40 CFR 131.38 - Establishment of numeric criteria for priority toxic pollutants for the State of California.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Great Lakes Water Quality Initiative Criteria Documents for the Protection of Aquatic Life in Ambient... water quality criteria to protect against acute effects in aquatic life and is the highest instream... any aquatic life or human health use classifications in the Water Quality Control Plans for the...

[Formal quality assessment of informed consent documents in 9 hospitals].

PubMed

Calle-Urra, J E; Parra-Hidalgo, P; Saturno-Hernández, P J; Martínez-Martínez, M J; Navarro-Moya, F J

2013-01-01

Informed consent forms are very important in the process of medical information. The aim of this study is to design reliable formal quality criteria of these documents and their application in the evaluation of those used in the hospitals of a regional health service. Criteria have been designed from the analysis of existing regulations, previous studies and consultation with key experts. The interobserver concordance was assessed using the kappa index. Criteria evaluation was performed on 1425 documents of 9 hospitals. A total of 19 criteria used in the evaluation of the quality of informed consent forms have been obtained. Kappa values were higher than 0,60 in 17 of them and higher than 0,52 in the other 2. The average number of defects per document was 7.6, with a high-low ratio among hospitals of 1.84. More than 90% of the documents had defects in the information on consequences and contraindications, and in about 90% it did not mention the copy to the patient. More than 60% did not comply with stating the purpose of the procedure, a statement of having understood and clarified doubts, and the treatment options. A tool has been obtained to reliably assess the formal quality of the informed consent forms. The documents assessed have a wide margin for improvement related to giving a copy to the patient, and some aspects of the specific information that patients should receive. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

Air Quality Criteria for Ozone and Related Photochemical Oxidants (First External Review Draft)

EPA Science Inventory

This first external review draft of the Air Quality Criteria for Ozone and Related Photochemical Oxidants (Ozone Criteria Document) is being released in January 2005 for public comment and for review by EPA's Clean A...

Air Quality Criteria for Ozone and Related Photochemical Oxidants (Second External Review Draft)

EPA Science Inventory

This second external review draft of the Air Quality Criteria for Ozone and Related Photochemical Oxidants, Volumes I-III (Ozone Criteria Document) is being released for public comment and for review by EPA's Clean Air Scientific Advisory Committee (CASAC) r...

Air Quality Criteria for Particulate Matter (Final Report, 2004)

EPA Science Inventory

EPA has completed the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter (PM) as issued in 1996 (usually referred to as the Criteria Document). Sections 108 and 109 of the Clean Air Act require that EPA carry out a periodic revi...

Air Quality Criteria for Ozone and Related Photochemical Oxidants (Final Report, 2006)

EPA Science Inventory

In February 2006, EPA released the final document, Air Quality Criteria for Ozone and Other Photochemical Oxidants. Tropospheric or surface-level ozone (O3) is one of six major air pollutants regulated by National Ambient Air Quality Standards (NAAQS) under the U.S...

Development of an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes: the Q-DIO.

PubMed

Müller-Staub, Maria; Lunney, Margaret; Odenbreit, Matthias; Needham, Ian; Lavin, Mary Ann; van Achterberg, Theo

2009-04-01

This paper aims to report the development stages of an audit instrument to assess standardised nursing language. Because research-based instruments were not available, the instrument Quality of documentation of nursing Diagnoses, Interventions and Outcomes (Q-DIO) was developed. Standardised nursing language such as nursing diagnoses, interventions and outcomes are being implemented worldwide and will be crucial for the electronic health record. The literature showed a lack of audit instruments to assess the quality of standardised nursing language in nursing documentation. A qualitative design was used for instrument development. Criteria were first derived from a theoretical framework and literature reviews. Second, the criteria were operationalized into items and eight experts assessed face and content validity of the Q-DIO. Criteria were developed and operationalized into 29 items. For each item, a three or five point scale was applied. The experts supported content validity and showed 88.25% agreement for the scores assigned to the 29 items of the Q-DIO. The Q-DIO provides a literature-based audit instrument for nursing documentation. The strength of Q-DIO is its ability to measure the quality of nursing diagnoses and related interventions and nursing-sensitive patient outcomes. Further testing of Q-DIO is recommended. Based on the results of this study, the Q-DIO provides an audit instrument to be used in clinical practice. Its criteria can set the stage for the electronic nursing documentation in electronic health records.

Photovoltaic system criteria documents. Volume 2: Quality assurance criteria for photovoltaic applications

NASA Technical Reports Server (NTRS)

Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

1979-01-01

Quality assurance criteria are described for manufacturers and installers of solar photovoltaic tests and applications. Quality oriented activities are outlined to be pursued by the contractor/subcontractor to assure the physical and operational quality of equipment produced is included. In the broad sense, guidelines are provided for establishing a QA organization if none exists. Mainly, criteria is provided to be considered in any PV quality assurance plan selected as appropriate by the responsible Field Center. A framework is established for a systematic approach to ensure that photovoltaic tests and applications are constructed in a timely and cost effective manner.

Air Quality Criteria for Lead (Final Report, 1986)

EPA Science Inventory

The Air Quality Criteria documents evaluate and assesse scientific information on the health and welfare effects associated with exposure to various concentrations of lead in ambient air. The literature through 1985 has been reviewed thoroughly for information relevant to air qua...

Air Quality Criteria for Particulate Matter (Fourth External Review Draft) [revised Chapter 9, August 2004

EPA Science Inventory

EPA is in the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter (PM) as issued in 1996 (usually referred to as the Criteria Document). Sections 108 and 109 of the Clean Air Act require that EPA carry out a periodic review and re...

AIR QUALITY CRITERIA FOR PARTICULATE MATTER (FOURTH EXTERNAL REVIEW DRAFT) [REVISED CHAPTERS 7, 8, AND 9, JUNE 2004

EPA Science Inventory

EPA is in the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter as issued in 1996 (usually referred to as the Criteria Document). Sections 108 and 109 of the Clean Air Act require that EPA carry out a periodic review and revisio...

The validation of AORN recommended practices in Finnish perioperative nursing documentation.

PubMed

Tiusanen, Teija Susanna; Junttila, Kristiina; Leinonen, Tuija; Salanterä, Sanna

2010-02-01

In Finland, there are no common guidelines or recommended practices for perioperative documentation. Thus, perioperative nursing documentation varies from one operating department to another. To create minimum criteria for nursing documentation in Finland, we conducted an investigation in a university hospital district in 2006. Purposive sampling was used to invite experts in perioperative nursing documentation (N = 42) to serve as a Delphi panel. The final criteria are 120 items, 71% of which are based on the AORN standards and recommended practices. These criteria may be used to educate students and new perioperative personnel and to enhance the quality of nursing practice. To ensure relevance and usability, the criteria should be tested in various perioperative settings with a variety of surgical patients. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Fact Sheet: Notice of Ambient Water Quality Criteria Document for Tributyltin (TBT) - Final

EPA Pesticide Factsheets

Information pertaining to 2004 Final Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Tributyltin (TBT) for freshwater and saltwater. This fact sheet includes the safe levels of TBT that should protect the majority of species.

Guidelines and standard procedures for studies of ground-water quality; selection and installation of wells, and supporting documentation

USGS Publications Warehouse

Lapham, W.W.; Wilde, F.D.; Koterba, M.T.

1997-01-01

This is the first of a two-part report to document guidelines and standard procedures of the U.S. Geological Survey for the acquisition of data in ground-water-quality studies. This report provides guidelines and procedures for the selection and installation of wells for water-quality studies/*, and the required or recommended supporting documentation of these activities. Topics include (1) documentation needed for well files, field folders, and electronic files; (2) criteria and information needed for the selection of water-supply and observation wells, including site inventory and data collection during field reconnaissance; and (3) criteria and preparation for installation of monitoring wells, including the effects of equipment and materials on the chemistry of ground-water samples, a summary of drilling and coring methods, and information concerning well completion, development, and disposition.

Aquatic Life Criterion - Selenium Documents

EPA Pesticide Factsheets

Documents pertaining to the 2016 Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Selenium (Freshwater). These documents include what the safe levels of Selenium are in water for the majority of species.

AIR QUALITY CRITERIA FOR LEAD, VOLUMES 1-4. (1983) FIRST EXTERNAL REVIEW DRAFT

EPA Science Inventory

The document evaluates and assesses scientific information on the health and welfare effects associated with exposure to various concentrations of lead in ambient air. The literature through 1983 has been reviewed thoroughly for information relevant to air quality criteria, altho...

AIR QUALITY CRITERIA FOR PARTICULATE MATTER, VOLUMES I-III

EPA Science Inventory

There is no abstract available for these documents. If further information is requested, please refer to the bibliographic citation and contact the Technical Information Staff at the number listed below.

• Air Quality Criteria for Particulate Matter, Volume I - EP...

• Air Quality Criteria for Particulate Matter (Fourth External Review Draft) [revised Drafts of Chapters 7 and 8, December 2003

  EPA Science Inventory

  EPA is in the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter as issued in 1996 (usually referred to as the Criteria Document). Sections 108 and 109 of the Clean Air Act require that EPA carry out a periodic review an...

• 76 FR 79176 - Notice of Availability of Draft Recreational Water Quality Criteria and Request for Scientific Views

  Federal Register 2010, 2011, 2012, 2013, 2014

  2011-12-21

  ... ENVIRONMENTAL PROTECTION AGENCY [EPA-OW-2011-0466; FRL-9609-3] Notice of Availability of Draft Recreational Water Quality Criteria and Request for Scientific Views AGENCY: Environmental Protection Agency... Environmental Protection Agency (EPA) is announcing the availability of the draft document Recreational Water...

• AIR QUALITY CRITERIA FOR PARTICULATE MATTER, VOLUMES I-III, (EXTERNAL REVIEW DRAFT, 1995)

  EPA Science Inventory

  There is no abstract available for these documents.
  
  If further information is requested, please refer to the bibliographic citation and contact the Technical Information Staff at the number listed above.

  • Air Quality Criteria for Particulate Matter, Volume I, Extern...

[Written information for patients: From papers to documents].

PubMed

Cortés-Criado, M C

2014-01-01

There is a high variability in the level of information intended for patients, with different content, format and presentation. To determine the perceived safety of the patients treated at the Country Hospital of Melilla (HCML) and to assess the quality of the documents using criteria adapted to the «International Patient Decision Aid Standards» (IPDAS). Descriptive study of the documents given to patients by the HCML. They included questionnaires on perceived safety, classification of the documents, and the level of adherence to the IPDAS criteria. The Information given to patients during their stay in the HCML, their participation in decision-making, and the information about medication, did not exceed the average on the acceptance scale. Only 40 documents were studied (of the 131 collected), on being published in-house, and were classified, following the definitions of the RAE, into instructions (20), recommendations (14) and guidelines (6). Of these, only the 27.5% showed hospital logo. In the content analysis according to the IPDAS criteria, there was an overall adherence rate of 24.1% in instructions, 24.8% in recommendations, and 61.5% in guidelines. The perception of patient safety expressed in the questionnaire, and its assessment according IPDAS criteria, shows there may be a significant improvement within the organization. Furthermore, the quality of patient documentation provided can help decision making. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

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

DTIC Science & Technology

2004-07-01

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

Aquatic Life Criterion - Selenium

EPA Pesticide Factsheets

Documents pertaining to the 2016 Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Selenium (Freshwater). These documents include what the safe levels of Selenium are in water for the majority of species.

Strategies for Meeting High Standards: Quality Management and the Baldrige Criteria in Education. Lessons from the States.

ERIC Educational Resources Information Center

Barth, John; Burk, Zona Sharp; Serfass, Richard; Harms, Barbara Ann; Houlihan, G. Thomas; Anderson, Gerald; Farley, Raymond P.; Rigsby, Ken; O'Rourke, John

This document, one of a series of reports, focuses on the adoption of principles of quality management, originally developed by W. Edwards Deming, and the Baldrige Criteria for use in education. These processes and tools for systemic organizational management, when comprehensively applied, produce performance excellence and continuous improvement.…

CORAL REEF BIOLOGICAL CRITERIA: USING THE CLEAN ...

EPA Pesticide Factsheets

Coral reefs are declining at unprecedented rates worldwide due to multiple interactive stressors including climate change and land-based sources of pollution. The Clean Water Act (CWA) can be a powerful legal instrument for protecting water resources, including the biological inhabitants of coral reefs. The objective of the CWA is to restore and maintain the chemical, physical and biological integrity of water resources. Coral reef protection and restoration under the Clean Water Act begins with water quality standards - provisions of state or Federal law that consist of a designated use(s) for the waters of the United States and water quality criteria sufficient to protect the uses. Aquatic life use is the designated use that is measured by biological criteria (biocriteria). Biocriteria are expectations set by a jurisdiction for the quality and quantity of living aquatic resources in a defined waterbody. Biocriteria are an important addition to existing management tools for coral reef ecosystems. The Technical Support Document “Coral Reef Biological Criteria: Using the Clean Water Act to Protect a National Treasure” will provide a framework to aid States and Territories in their development, adoption, and implementation of coral reef biocriteria in their respective water quality standards. The Technical Support Document “Coral Reef Biological Criteria: Using the Clean Water Act to Protect a National Treasure” will provide a framework for coral re

76 FR 67437 - Draft Aquatic Life Ambient Water Quality Criteria for Carbaryl-2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OW-2011-0787; FRL-9483-8] Draft Aquatic Life Ambient Water... criteria for the protection of aquatic life from effects of carbaryl (EPA-820-D-11-001). The draft criteria document incorporates the latest scientific knowledge on the toxicity of carbaryl to aquatic life. The...

Standard classification of software documentation

NASA Technical Reports Server (NTRS)

Tausworthe, R. C.

1976-01-01

General conceptual requirements for standard levels of documentation and for application of these requirements to intended usages. These standards encourage the policy to produce only those forms of documentation that are needed and adequate for the purpose. Documentation standards are defined with respect to detail and format quality. Classes A through D range, in order, from the most definitive down to the least definitive, and categories 1 through 4 range, in order, from high-quality typeset down to handwritten material. Criteria for each of the classes and categories, as well as suggested selection guidelines for each are given.

Improving the Quality of Oral and Maxillofacial Surgical Notes in an Indian Public Sector Hospital in Accordance with the Royal College of Surgeons Guidelines: A Completed Audit Loop Study.

PubMed

Krishnan, B; Prasad, G Arun; Madhan, B

2016-09-01

Proper and adequate documentation in operation notes is a basic tool of clinical practice with medical and legal implications. An audit was done to ascertain if oral and maxillofacial surgery operative notes in an Indian public sector hospital adhered to the guidelines published by the Royal College of Surgeons England. Fifty randomly selected operative notes were evaluated against the guidelines by RCS England with regards to the essential generic components of an operation note. Additional criteria relevant to oral and Maxillofacial Surgery were also evaluated. Changes were introduced in the form of Oral and Maxillofacial Surgery specific consent forms, diagram sheets and a computerized operation note proforma containing all essential and additional criteria along with prefilled template of operative findings. Re-audit of 50 randomly selected operation notes was performed after a 6 month period. In the 1st audit cycle, excellent documentation ranging from 94 to 100 % was seen in 9 essential criteria. Unsatisfactory documentation was observed in criteria like assistant name, date of surgery. Most consent forms contained abbreviations and some did not provide all details. Additional criteria specific to Oral and Maxillofacial Surgery scored poorly. In the 2nd Audit for loop completion, excellent documentation was seen in almost all essential and additional criteria. Mean percentage of data point inclusion improved from 84.6 to 98.4 % (0.001< P value <0.005). The use of abbreviations was seen in only 6 notes. Regular audits are now considered a mandatory quality improvement process that seeks to improve patient care and outcomes. To the best of our knowledge, this is the first completed audit on operation notes documentation in Oral and Maxillofacial Surgery from India. The introduction of a computerized operation note proforma showed excellent improvement in operation note documentation. Surgeons can follow the RCS guidelines to ensure standardization of operation notes.

Defining quality criteria for online continuing medical education modules using modified nominal group technique.

PubMed

Shortt, S E D; Guillemette, Jean-Marc; Duncan, Anne Marie; Kirby, Frances

2010-01-01

The rapid increase in the use of the Internet for continuing education by physicians suggests the need to define quality criteria for accredited online modules. Continuing medical education (CME) directors from Canadian medical schools and academic researchers participated in a consensus process, Modified Nominal Group Technique, to develop agreement on the most important quality criteria to guide module development. Rankings were compared to responses to a survey of a subset of Canadian Medical Association (CMA) members. A list of 17 items was developed, of which 10 were deemed by experts to be important and 7 were considered secondary. A quality module would: be needs-based; presented in a clinical format; utilize evidence-based information; permit interaction with content and experts; facilitate and attempt to document practice change; be accessible for later review; and include a robust course evaluation. There was less agreement among CMA members on criteria ranking, with consensus on ranking reached on only 12 of 17 items. In contrast to experts, members agreed that the need to assess performance change as a result of an educational experience was not important. This project identified 10 quality criteria for accredited online CME modules that representatives of Canadian organizations involved in continuing education believe should be taken into account when developing learning products. The lack of practitioner support for documentation of change in clinical behavior may suggest that they favor traditional attendance- or completion-based CME; this finding requires further research.

Priorities for Water Quality Criteria and Standards Programs FY 2017-2018

EPA Pesticide Factsheets

This document recommends priorities for states and authorized tribes as they plan WQS actions and updates in the upcoming two fiscal years. The document addresses new regulatory requirements in 40 CFR part 131 issued in August 2015.

Supplement to the Second Addendum (1986) to Air Quality Criteria for Particulate Matter and Sulfur Oxides (1982): Assessment of New Findings on Sulfur Dioxide and Acute Exposure Health Effects in Asthmatic Individuals (1994)

EPA Science Inventory

The present Supplement to the Second Addendum (1986) to the document Air Quality Criteria for Particulate Matter and Sulfur Oxides (1982) focuses on evaluation of newly available controlled human exposure studies of acute (a\\1h) sulfur dioxide (SO2) exposure effects on pulmonary ...

Air Quality Criteria for Oxides of Nitrogen (Final Report, 1993)

EPA Science Inventory

This criteria document focuses on a review and assessment of the effects on human health and welfare of the nitrogen oxides, nitric oxide (NO) and nitrogen dioxide (NO2), and the related compounds, nitrites, nitrates, nitrogenous acids, and nitrosamines. Although the emphasis is ...

Air Quality Criteria for Oxides of Nitrogen (Final Report, 1982)

EPA Science Inventory

This document is an evaluation and assessment of scientific information relative to determining the health and welfare effects associated with exposure to various concentrations of nitrogen oxides in ambient air. The document is not intended as a complete, detailed literature rev...

August 2015 Proposed Total Maximum Daily Load Document and Appendices for Vermont Segments of Lake Champlain

EPA Pesticide Factsheets

These documents provide allocations of phosphorus loads to Lake Champlain to meet water quality criteria, describe basis for allocation for future growth, & describe how implementation measures were simulated to determine that allocations can be achieved

Air Quality Criteria for Ozone and Other Photochemical Oxidants (1978)

EPA Science Inventory

This document consolidates and assesses current knowledge regarding the origin of ozone and other photochemical oxidants and discusses their effect on health, vegetation, certain ecosystems, and materials. This document summarizes current data on the effects of oxidant/ozone in t...

Deriving Chesapeake Bay Water Quality Standards

USGS Publications Warehouse

Tango, Peter J.; Batiuk, Richard A.

2013-01-01

Achieving and maintaining the water quality conditions necessary to protect the aquatic living resources of the Chesapeake Bay and its tidal tributaries has required a foundation of quantifiable water quality criteria. Quantitative criteria serve as a critical basis for assessing the attainment of designated uses and measuring progress toward meeting water quality goals of the Chesapeake Bay Program partnership. In 1987, the Chesapeake Bay Program partnership committed to defining the water quality conditions necessary to protect aquatic living resources. Under section 303(c) of the Clean Water Act, States and authorized tribes have the primary responsibility for adopting water quality standards into law or regulation. The Chesapeake Bay Program partnership worked with U.S. Environmental Protection Agency to develop and publish a guidance framework of ambient water quality criteria with designated uses and assessment procedures for dissolved oxygen, water clarity, and chlorophyll a for Chesapeake Bay and its tidal tributaries in 2003. This article reviews the derivation of the water quality criteria, criteria assessment protocols, designated use boundaries, and their refinements published in six addendum documents since 2003 and successfully adopted into each jurisdiction's water quality standards used in developing the Chesapeake Bay Total Maximum Daily Load.

Certification Criteria for Linked Learning Pathways

ERIC Educational Resources Information Center

ConnectEd: The California Center for College and Career, 2010

2010-01-01

Pathways offer a promising strategy for transforming high schools and improving student outcomes. However, to achieve these desired results, pathways must be of high quality. To guide sites in planning and implementing such pathways, a design team of experts developed the criteria outlined in this document. Sites can choose to go through a…

National Functional Guidelines for Inorganic Superfund Methods Data Review (ISM02.4)

EPA Pesticide Factsheets

This document is designed to assist the reviewer in evaluating (a) whether the analytical data meet the technical and Quality Control (QC) criteria specified in the SOW, and (b) the usability and extent of bias of any data that do not meet these criteria.

78 FR 70040 - Draft Integrated Science Assessment for Nitrogen Oxides-Health Criteria

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-22

... (NO 2 ). The Integrated Science Assessment (ISA), in conjunction with additional technical and policy... the secondary (welfare-based) NAAQS for NO 2 , in conjunction with a review of the secondary NAAQS for... called an Air Quality Criteria Document). The ISA, in conjunction with additional technical and policy...

Selection. ERIC Processing Manual, Section III.

ERIC Educational Resources Information Center

Brandhorst, Ted, Ed.

Rules and guidelines are provided governing the selection of documents and journal articles to be included in the ERIC database. Selection criteria are described under the five headings: (1) Appropriateness of content/subject matter; (2) Suitability of format, medium, document type; (3) Quality of content; (4) Legibility and reproducibility; (5)…

AIR QUALITY CRITERIA FOR PARTICULATE MATTER DOCUMENT

EPA Science Inventory

A Planning Document was produced by NCEA/RTP and reviewed by the Clean Air Scientific Advisory Committee (CASAC) (62 FR 55201, October 23, 1997). In FY99, a workshop draft of the PM AQCD was completed, a peer input workshop held, and an External Review Draft released for public ...

Review of the Primary National Ambient Air Quality Standards for Nitrogen Dioxide: Risk and Exposure Assessment Planning Document

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) is conducting a review of the air quality criteria and the primary (health-based) national ambient air quality standards (NAAQS) for nitrogen dioxide (NO2). The major phases of the process for reviewing NAAQS include the following: (...

Review of the Primary National Ambient Air Quality Standard for Sulfur Oxides: Risk and Exposure Assessment Planning Document

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) is conducting a review of the air quality criteria and the primary (health-based) national ambient air quality standards (NAAQS) for sulfur oxides (SOx). The major phases of the process for reviewing NAAQS include the following: (1) ...

TQM (Total Quality Management) SPARC (Special Process Action Review Committees) Handbook

DTIC Science & Technology

1989-08-01

This document describes the techniques used to support and guide the Special Process Action Review Committees for accomplishing their goals for Total Quality Management (TQM). It includes concepts and definitions, checklists, sample formats, and assessment criteria. Keywords: Continuous process improvement; Logistics information; Process analysis; Quality control; Quality assurance; Total Quality Management ; Statistical processes; Management Planning and control; Management training; Management information systems.

Update on US EPA's Revision to the 1985 Guidelines for ...

EPA Pesticide Factsheets

National Water Quality Criteria for the Protection of Aquatic Organisms and Their Uses (Stephan et al. 1985), to reflect the current state-of-the-science for aquatic effects assessments. Following a 2015 public meeting soliciting early input from the scientific community, EPA decided to undertake two overarching parallel tracks for this revision: 1) updating and refining methods for deriving state-of-the-science criteria through comprehensive analyses, and 2) developing criteria more rapidly for the broader protection of aquatic life from the potential adverse effects of the large number of chemicals released into the aquatic environment. The first track reflects that for a smaller group of chemicals, criteria development may be scientifically complex, and deriving robust criteria for these chemicals may require detailed investigation. The second track reflects the recognition that extensive testing of all chemicals is infeasible and there is a need to efficiently derive criteria using approaches that estimate safe environmental concentrations with limited empirical data. Based on these objectives, EPA will develop two criteria documents for this revision: 1) a Comprehensive Guidelines Document, intended to directly update and expand upon approaches presented in the 1985 Guidelines, and that will describe methods that provide criteria for chemicals requiring a more detailed level of evaluation, and 2) an Expedited Guidelines Document, which will focus on criteri

Auditing of chromatographic data.

PubMed

Mabie, J T

1998-01-01

During a data audit, it is important to ensure that there is clear documentation and an audit trail. The Quality Assurance Unit should review all areas, including the laboratory, during the conduct of the sample analyses. The analytical methodology that is developed should be documented prior to sample analyses. This is an important document for the auditor, as it is the instrumental piece used by the laboratory personnel to maintain integrity throughout the process. It is expected that this document will give insight into the sample analysis, run controls, run sequencing, instrument parameters, and acceptance criteria for the samples. The sample analysis and all supporting documentation should be audited in conjunction with this written analytical method and any supporting Standard Operating Procedures to ensure the quality and integrity of the data.

Tools Used to Evaluate Written Medicine and Health Information: Document and User Perspectives

ERIC Educational Resources Information Center

Luk, Alice; Aslani, Parisa

2011-01-01

This study aims to identify and review tools used to evaluate consumer-oriented written medicine (WMI) and health (WHI) information from a document and user perspective. Articles that met the following inclusion criteria were reviewed: studies evaluating readability, presentation, suitability, quality of WMI/WHI. A total of 152 articles were…

77 FR 50695 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-22

... guidance documents intended to improve contraceptive use and the delivery of quality family planning... implementation of recommendations included in the U.S. Medical Eligibility Criteria for Contraceptive Use... Contraceptive Use (U.S. SPR) and the forthcoming Guidance for Providing Quality Family Planning Services (QFPS...

Review of the Secondary National Ambient Air Quality Standard for Nitrogen Oxides, Sulfur Oxides and Particulate Matter: Risk and Exposure Assessment Planning Document

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) is conducting a review of the air quality criteria and the secondary (welfare-based) national ambient air quality standards (NAAQS) for nitrogen oxides (NOx), sulfur oxides (SOx), and particulate matter (PM). The major phases of the ...

75 FR 67361 - Release of Final Document Related to the Review of the National Ambient Air Quality Standards for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-02

... Administrator identifies and lists certain pollutants which ``cause or contribute to air pollution which may reasonably be anticipated to endanger public health or welfare.'' The EPA then issues air quality criteria... establishes primary (health-based) and secondary (welfare-based) national ambient air quality standards (NAAQS...

[Identification of Good-Practice Projects in Promoting Physical Activity - Methods, Pitfalls and Sampled Outcomes].

PubMed

Henn, Annette; Karger, Claudia; Wöhlken, Katrin; Meier, Diana; Ungerer-Röhrich, Ulrike; Graf, Christine; Woll, Alexander

2017-03-01

The aim of this paper is to identify and show examples of good practice of public health promotion. For this, uniform quality criteria were worked out under consideration of national and international scientific literature.For the identification of examples of good practice, a comparison of different quality criteria was carried out and combined with each other in a first step. In the following step, examples of good practice were identified after a comprehensive search. The choice of the "good-practice" projects is exemplary and lays no claim to completeness.6 main quality criteria (QC) of programs promoting physical activity could be identified in the national and international context. The analysis showed altogether 10 projects which can exemplarily be classified as examples of good practice of the target groups of children and teenagers, adults, older people and people with pre-existing illnesses. These projects, however, show major differences in their (methodological) quality.The analysis reports a lack of "Good-Practice" examples. Deficits lie mainly in documentation and sustainability. Because of incomplete documentation, an assessment as a "Good-Practice" example is only possible to a limited extent; a lot of information, particularly in the evaluation, is missing. © Georg Thieme Verlag KG Stuttgart · New York.

Environmental Technology Verification Program Quality Management Plan, Version 3.0

EPA Science Inventory

The ETV QMP is a document that addresses specific policies and procedures that have been established for managing quality-related activities in the ETV program. It is the “blueprint” that defines an organization’s QA policies and procedures; the criteria for and areas of QA appli...

Provisional assessment of recent studies on health and ecological effects of ozone exposure

EPA Science Inventory

A reconsideration of the national ambient air quality standards (NAAQS) for O₃ is currently underway. The last Air Quality Criteria Document for Ozone and Related Photochemical Oxidants (O_...

Great Lakes Initiative (GLI) Clearinghouse

EPA Pesticide Factsheets

The Great Lakes Initiative Toxicity Clearinghouse is a central location for information on criteria, toxicity data, exposure parameters and other supporting documents used in developing water quality standards in the Great Lakes watershed.

Criteria for Determining whether Equipment is Air Pollution Control Equipment or Process Equipment

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

IRIS Summary and Supporting Documents for Methylmercury ...

EPA Pesticide Factsheets

In January 2001, U.S. EPA finalized the guidance for methylmercury in the water quality criteria for states and authorized tribes. The links below take you to the best resources for this guidance. This final Guidance for Implementing the January 2001 Methylmercury Water Quality Criterion provides technical guidance to states and authorized tribes on how they may want to use the January 2001 fish tissue-based recommended water quality criterion for methylmercury in surface water protection programs (e.g., TMDLs, NPDES permitting). The guidance addresses questions related to water quality standards adoption (e.g., site-specific criteria, variances), assessments, monitoring, TMDLs, and NPDES permitting. The guidance consolidates existing EPA guidance where relevant to mercury.

Title V Program Approval Criteria for Section 112 Activities

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Policy and Guidance Database available at www2.epa.gov/title-v-operating-permits/title-v-operating-permit-policy-and-guidance-document-index. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

INFLUENCE OF ALTERNATE INDICATORS OF EXPOSURE TO PM (OR PM COMPONENTS) IN STATISTICAL CORRELATIONS OF EXPOSURE WITH MORTALITY AND MORBIDITY (PHILADELPHIA DATA BASE)

EPA Science Inventory

At the time the 1996 Air Quality Criteria for Particulate Matter Criteria Document was prepared there were several epidemiologic studies using multiple years of TSP and PM10 data for the exposure estimate but only one epidemiologic study using multiple years of PM2.5 data. That ...

[Consensus document on spasticity in patients with multiple sclerosis. Grupo de Enfermedades Desmielinizantes de la Sociedad Española de Neurología].

PubMed

Oreja-Guevara, Celia; Montalban, Xavier; de Andrés, Clara; Casanova-Estruch, Bonaventura; Muñoz-García, Delicias; García, Inmaculada; Fernández, Óscar

2013-10-16

Multiple sclerosis is a chronic neurological inflammatory demyelinating disease. Specialists involved in the symptomatic treatment of this disease tend to apply heterogeneous diagnostic and treatment criteria. To establish homogeneous criteria for treating spasticity based on available scientific knowledge, facilitating decision-making in regular clinical practice. A group of multiple sclerosis specialists from the Spanish Neurological Society demyelinating diseases working group met to review aspects related to spasticity in this disease and draw up the consensus. After an exhaustive bibliographic search and following a metaplan technique, a number of preliminary recommendations were established to incorporate into the document. Finally, each argument was classified depending on the degree of recommendation according to the SIGN (Scottish Intercollegiate Guidelines Network) system. The resulting text was submitted for review by the demyelinating disease group. An experts' consensus was reached regarding spasticity triggering factors, related symptoms, diagnostic criteria, assessment methods, quality of life and therapeutic management (drug and non-drug) criteria. The recommendations included in this consensus can be a useful tool for improving the quality of life of multiple sclerosis patients, as they enable improved diagnosis and treatment of spasticity.

[Certification of an ambulatory gastroenterologic service fulfilling ISO Law 9001--criteria and national guidelines of the Gastroenterologic Association].

PubMed

Birkner, B

2000-09-01

The objectives of certification and accreditation are the deployment and examination of quality improvement measures in health care services. The quality management system of the ISO 9001 is created to install measures and tools leading to assured and improved quality in health care. Only some experiences with certification fulfilling ISO 9001 criteria exist in the German health care system. Evidence-based clinical guidelines can serve as references for the development of standards in quality measurement. Only little data exists on the implementation strategy of guidelines and evaluation, respectively. A pilot quality management system in consistence with ISO 9001 criteria was developed for ambulatory, gastroenterological services. National guidelines of the German Society of Gastroenterology and Metabolism and the recommendations of the German Association of Physicians for quality assurance of gastrointestinal endoscopy were included in the documentation and internal auditing. This pilot quality management system is suitable for the first steps in the introduction of quality management in ambulatory health care. This system shows validity for accreditation and certification of gastrointestinal health care units as well.

Criteria for assessment of bridge aesthetic and visual quality

NASA Astrophysics Data System (ADS)

Rozentale, I.; Paeglitis, A.

2017-10-01

The bridge designers should find an ideal balance between structure, economy, buildability, aesthetics, durability and harmony with industrial or natural landscape. During the last years, the society has adopted documents providing procedures for evaluation of the impact of the structural appearance on surrounding landscape. The European Landscape Convention defines the landscape as an area perceived by people, whose character is the result of the action and interaction of natural and/or human factors. The Convention indicates the methods for clear and objective assessment of the landscape’s visual qualities. The esthetical qualities of bridge structures, appearance and attraction should satisfy not only the technicians - engineers and architects, but mostly the surrounding population. Each of these groups has a different perception of esthetical qualities of structure. Many authors have used different methods and criteria for assessment of bridge aesthetics. The aim of this paper is to provide an overview of the bridge aesthetic and visual quality assessment methods and criteria.

Can we trust cancer information on the Internet?--A comparison of interactive cancer risk sites.

PubMed

Ekman, Alexandra; Hall, Per; Litton, Jan-Eric

2005-08-01

To investigate the prevalence and quality of interactive cancer risk sites on the Internet. A cancer risk site was defined as a website that gave an estimate of the individual risk of developing cancer. Six search engines and one Meta crawler were used to search the Internet for cancer risk sites (including breast, prostate, colon, and lung cancer). A set of defined quality criteria for health related websites was used to evaluate the websites during 2001 and 2002. The number of cancer risk sites, as defined above, increased by 50% between 2001 and 2002. Only two out of 22 cancer risk sites fulfilled the quality criteria adequately. No signs of a change in trend (with regard to the quality criteria met) were noted in January 2005. The overall quality of the documentation on the cancer risk sites was poor and no improvement was seen during the study period. The majority of the cancer risk sites do not give reliable risk estimates.

IRIS Summary and Supporting Documents for Methylmercury

EPA Science Inventory

In January 2001, U.S. EPA finalized the guidance for methylmercury in the water quality criteria for states and authorized tribes. The links below take you to the best resources for this guidance.

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

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

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

2005-01-01

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

Best practice in clinical audit document.

PubMed

2016-12-01

A guide to best practice in clinical audit has been published by the Healthcare Quality Improvement Partnership. It outlines updated criteria for best practice to support clinicians and clinical audit staff with planning, designing and carrying out audits.

What criteria do consumer health librarians use to develop library collections? a phenomenological study.

PubMed

Papadakos, Janet; Trang, Aileen; Wiljer, David; Cipolat Mis, Chiara; Cyr, Alaina; Friedman, Audrey Jusko; Mazzocut, Mauro; Snow, Michelle; Raivich, Valeria; Catton, Pamela

2014-04-01

The criteria for determining whether resources are included in consumer health library collections are summarized in institutional collection development policies (CDPs). Evidence suggests that CDPs do not adequately capture all of these criteria. The aim of this study was to describe the resource review experience of librarians and compare it to what is described in CDPs. A phenomenological approach was used to explore and describe the process. Four consumer health librarians independently evaluated cancer-related consumer health resources and described their review process during a semi-structured telephone interview. Afterward, these librarians completed online questionnaires about their approaches to collection development. CDPs from participating libraries, interview transcripts, and questionnaire data were analyzed. Researchers summarized the findings, and participating librarians reviewed results for validation. Librarians all utilized similar criteria, as documented in their CDPs; however, of thirteen criteria described in the study, only four were documented in CDPs. CDPs for consumer health libraries may be missing important criteria that are considered integral parts of the collection development process. A better understanding of the criteria and contextual factors involved in the collection development process can assist with establishing high-quality consumer health library collections.

What criteria do consumer health librarians use to develop library collections? a phenomenological study*

PubMed Central

Papadakos, Janet; Trang, Aileen; Wiljer, David; Mis, Chiara Cipolat; Cyr, Alaina; Friedman, Audrey Jusko; Mazzocut, Mauro; Snow, Michelle; Raivich, Valeria; Catton, Pamela

2014-01-01

Objectives: The criteria for determining whether resources are included in consumer health library collections are summarized in institutional collection development policies (CDPs). Evidence suggests that CDPs do not adequately capture all of these criteria. The aim of this study was to describe the resource review experience of librarians and compare it to what is described in CDPs. Methods: A phenomenological approach was used to explore and describe the process. Four consumer health librarians independently evaluated cancer-related consumer health resources and described their review process during a semi-structured telephone interview. Afterward, these librarians completed online questionnaires about their approaches to collection development. CDPs from participating libraries, interview transcripts, and questionnaire data were analyzed. Researchers summarized the findings, and participating librarians reviewed results for validation. Results: Librarians all utilized similar criteria, as documented in their CDPs; however, of thirteen criteria described in the study, only four were documented in CDPs. Conclusions: CDPs for consumer health libraries may be missing important criteria that are considered integral parts of the collection development process. Implications: A better understanding of the criteria and contextual factors involved in the collection development process can assist with establishing high-quality consumer health library collections. PMID:24860261

Adolescent bariatric surgery: a systematic review of recommendation documents.

PubMed

Childerhose, Janet E; Alsamawi, Amal; Mehta, Tanvi; Smith, Judith E; Woolford, Susan; Tarini, Beth A

2017-10-01

Bariatric surgery has been performed on adolescents since the 1970s, but little is known about the guidance offered to providers in recommendation documents published in the United States. A systematic review was conducted to generate a complete record of all US recommendation documents and describe variability across the documents. This study had 3 aims: to identify the developers, examine selection criteria, and document reasons why developers have recommended this intervention for adolescents. Four databases (MEDLINE, National Guidelines Clearinghouse, Trip, and Embase) ertr searched, followed by a hand search. Documents were eligible for inclusion if they satisfied 5 criteria: written in the English language; developed and published by a US organization; comprised a clinical practice guideline, position statement, or consensus statement; offered a minimum 1-sentence recommendation on bariatric surgery for the treatment of obesity or related co-morbidities; and offered a minimum 1-sentence recommendation on bariatric surgery for children, adolescents, or both. No date limits were applied. Sixteen recommendation documents published between 1991 and 2013 met our inclusion criteria: 10 clinical practice guidelines, 4 position statements, and 2 consensus statements. Nine were produced by medical organizations, 3 by surgical organizations, and 4 by public health/governmental bodies. One document recommended against bariatric surgery for minors, and 15 endorsed the intervention for this population. Body mass index (a measure of obesity calculated by dividing weight in kilograms by the square of height in meters) thresholds were the selection criteria most often provided. Minimum age varied widely. Of the 15 endorsing documents, 10 provided a reason for performing bariatric surgery on minors, most often to treat obesity-related co-morbidities that threaten the health of the adolescent. We make 3 suggestions to improve the quality of future recommendation documents. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Template for updating regulations in QA manuals

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

White, M.G.; Banerjee, B.

1992-01-01

Recently, the U.S. Department of Energy (DOE) issued new quality assurance (QA) orders to reflect current policies for conduct and operation of DOE-authorized programs and facilities. Establishing traceability to new QA criteria and requirements from former multidraft orders, QA manuals, and guidance documentation for DOE-funded work can be confusing. Identified critical considerations still must be addressed. Most of the newly stated QA criteria can be cross referenced, where applicable, to former QA plans and manuals. Where additional criteria occur, new procedures may be required, together with revisions in QA plans and manuals.

Quality of nursing documentation: Paper-based health records versus electronic-based health records.

PubMed

Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

2018-02-01

To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and patients' outcomes. © 2017 John Wiley & Sons Ltd.

NASA Lewis Wind Tunnel Model Systems Criteria

NASA Technical Reports Server (NTRS)

Soeder, Ronald H.; Haller, Henry C.

1994-01-01

This report describes criteria for the design, analysis, quality assurance, and documentation of models or test articles that are to be tested in the aeropropulsion facilities at the NASA Lewis Research Center. The report presents three methods for computing model allowable stresses on the basis of the yield stress or ultimate stress, and it gives quality assurance criteria for models tested in Lewis' aeropropulsion facilities. Both customer-furnished model systems and in-house model systems are discussed. The functions of the facility manager, project engineer, operations engineer, research engineer, and facility electrical engineer are defined. The format for pretest meetings, prerun safety meetings, and the model criteria review are outlined Then, the format for the model systems report (a requirement for each model that is to be tested at NASA Lewis) is described, the engineers that are responsible for developing the model systems report are listed, and the time table for its delivery to the facility manager is given.

AIR QUALITY CRITERIA FOR LEAD (1977)

EPA Science Inventory

The document summarizes current knowledge about the relationships between airborne lead and consequent effects on man and his environment. The effects that have been observed to occur when airborne lead has reached or exceeded specific levels for time periods constitute the centr...

Integrated Science Assessment (ISA) for Carbon Monoxide ...

EPA Pesticide Factsheets

EPA announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Carbon Monoxide (CO) and related Annexes was made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA's decision regarding whether the current standards for CO sufficiently protect public health and the environment. Section 108(a) of the Clean Air Act directs the EPA Administrator to identify certain pollutants that “cause or contribute to air pollution which may reasonably be anticipated to endanger public health or welfare” and to issue air quality criteria for them. These air quality criteria are to “accurately reflect the latest scientific knowledge useful in indicating the kind and extent of all identifiable effects on public health or welfare which may be expected from the presence of such pollutant in the ambient air….” Under section 109 of the Act, EPA is to establish national ambient air quality standards (NAAQS) for each pollutant for which EPA has issued criteria. Section 109(d) of the Act requires periodic review and, if appropriate, revision of existing air quality criteria to reflect advances in scientific knowledge on the effects of the pollutant on public health or welfare. EPA is also to revise the NAAQS, if appropriate, based on the revised air quality criteria.

[External quality assurance in inpatient medical rehabilitation and prevention centers for mothers, fathers and children: development of instruments for assessing structural quality].

PubMed

Saupe-Heide, M; Gerlich, C; Lukasczik, M; Musekamp, G; Neuderth, S; Vogel, H

2013-12-01

As required by German law, inpatient institutions offering prevention and rehabilitation measures for mothers, fathers and children are obliged to implement external quality assurance measures. In 2 pilot projects funded by the German federal association of health insurance funds, external quality assurance procedures for in-hospital prevention and rehabilitation of mothers and fathers were analyzed with the aim of developing a set of instruments for the description of structural characteristics in this area of health care and to evaluate its appropriateness. Concerning structure-related quality, the project included a) designing and evaluating a questionnaire, b) the definition of assessment criteria for subsequent comparative data analyses, and c) the description and documentation of the current state in the field of rehabilitation and prevention for mothers, fathers and children. To document structural quality comprehensively, a modular questionnaire was developed and tested in a survey of 115 inpatient prevention and rehabilitation institutions for mothers, fathers and children. Involving an expert panel, preliminary basic and selection criteria were defined in order to assure a conducive assessment with regard to structural attributes. The majority of institutions had provider agreements for both prevention and rehabilitation. Measures for mothers/fathers with children were predominant; only 7 institutions exclusively treated mothers and fathers. Institution sizes varied strongly. Major indications included psychosomatics, dermatology, and pneumology. Overall, structural conditions of the institutions showed a high standard. Potential for development was found with regard to some aspects of the conceptual framework of institutional practice and the implementation of the International Classification of Functioning, Disability and Health (ICF) in diagnostics. In this article, the degrees of fulfillment with relation to the structural dimensions are presented, referring to the analysis of the preliminary basic criteria. The developed modular questionnaire tapping structural features of inpatient mother/father-child institutions has proven to be a useful instrument to describe the structural quality in future routine practice of quality assurance. In addition, the data can be used for the definition of the final set of criteria. © Georg Thieme Verlag KG Stuttgart · New York.

Space Tethers: Design Criteria

NASA Technical Reports Server (NTRS)

Tomlin, D. D.; Faile, G. C.; Hayashida, K. B.; Frost, C. L.; Wagner, C. Y.; Mitchell, M. L.; Vaughn, J. A.; Galuska, M. J.

1997-01-01

This document is prepared to provide a systematic process for the selection of tethers for space applications. Criteria arc provided for determining the strength requirement for tether missions and for mission success from tether severing due to micrometeoroids and orbital debris particle impacts. Background information of materials for use in space tethers is provided, including electricity-conducting tethers. Dynamic considerations for tether selection is also provided. Safety, quality, and reliability considerations are provided for a tether project.

Project Quality Assurance Plan for research and development services provided by Oak Ridge National Laboratory in support of the Westinghouse Materials Company of Ohio Operable Unit 1 Stabilization Development and Treatability Studies Program

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

Gilliam, T.M.

1991-05-01

This Project Quality Assurance Plan (PQAP) sets forth the quality assurance (QA) requirements that are applied to those elements of the Westinghouse Materials Company of Ohio (WMCO) Operable Unit 1 support at Oak Ridge National Laboratory (ORNL) project that involve research and development (R D) performed at ORNL. This is in compliance with the applicable criteria of 10 CFR Part 50, Appendix B, ANSI/ASME NQA-1, as specified by Department of Energy (DOE) Oak Ridge Operations (ORO) Order 5700.6B. For this application, NQA-1 is the core QA Program requirements document. QA policy, normally found in the requirements document, is contained herein.more » The requirements of this PQAP apply to project activities that affect the quality and reliability/credibility of research, development, and investigative data and documentation. These activities include the functions of attaining quality objectives and assuring that an appropriate QA program scope is established. The scope of activities affecting quality includes organization; personnel training and qualifications; design control; procurement; material handling and storage; operating procedures; testing, surveillance, and auditing; R D investigative activities and documentation; deficiencies; corrective actions; and QA record keeping. 12 figs.« less

Data Quality Objectives for Tank Farms Waste Compatibility Program

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

BANNING, D.L.

1999-07-02

There are 177 waste storage tanks containing over 210,000 m{sup 3} (55 million gal) of mixed waste at the Hanford Site. The River Protection Project (RPP) has adopted the data quality objective (DQO) process used by the U.S. Environmental Protection Agency (EPA) (EPA 1994a) and implemented by RPP internal procedure (Banning 1999a) to identify the information and data needed to address safety issues. This DQO document is based on several documents that provide the technical basis for inputs and decision/action levels used to develop the decision rules that evaluate the transfer of wastes. A number of these documents are presentlymore » in the process of being revised. This document will need to be revised if there are changes to the technical criteria in these supporting documents. This DQO process supports various documents, such as sampling and analysis plans and double-shell tank (DST) waste analysis plans. This document identifies the type, quality, and quantity of data needed to determine whether transfer of supernatant can be performed safely. The requirements in this document are designed to prevent the mixing of incompatible waste as defined in Washington Administrative Code (WAC) 173-303-040. Waste transfers which meet the requirements contained in this document and the Double-Shell Tank Waste Analysis Plan (Mulkey 1998) are considered to be compatible, and prevent the mixing of incompatible waste.« less

Documentation of medication changes in inpatient clinical notes: an audit to support quality improvement.

PubMed

Peusschers, Elsie; Twine, Jaryth; Wheeler, Amanda; Moudgil, Vikas; Patterson, Sue

2015-04-01

To describe completeness and accuracy of recording medication changes in progress notes during psychiatric inpatient admissions. A retrospective audit of records of 54 randomly selected psychiatric admissions at a metropolitan tertiary hospital. Medication changes recorded on National Inpatient Medication Chart (NIMC) were compared to documentation in the clinical progress records and assessed for completeness against seven quality criteria. With between one and 32 medication changes per admission, a total of 519 changes were recorded in NIMCs. Just over half were documented in progress notes. Psychotropic and regular medications were more frequently charted than 'other' and 'if required' medications. Documentation was seldom comprehensive. Medication name was most frequently documented; desired therapeutic effect or potential adverse effects were rarely documented. Evidence of patient involvement in, and an explicit rationale for, a change were infrequently recorded. Revealing substantial gaps in communication about medication changes during psychiatric admission, this audit sheds light on a previously undescribed source of medication error, warranting attention. Further research is needed to examine barriers to best practice, to support design and implementation of quality improvement activities but in the interim, attention should be addressed to development and articulation of content and procedures for documentation. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Evaluation of all African clinical practice guidelines for hypertension: Quality and opportunities for improvement.

PubMed

Okwen, Patrick Mbah; Maweu, Irene; Grimmer, Karen; Margarita Dizon, Janine

2018-06-14

Good-quality clinical practice guidelines (CPGs) provide recommendations based on current best-evidence summaries. Hypertension is a prevalent noncommunicable disease in Africa, with disastrous sequelae (stroke, heart, and kidney disease). Its effective management relies on good quality, current, locally relevant evidence. This paper reports on an all African review of the guidance documents currently informing hypertension management. Attempts were made to contact 62 African countries for formal guidance documents used nationally to inform diagnosis and management of hypertension. Their quality was assessed by using Appraisal of Guidelines for Research & Evaluation (AGREE) II, scored by 2 independent reviewers. Differences in domain scores were compared between documents written prior to 2011 and 2011 onward. Findings were compared with earlier African CPG reviews. Guidelines and protocols were provided by 26 countries. Six used country-specific stand-alone hypertension guidelines, and 10 used protocols embedded in Standard Treatment Guidelines for multiple conditions. Six used guidelines developed by the World Health Organization, and 4 indicated ad hoc use of international guidance (US, Portugal, and Brazil). Only 1 guidance document met CPG construction criteria, and none scored well on all AGREE domain scores. The lowest-scoring domain was rigour of development. There was no significant quality difference between pre-2011 and post-2011 guidance documents, and there were variable AGREE II scores for the same CPGs when comparing the African reviews. The quality of hypertension guidance used by African nations could be improved. The need for so many guidance documents is questioned. Adopting a common evidence base from international good-quality CPGs and layering it with local contexts offer 1 way to efficiently improve African hypertension CPG quality and implementation. © 2018 John Wiley & Sons, Ltd.

[How nationally concordated measures for quality assurance in clinical care of term and preterm infants are put into practice in Baden-Württemberg].

PubMed

Boehler, T; Schaeff, B; Hornberg, I; Waibel, B; Mohrmann, M

2009-01-01

By the end of the year 2007, pediatric hospitals in Baden-Württemberg had assigned themselves to one of three levels of perinatal care according to a checklist of the German Federal Joint Committee (F-JC) effective since January 1st, 2006. The Medical Service of Statutory Health Insurance had been assigned to prove the plausibility of that self-assessment according to quality criteria for clinical care of term and preterm newborn infants concordated by the F-JC. Between November 2007 and October 2008 31 providers were audited. Observations were documented in a checklist, reviewed and evaluated by expert auditors. For that purpose, quality criteria given by the F-JC were grouped into 7 quality categories which were weighted according to their practical relevance. In addition, a graded numeric system of evaluation was used for comparative analysis (absolute and relative benchmarking values). 3 of 23 providers fulfilled the quality criteria of the F-JC for PNC level 1 (highest level of care), 6 of 23 fulfilled them in part, and 14 of 23 did not fulfill them as judged by the auditors. Criteria for PNC level 2 were "fulfilled in part" by 2 of 6 providers and "not fulfilled" by 4. Both providers of perinatal special care ("level 3") fulfilled the quality criteria for "level 3" completely. There was no linear correlation between absolute or relative benchmarking values and assessment by expert auditors. If the criteria of the F-JC were interpreted very strictly, it would be difficult to guarantee comprehensive regional delivery of care in the state of Baden-Württemberg at the level formally requested by the F-JC for PNCs.

[Document management systems to support quality management systems at university hospitals - an interview-based study].

PubMed

Holderried, Martin; Bökel, Ann-Catrin; Ochsmann, Elke

2018-05-01

In order to save and control the processes and quality of medical services, a suitable steering system of all relevant documents is essential from the point of view of clinical quality management. Systems supporting an automated steering system of documents are called document management systems (DMS), and they also enter the healthcare sector. The use of DMS in the German healthcare sector has hardly been investigated so far. To close this knowledge gap, interviews were carried out with German university hospitals over a six-month period and subjected to a qualitative content analysis according to Mayring. In total, 25 university hospitals agreed to participate in this study, 19 of which have been working with a digital DMS for about six years on average. There was a great variety among the IT systems used. Document management and usability of the DMS as well as its integration into existing IT structures were key decision-making criteria for the selection of a digital DMS. In general, the long-term usability of the DMS is supported by regular evaluation of one's own requirements for the system, administration and training programs. In addition, DMS have a positive effect on patient safety and the quality of medical care. Copyright © 2018. Published by Elsevier GmbH.

Do European hospitals have quality and safety governance systems and structures in place?

PubMed

Shaw, C; Kutryba, B; Crisp, H; Vallejo, P; Suñol, R

2009-02-01

Internal systems for quality and safety were assessed in 89 hospitals in six European states, by external teams using standardised criteria and procedures, as part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The assessments were made primarily to identify the current use of quality management systems in the sample hospitals, and also to demonstrate a potential tool for comparable assessment of hospitals in general. The large majority of the hospitals had a formal, documented infrastructure to manage quality and safety, but a significant minority had no designated mission, programme or coordination. In two-thirds of hospitals, the governing body was active in defining policy and programmes for improvement, and received reports on quality, safety and patient satisfaction at least once a year. The brief on-site assessments identified systematic variations, within and between countries, in structures and processes of governance and to document the uptake of best practice. Unacceptable variations in practice could be reduced, to the benefit of consumers and providers, by developing and publishing basic organisational standards relevant to all European states. The simple assessment criteria designed for this project could be developed into a practical tool for self-assessment, peer review or benchmarking of hospitals across national borders. This assessment, combined with explicit, relevant and achievable standards, could provide a vehicle to promote the voluntary uptake of best practice and consistency in quality and safety among hospitals in Europe.

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

Malkoske, Kyle; Nielsen, Michelle; Brown, Erika

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

Experiences with the European guidelines on quality criteria for radiographic images in Tanzania

PubMed Central

Muhogora, W. E.; Nyanda, A. M.; Kazema, R. R.

2001-01-01

Objective assessment of the quality of radiographic images is practically a difficult task and protocols that address this problem are few. In 1996, the European union published nearly objective image quality criteria to unify the practices in Europe. However, experience with these criteria in countries of lower health care levels is little documented. As a case study in Tanzania, we present the general performance of European guidelines in some Tanzanian hospitals to a total of 200 radiographs obtained from some common x‐ray examinations. The results show that more than 70% of chest (PA), lumbar spine (AP), and pelvis AP radiographs passed the quality criteria, while the performance of lumbar spine LAT x‐ray examinations was about 50% and therefore less satisfactory. The corresponding mean entrance dose to the patient for specified x‐ray techniques was of range 0.08–0.56 mGy, 3.1–7.7 mGy, 2.53–5.4 mGy, and 4.0–16.78 mGy for chest PA, lumbar spine AP, pelvis AP and lumbar spine LAT x‐ray examinations, respectively. Although a good number of observers were not well familiar to the guidelines, the quality criteria have been found useful and their adoption in the country recommended. The need to provide relevant education and training to staff in the radiology departments is of utmost importance. PACS number(s): 87.57.–s, 87.52.–g PMID:11686743

Provisional Assessment of Recent Studies on Particulate Matter (2006)

EPA Science Inventory

A review of the national ambient air quality standards (NAAQS) for particulate matter (PM) is currently underway. The Criteria Document was completed in October 2004, and a proposed decision to revise the PM NAAQS was published in January 2006. The final decision is to be signe...

The Gideon Criterion: The Effects of Selection Criteria on Soldier Capabilities and Battle Results

DTIC Science & Technology

1982-01-01

United States Army Recruiting Command RESEARCH MEMORANDUM 82-1 AD______ I I THE GIDEON CRITERION: THE EFFECTS OF SELECTION CRITERIA ON SOLDIER...and Evaluation Directorate Fort Sheridan, Illinois 60037 83 05 09 056 ii 1 DISCLAIMER NOTICE THIS DOCUMENT IS BEST QUALITY PRACTICABLE. THE COPY...FURNISHED TO DTIC CONTAINED A SIGNIFICANT NUMBER OF PAGES WHICH DO NOT REPRODUCE LEGIBLY. j1 ... 4 ’ t c " " .. THE GIDEON CR17RION’. THE EFFECTS OF

Assessing decision quality in patient-centred care requires a preference-sensitive measure

PubMed Central

Kaltoft, Mette; Cunich, Michelle; Salkeld, Glenn; Dowie, Jack

2014-01-01

A theory-based instrument for measuring the quality of decisions made using any form of decision technology, including both decision-aided and unaided clinical consultations is required to enable person- and patient-centred care and to respond positively to individual heterogeneity in the value aspects of decision making. Current instruments using the term ‘decision quality’ have adopted a decision- and thus condition-specific approach. We argue that patient-centred care requires decision quality to be regarded as both preference-sensitive across multiple relevant criteria and generic across all conditions and decisions. MyDecisionQuality is grounded in prescriptive multi criteria decision analysis and employs a simple expected value algorithm to calculate a score for the quality of a decision that combines, in the clinical case, the patient’s individual preferences for eight quality criteria (expressed as importance weights) and their ratings of the decision just taken on each of these criteria (expressed as performance rates). It thus provides an index of decision quality that encompasses both these aspects. It also provides patients with help in prioritizing quality criteria for future decision making by calculating, for each criterion, the Incremental Value of Perfect Rating, that is, the increase in their decision quality score that would result if their performance rating on the criterion had been 100%, weightings unchanged. MyDecisionQuality, which is a web-based generic and preference-sensitive instrument, can constitute a key patient-reported measure of the quality of the decision-making process. It can provide the basis for future decision improvement, especially when the clinician (or other stakeholders) completes the equivalent instrument and the extent and nature of concordance and discordance can be established. Apart from its role in decision preparation and evaluation, it can also provide real time and relevant documentation for the patient’s record. PMID:24335587

10 CFR Appendix B to Part 50 - Quality Assurance Criteria for Nuclear Power Plants and Fuel Reprocessing Plants

Code of Federal Regulations, 2012 CFR

2012-01-01

... executing. III. Design Control Measures shall be established to assure that applicable regulatory... control of design interfaces and for coordination among participating design organizations. These measures..., approval, release, distribution, and revision of documents involving design interfaces. The design control...

10 CFR Appendix B to Part 50 - Quality Assurance Criteria for Nuclear Power Plants and Fuel Reprocessing Plants

Code of Federal Regulations, 2013 CFR

2013-01-01

... executing. III. Design Control Measures shall be established to assure that applicable regulatory... control of design interfaces and for coordination among participating design organizations. These measures..., approval, release, distribution, and revision of documents involving design interfaces. The design control...

[Criteria of quality of structure in rehabilitation units with inpatient treatment].

PubMed

Klein, K; Farin, E; Jäckel, W H; Blatt, O; Schliehe, F

2004-04-01

The structure of a rehabilitation unit is an important feature of the quality of care. Adequate and qualitatively good structures provide the basis for appropriate therapy offers and treatment and eventually, a better health for rehabilitants. The quality of structures is generally recorded without any evaluation of the aspects in particular. The definition of standards is the basis for such an evaluation. The project presented is aimed at the definition of relevant structural standards for rehab units with inpatient treatment for musculoskeletal, cardiac, neurological, gastroenterological, oncological, pneumological and dermatological diseases. Here, the distinction between basal criteria which have to be fulfilled by every rehab unit with inpatient treatment and criteria important for a well-aimed assignment of patients with specific needs ("assignment criteria") should be made. Apart from the documentation of structural attributes, the structural quality of a rehab unit can be described individually as well as in comparison with other units. Relevant structural criteria were defined in expert meetings by means of a modified Delphi-technique with five inquiries. Overall, 199 "basal criteria" and "assignment criteria" were defined. All criteria can be assigned to the two domains general structural characteristics (general characteristics and equipment of rooms; medical/technical equipment; therapy, education, care; staff) and process-related structures (conceptual frames; internal quality management; internal communication and personnel development). The structural standards are applicable to units for musculoskeletal, cardiac, neurological, oncological, gastroenterological, dermatological and pneumological rehabilitation financed by the two main providers of rehabilitation, the statutory pension insurance scheme and the statutory health insurance scheme for all other five indications. The definition of structural standards agreed by experts in a formal consensus process, provides comprehensive and concrete requirements for German rehab units with inpatient medical rehabilitation. If the two main providers of rehabilitation both use the standards this can be regarded as a hallmark on the path to a unitary programme for quality management. The results enable units to analyse their weak points not just on an individual basis but allow also for a comparison between units, along with contributing to optimizing the structural quality of rehab units.

Quality of outpatient clinical notes: a stakeholder definition derived through qualitative research.

PubMed

Hanson, Janice L; Stephens, Mark B; Pangaro, Louis N; Gimbel, Ronald W

2012-11-19

There are no empirically-grounded criteria or tools to define or benchmark the quality of outpatient clinical documentation. Outpatient clinical notes document care, communicate treatment plans and support patient safety, medical education, medico-legal investigations and reimbursement. Accurately describing and assessing quality of clinical documentation is a necessary improvement in an increasingly team-based healthcare delivery system. In this paper we describe the quality of outpatient clinical notes from the perspective of multiple stakeholders. Using purposeful sampling for maximum diversity, we conducted focus groups and individual interviews with clinicians, nursing and ancillary staff, patients, and healthcare administrators at six federal health care facilities between 2009 and 2011. All sessions were audio-recorded, transcribed and qualitatively analyzed using open, axial and selective coding. The 163 participants included 61 clinicians, 52 nurse/ancillary staff, 31 patients and 19 administrative staff. Three organizing themes emerged: 1) characteristics of quality in clinical notes, 2) desired elements within the clinical notes and 3) system supports to improve the quality of clinical notes. We identified 11 codes to describe characteristics of clinical notes, 20 codes to describe desired elements in quality clinical notes and 11 codes to describe clinical system elements that support quality when writing clinical notes. While there was substantial overlap between the aspects of quality described by the four stakeholder groups, only clinicians and administrators identified ease of translation into billing codes as an important characteristic of a quality note. Only patients rated prioritization of their medical problems as an aspect of quality. Nurses included care and education delivered to the patient, information added by the patient, interdisciplinary information, and infection alerts as important content. Perspectives of these four stakeholder groups provide a comprehensive description of quality in outpatient clinical documentation. The resulting description of characteristics and content necessary for quality notes provides a research-based foundation for assessing the quality of clinical documentation in outpatient health care settings.

Ten years of the International Patient Decision Aid Standards Collaboration: evolution of the core dimensions for assessing the quality of patient decision aids

PubMed Central

2013-01-01

In 2003, the International Patient Decision Aid Standards (IPDAS) Collaboration was established to enhance the quality and effectiveness of patient decision aids by establishing an evidence-informed framework for improving their content, development, implementation, and evaluation. Over this 10 year period, the Collaboration has established: a) the background document on 12 core dimensions to inform the original modified Delphi process to establish the IPDAS checklist (74 items); b) the valid and reliable IPDAS instrument (47 items); and c) the IPDAS qualifying (6 items), certifying (6 items + 4 items for screening), and quality criteria (28 items). The objective of this paper is to describe the evolution of the IPDAS Collaboration and discuss the standardized process used to update the background documents on the theoretical rationales, evidence and emerging issues underlying the 12 core dimensions for assessing the quality of patient decision aids. PMID:24624947

Photovoltaic module certification and laboratory accreditation criteria development

NASA Astrophysics Data System (ADS)

Osterwald, Carl R.; Zerlaut, Gene; Hammond, Robert; D'Aiello, Robert

1996-01-01

This paper overviews a model product certification and test laboratory accreditation program for photovoltaic (PV) modules that was recently developed by the National Renewable Energy Laboratory and Arizona State University. The specific objective of this project was to produce a document that details the equipment, facilities, quality assurance procedures, and technical expertise an accredited laboratory needs for performance and qualification testing of PV modules, along with the specific tests needed for a module design to be certified. The document was developed in conjunction with a criteria development committee consisting of representatives from 30 U.S. PV manufacturers, end users, standards and codes organizations, and testing laboratories. The intent is to lay the groundwork for a future U.S. PV certification and accreditation program that will be beneficial to the PV industry as a whole.

Process and implementation of participatory ergonomic interventions: a systematic review.

PubMed

van Eerd, Dwayne; Cole, Donald; Irvin, Emma; Mahood, Quenby; Keown, Kiera; Theberge, Nancy; Village, Judy; St Vincent, Marie; Cullen, Kim

2010-10-01

Participatory ergonomic (PE) interventions may vary in implementation. A systematic review was done to determine the evidence regarding context, barriers and facilitators to the implementation of participatory ergonomic interventions in workplaces. In total, 17 electronic databases were searched. Data on PE process and implementation were extracted from documents meeting content and quality criteria and synthesised. The search yielded 2151 references. Of these, 190 documents were relevant and 52 met content and quality criteria. Different ergonomic teams were described in the documents as were the type, duration and content of ergonomic training. PE interventions tended to focus on physical and work process changes and report positive impacts. Resources, programme support, ergonomic training, organisational training and communication were the most often noted facilitators or barriers. Successful PE interventions require the right people to be involved, appropriate ergonomic training and clear responsibilities. Addressing key facilitators and barriers such as programme support, resources, and communication is paramount. STATEMENT OF RELEVANCE: A recent systematic review has suggested that PE has some effect on reducing symptoms, lost days of work and claims. Systematic reviews of effectiveness provide practitioners with the desire to implement but do not provide clear information about how. This article reviews the literature on process and implementation of PE.

Organic food processing: a framework for concept, starting definitions and evaluation.

PubMed

Kahl, Johannes; Alborzi, Farnaz; Beck, Alexander; Bügel, Susanne; Busscher, Nicolaas; Geier, Uwe; Matt, Darja; Meischner, Tabea; Paoletti, Flavio; Pehme, Sirli; Ploeger, Angelika; Rembiałkowska, Ewa; Schmid, Otto; Strassner, Carola; Taupier-Letage, Bruno; Załęcka, Aneta

2014-10-01

In 2007 EU Regulation (EC) 834/2007 introduced principles and criteria for organic food processing. These regulations have been analysed and discussed in several scientific publications and research project reports. Recently, organic food quality was described by principles, aspects and criteria. These principles from organic agriculture were verified and adapted for organic food processing. Different levels for evaluation were suggested. In another document, underlying paradigms and consumer perception of organic food were reviewed against functional food, resulting in identifying integral product identity as the underlying paradigm and a holistic quality view connected to naturalness as consumers' perception of organic food quality. In a European study, the quality concept was applied to the organic food chain, resulting in a problem, namely that clear principles and related criteria were missing to evaluate processing methods. Therefore the goal of this paper is to describe and discuss the topic of organic food processing to make it operational. A conceptual background for organic food processing is given by verifying the underlying paradigms and principles of organic farming and organic food as well as on organic processing. The proposed definition connects organic processing to related systems such as minimal, sustainable and careful, gentle processing, and describes clear principles and related criteria. Based on food examples, such as milk with different heat treatments, the concept and definitions were verified. Organic processing can be defined by clear paradigms and principles and evaluated according criteria from a multidimensional approach. Further work has to be done on developing indicators and parameters for assessment of organic food quality. © 2013 Society of Chemical Industry.

[Reliable health information for patients with rare diseases : Quality demands defined by the National Action Plan and how they are put into practice].

PubMed

Schaefer, Corinna; Brunsmann, Frank; Siegert, Svenja

2017-05-01

Information for patients with rare diseases has to adhere to strict quality criteria in order to support individual treatment decisions or coping strategies. However, developers are facing specific challenges: For example, the evidence is often insufficient or of very low quality. In the context of the National Action League for People with Rare Diseases (NAMSE), criteria have been developed that assure high-quality information on rare diseases. Core criteria comprise the involvement of patients or their advocates in all stages of the development process, the systematic search and assessment of the evidence, systematic collection of patient experience, transparency in terms of people involved and funding, and nondirective and neutral formulation of content and documentation of the process. In a joint project between the Alliance for Chronic Rare Diseases (ACHSE e. V.) and the German Agency for Quality in Medicine (ÄZQ), ten short information leaflets on different rare diseases have been developed in the past three years, conceived to show the applicability of these criteria. First experiences with this format show that the criteria are adaptive to a broad range of diverse rare diseases and settings. Involving patients and their advocates throughout the whole development process - from prioritization to development of methods and provision of patient experience and coping strategies - is crucial. Insufficient evidence remains a challenge. The examples show that in the absence of proven findings, information that matters to patients and reflects this uncertainty is feasible.

Audit cycle of documentation in laser hair removal.

PubMed

Cohen, S N; Lanigan, S W

2005-09-01

Lasercare clinics are one of the largest providers of skin laser treatment in the United Kingdom, in both private sector and National Health Service. Laser hair removal is performed by trained nurses following written protocols. Choice of laser and fluence is tailored to Fitzpatrick skin type. We audited and re-audited documentation of six criteria in patients receiving laser hair removal (signed consent, Fitzpatrick skin type, use of appropriate laser, appropriate fluence, patient satisfaction and objective assessment) across 13 clinics at different points in time. Data were obtained on 772 treatments. Overall findings revealed excellent documentation of consent, use of appropriate laser and fluence (median 100%), good documentation of skin type (median 90%) and poor documentation of patient satisfaction and objective assessment (median 67% and 53%, respectively). Comparison between baseline and repeat audit at 6-8 months (nine clinics) showed significant improvement across clinics in these latter two criteria [patient satisfaction: odds ratio (OR) 0.38, 95% confidence interval (CI) 0.15-0.78, P=0.01; objective assessment: OR 0.23, 95% CI 0.07-0.50, P=0.0003 (Mantel-Haenszel weighted odds ratios)]. We conclude that quality of documentation was generally and consistently high in multiple clinics and that re-auditing led to significant improvement in poor scores. This simple measure could easily be implemented more widely across many disciplines.

Document of standardization of enteral nutrition access in adults.

PubMed

Arribas, Lorena; Frías, Laura; Creus, Gloria; Parejo, Juana; Urzola, Carmen; Ashbaugh, Rosana; Pérez-Portabella, Cleofé; Cuerda, Cristina

2014-07-01

The group of standardization and protocols of the Spanish Society of Parenteral and Enteral Nutrition (SENPE) published in 2011 a consensus document SENPE/SEGHNP/ANECIPN/SECP on enteral access for paediatric nutritional support. Along the lines of this document, we have developed another document on adult patients to homogenize the clinical practice and improve the quality of care in enteral access in this age group. The working group included health professionals (nurses, dietitians and doctor) with extensive experience in enteral nutrition and access. We tried to find scientific evidence through a literature review and we used the criteria of the Agency for Health-care Research and Quality (AHRQ) to classify the evidence (Grade of Recommendation A, B or C). Later the document was reviewed by external experts to the group and requested the endorsement of the Scientific and Educational Committee (CCE) and the group of home artificial nutrition (NADYA) of the SENPE. The full text will be published as a monograph number in this journal. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

42 CFR 420.303 - HHS criteria for requesting books, documents, and records.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false HHS criteria for requesting books, documents, and... Books, Documents, and Records of Subcontractors § 420.303 HHS criteria for requesting books, documents, and records. HHS will generally request books, documents, and records from a subcontractor only if one...

42 CFR 420.303 - HHS criteria for requesting books, documents, and records.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false HHS criteria for requesting books, documents, and... Books, Documents, and Records of Subcontractors § 420.303 HHS criteria for requesting books, documents, and records. HHS will generally request books, documents, and records from a subcontractor only if one...

42 CFR 420.303 - HHS criteria for requesting books, documents, and records.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false HHS criteria for requesting books, documents, and... Books, Documents, and Records of Subcontractors § 420.303 HHS criteria for requesting books, documents, and records. HHS will generally request books, documents, and records from a subcontractor only if one...

Auditing the nutrition content of patient charts: one hospital's perspective.

PubMed

Skopelianos, S

1993-01-01

Chart audits are traditionally based on patient charts categorized by disease. An alternate approach, using categorization by four types of nutrition care intervention, has been developed by University Hospital. This paper describes the process followed, criteria developed and the results of two complete chart audits. It was shown that nutrition profile forms improved documentation. Overall norms increased significantly from 81.5% to 90% (p < .05). Discussion centres on the evolutionary process from quality assurance to continuous quality improvement.

42 CFR 420.303 - HHS criteria for requesting books, documents, and records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false HHS criteria for requesting books, documents, and... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROGRAM INTEGRITY: MEDICARE Access to Books, Documents, and Records of Subcontractors § 420.303 HHS criteria for requesting books, documents, and records...

Development and Exchange of Instructional Resources in Water Quality Control Programs, III: Selecting Audio-Visual Equipment.

ERIC Educational Resources Information Center

Moon, Donald K.

This document is one in a series of reports which reviews instructional materials and equipment and offers suggestions about how to select equipment. Topics discussed include: (1) the general criteria for audio-visual equipment selection such as performance, safety, comparability, sturdiness and repairability; and (2) specific equipment criteria…

[Psychometric properties of Q-DIO, an instrument to measure the quality of documented nursing diagnoses, interventions and outcomes].

PubMed

Müller-Staub, Maria; Lunney, Margaret; Lavin, Mary Ann; Needham, Ian; Odenbreit, Matthias; van Achterberg, Theo

2010-04-01

The instrument Q-DIO was developed in the years 2005 till 2006 to measure the quality of documented nursing diagnoses, interventions, and nursing sensitive patient outcomes. Testing psychometric properties of the Q-DIO (Quality of nursing Diagnoses, Interventions and Outcomes.) was the study aim. Instrument testing included internal consistency, test-retest reliability, interrater reliability, item analyses, and an assessment of the objectivity. To render variation in scores, a random strata sample of 60 nursing documentations was drawn. The strata represented 30 nursing documentations with and 30 without application of theory based, standardised nursing language. Internal consistency of the subscale nursing diagnoses as process showed Cronbach's Alpha 0.83 [0.78, 0.88]; nursing diagnoses as product 0.98 [0.94, 0.99]; nursing interventions 0.90 [0.85, 0.94]; and nursing-sensitive patient outcomes 0.99 [0.95, 0.99]. With Cohen's Kappa of 0.95, the intrarater reliability was good. The interrater reliability showed a Kappa of 0.94 [0.90, 0.96]. Item analyses confirmed the fulfilment of criteria for degree of difficulty and discriminative validity of the items. In this study, Q-DIO has shown to be a reliable instrument. It allows measuring the documented quality of nursing diagnoses, interventions and outcomes with and without implementation of theory based, standardised nursing languages. Studies for further testing of Q-DIO in other settings are recommended. The results implicitly support the use of nursing classifications such as NANDA, NIC and NOC.

Gaining competitive advantage in personal dosimetry services through ISO 9001 certification.

PubMed

Noriah, M A

2007-01-01

This paper discusses the advantage of certification process in the quality assurance of individual dose monitoring in Malaysia. The demand by customers and the regulatory authority for a higher degree of quality service requires a switch in emphasis from a technically focused quality assurance program to a comprehensive quality management for service provision. Achieving the ISO 9001:2000 certification by an accredited third party demonstrates acceptable recognition and documents the fact that the methods used are capable of generating results that satisfy the performance criteria of the certification program. It also offers a proof of the commitment to quality and, as a benchmark, allows measurement of the progress for continual improvement of service performance.

Summary of inorganic compositional data for groundwater, soil-water, and surface-water samples collected at the Headgate Draw subsurface drip irrigation site, Johnson County, Wyoming

USGS Publications Warehouse

Geboy, Nicholas J.; Engle, Mark A.; Schroeder, Karl T.; Zupancic, John W.

2011-01-01

As part of a 5-year project on the impact of subsurface drip irrigation (SDI) application of coalbed-methane (CBM) produced waters, water samples were collected from the Headgate Draw SDI site in the Powder River Basin, Wyoming, USA. This research is part of a larger study to understand short- and long-term impacts on both soil and water quality from the beneficial use of CBM waters to grow forage crops through use of SDI. This document provides a summary of the context, sampling methodology, and quality assurance and quality control documentation of samples collected prior to and over the first year of SDI operation at the site (May 2008-October 2009). This report contains an associated database containing inorganic compositional data, water-quality criteria parameters, and calculated geochemical parameters for samples of groundwater, soil water, surface water, treated CBM waters, and as-received CBM waters collected at the Headgate Draw SDI site.

Regional differences in prescribing quality among elder veterans and the impact of rural residence

PubMed Central

Lund, BC; Charlton, ME; Steinman, MA; Kaboli, PJ

2014-01-01

Purpose Medication safety is a critical concern for older adults. Regional variation in potentially inappropriate prescribing practices may reflect important differences in health care quality. Therefore, the objectives of this study were to characterize prescribing quality variation among older adults across geographic region, and to compare prescribing quality across rural versus urban residence. Methods Cross-sectional study of 1,549,824 older adult veterans with regular Veterans Affairs (VA) primary care and medication use during fiscal year 2007. Prescribing quality was measured by 4 indicators of potentially inappropriate prescribing: Zhan criteria drugs to avoid, Fick criteria drugs to avoid, therapeutic duplication, and drug-drug interactions. Frequency differences across region and rural-urban residence were compared using adjusted odds-ratios. Findings Significant regional variation was observed for all indicators. Zhan criteria frequencies ranged from 13.2% in the Northeast to 21.2% in the South. Nationally, rural veterans had a significantly increased risk for inappropriate prescribing according to all quality indicators. However, regional analyses revealed this effect was limited to the South and Northeast, whereas rural residence was neutral in the Midwest and protective in the West. Conclusions Significant regional variation in prescribing quality was observed among older adult veterans, mirroring recent findings among Medicare beneficiaries. The association between rurality and prescribing quality is heterogeneous, and relying solely on national estimates may yield misleading conclusions. While we documented important variations in prescribing quality, the underlying factors driving these trends remain unknown, and they are a vital area for future research affecting older adults in both VA and non-VA health systems. PMID:23551647

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

Code of Federal Regulations, 2014 CFR

2014-07-01

...-conducted study of 90 days or greater designed to observe subchronic or chronic effects as defined in this document. 2. The avian data must come from at least one well-conducted study of 70 days or greater designed... poorly defined comparative toxicokinetic and toxicodynamic parameters between mammals and birds. However...

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

Code of Federal Regulations, 2011 CFR

2011-07-01

...-conducted study of 90 days or greater designed to observe subchronic or chronic effects as defined in this document. 2. The avian data must come from at least one well-conducted study of 70 days or greater designed... poorly defined comparative toxicokinetic and toxicodynamic parameters between mammals and birds. However...

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

Code of Federal Regulations, 2012 CFR

2012-07-01

...-conducted study of 90 days or greater designed to observe subchronic or chronic effects as defined in this document. 2. The avian data must come from at least one well-conducted study of 70 days or greater designed... poorly defined comparative toxicokinetic and toxicodynamic parameters between mammals and birds. However...

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

Code of Federal Regulations, 2013 CFR

2013-07-01

...-conducted study of 90 days or greater designed to observe subchronic or chronic effects as defined in this document. 2. The avian data must come from at least one well-conducted study of 70 days or greater designed... poorly defined comparative toxicokinetic and toxicodynamic parameters between mammals and birds. However...

40 CFR Appendix D to Part 132 - Great Lakes Water Quality Initiative Methodology for the Development of Wildlife Criteria

Code of Federal Regulations, 2010 CFR

2010-07-01

...-conducted study of 90 days or greater designed to observe subchronic or chronic effects as defined in this document. 2. The avian data must come from at least one well-conducted study of 70 days or greater designed... poorly defined comparative toxicokinetic and toxicodynamic parameters between mammals and birds. However...

Revised Evaluation of Health Effects Associated with Carbon Monoxide Exposure: An Addendum to the 1979 U.S. EPA Air Quality Criteria Document for Carbon Monoxide (1984)

EPA Science Inventory

The addendum re-evaluates the scientific data base concerning health effects associated with exposure to carbon monoxide (CO) at ambient or near ambient levels by providing: (1) a concise summary of key health effects information pertaining to relatively low-level CO exposure; an...

Compilation of historical water-quality data for selected springs in Texas, by ecoregion

USGS Publications Warehouse

Heitmuller, Franklin T.; Williams, Iona P.

2006-01-01

Springs are important hydrologic features in Texas. A database of about 2,000 historically documented springs and available spring-flow measurements previously has been compiled and published, but water-quality data remain scattered in published sources. This report by the U.S. Geological Survey, in cooperation with the Texas Parks and Wildlife Department, documents the compilation of data for 232 springs in Texas on the basis of a set of criteria and the development of a water-quality database for the selected springs. The selection of springs for compilation of historical water-quality data in Texas was made using existing digital and hard-copy data, responses to mailed surveys, selection criteria established by various stakeholders, geographic information systems, and digital database queries. Most springs were selected by computing the highest mean spring flows for each Texas level III ecoregion. A brief assessment of the water-quality data for springs in Texas shows that few data are available in the Arizona/New Mexico Mountains, High Plains, East Central Texas Plains, Western Gulf Coastal Plain, and South Central Plains ecoregions. Water-quality data are more abundant for the Chihuahuan Deserts, Edwards Plateau, and Texas Blackland Prairies ecoregions. Selected constituent concentrations in Texas springs, including silica, calcium, magnesium, sodium, potassium, strontium, sulfate, chloride, fluoride, nitrate (nitrogen), dissolved solids, and hardness (as calcium carbonate) are comparatively high in the Chihuahuan Deserts, Southwestern Tablelands, Central Great Plains, and Cross Timbers ecoregions, mostly as a result of subsurface geology. Comparatively low concentrations of selected constituents in Texas springs are associated with the Arizona/New Mexico Mountains, Southern Texas Plains, East Central Texas Plains, and South Central Plains ecoregions.

Drinking Water Criteria Document for Ethylene Dibromide (EDB) (Final Draft, 1985)

EPA Science Inventory

The Office of Drinking Water (ODW), U.S. Environmental Protection Agency has prepared a "Drinking Water Criteria Document on Ethylene Dibromide (EDB)". The Criteria Document is an extensive review of the following topics: Physical and chemical properties of ethylene dibromide, to...

Developing European guidelines for training care professionals in mental health promotion.

PubMed

Greacen, Tim; Jouet, Emmanuelle; Ryan, Peter; Cserhati, Zoltan; Grebenc, Vera; Griffiths, Chris; Hansen, Bettina; Leahy, Eithne; da Silva, Ksenija Maravic; Sabić, Amra; De Marco, Angela; Flores, Paz

2012-12-27

Although mental health promotion is a priority mental health action area for all European countries, high level training resources and high quality skills acquisition in mental health promotion are still relatively rare. The aim of the current paper is to present the results of the DG SANCO-funded PROMISE project concerning the development of European guidelines for training social and health care professionals in mental health promotion. The PROMISE project brought together a multidisciplinary scientific committee from eight European sites representing a variety of institutions including universities, mental health service providers and public health organisations. The committee used thematic content analysis to filter and analyse European and international policy documents, scientific literature reviews on mental health promotion and existing mental health promotion programmes with regard to identifying quality criteria for training care professionals on this subject. The resulting PROMISE Guidelines quality criteria were then subjected to an iterative feedback procedure with local steering groups and training professionals at all sites with the aim of developing resource kits and evaluation tools for using the PROMISE Guidelines. Scientific committees also collected information from European, national and local stakeholder groups and professional organisations on existing training programmes, policies and projects. The process identified ten quality criteria for training care professionals in mental health promotion: embracing the principle of positive mental health; empowering community stakeholders; adopting an interdisciplinary and intersectoral approach; including people with mental health problems; advocating; consulting the knowledge base; adapting interventions to local contexts; identifying and evaluating risks; using the media; evaluating training, implementation processes and outcomes. The iterative feedback process produced resource kits and evaluation checklists linked with each of these quality criteria in all PROMISE languages. The development of generic guidelines based on key quality criteria for training health and social care professionals in mental health promotion should contribute in a significant way to implementing policy in this important area.

Guidance on assessing the methodological and reporting quality of toxicologically relevant studies: A scoping review.

PubMed

Samuel, Gbeminiyi O; Hoffmann, Sebastian; Wright, Robert A; Lalu, Manoj Mathew; Patlewicz, Grace; Becker, Richard A; DeGeorge, George L; Fergusson, Dean; Hartung, Thomas; Lewis, R Jeffrey; Stephens, Martin L

2016-01-01

Assessments of methodological and reporting quality are critical to adequately judging the credibility of a study's conclusions and to gauging its potential reproducibility. To aid those seeking to assess the methodological or reporting quality of studies relevant to toxicology, we conducted a scoping review of the available guidance with respect to four types of studies: in vivo and in vitro, (quantitative) structure-activity relationships ([Q]SARs), physico-chemical, and human observational studies. Our aims were to identify the available guidance in this diverse literature, briefly summarize each document, and distill the common elements of these documents for each study type. In general, we found considerable guidance for in vivo and human studies, but only one paper addressed in vitro studies exclusively. The guidance for (Q)SAR studies and physico-chemical studies was scant but authoritative. There was substantial overlap across guidance documents in the proposed criteria for both methodological and reporting quality. Some guidance documents address toxicology research directly, whereas others address preclinical research generally or clinical research and therefore may not be fully applicable to the toxicology context without some translation. Another challenge is the degree to which assessments of methodological quality in toxicology should focus on risk of bias - as in clinical medicine and healthcare - or be broadened to include other quality measures, such as confirming the identity of test substances prior to exposure. Our review is intended primarily for those in toxicology and risk assessment seeking an entry point into the extensive and diverse literature on methodological and reporting quality applicable to their work. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Hanford Internal Dosimetry Project manual. Revision 1

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

Carbaugh, E.H.; Bihl, D.E.; MacLellan, J.A.

1994-07-01

This document describes the Hanford Internal Dosimetry Project, as it is administered by Pacific Northwest Laboratory (PNL) in support of the US Department of Energy and its Hanford contractors. Project services include administrating the bioassay monitoring program, evaluating and documenting assessment of potential intakes and internal dose, ensuring that analytical laboratories conform to requirements, selecting and applying appropriate models and procedures for evaluating radionuclide deposition and the resulting dose, and technically guiding and supporting Hanford contractors in matters regarding internal dosimetry. Specific chapters deal with the following subjects: practices of the project, including interpretation of applicable DOE Orders, regulations, andmore » guidance into criteria for assessment, documentation, and reporting of doses; assessment of internal dose, including summary explanations of when and how assessments are performed; recording and reporting practices for internal dose; selection of workers for bioassay monitoring and establishment of type and frequency of bioassay measurements; capability and scheduling of bioassay monitoring services; recommended dosimetry response to potential internal exposure incidents; quality control and quality assurance provisions of the program.« less

Optimisation of the digital radiographic imaging of suspected non-accidental injury

NASA Astrophysics Data System (ADS)

Offiah, Amaka

Aim: To optimise the digital (radiographic) imaging of children presenting with suspected non-accidental injury (NAI). Objectives: (i) To evaluate existing radiographic quality criteria, and to develop a more suitable system if these are found to be inapplicable to skeletal surveys obtained in suspected NAI. (ii) To document differences in image quality between conventional film-screen and the recently installed Fuji5000R computed radiography (CR) system at Great Ormond Street Hospital for Children, (iii) To document the extent of variability in the standard of skeletal surveys obtained in the UK for suspected NAI. (iv) To determine those radiographic parameters which yield the highest diagnostic accuracy, while still maintaining acceptable radiation dose to the child, (v) To determine how varying degrees of edge-enhancement affect diagnostic accuracy. (vi) To establish the accuracy of soft compared to hard copy interpretation of images in suspected NAI. Materials and Methods: (i) and (ii) Retrospective analysis of 286 paediatric lateral spine radiographs by two observers based on the Commission of European Communities (CEC) quality criteria, (iii) Review of the skeletal surveys of 50 consecutive infants referred from hospitals throughout the United Kingdom (UK) with suspected NAI. (iv) Phantom studies. Leeds TO. 10 and TO. 16 test objects were used to compare the relationship between film density, exposure parameters and visualisation of object details, (iv) Clinical study. Anteroposterior and lateral post mortem skull radiographs of six consecutive infants were obtained at various exposures. Six observers independently scored the images based on visualisation of five criteria, (v) and (vi) A study of diagnostic accuracy in which six observers independently interpreted 50 radiographs from printed copies (with varying degrees of edge-enhancement) and from a monitor. Results: The CEC criteria are useful for optimisation of imaging parameters and allow the detection of differences in quality of film-screen and digital images. There is much variability in the quality and number of radiographs performed as part of skeletal surveys in the UK for suspected NAI. The Leeds test objects are either not sensitive enough (TO. 10) or perhaps over sensitive (TO. 16) for the purposes of this project. Furthermore, the minimum spatial resolution required for digital imaging in NAI has not been established. Therefore the objective interpretation of phantom studies is difficult. There is scope for reduction of radiation dose to children with no effect on image quality. Diagnostic accuracy (fracture detection) in suspected NAI is generally low, and is not affected by image display modality. Conclusions: The CEC quality criteria are not applicable to the assessment of clinical image quality. A national protocol for skeletal surveys in NAI is required. Dedicated training, close supervision, collaboration and consistent exposure of radiologists to cases of NAI should improve diagnostic accuracy. The potential exists for dose reduction when performing skeletal surveys in children and infants with suspected NAI. Future studies should address this issue.

ACCF/AHA methodology for the development of quality measures for cardiovascular technology: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures.

PubMed

Bonow, Robert O; Douglas, Pamela S; Buxton, Alfred E; Cohen, David J; Curtis, Jeptha P; Delong, Elizabeth; Drozda, Joseph P; Ferguson, T Bruce; Heidenreich, Paul A; Hendel, Robert C; Masoudi, Frederick A; Peterson, Eric D; Taylor, Allen J

2011-09-27

Consistent with the growing national focus on healthcare quality, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have taken a leadership role over the past decade in developing measures of the quality of cardiovascular care by convening a joint ACCF/AHA Task Force on Performance Measures. The Task Force is charged with identifying the clinical topics appropriate for the development of performance measures and with assembling writing committees composed of clinical and methodological experts in collaboration with appropriate subspecialty societies. The Task Force has also created methodology documents that offer guidance in the development of process, outcome, composite, and efficiency measures. Cardiovascular performance measures using existing ACCF/AHA methodology are based on Class I or Class III guidelines recommendations, usually with Level A evidence. These performance measures, based on evidence-based ACCF/AHA guidelines, remain the most rigorous quality measures for both internal quality improvement and public reporting. However, many of the tools for diagnosis and treatment of cardiovascular disease involve advanced technologies, such as cardiac imaging, for which there are often no underlying guideline documents. Because these technologies affect the quality of cardiovascular care and also have the potential to contribute to cardiovascular health expenditures, there is a need for more critical assessment of the use of technology, including the development of quality and performance measures in areas in which guideline recommendations are absent. The evaluation of quality in the use of cardiovascular technologies requires consideration of multiple parameters that differ from other healthcare processes. The present document describes methodology for development of 2 new classes of quality measures in these situations, appropriate use measures and structure/safety measures. Appropriate use measures are based on specific indications, processes, or parameters of care for which high level of evidence data and Class I or Class III guideline recommendations may be lacking but are addressed in ACCF appropriate use criteria documents. Structure/safety measures represent measures developed to address structural aspects of the use of healthcare technology (e.g., laboratory accreditation, personnel training, and credentialing) or quality issues related to patient safety when there are neither guidelines recommendations nor appropriate use criteria. Although the strength of evidence for appropriate use measures and structure/safety measures may not be as strong as that for formal performance measures, they are quality measures that are otherwise rigorously developed, reviewed, tested, and approved in the same manner as ACCF/AHA performance measures. The ultimate goal of the present document is to provide direction in defining and measuring the appropriate use-avoiding not only underuse but also overuse and misuse-and proper application of cardiovascular technology and to describe how such appropriate use measures and structure/safety measures might be developed for the purposes of quality improvement and public reporting. It is anticipated that this effort will help focus the national dialogue on the use of cardiovascular technology and away from the current concerns about volume and cost alone to a more holistic emphasis on value.

Evaluation of the Present-on-Admission Indicator among Hospitalized Fee-for-Service Medicare Patients with a Pressure Ulcer Diagnosis: Coding Patterns and Impact on Hospital-Acquired Pressure Ulcer Rates.

PubMed

Squitieri, Lee; Waxman, Daniel A; Mangione, Carol M; Saliba, Debra; Ko, Clifford Y; Needleman, Jack; Ganz, David A

2018-01-25

To evaluate national present-on-admission (POA) reporting for hospital-acquired pressure ulcers (HAPUs) and examine the impact of quality measure exclusion criteria on HAPU rates. Medicare inpatient, outpatient, and nursing facility data as well as independent provider claims (2010-2011). Retrospective cross-sectional study. We evaluated acute inpatient hospital admissions among Medicare fee-for-service (FFS) beneficiaries in 2011. Admissions were categorized as follows: (1) no pressure ulcer diagnosis, (2) new pressure ulcer diagnosis, and (3) previously documented pressure ulcer diagnosis. HAPU rates were calculated by varying patient exclusion criteria. Among admissions with a pressure ulcer diagnosis, we observed a large discrepancy in the proportion of admissions with a HAPU based on hospital-reported POA data (5.2 percent) and the proportion with a new pressure ulcer diagnosis based on patient history in billing claims (49.7 percent). Applying quality measure exclusion criteria resulted in removal of 91.2 percent of admissions with a pressure injury diagnosis from HAPU rate calculations. As payers and health care organizations expand the use of quality measures, it is important to consider how the measures are implemented, coding revisions to improve measure validity, and the impact of patient exclusion criteria on provider performance evaluation. © Health Research and Educational Trust.

Audit of Endotracheal Tube Suction in a Pediatric Intensive Care Unit.

PubMed

Davies, Kylie; Bulsara, Max K; Ramelet, Anne-Sylvie; Monterosso, Leanne

2017-02-01

We report outcomes of a clinical audit examining criteria used in clinical practice to rationalize endotracheal tube (ETT) suction, and the extent these matched criteria in the Endotracheal Suction Assessment Tool(ESAT)©. A retrospective audit of patient notes ( N = 292) and analyses of criteria documented by pediatric intensive care nurses to rationalize ETT suction were undertaken. The median number of documented respiratory and ventilation status criteria per ETT suction event that matched the ESAT© criteria was 2 [Interquartile Range (IQR) 1-6]. All criteria listed within the ESAT© were documented within the reviewed notes. A direct link was established between criteria used for current clinical practice of ETT suction and the ESAT©. The ESAT©, therefore, reflects documented clinical decision making and could be used as both a clinical and educational guide for inexperienced pediatric critical care nurses. Modification to the ESAT © requires "preparation for extubation" to be added.

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

Gardner, S.

Louisiana, now in a developmental stage of policy and planning, has completed a project aimed at reducing hazardous releases of air toxics in thee state. The state is also conducting a Comparative Risk Project and is using risk assessment practices to develop its waste quality standards. In developing an air toxic list, Louisiana incorporated four major criteria into the ranking: emission levels, human health effects, potential population exposure, and persistence or accumulation in the environment. For the human health effects criterion, data for each substance was gathered from numerous sources, although the Integrated Risk Information System (IRIS) database was usedmore » as a primary source for toxicological information. Following guidelines established by the Environmental Protection Agency (EPA), the Office of Water Resources, Water Pollution Control Division, has developed numerical criteria for human health protection based on risk assessment procedures in the 1989 Water Quality Standards Revision. Currently over 30 toxic substances have risk-based criteria for th protection of human health in the standards. Numerical criteria were calculated for carcinogenic substances having an EPA Classification of A, B1, B2, or C. Cancer class designations along with cancer potency slopes and reference doses were extracted from the IRIS database, with the exception of those chemicals that had not been assessed in IRIS as of December 1, 1988. The parameters necessary for calculating human health criteria for the missing chemicals were taken from 1980, 1984, and 1985 ambient water quality criteria documents: data on bioconcentration factors were included. Currently, Louisiana is working on a Comparative Risk Project, a ranking of the environmental issues in the state relative to potential risk to the public, which is the basis for a widespread 1991 public outreach effort.« less

Pediatric eMental healthcare technologies: a systematic review of implementation foci in research studies, and government and organizational documents.

PubMed

Gehring, Nicole D; McGrath, Patrick; Wozney, Lori; Soleimani, Amir; Bennett, Kathryn; Hartling, Lisa; Huguet, Anna; Dyson, Michele P; Newton, Amanda S

2017-06-21

Researchers, healthcare planners, and policymakers convey a sense of urgency in using eMental healthcare technologies to improve pediatric mental healthcare availability and access. Yet, different stakeholders may focus on different aspects of implementation. We conducted a systematic review to identify implementation foci in research studies and government/organizational documents for eMental healthcare technologies for pediatric mental healthcare. A search of eleven electronic databases and grey literature was conducted. We included research studies and documents from organization and government websites if the focus included eMental healthcare technology for children/adolescents (0-18 years), and implementation was studied and reported (research studies) or goals/recommendations regarding implementation were made (documents). We assessed study quality using the Mixed Methods Appraisal Tool and document quality using the Appraisal of Guidelines for Research & Evaluation II. Implementation information was grouped according to Proctor and colleagues' implementation outcomes-acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability-and grouped separately for studies and documents. Twenty research studies and nine government/organizational documents met eligibility criteria. These articles represented implementation of eMental healthcare technologies in the USA (14 studies), United Kingdom (2 documents, 3 studies), Canada (2 documents, 1 study), Australia (4 documents, 1 study), New Zealand (1 study), and the Netherlands (1 document). The quality of research studies was excellent (n = 11), good (n = 6), and poor (n = 1). These eMental health studies focused on the acceptability (70%, n = 14) and appropriateness (50%, n = 10) of eMental healthcare technologies to users and mental healthcare professionals. The quality of government and organizational documents was high (n = 2), medium (n = 6), and low (n = 1). These documents focused on cost (100%, n = 9), penetration (89%, n = 8), feasibility (78%, n = 7), and sustainability (67%, n = 6) of implementing eMental healthcare technology. To date, research studies have largely focused on acceptability and appropriateness, while government/organizational documents state goals and recommendations regarding costs, feasibility, and sustainability of eMental healthcare technologies. These differences suggest that the research evidence available for pediatric eMental healthcare technologies does not reflect the focus of governments and organizations. Partnerships between researchers, healthcare planners, and policymakers may help to align implementation research with policy development, decision-making, and funding foci.

Quality of medicines in Canada: a retrospective review of risk communication documents (2005–2013)

PubMed Central

Almuzaini, Tariq; Sammons, Helen; Choonara, Imti

2014-01-01

Objective To explore the quality and safety of medicines in Canada. Design A retrospective review of drug recalls and risk communication documents conveying issues relating to defective (ie, substandard and falsified) medicines. Setting The Health Canada website search for drug recalls and risk communication documents issued between 2005 and 2013. Eligibility criteria Drug recalls and risk communication documents related to quality defect in medicinal products. Main outcome measure Relevant data about defective medicines reported in drug recalls and risk communication documents, including description of the defect, type of formulation, year of the recall and category of the recall or the document. Results There were 653 defective medicines of which 649 were substandard. The number of defective medicines reported by Health Canada increased from 42 in 2005 to 143 in 2013. The two most frequently reported types of defects were stability (205 incidents) and contamination issues (139 incidents). Some of these defects were found to be more prominent and repetitive over other types within some manufacturers. Tablet formulation (251 incidents) was the formulation most frequently compromised. No significant differences were observed between the manufacturers and distributors in the number of substandard medicines reported under each defect type. There were only four falsified medicines reported over the 9-year period. Conclusions Substandard medicines are a problem in Canada and have resulted in an increasing number of recalled medicines. Most of the failures were related to stability issues, raising the need to investigate the root causes and for stringent preventative measures to be implemented by manufacturers. PMID:25361839

Quality Assurance Program Plan for SFR Metallic Fuel Data Qualification

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

Benoit, Timothy; Hlotke, John Daniel; Yacout, Abdellatif

2017-07-05

This document contains an evaluation of the applicability of the current Quality Assurance Standards from the American Society of Mechanical Engineers Standard NQA-1 (NQA-1) criteria and identifies and describes the quality assurance process(es) by which attributes of historical, analytical, and other data associated with sodium-cooled fast reactor [SFR] metallic fuel and/or related reactor fuel designs and constituency will be evaluated. This process is being instituted to facilitate validation of data to the extent that such data may be used to support future licensing efforts associated with advanced reactor designs. The initial data to be evaluated under this program were generatedmore » during the US Integral Fast Reactor program between 1984-1994, where the data includes, but is not limited to, research and development data and associated documents, test plans and associated protocols, operations and test data, technical reports, and information associated with past United States Nuclear Regulatory Commission reviews of SFR designs.« less

Low-level radioactive waste management: transitioning to off-site disposal at Los Alamos National Laboratory

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

Dorries, Alison M

2010-11-09

Facing the closure of nearly all on-site management and disposal capability for low-level radioactive waste (LLW), Los Alamos National Laboratory (LANL) is making ready to ship the majority of LLW off-site. In order to ship off-site, waste must meet the Treatment, Storage, and Disposal Facility's (TSDF) Waste Acceptance Criteria (WAC). In preparation, LANL's waste management organization must ensure LANL waste generators characterize and package waste compliantly and waste characterization documentation is complete and accurate. Key challenges that must be addressed to successfully make the shift to off-site disposal of LLW include improving the detail, accuracy, and quality of process knowledgemore » (PK) and acceptable knowledge (AK) documentation, training waste generators and waste management staff on the higher standard of data quality and expectations, improved WAC compliance for off-site facilities, and enhanced quality assurance throughout the process. Certification of LANL generators will allow direct off-site shipping of LLW from their facilities.« less

RESRAD model presentation

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

Yu, C.; Faillace, E.; Chen, S.Y.

RESRAD was one of the multimedia models selected by the US Nuclear Regulatory Commission (NRC) to include in its workshop on radiation dose modeling and demonstration of compliance with the radiological criteria for license termination. This paper is a summary of the presentation made at the workshop and focuses on the 10 questions the NRC distributed to all participants prior to the workshop. The code selection criteria, which were solicited by the NRC, for demonstrating compliance with the license termination rule are also included. Among the RESRAD family of codes, RESRAD and RESRAD-BUILD are designed for evaluating radiological contamination inmore » soils and in buildings. Many documents have been published to support the use of these codes. This paper focuses on these two codes. The pathways considered, the databases and parameters used, quality control and quality assurance, benchmarking, verification and validation of these codes, and capabilities as well as limitations of these codes are discussed in detail.« less

Defibrillator implantations for primary prevention in the United States: Inappropriate care or inadequate documentation: Insights from the National Cardiovascular Data ICD Registry.

PubMed

Kaiser, Daniel W; Tsai, Vivian; Heidenreich, Paul A; Goldstein, Mary K; Wang, Yongfei; Curtis, Jeptha; Turakhia, Mintu P

2015-10-01

Prior studies have reported that more than 20% of implantable cardioverter-defibrillator (ICD) implantations in the United States do not adhere to trial-based criteria. We sought to investigate the patient characteristics associated with not meeting the inclusion criteria of the clinical trials that have demonstrated the efficacy of primary prevention ICDs. Using data from the National Cardiovascular Data Registry's ICD Registry, we identified patients who received ICDs for primary prevention from January 2006 to December 2008. We determined whether patients met the inclusion criteria of at least 1 of the 4 ICD primary prevention trials: Multicenter Automatic Defibrillator Implantation Trial (MADIT), MADIT-II, Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), and the Multicenter Unsustained Tachycardia Trial (MUSTT). Among 150,264 patients, 86% met criteria for an ICD implantation based on trial data. The proportion of patients who did not meet trial-based criteria increased as age decreased. In multivariate analysis, the significant predictors for not meeting trial criteria included prior cardiac transplantation (odds ratio [OR] 2.1), pediatric electrophysiology operator (OR 2.0), and high-grade atrioventricular conduction disease (OR 1.4). Among National Cardiovascular Data Registry registrants receiving first-time ICDs for primary prevention, the majority met trial-based criteria. Multivariate analyses suggested that many patients who did not meet the trial-based criteria may have had clinical circumstances that warranted ICD implantation. These findings caution against the use of trial-based indications to determine site quality metrics that could penalize sites that care for younger patients. The planned incorporation of appropriate use criteria into the ICD registry may better characterize patient- and site-level quality and performance. Published by Elsevier Inc.

Criteria, Methods and Implications. Proceedings of the International Symposium on the Evaluation of Physics Education (Helsinki, Finland, June 25-29, 1990). Research Report 96.

ERIC Educational Resources Information Center

Ahtee, Maija, Ed.; And Others

The main purpose of this symposium was to find new ideas and resources for the evaluation and improvement of physics education on all levels. The papers included in this document are entitled: (1) "Quality of Physics Teaching Through Building Models and Advancing Research Skills"; (2) "Evaluation of Physics Education in Terms of Its…

Orientation and mobility training for partially-sighted older adults using an identification cane: a systematic review

PubMed Central

Ballemans, Judith; Kempen, Gertrudis IJM; Zijlstra, GA Rixt

2011-01-01

Objective: This study aimed to provide an overview of the development, content, feasibility, and effectiveness of existing orientation and mobility training programmes in the use of the identification cane. Data sources: A systematic bibliographic database search in PubMed, PsychInfo, ERIC, CINAHL and the Cochrane Library was performed, in combination with the expert consultation (n = 42; orientation and mobility experts), and hand-searching of reference lists. Review methods: Selection criteria included a description of the development, the content, the feasibility, or the effectiveness of orientation and mobility training in the use of the identification cane. Two reviewers independently agreed on eligibility and methodological quality. A narrative/qualitative data analysis method was applied to extract data from obtained documents. Results: The sensitive database search and hand-searching of reference lists revealed 248 potentially relevant abstracts. None met the eligibility criteria. Expert consultation resulted in the inclusion of six documents in which the information presented on the orientation and mobility training in the use of the identification cane was incomplete and of low methodological quality. Conclusion: Our review of the literature showed a lack of well-described protocols and studies on orientation and mobility training in identification cane use. PMID:21795405

Sci-Fri AM: Quality, Safety, and Professional Issues 01: CPQR Technical Quality Control Suite Development including Quality Control Workload Results

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

Malkoske, Kyle; Nielsen, Michelle; Brown, Erika

A close partnership between the Canadian Partnership for Quality Radiotherapy (CPQR) and the Canadian Organization of Medical Physicist’s (COMP) Quality Assurance and Radiation Safety Advisory Committee (QARSAC) has resulted in the development of a suite of Technical Quality Control (TQC) Guidelines for radiation treatment equipment, that outline specific performance objectives and criteria that equipment should meet in order to assure an acceptable level of radiation treatment quality. The framework includes consolidation of existing guidelines and/or literature by expert reviewers, structured stages of public review, external field-testing and ratification by COMP. The adopted framework for the development and maintenance of themore » TQCs ensures the guidelines incorporate input from the medical physics community during development, measures the workload required to perform the QC tests outlined in each TQC, and remain relevant (i.e. “living documents”) through subsequent planned reviews and updates. This presentation will show the Multi-Leaf Linear Accelerator document as an example of how feedback and cross-national work to achieve a robust guidance document. During field-testing, each technology was tested at multiple centres in a variety of clinic environments. As part of the defined feedback, workload data was captured. This lead to average time associated with testing as defined in each TQC document. As a result, for a medium-sized centre comprising 6 linear accelerators and a comprehensive brachytherapy program, we evaluate the physics workload to 1.5 full-time equivalent physicist per year to complete all QC tests listed in this suite.« less

Parents on the web: risks for quality management of cough in children.

PubMed

Pandolfini, C; Impicciatore, P; Bonati, M

2000-01-01

Health information on the Internet, with respect to common, self-limited childhood illnesses, has been found to be unreliable. Therefore, parents navigating on the Internet risk finding advice that is incomplete or, more importantly, not evidence-based. The importance that a resource such as the Internet as a source of quality health information for consumers should, however, be taken into consideration. For this reason, studies need to be performed regarding the quality of material provided. Various strategies have been proposed that would allow parents to distinguish trustworthy web documents from unreliable ones. One of these strategies is the use of a checklist for the appraisal of web pages based on their technical aspects. The purpose of this study was to assess the quality of information present on the Internet regarding the home management of cough in children and to examine the applicability of a checklist strategy that would allow consumers to select more trustworthy web pages. The Internet was searched for web pages regarding the home treatment of cough in children with the use of different search engines. Medline and the Cochrane database were searched for available evidence concerning the management of cough in children. Three checklists were created to assess different aspects of the web documents. The first checklist was designed to allow for a technical appraisal of the web pages and was based on components such as the name of the author and references used. The second was constructed to examine the completeness of the health information contained in the documents, such as causes and mechanism of cough, and pharmacological and nonpharmacological treatment. The third checklist assessed the quality of the information by measuring it against a gold standard document. This document was created by combining the policy statement issued by the American Academy of Pediatrics regarding the pharmacological treatment of cough in children with the guide of the World Health Organization on drugs for children. For each checklist, the web page contents were analyzed and quantitative measurements were assigned. Of the 19 web pages identified, 9 explained the purpose and/or mechanism of cough and 14 the causes. The most frequently mentioned pharmacological treatments were single-ingredient suppressant preparations, followed by single-ingredient expectorants. Dextromethorphan was the most commonly referred to suppressant and guaifenesin the most common expectorant. No documents discouraged the use of suppressants, although 4 of the 10 web documents that addressed expectorants discouraged their use. Sixteen web pages addressed nonpharmacological treatment, 14 of which suggested exposure to a humid environment and/or extra fluid. In most cases, the criteria in the technical appraisal checklist were not present in the web documents; moreover, 2 web pages did not provide any of the items. Regarding content completeness, 3 web pages satisfied all the requirements considered in the checklist and 2 documents did not meet any of the criteria. Of the 3 web pages that scored highest in technical aspect, 2 also supplied complete information. No relationship was found, however, between the technical aspect and the content completeness. Concerning the quality of the health information supplied, 10 pages received a negative score because they contained more incorrect than correct information, and 1 web page received a high score. This document was 1 of the 2 that also scored high in technical aspect and content completeness. No relationship was found, however, among quality of information, technical aspect, and content completeness. As the results of this study show, a parent navigating the Internet for information on the home management of cough in children will no doubt find incorrect advice among the search results. (ABSTRACT TRUNCATED)

ACCF/AHA methodology for the development of quality measures for cardiovascular technology: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures.

PubMed

Bonow, Robert O; Douglas, Pamela S; Buxton, Alfred E; Cohen, David J; Curtis, Jeptha P; Delong, Elizabeth; Drozda, Joseph P; Ferguson, T Bruce; Heidenreich, Paul A; Hendel, Robert C; Masoudi, Frederick A; Peterson, Eric D; Taylor, Allen J

2011-09-27

Consistent with the growing national focus on healthcare quality, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have taken a leadership role over the past decade in developing measures of the quality of cardiovascular care by convening a joint ACCF/AHA Task Force on Performance Measures. The Task Force is charged with identifying the clinical topics appropriate for the development of performance measures and with assembling writing committees composed of clinical and methodological experts in collaboration with appropriate subspecialty societies. The Task Force has also created methodology documents that offer guidance in the development of process, outcome, composite, and efficiency measures. Cardiovascular performance measures using existing ACCF/AHA methodology are based on Class I or Class III guidelines recommendations, usually with Level A evidence. These performance measures, based on evidence-based ACCF/AHA guidelines, remain the most rigorous quality measures for both internal quality improvement and public reporting. However, many of the tools for diagnosis and treatment of cardiovascular disease involve advanced technologies, such as cardiac imaging, for which there are often no underlying guideline documents. Because these technologies affect the quality of cardiovascular care and also have the potential to contribute to cardiovascular health expenditures, there is a need for more critical assessment of the use of technology, including the development of quality and performance measures in areas in which guideline recommendations are absent. The evaluation of quality in the use of cardiovascular technologies requires consideration of multiple parameters that differ from other healthcare processes. The present document describes methodology for development of 2 new classes of quality measures in these situations, appropriate use measures and structure/safety measures. Appropriate use measures are based on specific indications, processes, or parameters of care for which high level of evidence data and Class I or Class III guideline recommendations may be lacking but are addressed in ACCF appropriate use criteria documents. Structure/safety measures represent measures developed to address structural aspects of the use of healthcare technology (e.g., laboratory accreditation, personnel training, and credentialing) or quality issues related to patient safety when there are neither guidelines recommendations nor appropriate use criteria. Although the strength of evidence for appropriate use measures and structure/safety measures may not be as strong as that for formal performance measures, they are quality measures that are otherwise rigorously developed, reviewed, tested, and approved in the same manner as ACCF/AHA performance measures. The ultimate goal of the present document is to provide direction in defining and measuring the appropriate use-avoiding not only underuse but also overuse and misuse-and proper application of cardiovascular technology and to describe how such appropriate use measures and structure/safety measures might be developed for the purposes of quality improvement and public reporting. It is anticipated that this effort will help focus the national dialogue on the use of cardiovascular technology and away from the current concerns about volume and cost alone to a more holistic emphasis on value. Copyright © 2011 American College of Cardiology Foundation and the American Heart Association, Inc. Published by Elsevier Inc. All rights reserved.

Good eggs? Evaluating consent forms for egg donation.

PubMed

Cattapan, Alana Rose

2016-07-01

Beyond gaps in the provision of information, the informed consent process for egg donation is complicated by conflicts of interest, payment and a lack of longitudinal data about physiological and psychological risks. Recent scholarship has suggested that egg donation programmes could improve the informed consent process by revising consent documents. At a minimum, these documents should include information about eight key criteria: the nature and objectives of treatment; the benefits, risks and inconveniences of egg donation; the privacy of donors and their anonymity (where applicable); disclosure that participation is voluntary (withdrawal); the availability of counselling; financial considerations; the possibility of an unsuccessful cycle and potential uses of the eggs retrieved. This study evaluates the incorporation of these minimum criteria in consent forms for egg donation, obtained through requests to Canadian fertility clinics. Even when clinics were considered to have met criteria simply by mentioning them, among the eight consent forms assessed, none met the minimum standards. Only half of clinics addressed privacy/anonymity concerns, financial issues and the possibility of a future cycle. Improving the quality of consent documentation to meet the minimum standards established by this study may not be an onerous task. For some, this will include re-evaluating how they include one or two elements of disclosure, and for others, this will require a substantial overhaul. Using the criteria provided by this study as the minimum standard for consent could ensure that donors have the basic information they need to make informed decisions. 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/

Some lessons learned in three years with ADS-33C. [rotorcraft handling qualities specification

NASA Technical Reports Server (NTRS)

Key, David L.; Blanken, Chris L.; Hoh, Roger H.

1993-01-01

Three years of using the U.S. Army's rotorcraft handling qualities specification, Aeronautical Design Standard - 33, has shown it to be surprisingly robust. It appears to provide an excellent basis for design and for assessment, however, as the subtleties become more well understood, several areas needing refinement became apparent. Three responses to these needs have been documented in this paper: (1) The yaw-axis attitude quickness for hover target acquisition and tracking can be relaxed slightly. (2) Understanding and application of criteria for degraded visual environments needed elaboration. This and some guidelines for testing to obtain visual cue ratings have been documented. (3) The flight test maneuvers were an innovation that turned out to be very valuable. Their extensive use has made it necessary to tighten definitions and testing guidance. This was accomplished for a good visual environment and is underway for degraded visual environments.

Natural language processing and the representation of clinical data.

PubMed Central

Sager, N; Lyman, M; Bucknall, C; Nhan, N; Tick, L J

1994-01-01

OBJECTIVE: Develop a representation of clinical observations and actions and a method of processing free-text patient documents to facilitate applications such as quality assurance. DESIGN: The Linguistic String Project (LSP) system of New York University utilizes syntactic analysis, augmented by a sublanguage grammar and an information structure that are specific to the clinical narrative, to map free-text documents into a database for querying. MEASUREMENTS: Information precision (I-P) and information recall (I-R) were measured for queries for the presence of 13 asthma-health-care quality assurance criteria in a database generated from 59 discharge letters. RESULTS: I-P, using counts of major errors only, was 95.7% for the 28-letter training set and 98.6% for the 31-letter test set. I-R, using counts of major omissions only, was 93.9% for the training set and 92.5% for the test set. PMID:7719796

[Consideration of guidelines, recommendations and quality indicators for treatment of stroke in the dataset "Emergency Department" of DIVI].

PubMed

Kulla, M; Friess, M; Schellinger, P D; Harth, A; Busse, O; Walcher, F; Helm, M

2015-12-01

The dataset "Emergency Department" of the German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI) has been developed during several expert meetings. Its goal is an all-encompassing documentation of the early clinical treatment of patients in emergency departments. Using the example of the index disease acute ischemic stroke (stroke), the aim was to analyze how far this approach has been fulfilled. In this study German, European and US American guidelines were used to analyze the extent of coverage of the datasets on current emergency department guidelines and recommendations from professional societies. In addition, it was examined whether the dataset includes recommended quality indicators (QI) for quality management (QM) and in a third step it was examined to what extent national provisions for billing are included. In each case a differentiation was made whether the respective rationale was primary, i.e. directly apparent or whether it was merely secondarily depicted by expertise. In the evaluation an additional differentiation was made between the level of recommendations and further quality relevant criteria. The modular design of the emergency department dataset comprising 676 data fields is briefly described. A total of 401 individual fields, divided into basic documentation, monitoring and specific neurological documentation of the treatment of stroke patients were considered. For 247 data fields a rationale was found. Partially overlapping, 78.9 % of 214 medical recommendations in 3 guidelines and 85.8 % of the 106 identified quality indicators were primarily covered. Of the 67 requirements for billing of performance of services, 55.5 % are primarily part of the emergency department dataset. Through appropriate expertise and documentation by a board certified neurologist, the results can be improved to almost 100 %. The index disease stroke illustrates that the emergency department dataset of the DIVI covers medical guidelines, especially 100 % of the German guidelines with a grade of recommendation. All necessary information to document the specialized stroke treatment procedure in the German diagnosis-related groups (DRG) system is also covered. The dataset is also suitable as a documentation tool of quality management, for example, to participate in the registry of the German Stroke Society (ADSR). Best results are obtained if the dataset is applied by a physician specialized in the treatment of patients with stroke (e.g. board certified neurologist). Finally the results show that changes in medical guidelines and recommendations for quality management as well as billing-relevant content should be implemented in the development of datasets for documentation to avoid duplicate documentation.

Impact of a structured intern education programme on clinical documentation in the emergency department.

PubMed

McLean, Andrew; Lawlor, Jenine; Mitchell, Rob; Kault, David; O'Kane, Carl; Lees, Michelle

2015-02-01

To evaluate the impact of More Learning for Interns in Emergency (MoLIE) on clinical documentation in the ED of a large regional hospital. MoLIE was implemented at The Townsville Hospital (TTH) in 2010, and has since provided ED interns with structured off-floor teaching and a dedicated clinical supervisor. A pre- and post-intervention study was conducted using retrospective medical record review methodology. Charts were selected by identifying all TTH ED patients seen by interns in the period 2008-2011. Two hundred pre-intervention records (2008-2009) and 200 post-intervention records (2010-2011) were reviewed. These were randomly selected following an initial screen by an ED staff specialist. The quality of clinical documentation for five common ED presentations (asthma, chest pain, lacerations, abdominal pain and upper limb fractures) was assessed. For each presentation, documentation quality was scored out of 10 using predefined criteria. An improvement of two or more was thought to be clinically significant. Mean scores for each group were compared using a Student's t-test for independent samples. Mean documentation scores (and 95% confidence intervals) were 5.55 (5.17-5.93) in 2008, 5.42 (4.98-5.86) in 2009, 6.37 (5.99-6.75) in 2010 and 6.08 (5.71-6.45) in 2011. There was a statistically but not clinically significant improvement in scores pre- and post-intervention (P ≤ 0.001). The introduction of MoLIE was associated with a small but statistically significant improvement in documentation, despite an 80% increase in intern placements. These results suggest that structured training programmes have potential to improve intern performance while simultaneously enhancing training capacity. The impact on quality of care requires further evaluation. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Well installation and documentation, and ground-water sampling protocols for the pilot National Water-Quality Assessment Program

USGS Publications Warehouse

Hardy, M.A.; Leahy, P.P.; Alley, W.M.

1989-01-01

Several pilot projects are being conducted as part of the National Water Quality Assessment (NAWQA) Program. The purpose of the pilot program is to test and refine concepts for a proposed full-scale program. Three of the pilot projects are specifically designed to assess groundwater. The purpose of this report is to describe the criteria that are being used in the NAWQA pilot projects for selecting and documenting wells, installing new wells, and sampling wells for different water quality constituents. Guidelines are presented for the selection of wells for sampling. Information needed to accurately document each well includes site characteristics related to the location of the well, land use near the well, and important well construction features. These guidelines ensure the consistency of the information collected and will provide comparable data for interpretive purposes. Guidelines for the installation of wells are presented and include procedures that need to be followed for preparations prior to drilling, the selection of the drilling technique and casing type, the grouting procedure, and the well-development technique. A major component of the protocols is related to water quality sampling. Tasks are identified that need to be completed prior to visiting the site for sampling. Guidelines are presented for purging the well prior t sampling, both in terms of the volume of water pumped and the chemical stability of field parameters. Guidelines are presented concerning sampler selection as related to both inorganic and organic constituents. Documentation needed to describe the measurements and observations related to sampling each well and treating and preserving the samples are also presented. Procedures are presented for the storage and shipping of water samples, equipment cleaning, and quality assurance. Quality assurance guidelines include the description of the general distribution of the various quality assurance samples (blanks, spikes, duplicates, and reference samples) that will be used in the pilot program. (Lantz-PTT)

[To improve the quality of requisitions for radiologic examinations].

PubMed

Roussel, P; Lelièvre, N

2002-05-01

This article presents the different steps implemented in order to improve the quality of requisitions for radiologic examinations in a hospital. and methods. The radiology requests sent from clinical units are periodically analyzed using criteria about tracking, prescription and security required for a good examination. Results are discussed with the clinical units in order to achieve improvements. The periodical analysis of nonconformities shows a gradual improvement of practices. This action contributes to the realization of a single document for every request of examination or analysis in the hospital. The described action is in the context of French regulations, first about the practice of radiology, second about the obligation of quality improvement that health care facilities now have to implement for their accreditation.

What information is provided in transcripts and Medical Student Performance Records from Canadian Medical Schools? A retrospective cohort study.

PubMed

Robins, Jason A; McInnes, Matthew D F; Esmail, Kaisra

2014-01-01

Resident selection committees must rely on information provided by medical schools in order to evaluate candidates. However, this information varies between institutions, limiting its value in comparing individuals and fairly assessing their quality. This study investigates what is included in candidates' documentation, the heterogeneity therein, as well as its objective data. Samples of recent transcripts and Medical Student Performance Records were anonymised prior to evaluation. Data were then extracted by two independent reviewers blinded to the submitting university, assessing for the presence of pre-selected criteria; disagreement was resolved through consensus. The data were subsequently analysed in multiple subgroups. Inter-rater agreement equalled 92%. Inclusion of important criteria varied by school, ranging from 22.2% inclusion to 70.4%; the mean equalled 47.4%. The frequency of specific criteria was highly variable as well. Only 17.7% of schools provided any basis for comparison of academic performance; the majority detailed only status regarding pass or fail, without any further qualification. Considerable heterogeneity exists in the information provided in official medical school documentation, as well as markedly little objective data. Standardization may be necessary in order to facilitate fair comparison of graduates from different institutions. Implementation of objective data may allow more effective intra- and inter-scholastic comparison.

Evaluation of physical activity programmes for elderly people - a descriptive study using the EFQM' criteria

PubMed Central

2011-01-01

Background In the past years, there has been a growing concern in designing physical activity (PA) programmes for elderly people, because evidence suggests that such health promotion interventions may reduce the deleterious effects of the ageing process. Quality is an important issue when designing a PA programme for older people. Some studies support the Excellence Model of the European Foundation for Quality Management (EFQM) as an operational framework for evaluating the quality of an organization. Within this context, the aim of this study was to characterize the quality management models of the PA programmes developed by Portuguese Local Administration to enhance quality of life for elderly people, according to the criteria of the EFQM Excellence Model. Methods A methodological triangulation was conducted in 26 PA programmes using questionnaire surveys, semi-structured interviews and document analysis. We used standard approaches to the statistical analysis of data including frequencies and percentages for the categorical data. Results Results showed that Processes (65,38%), Leadership (61,03%), Customer results (58,46) and People (51,28%) had high percentage occurrences of quality practices. In contrast, Partnerships and resources (45,77%), People results (41,03%), Policy and strategy (37,91%), Key performance results (19,23%) and Society results (19,23%) had lower percentage occurrences. Conclusions Our findings suggest that although there are some good practices in PA programmes, there are still relevant areas that require improvement. PMID:21338497

Reporting of harms outcomes: a comparison of journal publications with unpublished clinical study reports of orlistat trials.

PubMed

Hodkinson, Alex; Gamble, Carrol; Smith, Catrin Tudur

2016-04-22

The quality of harms reporting in journal publications is often poor, which can impede the risk-benefit interpretation of a clinical trial. Clinical study reports can provide more reliable, complete, and informative data on harms compared to the corresponding journal publication. This case study compares the quality and quantity of harms data reported in journal publications and clinical study reports of orlistat trials. Publications related to clinical trials of orlistat were identified through comprehensive literature searches. A request was made to Roche (Genentech; South San Francisco, CA, USA) for clinical study reports related to the orlistat trials identified in our search. We compared adverse events, serious adverse events, and the reporting of 15 harms criteria in both document types and compared meta-analytic results using data from the clinical study reports against the journal publications. Five journal publications with matching clinical study reports were available for five independent clinical trials. Journal publications did not always report the complete list of identified adverse events and serious adverse events. We found some differences in the magnitude of the pooled risk difference between both document types with a statistically significant risk difference for three adverse events and two serious adverse events using data reported in the clinical study reports; these events were of mild intensity and unrelated to the orlistat. The CONSORT harms reporting criteria were often satisfied in the methods section of the clinical study reports (70-90 % of the methods section criteria satisfied in the clinical study reports compared to 10-50 % in the journal publications), but both document types satisfied 80-100 % of the results section criteria, albeit with greater detail being provided in the clinical study reports. In this case study, journal publications provided insufficient information on harms outcomes of clinical trials and did not specify that a subset of harms data were being presented. Clinical study reports often present data on harms, including serious adverse events, which are not reported or mentioned in the journal publications. Therefore, clinical study reports could support a more complete, accurate, and reliable investigation, and researchers undertaking evidence synthesis of harm outcomes should not rely only on incomplete published data that are presented in the journal publications.

Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia.

PubMed

Lopez, Benjamin C; Hamlyn, Peter J; Zakrzewska, Joanna M

2004-04-01

There are no randomized controlled trials comparing retrogasserian percutaneous radiofrequency thermocoagulation, glycerol rhizolysis, balloon compression of the gasserian ganglion, and stereotactic radiosurgery, nor are there systematic reviews using predefined quality criteria. The objective of this study was to systematically identify all of the studies reporting outcomes and complications of ablative techniques for treatment of trigeminal neuralgia, from the development of electronic databases, and to evaluate them with predefined quality criteria. Inclusion criteria for the outcome analysis included thorough demographic documentation, defined diagnostic and outcome criteria, a minimum of 30 patients treated and median/mean follow-up times of 12 months, not more than 20% of patients lost to follow-up monitoring, Kaplan-Meier actuarial analysis of individual procedures, less than 10% of patients retreated because of failure or early recurrence, and a minimal dose of 70 Gy for stereotactic radiosurgery. High-quality studies with no actuarial analysis were used for the evaluation of complications. Of 175 studies identified, 9 could be used to evaluate rates of complete pain relief on a yearly basis and 22 could be used to evaluate complications. In mixed series, radiofrequency thermocoagulation offered higher rates of complete pain relief, compared with glycerol rhizolysis and stereotactic radiosurgery, although it demonstrated the greatest number of complications. Radiofrequency thermocoagulation offers the highest rates of complete pain relief, although further data on balloon microcompression are required. It is essential that uniform outcome measures and actuarial methods be universally adopted for the reporting of surgical results. Randomized controlled trials are required to reliably evaluate new surgical techniques.

Atmospheric Boundary Layer Wind Data During the Period January 1, 1998 Through January 31, 1999 at the Dallas-Fort Worth Airport. Volume 1; Quality Assessment

NASA Technical Reports Server (NTRS)

Zak, J. Allen; Rodgers, William G., Jr.

2000-01-01

The quality of the Aircraft Vortex Spacing System (AVOSS) is critically dependent on representative wind profiles in the atmospheric boundary layer. These winds observed from a number of sensor systems around the Dallas-Fort Worth airport were combined into single vertical wind profiles by an algorithm developed and implemented by MIT Lincoln Laboratory. This process, called the AVOSS Winds Analysis System (AWAS), is used by AVOSS for wake corridor predictions. During times when AWAS solutions were available, the quality of the resultant wind profiles and variance was judged from a series of plots combining all sensor observations and AWAS profiles during the period 1200 to 0400 UTC daily. First, input data was evaluated for continuity and consistency from criteria established. Next, the degree of agreement among all wind sensor systems was noted and cases of disagreement identified. Finally, the resultant AWAS solution was compared to the quality-assessed input data. When profiles differed by a specified amount from valid sensor consensus winds, times and altitudes were flagged. Volume one documents the process and quality of input sensor data. Volume two documents the data processing/sorting process and provides the resultant flagged files.

Quality standards in a rheumatology Day-Care Hospital Unit. The proposal of the Spanish Society of Rheumatology Day Hospitals' Working Group.

PubMed

García-Vicuña, Rosario; Montoro, María; Egües Dubuc, César Antonio; Bustabad Reyes, Sagrario; Gómez-Centeno, Antonio; Muñoz-Fernández, Santiago; Pérez Pampín, Eva; Román Ivorra, Jose Andrés; Balsa, Alejandro; Loza, Estíbaliz

2014-01-01

In recent years, the Rheumatology Day-Care Hospital Units (DHU have undergone extensive development. However, the quality standards are poorly documented and mainly limited to structure items rather than including broad and specific areas of this specialty. To develop specific quality standards for Rheumatology DHU. After a systematic review of the literature and related documents, a working group (WG) involving 8 DHU-experienced rheumatologists developed an initial proposal of the quality standards, under the supervision of an expert methodologist. A second round was held by the WG group to review the initial proposal and to consider further suggestions. Once the content was agreed upon by consensus, a final report was prepared. 17 structure standards, 25 process standards and 10 results standards were defined, with special emphasis on specific aspects of the Rheumatology DHU. The proposal includes: 1) essential standards to 2) excellent standards, 3) a Rheumatology DHU services portfolio and 4) performance criteria. The proposed quality standards are the basis for developing the indicators and other management tools for Rheumatology DHU, thereby ensuring a patient-oriented practice based on both the evidence and the experience. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

[Focus Notified Bodies. New requirements for designation and monitoring].

PubMed

Poos, U; Edelhäuser, R

2014-12-01

For medical devices with a higher risk, Notified Bodies assess whether the manufacturers and their products fulfill the requirements laid down in the European directives on medical devices. Notified Bodies are designated through a designation procedure by the designating authority, in Germany by ZLG. The requirements for the designation arise from the respective annexes of the directives on medical devices. Since these are only minimal criteria, different documents have been compiled on a European and national level to concretize these minimal criteria regarding the organization, quality management system, resources, and certification procedure. The rules of the ZLG are thereby the essential documents for designation in Germany. Moreover, according to Implementing Regulation (EU) no. 912/2013, the European commission and the other European designating authorities also have to be involved in the designation process. The aim of continuous monitoring of the Notified Bodies with assessments on the bodies' premises as well as with observed audits is to ensure the permanent fulfillment of the requirements. If nonconformities are found in a body's quality management system or in its implementation of the conformity assessment procedures, the body is obliged to provide ZLG with a corrective actions plan. In the case that the nonconformities are not resolved in time or critical nonconformities are found, ZLG may take actions, e.g., restrict the scope of designation, suspend, or - as last resort - withdraw the designation.

Plutonium storage criteria

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

Chung, D.; Ascanio, X.

1996-05-01

The Department of Energy has issued a technical standard for long-term (>50 years) storage and will soon issue a criteria document for interim (<20 years) storage of plutonium materials. The long-term technical standard, {open_quotes}Criteria for Safe Storage of Plutonium Metals and Oxides,{close_quotes} addresses the requirements for storing metals and oxides with greater than 50 wt % plutonium. It calls for a standardized package that meets both off-site transportation requirements, as well as remote handling requirements from future storage facilities. The interim criteria document, {open_quotes}Criteria for Interim Safe Storage of Plutonium-Bearing Solid Materials{close_quotes}, addresses requirements for storing materials with less thanmore » 50 wt% plutonium. The interim criteria document assumes the materials will be stored on existing sites, and existing facilities and equipment will be used for repackaging to improve the margin of safety.« less

Medical photography: principles for orthopedics.

PubMed

Uzun, Metin; Bülbül, Murat; Toker, Serdar; Beksaç, Burak; Kara, Adnan

2014-04-05

Medical photography is used clinically for patient evaluation, treatment decisions, and scientific documentation. Although standards for medical photography exist in many branches of medicine, we have not encountered such criteria in publications in the area of orthopedics. This study aims to (1) assess the quality of medical images used in an orthopedic publication and (2) to propose standards for medical photography in this area. Clinical photographs were reviewed from all issues of a journal published between the years 2008 and 2012. A quality of clinical images was developed based on the criteria published for the specialties of dermatology and cosmetic surgery. All images were reviewed on the appropriateness of background, patient preparation, and technique. In this study, only 44.9% of clinical images in an orthopedic publication adhered to the proposed conventions. Standards have not been established for medical photography in orthopedics as in other specialty areas. Our results suggest that photographic clinical information in orthopedic publications may be limited by inadequate presentation. We propose that formal conventions for clinical images should be established.

Reference guide to odor thresholds for hazardous air pollutants listed in the Clean Air Act amendments of 1990

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

Cain, W.S.; Shoaf, C.R.; Velasquez, S.F.

1992-03-01

In response to numerous requests for information related to odor thresholds, this document was prepared by the Air Risk Information Support Center in its role in providing technical assistance to State and Local government agencies on risk assessment of air pollutants. A discussion of basic concepts related to olfactory function and the measurement of odor thresholds is presented. A detailed discussion of criteria which are used to evaluate the quality of published odor threshold values is provided. The use of odor threshold information in risk assessment is discussed. The results of a literature search and review of odor threshold informationmore » for the chemicals listed as hazardous air pollutants in the Clean Air Act amendments of 1990 is presented. The published odor threshold values are critically evaluated based on the criteria discussed and the values of acceptable quality are used to determine a geometric mean or best estimate.« less

Low bandwidth robust controllers for flight

NASA Technical Reports Server (NTRS)

Biezad, Daniel J.; Chou, Hwei-Lan

1992-01-01

During the final reporting period (Jun. - Dec. 1992), analyses of the longitudinal and lateral flying qualities were made for propulsive-only flight control (POFC) of a Boeing 720 aircraft model. Performance resulting from compensators developed using Quantitative Feedback Theory (QFT) is documented and analyzed. This report is a first draft of a thesis to be presented by graduate student Hwei-Lan Chou. The final thesis will be presented to NASA when it is completed later this year. The latest landing metrics related to bandwidth criteria and based on the Neal-Smith approach to flying qualities prediction were used in developing performance criteria for the controllers. The compensator designs were tested on the NASA simulator and exhibited adequate performance for piloted flight. There was no significant impact of QFT on performance of the propulsive-only flight controllers in either the longitudinal or lateral modes of flight. This was attributed to the physical limits of thrust available and the engine rate of response, both of whiih severely limited the available bandwidth of the closed-loop system.

Integrated Science Assessment (ISA) for Oxides of Nitrogen ...

EPA Pesticide Factsheets

EPA is announcing the availability of the First External Review Draft of the Integrated Science Assessment for Oxides of Nitrogen – Health Criteria for public comment and independent peer review. This draft document provides EPA’s evaluation and synthesis of the most policy-relevant science related to the health effects of oxides of nitrogen. When final, it will provide a critical part of the scientific foundation for EPA’s decision regarding the adequacy of the current primary (health-based) national ambient air quality standards for nitrogen dioxide. The Clean Air Act (CAA) requires EPA to periodically review and revise, as appropriate, existing air quality criteria and NAAQS. The CAA also requires an independent scientific committee to review the criteria and to advise the Administrator regarding any recommended revisions to the existing criteria and standards, as may be appropriate. The Clean Air Scientific Advisory Committee (CASAC) of EPA’s Science Advisory Board serves as this independent scientific committee. The ISA is one of the four major elements of the NAAQS review process that will inform the Agency’s final decisions; other components of the process are an integrated plan highlighting the key policy-relevant issues; a risk/exposure assessment if warranted; and an advance notice of proposed rulemaking (ANPRM) reflecting the Agency’s views regarding options to retain or revise the NO2 NAAQS based on the evaluation of key information cont

The quality of assessments for childhood psychopathology within a regional medical center.

PubMed

Sattler, Adam F; Leffler, Jarrod M; Harrison, Nicole L; Bieber, Ewa D; Kosmach, Joseph J; Sim, Leslie A; Whiteside, Stephen P H

2018-05-17

Accurate assessment is essential to implementing effective mental health treatment; however, little research has explored child clinicians' assessment practices in applied settings. The current study thus examines practitioners' use of evidence-based assessment (EBA) instruments (i.e., self-report measures and structured interviews), specificity of identified diagnoses (i.e., use of specific diagnostic labels vs. nonstandardized labels, not otherwise specified [NOS] diagnoses, and adjustment disorder diagnoses), and documentation of Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR, American Psychiatric Association, 2000) criteria. Use of these practices was evaluated via analysis of documentation contained within a regional medical center's medical records. This analysis was limited to 2,499 session notes from patient appointments associated with psychiatric disorders newly diagnosed during 2013. In total, session notes were linked to 694 children aged 7 to 17. Results indicated that EBA use was low overall, although self-report measures were utilized relatively frequently versus structured interviews. Diagnostic specificity was also low overall and clinicians rarely documented full diagnostic criteria; however, EBA use was associated with increased diagnostic specificity. Further, clinicians practicing in psychological, psychiatric, and primary care settings were more likely to use self-report measures as compared to those practicing in an integrated behavioral health social work setting. In addition, structured interviews were most likely to be utilized by clinicians practicing in a psychological services setting. Finally, clinicians were more likely to use self-report measures when the identified primary concern was a mood disorder or attention-deficit/hyperactivity disorder (ADHD). Based on these results, we provide suggestions and references to resources for clinicians seeking to improve the quality of their assessments via implementation of EBA. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Integrated Science Assessment (ISA) for Oxides of Nitrogen ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, Integrated Science Assessment (ISA) for Oxides of Nitrogen and Sulfur - Ecological Criteria. This document represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA's decision on retaining or revising the current secondary standards for oxides of nitrogen (NO2 and SO2). The intent of the ISA, according to the CAA, is to “accurately reflect the latest scientific knowledge expected from the presence of [a] pollutant in ambient air” (U.S. Code, 1970a, 1970b). It includes scientific research from atmospheric sciences, exposure and deposition, biogeochemistry, hydrology, soil science, marine science, plant physiology, animal physiology, and ecology conducted at multiple scales (e.g., population, community, ecosystem, landscape levels). Key information and judgments formerly found in the Air Quality Criteria Documents (AQCDs) for NOX and SOX are included; Annexes provide a more detailed discussion of the most pertinent scientific literature. Together, the ISA and Annexes serve to update and revise the last NOX and SOX AQCDs which were published in 1993 and 1982, respectively.

Recommendations on basic requirements for intensive care units: structural and organizational aspects.

PubMed

Valentin, Andreas; Ferdinande, Patrick

2011-10-01

To provide guidance and recommendations for the planning or renovation of intensive care units (ICUs) with respect to the specific characteristics relevant to organizational and structural aspects of intensive care medicine. The Working Group on Quality Improvement (WGQI) of the European Society of Intensive Care Medicine (ESICM) identified the basic requirements for ICUs by a comprehensive literature search and an iterative process with several rounds of consensus finding with the participation of 47 intensive care physicians from 23 countries. The starting point of this process was an ESICM recommendation published in 1997 with the need for an updated version. The document consists of operational guidelines and design recommendations for ICUs. In the first part it covers the definition and objectives of an ICU, functional criteria, activity criteria, and the management of equipment. The second part deals with recommendations with respect to the planning process, floorplan and connections, accommodation, fire safety, central services, and the necessary communication systems. This document provides a detailed framework for the planning or renovation of ICUs based on a multinational consensus within the ESICM.

The Health Care Financing Administration's new examination documentation criteria: minimum auditing standards for the neurologic examination to be used by Medicare and other payors. Report from the American Academy of Neurology Medical Economics and Management Subcommittee.

PubMed

Nuwer, M R; Sigsbee, B

1998-02-01

Medicare recently announced the adoption of minimum documentation criteria for the neurologic examination. These criteria are added to existing standards for the history and medical decision-making. These criteria will be used in compliance audits by Medicare and other payors. Given the current federal initiative to eliminate fraud in the Medicare program, all neurologists need to comply with these standards. These criteria are for documentation only. Neurologic standards of care require a more complex and diverse examination pertinent to the problem(s) under consideration. Further guidance as to the content of a neurologic evaluation is outlined in the article "Practice guidelines: Neurologic evaluation" (Neurology 1990; 40: 871). The level of history and examination required for specific services is defined in the American Medical Association current procedural terminology book. Documentation standards for examination of children are not yet defined.

The efficacy and feasibility of aquatic physiotherapy for people with Parkinson's disease: a systematic review.

PubMed

Terrens, Aan Fleur; Soh, Sze-Ee; Morgan, Prue Elizabeth

2017-08-09

To critically evaluate the literature regarding the efficacy and feasibility of aquatic physiotherapy in people with Parkinson's disease. Relevant studies were identified through searches in nine health-related databases. Two independent reviewers assessed study quality using either the PEDro scale or a customised tool for safety and feasibility. Database searches yielded 88 articles, of which 10 met the inclusion criteria. Studies varied greatly in methodology, quality, interventions and outcome measures. Study quality was generally low in items reporting on safety precautions, adverse events, attrition, and adherence. Results suggest that aquatic physiotherapy may have a positive effect on motor symptoms, quality of life and balance. Aquatic physiotherapy may improve aspects of motor performance, quality of life and balance in people with Parkinson's disease, however, it remains unclear whether it is a safe and feasible treatment modality. The development of standardised outcome measures for people with Parkinson's disease (unified Parkinson's disease rating scale and Parkinson's disease questionnaire-39) would aid study comparability and validate study outcomes. As safety criteria was grossly underreported, guidelines for mandatory reporting of safety criteria are essential to make conclusions regarding the feasibility of aquatic physiotherapy for people with Parkinson's disease. Implications for Rehabilitation Aquatic physiotherapy may be a beneficial treatment modality for people with Parkinson's disease. A minimum data set that includes the unified Parkinson's disease rating scale and Parkinson's disease questionnaire 39 is required to aid future meta-analysis and to allow more definitive conclusions to be made regarding aquatic physiotherapy for people with Parkinson's disease. People with Parkinson's disease are a vulnerable population, where safety within an aquatic physiotherapy program needs to be well documented and addressed.

Deriving Sediment Interstitial Water Remediation Goals ...

EPA Pesticide Factsheets

This document contains a methodology for developing interstitial water remediation goals (IWRGs) for nonionic organic pollutants (toxicants) in sediments for the protection of benthic organisms. The document provides the basis for using the final chronic values (FCVs) from EPA’s aquatic water quality criteria (AWQC) for the protection of aquatic life to set the IWRGs for toxicants in sediments. Concentrations of the toxicants in the sediment interstitial water are measured using passive sampling. This document also discusses how to evaluate the consistency between passive sampling measurements and sediment toxicity test results. When these data are consistent, one can be reasonably assured that the causes of toxicity to benthic organisms in the sediment have been correctly identified and that the developed IWRGs for the toxicants will be protective of the benthic organisms at the site. The consistency evaluation is an important step in developing defensible IWRGs. To assist in developing defensible IWRGs.

A Study to Determine the Cost of Quality Assurance to the Department of Surgery at US Army Medical Department Activity. Fort Benning, Georgia

DTIC Science & Technology

1984-07-01

to make maximum use of available time. General Surgery averaged ninety-six operative procedures per month during 1983, ophthalmology averaged fifteen...health care providers 2. Document evaluation of: a) Surgical care review (tissue review) b) Blood utilization c) Antibiotics utilization d) Pharmacy and...21. Number Surgical Procedures Performed 470 470 on Patients Undergoing all Types of Surgery APPENDIX L EXAMPLES OF AUDIT CRITERIA 103 SERVICE MONTH

40 CFR 227.31 - Applicable marine water quality criteria.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Applicable marine water quality... § 227.31 Applicable marine water quality criteria. Applicable marine water quality criteria means the criteria given for marine waters in the EPA publication “Quality Criteria for Water” as published in 1976...

40 CFR 227.31 - Applicable marine water quality criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Applicable marine water quality... § 227.31 Applicable marine water quality criteria. Applicable marine water quality criteria means the criteria given for marine waters in the EPA publication “Quality Criteria for Water” as published in 1976...

40 CFR 227.31 - Applicable marine water quality criteria.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Applicable marine water quality... § 227.31 Applicable marine water quality criteria. Applicable marine water quality criteria means the criteria given for marine waters in the EPA publication “Quality Criteria for Water” as published in 1976...

Evaluation of drug interaction microcomputer software: Dambro's Drug Interactions.

PubMed

Poirier, T I; Giudici, R A

1990-01-01

Dambro's Drug Interactions was evaluated using general and specific criteria. The installation process, ease of learning and use were rated excellent. The user documentation and quality of the technical support were good. The scope of coverage, clinical documentation, frequency of updates, and overall clinical performance were fair. The primary advantages of the program are the quick searching and detection of drug interactions, and the attempt to provide useful interaction data, i.e., significance and reference. The disadvantages are the lack of current drug interaction information, outdated references, lack of evaluative drug interaction information, and the inability to save or print patient profiles. The program is not a good value for the pharmacist but has limited use as a quick screening tool.

Does teaching of documentation of shoulder dystocia delivery through simulation result in improved documentation in real life?

PubMed

Comeau, Robyn; Craig, Catherine

2014-03-01

Documentation of deliveries complicated by shoulder dystocia is a valuable communication skill necessary for residents to attain during residency training. Our objective was to determine whether the teaching of documentation of shoulder dystocia in a simulation environment would translate to improved documentation of the event in an actual clinical situation. We conducted a cohort study involving obstetrics and gynaecology residents in years 2 to 5 between November 2010 and December 2012. Each resident participated in a shoulder dystocia simulation teaching session and was asked to write a delivery note immediately afterwards. They were given feedback regarding their performance of the delivery and their documentation of the events. Following this, dictated records of shoulder dystocia deliveries immediately before and after the simulation session were identified through the Meditech system. An itemized checklist was used to assess the quality of residents' dictated documentation before and after the simulation session. All eligible residents (18) enrolled in the study, and 17 met the inclusion criteria. For 10 residents (59%) documentation of a delivery with shoulder dystocia was present before and after the simulation session, for five residents (29%) it was only present before the session, and for two residents (18%) it was only present after the session. When residents were assessed as a group, there were no differences in the proportion of residents recording items on the checklist before and after the simulation session (P > 0.05 for all). Similarly, analysis of the performance of the10 residents who had dictated documentation both before and after the session showed no differences in the number of elements recorded on dictations done before and after the simulation session (P > 0.05 for all). The teaching of shoulder dystocia documentation through simulation did not result in a measurable improvement in the quality of documentation of shoulder dystocia in actual clinical situations.

Proposal for agar disk diffusion interpretive criteria for susceptibility testing of bovine mastitis pathogens using cefoperazone 30μg disks.

PubMed

Feßler, Andrea T; Kaspar, Heike; Lindeman, Cynthia J; Peters, Thomas; Watts, Jeffrey L; Schwarz, Stefan

2017-02-01

Cefoperazone is a third generation cephalosporin which is commonly used for bovine mastitis therapy. Bacterial pathogens involved in bovine mastitis are frequently tested for their susceptibility to cefoperazone. So far, the cefoperazone susceptibility testing using 30μg disks has been hampered by the lack of quality control (QC) ranges as well as the lack of interpretive criteria. In 2014, QC ranges for 30 μg cefoperazone disks have been established for Staphylococcus aureus ATCC ® 25923 and Escherichia coli ATCC ® 25922. As a next step, interpretive criteria for the susceptibility testing of bovine mastitis pathogens should be developed. For this, 637 bovine mastitis pathogens (including 112 S. aureus, 121 coagulase-negative staphylococci (CoNS), 103 E. coli, 101 Streptococcus agalactiae, 100 Streptococcus dysgalactiae and 100 Streptococcus uberis) were investigated by agar disk diffusion according to the document Vet01-A4 of the Clinical and Laboratory Standards Institute (CLSI) using 30μg cefoperazone disks and the results were compared to the corresponding MIC values as determined by broth microdilution also according to the aforementioned CLSI document. Based on the results obtained and taking into account the achievable milk concentration of cefoperazone after regular dosing, the following interpretive criteria were proposed as a guidance for mastitis diagnostic laboratories: for staphylococci and E. coli ≥23mm (susceptible), 18-22mm (intermediate) and ≤17mm (resistant) and for streptococci ≥18mm (susceptible), and ≤17mm (non-susceptible). These proposed interpretive criteria shall contribute to a harmonization of cefoperazone susceptibility testing of bovine mastitis pathogens. Copyright © 2016 Elsevier B.V. All rights reserved.

Structure and Content Analysis for Vocational High School Website in Indonesia

NASA Astrophysics Data System (ADS)

Subagja, H.; Abdullah, A. G.; Trisno, B.; Nandiyanto, A. B. D.

2017-03-01

Statistics about the condition of the school’s website in Indonesia is still difficult. This study aims to determine website quality in terms of completeness of content’s criteria of Vocational High School (VHS) in West Java, Indonesia. The method used is the content analysis and survey. Content analysis is reviewing the documents comprising the general category, while the survey is a observation process to get the facts from 272 school websites. Aspects of the structure and content of school website are including institutional information, educators and education personnel, curriculum, student, infrastructure, school achievement, and public access. The results of this study showed the average quality of the VHS website in West Java is still low. The recommendations are needed to improve the quality of the school website.

Quality of clinical practice guidelines of lower extremity venous ulcers.

PubMed

Rumbo-Prieto, José María; Arantón-Areosa, Luis; Palomar-Llatas, Federico; Romero-Martín, Manuel

The clinical variability and professional uncertainty in the prevention and treatment of lower extremity venous ulcers (VU) has as a main consequence, the fact that patients can be subjected to diagnostic and therapeutic tests, sometimes of dubious utility, these may even be harmful to the health of the patient and that, at other times, certain procedures or processes that may be appropriate to the patient's situation and needs may be omitted. It is for this reason that a series of specific documents called clinical practice guidelines for the approach of VU (CPG-VU) have been created, with the aim of improving the effectiveness and quality of care, reducing unjustified variability and establishing homogeneous criteria for its handling. Nevertheless, the literature shows that not all CPGs have the same methodological and evidence-drawing criteria. Many of them are of poor scientific quality and editorial rigor. This implies that CPGs should be periodically reviewed and updated based on the most current evidence and their quality contrasted with validated instruments such as AGREE-II. After an analysis of the quality of six CPG-VU available today, it has been possible to identify what guidelines are recommended for its implementation in the practice of care, which should be modified to improve their applicability and development of the evidence. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Quality Assurance Specifications for Planetary Protection Assays

NASA Astrophysics Data System (ADS)

Baker, Amy

As the European Space Agency planetary protection (PP) activities move forward to support the ExoMars and other planetary missions, it will become necessary to increase staffing of labo-ratories that provide analyses for these programs. Standardization of procedures, a comprehen-sive quality assurance program, and unilateral training of personnel will be necessary to ensure that the planetary protection goals and schedules are met. The PP Quality Assurance/Quality Control (QAQC) program is designed to regulate and monitor procedures performed by labora-tory personnel to ensure that all work meets data quality objectives through the assembly and launch process. Because personnel time is at a premium and sampling schedules are often de-pendent on engineering schedules, it is necessary to have flexible staffing to support all sampling requirements. The most productive approach to having a competent and flexible work force is to establish well defined laboratory procedures and training programs that clearly address the needs of the program and the work force. The quality assurance specification for planetary protection assays has to ensure that labora-tories and associated personnel can demonstrate the competence to perform assays according to the applicable standard AD4. Detailed subjects included in the presentation are as follows: • field and laboratory control criteria • data reporting • personnel training requirements and certification • laboratory audit criteria. Based upon RD2 for primary and secondary validation and RD3 for data quality objectives, the QAQC will provide traceable quality assurance safeguards by providing structured laboratory requirements for guidelines and oversight including training and technical updates, standardized documentation, standardized QA/QC checks, data review and data archiving.

Nutrient mitigation in a temporary river basin.

PubMed

Tzoraki, Ourania; Nikolaidis, Nikolaos P; Cooper, David; Kassotaki, Elissavet

2014-04-01

We estimate the nutrient budget in a temporary Mediterranean river basin. We use field monitoring and modelling tools to estimate nutrient sources and transfer in both high and low flow conditions. Inverse modelling by the help of PHREEQC model validated the hypothesis of a losing stream during the dry period. Soil and Water Assessment Tool model captured the water quality of the basin. The 'total daily maximum load' approach is used to estimate the nutrient flux status by flow class, indicating that almost 60% of the river network fails to meet nitrogen criteria and 50% phosphate criteria. We recommend that existing well-documented remediation measures such as reforestation of the riparian area or composting of food process biosolids should be implemented to achieve load reduction in close conjunction with social needs.

Guidelines for the Design and Conduct of Clinical Studies in Knee Articular Cartilage Repair

PubMed Central

Mithoefer, Kai; Saris, Daniel B.F.; Farr, Jack; Kon, Elizaveta; Zaslav, Kenneth; Cole, Brian J.; Ranstam, Jonas; Yao, Jian; Shive, Matthew; Levine, David; Dalemans, Wilfried; Brittberg, Mats

2011-01-01

Objective: To summarize current clinical research practice and develop methodological standards for objective scientific evaluation of knee cartilage repair procedures and products. Design: A comprehensive literature review was performed of high-level original studies providing information relevant for the design of clinical studies on articular cartilage repair in the knee. Analysis of cartilage repair publications and synopses of ongoing trials were used to identify important criteria for the design, reporting, and interpretation of studies in this field. Results: Current literature reflects the methodological limitations of the scientific evidence available for articular cartilage repair. However, clinical trial databases of ongoing trials document a trend suggesting improved study designs and clinical evaluation methodology. Based on the current scientific information and standards of clinical care, detailed methodological recommendations were developed for the statistical study design, patient recruitment, control group considerations, study endpoint definition, documentation of results, use of validated patient-reported outcome instruments, and inclusion and exclusion criteria for the design and conduct of scientifically sound cartilage repair study protocols. A consensus statement among the International Cartilage Repair Society (ICRS) and contributing authors experienced in clinical trial design and implementation was achieved. Conclusions: High-quality clinical research methodology is critical for the optimal evaluation of current and new cartilage repair technologies. In addition to generally applicable principles for orthopedic study design, specific criteria and considerations apply to cartilage repair studies. Systematic application of these criteria and considerations can facilitate study designs that are scientifically rigorous, ethical, practical, and appropriate for the question(s) being addressed in any given cartilage repair research project. PMID:26069574

Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases

PubMed Central

Göbel, Jens; Storf, Holger; Litzkendorf, Svenja; Babac, Ana; Frank, Martin; Lührs, Verena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Thomas OF; Ückert, Frank; Graf von der Schulenburg, Johann-Matthias; Hartz, Tobias

2016-01-01

Background The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. Objective The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. Methods First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. Results We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. Conclusions The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases. Finally, transparently presented quality assessments can help people to find reliable information and to assess its quality. PMID:27562540

Adopting Quality Criteria for Websites Providing Medical Information About Rare Diseases.

PubMed

Pauer, Frédéric; Göbel, Jens; Storf, Holger; Litzkendorf, Svenja; Babac, Ana; Frank, Martin; Lührs, Verena; Schauer, Franziska; Schmidtke, Jörg; Biehl, Lisa; Wagner, Thomas Of; Ückert, Frank; Graf von der Schulenburg, Johann-Matthias; Hartz, Tobias

2016-08-25

The European Union considers diseases to be rare when they affect less than 5 in 10,000 people. It is estimated that there are between 5000 and 8000 different rare diseases. Consistent with this diversity, the quality of information available on the Web varies considerably. Thus, quality criteria for websites about rare diseases are needed. The objective of this study was to generate a catalog of quality criteria suitable for rare diseases. First, relevant certificates and quality recommendations for health information websites were identified through a comprehensive Web search. Second, all considered quality criteria of each certification program and catalog were examined, extracted into an overview table, and analyzed by thematic content. Finally, an interdisciplinary expert group verified the relevant quality criteria. We identified 9 quality certificates and criteria catalogs for health information websites with 304 single criteria items. Through this, we aggregated 163 various quality criteria, each assigned to one of the following categories: thematic, technical, service, content, and legal. Finally, a consensus about 13 quality criteria for websites offering medical information on rare diseases was determined. Of these categories, 4 (data protection concept, imprint, creation and updating date, and possibility to contact the website provider) were identified as being the most important for publishing medical information about rare diseases. The large number of different quality criteria appearing within a relatively small number of criteria catalogs shows that the opinion of what is important in the quality of health information differs. In addition, to define useful quality criteria for websites about rare diseases, which are an essential source of information for many patients, a trade-off is necessary between the high standard of quality criteria for health information websites in general and the limited provision of information about some rare diseases. Finally, transparently presented quality assessments can help people to find reliable information and to assess its quality.

Adherence to quality indicators and surveillance guidelines in the management of Barrett's esophagus: a retrospective analysis.

PubMed

Westerveld, Donevan; Khullar, Vikas; Mramba, Lazarus; Ayoub, Fares; Brar, Tony; Agarwal, Mitali; Forde, Justin; Chakraborty, Joydeep; Riverso, Michael; Perbtani, Yaseen B; Gupte, Anand; Forsmark, Chris E; Draganov, Peter; Yang, Dennis

2018-03-01

 Adherence to quality indicators and surveillance guidelines in the management of Barrett's esophagus (BE) promotes high-quality, cost-effective care. The aims of this study were (1) to evaluate adherence to standardized classification (Prague Criteria) and systematic (four-quadrant) biopsy protocol, (2) to identify predictors of practice patterns, and (3) to assess adherence to surveillance guidelines for non-dysplastic BE (NDBE).  This was a single-center retrospective study of esophagogastroduodenoscopy (EGD) performed for BE (June 2008 to December 2015). Patient demographics, procedure characteristics, and histology results were obtained from the procedure report-generating database and chart review. Adherence to Prague Criteria and systematic biopsies was based on operative report documentation. Multiple logistic regression analysis was performed to identify predictors of practice patterns. Guideline adherent surveillance EGD was defined as those performed within 6 months of the recommended 3- to 5-year interval.  In total, 397 patients (66.5 % male; mean age 60.1 ± 12.5 years) had an index EGD during the study period. Adherence to Prague Criteria and systematic biopsies was 27.4 % and 24.1 %, respectively. Endoscopists who performed therapeutic interventions for BE were more likely to use the Prague Criteria (OR: 3.16; 95 %CI: 1.47 - 6.82; P  < 0.01) than those who did not. Longer time in practice was positively associated with adherence to Prague Criteria (OR 1.07; 95 %CI: 1.02 - 1.12; P  < 0.01) but with a lower likelihood of performing systematic biopsies (OR 0.91; 95 %CI: 0.85 - 0.97; P  < 0.01). More than half (55.6 %) of patients with NDBE underwent surveillance EGD sooner (range 1 - 29 months) than the recommended interval.  Adherence to quality indicators and surveillance guidelines in BE is low. Operator characteristics, including experience with endoscopic therapy for BE and time in practice predicted practice pattern. Future efforts are needed to reduce variability in practice and promote high-value care.

[Multimodal document management in radiotherapy].

PubMed

Fahrner, H; Kirrmann, S; Röhner, F; Schmucker, M; Hall, M; Heinemann, F

2013-12-01

After incorporating treatment planning and the organisational model of treatment planning in the operating schedule system (BAS, "Betriebsablaufsystem"), complete document qualities were embedded in the digital environment. The aim of this project was to integrate all documents independent of their source (paper-bound or digital) and to make content from the BAS available in a structured manner. As many workflow steps as possible should be automated, e.g. assigning a document to a patient in the BAS. Additionally it must be guaranteed that at all times it could be traced who, when, how and from which source documents were imported into the departmental system. Furthermore work procedures should be changed that the documentation conducted either directly in the departmental system or from external systems can be incorporated digitally and paper document can be completely avoided (e.g. documents such as treatment certificate, treatment plans or documentation). It was a further aim, if possible, to automate the removal of paper documents from the departmental work flow, or even to make such paper documents superfluous. In this way patient letters for follow-up appointments should automatically generated from the BAS. Similarly patient record extracts in the form of PDF files should be enabled, e.g. for controlling purposes. The available document qualities were analysed in detail by a multidisciplinary working group (BAS-AG) and after this examination and assessment of the possibility of modelling in our departmental workflow (BAS) they were transcribed into a flow diagram. The gathered specifications were implemented in a test environment by the clinical and administrative IT group of the department of radiation oncology and subsequent to a detailed analysis introduced into clinical routine. The department has succeeded under the conditions of the aforementioned criteria to embed all relevant documents in the departmental workflow via continuous processes. Since the completion of the concepts and the implementation in our test environment 15,000 documents were introduced into the departmental workflow following routine approval. Furthermore approximately 5000 appointment letters for patient aftercare per year were automatically generated by the BAS. In addition patient record extracts in the form of PDF files for the medical services of the healthcare insurer can be generated.

C4ISR Architecture Working Group (AWG), Architecture Framework Version 2.0.

DTIC Science & Technology

1997-12-18

Vision Name Name/identifier of document that contains doctrine, goals, or vision Type Doctrine, goals, or vision Description Text summary description...e.g., organization, directive, order) Description Text summary of tasking •Rules, Criteria, or Conventions Name Name/identifier of document that...contains rules, criteria, or conventions Type One of: rules, criteria, or conventions Description Text summary description of contents or

78 FR 52192 - Final Aquatic Life Ambient Water Quality Criteria For Ammonia-Freshwater 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

... ambient water quality criteria for the protection of aquatic life from effects of ammonia in freshwater... life criteria are developed based on EPA's Guidelines for Deriving Numerical National Water Quality... quality standards for protecting aquatic life and human health. EPA's recommended water quality criteria...

How do professionals assess the quality of life of children with advanced cancer receiving palliative care, and what are their recommendations for improvement?

PubMed

Avoine-Blondin, Josianne; Parent, Véronique; Fasse, Léonor; Lopez, Clémentine; Humbert, Nago; Duval, Michel; Sultan, Serge

2018-05-08

It is known that information regarding the quality of life of a patient is central to pediatric palliative care. This information allows professionals to adapt the care and support provided to children and their families. Previous studies have documented the major areas to be investigated in order to assess the quality of life, although it is not yet known what operational criteria or piece of information should be used in the context of pediatric palliative care. The present study aims to: 1) Identify signs of quality of life and evaluation methods currently used by professionals to assess the quality of life of children with cancer receiving palliative care. 2) Collect recommendations from professionals to improve the evaluation of quality of life in this context. We selected a qualitative research design and applied an inductive thematic content analysis to the verbal material. Participants included 20 members of the Department of Hematology-Oncology at CHU Sainte-Justine from various professions (e.g. physicians, nurses, psychosocial staff) who had cared for at least one child with cancer receiving palliative care in the last year. Professionals did not have access to pre-established criteria or to a defined procedure to assess the quality of life of children they followed in the context of PPC. They reported basing their assessment on the child's non-verbal cues, relational availability and elements of his/her environment. These cues are typically collected through observation, interpretation and by asking the child, his/her parents, and other members of the care. To improve the assessment of quality of life professionals recommended optimizing interdisciplinary communication, involving the child and the family in the evaluation process, increasing training to palliative care in hematology/oncology, and developing formalized measurement tools. The formulation of explicit criteria to assess the quality of life in this context, along with detailed recommendations provided by professionals, support the development of systematic measurement strategy. Such a strategy would contribute to the development of common care goals and further facilitate communication between professionals and with the family.

HPV testing for primary cervical screening: Laboratory issues and evolving requirements for robust quality assurance.

PubMed

Carozzi, Francesca Maria; Del Mistro, Annarosa; Cuschieri, Kate; Frayle, Helena; Sani, Cristina; Burroni, Elena

2016-03-01

This review aims to highlight the importance of Quality Assurance for Laboratories performing HPV test for Cervical Cancer Screening. An HPV test, to be used as primary screening test, must be validated according to international criteria, based on comparison of its clinical accuracy to HC2 or GP5+/6+ PCR-EIA tests. The number of validated platforms is increasing and appropriate Quality Assurance Programs (QAPs) which can interrogate longitudinal robustness and quality are paramount. This document describes the following topics: (1) the characteristics of an HPV laboratory and the personnel training needs, to ensure an elevated quality of the entire process and the optimal use of the resources; (2) the Quality Assurance, as both internal (IQA) and external quality assessment (EQA) systems, to be implemented and performed, and the description of the existing EQAs, including limitations; (3) general considerations for an optimal EQA program for hrHPV primary screening Due to the importance of Quality Assurance for this field, international efforts are necessary to improve QA International Collaboration. Copyright © 2015 Elsevier B.V. All rights reserved.

Management of Nursing Workplace Incivility in the Health Care Settings: A Systematic Review.

PubMed

Armstrong, Nancy

2018-05-01

Workplace incivility is a well-documented issue in nursing in the health care setting. It has the potential to cause emotional and physical distress in victims and potentially affects the quality of care provided. The purpose of this study was to critique and summarize the most recent, available evidence related to interventions in assisting nursing staff working in health care settings in managing incivility. This systematic review of literature yielded 10 studies meeting the criteria. The studies were mostly identified as lower quality research. Despite the lower quality of research, the collection of evidence suggests the use of a combination of educational training about workplace incivility, training about effective responses to uncivil workplace behaviors, and active learning activities to practice newly learned communication skills, in assisting nurses in improving their ability to manage incivility in the workplace.

Piloting Vertical Flight Aircraft: A Conference on Flying Qualities and Human Factors

NASA Technical Reports Server (NTRS)

Blanken, Christopher L. (Editor); Whalley, Matthew S. (Editor)

1993-01-01

This document contains papers from a specialists' meeting entitled 'Piloting Vertical Flight Aircraft: A Conference on Flying Qualities and Human Factors.' Vertical flight aircraft, including helicopters and a variety of Vertical Takeoff and Landing (VTOL) concepts, place unique requirements on human perception, control, and performance for the conduct of their design missions. The intent of this conference was to examine, for these vehicles, advances in: (1) design of flight control systems for ADS-33C standards; (2) assessment of human factors influences of cockpit displays and operational procedures; (3) development of VTOL design and operational criteria; and (4) development of theoretical methods or models for predicting pilot/vehicle performance and mission suitability. A secondary goal of the conference was to provide an initial venue for enhanced interaction between human factors and handling qualities specialists.

Design criteria for the light duty utility arm system end effectors

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

Pardini, A.F.; Kiebel, G.R.

1995-12-01

The purpose of this document is to provide criteria for the design of end effectors that will be used as part of the Light Duty Utility Arm (LDUA) System. Actual component design, fabrication, testing, and inspection will be performed by various DOE laboratories, industry, and academia. This document augments WHC-SD-TD-FRD-003, `Functions and Requirements for the Light Duty Utility Arm Integrated System` (F). All requirements dictated in the F shall also be applicable in this document. Whenever conflicts arise between this document and the F, this document shall take precedence.

National Recommended Water Quality Criteria

EPA Pesticide Factsheets

The National Recommended Water Quality Criteria is a compilation of national recommended water quality criteria for the protection of aquatic life and human health in surface water for approximately 150 pollutants. These criteria provide guidance for states and tribes to use in adopting water quality standards.

Systematic Review of International Colposcopy Quality Improvement Guidelines.

PubMed

Mayeaux, Edward J; Novetsky, Akiva P; Chelmow, David; Choma, Kim; Garcia, Francisco; Liu, Angela H; Papasozomenos, Theognosia; Einstein, Mark H

2017-10-01

The American Society for Colposcopy and Cervical Pathology Colposcopy Standards Committee organized multiple working groups to draft colposcopy standards for the United States. As part of this project, international quality assurance and improvement measures were examined. The quality improvement working group performed a systematic review of the literature to collate international guidelines related to quality improvement. Source guidelines were collected using searches in Medline, Google Scholar, the International Federation of Cervical Pathology and Colposcopy Web site, other regional colposcopy group's Web sites, and communications with International Federation of Cervical Pathology and Colposcopy board of directors' members and other expert members of various national groups. Once identified, the sources were reviewed by multiple workgroup members for potential guideline materials. Fifty-six unique documents were identified, of which 18 met inclusion criteria and contributed data to the analysis. Information was abstracted and grouped by related subject. Wide variation exists in colposcopy guidance and quality indicators from regional and national colposcopy societies. Abstracted international guidelines are presented.

Guidelines for the use of fiberglass reinforced plastic in utility FGD systems. [Flue gas desulfurization (FGD); contains glossary

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

Rapoza, R.J.; Vollmer, H.R.; Haberly, K.L.

1992-11-01

Fiberglass reinforced plastic (FRP) materials offer excellent corrosion-resistant properties and long-term cost advantages compared to exotic alloys or organic lining systems. This guideline document provides potential buyers of FRP FGD (flue gas desulfurization) equipment with enough knowledge of FRP materials and methods to make informed decisions when procuring FRP equipment or services. It is divided into the following chapters: application criteria, procurement strategies, FRP basics, guidelines for designing FRP equipment, quality management. A glossary and manufacturers information/recommendations are included.

Integrated Science Assessment (ISA) for Sulfur Oxides ...

EPA Pesticide Factsheets

EPA has announced that the Second External Review Draft of the Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA’s decision regarding whether the current standard for SO2 sufficiently protects public health. Sulfur oxides is one of six principal (or “criteria”) pollutants for which EPA has established national ambient air quality standards (NAAQS).

Integrated Science Assessment (ISA) for Sulfur Oxides ...

EPA Pesticide Factsheets

EPA has announced that the First External Review Draft of the Integrated Science Assessment (ISA) for Sulfur Oxides – Health Criteria has been made available for independent peer review and public review. This draft ISA document represents a concise synthesis and evaluation of the most policy-relevant science and will ultimately provide the scientific bases for EPA’s decision regarding whether the current standard for SO2 sufficiently protects public health. Sulfur oxides is one of six principal (or “criteria”) pollutants for which EPA has established national ambient air quality standards (NAAQS).

Validation of Diagnoses of Transient Ischemic Attack in the Swedish Stroke Register (Riksstroke) TIA-Module.

PubMed

Buchwald, Fredrik; Ström, Jakob O; Norrving, Bo; Petersson, Jesper

2015-01-01

In 2010, the Swedish Stroke Register (Riksstroke; RS) established a module for transient ischemic attacks (RS-TIA). We report a diagnostic validation study of patients included in RS-TIA. During the first year, 7,825 patients were registered at 59 out of 74 Swedish hospitals. A time-based TIA definition was applied. A sample of 180 patients (30 patients each from 6 hospitals), with a similar distribution of age and sex as in RS-TIA, was prepared. Two independent observers assessed medical records for quality of documentation and assigned a diagnosis of likely, possible, unlikely TIA or ischemic stroke, according to prespecified criteria. The 2 observers agreed in 77% of cases that the event was a likely or possible TIA, in 3% that the event was an ischemic stroke, and in 2% that the event was an unlikely TIA. The observers disagreed in 8% of patients on TIA vs. ischemic stroke, and in 11% on a vascular vs. non-vascular cause. Quality of documentation was fair. There was interobserver agreement on diagnosis of TIA in the majority of patients included in RS-TIA. Diagnostic accuracy may be further improved by more systematic documentation of symptoms and signs. © 2015 S. Karger AG, Basel.

Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A Pituitary Society Statement.

PubMed

Casanueva, Felipe F; Barkan, Ariel L; Buchfelder, Michael; Klibanski, Anne; Laws, Edward R; Loeffler, Jay S; Melmed, Shlomo; Mortini, Pietro; Wass, John; Giustina, Andrea

2017-10-01

With the goal of generate uniform criteria among centers dealing with pituitary tumors and to enhance patient care, the Pituitary Society decided to generate criteria for developing Pituitary Tumors Centers of Excellence (PTCOE). To develop that task, a group of ten experts served as a Task Force and through two years of iterative work an initial draft was elaborated. This draft was discussed, modified and finally approved by the Board of Directors of the Pituitary Society. Such document was presented and debated at a specific session of the Congress of the Pituitary Society, Orlando 2017, and suggestions were incorporated. Finally the document was distributed to a large group of global experts that introduced further modifications with final endorsement. After five years of iterative work a document with the ideal criteria for a PTCOE is presented. Acknowledging that very few centers in the world, if any, likely fulfill the requirements here presented, the document may be a tool to guide improvements of care delivery to patients with pituitary disorders. All these criteria must be accommodated to the regulations and organization of Health of a given country.

Synonym-Based Word Frequency Analysis to Support the Development and Presentation of a Public Health Quality Improvement Taxonomy.

PubMed

Pina, Jamie; Massoudi, Barbara L; Chester, Kelley; Koyanagi, Mark

2018-06-07

Researchers and analysts have not completely examined word frequency analysis as an approach to creating a public health quality improvement taxonomy. To develop a taxonomy of public health quality improvement concepts for an online exchange of quality improvement work. We analyzed documents, conducted an expert review, and employed a user-centered design along with a faceted search approach to make online entries searchable for users. To provide the most targeted facets to users, we used word frequency to analyze 334 published public health quality improvement documents to find the most common clusters of word meanings. We then reviewed the highest-weighted concepts and categorized their relationships to quality improvement details in our taxonomy. Next, we mapped meanings to items in our taxonomy and presented them in order of their weighted percentages in the data. Using these methods, we developed and sorted concepts in the faceted search presentation so that online exchange users could access relevant search criteria. We reviewed 50 of the top synonym clusters and identified 12 categories for our taxonomy data. The final categories were as follows: Summary; Planning and Execution Details; Health Impact; Training and Preparation; Information About the Community; Information About the Health Department; Results; Quality Improvement (QI) Staff; Information; Accreditation Details; Collaborations; and Contact Information of the Submitter. Feedback about the elements in the taxonomy and presentation of elements in our search environment from users has been positive. When relevant data are available, the word frequency analysis method may be useful in other taxonomy development efforts for public health.

[Evaluation of good manufacturing practices in the elaboration of enteral formulas in public hospitals of Santiago (Chile)].

PubMed

Lara González, Sandra; Domecq Jendres, C; Atalah Samur, Eduardo

2013-11-01

The development of enteral formulas (FE) is subject to various risks of contamination. The World Health Organization (WHO) and the Food and Agriculture Organization (FAO), have worried about alerting, recommendations and documents released to prevent contamination the FE, suggesting the standardization and protocols for all procedures involved. The study was aimed to evaluate compliance with the technical criteria contained in a Guideline for Good Practice of Manufacture in relation to the development, maintenance and administration of enteral nutrition in hospitals of Santiago, in the Metropolitan Area. The verification criteria considered Physical Plant, Equipment and Implementation, Hygienic and Sanitary Standards, Human Resources, Organization and Management, Safety and Warranty Quality Assurance. 639 criteria were defined, 309 risk Type 1, by mayor risk of producing pollution. The study was conducted by observing Central Units Enteral Formulas and interview with the caregiver. Medium of compliance for each group of criteria risk 1 and overall, was analyzed. A total of 14 public hospitals were studied. The degree of compliance with the 639 reached a median of 33.2% (p25-75 31.6%-40.4%), with the lowest value for physical plant with 27.9% (p25-75 23.9%-38.2%) and the highest for human resources with 52.4% (p25-75 44.1%-52.4%). Median compliance for risk criteria Type 1 was only 31.8% (p25-75 27.5%-41.2%). Most of the units tested, meets less than half of the internationals recommendations, or the Ministry of Health of Chile. It should develop protocols and train staff to ensure quality and safety in the development of enteral formulas and reduce risk of infection. Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

77 FR 30280 - Final National Recommended Ambient Water Quality Criteria for Carbaryl-2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-22

... national recommended water quality criteria for the protection of aquatic life from effects of carbaryl... developed the aquatic life criteria based on EPA's Guidelines for Deriving Numerical National Water Quality... quality standards for protecting aquatic life and human health. These criteria are intended to protect...

NASA Glenn Wind Tunnel Model Systems Criteria

NASA Technical Reports Server (NTRS)

Soeder, Ronald H.; Roeder, James W.; Stark, David E.; Linne, Alan A.

2004-01-01

This report describes criteria for the design, analysis, quality assurance, and documentation of models that are to be tested in the wind tunnel facilities at the NASA Glenn Research Center. This report presents two methods for computing model allowable stresses on the basis of the yield stress or ultimate stress, and it defines project procedures to test models in the NASA Glenn aeropropulsion facilities. Both customer-furnished and in-house model systems are discussed. The functions of the facility personnel and customers are defined. The format for the pretest meetings, safety permit process, and model reviews are outlined. The format for the model systems report (a requirement for each model that is to be tested at NASA Glenn) is described, the engineers responsible for developing the model systems report are listed, and the timetable for its delivery to the project engineer is given.

Sampling criteria in multicollection searching.

NASA Astrophysics Data System (ADS)

Gilio, A.; Scozzafava, R.; Marchetti, P. G.

In the first stage of the document retrieval process, no information concerning relevance of a particular document is available. On the other hand, computer implementation requires that the analysis be made only for a sample of retrieved documents. This paper addresses the significance and suitability of two different sampling criteria for a multicollection online search facility. The inevitability of resorting to a logarithmic criterion in order to achieve a "spread of representativeness" from the multicollection is demonstrated.

Integrated Science Assessment (ISA) for Sulfur Oxides ...

EPA Pesticide Factsheets

This draft document provides EPA’s evaluation and synthesis of the most policy-relevant science related to the health effects of sulfur oxides. When final, it will provide a critical part of the scientific foundation for EPA’s decision regarding the adequacy of the current primary (health-based) National Ambient Air Quality Standard (NAAQS) for sulfur dioxide. The references considered for inclusion in or cited in the external review draft ISA are available at https://hero.epa.gov/hero/sulfur-oxides. The intent of the ISA, according to the CAA, is to “accurately reflect the latest scientific knowledge expected from the presence of [a] pollutant in ambient air” (U.S. Code, 1970a, 1970b). It includes an assessment of scientific research from atmospheric sciences, exposure sciences, dosimetry, mode of action, animal and human toxicology, and epidemiology. Key information and judgments formerly found in the Air Quality Criteria Documents (AQCDs) for sulfur oxides (SOx) are included; Annexes provide additional details supporting the ISA. Together, the ISA and Annexes serve to update and revise the last SOx ISA which was published in 2008.

Integrated Science Assessment (ISA) for Particulate Matter ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, Integrated Science Assessment (ISA) for Particulate Matter (PM). This report is EPA’s latest evaluation of the scientific literature on the potential human health and welfare effects associated with ambient exposures to particulate matter (PM). The development of this document is part of the Agency's periodic review of the national ambient air quality standards (NAAQS) for PM. The recently completed PM ISA and supplementary annexes, in conjunction with additional technical and policy assessments developed by EPA’s Office of Air and Radiation, will provide the scientific basis to inform EPA decisions related to the review of the current PM NAAQS. Key information and judgments formerly contained in an Air Quality Criteria Document (AQCD) for PM are incorporated in this assessment. Additional details of the pertinent literature published since the last review, as well as selected older studies of particular interest, are included in a series of annexes. This ISA thus serves to update and revise the evaluation of the scientific evidence available at the time of the previous review of the NAAQS for PM that was concluded in 2006.

Specialized food composition dataset for vitamin D content in foods based on European standards: Application to dietary intake assessment.

PubMed

Milešević, Jelena; Samaniego, Lourdes; Kiely, Mairead; Glibetić, Maria; Roe, Mark; Finglas, Paul

2018-02-01

A review of national nutrition surveys from 2000 to date, demonstrated high prevalence of vitamin D intakes below the EFSA Adequate Intake (AI) (<15μg/d vitamin D) in adults across Europe. Dietary assessment and modelling are required to monitor efficacy and safety of ongoing strategic vitamin D fortification. To support these studies, a specialized vitamin D food composition dataset, based on EuroFIR standards, was compiled. The FoodEXplorer™ tool was used to retrieve well documented analytical data for vitamin D and arrange the data into two datasets - European (8 European countries, 981 data values) and US (1836 data values). Data were classified, using the LanguaL™, FoodEX2 and ODIN classification systems and ranked according to quality criteria. Significant differences in the content, quality of data values, missing data on vitamin D 2 and 25(OH)D 3 and documentation of analytical methods were observed. The dataset is available through the EuroFIR platform. Copyright © 2017 Elsevier Ltd. All rights reserved.

Validity as a social imperative for assessment in health professions education: a concept analysis.

PubMed

Marceau, Mélanie; Gallagher, Frances; Young, Meredith; St-Onge, Christina

2018-06-01

Assessment can have far-reaching consequences for future health care professionals and for society. Thus, it is essential to establish the quality of assessment. Few modern approaches to validity are well situated to ensure the quality of complex assessment approaches, such as authentic and programmatic assessments. Here, we explore and delineate the concept of validity as a social imperative in the context of assessment in health professions education (HPE) as a potential framework for examining the quality of complex and programmatic assessment approaches. We conducted a concept analysis using Rodgers' evolutionary method to describe the concept of validity as a social imperative in the context of assessment in HPE. Supported by an academic librarian, we developed and executed a search strategy across several databases for literature published between 1995 and 2016. From a total of 321 citations, we identified 67 articles that met our inclusion criteria. Two team members analysed the texts using a specified approach to qualitative data analysis. Consensus was achieved through full team discussions. Attributes that characterise the concept were: (i) demonstration of the use of evidence considered credible by society to document the quality of assessment; (ii) validation embedded through the assessment process and score interpretation; (iii) documented validity evidence supporting the interpretation of the combination of assessment findings, and (iv) demonstration of a justified use of a variety of evidence (quantitative and qualitative) to document the quality of assessment strategies. The emerging concept of validity as a social imperative highlights some areas of focus in traditional validation frameworks, whereas some characteristics appear unique to HPE and move beyond traditional frameworks. The study reflects the importance of embedding consideration for society and societal concerns throughout the assessment and validation process, and may represent a potential lens through which to examine the quality of complex and programmatic assessment approaches. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

The importance of having a flexible scope ISO 15189 accreditation and quality specifications based on biological variation--the case of validation of the biochemistry analyzer Dimension Vista.

PubMed

Fernandez-Calle, Pilar; Pelaz, Sandra; Oliver, Paloma; Alcaide, Maria Jose; Gomez-Rioja, Ruben; Buno, Antonio; Iturzaeta, Jose Manuel

2013-01-01

Technological innovation requires the laboratories to ensure that modifications or incorporations of new techniques do not alter the quality of their results. In an ISO 15189 accredited laboratory, flexible scope accreditation facilitates the inclusion of these changes prior to accreditation body evaluation. A strategy to perform the validation of a biochemistry analyzer in an accredited laboratory having a flexible scope is shown. A validation procedure including the evaluation of imprecision and bias of two Dimension Vista analysers 1500 was conducted. Comparability of patient results between one of them and the lately replaced Dimension RxL Max was evaluated. All studies followed the respective Clinical and Laboratory Standards Institute (CLSI) protocols. 30 chemistry assays were studied. Coefficients of variation, percent bias and total error were calculated for all tests and biological variation was considered as acceptance criteria. Quality control material and patient samples were used as test materials. Interchangeability of the results was established by processing forty patients' samples in both devices. 27 of the 30 studied parameters met allowable performance criteria. Sodium, chloride and magnesium did not fulfil acceptance criteria. Evidence of interchangeability of patient results was obtained for all parameters except magnesium, NT-proBNP, cTroponin I and C-reactive protein. A laboratory having a well structured and documented validation procedure can opt to get a flexible scope of accreditation. In addition, performing these activities prior to use on patient samples may evidence technical issues which must be corrected to minimize their impact on patient results.

Evaluation criteria for the district health management information systems: lessons from the Ministry of Health, Kenya.

PubMed

Odhiambo-Otieno, George W; Odero, Wilson W O

2005-03-01

The District Health Management Information Systems (DHMISs) were established by the Ministry of Health (MoH) in Kenya more than two decades ago. Since then, no comprehensive evaluation has been undertaken. This can partly be attributed to lack of defined criteria for evaluating them. To propose evaluation criteria for assessing the design, implementation and impact of DHMIS in the management of the District Health System (DHS) in Kenya. A descriptive cross-sectional study conducted in three DHSs in Kenya: Bungoma, Murang'a and Uasin Gishu districts. Data was collected through focus group discussions, key informant interviews, and documents' review. The respondents, purposely selected from the Ministry of Health headquarters and the three DHS districts, included designers, managers and end-users of the systems. A set of evaluation criteria for DHMISs was identified for each of the three phases of implementation: pre-implementation evaluation criteria (categorised as policy and objectives, technical feasibility, financial viability, political viability and administrative operability) to be applied at the design stage; concurrent implementation evaluation criteria to be applied during implementation of the new system; and post-implementation evaluation criteria (classified as internal - quality of information; external - resources and managerial support; ultimate - systems impact) to be applied after implementation of the system for at least three years. In designing a DHMIS model there is need to have built-in these three sets of evaluation criteria which should be used in a phased manner. Pre-implementation evaluation criteria should be used to evaluate the system's viability before more resources are committed to it; concurrent (operational) - implementation evaluation criteria should be used to monitor the process; and post-implementation evaluation criteria should be applied to assess the system's effectiveness.

Quality standards for rheumatology outpatient clinic. The EXTRELLA project.

PubMed

Nolla, Joan M; Martínez, Carmen; García-Vicuña, Rosario; Seoane-Mato, Daniel; Rosario Lozano, M Piedad; Alonso, Alberto; Alperi, Mercedes; Barbazán, Ceferino; Calvo, Jaime; Delgado, Concepción; Fernández-Nebro, Antonio; Mateo, Lourdes; Pérez Sandoval, Trinidad; Pérez Venegas, José; Rodríguez Lozano, Carlos; Rosas, José

2016-01-01

In recent years, outpatient clinics have undergone extensive development. At present, patients with rheumatic diseases are mainly assisted in this area. However, the quality standards of care are poorly documented. To develop specific quality criteria and standards for an outpatient rheumatology clinic. The project was based on the two-round Delphi method. The following groups of participants took part: scientific committee (13 rheumatologists), five nominal groups (45 rheumatologists and 12 nurses) and a group of discussion formed by 9 patients. Different drafts were consecutively generated until a final document was obtained that included the standards that received a punctuation equal or over 7 in at least 70% of the participants. 148 standards were developed, grouped into the following 9 dimensions: a) structure (22), b) clinical activity and relationship with the patients (34), c) planning (7), d) levels of priority (5), e) relations with primary care physicians, with Emergency Department and with other clinical departments, f) process (26), g) nursing (13), h) teaching and research (13) and i) activity measures (8). This study established specific quality standards for rheumatology outpatient clinic. It can be a useful tool for organising this area in the Rheumatology Department and as a reference when proposing improvement measures to health administrators. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Development of quality indicators to evaluate antibiotic treatment of patients with community-acquired pneumonia in Indonesia.

PubMed

Farida, Helmia; Rondags, Angelique; Gasem, M Hussein; Leong, Katharina; Adityana, A; van den Broek, Peterhans J; Keuter, Monique; Natsch, Stephanie

2015-04-01

To develop an instrument for evaluating the quality of antibiotic management of patients with community-acquired pneumonia (CAP) applicable in a middle-income developing country. A previous study and Indonesian guidelines were reviewed to derive potential quality of care indicators (QIs). An expert panel performed a two-round Delphi consensus procedure on the QI's relevance to patient recovery, reduction of antimicrobial resistance and cost containment. Applicability in practice, including reliability, feasibility and opportunity for improvement, was determined in a data set of 128 patients hospitalised with CAP in Semarang, Indonesia. Fifteen QIs were selected by the consensus procedure. Five QIs did not pass feasibility criteria, because of inappropriate documentation, inefficient laboratory services or patient factors. Three QIs provided minor opportunity for improvement. Two QIs contradicted each other; one of these was considered not valid and excluded. A final set of six QIs was defined for use in the Indonesian setting. Using the Delphi method, we defined a list of QIs for assessing the quality of care, in particular antibiotic treatment, for CAP in Indonesia. For further improvement, a modified Delphi method that includes discussion, a sound medical documentation system, improvement of microbiology laboratory services, and multi-center applicability tests are needed to develop a valid and applicable QI list for the Indonesian setting. © 2014 John Wiley & Sons Ltd.

Availability and Quality of Size Estimations of Female Sex Workers, Men Who Have Sex with Men, People Who Inject Drugs and Transgender Women in Low- and Middle-Income Countries

PubMed Central

Sabin, Keith; Zhao, Jinkou; Garcia Calleja, Jesus Maria; Sheng, Yaou; Arias Garcia, Sonia; Reinisch, Annette; Komatsu, Ryuichi

2016-01-01

Objective To assess the availability and quality of population size estimations of female sex workers (FSW), men who have sex with men (MSM), people who inject drug (PWID) and transgender women. Methods Size estimation data since 2010 were retrieved from global reporting databases, Global Fund grant application documents, and the peer-reviewed and grey literature. Overall quality and availability were assessed against a defined set of criteria, including estimation methods, geographic coverage, and extrapolation approaches. Estimates were compositely categorized into ‘nationally adequate’, ‘nationally inadequate but locally adequate’, ‘documented but inadequate methods’, ‘undocumented or untimely’ and ‘no data.’ Findings Of 140 countries assessed, 41 did not report any estimates since 2010. Among 99 countries with at least one estimate, 38 were categorized as having nationally adequate estimates and 30 as having nationally inadequate but locally adequate estimates. Multiplier, capture-recapture, census and enumeration, and programmatic mapping were the most commonly used methods. Most countries relied on only one estimate for a given population while about half of all reports included national estimates. A variety of approaches were applied to extrapolate from sites-level numbers to national estimates in two-thirds of countries. Conclusions Size estimates for FSW, MSM, PWID and transgender women are increasingly available but quality varies widely. The different approaches present challenges for data use in design, implementation and evaluation of programs for these populations in half of the countries assessed. Guidance should be further developed to recommend: a) applying multiple estimation methods; b) estimating size for a minimum number of sites; and, c) documenting extrapolation approaches. PMID:27163256

The impact of irritable bowel syndrome on daily functioning: Characterizing and understanding daily consequences of IBS.

PubMed

Ballou, S; Keefer, L

2017-04-01

Despite the well-documented economic and psychosocial burden of irritable bowel syndrome (IBS), few studies have focused on the impact of IBS on daily activities. This study aims to quantitate impairment in daily activities among IBS patients and to evaluate the relationship between impairment, IBS, quality of life, and psychiatric symptoms. A total of 179 participants meeting ROME-III criteria for IBS completed an online research survey evaluating the following variables: (i) the impact of IBS on daily activities, (ii) comorbid psychiatric diagnoses, (iii) symptom severity, (iv) quality of life, and (v) symptom-specific cognitive affective factors related to IBS. This sample reported a high degree of impairment due to IBS, with 76% of the sample reporting some degree of IBS-related impairment in at least five different domains of daily life. Rates of impairment were significantly higher for participants who met criteria for anxiety, depression, and/or panic disorder. This study contributes to existing literature by demonstrating a high level of daily impairment among patients with IBS, particularly those who meet criteria for anxiety, depression, and panic disorder. These findings support the importance of integrated psychosocial and medical care for IBS patients, and highlight the utility of evaluation and intervention for behavioral avoidance/impairment especially among those who exhibit signs or symptoms of psychiatric diagnoses. © 2016 John Wiley & Sons Ltd.

Workplace mental health: An international review of guidelines.

PubMed

Memish, Kate; Martin, Angela; Bartlett, Larissa; Dawkins, Sarah; Sanderson, Kristy

2017-08-01

The aim of this systematic review was to determine the quality and comprehensiveness of guidelines developed for employers to detect, prevent, and manage mental health problems in the workplace. An integrated approach that combined expertise from medicine, psychology, public health, management, and occupational health and safety was identified as a best practice framework to assess guideline comprehensiveness. An iterative search strategy of the grey literature was used plus consultation with experts in psychology, public health, and mental health promotion. Inclusion criteria were documents published in English and developed specifically for employers to detect, prevent, and manage mental health problems in the workplace. A total of 20 guidelines met these criteria and were reviewed. Development documents were included to inform quality assessment. This was performed using the AGREE II rating system. Our results indicated that low scores were often due to a lack of focus on prevention and rather a focus on the detection and treatment of mental health problems in the workplace. When prevention recommendations were included they were often individually focused and did not include practical tools or advice to implement. An inconsistency in language, lack of consultation with relevant population groups in the development process and a failure to outline and differentiate between the legal/minimum requirements of a region were also observed. The findings from this systematic review will inform translation of scientific evidence into practical recommendations to prevent mental health problems within the workplace. It will also direct employers, clinicians, and policy-makers towards examples of best-practice guidelines. Copyright © 2017 Elsevier Inc. All rights reserved.

DATA QUALITY OBJECTIVES FOR SELECTING WASTE SAMPLES FOR THE BENCH STEAM REFORMER TEST

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

BANNING DL

2010-08-03

This document describes the data quality objectives to select archived samples located at the 222-S Laboratory for Fluid Bed Steam Reformer testing. The type, quantity and quality of the data required to select the samples for Fluid Bed Steam Reformer testing are discussed. In order to maximize the efficiency and minimize the time to treat Hanford tank waste in the Waste Treatment and Immobilization Plant, additional treatment processes may be required. One of the potential treatment processes is the fluid bed steam reformer (FBSR). A determination of the adequacy of the FBSR process to treat Hanford tank waste is required.more » The initial step in determining the adequacy of the FBSR process is to select archived waste samples from the 222-S Laboratory that will be used to test the FBSR process. Analyses of the selected samples will be required to confirm the samples meet the testing criteria.« less

Data Quality Screening Service

NASA Technical Reports Server (NTRS)

Strub, Richard; Lynnes, Christopher; Hearty, Thomas; Won, Young-In; Fox, Peter; Zednik, Stephan

2013-01-01

A report describes the Data Quality Screening Service (DQSS), which is designed to help automate the filtering of remote sensing data on behalf of science users. Whereas this process often involves much research through quality documents followed by laborious coding, the DQSS is a Web Service that provides data users with data pre-filtered to their particular criteria, while at the same time guiding the user with filtering recommendations of the cognizant data experts. The DQSS design is based on a formal semantic Web ontology that describes data fields and the quality fields for applying quality control within a data product. The accompanying code base handles several remote sensing datasets and quality control schemes for data products stored in Hierarchical Data Format (HDF), a common format for NASA remote sensing data. Together, the ontology and code support a variety of quality control schemes through the implementation of the Boolean expression with simple, reusable conditional expressions as operands. Additional datasets are added to the DQSS simply by registering instances in the ontology if they follow a quality scheme that is already modeled in the ontology. New quality schemes are added by extending the ontology and adding code for each new scheme.

Process of Care for Patients With Benign Cysts and Tumors: Consensus Document of the Andalusian Regional Section of the Spanish Academy of Dermatology and Venereology (AEDV).

PubMed

Moreno-Ramírez, D; Ruiz-Villaverde, R; de Troya, M; Reyes-Alcázar, V; Alcalde, M; Galán, M; García-Lora, E; García, E I; Linares, M; Martínez, L; Pulpillo, Á; Suárez, C; Vélez, A; Torres, A

2016-06-01

Benign skin lesions are a common reason for visits to primary care physicians and dermatologists. However, access to diagnosis and treatment for these lesions varies considerably between users, primarily because no explicit or standardized criteria for dealing with these patients have been defined. Principally with a view to reducing this variability in the care of patients with benign cysts or tumors, the Andalusian Regional Section of the Spanish Academy of Dermatology and Venereology (AEDV) has created a Process of Care document that describes a clinical pathway and quality-of-care characteristics for each action. This report also makes recommendations for decision-making with respect to lesions of this type. Copyright © 2016. Published by Elsevier España, S.L.U.

78 FR 20252 - Water Quality Standards; Withdrawal of Certain Federal Water Quality Criteria Applicable to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

... aquatic life water quality criteria applicable to waters of New Jersey, Puerto Rico, and California's San Francisco Bay. In 1992, EPA promulgated the National Toxics Rule or NTR to establish numeric water quality... Water Quality Standards; Withdrawal of Certain Federal Water Quality Criteria Applicable to California...

Primary display latency criteria based on flying qualities and performance data

NASA Technical Reports Server (NTRS)

Funk, John D., Jr.; Beck, Corin P.; Johns, John B.

1993-01-01

With a pilots' increasing use of visual cue augmentation, much requiring extensive pre-processing, there is a need to establish criteria for new avionics/display design. The timeliness and synchronization of the augmented cues is vital to ensure the performance quality required for precision mission task elements (MTEs) where augmented cues are the primary source of information to the pilot. Processing delays incurred while transforming sensor-supplied flight information into visual cues are unavoidable. Relationships between maximum control system delays and associated flying qualities levels are documented in MIL-F-83300 and MIL-F-8785. While cues representing aircraft status may be just as vital to the pilot as prompt control response for operations in instrument meteorological conditions, presently, there are no specification requirements on avionics system latency. To produce data relating avionics system latency to degradations in flying qualities, the Navy conducted two simulation investigations. During the investigations, flying qualities and performance data were recorded as simulated avionics system latency was varied. Correlated results of the investigation indicates that there is a detrimental impact of latency on flying qualities. Analysis of these results and consideration of key factors influencing their application indicate that: (1) Task performance degrades and pilot workload increases as latency is increased. Inconsistency in task performance increases as latency increases. (2) Latency reduces the probability of achieving Level 1 handling qualities with avionics system latency as low as 70 ms. (3) The data suggest that the achievement of desired performance will be ensured only at display latency values below 120 ms. (4) These data also suggest that avoidance of inadequate performance will be ensured only at display latency values below 150 ms.

Development of Criteria and Procedures for Management of Classified Document Collections.

ERIC Educational Resources Information Center

Rea, Jack C.

The report describes work done in development of criteria and procedures for management of collections of classified documents. Material is presented on philosophy of operation, concept of user service, accession and retention. Much of the discussion is based upon the concept of conversion to a microfiche-oriented library; however, hard copy…

40 CFR 131.11 - Criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Establishment of Water Quality Standards § 131.11 Criteria. (a) Inclusion of pollutants: (1) States must adopt those water quality criteria that protect the designated use. Such criteria must be based on sound...

Rubber stamp templates for improving clinical documentation: A paper-based, m-Health approach for quality improvement in low-resource settings.

PubMed

Kleczka, Bernadette; Musiega, Anita; Rabut, Grace; Wekesa, Phoebe; Mwaniki, Paul; Marx, Michael; Kumar, Pratap

2018-06-01

The United Nations' Sustainable Development Goal #3.8 targets 'access to quality essential healthcare services'. Clinical practice guidelines are an important tool for ensuring quality of clinical care, but many challenges prevent their use in low-resource settings. Monitoring the use of guidelines relies on cumbersome clinical audits of paper records, and electronic systems face financial and other limitations. Here we describe a unique approach to generating digital data from paper using guideline-based templates, rubber stamps and mobile phones. The Guidelines Adherence in Slums Project targeted ten private sector primary healthcare clinics serving informal settlements in Nairobi, Kenya. Each clinic was provided with rubber stamp templates to support documentation and management of commonly encountered outpatient conditions. Participatory design methods were used to customize templates to the workflows and infrastructure of each clinic. Rubber stamps were used to print templates into paper charts, providing clinicians with checklists for use during consultations. Templates used bubble format data entry, which could be digitized from images taken on mobile phones. Besides rubber stamp templates, the intervention included booklets of guideline compilations, one Android phone for digitizing images of templates, and one data feedback/continuing medical education session per clinic each month. In this paper we focus on the effect of the intervention on documentation of three non-communicable diseases in one clinic. Seventy charts of patients enrolled in the chronic disease program (hypertension/diabetes, n=867; chronic respiratory diseases, n=223) at one of the ten intervention clinics were sampled. Documentation of each individual patient encounter in the pre-intervention (January-March 2016) and post-intervention period (May-July) was scored for information in four dimensions - general data, patient assessment, testing, and management. Control criteria included information with no counterparts in templates (e.g. notes on presenting complaints, vital signs). Documentation scores for each patient were compared between both pre- and post-intervention periods and between encounters documented with and without templates (post-intervention only). The total number of patient encounters in the pre-intervention (282) and post-intervention periods (264) did not differ. Mean documentation scores increased significantly in the post-intervention period on average by 21%, 24% and 17% for hypertension, diabetes and chronic respiratory diseases, respectively. Differences were greater (47%, 43% and 27%, respectively) when documentation with and without templates was compared. Changes between pre- vs.post-intervention, and with vs.without template, varied between individual dimensions of documentation. Overall, documentation improved more for general data and patient assessment than in testing or management. The use of templates improves paper-based documentation of patient care, a first step towards improving the quality of care. Rubber stamps provide a simple and low-cost method to print templates on demand. In combination with ubiquitously available mobile phones, information entered on paper can be easily and rapidly digitized. This 'frugal innovation' in m-Health can empower small, private sector facilities, where large numbers of urban patients seek healthcare, to generate digital data on routine outpatient care. These data can form the basis for evidence-based quality improvement efforts at large scale, and help deliver on the SDG promise of quality essential healthcare services for all. Copyright © 2017 Elsevier B.V. All rights reserved.

Use of Electronic Documentation for Quality Improvement in Hospice

PubMed Central

Cagle, John G.; Rokoske, Franziska S.; Durham, Danielle; Schenck, Anna P.; Spence, Carol; Hanson, Laura C.

2015-01-01

Little evidence exists on the use of electronic documentation in hospice and its relationship to quality improvement practices. The purposes of this study were to: (1) estimate the prevalence of electronic documentation use in hospice; (2) identify organizational characteristics associated with use of electronic documentation; and (3) determine whether quality measurement practices differed based on documentation format (electronic vs. nonelectronic). Surveys concerning the use of electronic documentation for quality improvement practices and the monitoring of quality-related care and outcomes were collected from 653 hospices. Users of electronic documentation were able to monitor a wider range of quality-related data than users of nonelectronic documentation. Quality components such as advanced care planning, cultural needs, experience during care of the actively dying, and the number/types of care being delivered were more likely to be documented by users of electronic documentation. Use of electronic documentation may help hospices to monitor quality and compliance. PMID:22267819

Documentation of penicillin adverse drug reactions in electronic health records: inconsistent use of allergy and intolerance labels.

PubMed

Inglis, Joshua M; Caughey, Gillian E; Smith, William; Shakib, Sepehr

2017-11-01

The majority of patients with penicillin allergy labels tolerate penicillins. Inappropriate avoidance of penicillin is associated with increased hospitalisation, infections and healthcare costs. To examine the documentation of penicillin adverse drug reactions (ADR) in a large-scale hospital-based electronic health record. Penicillin ADR were extracted from 96 708 patient records in the Enterprise Patient Administration System in South Australia. Expert criteria were used to determine consistency of ADR entry and suitability for further evaluation. Of 43 011 unique ADR reports, there were 5023 ADR to penicillins with most being entered as allergy (n = 4773, 95.0%) rather than intolerance (n = 250, 5.0%). A significant proportion did not include a reaction description (n = 1052, 20.9%). Using pre-set criteria, 10.1% of reports entered as allergy had a reaction description that was consistent with intolerance and 31.0% of the entered intolerances had descriptions consistent with allergy. Virtually all ADR (n = 4979, 99.1%) were appropriate for further evaluation by history taking or immunological testing and half (50.7%, n = 2549) had documented reactions suggesting low-risk of penicillin allergy. The frequency of penicillin allergy label in this data set is consistent with the known overdiagnosis of penicillin allergy in the hospital population. ADR documentation was poor with incomplete entries and inconsistent categorisation. The concepts of allergy and intolerance for ADR classification, whilst mechanistically valid, may not be useful at the point of ADR entry by generalist clinicians. Systematic evaluation of reported ADR is needed to improve the quality of information for future prescribers. © 2017 Royal Australasian College of Physicians.

BASIS FOR PRIMARY AIR QUALITY CRITERIA AND STANDARDS

EPA Science Inventory

The Environmental Criteria and Assessment Office and the Office of Air Quality Planning and Standards are charged with responsibility for reviewing and assessing air quality criteria and air quality standards, respectively. Since adoption of the 1977 Clean Air Act Amendments, the...

Quality evaluation of JAMA Patient Pages on diabetes using the Ensuring Quality Information for Patient (EQIP) tool.

PubMed

Vaona, Alberto; Marcon, Alessandro; Rava, Marta; Buzzetti, Roberto; Sartori, Marco; Abbinante, Crescenza; Moser, Andrea; Seddaiu, Antonia; Prontera, Manuela; Quaglio, Alessandro; Pallazzoni, Piera; Sartori, Valentina; Rigon, Giulio

2011-12-01

Many medical journals provide patient information leaflets on the correct use of medicines and/or appropriate lifestyles. Only a few studies have assessed the quality of this patient-specific literature. The purpose of this study was to evaluate the quality of JAMA Patient Pages on diabetes using the Ensuring Quality Information for Patient (EQIP) tool. A multidisciplinary group of 10 medical doctors analyzed all diabetes-related Patient Pages published by JAMA from 1998 to 2010 using the EQIP tool. Inter-rater reliability was assessed using the percentage of observed total agreement (p(o)). A quality score between 0 and 1 (the higher score indicating higher quality) was calculated for each item on every page as a function of raters' answers to the EQIP checklist. A mean score per item and a mean score per page were then calculated. We found 8 Patient Pages on diabetes on the JAMA web site. The overall quality score of the documents ranged between 0.55 (Managing Diabetes and Diabetes) and 0.67 (weight and diabetes). p(o) was at least moderate (>50%) for 15 of the 20 EQIP items. Despite generally favorable quality scores, some items received low scores. The worst scores were for the item assessing provision of an empty space to customize information for individual patients (score=0.01, p(o)=95%) and patients involvement in document drafting (score=0.11, p(o)=79%). The Patient Pages on diabetes published by JAMA were found to present weak points that limit their overall quality and may jeopardize their efficacy. We therefore recommend that authors and publishers of written patient information comply with published quality criteria. Further research is needed to evaluate the quality and efficacy of existing written health care information. Copyright © 2011 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Research Notes - Openness and Evolvability - Documentation Quality Assessment

DTIC Science & Technology

2016-08-01

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

Management Documentation: Indicators & Good Practice at Cultural Heritage Places

NASA Astrophysics Data System (ADS)

Eppich, R.; Garcia Grinda, J. L.

2015-08-01

Documentation for cultural heritage places usually refers to describing the physical attributes, surrounding context, condition or environment; most of the time with images, graphics, maps or digital 3D models in their various forms with supporting textural information. Just as important as this type of information is the documentation of managerial attributes. How do managers of cultural heritage places collect information related to financial or economic well-being? How are data collected over time measured, and what are significant indicators for improvement? What quality of indicator is good enough? Good management of cultural heritage places is essential for conservation longevity, preservation of values and enjoyment by the public. But how is management documented? The paper will describe the research methodology, selection and description of attributes or indicators related to good management practice. It will describe the criteria for indicator selection and why they are important, how and when they are collected, by whom, and the difficulties in obtaining this information. As importantly it will describe how this type of documentation directly contributes to improving conservation practice. Good practice summaries will be presented that highlight this type of documentation including Pamplona and Ávila, Spain and Valletta, Malta. Conclusions are drawn with preliminary recommendations for improvement of this important aspect of documentation. Documentation of this nature is not typical and presents a unique challenge to collect, measure and communicate easily. However, it is an essential category that is often ignored yet absolutely essential in order to conserve cultural heritage places.

Improving the Quality of Health Care Services for Adolescents, Globally: A Standards-Driven Approach

PubMed Central

Nair, Manisha; Baltag, Valentina; Bose, Krishna; Boschi-Pinto, Cynthia; Lambrechts, Thierry; Mathai, Matthews

2015-01-01

Purpose The World Health Organization (WHO) undertook an extensive and elaborate process to develop eight Global Standards to improve quality of health care services for adolescents. The objectives of this article are to present the Global Standards and their method of development. Methods The Global Standards were developed through a four-stage process: (1) conducting needs assessment; (2) developing the Global Standards and their criteria; (3) expert consultations; and (4) assessing their usability. Needs assessment involved conducting a meta-review of systematic reviews and two online global surveys in 2013, one with primary health care providers and another with adolescents. The Global Standards were developed based on the needs assessment in conjunction with analysis of 26 national standards from 25 countries. The final document was reviewed by experts from the World Health Organization regional and country offices, governments, academia, nongovernmental organizations, and development partners. The standards were subsequently tested in Benin and in a regional expert consultation of Latin America and Caribbean countries for their usability. Results The process resulted in the development of eight Global Standards and 79 criteria for measuring them: (1) adolescents' health literacy; (2) community support; (3) appropriate package of services; (4) providers' competencies; (5) facility characteristics; (6) equity and nondiscrimination; (7) data and quality improvement; and (8) adolescents' participation. Conclusions The eight standards are intended to act as benchmarks against which quality of health care provided to adolescents could be compared. Health care services can use the standards as part of their internal quality assurance mechanisms or as part of an external accreditation process. PMID:26299556

Performance criteria and quality indicators for the post-analytical phase.

PubMed

Sciacovelli, Laura; Aita, Ada; Padoan, Andrea; Pelloso, Michela; Antonelli, Giorgia; Piva, Elisa; Chiozza, Maria Laura; Plebani, Mario

2016-07-01

Quality indicators (QIs) used as performance measurements are an effective tool in accurately estimating quality, identifying problems that may need to be addressed, and monitoring the processes over time. In Laboratory Medicine, QIs should cover all steps of the testing process, as error studies have confirmed that most errors occur in the pre- and post-analytical phase of testing. Aim of the present study is to provide preliminary results on QIs and related performance criteria in the post-analytical phase. This work was conducted according to a previously described study design based on the voluntary participation of clinical laboratories in the project on QIs of the Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). Overall, data collected highlighted an improvement or stability in performances over time for all reported indicators thus demonstrating that the use of QIs is effective in the quality improvement strategy. Moreover, QIs data are an important source for defining the state-of-the-art concerning the error rate in the total testing process. The definition of performance specifications based on the state-of-the-art, as suggested by consensus documents, is a valuable benchmark point in evaluating the performance of each laboratory. Laboratory tests play a relevant role in the monitoring and evaluation of the efficacy of patient outcome thus assisting clinicians in decision-making. Laboratory performance evaluation is therefore crucial to providing patients with safe, effective and efficient care.

Documentation of the U.S. Geological Survey Oceanographic Time-Series Measurement Database

USGS Publications Warehouse

Montgomery, Ellyn T.; Martini, Marinna A.; Lightsom, Frances L.; Butman, Bradford

2008-01-02

This report describes the instrumentation and platforms used to make the measurements; the methods used to process, apply quality-control criteria, and archive the data; the data storage format, and how the data are released and distributed. The report also includes instructions on how to access the data from the online database at http://stellwagen.er.usgs.gov/. As of 2016, the database contains about 5,000 files, which may include observations of current velocity, wave statistics, ocean temperature, conductivity, pressure, and light transmission at one or more depths over some duration of time.

Background Information and User Guide for MIL-F-8785C, Military Specification - Flying Qualities of Piloted Airplanes

DTIC Science & Technology

1982-07-01

Design Military Specification 20. ABSTRACT (Co.itInue o., revorse.• de if ,lec0O.•,•dr’ 1 Id•ntnify’’ bY bI. rk ,CI•,ti lim r) ’This document is published...criteria to Insert into the basic requirements, verification proceduresand leason: learned from past experience. The Standkerd will thus be the framework ...equations with sketch: Each of the three paired quantities in the de - nominators of KS and KR should have a hir over them, as is done in the numerators

Development of Handling Qualities Criteria for Rotorcraft with Externally Slung Loads

NASA Technical Reports Server (NTRS)

Hoh, Roger H.; Heffley, Robert K.; Mitchell, David G.

2006-01-01

Piloted simulations were performed on the NASA-Ames Vertical Motion Simulator (VMS) to explore handling qualities issues for large cargo helicopters, particularly focusing on external slung load operations. The purpose of this work was based upon the need to include handling qualities criteria for cargo helicopters in an upgrade to the U.S. Army's rotorcraft handling qualities specification, Aeronautical Design Standard-33 (ADS-33E-PRF). From the VMS results, handling qualities criteria were developed fro cargo helicopters carrying external slung loads in the degraded visual environment (DVE). If satisfied, these criteria provide assurance that the handling quality rating (HQR) will be 4 or better for operations in the DVE, and with a load mass ratio of 0.33 or less. For lighter loads, flying qualities were found to be less dependent on the load geometry and therefore the significance of the criteria is less. For heavier loads, meeting the criteria ensures the best possible handling qualities, albeit Level 2 for load mass ratios greater than 0.33.

Initial Steps toward Validating and Measuring the Quality of Computerized Provider Documentation

PubMed Central

Hammond, Kenric W.; Efthimiadis, Efthimis N.; Weir, Charlene R.; Embi, Peter J.; Thielke, Stephen M.; Laundry, Ryan M.; Hedeen, Ashley

2010-01-01

Background: Concerns exist about the quality of electronic health care documentation. Prior studies have focused on physicians. This investigation studied document quality perceptions of practitioners (including physicians), nurses and administrative staff. Methods: An instrument developed from staff interviews and literature sources was administered to 110 practitioners, nurses and administrative staff. Short, long and original versions of records were rated. Results: Length transformation did not affect quality ratings. On several scales practitioners rated notes less favorably than administrators or nurses. The original source document was associated with the quality rating, as was tf·idf, a relevance statistic computed from document text. Tf·idf was strongly associated with practitioner quality ratings. Conclusion: Document quality estimates were not sensitive to modifying redundancy in documents. Some perceptions of quality differ by role. Intrinsic document properties are associated with staff judgments of document quality. For practitioners, the tf·idf statistic was strongly associated with the quality dimensions evaluated. PMID:21346983

Clustering of Farsi sub-word images for whole-book recognition

NASA Astrophysics Data System (ADS)

Soheili, Mohammad Reza; Kabir, Ehsanollah; Stricker, Didier

2015-01-01

Redundancy of word and sub-word occurrences in large documents can be effectively utilized in an OCR system to improve recognition results. Most OCR systems employ language modeling techniques as a post-processing step; however these techniques do not use important pictorial information that exist in the text image. In case of large-scale recognition of degraded documents, this information is even more valuable. In our previous work, we proposed a subword image clustering method for the applications dealing with large printed documents. In our clustering method, the ideal case is when all equivalent sub-word images lie in one cluster. To overcome the issues of low print quality, the clustering method uses an image matching algorithm for measuring the distance between two sub-word images. The measured distance with a set of simple shape features were used to cluster all sub-word images. In this paper, we analyze the effects of adding more shape features on processing time, purity of clustering, and the final recognition rate. Previously published experiments have shown the efficiency of our method on a book. Here we present extended experimental results and evaluate our method on another book with totally different font face. Also we show that the number of the new created clusters in a page can be used as a criteria for assessing the quality of print and evaluating preprocessing phases.

In pursuit of goodness in bioethics: analysis of an exemplary article.

PubMed

Hofmann, Bjørn; Magelssen, Morten

2018-06-15

What is good bioethics? Addressing this question is key for reinforcing and developing the field. In particular, a discussion of potential quality criteria can heighten awareness and contribute to the quality of bioethics publications. Accordingly, the objective of this article is threefold: first, we want to identify a set of criteria for quality in bioethics. Second, we want to illustrate the added value of a novel method: in-depth analysis of a single article with the aim of deriving quality criteria. The third and ultimate goal is to stimulate a broad and vivid debate on goodness in bioethics. An initial literature search reveals a range of diverse quality criteria. In order to expand on the realm of such quality criteria, we perform an in-depth analysis of an article that is acclaimed for being exemplary. The analysis results in eleven specific quality criteria for good bioethics in three categories: argumentative, empirical, and dialectic. Although we do not claim that the identified criteria are universal or absolute, we argue that they are fruitful for fueling a continuous constitutive debate on what is "good bioethics." Identifying, debating, refining, and applying such criteria is an important part of defining and improving bioethics.

The quality of information about sickle cell disease on the Internet for youth.

PubMed

Breakey, Vicky R; Harris, Lauren; Davis, Omar; Agarwal, Arnav; Ouellette, Carley; Akinnawo, Elizabeth; Stinson, Jennifer

2017-04-01

Adolescence is a vulnerable time for teens with sickle cell disease (SCD). Although there is evidence to support the use of web-based education to promote self-management skills in patients with chronic illnesses, the quality of SCD-related information on the Internet has not been assessed. A website review was conducted to appraise the quality, content, accuracy, readability, and desirability of online information for the adolescents with SCD. Relevant keywords were searched on the most popular search engines. Websites meeting predetermined criteria were reviewed. The quality of information was appraised using the validated DISCERN tool. Two physicians independently rated website completeness and accuracy. Readability of the sites was documented using the simple measure of gobbledygook (SMOG) scores and the Flesch Reading Ease (FRE). The website features considered desirable by youth were tracked. Search results yielded >600 websites with 25 unique hits meeting criteria. The overall quality of the information was "fair" and the average DISCERN rating score was 50.1 (±9.3, range 31.0-67.5). Only 12 of 25 (48%) websites had scores >50. The average completeness score was 20 of 29 (±5, range 12-27). No errors were identified. The mean SMOG score was 13.04 (±2.80, range 10.21-22.85) and the mean FRE score was 46.05 (±11.47; range 17.50-66.10), suggesting that the material was written well beyond the acceptable reading level for patient education. The websites were text-heavy and lacked the features that appeal to youth (chat, games, videos, etc.). Given the paucity of high-quality health information available for the teens with SCD, it is essential that additional online resources be developed. © 2016 Wiley Periodicals, Inc.

Using Feedback from Data Consumers to Capture Quality Information on Environmental Research Data

NASA Astrophysics Data System (ADS)

Devaraju, A.; Klump, J. F.

2015-12-01

Data quality information is essential to facilitate reuse of Earth science data. Recorded quality information must be sufficient for other researchers to select suitable data sets for their analysis and confirm the results and conclusions. In the research data ecosystem, several entities are responsible for data quality. Data producers (researchers and agencies) play a major role in this aspect as they often include validation checks or data cleaning as part of their work. It is possible that the quality information is not supplied with published data sets; if it is available, the descriptions might be incomplete, ambiguous or address specific quality aspects. Data repositories have built infrastructures to share data, but not all of them assess data quality. They normally provide guidelines of documenting quality information. Some suggests that scholarly and data journals should take a role in ensuring data quality by involving reviewers to assess data sets used in articles, and incorporating data quality criteria in the author guidelines. However, this mechanism primarily addresses data sets submitted to journals. We believe that data consumers will complement existing entities to assess and document the quality of published data sets. This has been adopted in crowd-source platforms such as Zooniverse, OpenStreetMap, Wikipedia, Mechanical Turk and Tomnod. This paper presents a framework designed based on open source tools to capture and share data users' feedback on the application and assessment of research data. The framework comprises a browser plug-in, a web service and a data model such that feedback can be easily reported, retrieved and searched. The feedback records are also made available as Linked Data to promote integration with other sources on the Web. Vocabularies from Dublin Core and PROV-O are used to clarify the source and attribution of feedback. The application of the framework is illustrated with the CSIRO's Data Access Portal.

Benefits of physical exercise training on cognition and quality of life in frail older adults.

PubMed

Langlois, Francis; Vu, Thien Tuong Minh; Chassé, Kathleen; Dupuis, Gilles; Kergoat, Marie-Jeanne; Bherer, Louis

2013-05-01

Frailty is a state of vulnerability associated with increased risks of fall, hospitalization, cognitive deficits, and psychological distress. Studies with healthy senior suggest that physical exercise can help improve cognition and quality of life. Whether frail older adults can show such benefits remains to be documented. A total of 83 participants aged 61-89 years were assigned to an exercise-training group (3 times a week for 12 weeks) or a control group (waiting list). Frailty was determined by a complete geriatric examination using specific criteria. Pre- and post-test measures assessed physical capacity, cognitive performance, and quality of life. Compared with controls, the intervention group showed significant improvement in physical capacity (functional capacities and physical endurance), cognitive performance (executive functions, processing speed, and working memory), and quality of life (global quality of life, leisure activities, physical capacity, social/family relationships, and physical health). Benefits were overall equivalent between frail and nonfrail participants. Physical exercise training leads to improved cognitive functioning and psychological well-being in frail older adults.

Federal standards and procedures for the National Watershed Boundary Dataset (WBD)

USGS Publications Warehouse

,; ,; ,

2013-01-01

The Watershed Boundary Dataset (WBD) is a comprehensive aggregated collection of hydrologic unit data consistent with the national criteria for delineation and resolution. This document establishes Federal standards and procedures for creating the WBD as seamless and hierarchical hydrologic unit data, based on topographic and hydrologic features at a 1:24,000 scale in the United States, except for Alaska at 1:63,360 scale, and 1:25,000 scale in the Caribbean. The data within the WBD have been reviewed for certification through the 12-digit hydrologic unit for compliance with the criteria outlined in this document. Any edits to certified data will be reviewed against this standard prior to inclusion. Although not required as part of the framework WBD, the guidelines contain details for compiling and delineating the boundaries of two additional levels, the 14- and 16-digit hydrologic units, as well as the use of higher resolution base information to improve delineations. The guidelines presented herein are designed to enable local, regional, and national partners to delineate hydrologic units consistently and accurately. Such consistency improves watershed management through efficient sharing of information and resources and by ensuring that digital geographic data are usable with other related Geographic Information System (GIS) data.Terminology, definitions, and procedural information are provided to ensure uniformity in hydrologic unit boundaries, names, and numerical codes. Detailed standards and specifications for data are included. The document also includes discussion of objectives, communications required for revising the data resolution in the United States and the Caribbean, as well as final review and data-quality criteria. Instances of unusual landforms or artificial features that affect the hydrologic units are described with metadata standards. Up-to-date information and availability of the hydrologic units are listed at http:// www.nrcs.usda.gov/wps/portal/nrcs/detail/national/technical/ nra/dma/?&cid=nrcs143_021630/.

Federal standards and procedures for the National Watershed Boundary Dataset (WBD)

USGS Publications Warehouse

U.S. Geological Survey and U.S. Department of Agriculture, Natural Resources Conservation Service

2012-01-01

The Watershed Boundary Dataset (WBD) is a comprehensive aggregated collection of hydrologic unit data consistent with the national criteria for delineation and resolution. This document establishes Federal standards and procedures for creating the WBD as seamless and hierarchical hydrologic unit data, based on topographic and hydrologic features at a 1:24,000 scale in the United States, except for Alaska at 1:63,360 scale, and 1:25,000 scale in the Caribbean. The data within the WBD have been reviewed for certification through the 12-digit hydrologic unit for compliance with the criteria outlined in this document. Any edits to certified data will be reviewed against this standard prior to inclusion. Although not required as part of the framework WBD, the guidelines contain details for compiling and delineating the boundaries of two additional levels, the 14- and 16-digit hydrologic units, as well as the use of higher resolution base information to improve delineations. The guidelines presented herein are designed to enable local, regional, and national partners to delineate hydrologic units consistently and accurately. Such consistency improves watershed management through efficient sharing of information and resources and by ensuring that digital geographic data are usable with other related Geographic Information System (GIS) data. Terminology, definitions, and procedural information are provided to ensure uniformity in hydrologic unit boundaries, names, and numerical codes. Detailed standards and specifications for data are included. The document also includes discussion of objectives, communications required for revising the data resolution in the United States and the Caribbean, as well as final review and data-quality criteria. Instances of unusual landforms or artificial features that affect the hydrologic units are described with metadata standards. Up-to-date information and availability of the hydrologic units are listed at http://www.nrcs.usda.gov/wps/portal/nrcs/detail/national/water/watersheds/?cid=nrcs143_021630/.

Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders

PubMed Central

Teschke, Rolf; Wolff, Albrecht; Frenzel, Christian; Eickhoff, Axel; Schulze, Johannes

2015-01-01

Herbal traditional Chinese medicine (TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providing effective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in PubMed and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn’s disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmatic modern medicine by bridging the gap between the two medicinal cultures. PMID:25914456

Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders.

PubMed

Teschke, Rolf; Wolff, Albrecht; Frenzel, Christian; Eickhoff, Axel; Schulze, Johannes

2015-04-21

Herbal traditional Chinese medicine (TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providing effective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in PubMed and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn's disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmatic modern medicine by bridging the gap between the two medicinal cultures.

The importance of having a flexible scope ISO 15189 accreditation and quality specifications based on biological variation – the case of validation of the biochemistry analyzer Dimension Vista

PubMed Central

Fernandez-Calle, Pilar; Pelaz, Sandra; Oliver, Paloma; Alcaide, Maria Jose; Gomez-Rioja, Ruben; Buno, Antonio; Iturzaeta, Jose Manuel

2013-01-01

Introduction Technological innovation requires the laboratories to ensure that modifications or incorporations of new techniques do not alter the quality of their results. In an ISO 15189 accredited laboratory, flexible scope accreditation facilitates the inclusion of these changes prior to accreditation body evaluation. A strategy to perform the validation of a biochemistry analyzer in an accredited laboratory having a flexible scope is shown. Materials and methods: A validation procedure including the evaluation of imprecision and bias of two Dimension Vista analysers 1500 was conducted. Comparability of patient results between one of them and the lately replaced Dimension RxL Max was evaluated. All studies followed the respective Clinical and Laboratory Standards Institute (CLSI) protocols. 30 chemistry assays were studied. Coefficients of variation, percent bias and total error were calculated for all tests and biological variation was considered as acceptance criteria. Quality control material and patient samples were used as test materials. Interchangeability of the results was established by processing forty patients’ samples in both devices. Results: 27 of the 30 studied parameters met allowable performance criteria. Sodium, chloride and magnesium did not fulfil acceptance criteria. Evidence of interchangeability of patient results was obtained for all parameters except magnesium, NT-proBNP, cTroponin I and C-reactive protein. Conclusions: A laboratory having a well structured and documented validation procedure can opt to get a flexible scope of accreditation. In addition, performing these activities prior to use on patient samples may evidence technical issues which must be corrected to minimize their impact on patient results. PMID:23457769

An audit of growth hormone replacement for GH-deficient adults in Scotland.

PubMed

Philip, Sam; Howat, Isobel; Carson, Maggie; Booth, Anne; Campbell, Karen; Grant, Donna; Patterson, Catherine; Schofield, Christopher; Bevan, John; Patrick, Alan; Leese, Graham; Connell, John

2013-04-01

Guidelines on the clinical use of growth hormone therapy in adults were issued by the UK National Institute for Clinical Excellence (NICE) in August 2003. We conducted a retrospective clinical audit on the use of growth hormone (GH) in Scotland to evaluate the use of these guidelines and their impact on clinical practice. The audit had two phases. In phase I, the impact of NICE criteria on specialist endocrine practice in starting and continuing GH replacement was assessed. In phase II, the reasons why some adults in Scotland with growth hormone deficiency were not on replacement therapy were evaluated. A retrospective cross-sectional case note review was carried out of all adult patients being followed up for growth hormone deficiency during the study period (1 March 2005 to 31 March 2008). Phase I of the audit included 208 patients and phase II 108 patients. Sellar tumours were the main cause of GH deficiency in both phases of the audit. In phase I, 53 patients (77%) had an AGHDA-QoL score >11 documented before commencing GH post-NICE guidance, compared with 35 (25%) pre-NICE guidance. Overall, only 39 patients (18%) met the full NICE criteria for starting and continuing GH (pre-NICE, 11%; post-NICE, 35%). Phase II indicated that the main reasons for not starting GH included perceived satisfactory quality of life (n = 47, 43%), patient reluctance (16, 15%) or a medical contraindication (16, 15%). Although the use of quality of life assessments has increased following publication of the NICE guidelines, most adults on GH in Scotland did not fulfil the complete set of NICE criteria. The main reason for not starting GH therapy in adult GH-deficient patients was perceived satisfactory quality of life. © 2012 Blackwell Publishing Ltd.

What Every Child Should Know...Music. Course of Study and Criteria for Textbook Selection.

ERIC Educational Resources Information Center

Arizona State Dept. of Education, Phoenix.

This document outlines the music curriculum for students in grades K-8 in Arizona public schools. Developers state that music educators should use the document as the content criteria for selecting state adopted textbooks and materials. As a result of participating in the music program, students should develop an increasing commitment to music,…

DEVELOPMENT OF MARINE WATER QUALITY CRITERIA

EPA Science Inventory

The U.S. Environmental Protectional Agency has developed guidelines for deriving numerical national water quality criteria for the protection of aquatic organisms and their uses. These guidelines provide the method for deriving water quality criteria, including minimum data base...

Developing Water Quality Criteria for Suspended and Bedded Sediments (SABs)

EPA Pesticide Factsheets

This paper provides an introduction to SABS and water quality criteria and discusses the types and status of water quality criteria that have been or are currently being used by the States, Canada and elsewhere.

Drivers of Dashboard Development (3-D): A Curricular Continuous Quality Improvement Approach.

PubMed

Shroyer, A Laurie; Lu, Wei-Hsin; Chandran, Latha

2016-04-01

Undergraduate medical education (UME) programs are seeking systematic ways to monitor and manage their educational performance metrics and document their achievement of external goals (e.g., Liaison Committee on Medical Education [LCME] accreditation requirements) and internal objectives (institution-specific metrics). In other continuous quality improvement (CQI) settings, summary dashboard reports have been used to evaluate and improve performance. The Stony Brook University School of Medicine UME leadership team developed and implemented summary dashboard performance reports in 2009 to document LCME standards/criteria compliance, evaluate medical student performance, and identify progress in attaining institutional curricular goals and objectives. Key performance indicators (KPIs) and benchmarks were established and have been routinely monitored as part of the novel Drivers of Dashboard Development (3-D) approach to curricular CQI. The systematic 3-D approach has had positive CQI impacts. Substantial improvements over time have been documented in KPIs including timeliness of clerkship grades, midclerkship feedback, student mistreatment policy awareness, and student satisfaction. Stakeholder feedback indicates that the dashboards have provided useful information guiding data-driven curricular changes, such as integrating clinician-scientists as lecturers in basic science courses to clarify the clinical relevance of specific topics. Gaining stakeholder acceptance of the 3-D approach required clear communication of preestablished targets and annual meetings with department leaders and course/clerkship directors. The 3-D approach may be considered by UME programs as a template for providing faculty and leadership with a CQI framework to establish shared goals, document compliance, report accomplishments, enrich communications, facilitate decisions, and improve performance.

Recommendations for the Diagnosis and Management of Bladder Pain Syndrome. Spanish Urological Association Consensus Document.

PubMed

Esteban, M; Adot, J M; Arlandis, S; Peri, L; Prieto, L; Salinas, J; Cozar, J M

2015-10-01

Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) and other bladder pathologies share common manifestations, such as the presence of mictional symptoms and a negative impact on the patient's quality of life. To be properly diagnosed and clinically managed, it is important to distinguish between its clinical modalities and diagnostic criteria for adequate exclusion. The purpose of this study was to standardize criteria for making decisions in BPS management, for its diagnosis, initial treatment and follow-up. A nominal group methodology was employed, using scientific evidence on BPS taken from a systematic (non-exhaustive) literature review for developing recommendations along with specialist expert opinions. The diagnosis of BPS should be made based on the patient's clinical history, with emphasis on pain and mictional symptoms as well as excluding other pathologies with similar symptomatology. BPS treatment should be directed towards restoring normal bladder function, preventing symptom relapse and improving patients' quality of life. It is therefore advisable to start with conservative treatment and to adopt less conservative treatments as the level of clinical severity increases. It is also recommended to abandon ineffective treatments and reconsider other therapeutic options. Quickly identifying the pathology is important when trying to positively influence morbidity and care quality for these patients. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Federal Transit Administration's noise and vibration Guidance Manual: Updates after 10 years of experience

NASA Astrophysics Data System (ADS)

Hanson, Carl E.

2005-09-01

In April 1995, the Federal Transit Administration of the U.S. Department of Transportation issued its guidance manual, ``Transit Noise and Vibration Impact Assessment.'' The manual was written to provide direction for the preparation of noise and vibration sections of environmental documents for public transportation projects in the interest of promoting quality and uniformity in assessments. In the 10 years since its release, the guidance manual has been used as the basis of noise and vibration assessments in over 80 environmental documents and has been used worldwide as a standard method for performing transit noise analyses. An updated version has recently been prepared that takes account of improvements in tools, changes in the environmental assessment procedures, modifications of impact criteria, and experience with mitigation measures. These factors, and other background information, will be discussed to provide insight regarding the revisions in the new edition.

A systematic approach towards the development of quality indicators for postnatal care after discharge in Flanders, Belgium.

PubMed

Helsloot, Kaat; Walraevens, Mieke; Besauw, Saskia Van; Van Parys, An-Sofie; Devos, Hanne; Holsbeeck, Ann Van; Roelens, Kristien

2017-05-01

to develop a set of quality indicators for postnatal care after discharge from the hospital, using a systematic approach. key elements of qualitative postnatal care were defined by performing a systematic review and the literature was searched for potential indicators (step 1). The potential indicators were evaluated by five criteria (validity, reliability, sensitivity, feasibility and acceptability) and by making use of the 'Appraisal of Guidelines for Research and Evaluation', the AIRE-instrument (step 2). In a modified Delphi-survey, the quality indicators were presented to a panel of experts in the field of postnatal care using an online tool (step 3). The final results led to a Flemish model of postnatal care (step 4). Flanders, Belgium PARTICIPANTS: health care professionals, representatives of health care organisations and policy makers with expertise in the field of postnatal care. after analysis 57 research articles, 10 reviews, one book and eight other documents resulted in 150 potential quality indicators in seven critical care domains. Quality assessment of the indicators resulted in 58 concept quality indicators which were presented to an expert-panel of health care professionals. After two Delphi-rounds, 30 quality indicators (six structure, 17 process, and seven outcome indicators) were found appropriate to monitor and improve the quality of postnatal care after discharge from the hospital. KEY CONCLUSIONS AND IMPLICATIONS FOR CLINICAL PRACTICE: the quality indicators resulted in a Flemish model of qualitative postnatal care that was implemented by health authorities as a minimum standard in the context of shortened length of stay. Postnatal care should be adjusted to a flexible length of stay and start in pregnancy with an individualised care plan that follows mother and new-born throughout pregnancy, childbirth and postnatal period. Criteria for discharge and local protocols about the organisation and content of care are essential to facilitate continuity of care. Copyright © 2017 Elsevier Ltd. All rights reserved.

40 CFR 132.3 - Adoption of criteria.

Code of Federal Regulations, 2012 CFR

2012-07-01

... with: (a) The acute water quality criteria for protection of aquatic life in Table 1 of this part, or a... chronic water quality criteria for protection of aquatic life in Table 2 of this part, or a site-specific... QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.3 Adoption of criteria. The Great Lakes States and...

40 CFR 132.3 - Adoption of criteria.

Code of Federal Regulations, 2013 CFR

2013-07-01

... with: (a) The acute water quality criteria for protection of aquatic life in Table 1 of this part, or a... chronic water quality criteria for protection of aquatic life in Table 2 of this part, or a site-specific... QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.3 Adoption of criteria. The Great Lakes States and...

40 CFR 132.3 - Adoption of criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... with: (a) The acute water quality criteria for protection of aquatic life in Table 1 of this part, or a... chronic water quality criteria for protection of aquatic life in Table 2 of this part, or a site-specific... QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.3 Adoption of criteria. The Great Lakes States and...

40 CFR 132.3 - Adoption of criteria.

Code of Federal Regulations, 2011 CFR

2011-07-01

... with: (a) The acute water quality criteria for protection of aquatic life in Table 1 of this part, or a... chronic water quality criteria for protection of aquatic life in Table 2 of this part, or a site-specific... QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM § 132.3 Adoption of criteria. The Great Lakes States and...

Quality and Usability of Arthritic Pain Self-Management Apps for Older Adults: A Systematic Review.

PubMed

Bhattarai, Priyanka; Newton-John, T R O; Phillips, Jane L

2018-03-01

To appraise the quality and usability of currently available pain applications that could be used by community-dwelling older adults to self-manage their arthritic pain. A systematic review. Searches were conducted in App Store and Google Play to identify pain self-management apps relevant to arthritic pain management. English language pain management apps providing pain assessment and documentation function and pain management education were considered for inclusion. A quality evaluation audit tool based on the Stanford Arthritis Self-Management Program was developed a priori to evaluate app content quality. The usability of included apps was assessed using an established usability evaluation tool. Out of the 373 apps that were identified, four met the inclusion criteria. The included apps all included a pain assessment and documentation function and instructions on medication use, communication with health professionals, cognitive behavioral therapy-based pain management, and physical exercise. Management of mood, depression, anxiety, and sleep were featured in most apps (N = 3). Three-quarters (N = 3) of the apps fell below the acceptable moderate usability score (≥3), while one app obtained a moderate score (3.2). Few of the currently available pain apps offer a comprehensive pain self-management approach incorporating evidence-based strategies in accordance with the Stanford Arthritis Self-Management Program. The moderate-level usability across the included apps indicates a need to consider the usability needs of the older population in future pain self-management app development endeavors.

Recommendations and Justifications To Remove Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office Federal Facility Agreement and Consent Order, Revision 0

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

Birney, Cathleen; Krauss, Mark J

This document is part of an effort to reevaluate 37 FFACO and Administrative URs against the current Soils Risk-Based Corrective Action Evaluation Process. After reviewing 37 existing FFACO and Administrative URs, 3 URs addressed in this document have sufficient information to determine that these current URs may be removed, based on the RBCA criteria. This document presents recommendations on modifications to existing URs that will be consistent with the RBCA criteria.

What constitutes a nesting attempt? Variation in criteria causes bias and hinders comparisons across studies

USGS Publications Warehouse

Garcia, V.; Conway, C.J.

2009-01-01

Because reliable estimates of nesting success are very important to avian studies, the defnition of a “successful nest” and the use of different analytical methods to estimate success have received much attention. By contrast, variation in the criteria used to determine whether an occupied site that did not produce offspring contained a nesting attempt is a source of bias that has been largely ignored. This problem is especially severe in studies that deal with species whose nest contents are relatively inaccessible because observers cannot determine whether or not an egg was laid for a large proportion of occupied sites. Burrowing Owls (Athene cunicularia) often lay their eggs ≥3 m below ground, so past Burrowing Owl studies have used a variety of criteria to determine whether a nesting attempt was initiated. We searched the literature to document the extent of that variation and examined how that variation influenced estimates of daily nest survival. We found 13 different sets of criteria used by previous authors and applied each criterion to our data set of 1,300 occupied burrows. We found significant variation in estimates of daily nest survival depending on the criteria used. Moreover, differences in daily nest survival among populations were apparent using some sets of criteria but not others. These inconsistencies may lead to incorrect conclusions and invalidate comparisons of the productivity and relative site quality among populations. We encourage future authors working on cavity-, canopy-, or burrow-nesting birds to provide specific details on the criteria they used to identify a nesting attempt.

Differences in the diagnosis and management of systemic lupus erythematosus by primary care and specialist providers in the American Indian/Alaska Native population.

PubMed

McDougall, J A; Helmick, C G; Lim, S S; Johnston, J M; Gaddy, J R; Gordon, C; Ferucci, E D

2018-06-01

Objectives The objective of this study is to investigate differences in the diagnosis and management of systemic lupus erythematosus (SLE) by primary care and specialist physicians in a population-based registry. Methods This study includes individuals from the 2009 Indian Health Service lupus registry population with a diagnosis of SLE documented by either a primary care provider or specialist. SLE classification criteria, laboratory testing, and medication use at any time during the course of disease were determined by medical record abstraction. Results Of the 320 individuals with a diagnosis of SLE, 249 had the diagnosis documented by a specialist, with 71 documented by primary care. Individuals with a specialist diagnosis of SLE were more likely to have medical record documentation of meeting criteria for SLE by all criteria sets (American College of Rheumatology, 79% vs 22%; Boston Weighted, 82% vs 32%; and Systemic Lupus International Collaborating Clinics, 83% vs 35%; p < 0.001 for all comparisons). In addition, specialist diagnosis was associated with documentation of ever having been tested for anti-double-stranded DNA antibody and complement 3 and complement 4 ( p < 0.001). Documentation of ever receiving hydroxychloroquine was also more common with specialist diagnosis (86% vs 64%, p < 0.001). Conclusions Within the population studied, specialist diagnosis of SLE was associated with a higher likelihood of having SLE classification criteria documented, being tested for biomarkers of disease, and ever receiving treatment with hydroxychloroquine. These data support efforts both to increase specialist access for patients with suspected SLE and to provide lupus education to primary care providers.

Multiple Criteria Evaluation of Quality and Optimisation of e-Learning System Components

ERIC Educational Resources Information Center

Kurilovas, Eugenijus; Dagiene, Valentina

2010-01-01

The main research object of the paper is investigation and proposal of the comprehensive Learning Object Repositories (LORs) quality evaluation tool suitable for their multiple criteria decision analysis, evaluation and optimisation. Both LORs "internal quality" and "quality in use" evaluation (decision making) criteria are analysed in the paper.…

Identifying process and outcome indicators of successful transitions from child to adult mental health services: protocol for a scoping review.

PubMed

Cleverley, Kristin; Bennett, Kathryn; Jeffs, Lianne

2016-07-05

A significant proportion of youth need to transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS); however, the transition process is not well understood and often experienced poorly by youth. In the effort to design and evaluate standards of practice for transitions, there is a need to identify key elements of a successful transition. The objectives of this scoping review are to: (1) identify definitions of successful transitions from CAMHS to AMHS; and (2) identify indicators that have been used to measure CAMHS-AMHS transition care processes and quality, and outcomes. We will search 8 electronic bibliographic databases from 1980 to 2016 (eg, Medline, EMBASE, PsycINFO), professional associations, policy documents, and other grey literature to identify relevant material. We will include experimental, quasi-experimental, observational studies, and non-research studies (guidelines, narrative reviews, policy documents) examining the transition from CAMHS to AMHS. 2 raters will independently screen each retrieved title and abstract for eligibility using the study inclusion criteria (level 1), and then will independently assess full-text articles to determine if these meet the inclusion criteria (level 2). Data extraction will be completed and results will be synthesised both quantitatively and qualitatively. The results of the scoping review will be used to develop a set of indicators that will be prioritised and evaluated in a Delphi consensus study. This will serve as a foundation for the development of the first instrument to assess the quality and success of CAMHS-AMHS transitions. Ethics approval is not required for this scoping study. 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/

Identifying process and outcome indicators of successful transitions from child to adult mental health services: protocol for a scoping review

PubMed Central

Cleverley, Kristin; Bennett, Kathryn; Jeffs, Lianne

2016-01-01

Introduction A significant proportion of youth need to transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS); however, the transition process is not well understood and often experienced poorly by youth. In the effort to design and evaluate standards of practice for transitions, there is a need to identify key elements of a successful transition. The objectives of this scoping review are to: (1) identify definitions of successful transitions from CAMHS to AMHS; and (2) identify indicators that have been used to measure CAMHS–AMHS transition care processes and quality, and outcomes. Methods We will search 8 electronic bibliographic databases from 1980 to 2016 (eg, Medline, EMBASE, PsycINFO), professional associations, policy documents, and other grey literature to identify relevant material. We will include experimental, quasi-experimental, observational studies, and non-research studies (guidelines, narrative reviews, policy documents) examining the transition from CAMHS to AMHS. 2 raters will independently screen each retrieved title and abstract for eligibility using the study inclusion criteria (level 1), and then will independently assess full-text articles to determine if these meet the inclusion criteria (level 2). Data extraction will be completed and results will be synthesised both quantitatively and qualitatively. Ethics and dissemination The results of the scoping review will be used to develop a set of indicators that will be prioritised and evaluated in a Delphi consensus study. This will serve as a foundation for the development of the first instrument to assess the quality and success of CAMHS–AMHS transitions. Ethics approval is not required for this scoping study. PMID:27381213

Cost justification of clinical pharmacy services on a general surgery team: focus on diagnosis-related group cases.

PubMed

Bertch, K E; Hatoum, H T; Willett, M S; Witte, K W

1988-11-01

We used a novel approach to cost-justify clinical pharmacy services on a general surgery team in nine diagnosis-related group cases. The clinical pharmacist monitored nine patients longitudinally on a general surgery team from admission to discharge and intervened in their therapeutic management. Each recommendation was analyzed for rationale, acceptance, perceived impact on quality and/or cost of patient care, whether self-initiated or solicited, and impact on patient outcome. Types of recommendations and outcomes were categorized by process and outcome measurement criteria. Total cost avoidance per patient was calculated using costs of drug therapy, laboratory tests, and length of stay. Accounting for cost of clinical pharmacy services, net cost avoidance per patient was calculated. The clinical pharmacist made 101 recommendations on nine patients. Physicians accepted 82 percent of the recommendations; 77 percent of the recommendations were self-initiated and 23 percent were solicited. Recommendations had a perceived impact on cost, quality, or both at 13, 31, and 56 percent, respectively. Most recommendations (79 percent) brought patient therapy to a level of conformance with current standards of practice as documented in the medical literature. Recommendations that potentially preserved a major organ function by preventing drug-induced toxicity or the exacerbation of existing problems constituted 16 percent of the total. None of the accepted recommendations adversely affected patient outcome and 23 percent directly resulted in a measurable positive outcome in patient care. A total of four hospital days was potentially saved for two cases. Based on objective outcome criteria, a 1.9-day increase in therapeutic control was documented per patient.(ABSTRACT TRUNCATED AT 250 WORDS)

DEVELOPING WATER QUALITY CRITERIA FOR SUSPENDED AND BEDDED SEDIMENTS

EPA Science Inventory

The U.S. EPA’s Framework for Developing Suspended and Bedded Sediments (SABS) Water Quality Criteria (SABS Framework) is a nationally-consistent process for developing ambient sediment quality criteria for surface waters. The SABS Framework accommodates natural variation among wa...

QUADAS and STARD: evaluating the quality of diagnostic accuracy studies.

PubMed

Oliveira, Maria Regina Fernandes de; Gomes, Almério de Castro; Toscano, Cristiana Maria

2011-04-01

To compare the performance of two approaches, one based on the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) and another on the Standards for Reporting Studies of Diagnostic Accuracy (STARD), in evaluating the quality of studies validating the OptiMal® rapid malaria diagnostic test. Articles validating the rapid test published until 2007 were searched in the Medline/PubMed database. This search retrieved 13 articles. A combination of 12 QUADAS criteria and three STARD criteria were compared with the 12 QUADAS criteria alone. Articles that fulfilled at least 50% of QUADAS criteria were considered as regular to good quality. Of the 13 articles retrieved, 12 fulfilled at least 50% of QUADAS criteria, and only two fulfilled the STARD/QUADAS criteria combined. Considering the two criteria combination (> 6 QUADAS and > 3 STARD), two studies (15.4%) showed good methodological quality. The articles selection using the proposed combination resulted in two to eight articles, depending on the number of items assumed as cutoff point. The STARD/QUADAS combination has the potential to provide greater rigor when evaluating the quality of studies validating malaria diagnostic tests, given that it incorporates relevant information not contemplated in the QUADAS criteria alone.

Quality of core collections for effective utilisation of genetic resources review, discussion and interpretation.

PubMed

Odong, T L; Jansen, J; van Eeuwijk, F A; van Hintum, T J L

2013-02-01

Definition of clear criteria for evaluation of the quality of core collections is a prerequisite for selecting high-quality cores. However, a critical examination of the different methods used in literature, for evaluating the quality of core collections, shows that there are no clear guidelines on the choices of quality evaluation criteria and as a result, inappropriate analyses are sometimes made leading to false conclusions being drawn regarding the quality of core collections and the methods to select such core collections. The choice of criteria for evaluating core collections appears to be based mainly on the fact that those criteria have been used in earlier publications rather than on the actual objectives of the core collection. In this study, we provide insight into different criteria used for evaluating core collections. We also discussed different types of core collections and related each type of core collection to their respective evaluation criteria. Two new criteria based on genetic distance are introduced. The consequences of the different evaluation criteria are illustrated using simulated and experimental data. We strongly recommend the use of the distance-based criteria since they not only allow the simultaneous evaluation of all variables describing the accessions, but they also provide intuitive and interpretable criteria, as compared with the univariate criteria generally used for the evaluation of core collections. Our findings will provide genebank curators and researchers with possibilities to make informed choices when creating, comparing and using core collections.

Design and development of a structural mode control system

NASA Technical Reports Server (NTRS)

1977-01-01

A program was conducted to compile and document some of the existing information about the conceptual design, development, and tests of the B-1 structural mode control system (SMCS) and its impact on ride quality. This report covers the following topics: (1) Rationale of selection of SMCS to meet ride quality criteria versus basic aircraft stiffening. (2) Key considerations in designing an SMCS, including vane geometry, rate and deflection requirements, power required, compensation network design, and fail-safe requirements. (3) Summary of key results of SMCS vane wind tunnel tests. (4) SMCS performance. (5) SMCS design details, including materials, bearings, and actuators. (6) Results of qualification testing of SMCS on the "Iron Bird" flight control simulator, and lab qualification testing of the actuators. (7) Impact of SMCS vanes on engine inlet characteristics from wind tunnel tests.

77 FR 20585 - Proposed Withdrawal of Certain Federal Water Quality Criteria Applicable to California, New...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-05

... proposing to amend the federal regulations to withdraw human health and aquatic life water quality criteria... to its surface water quality standards (New Jersey Administrative Code 7:9B), including aquatic life... pollutants covered in the 2002 and 2006 actions, New Jersey adopted water quality criteria for aquatic life...

Criteria for High Quality Biology Teaching: An Analysis

ERIC Educational Resources Information Center

Tasci, Guntay

2015-01-01

This study aims to analyze the process under which biology lessons are taught in terms of teaching quality criteria (TQC). Teaching quality is defined as the properties of efficient teaching and is considered to be the criteria used to measure teaching quality both in general and specific to a field. The data were collected through classroom…

Implementation of Quality Management in Core Service Laboratories

PubMed Central

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

2010-01-01

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

Review and comparison of quality standards, guidelines and regulations for laboratories.

PubMed

Datema, Tjeerd A M; Oskam, Linda; Klatser, Paul R

2012-01-01

The variety and number of laboratory quality standards, guidelines and regulations (hereafter: quality documents) makes it difficult to choose the most suitable one for establishing and maintaining a laboratory quality management system. There is a need to compare the characteristics, suitability and applicability of quality documents in view of the increasing efforts to introduce quality management in laboratories, especially in clinical diagnostic laboratories in low income and middle income countries. This may provide valuable insights for policy makers developing national laboratory policies, and for laboratory managers and quality officers in choosing the most appropriate quality document for upgrading their laboratories. We reviewed the history of quality document development and then selected a subset based on their current use. We analysed these documents following a framework for comparison of quality documents that was adapted from the Clinical Laboratory Standards Institute guideline GP26 Quality management system model for clinical laboratory services . Differences were identified between national and international, and non-clinical and clinical quality documents. The most salient findings were the absence of provisions on occurrence management and customer service in almost all non-clinical quality documents, a low number of safety requirements aimed at protecting laboratory personnel in international quality documents and no requirements regarding ethical behaviour in almost all quality documents. Each laboratory needs to investigate whether national regulatory standards are present. These are preferred as they most closely suit the needs of laboratories in the country. A laboratory should always use both a standard and a guideline: a standard sums up the requirements to a quality management system, a guideline describes how quality management can be integrated in the laboratory processes.

Evaluation models and criteria of the quality of hospital websites: a systematic review study

PubMed Central

Jeddi, Fatemeh Rangraz; Gilasi, Hamidreza; Khademi, Sahar

2017-01-01

Introduction Hospital websites are important tools in establishing communication and exchanging information between patients and staff, and thus should enjoy an acceptable level of quality. The aim of this study was to identify proper models and criteria to evaluate the quality of hospital websites. Methods This research was a systematic review study. The international databases such as Science Direct, Google Scholar, PubMed, Proquest, Ovid, Elsevier, Springer, and EBSCO together with regional database such as Magiran, Scientific Information Database, Persian Journal Citation Report (PJCR) and IranMedex were searched. Suitable keywords including website, evaluation, and quality of website were used. Full text papers related to the research were included. The criteria and sub criteria of the evaluation of website quality were extracted and classified. Results To evaluate the quality of the websites, various models and criteria were presented. The WEB-Q-IM, Mile, Minerva, Seruni Luci, and Web-Qual models were the designed models. The criteria of accessibility, content and apparent features of the websites, the design procedure, the graphics applied in the website, and the page’s attractions have been mentioned in the majority of studies. Conclusion The criteria of accessibility, content, design method, security, and confidentiality of personal information are the essential criteria in the evaluation of all websites. It is suggested that the ease of use, graphics, attractiveness and other apparent properties of websites are considered as the user-friendliness sub criteria. Further, the criteria of speed and accessibility of the website should be considered as sub criterion of efficiency. When determining the evaluation criteria of the quality of websites, attention to major differences in the specific features of any website is essential. PMID:28465807

Evaluation models and criteria of the quality of hospital websites: a systematic review study.

PubMed

Jeddi, Fatemeh Rangraz; Gilasi, Hamidreza; Khademi, Sahar

2017-02-01

Hospital websites are important tools in establishing communication and exchanging information between patients and staff, and thus should enjoy an acceptable level of quality. The aim of this study was to identify proper models and criteria to evaluate the quality of hospital websites. This research was a systematic review study. The international databases such as Science Direct, Google Scholar, PubMed, Proquest, Ovid, Elsevier, Springer, and EBSCO together with regional database such as Magiran, Scientific Information Database, Persian Journal Citation Report (PJCR) and IranMedex were searched. Suitable keywords including website, evaluation, and quality of website were used. Full text papers related to the research were included. The criteria and sub criteria of the evaluation of website quality were extracted and classified. To evaluate the quality of the websites, various models and criteria were presented. The WEB-Q-IM, Mile, Minerva, Seruni Luci, and Web-Qual models were the designed models. The criteria of accessibility, content and apparent features of the websites, the design procedure, the graphics applied in the website, and the page's attractions have been mentioned in the majority of studies. The criteria of accessibility, content, design method, security, and confidentiality of personal information are the essential criteria in the evaluation of all websites. It is suggested that the ease of use, graphics, attractiveness and other apparent properties of websites are considered as the user-friendliness sub criteria. Further, the criteria of speed and accessibility of the website should be considered as sub criterion of efficiency. When determining the evaluation criteria of the quality of websites, attention to major differences in the specific features of any website is essential.

Human Research Program Unique Processes, Criteria, and Guidelines (UPCG). Revision C, July 28, 2011

NASA Technical Reports Server (NTRS)

Chin, Duane

2011-01-01

This document defines the processes, criteria, and guidelines exclusive to managing the Human Research Program (HRP). The intent of this document is to provide instruction to the reader in the form of processes, criteria, and guidelines. Of the three instructional categories, processes contain the most detail because of the need for a systematic series of actions directed to some end. In contrast, criteria have lesser detail than processes with the idea of creating a rule or principle structure for evaluating or testing something. Guidelines are a higher level indication of a course of action typically with the least amount of detail. The lack of detail in guidelines allows the reader flexibility when performing an action or actions.

Evaluation of High-Speed Civil Transport Handling Qualities Criteria with Supersonic Flight Data

NASA Technical Reports Server (NTRS)

Cox, Timothy H.; Jackson, Dante W.

1997-01-01

Most flying qualities criteria have been developed from data in the subsonic flight regime. Unique characteristics of supersonic flight raise questions about whether these criteria successfully extend into the supersonic flight regime. Approximately 25 years ago NASA Dryden Flight Research Center addressed this issue with handling qualities evaluations of the XB-70 and YF-12. Good correlations between some of the classical handling qualities parameters, such as the control anticipation parameter as a function of damping, were discovered. More criteria have been developed since these studies. Some of these more recent criteria are being used in designing the High-Speed Civil Transport (HSCT). A second research study recently addressed this issue through flying qualities evaluations of the SR-71 at Mach 3. The research goal was to extend the high-speed flying qualities experience of large airplanes and to evaluate more recent MIL-STD-1797 criteria against pilot comments and ratings. Emphasis was placed on evaluating the criteria used for designing the HSCT. XB-70 and YF-12 data from the previous research supplemented the SR-71 data. The results indicate that the criteria used in the HSCT design are conservative and should provide good flying qualities for typical high-speed maneuvering. Additional results show correlation between the ratings and comments and criteria for gradual maneuvering with precision control. Correlation is shown between ratings and comments and an extension of the Neal/Smith criterion using normal acceleration instead of pitch rate.

Systematic review of the application of the plan–do–study–act method to improve quality in healthcare

PubMed Central

Taylor, Michael J; McNicholas, Chris; Nicolay, Chris; Darzi, Ara; Bell, Derek; Reed, Julie E

2014-01-01

Background Plan–do–study–act (PDSA) cycles provide a structure for iterative testing of changes to improve quality of systems. The method is widely accepted in healthcare improvement; however there is little overarching evaluation of how the method is applied. This paper proposes a theoretical framework for assessing the quality of application of PDSA cycles and explores the consistency with which the method has been applied in peer-reviewed literature against this framework. Methods NHS Evidence and Cochrane databases were searched by three independent reviewers. Empirical studies were included that reported application of the PDSA method in healthcare. Application of PDSA cycles was assessed against key features of the method, including documentation characteristics, use of iterative cycles, prediction-based testing of change, initial small-scale testing and use of data over time. Results 73 of 409 individual articles identified met the inclusion criteria. Of the 73 articles, 47 documented PDSA cycles in sufficient detail for full analysis against the whole framework. Many of these studies reported application of the PDSA method that failed to accord with primary features of the method. Less than 20% (14/73) fully documented the application of a sequence of iterative cycles. Furthermore, a lack of adherence to the notion of small-scale change is apparent and only 15% (7/47) reported the use of quantitative data at monthly or more frequent data intervals to inform progression of cycles. Discussion To progress the development of the science of improvement, a greater understanding of the use of improvement methods, including PDSA, is essential to draw reliable conclusions about their effectiveness. This would be supported by the development of systematic and rigorous standards for the application and reporting of PDSAs. PMID:24025320

PFLOTRAN Verification: Development of a Testing Suite to Ensure Software Quality

NASA Astrophysics Data System (ADS)

Hammond, G. E.; Frederick, J. M.

2016-12-01

In scientific computing, code verification ensures the reliability and numerical accuracy of a model simulation by comparing the simulation results to experimental data or known analytical solutions. The model is typically defined by a set of partial differential equations with initial and boundary conditions, and verification ensures whether the mathematical model is solved correctly by the software. Code verification is especially important if the software is used to model high-consequence systems which cannot be physically tested in a fully representative environment [Oberkampf and Trucano (2007)]. Justified confidence in a particular computational tool requires clarity in the exercised physics and transparency in its verification process with proper documentation. We present a quality assurance (QA) testing suite developed by Sandia National Laboratories that performs code verification for PFLOTRAN, an open source, massively-parallel subsurface simulator. PFLOTRAN solves systems of generally nonlinear partial differential equations describing multiphase, multicomponent and multiscale reactive flow and transport processes in porous media. PFLOTRAN's QA test suite compares the numerical solutions of benchmark problems in heat and mass transport against known, closed-form, analytical solutions, including documentation of the exercised physical process models implemented in each PFLOTRAN benchmark simulation. The QA test suite development strives to follow the recommendations given by Oberkampf and Trucano (2007), which describes four essential elements in high-quality verification benchmark construction: (1) conceptual description, (2) mathematical description, (3) accuracy assessment, and (4) additional documentation and user information. Several QA tests within the suite will be presented, including details of the benchmark problems and their closed-form analytical solutions, implementation of benchmark problems in PFLOTRAN simulations, and the criteria used to assess PFLOTRAN's performance in the code verification procedure. References Oberkampf, W. L., and T. G. Trucano (2007), Verification and Validation Benchmarks, SAND2007-0853, 67 pgs., Sandia National Laboratories, Albuquerque, NM.

Validation of a Novel Electronic Health Record Patient Portal Advance Care Planning Delivery System.

PubMed

Bose-Brill, Seuli; Feeney, Michelle; Prater, Laura; Miles, Laura; Corbett, Angela; Koesters, Stephen

2018-06-26

Advance care planning allows patients to articulate their future care preferences should they no longer be able to make decisions on their own. Early advance care planning in outpatient settings provides benefits such as less aggressive care and fewer hospitalizations, yet it is underutilized due to barriers such as provider time constraints and communication complexity. Novel methods, such as patient portals, provide a unique opportunity to conduct advance care planning previsit planning for outpatient care. This follow-up to our pilot study aimed to conduct pragmatic testing of a novel electronic health record-tethered framework and its effects on advance care planning delivery in a real-world primary care setting. Our intervention tested a previsit advance care planning workflow centered around a framework sent via secure electronic health record-linked patient portal in a real-world clinical setting. The primary objective of this study was to determine its impact on frequency and quality of advance care planning documentation. We conducted a pragmatic trial including 2 sister clinical sites, one site implementing the intervention and the other continuing standard care. A total of 419 patients aged between 50 and 93 years with active portal accounts received intervention (n=200) or standard care (n=219). Chart review analyzed the presence of advance care planning and its quality and was graded with previously established scoring criteria based on advance care planning best practice guidelines from multiple nations. A total of 19.5% (39/200) of patients who received previsit planning responded to the framework. We found that the intervention site had statistically significant improvement in new advance care planning documentation rates (P<.01) and quality (P<.01) among all eligible patients. Advance care planning documentation rates increased by 105% (19/39 to 39/39) and quality improved among all patients who engaged in the previsit planning framework (n=39). Among eligible patients aged between 50 and 60 years at the intervention site, advance care planning documentation rates increased by 37% (27/96 to 37/96). Advance care planning documentation rates increased 34% among high users (27/67 to 36/67). Advance care planning previsit planning using a secure electronic health record-supported patient portal framework yielded improvement in the presence of advance care planning documentation, with highest improvement in active patient portal users and patients aged between 50 and 60 years. Targeted previsit patient portal advance care planning delivery in these populations can potentially improve the quality of care in these populations. ©Seuli Bose-Brill, Michelle Feeney, Laura Prater, Laura Miles, Angela Corbett, Stephen Koesters. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.06.2018.

Recommendations and Justifications for Modifications To Downgrade Use Restrictions Established under the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office Federal Facility Agreement and Consent Order, Revision 1

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

Birney, Cathleen; Krauss, Mark J

This document is part of an effort to reevaluate 37 FFACO and Administrative URs against the current Soils Risk-Based Corrective Action Evaluation Process. After reviewing 37 existing FFACO and Administrative URs, 11 URs addressed in this document have sufficient information to determine that these current URs may be downgraded to Administrative URs based on the RBCA criteria. This document presents recommendations on modifications to existing URs that will be consistent with the RBCA criteria.

Mission-oriented requirements for updating MIL-H-8501: Calspan proposed structure and rationale

NASA Technical Reports Server (NTRS)

Chalk, C. R.; Radford, R. C.

1985-01-01

This report documents the effort by Arvin/Calspan Corporation to formulate a revision of MIL-H-8501A in terms of Mission-Oriented Flying Qualities Requirements for Military Rotorcraft. Emphasis is placed on development of a specification structure which will permit addressing Operational Missions and Flight Phases, Flight Regions, Classification of Required Operational Capability, Categorization of Flight Phases, and Levels of Flying Qualities. A number of definitions is established to permit addressing the rotorcraft state, flight envelopes, environments, and the conditions under which degraded flying qualities are permitted. Tentative requirements are drafted for Required Operational Capability Class 1. Also included is a Background Information and Users Guide for the draft specification structure proposed for the MIL-H-8501A revision. The report also contains a discussion of critical data gaps and attempts to prioritize these data gaps and to suggest experiments that should be performed to generate data needed to support formulation of quantitative design criteria for the additional Operational Capability Classes 2, 3, and 4.

Quality assurance in surgical practice through auditing.

PubMed

Wong, W T

1980-05-01

An efficient auditing method is presented which involves objective criteria-based numerical screening of medical process and treatment outcome by paramedical staff and detailed analysis of deviated cases by surgeons. If properly performed it requires the study of no more than 50 cases in a diagnostic category to provide sufficient information about the quality of care. Encouraging points as well as problems are communicated to the surgeons to induce the maintenance or improvement of the standard of care. Graphic documentation of case performance is possible, allowing surgeons to compare results with their colleagues. The general performance level of several consecutive studies can be compared at a glance. In addition, logical education programs to improve the medical process can be designed on the basis of the problems identified. As all the cases with an unacceptable outcome are traceable to inadequate medical process, improvement in this area will decrease outcome defects. With the use of auditing and the follow-up technique described, the quality of care in surgery may be assured.

Physical Property Analysis and Report for Sediments at 100-BC-5 Operable Unit, Boreholes C7505, C7506, C7507, and C7665

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

Lindberg, Michael J.

2010-09-28

Between October 14, 2009 and February 22, 2010 sediment samples were received from 100-BC Decision Unit for geochemical studies. This is an analytical data report for sediments received from CHPRC at the 100 BC 5 OU. The analyses for this project were performed at the 325 building located in the 300 Area of the Hanford Site. The analyses were performed according to Pacific Northwest National Laboratory (PNNL) approved procedures and/or nationally recognized test procedures. The data sets include the sample identification numbers, analytical results, estimated quantification limits (EQL), and quality control data. The preparatory and analytical quality control requirements, calibrationmore » requirements, acceptance criteria, and failure actions are defined in the on-line QA plan 'Conducting Analytical Work in Support of Regulatory Programs' (CAW). This QA plan implements the Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD) for PNNL.« less

Standards for Cell Line Authentication and Beyond

PubMed Central

Cole, Kenneth D.; Plant, Anne L.

2016-01-01

Different genomic technologies have been applied to cell line authentication, but only one method (short tandem repeat [STR] profiling) has been the subject of a comprehensive and definitive standard (ASN-0002). Here we discuss the power of this document and why standards such as this are so critical for establishing the consensus technical criteria and practices that can enable progress in the fields of research that use cell lines. We also examine other methods that could be used for authentication and discuss how a combination of methods could be used in a holistic fashion to assess various critical aspects of the quality of cell lines. PMID:27300367

Outcomes in controlled and comparative studies on non-healing wounds: recommendations to improve the quality of evidence in wound management.

PubMed

Gottrup, F; Apelqvist, J; Price, P

2010-06-01

While there is a consensus that clinical practice should be evidence based, this can be difficult to achieve due to confusion about the value of the various approaches to wound management. To address this, the European Wound Management Association (EWMA) set up a Patient Outcome Group whose remit was to produce recommendations on clinical data collection in wound care. This document, produced by the group and disseminated by JWC, identifies criteria for producing rigorous outcomes in both randomised controlled trials and clinical studies, and describes how to ensure studies are consistent and reproducible.

[Use of ionizing radiation sources in metallurgy: risk assessment].

PubMed

Giugni, U

2012-01-01

Use of ionizing radiation sources in the metallurgical industry: risk assessment. Radioactive sources and fixed or mobile X-ray equipment are used for both process and quality control. The use of ionizing radiation sources requires careful risk assessment. The text lists the characteristics of the sources and the legal requirements, and contains a description of the documentation required and the methods used for risk assessment. It describes how to estimate the doses to operators and the relevant classification criteria used for the purpose of radiation protection. Training programs must be organized in close collaboration between the radiation protection expert and the occupational physician.

Federal standards and procedures for the National Watershed Boundary Dataset (WBD)

USGS Publications Warehouse

,; ,; ,

2009-03-11

Terminology, definitions, and procedural information are provided to ensure uniformity in hydrologic unit boundaries, names, and numerical codes. Detailed standards and specifications for data are included. The document also includes discussion of objectives, communications required for revising the data resolution in the United States and the Caribbean, as well as final review and data-quality criteria. Instances of unusual landforms or artificial features that affect the hydrologic units are described with metadata standards. Up-to-date information and availability of the hydrologic units are listed athttp://www.nrcs.usda.gov/wps/portal/nrcs/detail/national/technical/nra/dma/?&cid=nrcs143_021630/.

The clinimetric qualities of patient-assessed instruments for measuring chronic ankle instability: a systematic review.

PubMed

Eechaute, Christophe; Vaes, Peter; Van Aerschot, Lieve; Asman, Sara; Duquet, William

2007-01-18

The assessment of outcomes from the patient's perspective becomes more recognized in health care. Also in patients with chronic ankle instability, the degree of present impairments, disabilities and participation problems should be documented from the perspective of the patient. The decision about which patient-assessed instrument is most appropriate for clinical practice should be based upon systematic reviews. Only rating scales constructed for patients with acute ligament injuries were systematically reviewed in the past. The aim of this study was to review systematically the clinimetric qualities of patient-assessed instruments designed for patients with chronic ankle instability. A computerized literature search of Medline, Embase, Cinahl, Web of Science, Sport Discus and the Cochrane Controlled Trial Register was performed to identify eligible instruments. Two reviewers independently evaluated the clinimetric qualities of the selected instruments using a criteria list. The inter-observer reliability of both the selection procedure and the clinimetric evaluation was calculated using modified kappa coefficients. The inter-observer reliability of the selection procedure was excellent (k = .86). Four instruments met the eligibility criteria: the Ankle Joint Functional Assessment Tool (AJFAT), the Functional Ankle Outcome Score (FAOS), the Foot and Ankle Disability Index (FADI) and the Functional Ankle Ability Measure (FAAM). The inter-observer reliability of the quality assessment was substantial to excellent (k between .64 and .88). Test-retest reliability was demonstrated for the FAOS, the FADI and the FAAM but not for the AJFAT. The FAOS and the FAAM met the criteria for content validity and construct validity. For none of the studied instruments, the internal consistency was sufficiently demonstrated. The presence of floor- and ceiling effects was assessed for the FAOS but ceiling effects were present for all subscales. Responsiveness was demonstrated for the AJFAT, FADI and the FAAM. Only for the FAAM, a minimal clinical important difference (MCID) was presented. The FADI and the FAAM can be considered as the most appropriate, patient-assessed tools to quantify functional disabilities in patients with chronic ankle instability. The clinimetric qualities of the FAAM need to be further demonstrated in a specific population of patients with chronic ankle instability.

[Quality of information in the process of informed consent for anesthesia].

PubMed

Guillén-Perales, José; Luna-Maldonado, Aurelio; Fernández-Prada, María; Guillén-Solvas, José Francisco; Bueno-Cavanillas, Aurora

2013-11-01

To assess the quality of the information that patients receive in the informed consent document signed prior to surgery. Cross-sectional study of a sample of cancer patients admitted for surgery at the University Hospital San Cecilio of Granada in 2011. After checking the inclusion criteria and obtaining their consent, demographic data were collected and procedure data, and a questionnaire «ad hoc» to assess the quality and comprehensiveness of the information provided in the informed consent. 150 patients were studied. The majority (109 over 150) said they had received sufficient information, in appropriate language, and had the opportunity to ask questions, but only 44.7% correctly answered three or more issues related to anesthesia. University education level, knowledge of the intervention, information about the anesthesia problems and appropriate language were associated. Although systematic informed consent was performed, half of the patients did not comprehend the anesthesia risks. Variables primarily related to the information received were associated with the quality of the response, but not with patient characteristics. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

40 CFR 132.3 - Adoption of criteria.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) The acute water quality criteria for protection of aquatic life in Table 1 of this part, or a site... water quality criteria for protection of aquatic life in Table 2 of this part, or a site-specific....3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY...

Research and Development for Health and Environmental Hazard Assessment. Task Order 1. Development of Data Base Requirements for Human Health Based Water Quality Criteria for Military Recycle/Reuse Applications.

DTIC Science & Technology

1980-06-01

Environmental Hazard Assessment -. .’.’ASK ORDER I j EVELOPMENT OF DATA BASE REQUIREMENTS I . .oR HUMAN HEALTH BASED WATER QUALITY CRITERIA | COR MILITARY...Requirements for Human Sep a -1979- June 89 Health Based Water Quality Criteria for Military -%4,o ER Reevcle/ Reuse Applications Is 8_ 3.7𔃾__=1_...KEY WORDS (Continue on reverse aide If neceseary and Identify by block number) Water Reuse, Water Recycle, Water Quality Criteria, Human Health

Rationales for the Lightning Launch Commit Criteria

NASA Technical Reports Server (NTRS)

Willett, John C. (Editor); Merceret, Francis J. (Editor); Krider, E. Philip; O'Brien, T. Paul; Dye, James E.; Walterscheid, Richard L.; Stolzenburg, Maribeth; Cummins, Kenneth; Christian, Hugh J.; Madura, John T.

2016-01-01

Since natural and triggered lightning are demonstrated hazards to launch vehicles, payloads, and spacecraft, NASA and the Department of Defense (DoD) follow the Lightning Launch Commit Criteria (LLCC) for launches from Federal Ranges. The LLCC were developed to prevent future instances of a rocket intercepting natural lightning or triggering a lightning flash during launch from a Federal Range. NASA and DoD utilize the Lightning Advisory Panel (LAP) to establish and develop robust rationale from which the criteria originate. The rationale document also contains appendices that provide additional scientific background, including detailed descriptions of the theory and observations behind the rationales. The LLCC in whole or part are used across the globe due to the rigor of the documented criteria and associated rationale. The Federal Aviation Administration (FAA) adopted the LLCC in 2006 for commercial space transportation and the criteria were codified in the FAA's Code of Federal Regulations (CFR) for Safety of an Expendable Launch Vehicle (Appendix G to 14 CFR Part 417, (G417)) and renamed Lightning Flight Commit Criteria in G417.

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

NASA Astrophysics Data System (ADS)

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

2018-03-01

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

Assessment of documentation of DSM-IV-TR Criteria A for diagnosis of schizophrenia in psychiatric unit, tertiary hospital, Malaysia.

PubMed

Maung, K; Ohnmar, H; Than, W; Ramli, M; Najwa Hanim, M R; Ali Sabri, R; Ahmad Zafri, A B

The purposes of this study were to investigate the documentation of the DSM-IV-TR- Criteria A in diagnoses of schizophrenia and to identify the symptoms associated with over diagnosis of schizophrenia. This study involved a retrospective review and analysis of data from case notes. Data of 107 newly diagnosed patients with schizophrenia were keyed in and analyzed using SPSS v 19. The cases were then evaluated for the use of the DSM-IV-TR- Criteria A. Over diagnosis was noted in 37.39% of the patients. Disorganised behaviour (12.5%), affective flattening (12.5%), hallucination (16%) and non-bizarre delusion (18.3%) significantly contributed to the over-diagnosis of schizophrenia. Symptoms such as non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia and were statistically significant with p ≤0.05. There was a significant lack of DSM-IV-TR Criteria A among the data documented to diagnose schizophrenia and non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia. This key problem needs to be addressed. The reliability of a diagnosis is indispensable and achievable with the proper clinical application of DSM-IV-TR Criteria A. The DSM-IV-TR Criteria have been perceived to be useful and reliable and is most widely used throughout the world.

Assay Characterization Guidance Documents | Office of Cancer Clinical Proteomics Research

Cancer.gov

CPTAC characterized assays are defined as those that meet the criteria described in the Assay Characterization Guidance Document. This guidance document aligns with recommendations by the research community as “fit-for-purpose” validation requirements of targeted proteomics assays.

Clinical practice guidelines and consensus statements in oncology--an assessment of their methodological quality.

PubMed

Jacobs, Carmel; Graham, Ian D; Makarski, Julie; Chassé, Michaël; Fergusson, Dean; Hutton, Brian; Clemons, Mark

2014-01-01

Consensus statements and clinical practice guidelines are widely available for enhancing the care of cancer patients. Despite subtle differences in their definition and purpose, these terms are often used interchangeably. We systematically assessed the methodological quality of consensus statements and clinical practice guidelines published in three commonly read, geographically diverse, cancer-specific journals. Methods Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal of Clinical Oncology were evaluated. Each publication was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) rigour of development and editorial independence domains. For assessment of transparency of document development, 7 additional items were taken from the Institute of Medicine's standards for practice guidelines and the Journal of Clinical Oncology guidelines for authors of guidance documents. Consensus statements and clinical practice guidelines published between January 2005 and September 2013 in Current Oncology, European Journal of Cancer and Journal of Clinical Oncology were evaluated. Each publication was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) rigour of development and editorial independence domains. For assessment of transparency of document development, 7 additional items were taken from the Institute of Medicine's standards for practice guidelines and the Journal of Clinical Oncology guidelines for authors of guidance documents. Thirty-four consensus statements and 67 clinical practice guidelines were evaluated. The rigour of development score for consensus statements over the three journals was 32% lower than that of clinical practice guidelines. The editorial independence score was 15% lower for consensus statements than clinical practice guidelines. One journal scored consistently lower than the others over both domains. No journals adhered to all the items related to the transparency of document development. One journal's consensus statements endorsed a product made by the sponsoring pharmaceutical company in 64% of cases. Guidance documents are an essential part of oncology care and should be subjected to a rigorous and validated development process. Consensus statements had lower methodological quality than clinical practice guidelines using AGREE II. At a minimum, journals should ensure that that all consensus statements and clinical practice guidelines adhere to AGREE II criteria. Journals should consider explicitly requiring guidelines to declare pharmaceutical company sponsorship and to identify the sponsor's product to enhance transparency.

The adverse drug reaction reporting assignment for specialist oncology nurses: a preliminary evaluation of quality, relevance and educational value in a prospective cohort study.

PubMed

Schutte, Tim; van Eekeren, Rike; Richir, Milan; van Staveren, Jojanneke; van Puijenbroek, Eugène; Tichelaar, Jelle; van Agtmael, Michiel

2018-01-01

In a new prescribing qualification course for specialist oncology nurses, we thought that it is important to emphasize pharmacovigilance and adverse drug reaction (ADR) reporting. We aimed to develop and evaluate an ADR reporting assignment for specialist oncology nurses. The quality of report documentation was assessed with the "Clinical Documentation tool to assess Individual Case Safety Reports" (ClinDoc). The relevance of the reports was evaluated in terms of ADR seriousness, the listing for additional monitoring of the drug by European Medicines Agency (EMA), and lack of labelling information about the ADR. Nurses' opinions of the assignment were evaluated using an E-survey. Thirty-three ADRs were reported, 32 (97%) of which were well documented according to ClinDoc. Thirteen ADRs (39%) were "serious" according to CIOMS criteria. In five cases (15%), the suspect drugs were listed for additional monitoring by EMA and in seven cases (21%), the ADR was not mentioned in the Summary of Product Characteristics. Twenty-five (78.1%) of the 32 enrolled nurses completed the E-survey. Most were > 45 years of age (68%), female (92%) and had extensive clinical experience (6-33 years). All agreed or completely agreed that the reporting assignment was useful, that it fitted in daily practice and that it increased their attention for medication/patient safety. A large majority (84.0%) agreed the assignment changed how they dealt with ADRs. Specialist oncology nurses are capable of reporting ADRs, and they considered the assignment useful. The assignment yielded valuable, relevant, and well-documented ADR reports for pharmacovigilance practice.

Electronic Medical Record-Based Radiation Oncology Toxicity Recording Instrument Aids Benchmarking and Quality Improvement in the Clinic.

PubMed

Albuquerque, Kevin; Rodgers, Kellie; Spangler, Ann; Rahimi, Asal; Willett, DuWayne

2018-03-01

The on-treatment visit (OTV) for radiation oncology is essential for patient management. Radiation toxicities recorded during the OTV may be inconsistent because of the use of free text and the lack of treatment site-specific templates. We developed a radiation oncology toxicity recording instrument (ROTOX) in a health system electronic medical record (EMR). Our aims were to assess improvement in documentation of toxicities and to develop clinic toxicity benchmarks. A ROTOX that was based on National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0) with flow-sheet functionality was developed in the EMR. Improvement in documentation was assessed at various time intervals. High-grade toxicities (ie, grade ≥ 3 by CTCAE) by site were audited to develop benchmarks and to track nursing and physician actions taken in response to these. A random sample of OTV notes from each clinic physician before ROTOX implementation was reviewed and assigned a numerical document quality score (DQS) that was based on completeness and comprehensiveness of toxicity grading. The mean DQS improved from an initial level of 41% to 99% (of the maximum possible DQS) when resampled at 6 months post-ROTOX. This high-level DQS was maintained 3 years after ROTOX implementation at 96% of the maximum. For months 7 to 9 after implementation (during a 3-month period), toxicity grading was recorded in 4,443 OTVs for 698 unique patients; 107 episodes of high-grade toxicity were identified during this period, and toxicity-specific intervention was documented in 95%. An EMR-based ROTOX enables consistent recording of treatment toxicity. In a uniform sample of patients, local population toxicity benchmarks can be developed, and clinic response can be tracked.

Derivation of site-specific surface water quality criteria for the protection of aquatic ecosystems near a Korean military training facility.

PubMed

Jeong, Seung-Woo; An, Youn-Joo

2014-01-01

This study suggested the first Korean site-specific ecological surface water quality criteria for the protection of ecosystems near an artillery range at a Korean military training facility. Surface water quality (SWQ) criteria in Korea address human health protection but do not encompass ecological criteria such as limits for metals and explosives. The first objective of this study was to derive site-specific SWQ criteria for the protection of aquatic ecosystems in Hantan River, Korea. The second objective was to establish discharge criteria for the artillery range to protect the aquatic ecosystems of Hantan River. In this study, we first identified aquatic organisms living in the Hantan River, including fishes, reptiles, invertebrates, phytoplankton, zooplankton, and amphibians. Second, we collected ecotoxicity data for these aquatic organisms and constructed an ecotoxicity database for Cd, Cu, Zn, TNT, and RDX. This study determined the ecological maximum permissible concentrations for metals and explosives based on the ecotoxicity database and suggested ecological surface water quality criteria for the Hantan River by considering analytical detection limits. Discharge limit criteria for the shooting range were determined based on the ecological surface water quality criteria suggested for Hantan River with further consideration of the dilution of the contaminants discharged into the river.

1 CFR 17.3 - Criteria for emergency publication.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Criteria for emergency publication. 17.3..., AND PROCESSING OF DOCUMENTS FILING FOR PUBLIC INSPECTION AND PUBLICATION SCHEDULES Emergency Schedule § 17.3 Criteria for emergency publication. The emergency schedule is designed to provide the fastest...

Aspirational Model Teaching Criteria for Psychology

ERIC Educational Resources Information Center

Richmond, Aaron S.; Boysen, Guy A.; Gurung, Regan A. R.; Tazeau, Yvette N.; Meyers, Steven A.; Sciutto, Mark J.

2014-01-01

In 2011, the Society for the Teaching of Psychology commissioned a presidential task force to document teaching criteria for model psychology teachers in undergraduate education. The resulting list of criteria reflects activities related to face-to-face course interaction and online teaching, training, and education; course design; implementation…

1 CFR 17.3 - Criteria for emergency publication.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1 General Provisions 1 2014-01-01 2012-01-01 true Criteria for emergency publication. 17.3 Section..., AND PROCESSING OF DOCUMENTS FILING FOR PUBLIC INSPECTION AND PUBLICATION SCHEDULES Emergency Schedule § 17.3 Criteria for emergency publication. The emergency schedule is designed to provide the fastest...

1 CFR 17.3 - Criteria for emergency publication.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1 General Provisions 1 2013-01-01 2012-01-01 true Criteria for emergency publication. 17.3 Section..., AND PROCESSING OF DOCUMENTS FILING FOR PUBLIC INSPECTION AND PUBLICATION SCHEDULES Emergency Schedule § 17.3 Criteria for emergency publication. The emergency schedule is designed to provide the fastest...

Providing Our Fellows in Training with Education on Inflammatory Bowel Disease Health Maintenance to Improve the Quality of Care in Our Health Care System.

PubMed

Lee, Ann Joo; Kraemer, Dale F; Smotherman, Carmen; Eid, Emely

2016-01-01

Inflammatory bowel disease (IBD) quality measures were established in an effort to standardize IBD health care. Despite effort to improve clinical performance, considerable variations in practice still exist. To further improve IBD health care, we propose incorporating an in-service educational session on IBD health maintenance to provide trainees with increasing awareness and knowledge on IBD management. Fifty electronic medical charts were randomly selected, and the level of quality documentation was assessed for 15 core IBD quality measures. Data were reported as the percentage of charts meeting audit criteria (compliance score). Fellows then attended an in-service educational session to review IBD quality measures and reinforce practice expectations. A second audit was then performed on an additional 50 patient charts to determine whether documentation practices improved after the educational session. We found a positive correlation between an in-service educational session and fellows' compliance with IBD health maintenance. Overall, the fellows' compliance score increased by 18% (before intervention, 65%; after intervention, 83%; P < 0.0001). The intervention was equally beneficial irrespective of training level. Although the magnitude of improvement was comparable, the mean compliance score was highest in year 2 at 81% (year 1: 72% [P = 0.019] and year 3: 70% [P = 0.002]). Fellows expressed a high degree of satisfaction with the educational intervention and emphasized the value in reviewing the conceptual bases for IBD health maintenance. Incorporating a standard curriculum on IBD health maintenance provides fellows in training with increased awareness and guidance on managing the unique preventive care needs of patients with IBD.

40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2011 CFR

2011-07-01

... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2013 CFR

2013-07-01

... level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final...

40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2014 CFR

2014-07-01

... level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final...

40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2014 CFR

2014-07-01

... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2013 CFR

2013-07-01

... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed engine is one whose final test...

40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective...

40 CFR 227.31 - Applicable marine water quality criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Applicable marine water quality criteria. 227.31 Section 227.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING CRITERIA FOR THE EVALUATION OF PERMIT APPLICATIONS FOR OCEAN DUMPING OF MATERIALS Definitions § 227.31 Applicable marine water quality...

40 CFR 227.31 - Applicable marine water quality criteria.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Applicable marine water quality criteria. 227.31 Section 227.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING CRITERIA FOR THE EVALUATION OF PERMIT APPLICATIONS FOR OCEAN DUMPING OF MATERIALS Definitions § 227.31 Applicable marine water quality...

A review of Quality of Life studies in Nigerian patients with psychiatric disorders.

PubMed

Aloba, O; Fatoye, O; Mapayi, B; Akinsulore, S

2013-09-01

The concept of Quality of Life is becoming an increasingly important measure of the impact of psychiatric disorders and is now recognized as useful in the healthcare evaluation of patients with psychiatric disorders. The aim of this review was to document and analyze the research data on quality of life in Nigerian patients with psychiatric disorders. The electronic databases, Medline and Pubmed were searched for published articles on quality of life in Nigerian patients with psychiatric disorders. A total of 6 studies met the inclusion criteria. All the studies employed the generic World Health Organization Quality of Life Scale - Brief version, which is the only quality of life instrument whose psychometric properties have been evaluated among Nigerian patients with psychiatric disorders. Some of the studies revealed that quality of life was significantly associated with socio demographic factors such marital and employment status and social support. Poor quality of life was reported to be associated with illness related factors such as co morbid medical problems, presence of anxiety and depressive symptoms and non adherence to medications. All the studies with the exception of two were conducted in centers located in South-western Nigeria. Quality of life in Nigerian patients suffering from psychiatric disorders is under-researched. There is need for more studies to prospectively investigate quality of life and associated factors among Nigerian patients with psychiatric disorders.

Practice guidelines for the implementation of a quality program in thromboprophylaxis and treatment management in patients with venous thromboembolic disease.

PubMed

Carrillo-Esper, Raúl; Alcántar-Luna, Ernesto; Herrera-Cornejo, Martín Alberto; Jaimovich, David; Ramos-Corrales, Marco Antonio; Villagómez-Ortiz, Asisclo

2012-01-01

Venous thromboembolic disease is a major cause of morbidity and hospital mortality worldwide. Although exact figures are unknown in Mexico, achieving uniformity of criteria among the specialties involved in the prophylaxis and treatment will offer a clearer picture and contribute to a more rational and interdisciplinary approach in order to improve the quality of care for patients and increase the level of awareness of this entity. For the preparation of this document, a total of 11 medical specialists from Mexico City and the interior of the country met along with a highly experienced professional from Chicago, IL, USA with wide experience in the field and knowledge of methodology for the development of a management algorithm for prophylaxis in at-risk patients of venous thromboembolic disease. The expert group met in plenary working sessions, managed uniform criteria and reached consensus agreement by issuing a series of useful recommendations for the care of patients with venous thromboembolism in Mexican hospitals. In Mexico there is the need to develop and disseminate guidelines on thromboprophylaxis and treatment of venous thromboembolic disease because of the wide disparity of views or simple misinformation, leading to diagnostic and treatment behaviors unique to each institution.

Factors Affecting the Retention of Indigenous Australians in the Health Workforce: A Systematic Review

PubMed Central

Lai, Genevieve C.; Haigh, Margaret M.

2018-01-01

Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of Indigenous Australians within the health workforce and to describe strategies to assist with development and retention of Indigenous health professionals after qualification. Four electronic databases were systematically searched in August 2017. Supplementary searches of relevant websites were also undertaken. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool. Fifteen articles met the criteria for inclusion. Important factors affecting the retention of Indigenous health professionals included work environment, heavy workloads, poorly documented/understood roles and responsibilities, low salary and a perception of salary disparity, and the influence of community as both a strong personal motivator and source of stress when work/life boundaries could not be maintained. Evidence suggests that retention of Indigenous health professionals will be improved through building supportive and culturally safe workplaces; clearly documenting and communicating roles, scope of practice and responsibilities; and ensuring that employees are appropriately supported and remunerated. The absence of intervention studies highlights the need for deliberative interventions that rigorously evaluate all aspects of implementation of relevant workforce, health service policy, and practice change. PMID:29734679

Factors Affecting the Retention of Indigenous Australians in the Health Workforce: A Systematic Review.

PubMed

Lai, Genevieve C; Taylor, Emma V; Haigh, Margaret M; Thompson, Sandra C

2018-05-04

Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of Indigenous Australians within the health workforce and to describe strategies to assist with development and retention of Indigenous health professionals after qualification. Four electronic databases were systematically searched in August 2017. Supplementary searches of relevant websites were also undertaken. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool. Fifteen articles met the criteria for inclusion. Important factors affecting the retention of Indigenous health professionals included work environment, heavy workloads, poorly documented/understood roles and responsibilities, low salary and a perception of salary disparity, and the influence of community as both a strong personal motivator and source of stress when work/life boundaries could not be maintained. Evidence suggests that retention of Indigenous health professionals will be improved through building supportive and culturally safe workplaces; clearly documenting and communicating roles, scope of practice and responsibilities; and ensuring that employees are appropriately supported and remunerated. The absence of intervention studies highlights the need for deliberative interventions that rigorously evaluate all aspects of implementation of relevant workforce, health service policy, and practice change.

Data from selected U.S. Geological Survey National Stream Water Quality Monitoring Networks

USGS Publications Warehouse

Alexander, Richard B.; Slack, James R.; Ludtke, Amy S.; Fitzgerald, Kathleen K.; Schertz, Terry L.

1998-01-01

A nationally consistent and well-documented collection of water quality and quantity data compiled during the past 30 years for streams and rivers in the United States is now available on CD-ROM and accessible over the World Wide Web. The data include measurements from two U.S. Geological Survey (USGS) national networks for 122 physical, chemical, and biological properties of water collected at 680 monitoring stations from 1962 to 1995, quality assurance information that describes the sample collection agencies, laboratories, analytical methods, and estimates of laboratory measurement error (bias and variance), and information on selected cultural and natural characteristics of the station watersheds. The data are easily accessed via user-supplied software including Web browser, spreadsheet, and word processor, or may be queried and printed according to user-specified criteria using the supplied retrieval software on CD-ROM. The water quality data serve a variety of scientific uses including research and educational applications related to trend detection, flux estimation, investigations of the effects of the natural environment and cultural sources on water quality, and the development of statistical methods for designing efficient monitoring networks and interpreting water resources data.

How healthcare systems evaluate their advance care planning initiatives: Results from a systematic review.

PubMed

Biondo, Patricia D; Lee, Lydia D; Davison, Sara N; Simon, Jessica E

2016-09-01

Advance care planning initiatives are being implemented across healthcare systems around the world, but how best to evaluate their implementation is unknown. To identify gaps and/or redundancies in current evaluative strategies to help healthcare systems develop future evaluative frameworks for ACP. Systematic review. Peer-reviewed and gray literature searches were conducted till February 2015 to answer: "What methods have healthcare systems used to evaluate implementation of advance care planning initiatives?" A PICOS framework was developed to identify articles describing the implementation and evaluation of a health system-level advance care planning initiative. Outcome measures were mapped onto a conceptual quality indicator framework based on the Institute of Medicine and Donabedian models of healthcare quality. A total of 46 studies met inclusion criteria for analysis. Most articles reported on single parts of a healthcare system (e.g. continuing care). The most common outcome measures pertained to document completion, followed by healthcare resource use. Patient-, family-, or healthcare provider-reported outcomes were less commonly measured. Concordance measures (e.g. dying in place of choice) were reported by only 26% of studies. The conceptual quality indicator framework identified gaps and redundancies in measurement and is presented as a potential foundation from which to develop a comprehensive advance care planning evaluation framework. Document completion is frequently used to evaluate advance care planning program implementation; capturing the quality of care appears to be more difficult. This systematic review provides health system administrators with a comprehensive summary of measures used to evaluate advance care planning and may identify gaps in evaluation within their local context. © The Author(s) 2016.

Assessment of three different software systems in the evaluation of dynamic MRI of the breast.

PubMed

Kurz, K D; Steinhaus, D; Klar, V; Cohnen, M; Wittsack, H J; Saleh, A; Mödder, U; Blondin, D

2009-02-01

The aim was to compare the diagnostic performance and handling of dynamic contrast-enhanced MRI of the breast with two commercial software solutions ("CADstream" and "3TP") and one self-developed software system ("Mammatool"). Identical data sets of dynamic breast MRI from 21 patients were evaluated retrospectively with all three software systems. The exams were classified according to the BI-RADS classification. The number of lesions in the parametric mapping was compared to histology or follow-up of more than 2 years. In addition, 25 quality criteria were judged by 3 independent investigators with a score from 0 to 5. Statistical analysis was performed to document the quality ranking of the different software systems. There were 9 invasive carcinomas, one pure DCIS, one papilloma, one radial scar, three histologically proven changes due to mastopathy, one adenosis and two fibroadenomas. Additionally two patients with enhancing parenchyma followed with MRI for more than 3 years and one scar after breast conserving therapy were included. All malignant lesions were classified as BI-RADS 4 or 5 using all software systems and showed significant enhancement in the parametric mapping. "CADstream" showed the best score on subjective quality criteria. "3TP" showed the lowest number of false-positive results. "Mammatool" produced the lowest number of benign tissues indicated with parametric overlay. All three software programs tested were adequate for sensitive and efficient assessment of dynamic MRI of the breast. Improvements in specificity may be achievable.

Multi-station basis for Polar Cap (PC) indices: ensuring credibility and operational reliability

NASA Astrophysics Data System (ADS)

Stauning, Peter

2018-02-01

The Polar Cap (PC) indices, PCN (North) and PCS (South) are based on polar geomagnetic observations from Qaanaaq (Thule) and Vostok, respectively, processed to measure the transpolar plasma convection that may seriously affect space weather conditions. To establish reliable space weather forecasts based on PC indices, and also to ensure credibility of their use for scientific analyses of solar wind-magnetosphere interactions, additional sources of data for the PC indices are investigated. In the search for alternative index sources, objective quality criteria are established here to be used for the selection among potential candidates. These criteria are applied to existing PC index series to establish a quality scale. In the Canadian region, the data from Resolute Bay magnetometer are shown to provide alternative PCN indices of adequate quality. In Antarctica, the data from Concordia Dome-C observatory are shown to provide basis for alternative PCS indices. In examples to document the usefulness of these alternative index sources it is shown that PCN indices in a real-time version based on magnetometer data from Resolute Bay could have given 6 h of early warning, of which the last 2 h were "red alert", up to the onset of the strong substorm event on 13 March 1989 that caused power outage in Quebec. The alternative PCS indices based on data from Dome-C have helped to disclose that presently available Vostok-based PCS index values are corrupted throughout most of 2011.

PepsNMR for 1H NMR metabolomic data pre-processing.

PubMed

Martin, Manon; Legat, Benoît; Leenders, Justine; Vanwinsberghe, Julien; Rousseau, Réjane; Boulanger, Bruno; Eilers, Paul H C; De Tullio, Pascal; Govaerts, Bernadette

2018-08-17

In the analysis of biological samples, control over experimental design and data acquisition procedures alone cannot ensure well-conditioned 1 H NMR spectra with maximal information recovery for data analysis. A third major element affects the accuracy and robustness of results: the data pre-processing/pre-treatment for which not enough attention is usually devoted, in particular in metabolomic studies. The usual approach is to use proprietary software provided by the analytical instruments' manufacturers to conduct the entire pre-processing strategy. This widespread practice has a number of advantages such as a user-friendly interface with graphical facilities, but it involves non-negligible drawbacks: a lack of methodological information and automation, a dependency of subjective human choices, only standard processing possibilities and an absence of objective quality criteria to evaluate pre-processing quality. This paper introduces PepsNMR to meet these needs, an R package dedicated to the whole processing chain prior to multivariate data analysis, including, among other tools, solvent signal suppression, internal calibration, phase, baseline and misalignment corrections, bucketing and normalisation. Methodological aspects are discussed and the package is compared to the gold standard procedure with two metabolomic case studies. The use of PepsNMR on these data shows better information recovery and predictive power based on objective and quantitative quality criteria. Other key assets of the package are workflow processing speed, reproducibility, reporting and flexibility, graphical outputs and documented routines. Copyright © 2018 Elsevier B.V. All rights reserved.

Shade Trading: An Emerging Riparian Forest-Based Payment for Ecosystem Services Market in Oregon, USA

NASA Astrophysics Data System (ADS)

Guillozet, Kathleen

2015-10-01

This paper describes the regulatory and compliance context for Oregon's emerging ecosystem services (ES) market in riparian shade to meet water quality obligations. In Oregon's market as with many other ES programs, contracts and other regulatory documents not only delimit the obligations and liabilities of different parties, but also constitute a primary mechanism through which ES service delivery is measured. Through a review of compliance criteria I find that under Oregon's shade trades, permittees are held to a number of input-based criteria, which essentially affirm that parties comply with predetermined practices and procedures, and one `pseudo output based' criterion, in which ES delivery is estimated through a model. The case presented in the paper critically engages with the challenges of measuring ES and in assessing the outcomes of ES projects. It places these challenges as interrelated and proposes that market designers, policymakers, and other stakeholders should consider explicit efficacy, efficiency, and equity targets.

Shade Trading: An Emerging Riparian Forest-Based Payment for Ecosystem Services Market in Oregon, USA.

PubMed

Guillozet, Kathleen

2015-10-01

This paper describes the regulatory and compliance context for Oregon's emerging ecosystem services (ES) market in riparian shade to meet water quality obligations. In Oregon's market as with many other ES programs, contracts and other regulatory documents not only delimit the obligations and liabilities of different parties, but also constitute a primary mechanism through which ES service delivery is measured. Through a review of compliance criteria I find that under Oregon's shade trades, permittees are held to a number of input-based criteria, which essentially affirm that parties comply with predetermined practices and procedures, and one 'pseudo output based' criterion, in which ES delivery is estimated through a model. The case presented in the paper critically engages with the challenges of measuring ES and in assessing the outcomes of ES projects. It places these challenges as interrelated and proposes that market designers, policymakers, and other stakeholders should consider explicit efficacy, efficiency, and equity targets.

CFD Validation Experiment of a Mach 2.5 Axisymmetric Shock-Wave/Boundary-Layer Interaction

NASA Technical Reports Server (NTRS)

Davis, David O.

2015-01-01

Experimental investigations of specific flow phenomena, e.g., Shock Wave Boundary-Layer Interactions (SWBLI), provide great insight to the flow behavior but often lack the necessary details to be useful as CFD validation experiments. Reasons include: 1.Undefined boundary conditions Inconsistent results 2.Undocumented 3D effects (CL only measurements) 3.Lack of uncertainty analysis While there are a number of good subsonic experimental investigations that are sufficiently documented to be considered test cases for CFD and turbulence model validation, the number of supersonic and hypersonic cases is much less. This was highlighted by Settles and Dodsons [1] comprehensive review of available supersonic and hypersonic experimental studies. In all, several hundred studies were considered for their database.Of these, over a hundred were subjected to rigorous acceptance criteria. Based on their criteria, only 19 (12 supersonic, 7 hypersonic) were considered of sufficient quality to be used for validation purposes. Aeschliman and Oberkampf [2] recognized the need to develop a specific methodology for experimental studies intended specifically for validation purposes.

Assessment of total nitrogen and total phosphorus in selected surface water of the National Park Service Northern Colorado Plateau Network, Colorado, Utah, and Wyoming, from 1972 through 2007

USGS Publications Warehouse

Brown, Juliane B.; Thoma, David P.

2012-01-01

Nutrients are a nationally recognized concern for water quality of streams, rivers, groundwater, and water bodies. Nutrient impairment is documented by the U.S. Environmental Protection Agency as a primary cause of degradation in lakes and reservoirs, and nutrients are related to organic enrichment and oxygen depletion, which is an important cause of degradation in streams. Recently (2011), an effort to develop State-based numeric nutrient criteria has resulted in renewed emphasis on nutrients in surface water throughout the Nation. In response to this renewed emphasis and to investigate nutrient water quality for Northern Colorado Plateau Network streams, the U.S. Geological Survey, in cooperation with the National Park Service, assessed total nitrogen and total phosphorus concentration data for 93 sites in or near 14 National Park units for the time period 1972 through 2007.

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

Haney, Thomas Jay

This report documents the Data Quality Objectives (DQOs) developed for the Idaho National Laboratory (INL) Site ambient air surveillance program. The development of the DQOs was based on the seven-step process recommended “for systematic planning to generate performance and acceptance criteria for collecting environmental data” (EPA 2006). The process helped to determine the type, quantity, and quality of data needed to meet current regulatory requirements and to follow U.S. Department of Energy guidance for environmental surveillance air monitoring design. It also considered the current air monitoring program that has existed at INL Site since the 1950s. The development of themore » DQOs involved the application of the atmospheric dispersion model CALPUFF to identify likely contamination dispersion patterns at and around the INL Site using site-specific meteorological data. Model simulations were used to quantitatively assess the probable frequency of detection of airborne radionuclides released by INL Site facilities using existing and proposed air monitors.« less

Modern researches on Blood Stasis syndrome 1989–2015

PubMed Central

Liao, Jiangquan; Wang, Jie; Liu, Yongmei; Li, Jun; Duan, Lian; Chen, Guang; Hu, Junyuan

2016-01-01

Abstract Background: Blood Stasis syndrome (BSS) is one of the major syndromes in Traditional East Asia medicine (TEAM). Modern research of BSS began in the late1980s. Methods: We searched in PubMed for BSS-related articles published between 1989 and 2015. The publication information, study contents, and bibliometric indicators were documented and analyzed. Results: Most of the BSS-related studies were conducted by Chinese researchers in China. The number of publications on BSS-related increased rapidly in recent years, so did the quality of them. The disease diversity of BSS-related studies increased along with the number of publications. Yet the academic influence of them remained on average low; further, the diagnostic criteria of BSS were not uniform. Conclusions: BSS-related studies have increased in quantity and quality, but there are limitations to them which require improvement in research productivity and academic influence. PMID:27930547

Review and Synthesis: Criteria for the Evaluation of Organizational Communication Effectiveness.

ERIC Educational Resources Information Center

Farace, Richard V.; And Others

Twenty-one criteria for assessing communication effectiveness in organizations provide the basis for discussion in this document. Grouped under the general heading of communication rules, the criteria are described according to five categories: structure, messages, media, communicator, and potpourri (factors that affect the decision making of…

75 FR 69140 - NUREG-1953, Confirmatory Thermal-Hydraulic Analysis To Support Specific Success Criteria in the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... To Support Specific Success Criteria in the Standardized Plant Analysis Risk Models--Surry and Peach... INFORMATION: NUREG-1953, ``Confirmatory Thermal-Hydraulic Analysis to Support Specific Success Criteria in the... document entitled: NUREG-1953, ``Confirmatory Thermal- Hydraulic Analysis to Support Specific Success...

Water Quality Criteria

EPA Pesticide Factsheets

EPA develops water quality criteria based on the latest scientific knowledge to protect human health and aquatic life. This information serves as guidance to states and tribes in adopting water quality standards.

Development of longitudinal handling qualities criteria for large advanced supersonic aircraft

NASA Technical Reports Server (NTRS)

Sudderth, R. W.; Bohn, J. G.; Caniff, M. A.; Bennett, G. R.

1975-01-01

Longitudinal handling qualities criteria in terms of airplane response characteristics were developed. The criteria cover high speed cruise maneuvering, landing approach, and stall recovery. Data substantiating the study results are reported.

Dysphagia screening after acute stroke: a quality improvement project using criteria-based clinical audit.

PubMed

Sivertsen, Jorun; Graverholt, Birgitte; Espehaug, Birgitte

2017-01-01

Dysphagia is common after stroke and represents a major risk factor for developing aspiration pneumonia. Early detection can reduce the risk of pulmonary complications and death. Despite the fact that evidence-based guidelines recommend screening for swallowing deficit using a standardized screening tool, national audits has identified a gap between practice and this recommendation. The aim was to determine the level of adherence to an evidence-based recommendation on swallow assessment and to take actions to improve practice if necessary. We carried out a criteria-based clinical audit (CBCA) in a small stroke unit at a Norwegian hospital. Patients with hemorrhagic stroke, ischemic stroke and transient ischemic attack were included. A power calculation informed the number of included patients at baseline ( n  = 80) and at re-audit ( n  = 35). We compared the baseline result with the evidence-based criteria and gave feedback to management and staff. A brainstorming session, a root-cause analysis and implementation science were used to inform the quality improvement actions which consisted of workshops, use of local opinion leaders, manual paper reminders and feedback. We completed a re-audit after implementation. Percentages and median are reported with 95% confidence intervals (CI). Among 88 cases at baseline, documentation of swallow screening was complete for 6% (95% CI 2-11). In the re-audit ( n  = 51) 61% (95% CI 45-74) had a complete screening. A CBCA involving management and staff, and using multiple tailored intervention targeting barriers, led to greater adherence with the recommendation for screening stroke patients for dysphagia.

40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

Code of Federal Regulations, 2012 CFR

2012-07-01

... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

Code of Federal Regulations, 2010 CFR

2010-07-01

... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

Code of Federal Regulations, 2011 CFR

2011-07-01

... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

Code of Federal Regulations, 2013 CFR

2013-07-01

... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed acceptable quality level is 40 percent. (b) A failed vehicle is one whose final deteriorated test results...

Documenting Student Competence through Effective Performance Assessment: Employability Skills. Workshop Summary.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. Agricultural Curriculum Materials Service.

This report contains 26 performance assessments for documenting student employability skills. Each performance assessment consists of the following: a competency; a terminal performance objective (outcome); competency builders and pupil performance objectives (criteria for documenting mastery of the objective); applied academic competencies;…

Recommendations for and Documentation of Biological Values for Use in Risk Assessment

EPA Science Inventory

The document was prepared by the Office of Health and Environmental Assessment, Environmental Criteria and Assessment Office, Cincinnati, OH for the Office of Solid Waste and Emergency Response. The document consists of an extensive compliation of values gleaned from published li...

Impacts of a participatory approach to developing national level sustainable development indicators in Finland.

PubMed

Rosenström, Ulla; Kyllönen, Simo

2007-08-01

The paper explores the role of a participatory approach in the outcome of the Finnish sustainable development indicator (SDI) exercise in 1998-2002. The process is analysed through three main objectives: to achieve stronger democracy, better quality of the end product and a more effective process. The analysis is further structured by a set of criteria needed for successful participation and differentiation of types of participants. The criteria comprise three main aspects: fairness, competence and social learning. In addition to the normally mentioned stakeholders (e.g. citizens and interest groups) participants also include experts and civil servants. Using the set of criteria above the participatory approach of the Finnish SDI process is then evaluated, and in the light of this evaluation the paper also discusses the specifications needed as evaluation criteria for national level policy programme processes like developing the SDIs. The results are based on documentation of the indicator task force meetings, written comments and a study of the putative end-users conducted after the publication of the indicators. The results show that the intense and broad participation of experts and civil servants increased the competence of the outcome and led to greater efficiency in working methods. However, this led to technocratic participation, absence of democratic participation and absence of social learning. Thus the ultimate goal of SDIs to contribute to achieving sustainability was not reached.

222-S Laboratory Quality Assurance Plan. Revision 1

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

Meznarich, H.K.

1995-07-31

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

Tonsillectomy under threat: auditing the indications for performing tonsillectomy.

PubMed

Silva, S; Ouda, M; Mathanakumara, S; Ridyard, E; Morar, P

2012-06-01

The 2009 McKinsey National Health Service report considered that tonsillectomy was relatively ineffective and often unjustified, and that its frequently could be greatly reduced. ENTUK argued against this, for severe recurrent tonsillitis. This study audited clinical indications for tonsillectomy. CRITERIA AND STANDARDS: Current guidelines state that patients with recurrent tonsillitis must have disabling sore throat episodes five or more times per year, and symptoms for at least a year, to justify tonsillectomy. Seventeen recurrent tonsillitis patients receiving tonsillectomy were audited prospectively. Indications were poorly documented in the referral letter, so surgeons agreed to list specified tonsillectomy criteria when scheduling patients for tonsillectomy. A pro forma reminder was distributed to all clinics, and the next 100 scheduled tonsillectomy patients were audited. In the first audit, all 17 tonsillectomies were justified but only two (11.8 per cent) had documented indications. In the second audit, 85 per cent of patients had all essential criteria, which were documented in the listing letter. Tonsillectomy risks being removed from the UK essential otolaryngological surgical register, risking increased patient morbidity and work absence, despite valid supporting evidence of efficacy for recurrent tonsillitis. All UK otolaryngology units should strictly adhere to the ENTUK and Scottish Intercollegiate Guidelines Network recommendations for tonsillectomy, and should document essential criteria in the listing letter, to strengthen the advocacy argument for tonsillectomy as essential, valid treatment for recurrent tonsillitis.

Methods for Environments and Contaminants: Criteria Air Pollutants

EPA Pesticide Factsheets

EPA’s Office of Air Quality Planning and Standards (OAQPS) has set primary (health-based) National Ambient Air Quality Standards (NAAQS) for six common air pollutants, often referred to as criteria air pollutants (or simply criteria pollutants).

Fact Sheet: Revised National Recommended Water Quality Criteria for the Protection of Human Health

EPA Pesticide Factsheets

2003 Revised National Recommended Ambient Water Quality Criteria for the Protection of Human Health. 15 Pollutants revised criteria will be published including, chlorobenzene, cyanide, endrin, ethylbenzene, lindane, thallium, toluene, and more.

A scoping review of training and deployment policies for human resources for health for maternal, newborn, and child health in rural Africa.

PubMed

Murphy, Gail Tomblin; Goma, Fastone; MacKenzie, Adrian; Bradish, Stephanie; Price, Sheri; Nzala, Selestine; Rose, Annette Elliott; Rigby, Janet; Muzongwe, Chilweza; Chizuni, Nellisiwe; Carey, Amanda; Hamavhwa, Derrick

2014-12-16

Most African countries are facing a human resources for health (HRH) crisis, lacking the required workforce to deliver basic health care, including care for mothers and children. This is especially acute in rural areas and has limited countries' abilities to meet maternal, newborn, and child health (MNCH) targets outlined by Millennium Development Goals 4 and 5. To address the HRH challenges, evidence-based deployment and training policies are required. However, the resources available to country-level policy makers to create such policies are limited. To inform future HRH planning, a scoping review was conducted to identify the type, extent, and quality of evidence that exists on HRH policies for rural MNCH in Africa. Fourteen electronic health and health education databases were searched for peer-reviewed papers specific to training and deployment policies for doctors, nurses, and midwives for rural MNCH in African countries with English, Portuguese, or French as official languages. Non-peer reviewed literature and policy documents were also identified through systematic searches of selected international organizations and government websites. Documents were included based on pre-determined criteria. There was an overall paucity of information on training and deployment policies for HRH for MNCH in rural Africa; 37 articles met the inclusion criteria. Of these, the majority of primary research studies employed a variety of qualitative and quantitative methods. Doctors, nurses, and midwives were equally represented in the selected policy literature. Policies focusing exclusively on training or deployment were limited; most documents focused on both training and deployment or were broader with embedded implications for the management of HRH or MNCH. Relevant government websites varied in functionality and in the availability of policy documents. The lack of available documentation and an apparent bias towards HRH research in developed areas suggest a need for strengthened capacity for HRH policy research in Africa. This will result in enhanced potential for evidence uptake into policy. Enhanced alignment between policy-makers' information needs and the independent research agenda could further assist knowledge development and uptake. The results of this scoping review informed an in-depth analysis of relevant policies in a sub-set of African countries.

First International Public Health Film Competition 2016-reflections on the development and use of competition judging criteria.

PubMed

Hoang, U; Luna, P; Russell, P; Bergonzi-King, L; Ashton, J; McCarthy, C; Donovan, H; Inman, P; Seminog, O; Botchway, S

2018-03-01

Film competitions can be a helpful method to understand issues of quality in health films. In this paper, we describe the development and use of explicit quality criteria to identify the 'best' films for the first ever international public health film competition. A film selection committee encompassing a range of stakeholders was compiled. The committee drew up 10 explicit quality criteria to judge films drawing upon other film festival's selection criteria. These criteria were then applied to a broad range of health-related films entered into a film competition to select the 'best' film to screen. Eighty-four films from 20 different countries were submitted to the public health film competition. The originality of the subject covered by the film, the public health importance of the issue and story-telling approach in the film were found to be the most discriminatory criteria to select films. Selection of health films for festivals can be undertaken using explicit quality criteria. There are a number of advantages to such an approach; however, explicit selection involves a large commitment of resources from film festival organizers and there is further research required to test the validity of the quality criteria applied to health-related films.

Space shuttle flying qualities and criteria assessment

NASA Technical Reports Server (NTRS)

Myers, T. T.; Johnston, D. E.; Mcruer, Duane T.

1987-01-01

Work accomplished under a series of study tasks for the Flying Qualities and Flight Control Systems Design Criteria Experiment (OFQ) of the Shuttle Orbiter Experiments Program (OEX) is summarized. The tasks involved review of applicability of existing flying quality and flight control system specification and criteria for the Shuttle; identification of potentially crucial flying quality deficiencies; dynamic modeling of the Shuttle Orbiter pilot/vehicle system in the terminal flight phases; devising a nonintrusive experimental program for extraction and identification of vehicle dynamics, pilot control strategy, and approach and landing performance metrics, and preparation of an OEX approach to produce a data archive and optimize use of the data to develop flying qualities for future space shuttle craft in general. Analytic modeling of the Orbiter's unconventional closed-loop dynamics in landing, modeling pilot control strategies, verification of vehicle dynamics and pilot control strategy from flight data, review of various existent or proposed aircraft flying quality parameters and criteria in comparison with the unique dynamic characteristics and control aspects of the Shuttle in landing; and finally a summary of conclusions and recommendations for developing flying quality criteria and design guides for future Shuttle craft.

Development and Validation of Quality Criteria for Providing Patient- and Family-centered Injury Care.

PubMed

Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T

2017-08-01

The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.

TECHNICAL GUIDANCE DOCUMENT: QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES

EPA Science Inventory

This Technical Guidance Document provides comprehensive guidance on procedures for quality assurance and quality control for waste containment facilities. he document includes a discussion of principles and concepts, compacted soil liners, soil drainage systems, geosynthetic drai...

TECHNICAL GUIDANCE DOCUMENT: QUALITY ASSURANCE AND QUALITY CONTROL FOR WASTE CONTAINMENT FACILITIES

EPA Science Inventory

This Technical Guidance Document provides comprehensive guidance on procedures for quality assurance and quality control for waste containment facilities. The document includes a discussion of principles and concepts, compacted soil liners, soil drainage systems, geosynthetic dr...

Documenting an ISO 9000 Quality System.

ERIC Educational Resources Information Center

Fisher, Barry

1995-01-01

Discusses six steps to follow when documenting an ISO 9000 quality system: using ISO 9000 to develop a quality system, identifying a company's business processes, analyzing the business processes; describing the procedures, writing the quality manual, and working to the documented procedures. (SR)

Designing Excellence and Quality Model for Training Centers of Primary Health Care: A Delphi Method Study.

PubMed

Tabrizi, Jafar-Sadegh; Farahbakhsh, Mostafa; Shahgoli, Javad; Rahbar, Mohammad Reza; Naghavi-Behzad, Mohammad; Ahadi, Hamid-Reza; Azami-Aghdash, Saber

2015-10-01

Excellence and quality models are comprehensive methods for improving the quality of healthcare. The aim of this study was to design excellence and quality model for training centers of primary health care using Delphi method. In this study, Delphi method was used. First, comprehensive information were collected using literature review. In extracted references, 39 models were identified from 34 countries and related sub-criteria and standards were extracted from 34 models (from primary 39 models). Then primary pattern including 8 criteria, 55 sub-criteria, and 236 standards was developed as a Delphi questionnaire and evaluated in four stages by 9 specialists of health care system in Tabriz and 50 specialists from all around the country. Designed primary model (8 criteria, 55 sub-criteria, and 236 standards) were concluded with 8 criteria, 45 sub-criteria, and 192 standards after 4 stages of evaluations by specialists. Major criteria of the model are leadership, strategic and operational planning, resource management, information analysis, human resources management, process management, costumer results, and functional results, where the top score was assigned as 1000 by specialists. Functional results had the maximum score of 195 whereas planning had the minimum score of 60. Furthermore the most and the least sub-criteria was for leadership with 10 sub-criteria and strategic planning with 3 sub-criteria, respectively. The model that introduced in this research has been designed following 34 reference models of the world. This model could provide a proper frame for managers of health system in improving quality.

Permanent Ground Anchors : Stump Design Criteria

DOT National Transportation Integrated Search

1982-09-01

This document summarizes the main design methods used by the principal investigators in the design of permanent ground anchors, including basic concepts, design criteria, and analytical techniques. The application of these design methods are illustra...

PROCEDURES FOR THE DERIVATION OF EQUILIBRIUM ...

EPA Pesticide Factsheets

This equilibrium partitioning sediment benchmark (ESB) document describes procedures to derive concentrations for 32 nonionic organic chemicals in sediment which are protective of the presence of freshwater and marine benthic organisms. The equilibrium partitioning (EqP) approach was chosen because it accounts for the varying biological availability of chemicals in different sediments and allows for the incorporation of the appropriate biological effects concentration. This provides for the derivation of benchmarks that are causally linked to the specific chemical, applicable across sediments, and appropriately protective of benthic organisms. EqP can be used to calculate ESBs for any toxicity endpoint for which there are water-only toxicity data; it is not limited to any single effect endpoint. For the purposes of this document, ESBs for 32 nonionic organic chemicals, including several low molecular weight aliphatic and aromatic compounds, pesticides, and phthalates, were derived using Final Chronic Values (FCV) from Water Quality Criteria (WQC) or Secondary Chronic Values (SCV) derived from existing toxicological data using the Great Lakes Water Quality Initiative (GLI) or narcosis theory approaches. These values are intended to be the concentration of each chemical in water that is protective of the presence of aquatic life. For nonionic organic chemicals demonstrating a narcotic mode of action, ESBs derived using the GLI approach specifically for fres

Health system guidance appraisal--concept evaluation and usability testing.

PubMed

Ako-Arrey, Denis E; Brouwers, Melissa C; Lavis, John N; Giacomini, Mita K

2016-01-05

Health system guidance (HSG) provides recommendations aimed to address health system challenges. However, there is a paucity of methods to direct, appraise, and report HSG. Earlier research identified 30 candidate criteria (concepts) that can be used to evaluate the quality of HSG and guide development and reporting requirements. The objective of this paper was to describe two studies aimed at evaluating the importance of these 30 criteria, design a draft HSG appraisal tool, and test its usability. This study involved a two-step survey process. In step 1, respondents rated the 30 concepts for appropriateness to, relevance to, and priority for health system decisions and HSG. This led to a draft tool. In step 2, respondents reviewed HSG documents, appraised them using the tool, and answered a series of questions. Descriptive analyses were computed. Fifty participants were invited in step 1, and we had a response rate of 82 %. The mean response rates for each concept within each survey question were universally favorable. There was also an overall agreement about the need for a high-quality tool to systematically direct the development, appraisal, and reporting of HSG. Qualitative feedback and a consensus process by the team led to refinements to some of the concepts and the creation of a beta (draft) version of the HSG tool. In step 2, 35 participants were invited and we had a response rate of 74 %. Exploratory analyses showed that the quality of the HSGs reviewed varied as a function of the HSG item and the specific document assessed. A favorable consensus was reached with participants agreeing that the HSG items were easy to understand and easy to apply. Moreover, the overall agreement was high for the usability of the tool to systematically direct the development (85 %), appraisal (92 %), and reporting (81 %) of HSG. From this process, version 1.0 of the HSG appraisal tool was generated complete with 32 items (and their descriptions) and 4 domains. The final tool, named the Appraisal of Guidelines for Research and Evaluation for Health Systems (AGREE-HS) (version 1), defines expectations of HSG and facilitates informed decisions among policymakers on health system delivery, financial, and governance arrangements.

Seismic assessment of Technical Area V (TA-V).

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

Medrano, Carlos S.

The Technical Area V (TA-V) Seismic Assessment Report was commissioned as part of Sandia National Laboratories (SNL) Self Assessment Requirement per DOE O 414.1, Quality Assurance, for seismic impact on existing facilities at Technical Area-V (TA-V). SNL TA-V facilities are located on an existing Uniform Building Code (UBC) Seismic Zone IIB Site within the physical boundary of the Kirtland Air Force Base (KAFB). The document delineates a summary of the existing facilities with their safety-significant structure, system and components, identifies DOE Guidance, conceptual framework, past assessments and the present Geological and Seismic conditions. Building upon the past information and themore » evolution of the new seismic design criteria, the document discusses the potential impact of the new standards and provides recommendations based upon the current International Building Code (IBC) per DOE O 420.1B, Facility Safety and DOE G 420.1-2, Guide for the Mitigation of Natural Phenomena Hazards for DOE Nuclear Facilities and Non-Nuclear Facilities.« less

Measure Guideline: Passive Vents

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

Berger, David; Neri, Robin

2016-02-05

This document addresses the use of passive vents as a source of outdoor air in multifamily buildings. The challenges associated with implementing passive vents and the factors affecting performance are outlined. A comprehensive design methodology and quantified performance metrics are provided. Two hypothetical design examples are provided to illustrate the process. This document is intended to be useful to designers, decision-makers, and contractors implementing passive ventilation strategies. It is also intended to be a resource for those responsible for setting high-performance building program requirements, especially pertaining to ventilation and outdoor air. To ensure good indoor air quality, a dedicated sourcemore » of outdoor air is an integral part of high-performance buildings. Presently, there is a lack of guidance pertaining to the design and installation of passive vents, resulting in poor system performance. This report details the criteria necessary for designing, constructing, and testing passive vent systems to enable them to provide consistent and reliable levels of ventilation air from outdoors.« less

Improving the Quality of Electronic Documentation in Critical Care Nursing

ERIC Educational Resources Information Center

Stevens, Brent

2017-01-01

Electronic nursing documentation systems can facilitate complete, accurate, timely documentation practices, but without effective policies and procedures in place, a gap in practice exists and quality of care may be impacted. This systematic review of literature examined current evidence regarding electronic nursing documentation quality. General…

Spectrum analysis on quality requirements consideration in software design documents.

PubMed

Kaiya, Haruhiko; Umemura, Masahiro; Ogata, Shinpei; Kaijiri, Kenji

2013-12-01

Software quality requirements defined in the requirements analysis stage should be implemented in the final products, such as source codes and system deployment. To guarantee this meta-requirement, quality requirements should be considered in the intermediate stages, such as the design stage or the architectural definition stage. We propose a novel method for checking whether quality requirements are considered in the design stage. In this method, a technique called "spectrum analysis for quality requirements" is applied not only to requirements specifications but also to design documents. The technique enables us to derive the spectrum of a document, and quality requirements considerations in the document are numerically represented in the spectrum. We can thus objectively identify whether the considerations of quality requirements in a requirements document are adapted to its design document. To validate the method, we applied it to commercial software systems with the help of a supporting tool, and we confirmed that the method worked well.

Quality in End User Documentation.

ERIC Educational Resources Information Center

Morrison, Ronald

1994-01-01

Discusses quality in end-user documentation for computer applications and explains four approaches to improving quality in end-user documents. Highlights include online help, usability testing, technical writing elements, statistical approaches, and concepts relating to software quality that are also applicable to user manuals. (LRW)

32 CFR 2700.12 - Criteria for and level of original classification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Criteria for and level of original classification. (a) General Policy. Documents or other material are to... authorized or shall have force. (d) Unnecessary classification, and classification at a level higher than is... 32 National Defense 6 2010-07-01 2010-07-01 false Criteria for and level of original...

TU-F-CAMPUS-I-05: Semi-Automated, Open Source MRI Quality Assurance and Quality Control Program for Multi-Unit Institution

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

Yung, J; Stefan, W; Reeve, D

2015-06-15

Purpose: Phantom measurements allow for the performance of magnetic resonance (MR) systems to be evaluated. Association of Physicists in Medicine (AAPM) Report No. 100 Acceptance Testing and Quality Assurance Procedures for MR Imaging Facilities, American College of Radiology (ACR) MR Accreditation Program MR phantom testing, and ACR MRI quality control (QC) program documents help to outline specific tests for establishing system performance baselines as well as system stability over time. Analyzing and processing tests from multiple systems can be time-consuming for medical physicists. Besides determining whether tests are within predetermined limits or criteria, monitoring longitudinal trends can also help preventmore » costly downtime of systems during clinical operation. In this work, a semi-automated QC program was developed to analyze and record measurements in a database that allowed for easy access to historical data. Methods: Image analysis was performed on 27 different MR systems of 1.5T and 3.0T field strengths from GE and Siemens manufacturers. Recommended measurements involved the ACR MRI Accreditation Phantom, spherical homogenous phantoms, and a phantom with an uniform hole pattern. Measurements assessed geometric accuracy and linearity, position accuracy, image uniformity, signal, noise, ghosting, transmit gain, center frequency, and magnetic field drift. The program was designed with open source tools, employing Linux, Apache, MySQL database and Python programming language for the front and backend. Results: Processing time for each image is <2 seconds. Figures are produced to show regions of interests (ROIs) for analysis. Historical data can be reviewed to compare previous year data and to inspect for trends. Conclusion: A MRI quality assurance and QC program is necessary for maintaining high quality, ACR MRI Accredited MR programs. A reviewable database of phantom measurements assists medical physicists with processing and monitoring of large datasets. Longitudinal data can reveal trends that although are within passing criteria indicate underlying system issues.« less

Quality tools and resources to support organisational improvement integral to high-quality primary care: a systematic review of published and grey literature.

PubMed

Janamian, Tina; Upham, Susan J; Crossland, Lisa; Jackson, Claire L

2016-04-18

To conduct a systematic review of the literature to identify existing online primary care quality improvement tools and resources to support organisational improvement related to the seven elements in the Primary Care Practice Improvement Tool (PC-PIT), with the identified tools and resources to progress to a Delphi study for further assessment of relevance and utility. Systematic review of the international published and grey literature. CINAHL, Embase and PubMed databases were searched in March 2014 for articles published between January 2004 and December 2013. GreyNet International and other relevant websites and repositories were also searched in March-April 2014 for documents dated between 1992 and 2012. All citations were imported into a bibliographic database. Published and unpublished tools and resources were included in the review if they were in English, related to primary care quality improvement and addressed any of the seven PC-PIT elements of a high-performing practice. Tools and resources that met the eligibility criteria were then evaluated for their accessibility, relevance, utility and comprehensiveness using a four-criteria appraisal framework. We used a data extraction template to systematically extract information from eligible tools and resources. A content analysis approach was used to explore the tools and resources and collate relevant information: name of the tool or resource, year and country of development, author, name of the organisation that provided access and its URL, accessibility information or problems, overview of each tool or resource and the quality improvement element(s) it addresses. If available, a copy of the tool or resource was downloaded into the bibliographic database, along with supporting evidence (published or unpublished) on its use in primary care. This systematic review identified 53 tools and resources that can potentially be provided as part of a suite of tools and resources to support primary care practices in improving the quality of their practice, to achieve improved health outcomes.

75 FR 8854 - Teacher Incentive Fund Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-26

...The Secretary of Education (Secretary) proposes priorities, requirements, definitions, and selection criteria under the Teacher Incentive Fund (TIF) program. These proposed priorities, requirements, definitions, and selection criteria are designed to be used in two separate and distinct TIF grant competitions: The Main TIF competition, which will provide TIF funding to eligible entities to support their implementation of performance-based compensation systems (PBCSs) in accordance with the priorities, the Main TIF requirements, the definitions, and the selection criteria proposed in this document, and the TIF Evaluation competition, which will provide, in accordance with the priorities, the Main TIF requirements, the definitions, and the selection criteria as well as the Evaluation requirements proposed in this document, TIF funding to help pay for the costs of implementing these eligible entities' PBCS in exchange for an agreement to participate in the national evaluation. The Secretary may use these proposed TIF priorities, requirements, definitions, and selection criteria in fiscal year (FY) 2010 and subsequent years. We intend the proposed priorities, requirements, definitions, and selection criteria to improve student achievement in high-need schools by creating incentives for effective teachers and principals in these schools.

Resource Conservation and Recovery Act, Part B Permit Application [for the Waste Isolation Pilot Plant (WIPP)]. Volume 5, Chapter D, Appendix D1 (conclusion), Revision 3

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

Cook, Neville G.W.; Heuze, Francois E.; Miller, Hamish D.S.

1993-03-01

The reference design for the underground facilities at the Waste Isolation Pilot Plant was developed using the best criteria available at initiation of the detailed design effort. These design criteria are contained in the US Department of Energy document titled Design Criteria, Waste Isolation Pilot Plant (WIPP). Revised Mission Concept-IIA (RMC-IIA), Rev. 4, dated February 1984. The validation process described in the Design Validation Final Report has resulted in validation of the reference design of the underground openings based on these criteria. Future changes may necessitate modification of the Design Criteria document and/or the reference design. Validation of the referencemore » design as presented in this report permits the consideration of future design or design criteria modifications necessitated by these changes or by experience gained at the WIPP. Any future modifications to the design criteria and/or the reference design will be governed by a DOE Standard Operation Procedure (SOP) covering underground design changes. This procedure will explain the process to be followed in describing, evaluating and approving the change.« less

Doctors on the move: a European case study on the key characteristics of national recertification systems

PubMed Central

Govaerts, Marjan J; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

2018-01-01

Objectives With increased cross-border movement, ensuring safe and high-quality healthcare has gained primacy. The purpose of recertification is to ensure quality of care through periodically attesting doctors’ professional proficiency in their field. Professional migration and facilitated cross-border recognition of qualifications, however, make us question the fitness of national policies for safeguarding patient care and the international accountability of doctors. Design and setting We performed document analyses and conducted 19 semistructured interviews to identify and describe key characteristics and effective components of 10 different European recertification systems, each representing one case (collective case study). We subsequently compared these systems to explore similarities and differences in terms of assessment criteria used to determine process quality. Results Great variety existed between countries in terms and assessment formats used, targeting cognition, competence and performance (Miller’s assessment pyramid). Recertification procedures and requirements also varied significantly, ranging from voluntary participation in professional development modules to the mandatory collection of multiple performance data in a competency-based portfolio. Knowledge assessment was fundamental to recertification in most countries. Another difference concerned the stakeholders involved in the recertification process: while some systems exclusively relied on doctors’ self-assessment, others involved multiple stakeholders but rarely included patients in assessment of doctors’ professional competence. Differences between systems partly reflected different goals and primary purposes of recertification. Conclusion Recertification systems differ substantially internationally with regard to the criteria they apply to assess doctors’ competence, their aims, requirements, assessment formats and patient involvement. In the light of professional mobility and associated demands for accountability, we recommend that competence assessment includes patients’ perspectives, and recertification practices be shared internationally to enhance transparency. This can help facilitate cross-border movement, while guaranteeing high-quality patient care. PMID:29666131

Evaluation of available data sources to prioritize parishes for arsenic monitoring and outreach related to private well drinking water.

PubMed

Katner, Adrienne; Lackovic, Michelle; Streva, Kate; Paul, Vanessa; Trachtman, William Clay

2015-01-01

The objective of this assessment was to identify and evaluate data sets for use in the surveillance of arsenic hazards and private well drinking water use in Louisiana. Features, strengths, and limitations of the data sets are described, and prioritization criteria are applied to identify areas in need of further monitoring or outreach. Recent efforts have been made by the Environmental Public Health Tracking Network to evaluate the quality of private well water data for the purpose of supporting state and national surveillance activities. Like most states, Louisiana does not collect or mandate reporting of private well water quality data. Therefore, responding to public concerns about private well water quality requires an identification and evaluation of existing data. Data evaluated include measures of arsenic in groundwater and soil, private well water use, and biomonitoring results. The Environmental Protection Agency's Safe Drinking Water Information System and the US Geological Survey's Water Use data set were the most informative, nationally available data sets for conducting private well water arsenic surveillance. Three priority parishes were identified on the basis of a selection criteria, although all parishes require more private well sampling data. While the data reviewed enabled preliminary identification of parishes in need of monitoring and outreach, data limitations (particularly, a lack of statewide well water quality data) prevent a comprehensive evaluation of well water arsenic hazards and private well water use. A large number of unregistered wells further impede risk determination. Reliance on existing data sources is necessary, but development of metadata documentation is essential to prevent data misinterpretation. Increased outreach and policies to promote or mandate private well testing and reporting are needed to enable a comprehensive private well water tracking system.

Sound Medication Therapy Management Programs, Version 2.0 with validation study.

PubMed

2008-01-01

The Academy of Managed Care Pharmacy (AMCP, the Academy) contracted with the National Committee for Quality Assurance (NCQA) to conduct a field study to validate and assess the 2006 Sound Medication Therapy Management Programs, Version 1.0 document. Version 1.0 posits several principles of sound medication therapy management (MTM) programs: they (1) recruit patients whose data show they may need assistance with managing medications; (2) have health professionals who intervene with patients and their physicians to improve medication regimens; and (3) measure their results. The validation study determined the extent to which the principles identified in version 1.0 are incorporated in MTM programs. The method was designed to determine to what extent the important features and operational elements of sound MTM programs as described in version 1.0 are (1) acceptable and seen as comprehensive to users, (2) incorporated into MTM programs in the field, (3) reflective of the consensus group's intentions, and (4) in need of modification or updating. NCQA first conducted Phase One, in which NCQA gathered perspectives on the principles in the consensus document from a mixed group of stakeholders representing both providers and users of MTM programs. Phase Two involved a deeper analysis of existing programs related to the consensus document, in which NCQA conducted a Web-based survey of 20 varied MTM programs and conducted in-depth site visits with 5 programs. NCQA selected programs offered by a range of MTM-providing organizations -- health plans, pharmacy benefit management companies, disease management organizations, and stand-alone MTM providers. NCQA analyzed the results of both phases. The Phase Two survey asked specific questions of the programs and found that some programs perform beyond the principles listed in version 1.0. NCQA found that none of the elements of the consensus document should be eliminated because programs cannot perform them, although NCQA suggested some areas where the document could be more expansive or more specific, given the state of MTM operations in the field. The important features and operational elements in the document were categorized into the following 3 overall categories, which NCQA used to structure the survey and conduct the site visits in Phase Two: (1) eligibility and enrollment, (2) operations, and (3) quality management. NCQA found that the original consensus document was realistic in identifying the elements of sound MTM. In the current project, NCQA's purpose was not to make judgments about the effectiveness of MTM programs in general or any individual program in particular. NCQA recommended that the consensus document could be made stronger and more specific in 3 areas: (1) specifically state that the Patient Identification and Recruitment section advocates use of various eligibility criteria that may include, but are not limited to, Medicare-defined MTM eligibility criteria; (2) reframe or remove the statement in Appendix A of the consensus document that the preferred modality for MTM is face-to-face interaction between patient and pharmacist, unless there are comparative data to support it as currently written; and (3) specifically recommend that programs measure performance across the entire populations in their plans in addition to measuring results for those patients selected into MTM. This will make benchmarking among programs possible and will lead to substantiated best practices in this growing field.

Document Delivery for the '90s and Beyond.

ERIC Educational Resources Information Center

Fitzsimmons, Joseph J.

1996-01-01

The story of the pony express offers lessons for today's document delivery. Pricing, policy, competition, and evolving technology need to be considered. To evaluate future options, researchers need to examine: types of document delivery; benefits of combining outside services with in-house systems; criteria for selecting technologies and…

Quality management of clinical-practical instruction for Practical Year medical students in Germany - proposal for a catalogue of criteria from the German Society of Medical Education.

PubMed

Raes, Patricia; Angstwurm, Matthias; Berberat, Pascal; Kadmon, Martina; Rotgans, Jerome; Streitlein-Böhme, Irmgard; Burckhardt, Gerhard; Fischer, Martin R

2014-01-01

Amended in 2013, the current version of the German Medical Licensure Regulation contains structural specifications that are also required of non-university institutions involved in Practical Year clinical training. The criteria are worded in relatively general terms. Furthermore, not all of the structural specifications can be readily applied to every subject area. In order to ensure commensurability in Practical Year instruction in Germany, not least in light of recently introduced Practical Year mobility, it is necessary to define consistent quality criteria for Practical Year training. The authors therefore propose a catalogue of criteria for the quality management process in Practical Year instruction facilities. In January 2014, the board of directors of the German Society for Medical Education decided to establish a committee comprised of representatives from various German medical faculties. In a process similar to the Delphi methodology, the group developed criteria for structure, process and outcome quality in Practical Year training in Germany. The criteria developed for structure, process and outcome quality apply to Practical Year training in academic teaching hospitals and university medical centres. Furthermore, modalities for review are proposed. The present catalogue of criteria is intended to contribute to the formation of a basis for the most consistent quality standards possible for Practical Year instruction in Germany.

Probability-based estimates of site-specific copper water quality criteria for the Chesapeake Bay, USA.

PubMed

Arnold, W Ray; Warren-Hicks, William J

2007-01-01

The object of this study was to estimate site- and region-specific dissolved copper criteria for a large embayment, the Chesapeake Bay, USA. The intent is to show the utility of 2 copper saltwater quality site-specific criteria estimation models and associated region-specific criteria selection methods. The criteria estimation models and selection methods are simple, efficient, and cost-effective tools for resource managers. The methods are proposed as potential substitutes for the US Environmental Protection Agency's water effect ratio methods. Dissolved organic carbon data and the copper criteria models were used to produce probability-based estimates of site-specific copper saltwater quality criteria. Site- and date-specific criteria estimations were made for 88 sites (n = 5,296) in the Chesapeake Bay. The average and range of estimated site-specific chronic dissolved copper criteria for the Chesapeake Bay were 7.5 and 5.3 to 16.9 microg Cu/L. The average and range of estimated site-specific acute dissolved copper criteria for the Chesapeake Bay were 11.7 and 8.3 to 26.4 microg Cu/L. The results suggest that applicable national and state copper criteria can increase in much of the Chesapeake Bay and remain protective. Virginia Department of Environmental Quality copper criteria near the mouth of the Chesapeake Bay, however, need to decrease to protect species of equal or greater sensitivity to that of the marine mussel, Mytilus sp.

The Clinician-Educator Pathway in Radiology: An Analysis of Institutional Promotion Criteria.

PubMed

Jhala, Khushboo; Kim, Jisoo; Chetlen, Alison; Nickerson, Joshua P; Lewis, Petra J

2017-12-01

To provide radiology departmental promotional committees and vice chairs of education with a more global perspective on the types of academic activity valued by institutions to aid in their faculty mentoring and standardizing of the Clinician-Educator (ClinEd) pathway. Ninety-two research schools were ranked into three tiers. Ranking was correlated with the presence of a ClinEd track. Thirty promotion documents (ten from each tier) were analyzed to identify common criteria. Differences in guidelines between tiers were assessed by the frequency distribution of criteria. Tier 1 had a significantly greater proportion of schools with a ClinEd track than tier 2 (73% versus 44%, p < 0.05). Thirty-nine criteria were identified and organized into four categories teaching (13), scholarship (12), service/clinical excellence (7), and research (7). The top five included meeting presentations, trainee evaluations, leadership in committees, development of teaching methodologies and materials, and publication of book chapters. First and second tier schools were most similar in frequency distribution. The criteria for the ClinEd promotion track still vary across institutions, though many commonalities exist. A handful of innovative criteria reflect the changing structure of modern health care systems, such as incorporation of online teaching modules and quality improvement efforts. As health care changes, guidelines and incentive structures for faculty should change as well. The information gathered may provide promotion committees with a more global perspective on the types of academic activity valued by modern-day institutions to aid in the national standardization of this pathway and to assist in faculty mentoring. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Campania Preventability Assessment Committee (Italy): A Focus on the Preventability of Non-steroidal Anti-inflammatory Drugs' Adverse Drug Reactions.

PubMed

Sessa, Maurizio; Sportiello, Liberata; Mascolo, Annamaria; Scavone, Cristina; Gallipoli, Silvia; di Mauro, Gabriella; Cimmaruta, Daniela; Rafaniello, Concetta; Capuano, Annalisa

2017-01-01

Purpose: This study aims to investigate preventability criteria of adverse drug reactions (ADRs) involving non-steroidal anti-inflammatory drugs (NSAIDs) by analyzing individual case safety reports (ICSRs) sent through Campania region (Italy) spontaneous reporting system from July 2012 to October 2016. Methods: For all the ICSRs that reported NSAIDs as suspected drug, a trained multidisciplinary team of Campania Pharmacovigilance Regional Centre composed of clinical pharmacologists and pharmacists with pluriannual experience in Pharmacovigilance assessed preventability by using the P-method. Results: In all 19,039 ICSRs were sent to Campania Pharmacovigilance Regional Centre, of which 550 reported NSAIDs as suspected drug. In total, 94 cases (17.1%) out of 550 ICSRs were preventable. In the 94 preventable cases, 201 critical criteria were detected of which 182/201 (90.5%) related to healthcare professionals' practices, 0/201 (0.0%) to drug quality, and 19/201 (9.5%) to patient behavior. The most detected critical criteria were the necessary medication not given (52/182; 28.6%), labeled drug-drug interaction (36/182; 19.7%), incorrect drug administration duration (31/182; 16.9%), wrong indication (26/182; 14.2%), therapeutic duplication (18/182; 10.0%), and documented hypersensitivity to administered drug or drug class (10/182; 5.6%). In seventeen (18.1%) preventable cases, there were 19 critical criteria involving non-compliance (15/19 critical criteria; 78.9%) and self-medication with the non-over-the-counter drugs (4/19 critical criteria; 21.1%). In all, 17 out 94 (18.1%) preventable cases involved over-the-counter drugs. Conclusion: A call for action for Campania Pharmacovigilance Regional Centre is necessary in order to promote initiatives to increase the awareness of healthcare professionals and citizens on the risk associated with inappropriate use of NSAIDs.

Campania Preventability Assessment Committee (Italy): A Focus on the Preventability of Non-steroidal Anti-inflammatory Drugs' Adverse Drug Reactions

PubMed Central

Sessa, Maurizio; Sportiello, Liberata; Mascolo, Annamaria; Scavone, Cristina; Gallipoli, Silvia; di Mauro, Gabriella; Cimmaruta, Daniela; Rafaniello, Concetta; Capuano, Annalisa

2017-01-01

Purpose: This study aims to investigate preventability criteria of adverse drug reactions (ADRs) involving non-steroidal anti-inflammatory drugs (NSAIDs) by analyzing individual case safety reports (ICSRs) sent through Campania region (Italy) spontaneous reporting system from July 2012 to October 2016. Methods: For all the ICSRs that reported NSAIDs as suspected drug, a trained multidisciplinary team of Campania Pharmacovigilance Regional Centre composed of clinical pharmacologists and pharmacists with pluriannual experience in Pharmacovigilance assessed preventability by using the P-method. Results: In all 19,039 ICSRs were sent to Campania Pharmacovigilance Regional Centre, of which 550 reported NSAIDs as suspected drug. In total, 94 cases (17.1%) out of 550 ICSRs were preventable. In the 94 preventable cases, 201 critical criteria were detected of which 182/201 (90.5%) related to healthcare professionals' practices, 0/201 (0.0%) to drug quality, and 19/201 (9.5%) to patient behavior. The most detected critical criteria were the necessary medication not given (52/182; 28.6%), labeled drug–drug interaction (36/182; 19.7%), incorrect drug administration duration (31/182; 16.9%), wrong indication (26/182; 14.2%), therapeutic duplication (18/182; 10.0%), and documented hypersensitivity to administered drug or drug class (10/182; 5.6%). In seventeen (18.1%) preventable cases, there were 19 critical criteria involving non-compliance (15/19 critical criteria; 78.9%) and self-medication with the non-over-the-counter drugs (4/19 critical criteria; 21.1%). In all, 17 out 94 (18.1%) preventable cases involved over-the-counter drugs. Conclusion: A call for action for Campania Pharmacovigilance Regional Centre is necessary in order to promote initiatives to increase the awareness of healthcare professionals and citizens on the risk associated with inappropriate use of NSAIDs. PMID:28603499

Photovoltaic system criteria documents. Volume 3: Environmental issues and evaluation criteria for photovoltaic applications

NASA Technical Reports Server (NTRS)

Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

1979-01-01

The environmental issues and evaluation criteria relating to the suitability of sites proposed for photovoltaic (PV) system deployment are identified. The important issues are defined, briefly discussed and then developed into evaluation criteria. System designers are provided with information on the environmental sensitivity of PV systems in realistic applications, background material which indicates the applicability of the siting issues identified, and evaluation criteria are defined to facilitate the selection of sites that maximize PV system operation.

The match between institutional elderly care management research and management challenges - a systematic literature review.

PubMed

Kokkonen, Kaija; Rissanen, Sari; Hujala, Anneli

2012-11-08

Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers' and policymakers' scientific literacy needs to be enhanced.

The match between institutional elderly care management research and management challenges - a systematic literature review

PubMed Central

2012-01-01

Background Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. Methods This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. Results The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Conclusions Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced. PMID:23137416

Sediment quality criteria: A review with recommendations for developing criteria for the Hanford Site

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

Driver, C.J.

1994-05-01

Criteria for determining the quality of liver sediment are necessary to ensure that concentrations of contaminants in aquatic systems are within acceptable limits for the protection of aquatic and human life. Such criteria should facilitate decision-making about remediation, handling, and disposal of contaminants. Several approaches to the development of sediment quality criteria (SQC) have been described and include both descriptive and numerical methods. However, no single method measures all impacts at all times to all organisms (U.S. EPA 1992b). The U.S. EPA`s interest is primarily in establishing chemically based, numerical SQC that are applicable nation-wide (Shea 1988). Of the approachesmore » proposed for SQC development, only three are being considered for numerical SQC on a national level. These approaches include an Equilibrium Partitioning Approach, a site-specific method using bioassays (the Apparent Effects Threshold Approach), and an approach similar to EPA`s water quality criteria (Pavlou and Weston 1984). Although national (or even regional) criteria address a number of political, litigative, and engineering needs, some researchers feel that protection of benthic communities require site-specific, biologically based criteria (Baudo et al. 1990). This is particularly true for areas where complex mixtures of contaminants are present in sediments. Other scientifically valid and accepted procedures for freshwater SQC include a background concentration approach, methods using field or spiked bioassays, a screening level concentration approach, the Apparent Effects Threshold Approach, the Sediment Quality Triad, the International Joint Commission Sediment Assessment Strategy, and the National Status and Trends Program Approach. The various sediment assessment approaches are evaluated for application to the Hanford Reach and recommendations for Hanford Site sediment quality criteria are discussed.« less

Ride qualities criteria validation/pilot performance study: Flight test results

NASA Technical Reports Server (NTRS)

Nardi, L. U.; Kawana, H. Y.; Greek, D. C.

1979-01-01

Pilot performance during a terrain following flight was studied for ride quality criteria validation. Data from manual and automatic terrain following operations conducted during low level penetrations were analyzed to determine the effect of ride qualities on crew performance. The conditions analyzed included varying levels of turbulence, terrain roughness, and mission duration with a ride smoothing system on and off. Limited validation of the B-1 ride quality criteria and some of the first order interactions between ride qualities and pilot/vehicle performance are highlighted. An earlier B-1 flight simulation program correlated well with the flight test results.

75 FR 66759 - Science Advisory Board Staff Office; Notification of a Public Meeting of the Science Advisory...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... TSD will describe methods and approaches for developing numeric nutrient criteria for Florida's... support document on development of numeric nutrient criteria for Florida's estuarine and coastal waters...

Potential External (non-DOE) Constraints on U.S. Fuel Cycle Options

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

Steven J. Piet

2012-07-01

The DOE Fuel Cycle Technologies (FCT) Program will be conducting a screening of fuel cycle options in FY2013 to help focus fuel cycle R&D activities. As part of this screening, performance criteria and go/no-go criteria are being identified. To help ensure that these criteria are consistent with current policy, an effort was initiated to identify the status and basis of potentially relevant regulations, laws, and policies that have been established external to DOE. As such regulations, laws, and policies may be beyond DOE’s control to change, they may constrain the screening criteria and internally-developed policy. This report contains a historicalmore » survey and analysis of publically available domestic documents that could pertain to external constraints on advanced nuclear fuel cycles. “External” is defined as public documents outside DOE. This effort did not include survey and analysis of constraints established internal to DOE.« less

A Guide for the Identification of a Student Meriting Special Dropout Prevention Initiatives.

ERIC Educational Resources Information Center

Mizell, M. Hayes

A risk assessment instrument for identifying potential dropouts at the middle and high school levels and an accompanying explanation of the instrument are provided in this document. The instrument provides a checklist of 21 criteria; the more criteria the student meets, the greater his risk of dropping out. Criteria include age in comparison to…

AIR QUALITY CRITERIA FOR LEAD (SECOND EXTERNAL REVIEW DRAFT)

EPA Science Inventory

The Clean Air Act mandates periodic review of the National Ambient Air Quality Standards (NAAQS) for six common air pollutants, also referred to as criteria pollutants, including lead. Under the review process, EPA's Office of Research and Development develops a criteria docu...