheat. Soil samples were taken for three consecutive years after harvest and analyzed for their content in phosphates, ß-glucosidase, urease and invertase. An alteration index based on these enzymatic activities levels was applied as well. The biomimetic porfirin application didn't cause changes in enzymatic activities compared to the control at any treatment or location. Enzymatic activities were generally higher in the minimum tillage and compost treatment, while differences between location and date of samplings were limited. Application of the soil alteration index based on enzymatic activities showed that soils treated with compost or subjected to minimum tillage generally have a higher biological quality. The work confirms the environmental sustainability of the carbon sequestering agronomical practices studied.

Quality and Efficiency Improvement Tools for Every Radiologist.

PubMed

Kudla, Alexei U; Brook, Olga R

2018-06-01

In an era of value-based medicine, data-driven quality improvement is more important than ever to ensure safe and efficient imaging services. Familiarity with high-value tools enables all radiologists to successfully engage in quality and efficiency improvement. In this article, we review the model for improvement, strategies for measurement, and common practical tools with real-life examples that include Run chart, Control chart (Shewhart chart), Fishbone (Cause-and-Effect or Ishikawa) diagram, Pareto chart, 5 Whys, and Root Cause Analysis. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Space Shuttle flying qualities criteria assessment. Phase 5: Data acquistion and analysis

NASA Technical Reports Server (NTRS)

Myers, T. T.; Johnston, D. E.; Mcruer, D. T.

1986-01-01

The development of flying qualities experiments (OFQ) as a part of the Orbiter Experiments Program (OEX) was continued. The data base was extended to use the ground based cinetheodolite measurements of orbiter approach and landing. Onboard the cinetheodolite data were analyzed from flights STS 2 through 7 to identify the effective augmented vehicle dynamics, the control strategy employed by the pilot during preflare, shallow glide, and final flare segments of the landing, and the key approach and touchdown performance measures. A plan for an OFQ flying qualities data archive and processing is presented.

Stress-buffering Effect of Coping Strategies on Interrole Conflict among Family Caregivers of People with Dementia.

PubMed

Morimoto, Hiroshi; Furuta, Nobuo; Kono, Mitsue; Kabeya, Mayumi

2017-08-23

To examine the stress-buffering effect of coping strategies on the adverse effects of interrole conflict on the mental health of employed family caregivers, and clarify the moderating role of attentional control on this stress-buffering effect. Data were drawn from a two-wave longitudinal online survey of employed Japanese family caregivers of people with dementia (263 males, 116 females; age 51.54 ± 9.07 years). We assessed interrole conflict, coping strategies, attentional control, mental health variables (psychological strain and quality of life), and confounding factors. Hierarchical regression analyses controlled for sociodemographic factors found formal support seeking had a stress-buffering effect for strain- and behavior-based caregiving interfering with work (CIW) only on psychological strain, and was moderated by attentional control. Single slope analysis showed higher CIW was related to higher psychological strain in those with greater use of formal support seeking and lower attentional control, but not in those with higher attentional control. Greater use of formal support seeking weakens the adverse effects of strain- and behavior-based CIW on psychological strain in people with high attentional control. Attentional control is a key factor in the stress-buffering effect of formal support seeking on strain- and behavior-based CIW.

Quality Assurance of RNA Expression Profiling in Clinical Laboratories

PubMed Central

Tang, Weihua; Hu, Zhiyuan; Muallem, Hind; Gulley, Margaret L.

2012-01-01

RNA expression profiles are increasingly used to diagnose and classify disease, based on expression patterns of as many as several thousand RNAs. To ensure quality of expression profiling services in clinical settings, a standard operating procedure incorporates multiple quality indicators and controls, beginning with preanalytic specimen preparation and proceeding thorough analysis, interpretation, and reporting. Before testing, histopathological examination of each cellular specimen, along with optional cell enrichment procedures, ensures adequacy of the input tissue. Other tactics include endogenous controls to evaluate adequacy of RNA and exogenous or spiked controls to evaluate run- and patient-specific performance of the test system, respectively. Unique aspects of quality assurance for array-based tests include controls for the pertinent outcome signatures that often supersede controls for each individual analyte, built-in redundancy for critical analytes or biochemical pathways, and software-supported scrutiny of abundant data by a laboratory physician who interprets the findings in a manner facilitating appropriate medical intervention. Access to high-quality reagents, instruments, and software from commercial sources promotes standardization and adoption in clinical settings, once an assay is vetted in validation studies as being analytically sound and clinically useful. Careful attention to the well-honed principles of laboratory medicine, along with guidance from government and professional groups on strategies to preserve RNA and manage large data sets, promotes clinical-grade assay performance. PMID:22020152

Assessing concentrations and health impacts of air quality management strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST).

PubMed

Milando, Chad W; Martenies, Sheena E; Batterman, Stuart A

2016-09-01

In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest that FRESH-EST could be used to identify potentially more desirable pollution control alternatives in air quality management planning. Copyright © 2016 Elsevier Ltd. All rights reserved.

Resource allocation for mitigating regional air pollution–related mortality: A summertime case study for five cities in the United States

PubMed Central

Liao, Kuo-Jen; Hou, Xiangting; Strickland, Matthew J.

2016-01-01

ABSTRACT An important issue of regional air quality management is to allocate air quality management funds to maximize environmental and human health benefits. In this study, we use an innovative approach to tackle this air quality management issue. We develop an innovative resource allocation model that allows identification of air pollutant emission control strategies that maximize mortality avoidances subject to a resource constraint. We first present the development of the resource allocation model and then a case study to show how the model can be used to identify resource allocation strategies that maximize mortality avoidances for top five Metropolitan Statistical Areas (MSAs) (i.e., New York, Los Angeles, Chicago, Dallas-Fort Worth, and Philadelphia) in the continental United States collectively. Given budget constraints in the U.S. Environmental Protection Agency’s (EPA) Clean Air Act assessment, the results of the case study suggest that controls of sulfur dioxide (SO2) and primary carbon (PC) emissions from EPA Regions 2, 3, 5, 6, and 9 would have significant health benefits for the five selected cities collectively. Around 30,800 air pollution–related mortalities could be avoided during the selected 2-week summertime episode for the five cities collectively if the budget could be allocated based on the results of the resource allocation model. Although only five U.S. cities during a 2-week episode are considered in the case study, the resource allocation model can be used by decision-makers to plan air pollution mitigation strategies to achieve the most significant health benefits for other seasons and more cities over a region or the continental U.S.Implications: Effective allocations of air quality management resources are challenging and complicated, and it is desired to have a tool that can help decision-makers better allocate the funds to maximize health benefits of air pollution mitigation. An innovative resource allocation model developed in this study can help decision-makers identify the best resource allocation strategies for multiple cities collectively. The results of a case study suggest that controls of primary carbon and sulfur dioxides emissions would achieve the most significant health benefits for five selected cities collectively. PMID:27441782

A molecular insight into papaya leaf curl-a severe viral disease.

PubMed

Varun, Priyanka; Ranade, S A; Saxena, Sangeeta

2017-11-01

Papaya leaf curl disease (PaLCuD) caused by papaya leaf curl virus (PaLCuV) not only affects yield but also plant growth and fruit size and quality of papaya and is one of the most damaging and economically important disease. Management of PaLCuV is a challenging task due to diversity of viral strains, the alternate hosts, and the genomic complexities of the viruses. Several management strategies currently used by plant virologists to broadly control or eliminate the viruses have been discussed. In the absence of such strategies in the case of PaLCuV at present, the few available options to control the disease include methods like removal of affected plants from the field, insecticide treatments against the insect vector (Bemisia tabaci), and gene-specific control through transgenic constructs. This review presents the current understanding of papaya leaf curl disease, genomic components including satellite DNA associated with the virus, wide host and vector range, and management of the disease and suggests possible generic resistance strategies.

[Monitoring medication errors in personalised dispensing using the Sentinel Surveillance System method].

PubMed

Pérez-Cebrián, M; Font-Noguera, I; Doménech-Moral, L; Bosó-Ribelles, V; Romero-Boyero, P; Poveda-Andrés, J L

2011-01-01

To assess the efficacy of a new quality control strategy based on daily randomised sampling and monitoring a Sentinel Surveillance System (SSS) medication cart, in order to identify medication errors and their origin at different levels of the process. Prospective quality control study with one year follow-up. A SSS medication cart was randomly selected once a week and double-checked before dispensing medication. Medication errors were recorded before it was taken to the relevant hospital ward. Information concerning complaints after receiving medication and 24-hour monitoring were also noted. Type and origin error data were assessed by a Unit Dose Quality Control Group, which proposed relevant improvement measures. Thirty-four SSS carts were assessed, including 5130 medication lines and 9952 dispensed doses, corresponding to 753 patients. Ninety erroneous lines (1.8%) and 142 mistaken doses (1.4%) were identified at the Pharmacy Department. The most frequent error was dose duplication (38%) and its main cause inappropriate management and forgetfulness (69%). Fifty medication complaints (6.6% of patients) were mainly due to new treatment at admission (52%), and 41 (0.8% of all medication lines), did not completely match the prescription (0.6% lines) as recorded by the Pharmacy Department. Thirty-seven (4.9% of patients) medication complaints due to changes at admission and 32 matching errors (0.6% medication lines) were recorded. The main cause also was inappropriate management and forgetfulness (24%). The simultaneous recording of incidences due to complaints and new medication coincided in 33.3%. In addition, 433 (4.3%) of dispensed doses were returned to the Pharmacy Department. After the Unit Dose Quality Control Group conducted their feedback analysis, 64 improvement measures for Pharmacy Department nurses, 37 for pharmacists, and 24 for the hospital ward were introduced. The SSS programme has proven to be useful as a quality control strategy to identify Unit Dose Distribution System errors at initial, intermediate and final stages of the process, improving the involvement of the Pharmacy Department and ward nurses. Copyright © 2009 SEFH. Published by Elsevier Espana. All rights reserved.

Enhancing Leadership Quality. TQ Source Tips & Tools: Emerging Strategies to Enhance Educator Quality

ERIC Educational Resources Information Center

National Comprehensive Center for Teacher Quality, 2008

2008-01-01

Teaching Quality (TQ) Source Tips & Tools: Emerging Strategies to Enhance Educator Quality is an online resource developed by the TQ Center. It is designed to help education practitioners tap into strategies and resources they can use to enhance educator quality. This publication is based on the TQ Source Tips & Tools topic area "Enhancing…

Express quality control of chicken eggs by machine vision

NASA Astrophysics Data System (ADS)

Gorbunova, Elena V.; Chertov, Aleksandr N.; Peretyagin, Vladimir S.; Korotaev, Valery V.; Arbuzova, Evgeniia A.

2017-06-01

The urgency of the task of analyzing the foodstuffs quality is determined by the strategy for the formation of a healthy lifestyle and the rational nutrition of the world population. This applies to products, such as chicken eggs. In particular, it is necessary to control the chicken eggs quality at the farm production prior to incubation in order to eliminate the possible hereditary diseases, as well as high embryonic mortality and a sharp decrease in the quality of the bred young. Up to this day, in the market there are no objective instruments of contactless express quality control as analytical equipment that allow the high-precision quality examination of the chicken eggs, which is determined by the color parameters of the eggshell (color uniformity) and yolk of eggs, and by the presence in the eggshell of various defects (cracks, growths, wrinkles, dirty). All mentioned features are usually evaluated only visually (subjectively) with the help of normalized color standards and ovoscopes. Therefore, this work is devoted to the investigation of the application opportunities of contactless express control method with the help of technical vision to implement the chicken eggs' quality analysis. As a result of the studies, a prototype with the appropriate software was proposed. Experimental studies of this equipment on a representative sample of eggs from chickens of different breeds have been carried out (the total number of analyzed samples exceeds 300 pieces). The correctness of the color analysis was verified by spectrophotometric studies of the surface of the eggshell.

Ride performance of a high speed rail vehicle using controlled semi active suspension system

NASA Astrophysics Data System (ADS)

Sharma, Sunil Kumar; Kumar, Anil

2017-05-01

The rail-wheel interaction in a rail vehicle running at high speed results in large amplitude vibration of carbody that deteriorates the ride comfort of travellers. The role of suspension system is crucial to provide an acceptable level of ride performance. In this context, an existing rail vehicle is modelled in vertical, pitch and roll motions of carbody and bogies. Additionally, nonlinear stiffness and damping parameters of passive suspension system are defined based on experimental data. In the secondary vertical suspension system, a magneto-rheological (MR) damper is included to improve the ride quality and comfort. The parameters of MR damper depend on the current, amplitude and frequency of excitations. At different running speeds, three semi-active suspension strategies with MR damper are analysed for periodic track irregularity and the resulting performance indices are juxtaposed with the nonlinear passive suspension system. The disturbance rejection and force tracking damper controller algorithms are applied to control the desired force of MR damper. This study reveals that the vertical vibrations of a vehicle can be reduced significantly by using the proposed semi-active suspension strategies. Moreover, it naturally results in improved ride quality and passenger’s comfort in comparison to the existing passive system.

Religious and Spiritual Coping and Quality of Life Among Patients With Emphysema in the National Emphysema Treatment Trial

PubMed Central

Green, Marquisha R; Emery, Charles F; Kozora, Elizabeth; Diaz, Philip T; Make, Barry J

2013-01-01

BACKGROUND Although prior research indicates that religious and spiritual coping is associated with positive health outcomes, few studies have examined religious and spiritual coping among patients with emphysema. OBJECTIVE To describe the utilization of religious and spiritual coping and its relationship to quality of life among patients with emphysema, in a 2-year longitudinal follow-up study. METHODS Forty patients with emphysema (mean age 63.5 ± 6.0 y, 8 women) who participated in the National Emphysema Treatment Trial were matched on age, sex, race, and education with 40 healthy individuals recruited from the community. We conducted baseline assessment of overall coping strategies, psychological functioning, quality of life, pulmonary function, and exercise capacity, and we assessed overall coping strategies and religious and spiritual coping at 2-year follow-up. RESULTS Ninety percent of the patients with emphysema considered themselves at least slightly religious and spiritual. The patients reported using both negative religious coping (eg, questioning God) and positive religious coping (eg, prayer) more than the healthy control subjects at follow-up. However, greater use of religious and spiritual coping was associated with poorer illness-related quality of life. CONCLUSIONS Patients with emphysema appear to use various coping strategies in responding to their illness. Future research should investigate if patients using religious and spiritual coping would benefit from interventions to address emotional distress and reduced quality of life. PMID:21513606

Food-Based Interventions to Modify Diet Quality and Diversity to Address Multiple Micronutrient Deficiency.

PubMed

Nair, Madhavan K; Augustine, Little Flower; Konapur, Archana

2015-01-01

Global data indicate a high prevalence of hidden hunger among population. Deficiencies of certain micronutrients such as folic acid, iodine, iron, and vitamin A have long lasting effects on growth and development and therefore have been a National priority from many decades. The strategy implemented so far limits to the use of supplemental sources or fortified foods in alleviating the burden of deficiencies. These approaches however undermine the food-based strategies involving dietary diversification as the long-term sustainable strategy. There is lack of understanding on the level of evidence needed to implement such strategies and the level of monitoring required for impact evaluation. Dietary diversity concerns how to ensure access for each individual to a quality and safe diet with adequate macro- and micronutrients. The key to success in using dietary diversity as a strategy to tackle hidden hunger is in integrating it with the principles of bioavailability, translated to efficient food synergies with due emphasis on food accessibility, affordability, and outdoor physical activity/life style modifications. Promoting enabling environment and sustainable agriculture is crucial for practicing dietary diversification with behavior change communication as an integral segment. It can be concluded that food-based strategies require careful understanding of the factors associated with it and moderate it to form an effective strategy for controlling multiple micronutrient deficiencies.

Food-Based Interventions to Modify Diet Quality and Diversity to Address Multiple Micronutrient Deficiency

PubMed Central

Nair, Madhavan K.; Augustine, Little Flower; Konapur, Archana

2016-01-01

Global data indicate a high prevalence of hidden hunger among population. Deficiencies of certain micronutrients such as folic acid, iodine, iron, and vitamin A have long lasting effects on growth and development and therefore have been a National priority from many decades. The strategy implemented so far limits to the use of supplemental sources or fortified foods in alleviating the burden of deficiencies. These approaches however undermine the food-based strategies involving dietary diversification as the long-term sustainable strategy. There is lack of understanding on the level of evidence needed to implement such strategies and the level of monitoring required for impact evaluation. Dietary diversity concerns how to ensure access for each individual to a quality and safe diet with adequate macro- and micronutrients. The key to success in using dietary diversity as a strategy to tackle hidden hunger is in integrating it with the principles of bioavailability, translated to efficient food synergies with due emphasis on food accessibility, affordability, and outdoor physical activity/life style modifications. Promoting enabling environment and sustainable agriculture is crucial for practicing dietary diversification with behavior change communication as an integral segment. It can be concluded that food-based strategies require careful understanding of the factors associated with it and moderate it to form an effective strategy for controlling multiple micronutrient deficiencies. PMID:26779472

Ensuring quality: a key consideration in scaling-up HIV-related point-of-care testing programs

PubMed Central

Fonjungo, Peter N.; Osmanov, Saladin; Kuritsky, Joel; Ndihokubwayo, Jean Bosco; Bachanas, Pam; Peeling, Rosanna W.; Timperi, Ralph; Fine, Glenn; Stevens, Wendy; Habiyambere, Vincent; Nkengasong, John N.

2016-01-01

Objective: The objective of the WHO/US President's Emergency Plan for AIDS Relief consultation was to discuss innovative strategies, offer guidance, and develop a comprehensive policy framework for implementing quality-assured HIV-related point-of-care testing (POCT). Methods: The consultation was attended by representatives from international agencies (WHO, UNICEF, UNITAID, Clinton Health Access Initiative), United States Agency for International Development, Centers for Disease Control and Prevention/President's Emergency Plan for AIDS Relief Cooperative Agreement Partners, and experts from more than 25 countries, including policy makers, clinicians, laboratory experts, and program implementers. Main outcomes: There was strong consensus among all participants that ensuring access to quality of POCT represents one of the key challenges for the success of HIV prevention, treatment, and care programs. The following four strategies were recommended: implement a newly proposed concept of a sustainable quality assurance cycle that includes careful planning; definition of goals and targets; timely implementation; continuous monitoring; improvements and adjustments, where necessary; and a detailed evaluation; the importance of supporting a cadre of workers [e.g. volunteer quality corps (Q-Corps)] with the role to ensure that the quality assurance cycle is followed and sustained; implementation of the new strategy should be seen as a step-wise process, supported by development of appropriate policies and tools; and joint partnership under the leadership of the ministries of health to ensure sustainability of implementing novel approaches. Conclusion: The outcomes of this consultation have been well received by program implementers in the field. The recommendations also laid the groundwork for developing key policy and quality documents for the implementation of HIV-related POCT. PMID:26807969

Effects of Direct Instruction and Strategy Modeling on Upper-Primary Students’ Writing Development

PubMed Central

López, Paula; Torrance, Mark; Rijlaarsdam, Gert; Fidalgo, Raquel

2017-01-01

Strategy-focused instruction is one of the most effective approaches to improve writing skills. It aims to teach developing writers strategies that give them executive control over their writing processes. Programs under this kind of instruction tend to have multiple components that include direct instruction, modeling and scaffolded practice. This multi-component nature has two drawbacks: it makes implementation challenging due to the amount of time and training required to perform each stage, and it is difficult to determine the underlying mechanisms that contribute to its effectiveness. To unpack why strategy-focused instruction is effective, we explored the specific effects of two key components: direct teaching of writing strategies and modeling of strategy use. Six classes (133 students) of upper-primary education were randomly assigned to one of the two experimental conditions, in which students received instruction aimed at developing effective strategies for planning and drafting, or control group with no strategy instruction: Direct Instruction (N = 46), Modeling (N = 45), and Control (N = 42). Writing performance was assessed before the intervention and immediately after the intervention with two tasks, one collaborative and the other one individual to explore whether differential effects resulted from students writing alone or in pairs. Writing performance was assessed through reader-based and text-based measures of text quality. Results at post-test showed similar improvement in both intervention conditions, relatively to controls, in all measures and in both the collaborative and the individual task. No statistically significant differences were observed between experimental conditions. These findings suggest that both components, direct teaching and modeling, are equally effective in improving writing skills in upper primary students, and these effects are present even after a short training. PMID:28713299

42 CFR 438.204 - Elements of State quality strategies.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Elements of State quality strategies. 438.204 Section 438.204 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Improvement § 438.204 Elements of State quality strategies. At a minimum, State strategies must include the...

42 CFR 438.204 - Elements of State quality strategies.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Elements of State quality strategies. 438.204 Section 438.204 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Improvement § 438.204 Elements of State quality strategies. At a minimum, State strategies must include the...

42 CFR 438.204 - Elements of State quality strategies.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Elements of State quality strategies. 438.204 Section 438.204 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Improvement § 438.204 Elements of State quality strategies. At a minimum, State strategies must include the...

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)

Methods for reducing biases and errors in regional photochemical model outputs for use in emission reduction and exposure assessments

EPA Science Inventory

In the United States, regional-scale photochemical models are being used to design emission control strategies needed to meet the relevant National Ambient Air Quality Standards (NAAQS) within the framework of the attainment demonstration process. Previous studies have shown that...

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

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2014

2014-01-01

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

40 CFR 52.725 - Control strategy: Particulates.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Approval—On March 19, 1996, and October 15, 1996, Illinois submitted requests to redesignate the Granite... Quality Standards (NAAQS), as well as a maintenance plan for the Granite City area to ensure continued... approval of Illinois' May 15, 1992, SIP submittal for the Lake Calumet (SE Chicago), McCook, and Granite...

A SIMPLE APPROACH TO ASSESSING COPPER PITTING CORROSION TENDENCIES AND DEVELOPING CONTROL STRATEGIES

EPA Science Inventory

Localized corrosion of copper plumbing in drinking water distribution systems can lead to pinhole leaks, which are a growing problem for many homeowners. Although water quality is one factor that can be responsible for localized copper corrosion, there is not a good approach to ...

Industrial Sectors Integrated Solutions (ISIS) - An Engineering–Economic and Multi-Pollutant Modeling Framework for Comprehensive Regulatory Analyses

EPA Science Inventory

Based on the National Academy of Science’s 2004 report, “Air Quality Management in the United States”, the National Research Council (NRC) recommended to the US Environmental Protection Agency (EPA) that standard setting, planning, and control strategy development should be based...

Repurposing a bacterial quality control mechanism to enhance enzyme production in living cells

USDA-ARS?s Scientific Manuscript database

Heterologous expression of many proteins in bacteria, yeasts, and plants is often limited by low titers of functional protein. To address this problem, we have created a two-tiered directed evolution strategy in Escherichia coli that enables optimization of protein production while maintaining high ...

Construction of high-quality recombination maps with low-coverage genomic sequencing for joint linkage analysis in maize

USDA-ARS?s Scientific Manuscript database

A genome-wide association study (GWAS) is the foremost strategy used for finding genes that control human diseases and agriculturally important traits, but it often reports false positives. In contrast, its complementary method, linkage analysis, provides direct genetic confirmation, but with limite...

Information Technology in Education: The Critical Lack of Principled Leadership.

ERIC Educational Resources Information Center

Maddux, Cleborne D.

2002-01-01

Suggests there is a crisis in educational leadership, especially as it affects information technology. Highlights include educational leaders as managers; the commercialization of education; management strategies on campus; students as customers; quality control, online distance education, and the business model; and the future of online distance…

Marketization in Long-Term Care: A Cross-Country Comparison of Large For-Profit Nursing Home Chains.

PubMed

Harrington, Charlene; Jacobsen, Frode F; Panos, Justin; Pollock, Allyson; Sutaria, Shailen; Szebehely, Marta

2017-01-01

This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability.

Marketization in Long-Term Care: A Cross-Country Comparison of Large For-Profit Nursing Home Chains

PubMed Central

Harrington, Charlene; Jacobsen, Frode F; Panos, Justin; Pollock, Allyson; Sutaria, Shailen; Szebehely, Marta

2017-01-01

This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability. PMID:28634428

Struggling With Adversities of Life: The Role of Forgiveness in Patients Suffering from Fibromyalgia.

PubMed

Offenbaecher, Martin; Dezutter, Jessie; Kohls, Niko; Sigl, Claudia; Vallejo, Miguel A; Rivera, Javier; Bauerdorf, Felix; Schelling, Jörg; Vincent, Ann; Hirsch, Jameson K; Sirois, Fuschia M; Webb, Jon R; Toussaint, Loren L

2017-06-01

We compared the magnitude and direction of associations between forgiveness and pain, mental and physical health, quality of life, and anger in a sample of fibromyalgia syndrome (FM) participants and healthy controls. In addition, we compared FM and controls on mean levels of these variables. A total of 173 individuals with FM and 81 controls completed this study. FM participants and controls were residents of Germany recruited with the support of the German Fibromyalgia Patient Association and several self-help groups. FM participants and controls were about 53 years of age, mostly married (70%), Christians (81%), with levels of education ranging from 9 to 13+ years. All participants completed assessments of forgiveness, pain, health, quality of life, and anger. Analyses revealed that FM participants reported higher pain and anger and poorer health and quality of life. FM participants also reported lower levels of both forgiveness of self and others. Size and direction of associations of forgiveness with pain, health, quality of life, and anger in were not significantly different between healthy individuals and individuals with FM. Forgiveness of self and others is beneficially associated with pain, health, quality of life, and anger in FM participants at levels that are of similar size and direction as in healthy controls. However, FM participants manifest lower levels of forgiveness of self and others. Therapeutic promotion of forgiveness as a psychosocial coping strategy may help patients with FM to better manage psychological and physical symptoms, thereby enhancing well-being.

City-specific vehicle emission control strategies to achieve stringent emission reduction targets in China's Yangtze River Delta region.

PubMed

Zhang, Shaojun; Wu, Ye; Zhao, Bin; Wu, Xiaomeng; Shu, Jiawei; Hao, Jiming

2017-01-01

The Yangtze River Delta (YRD) region is one of the most prosperous and densely populated regions in China and is facing tremendous pressure to mitigate vehicle emissions and improve air quality. Our assessment has revealed that mitigating vehicle emissions of NOx would be more difficult than reducing the emissions of other major vehicular pollutants (e.g., CO, HC and PM 2.5 ) in the YRD region. Even in Shanghai, where the emission control implemented are more stringent than in Jiangsu and Zhejiang, we observed little to no reduction in NOx emissions from 2000 to 2010. Emission-reduction targets for HC, NOx and PM 2.5 are determined using a response surface modeling tool for better air quality. We design city-specific emission control strategies for three vehicle-populated cities in the YRD region: Shanghai and Nanjing and Wuxi in Jiangsu. Our results indicate that even if stringent emission control consisting of the Euro 6/VI standards, the limitation of vehicle population and usage, and the scrappage of older vehicles is applied, Nanjing and Wuxi will not be able to meet the NOx emissions target by 2020. Therefore, additional control measures are proposed for Nanjing and Wuxi to further mitigate NOx emissions from heavy-duty diesel vehicles. Copyright © 2016. Published by Elsevier B.V.

Computational strategy for the solution of large strain nonlinear problems using the Wilkins explicit finite-difference approach

NASA Technical Reports Server (NTRS)

Hofmann, R.

1980-01-01

The STEALTH code system, which solves large strain, nonlinear continuum mechanics problems, was rigorously structured in both overall design and programming standards. The design is based on the theoretical elements of analysis while the programming standards attempt to establish a parallelism between physical theory, programming structure, and documentation. These features have made it easy to maintain, modify, and transport the codes. It has also guaranteed users a high level of quality control and quality assurance.

Habitat manipulation in lowland rice-coconut cropping systems of the Philippines--an effective rodent pest management strategy?

PubMed

Stuart, Alexander M; Prescott, Colin V; Singleton, Grant R

2014-06-01

Reduction of vegetation height is recommended as a management strategy for controlling rodent pests of rice in South-east Asia, but there are limited field data to assess its effectiveness. The breeding biology of the main pest species of rodent in the Philippines, Rattus tanezumi, suggests that habitat manipulation in irrigated rice-coconut cropping systems may be an effective strategy to limit the quality and availability of their nesting habitat. The authors imposed a replicated manipulation of vegetation cover in adjacent coconut groves during a single rice-cropping season, and added artificial nest sites to facilitate capture and culling of young. Three trapping sessions in four rice fields (two treatments, two controls) adjacent to coconut groves led to the capture of 176 R. tanezumi, 12 Rattus exulans and seven Chrotomys mindorensis individuals. There was no significant difference in overall abundance between crop stages or between treatments, and there was no treatment effect on damage to tillers or rice yield. Only two R. tanezumi were caught at the artificial nest sites. Habitat manipulation to reduce the quality of R. tanezumi nesting habitat adjacent to rice fields is not effective as a lone rodent management tool in rice-coconut cropping systems. © 2013 Society of Chemical Industry.

Study of Measurement Strategies of Geometric Deviation of the Position of the Threaded Holes

NASA Astrophysics Data System (ADS)

Drbul, Mário; Martikan, Pavol; Sajgalik, Michal; Czan, Andrej; Broncek, Jozef; Babik, Ondrej

2017-12-01

Verification of product and quality control is an integral part of current production process. In terms of functional requirements and product interoperability, it is necessary to analyze their dimensional and also geometric specifications. Threaded holes are verified elements too, which are a substantial part of detachable screw connections and have a broad presence in engineering products. This paper deals with on the analysing of measurement strategies of verification geometric deviation of the position of the threaded holes, which are the indirect method of measuring threaded pins when applying different measurement strategies which can affect the result of the verification of the product..

Marketing environment dynamics and implications for pricing strategies: the case of home health care.

PubMed

Ponsford, B J; Barlow, D

1999-01-01

This research reviews the factors affecting the pricing or rate schedules of home health care agencies. A large number of factors affect costs and thus rate structures. The major factors include reimbursement structures with accompanying discount structures, administrative burdens, and risks. Channel issues include bargaining power, competition, and size. Staffing issues affect pricing and product through the provider level, productivity, and quality outcomes. Physician and patient issues include quality concerns and choices. These factors are discussed in light of overall marketing strategy and the interaction of pricing with other marketing controllables such as product, place/distribution, and promotion. Economic and accounting principles are also reviewed with consideration to understanding direct and indirect costs in order to enable negotiators to effectively price health care services.

Process evaluation of the project P.A.T.H.S. (secondary 2 program): findings based on the co-walker scheme.

PubMed

Shek, Daniel T L; Tam, Suet-yan

2009-01-01

To understand the implementation quality of the Tier 1 Program (Secondary 2 Curriculum) of the P.A.T.H.S. Project, process evaluation was carried out by co-walkers through classroom observation of 195 units in 131 schools. Results showed that the overall level of program adherence was generally high with an average of 84.55%, and different factors of the implementation process were evaluated as positive. Quality of program implementation and achievement of program objectives were predicted by students' participation and involvement, strategies to enhance students' motivation, opportunity for reflection, time management, and class preparation. Success in program implementation was predicted by students' participation and involvement, classroom control, interactive delivery method, strategies to enhance students' motivation, opportunity for reflection, and lesson preparation.

Relationships between undergraduates' argumentation skills, conceptual quality of problem solutions, and problem solving strategies in introductory physics

NASA Astrophysics Data System (ADS)

Rebello, Carina M.

This study explored the effects of alternative forms of argumentation on undergraduates' physics solutions in introductory calculus-based physics. A two-phase concurrent mixed methods design was employed to investigate relationships between undergraduates' written argumentation abilities, conceptual quality of problem solutions, as well as approaches and strategies for solving argumentative physics problems across multiple physics topics. Participants were assigned via stratified sampling to one of three conditions (control, guided construct, or guided evaluate) based on gender and pre-test scores on a conceptual instrument. The guided construct and guided evaluate groups received tasks and prompts drawn from literature to facilitate argument construction or evaluation. Using a multiple case study design, with each condition serving as a case, interviews were conducted consisting of a think-aloud problem solving session paired with a semi-structured interview. The analysis of problem solving strategies was guided by the theoretical framework on epistemic games adapted by Tuminaro and Redish (2007). This study provides empirical evidence that integration of written argumentation into physics problems can potentially improve the conceptual quality of solutions, expand their repertoire of problem solving strategies and show promise for addressing the gender gap in physics. The study suggests further avenues for research in this area and implications for designing and implementing argumentation tasks in introductory college physics.

A vehicle stability control strategy with adaptive neural network sliding mode theory based on system uncertainty approximation

NASA Astrophysics Data System (ADS)

Ji, Xuewu; He, Xiangkun; Lv, Chen; Liu, Yahui; Wu, Jian

2018-06-01

Modelling uncertainty, parameter variation and unknown external disturbance are the major concerns in the development of an advanced controller for vehicle stability at the limits of handling. Sliding mode control (SMC) method has proved to be robust against parameter variation and unknown external disturbance with satisfactory tracking performance. But modelling uncertainty, such as errors caused in model simplification, is inevitable in model-based controller design, resulting in lowered control quality. The adaptive radial basis function network (ARBFN) can effectively improve the control performance against large system uncertainty by learning to approximate arbitrary nonlinear functions and ensure the global asymptotic stability of the closed-loop system. In this paper, a novel vehicle dynamics stability control strategy is proposed using the adaptive radial basis function network sliding mode control (ARBFN-SMC) to learn system uncertainty and eliminate its adverse effects. This strategy adopts a hierarchical control structure which consists of reference model layer, yaw moment control layer, braking torque allocation layer and executive layer. Co-simulation using MATLAB/Simulink and AMESim is conducted on a verified 15-DOF nonlinear vehicle system model with the integrated-electro-hydraulic brake system (I-EHB) actuator in a Sine With Dwell manoeuvre. The simulation results show that ARBFN-SMC scheme exhibits superior stability and tracking performance in different running conditions compared with SMC scheme.

Quality of life as an endpoint for atrial fibrillation research: pitfalls and practice.

PubMed

Newman, David

2004-07-01

There have been few health-related quality-of-life (HR-QOL) studies of atrial fibrillation in nontreated cohorts, even though it often is used as an endpoint in clinical trials. Nonintervention data now available are selected for those in whom novel therapies are most often offered. These data suggest that atrial fibrillation confers an HR-QOL impact commensurate with postangioplasty and significant coronary disease groups. The correlation of HR-QOL measures and formal measures of atrial fibrillation "burden" (frequency or duration) is either poor or unknown (in the case of permanent atrial fibrillation). HR-QOL tools, although relevant, may not be as precise as traditional outcome measures. As a result, a 0.5 standard deviation unit of change in scale is needed to be considered moderate. There is a need to use validated instruments that are hypothesized to be sensitive to any intervention under study. The most studied area in atrial fibrillation has been that of ablation and pacing as rate control strategy. Depending on selection bias, SF-36 full standard deviation unit changes have been observed. Less controlled studies have documented significant benefit to left atrial ablative strategies. Device- and drug-based strategies in atrial fibrillation management have not demonstrated significant HR-QOL benefits, other than one controlled evaluation of an atrial defibrillator. Further study is needed both to refine instrument precision and to translate HR-QOL data into the denominator of cost-efficacy evaluations.

Fostering High-Quality Teaching with an Enriched Curriculum and Professional Development Support: The Head Start REDI Program

PubMed Central

Domitrovich, Celene E.; Gest, Scott D.; Gill, Sukhdeep; Bierman, Karen L.; Welsh, Janet; Jones, Damon

2017-01-01

This randomized controlled trial tested whether teaching quality in Head Start classrooms could be improved with the addition of evidence-based curriculum components targeting emergent language/literacy and social-emotional development and the provision of associated professional development support. Participants were lead and assistant teachers in 44 Head Start classrooms. Teachers received 4 days of workshop training along with weekly in-class support from a mentor teacher. End-of-year observations indicated that, compared to the control group, intervention teachers talked with children more frequently and in more cognitively complex ways, established a more positive classroom climate, and used more preventive behavior management strategies. Results supported the conclusion that enriched curriculum components and professional development support can produce improvements in multiple domains of teaching quality. PMID:29081534

Water Deficit and Salinity Stress Reveal Many Specific QTL for Plant Growth and Fruit Quality Traits in Tomato

PubMed Central

Diouf, Isidore A.; Derivot, Laurent; Bitton, Frédérique; Pascual, Laura; Causse, Mathilde

2018-01-01

Quality is a key trait in plant breeding, especially for fruit and vegetables. Quality involves several polygenic components, often influenced by environmental conditions with variable levels of genotype × environment interaction that must be considered in breeding strategies aiming to improve quality. In order to assess the impact of water deficit and salinity on tomato fruit quality, we evaluated a multi-parent advanced generation intercross (MAGIC) tomato population in contrasted environmental conditions over 2 years, one year in control vs. drought condition and the other in control vs. salt condition. Overall 250 individual lines from the MAGIC population—derived from eight parental lines covering a large diversity in cultivated tomato—were used to identify QTL in both experiments for fruit quality and yield component traits (fruit weight, number of fruit, Soluble Solid Content, firmness), phenology traits (time to flower and ripe) and a vegetative trait, leaf length. All the traits showed a large genotype variation (33–86% of total phenotypic variation) in both experiments and high heritability whatever the year or treatment. Significant genotype × treatment interactions were detected for five of the seven traits over the 2 years of experiments. QTL were mapped using 1,345 SNP markers. A total of 54 QTL were found among which 15 revealed genotype × environment interactions and 65% (35 QTL) were treatment specific. Confidence intervals of the QTL were projected on the genome physical map and allowed identifying regions carrying QTL co-localizations, suggesting pleiotropic regulation. We then applied a strategy for candidate gene detection based on the high resolution mapping offered by the MAGIC population, the allelic effect of each parental line at the QTL and the sequence information of the eight parental lines. PMID:29559986

[Quality management and strategic consequences of assessing documentation and coding under the German Diagnostic Related Groups system].

PubMed

Schnabel, M; Mann, D; Efe, T; Schrappe, M; V Garrel, T; Gotzen, L; Schaeg, M

2004-10-01

The introduction of the German Diagnostic Related Groups (D-DRG) system requires redesigning administrative patient management strategies. Wrong coding leads to inaccurate grouping and endangers the reimbursement of treatment costs. This situation emphasizes the roles of documentation and coding as factors of economical success. The aims of this study were to assess the quantity and quality of initial documentation and coding (ICD-10 and OPS-301) and find operative strategies to improve efficiency and strategic means to ensure optimal documentation and coding quality. In a prospective study, documentation and coding quality were evaluated in a standardized way by weekly assessment. Clinical data from 1385 inpatients were processed for initial correctness and quality of documentation and coding. Principal diagnoses were found to be accurate in 82.7% of cases, inexact in 7.1%, and wrong in 10.1%. Effects on financial returns occurred in 16%. Based on these findings, an optimized, interdisciplinary, and multiprofessional workflow on medical documentation, coding, and data control was developed. Workflow incorporating regular assessment of documentation and coding quality is required by the DRG system to ensure efficient accounting of hospital services. Interdisciplinary and multiprofessional cooperation is recognized to be an important factor in establishing an efficient workflow in medical documentation and coding.

Canopy management in rainfed vineyards (cv. Tempranillo) for optimising water use and enhancing wine quality.

PubMed

Pascual, Miquel; Romero, María-Paz; Rufat, Josep; Villar, Josep M

2015-12-01

Rainfed viticulture, mainly in semi-arid environments, is limited by environmental variability, particularly precipitation and its seasonal distribution, and soil water availability, thus ultimately determining the final quality of grape and wine. Studies on the feasibility of practices such as canopy management to adapt plant growth and yield to soil water availability open up possibilities to preserve wine quality and reinforce the characteristics of the terroir. Principal components analysis was used to identify the relationships between a large set of variables, including soil, plant, canopy management, and wine characteristics. Canopy management was found to have a predominant influence on plant response to soil water by modifying plant water status, changing the amino acid profile in berries and, concomitantly, altering the sensorial attributes of the wine obtained. Grapevine canopy management strategies, such as reiterate shoot trimming to restrict growth during early phases, are effective in adapting plant response to soil water availability. Such strategies affect berry and wine quality, mainly the amino acid profile and sensorial attributes of the wine, without changing yield or grape harvest quality control parameters. Also, in such conditions, nitrogen does not make a significant contribution to grapevine growth or yield or to grape quality. © 2015 Society of Chemical Industry.

An Analysis of Organizational Performance Based on Hospital Specialization Level and Strategy Type

PubMed Central

Kim, Han-Sung; Kim, Young-Hoon; Woo, Jung-Sik; Hyun, Sook-Jung

2015-01-01

Introduction Hospitals are studying the focused factory concept and attempting to increase their power in a competitive industry by becoming more specialized. Methodology This study uses the information theory index (ITI) and the Herfindahl-Hirschman index (HHI) to analyze the extent of specialization by Korean hospitals that receive national health insurance reimbursements. Hierarchical regression analysis is used to assess the impact of hospital specialization on the following four aspects of operational performance: productivity, profitability, efficiency and quality of care. Study Results The results show that a focused strategy (high HHI) improves the income and adjusted number of patients per specialist through the efficient utilization of human resources. However, a diversified strategy (high ITI) improves the hospital utilization ratio, income per bed and adjusted number of patients per bed (controlling for material resources such as beds). In addition, as the concentration index increases, case-mix mortality rates and referral rates decrease, indicating that specialization has a positive relationship with quality of care. PMID:26218570

An Analysis of Organizational Performance Based on Hospital Specialization Level and Strategy Type.

PubMed

Kim, Han-Sung; Kim, Young-Hoon; Woo, Jung-Sik; Hyun, Sook-Jung

2015-01-01

Hospitals are studying the focused factory concept and attempting to increase their power in a competitive industry by becoming more specialized. This study uses the information theory index (ITI) and the Herfindahl-Hirschman index (HHI) to analyze the extent of specialization by Korean hospitals that receive national health insurance reimbursements. Hierarchical regression analysis is used to assess the impact of hospital specialization on the following four aspects of operational performance: productivity, profitability, efficiency and quality of care. The results show that a focused strategy (high HHI) improves the income and adjusted number of patients per specialist through the efficient utilization of human resources. However, a diversified strategy (high ITI) improves the hospital utilization ratio, income per bed and adjusted number of patients per bed (controlling for material resources such as beds). In addition, as the concentration index increases, case-mix mortality rates and referral rates decrease, indicating that specialization has a positive relationship with quality of care.

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

PubMed

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

2008-08-01

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

A mixed methods multiple case study of implementation as usual in children’s social service organizations: study protocol

PubMed Central

2013-01-01

Background Improving quality in children’s mental health and social service settings will require implementation strategies capable of moving effective treatments and other innovations (e.g., assessment tools) into routine care. It is likely that efforts to identify, develop, and refine implementation strategies will be more successful if they are informed by relevant stakeholders and are responsive to the strengths and limitations of the contexts and implementation processes identified in usual care settings. This study will describe: the types of implementation strategies used; how organizational leaders make decisions about what to implement and how to approach the implementation process; organizational stakeholders’ perceptions of different implementation strategies; and the potential influence of organizational culture and climate on implementation strategy selection, implementation decision-making, and stakeholders’ perceptions of implementation strategies. Methods/design This study is a mixed methods multiple case study of seven children’s social service organizations in one Midwestern city in the United States that compose the control group of a larger randomized controlled trial. Qualitative data will include semi-structured interviews with organizational leaders (e.g., CEOs/directors, clinical directors, program managers) and a review of documents (e.g., implementation and quality improvement plans, program manuals, etc.) that will shed light on implementation decision-making and specific implementation strategies that are used to implement new programs and practices. Additionally, focus groups with clinicians will explore their perceptions of a range of implementation strategies. This qualitative work will inform the development of a Web-based survey that will assess the perceived effectiveness, relative importance, acceptability, feasibility, and appropriateness of implementation strategies from the perspective of both clinicians and organizational leaders. Finally, the Organizational Social Context measure will be used to assess organizational culture and climate. Qualitative, quantitative, and mixed methods data will be analyzed and interpreted at the case level as well as across cases in order to highlight meaningful similarities, differences, and site-specific experiences. Discussion This study is designed to inform efforts to develop more effective implementation strategies by fully describing the implementation experiences of a sample of community-based organizations that provide mental health services to youth in one Midwestern city. PMID:23961701

What Strategies Do the Nurses Apply to Cope With Job Stress?: A Qualitative Study

PubMed Central

Akbar, Rasool Eslami; Elahi, Nasrin; Mohammadi, Eesa; Khoshknab, Masoud Fallahi

2016-01-01

Background: Nursing staff encounter a lot of physical, psychological and social stressors at work. Because the adverse effects of job stress on the health of this group of staff and subsequently on the quality of care services provided by nurses; study and identify how nurses cope with the job stress is very important and can help prevent the occurrence of unfavorable outcomes. Objectives: The aim of this study was to explore the experiences of nurses to identify the strategies they used to cope with the job stress. Methods: In this qualitative study content analysis approach was used. Purposive sampling approach was applied. The sample population included 18 nurses working in three hospitals. Data collection was conducted through face to face unstructured interview and was analyzed using conventional content analysis approach. Findings: The analysis of the data emerged six main themes about the strategies used by nurses to cope with job stress, which, include: situational control of conditions, seeking help, preventive monitoring of situation, self-controlling, avoidance and escape and spiritual coping. Conclusions: Exploring experiences of nurses on how to cope with job stress emerged context-dependent and original strategies and this knowledge can pave the ground for nurses to increase self-awareness of how to cope with job stress. And could also be the basis for planning and the adoption of necessary measures by the authorities to adapt nurses with their profession better and improves their health which are essential elements to fulfill high-quality nursing care. PMID:26755462

A design space exploration for control of Critical Quality Attributes of mAb.

PubMed

Bhatia, Hemlata; Read, Erik; Agarabi, Cyrus; Brorson, Kurt; Lute, Scott; Yoon, Seongkyu

2016-10-15

A unique "design space (DSp) exploration strategy," defined as a function of four key scenarios, was successfully integrated and validated to enhance the DSp building exercise, by increasing the accuracy of analyses and interpretation of processed data. The four key scenarios, defining the strategy, were based on cumulative analyses of individual models developed for the Critical Quality Attributes (23 Glycan Profiles) considered for the study. The analyses of the CQA estimates and model performances were interpreted as (1) Inside Specification/Significant Model (2) Inside Specification/Non-significant Model (3) Outside Specification/Significant Model (4) Outside Specification/Non-significant Model. Each scenario was defined and illustrated through individual models of CQA aligning the description. The R(2), Q(2), Model Validity and Model Reproducibility estimates of G2, G2FaGbGN, G0 and G2FaG2, respectively, signified the four scenarios stated above. Through further optimizations, including the estimation of Edge of Failure and Set Point Analysis, wider and accurate DSps were created for each scenario, establishing critical functional relationship between Critical Process Parameters (CPPs) and Critical Quality Attributes (CQAs). A DSp provides the optimal region for systematic evaluation, mechanistic understanding and refining of a QbD approach. DSp exploration strategy will aid the critical process of consistently and reproducibly achieving predefined quality of a product throughout its lifecycle. Copyright © 2016 Elsevier B.V. All rights reserved.

The effect of laser focus and process parameters on microstructure and mechanical properties of SLM Inconel 718

NASA Astrophysics Data System (ADS)

Bean, Glenn E.; Witkin, David B.; McLouth, Tait D.; Zaldivar, Rafael J.

2018-02-01

Research on the selective laser melting (SLM) method of laser powder bed fusion additive manufacturing (AM) has shown that surface and internal quality of AM parts is directly related to machine settings such as laser energy density, scanning strategies, and atmosphere. To optimize laser parameters for improved component quality, the energy density is typically controlled via laser power, scanning rate, and scanning strategy, but can also be controlled by changing the spot size via laser focal plane shift. Present work being conducted by The Aerospace Corporation was initiated after observing inconsistent build quality of parts printed using OEM-installed settings. Initial builds of Inconel 718 witness geometries using OEM laser parameters were evaluated for surface roughness, density, and porosity while varying energy density via laser focus shift. Based on these results, hardware and laser parameter adjustments were conducted in order to improve build quality and consistency. Tensile testing was also conducted to investigate the effect of build plate location and laser settings on SLM 718. This work has provided insight into the limitations of OEM parameters compared with optimized parameters towards the goal of manufacturing aerospace-grade parts, and has led to the development of a methodology for laser parameter tuning that can be applied to other alloy systems. Additionally, evidence was found that for 718, which derives its strength from post-manufacturing heat treatment, there is a possibility that tensile testing may not be perceptive to defects which would reduce component performance. Ongoing research is being conducted towards identifying appropriate testing and analysis methods for screening and quality assurance.

Quality of drug information on the World Wide Web and strategies to improve pages with poor information quality. An intervention study on pages about sildenafil.

PubMed

Martin-Facklam, Meret; Kostrzewa, Michael; Martin, Peter; Haefeli, Walter E

2004-01-01

The generally poor quality of health information on the world wide web (WWW) has caused preventable adverse outcomes. Quality management of information on the internet is therefore critical given its widespread use. In order to develop strategies for the safe use of drugs, we scored general and content quality of pages about sildenafil and performed an intervention to improve their quality. The internet was searched with Yahoo and AltaVista for pages about sildenafil and 303 pages were included. For assessment of content quality a score based on accuracy and completeness of essential drug information was assigned. For assessment of general quality, four criteria were evaluated and their association with high content quality was determined by multivariate logistic regression analysis. The pages were randomly allocated to either control or intervention group. Evaluation took place before, as well as 7 and 22 weeks after an intervention which consisted of two letters with individualized feedback information on the respective page which were sent electronically to the address mentioned on the page. Providing references to scientific publications or prescribing information was significantly associated with high content quality (odds ratio: 8.2, 95% CI 3.2, 20.5). The intervention had no influence on general or content quality. To prevent adverse outcomes caused by misinformation on the WWW individualized feedback to the address mentioned on the page was ineffective. It is currently probably the most straight-forward approach to inform lay persons about indicators of high information quality, i.e. the provision of references.

Factors associated with health-related quality of life among overweight and obese Korean women.

PubMed

Choo, Jina; Turk, Melanie T; Jae, Sae Young; Choo, Il Han

2015-01-01

Health-related quality of life (HRQOL) tends to be lower among individuals who are overweight and obese than those of normal weight, and women may be more vulnerable to lower HRQOL associated with obesity than men. Identifying factors associated with HRQOL may be crucial for improving HRQOL for overweight/obese women. We aimed to determine the factors associated with obesity-specific HRQOL among overweight/obese Korean women. A cross-sectional study was conducted with 125 women aged 20-64 years, who comprised a baseline sample in the Community-based Heart and Weight Management Trial. The data were collected from September 2010 to November 2011. The Weight Efficacy Lifestyle, Beck Depression Inventory-II, Interpersonal Social Evaluation List, and Impact of Weight on Quality of Life (IWQOL)-Lite scales were used to measure self-efficacy for weight control, depressive symptoms, social support, and HRQOL, respectively. Increased body mass index, lower self-efficacy for weight control, and higher levels of depressive symptoms were significantly associated with greater impairment in total IWQOL in the regression models. However, social support was not significantly associated with IWQOL. Along with weight loss strategies, other strategies for improving self-efficacy and alleviating depressive symptoms may be essential for improving HRQOL among overweight and obese women.

The effectiveness of strategies to change organisational culture to improve healthcare performance

PubMed Central

Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P

2014-01-01

Background Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. Great emphasis has been placed during the last years on the need to change organisational culture in order to pursue effective improvement of healthcare performance. However, the precise nature of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted has been called into question. Objectives To determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. To examine the effectiveness of these strategies according to different patterns of organisational culture. Search methods We searched the following electronic databases for primary studies: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. Selection criteria We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies, controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series analyses (ITS) meeting the quality criteria used by the Cochrane Effective Practice and Organisation of Care Group (EPOC). Studies should be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. Data collection and analysis At least two review authors independently applied the criteria for inclusion and exclusion criteria to scan titles and abstracts and then to screen the full reports of selected citations. At each stage results were compared and discrepancies solved through discussion. Main results The search strategy yielded 4239 records. After the full text assessment, no studies met the quality criteria used by the EPOC Group and evaluated the effectiveness of strategies to change organisational culture to improve healthcare performance. Authors’ conclusions It is not possible to draw any conclusions about the effectiveness of strategies to change organisational culture because we found no studies that fulfilled the methodological criteria for this review. Research efforts should focus on strengthening the evidence about the effectiveness of methods to change organisational culture to improve health care performance. PMID:21249706

Predictors of Nurses’ Intention and Behavior in Using Health Literacy Strategies in Patient Education Based on the Theory of Planned Behavior

PubMed Central

Sharifirad, Gholamreza; Mostafavi, Firoozeh; Reisi, Mahnouush; Mahaki, Behzad; Javadzade, Homamodin; Heydarabadi, Akbar Babaei; Esfahani, Mahmoud Nasr

2015-01-01

Background: Health literacy is one of the most important priorities for improving health care quality through enhancing patient-provider communication. Implementing health literacy strategies enable nurses to provide information and instructions for patients in a manner that is more commensurate and understandable. The purpose of this study was to investigate the factors affecting nurses’ intention to implement health literacy strategies in patient education based on theory of planned behavior. Methods: A cross-sectional study was done on 148 nurse practitioners of AL-Zahra educational hospital in Isfahan, Iran, using a descriptive-analytic method. Data collected via a standardized questionnaire based on theory of planned behavior constructed and analyzed by SPSS v.17 using ANOVA, Independent T-test, Pearson correlation and linear regression. Results: There was statistically significant correlation between using health literacy strategies and marriage status, attending in retraining courses, employment type, job history, and job status. Perceived behavioral control was the most powerful predictor of intention (β=0.417) and use health literacy strategies in patient education and behavior of nurses (β=0.33). Conclusion: According to the findings of this study, perceived behavioral control is a powerful determinant of nurses’ intention and behavior of using health literacy strategies in patient education. Hence we recommend nurse educators to pay special attention to the constructs of this theory mainly perceived behavioral control in retrain courses about patient education and health literacy strategies. PMID:25945078

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

PubMed

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

2011-01-01

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

MALDI-TOF MS for quality control of high protein content sport supplements.

PubMed

De Ceglie, Cristina; Calvano, Cosima D; Zambonin, Carlo G

2015-06-01

High protein content sport nutritional supplements are found as powder products containing, as ingredients, amino acids and proteins with important nutritional values as milk, soy and egg proteins. An EU Food Supplements Directive (2002) requires that supplements should be safe, both in dosages and in purity. It is important, then, to develop rapid and sensitive methods to be employed for the quality control of these substances. In this work, we apply, for the first time, matrix-assisted laser desorption ionization-mass spectrometry as a fast, reproducible and sensitive method for the quality control of sport nutritional supplements based on proteins. To this aim, several commercial egg- and/or milk-based powder products have been processed by in gel or in solution digestion and analyzed in comparison to pure standard products. This strategy allowed to assess the reliability of the indications on proteins (as caseins, whey proteins and ovalbumin) declared in the label of several sport nutritional supplements. Copyright © 2014 Elsevier Ltd. All rights reserved.

Controllable Growth of Monolayer MoS2 and MoSe2 Crystals Using Three-temperature-zone Furnace

NASA Astrophysics Data System (ADS)

Zheng, Binjie; Chen, Yuanfu

2017-12-01

Monolayer molybdenum disulfide (MoS2) and molybdenum diselenide (MoSe2) have attracted a great attention for their exceptional electronic and optoelectronic properties among the two dimensional family. However, controllable synthesis of monolayer crystals with high quality needs to be improved urgently. Here we demonstrate a chemical vapor deposition (CVD) growth of monolayer MoS2 and MoSe2 crystals using three-temperature-zone furnace. Systematical study of the effects of growth pressure, temperature and time on the thickness, morphology and grain size of crystals shows the good controllability. The photoluminescence (PL) characterizations indicate that the as-grown monolayer MoS2 and MoSe2 crystals possess excellent optical qualities with very small full-width-half-maximum (FWHM) of 96 me V and 57 me V, respectively. It is comparable to that of exfoliated monolayers and reveals their high crystal quality. It is promising that our strategy should be applicable for the growth of other transition metal dichalcogenides (TMDs) monolayer crystals.

Implementing international osteoarthritis treatment guidelines in primary health care: study protocol for the SAMBA stepped wedge cluster randomized controlled trial.

PubMed

Østerås, Nina; van Bodegom-Vos, Leti; Dziedzic, Krysia; Moseng, Tuva; Aas, Eline; Andreassen, Øyvor; Mdala, Ibrahim; Natvig, Bård; Røtterud, Jan Harald; Schjervheim, Unni-Berit; Vlieland, Thea Vliet; Hagen, Kåre Birger

2015-12-02

Previous research indicates that people with osteoarthritis (OA) are not receiving the recommended and optimal treatment. Based on international treatment recommendations for hip and knee OA and previous research, the SAMBA model for integrated OA care in Norwegian primary health care has been developed. The model includes physiotherapist (PT) led patient OA education sessions and an exercise programme lasting 8-12 weeks. This study aims to assess the effectiveness, feasibility, and costs of a tailored strategy to implement the SAMBA model. A cluster randomized controlled trial with stepped wedge design including an effect, process, and cost evaluation will be conducted in six municipalities (clusters) in Norway. The municipalities will be randomized for time of crossover from current usual care to the implementation of the SAMBA model by a tailored strategy. The tailored strategy includes interactive workshops for general practitioners (GPs) and PTs in primary care covering the SAMBA model for integrated OA care, educational material, educational outreach visits, feedback, and reminder material. Outcomes will be measured at the patient, GP, and PT levels using self-report, semi-structured interviews, and register based data. The primary outcome measure is patient-reported quality of care (OsteoArthritis Quality Indicator questionnaire) at 6-month follow-up. Secondary outcomes include referrals to PT, imaging, and referrals to the orthopaedic surgeon as well as participants' treatment satisfaction, symptoms, physical activity level, body weight, and self-reported and measured lower limb function. The actual exposure to the tailor made implementation strategy and user experiences will be measured in a process evaluation. In the economic evaluation, the difference in costs of usual OA care and the SAMBA model for integrated OA care will be compared with the difference in health outcomes and reported by the incremental cost-effectiveness ratio (ICER). The results from the present study will add to the current knowledge on tailored strategies, which aims to improve the uptake of evidence-based OA care recommendations and improve the quality of OA care in primary health care. The new knowledge can be used in national and international initiatives designed to improve the quality of OA care. ClinicalTrials.gov NCT02333656.

114.1 What is New in the Treatment of Schizophrenia?

PubMed Central

Correll, Christoph

2017-01-01

Abstract Background: Despite psychopharmacological advances, the evidence-based pharmacologic treatment of schizophrenia is still restricted to antidopaminergic compounds that predominantly address positive symptoms and agitation as well as aggression. Rational augmentation strategies to enhance effects in treatment resistant cases and to address relevant negative and cognitive symptoms are needed. Methods: Systematic review and critical appraisal of (1) meta-analytic evidence of augmentation and combination treatments, as well as (2) agents that are in phase III development for different domains on schizophrenia. Results: Out of 3397 publications, 29 meta-analyses testing 42 combination strategies in 381 individual trials and 19 833 participants were included. For total symptom reduction, 32 strategies augmenting any antipsychotic and 5 strategies augmenting clozapine were examined. Fourteen combination treatments outperformed control (SMD/Hedges’ g= −1.27 to −0.23). No combination strategies with clozapine outperformed control. Methodological quality of the meta-analyses was generally high (mean score = 9.4/11). However, content quality of the meta-analyzed studies was low (mean score = 2.8/8). Poorer content quality was significantly related to higher effect sizes in total psychopathology. We also identified 253 recent phase III clinical trials in schizophrenia that included 16 investigational compounds. Encenicline and valbenazine are first-in-class candidates for treatment of cognitive deficits and tardive dyskinesia, respectively, but recent encenicline data were negative. Eleven add-on compounds were previously approved for other therapeutic indications; they are for the most part being studied at academic medical centers and smaller pharmaceutical companies for new therapeutic targets (negative symptoms and cognitive deficits) or for specific populations with comorbidities and adverse effects (e.g., tardive dyskinesia and weight gain/obesity). Details of these agents will be discussed. Conclusion: Several augmentation and combination treatments have been studies, but despite selected agents being recommended in meta-analyses, no high-quality evidence exists for effective agents. Furthermore, although a number of different agents with dopaminergic and extradopaminergic mechanisms are in later stage development, some showing promising earlier results, none of the agents that do not modulate dopaminergic transmission have yet accumulated sufficient evidence to be recommendable for clinical use. An exception are agents that are being developed for the improvement of tardive dyskinesia.

Quality improvement, implementation, and dissemination strategies to improve mental health care for children and adolescents: a systematic review.

PubMed

Forman-Hoffman, Valerie L; Middleton, Jennifer Cook; McKeeman, Joni L; Stambaugh, Leyla F; Christian, Robert B; Gaynes, Bradley N; Kane, Heather Lynne; Kahwati, Leila C; Lohr, Kathleen N; Viswanathan, Meera

2017-07-24

Some outcomes for children with mental health problems remain suboptimal because of poor access to care and the failure of systems and providers to adopt established quality improvement strategies and interventions with proven effectiveness. This review had three goals: (1) assess the effectiveness of quality improvement, implementation, and dissemination strategies intended to improve the mental health care of children and adolescents; (2) examine harms associated with these strategies; and (3) determine whether effectiveness or harms differ for subgroups based on system, organizational, practitioner, or patient characteristics. Sources included MEDLINE®, the Cochrane Library, PsycINFO, and CINAHL, from database inception through February 17, 2017. Additional sources included gray literature, additional studies from reference lists, and technical experts. Two reviewers selected relevant randomized controlled trials (RCTs) and observational studies, extracted data, and assessed risk of bias. Dual analysis, synthesis, and grading of the strength of evidence for each outcome followed for studies meeting inclusion criteria. We also used qualitative comparative analysis to examine relationships between combinations of strategy components and improvements in outcomes. We identified 18 strategies described in 19 studies. Eleven strategies significantly improved at least one measure of intermediate outcomes, final health outcomes, or resource use. Moderate strength of evidence (from one RCT) supported using provider financial incentives such as pay for performance to improve the competence with which practitioners can implement evidence-based practices (EBPs). We found inconsistent evidence involving strategies with educational meetings, materials, and outreach; programs appeared to be successful in combination with reminders or providing practitioners with newly collected clinical information. We also found low strength of evidence for no benefit for initiatives that included only educational materials or meetings (or both), or only educational materials and outreach components. Evidence was insufficient to draw conclusions on harms and moderators of interventions. Several strategies can improve both intermediate and final health outcomes and resource use. This complex and heterogeneous body of evidence does not permit us to have a high degree of confidence about the efficacy of any one strategy because we generally found only a single study testing each strategy. PROSPERO, CRD42015024759 .

Purchaser strategies to influence quality of care: from rhetoric to global applications.

PubMed

McNamara, P

2006-06-01

The potential of purchasers to influence the quality and safety of care has captured the attention of health sector leaders worldwide. Quality based purchasing explicitly seeks to hold providers accountable for the quality and safety of care. Three strategies are available to purchasers: (1) selective contracting based on quality; (2) payment differentials based on quality; and (3) sponsorship of comparative provider report cards. Examples are given to illustrate each of the three strategies. Governments, employers, social insurance funds, community based insurance organizations, health plans, donors, and other buyers of health services are encouraged to explore and debate these purchaser strategies within the context of an overarching national or local quality framework. Public and private funders of operations research are encouraged to support and disseminate evaluations of purchaser efforts to improve quality. This paper is designed to highlight and frame purchasers' strategies explicitly crafted to enhance the quality and safety of care. The ultimate aim is to encourage thoughtful discussion about whether or not one or more purchaser strategy might support a particular country's goals to improve care. Experiences from both developed and developing countries are included to facilitate the exchange of ideas and provide the broadest of perspectives.

A nutrition strategy to reduce the burden of diet related disease: access to dietician services must complement population health approaches.

PubMed

Segal, Leonie; Opie, Rachelle S

2015-01-01

Poor diet quality is implicated in almost every disease and health issue. And yet, in most advanced market economies diet quality is poor, with a minority meeting guidelines for healthy eating. Poor diet is thus responsible for substantial disease burden. Societies have at their disposal a range of strategies to influence diet behaviors. These can be classified into: (i) population level socio-educational approaches to enhance diet knowledge; (ii) pricing incentives (subsidies on healthy foods, punitive taxes on unhealthy foods); (iii) regulations to modify the food environment, and (iv) the provision of clinical dietetic services. There is little evidence that societies are active in implementing the available strategies. Advertising of "junk foods" is largely unchecked, contrasting with strict controls on advertising tobacco products, which also attract punitive taxes. Access to dieticians is restricted in most countries, even in the context of universal health care. In Australia in 2011 there were just 2,969 practicing dieticians/nutritionists or 1.3 clinicians per 10,000 persons, compared with 5.8 physiotherapists per 10,000 persons, 14.8 general practitioners (family physicians) per 10,000 persons or 75 nurses per 10,000 persons. It is time to implement comprehensive national nutrition strategies capable of effecting change. Such strategies need to be multi-component, incorporating both public health approaches and expanded publicly funded dietetic services. Access to individualized dietetic services is needed by those at risk, or with current chronic conditions, given the complexity of the diet message, the need for professional support for behavior change and to reflect individual circumstances. The adoption of a comprehensive nutrition strategy offers the promise of substantial improvement in diet quality, better health and wellbeing and lower health care costs.

Caught in the Web: A Review of Web-Based Suicide Prevention

PubMed Central

Lai, Mee Huong; Maniam, Thambu; Ravindran, Arun V

2014-01-01

Background Suicide is a serious and increasing problem worldwide. The emergence of the digital world has had a tremendous impact on people’s lives, both negative and positive, including an impact on suicidal behaviors. Objective Our aim was to perform a review of the published literature on Web-based suicide prevention strategies, focusing on their efficacy, benefits, and challenges. Methods The EBSCOhost (Medline, PsycINFO, CINAHL), OvidSP, the Cochrane Library, and ScienceDirect databases were searched for literature regarding Web-based suicide prevention strategies from 1997 to 2013 according to the modified PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The selected articles were subjected to quality rating and data extraction. Results Good quality literature was surprisingly sparse, with only 15 fulfilling criteria for inclusion in the review, and most were rated as being medium to low quality. Internet-based cognitive behavior therapy (iCBT) reduced suicidal ideation in the general population in two randomized controlled trial (effect sizes, d=0.04-0.45) and in a clinical audit of depressed primary care patients. Descriptive studies reported improved accessibility and reduced barriers to treatment with Internet among students. Besides automated iCBT, preventive strategies were mainly interactive (email communication, online individual or supervised group support) or information-based (website postings). The benefits and potential challenges of accessibility, anonymity, and text-based communication as key components for Web-based suicide prevention strategies were emphasized. Conclusions There is preliminary evidence that suggests the probable benefit of Web-based strategies in suicide prevention. Future larger systematic research is needed to confirm the effectiveness and risk benefit ratio of such strategies. PMID:24472876

Cost-effectiveness of FENO-based and web-based monitoring in paediatric asthma management: a randomised controlled trial.

PubMed

Beerthuizen, Thijs; Voorend-van Bergen, Sandra; van den Hout, Wilbert B; Vaessen-Verberne, Anja A; Brackel, Hein J; Landstra, Anneke M; van den Berg, Norbert J; de Jongste, Johan C; Merkus, Peter J; Pijnenburg, Mariëlle W; Sont, Jacob K

2016-07-01

In children with asthma, web-based monitoring and inflammation-driven therapy may lead to improved asthma control and reduction in medications. However, the cost-effectiveness of these monitoring strategies is yet unknown. We assessed the cost-effectiveness of web-based monthly monitoring and of 4-monthly monitoring of FENO as compared with standard care. An economic evaluation was performed alongside a randomised controlled multicentre trial with a 1-year follow-up. Two hundred and seventy-two children with asthma, aged 4-18 years, were randomised to one of three strategies. In standard care, treatment was adapted according to Asthma Control Test (ACT) at 4-monthly visits, in the web-based strategy also according to web-ACT at 1 month intervals, and in the FENO-based strategy according to ACT and FENO at 4-monthly visits. Outcome measures were patient utilities, healthcare costs, societal costs and incremental cost per quality-adjusted life year (QALY) gained. No statistically significant differences were found in QALYs and costs between the three strategies. The web-based strategy had 77% chance of being most cost-effective from a healthcare perspective at a willingness to pay a generally accepted €40 000/QALY. The FENO-based strategy had 83% chance of being most cost-effective at €40 000/QALY from a societal perspective. Economically, web-based monitoring was preferred from a healthcare perspective, while the FENO-based strategy was preferred from a societal perspective, although in QALYs and costs no statistically significant changes were found as compared with standard care. As clinical outcomes also favoured the web-based and FENO-based strategies, these strategies may be useful additions to standard care. Netherlands Trial Register (NTR1995). 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/

Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach.

PubMed

Ralph, Anna P; Fittock, Marea; Schultz, Rosalie; Thompson, Dale; Dowden, Michelle; Clemens, Tom; Parnaby, Matthew G; Clark, Michele; McDonald, Malcolm I; Edwards, Keith N; Carapetis, Jonathan R; Bailie, Ross S

2013-12-18

Rheumatic heart disease (RHD) remains a major health concern for Aboriginal Australians. A key component of RHD control is prevention of recurrent acute rheumatic fever (ARF) using long-term secondary prophylaxis with intramuscular benzathine penicillin (BPG). This is the most important and cost-effective step in RHD control. However, there are significant challenges to effective implementation of secondary prophylaxis programs. This project aimed to increase understanding and improve quality of RHD care through development and implementation of a continuous quality improvement (CQI) strategy. We used a CQI strategy to promote implementation of national best-practice ARF/RHD management guidelines at primary health care level in Indigenous communities of the Northern Territory (NT), Australia, 2008-2010. Participatory action research methods were employed to identify system barriers to delivery of high quality care. This entailed facilitated discussion with primary care staff aided by a system assessment tool (SAT). Participants were encouraged to develop and implement strategies to overcome identified barriers, including better record-keeping, triage systems and strategies for patient follow-up. To assess performance, clinical records were audited at baseline, then annually for two years. Key performance indicators included proportion of people receiving adequate secondary prophylaxis (≥80% of scheduled 4-weekly penicillin injections) and quality of documentation. Six health centres participated, servicing approximately 154 people with ARF/RHD. Improvements occurred in indicators of service delivery including proportion of people receiving ≥40% of their scheduled BPG (increasing from 81/116 [70%] at baseline to 84/103 [82%] in year three, p = 0.04), proportion of people reviewed by a doctor within the past two years (112/154 [73%] and 134/156 [86%], p = 0.003), and proportion of people who received influenza vaccination (57/154 [37%] to 86/156 [55%], p = 0.001). However, the proportion receiving ≥80% of scheduled BPG did not change. Documentation in medical files improved: ARF episode documentation increased from 31/55 (56%) to 50/62 (81%) (p = 0.004), and RHD risk category documentation from 87/154 (56%) to 103/145 (76%) (p < 0.001). Large differences in performance were noted between health centres, reflected to some extent in SAT scores. A CQI process using a systems approach and participatory action research methodology can significantly improve delivery of ARF/RHD care.

Model of epidemic control based on quarantine and message delivery

NASA Astrophysics Data System (ADS)

Wang, Xingyuan; Zhao, Tianfang; Qin, Xiaomeng

2016-09-01

The model provides two novel strategies for the preventive control of epidemic diseases. One approach is related to the different isolating rates in latent period and invasion period. Experiments show that the increasing of isolating rates in invasion period, as long as over 0.5, contributes little to the preventing of epidemic; the improvement of isolation rate in latent period is key to control the disease spreading. Another is a specific mechanism of message delivering and forwarding. Information quality and information accumulating process are also considered there. Macroscopically, diseases are easy to control as long as the immune messages reach a certain quality. Individually, the accumulating messages bring people with certain immunity to the disease. Also, the model is performed on the classic complex networks like scale-free network and small-world network, and location-based social networks. Results show that the proposed measures demonstrate superior performance and significantly reduce the negative impact of epidemic disease.

A Systematic Review of the Effect of Cognitive Strategies on Strength Performance.

PubMed

Tod, David; Edwards, Christian; McGuigan, Mike; Lovell, Geoff

2015-11-01

Researchers have tested the beliefs of sportspeople and sports medicine specialists that cognitive strategies influence strength performance. Few investigators have synthesised the literature. The specific objectives were to review evidence regarding (a) the cognitive strategy-strength performance relationship; (b) participant skill level as a moderator; and (c) cognitive, motivational, biomechanical/physiological, and emotional mediators. Studies were sourced via electronic databases, reference lists of retrieved articles, and manual searches of relevant journals. Studies had to be randomised or counterbalanced experiments with a control group or condition, repeated measures, and a quality control score above 0.5 (out of 1). Cognitive strategies included goal setting, imagery, self-talk, preparatory arousal, and free choice. Dependent variables included maximal strength, local muscular endurance, or muscular power. Globally, cognitive strategies were reliability associated with increased strength performance (results ranged from 61 to 65 %). Results were mixed when examining the effects of specific strategies on particular dependent variables, although no intervention had an overall negative influence. Indeterminate relationships emerged regarding hypothesised mediators (except cognitive variables) and participant skill level as a moderator. Although cognitive strategies influence strength performance, there are knowledge gaps regarding specific types of strength, especially muscular power. Cognitive variables, such as concentration, show promise as possible mediators.

Mitigation of nonpoint source pollution in rural areas: From control to synergies of multi ecosystem services.

PubMed

Wu, Yonghong; Liu, Junzhuo; Shen, Renfang; Fu, Bojie

2017-12-31

Nonpoint source (NPS) pollution produced by human activities in rural areas has induced excessive nutrient input into surface waters and the decline of water quality. The essence of NPS pollution is the transport of nutrients between soil and water. Traditional NPS pollution control strategies, however, are mainly based on the solid and liquid phases, with little focus on the bio-phase between water and soil. The pollutants produced from NPS can be regarded as a resource if recycled or reused in an appropriate way in the agricultural ecosystem. This mini review proposes novel strategies for NPS pollution control based on three phases (liquid, solid and bio-phase) and highlights the regulating services of an agricultural ecosystem by optimizing land use/cover types. Copyright © 2017 Elsevier B.V. All rights reserved.

Application of NIR hyperspectral imaging for post-consumer polyolefins recycling

NASA Astrophysics Data System (ADS)

Serranti, Silvia; Gargiulo, Aldo; Bonifazi, Giuseppe

2012-06-01

An efficient large-scale recycling approach of particulate solid wastes is always accomplished according to the quality of the materials fed to the recycling plant and/or to any possible continuous and reliable control of the different streams inside the processing plants. Processing technologies addressed to recover plastics need to be extremely powerful, since they must be relatively simple to be cost-effective, but also accurate enough to create high-purity products and able to valorize a substantial fraction of the plastic waste materials into useful products of consistent quality in order to be economical. On the other hand, the potential market for such technologies is large and the boost of environmental regulations, and the oil price increase, has made many industries interested both in "general purpose" waste sorting technologies, as well as in developing more specialized sensing devices and/or inspection logics for a better quality assessment of plastic products. In this perspective recycling strategies have to be developed taking into account some specific aspects as i) mixtures complexity: the valuable material has to be extracted from the residue, ii) overall production: the profitability of plastic can be achieved only with mass production and iii) costs: low-cost sorting processes are required. In this paper new analytical strategies, based on hyperspectral imaging in the near infrared field (1000-1700 nm), have been investigated and set up in order to define sorting and/or quality control logics that could be profitably applied, at industrial plant level, for polyolefins recycling.

Learning from death: a hospital mortality reduction programme.

PubMed

Wright, John; Dugdale, Bob; Hammond, Ian; Jarman, Brian; Neary, Maria; Newton, Duncan; Patterson, Chris; Russon, Lynne; Stanley, Philip; Stephens, Rose; Warren, Erica

2006-06-01

There are wide variations in hospital mortality. Much of this variation remains unexplained and may reflect quality of care. A large acute hospital in an urban district in the North of England. Before and after evaluation of a hospital mortality reduction programme. Audit of hospital deaths to inform an evidence-based approach to identify processes of care to target for the hospital strategy. Establishment of a hospital mortality reduction group with senior leadership and support to ensure the alignment of the hospital departments to achieve a common goal. Robust measurement and regular feedback of hospital deaths using statistical process control charts and summaries of death certificates and routine hospital data. Whole system working across a health community to provide appropriate end of life care. Training and awareness in processes of high quality care such as clinical observation, medication safety and infection control. Hospital standardized mortality ratios fell significantly in the 3 years following the start of the programme from 94.6 (95% confidence interval 89.4, 99.9) in 2001 to 77.5 (95% CI 73.1, 82.1) in 2005. This translates as 905 fewer hospital deaths than expected during the period 2002-2005. Improving the safety of hospital care and reducing hospital deaths provides a clear and well supported goal from clinicians, managers and patients. Good leadership, good information, a quality improvement strategy based on good local evidence and a community-wide approach may be effective in improving the quality of processes of care sufficiently to reduce hospital mortality.

Development of a practical approach to expert elicitation for randomised controlled trials with missing health outcomes: Application to the IMPROVE trial.

PubMed

Mason, Alexina J; Gomes, Manuel; Grieve, Richard; Ulug, Pinar; Powell, Janet T; Carpenter, James

2017-08-01

The analyses of randomised controlled trials with missing data typically assume that, after conditioning on the observed data, the probability of missing data does not depend on the patient's outcome, and so the data are 'missing at random' . This assumption is usually implausible, for example, because patients in relatively poor health may be more likely to drop out. Methodological guidelines recommend that trials require sensitivity analysis, which is best informed by elicited expert opinion, to assess whether conclusions are robust to alternative assumptions about the missing data. A major barrier to implementing these methods in practice is the lack of relevant practical tools for eliciting expert opinion. We develop a new practical tool for eliciting expert opinion and demonstrate its use for randomised controlled trials with missing data. We develop and illustrate our approach for eliciting expert opinion with the IMPROVE trial (ISRCTN 48334791), an ongoing multi-centre randomised controlled trial which compares an emergency endovascular strategy versus open repair for patients with ruptured abdominal aortic aneurysm. In the IMPROVE trial at 3 months post-randomisation, 21% of surviving patients did not complete health-related quality of life questionnaires (assessed by EQ-5D-3L). We address this problem by developing a web-based tool that provides a practical approach for eliciting expert opinion about quality of life differences between patients with missing versus complete data. We show how this expert opinion can define informative priors within a fully Bayesian framework to perform sensitivity analyses that allow the missing data to depend upon unobserved patient characteristics. A total of 26 experts, of 46 asked to participate, completed the elicitation exercise. The elicited quality of life scores were lower on average for the patients with missing versus complete data, but there was considerable uncertainty in these elicited values. The missing at random analysis found that patients randomised to the emergency endovascular strategy versus open repair had higher average (95% credible interval) quality of life scores of 0.062 (-0.005 to 0.130). Our sensitivity analysis that used the elicited expert information as pooled priors found that the gain in average quality of life for the emergency endovascular strategy versus open repair was 0.076 (-0.054 to 0.198). We provide and exemplify a practical tool for eliciting the expert opinion required by recommended approaches to the sensitivity analyses of randomised controlled trials. We show how this approach allows the trial analysis to fully recognise the uncertainty that arises from making alternative, plausible assumptions about the reasons for missing data. This tool can be widely used in the design, analysis and interpretation of future trials, and to facilitate this, materials are available for download.

Use of Six Sigma strategies to pull the line on central line-associated bloodstream infections in a neurotrauma intensive care unit.

PubMed

Loftus, Kelli; Tilley, Terry; Hoffman, Jason; Bradburn, Eric; Harvey, Ellen

2015-01-01

The creation of a consistent culture of safety and quality in an intensive care unit is challenging. We applied the Six Sigma Define-Measure-Analyze-Improve-Control (DMAIC) model for quality improvement (QI) to develop a long-term solution to improve outcomes in a high-risk neurotrauma intensive care unit. We sought to reduce central line utilization as a cornerstone in preventing central line-associated bloodstream infections (CLABSIs). This study describes the successful application of the DMAIC model in the creation and implementation of evidence-based quality improvement designed to reduce CLABSIs to below national benchmarks.

[Air quality control systems: heating, ventilating, and air conditioning (HVAC)].

PubMed

Bellucci Sessa, R; Riccio, G

2004-01-01

After a brief illustration of the principal layout schemes of Heating, Ventilating, and Air Conditioning (HVAC), the first part of this paper summarizes the standards, both voluntary and compulsory, regulating HVAC facilities design and installation with regard to the question of Indoor Air Quality (IAQ). The paper then examines the problem of ventilation systems maintenance and the essential hygienistic requirements in whose absence HVAC facilities may become a risk factor for people working or living in the building. Lastly, the paper deals with HVAC design strategies and methods, which aim not only to satisfy comfort and air quality requirements, but also to ensure easy and effective maintenance procedures.

Home- or community-based programmes for treating malaria.

PubMed

Okwundu, Charles I; Nagpal, Sukrti; Musekiwa, Alfred; Sinclair, David

2013-05-31

Malaria is an important cause of morbidity and mortality, in particular among children and pregnant women in sub-Saharan Africa. Prompt access to diagnosis and treatment with effective antimalarial drugs is a central component of the World Health Organization's (WHO) strategy for malaria control. Home- or community-based programmes for managing malaria are one strategy that has been proposed to overcome the geographical barrier to malaria treatment.  To evaluate home- and community-based management strategies for treating malaria. We searched the Cochrane Central Register of Controlled Trials published in The Cochrane Library; MEDLINE; EMBASE; Science Citation Index; PsycINFO/LIT; CINAHL; WHO clinical trial registry platform; and the metaRegister of Controlled Trials up to September 2012. Randomized controlled trials (RCTs) and non-RCTs that evaluated the effects of a home- or community-based programme for treating malaria in a malaria endemic setting. Two authors independently screened and selected studies, extracted data, and assessed the risk of bias. Where possible the effects of interventions are compared using risk ratios (RR), and presented with 95% confidence intervals (CI). The quality of the evidence was assessed using the GRADE approach. We identified 10 trials that met the inclusion criteria. The interventions involved brief training of basic-level health workers or mothers, and most provided the antimalarial for free or at a highly subsidized cost. In eight of the studies, fevers were treated presumptively without parasitological confirmation with microscopy or a rapid diagnostic test (RDT). Two studies trained community health workers to use RDTs as a component of community management of fever.Home- or community-based strategies probably increase the number of people with fever who receive an appropriate antimalarial within 24 hours (RR 2.27, 95% CI 1.79 to 2.88 in one trial; RR 9.79, 95% CI 6.87 to 13.95 in a second trial; 3099 participants, moderate quality evidence). They may also reduce all-cause mortality, but to date this has only been demonstrated in rural Ethiopia (RR 0.58, 95% CI 0.44 to 0.77, one trial, 13,677 participants, moderate quality evidence).Hospital admissions in children were reported in one small trial from urban Uganda, with no effect detected (437 participants, very low quality evidence). No studies reported on severe malaria. For parasitaemia prevalence, the study from urban Uganda demonstrated a reduction in community parasite prevalence (RR 0.22, 95% CI 0.08 to 0.64, 365 participants), but a second study in rural Burkina Faso did not (1006 participants). Home- or community-based programmes may have little or no effect on the prevalence of anaemia (three trials, 3612 participants, low quality evidence). None of the included studies reported on adverse effects of using home- or community-based programmes for treating malaria.In two studies which trained community health workers to only prescribe antimalarials after a positive RDT, prescriptions of antimalarials were reduced compared to the control group where community health workers used clinical diagnosis (RR 0.39, 95% CI 0.18 to 0.84, two trials, 5944 participants, moderate quality evidence). In these two studies, mortality and hospitalizations remained very low in both groups despite the lower use of antimalarials (two trials, 5977 participants, low quality evidence). Home- or community-based interventions which provide antimalarial drugs free of charge probably improve prompt access to antimalarials, and there is moderate quality evidence from rural Ethiopia that they may impact on childhood mortality when implemented in appropriate settings.Programmes which treat all fevers presumptively with antimalarials lead to overuse antimalarials, and potentially undertreat other causes of fever such as pneumonia. Incorporating RDT diagnosis into home- or community-based programmes for malaria may help to reduce this overuse of antimalarials, and has been shown to be safe under trial conditions.

Is biochar-manure co-compost a better solution for soil health improvement and N2O emissions mitigation?

EPA Science Inventory

Land application of compost has been a promising remediation strategy for soil health and environmental quality, but substantial emissions of greenhouse gases, especially N2O, need to be controlled during making and using compost. Biochar as a bulking agent for composting has bee...

40 CFR Appendix W to Part 51 - Guideline on Air Quality Models

Code of Federal Regulations, 2011 CFR

2011-07-01

... sufficient spatial and temporal coverage are available. c. It would be advantageous to categorize the various... control strategies. These are referred to as refined models. c. The use of screening techniques followed... location of the source in question and its expected impacts. c. In all regulatory analyses, especially if...

75 FR 48860 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Revisions to Emissions...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

... matter, and carbon monoxide. The revisions add new definitions; modify existing definitions; and require..., particulate matter, and sulfur dioxide. The SIP is a set of air pollution regulations, control strategies... to submit an annual report of sulfur input in tons per year, and added emission tracking requirements...

EMISSION REDUCTIONS AIMED AT IMPROVING AIR QUALITY: UNINTENDED CLIMATIC CONSEQUENCES AND THE EFFECT OF CLIMATE CHANGE ON THEIR SUCCESS

EPA Science Inventory

This work will provide improved understanding of the role of climate change, both in the recent past and future, on the success of pollutant control strategies, allowing for better planning and accountability of emission reductions. This work will also provide a quantitative a...

Dredging Operations Technical Support Program. Management Strategy for Disposal of Dredged Material: Contaminant Testing and Controls.

DTIC Science & Technology

1985-08-01

laboratory test using a rainfall simulator has been developed ( Westerdahl and Skogerboe 1981) and is being used to predict surface runoff water quality...Marine Protection, Research, and Sanctuaries Act of 1972)," US Army Engineer Waterways Experiment Station, Vicksburg, Miss. Westerdahl , H. E., and

Evaluating soybean breeding lines developed from differenct sources of resistance to phomopsis seed decay

USDA-ARS?s Scientific Manuscript database

Phomopsis seed decay (PSD) causes poor soybean seed quality worldwide. The primary causal agent of PSD is Phomopsis longicolla (syn. Diaporthe longicolla). Breeding for PSD-resistance is the most effective long-term strategy to control this disease. To develop soybean lines with resistance to PSD, m...

40 CFR 52.2780 - Control strategy for sulfur oxides.

Code of Federal Regulations, 2010 CFR

2010-07-01

... maintenance of the national ambient air quality standards for sulfur oxides on the island of St. Croix. (b...) The entire regulation as it applies to the islands of St. Thomas and St. John. (2) The entire... island of St. Croix. (3) The entire regulation excluding subsection (a)(2) as it applies to the remaining...

Strategies for field use of baculoviruses

Treesearch

J.D. Podgwaite

1985-01-01

In recent years, there has been increased awareness in maintaining the quality of the environment. This has led to the development and use of microbial agents as alternatives to chemicals for controlling noxious insect populations. The insect pathogens in the family Baculoviridae, by virtue of their specificity, virulence, and safety for nontarget species, have become...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

34 CFR 611.24 - What additional selection criteria are used for a full application that proposes teacher...

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Appropriate academic and student support services; and (3) A comprehensive strategy for addressing shortages... high-quality teacher preparation and an effective support system during their first three years of teaching. (Approved by the Office of Management and Budget under control number 1840-0007) (Authority: 20 U...

The March to Accountable Care Organizations--How Will Rural Fare?

ERIC Educational Resources Information Center

MacKinney, A. Clinton; Mueller, Keith J.; McBride, Timothy D.

2011-01-01

Purpose: This article describes a strategy for rural providers, communities, and policy makers to support or establish accountable care organizations (ACOs). Methods: ACOs represent a new health care delivery and provider payment system designed to improve clinical quality and control costs. The Patient Protection and Affordable Care Act (ACA)…

MONITORING AND MODELING METHODS FOR DEVELOPING AIR POLLUTION CONTROL STRATEGIES: A CASE STUDY IN THE NORTHWEST CZECH REPUBLIC

EPA Science Inventory

Scientists from the United States and the Czech Republic recently completed a study to investigate the ambient air quality impact of industrial and motor vehicle sources in Teplice. ir pollution measurements made from 1992 through 1993 provide data on ambient concentrations of su...

Comparison of phenotyping methods for resistance to stem rot and aggregated sheath spot in rice

USDA-ARS?s Scientific Manuscript database

Stem and sheath diseases caused by Sclerotium oryzae Cattaneo (SCL) and Rhizoctonia oryzae-sativae Sawada Mordue (ROS) can severely reduce rice (Oryza sativa L.) yield and grain quality. Genetic resistance is the best strategy to control them. Phenotypic selection for resistance is hampered due to a...

Triage of oxidation-prone proteins by Sqstm1/p62 within the mitochondria

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

Lee, Minjung; Shin, Jaekyoon, E-mail: jkshin@med.skku.ac.kr

2011-09-16

Highlights: {yields} The mitochondrion contains its own protein quality control system. {yields} p62 localizes within the mitochondria and forms mega-dalton sized complexes. {yields} p62 interacts with oxidation-prone proteins and the proteins of quality control. {yields} In vitro delivery of p62 improves mitochondrial functions. {yields} p62 is implicated as a participant in mitochondrial protein quality control. -- Abstract: As the mitochondrion is vulnerable to oxidative stress, cells have evolved several strategies to maintain mitochondrial integrity, including mitochondrial protein quality control mechanisms and autophagic removal of damaged mitochondria. Involvement of an autophagy adaptor, Sqstm1/p62, in the latter process has been recently described.more » In the present study, we provide evidence that a portion of p62 directly localizes within the mitochondria and supports stable electron transport by forming heterogeneous protein complexes. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF) of mitochondrial proteins co-purified with p62 revealed that p62 interacts with several oxidation-prone proteins, including a few components of the electron transport chain complexes, as well as multiple chaperone molecules and redox regulatory enzymes. Accordingly, p62-deficient mitochondria exhibited compromised electron transport, and the compromised function was partially restored by in vitro delivery of p62. These results suggest that p62 plays an additional role in maintaining mitochondrial integrity at the vicinity of target machineries through its function in relation to protein quality control.« less

Coping and social problem solving correlates of asthma control and quality of life.

PubMed

McCormick, Sean P; Nezu, Christine M; Nezu, Arthur M; Sherman, Michael; Davey, Adam; Collins, Bradley N

2014-02-01

In a sample of adults with asthma receiving care and medication in an outpatient pulmonary clinic, this study tested for statistical associations between social problem-solving styles, asthma control, and asthma-related quality of life. These variables were measured cross sectionally as a first step toward more systematic application of social problem-solving frameworks in asthma self-management training. Recruitment occurred during pulmonology clinic service hours. Forty-four adults with physician-confirmed diagnosis of asthma provided data including age, gender, height, weight, race, income, and comorbid conditions. The Asthma Control Questionnaire, the Mini Asthma Quality of Life Questionnaire (Short Form), and peak expiratory force measures offered multiple views of asthma health at the time of the study. Maladaptive coping (impulsive and careless problem-solving styles) based on transactional stress models of health were assessed with the Social Problem-Solving Inventory-Revised: Short Form. Controlling for variance associated with gender, age, and income, individuals reporting higher impulsive-careless scores exhibited significantly lower scores on asthma control (β = 0.70, p = 0.001, confidence interval (CI) [0.37-1.04]) and lower asthma-related quality of life (β = 0.79, p = 0.017, CI [0.15-1.42]). These findings suggest that specific maladaptive problem-solving styles may uniquely contribute to asthma health burdens. Because problem-solving coping strategies are both measureable and teachable, behavioral interventions aimed at facilitating adaptive coping and problem solving could positively affect patient's asthma management and quality of life.

Sample size determination for bibliographic retrieval studies

PubMed Central

Yao, Xiaomei; Wilczynski, Nancy L; Walter, Stephen D; Haynes, R Brian

2008-01-01

Background Research for developing search strategies to retrieve high-quality clinical journal articles from MEDLINE is expensive and time-consuming. The objective of this study was to determine the minimal number of high-quality articles in a journal subset that would need to be hand-searched to update or create new MEDLINE search strategies for treatment, diagnosis, and prognosis studies. Methods The desired width of the 95% confidence intervals (W) for the lowest sensitivity among existing search strategies was used to calculate the number of high-quality articles needed to reliably update search strategies. New search strategies were derived in journal subsets formed by 2 approaches: random sampling of journals and top journals (having the most high-quality articles). The new strategies were tested in both the original large journal database and in a low-yielding journal (having few high-quality articles) subset. Results For treatment studies, if W was 10% or less for the lowest sensitivity among our existing search strategies, a subset of 15 randomly selected journals or 2 top journals were adequate for updating search strategies, based on each approach having at least 99 high-quality articles. The new strategies derived in 15 randomly selected journals or 2 top journals performed well in the original large journal database. Nevertheless, the new search strategies developed using the random sampling approach performed better than those developed using the top journal approach in a low-yielding journal subset. For studies of diagnosis and prognosis, no journal subset had enough high-quality articles to achieve the expected W (10%). Conclusion The approach of randomly sampling a small subset of journals that includes sufficient high-quality articles is an efficient way to update or create search strategies for high-quality articles on therapy in MEDLINE. The concentrations of diagnosis and prognosis articles are too low for this approach. PMID:18823538