Pruning Allegheny hardwoods

Treesearch

W. D. Zeedyk; A. F. Hough

1958-01-01

The continuing heavy demand for high-quality Allegheny hardwoods, particularly black cherry and sugar maple, impresses on us the need for more information responses of hardwoods to pruning. Pruning may have beneficial effects: it may increase quality without sacrificing growth. Or it may have detrimental effects: it may cause dieback of cambium, decay, staining and...

Health and aesthetic impacts of copper corrosion on drinking water.

PubMed

Dietrich, A M; Glindemann, D; Pizarro, F; Gidi, V; Olivares, M; Araya, M; Camper, A; Duncan, S; Dwyer, S; Whelton, A J; Younos, T; Subramanian, S; Burlingame, G A; Khiari, D; Edwards, M

2004-01-01

Traditional research has focused on the visible effects of corrosion--failures, leaks, and financial debits--and often overlooked the more hidden health and aesthetic aspects. Clearly, corrosion of copper pipe can lead to levels of copper in the drinking water that exceed health guidelines and cause bitter or metallic tasting water. Because water will continue to be conveyed to consumers worldwide through metal pipes, the water industry has to consider both the effects of water quality on corrosion and the effects of corrosion on water quality. Integrating four key factors--chemical/biological causes, economics, health and aesthetics--is critical for managing the distribution system to produce safe water that consumers will use with confidence. As technological developments improve copper pipes to minimize scaling and corrosion, it is essential to consider the health and aesthetic effects on an equal plane with chemical/biological causes and economics to produce water that is acceptable for public consumption.

Ecological effects of nitrogen and sulfur air pollution in the US: what do we know?

USGS Publications Warehouse

Greaver, Tara L.; Sullivan, Timothy J.; Herrick, Jeffrey D.; Barber, Mary C.; Baron, Jill S.; Cosby, Bernard J.; Deerhake, Marion E.; Dennis, Robin L.; Dubois, Jean-Jacque B.; Goodale, Christine L.; Herlihy, Alan T.; Lawrence, Gregory B.; Liu, Lingli; Lynch, Jason A.; Novak, Kristopher J.

2012-01-01

Four decades after the passage of the US Clean Air Act, air-quality standards are set to protect ecosystems from damage caused by gas-phase nitrogen (N) and sulfur (S) compounds, but not from the deposition of these air pollutants to land and water. Here, we synthesize recent scientific literature on the ecological effects of N and S air pollution in the US. Deposition of N and S is the main driver of ecosystem acidification and contributes to nutrient enrichment in many natural systems. Although surface-water acidification has decreased in the US since 1990, it remains a problem in many regions. Perturbations to ecosystems caused by the nutrient effects of N deposition continue to emerge, although gas-phase concentrations are generally not high enough to cause phytotoxicity. In all, there is overwhelming evidence of a broad range of damaging effects to ecosystems in the US under current air quality conditions.

40 CFR 93.152 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... official charged with direct responsibility for management of an area designated as Class I under the Act... 301(d) of the Act and which implements the relevant requirements of the Act. Areawide air quality... which uses an air quality dispersion model to determine the effects of emissions on air quality. Cause...

Assessing Educational Processes Using Total-Quality-Management Measurement Tools.

ERIC Educational Resources Information Center

Macchia, Peter, Jr.

1993-01-01

Discussion of the use of Total Quality Management (TQM) assessment tools in educational settings highlights and gives examples of fishbone diagrams, or cause and effect charts; Pareto diagrams; control charts; histograms and check sheets; scatter diagrams; and flowcharts. Variation and quality are discussed in terms of continuous process…

Office-Based Intracordal Hyaluronate Injections Improve Quality of Life in Thoracic-Surgery-Related Unilateral Vocal Fold Paralysis.

PubMed

Fang, Tuan-Jen; Hsin, Li-Jen; Chung, Hsiu-Feng; Chiang, Hui-Chen; Li, Hsueh-Yu; Wong, Alice M K; Pei, Yu-Chen

2015-10-01

Thoracic-surgery-related unilateral vocal fold paralysis (UVFP) may cause severe morbidity and can cause profound functional impairment and psychosocial stress in patients with pre-existing thoracic diseases. In-office intracordal hyaluronate (HA) injections have recently been applied to improve voice and quality of life in patients with vocal incompetence, but their effect on thoracic-surgery-related UVFP remains inconclusive. We therefore conducted a prospective study to clarify the effect of early HA injection on voice and quality of life in patients with thoracic-surgery-related UVFP. Patients with UVFP within 3 months after thoracic surgery who received office-based HA injection were recruited. Quantitative laryngeal electromyography, videolaryngostroboscopy, voice-related life quality (voice outcome survey), laboratory voice analysis, and health-related quality of life (SF-36) were evaluated at baseline, and at 1 month postinjection. A total of 104 consecutive patients accepted office-based HA intracordal injection during the study period, 34 of whom were treated in relation to thoracic surgery and were eligible for inclusion. Voice-related life quality, voice laboratory analysis, and most generic quality of life domains were significantly improved at 1 month after in-office HA intracordal injection. No HA-related complications were reported. Single office-based HA intracordal injection is a safe and effective treatment for thoracic-surgery-related UVFP, resulting in immediate improvements in patient quality of life, voice quality, and swallowing ability.

Quality Tools and TRIZ Based Quality Improvement Case Study at PT ‘X’ A Plastic Moulding Manufacturing Industry

NASA Astrophysics Data System (ADS)

Wirawan, Christina; Chandra, Fory

2016-02-01

Theory of Inventive Problem Solving (TRIZ) is a creative encouraging problem solving method. TRIZ is prepared by Altshuller for product design. Altshuller prepared contradiction matrix and suggestion to solve contradictions usually occur in product design. This paper try to combine TRIZ with quality tools such as Pareto and Fault Tree Analysis (FTA) to solve contradiction in quality improvement problem, neither than product design problem. Pareto used to identify defect priority, FTA used to analysis and identify root cause of defect. When there is contradiction in solving defect causes, TRIZ used to find creative problem solving. As a case study, PT ’X’, a plastic molding manufacturing industry was taken. PT ‘X’ using traditional press machine to produce plastic thread cone. There are 5 defect types that might occur in plastic thread cone production, incomplete form, dirty, mottle, excessive form, rugged. Research about quality improvement effort using DMAIC at PT ‘X’ have been done by Fory Candra. From this research, defect types, priority, root cause from FTA, recommendation from FMEA. In this research, from FTA reviewed, contradictions found among causes troublesome quality improvement efforts. TRIZ used to solve the contradictions and quality improvement effort can be made effectively.

Spatiotemporal influence of temperature, air quality, and urban environment on cause-specific mortality during hazy days.

PubMed

Ho, Hung Chak; Wong, Man Sing; Yang, Lin; Shi, Wenzhong; Yang, Jinxin; Bilal, Muhammad; Chan, Ta-Chien

2018-03-01

Haze is an extreme weather event that can severely increase air pollution exposure, resulting in higher burdens on human health. Few studies have explored the health effects of haze, and none have investigated the spatiotemporal interaction between temperature, air quality and urban environment that may exacerbate the adverse health effects of haze. We investigated the spatiotemporal pattern of haze effects and explored the additional effects of temperature, air pollution and urban environment on the short-term mortality risk during hazy days. We applied a Poisson regression model to daily mortality data from 2007 through 2014, to analyze the short-term mortality risk during haze events in Hong Kong. We evaluated the adverse effect on five types of cause-specific mortality after four types of haze event. We also analyzed the additional effect contributed by the spatial variability of urban environment on each type of cause-specific mortality during a specific haze event. A regular hazy day (lag 0) has higher all-cause mortality risk than a day without haze (odds ratio: 1.029 [1.009, 1.049]). We have also observed high mortality risks associated with mental disorders and diseases of the nervous system during hazy days. In addition, extreme weather and air quality contributed to haze-related mortality, while cold weather and higher ground-level ozone had stronger influences on mortality risk. Areas with a high-density environment, lower vegetation, higher anthropogenic heat, and higher PM 2.5 featured stronger effects of haze on mortality than the others. A combined influence of haze, extreme weather/air quality, and urban environment can result in extremely high mortality due to mental/behavioral disorders or diseases of the nervous system. In conclusion, we developed a data-driven technique to analyze the effects of haze on mortality. Our results target the specific dates and areas with higher mortality during haze events, which can be used for development of health warning protocols/systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

INDOOR AIR PURIFICATION VIA LOW-ENERGY, IN-SITU REGENERATED SILICA-TITANIA COMPOSITES - PHASE I

EPA Science Inventory

“Sick building syndrome,” used to describe acute negative health effects linked to time spent in a building, has been related to poor indoor air quality.  Similarly, poor aircraft cabin air quality has been identified as a cause of negative health effects on pilots and fli...

18 CFR 801.3 - Allocations, diversions, withdrawals and release.

Code of Federal Regulations, 2011 CFR

2011-04-01

... portions of the basin due to drought conditions or other causes. The Commission will act promptly to effect... environmental quality. (4) In the matter of drought, disasters or catastrophes, natural or manmade, which cause...

18 CFR 801.3 - Allocations, diversions, withdrawals and release.

Code of Federal Regulations, 2010 CFR

2010-04-01

... portions of the basin due to drought conditions or other causes. The Commission will act promptly to effect... environmental quality. (4) In the matter of drought, disasters or catastrophes, natural or manmade, which cause...

18 CFR 801.3 - Allocations, diversions, withdrawals and release.

Code of Federal Regulations, 2012 CFR

2012-04-01

... portions of the basin due to drought conditions or other causes. The Commission will act promptly to effect... environmental quality. (4) In the matter of drought, disasters or catastrophes, natural or manmade, which cause...

18 CFR 801.3 - Allocations, diversions, withdrawals and release.

Code of Federal Regulations, 2013 CFR

2013-04-01

... portions of the basin due to drought conditions or other causes. The Commission will act promptly to effect... environmental quality. (4) In the matter of drought, disasters or catastrophes, natural or manmade, which cause...

18 CFR 801.3 - Allocations, diversions, withdrawals and release.

Code of Federal Regulations, 2014 CFR

2014-04-01

... portions of the basin due to drought conditions or other causes. The Commission will act promptly to effect... environmental quality. (4) In the matter of drought, disasters or catastrophes, natural or manmade, which cause...

Implementing Quality Assurance in Saudi Arabia: A Comparison between the MESO and the MICRO Levels at PSU

ERIC Educational Resources Information Center

Albaqami, Saud

2015-01-01

Quality assurance in higher education remains to be one of the most prominent fields of research at the present. In the Saudi Arabian higher education institutions (HEIs), quality assurance is a relatively new concept and Saudi universities seem not to effectively implement quality assurance caused by the certain obstacles. As such, there are two…

Indoor Air Quality in Schools: Clean Air Is Good Business.

ERIC Educational Resources Information Center

Guarneiri, Michele A.

2003-01-01

Describes the effect of poor indoor air quality (IAQ) on student health, the cost of safeguarding good IAQ, the cause of poor IAQ in schools, how to tell whether a school has an IAQ problem, and how the U.S. Environmental Protection Agency can help schools improve indoor air quality though the use of their free "Indoor Air Quality Tools for…

Effects of obesity on lung volume and capacity in children and adolescents: a systematic review

PubMed Central

Winck, Aline Dill; Heinzmann-Filho, João Paulo; Soares, Rafaela Borges; da Silva, Juliana Severo; Woszezenki, Cristhiele Taís; Zanatta, Letiane Bueno

2016-01-01

Abstract Objective: To assess the effects of obesity on lung volume and capacity in children and adolescents. Data source: This is a systematic review, carried out in Pubmed, Lilacs, Scielo and PEDro databases, using the following Keywords: Plethysmography; Whole Body OR Lung Volume Measurements OR Total Lung Capacity OR Functional Residual Capacity OR Residual Volume AND Obesity. Observational studies or clinical trials that assessed the effects of obesity on lung volume and capacity in children and adolescents (0-18 years) without any other associated disease; in English; Portuguese and Spanish languages were selected. Methodological quality was assessed by the Agency for Healthcare Research and Quality. Data synthesis: Of the 1,030 articles, only four were included in the review. The studies amounted to 548 participants, predominantly males, with sample size ranging from 45 to 327 individuals. 100% of the studies evaluated nutritional status through BMI (z-score) and 50.0% reported the data on abdominal circumference. All demonstrated that obesity causes negative effects on lung volume and capacity, causing a reduction mainly in functional residual capacity in 75.0% of the studies; in the expiratory reserve volume in 50.0% and in the residual volume in 25.0%. The methodological quality ranged from moderate to high, with 75.0% of the studies classified as having high methodological quality. Conclusions: Obesity causes deleterious effects on lung volume and capacity in children and adolescents, mainly by reducing functional residual capacity, expiratory reserve volume and residual volume. PMID:27130483

Applying Total Quality Leadership to an Aviation Squadron

DTIC Science & Technology

1991-12-01

was developed in 1950 by Professor Kaoru Ishikawa . (Juran,1988,pp.22.37) It was developed to show the relationship between some fail point or desired...AND-EFmECT DIAGRAM 1. Description of Cause-and-Effect Diagram The cause-and-effect diagram (also known as the Ishikawa diagram or the fishbone diagram

Electrical impedance spectroscopy for quality assessment of meat and fish: A review on basic principles, measurement methods, and recent advances

USDA-ARS?s Scientific Manuscript database

Electrical impedance spectroscopy (EIS), as an effective analytical technique for electrochemical system, has shown a wide application for food quality and safety assessment recently. Individual differences of livestock cause high variation in quality of raw meat and fish and their commercialized pr...

Approach to developing numeric water quality criteria for coastal waters: a transition from SeaWiFS to MODIS and MERIS satellites.

EPA Science Inventory

Human activities on land increase nutrient loads to coastal waters, which can increase phytoplankton production and biomass and potentially cause harmful ecological effects. States can adopt numeric water quality criteria into their water quality standards to protect the designa...

Quality and Efficiency Improvement Tools for Every Radiologist.

PubMed

Kudla, Alexei U; Brook, Olga R

2018-06-01

In an era of value-based medicine, data-driven quality improvement is more important than ever to ensure safe and efficient imaging services. Familiarity with high-value tools enables all radiologists to successfully engage in quality and efficiency improvement. In this article, we review the model for improvement, strategies for measurement, and common practical tools with real-life examples that include Run chart, Control chart (Shewhart chart), Fishbone (Cause-and-Effect or Ishikawa) diagram, Pareto chart, 5 Whys, and Root Cause Analysis. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

An efficient transmission power control scheme for temperature variation in wireless sensor networks.

PubMed

Lee, Jungwook; Chung, Kwangsue

2011-01-01

Wireless sensor networks collect data from several nodes dispersed at remote sites. Sensor nodes can be installed in harsh environments such as deserts, cities, and indoors, where the link quality changes considerably over time. Particularly, changes in transmission power may be caused by temperature, humidity, and other factors. In order to compensate for link quality changes, existing schemes detect the link quality changes between nodes and control transmission power through a series of feedback processes, but these approaches can cause heavy overhead with the additional control packets needed. In this paper, the change of the link quality according to temperature is examined through empirical experimentation. A new power control scheme combining both temperature-aware link quality compensation and a closed-loop feedback process to adapt to link quality changes is proposed. We prove that the proposed scheme effectively adapts the transmission power to the changing link quality with less control overhead and energy consumption.

USDA Forest Service national protocols for sampling air pollution-sensitive waters

Treesearch

T. J. Sullivan

2012-01-01

The first step in designing a surface water sampling program is identifying one or more problems or questions that require information on water quality. Common water quality problems include nutrient enrichment (from a variety of causes), effects of atmospheric deposition (acidification, eutrophication, toxicity), and effects of major disturbances such as fire or pest...

Summary of the effects of engine throttle response on airplane formation-flying qualities

NASA Technical Reports Server (NTRS)

Walsh, Kevin R.

1992-01-01

A flight evaluation as conducted to determine the effect of engine throttle response characteristics on precision formation-flying qualities. A variable electronic throttle control system was developed and flight-tested on a TF-104G airplane with a J79-11B engine at the NASA Dryden Flight Research Facility. Ten research flights were flown to evaluate the effects of throttle gain, time delay, and fuel control rate limiting on engine handling qualities during a demanding precision wing formation task. Handling quality effects of lag filters and lead compensation time delays were also evaluated. Data from pilot ratings and comments indicate that throttle control system time delays and rate limits cause significant degradations in handling qualities. Threshold values for satisfactory (level 1) and adequate (level 2) handling qualities of these key variables are presented.

Theoretical Investigation For The Effect of Fuel Quality on Gas Turbine Power Plants

NASA Astrophysics Data System (ADS)

AbdulRazzak khudair, Omar; Alwan Abass, Khetam; Saadi Abed, Noor; Hussain Ali, Khalid; AbdulAziz, Saad; Chlaib Shaboot, Ali

2018-05-01

Gas turbine engine power generation is declined dramatically because of the reduction in thermodynamic parameters as a work of turbine, compressor ratio, compressor work, and air mass flow rate and fuel consumption. There are two main objectives of this work, the first is related with the effect of fuel kinds and their quality on the operation of fuel flow divider and its performance specifically gear pump displacement and fuel flow rate to the combustion chambers of gas power plant. AL-DORA gas turbine power plant 35MW was chosen to predict these effects on its performance MATLAB Software program is used to perform thermodynamic calculations. Fuel distribution stage before the process of combustion and as a result of the kind and its quality, chemical reaction will occur between the fuel and the parts of the gear system of each pump of the flow divider, which causes the erosion of the internal pump wall and the teeth of the gear system, thus hampering the pump operation in terms of fuel discharge. The discharge of fuel form the eight external gates of flow divider is decreased and varied when going to the combustion chambers, so that, flow divider does not give reliable mass flow rate due to absence of accurate pressure in each of eight exit pipes. The second objective deals with the stage of fuel combustion process inside the combustion chamber. A comparative study based upon performance parameters, such as specific fuel consumption for gas and gasoil and power generation. Fuel poor quality causes incomplete combustion and increased its consumption, so that combustion products are interacted with the surface of the turbine blades, causing the erosion and create surface roughness of the blade and disruption of gas flow. As a result of this situation, turbulence flow of these gases will increase causing the separation of gas boundary layers over the suction surface of the blade. Therefore the amount of extracted gas will decrease causing retreat work done by turbine, as a result decline of power and gas turbine power plant efficiency causing the drop in the level of electric generation. The fuel quality is found to be a strong function of specific fuel consumption and its effects on the power generation and the efficiency of the gas turbine power plants and hence, the cycle performance shifts towards favorable conditions.

Quality circles: the nurse executive as mentor.

PubMed

Flarey, D L

1991-12-01

Changes within and around the health care environment are forcing health care executives to reexamine their managerial and leadership styles to confront the resulting turbulence. The nurse executive is charged with the profound responsibility of directing the delivery of nursing care throughout the organization. Care delivered today must be of high quality. Declining financial resources as well as personnel shortages cause the executive to be an effective innovator in meeting the increasing demands. Quality circles offer the nurse executive an avenue of recourse. Circles have been effectively implemented in the health care setting, as has been consistently documented over time. By way of a participative management approach, quality circles may lead to increased employee morale and productivity, cost savings, and decreased employee turnover rates, as well as realization of socialization and self-actualization needs. A most effective approach to their introduction would be implementation at the first-line manager level. This promotes an acceptance of the concept at the management level as well as a training course for managers to implement the process at the unit level. The nurse executive facilitates the process at the first-line manager level. This facilitation will cause a positive outcome to diffuse throughout the entire organization. Quality circles offer the nurse executive the opportunity to challenge the existing environmental turmoil and effect a positive and lasting change.

Long-term Effects of Child Death on Parents' Health Related Quality of Life: A Dyadic Analysis

PubMed Central

Song, Jieun; Floyd, Frank J.; Seltzer, Marsha Mailick; Greenberg, Jan S.; Hong, Jinkuk

2010-01-01

This study examines the long-term effects of child death on bereaved parents' health-related quality of life (HRQoL). Using data from the Wisconsin Longitudinal Study, we compared 233 bereaved couples and 229 comparison couples (mean age = 65.11 years) and examined the life course effects of child death on parents' HRQoL. Variations in bereavement effects were examined by gender and for different causes of death. Bereaved parents had significantly worse HRQoL than comparison group parents, and there was no evidence of gender differences for this effect. With respect to the cause of a child's death, bereaved parents whose child died in violent circumstances had particularly low levels of HRQoL. Multilevel models indicated that marital closeness mitigated the negative effects of bereavement. PMID:20676393

40 CFR 230.11 - Factual determinations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... changes will cause violations of applicable water quality standards. Consideration should also be given to..., particularly concentrations of constituents, amount of material, type of material (sand, silt, clay, etc.) and... the productivity and water quality of existing aquatic ecosystems. (2) Cumulative effects attributable...

Use of low-dose UV-C irradiation to control powdery mildew caused by Podosphaera aphanis on strawberry plants

USDA-ARS?s Scientific Manuscript database

Powdery mildew of strawberry plants, caused by Podoshaera aphanis, can cause severe losses by reducing fruit yield, quality and predisposing fruit to other diseases. Fungicides have been routinely used to control this disease. However, limitations mainly related to their effectiveness, re-entry pe...

77 FR 55144 - Ocean Dumping; Designation of Ocean Dredged Material Disposal Sites Offshore of Yaquina Bay, Oregon

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... minimize that conflict. (2) Sites must be situated such that temporary perturbations to water quality or... detectable contaminant concentrations or water quality effects, e.g., suspended solids, would be expected to... activities on water quality is expected to be temporary turbidity caused by the physical movement of sediment...

Breakdown Cause and Effect Analysis. Case Study

NASA Astrophysics Data System (ADS)

Biały, Witold; Ružbarský, Juraj

2018-06-01

Every company must ensure that the production process proceeds without interferences. Within this article, the author uses the term "interferences" in reference to unplanned stoppages caused by breakdowns. Unfortunately, usually due to machine operators' mistakes, machines break, which causes stoppages thus generating additional costs for the company. This article shows a cause and effect analysis of a breakdown in a production process. The FMEA as well as quality management tools: the Ishikawa diagram and Pareto chart were used for the analysis. Correction measures were presented which allowed for a significant reduction in the number of stoppages caused by breakdowns.

Low Voltage Activated Calcium Channels - Their Role in HER2 Driven Breast Cancer and Potential as a New Therapeutic Target

DTIC Science & Technology

2016-10-01

combined with chemotherapy , but chemotherapy causes undesirable side effects due to off-target effects on normal tissue, which diminishes quality of life...highest response rates when combined with chemotherapy , but chemotherapy causes undesirable side effects due to off-target effects on normal...patients. Therefore, the overall goal of this proposal is to develop a tumor-specific, safe and effective therapy for breast cancer. We concentrate on

Defense Manufacturing Management Guide for Program Managers, Third Edition

DTIC Science & Technology

1989-04-01

Crosby (Quality goals of quality, cost, schedule, mission need, College), Genechi Taguchi (Experimental 5-1 Design), Dr. Kaoru Ishikawa (Cause/Effect...the remaining problems were resolved. 5-7 6. Ishikawa Diagram 7. Control Charts This technique was developed by Dr. In the minds of some quality Kaoru ... Ishikawa , one of the foremost professionals and nonprofesslonals alike, the authorities on quality control in Japan. The control chart is synonymous

MICROORGANISMS DIE-OFF RATES IN URBAN STORMWATER RUNOFF

EPA Science Inventory

Urban stormwater runoff, a leading cause of water quality impairment related to human activities in lakes and reservoirs, can have significant negative effects on receiving water quality. It can also create human health concerns when these waters are used for drinking water reso...

Potential impacts of changing supply-water quality on drinking water distribution: A review.

PubMed

Liu, Gang; Zhang, Ya; Knibbe, Willem-Jan; Feng, Cuijie; Liu, Wentso; Medema, Gertjan; van der Meer, Walter

2017-06-01

Driven by the development of water purification technologies and water quality regulations, the use of better source water and/or upgraded water treatment processes to improve drinking water quality have become common practices worldwide. However, even though these elements lead to improved water quality, the water quality may be impacted during its distribution through piped networks due to the processes such as pipe material release, biofilm formation and detachment, accumulation and resuspension of loose deposits. Irregular changes in supply-water quality may cause physiochemical and microbiological de-stabilization of pipe material, biofilms and loose deposits in the distribution system that have been established over decades and may harbor components that cause health or esthetical issues (brown water). Even though it is clearly relevant to customers' health (e.g., recent Flint water crisis), until now, switching of supply-water quality is done without any systematic evaluation. This article reviews the contaminants that develop in the water distribution system and their characteristics, as well as the possible transition effects during the switching of treated water quality by destabilization and the release of pipe material and contaminants into the water and the subsequent risks. At the end of this article, a framework is proposed for the evaluation of potential transition effects. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of obesity on lung volume and capacity in children and adolescents: a systematic review.

PubMed

Winck, Aline Dill; Heinzmann-Filho, João Paulo; Soares, Rafaela Borges; da Silva, Juliana Severo; Woszezenki, Cristhiele Taís; Zanatta, Letiane Bueno

2016-12-01

To assess the effects of obesity on lung volume and capacity in children and adolescents. This is a systematic review, carried out in Pubmed, Lilacs, Scielo and PEDro databases, using the following Keywords: Plethysmography; Whole Body OR Lung Volume Measurements OR Total Lung Capacity OR Functional Residual Capacity OR Residual Volume AND Obesity. Observational studies or clinical trials that assessed the effects of obesity on lung volume and capacity in children and adolescents (0-18 years) without any other associated disease; in English; Portuguese and Spanish languages were selected. Methodological quality was assessed by the Agency for Healthcare Research and Quality. Of the 1,030 articles, only four were included in the review. The studies amounted to 548 participants, predominantly males, with sample size ranging from 45 to 327 individuals. 100% of the studies evaluated nutritional status through BMI (z-score) and 50.0% reported the data on abdominal circumference. All demonstrated that obesity causes negative effects on lung volume and capacity, causing a reduction mainly in functional residual capacity in 75.0% of the studies; in the expiratory reserve volume in 50.0% and in the residual volume in 25.0%. The methodological quality ranged from moderate to high, with 75.0% of the studies classified as having high methodological quality. Obesity causes deleterious effects on lung volume and capacity in children and adolescents, mainly by reducing functional residual capacity, expiratory reserve volume and residual volume. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Simulation analysis of space remote sensing image quality degradation induced by satellite platform vibration

NASA Astrophysics Data System (ADS)

Yang, Feng; Zhang, Xiaofang; Huang, Yu; Hao, Weiwei; Guo, Baiwei

2012-11-01

Satellite platform vibration causes the image quality to be degraded, it is necessary to study its influence on image quality. The forms of Satellite platform vibration consist of linear vibration, sinusoidal vibration and random vibration. Based on Matlab & Zemax, the simulation system has been developed for simulating impact caused by satellite platform vibration on image quality. Dynamic Data Exchange is used for the communication between Matlab and Zemax. The data of sinusoidal vibration are produced by sinusoidal curve with specific amplitude and frequency. The data of random vibration are obtained by combining sinusoidal signals with 10Hz, 100Hz and 200Hz's frequency, 100, 12, 1.9's amplitude and white noise with zero mean value. Satellite platform vibration data which produced by Matlab are added to the optical system, and its point spread function can be obtained by Zemax. Blurred image can be gained by making the convolution of PSF and the original image. The definition of the original image and the blurred image are evaluated by using average gradient values of image gray. The impact caused by the sine and random vibration of six DOFs on the image quality are respectively simulated. The simulation result reveal that the decenter of X-, Y-, Z- direction and the tilt of Z-direction have a little effect on image quality, while the tilt of X-, Y- direction make image quality seriously degraded. Thus, it can be concluded that correcting the error of satellite platform vibration by FSM is a viable and effective way.

Age-related macular degeneration: economic burden and value-based medicine analysis.

PubMed

Brown, Melissa M; Brown, Gary C; Stein, Joshua D; Roth, Zachary; Campanella, Joseph; Beauchamp, George R

2005-06-01

It can be estimated that 17,100 new cases of neovascular (wet) AMD and 180,000 new cases of geographic-atrophy (dry) AMD occur in Canada annually. In addition to having a devastating effect on patients' lives, the condition causes significant adverse consequences for the economy. The deleterious effect of AMD on quality of life is markedly underestimated by ophthalmologists who treat patients with AMD, by non-ophthalmic physicians and by the public. In fact, patients with different degrees of severity of AMD have a perceived impairment of their quality of life that is 96% to 750% greater than the impairment estimated by treating ophthalmologists. Mild AMD causes a 17% decrease in the quality of life of the average patient, a decrease similar to that encountered with symptomatic human immunodeficiency virus infection or moderate cardiac angina. Moderate AMD produces a 40% decrease in quality of life, a decrease similar to that associated with permanent renal dialysis or severe cardiac angina. Very severe AMD causes a 63% decrement in quality of life, a decrease similar to that encountered with advanced prostatic cancer with uncontrollable pain or a severe stroke that leaves a person bedridden, incontinent and requiring constant nursing care. The adverse economic consequences of AMD include an annual $2.6 billion negative impact on Canada's gross domestic product. The return on investment is high for both current AMD therapies and research into new treatment modalities.

The effect of an industrial effluent on an urban stream benthic community: water quality vs habitat quality.

PubMed

Nedeau, Ethan J; Merritt, Richard W; Kaufman, Michael G

2003-01-01

We studied the effect of an industrial effluent on the water quality, habitat quality, and benthic macroinvertebrates of an urban stream in southwestern Michigan (USA). The effluent affected water quality by raising in-stream temperatures 13-18 degree C during colder months and carrying high amounts of iron (> 20 x higher than ambient) that covered the streambed. The effluent also affected habitat conditions by increasing total stream discharge by 50-150%, causing a significant change in substrate and flow conditions. We used three methods to collect benthic macroinvertebrates in depositional and erosional habitats and to understand the relative importance of habitat quality and water quality alterations. Macroinvertebrate response variables included taxonomic richness, abundance, and proportional abundance of sensitive taxonomic groups. Results indicated that the effluent had a positive effect on macroinvertebrate communities by increasing the quantity of riffle habitat, but a negative effect on macroinvertebrate communities by reducing water quality. Results illustrated the need for careful consideration of habitat quality and water quality in restoration or remediation programs.

Social-psychological implications for recreation resource planning

Treesearch

Hardeep S. Bhullar; Alan R. Everson; Scout L. Gunn

1980-01-01

Many claims have been made concerning the cause/effect relationship between recreation and leisure activity, and the acquisition of quality living. Studies have investigated the utility, quality, and quantity of recreation facilities. Studies of programs, leadership, members, and general classifications of users have also been conducted.

MICROORGANISMS DIE-OFF RATES IN URBAN STORMWATER RUNOFF, 2006

EPA Science Inventory

Urban stormwater runoff is a leading cause of water quality impairment related to human activities in lakes and reservoirs. It can have significant negative effects on receiving water quality and can create human health concerns when these waters are used for drinking water resou...

Assessment of heavy metal impact on sediment quality of the Xiaoqinghe estuary in the coastal Laizhou Bay, Bohai Sea: inconsistency between two commonly used criteria.

PubMed

Zhuang, Wen; Gao, Xuelu

2014-06-15

Surface sediments in the Xiaoqinghe estuary, southwestern coastal Laizhou Bay, were examined to assess the bio-toxic risk of heavy metals (Cd, Cu, Ni, Pb and Zn) with the effects range-low and effects range-median guidelines (ERL-ERMs) and the concentration ratio of simultaneously extractable metals to acid volatile sulfides ([SEM]/[AVS]). Based on the ERL-ERM guidelines, bio-toxic effect caused by Cu, Ni, Pb and Zn could be expected in the riverine surface sediments of the Xiaoqinghe estuary; and the surface sediments in the marine area were in good quality and only Ni might cause bio-toxic effect occasionally. The AVS-SEM guidelines revealed that no bio-toxic effect could be caused by any of the studied metals in both the riverine and marine sediments, since there were excess sulfides in surface sediments which could form water-insoluble substances with free metal ions and reduce the bioavailability of heavy metals. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Logistic Life Cycle Cost-Benefit Analysis of Power Quality Management in the Avionics Repair Facility

DTIC Science & Technology

1998-06-01

quality management can have on the intermediate level of maintenance. Power quality management is a preventative process that focuses on identifying and correcting problems that cause bad power. Using cost-benefit analysis we compare the effects of implementing a power quality management program at AIMD Lemoore and AIMD Fallon. The implementation of power quality management can result in wide scale logistical support changes in regards to the life cycle costs of maintaining the DoD’s current inventory

Defining the best quality-control systems by design and inspection.

PubMed

Hinckley, C M

1997-05-01

Not all of the many approaches to quality control are equally effective. Nonconformities in laboratory testing are caused basically by excessive process variation and mistakes. Statistical quality control can effectively control process variation, but it cannot detect or prevent most mistakes. Because mistakes or blunders are frequently the dominant source of nonconformities, we conclude that statistical quality control by itself is not effective. I explore the 100% inspection methods essential for controlling mistakes. Unlike the inspection techniques that Deming described as ineffective, the new "source" inspection methods can detect mistakes and enable corrections before nonconformities are generated, achieving the highest degree of quality at a fraction of the cost of traditional methods. Key relationships between task complexity and nonconformity rates are also described, along with cultural changes that are essential for implementing the best quality-control practices.

Effect of Strip Mining on Water Quality in Small Streams in Eastern Kentucky, 1967-1975

Treesearch

Kenneth L. Dyer; Willie R. Curtis

1977-01-01

Eight years of streamflow data are analyzed to show the effects of strip mining on chemical quality of water in six first-order streams in Breathitt County, Kentucky. All these watersheds were unmined in August, 1967, but five have since been strip mined. The accumulated data from this case history study indicate that strip mining causes large increases in the...

Root-Cause Analysis of Persistently High Maternal Mortality in a Rural District of Indonesia: Role of Clinical Care Quality and Health Services Organizational Factors.

PubMed

Mahmood, Mohammad Afzal; Mufidah, Ismi; Scroggs, Steven; Siddiqui, Amna Rehana; Raheel, Hafsa; Wibdarminto, Koentijo; Dirgantoro, Bernardus; Vercruyssen, Jorien; Wahabi, Hayfaa A

2018-01-01

Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants. Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays. The root causes were found in poor quality of care, which caused hospital to be unprepared to manage deteriorating patients. In hospital, poor implementation of standard operating procedures was rooted in inadequate skills, lack of forward planning, ineffective communication, and unavailability of essential services. In primary care, root causes included inadequate risk management, referrals to facilities where needed services are not available, and lack of coordination between primary healthcare and hospitals. There is an urgent need for a shift in focus to quality of care through knowledge, skills, and support for consistent application of protocols, making essential services available, effective risk assessment and management, and facilitating timely referrals to facilities that are adequately equipped.

Root-Cause Analysis of Persistently High Maternal Mortality in a Rural District of Indonesia: Role of Clinical Care Quality and Health Services Organizational Factors

PubMed Central

Mufidah, Ismi; Scroggs, Steven; Siddiqui, Amna Rehana; Raheel, Hafsa; Wibdarminto, Koentijo; Dirgantoro, Bernardus; Vercruyssen, Jorien

2018-01-01

Background Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants. Method Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays. Findings The root causes were found in poor quality of care, which caused hospital to be unprepared to manage deteriorating patients. In hospital, poor implementation of standard operating procedures was rooted in inadequate skills, lack of forward planning, ineffective communication, and unavailability of essential services. In primary care, root causes included inadequate risk management, referrals to facilities where needed services are not available, and lack of coordination between primary healthcare and hospitals. Conclusion There is an urgent need for a shift in focus to quality of care through knowledge, skills, and support for consistent application of protocols, making essential services available, effective risk assessment and management, and facilitating timely referrals to facilities that are adequately equipped. PMID:29682538

HEPATOTROPHIC EFFECTS OF FK506 IN DOGS1

PubMed Central

Starzl, Thomas E.; Porter, Kendrick A.; Mazzaferro, Vincenzo; Todo, Satoru; Fung, John; Francavilla, Antonio

2010-01-01

Portacaval shunt (Eck fistula) in dogs causes hepatocyte atrophy and organelle disruption, as well as tripling of hepatocyte mitoses. After submitting dogs to this procedure, FK506 was infused into the tied-off left portal vein. The size, anatomic quality, and replication of hepatocytes were enhanced in the portion of liver infused with FK506, with a significant spillover effect in the noninfused portion. These hepatotrophic qualities of FK506 may explain part of FK506’s efficacy for the treatment of chronic liver rejection. Also, the observations support a trial with this drug for the treatment of autoimmune liver diseases because, in addition to turning off the immunologic genesis of such disorders, repair and regeneration of the damaged liver may be augmented. Finally, these hepatrophic qualities are part of an emerging spectrum of biologic effects caused by drugs that may modulate the enzyme cis-trans peptidyl-prolyl isomerase (PPIase), the principal constituent of the cytosolic binding sites of FK506, repamycin, cyclosporine, and presumably other immunosuppressive drugs as yet undiscovered. PMID:1702912

Effect of Novel Quick Freezing Techniques Combined with Different Thawing Processes on Beef Quality

PubMed Central

Yoo, Seon-Mi; Han, Gui-Jung

2014-01-01

This study investigated the effect of various freezing and thawing techniques on the quality of beef. Meat samples were frozen using natural convection freezing (NF), individual quick freezing (IQF), or cryogenic freezing (CF) techniques, followed by natural convection thawing (NCT) or running water thawing (RT). The meat was frozen until the core temperature reached -12℃ and then stored at -24℃, followed by thawing until the temperature reached 5℃. Quality parameters, such as the pH, water binding properties, CIE color, shear force, and microstructure of the beef were elucidated. Although the freezing and thawing combinations did not cause remarkable changes in the quality parameters, rapid freezing, in the order of CF, IQF, and NF, was found to minimize the quality deterioration. In the case of thawing methods, NCT was better than RT and the meat quality was influence on the thawing temperature rather than the thawing rate. Although the microstructure of the frozen beef exhibited an excessive loss of integrity after the freezing and thawing, it did not cause any remarkable change in the beef quality. Taken together, these results demonstrate that CF and NCT form the best combination for beef processing; however, IQF and NCT may have practical applications in the frozen food industry. PMID:26761674

Effects of Artificial Supercooling Followed by Slow Freezing on the Microstructure and Qualities of Pork Loin

PubMed Central

2016-01-01

This study investigated the effects of artificial supercooling followed by still air freezing (SSF) on the qualities of pork loin. The qualities of pork frozen by SSF were compared with the fresh control (CT, stored at 4℃ for 24 h), slow freezing (SAF, still air freezing) and rapid freezing (EIF, ethanol immersion freezing) treatments. Compared with no supercooling phenomena of SAF and EIF, the extent of supercooling obtained by SSF treatment was 1.4℃. Despite that SSF was conducted with the same method with SAF, application of artificial supercooling accelerated the phase transition (traverse from -0.6℃ to -5℃) from 3.07 h (SAF) to 2.23 h (SSF). The observation of a microstructure indicated that the SSF prevented tissue damage caused by ice crystallization and maintained the structural integrity. The estimated quality parameters reflected that SSF exhibited superior meat quality compared with slow freezing (SAF). SSF showed better water-holding capacity (lower thawing loss, cooking loss and expressible moisture) and tenderness than SAF, and these quality parameters of SSF were not significantly different with ultra-fast freezing treatment (EIF). Consequently, the results demonstrated that the generation of supercooling followed by conventional freezing potentially had the advantage of minimizing the quality deterioration caused by the slow freezing of meat. PMID:27857541

Do interruptions affect quality of work?

PubMed

Foroughi, Cyrus K; Werner, Nicole E; Nelson, Erik T; Boehm-Davis, Deborah A

2014-11-01

The aim of this study was to determine if interruptions affect the quality of work. Interruptions are commonplace at home and in the office. Previous research in this area has traditionally involved time and errors as the primary measures of disruption. Little is known about the effect interruptions have on quality of work. Fifty-four students outlined and wrote three essays using a within-subjects design. During Condition 1, interruptions occurred while participants were outlining. During Condition 2, interruptions occurred while they were writing. No interruptions occurred in Condition 3. Quality of work was significantly reduced in both interruption conditions when compared to the non-interruption condition. The number of words produced was significantly reduced when participants were interrupted while writing the essay but not when outlining the essay. This research represents a crucial first step in understanding the effect interruptions have on quality of work. Our research suggests that interruptions negatively impact quality of work during a complex, creative writing task. Since interruptions are such a prevalent part of daily life, more research needs to be conducted to determine what other tasks are negatively impacted. Moreover, the underlying mechanism(s) causing these decrements needs to be identified. Finally, strategies and systems need to be designed and put in place to help counteract the decline in quality of work caused by interruptions.

Interactions between antiepileptic drugs and hormones.

PubMed

Svalheim, Sigrid; Sveberg, Line; Mochol, Monika; Taubøll, Erik

2015-05-01

Antiepileptic drugs (AEDs) are known to have endocrine side effects in both men and women. These can affect fertility, sexuality, thyroid function, and bone health, all functions of major importance for well-being and quality of life. The liver enzyme inducing antiepileptic drugs (EIAEDs), like phenobarbital, phenytoin, and carbamazepine, and also valproate (VPA), a non-EIAED, are most likely to cause such side effects. AED treatment can alter the levels of different sex hormones. EIAEDs increase sex hormone binding globulin (SHBG) concentrations in both men and women. Over time, this elevation can lead to lower levels of bioactive testosterone and estradiol, which may cause menstrual disturbances, sexual problems, and eventually reduced fertility. VPA can cause weight gain in both men and women. In women, VPA can also lead to androgenization with increased serum testosterone concentrations, menstrual disturbances, and polycystic ovaries. Lamotrigine has not been shown to result in endocrine side effects. The newer AEDs have not yet been thoroughly studied, but case reports indicate that some of these drugs could also be suspected to cause such effects if endocrine changes commence after treatment initiation. It is important to be aware of possible endocrine side effects of AEDs as they can have a major impact on quality of life, and are, at least partly, reversible after AED discontinuation. Copyright © 2015. Published by Elsevier Ltd.

Defect Analysis Of Quality Palm Kernel Meal Using Statistical Quality Control In Kernels Factory

NASA Astrophysics Data System (ADS)

Sembiring, M. T.; Marbun, N. J.

2018-04-01

The production quality has an important impact retain the totality of characteristics of a product or service to pay attention to its capabilities to meet the needs that have been established. Quality criteria Palm Kernel Meal (PKM) set Factory kernel is as follows: oil content: max 8.50%, water content: max 12,00% and impurity content: max 4.00% While the average quality of the oil content of 8.94%, the water content of 5.51%, and 8.45% impurity content. To identify the defective product quality PKM produced, then used a method of analysis using Statistical Quality Control (SQC). PKM Plant Quality Kernel shows the oil content was 0.44% excess of a predetermined maximum value, and 4.50% impurity content. With excessive PKM content of oil and dirt cause disability content of production for oil, amounted to 854.6078 kg PKM and 8643.193 kg impurity content of PKM. Analysis of the results of cause and effect diagram and SQC, the factors that lead to poor quality of PKM is Ampere second press oil expeller and hours second press oil expeller.

Effectiveness of chronic obstructive pulmonary disease-management programs: systematic review and meta-analysis.

PubMed

Peytremann-Bridevaux, Isabelle; Staeger, Philippe; Bridevaux, Pierre-Olivier; Ghali, William A; Burnand, Bernard

2008-05-01

Disease-management programs may enhance the quality of care provided to patients with chronic diseases, such as chronic obstructive pulmonary disease (COPD). The aim of this systematic review was to assess the effectiveness of COPD disease-management programs. We conducted a computerized search of MEDLINE, EMBASE, CINAHL, PsychINFO, and the Cochrane Library (CENTRAL) for studies evaluating interventions meeting our operational definition of disease management: patient education, 2 or more different intervention components, 2 or more health care professionals actively involved in patients' care, and intervention lasting 12 months or more. Programs conducted in hospital only and those targeting patients receiving palliative care were excluded. Two reviewers evaluated 12,749 titles and fully reviewed 139 articles; among these, data from 13 studies were included and extracted. Clinical outcomes considered were all-cause mortality, lung function, exercise capacity (walking distance), health-related quality of life, symptoms, COPD exacerbations, and health care use. A meta-analysis of exercise capacity and all-cause mortality was performed using random-effects models. The studies included were 9 randomized controlled trials, 1 controlled trial, and 3 uncontrolled before-after trials. Results indicate that the disease-management programs studied significantly improved exercise capacity (32.2 m, 95% confidence interval [CI], 4.1-60.3), decreased risk of hospitalization, and moderately improved health-related quality of life. All-cause mortality did not differ between groups (pooled odds ratio 0.84, 95% CI, 0.54-1.40). COPD disease-management programs modestly improved exercise capacity, health-related quality of life, and hospital admissions, but not all-cause mortality. Future studies should explore the specific elements or characteristics of these programs that bring the greatest benefit.

Recent advances in drying and dehydration of fruits and vegetables: a review.

PubMed

Sagar, V R; Suresh Kumar, P

2010-01-01

Fruits and vegetables are dried to enhance storage stability, minimize packaging requirement and reduce transport weight. Preservation of fruits and vegetables through drying based on sun and solar drying techniques which cause poor quality and product contamination. Energy consumption and quality of dried products are critical parameters in the selection of drying process. An optimum drying system for the preparation of quality dehydrated products is cost effective as it shortens the drying time and cause minimum damage to the product. To reduce the energy utilization and operational cost new dimensions came up in drying techniques. Among the technologies osmotic dehydration, vacuum drying, freeze drying, superheated steam drying, heat pump drying and spray drying have great scope for the production of quality dried products and powders.

Effect of ambiguities on SAR picture quality

NASA Technical Reports Server (NTRS)

Korwar, V. N.; Lipes, R. G.

1978-01-01

The degradation of picture quality in a high-resolution, large-swath SAR mapping system caused by speckle, additive white Gaussian noise and range and azimuthal ambiguities occurring because of the nonfinite antenna pattern produced by a square aperture antenna was studied and simulated. The effect of the azimuth antenna pattern was accounted for by calculating the azimuth ambiguity function. Range ambiguities were accounted for by adding, to each pixel of interest, appropriate pixels at a range separation corresponding to one pulse repetition period, but attenuated by the antenna pattern. It is concluded that azimuth ambiguities do not cause any noticeable degradation (for large time bandwidth product systems, at least) but range ambiguities might.

Defective Reduction in Automotive Headlining Manufacturing Process

NASA Astrophysics Data System (ADS)

Rittichai, Saranya; Chutima, Parames

2016-05-01

In an automobile parts manufacturing company, currently the headlining process has a lot of wastes resulting in a high cost of quality per year. In this paper, the Six Sigma method is used to reduce the defects in the headlining process. Cause-and-effect matrix and failure mode and effect analysis (FMEA) were adopted to screen the factors that affect the quality of headlining. The 2k-1 fractional factorials design was also use to determine the potential preliminary root causes. The full factorial experiments was conducted to identify appropriate settings of the significant factors. The result showed that the process can reduce the defects of headlining from 12.21% to 6.95%

Effect of alternative postharvest control treatments on the storability of 'Golden Delicious' apples.

PubMed

Moscetti, Roberto; Carletti, Letizia; Monarca, Danilo; Cecchini, Massimo; Stella, Elisabetta; Massantini, Riccardo

2013-08-30

Apples are subject to a high degree of fungal diseases, but the use of synthetic fungicides has been questioned because of public safety concerns, social rejection, and the development of resistance in pathogens. Thus, development of new postharvest treatments against apple fungal pathogens is necessary. Most studies have reported their effectiveness, but not all report the effects on the quality and storability of the fruit. In this study, the effects of physical (hot water), chemical (quercetin) and biological (yeast antagonist) microfungal control on the quality of 'Golden Delicious' apple during storage at 2 ± 0.5 °C, and 90 ± 2% of relative humidity, for 2 months were investigated and compared. Heat-treated apples exhibited peel fruit damage (surface browning and internal breakdown disorders) and promoted ripening in the fruit. The quercetin caustic spray caused the development of peel chemical burn in all treated fruit. Both yeast antagonist and quercetin treatments did not affect the apple ripening process but stimulated an increase in ethylene production and in respiratory activity. The data indicated that the effects on quality and storability were dependent on the method of treatment used, and antagonistic yeast was the best microfungal control because of it did not cause any disorders or negative effects on apple quality during storage. © 2013 Society of Chemical Industry.

Design of an instrument to measure the quality of care in Physical Therapy.

PubMed

Cavalheiro, Leny Vieira; Eid, Raquel Afonso Caserta; Talerman, Claudia; Prado, Cristiane do; Gobbi, Fátima Cristina Martorano; Andreoli, Paola Bruno de Araujo

2015-01-01

To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care.

Simulation and Experiment of Air Quality Effects of Prescribed Fires in the Southeast

Treesearch

Yongqiang Liu; Gary Achtemeier; Scott Goodrick

2005-01-01

Wildfires can cause degradation of air quality by releasing large amounts of particulate matter (PM) and precursors of ozone (Sandberg et al., 1999; Riebau and Fox, 2001). EPA has issued the Interim Air Quality Policy on Wildland and Prescribed Fire to protect public health and welfare by mitigating the impacts of air pollutant emissions from wildland fires on air...

Improving the accuracy of total quality management instruments.

PubMed

Bechtel, G A; Wood, D

1996-03-01

Total quality management (TQM) instruments are essential tools in defining concepts identified in an Ishikawa or ¿cause-and-effect¿ diagram. Collecting meaningful and accurate data using TQM instruments is imperative if productivity and quality of care are to be enhanced. This article provides managers with techniques and guidelines that will enhance the reliability and validity of TQM instruments, thereby promoting organization efficiency and customer satisfaction.

Evaluation of commercial soybean cultivars for reaction to Phomopsis seed decay

USDA-ARS?s Scientific Manuscript database

Phomopsis seed decay (PSD), caused by Phomopsis longicolla (syn. Diaporthe longicolla), is an economically important soybean disease causing poor seed quality. Planting resistant cultivars is one of the most effective means to control PSD. In this study, 16 commercially available maturity groups IV ...

Soil quality is fundamental to ensuring healthy forests

Treesearch

Deborah Page-Dumroese; Martin Jurgensen; Dan Neary; Mike Curran; Carl Trettin

2010-01-01

Government agencies, industrial landowners, and private landowners often strive to maintain soil quality after site management activities in order to maintain site productivity, hydrologic function, and ecosystem health. Soil disturbance resulting from timber harvesting, prescribed fire, or site preparation activities can cause declines, improvements, or have no effect...

The Potential Importance of Conservation, Restoration, and Altered Management Practices for Water Quality in the Wabash River Watershed

EPA Science Inventory

Non-point source (NPS) pollution is one of the leading causes of water quality impairment within the United States. Conservation, restoration and altered management (CRAM) practices may effectively reduce NPS pollutants discharge into receiving water bodies and enhance local and ...

Soil quality is fundamental to ensuring healthy forests

Treesearch

D. Page-Dumroese; M. Jurgensen; D. Neary; M. Curran; C. Trettin

2008-01-01

Government agencies, industrial landowners, and private landowners often strive to maintain soil quality after site management activities in order to maintain site productivity, hydrologic function, and ecosystem health. Soil disturbance resulting from timber harvesting, prescribed fire, or site preparation activities can cause declines, improvements, or have no effect...

Managing Indoor Air Quality in Schools.

ERIC Educational Resources Information Center

Woolums, Jennifer

This publication examines the causes and effects of poor indoor air quality and provides information for reducing exposure to indoor contaminants in schools. It discusses the various indoor pollutants found in schools, including dust, chemical agents, gases, and volatile organic compounds; where they are found in schools; and their health effects…

[The comprehensive approach to ensure the quality of forensic medical examination of a cadaver].

PubMed

Mel'nikov, O V; Mal'tsev, A E; Petrov, S B; Petrov, B A

2015-01-01

The objective of the present work was to estimate the effectiveness of the comprehensive monitoring system designed to enhance the quality of forensic medical expertise for determining the cause of death in the hanging cases. It was shown that the practical application of the algorithmization and automated quality control system improves the effectiveness of forensic medical examination of the cadavers in the hanging cases. The system performs the control, directing, and teaching functions. Moreover, it allows to estimate the completeness of the examination of the cadaver.

Summary of the effects of engine throttle response on airplane formation-flying qualities

NASA Technical Reports Server (NTRS)

Walsh, Kevin R.

1993-01-01

A flight evaluation was conducted to determine the effect of engine throttle response characteristics on precision formation-flying qualities. A variable electronic throttle control system was developed and flight-tested on a TF-104G airplane with a J79-11B engine at the NASA Dryden Flight Research Facility. This airplane was chosen because of its known, very favorable thrust response characteristics. Ten research flights were flown to evaluate the effects of throttle gain, time delay, and fuel control rate limiting on engine handling qualities during a demanding precision wing formation task. Handling quality effects of lag filters and lead compensation time delays were also evaluated. The Cooper and Harper Pilot Rating Scale was used to assign levels of handling quality. Data from pilot ratings and comments indicate that throttle control system time delays and rate limits cause significant degradations in handling qualities. Threshold values for satisfactory (level 1) and adequate (level 2) handling qualities of these key variables are presented. These results may provide engine manufacturers with guidelines to assure satisfactory handling qualities in future engine designs.

Guide to the Business Capability Lifecycle for Department of Defense ACAT III Programs

DTIC Science & Technology

2012-07-01

Cause and Effect matix SCAMPER Analysis Goal Quality Metrics Gap Analysis Bottlenecks Defects Goal Quality Metrics E2E Supported BPMN Q1/2 Q3 Q4 Q6 Q6...analysis a. Identify the root causes of the business problem b. Provide an as-is map, using Business Process Model and Notation ( BPMN ), of the...why they were eliminated from further consideration 8. To-be analysis a. Provide a to-be map, in BPMN , of the target process that illustrates the

Piloted Simulation Assessment of the Impact of Flexible Structures on Handling Qualities of Generic Supersonic Aircraft

NASA Technical Reports Server (NTRS)

Stringer, Mary T.; Cowen, Brandon; Hoffler, Keith D.; Couch, Jesse C.; Ogburn, Marilyn E.; Diebler, Corey G.

2013-01-01

The NASA Langley Research Center Cockpit Motion Facility (CMF) was used to conduct a piloted simulation assessment of the impact of flexible structures on flying qualities. The CMF was used because of its relatively high bandwidth, six degree-of-freedom motion capability. Previous studies assessed and attempted to mitigate the effects of multiple dynamic aeroservoelastic modes (DASE). Those results indicated problems existed, but the specific cause and effect was difficult to ascertain. The goal of this study was to identify specific DASE frequencies, damping ratios, and gains that cause degradation in handling qualities. A generic aircraft simulation was developed and designed to have Cooper-Harper Level 1 handling qualities when flown without DASE models. A test matrix of thirty-six DASE modes was implemented. The modes had frequencies ranging from 1 to 3.5 Hz and were applied to each axis independently. Each mode consisted of a single axis, frequency, damping, and gain, and was evaluated individually by six subject pilots with test pilot backgrounds. Analysis completed to date suggests that a number of the DASE models evaluated degrade the handling qualities of this class of aircraft to an uncontrollable condition.

The burden of age-related macular degeneration: a value-based analysis.

PubMed

Brown, Melissa M; Brown, Gary C; Sharma, Sanjay; Stein, Joshua D; Roth, Zachary; Campanella, Joseph; Beauchamp, George R

2006-06-01

The quality-of-life loss and the financial consequences associated with age-related macular degeneration are assessed. The quality-of-life loss associated with macular degeneration is markedly underestimated by the general public, nonophthalmic physicians, and ophthalmologists who treat patients with this condition. Mild age-related macular degeneration causes a 17% decrement in the quality of life of the average patient, similar to that encountered with moderate cardiac angina or symptomatic human immunodeficiency virus syndrome. Moderate age-related macular degeneration causes a 40% decrease in the average patient's quality of life, similar to that associated with severe cardiac angina or renal dialysis. Very severe age-related macular degeneration causes a large 63% decrease in the average patient's quality of life, similar to that encountered with end-stage prostatic cancer or a catastrophic stroke that leaves a person bedridden, incontinent and requiring constant nursing care. The return on investment is high for both treatment with current age-related macular degeneration therapies and the research costs invested in the development of age-related macular degeneration treatment modalities. Age-related macular degeneration is a major public health problem that has a devastating effect upon patients and marked adverse financial consequences for the economy.

Grain dormancy and light quality effects on germination in the model grass Brachypodium distachyon

USDA-ARS?s Scientific Manuscript database

Lack of seed dormancy in cereal crops such as barley and wheat is a common problem affecting farming areas around the world, causing losses in yield and quality due to pre-harvest sprouting. Control of seed dormancy has been investigated extensively using various approaches in different species incl...

Student Satisfaction and Perceptions of Quality: Testing the Linkages for PhD Students

ERIC Educational Resources Information Center

Cheng, Ming; Taylor, John; Williams, James; Tong, Kang

2016-01-01

Student satisfaction and the quality of education are of compelling interest to students, academic staff, policy-makers and higher education researchers internationally. There is a widespread belief in their "cause and effect" relationship. This paper tests these beliefs and explores how the level of student satisfaction is linked with…

Improving Reference Service: The Case for Using a Continuous Quality Improvement Method.

ERIC Educational Resources Information Center

Aluri, Rao

1993-01-01

Discusses the evaluation of library reference service; examines problems with past evaluations, including the lack of long-term planning and a systems perspective; and suggests a method for continuously monitoring and improving reference service using quality improvement tools such as checklists, cause and effect diagrams, Pareto charts, and…

Corrections on energy spectrum and scatterings for fast neutron radiography at NECTAR facility

NASA Astrophysics Data System (ADS)

Liu, Shu-Quan; Bücherl, Thomas; Li, Hang; Zou, Yu-Bin; Lu, Yuan-Rong; Guo, Zhi-Yu

2013-11-01

Distortions caused by the neutron spectrum and scattered neutrons are major problems in fast neutron radiography and should be considered for improving the image quality. This paper puts emphasis on the removal of these image distortions and deviations for fast neutron radiography performed at the NECTAR facility of the research reactor FRM- II in Technische Universität München (TUM), Germany. The NECTAR energy spectrum is analyzed and established to modify the influence caused by the neutron spectrum, and the Point Scattered Function (PScF) simulated by the Monte-Carlo program MCNPX is used to evaluate scattering effects from the object and improve image quality. Good analysis results prove the sound effects of the above two corrections.

Effects of Cathode Surface Roughness on the Quality of Electron Beams

DTIC Science & Technology

1986-09-12

ignored. Thus, magnetic field effects are ignored altogether in the present study and the beam tranverse velocities are caused only by the electrostatic...in experiments. This depends on the resolving power and on the competing effects such as nonlinear space charge and thermal effects. Based on the

The cumulative effects assessment of a coastal ecological restoration project in China: An integrated perspective.

PubMed

Ma, Deqiang; Zhang, Liyu; Fang, Qinhua; Jiang, Yuwu; Elliott, Michael

2017-05-15

Large scale coastal land-claim and sea-enclosing (CLASE) activities have caused habitat destruction, biodiversity losses and water deterioration, thus the local governments in China have recently undertaken seabed dredging and dyke opening (SDADO) as typical ecological restoration projects. However, some projects focus on a single impact on hydrodynamic conditions, water quality or marine organisms. In a case study in Xiamen, China, an integrated effects assessment framework centres on ecohydrology, using modeling of hydrodynamic conditions and statistical analysis of water quality, was developed to assess the effects of ecological restoration projects. The benefits of SDADO projects include improving hydrodynamic conditions and water quality, as a precursor to further marine biological improvements. This study highlights the need to comprehensively consider ecological effects of SDADO projects in the planning stage, and an integrative assessment method combining cumulative effects of hydrodynamic conditions, water quality and biological factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of self-management intervention on health outcomes of patients with heart failure: a systematic review of randomized controlled trials

PubMed Central

Jovicic, Aleksandra; Holroyd-Leduc, Jayna M; Straus, Sharon E

2006-01-01

Background Heart failure is the most common cause of hospitalization among adults over 65. Over 60% of patients die within 10 years of first onset of symptoms. The objective of this study is to determine the effectiveness of self-management interventions on hospital readmission rates, mortality, and health-related quality of life in patients diagnosed with heart failure. Methods The study is a systematic review of randomized controlled trials. The following data sources were used: MEDLINE (1966-11/2005), EMBASE (1980-11/2005), CINAHL (1982-11/2005), the ACP Journal Club database (to 11/2005), the Cochrane Central Trial Registry and the Cochrane Database of Systematic Reviews (to 11/2005); article reference lists; and experts in the field. We included randomized controlled trials of self-management interventions that enrolled patients 18 years of age or older who were diagnosed with heart failure. The primary outcomes of interest were all-cause hospital readmissions, hospital readmissions due to heart failure, and mortality. Secondary outcomes were compliance with treatment and quality of life scores. Three reviewers independently assessed the quality of each study and abstracted the results. For each included study, we computed the pooled odds ratios (OR) for all-cause hospital readmission, hospital readmission due to heart failure, and death. We used a fixed effects model to quantitatively synthesize results. We were not able to pool effects on health-related quality of life and measures of compliance with treatment, but we summarized the findings from the relevant studies. We also summarized the reported cost savings. Results From 671 citations that were identified, 6 randomized trials with 857 patients were included in the review. Self-management decreased all-cause hospital readmissions (OR 0.59; 95% confidence interval (CI) 0.44 to 0.80, P = 0.001) and heart failure readmissions (OR 0.44; 95% CI 0.27 to 0.71, P = 0.001). The effect on mortality was not significant (OR = 0.93; 95% CI 0.57 to 1.51, P = 0.76). Adherence to prescribed medical advice improved, but there was no significant difference in functional capabilities, symptom status and quality of life. The reported savings ranged from $1300 to $7515 per patient per year. Conclusion Self-management programs targeted for patients with heart failure decrease overall hospital readmissions and readmissions for heart failure. PMID:17081306

Root Cause Analysis of Quality Defects Using HPLC-MS Fingerprint Knowledgebase for Batch-to-batch Quality Control of Herbal Drugs.

PubMed

Yan, Binjun; Fang, Zhonghua; Shen, Lijuan; Qu, Haibin

2015-01-01

The batch-to-batch quality consistency of herbal drugs has always been an important issue. To propose a methodology for batch-to-batch quality control based on HPLC-MS fingerprints and process knowledgebase. The extraction process of Compound E-jiao Oral Liquid was taken as a case study. After establishing the HPLC-MS fingerprint analysis method, the fingerprints of the extract solutions produced under normal and abnormal operation conditions were obtained. Multivariate statistical models were built for fault detection and a discriminant analysis model was built using the probabilistic discriminant partial-least-squares method for fault diagnosis. Based on multivariate statistical analysis, process knowledge was acquired and the cause-effect relationship between process deviations and quality defects was revealed. The quality defects were detected successfully by multivariate statistical control charts and the type of process deviations were diagnosed correctly by discriminant analysis. This work has demonstrated the benefits of combining HPLC-MS fingerprints, process knowledge and multivariate analysis for the quality control of herbal drugs. Copyright © 2015 John Wiley & Sons, Ltd.

Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex

PubMed Central

Xie, Shan Juan; Lu, Yu; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

2015-01-01

Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc.) vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs). In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an intensity variation (IV) normalization method using guided filter based single scale retinex (GFSSR) is proposed for finger vein image enhancement. The experimental results on two public datasets demonstrate the effectiveness of the proposed method in enhancing the image quality and finger vein recognition accuracy. PMID:26184226

Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex.

PubMed

Xie, Shan Juan; Lu, Yu; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

2015-07-14

Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc.) vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs). In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an intensity variation (IV) normalization method using guided filter based single scale retinex (GFSSR) is proposed for finger vein image enhancement. The experimental results on two public datasets demonstrate the effectiveness of the proposed method in enhancing the image quality and finger vein recognition accuracy.

Comparative Effectiveness of Disease Management With Information Communication Technology for Preventing Hospitalization and Readmission in Adults With Chronic Congestive Heart Failure.

PubMed

Aronow, Wilbert S; Shamliyan, Tatyana A

2018-06-01

Critical appraisal of all available evidence regarding the role of noninvasive communication technology for improving patient survival and reducing hospital admissions in adults with chronic heart failure (HF). Systematic literature review and grading of the quality of evidence according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group approach. Four databases were searched in March 2018 to find 2 high-quality meta-analyses and published and unpublished data from 58 randomized controlled trials (RCTs) that compared noninvasive communication technology with usual care in community-dwelling adults with HF. Direct meta-analysis of aggregate data with random effects models. Moderate-quality evidence suggests that there are no differences in all-cause mortality between telemonitoring and usual care, whereas complex telemonitoring that includes transmission of patient parameters and analysis by health care professionals decreases all-cause mortality (relative risk [RR] 0.78, 95% confidence interval [CI] 0.62, 0.99; 2885 people in 12 RCTs). Moderate-quality evidence suggests that telemonitoring prevents HF-related hospitalizations (RR 0.74; 95% CI 0.62, 0.88; 4001 people in 11 RCTs). Moderate-quality evidence suggests that structured telephone support decreases all-cause mortality (RR 0.86; 95% CI 0.77, 0.97; 9535 people in 24 RCTs) and HF-related hospitalizations (RR 0.83; 95% CI 0.73, 0.94; 7030 people in 16 RCTs). Use of a mobile personal digital assistant prevents HF-related hospitalizations (RR 0.58; 95% CI 0.44, 0.77; 674 people in 3 RCTs). The evidence regarding the comparative effectiveness of specific telecommunication devices is insufficient. The results from many completed studies are not available. Clinicians should offer noninvasive monitoring with communication technology applications to all HF patients. Future research should examine comparative effectiveness of technology applications in patient subpopulations. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Primary focal hyperhidrosis: diagnosis and management. .

PubMed

Wang, Rena; Solish, Nowell; Murray, Christian A

2008-12-01

Primary focal hyperhidrosis is a common and serious medical condition that causes considerable psychosocial morbidity. Diagnostic and effective management strategies can improve patients' quality of living dramatically.

A 2-1-1 Research Collaboration

PubMed Central

Eddens, Katherine S.; Alcaraz, Kassandra I.; Kreuter, Matthew W.; Rath, Suchitra; Greer, Regina

2012-01-01

Background 2-1-1 serves as a lifeline in times of crises. These crises often cause a spike in call volume that can challenge 2-1-1’s ability to meet their service quality standards. For researchers gathering data through 2-1-1s, a sudden increase in call volume might reduce accrual as 2-1-1 has less time to administer study protocols. Research activities imbedded in 2-1-1 systems may directly affect 2-1-1 service quality indicators. Purpose Using data from a 2-1-1 research collaboration, this paper examines the impact of crises on call volume to 2-1-1, how call volume affects research participant accrual through 2-1-1, and how research recruitment efforts affect 2-1-1 service quality indicators. Methods t-tests were used to examine the effect of call volume on research participant accrual. Linear and logistic regressions were used to examine the effect of research participant accrual on 2-1-1 service quality indicators. Data were collected June 2010–December 2011; data were analyzed in 2012. Results Findings from this collaboration suggest that crises causing spikes in call volume adversely affect 2-1-1 service quality indicators as well as accrual of research participants. Administering a brief (2–3 minute) health risk assessment did not negatively affect service quality, but administering a longer (15–18 minute) survey had a modest adverse effect on these indicators. Conclusions In 2-1-1 research collaborations, both partners need to understand the dynamic relationship between call volume, research accrual, and service quality, and adjust expectations accordingly. If research goals include administering a longer survey, increased staffing of 2-1-1 call centers may be needed to avoid compromising service quality. PMID:23157769

Joint Conference on Sensing of Environmental Pollutants, 4th, New Orleans, La., November 6-11, 1977, Proceedings

NASA Technical Reports Server (NTRS)

1978-01-01

Papers are presented on such topics as environmental chemistry, the effects of sulfur compounds on air quality, the prediction and monitoring of biological effects caused by environmental pollutants, environmental indicators, the satellite remote sensing of air pollution, weather and climate modification by pollution, and the monitoring and assessment of radioactive pollutants. Consideration is also given to empirical and quantitative modeling of air quality, disposal of hazardous and nontoxic materials, sensing and assessment of water quality, pollution source monitoring, and assessment of some environmental impacts of fossil and nuclear fuels.

75 FR 21307 - Injury Prevention Program; Announcement Type: Cooperative Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... effective will be considered. Motor vehicle related injuries and deaths impact AI/AN communities in... leading cause of death and disability for AI/AN communities. Injuries cause more deaths among AI/AN ages 1... AI/AN communities. Unintentional falls reduce independence and quality of life for adults ages 65 and...

Model-based quantification of image quality

NASA Technical Reports Server (NTRS)

Hazra, Rajeeb; Miller, Keith W.; Park, Stephen K.

1989-01-01

In 1982, Park and Schowengerdt published an end-to-end analysis of a digital imaging system quantifying three principal degradation components: (1) image blur - blurring caused by the acquisition system, (2) aliasing - caused by insufficient sampling, and (3) reconstruction blur - blurring caused by the imperfect interpolative reconstruction. This analysis, which measures degradation as the square of the radiometric error, includes the sample-scene phase as an explicit random parameter and characterizes the image degradation caused by imperfect acquisition and reconstruction together with the effects of undersampling and random sample-scene phases. In a recent paper Mitchell and Netravelli displayed the visual effects of the above mentioned degradations and presented subjective analysis about their relative importance in determining image quality. The primary aim of the research is to use the analysis of Park and Schowengerdt to correlate their mathematical criteria for measuring image degradations with subjective visual criteria. Insight gained from this research can be exploited in the end-to-end design of optical systems, so that system parameters (transfer functions of the acquisition and display systems) can be designed relative to each other, to obtain the best possible results using quantitative measurements.

75 FR 58312 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

... Allegan County area. In accordance with 5 U.S.C. 553(d), EPA finds there is good cause for this action to... provided by the agency for good cause found and published with the rule.'' The purpose of the 30-day.... For these reasons, EPA finds good cause under 5 U.S.C. 553(d)(3) for this action to become effective...

Ranolazine for stable angina pectoris.

PubMed

Salazar, Carlos A; Basilio Flores, Juan E; Veramendi Espinoza, Liz E; Mejia Dolores, Jhon W; Rey Rodriguez, Diego E; Loza Munárriz, César

2017-02-08

Stable angina pectoris is a chronic medical condition with significant impact on mortality and quality of life; it can be macrovascular or microvascular in origin. Ranolazine is a second-line anti-anginal drug approved for use in people with stable angina. However, the effects of ranolazine for people with angina are considered to be modest, with uncertain clinical relevance. To assess the effects of ranolazine on cardiovascular and non-cardiovascular mortality, all-cause mortality, quality of life, acute myocardial infarction incidence, angina episodes frequency and adverse events incidence in stable angina patients, used either as monotherapy or as add-on therapy, and compared to placebo or any other anti-anginal agent. We searched CENTRAL, MEDLINE, Embase and the Conference Proceedings Citation Index - Science in February 2016, as well as regional databases and trials registers. We also screened reference lists. Randomised controlled trials (RCTs) which directly compared the effects of ranolazine versus placebo or other anti-anginals in people with stable angina pectoris were eligible for inclusion. Two authors independently selected studies, extracted data and assessed risk of bias. Estimates of treatment effects were calculated using risk ratios (RR), mean differences (MD) and standardised mean differences (SMD) with 95% confidence intervals (CI) using a fixed-effect model. Where we found statistically significant heterogeneity (Chi² P < 0.10), we used a random-effects model for pooling estimates. Meta-analysis was not performed where we found considerable heterogeneity (I² ≥ 75%). We used GRADE criteria to assess evidence quality and the GRADE profiler (GRADEpro GDT) to import data from Review Manager 5.3 to create 'Summary of findings' tables. We included 17 RCTs (9975 participants, mean age 63.3 years). We found very limited (or no) data to inform most planned comparisons. Summary data were used to inform comparison of ranolazine versus placebo. Overall, risk of bias was assessed as unclear.For add-on ranolazine compared to placebo, no data were available to estimate cardiovascular and non-cardiovascular mortality. We found uncertainty about the effect of ranolazine on: all-cause mortality (1000 mg twice daily, RR 0.83, 95% CI 0.26 to 2.71; 3 studies, 2053 participants; low quality evidence); quality of life (any dose, SMD 0.25, 95% CI -0.01 to 0.52; 4 studies, 1563 participants; I² = 73%; moderate quality evidence); and incidence of non-fatal acute myocardial infarction (AMI) (1000mg twice daily, RR 0.40, 95% CI 0.08 to 2.07; 2 studies, 1509 participants; low quality evidence). Add-on ranolazine 1000 mg twice daily reduced the fervour of angina episodes (MD -0.66, 95% CI -0.97 to -0.35; 3 studies, 2004 participants; I² = 39%; moderate quality evidence) but increased the risk of non-serious adverse events (RR 1.22, 95% CI 1.06 to 1.40; 3 studies, 2053 participants; moderate quality evidence).For ranolazine as monotherapy compared to placebo, we found uncertain effect on cardiovascular mortality (1000 mg twice daily, RR 1.03, 95% CI 0.56 to 1.88; 1 study, 2604 participants; low quality evidence). No data were available to estimate non-cardiovascular mortality. We also found an uncertain effect on all-cause mortality for ranolazine (1000 mg twice daily, RR 1.00, 95% CI 0.81 to 1.25; 3 studies, 6249 participants; low quality evidence), quality of life (1000 mg twice daily, MD 0.28, 95% CI -1.57 to 2.13; 3 studies, 2254 participants; moderate quality evidence), non-fatal AMI incidence (any dose, RR 0.88, 95% CI 0.69 to 1.12; 3 studies, 2983 participants; I² = 50%; low quality evidence), and frequency of angina episodes (any dose, MD 0.08, 95% CI -0.85 to 1.01; 2 studies, 402 participants; low quality evidence). We found an increased risk for non-serious adverse events associated with ranolazine (any dose, RR 1.50, 95% CI 1.12 to 2.00; 3 studies, 947 participants; very low quality evidence). We found very low quality evidence showing that people with stable angina who received ranolazine as monotherapy had increased risk of presenting non-serious adverse events compared to those given placebo. We found low quality evidence indicating that people with stable angina who received ranolazine showed uncertain effect on the risk of cardiovascular death (for ranolazine given as monotherapy), all-cause death and non-fatal AMI, and the frequency of angina episodes (for ranolazine given as monotherapy) compared to those given placebo. Moderate quality evidence indicated that people with stable angina who received ranolazine showed uncertain effect on quality of life compared with people who received placebo. Moderate quality evidence also indicated that people with stable angina who received ranolazine as add-on therapy had fewer angina episodes but increased risk of presenting non-serious adverse events compared to those given placebo.

Hurricane Katrina Impact on Water Quality in the East Pearl River, Mississippi

NASA Astrophysics Data System (ADS)

Shiller, A. M.; Shim, M.; Guo, L.; Bianchi, T. S.; Smith, R. W.; Duan, S.

2010-12-01

Hurricanes and other intense storms have previously been reported to cause short term changes in surface water quality. We examined the water quality of the East Pearl River in southern Mississippi both before and after Hurricane Katrina caused extensive damage to the watershed in 2005. Our post-storm sampling began two months after the hurricane, and thus we missed any immediate short-term consequences. However, sampling over the following two years allowed us to examine whether damage to watershed resulted in significant longer term effects on water quality. Interpretation of the time series data is complicated by the natural seasonal and climatic variability of the system. Thus, we utilized property-property plots as well as empirical relationships to compare pre- and post-storm water quality. Based on the variability of our empirical relationships, we estimate that to within 20%, the hurricane-induced vegetative destruction within this river basin has not changed the concentrations of DOC, POC, SPM, pH, or dissolved Fe. Nor has the quality of the DOC, as inferred from lignin-phenol analysis and the Fe-DOC relationship, been significantly changed either. This may be partly due to the slow degradation of woody materials that occurs only over a period of a few years, even in the sub-tropical climate of this region. Also, transport of DOC material from the land, through the soils, and into the river is not always instantaneous because DOC may stay in soils for a long time. Our work can be examined in the context of other research focused on hurricane effects on different time scales. For instance, shorter term hurricane influences, such as immediate flooding, can cause concurrent, short-lived water quality changes. Likewise, if increased hurricane activity (as might result from climate change) results in permanent landscape or ecosystem changes, then significant long-term water quality changes might be expected.

Conditions for Confirmatory Analysis and Causal Inference.

DTIC Science & Technology

1982-05-03

to subordinates regarding quality and quantity of subordinates’ performance , may cause subordinates to perceive that they have too much work to do...xl) and quantity (x2 ) of role performance do not cause state anxiety (y 2 ) directly, rather they affect it indirectly through their effects on the...and quantity of performance than managers more attuned to the effects of their demands on employees. on the other hand, impersonality is not expected

A Discussion of Commercially Available Intra-ocular Telescopic Implants for Patients with Age-Related Macular Degeneration.

PubMed

Dunbar, Hannah M P; Dhawahir-Scala, Felipe E

2018-06-01

Age-related macular degeneration (AMD) is the leading cause of visual impairment in the western world, causing significant reduction in quality of life. Despite treatment advances, the burden of visual impairment caused by AMD continues to rise. In addition to traditional low vision rehabilitation and support, optical and electronic aids, and strategies to enhance the use of peripheral vision, implantable telescopic devices have been indicated as a surgical means of enhancing vision. Here we examine the literature on commercially available telescopic devices discussing their design, mode of action, surgical procedure and published outcomes on visual acuity, quality of life, surgical complication rates and cost effectiveness data where available.Funding Article processing charges were funded by VisionCare Inc.

Acids in combination with sodium dodecyl sulfate caused quality deterioration of fresh-cut iceberg lettuce during storage in modified atmosphere package.

PubMed

Guan, Wenqiang; Huang, Lihan; Fan, Xuetong

2010-10-01

Recent studies showed that sodium acid sulfate (SAS) and levulinic acid (LA) in combination with sodium dodecyl sulfate (SDS) was effective in inactivating human pathogens on Romaine lettuce. The present study investigated the effects of LA and SAS in combination with SDS (as compared with citric acid and chlorine) on the inactivation of E. coli O157:H7 and sensory quality of fresh-cut Iceberg lettuce in modified atmosphere packages during storage at 4 °C. Results showed that LA (0.5% to 3%) and SAS (0.25% to 0.75%) with 0.05% SDS caused detrimental effects on visual quality and texture of lettuce. LA- and SAS-treated samples were sensorially unacceptable due to development of sogginess and softening after 7 and 14 d storage. It appears that the combined treatments caused an increase in the respiration rate of fresh-cut lettuce as indicated by higher CO(2) and lower O(2) in modified atmosphere packages. On the positive side, the acid treatments inhibited cut edge browning of lettuce pieces developed during storage. LA (0.5%), SAS (0.25%), and citric acid (approximately 0.25%) in combination with SDS reduced population of E. coli OH157:H7 by 0.41, 0.87, and 0.58 log CFU/g, respectively, while chlorine achieved a reduction of 0.94 log CFU/g without damage to the lettuce. Therefore, compared to chlorine, LA and SAS in combination with SDS have limited commercial value for fresh-cut Iceberg lettuce due to quality deterioration during storage.

Emerging technology: A key enabler for modernizing pharmaceutical manufacturing and advancing product quality.

PubMed

O'Connor, Thomas F; Yu, Lawrence X; Lee, Sau L

2016-07-25

Issues in product quality have produced recalls and caused drug shortages in United States (U.S.) in the past few years. These quality issues were often due to outdated manufacturing technologies and equipment as well as lack of an effective quality management system. To ensure consistent supply of safe, effective and high-quality drug products available to the patients, the U.S. Food and Drug Administration (FDA) supports modernizing pharmaceutical manufacturing for improvements in product quality. Specifically, five new initiatives are proposed here to achieve this goal. They include: (i) advancing regulatory science for pharmaceutical manufacturing; (ii) establishing a public-private institute for pharmaceutical manufacturing innovation; (iii) creating incentives for investment in the technological upgrade of manufacturing processes and facilities; (iv) leveraging external expertise for regulatory quality assessment of emerging technologies; and (v) promoting the international harmonization of approaches for expediting the global adoption of emerging technologies. Published by Elsevier B.V.

Predicting Software Suitability Using a Bayesian Belief Network

NASA Technical Reports Server (NTRS)

Beaver, Justin M.; Schiavone, Guy A.; Berrios, Joseph S.

2005-01-01

The ability to reliably predict the end quality of software under development presents a significant advantage for a development team. It provides an opportunity to address high risk components earlier in the development life cycle, when their impact is minimized. This research proposes a model that captures the evolution of the quality of a software product, and provides reliable forecasts of the end quality of the software being developed in terms of product suitability. Development team skill, software process maturity, and software problem complexity are hypothesized as driving factors of software product quality. The cause-effect relationships between these factors and the elements of software suitability are modeled using Bayesian Belief Networks, a machine learning method. This research presents a Bayesian Network for software quality, and the techniques used to quantify the factors that influence and represent software quality. The developed model is found to be effective in predicting the end product quality of small-scale software development efforts.

Analysis of Station Quality Issues from EarthScope's Transportable Array

NASA Astrophysics Data System (ADS)

Pfeifer, C.; Barstow, N.; Busby, R.; Hafner, K.

2008-12-01

160 of the first 400 Earthscope USARRY transportable array (TA) stations have completed their first two-year deployment and are being moved to their next locations. Over the past 4 years the majority of stations have run with few interruptions in the transfer of real time data to the Array Network Facility (ANF) at the Univ of CA San Diego and near real time data to the IRIS Data Management System (DMS). The combination of telemetered data and dedicated people reviewing the waveforms and state of health data have revealed several conditions that can affect the data quality or cause loss of data. The data problems fall into three broad categories; station power, equipment malfunction, and communication failures. Station power issues have been implicated in several types of noise seen in the seismic data (as well as causing station failures and resultant data gaps). The most common type of equipment problem that has been found to degrade data quality is caused by sensor problems, and has affected all 3 types of sensors used in the TA to varying degrees. While communication problems can cause real time data loss, they do not cause a degradation of the quality of the data, and any gaps in the real time data due solely to communications problems are filled in later with the continuous data recorded to disk at each TA station. Over the past 4 years the TA team has recognized a number of noise sources and have made several design changes to minimize the effects on data quality. Design/procedural changes include: stopping water incursion into the stations, power conditioning, changing mass re-center voltage thresholds. Figures that demonstrate examples are provided. Changes have created better data quality and improved the station performance. Vigilance and deployment of service teams to reestablish communications, replace noisy sensors, and troubleshoot problems is also key to maintaining the high-quality TA network.

Predictors and Outcomes of Health–Related Quality of Life in Adults with CKD

PubMed Central

Lash, James P.; Xie, Dawei; Pan, Qiang; DeLuca, Jennifer; Kanthety, Radhika; Kusek, John W.; Lora, Claudia M.; Nessel, Lisa; Ricardo, Ana C.; Wright Nunes, Julie; Fischer, Michael J.

2016-01-01

Background and objectives Low health–related quality of life is associated with increased mortality in patients with ESRD. However, little is known about demographic and clinical factors associated with health–related quality of life or its effect on outcomes in adults with CKD. Design, settings, participants, & measurements Data from 3837 adult participants with mild to severe CKD enrolled in the prospective observational Chronic Renal Insufficiency Cohort and Hispanic Chronic Renal Insufficiency Cohort Studies were analyzed. Health–related quality of life was assessed at baseline with the Kidney Disease Quality of Life-36 and its five subscales: mental component summary, physical component summary, burden of kidney disease (burden), effects of kidney disease (effects), and symptoms and problems of kidney disease (symptoms). Low health–related quality of life was defined as baseline score >1 SD below the mean. Using Cox proportional hazards analysis, the relationships between low health–related quality of life and the following outcomes were examined: (1) CKD progression (50% eGFR loss or incident ESRD), (2) incident cardiovascular events, and (3) all-cause death. Results Younger age, women, low education, diabetes, vascular disease, congestive heart failure, obesity, and lower eGFR were associated with low baseline health–related quality of life (P<0.05). During a median follow-up of 6.2 years, there were 1055 CKD progression events, 841 cardiovascular events, and 694 deaths. Significantly higher crude rates of CKD progression, incident cardiovascular events, and all-cause death were observed among participants with low health–related quality of life in all subscales (P<0.05). In fully adjusted models, low physical component summary, effects, and symptoms subscales were independently associated with a higher risk of incident cardiovascular events and death, whereas low mental component summary was independently associated with a higher risk of death (P<0.05). Low health–related quality of life was not associated with CKD progression. Conclusions Low health–related quality of life across several subscales was independently associated with a higher risk of incident cardiovascular events and death but not associated with CKD progression. PMID:27246012

Research on the Purification Effect of Aquatic Plants Based on Grey Clustering Method

NASA Astrophysics Data System (ADS)

Gu, Sudan; Du, Fuhui

2018-01-01

This paper uses the grey clustering method to evaluate the water quality level of the MingGuan constructed wetland at the import and export of artificial wetlands. Constructed wetland of Ming Guanis established on the basis of the Fuyang River’s water quality improvement, to choose suitable aquatic plants, in order to achieve the Fuyang River water purification effect. Namely TP, TN, NH3-N, DO, COD and COMMn and permanganate index are selected as clustering indicators. Water quality is divided into five grades according to the Surface Water Environmental Quality Standard (GB3838-2002) as the evaluation standard. In order to select the suitable wetland plants, the purification effect of 6 kinds of higher aquatic plants on the sewage of fuyang river was tested. one kind of plants was selected: Typha. The results show that the water quality of the section is gradually changed from V water quality to III water quality. After tartificial wetland of cycle for a long time, Typha has good purification effect. In November, water quality categories are basically concentrated in the VI, V class, may be caused by chemical decomposition of aquatic plants, should strengthen the academic research.

Examining the Effects of Altered Water Quality on Sea Urchin Fertilization Success and Embryo Development

ERIC Educational Resources Information Center

Haverkort-Yeh, Roxanne Dominique; Tamaru, Clyde S.; Gorospe, Kelvin Dalauta; Rivera, Malia Ana J.

2013-01-01

As a result of shifting marine environmental conditions caused by global climate change and localized water pollution, marine organisms are becoming increasingly exposed to changing water quality conditions. For example, they are exposed to more extreme salinity fluctuations as a result of heavier rainfall, melting polar caps, or extreme droughts.…

Evaluating Quality Circles in a College of Further Education. Manchester Monographs 31.

ERIC Educational Resources Information Center

Atkinson, Tim

Quality circles (QCs) are small volunteer groups of workers who meet weekly with a trained leader operating to a strict code of conduct. They use techniques of brainstorming, cause and effect classification, pareto analysis, and presentation to consider work-related problems and recommend solutions to management. QCs have been tried in educational…

Implementation Quality of Family Literacy Programmes: A Review of Literature

ERIC Educational Resources Information Center

de la Rie, S.; van Steensel, R. C. M.; van Gelderen, A. J. S.

2017-01-01

Raising the literacy levels of young children is a major concern in many countries for which various programmes have been suggested. One of these is family literacy programmes. In previous meta-analyses wide variability in effects has been found and it has been suggested that this is partly caused by variability in implementation quality. This…

Prevalence and Outcome of Anemia After Restorative Proctocolectomy: A Clinical Literature Review

PubMed Central

M'Koma, Amosy E.; Wise, Paul E.; Schwartz, David A.; Muldoon, Roberta L.; Herline, Alan J.

2014-01-01

PURPOSE Iron and/or vitamin B12 deficiency anemias, which have adverse effects on patients’ quality of life, are commonly observed and often overlooked complications after restorative proctocolectomy. We performed a systematic review of publications on the prevalence of anemia as well as on the impact of anemia on a range of clinical, functional, quality of life, and economic outcomes in restorative proctocolectomy patients. This information is important to help healthcare providers through a comprehensive overview to increase awareness about a condition that could require therapy to improve patient healthcare and quality of life. METHODS We reviewed the English language publications on the incidence of anemia and its adverse effect after restorative proctocolectomy The United States National Library of Medicine database (MEDLINE), the Excerpta Medica database (EMBASE), the Cochran Library, and the Google® search engine were searched for published articles on the prevalence and impact of anemia in post-restorative proctocolectomy surgical patients. RESULTS The long-term complication most frequently described after RPC is pouchitis. Pouchitis is significantly associated with iron deficiency anemia caused by pouch mucosal bleeding. Other causes are insufficient and/or impaired iron absorption. It has also been observed, however, that restorative proctocolectomy patients with underlying familial adenomatous polyposis rarely develop pouchitis yet show higher rates of iron deficiency anemia compared to those patients with underlying ulcerative colitis. Other causes shown as independent risk factors for iron deficiency anemia in restorative proctocolectomy patients are malignancy, desmoid tumors, and J-pouch configuration. Vitamin B12 deficiency anemia is also common after restorative proctocolectomy. About one-third of restorative proctocolectomy patients show abnormal Schilling test and 5 percent have low referenced serum cobalamin. It has been observed that the degree resection of the terminal-ileum, malabsorption, bacterial overgrowth, and dietary factors are among the known causes of cobalamin deficiency. Folate deficiency has not been reported in restorative proctocolectomy patients. Describing restorative proctocolectomy surgery and its outcomes, in patients without anemia, the quality of life is reported excellent regardless of operative technique. CONCLUSIONS Anemia is not uncommon following restorative proctocolectomy and has been shown to have negative effects on the patient's quality of life and the economy and may substantially increase healthcare costs. The treatment of anemia and its underlying causes is important to improving clinical and economic outcomes. PMID:19404082

Cause-and-effect mapping of critical events.

PubMed

Graves, Krisanne; Simmons, Debora; Galley, Mark D

2010-06-01

Health care errors are routinely reported in the scientific and public press and have become a major concern for most Americans. In learning to identify and analyze errors health care can develop some of the skills of a learning organization, including the concept of systems thinking. Modern experts in improving quality have been working in other high-risk industries since the 1920s making structured organizational changes through various frameworks for quality methods including continuous quality improvement and total quality management. When using these tools, it is important to understand systems thinking and the concept of processes within organization. Within these frameworks of improvement, several tools can be used in the analysis of errors. This article introduces a robust tool with a broad analytical view consistent with systems thinking, called CauseMapping (ThinkReliability, Houston, TX, USA), which can be used to systematically analyze the process and the problem at the same time. Copyright 2010 Elsevier Inc. All rights reserved.

Design of an instrument to measure the quality of care in Physical Therapy

PubMed Central

Cavalheiro, Leny Vieira; Eid, Raquel Afonso Caserta; Talerman, Claudia; do Prado, Cristiane; Gobbi, Fátima Cristina Martorano; Andreoli, Paola Bruno de Araujo

2015-01-01

ABSTRACT Objective: To design an instrument composed of domains that would demonstrate physical therapy activities and generate a consistent index to represent the quality of care in physical therapy. Methods: The methodology Lean Six Sigma was used to design the tool. The discussion involved seven different management groups staff. By means of brainstorming and Cause & Effect Matrix, we set up the process map. Results: Five requirements composed the quality of care index in physical therapy, after application of the tool called Cause & Effect Matrix. The following requirements were assessed: physical therapist performance, care outcome indicator, adherence to physical therapy protocols, measure whether the prognosis and treatment outcome was achieved and Infrastructure. Conclusion: The proposed design allowed evaluating several items related to physical therapy service, enabling customization, reproducibility and benchmarking with other organizations. For management, this index provides the opportunity to identify areas for improvement and the strengths of the team and process of physical therapy care. PMID:26154548

Pressure ulcer prevention in frail older people.

PubMed

Barry, Maree; Nugent, Linda

2015-12-16

Pressure ulcers are painful and cause discomfort, have a negative effect on quality of life, and are costly to treat. The incidence and severity of preventable pressure ulcers is an important indicator of quality of care; it is essential that healthcare providers monitor prevalence and incidence rates to ensure that care strategies implemented are effective. Frail older people are at increased risk of developing pressure ulcers. This article discusses the complexities of preventing pressure ulcers in frail older people and emphasises the importance of structured educational programmes that incorporate effective clinical leadership and multidisciplinary teamwork.

Causes and consequences of fatigue in rheumatoid arthritis.

PubMed

Katz, Patricia

2017-05-01

To review current information on the causes, treatments, and consequences of fatigue in rheumatoid arthritis. Disease activity (inflammation, pain, joint symptoms) is associated with greater fatigue. However, disease activity per se accounts for only a small portion of fatigue, and rheumatoid arthritis medications that reduce disease activity have small effects on fatigue. Instead, factors outside the direct effects of rheumatoid arthritis, such as obesity, physical inactivity, sleep disturbance, and depression, explain the majority of variation in fatigue. Some of these factors may be indirect effects of disease (e.g. pain can lead to sleep disturbance). Rheumatoid arthritis has significant effects on the quality of life of individuals with rheumatoid arthritis. The most effective approaches to reducing rheumatoid arthritis fatigue appear to be behavioral, such as increasing physical activity, or cognitive, such as cognitive behavioral interventions. Fatigue in rheumatoid arthritis appears to be largely because of factors outside the direct effects of the disease, such as behavioral and psychological factors. In spite of the tremendous impact of fatigue on patient health and quality of life, effective treatments remain elusive, but existing data show that behavioral and cognitive approaches may be most effective.

Effects of defoliation by gypsy moth

Treesearch

Mark J. Twery

1991-01-01

Defoliation of trees by the gypsy moth (Lymantria dispar L.) has many and varied effects. It causes economic losses through lost forest production and reduced aesthetic qualities of the forest. However, defoliation may improve habitat for many species of wildlife and contribute to increased diversity of eastern forests. Effects on water resources,...

Event Reports Promoting Root Cause Analysis.

PubMed

Pandit, Swananda; Gong, Yang

2016-01-01

Improving health is the sole objective of medical care. Unfortunately, mishaps or patient safety events happen during the care. If the safety events were collected effectively, they would help identify patterns, underlying causes, and ultimately generate proactive and remedial solutions for prevention of recurrence. Based on the AHRQ Common Formats, we examine the quality of patient safety incident reports and describe the initial data requirement that can support and accelerate effective root cause analysis. The ultimate goal is to develop a knowledge base of patient safety events and their common solutions which can be readily available for sharing and learning.

Hydrogeology and ground-water/surface water interactions in the Des Moines River valley, southwestern Minnesota, 1997-2001

USGS Publications Warehouse

Cowdery, Timothy K.

2005-01-01

Long-term withdrawals of water for public supplies may cause a net decrease in ground-water discharge to surface water. Water that does not evaporate, or that is not exported, is discharged to the Des Moines River but with changed water quality. Because ground-water and surface-water qualities in the study area are similar, the ground-water discharge probably has little effect on river water quality.

Effects of tear film dynamics on quality of vision.

PubMed

Koh, Shizuka; Tung, Cynthia I; Inoue, Yasushi; Jhanji, Vishal

2018-06-15

The precorneal tear film is maintained by blinking and exhibits different phases in the tear cycle. The tear film serves as the most anterior surface of the eye and plays an important role as a first refractive component of the eye. Alterations in tear film dynamics may cause both vision-related and ocular surface-related symptoms. Although the optical quality associated with the tear film dynamics previously received little attention, objective measurements of optical quality using wavefront sensors have enabled us to quantify optical aberrations induced by the tear film. This has provided an objective method for assessing reduced optical quality in dry eye; thus, visual disturbances were included in the definition of dry eye disease in the 2007 Dry Eye Workshop report. In addition, sequential measurements of wavefront aberrations have provided us with valuable insights into the dynamic optical changes associated with tear film dynamics. This review will focus on the current knowledge of the mechanisms of wavefront variations that are caused by different aspects of tear film dynamics: specifically, quality, quantity and properties of the tear film, demonstrating the respective effects of dry eye, epiphora and instillation of eye drops on the quality of vision. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Intermittent Water Supply: Prevalence, Practice, and Microbial Water Quality.

PubMed

Kumpel, Emily; Nelson, Kara L

2016-01-19

Intermittent water supplies (IWS), in which water is provided through pipes for only limited durations, serve at least 300 million people around the world. However, providing water intermittently can compromise water quality in the distribution system. In IWS systems, the pipes do not supply water for periods of time, supply periods are shortened, and pipes experience regular flow restarting and draining. These unique behaviors affect distribution system water quality in ways that are different than during normal operations in continuous water supplies (CWS). A better understanding of the influence of IWS on mechanisms causing contamination can help lead to incremental steps that protect water quality and minimize health risks. This review examines the status and nature of IWS practices throughout the world, the evidence of the effect of IWS on water quality, and how the typical contexts in which IWS systems often exist-low-income countries with under-resourced utilities and inadequate sanitation infrastructure-can exacerbate mechanisms causing contamination. We then highlight knowledge gaps for further research to improve our understanding of water quality in IWS.

Adolescent Summaries of Narrative and Expository Discourse: Differences and Predictors.

PubMed

Lundine, Jennifer P; Harnish, Stacy M; McCauley, Rebecca J; Blackett, Deena Schwen; Zezinka, Alexandra; Chen, Wei; Fox, Robert A

2018-05-03

Summarizing expository passages is a critical academic skill that is understudied in language research. The purpose of this study was to compare the quality of verbal summaries produced by adolescents for 3 different discourse types and to determine whether a composite measure of cognitive skill or a test of expressive syntax predicted their performance. Fifty adolescents listened to, and then verbally summarized, 1 narrative and 2 expository lectures (compare-contrast and cause-effect). They also participated in testing that targeted expressive syntax and 5 cognitive subdomains. Summary quality scores were significantly different across discourse types, with a medium effect size. Analyses revealed significantly higher summary quality scores for cause-effect than compare-contrast summaries. Although the composite cognitive measure contributed significantly to the prediction of quality scores for both types of expository summaries, the expressive syntax score only contributed significantly to the quality scores for narrative summaries. These results support previous research indicating that type of expository discourse may impact student performance. These results also show, for the first time, that cognition may play a predictive role in determining summary quality for expository but not narrative passages in this population. In addition, despite the more complex syntax commonly associated with exposition versus narratives, an expressive syntax score was only predictive of performance on narrative summaries. These findings provide new information, questions, and directions for future research for those who study academic discourse and for professionals who must identify and manage the problems of students struggling with different types of academic discourse. https://doi.org/10.23641/asha.6167879.

Effects of Elevated CO2 and Temperature on Yield and Fruit Quality of Strawberry (Fragaria × ananassa Duch.) at Two Levels of Nitrogen Application

PubMed Central

Sun, Peng; Mantri, Nitin; Lou, Heqiang; Hu, Ya; Sun, Dan; Zhu, Yueqing; Dong, Tingting; Lu, Hongfei

2012-01-01

We investigated if elevated CO2 could alleviate the negative effect of high temperature on fruit yield of strawberry (Fragaria × ananassa Duch. cv. Toyonoka) at different levels of nitrogen and also tested the combined effects of CO2, temperature and nitrogen on fruit quality of plants cultivated in controlled growth chambers. Results show that elevated CO2 and high temperature caused a further 12% and 35% decrease in fruit yield at low and high nitrogen, respectively. The fewer inflorescences and smaller umbel size during flower induction caused the reduction of fruit yield at elevated CO2 and high temperature. Interestingly, nitrogen application has no beneficial effect on fruit yield, and this may be because of decreased sucrose export to the shoot apical meristem at floral transition. Moreover, elevated CO2 increased the levels of dry matter-content, fructose, glucose, total sugar and sweetness index per dry matter, but decreased fruit nitrogen content, total antioxidant capacity and all antioxidant compounds per dry matter in strawberry fruit. The reduction of fruit nitrogen content and antioxidant activity was mainly caused by the dilution effect of accumulated non-structural carbohydrates sourced from the increased net photosynthetic rate at elevated CO2. Thus, the quality of strawberry fruit would increase because of the increased sweetness and the similar amount of fruit nitrogen content, antioxidant activity per fresh matter at elevated CO2. Overall, we found that elevated CO2 improved the production of strawberry (including yield and quality) at low temperature, but decreased it at high temperature. The dramatic fluctuation in strawberry yield between low and high temperature at elevated CO2 implies that more attention should be paid to the process of flower induction under climate change, especially in fruits that require winter chilling for reproductive growth. PMID:22911728

Effect of hemodiafiltration on quality of life over time.

PubMed

Mazairac, Albert H A; de Wit, G Ardine; Grooteman, Muriel P C; Penne, E Lars; van der Weerd, Neelke C; den Hoedt, Claire H; Lévesque, Renée; van den Dorpel, Marinus A; Nubé, Menso J; ter Wee, Piet M; Bots, Michiel L; Blankestijn, Peter J

2013-01-01

It is unclear if hemodiafiltration leads to a better quality of life compared with hemodialysis. It was, therefore, the aim of this study to assess the effect of hemodiafiltration on quality of life compared with hemodialysis in patients with ESRD. This study analyzed the data of 714 patients with a median follow-up of 2 years from the Convective Transport Study. The patients were enrolled between June of 2004 and December of 2009. The Convective Transport Study is a randomized controlled trial on the effect of online hemodiafiltration versus low-flux hemodialysis on all-cause mortality. Quality of life was assessed with the Kidney Disease Quality of Life-Short Form. This questionnaire provides data for a physical and mental composite score and describes kidney disease-specific quality of life in 12 domains. The domains have scales from 0 to 100. There were no significant differences in changes in health-related quality of life over time between patients treated with hemodialysis (n=358) or hemodiafiltration (n=356). The quality of life domain patient satisfaction declined over time in both dialysis modalities (hemodialysis: -2.5/yr, -3.4 to -1.5, P<0.001; hemodiafiltration: -1.4/yr, -2.4 to -0.5, P=0.004). Compared with hemodialysis, hemodiafiltration had no significant effect on quality of life over time.

Hurricane Katrina impact on water quality in the East Pearl River, Mississippi

NASA Astrophysics Data System (ADS)

Shiller, Alan M.; Shim, Moo-Joon; Guo, Laodong; Bianchi, Thomas S.; Smith, Richard W.; Duan, Shuiwang

2012-01-01

SummaryHurricanes and other intense storms have previously been reported to cause short-term changes in surface water quality. We examined the water quality of the East Pearl River in southern Mississippi both before and after Hurricane Katrina caused extensive damage to the watershed in 2005. Our post-storm sampling began two months after the hurricane, and thus we missed any immediate short-term consequences. However, sampling over the following two years allowed us to examine whether damage to the watershed resulted in significant longer-term effects on water quality. Interpretation of the time series data is complicated by the natural seasonal and climatic variability of the system. Thus, we utilized chemical property-property plots as well as semi-empirical relationships to compare pre- and post-storm water quality. Our analysis suggests that hurricane-induced vegetative destruction within this river basin has not substantially changed the concentrations of DOC, POC, SPM, pH, or dissolved Fe. However, lignin-phenol analysis of colloidal organic matter did show some significant changes in carbon-normalized concentration as well as in some degradation and source parameters. Nonetheless, even these changes were small and likely temporary. This lack of change may be partly due to the slow degradation of woody materials that occurs only over a period of a few years, even in the sub-tropical climate of this region. Also, transport of DOC material from the land, through the soils, and into the river is not always instantaneous because DOC may stay in soils for a long time. Our work can be examined in the context of other research focused on hurricane effects on different time scales. For instance, shorter term hurricane influences, such as immediate flooding, can cause concurrent, short-lived water quality changes. Likewise, if increased hurricane activity (as might result from climate change) results in permanent landscape or ecosystem changes, then significant long-term water quality changes might be expected.

The Effect of Ambient Water Quality on Lakefront Property Values: Evidence from Coeur d'Alene, Idaho

NASA Astrophysics Data System (ADS)

Liao, H.

2015-12-01

Climate warming is causing water temperatures to increase and subsequent changes in water quality. To develop innovative approaches for mitigating the possible negative social consequences of such changes, more research efforts are needed to investigate how people perceive and respond to ambient water quality. This research examines the amenity value of water quality in the areas centered on Lake Coeur d'Alene of Northern Idaho. Through a hedonic analysis, we find that two important water-quality variables have had significant effects on lakefront property values, including Secchi disc reading, a technical measure of water clarity, and the presence of Eurasian watermilfoil, an aquatic invasive species. We further explore the spatial heterogeneity of water-quality benefits along the urban-rural gradient and find that access to urban amenities has strengthened the water-quality benefits in the lakefront housing market. Our findings could be used to incentivize private property owners and stakeholders to commit time and funding to cope with the potential degradation of water quality under climate change.

[Will publication of quality indicators in the health service improve the quality? International experiences and Danish perspectives].

PubMed

Endahl, Lars A; Utzon, Jan

2002-09-16

It is well known that publication of hospital quality indicators may lead to improving of treatments. But the publication can also have some negative side effects: Focus may shift to the evaluated areas at the expense of non-evaluated areas. The most ill patients may be sorted out and high risk patients may be transferred to other hospitals or discharged in order to avoid their dying during hospitalisation and improve statistics. Overestimation of patient risk in order to improve relative treatment outcome. Increasing flow of patients to hospitals with high scores on quality indicators may cause imbalance between activities and budgets and hence longer waiting times and reduced quality of treatment. Negative publicity due to low scores on quality indicators may lead to under-utilisation of hospital capacity, patient and staff insecurity and staff wastage. Thus, publication of quality indicators may improve quality within the health sector, but it is very important to recognise potential pitfalls and negative side effects.

Teaching Large Classes in an Increasingly Internationalising Higher Education Environment: Pedagogical, Quality and Equity Issues

ERIC Educational Resources Information Center

Maringe, Felix; Sing, Nevensha

2014-01-01

Marketisation, increased student mobility, the massification of Higher Education (HE) and stagnating staff numbers in universities have combined to cause a ripple effect of change both in the demography and size of university classes across the world. This has implications for the quality and equity of learning and the need to examine and to…

A 2-1-1 research collaboration: participant accrual and service quality indicators.

PubMed

Eddens, Katherine S; Alcaraz, Kassandra I; Kreuter, Matthew W; Rath, Suchitra; Greer, Regina

2012-12-01

In times of crises, 2-1-1 serves as a lifeline in many ways. These crises often cause a spike in call volume that can challenge 2-1-1's ability to meet its service quality standards. For researchers gathering data through 2-1-1s, a sudden increase in call volume might reduce accrual as 2-1-1 has less time to administer study protocols. Research activities imbedded in 2-1-1 systems may affect directly 2-1-1 service quality indicators. Using data from a 2-1-1 research collaboration, this paper examines the impact of crises on call volume to 2-1-1, how call volume affects research participant accrual through 2-1-1, and how research recruitment efforts affect 2-1-1 service quality indicators. t-tests were used to examine the effect of call volume on research participant accrual. Linear and logistic regressions were used to examine the effect of research participant accrual on 2-1-1 service quality indicators. Data were collected June 2010-December 2011; data were analyzed in 2012. Findings from this collaboration suggest that crises causing spikes in call volume adversely affect 2-1-1 service quality indicators as well as accrual of research participants. Administering a brief (2-3 minute) health risk assessment did not affect service quality negatively, but administering a longer (15-18 minute) survey had a modest adverse effect on these indicators. In 2-1-1 research collaborations, both partners need to understand the dynamic relationship among call volume, research accrual, and service quality and adjust expectations accordingly. If research goals include administering a longer survey, increased staffing of 2-1-1 call centers may be needed to avoid compromising service quality. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Assessing the comparative effectiveness of Tai Chi versus physical therapy for knee osteoarthritis: design and rationale for a randomized trial

USDA-ARS?s Scientific Manuscript database

Background: Knee osteoarthritis (OA) causes pain and long-term disability with annual healthcare costs exceeding $185 billion in the United States. Few medical remedies effectively influence the course of the disease. Finding effective treatments to maintain function and quality of life in patients ...

Practical quality control tools for curves and surfaces

NASA Technical Reports Server (NTRS)

Small, Scott G.

1992-01-01

Curves (geometry) and surfaces created by Computer Aided Geometric Design systems in the engineering environment must satisfy two basic quality criteria: the geometric shape must have the desired engineering properties; and the objects must be parameterized in a way which does not cause computational difficulty for geometric processing and engineering analysis. Interactive techniques are described which are in use at Boeing to evaluate the quality of aircraft geometry prior to Computational Fluid Dynamic analysis, including newly developed methods for examining surface parameterization and its effects.

Health Effects of Ozone Pollution

EPA Pesticide Factsheets

Inhaling ozone can cause coughing, shortness of breath, worse asthma or bronchitis symptoms, and irritation and damage to airways.You can reduce your exposure to ozone pollution by checking air quality where you live.

The case for regime-based water quality standards

USGS Publications Warehouse

Poole, Geoffrey C.; Dunham, J.B.; Keenan, D.M.; Sauter, S.T.; McCullough, D.A.; Mebane, Christopher; Lockwood, Jeffrey C.; Essig, Don A.; Hicks, Mark P.; Sturdevant, Debra J.; Materna, E.J.; Spalding, M.; Risley, John; Deppman, Marianne

2004-01-01

Conventional water quality standards have been successful in reducing the concentration of toxic substances in US waters. However, conventional standards are based on simple thresholds and are therefore poorly structured to address human-caused imbalances in dynamic, natural water quality parameters, such as nutrients, sediment, and temperature. A more applicable type of water quality standarda??a a??regime standarda??a??would describe desirable distributions of conditions over space and time within a stream network. By mandating the protection and restoration of the aquatic ecosystem dynamics that are required to support beneficial uses in streams, well-designed regime standards would facilitate more effective strategies for management of natural water quality parameters.

Application of low frequency pulsed ohmic heating for inactivation of foodborne pathogens and MS-2 phage in buffered peptone water and tomato juice.

PubMed

Kim, Sang-Soon; Choi, Won; Kang, Dong-Hyun

2017-05-01

The purpose of this study was to inactivate foodborne pathogens effectively by ohmic heating in buffered peptone water and tomato juice without causing electrode corrosion and quality degradation. Escherichia coli O157:H7, Salmonella Typhimurium, and Listeria monocytogenes were used as representative foodborne pathogens and MS-2 phage was used as a norovirus surrogate. Buffered peptone water and tomato juice inoculated with pathogens were treated with pulsed ohmic heating at different frequencies (0.06-1 kHz). Propidium iodide uptake values of bacterial pathogens were significantly (p < 0.05) larger at 0.06-0.5 kHz than at 1 kHz, and sub-lethal injury of pathogenic bacteria was reduced by decreasing frequency. MS-2 phage was inactivated more effectively at low frequency, and was more sensitive to acidic conditions than pathogenic bacteria. Electrode corrosion and quality degradation of tomato juice were not observed regardless of frequency. This study suggests that low frequency pulsed ohmic heating is applicable to inactivate foodborne pathogens effectively without causing electrode corrosion and quality degradation in tomato juice. Copyright © 2016. Published by Elsevier Ltd.

Integrating research on wildland fires and air quality: needs and recommendations

EPA Science Inventory

A summary is presented that integrates general information on the causes and effects of wildland fires and emissions with various ecological impacts of forest fires and air pollution in forests and other ecosystems. We also synthesize information on the regional effects of wildl...

Effect of Gynostemma Pentaphyllum polysaccharide on boar spermatozoa quality following freezing-thawing.

PubMed

Hu, Jian-Hong; Li, Qing-Wang; Zhang, Ting; Jiang, Zhong-Liang

2009-12-01

Gynostemma Pentaphyllum Polysaccharide (GPP) was added at concentrations of 0.25, 0.5, 1.0, 1.5 and 2.0 mg/ml to the extenders used to freeze boar semen and its effects on the quality of frozen-thawed sperm were assessed. The sperm motility was significantly higher in the extenders containing 0.25 and 0.5 mg/ml GPP, as compared to other groups (P<0.05). The extender supplemented with 0.5 mg/ml GPP favored the highest intact membrane and intact acrosome percentages in comparison with other groups (P<0.05), respectively. The mitochondrial activity was significantly higher at the concentrations of 0.25, 0.5 and 1.0 mg/ml GPP than that of other treatments, and the control group (P<0.05). In biochemical assays, the extender supplemented with 0.25 and 0.5 mg/ml GPP significantly improved SOD levels, compared to other groups (P>0.05). However, the extenders supplemented with GPP did not cause significant differences in levels of CAT and GSH-Px, compared to the control (P>0.05). In summary, GPP exhibited a dose-related response and the lower concentration produced greater protective effect. According to the standard semen quality parameters and antioxidant activities measured in this study, the concentration of 0.5 mg/ml GPP caused a beneficial cryoprotective effects on the quality of frozen-thawed boar semen. It is proposed that an extender containing 0.5 mg/ml GPP could be used as cryoprotective medium of better efficiency.

Comparative Effectiveness of Phosphate Binders in Patients with Chronic Kidney Disease: A Systematic Review and Network Meta-Analysis.

PubMed

Sekercioglu, Nigar; Thabane, Lehana; Díaz Martínez, Juan Pablo; Nesrallah, Gihad; Longo, Christopher J; Busse, Jason W; Akhtar-Danesh, Noori; Agarwal, Arnav; Al-Khalifah, Reem; Iorio, Alfonso; Guyatt, Gordon H

2016-01-01

Chronic kidney disease-mineral and bone disorder (CKD-MBD) has been linked to poor health outcomes, including diminished quality and length of life. This condition is characterized by high phosphate levels and requires phosphate-lowering agents-phosphate binders. The objective of this systematic review is to compare the effects of available phosphate binders on patient-important outcomes in patients with CKD-MBD. Data sources included MEDLINE and EMBASE Trials from 1996 to February 2016. We also searched the Cochrane Register of Controlled Trials up to April 2016. Teams of two reviewers, independently and in duplicate, screened titles and abstracts and potentially eligible full text reports to determine eligibility, and subsequently abstracted data and assessed risk of bias in eligible randomized controlled trials (RCTs). Eligible trials enrolled patients with CKD-MBD, randomized them to receive calcium (delivered as calcium acetate, calcium citrate or calcium carbonate), non-calcium-based phosphate binders (NCBPB) (sevelamer hydrochloride, sevelamer carbonate, lanthanum carbonate, sucroferric oxyhydroxide and ferric citrate), phosphorus restricted diet, placebo or no treatment, and reported effects on all-cause mortality, cardiovascular mortality or hospitalization at ≥4 weeks follow-up. We performed network meta-analyses (NMA) for all cause-mortality for individual agents (seven-node analysis) and conventional meta-analysis of calcium vs. NCBPBs for all-cause mortality, cardiovascular mortality and hospitalization. In the NMAs, we calculated the effect estimates for direct, indirect and network meta-analysis estimates; for both NMA and conventional meta-analysis, we pooled treatment effects as risk ratios (RR) and calculated 95% confidence intervals (CIs) using random effect models. We used the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to rate the quality of evidence for each paired comparison. Our search yielded 1190 citations, of which 71 RCTs were retrieved for full review and 15 proved eligible. With 13 eligible studies from a prior review, we included 28 studies with 8335 participants; 25 trials provided data for our quantitative synthesis. Results suggest higher mortality with calcium than either sevelamer (NMA RR, 1.89 [95% CI, 1.02 to 3.50], moderate quality evidence) or NCBPBs (conventional meta-analysis RR, 1.76 [95% CI, 1.21 to 2.56, moderate quality evidence). Conventional meta-analysis suggested no difference in cardiovascular mortality between calcium and NCBPBs (RR, 2.54 [95% CI, 0.67 to 9.62 low quality evidence). Our results suggest higher hospitalization, although non-significant, with calcium than NCBPBs (RR, 1.293 [95% CI, 0.94 to 1.74, moderate quality evidence). Use of calcium results in higher mortality than either sevelamer in particular and NCBPBs in general (moderate quality evidence). Our results raise questions about whether administration of calcium as an intervention for CKD- MBD remains ethical. Further research is needed to explore the effects of different types of phosphate binders, including novel agents such as iron, on quality and quantity of life. PROSPERO CRD-42016032945.

Understanding Chemistry: Current and Possible

ERIC Educational Resources Information Center

Sanderson, R. T.

1976-01-01

Describes an instructional approach for teaching the cause-and-effect relationship between the qualities of atoms and the properties of their chemical compositions. Discusses atomic structure, ionization energies, homonuclear and heteronuclear bonding, and bond dissociation. (MLH)

Endocrine Disrupting Chemicals (EDCs)

MedlinePlus

... body’s hormones work. They have been linked to human health issues related to sperm quality, fertility, abnormalities in ... support a link between EDCs and harm to human health, but the cause-and-effect relationship is not ...

Effect-directed analysis supporting monitoring of aquatic ...

EPA Pesticide Factsheets

Aquatic environments are often contaminated with complex mixtures of chemicals that may pose a risk to ecosystems and human health. This contamination cannot be addressed with target analysis alone but tools are required to reduce this complexity and identify those chemicals that might cause adverse effects. Effect-directed analysis (EDA) is designed to meet this challenge and faces increasing interest in water and sediment quality monitoring. Thus, the present paper summarizes current experience with the EDA approach and the tools required,and provides practical advice on their application. The paper highlights the need for proper problem formulation and gives general advice for study design. As the EDA approach is directed by toxicity, basic principles for the selection of bioassays are given as well as a comprehensive compilation of appropriate assays, includingtheir strengths andweaknesses. A specific focus is given to strategies for sampling, extraction and bioassay dosing since they strongly impact prioritization of toxicants in EDA. Reduction of sample complexity mainly relies onfractionation procedures, which are discussed in this paper, including quality assurance and quality control. Automated combinations of fractionation, biotesting and chemical analysis using so-called hyphenated tools can enhance the throughput and might reduce the risk of artifacts in laboratory work. The key to determiningthe chemical structures causing effects is analytical toxi

Does Competition Have an Effect on Price and Quality in Physiotherapy?

PubMed

Pekola, Piia; Linnosmaa, Ismo; Mikkola, Hennamari

2017-10-01

We estimate the effect of competition on quality and prices in physiotherapy organised and financed by the Social Insurance Institution of Finland for disabled individuals. Within the physiotherapy market, firms participate in competitive bidding, prices are determined by the market, services are free at the point of use and firms are allowed to react to patient choice only by enhancing quality. Firm-level data (n = 854) regarding quality and price were analysed. Using 2SLS estimation techniques, we analysed the relationship between quality and competition, and price and competition. Our study found that competition has a negative (yet weak) effect on quality. Prices on the other hand are not affected by competition. The result is likely caused by imperfect information, because it seems that the Social Insurance Institution of Finland has provided too little information for patients to make adequate choices about proper service providers. We argue that by publishing quality information, it is possible to ease the decision-making of patients and influence the quality strategies of firms active in the physiotherapy market. Moreover, we found that competition appeared as an exogenous variable in this study. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Comparative Effects of Gamma Irradiation and Ozone Treatment on Hygienic Quality of Korean Red Ginseng Powder

NASA Astrophysics Data System (ADS)

Byun, Myung-Woo; Yook, Hong-Sun; Kang, Il-Jun; Chung, Cha-Kwon; Kwon, Joong-Ho; Choi, Kang-Ju

1998-06-01

For the purpose of improving hygienic quality of Korean red ginseng powder, the comparative effects of gamma irradiation and ozone treatment on the microbial and physicochemical properties were investigated. Gamma irradiation at 7.5 kGy resulted in sterilization of total aerobic bacteria, molds and coliforms below detective levels, while ozone treatment for 8 hours up to 18 ppm did not sufficiently eliminate the microorganisms of the red ginseng powder. Physicochemical properties including compositions of the red ginseng saponin (ginsenosides) and fatty acids, pH and hydrogen doanting activity were not significantly changed by gamma irradiation, whereas, ozone treatment caused significant changes in fatty acid compositions, TBA value, pH, acidity and hydrogen donating activity. The results from this study led us to conclude that gamma irradiation was more effective than ozone treatment both for the improvement of hygienic quality and for the maintenance of physicochemical quality of red ginseng powder.

Workplace Violence and Job Performance among Community Healthcare Workers in China: The Mediator Role of Quality of Life.

PubMed

Lin, Wei-Quan; Wu, Jiang; Yuan, Le-Xin; Zhang, Sheng-Chao; Jing, Meng-Juan; Zhang, Hui-Shan; Luo, Jia-Li; Lei, Yi-Xiong; Wang, Pei-Xi

2015-11-20

To explore the impact of workplace violence on job performance and quality of life of community healthcare workers in China, especially the relationship of these three variables. From December 2013 to April 2014, a total of 1404 healthcare workers were recruited by using the random cluster sampling method from Community Health Centers in Guangzhou and Shenzhen. The workplace violence scale, the job performance scale and the quality of life scale (SF-36) were self-administered. The structural equation model constructed by Amos 17.0 was employed to assess the relationship among these variables. Our study found that 51.64% of the respondents had an experience of workplace violence. It was found that both job performance and quality of life had a negative correlation with workplace violence. A positive association was identified between job performance and quality of life. The path analysis showed the total effect (β = -0.243) of workplace violence on job performance consisted of a direct effect (β = -0.113) and an indirect effect (β = -0.130), which was mediated by quality of life. Workplace violence among community healthcare workers is prevalent in China. The workplace violence had negative effects on the job performance and quality of life of CHCs' workers. The study suggests that improvement in the quality of life may lead to an effective reduction of the damages in job performance caused by workplace violence.

Effects of nonindigenous invasive species on water quality and quantity

Treesearch

Frank H. McCormick; Glen C. Contreras; Sherri L. Johnson

2010-01-01

Physical and biological disruptions of aquatic systems caused by invasive species alter water quantity and water quality. Recent evidence suggests that water is a vector for the spread of Sudden Oak Death disease and Port-Orfordcedar root disease. Since the 1990s, the public has become increasingly aware of the presence of invasive species in the Nation’s waters. Media...

Integration of HIV care into maternal health services: a crucial change required in improving quality of obstetric care in countries with high HIV prevalence.

PubMed

Madzimbamuto, Farai D; Ray, Sunanda; Mogobe, Keitshokile D

2013-06-10

The failure to reduce preventable maternal deaths represents a violation of women's right to life, health, non-discrimination and equality. Maternal deaths result from weaknesses in health systems: inadequate financing of services, poor information systems, inefficient logistics management and most important, the lack of investment in the most valuable resource, the human resource of health workers. Inadequate senior leadership, poor communication and low staff morale are cited repeatedly in explaining low quality of healthcare. Vertical programmes undermine other service areas by creating competition for scarce skilled staff, separate reporting systems and duplication of training and tasks. Confidential enquiries and other quality-improvement activities have identified underlying causes of maternal deaths, but depend on the health system to respond with remedies. Instead of separate vertical programmes for management of HIV, tuberculosis, and reproductive health, integration of care and joint management of pregnancy and HIV would be more effective. Addressing health system failures that lead to each woman's death would have a wider impact on improving the quality of care provided in the health service as a whole. More could be achieved if existing resources were used more effectively. The challenge for African countries is how to get into practice interventions known from research to be effective in improving quality of care. Advocacy and commitment to saving women's lives are crucial elements for campaigns to influence governments and policy -makers to act on the findings of these enquiries. Health professional training curricula should be updated to include perspectives on patients' rights, communication skills, and integrated approaches, while using adult learning methods and problem-solving techniques. In countries with high rates of Human Immunodeficiency Virus (HIV), indirect causes of maternal deaths from HIV-associated infections now exceed direct causes of hemorrhage, hypertension and sepsis. Advocacy for all pregnant HIV-positive women to be on anti-retroviral therapy must extend to improvements in the quality of service offered, better organised obstetric services and integration of clinical HIV care into maternity services. Improved communication and specialist support to peripheral facilities can be facilitated through advances in technology such as mobile phones.

Quality management: reduction of waiting time and efficiency enhancement in an ENT-university outpatients' department

PubMed Central

Helbig, Matthias; Helbig, Silke; Kahla-Witzsch, Heike A; May, Angelika

2009-01-01

Background Public health systems are confronted with constantly rising costs. Furthermore, diagnostic as well as treatment services become more and more specialized. These are the reasons for an interdisciplinary project on the one hand aiming at simplification of planning and scheduling patient appointments, on the other hand at fulfilling all requirements of efficiency and treatment quality. Methods As to understanding procedure and problem solving activities, the responsible project group strictly proceeded with four methodical steps: actual state analysis, analysis of causes, correcting measures, and examination of effectiveness. Various methods of quality management, as for instance opinion polls, data collections, and several procedures of problem identification as well as of solution proposals were applied. All activities were realized according to the requirements of the clinic's ISO 9001:2000 certified quality management system. The development of this project is described step by step from planning phase to inauguration into the daily routine of the clinic and subsequent control of effectiveness. Results Five significant problem fields could be identified. After an analysis of causes the major remedial measures were: installation of a patient telephone hotline, standardization of appointment arrangements for all patients, modification of the appointments book considering the reason for coming in planning defined working periods for certain symptoms and treatments, improvement of telephonic counselling, and transition to flexible time planning by daily updates of the appointments book. After implementation of these changes into the clinic's routine success could be demonstrated by significantly reduced waiting times and resulting increased patient satisfaction. Conclusion Systematic scrutiny of the existing organizational structures of the outpatients' department of our clinic by means of actual state analysis and analysis of causes revealed the necessity of improvement. According to rules of quality management correcting measures and subsequent examination of effectiveness were performed. These changes resulted in higher satisfaction of patients, referring colleagues and clinic staff the like. Additionally the clinic is able to cope with an increasing demand for appointments in outpatients' departments, and the clinic's human resources are employed more effectively. PMID:19183496

Comparative effects of gamma irradiation and phosphine fumigation on the quality of white ginseng

NASA Astrophysics Data System (ADS)

Kwon, J.-H. J.-H.; Byun, M.-W. M.-W.; Kim, K.-S. K.-S.; Kang, I.-J. I.-J.

2000-03-01

The hygienic, physicochemical, and organoleptic qualities of white ginseng were monitored during 6 months under accelerated conditions (40°C, 90% r.h.) by observing its microbial populations, disinfestation, and some quality attributes following either gamma irradiation at 2.5-10 kGy or commercial phosphine (PH 3) fumigation. In a comparative study, both treatments were found to be effective for disinfecting the stored samples. Phosphine showed no appreciable decontaminating effects on microorganisms contaminated including coliforms, while 5 kGy irradiation was sufficient to control all microorganisms related to the quality of the packed samples. Irradiation at 5 kGy caused negligible changes in physicochemical attributes of the samples, such as ginsenosides, amino acids, fatty acids, and organoleptic properties, whereas phosphine fumigation was found detrimental to sensory flavor ( P<0.01). Quality deterioration occurred in the commercially-packed samples was in the following order: the control, 10 kGy-, phosphine-, and 2.5-5 kGy-treated samples. Accordingly, irradiation at <5 kGy was found to be an effective alternative to phosphine fumigation for white ginseng.

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

Bell, L.; Castaldi, A.; Jones, C.

The ultimate goal of the project is to develop procedures, techniques, data and other information that will aid in the design of cost effective and energy efficient drying processes that produce high quality foods. This objective has been sought by performing studies to determine the pertinent properties of food products, by developing models to describe the fundamental phenomena of food drying and by testing the models at laboratory scale. Finally, this information is used to develop recommendations and strategies for improved dryer design and control. This volume emphasizes a detailed literature review and several extensive experimental studies. Since the basicmore » principle of food dehydration is the removal of water from food, the process of removing water causes quality changes which can be categorized as physical, chemical, and nutritional. These changes often have adverse effects on the quality of the resulting dehydrated food. In this work, the types of physical and chemical changes common in food drying and the important factors for them were reviewed. Pertinent kinetic models and kinetic data reported in literature were also collected and compiled as the results of review study. The overall objectives of this study were to identify major quality change in foods caused by drying process and to get the knowledge of the relationship between the quality change and factors known to affect them. The quality parameters reviewed included: browning, lipid oxidation, color loss, shrinkage, solubility, texture, aroma and flavor, vitamin and protein loss and microbiological concerns. 54 refs., 74 figs., 49 tabs.« less

[Development and current status of atmospheric pollution].

PubMed

Elichegaray, C; Bouallala, S; Maitre, A; Ba, M

2009-02-01

Air quality is a public health issue and this article includes a reminder of the related causes and issues and a description of the monitoring of ambient air quality in France. It also provides a review of major developments in recent years of the pollutants measured. Emissions of major air pollutants have declined significantly since the 1970s, and this is reflected in an overall improvement in the quality of ambient air. Nevertheless, various forms of air pollution remain a concern (in the case of photochemical pollution) and health data show that air pollution is still a cause of morbidity and mortality. The fight against air pollution must remain a priority and requires multi-pollutant and multi-effect approaches. The National Health and Environment Program adopted during the Grenelle environment stakeholder consultation processes includes targets for reducing human exposure to air pollution, especially particulate matter, as well as measures to improve indoor air quality. In a context dominated by the struggle against the emission of greenhouse gases, problems of air quality should not be underestimated and policies relating to climate protection must be taken into account.

Causes of toxicity to Hyalella azteca in a stormwater management facility receiving highway runoff and snowmelt. Part II: salts, nutrients, and water quality.

PubMed

Bartlett, A J; Rochfort, Q; Brown, L R; Marsalek, J

2012-01-01

The Terraview-Willowfield Stormwater Management Facility (TWSMF) features a tandem of stormwater management ponds, which receive inputs of multiple contaminants from highway and residential runoff. Previous research determined that benthic communities in the ponds were impacted by poor habitat quality, due to elevated sediment concentrations of metals and polycyclic aromatic hydrocarbons (PAHS), and salinity in the overlying water, but did not address seasonal changes, including those caused by the influx of contaminants with the snowmelt. In order to address this issue, water and sediment samples were collected from the TWSMF during the fall and spring, and four-week sediment toxicity tests were conducted with Hyalella azteca. The effects of metals and PAHs are discussed in a companion paper; the effects of road salt, nutrients, and water quality are discussed here. After exposure to fall samples, survival of Hyalella was reduced (64-74% of controls) at three out of four sites, but growth was not negatively affected. After exposure to spring samples, survival was 0-75% of controls at the two sites furthest downstream, and growth was significantly lower in four out of five sites when comparing Hyalella exposed to site water overlying site sediment versus control water overlying site sediment. Toxicity appeared to be related to chloride concentrations: little or no toxicity occurred in fall samples (200 mg Cl(-)/L), and significant effects on survival and growth occurred in spring samples above 1550 mg Cl(-)/L and 380 mg Cl(-)/L, respectively. Sodium chloride toxicity tests showed similar results: four-week LC50s and EC25s (growth) were 1200 and 420 mg Cl(-)/L, respectively. Although water quality and nutrients were associated with effects observed in the TWSMF, chloride from road salt was the primary cause of toxicity in this study. Chloride persists during much of the year at concentrations representing a significant threat to benthic communities in the TWSMF. Copyright © 2011. Published by Elsevier B.V.

Temperature-induced impacts on groundwater quality and arsenic mobility in anoxic aquifer sediments used for both drinking water and shallow geothermal energy production.

PubMed

Bonte, Matthijs; van Breukelen, Boris M; Stuyfzand, Pieter J

2013-09-15

Aquifers used for the production of drinking water are increasingly being used for the generation of shallow geothermal energy. This causes temperature perturbations far beyond the natural variations in aquifers and the effects of these temperature variations on groundwater quality, in particular trace elements, have not been investigated. Here, we report the results of column experiments to assess the impacts of temperature variations (5°C, 11°C, 25°C and 60°C) on groundwater quality in anoxic reactive unconsolidated sandy sediments derived from an aquifer system widely used for drinking water production in the Netherlands. Our results showed that at 5 °C no effects on water quality were observed compared to the reference of 11°C (in situ temperature). At 25°C, As concentrations were significantly increased and at 60 °C, significant increases were observed pH and DOC, P, K, Si, As, Mo, V, B, and F concentrations. These elements should therefore be considered for water quality monitoring programs of shallow geothermal energy projects. No consistent temperature effects were observed on Na, Ca, Mg, Sr, Fe, Mn, Al, Ba, Co, Cu, Ni, Pb, Zn, Eu, Ho, Sb, Sc, Yb, Ga, La, and Th concentrations, all of which were present in the sediment. The temperature-induced chemical effects were probably caused by (incongruent) dissolution of silicate minerals (K and Si), desorption from, and potentially reductive dissolution of, iron oxides (As, B, Mo, V, and possibly P and DOC), and mineralisation of sedimentary organic matter (DOC and P). Copyright © 2013 Elsevier Ltd. All rights reserved.

The burden of age-related macular degeneration: a value-based medicine analysis.

PubMed

Brown, Gary C; Brown, Melissa M; Sharma, Sanjay; Stein, Joshua D; Roth, Zachary; Campanella, Joseph; Beauchamp, George R

2005-01-01

To assess the quality-of-life loss and the macroeconomic financial consequences associated with age-related macular degeneration (ARMD). Time tradeoff utility analysis was performed to assess the quality-of-life diminution caused by ARMD (both dry and neovascular) in cohorts consisting of (1) patients with ARMD, (2) ophthalmologists asked to assume they had various degrees of severity of ARMD, (3) healthcare providers asked to assume they had various degrees of severity of ARMD, and (4) participants from the general community asked to assume they had various degrees of severity of ARMD. ARMD was classified according to vision in the better-seeing eye as (1) mild: 20/20 to 20/40, (2) moderate: 20/50 to 20/100, (3) severe: < or = 20/200, or (4) very severe: < or = 20/800. Mild ARMD caused a 17% decrement in the quality of life of the average patient, similar to that encountered with moderate cardiac angina or symptomatic human immunodeficiency virus syndrome. Moderate ARMD caused a 32% decrease in the average patient's quality of life, similar to that associated with severe cardiac angina or a fractured hip. Severe ARMD caused a 53% decrease in quality, more than that of dialysis, and very severe ARMD caused a 60% decrease in the average ARMD patient's quality of life, similar to that encountered with end-stage prostate cancer or a catastrophic stroke that leaves a person bedridden, incontinent, and requiring constant nursing care. Patients with varying degrees of severity of ARMD were found to have quality-of-life impairment ranging from 96% to 750% greater than that estimated by treating ophthalmologists for the same condition. An economic analysis based upon losses to the gross domestic product suggests that ARMD has approximately a $30 billion annual negative impact. The return on investment is therefore potentially high for both treatment with current ARMD therapies and the research costs invested in the development of new ARMD treatment modalities. ARMD is a major public health problem that has a devastating effect upon patients and marked adverse financial consequences for the economy.

THE BURDEN OF AGE-RELATED MACULAR DEGENERATION: A VALUE-BASED MEDICINE ANALYSIS

PubMed Central

Brown, Gary C; Brown, Melissa M; Sharma, Sanjay; Stein, Joshua D; Roth, Zachary; Campanella, Joseph; Beauchamp, George R

2005-01-01

Purpose To assess the quality-of-life loss and the macroeconomic financial consequences associated with age-related macular degeneration (ARMD). Methods Time tradeoff utility analysis was performed to assess the quality-of-life diminution caused by ARMD (both dry and neovascular) in cohorts consisting of (1) patients with ARMD, (2) ophthalmologists asked to assume they had various degrees of severity of ARMD, (3) healthcare providers asked to assume they had various degrees of severity of ARMD, and (4) participants from the general community asked to assume they had various degrees of severity of ARMD. ARMD was classified according to vision in the better-seeing eye as (1) mild: 20/20 to 20/40, (2) moderate: 20/50 to 20/100, (3) severe: ≤ 20/200, or (4) very severe: ≤ 20/800. Results Mild ARMD caused a 17% decrement in the quality of life of the average patient, similar to that encountered with moderate cardiac angina or symptomatic human immunodeficiency virus syndrome. Moderate ARMD caused a 32% decrease in the average patient’s quality of life, similar to that associated with severe cardiac angina or a fractured hip. Severe ARMD caused a 53% decrease in quality, more than that of dialysis, and very severe ARMD caused a 60% decrease in the average ARMD patient’s quality of life, similar to that encountered with end-stage prostate cancer or a catastrophic stroke that leaves a person bedridden, incontinent, and requiring constant nursing care. Patients with varying degrees of severity of ARMD were found to have quality-of-life impairment ranging from 96% to 750% greater than that estimated by treating ophthalmologists for the same condition. An economic analysis based upon losses to the gross domestic product suggests that ARMD has approximately a $30 billion annual negative impact. The return on investment is therefore potentially high for both treatment with current ARMD therapies and the research costs invested in the development of new ARMD treatment modalities. Conclusions ARMD is a major public health problem that has a devastating effect upon patients and marked adverse financial consequences for the economy. PMID:17057801

Effect of Hemodiafiltration on Quality of Life over Time

PubMed Central

Mazairac, Albert H.A.; de Wit, G. Ardine; Grooteman, Muriel P.C.; Penne, E. Lars; van der Weerd, Neelke C.; den Hoedt, Claire H.; Lévesque, Renée; van den Dorpel, Marinus A.; Nubé, Menso J.; ter Wee, Piet M.; Bots, Michiel L.

2013-01-01

Summary Background and objectives It is unclear if hemodiafiltration leads to a better quality of life compared with hemodialysis. It was, therefore, the aim of this study to assess the effect of hemodiafiltration on quality of life compared with hemodialysis in patients with ESRD. Design, setting, participants, & measurements This study analyzed the data of 714 patients with a median follow-up of 2 years from the Convective Transport Study. The patients were enrolled between June of 2004 and December of 2009. The Convective Transport Study is a randomized controlled trial on the effect of online hemodiafiltration versus low-flux hemodialysis on all-cause mortality. Quality of life was assessed with the Kidney Disease Quality of Life—Short Form. This questionnaire provides data for a physical and mental composite score and describes kidney disease-specific quality of life in 12 domains. The domains have scales from 0 to 100. Results There were no significant differences in changes in health-related quality of life over time between patients treated with hemodialysis (n=358) or hemodiafiltration (n=356). The quality of life domain patient satisfaction declined over time in both dialysis modalities (hemodialysis: −2.5/yr, −3.4 to −1.5, P<0.001; hemodiafiltration: −1.4/yr, −2.4 to −0.5, P=0.004). Conclusions Compared with hemodialysis, hemodiafiltration had no significant effect on quality of life over time. PMID:23124783

Yoga might be an alternative training for the quality of life and balance in postmenopausal osteoporosis.

PubMed

Tüzün, S; Aktas, I; Akarirmak, U; Sipahi, S; Tüzün, F

2010-03-01

Osteoporotic vertebra and hip fractures are major causes of dysfunction, disability, mortality and impaired life quality in the ageing population. In the postmenopausal period, exercises prevent rapid bone loss and increase muscle strength, mobility and flexibility thereby decreasing the risk of falls and fractures. Yoga exercises, which have been an inseparable part of Eastern culture for hundreds of years, are now being used in the field of osteoporosis rehabilitation. Yoga has a positive effect on balance, posture, flexibility, and life quality resulting from its effects on balance, stretching, relaxation and strengthening. The aim of this study was to evaluate the effect of yoga exercises in postmenopausal osteoporotic women on balance and life quality and to compare the results with a classic osteoporosis exercise program. Twenty-six postmenopausal osteoporotic women over 55 years of age were included in the study. A neuromuscular test battery and the QUALEFFO as a life quality index were used for the assessment of balance and life quality, respectively. The results showed that yoga education has a positive effect on pain, physical functions, social functions, general In conclusion, yoga appears to be an alternative physical activity for the rehabilitation of osteoporotic subjects.

Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: systematic review and meta-analysis.

PubMed

Ma, Chenhan; Avenell, Alison; Bolland, Mark; Hudson, Jemma; Stewart, Fiona; Robertson, Clare; Sharma, Pawana; Fraser, Cynthia; MacLennan, Graeme

2017-11-14

Objective  To assess whether weight loss interventions for adults with obesity affect all cause, cardiovascular, and cancer mortality, cardiovascular disease, cancer, and body weight. Design  Systematic review and meta-analysis of randomised controlled trials (RCTs) using random effects, estimating risk ratios, and mean differences. Heterogeneity investigated using Cochran's Q and I 2 statistics. Quality of evidence assessed by GRADE criteria. Data sources  Medline, Embase, the Cochrane Central Register of Controlled Trials, and full texts in our trials' registry for data not evident in databases. Authors were contacted for unpublished data. Eligibility criteria for selecting studies  RCTs of dietary interventions targeting weight loss, with or without exercise advice or programmes, for adults with obesity and follow-up ≥1 year. Results  54 RCTs with 30 206 participants were identified. All but one trial evaluated low fat, weight reducing diets. For the primary outcome, high quality evidence showed that weight loss interventions decrease all cause mortality (34 trials, 685 events; risk ratio 0.82, 95% confidence interval 0.71 to 0.95), with six fewer deaths per 1000 participants (95% confidence interval two to 10). For other primary outcomes moderate quality evidence showed an effect on cardiovascular mortality (eight trials, 134 events; risk ratio 0.93, 95% confidence interval 0.67 to 1.31), and very low quality evidence showed an effect on cancer mortality (eight trials, 34 events; risk ratio 0.58, 95% confidence interval 0.30 to 1.11). Twenty four trials (15 176 participants) reported high quality evidence on participants developing new cardiovascular events (1043 events; risk ratio 0.93, 95% confidence interval 0.83 to 1.04). Nineteen trials (6330 participants) provided very low quality evidence on participants developing new cancers (103 events; risk ratio 0.92, 95% confidence interval 0.63 to 1.36). Conclusions  Weight reducing diets, usually low in fat and saturated fat, with or without exercise advice or programmes, may reduce premature all cause mortality in adults with obesity. Systematic review registration  PROSPERO CRD42016033217. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Air Pollution.

EPA Science Inventory

Air quality is affected by many types of pollutants that are emitted from various sources, including stationary and mobile. These sources release both criteria and hazardous air pollutants, which cause health effects, ecological harm, and material damage. They are generally categ...

Use of sediment quality guidelines

USGS Publications Warehouse

Wenning, R. J.; Batley, G. E.; Ingersoll, Christopher G.; Moore, David W.

2005-01-01

Are sediment quality guidelines (SQGs) adequately able to predict the presence or absence of chronic toxicity to sediment-dwelling organisms in field-collected sediments? Can SQGs predict effects resulting from the bioaccumulation of sediment-associated contaminants? Do SQGs define cause-and-effect relationships? Can they predict effects on organisms exposed in the field on the basis of amphipod mortality measured in the laboratory?These and other questions brought together 55 scientists from 8 countries for a Pellston Workshop convened by the Society of Environmental Toxicology and Chemistry (SETAC) in Fairmont, Montana, USA. In this book, these experts in ecology, ecotoxicology, engineering, environmental regulation, and risk assessment examine the scientific underpinnings of sediment quality guidelines and provide recommendations on the appropriate use of SQGs in the assessment and management of contaminated sediments.

Harnessing the complexity of education with information technology

NASA Astrophysics Data System (ADS)

Gershenson, Carlos

2015-05-01

Education at all levels is facing several challenges in most countries, such as low quality, high costs, lack of educators, and unsatisfied student demand. Traditional approaches are becoming unable to deliver the required education. Several causes for this inefficiency can be identified. I argue that beyond specific causes, the lack of effective education is related to complexity. However, information technology is helping us overcome this complexity.

Lysosome and endoplasmic reticulum quality control pathways in Niemann-Pick type C disease

PubMed Central

Schultz, Mark L.; Krus, Kelsey L.; Lieberman, Andrew P.

2017-01-01

Lysosomal storage diseases result from inherited deficiencies of lysosomal hydrolytic activities or lipid transport. Collectively, these disorders are a common cause of morbidity in the pediatric population and are often associated with severe neurodegeneration. Among this group of diseases is Niemann-Pick type C, an autosomal recessive disorder of lipid trafficking that causes cognitive impairment, ataxia and death, most often in childhood. Here, we review the current knowledge of disease pathogenesis, with particular focus on insights gleaned from genetics and the study of model systems. Critical advances in understanding mechanisms that regulate intracellular cholesterol trafficking have emerged from this work and are highlighted. We review effects of disease-causing mutations on quality control pathways involving the lysosome and endoplasmic reticulum, and discuss how they function to clear the most common mutant protein found in Niemann-Pick type C patients, NPC1-I1061T. Finally, we summarize insights into the mechanisms that degrade misfolded transmembrane proteins in the endoplasmic reticulum and how manipulating these quality control pathways may lead to the identification of novel targets for disease-modifying therapies. PMID:27026653

Characterizing Spatial and Temporal Patterns of Thermal Environment and Air Quality in Taipei Metropolitan Area

NASA Astrophysics Data System (ADS)

Juang, J. Y.; Sun, C. H.; Jiang, J. A.; Wen, T. H.

2017-12-01

The urban heat island effect (UHI) caused by the regional-to-global environmental changes, dramatic urbanization, and shifting in land-use compositions has becoming an important environmental issue in recent years. In the past century, the coverage of urban area in Taipei Basin has dramatically increasing by ten folds. The strengthen of UHI effect significantly enhances the frequency of warm-night effect, and strongly influences the thermal environment of the residents in the Greater Taipei Metropolitan. In addition, the urban expansions due to dramatic increasing in urban populations and traffic loading significantly impacts the air quality and causes health issue in Taipei. In this study, the main objective is to quantify and characterize the temporal and spatial distributions of thermal environmental and air quality in the Greater Taipei Metropolitan Area by using monitoring data from Central Weather Bureau, Environmental Protection Administration. In addition, in this study, we conduct the analysis on the distribution of physiological equivalent temperature in the micro scale in the metropolitan area by using the observation data and quantitative simulation to investigate how the thermal environment is influenced under different conditions. Furthermore, we establish a real-time mobile monitoring system by using wireless sensor network to investigate the correlation between the thermal environment, air quality and other environmental factors, and propose to develop the early warning system for heat stress and air quality in the metropolitan area. The results from this study can be integrated into the management and planning system, and provide sufficient and important background information for the development of smart city in the metropolitan area in the future.

Effect of the patient-to-patient communication model on dysphagia caused by total laryngectomy.

PubMed

Tian, L; An, R; Zhang, J; Sun, Y; Zhao, R; Liu, M

2017-03-01

The study aimed to evaluate the effect of a patient-to-patient communication model on dysphagia in laryngeal cancer patients after total laryngectomy. Sixty-five patients who had undergone total laryngectomy were randomly divided into three groups: a routine communication group, a patient communication group (that received the patient-to-patient communication model) and a physician communication group. Questionnaires were used to compare quality of life and swallowing problems among all patient groups. The main factors causing dysphagia in total laryngectomy patients were related to fear and mental health. The patient communication group had improved visual analogue scale scores at one week after starting to eat. Quality of life in swallowing disorders questionnaire scores were significantly higher in the patient communication and physician communication groups than in the routine communication group. In addition, swallowing problems were much more severe in patients educated to high school level and above than in others. The patient-to-patient communication model can be used to resolve swallowing problems caused by psychological factors in total laryngectomy patients.

Overtaking collision effects in a cw double-pass proton linac

DOE PAGES

Tao, Yue; Qiang, Ji; Hwang, Kilean

2017-12-22

The recirculating superconducting proton linac has the advantage of reducing the number of cavities in the accelerator and the corresponding construction and operational costs. Beam dynamics simulations were done recently in a double-pass recirculating proton linac using a single proton beam bunch. For continuous wave (cw) operation, the high-energy proton bunch during the second pass through the linac will overtake and collide with the low-energy bunch during the first pass at a number of locations of the linac. These collisions might cause proton bunch emittance growth and beam quality degradation. Here, we study the collisional effects due to Coulomb space-chargemore » forces between the high-energy bunch and the low-energy bunch. Our results suggest that these effects on the proton beam quality would be small and might not cause significant emittance growth or beam blowup through the linac. A 10 mA, 500 MeV cw double-pass proton linac is feasible without using extra hardware for phase synchronization.« less

Overtaking collision effects in a cw double-pass proton linac

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

Tao, Yue; Qiang, Ji; Hwang, Kilean

The recirculating superconducting proton linac has the advantage of reducing the number of cavities in the accelerator and the corresponding construction and operational costs. Beam dynamics simulations were done recently in a double-pass recirculating proton linac using a single proton beam bunch. For continuous wave (cw) operation, the high-energy proton bunch during the second pass through the linac will overtake and collide with the low-energy bunch during the first pass at a number of locations of the linac. These collisions might cause proton bunch emittance growth and beam quality degradation. Here, we study the collisional effects due to Coulomb space-chargemore » forces between the high-energy bunch and the low-energy bunch. Our results suggest that these effects on the proton beam quality would be small and might not cause significant emittance growth or beam blowup through the linac. A 10 mA, 500 MeV cw double-pass proton linac is feasible without using extra hardware for phase synchronization.« less

Effects of missing low-frequency information on ptychographic and plane-wave coherent diffraction imaging.

PubMed

Liu, Haigang; Xu, Zijian; Zhang, Xiangzhi; Wu, Yanqing; Guo, Zhi; Tai, Renzhong

2013-04-10

In coherent diffractive imaging (CDI) experiments, a beamstop (BS) is commonly used to extend the exposure time of the charge-coupled detector and obtain high-angle diffraction signals. However, the negative effect of a large BS is also evident, causing low-frequency signals to be missed and making CDI reconstruction unstable or causing it to fail. We performed a systematic simulation investigation of the effects of BSs on the quality of reconstructed images from both plane-wave and ptychographic CDI (PCDI). For the same imaging quality, we found that ptychography can tolerate BSs that are at least 20 times larger than those for plane-wave CDI. For PCDI, a larger overlap ratio and a smaller illumination spot can significantly increase the imaging robustness to the negative influence of BSs. Our results provide guidelines for the usage of BSs in CDI, especially in PCDI experiments, which can help to further improve the spatial resolution of PCDI.

Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect

PubMed Central

2011-01-01

Background Annually over 520,000 newborns die from neonatal sepsis, and 60,000 more from tetanus. Estimates of the effect of clean birth and postnatal care practices are required for evidence-based program planning. Objective To review the evidence for clean birth and postnatal care practices and estimate the effect on neonatal mortality from sepsis and tetanus for the Lives Saved Tool (LiST). Methods We conducted a systematic review of multiple databases. Data were abstracted into standard tables and assessed by GRADE criteria. Where appropriate, meta-analyses were undertaken. For interventions with low quality evidence but a strong GRADE recommendation, a Delphi process was conducted. Results Low quality evidence supports a reduction in all-cause neonatal mortality (19% (95% c.i. 1–34%)), cord infection (30% (95% c.i. 20–39%)) and neonatal tetanus (49% (95% c.i. 35–62%)) with birth attendant handwashing. Very low quality evidence supports a reduction in neonatal tetanus mortality with a clean birth surface (93% (95% c.i. 77-100%)) and no relationship between a clean perineum and tetanus. Low quality evidence supports a reduction of neonatal tetanus with facility birth (68% (95% c.i. 47-88%). No relationship was found between birth place and cord infections or sepsis mortality. For postnatal clean practices, all-cause mortality is reduced with chlorhexidine cord applications in the first 24 hours of life (34% (95% c.i. 5–54%, moderate quality evidence) and antimicrobial cord applications (63% (95% c.i. 41–86%, low quality evidence). One study of postnatal maternal handwashing reported reductions in all-cause mortality (44% (95% c.i. 18–62%)) and cord infection ((24% (95% c.i. 5-40%)). Given the low quality of evidence, a Delphi expert opinion process was undertaken. Thirty experts reached consensus regarding reduction of neonatal sepsis deaths by clean birth practices at home (15% (IQR 10–20)) or in a facility (27% IQR 24–36)), and by clean postnatal care practices (40% (IQR 25–50)). The panel estimated that neonatal tetanus mortality was reduced by clean birth practices at home (30% (IQR(20–30)), or in a facility (38% (IQR 34–40)), and by clean postnatal care practices (40% (IQR 30–50)). Conclusion According to expert opinion, clean birth and particularly postnatal care practices are effective in reducing neonatal mortality from sepsis and tetanus. Further research is required regarding optimal implementation strategies. PMID:21501428

The interdisciplinary approach to the implementation of a diabetes home care disease management program.

PubMed

Rosa, Mary Ann; Lapides, Shawn; Hayden, Corrine; Santangelo, Roxanne

2014-02-01

Diabetes is a national epidemic and a leading cause of hospitalizations in the United States. Home care agencies need to be able to provide effective Diabetes Disease Management to help prevent avoidable hospitalizations and assist patients to live a good quality of life. This article describes one organization's journey toward providing patients with better diabetes care resulting in an improved quality of life.

Quantity-Quality and the One Child Policy: The Only-Child Disadvantage in School Enrollment in Rural China. NBER Working Paper No. 14973

ERIC Educational Resources Information Center

Qian, Nancy

2009-01-01

Many believe that increasing the quantity of children will lead to a decrease in their quality. This paper exploits plausibly exogenous changes in family size caused by relaxations in China's One Child Policy to estimate the causal effect of family size on school enrollment of the first child. The results show that for one-child families, an…

Skeletal-related events among breast and prostate cancer patients: towards new treatment initiation in Malaysia's hospital setting.

PubMed

Ezat, Sharifa Wan Puteh; Syed Junid, Syed Mohamed Aljunid; Noraziani, Khamis; Zafar, Ahmed; Saperi, Sulong; Nur, Amrizal Muhammad; Aizuddin, Azimatun Noor; Ismail, Fuad; Abdullah, Norlia; Zainuddin, Zulkifli Md; Mohd Kassim, Abdul Yazid; Haflah, Nor Hazla Mohamed

2013-01-01

The human skeleton is the most common organ to be affected by metastatic cancer and bone metastases are a major cause of cancer morbidity. The five most frequent cancers in Malaysia among males includes prostate whereas breast cancer is among those in females, both being associated with skeletal lesions. Bone metastases weaken bone structure, causing a range of symptoms and complications thus developing skeletal-related events (SRE). Patients with SRE may require palliative radiotherapy or surgery to bone for pain, having hypercalcaemia, pathologic fractures, and spinal cord compression. These complications contribute to a decline in patient health- related quality of life. The multidimensional assessment of health-related quality of life for those patients is important other than considering a beneficial treatment impact on patient survival, since the side effects of treatment and disease symptoms can significantly impact health-related quality of life. Cancer treatment could contribute to significant financial implications for the healthcare system. Therefore, it is essential to assess the health-related quality of life and treatment cost, among prostate and breast cancer patients in countries like Malaysia to rationalized cost-effective way for budget allocation or utilization of health care resources, hence helping in providing more personalized treatment for cancer patients.

Effect of Power Ultrasound on Food Quality

NASA Astrophysics Data System (ADS)

Lee, Hyoungill; Feng, Hao

Recent food processing technology innovations have been centered around producing foods with fresh-like attributes through minimal processing or nonthermal processing technologies. Instead of using thermal energy to secure food safety that is often accompanied by quality degradation in processed foods, the newly developed processing modalities utilize other types of physical energy such as high pressure, pulsed electric field or magnetic field, ultraviolet light, or acoustic energy to process foods. An improvement in food quality by the new processing methods has been widely reported. In comparison with its low-energy (high-frequency) counterpart which finds applications in food quality inspection, the use of high-intensity ultrasound, also called power ultrasound, in food processing is a relatively new endeavor. To understand the effect of high-intensity ultrasound treatment on food quality, it is important to understand the interactions between acoustic energy and food ingredients, which is covered in Chapter 10. In this chapter, the focus will be on changes in overall food quality attributes that are caused by ultrasound, such as texture, color, flavor, and nutrients.

Assessment of water quality in canals of eastern Broward County, Florida, 1969-74

USGS Publications Warehouse

Waller, Bradley G.; Miller, Wesley L.

1982-01-01

An intensive water-quality monitoring program was started in 1969 to determine the effects of man-induced contaminants on the water quality in the primary canal system of eastern Broward County, Florida. This report covers the first 6 years of the program and provides a data base that can be used to compare future changes in water-quality conditions. Most data indicate that beyond the small seasonal fluctuation in constituent level, the greatest adverse effect on the quality of water is caused by discharge of sewage and treated sewage effluent to the canals. The areas affected by sewage have greater concentrations of macronutrients, trace metals, and pesticides than unaffected areas. Major-ion concentrations were affected only by season and local lithology. Over the 6-year study a gradual decrease in macronutrient concentration and an increase in dissolved oxygen have occurred. This improvement in water quality is attributed to a decrease of sewage discharge into canals and better treatment of sewage effluents. (USGS)

Intractable epilepsy: management and therapeutic alternatives.

PubMed

Schuele, Stephan U; Lüders, Hans O

2008-06-01

More than half of patients with newly diagnosed epilepsy achieve complete seizure control without major side-effects. Patients who continue to have seizures after initial medical therapy should have an early and detailed assessment to confirm the diagnosis, to determine the underlying cause and epilepsy syndrome, and to choose an adequate treatment strategy. The risks and potential benefits of surgical procedures or experimental therapy have to be weighed against the chance of improvement and the potential side-effects of additional medical therapy. Surgery for temporal lobe epilepsy, the most common cause of focal epilepsy, can control seizures and improve quality of life in appropriately selected patients. However, around 20-30% of patients do not respond to medical or surgical treatment. The management of chronic intractable epilepsy requires comprehensive care to address the adverse events of medical treatment, quality of life issues, and comorbid disorders. Much research focuses on the experimental treatment options that offer hope of seizure reduction or cure.

Quality of life in patients with visual impairment in Ibadan: a clinical study in primary care.

PubMed

Adigun, Kehinde; Oluleye, Tunji S; Ladipo, Modupe Ma; Olowookere, Samuel Anu

2014-01-01

Visual function is important for optimal orientation in functional and social life, and has an effect on physical and emotional well-being. Visual impairment, therefore, leads to restrictions in all aspects of daily living and is related to quality of life. The aim of this study was to provide information on the causes of visual impairment in patients presenting to their family physician, the spectrum of impairment, and its impact on quality of life for these patients. This descriptive cross-sectional study of 375 adult patients with ocular symptoms was performed in the general outpatient department of the University College Hospital, Ibadan, from July to September, 2009. After checking their presenting visual acuity, the patients were interviewed using the Vision-Related Quality of Life questionnaire to determine the impact of visual impairment on their quality of life. Ophthalmic examinations were performed to determine the causes of visual impairment. The results were analyzed using proportions and percentages. The main causes of visual impairment were cataracts (58.7%), refractive error (19.4%), and glaucoma (2.9%). Visual impairment was found to be associated with advancing age, low education, and unemployment (P<0.001). Most patients (85.1%) were found to have good quality of life overall. Quality of life was found to be poor in the domains of visual function (64.2%) and social interaction (50.9%). Quality of life was found to be related to the degree of visual impairment, ie, blind patients reported poor quality of life (41.4%) when compared with those having low vision (8.6%) or near normal vision (2.4%, P<0.001). This study identified poor quality of life in patients with a higher degree of visual impairment. Family physicians need to identify these visually impaired patients early and make timely referrals.

Effects of short-term high temperature on grain quality and starch granules of rice (Oryza sativa L.) at post-anthesis stage.

PubMed

Chen, Jianlin; Tang, Liang; Shi, Peihua; Yang, Baohua; Sun, Ting; Cao, Weixing; Zhu, Yan

2017-03-01

High temperature causes negative effects on grain yield and quality of rice (Oryza sativa L.). In this study, the effects of short-term high temperature (SHT) on grain quality and starch granules were investigated in two rice cultivars Nanjing 41 (NJ41, heat-sensitive) and Wuxiangjing 14 (WJ14, heat-tolerant) at post-anthesis stage (anthesis and early grain-filling stage). The results of rice quality analysis showed that chalky rate and chalkiness increased while brown rice rate, milled rice rate, and head rice rate decreased in two rice cultivars with the increase of high temperature and prolonged duration. Moreover, SHT stress reduced the accumulation of amylose as well as starch accumulation. The starch accumulation and eating quality were more sensitive to SHT than the appearance and milling quality. The starch structure data observed by scanning electron microscope further showed that the starch granules are arranged loosely and more single starch granules appeared after SHT treatment. The extent of change in rice quality and starch traits of WJ14 under SHT was lower than that of NJ41. The effects of SHT at anthesis stage were greater than that at grain-filling stage. Taken together, the results could help further understand the physiological and biochemical processes governing rice quality under high-temperature conditions.

Making stillbirths visible: a systematic review of globally reported causes of stillbirth.

PubMed

Reinebrant, H E; Leisher, S H; Coory, M; Henry, S; Wojcieszek, A M; Gardener, G; Lourie, R; Ellwood, D; Teoh, Z; Allanson, E; Blencowe, H; Draper, E S; Erwich, J J; Frøen, J F; Gardosi, J; Gold, K; Gordijn, S; Gordon, A; Heazell, Aep; Khong, T Y; Korteweg, F; Lawn, J E; McClure, E M; Oats, J; Pattinson, R; Pettersson, K; Siassakos, D; Silver, R M; Smith, Gcs; Tunçalp, Ö; Flenady, V

2018-01-01

Stillbirth is a global health problem. The World Health Organization (WHO) application of the International Classification of Diseases for perinatal mortality (ICD-PM) aims to improve data on stillbirth to enable prevention. To identify globally reported causes of stillbirth, classification systems, and alignment with the ICD-PM. We searched CINAHL, EMBASE, Medline, Global Health, and Pubmed from 2009 to 2016. Reports of stillbirth causes in unselective cohorts. Pooled estimates of causes were derived for country representative reports. Systems and causes were assessed for alignment with the ICD-PM. Data are presented by income setting (low, middle, and high income countries; LIC, MIC, HIC). Eighty-five reports from 50 countries (489 089 stillbirths) were included. The most frequent categories were Unexplained, Antepartum haemorrhage, and Other (all settings); Infection and Hypoxic peripartum (LIC), and Placental (MIC, HIC). Overall report quality was low. Only one classification system fully aligned with ICD-PM. All stillbirth causes mapped to ICD-PM. In a subset from HIC, mapping obscured major causes. There is a paucity of quality information on causes of stillbirth globally. Improving investigation of stillbirths and standardisation of audit and classification is urgently needed and should be achievable in all well-resourced settings. Implementation of the WHO Perinatal Mortality Audit and Review guide is needed, particularly across high burden settings. HR, SH, SHL, and AW were supported by an NHMRC-CRE grant (APP1116640). VF was funded by an NHMRC-CDF (APP1123611). Urgent need to improve data on causes of stillbirths across all settings to meet global targets. Background and methods Nearly three million babies are stillborn every year. These deaths have deep and long-lasting effects on parents, healthcare providers, and the society. One of the major challenges to preventing stillbirths is the lack of information about why they happen. In this study, we collected reports on the causes of stillbirth from high-, middle-, and low-income countries to: (1) Understand the causes of stillbirth, and (2) Understand how to improve reporting of stillbirths. Findings We found 85 reports from 50 different countries. The information available from the reports was inconsistent and often of poor quality, so it was hard to get a clear picture about what are the causes of stillbirth across the world. Many different definitions of stillbirth were used. There was also wide variation in what investigations of the mother and baby were undertaken to identify the cause of stillbirth. Stillbirths in all income settings (low-, middle-, and high-income countries) were most frequently reported as Unexplained, Other, and Haemorrhage (bleeding). Unexplained and Other are not helpful in understanding why a baby was stillborn. In low-income countries, stillbirths were often attributed to Infection and Complications during labour and birth. In middle- and high-income countries, stillbirths were often reported as Placental complications. Limitations We may have missed some reports as searches were carried out in English only. The available reports were of poor quality. Implications Many countries, particularly those where the majority of stillbirths occur, do not report any information about these deaths. Where there are reports, the quality is often poor. It is important to improve the investigation and reporting of stillbirth using a standardised system so that policy makers and healthcare workers can develop effective stillbirth prevention programs. All stillbirths should be investigated and reported in line with the World Health Organization standards. © 2017 Royal College of Obstetricians and Gynaecologists.

Risk factors and treatment for steroid-related mood and behavior symptoms in preschool children with leukemia: A case series.

PubMed

Samsel, Chase; Muriel, Anna C

2017-02-01

Treatment of pediatric acute lymphoblastic leukemia (ALL) relies on systemic corticosteroids for remission; however, they can cause significant mood and behavior changes that interfere with quality of life and may increase risk for injury. This case series reports on preschool children with preexisting developmental and psychiatric risk factors who presented with behavioral side effects that required intervention. Identification of these vulnerable children may provide opportunities for early intervention, anticipatory guidance, and effective treatment to minimize behavioral side effects and improve quality of life and safety during ALL treatment. © 2016 Wiley Periodicals, Inc.

[The nameless pill. The effects and side-effects of the therapeutic use of placebo preparations].

PubMed

Piechowiak, H

1981-08-22

Information is provided on the frequency of therapeutic use of placebos and on the quality and quantity of the effects observed after placebo treatment. The possible causes of these effects and theoretical explanatory models are also discussed. The ethical aspects of the clinical use of placebos are considered and more scientific investigation to enhance unspecific effects of all pharmacotherapy is called for.

Tillage system and time post-liquid dairy manure: Effects on runoff, sediment and nutrients losses

USDA-ARS?s Scientific Manuscript database

Liquid manure applied in agricultural lands improves soil quality. However, incorrect management of manure may cause environmental problems due to sediments and nutrients losses associated to runoff. The aims of this work were to: (i) evaluate the time effect of post-liquid dairy manure (LDM) applic...

76 FR 57871 - Approval of Air Quality Implementation Plans; California; South Coast; Attainment Plan for 1997 8...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... indicates that adverse public health effects occur following exposure to ozone, particularly in children and... be active outdoors, which increases their exposure. See ``Fact Sheet, Proposal To Revise the National... evidence demonstrating that ozone causes adverse health effects at lower concentrations and over longer...

A Breath of Fresh Air: Addressing Indoor Air Quality

ERIC Educational Resources Information Center

Palliser, Janna

2011-01-01

Indoor air pollution refers to "chemical, biological, and physical contamination of indoor air," which may result in adverse health effects (OECD 2003). The causes, sources, and types of indoor air pollutants will be addressed in this article, as well as health effects and how to reduce exposure. Learning more about potential pollutants in home…

Meta-Analysis of the Effects of Xingnaojing Injection on Consciousness Disturbance

PubMed Central

Wu, Lijun; Zhang, Hua; Xing, Yanwei; Gao, Yonghong; Li, Yanda; Ren, Xiaomeng; Li, Jie; Nie, Bo; Zhu, Lingqun; Shang, Hongcai; Gao, Ying

2016-01-01

Abstract Xingnaojing (XNJ) is commonly extracted from Angongniuhuang, a classic Chinese emergency prescription, and widely used in the treatment of nervous system disorders including consciousness disturbance in China. To evaluate the beneficial and adverse effects of XNJ injection, on consciousness disturbance. Seven major electronic databases were searched to retrieve randomized controlled trials designed to evaluate the clinical efficacy of XNJ alone or combined with Western medicine in treating consciousness disturbance caused by conditions such as high fever, poisoning, and stroke. The methodological quality of the included studies was assessed using criteria from the Cochrane Handbook for Systematic Review of Interventions, and analyzed using the RevMan 5.3.0 software. Seventeen randomized controlled trials on XNJ were included in this study and the trials generally showed low methodological quality. The results revealed that XNJ alone or in combination with other medicines and adjuvant methods had a positive effect on patients with fever-, poisoning-, and stroke-induced coma. XNJ effectively treated consciousness disturbances that were caused by high fever, poisoning, or stroke. PMID:26886655

Effects of ionizing radiation on sensorial, chemical, and microbiological quality of frozen corn and peas.

PubMed

Fan, Xuetong; Sokorai, Kimberly J B

2007-08-01

The effects of irradiation (0, 1.8, and 4.5 kGy) on the quality of frozen corn and peas were investigated during a 12month period of postirradiation storage at -18 degrees C. Irradiation of frozen corn and peas caused a reduction in ascorbic acid content of both vegetables and a loss of texture in peas but had no significant effects on instrumental color parameters (L*, a*, and b*), carotenoid and chlorophyll content, or antioxidant capacity of corn and peas. Irradiation reduced microbial loads of frozen peas and increased display life at 23 degrees C of thawed peas by preserving the green color, apparently because of slower increases in the population of acid-producing microorganisms in the irradiated samples. Overall, irradiation significantly reduced the microbial load and increased the display life of peas and had minimal detrimental effects on the quality of frozen corn and peas.

Effect of production variables on microbiological removal in locally-produced ceramic filters for household water treatment.

PubMed

Lantagne, Daniele; Klarman, Molly; Mayer, Ally; Preston, Kelsey; Napotnik, Julie; Jellison, Kristen

2010-06-01

Diarrhoeal diseases cause an estimated 1.87 million child deaths per year. Point-of-use filtration using locally made ceramic filters improves microbiological quality of stored drinking water and prevents diarrhoeal disease. Scaling-up ceramic filtration is inhibited by lack of universal quality control standards. We investigated filter production variables to determine their affect on microbiological removal during 5-6 weeks of simulated normal use. Decreases in the clay:sawdust ratio and changes in the burnable decreased effectiveness of the filter. Method of silver application and shape of filter did not impact filter effectiveness. A maximum flow rate of 1.7 l(-hr) was established as a potential quality control measure for one particular filter to ensure 99% (2- log(10)) removal of total coliforms. Further research is indicated to determine additional production variables associated with filter effectiveness and develop standardized filter production procedures prior to scaling-up.

Clinical image quality evaluation for panoramic radiography in Korean dental clinics

PubMed Central

Choi, Bo-Ram; Choi, Da-Hye; Huh, Kyung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Choi, Soon-Chul; Bae, Kwang-Hak

2012-01-01

Purpose The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Materials and Methods Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. Results A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Conclusion Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively. PMID:23071969

Workplace Violence and Job Performance among Community Healthcare Workers in China: The Mediator Role of Quality of Life

PubMed Central

Lin, Wei-Quan; Wu, Jiang; Yuan, Le-Xin; Zhang, Sheng-Chao; Jing, Meng-Juan; Zhang, Hui-Shan; Luo, Jia-Li; Lei, Yi-Xiong; Wang, Pei-Xi

2015-01-01

Objective: To explore the impact of workplace violence on job performance and quality of life of community healthcare workers in China, especially the relationship of these three variables. Methods: From December 2013 to April 2014, a total of 1404 healthcare workers were recruited by using the random cluster sampling method from Community Health Centers in Guangzhou and Shenzhen. The workplace violence scale, the job performance scale and the quality of life scale (SF-36) were self-administered. The structural equation model constructed by Amos 17.0 was employed to assess the relationship among these variables. Results: Our study found that 51.64% of the respondents had an experience of workplace violence. It was found that both job performance and quality of life had a negative correlation with workplace violence. A positive association was identified between job performance and quality of life. The path analysis showed the total effect (β = −0.243) of workplace violence on job performance consisted of a direct effect (β = −0.113) and an indirect effect (β = −0.130), which was mediated by quality of life. Conclusions: Workplace violence among community healthcare workers is prevalent in China. The workplace violence had negative effects on the job performance and quality of life of CHCs’ workers. The study suggests that improvement in the quality of life may lead to an effective reduction of the damages in job performance caused by workplace violence. PMID:26610538

The effect of massage therapy on the quality of sleep in breast cancer patients.

PubMed

Kashani, Fahimeh; Kashani, Parisa

2014-03-01

Annually, about 6000 new cases are diagnosed with breast cancer in Iran. In Iran, more women are affected with breast cancer than a decade earlier in comparison with other countries, and 70% of them are diagnosed at an advanced phase. Insomnia is the most common disorder following breast cancer, and interference in sleep quality and rest causes changes in physiological functions and reduces the body's daily performance. The objective of this study was to determine the effect of massage therapy on the quality of sleep in patients with breast cancer. This clinical trial was conducted for about 1 month in a referral chemotherapy clinic of a teaching hospital in Isfahan, Iran. The participants consisted of 57 women with breast cancer who were selected by simple random sampling. They were randomly assigned to two groups of control and experimental. The control group was treated only by usual medical therapy, whereas the case group was treated by combined medical-massage therapy. Data collection tools were the validated Pittsburgh Sleep Quality Index and a demographic questionnaire. Data were analyzed by SPSS using descriptive statistics, Chi-square test, paired t-test, and Student's t-test. The results showed significant differences in the mean scores of quality of sleep before and after the intervention in the case group, while no significant differences were observed in the mean scores of quality of sleep before and after the intervention in the control group. In addition, no significant differences were observed in the mean scores of quality of sleep before the intervention between case and control groups. However, significant differences were observed in the mean scores of quality of sleep after the intervention between case and control groups. According to the results of this study, learning and applying massage techniques by medical staff causes health promotion and improves the quality of sleep in cancer patients. Furthermore, massage therapy is suggested as a non-pharmacologic method to improve sleep quality in these patients.

Thermal environmental case study of an existing underfloor air distribution (UFAD) system in a high-rise building in the tropics

NASA Astrophysics Data System (ADS)

Ya, Y. H.; Poh, K. S.

2015-09-01

The performance of an existing underfloor air distribution (UFAD) system in a renowned high-rise office tower in Malaysia was studied to identify the root cause issues behind the poor indoor air quality. Occupants are the best thermal sensor. The building was detected with the sick building syndrome (SBS) that causes runny noses, flu-like symptoms, irritated skin, and etc. Long period of exposure to indoor air pollutants may increase the occupant's health risk. The parameters such as the space temperature, relative humidity, air movement, air change, fresh air flow rate, chilled water supply and return are evaluated at three stories that consist of five open offices. A full traverse study was carried out at one of the fresh air duct. A simplified duct flow measurement method using pitot-tubes was developed. The results showed that the diffusers were not effective in creating the swirl effect to the space. Internal heat gain from human and office electrical equipment were not drawn out effectively. Besides, relative humidity has exceeded the recommended level. These issues were caused by the poor maintenance of the building. The energy efficiency strategy of the UFAD system comes from the higher supply air temperature. It may leads to insufficient cooling load for the latent heat gained under improper system performance. Special care and considerations in design, construction and maintenance are needed to ensure the indoor air quality to be maintained. Several improvements were recommended to tackle the existing indoor air quality issues. Solar system was studied as one of the innovative method for retrofitting.

The quality management journey: the progress of health facilities in Australia.

PubMed

Carr, B J

1994-12-01

Many facilities in Australia have taken the Total Quality Management (TQM) step. The objective of this study was to examine progress of adopted formal quality systems in health. Sixty per cent of organizations surveyed have adopted formal systems. Of these, Deming adherents are the most common, followed by eclectic choices. Only 35% considered the quality transition as reasonably easy. There was no relationship between accreditation and formal quality systems identified. The most common improvement techniques were: flow charts, histograms, and cause and effect diagrams. Quality practitioners are happy to use several tools exceptionally well rather than have many tools at their disposal. The greatest impediment to the adoption of quality was the lack of top management support. This study did not support the view that clinicians are not readily actively supporting quality initiatives. Total Quality Management is not a mature concept; however, Chief Executive Officers are assured that rewards will be realized over time.

[Cause-of-death statistics and ICD, quo vadis?

PubMed

Eckert, Olaf; Vogel, Ulrich

2018-07-01

The International Statistical Classification of Diseases and Related Health Problems (ICD) is the worldwide binding standard for generating underlying cause-of-death statistics. What are the effects of former revisions of the ICD on underlying cause-of-death statistics and which opportunities and challenges are becoming apparent in a possible transition process from ICD-10 to ICD-11?This article presents the calculation of the exploitation grade of ICD-9 and ICD-10 in the German cause-of-death statistics and quality of documentation. Approximately 67,000 anonymized German death certificates are processed by Iris/MUSE and official German cause-of-death statistics are analyzed.In addition to substantial changes in the exploitation grade in the transition from ICD-9 to ICD-10, regional effects become visible. The rate of so-called "ill-defined" conditions exceeds 10%.Despite substantial improvement of ICD revisions there are long-known deficits in the coroner's inquest, filling death certificates and quality of coding. To make better use of the ICD as a methodological framework for mortality statistics and health reporting in Germany, the following measures are necessary: 1. General use of Iris/MUSE, 2. Establishing multiple underlying cause-of-death statistics, 3. Introduction of an electronic death certificate, 4. Improvement of the medical assessment of cause of death.Within short time the WHO will release the 11th revision of the ICD that will provide additional opportunities for the development of underlying cause-of-death statistics and their use in science, public health and politics. A coordinated effort including participants in the process and users is necessary to meet the related challenges.

[Failure mode and effects analysis to improve quality in clinical trials].

PubMed

Mañes-Sevilla, M; Marzal-Alfaro, M B; Romero Jiménez, R; Herranz-Alonso, A; Sanchez Fresneda, M N; Benedi Gonzalez, J; Sanjurjo-Sáez, M

The failure mode and effects analysis (FMEA) has been used as a tool in risk management and quality improvement. The objective of this study is to identify the weaknesses in processes in the clinical trials area, of a Pharmacy Department (PD) with great research activity, in order to improve the safety of the usual procedures. A multidisciplinary team was created to analyse each of the critical points, identified as possible failure modes, in the development of clinical trial in the PD. For each failure mode, the possible cause and effect were identified, criticality was calculated using the risk priority number and the possible corrective actions were discussed. Six sub-processes were defined in the development of the clinical trials in PD. The FMEA identified 67 failure modes, being the dispensing and prescription/validation sub-processes the most likely to generate errors. All the improvement actions established in the AMFE were implemented in the Clinical Trials area. The FMEA is a useful tool in proactive risk management because it allows us to identify where we are making mistakes and analyze the causes that originate them, to prioritize and to adopt solutions to risk reduction. The FMEA improves process safety and quality in PD. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Predicting spatial distribution of privet (liguestrum spp.) in South Carolina from MODIS and forest inventory plot data

Treesearch

Dumitru Salajanu; Dennis M. Jacobs

2009-01-01

Privet's aggressive competitive behavior causes environmental harm to the ecosystem by degrading species diversity and wildlife habitat. Effective control of its spread requires high-quality spatial distribution information. Our...

Air quality impact of traffic congestion in midtown Manhattan.

DOT National Transportation Integrated Search

2014-01-01

Exposure to fine particle pollution can cause premature death and harmful cardiovascular effects such as heart : attacks and strokes, and is linked to a variety of other significant health problem. A pilot project was : commissioned by the University...

Integrating research on wildland fires and air quality: needs and recommendations

Treesearch

Andrzej Bytnerowicz; Michael J. Arbaugh; Christian Andersen; Allen R. Riebau

2009-01-01

A summary is presented that integrates general information on the causes and effects of wildland fires and emissions with various ecological impacts of forest fires and air pollution in forests and other ecosystems. We also...

Effect of Melatonin Administration on Sleep Quality in Sulfur Mustard Exposed Patients with Sleep Disorders

PubMed Central

Mousavi, Seyyedeh Soghra; Shohrati, Majid; Vahedi, Ensieh; Abdollahpour-Alitappeh, Meghdad; Panahi, Yunes

2018-01-01

Sulfur mustard (SM) is a toxic agent that targets several tissues. It is the leading cause of persistent lung disease, progressive deterioration in lung function, and mortality among injured patients. Disturbed sleep and poor quality of sleep are common in SM-exposed patients with chronic respiratory problems. Melatonin is an alternative medication that has been widely used to treat poor sleep quality caused by several specific conditions. This study aimed to evaluate the efficacy of melatonin administration in improvement of sleep quality in SM-injured patients. In this randomized, double-blind and placebo-controlled trial study a total of 30 SM-exposed male patients were recruited. Patients received 3 mg melatonin (N = 15) or placebo (N = 15), orally in a single dose, 1 h before bedtime for 56 consecutive days. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI); daytime sleepiness was measured by Epworth Sleepiness Scale (ESS), and the risk of obstructive sleep apnea was determined by STOP-Bang questionnaire. Compared with placebo, melatonin administration significantly improved global PSQI score, particularly sleep latency (P = 0.03) and subjective sleep quality (P = 0.004). Mean of global PSQI score was declined significantly (P = 0.01) from 10.13 ± 3.44 to 6.66 ± 3.08 in melatonin group. No differences in ESS and STOP-Bang scores were observed between two groups. Melatonin was effective in improving global PSQI score and sleep latency, but not daytime sleepiness and obstructive sleep apnea in SM-exposed patients. Further long-term studies involving larger number of patients are needed before melatonin can be safely recommended for the management of sleep disturbances in these patients.

Health Management Technology as a General Solution Framework

NASA Astrophysics Data System (ADS)

Nakajima, Hiroshi; Hasegawa, Yoshifumi; Tasaki, Hiroshi; Iwami, Taro; Tsuchiya, Naoki

Health maintenance and improvement of humans, artifacts, and nature are pressing requirements considering the problems human beings have faced. In this article, the health management technology is proposed by centering cause-effect structure. The important aspect of the technology is evolvement through human-machine collaboration in response to changes of target systems. One of the reasons why the cause-effect structure is centered in the technology is its feature of transparency to humans by instinct point of view. The notion has been spreaded over wide application areas such as quality control, energy management, and healthcare. Some experiments were conducted to prove effectiveness of the technology in the article.

[QUALITY MEASURES IN MEDICINE-- A PLEA FOR NEW, VALUE BASED THINKING].

PubMed

Fisher, Menachem; Wagner, Oded; Keinarl, Talia; Solt, Ido

2015-09-01

Quality is an important and basic conduct of complex systems in general and health systems in particular. Quality is a cornerstone of medicine, necessary in the eyes of the community of consumers, caregivers, and the systems that manage both. In Israel, the Ministry of Health has set the quality issue on the agenda of healthcare organizations in all existing frameworks. In this article we seek to offer an acceptable alternative perspective, in examining the quality of public health. We suggest highlighting the ethical aspect of medical care, while reducing the quantitative monitoring component of existing quality metrics. Relying solely on indices has negative effects that might cause damage. The proposed alternative focuses on the personal responsibility of health care providers, using. values and moral reasonin.

Competition and quality in a physiotherapy market with fixed prices.

PubMed

Pekola, Piia; Linnosmaa, Ismo; Mikkola, Hennamari

2017-01-01

Our study focuses on competition and quality in physiotherapy organized and regulated by the Social Insurance Institution of Finland (Kela). We first derive a hypothesis with a theoretical model and then perform empirical analyses of the data. Within the physiotherapy market, prices are regulated by Kela, and after registration eligible firms are accepted to join a pool of firms from which patients choose service providers based on their individual preferences. By using 2SLS estimation techniques, we analyzed the relationship among quality, competition and regulated price. According to the results, competition has a statistically significant (yet weak) negative effect (p = 0.019) on quality. The outcome for quality is likely caused by imperfect information. It seems that Kela has provided too little information for patients about the quality of the service.

Predicting Causes of Data Quality Issues in a Clinical Data Research Network.

PubMed

Khare, Ritu; Ruth, Byron J; Miller, Matthew; Tucker, Joshua; Utidjian, Levon H; Razzaghi, Hanieh; Patibandla, Nandan; Burrows, Evanette K; Bailey, L Charles

2018-01-01

Clinical data research networks (CDRNs) invest substantially in identifying and investigating data quality problems. While identification is largely automated, the investigation and resolution are carried out manually at individual institutions. In the PEDSnet CDRN, we found that only approximately 35% of the identified data quality issues are resolvable as they are caused by errors in the extract-transform-load (ETL) code. Nonetheless, with no prior knowledge of issue causes, partner institutions end up spending significant time investigating issues that represent either inherent data characteristics or false alarms. This work investigates whether the causes (ETL, Characteristic, or False alarm) can be predicted before spending time investigating issues. We trained a classifier on the metadata from 10,281 real-world data quality issues, and achieved a cause prediction F1-measure of up to 90%. While initially tested on PEDSnet, the proposed methodology is applicable to other CDRNs facing similar bottlenecks in handling data quality results.

Resveratrol reverses the adverse effects of a diet-induced obese murine model on oocyte quality and zona pellucida softening.

PubMed

Jia, Zhenzhen; Feng, Zeyang; Wang, Lining; Li, Hao; Wang, Hongyu; Xu, Dingqi; Zhao, Xin; Feng, Daofu; Feng, Xizeng

2018-05-23

Reproductive dysfunction associated with obesity is increasing among women of reproductive age, including infertility and increasing risk of miscarriage. In females, reproductive disorders are linked to declining quality of oocytes. Using a model of diet-induced obesity, we have investigated the possible effects of obesity on oocyte quality, including metabolism, lipid accumulation, ROS levels, meiosis and changes in spindle structure in Metaphase II. Our study showed that obesity induced by a high fat diet can impair oocyte meiosis, destroy spindle assembly, and promote oxidative stress and abnormal mitochondrial distribution. With the addition of resveratrol, the negative impact of diet-induced obesity on the quality of oocytes was alleviated to some extent. In addition, we found that obesity causes mouse oocytes to soften, and resveratrol can restore the zona pellucida of oocytes to the same state as the control group. In conclusion, resveratrol can reverse the adverse effects of obesity on oocytes, which is beneficial for subsequent embryonic development.

The integration of FMEA with other problem solving tools: A review of enhancement opportunities

NASA Astrophysics Data System (ADS)

Ng, W. C.; Teh, S. Y.; Low, H. C.; Teoh, P. C.

2017-09-01

Failure Mode Effect Analysis (FMEA) is one the most effective and accepted problem solving (PS) tools for most of the companies in the world. Since FMEA was first introduced in 1949, practitioners have implemented FMEA in various industries for their quality improvement initiatives. However, studies have shown that there are drawbacks that hinder the effectiveness of FMEA for continuous quality improvement from product design to manufacturing. Therefore, FMEA is integrated with other PS tools such as inventive problem solving methodology (TRIZ), Quality Function Deployment (QFD), Root Cause Analysis (RCA) and seven basic tools of quality to address the drawbacks. This study begins by identifying the drawbacks in FMEA. A comprehensive literature review on the integration of FMEA with other tools is carried out to categorise the integrations based on the drawbacks identified. The three categories are inefficiency of failure analysis, psychological inertia and neglect of customers’ perspective. This study concludes by discussing the gaps and opportunities in the integration for future research.

Olive (Olea europaea L.) tree nitrogen status is a key factor for olive oil quality.

PubMed

Erel, Ran; Kerem, Zohar; Ben-Gal, Alon; Dag, Arnon; Schwartz, Amnon; Zipori, Isaac; Basheer, Loai; Yermiyahu, Uri

2013-11-27

The influence of macronutrient status on olive oil properties was studied for three years. Data were analyzed by a multivariate model considering N, P, K, and fruiting year as explanatory factors. Oil quality parameters were primarily associated with N concentration in leaves and fruits which increased with N in irrigation solution. The effect of P on oil quality was mainly indirect since increased P availability increased N accumulation. The potassium level had negligible effects. The oil phenolic content decreased linearly as a function of increased leaf N, indicating protein-phenol competition in leaves. The overall saturation level of the fatty acids decreased with fruit N, resulting in increased polyunsaturated fatty acids. Free fatty acids increased with increased levels of fruit N. High fruit load tended to reduce fruit N and subsequently improve oil quality. The effect of N on oil properties depended solely on its concentration in leaves or fruits, regardless of the cause.

THE EFFECT OF $gamma$-IRRADIATION ON ALCOHOLIC BEVERAGES AND ITS POTENTIALITY FOR PRACTICAL APLICATION (in Japanese)

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

Okazawa, Y.; Namiki, M.; Iida, S.

Generally, changes in flavor and taste of alcoholic beverages caused by irradiation of Co/sub gamma / rays are remarkable. In the case of Sake (Japanese rice wine), artificial Sake, and wines, occurrence of off-flavor and deterioration in qualities are unavoidable when they are irradiated more than about 5 x 10/sup 4/ r. However, maturing of taste and improvement of qualities by irradiation of relatively lower doses are found. The suitabie dose range for maturing effect depends on the condition of materials exposed to irradiation, and in order to prevent off-flavor development, substitution of gas phase during irradiation seems to bemore » effective. Similar maturing effects are obtained with many distilled liquors. The maturities are markediy promoted with doses of 1 x 10/sup 5/ to 3 x 10/sup 5/ r. As doses become greater, losses of characteristic original flavor and stimulative tastes are observed. Radiation effects are able to improve qualities of Sho-chu spirits (distillates of ferment mashes prepared from rice and sweet potato). The changes of whiskies and brandies caused by gamma irradiation, immediately after distillation and before storage, are of interest. Flavor change is similar to that occurring in the eariy period of storage in barrels, and the maturity is equal to that of beverages stored several years. Chemical analysis of components and measurements of physical properties are carried out in relation with the changes in flavors and taste. (JAIF)« less

A continuous quality improvement project to improve the quality of cervical Papanicolaou smears.

PubMed

Burkman, R T; Ward, R; Balchandani, K; Kini, S

1994-09-01

To improve the quality of cervical Papanicolaou smears by continuous quality improvement techniques. The study used a Papanicolaou smear data base of over 200,000 specimens collected between June 1988 and December 1992. A team approach employing techniques such as process flow-charting, cause and effect diagrams, run charts, and a randomized trial of collection methods was used to evaluate potential causes of Papanicolaou smear reports with the notation "inadequate" or "less than optimal" due to too few or absent endocervical cells. Once a key process variable (method of collection) was identified, the proportion of Papanicolaou smears with inadequate or absent endocervical cells was determined before and after employment of a collection technique using a spatula and Cytobrush. We measured the rate of less than optimal Papanicolaou smears due to too few or absent endocervical cells. Before implementing the new collection technique fully by June 1990, the overall rate of less than optimal cervical Papanicolaou smears ranged from 20-25%; by December 1993, it had stabilized at about 10%. Continuous quality improvement can be used successfully to study a clinical process and implement change that will lead to improvement.

Rational and design of a stepped-wedge cluster randomized trial evaluating quality improvement initiative for reducing cardiovascular events among patients with acute coronary syndromes in resource-constrained hospitals in China.

PubMed

Li, Shenshen; Wu, Yangfeng; Du, Xin; Li, Xian; Patel, Anushka; Peterson, Eric D; Turnbull, Fiona; Lo, Serigne; Billot, Laurent; Laba, Tracey; Gao, Runlin

2015-03-01

Acute coronary syndromes (ACSs) are a major cause of morbidity and mortality, yet effective ACS treatments are frequently underused in clinical practice. Randomized trials including the CPACS-2 study suggest that quality improvement initiatives can increase the use of effective treatments, but whether such programs can impact hard clinical outcomes has never been demonstrated in a well-powered randomized controlled trial. The CPACS-3 study is a stepped-wedge cluster-randomized trial conducted in 104 remote level 2 hospitals without PCI facilities in China. All hospitalized ACS patients will be recruited consecutively over a 30-month period to an anticipated total study population of more than 25,000 patients. After a 6-month baseline period, hospitals will be randomized to 1 of 4 groups, and a 6-component quality improvement intervention will be implemented sequentially in each group every 6months. These components include the following: establishment of a quality improvement team, implementation of a clinical pathway, training of physicians and nurses, hospital performance audit and feedback, online technical support, and patient education. All patients will be followed up for 6months postdischarge. The primary outcome will be the incidence of in-hospital major adverse cardiovascular events comprising all-cause mortality, myocardial infarction or reinfarction, and nonfatal stroke. The CPACS-3 study will be the first large randomized trial with sufficient power to assess the effects of a multifaceted quality of care improvement initiative on hard clinical outcomes, in patients with ACS. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of the First Floods on Water Quality and Sediment Transport in the Sierra Nevada Foothill Streams, California

NASA Astrophysics Data System (ADS)

Wang, Z.; Baca, J.; He, Z.; Blunmenshine, S.

2010-12-01

The typical Mediterranean climate of California (wet winter and spring season followed by dry summer and fall season) makes it necessary to closely monitor the first few floods in early November or December when the accumulated surface matters in the past rainless months would be flushed into the streams causing water quality impairment and sediment mobilization. In order to evaluate the effects of the first floods, two storm water samplers were installed, one on the main stem of the Fresno River and the other on the Coarsegold tributary. The storm water sampler collects two different samples during a storm event. The “first flush” sample is collected at the beginning of a storm event and the “time weighted” composite sample is collected at selected intervals during the storm. Nutrient contents in all the water samples were measured to evaluate water quality status, and the fine particle size distributions of the suspended sediments in the flood water were measured using laser diffraction. Results show that: (1)The effects of the first floods are significant: it cleans the tributary (nutrient losing) streams while aggravating nutrient loadings in the main stem of the river; (2) The sediment flux in the upper areas of the watershed is generally low, however it increases ten folds during the flood in the lower part of the watershed, loading large amounts of sediments in the Hensley Lake; and (3) After the first floods, the river channel is typically deposited with increased amount of very fine (< 2 micros) and very coarse particles (>200 microns), causing significant substrate siltation thus affecting habitat quality for the stream biota. The hydrology of the first floods needs to be further studied for water quality assessment in the Mediterranean climate regions.

Aspirin for the Primary Prevention of Cardiovascular Events: A Systematic Evidence Review for the U.S. Preventive Services Task Force.

PubMed

Guirguis-Blake, Janelle M; Evans, Corinne V; Senger, Caitlyn A; O'Connor, Elizabeth A; Whitlock, Evelyn P

2016-06-21

Cardiovascular disease (CVD) is the leading cause of death in the United States. To update a systematic review about the benefits of aspirin for the primary prevention of cardiovascular events in adults aged 40 years or older and to evaluate effect modification in subpopulations. MEDLINE, PubMed, Cochrane Central Register of Controlled Trials (January 2008 to January 2015), and Cochrane Database of Systematic Reviews. Two investigators independently reviewed 3396 abstracts and 65 articles according to prespecified criteria. All included trials evaluated aspirin for the primary prevention of cardiovascular events. Two investigators assessed study quality; data were abstracted by 1 reviewer and checked by a second. Two good-quality and 9 fair-quality randomized, controlled trials were identified. In analyses of all doses, aspirin reduced the risk for nonfatal myocardial infarction (MI) (relative risk [RR], 0.78 [95% CI, 0.71 to 0.87]) but not nonfatal stroke; aspirin showed little or no benefit for all-cause or cardiovascular mortality. Benefits began within the first 5 years. Older adults achieved greater relative MI reduction, but no other effect modifications were found in analyzed subpopulations. In trials with aspirin doses of 100 mg or less per day, the reduction in nonfatal MI benefit persisted (absolute risk reduction, 0.15 to 1.43 events per 1000 person-years) and a 14% reduction in nonfatal stroke benefit was noted, but no benefit was found for all-cause mortality (RR, 0.95 [CI, 0.89 to 1.01]) or cardiovascular mortality (RR, 0.97 [CI, 0.85 to 1.10]). Evidence for aspirin in primary prevention is heterogeneous and limited by rare events and few credible subgroup analyses. The beneficial effect of aspirin for the primary prevention of CVD is modest and occurs at doses of 100 mg or less per day. Older adults seem to achieve a greater relative MI benefit. Agency for Healthcare Research and Quality.

A weight of evidence framework for environmental assessments: Inferring Qualities

EPA Science Inventory

The weighing of heterogeneous evidence such as conventional laboratory toxicity tests, field tests, biomarkers, and community surveys is essential to environmental assessments. Evidence synthesis and weighing is needed to determine causes of observed effects, hazards posed by ch...

[Effects of tobacco smoke on fetus and children].

PubMed

Noda, Takashi

2013-03-01

What is caused on fetus and children by parental smoking? Parental smoking, especially maternal smoking cause oral cleft which makes baby difficult to suck milk. It causes not only respiratory illness such as asthma bronchialis but also fire accident or burn by child abuse. These things decrease quality of life of children. Low birth weight caused by parental smoking is the major risk factor of lifestyle-related diseases, according to DOHaD hypothesis. Moreover, parental smoking drive children active smokers. If children start to smoke, they will get bad lifestyle led to metabolic syndrome. So it is important not to make children start the first smoking.

[Dignity of human life: euthanasia and suicide].

PubMed

Niebrój, Lesław

2005-07-01

Euthanasia is commonly considered as a form of suicide. The study aims to explore if such a presumption could be justified. Philosophical analysis of concepts of "human being", "human person", "biological life" and "life of human person", undertaken in this article, proved that the effective cause of suicide is obviously different from such a cause of euthanasia. Suicide aims to destruct life of a human person which is considered deprived of its dignity. Euthanasia's effective cause is to protect the dignity of such a life which is threatened by low quality of biological life caused both by the disease as well as by the applied treatment even if palliative only. On the basis of these considerations the main conclusion is drawn: suicide and euthanasia having different moral (material) subjects should be also ethically evaluated in a different way.

Effects of Hurricane Katrina on the fish fauna of the Pascagoula River Drainage

Treesearch

J. Schaefer; P. Mickle; J. Spaeth; B.R. Kreiser; S.B. Adams; W. Matamoros; B. Zuber; P. Vigueira

2006-01-01

Large tropical storms can have dramatic effects on coastal, estuarine and terrestrial ecosystems. However, it is not as well understood how these types of disturbances might impact freshwater communities further inland. Storm surges can change critical water quality parameters for kilometers upstream, potentially causing subtle shifts in community structure or more...

Water quality degradation effects on freshwater availability: Impacts to human activities

USGS Publications Warehouse

Peters, N.E.; Meybeck, Michel

2000-01-01

The quality of freshwater at any point on the landscape reflects the combined effects of many processes along water pathways. Human activities on all spatial scales affect both water quality and quantity. Alteration of the landscape and associated vegetation has not only changed the water balance, but typically has altered processes that control water quality. Effects of human activities on a small scale are relevant to an entire drainage basin. Furthermore, local, regional, and global differences in climate and water flow are considerable, causing varying effects of human activities on land and water quality and quantity, depending on location within a watershed, geology, biology, physiographic characteristics, and climate. These natural characteristics also greatly control human activities, which will, in turn, modify (or affect) the natural composition of water. One of the most important issues for effective resource management is recognition of cyclical and cascading effects of human activities on the water quality and quantity along hydrologic pathways. The degradation of water quality in one part of a watershed can have negative effects on users downstream. Everyone lives downstream of the effects of some human activity. An extremely important factor is that substances added to the atmosphere, land, and water generally have relatively long time scales for removal or clean up. The nature of the substance, including its affinity for adhering to soil and its ability to be transformed, affects the mobility and the time scale for removal of the substance. Policy alone will not solve many of the degradation issues, but a combination of policy, education, scientific knowledge, planning, and enforcement of applicable laws can provide mechanisms for slowing the rate of degradation and provide human and environmental protection. Such an integrated approach is needed to effectively manage land and water resources.

Assessment of the nutritional status of Nigerian rural children and mothers' perceptions of quality of life.

PubMed

Ojofeitimi, E O

1984-01-01

One hundred and fourteen preschool school children and their 30 mothers from three selected villages in Ile-Ife, Nigeria were assessed for nutritional status using selected and sensitive anthropometric techniques. The mothers' dietary patterns, their perceptions as to components of a good quality of life, infants' immunization status and major cause of infant death were also examined. Approximately 56% of the children and 80% of the women were identified to be suffering from mild to moderate malnutrition. The major cause of infant death as reported by the mothers was high fever and convulsion. Practically all the children under 3 years had not received any form of immunization. Ability to have plenty of children, good health and money, were highly perceived as measures of essential components of quality of life by all the mothers, while 20% listed good feeding, housing, clothing, and only 7% listed potable water. The need for effective health services, regular home visits, supplementary feeding programmes for school children and an effective health education campaign on the importance of immunization and nutrition for rural people are discussed. The training of agricultural extension workers in the use of simple anthropometric techniques to identify covert malnutrition is also highlighted.

The effect of melatonin treatment on postural stability, muscle strength, and quality of life and sleep in postmenopausal women: a randomized controlled trial.

PubMed

Amstrup, Anne Kristine; Sikjaer, Tanja; Mosekilde, Leif; Rejnmark, Lars

2015-09-30

Melatonin is often used as a sleeping aid in elderly adults. As previous studies suggest a protective role of melatonin against osteoporosis, it is important to document its safety. Treatment should not cause any hangover effect that could potentially lead to falls and fractures. We therefore aimed to evaluate the effect of melatonin on balance- and muscle function. In a double-blind placebo-controlled study, we randomized 81 postmenopausal women with osteopenia to receive 1 or 3 mg melatonin, or placebo nightly for 12 months. Postural balance as well as muscle function was measured. In addition, we assessed quality of life and sleep at baseline and after 12 months treatment. Compared to placebo, one-year treatment with melatonin did not affect postural balance or risk of falls. Furthermore, no significant changes between groups were observed in muscle strength in neither upper- nor lower extremities. Treatment did not affect quality of life or sleep. However, in the subgroup of women with sleep disturbances at baseline, a trend towards an improved sleep quality was seen (p = 0.08). Treatment with melatonin is safe in postmenopausal women with osteopenia. There is no hangover effect affecting balance- and muscle function following the intake of melatonin. In women with a good quality of sleep, melatonin has no effect, however in poor quality of sleep, small doses of melatonin trended towards improving the quality. (# NCT01690000).

Examining quality and efficiency of the U.S. healthcare system.

PubMed

Kumar, Sameer; Ghildayal, Neha S; Shah, Ronak N

2011-01-01

The fundamental concern of this research study is to learn the quality and efficiency of U.S. healthcare services. It seeks to examine the impact of quality and efficiency on various stakeholders to achieve the best value for each dollar spent for healthcare. The study aims to offer insights on quality reformation efforts, contemporary healthcare policy and a forthcoming change shaped by the Federal healthcare fiscal policy and to recommend the improvement objective by comparing the U.S. healthcare system with those of other developed nations. The US healthcare system is examined utilizing various data on recent trends in: spending, budgetary implications, economic indicators, i.e., GDP, inflation, wage and population growth. Process maps, cause and effect diagrams and descriptive data statistics are utilized to understand the various drivers that influence the rising healthcare cost. A proposed cause and effect diagram is presented to offer potential solutions, for significant improvement in U.S. healthcare. At present, the US healthcare system is of vital interest to the nation's economy and government policy (spending). The U.S. healthcare system is characterized as the world's most expensive yet least effective compared with other nations. Growing healthcare costs have made millions of citizens vulnerable. Major drivers of the healthcare costs are institutionalized medical practices and reimbursement policies, technology-induced costs and consumer behavior. Reviewing many articles, congressional reports, internet websites and related material, a simplified process map of the US healthcare system is presented. The financial process map is also created to further understand the overall process that connects the stakeholders in the healthcare system. Factors impacting healthcare are presented by a cause and effect diagram to further simplify the complexities of healthcare. This tool can also be used as a guide to improve efficiency by removing the "waste" from the system. Trend analyses are presented that display the crucial relationship between economic growth and healthcare spending. There are many articles and reports published on the US healthcare system. However, very few articles have explored, in a comprehensive manner, the links between the economic indicators and measures of the healthcare system and how to reform this system. As a result of the US healthcare system's complex structure, process map and cause-effect diagrams are utilized to simplify, address and understand. This study linked top-level factors, i.e., the societal, government policies, healthcare system comparison, potential reformation solutions and the enormity of the recent trends by presenting serious issues associated with U.S. healthcare.

Effect of Vitamin E and Polyunsaturated Fatty Acids on Cryopreserved Sperm Quality in Bos taurus Bulls Under Testicular Heat Stress.

PubMed

Losano, João D A; Angrimani, Daniel S R; Dalmazzo, Andressa; Rocha, Carolina C; Brito, Maíra M; Perez, Eduardo G A; Tsunoda, Roberta H; Góes, Paola A A; Mendes, Camilla M; Assumpção, Mayra E O A; Barnabe, Valquiria H; Nichi, Marcilio

2018-04-03

Taurine bulls are highly susceptible to heat stress, leading to increased oxidative stress (OS) and impaired sperm viability. Polyunsaturated fatty acids (PUFAs) supplementation can be an alternative to improve semen quality, which also results in more sperm susceptibility to lipid peroxidation. Moreover, this deleterious effect can be exacerbated in animals affected by heat stress. Vitamin E is a key antioxidant that counteracts lipid peroxidation of sperm membrane caused by OS. Thus, combining PUFAs with vitamin E may improve sperm quality. In this context, this study aimed to evaluate the effect of interaction between PUFAs and vitamin E on sperm quality in Bos taurus bulls under testicular heat stress. Sixteen taurine bulls under testicular heat stress were randomly assigned in four groups: Control, Vitamin E, PUFA, and PUFA + Vitamin E. All groups lasted for 60 days. Samples were cryopreserved/thawed and analyzed for motility variables (CASA), membrane and acrosome integrity, mitochondrial activity, susceptibility to oxidative stress, DNA integrity, and sperm-binding capacity. Results showed that vitamin E had a beneficial effect on some sperm characteristics, whereas PUFA supplementation had an adverse effect when the two treatments were evaluated separately. Finally, the association between PUFAs and vitamin E did not improve sperm quality.

[Continuous quality improvement in anesthesia].

PubMed

Gaitini, L; Vaida, S; Madgar, S

1998-01-01

Slow continuous quality improvement (SCQI) in anesthesia is a process that allows identification of problems and their causes. Implementing measures to correct them and continuous monitoring to ensure that the problems have been eliminated are necessary. The basic assumption of CQI is that the employees of an organization are competent and working to the best of their abilities. If problems occur they are the consequences of inadequacies in the process rather that in the individual. The CQI program is a dynamic but gradual system that invokes a slower rate of response in comparison with other quality methods, like quality assurance. Spectacular results following a system change are not to be expected an the ideal is slow and continuous improvement. A SCQI program was adapted by our department in May 1994, according to the recommendations of the American Society of Anesthesiologists. Problem identification was based on 65 clinical indicators, reflecting negative events related to anesthesia. Data were collected using a specially designed computer database. 4 events were identified as crossing previously established thresholds (hypertension, hypotension, hypoxia and inadequate nerve block). Statistical process control was used to establish stability of the system and whether negative events were influenced only by the common causes. The causes responsible for these negative events were identified using specific SCQI tools, such as control-charts, cause-effect diagrams and Pareto diagrams. Hypertension and inadequate nerve block were successfully managed. The implementation of corrective measures for the other events that cross the threshold is still in evolution. This program requires considerable dedication on the part of the staff, and it is hoped that it will improve our clinical performance.

Use of Budesonide in the Treatment of Microscopic Colitis

PubMed Central

Tangri, Vikram; Chande, Nilesh

2010-01-01

Collagenous colitis and lymphocytic colitis, the two types of microscopic colitis, cause watery diarrhea. Budesonide, a glucocorticoid medication with limited systemic availability, is commonly used to treat these illnesses. Budesonide has proven efficacy in the induction of clinical remission in both collagenous colitis and lymphocytic colitis. Budesonide is effective as a maintenance drug for patients with collagenous colitis, but has not been studied for this indication in patients with lymphocytic colitis. This drug improves quality of life in patients while causing few mild adverse events. Budesonide is an effective treatment of microscopic colitis that is safe and well tolerated. PMID:20616427

A World Health Organization field trial assessing a proposed ICD-11 framework for classifying patient safety events.

PubMed

Forster, Alan J; Bernard, Burnand; Drösler, Saskia E; Gurevich, Yana; Harrison, James; Januel, Jean-Marie; Romano, Patrick S; Southern, Danielle A; Sundararajan, Vijaya; Quan, Hude; Vanderloo, Saskia E; Pincus, Harold A; Ghali, William A

2017-08-01

To assess the utility of the proposed World Health Organization (WHO)'s International Classification of Disease (ICD) framework for classifying patient safety events. Independent classification of 45 clinical vignettes using a web-based platform. The WHO's multi-disciplinary Quality and Safety Topic Advisory Group. The framework consists of three concepts: harm, cause and mode. We defined a concept as 'classifiable' if more than half of the raters could assign an ICD-11 code for the case. We evaluated reasons why cases were nonclassifiable using a qualitative approach. Harm was classifiable in 31 of 45 cases (69%). Of these, only 20 could be classified according to cause and mode. Classifiable cases were those in which a clear cause and effect relationship existed (e.g. medication administration error). Nonclassifiable cases were those without clear causal attribution (e.g. pressure ulcer). Of the 14 cases in which harm was not evident (31%), only 5 could be classified according to cause and mode and represented potential adverse events. Overall, nine cases (20%) were nonclassifiable using the three-part patient safety framework and contained significant ambiguity in the relationship between healthcare outcome and putative cause. The proposed framework enabled classification of the majority of patient safety events. Cases in which potentially harmful events did not cause harm were not classifiable; additional code categories within the ICD-11 are one proposal to address this concern. Cases with ambiguity in cause and effect relationship between healthcare processes and outcomes remain difficult to classify. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Minimizing variability of cascade impaction measurements in inhalers and nebulizers.

PubMed

Bonam, Matthew; Christopher, David; Cipolla, David; Donovan, Brent; Goodwin, David; Holmes, Susan; Lyapustina, Svetlana; Mitchell, Jolyon; Nichols, Steve; Pettersson, Gunilla; Quale, Chris; Rao, Nagaraja; Singh, Dilraj; Tougas, Terrence; Van Oort, Mike; Walther, Bernd; Wyka, Bruce

2008-01-01

The purpose of this article is to catalogue in a systematic way the available information about factors that may influence the outcome and variability of cascade impactor (CI) measurements of pharmaceutical aerosols for inhalation, such as those obtained from metered dose inhalers (MDIs), dry powder inhalers (DPIs) or products for nebulization; and to suggest ways to minimize the influence of such factors. To accomplish this task, the authors constructed a cause-and-effect Ishikawa diagram for a CI measurement and considered the influence of each root cause based on industry experience and thorough literature review. The results illustrate the intricate network of underlying causes of CI variability, with the potential for several multi-way statistical interactions. It was also found that significantly more quantitative information exists about impactor-related causes than about operator-derived influences, the contribution of drug assay methodology and product-related causes, suggesting a need for further research in those areas. The understanding and awareness of all these factors should aid in the development of optimized CI methods and appropriate quality control measures for aerodynamic particle size distribution (APSD) of pharmaceutical aerosols, in line with the current regulatory initiatives involving quality-by-design (QbD).

Bruxism is unlikely to cause damage to the periodontium: findings from a systematic literature assessment.

PubMed

Manfredini, Daniele; Ahlberg, Jari; Mura, Rossano; Lobbezoo, Frank

2015-04-01

This paper systematically reviews the MEDLINE and SCOPUS literature to answer the following question: Is there any evidence that bruxism may cause periodontal damage per se? Clinical studies on humans, assessing the potential relationship between bruxism and periodontal lesions (i.e., decreased attachment level, bone loss, tooth mobility/migration, altered periodontal perception) were eligible. Methodologic shortcomings were identified by the adoption of the Critical Appraisal Skills Program quality assessment, mainly concerning the internal validity of findings according to an unspecific bruxism diagnosis. The six included articles covered a high variability of topics, without multiple papers on the same argument. Findings showed that the only effect of bruxism on periodontal structures was an increase in periodontal sensation, whereas a relationship with periodontal lesions was absent. Based on the analysis of Hill criteria, the validity of causation conclusions was limited, mainly owing to the absence of a longitudinal evaluation of the temporal relationship and dose-response effects between bruxism and periodontal lesions. Despite the scarce quantity and quality of the literature that prevents sound conclusions on the causal link between bruxism and the periodontal problems assessed in this review, it seems reasonable to suggest that bruxism cannot cause periodontal damage per se. It is also important to emphasize, however, that because of methodologic problems, particularly regarding sleep bruxism assessment, more high-quality studies (e.g., randomized controlled trials) are needed to further clarify this issue.

Interrelation of the effects caused by the rotation of the whispering gallery modes resonator

NASA Astrophysics Data System (ADS)

Dmitriyeva, Anna D.; Filatov, Yuri V.; Shalymov, Egor V.; Venediktov, Vladimir Yu.

2016-11-01

Optical whispering gallery modes resonators are characterized by unique properties: ultrahigh quality factor, small amount of the modes and small size. It allows to use them in compact high-precision measuring devices. In particular these resonators can be used in the composition of gyros. For today all researches, devoted to the application of the whispering gallery modes resonators in gyros, deals only with one of induced by the rotation effects (Sagnac effect or the influence of centrifugal forces on the resonator size). In this work we study the interrelation of the effects caused by the rotation of the whispering gallery modes resonator. Also in work we consider the possibility of joint application of both effects (the influence of centrifugal forces and Sagnac effect) for measuring angular velocity.

EFFECT OF THE DISTRIBUTION SYSTEM ON DRINKING WATER QUALITY

EPA Science Inventory

The SDWA and its amendments has focused interest on the factors that cause the deterioration of water between the treatment plant and the consumer. The distribution system itself can contribute to this deterioration. Numerous examples of waterborne outbreaks have demonstrated the...

Lymphedema (PDQ®)—Patient Version

Cancer.gov

Lymphedema (the build-up of lymph fluid in tissues causing swelling) can have significant negative effects on function and quality of life. Learn about ways to prevent and treat it with exercise, compression, laser and drug therapy, surgery, massage, and more in this expert-reviewed summary.

Pathway-based monitoring of biological effects at Great Lakes sites (Presntation)

EPA Science Inventory

The Great Lakes region suffers from degradation of water and environmental quality due to release of chemicals of emerging concern. Critical issues remain in delisting Areas of Concern (AOC) including determining sources of chemicals causing fish health impacts, relating health ...

Potential of UVC germicidal irradiation in suppressing crown rot disease, retaining postharvest quality and antioxidant capacity of Musa AAA "Berangan" during fruit ripening.

PubMed

S Mohamed, Nuratika Tamimi; Ding, Phebe; Kadir, Jugah; M Ghazali, Hasanah

2017-09-01

Crown rot caused by fungal pathogen is the most prevalent postharvest disease in banana fruit that results significant economic losses during transportation, storage, and ripening period. Antifungal effects of ultraviolet C (UVC) irradiation at doses varied from 0.01 to 0.30 kJ m -2 were investigated in controlling postharvest crown rot disease, maintenance of fruit quality, and the effects on antioxidant capacity of Berangan banana fruit during ripening days at 25 ± 2°C and 85% RH. Fruits irradiated with 0.30 kJ m -2 exhibited the highest (i.e., 62.51%) reduction in disease severity. However, the application of UVC at all doses caused significant browning damages on fruit peel except the dose of 0.01 kJ m -2 . This dose synergistically reduced 46.25% development of postharvest crown and did not give adverse effects on respiration rate, ethylene production, weight loss, firmness, color changes, soluble solids concentration, titratable acidity, and pH in banana as compared to the other treatments and control. Meanwhile, the dose also enhanced a significant higher level of total phenolic content, FRAP, and DPPH values than in control fruits indicating the beneficial impact of UVC in fruit nutritional quality. The results of scanning electron micrographs confirmed that UVC irradiation retarded the losses of wall compartments, thereby maintained the cell wall integrity in the crown tissue of banana fruit. The results suggest that using 0.01 kJ m -2 UVC irradiation dose as postharvest physical treatment, the crown rot disease has potential to be controlled effectively together with maintaining quality and antioxidant of banana fruit.

Effect-directed analysis supporting monitoring of aquatic environments--An in-depth overview.

PubMed

Brack, Werner; Ait-Aissa, Selim; Burgess, Robert M; Busch, Wibke; Creusot, Nicolas; Di Paolo, Carolina; Escher, Beate I; Mark Hewitt, L; Hilscherova, Klara; Hollender, Juliane; Hollert, Henner; Jonker, Willem; Kool, Jeroen; Lamoree, Marja; Muschket, Matthias; Neumann, Steffen; Rostkowski, Pawel; Ruttkies, Christoph; Schollee, Jennifer; Schymanski, Emma L; Schulze, Tobias; Seiler, Thomas-Benjamin; Tindall, Andrew J; De Aragão Umbuzeiro, Gisela; Vrana, Branislav; Krauss, Martin

2016-02-15

Aquatic environments are often contaminated with complex mixtures of chemicals that may pose a risk to ecosystems and human health. This contamination cannot be addressed with target analysis alone but tools are required to reduce this complexity and identify those chemicals that might cause adverse effects. Effect-directed analysis (EDA) is designed to meet this challenge and faces increasing interest in water and sediment quality monitoring. Thus, the present paper summarizes current experience with the EDA approach and the tools required, and provides practical advice on their application. The paper highlights the need for proper problem formulation and gives general advice for study design. As the EDA approach is directed by toxicity, basic principles for the selection of bioassays are given as well as a comprehensive compilation of appropriate assays, including their strengths and weaknesses. A specific focus is given to strategies for sampling, extraction and bioassay dosing since they strongly impact prioritization of toxicants in EDA. Reduction of sample complexity mainly relies on fractionation procedures, which are discussed in this paper, including quality assurance and quality control. Automated combinations of fractionation, biotesting and chemical analysis using so-called hyphenated tools can enhance the throughput and might reduce the risk of artifacts in laboratory work. The key to determining the chemical structures causing effects is analytical toxicant identification. The latest approaches, tools, software and databases for target-, suspect and non-target screening as well as unknown identification are discussed together with analytical and toxicological confirmation approaches. A better understanding of optimal use and combination of EDA tools will help to design efficient and successful toxicant identification studies in the context of quality monitoring in multiply stressed environments. Copyright © 2015 Elsevier B.V. All rights reserved.

Heterosis for meat quality and fatty acid profiles in crosses among Bos indicus and Bos taurus finished on pasture or grain.

PubMed

Gama, L T; Bressan, M C; Rodrigues, E C; Rossato, L V; Moreira, O C; Alves, S P; Bessa, R J B

2013-01-01

Physicochemical properties and fatty acid profiles of meat from Bos indicus, Bos taurus and crossbred B. taurus×B. indicus bullocks (n=216), finished on pasture or grain, were used to estimate the effects of heterosis. Meat quality and fatty acid profiles generally benefited with crossbreeding, but the advantages from heterosis differed among finishing systems. The Warner-Bratzler shear-force in fresh and aged meat was reduced due to heterosis in pasture-finishing, but the effect was minor under grain-finishing. With pasture-finishing, heterosis caused an increase of 5% in CLA concentration, but few other changes in fatty acid profiles. In grain-finishing, heterosis caused a reduction in intramuscular fat and cholesterol, increased amounts of PUFA, n-6 fatty acids and PUFA/SFA ratio, and a decline in atherogenic index. The Δ(9) desaturase estimated activity in crossbreds showed a behavior close to B. indicus, suggesting the existence of few loci and a dominance genetic effect on enzymes involved in fatty acid synthesis and metabolism. Copyright © 2012 Elsevier Ltd. All rights reserved.

Preventable readmissions within 30 days of ischemic stroke among Medicare beneficiaries.

PubMed

Lichtman, Judith H; Leifheit-Limson, Erica C; Jones, Sara B; Wang, Yun; Goldstein, Larry B

2013-12-01

The Centers for Medicare and Medicaid Services proposes to use 30-day hospital readmissions after ischemic stroke as part of the Hospital Inpatient Quality Reporting Program for payment determination beginning in 2016. The proportion of poststroke readmissions that is potentially preventable is unknown. Thirty-day readmissions for all Medicare fee-for-service beneficiaries aged≥65 years discharged alive with a primary diagnosis of ischemic stroke (International Classification of Diseases, Ninth Revision, Clinical Modification 433, 434, 436) between December 2005 and November 2006 were analyzed. Preventable readmissions were identified based on 14 Prevention Quality Indicators developed for use with administrative data by the US Agency for Healthcare Research and Quality. National, hospital-level, and regional preventable readmission rates were estimated. Random-effects logistic regression was also used to determine patient-level factors associated with preventable readmissions. Among 307 887 ischemic stroke discharges, 44 379 (14.4%) were readmitted within 30 days; 5322 (1.7% of all discharges) were the result of a preventable cause (eg, pneumonia), and 39 057 (12.7%) were for other reasons (eg, cancer). In multivariate analysis, older age and cardiovascular-related comorbid conditions were strong predictors of preventable readmissions. Preventable readmission rates were highest in the Southeast, Mid-Atlantic, and US territories and lowest in the Mountain and Pacific regions. On the basis of Agency for Healthcare Research and Quality Prevention Quality Indicators, we found that a small proportion of readmissions after ischemic stroke were classified as preventable. Although other causes of readmissions not reflected in the Agency for Healthcare Research and Quality measures could also be avoidable, hospital-level programs intended to reduce all-cause readmissions and costs should target high-risk patients.

Understanding and managing experiential aspects of soundscapes at Muir woods national monument.

PubMed

Pilcher, Ericka J; Newman, Peter; Manning, Robert E

2009-03-01

Research has found that human-caused noise can detract from the quality of the visitor experience in national parks and related areas. Moreover, impacts to the visitor experience can be managed by formulating indicators and standards of quality as suggested in park and outdoor recreation management frameworks, such as Visitor Experience and Resource Protection (VERP), as developed by the U.S. National Park Service. The research reported in this article supports the formulation of indicators and standards of quality for human-caused noise at Muir Woods National Monument, California. Phase I identified potential indicators of quality for the soundscape of Muir Woods. A visitor "listening exercise" was conducted, where respondents identified natural and human-caused sounds heard in the park and rated the degree to which each sound was "pleasing" or "annoying." Certain visitor-caused sounds such as groups talking were heard by most respondents and were rated as annoying, suggesting that these sounds may be a good indicator of quality. Loud groups were heard by few people but were rated as highly annoying, whereas wind and water were heard by most visitors and were rated as highly pleasing. Phase II measured standards of quality for visitor-caused noise. Visitors were presented with a series of 30-second audio clips representing increasing amounts of visitor-caused sound in the park. Respondents were asked to rate the acceptability of each audio clip on a survey. Findings suggest a threshold at which visitor-caused sound is judged to be unacceptable, and is therefore considered as noise. A parallel program of sound monitoring in the park found that current levels of visitor-caused sound sometimes violate this threshold. Study findings provide an empirical basis to help formulate noise-related indicators and standards of quality in parks and related areas.

Relationship between Hydrodynamic Conditions and Water Quality in Landscape Water Body

NASA Astrophysics Data System (ADS)

Kang, Mengxin; Tian, Yimei; Zhang, Haiya; Wang, Dehong

2018-01-01

The urban landscape water usually lacks necessary water cycle and water speed is closed to zero, which easily lead to eutrophication in water system and deterioration of water quality. Therefore, understanding the impact of water circulation on the water quality is of great significance. With that significance, this research has been done to investigate the relationship between hydrodynamic conditions and water quality of urban landscape water based on adopted water quality indexes such as chemical oxygen demand (COD), total nitrogen (TN), total phosphorus (TP) and nitrogen-ammonia (NH3-N). Moreover, MIKE 21 model is used to simulate the hydrodynamics and water quality under different cases in an urban landscape lake. The results of simulation show that water circulation system could effectively improve current speeds, reduce the proportion of stagnation area, and solve the problem of water quality deterioration caused by reclaimed water in the lake.

Critical maternal health knowledge gaps in low- and middle-income countries for the post-2015 era.

PubMed

Kendall, Tamil; Langer, Ana

2015-06-05

Effective interventions to promote maternal health and address obstetric complications exist, however 800 women die every day during pregnancy and childbirth from largely preventable causes and more than 90% of these deaths occur in low and middle income countries (LMIC). In 2014, the Maternal Health Task Force consulted 26 global maternal health researchers to identify persistent and critical knowledge gaps to be filled to reduce maternal morbidity and mortality and improve maternal health. The vision of maternal health articulated was comprehensive and priorities for knowledge generation encompassed improving the availability, accessibility, acceptability, and quality of institutional labor and delivery services and other effective interventions, such as contraception and safe abortion services. Respondents emphasized the need for health systems research to identify models that can deliver what is known to be effective to prevent and treat the main causes of maternal death at scale in different contexts and to sustain coverage and quality over time. Researchers also emphasized the development of tools to measure quality of care and promote ongoing quality improvement at the facility, district, and national level. Knowledge generation to improve distribution and retention of healthcare workers, facilitate task shifting, develop and evaluate training models to improve "hands-on" skills and promote evidence-based practice, and increase managerial capacity at different levels of the health system were also prioritized. Interviewees noted that attitudes, behavior, and power relationships between health professionals and within institutions must be transformed to achieve coverage of high-quality maternal health services in LMIC. The increasing burden of non-communicable diseases, urbanization, and the persistence of social and economic inequality were identified as emerging challenges that require knowledge generation to improve health system responses and evaluate progress. Respondents emphasized evaluating effectiveness, feasibility, and equity impacts of health system interventions. A prominent role for implementation science, evidence for policy advocacy, and interdisciplinary collaboration were identified as critical areas for knowledge generation to improve maternal health in the post-2015 era.

Effectiveness of trauma team on medical resource utilization and quality of care for patients with major trauma.

PubMed

Wang, Chih-Jung; Yen, Shu-Ting; Huang, Shih-Fang; Hsu, Su-Chen; Ying, Jeremy C; Shan, Yan-Shen

2017-07-24

Trauma is one of the leading causes of death in Taiwan, and its medical expenditure escalated drastically. This study aimed to explore the effectiveness of trauma team, which was established in September 2010, on medical resource utilization and quality of care among major trauma patients. This was a retrospective study, using trauma registry data bank and inpatient medical service charge databases. Study subjects were major trauma patients admitted to a medical center in Tainan during 2009 and 2013, and was divided into case group (from January, 2011 to August, 2013) and comparison group (from January, 2009 to August, 2010). Significant reductions in several items of medical resource utilization were identified after the establishment of trauma team. In the sub-group of patients who survived to discharge, examination, radiology and operation charges declined significantly. The radiation and examination charges reduced significantly in the subcategories of ISS = 16 ~ 24 and ISS > 24 respectively. However, no significant effectiveness on quality of care was identified. The establishment of trauma team is effective in containing medical resource utilization. In order to verify the effectiveness on quality of care, extended time frame and extra study subjects are needed.

Environmental Assessment On-Base Snowmobile Trail at Grand Forks AFB, North Dakota

DTIC Science & Technology

2004-04-01

Water: Surface water quality could be degraded, both in the short-term, and over the long-term due to reduced storm water quality caused by a potential...Surface water quality could be degraded, both in the short-term, and over the long-term due to reduced storm water quality caused by a potential increase

Thyme and Savory Essential Oil Vapor Treatments Control Brown Rot and Improve the Storage Quality of Peaches and Nectarines, but Could Favor Gray Mold

PubMed Central

Santoro, Karin; Maghenzani, Marco; Chiabrando, Valentina; Gullino, Maria Lodovica; Giacalone, Giovanna

2018-01-01

The effect of biofumigation, through slow-release diffusors, of thyme and savory essential oils (EO), was evaluated on the control of postharvest diseases and quality of peaches and nectarines. EO fumigation was effective in controlling postharvest rots. Naturally contaminated peaches and nectarines were exposed to EO vapors for 28 days at 0 °C in sealed storage cabinets and then exposed at 20 °C for five days during shelf-life in normal atmosphere, simulating retail conditions. Under low disease pressure, most treatments significantly reduced fruit rot incidence during shelf-life, while, under high disease pressure, only vapors of thyme essential oil at the highest concentration tested (10% v/v in the diffusor) significantly reduced the rots. The application of thyme or savory EO favored a reduction of brown rot incidence, caused by Monilinia fructicola, but increased gray mold, caused by Botrytis cinerea. In vitro tests confirmed that M. fructicola was more sensitive to EO vapors than B. cinerea. Essential oil volatile components were characterized in storage cabinets during postharvest. The antifungal components of the essential oils increased during storage, but they were a low fraction of the volatile organic compounds in storage chambers. EO vapors did not influence the overall quality of the fruit, but showed a positive effect in reducing weight loss and in maintaining ascorbic acid and carotenoid content. The application of thyme and savory essential oil vapors represents a promising tool for reducing postharvest losses and preserving the quality of peaches and nectarines. PMID:29303966

Thyme and Savory Essential Oil Vapor Treatments Control Brown Rot and Improve the Storage Quality of Peaches and Nectarines, but Could Favor Gray Mold.

PubMed

Santoro, Karin; Maghenzani, Marco; Chiabrando, Valentina; Bosio, Pietro; Gullino, Maria Lodovica; Spadaro, Davide; Giacalone, Giovanna

2018-01-05

The effect of biofumigation, through slow-release diffusors, of thyme and savory essential oils (EO), was evaluated on the control of postharvest diseases and quality of peaches and nectarines. EO fumigation was effective in controlling postharvest rots. Naturally contaminated peaches and nectarines were exposed to EO vapors for 28 days at 0 °C in sealed storage cabinets and then exposed at 20 °C for five days during shelf-life in normal atmosphere, simulating retail conditions. Under low disease pressure, most treatments significantly reduced fruit rot incidence during shelf-life, while, under high disease pressure, only vapors of thyme essential oil at the highest concentration tested (10% v / v in the diffusor) significantly reduced the rots. The application of thyme or savory EO favored a reduction of brown rot incidence, caused by Monilinia fructicola , but increased gray mold, caused by Botrytis cinerea . In vitro tests confirmed that M. fructicola was more sensitive to EO vapors than B. cinerea . Essential oil volatile components were characterized in storage cabinets during postharvest. The antifungal components of the essential oils increased during storage, but they were a low fraction of the volatile organic compounds in storage chambers. EO vapors did not influence the overall quality of the fruit, but showed a positive effect in reducing weight loss and in maintaining ascorbic acid and carotenoid content. The application of thyme and savory essential oil vapors represents a promising tool for reducing postharvest losses and preserving the quality of peaches and nectarines.

Effects of contaminated dredge spoils on wetland plant communities: A literature review

USGS Publications Warehouse

Stewart, Paul M.; Garza, Eric L.; Butcher, Jason T.; Simon, Thomas P.

2003-01-01

Contaminated dredge spoil is a national concern due to its scope and effects on biota, water quality, and the physical environment. This literature review discusses the effects of contaminated dredge spoils on wetland plant communities. Plant communities naturally shift over time with changing environmental conditions. Addition of toxins and nutrients and changes in hydrology may influence plant community structure. The storage and disposal of nutrient and metal contaminated dredge spoils may cause shifts in nearby plant communities. Shifts in species composition and diversity may not be observed for decades after nutrient enrichment, causing any disturbance to remain undetected. Plant community shifts often have great amounts of inertia and are difficult to reverse.

Impact of Expert Teaching Quality on Novice Academic Performance in the Jigsaw Cooperative Learning Method

NASA Astrophysics Data System (ADS)

Berger, Roland; Hänze, Martin

2015-01-01

We assessed the impact of expert students' instructional quality on the academic performance of novice students in 12th-grade physics classes organized in an expert model of cooperative learning ('jigsaw classroom'). The instructional quality of 129 expert students was measured by a newly developed rating system. As expected, when aggregating across all four subtopics taught, regression analysis revealed that academic performance of novice students increases with the quality of expert students' instruction. The difficulty of subtopics, however, moderates this effect: higher instructional quality of more difficult subtopics did not lead to better academic performance of novice students. We interpret this finding in the light of Cognitive Load Theory. Demanding tasks cause high intrinsic cognitive load and hindered the novice students' learning.

Identification of Surface Water Quality along the Coast of Sanya, South China Sea

PubMed Central

Wu, Zhen-Zhen; Che, Zhi-Wei; Wang, You-Shao; Dong, Jun-De; Wu, Mei-Lin

2015-01-01

Principal component analysis (PCA) and cluster analysis (CA) are utilized to identify the effects caused by human activities on water quality along the coast of Sanya, South China Sea. PCA and CA identify the seasonality of water quality (dry and wet seasons) and polluted status (polluted area). The seasonality of water quality is related to climate change and Southeast monsoons. Spatial pattern is mainly related to anthropogenic activities (especially land input of pollutions). PCA reveals the characteristics underlying the generation of coastal water quality. The temporal and spatial variation of the trophic status along the coast of Sanya is governed by hydrodynamics and human activities. The results provide a novel typological understanding of seasonal trophic status in a shallow, tropical, open marine bay. PMID:25894980

Ten tools of continuous quality improvement: a review and case example of hospital discharge.

PubMed

Ziegenfuss, J T; McKenna, C K

1995-01-01

Concepts and methods of continuous quality improvement have been endorsed by quality specialists in American Health care, and their use has convinced CEOs that industrial methods can make a contribution to health and medical care. For all the quality improvement publications, there are still few that offer a clear, concise definition and an explanation of the primary tools for teaching purposes. This report reviews ten continuous quality improvement methods including: problem solving cycle, affinity diagrams, cause and effect diagrams, Pareto diagrams, histograms, bar charts, control charts, scatter diagrams, checklists, and a process decision program chart. These do not represent an exhaustive list, but a set of commonly used tools. They are applied to a case study of bed utilization in a university hospital.

Pharmacological interventions for sleepiness and sleep disturbances caused by shift work.

PubMed

Liira, Juha; Verbeek, Jos H; Costa, Giovanni; Driscoll, Tim R; Sallinen, Mikael; Isotalo, Leena K; Ruotsalainen, Jani H

2015-02-01

Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and quality. To evaluate the effects of pharmacological interventions to reduce sleepiness or to improve alertness at work and decrease sleep disturbances whilst of work, or both, in workers undertaking shift work. We searched CENTRAL, MEDLINE, EMBASE, PubMed and PsycINFO up to 20 September 2013 and ClinicalTrials.gov up to July 2013. We also screened reference lists of included trials and relevant reviews. We included all eligible randomised controlled trials (RCTs), including cross-over RCTs, of pharmacological products among workers who were engaged in shift work (including night shifts) in their present jobs and who may or may not have had sleep problems. Primary outcomes were sleep length and sleep quality while of work, alertness and sleepiness, or fatigue at work. Two authors independently selected studies, extracted data and assessed risk of bias in included trials. We performed meta-analyses where appropriate. We included 15 randomised placebo-controlled trials with 718 participants. Nine trials evaluated the effect of melatonin and two the effect of hypnotics for improving sleep problems. One trial assessed the effect of modafinil, two of armodafinil and one examined caffeine plus naps to decrease sleepiness or to increase alertness.

Effect of cause-of-death training on agreement between hospital discharge diagnoses and cause of death reported, inpatient hospital deaths, New York City, 2008-2010.

PubMed

Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio; Madsen, Ann

2015-01-15

Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to improve cause-of-death reporting and use linked discharge data to monitor data quality.

Scheduling periodic jobs using imprecise results

NASA Technical Reports Server (NTRS)

Chung, Jen-Yao; Liu, Jane W. S.; Lin, Kwei-Jay

1987-01-01

One approach to avoid timing faults in hard, real-time systems is to make available intermediate, imprecise results produced by real-time processes. When a result of the desired quality cannot be produced in time, an imprecise result of acceptable quality produced before the deadline can be used. The problem of scheduling periodic jobs to meet deadlines on a system that provides the necessary programming language primitives and run-time support for processes to return imprecise results is discussed. Since the scheduler may choose to terminate a task before it is completed, causing it to produce an acceptable but imprecise result, the amount of processor time assigned to any task in a valid schedule can be less than the amount of time required to complete the task. A meaningful formulation of the scheduling problem must take into account the overall quality of the results. Depending on the different types of undesirable effects caused by errors, jobs are classified as type N or type C. For type N jobs, the effects of errors in results produced in different periods are not cumulative. A reasonable performance measure is the average error over all jobs. Three heuristic algorithms that lead to feasible schedules with small average errors are described. For type C jobs, the undesirable effects of errors produced in different periods are cumulative. Schedulability criteria of type C jobs are discussed.

Pathway-based monitoring of biological effects at Great Lakes sites

EPA Science Inventory

The Great Lakes region suffers from degradation of water and environmental quality due to release of chemicals of emerging concern (CEC) that may threaten near shore health. Critical issues remain in delisting AOC including determining sources of chemicals causing fish health im...

Efficacy of supercritical carbon dioxide for inactivating Lactobacillus plantarum in apple cider

USDA-ARS?s Scientific Manuscript database

Juice makers have traditionally used thermal pasteurization to prevent deterioration by spoilage bacteria such as Lactobacillus plantarum; however this thermal processing causes adverse effects on product quality such as undesirable taste and destruction of heat sensitive nutrients. For this reason,...

Inactivation of microorganisms in apple cider and orange juice using supercritical carbon dioxide

USDA-ARS?s Scientific Manuscript database

Juice processors have traditionally used thermal pasteurization to prevent deterioration by spoilage bacteria such as Lactobacillus plantarum and Saccharomyces cerevisiae; however, thermal processing may cause adverse effects on product quality such as undesirable taste and destruction of heat sensi...

Differential Susceptibility to Rearing Experience: The Case of Childcare

ERIC Educational Resources Information Center

Pluess, Michael; Belsky, Jay

2009-01-01

Background: Inconsistencies regarding developmental effects of non-maternal childcare may be caused by neglecting the possibility that children are differentially susceptible towards such experiences. Method: Interactions between difficult/negative child temperament and childcare type, quantity, and quality on teacher-rated behavior problems and…

Effect of calcium nitrite on the properties of concrete used in bridge decks.

DOT National Transportation Integrated Search

1992-01-01

Chloride-induced corrosion of the reinforcing steel in bridge decks can impair its structural integrity and cause spalling, which reduces the ride quality of the deck. One system to prevent corrosion involves the use of corrosion inhibitors in freshl...

Air quality

Treesearch

Andrzej Bytnerowicz; Mark Fenn; Jonathan W. Long

2014-01-01

The major pollutants causing ecological harm in the Sierra Nevada are ozone, which can be toxic to plants, and nitrogen deposition, which can induce undesirable effects on terrestrial and aquatic ecosystems. Other airborne pollutants of concern include black carbon, particulate matter (PM), pesticides, and heavy metals, including mercury. Atmospheric pollutants that...

The effects of larval habitat quality on Aedes albopictus skip oviposition

USDA-ARS?s Scientific Manuscript database

Aedes albopictus, an invasive mosquito species that transmits disease-causing pathogens, oviposits in containers in resource-limited habitats. To mitigate larval competition, Ae. albopictus females may choose to distribute eggs from a single gonotrophic cycle among multiple containers through skip o...

Stressors in Atopic Dermatitis.

PubMed

Barilla, Steven; Felix, Kayla; Jorizzo, Joseph L

2017-01-01

As with other inflammatory skin disorders, atopic dermatitis has a tendency to cause stress and also be exacerbated by it. Patients with atopic dermatitis have several disease-associated stressors, some of which include physical discomfort due to itching and altered appearance due to flare-ups. These stressors have been shown to effect patients psychosocially by altering sleep patterns, decreasing self-esteem and interfering with interpersonal relationships. In combination with its direct effect on patients, atopic dermatitis also causes stress for parents and caregivers. Studies suggest that atopic dermatitis is strongly correlated with co-sleeping habits, which can negatively impact the health and mood of parents or caregivers. It has also been reported to interfere with the formation of a strong mother-child relationship. In order to optimize treatment for patients with atopic dermatitis, it is important to note the impact that it has on quality of life. By implementing patient counseling, sleep-targeted therapies, and the use of quality of life (QoL) indices, atopic dermatitis patients and caregivers have the potential to experience greater satisfaction with treatment.

The interaction between nitrobenzene and Microcystis aeruginosa and its potential to impact water quality.

PubMed

Liu, Zhiquan; Cui, Fuyi; Ma, Hua; Fan, Zhenqiang; Zhao, Zhiwei; Hou, Zhenling; Liu, Dongmei; Jia, Xuebin

2013-08-01

The potential water quality problems caused by the interaction between nitrobezene (NB) and Microcystis aeruginosa was investigated by studying the growth inhibition, the haloacetic acids formation potential (HAAFP) and the secretion of microcystin-LR (MC-LR). The results showed that NB can inhibit the growth of M. aeruginosa, and the value of EC50 increased with the increase of initial algal density. Although NB can hardly react with chlorine to form HAAs, the presence of NB can enhance the HAAFP productivity. The secretion of the intracellular MC-LR is constant under the steady experimental conditions. However, the presence of NB can reduce the MC-LR productivity of M. aeruginosa. Overall, the increased disinfection risk caused by the interaction has more important effect on the safety of drinking water quality than the benefit of the decreased MC-LR productivity, and should be serious considered when the water contained NB and M. aeruginosa is used as drinking water source. Copyright © 2013 Elsevier Ltd. All rights reserved.

Six Sigma Approach to Improve Stripping Quality of Automotive Electronics Component – a case study

NASA Astrophysics Data System (ADS)

Razali, Noraini Mohd; Murni Mohamad Kadri, Siti; Con Ee, Toh

2018-03-01

Lacking of problem solving skill techniques and cooperation between support groups are the two obstacles that always been faced in actual production line. Inadequate detail analysis and inappropriate technique in solving the problem may cause the repeating issues which may give impact to the organization performance. This study utilizes a well-structured six sigma DMAIC with combination of other problem solving tools to solve product quality problem in manufacturing of automotive electronics component. The study is concentrated at the stripping process, a critical process steps with highest rejection rate that contribute to the scrap and rework performance. The detail analysis is conducted in the analysis phase to identify the actual root cause of the problem. Then several improvement activities are implemented and the results show that the rejection rate due to stripping defect decrease tremendously and the process capability index improved from 0.75 to 1.67. This results prove that the six sigma approach used to tackle the quality problem is substantially effective.

Particle counter as a tool to control pre-hydrolyzed coagulant dosing and rapid filtration efficiency in a conventional treatment system.

PubMed

Gumińska, Jolanta; Kłos, Marcin

2015-01-01

Filtration efficiency in a conventional water treatment system was analyzed in the context of pre-hydrolyzed coagulant overdosing. Two commercial coagulants of different aluminum speciation were tested. A study was carried out at a water treatment plant supplied with raw water of variable quality. The lack of stability of water quality caused many problems with maintaining the optimal coagulant dose. The achieved results show that the type of coagulant had a very strong influence on the effectiveness of filtration resulting from the application of an improper coagulant dose. The overdosing of high basicity coagulant (PAC85) caused a significant increase of fine particles in the outflow from the sedimentation tanks, which could not be retained in the filter bed due to high surface charge and the small size of hydrolysis products. When using a coagulant of lower basicity (PAC70), it was much easier to control the dose of coagulant and to adjust it to the changing water quality.

Research of Influence Modification of Natural Concentrate on Quality Metal

NASA Astrophysics Data System (ADS)

Fedoseev, S. N.; Gizatulin, R. A.; Korotkova, E. A.

2016-08-01

Questions of increase of mechanical, technological and service properties of metal at minimum cost to produce it are relevant for the metallurgical enterprises. Modification of complex steel alloys containing reactive elements is one of the effective ways to improve the quality of steel. At the same time the direct costs for the use of modifiers are 0.2-0.3%, which little effect on the cost of production. The paper presents the results of the application of natural concentrates as a modifier steel. The effects on the metal quality changes due to the impact of the modification concentrates demonstrate the effectiveness of their application. As a result of modification decreased the content of nonmetallic inclusions and grain size. Reduction of impurity modified metal of was the cause more high plastic properties, especially, impact strength at ordinary and low temperatures of tests. Based on the experimental data evaluated hardening mechanisms that lead to a significant improvement of physic-mechanical properties of the metal workpiece after administration modifier.

Effects of farm management practices and transport duration on stress response and meat quality traits of suckling goat kids.

PubMed

Alcalde, M J; Suárez, M D; Rodero, E; Álvarez, R; Sáez, M I; Martínez, T F

2017-09-01

Studies aimed to assess up to what extent farming and transport previous to slaughtering might affect physiology and meat quality in young goat kids are needed, with the ultimate purpose of promoting practices that minimize stress in these animals. In this regard the effects of on-farm management and transport duration on some physiological responses and meat quality parameters in goat kids were assessed. Two farms representing 'high' and 'low' welfare-friendly management practices were selected. In total, 32 suckling kids were withdrawn from each farm, transported by road for 2 or 6 h, and then slaughtered. Blood samples were collected both on-farm and in the slaughterhouse, and biochemistry, cell counts and haematocrit were determined. After slaughtering, carcass quality parameters were measured. Longissimus dorsi muscle was dissected and pH, colour parameters, water holding capacity and shear force were measured throughout 8-day ageing period. Results indicate that, regardless its duration, transport caused significant effects on some blood parameters suggesting stress in live animals, like glucose, cortisol or creatine kinase. Despite the marked stress status in animals, this condition was not decisively reflected on L. dorsi quality parameters, but some effects were observed regarding fat cover in carcasses and colour parameters. The results suggest that postmortem changes throughout ageing were more decisive in terms of meat quality than stressful management either on-farm or during transport.

The quality of medical death certification of cause of death in hospitals in rural Bangladesh: impact of introducing the International Form of Medical Certificate of Cause of Death.

PubMed

Hazard, Riley H; Chowdhury, Hafizur Rahman; Adair, Tim; Ansar, Adnan; Quaiyum Rahman, A M; Alam, Saidul; Alam, Nurul; Rampatige, Rasika; Streatfield, Peter Kim; Riley, Ian Douglas; Lopez, Alan D

2017-10-02

Accurate and timely data on cause of death are critically important for guiding health programs and policies. Deaths certified by doctors are implicitly considered to be reliable and accurate, yet the quality of information provided in the international Medical Certificate of Cause of Death (MCCD) usually varies according to the personnel involved in certification, the diagnostic capacity of the hospital, and the category of hospitals. There are no published studies that have analysed how certifying doctors in Bangladesh adhere to international rules when completing the MCCD or have assessed the quality of clinical record keeping. The study took place between January 2011 and April 2014 in the Chandpur and Comilla districts of Bangladesh. We introduced the international MCCD to all study hospitals. Trained project physicians assigned an underlying cause of death, assessed the quality of the death certificate, and reported the degree of certainty of the medical records provided for a given cause. We examined the frequency of common errors in completing the MCCD, the leading causes of in-hospital deaths, and the degree of certainty in the cause of death data. The study included 4914 death certificates. 72.9% of medical records were of too poor quality to assign a cause of death, with little difference by age, hospital, and cause of death. 95.6% of death certificates did not indicate the time interval between onset and death, 31.6% required a change in sequence, 13.9% required to include a new diagnosis, 50.7% used abbreviations, 41.5% used multiple causes per line, and 33.2% used an ill-defined condition as the underlying cause of death. 99.1% of death certificates had at least one error. The leading cause of death among adults was stroke (15.8%), among children was pneumonia (31.7%), and among neonates was birth asphyxia (52.8%). Physicians in Bangladeshi hospitals had difficulties in completing the MCCD correctly. Physicians routinely made errors in death certification practices and medical record quality was poor. There is an urgent need to improve death certification practices and the quality of hospital data in Bangladesh if these data are to be useful for policy.

Colonization by Phloem-Feeding Herbivore Overrides Effects of Plant Virus on Amino Acid Composition in Phloem of Chili Plants.

PubMed

Ángeles-López, Yesenia Ithaí; Rivera-Bustamante, Rafael F; Heil, Martin

2016-10-01

The 'adaptive host manipulation' hypothesis predicts that parasites can enhance their transmission rates via manipulation of their host's phenotype. For example, many plant pathogens alter the nutritional quality of their host for herbivores that serve as their vectors. However, herbivores, including non-vectors, might cause additional alterations in the plant phenotype. Here, we studied changes in the amino acid (AA) content in the phloem of chilli (Capsicum annuum) plants infected with Pepper golden mosaic virus (PepGMV) upon subsequent colonization with a non-vector, the phloem-feeding whitefly (Trialeurodes vaporariorum). Virus infection alone caused an almost 30-fold increase in overall phloem AAs, but colonization by T. vaporariorum completely reversed this effect. At the level of individual AAs, contents of proline, tyrosine, and valine increased, and histidine and alanine decreased in PepGMV -infected as compared to control plants, whereas colonization by T. vaporariorum caused decreased contents of proline, tyrosine, and valine, and increased contents of histidine and alanine. Overall, the colonization by the whitefly had much stronger effects on phloem AA composition than virus infection. We conclude that the phloem composition of a virus-infected host plant can rapidly change upon arrival of an herbivore and that these changes need to be monitored to predict the nutritional quality of the plant in the long run.

Effects of endogenous cysteine proteinases on structures of collagen fibres from dermis of sea cucumber (Stichopus japonicus).

PubMed

Liu, Yu-Xin; Zhou, Da-Yong; Ma, Dong-Dong; Liu, Zi-Qiang; Liu, Yan-Fei; Song, Liang; Dong, Xiu-Ping; Li, Dong-Mei; Zhu, Bei-Wei; Konno, Kunihiko; Shahidi, Fereidoon

2017-10-01

Autolysis of sea cucumber, caused by endogenous enzymes, leads to postharvest quality deterioration of sea cucumber. However, the effects of endogenous proteinases on structures of collagen fibres, the major biologically relevant substrates in the body wall of sea cucumber, are less clear. Collagen fibres were prepared from the dermis of sea cucumber (Stichopus japonicus), and the structural consequences of degradation of the collagen fibres caused by endogenous cysteine proteinases (ECP) from Stichopus japonicus were examined. Scanning electron microscopic images showed that ECP caused partial disaggregation of collagen fibres into collagen fibrils by disrupting interfibrillar proteoglycan bridges. Differential scanning calorimetry and Fourier transform infrared analysis revealed increased structural disorder of fibrillar collagen caused by ECP. SDS-PAGE and chemical analysis indicated that ECP can liberate glycosaminoglycan, hydroxyproline and collagen fragments from collagen fibres. Thus ECP can cause disintegration of collagen fibres by degrading interfibrillar proteoglycan bridges. Copyright © 2017 Elsevier Ltd. All rights reserved.

Combined environmental stress from shrimp farm and dredging releases in a subtropical coastal lagoon (SE Gulf of California).

PubMed

Cardoso-Mohedano, J G; Páez-Osuna, F; Amezcua-Martínez, F; Ruiz-Fernández, A C; Ramírez-Reséndiz, G; Sanchez-Cabeza, J A

2016-03-15

Nutrient pollution causes environmental damages on aquatic ecosystems worldwide. Eutrophication produces impacts in coastal ecosystems, affecting biota and ecosystem services. The Urias coastal lagoon (SE Gulf of California) is a sub-tropical estuary under several environmental pressures such as nutrient inputs from shrimp farm effluents and dredging related to port operations, which can release substances accumulated in sediments. We assessed the water quality impacts caused by these activities and results showed that i) nitrogen was the limiting nutrient, ii) shrimp farm effluents increased particulate organic matter and chlorophyll a in the receiving stations, and iii) dredging activities increased nitrite and reduced dissolved oxygen concentrations. The co-occurrence of the shrimp farm releases and dredging activities was likely the cause of a negative synergistic effect on water quality which mainly decreases dissolved oxygen and increases nitrite concentrations. Coastal zone management should avoid the co-occurrence of these, and likely others, stressors in coastal ecosystems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessment and prediction of land ecological environment quality change based on remote sensing-a case study of the Dongting lake area in China

NASA Astrophysics Data System (ADS)

Hu, Wenmin; Wang, Zhongcheng; Li, Chunhua; Zhao, Jin; Li, Yi

2018-02-01

Multi-source remote sensing data is rarely used for the comprehensive assessment of land ecologic environment quality. In this study, a digital environmental model was proposed with the inversion algorithm of land and environmental factors based on the multi-source remote sensing data, and a comprehensive index (Ecoindex) was applied to reconstruct and predict the land environment quality of the Dongting Lake Area to assess the effect of human activities on the environment. The main finding was that with the decrease of Grade I and Grade II quality had a decreasing tendency in the lake area, mostly in suburbs and wetlands. Atmospheric water vapour, land use intensity, surface temperature, vegetation coverage, and soil water content were the main driving factors. The cause of degradation was the interference of multi-factor combinations, which led to positive and negative environmental agglomeration effects. Positive agglomeration, such as increased rainfall and vegetation coverage and reduced land use intensity, could increase environmental quality, while negative agglomeration resulted in the opposite. Therefore, reasonable ecological restoration measures should be beneficial to limit the negative effects and decreasing tendency, improve the land ecological environment quality and provide references for macroscopic planning by the government.

Improving Quality of Life With Nabilone During Radiotherapy Treatments for Head and Neck Cancers: A Randomized Double-Blind Placebo-Controlled Trial.

PubMed

Côté, Mathieu; Trudel, Mathieu; Wang, Changshu; Fortin, André

2016-04-01

Patients treated for head and neck carcinomas experience a significant deterioration of their quality of life during treatments because of severe side effects. Nabilone has many properties that could alleviate symptoms caused by radiotherapy and improve patients' quality of life. The aim of the present study was to compare the effects of nabilone versus placebo on the quality of life and side effects during radiotherapy for head and neck carcinomas. Fifty-six patients were randomized to nabilone or placebo. Patients filled the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC QLQ-H&N35; three independent questionnaires assessing appetite, nausea, and toxicity; and a visual analog scale for pain. These data were collected before radiotherapy, each week during radiotherapy, and 4 weeks after radiotherapy. Patients were weighed every week. Nabilone did not lengthen the time necessary for a 15% deterioration of quality of life (P = .4279), and it was not better than placebo for relieving symptoms like pain (P = .6048), nausea (P = .7105), loss of appetite (P = .3295), weight (P = .1454), mood (P = .3214), and sleep (P = .4438). At the dosage used, nabilone was not potent enough to improve the patients' quality of life over placebo. © The Author(s) 2015.

[Reliability theory based on quality risk network analysis for Chinese medicine injection].

PubMed

Li, Zheng; Kang, Li-Yuan; Fan, Xiao-Hui

2014-08-01

A new risk analysis method based upon reliability theory was introduced in this paper for the quality risk management of Chinese medicine injection manufacturing plants. The risk events including both cause and effect ones were derived in the framework as nodes with a Bayesian network analysis approach. It thus transforms the risk analysis results from failure mode and effect analysis (FMEA) into a Bayesian network platform. With its structure and parameters determined, the network can be used to evaluate the system reliability quantitatively with probabilistic analytical appraoches. Using network analysis tools such as GeNie and AgenaRisk, we are able to find the nodes that are most critical to influence the system reliability. The importance of each node to the system can be quantitatively evaluated by calculating the effect of the node on the overall risk, and minimization plan can be determined accordingly to reduce their influences and improve the system reliability. Using the Shengmai injection manufacturing plant of SZYY Ltd as a user case, we analyzed the quality risk with both static FMEA analysis and dynamic Bayesian Network analysis. The potential risk factors for the quality of Shengmai injection manufacturing were identified with the network analysis platform. Quality assurance actions were further defined to reduce the risk and improve the product quality.

Handling Qualities Evaluation of Pilot Tools for Spacecraft Docking in Earth Orbit

NASA Technical Reports Server (NTRS)

Bilimoria, Karl D.; Mueller, Eric; Frost, Chad

2009-01-01

A new generation of spacecraft is now under development by NASA to replace the Space Shuttle and return astronauts to the Moon. These spacecraft will have a manual control capability for several mission tasks, and the ease and precision with which pilots can execute these tasks will have an important effect on mission risk and training costs. This paper focuses on the handling qualities of a spacecraft based on dynamics similar to that of the Crew Exploration Vehicle, during the last segment of the docking task with a space station in low Earth orbit. A previous study established that handling qualities for this task degrade significantly as the level of translation-into-rotation coupling increases. The goal of this study is to evaluate the efficacy of various pilot aids designed to mitigate the handling qualities degradation caused by this coupling. Four pilot tools were ev adluaetead:d-band box/indicator, flight-path marker, translation guidance cues, and feed-forward control. Each of these pilot tools improved handling qualities, generally with greater improvements resulting from using these tools in combination. A key result of this study is that feedforward control effectively counteracts coupling effects, providing solid Level 1 handling qualities for the spacecraft configuration evaluated.

[Epidemiological aspects in occupational neurology. Investigational methodology

PubMed

Solé-García, M D

In the working population, unsatisfactory working conditions (in the broadest sense) may cause effects whose gravity depends mainly on the characteristics of exposure and the general condition of the individual. These effects may, in practice, be classified as occupational accidents and professional illness (both legal concepts), illnesses related to work, diminished quality of life and effects on offspring. Agents as varied as head injuries and metals are known to cause from loss of memory or behavior disorders to chronic toxic encephalopathy or Parkinsonism. There is little data on exposure to neurotoxic agents or disorders of the central nervous system caused by work and what there is not reliable. Therefore it is necessary to facilitate and encourage collaboration between neurologists and occupational medicine specialists so as to determine the importance/extent of the problem, undertake investigation as to aetiology and develop methods for early detection of these disorders.

How the factoid of wind turbines causing 'vibroacoustic disease' came to be 'irrefutably demonstrated'.

PubMed

Chapman, Simon; St George, Alexis

2013-06-01

In recent years, claims have proliferated in cyberspace that wind turbines cause a large variety of symptoms and diseases. One of these, "vibroacoustic disease" (VAD) is frequently mentioned. The aim of this study is to examine the quality of the evidence on how VAD came to be associated with wind turbine exposure by wind farm opponents. Searches of the web (Google advanced) and major research databases for papers on VAD and wind turbines. Self-citation analysis of research papers on VAD. Google returned 24,700 hits for VAD and wind turbines. Thirty-five research papers on VAD were found, none reporting any association between VAD and wind turbines. Of the 35 papers, 34 had a first author from a single Portuguese research group. Seventy-four per cent of citations to these papers were self-citations by the group. Median self-citation rates in science are around 7%. Two unpublished case reports presented at conferences were found asserting that VAD was "irrefutably demonstrated" to be caused by wind turbines. The quality of these reports was abject. VAD has received virtually no scientific recognition beyond the group who coined and promoted the concept. There is no evidence of even rudimentary quality that vibroacoustic disease is associated with or caused by wind turbines. The claim that wind turbines cause VAD is a factoid that has gone 'viral' in cyberspace and may be contributing to nocebo effects among those living near turbines. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015.

PubMed

2017-07-15

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0-42·8) in 1990 to 53·7 (52·2-55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Sperm Parameters: Paradigmatic Index of Good Health and Longevity

PubMed Central

Omu, Alexander E.

2013-01-01

Since the discovery of spermatozoon by Anton van Leeuwenhoek in 1677, there has been an ever increasing understanding of its role in reproduction. Many factors adversely affect sperm quality, including varicocele, accessory gland infection, immunological factors, congenital abnormalities, and iatrogenic systemic and endocrine causes, such as diabetes mellitus, obesity, metabolic syndrome, and smoking. The mechanisms responsible for the association between poor sperm parameters and ill health may include oxidative stress, low-grade inflammation, low testosterone, and low sex-hormone-binding globulin. Oxidative stress in the testicular microenvironment may result in decreased spermatogenesis and sperm DNA damage, loss of sperm motility, and abnormal sperm morphology. Low testosterone caused by advanced age, visceral obesity, and inflammation is associated with the development of cardiovascular disease. Hence, semen analysis has an important role in the routine evaluation of idiopathic male infertility, usually manifested as low sperm counts, impaired sperm motility, or absence of sperm, and remains the most common single diagnostic tool. Several studies have shown an inverse relationship between semen quality and medical disorders. This review elucidates the effect of medical disorders and social habits on sperm quality, the mechanisms that are involved in the impairment of sperm quality, and whether or not sperm quality can be used as an index of good health and longevity in a man. PMID:24051979

Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events.

PubMed

Squizzato, Alessandro; Bellesini, Marta; Takeda, Andrea; Middeldorp, Saskia; Donadini, Marco Paolo

2017-12-14

Aspirin is the prophylactic antiplatelet drug of choice for people with cardiovascular disease. Adding a second antiplatelet drug to aspirin may produce additional benefit for people at high risk and people with established cardiovascular disease. This is an update to a previously published review from 2011. To review the benefit and harm of adding clopidogrel to aspirin therapy for preventing cardiovascular events in people who have coronary disease, ischaemic cerebrovascular disease, peripheral arterial disease, or were at high risk of atherothrombotic disease, but did not have a coronary stent. We updated the searches of CENTRAL (2017, Issue 6), MEDLINE (Ovid, 1946 to 4 July 2017) and Embase (Ovid, 1947 to 3 July 2017) on 4 July 2017. We also searched ClinicalTrials.gov and the WHO ICTRP portal, and handsearched reference lists. We applied no language restrictions. We included all randomised controlled trials comparing over 30 days use of aspirin plus clopidogrel with aspirin plus placebo or aspirin alone in people with coronary disease, ischaemic cerebrovascular disease, peripheral arterial disease, or at high risk of atherothrombotic disease. We excluded studies including only people with coronary drug-eluting stent (DES) or non-DES, or both. We collected data on mortality from cardiovascular causes, all-cause mortality, fatal and non-fatal myocardial infarction, fatal and non-fatal ischaemic stroke, major and minor bleeding. The overall treatment effect was estimated by the pooled risk ratio (RR) with 95% confidence interval (CI), using a fixed-effect model (Mantel-Haenszel); we used a random-effects model in cases of moderate or severe heterogeneity (I 2 ≥ 30%). We assessed the quality of the evidence using the GRADE approach. We used GRADE profiler (GRADE Pro) to import data from Review Manager to create a 'Summary of findings' table. The search identified 13 studies in addition to the two studies in the previous version of our systematic review. Overall, we included data from 15 trials with 33,970 people. We completed a 'Risk of bias' assessment for all studies. The risk of bias was low in four trials because they were at low risk of bias for all key domains (random sequence generation, allocation concealment, blinding, selective outcome reporting and incomplete outcome data), even if some of them were funded by the pharmaceutical industry.Analysis showed no difference in the effectiveness of aspirin plus clopidogrel in preventing cardiovascular mortality (RR 0.98, 95% CI 0.88 to 1.10; participants = 31,903; studies = 7; moderate quality evidence), and no evidence of a difference in all-cause mortality (RR 1.05, 95% CI 0.87 to 1.25; participants = 32,908; studies = 9; low quality evidence).There was a lower risk of fatal and non-fatal myocardial infarction with clopidogrel plus aspirin compared with aspirin plus placebo or aspirin alone (RR 0.78, 95% CI 0.69 to 0.90; participants = 16,175; studies = 6; moderate quality evidence). There was a reduction in the risk of fatal and non-fatal ischaemic stroke (RR 0.73, 95% CI 0.59 to 0.91; participants = 4006; studies = 5; moderate quality evidence).However, there was a higher risk of major bleeding with clopidogrel plus aspirin compared with aspirin plus placebo or aspirin alone (RR 1.44, 95% CI 1.25 to 1.64; participants = 33,300; studies = 10; moderate quality evidence) and of minor bleeding (RR 2.03, 95% CI 1.75 to 2.36; participants = 14,731; studies = 8; moderate quality evidence).Overall, we would expect 13 myocardial infarctions and 23 ischaemic strokes be prevented for every 1000 patients treated with the combination in a median follow-up period of 12 months, but 9 major bleeds and 33 minor bleeds would be caused during a median follow-up period of 10.5 and 6 months, respectively. The available evidence demonstrates that the use of clopidogrel plus aspirin in people at high risk of cardiovascular disease and people with established cardiovascular disease without a coronary stent is associated with a reduction in the risk of myocardial infarction and ischaemic stroke, and an increased risk of major and minor bleeding compared with aspirin alone. According to GRADE criteria, the quality of evidence was moderate for all outcomes except all-cause mortality (low quality evidence) and adverse events (very low quality evidence).

Is Your School Suffering from Sick Building Syndrome?

ERIC Educational Resources Information Center

Wulf, Margaret

1993-01-01

Three-fourths of American schools are in substandard condition. Health effects associated with indoor air/environmental quality are a major concern. Sick building syndrome, which causes illness in occupants, generally results from particulates, volatile organic compounds, biologicals, or radio-nucleotides. The article recommends how to deal with…

32 CFR 651.42 - Actions normally requiring an EIS.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.42... effect on wetlands, coastal zones, or other areas of critical environmental concern. (c) The disposal of... substances that have the potential to cause significant environmental impact. (d) Land acquisition, leasing...

32 CFR 651.42 - Actions normally requiring an EIS.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.42... effect on wetlands, coastal zones, or other areas of critical environmental concern. (c) The disposal of... substances that have the potential to cause significant environmental impact. (d) Land acquisition, leasing...

32 CFR 651.42 - Actions normally requiring an EIS.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.42... effect on wetlands, coastal zones, or other areas of critical environmental concern. (c) The disposal of... substances that have the potential to cause significant environmental impact. (d) Land acquisition, leasing...

Effects of surface inactivation, high temperature drying and preservative treatment on surface roughness and colour of alder and beech wood

NASA Astrophysics Data System (ADS)

Aydin, Ismail; Colakoglu, Gursel

2005-10-01

Although extensive research has been conducted in wood surface quality analysis, a unified approach to surface quality characterisation does not exist. Measurements of the variation in surface roughness and surface colour are used widely for the evaluation of wood surface quality. Colour is a basic visual feature for wood and wood-based products. Colour measurement is one of the quality control tests that should be carried out because the colour deviations are spotted easily by the consumers. On the other hand, a common problem faced by plywood manufacturers is panel delamination, for which a major cause is poor quality glue-bonds resulting from rough veneer. Rotary cut veneers with dimensions of 500 mm × 500 mm × 2 mm manufactured from alder ( Alnus glutinosa subsp. barbata) and beech ( Fagus orientalis Lipsky) logs were used as materials in this study. Veneer sheets were oven-dried in a veneer dryer at 110 °C (normal drying temperature) and 180 °C (high drying temperature) after peeling process. The surfaces of some veneers were then exposed at indoor laboratory conditions to obtain inactive wood surfaces for glue bonds, and some veneers were treated with borax, boric acid and ammonium acetate solutions. After these treatments, surface roughness and colour measurements were made on veneer surfaces. High temperature drying process caused a darkening on the surfaces of alder and beech veneers. Total colour change value (Δ E*) increased linear with increasing exposure time. Among the treatment solutions, ammonium acetate caused the biggest colour change while treatment with borax caused the lowest changes in Δ E* values. Considerable changes in surface roughness after preservative treatment did not occur on veneer surfaces. Generally, no clear changes were obtained or the values mean roughness profile ( Ra) decreased slightly in Ra values after the natural inactivation process.

Eye of the Beholder: Stage Entrance Behavior and Facial Expression Affect Continuous Quality Ratings in Music Performance

PubMed Central

Waddell, George; Williamon, Aaron

2017-01-01

Judgments of music performance quality are commonly employed in music practice, education, and research. However, previous studies have demonstrated the limited reliability of such judgments, and there is now evidence that extraneous visual, social, and other “non-musical” features can unduly influence them. The present study employed continuous measurement techniques to examine how the process of forming a music quality judgment is affected by the manipulation of temporally specific visual cues. Video footage comprising an appropriate stage entrance and error-free performance served as the standard condition (Video 1). This footage was manipulated to provide four additional conditions, each identical save for a single variation: an inappropriate stage entrance (Video 2); the presence of an aural performance error midway through the piece (Video 3); the same error accompanied by a negative facial reaction by the performer (Video 4); the facial reaction with no corresponding aural error (Video 5). The participants were 53 musicians and 52 non-musicians (N = 105) who individually assessed the performance quality of one of the five randomly assigned videos via a digital continuous measurement interface and headphones. The results showed that participants viewing the “inappropriate” stage entrance made judgments significantly more quickly than those viewing the “appropriate” entrance, and while the poor entrance caused significantly lower initial scores among those with musical training, the effect did not persist long into the performance. The aural error caused an immediate drop in quality judgments that persisted to a lower final score only when accompanied by the frustrated facial expression from the pianist; the performance error alone caused a temporary drop only in the musicians' ratings, and the negative facial reaction alone caused no reaction regardless of participants' musical experience. These findings demonstrate the importance of visual information in forming evaluative and aesthetic judgments in musical contexts and highlight how visual cues dynamically influence those judgments over time. PMID:28487662

Effects of Cultural Assimilation in a Cross-Border M&A

NASA Astrophysics Data System (ADS)

Ito, Satoshi; Tamiya, Toshihiko; Fujimura, Shuzo

2010-06-01

This paper examines a merger of two companies with respect to the assimilation of corporate culture differences, particularly quality culture. The study aims to clarify the root cause of declines in quality ratings from customers after a merger despite maintaining products and services as they were before the merger, and whether cultural differences affect decision-making in a newly merged company. Examination is reported of the relationship between actions taken to assimilate quality culture and the resulting quality ratings given by customers, and analyzed is the time required to address quality incidents and the progress of cultural assimilation. A total of 301 incidents in the 5 years after a merger were analyzed, focusing on the time required to resolve the incidents. These empirical analyses reveal that the extent of cultural assimilation is associated with the speed of organizational decision-making and affects the quality ratings given by customers.

Ship Production Symposium Held in Arlington, Virginia on September 13-15, 1989 (The National Shipbuilding Research Program)

DTIC Science & Technology

1989-09-01

1986. 4. Kaoru Ishikawa , What is Total quality control? The Japanese way, Prentice-Hall, Englewood Cliffs, New Jersey, 1985. 22-1o No. 23 C o m b i n...Y. Ichinose presented a paper which disclosed how standards, including flexible standards, were organized and employed by Ishikawa - jima-Harima Heavy...result by sorting out and relating the causes. The cause-and- effect diagram, sometimes called an “ Ishikawa diagram” after the Japanese professor that

Is the hospital decision to seek accreditation an effective one?

PubMed

Grepperud, Sverre

2015-01-01

The rapid expansion in the number of accredited hospitals justifies inquiry into the motives of hospitals in seeking accreditation and its social effectiveness. This paper presents a simple decision-theoretic framework where cost reductions and improved quality of care represent the endpoint benefits from accreditation. We argue that hospital accreditation, although acting as a market-signaling device, might be a socially inefficient institution. First, there is at present no convincing evidence for accreditation causing output quality improvements. Second, hospitals could seek accreditation, even though doing so is socially inefficient, because of moral hazard, consumer misperceptions, and nonprofit motivations. Finally, hospitals that seek accreditation need not themselves believe in output quality improvements from accreditation. Consequently, while awaiting additional evidence on accreditation, policy makers and third-party payers should exercise caution in encouraging such programs. Copyright © 2014 John Wiley & Sons, Ltd.

Interventions to improve water quality for preventing diarrhoea

PubMed Central

Clasen, Thomas F; Alexander, Kelly T; Sinclair, David; Boisson, Sophie; Peletz, Rachel; Chang, Howard H; Majorin, Fiona; Cairncross, Sandy

2015-01-01

Background Diarrhoea is a major cause of death and disease, especially among young children in low-income countries. In these settings, many infectious agents associated with diarrhoea are spread through water contaminated with faeces. In remote and low-income settings, source-based water quality improvement includes providing protected groundwater (springs, wells, and bore holes), or harvested rainwater as an alternative to surface sources (rivers and lakes). Point-of-use water quality improvement interventions include boiling, chlorination, flocculation, filtration, or solar disinfection, mainly conducted at home. Objectives To assess the effectiveness of interventions to improve water quality for preventing diarrhoea. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register (11 November 2014), CENTRAL (the Cochrane Library, 7 November 2014), MEDLINE (1966 to 10 November 2014), EMBASE (1974 to 10 November 2014), and LILACS (1982 to 7 November 2014). We also handsearched relevant conference proceedings, contacted researchers and organizations working in the field, and checked references from identified studies through 11 November 2014. Selection criteria Randomized controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies (CBA) comparing interventions aimed at improving the microbiological quality of drinking water with no intervention in children and adults. Data collection and analysis Two review authors independently assessed trial quality and extracted data. We used meta-analyses to estimate pooled measures of effect, where appropriate, and investigated potential sources of heterogeneity using subgroup analyses. We assessed the quality of evidence using the GRADE approach. Main results Forty-five cluster-RCTs, two quasi-RCTs, and eight CBA studies, including over 84,000 participants, met the inclusion criteria. Most included studies were conducted in low- or middle-income countries (LMICs) (50 studies) with unimproved water sources (30 studies) and unimproved or unclear sanitation (34 studies). The primary outcome in most studies was self-reported diarrhoea, which is at high risk of bias due to the lack of blinding in over 80% of the included studies. Source-based water quality improvements There is currently insufficient evidence to know if source-based improvements such as protected wells, communal tap stands, or chlorination/filtration of community sources consistently reduce diarrhoea (one cluster-RCT, five CBA studies, very low quality evidence). We found no studies evaluating reliable piped-in water supplies delivered to households. Point-of-use water quality interventions On average, distributing water disinfection products for use at the household level may reduce diarrhoea by around one quarter (Home chlorination products: RR 0.77, 95% CI 0.65 to 0.91; 14 trials, 30,746 participants, low quality evidence; flocculation and disinfection sachets: RR 0.69, 95% CI 0.58 to 0.82, four trials, 11,788 participants, moderate quality evidence). However, there was substantial heterogeneity in the size of the effect estimates between individual studies. Point-of-use filtration systems probably reduce diarrhoea by around a half (RR 0.48, 95% CI 0.38 to 0.59, 18 trials, 15,582 participants, moderate quality evidence). Important reductions in diarrhoea episodes were shown with ceramic filters, biosand systems and LifeStraw® filters; (Ceramic: RR 0.39, 95% CI 0.28 to 0.53; eight trials, 5763 participants, moderate quality evidence; Biosand: RR 0.47, 95% CI 0.39 to 0.57; four trials, 5504 participants, moderate quality evidence; LifeStraw®: RR 0.69, 95% CI 0.51 to 0.93; three trials, 3259 participants, low quality evidence). Plumbed in filters have only been evaluated in high-income settings (RR 0.81, 95% CI 0.71 to 0.94, three trials, 1056 participants, fixed effects model). In low-income settings, solar water disinfection (SODIS) by distribution of plastic bottles with instructions to leave filled bottles in direct sunlight for at least six hours before drinking probably reduces diarrhoea by around a third (RR 0.62, 95% CI 0.42 to 0.94; four trials, 3460 participants, moderate quality evidence). In subgroup analyses, larger effects were seen in trials with higher adherence, and trials that provided a safe storage container. In most cases, the reduction in diarrhoea shown in the studies was evident in settings with improved and unimproved water sources and sanitation. Authors' conclusions Interventions that address the microbial contamination of water at the point-of-use may be important interim measures to improve drinking water quality until homes can be reached with safe, reliable, piped-in water connections. The average estimates of effect for each individual point-of-use intervention generally show important effects. Comparisons between these estimates do not provide evidence of superiority of one intervention over another, as such comparisons are confounded by the study setting, design, and population. Further studies assessing the effects of household connections and chlorination at the point of delivery will help improve our knowledge base. As evidence suggests effectiveness improves with adherence, studies assessing programmatic approaches to optimising coverage and long-term utilization of these interventions among vulnerable populations could also help strategies to improve health outcomes. PLAIN LANGUAGE SUMMARY Interventions to improve water quality and prevent diarrhoea This Cochrane Review summarizes trials evaluating different interventions to improve water quality and prevent diarrhoea. After searching for relevant trials up to 11 November 2014, we included 55 studies enrolling over 84,000 participants. Most included studies were conducted in low- or middle-income countries (LMICs) (50 studies), with unimproved water sources (30 studies), and unimproved or unclear sanitation (34 studies). What causes diarrhoea and what water quality interventions might prevent diarrhoea? Diarrhoea is a major cause of death and disease, especially among young children in low-income countries where the most common causes are faecally contaminated water and food, or poor hygiene practices. In remote and low-income settings, source-based water quality improvement may include providing protected groundwater (springs, wells, and bore holes) or harvested rainwater as an alternative to surface sources (rivers and lakes). Alternatively water may be treated at the point-of-use in people's homes by boiling, chlorination, flocculation, filtration, or solar disinfection. These point-of-use interventions have the potential to overcome both contaminated sources and recontamination of safe water in the home. What the research says There is currently insufficient evidence to know if source-based improvements in water supplies, such as protected wells and communal tap stands or treatment of communal supplies, consistently reduce diarrhoea in low-income settings (very low quality evidence). We found no trials evaluating reliable piped-in water supplies to people's homes. On average, distributing disinfection products for use in the home may reduce diarrhoea by around one quarter in the case of chlorine products (low quality evidence), and around a third in the case of flocculation and disinfection sachets (moderate quality evidence). Water filtration at home probably reduces diarrhoea by around a half (moderate quality evidence), and effects were consistently seen with ceramic filters (moderate quality evidence), biosand systems (moderate quality evidence) and LifeStraw® filters (low quality evidence). Plumbed-in filtration has only been evaluated in high-income settings (low quality evidence). In low-income settings, distributing plastic bottles with instructions to leave filled bottles in direct sunlight for at least six hours before drinking probably reduces diarrhoea by around a third (moderate quality evidence). Research assessing the effects of household connections and chlorination at the point of delivery will help improve our knowledge base. Evidence indicates the more people use the various interventions for improving water quality, the larger the effects, so research into practical approaches to increase coverage and help assure long term use of them in poor groups will help improve impact. PMID:26488938

Acids in combination with sodium dodecyl sulfate caused quality deterioration of fresh-cut iceburg lettuce during storage in modified atmosphere package

USDA-ARS?s Scientific Manuscript database

Recent studies showed that levulinic acid (LA) and sodium acid sulfate (SAS) were effective in inactivating human pathogens on fresh produce. The present study investigated the effects of LA and SAS in comparison with citric acid and chlorine on the inactivation of E. coli O157:H7 and the sensory qu...

Drug utilization research in primary health care as exemplified by physicians' quality assessment groups.

PubMed

von Ferber, L; Luciano, A; Köster, I; Krappweis, J

1992-11-01

Drugs in primary health care are often prescribed for nonrational reasons. Drug utilization research investigates the prescription of drugs with an eye to medical, social and economic causes and consequences of the prescribed drug's utilization. The results of this research show distinct differences in drug utilization in different age groups and between men and women. Indication and dosage appear irrational from a textbook point of view. This indicates nonpharmacological causes of drug utilization. To advice successfully changes for the better quality assessment groups of primary health care physicians get information about their established behavior by analysis of their prescriptions. The discussion and the comparisons in the group allow them to recognize their irrational prescribing and the social, psychological and economic reasons behind it. Guidelines for treatment are worked out which take into account the primary health care physician's situation. After a year with 6 meetings of the quality assessment groups the education process is evaluated by another drug utilization analysis on the basis of the physicians prescription. The evaluation shows a remarkable improvement of quality and cost effectiveness of the drug therapy of the participating physicians.

Effects of high glucose and advanced glycation end products on the expressions of sclerostin and RANKL as well as apoptosis in osteocyte-like MLO-Y4-A2 cells

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

Tanaka, Ken-ichiro, E-mail: ken1nai@med.shimane-u.ac.jp; Yamaguchi, Toru, E-mail: yamaguch@med.shimane-u.ac.jp; Kanazawa, Ippei, E-mail: ippei.k@med.shimane-u.ac.jp

In diabetes mellitus (DM), high glucose (HG) and advanced glycation end products (AGEs) are involved in bone quality deterioration. Osteocytes produce sclerostin and receptor activator of nuclear factor-kB ligand (RANKL) and regulate osteoblast and osteoclast function. However, whether HG or AGEs directly affect osteocytes and regulate sclerostin and RANKL production is unknown. Here, we examined the effects of HG, AGE2, and AGE3 on the expression of sclerostin and RANKL and on apoptosis in osteocyte-like MLO-Y4-A2 cells. Treatment of the cells with 22 mM glucose, 100 μg/mL either AGE2 or AGE3 significantly increased the expression of sclerostin protein and mRNA; however, both AGEs,more » but not glucose, significantly decreased the expression of RANKL protein and mRNA. Moreover, treatment of the cells with HG, AGE2, or AGE3 for 72 h induced significant apoptosis. These detrimental effects of HG, AGE2, and AGE3 on sclerostin and RANKL expressions and on apoptosis were antagonized by pretreatment of the cells with 10{sup −8} M human parathyroid hormone (PTH)-(1–34). Thus, HG and AGEs likely suppress bone formation by increasing sclerostin expression in osteocytes, whereas AGEs suppress bone resorption by decreasing RANKL expression. Together, these processes may cause low bone turnover in DM. In addition, HG and AGEs may cause cortical bone deterioration by inducing osteocyte apoptosis. PTH may effectively treat these pathological processes and improve osteocyte function. - Highlights: • AGEs are involved in bone quality deterioration in diabetes mellitus (DM). • AGEs increased sclerostin as well as apoptosis, and decreased RANKL in osteocytes. • The effects of AGEs on osteocyte function were antagonized by human PTH-(1–34). • AGEs may cause low bone turnover and cortical porosity in DM. • PTH may be effective in bone quality deterioration by improving osteocyte function.« less

TU-AB-BRD-02: Failure Modes and Effects Analysis

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

Huq, M.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

Effect of land cover, stream discharge, and precipitation on water quality in Puerto Rico

NASA Astrophysics Data System (ADS)

Hall, J. S.; Uriarte, M.

2017-12-01

In 2015, Puerto Rico experienced one of the worst droughts in its history, causing widespread water rationing and sparking concerns for future resources. The drought represents precipitation extremes that provide valuable insight into the effects of land cover (LC), on modulating discharge and water quality indices at varying spatial scales. We used data collected from 38 water quality and 55 precipitation monitoring stations in Puerto Rico from 2005 to 2016, paired with a 2010 land cover map to (1) determine whether temporal variability in discharge, precipitation, or antecedent precipitation was a better predictor of water quality, (2) find the spatial scale where LC has the greatest impact on water quality, and (3) quantify impacts of LC on water quality indices, including dissolved oxygen (mg/L), total nitrogen (mg/L), phosphorous (mg/L), turbidity (NTRU), fecal coliforms (colony units/100mL) and instantaneous discharge (ft3/s). The resulting linear mixed effects models account for between 36-68% of the variance in water quality. Preliminary results indicate that phosphorous and nitrogen were best predicted from instantaneous stream discharge, the log of discharge was the better predictor for turbidity and fecal coliforms, and summed 2 and 14-day antecedent precipitation indices were better predictors for dissolved oxygen and discharge, respectively. Increased urban and pasture area reliably decreased water quality in relation to forest cover, while agriculture and wetlands had little or mixed effects. Turbidity and nitrogen responded to a watershed level LC, while phosphorous, fecal coliforms, and discharge responded to LC in 60 m riparian buffers at the watershed scale. Our results indicate that LC modulates changing precipitation regimes and the ensuing impacts on water quality at a range of spatial scales.

The effects of thoracic surgery operations on quality of life: a multicenter study.

PubMed

Öz, Gürhan; Solak, Okan; Metin, Muzaffer; Esme, Hıdır; Sayar, Adnan

2015-10-01

Some treatment modalities may cause losses in patients' life comfort because of the treatment process. Our aim is to determine the effects of thoracic surgery operations on patients' quality of life. This is a multicenter and prospective study. A hundred patients, who had undergone posterolateral thoracotomy (PLT) and/or lateral thoracotomy (LT), were included in the study. A quality of life questionnaire (SF-36) was used to determine the changes in life comfort. SF-36 was performed before the operation, on the first month, third month, sixth month and twelfth month after the operation. Seventy-two percent (n = 72) of the patients were male. PLT was performed in 66% (n = 66) of the patients, and LT was performed in 34% (n = 34) of the patients. The types of resections in patients were pneumonectomy in four patients, lobectomy in 59 patients and wedge resection in 11 patients. No resection was performed in 26 patients. Thoracotomy caused deteriorations in physical function (PF), physical role (RP), bodily pain (BP), health, vitality and social function scores. The deteriorations observed in the third month improved in the sixth and twelfth months. The PF, RP, BP and MH scores of the patients with lung resection were much more worsened compared with the patients who did not undergo lung resection. Thoracic surgery operations caused substantial dissatisfaction in life comfort especially in the third month postoperatively. The worsening in physical function, physical role, pain and mental health is much more in patients with resection compared with the patients who did not undergo resection. © 2014 John Wiley & Sons Ltd.

Surgical improvement of speech disorder caused by amyotrophic lateral sclerosis.

PubMed

Saigusa, Hideto; Yamaguchi, Satoshi; Nakamura, Tsuyoshi; Komachi, Taro; Kadosono, Osamu; Ito, Hiroyuki; Saigusa, Makoto; Niimi, Seiji

2012-12-01

Amyotrophic lateral sclerosis (ALS) is a progressive debilitating neurological disease. ALS disturbs the quality of life by affecting speech, swallowing and free mobility of the arms without affecting intellectual function. It is therefore of significance to improve intelligibility and quality of speech sounds, especially for ALS patients with slowly progressive courses. Currently, however, there is no effective or established approach to improve speech disorder caused by ALS. We investigated a surgical procedure to improve speech disorder for some patients with neuromuscular diseases with velopharyngeal closure incompetence. In this study, we performed the surgical procedure for two patients suffering from severe speech disorder caused by slowly progressing ALS. The patients suffered from speech disorder with hypernasality and imprecise and weak articulation during a 6-year course (patient 1) and a 3-year course (patient 2) of slowly progressing ALS. We narrowed bilateral lateral palatopharyngeal wall at velopharyngeal port, and performed this surgery under general anesthesia without muscle relaxant for the two patients. Postoperatively, intelligibility and quality of their speech sounds were greatly improved within one month without any speech therapy. The patients were also able to generate longer speech phrases after the surgery. Importantly, there was no serious complication during or after the surgery. In summary, we performed bilateral narrowing of lateral palatopharyngeal wall as a speech surgery for two patients suffering from severe speech disorder associated with ALS. With this technique, improved intelligibility and quality of speech can be maintained for longer duration for the patients with slowly progressing ALS.

Efavirenz or nevirapine in three-drug combination therapy with two nucleoside or nucleotide-reverse transcriptase inhibitors for initial treatment of HIV infection in antiretroviral-naïve individuals

PubMed Central

Mbuagbaw, Lawrence; Mursleen, Sara; Irlam, James H; Spaulding, Alicen B; Rutherford, George W; Siegfried, Nandi

2016-01-01

Background The advent of highly active antiretroviral therapy (ART) has reduced the morbidity and mortality due to HIV infection. The World Health Organization (WHO) ART guidelines focus on three classes of antiretroviral drugs, namely nucleoside or nucleotide reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitors. Two of the most common medications given as first-line treatment are the NNRTIs, efavirenz (EFV) and nevirapine (NVP). It is unclear which NNRTI is more efficacious for initial therapy. This systematic review was first published in 2010. Objectives To determine which non-nucleoside reverse transcriptase inhibitor, either EFV or NVP, is more effective in suppressing viral load when given in combination with two nucleoside reverse transcriptase inhibitors as part of initial antiretroviral therapy for HIV infection in adults and children. Search methods We attempted to identify all relevant studies, regardless of language or publication status, in electronic databases and conference proceedings up to 12 August 2016. We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov to 12 August 2016. We searched LILACS (Latin American and Caribbean Health Sciences Literature) and the Web of Science from 1996 to 12 August 2016. We checked the National Library of Medicine (NLM) Gateway from 1996 to 2009, as it was no longer available after 2009. Selection criteria We included all randomized controlled trials (RCTs) that compared EFV to NVP in people with HIV without prior exposure to ART, irrespective of the dosage or NRTI's given in combination. The primary outcome of interest was virological success. Other primary outcomes included mortality, clinical progression to AIDS, severe adverse events, and discontinuation of therapy for any reason. Secondary outcomes were change in CD4 count, treatment failure, development of ART drug resistance, and prevention of sexual transmission of HIV. Data collection and analysis Two review authors assessed each reference for inclusion using exclusion criteria that we had established a priori. Two review authors independently extracted data from each included trial using a standardized data extraction form. We analysed data on an intention-to-treat basis. We performed subgroup analyses for concurrent treatment for tuberculosis and dosage of NVP. We followed standard Cochrane methodological procedures. Main results Twelve RCTs, which included 3278 participants, met our inclusion criteria. None of these trials included children. The length of follow-up time, study settings, and NRTI combination drugs varied greatly. In five included trials, participants were receiving concurrent treatment for tuberculosis. There was little or no difference between EFV and NVP in virological success (RR 1.04, 95% CI 0.99 to 1.09; 10 trials, 2438 participants; high quality evidence), probably little or no difference in mortality (RR 0.84, 95% CI 0.59 to 1.19; 8 trials, 2317 participants; moderate quality evidence) and progression to AIDS (RR 1.23, 95% CI 0.72 to 2.11; 5 trials, 2005 participants; moderate quality evidence). We are uncertain whether there is a difference in all severe adverse events (RR 0.91, 95% CI 0.71 to 1.18; 8 trials, 2329 participants; very low quality evidence). There is probably little or no difference in discontinuation rate (RR 0.93, 95% CI 0.69 to 1.25; 9 trials, 2384 participants; moderate quality evidence) and change in CD4 count (MD −3.03; 95% CI −17.41 to 11.35; 9 trials, 1829 participants; moderate quality evidence). There may be little or no difference in treatment failure (RR 0.97, 95% CI 0.76 to 1.24; 5 trials, 737 participants; low quality evidence). Development of drug resistance is probably slightly less in the EFV arms (RR 0.76, 95% CI 0.60 to 0.95; 4 trials, 988 participants; moderate quality evidence). No studies were found that looked at sexual transmission of HIV. When we examined the adverse events individually, EFV probably is associated with more people with impaired mental function (7 per 1000) compared to NVP (2 per 1000; RR 4.46, 95% CI 1.65 to 12.03; 6 trials, 2049 participants; moderate quality evidence) but fewer people with elevated transaminases (RR 0.52, 95% CI 0.35 to 0.78; 3 trials, 1299 participants; high quality evidence), fewer people with neutropenia (RR 0.48, 95% CI 0.28 to 0.82; 3 trials, 1799 participants; high quality evidence), and probably fewer people withrash (229 per 100 with NVP versus 133 per 1000 with EFV; RR 0.58, 95% CI 0.34 to 1.00; 7 trials, 2277 participants; moderate quality evidence). We found that there may be little or no difference in gastrointestinal adverse events (RR 0.76, 95% CI 0.48 to 1.21; 6 trials, 2049 participants; low quality evidence), pyrexia (RR 0.65, 95% CI 0.15 to 2.73; 3 trials, 1799 participants; low quality evidence), raised alkaline phosphatase (RR 0.65, 95% CI 0.17 to 2.50; 1 trial, 1007 participants; low quality evidence), raised amylase (RR 1.40, 95% CI 0.72 to 2.73; 2 trials, 1071 participants; low quality evidence) and raised triglycerides (RR 1.10, 95% CI 0.39 to 3.13; 2 trials, 1071 participants; low quality evidence). There was probably little or no difference in serum glutamic oxaloacetic transaminase (SGOT; MD 3.3, 95% CI -2.06 to 8.66; 1 trial, 135 participants; moderate quality evidence), serum glutamic- pyruvic transaminase (SGPT; MD 5.7, 95% CI -4.23 to 15.63; 1 trial, 135 participants; moderate quality evidence) and raised cholesterol (RR 6.03, 95% CI 0.75 to 48.78; 1 trial, 64 participants; moderate quality evidence). Our subgroup analyses revealed that NVP slightly increases mortality when given once daily (RR 0.34, 95% CI 0.13 to 0.90; 3 trials, 678 participants; high quality evidence). There were little or no differences in the primary outcomes for patients who were concurrently receiving treatment for tuberculosis. Authors' conclusions Both drugs have similar benefits in initial treatment of HIV infection when combined with two NRTIs. The adverse events encountered affect different systems, with EFV more likely to cause central nervous system adverse events and NVP more likely to raise transaminases, cause neutropenia and rash. Effectiveness of EFV compared to NVP in the suppression of HIV infection when used as part of initial three-drug combination Research question For people living with HIV who have never received antiretroviral therapy (ART), which drug is more effective in suppressing HIV infection in combination with two nucleoside reverse transcriptase inhibitors (NRTI): efavirenz (EFV) or nevirapine (NVP)? Background The introduction of highly active ART as treatment for HIV infection has greatly reduced mortality and morbidity for adults and adolescents living with HIV around the world. The recommended initial treatments for HIV infection include two drugs from a class of drugs known as NRTI and one from a related class of drugs called non-nucleoside reverse transcriptase inhibitors (NNRTI). The two NNRTIs most commonly used are NVP and EFV. However, NVP can cause liver damage and severe rash, both of which can be fatal. EFV may also cause a rash, impair mental function, and cause foetal malformations. Main results Cochrane researchers examined the available literature up to 12 August 2016 and identified 12 randomized controlled trials, with a total of 3278 people, that met the inclusion criteria of this review. None of the included trials included children. Four trials included people who were also receiving treatment for tuberculosis. There was little or no difference in suppression of HIV infection (high quality evidence), probably little or no difference in mortality, progression to AIDS, stopping treatment early and changes in blood cells affected by HIV (moderate quality evidence). There may be little or no difference in treatment failure (low quality evidence). We are uncertain whether there is a difference in side-effects (very low quality evidence). No studies were found that looked at sexual transmission of HIV. Development of drug resistance is probably slightly less in the EFV group (moderate quality evidence). When the side effects were examined individually, EFV probably caused more impaired mental function (6% in the EFV group and 2% in the NVP group; moderate quality evidence), while NVP probably caused more people to have a rash (3% in the EFV group and 6% in the NVP group; moderate quality evidence), caused more people to have reduced white blood cells (2% in the EFV group and 5% in the NVP group; high quality evidence), and signs of liver damage (6% in the EFV group and 11% in the NVP group; high quality evidence). There was probably little or no difference in increases in liver enzymes and levels of cholesterol (moderate quality evidence). There may be little or no difference in digestive side-effects, fever, enzymes from the liver and pancreas, and fat in the blood (low quality evidence). People on NVP were probably more likely to die when given a once-daily regimen (2% in the EFV group and 4% in the NVP group; moderate quality evidence). In people who were taking treatment for tuberculosis compared to those who were not, there was probably little or no difference in suppression of HIV, deaths, progression to AIDS or stopping treatment early (moderate to high quality evidence). Conclusion EFV and NVP are similarly effective in viral suppression, preventing HIV progression and reducing mortality. EFV is more likely to affect mental function, while NVP is more likely to cause signs of liver damage, reduced white blood cells and rash. PMID:27943261

Changes in Subjective Sleep Quality Before a Competition and Their Relation to Competitive Anxiety.

PubMed

Ehrlenspiel, Felix; Erlacher, Daniel; Ziegler, Matthias

2016-12-09

The aim of this study was to examine the effects of competitions on subjective sleep quality. Previous studies have been inconclusive and lack differentiated and standardized measurements of subjective sleep quality. Furthermore the temporal relation between precompetitive anxiety and sleep quality was investigated. Anxiety and nervousness associated with competitions are considered to cause sleep impairments. A convenience sample of N = 79 elite male athletes from various sports participated. In a time-to-event paradigm, sleep quality and competitive anxiety were assessed via standardized self-report measurements 4 days before a competition and on the day of the competition. Univariate analyses were used to examine differences between time points. To examine cross-lagged effects between anxiety and sleep quality a latent change score model (LCSM) was specified that tested an effect of anxiety on changes in sleep quality. Evaluations of nocturnal sleep deteriorated significantly from 4 days before competition to the day of competition, but there were no differences regarding perceptions of the restorative value of sleep. LCSM revealed that athletes who reported more intense worry symptoms 4 days before competition also reported greater deterioration in evaluations of nocturnal sleep. The findings support earlier reports of impaired subjective sleep quality before competitions. Precompetitive sleep impairments appear also to be preceded by cognitive anxiety. Whereas interventions should thus address worry-cognitions associated with competition and sleep, research should address the practical importance of these perceptions of sleep impairments.

The freckle plot (daily turnaround time chart): a technique for timely and effective quality improvement of test turnaround times.

PubMed

Pellar, T G; Ward, P J; Tuckerman, J F; Henderson, A R

1993-06-01

Test turnaround times are often monitored on a monthly basis. However, such an interval usually means that not all causes for delay in test reporting can be unequivocally identified for institution of remedial action. We have devised a daily chart--the freckle plot--that graphically displays the test turnaround times by laboratory receipt time. Different symbols are used to designate specimens reported within the test's turnaround time limit, those within 10 min beyond that limit, and those well outside the limit. These categories are adjustable to suit different limits of stringency. Freckle plots are produced on a daily basis and can be used to track down causes for test delays. Using the 1-h turnaround time "stat" potassium test as a model, we found 16 causes for test delay, of which 9 were potentially remediable. By applying these remedies, we were able to increase test compliance, in the day shift, from 91.5% (95% confidence interval 88.8%-93.7%) to 97.6% (95% confidence interval 96.4-98.55%), which is significant at P < 10(-7). This daily plot is a useful quality assurance tool, supplementing the more conventional tests used to ensure laboratory quality improvement.

Constrained motion estimation-based error resilient coding for HEVC

NASA Astrophysics Data System (ADS)

Guo, Weihan; Zhang, Yongfei; Li, Bo

2018-04-01

Unreliable communication channels might lead to packet losses and bit errors in the videos transmitted through it, which will cause severe video quality degradation. This is even worse for HEVC since more advanced and powerful motion estimation methods are introduced to further remove the inter-frame dependency and thus improve the coding efficiency. Once a Motion Vector (MV) is lost or corrupted, it will cause distortion in the decoded frame. More importantly, due to motion compensation, the error will propagate along the motion prediction path, accumulate over time, and significantly degrade the overall video presentation quality. To address this problem, we study the problem of encoder-sider error resilient coding for HEVC and propose a constrained motion estimation scheme to mitigate the problem of error propagation to subsequent frames. The approach is achieved by cutting off MV dependencies and limiting the block regions which are predicted by temporal motion vector. The experimental results show that the proposed method can effectively suppress the error propagation caused by bit errors of motion vector and can improve the robustness of the stream in the bit error channels. When the bit error probability is 10-5, an increase of the decoded video quality (PSNR) by up to1.310dB and on average 0.762 dB can be achieved, compared to the reference HEVC.

Continuity of Care to Prevent Readmissions for Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.

PubMed

Yang, Fen; Xiong, Zhen-Fang; Yang, Chongming; Li, Lin; Qiao, Guiyuan; Wang, Yuncui; Zheng, Taoyun; He, Huijuan; Hu, Hui

2017-04-01

Readmissions of patients with chronic obstructive pulmonary disease (COPD) to hospitals cast a heavy burden to health care systems. This meta-analysis was aimed to assess the efficacy of continuity of care as interventions, which reduced readmission and mortality rates of such patients. PubMed, Cochrane Library and Embase were searched for articles published before July 2015. A total of 31 reports with randomized controlled trials (RCTs) were finally included in this meta-analysis. The results showed that health education reduced all-cause readmission at 3 months. In addition, health education, comprehensive nursing intervention (CNI) and telemonitoring reduced all-cause readmissions over 6-12 months, and the effect of CNI was best because CNI also reduced COPD-specific readmissions. Home visits also reduced COPD-specific readmissions (the quality more than moderate), but it did not reduce the risk for all-cause readmissions (risk ratios (RRs), 0.92 [95% CI, 0.82-1.04]; moderate quality). There was no statistically significant difference in reducing mortality and quality of life (QOL) among various continued cares. In conclusion, CNI, telemonitoring, health education and home visits should receive more consideration than other interventions by caregivers seeking to implement continued care interventions for patients with COPD.

A time-varying subjective quality model for mobile streaming videos with stalling events

NASA Astrophysics Data System (ADS)

Ghadiyaram, Deepti; Pan, Janice; Bovik, Alan C.

2015-09-01

Over-the-top mobile video streaming is invariably influenced by volatile network conditions which cause playback interruptions (stalling events), thereby impairing users' quality of experience (QoE). Developing models that can accurately predict users' QoE could enable the more efficient design of quality-control protocols for video streaming networks that reduce network operational costs while still delivering high-quality video content to the customers. Existing objective models that predict QoE are based on global video features, such as the number of stall events and their lengths, and are trained and validated on a small pool of ad hoc video datasets, most of which are not publicly available. The model we propose in this work goes beyond previous models as it also accounts for the fundamental effect that a viewer's recent level of satisfaction or dissatisfaction has on their overall viewing experience. In other words, the proposed model accounts for and adapts to the recency, or hysteresis effect caused by a stall event in addition to accounting for the lengths, frequency of occurrence, and the positions of stall events - factors that interact in a complex way to affect a user's QoE. On the recently introduced LIVE-Avvasi Mobile Video Database, which consists of 180 distorted videos of varied content that are afflicted solely with over 25 unique realistic stalling events, we trained and validated our model to accurately predict the QoE, attaining standout QoE prediction performance.

The effect of antiresorptives on bone quality.

PubMed

Recker, Robert R; Armas, Laura

2011-08-01

Currently, antiresorptive therapy in the treatment and prevention of osteoporosis includes bisphosphonates, estrogen replacement, selective estrogen receptor modulators (raloxifene), and denosumab (a human antibody that inactivates RANKL). The original paradigm driving the development of antiresorptive therapy was that inhibition of bone resorption would allow bone formation to continue and correct the defect. However, it is now clear increases in bone density account for little of the antifracture effect of these treatments. We examined the antifracture benefit of antiresorptives deriving from bone quality changes. We searched the archive of nearly 30,000 articles accumulated over more than 40 years in our research center library using a software program (Refman™). Approximately 250 publications were identified in locating the 69 cited here. The findings document antiresorptive agents are not primarily anabolic. All cause a modest increase in bone density due to a reduction in the bone remodeling space; however, the majority of their efficacy is due to suppression of the primary cause of osteoporosis, ie, excessive bone remodeling not driven by mechanical need. All of them improve some element(s) of bone quality. Antiresorptive therapy reduces risk of fracture by improving bone quality through halting removal of bone tissue and the resultant destruction of microarchitecture of bone and, perhaps to some extent, by improving the intrinsic material properties of bone tissue. Information presented here may help clinicians to improve selection of patients for antiresorptive therapy by avoiding them in cases clearly not due to excessive bone remodeling.

An Approach to Improve the Quality of Infrared Images of Vein-Patterns

PubMed Central

Lin, Chih-Lung

2011-01-01

This study develops an approach to improve the quality of infrared (IR) images of vein-patterns, which usually have noise, low contrast, low brightness and small objects of interest, thus requiring preprocessing to improve their quality. The main characteristics of the proposed approach are that no prior knowledge about the IR image is necessary and no parameters must be preset. Two main goals are sought: impulse noise reduction and adaptive contrast enhancement technologies. In our study, a fast median-based filter (FMBF) is developed as a noise reduction method. It is based on an IR imaging mechanism to detect the noisy pixels and on a modified median-based filter to remove the noisy pixels in IR images. FMBF has the advantage of a low computation load. In addition, FMBF can retain reasonably good edges and texture information when the size of the filter window increases. The most important advantage is that the peak signal-to-noise ratio (PSNR) caused by FMBF is higher than the PSNR caused by the median filter. A hybrid cumulative histogram equalization (HCHE) is proposed for adaptive contrast enhancement. HCHE can automatically generate a hybrid cumulative histogram (HCH) based on two different pieces of information about the image histogram. HCHE can improve the enhancement effect on hot objects rather than background. The experimental results are addressed and demonstrate that the proposed approach is feasible for use as an effective and adaptive process for enhancing the quality of IR vein-pattern images. PMID:22247674

An approach to improve the quality of infrared images of vein-patterns.

PubMed

Lin, Chih-Lung

2011-01-01

This study develops an approach to improve the quality of infrared (IR) images of vein-patterns, which usually have noise, low contrast, low brightness and small objects of interest, thus requiring preprocessing to improve their quality. The main characteristics of the proposed approach are that no prior knowledge about the IR image is necessary and no parameters must be preset. Two main goals are sought: impulse noise reduction and adaptive contrast enhancement technologies. In our study, a fast median-based filter (FMBF) is developed as a noise reduction method. It is based on an IR imaging mechanism to detect the noisy pixels and on a modified median-based filter to remove the noisy pixels in IR images. FMBF has the advantage of a low computation load. In addition, FMBF can retain reasonably good edges and texture information when the size of the filter window increases. The most important advantage is that the peak signal-to-noise ratio (PSNR) caused by FMBF is higher than the PSNR caused by the median filter. A hybrid cumulative histogram equalization (HCHE) is proposed for adaptive contrast enhancement. HCHE can automatically generate a hybrid cumulative histogram (HCH) based on two different pieces of information about the image histogram. HCHE can improve the enhancement effect on hot objects rather than background. The experimental results are addressed and demonstrate that the proposed approach is feasible for use as an effective and adaptive process for enhancing the quality of IR vein-pattern images.

A reliable sewage quality abnormal event monitoring system.

PubMed

Li, Tianling; Winnel, Melissa; Lin, Hao; Panther, Jared; Liu, Chang; O'Halloran, Roger; Wang, Kewen; An, Taicheng; Wong, Po Keung; Zhang, Shanqing; Zhao, Huijun

2017-09-15

With closing water loop through purified recycled water, wastewater becomes a part of source water, requiring reliable wastewater quality monitoring system (WQMS) to manage wastewater source and mitigate potential health risks. However, the development of reliable WQMS is fatally constrained by severe contamination and biofouling of sensors due to the hostile analytical environment of wastewaters, especially raw sewages, that challenges the limit of existing sensing technologies. In this work, we report a technological solution to enable the development of WQMS for real-time abnormal event detection with high reliability and practicality. A vectored high flow hydrodynamic self-cleaning approach and a dual-sensor self-diagnostic concept are adopted for WQMS to effectively encounter vital sensor failing issues caused by contamination and biofouling and ensure the integrity of sensing data. The performance of the WQMS has been evaluated over a 3-year trial period at different sewage catchment sites across three Australian states. It has demonstrated that the developed WQMS is capable of continuously operating in raw sewage for a prolonged period up to 24 months without maintenance and failure, signifying the high reliability and practicality. The demonstrated WQMS capability to reliably acquire real-time wastewater quality information leaps forward the development of effective wastewater source management system. The reported self-cleaning and self-diagnostic concepts should be applicable to other online water quality monitoring systems, opening a new way to encounter the common reliability and stability issues caused by sensor contamination and biofouling. Copyright © 2017 Elsevier Ltd. All rights reserved.

The prevalence and association with health-related quality of life of tungiasis and scabies in schoolchildren in southern Ethiopia.

PubMed

Walker, Stephen L; Lebas, Eglantine; De Sario, Valentina; Deyasso, Zeleke; Doni, Shimelis N; Marks, Michael; Roberts, Chrissy H; Lambert, Saba M

2017-08-01

The prevalence of skin disease in low and middle income countries is high and communicable skin diseases are a significant public health problem. Tungiasis is an ectoparasite infestation caused by the flea Tunga penetrans, which has a widespread geographical distribution. Tungiasis causes painful skin lesions and may affect activities of daily living. We wished to determine the prevalence and impact of tungiasis and scabies in schoolchildren in southern Ethiopia. A cross-sectional study was performed in which students were examined by dermatologists and the skin disorders recorded. Individuals with pyogenic skin infections, scabies and tungiasis were also invited to complete the Children's Dermatology Life Quality Index. There was a high burden of skin disease amongst this cohort with more than 40% having an ectodermal parasitic skin disease. The majority of these were due to tungiasis. Tungiasis was evident in more than a third of children and was associated with onychodystophy. There was a significant association between wearing "closed" footwear and a greater number of tungiasis lesions but not tungiasis per se. Dermatophyte infections, acne and plantar maceration secondary to occlusive footwear were also common. Scabies and tungiasis appeared to have a significant negative effect on quality of life. Tungiasis is highly prevalent in schoolchildren in the part of Ethiopia where the study was conducted and is associated with a deleterious effect on quality of life. The role of footwear in both preventing and possibly exacerbating cutaneous ailments in this setting requires further study.

Lower gastrointestinal symptoms are associated with worse glycemic control and quality of life in type 1 diabetes mellitus.

PubMed

Leeds, John S; Hadjivassiliou, Marios; Tesfaye, Solomon; Sanders, David S

2018-01-01

Lower gastrointestinal symptoms are not well characterized in people with type 1 diabetes, and the effects on quality of life and glycemic control are unknown. This study aimed to determine the prevalence of lower gastrointestinal symptoms and the effects on glycemic control and quality of life, and to investigate for underlying causes. This is a prospective, cohort study in secondary care. Patients with type 1 diabetes completed a gastrointestinal symptom questionnaire and the Short Form 36 V.2 quality of life questionnaire and had their hemoglobin A1c measured. Patients with diarrhea were offered reassessment and investigation as per the national guidelines. Controls without diabetes were used to compare symptom prevalence and quality of life scores. 706 with type 1 diabetes (mean age 41.9 years) and 604 controls (mean age 41.9 years) were enrolled. Gastrointestinal symptoms were significantly more frequent in type 1 diabetes compared with controls, in particular constipation (OR 2.4), diarrhea (OR 2.5), alternating bowel habit (OR 2.1), abdominal pain (OR 1.4), floating stools (OR 2.7), bloating (OR 1.4) and flatulence (OR 1.3) (all p<0.05). Previous pancreatitis was more frequent in type 1 diabetes (OR 4.6), but other gastrointestinal conditions were not. Gastrointestinal symptoms were associated with poorer glycemic control (p<0.01) and worse quality of life particularly in those with diarrhea. Investigation of those with diarrhea, including those with alternating bowel habit, (n=105), identified a cause in 72.3% with subsequent change in management. Gastrointestinal symptoms are twice as common in type 1 diabetes and associated with poorer quality of life and glycemic control. Investigation of diarrhea in people with type 1 diabetes leads to a high yield of treatable conditions and a change in management in about three-quarters.

[Quality assessment in anesthesia].

PubMed

Kupperwasser, B

1996-01-01

Quality assessment (assurance/improvement) is the set of methods used to measure and improve the delivered care and the department's performance against pre-established criteria or standards. The four stages of the self-maintained quality assessment cycle are: problem identification, problem analysis, problem correction and evaluation of corrective actions. Quality assessment is a measurable entity for which it is necessary to define and calibrate measurement parameters (indicators) from available data gathered from the hospital anaesthesia environment. Problem identification comes from the accumulation of indicators. There are four types of quality indicators: structure, process, outcome and sentinel indicators. The latter signal a quality defect, are independent of outcomes, are easier to analyse by statistical methods and closely related to processes and main targets of quality improvement. The three types of methods to analyse the problems (indicators) are: peer review, quantitative methods and risks management techniques. Peer review is performed by qualified anaesthesiologists. To improve its validity, the review process should be explicited and conclusions based on standards of practice and literature references. The quantitative methods are statistical analyses applied to the collected data and presented in a graphic format (histogram, Pareto diagram, control charts). The risks management techniques include: a) critical incident analysis establishing an objective relationship between a 'critical' event and the associated human behaviours; b) system accident analysis, based on the fact that accidents continue to occur despite safety systems and sophisticated technologies, checks of all the process components leading to the impredictable outcome and not just the human factors; c) cause-effect diagrams facilitate the problem analysis in reducing its causes to four fundamental components (persons, regulations, equipment, process). Definition and implementation of corrective measures, based on the findings of the two previous stages, are the third step of the evaluation cycle. The Hawthorne effect is an outcome improvement, before the implementation of any corrective actions. Verification of the implemented actions is the final and mandatory step closing the evaluation cycle.

Combined Effect of Polyphenol-Chitosan Coating and Irradiation on the Microbial and Sensory Quality of Carp Fillets.

PubMed

Zhang, Qiu Qin; Rui, Xin; Guo, Yi; He, Min; Xu, Xing Lian; Dong, Ming Sheng

2017-09-01

Irradiation can extend the shelf-life of fish, but it may cause unacceptable change on quality. Since rose polyphenols have high antioxidant and antibacterial activities, this study evaluated the combined effect of polyphenol-chitosan coatings and irradiation (3 kGy) on the microbial and sensory qualities of carp fillets during storage at 4 °C. A dose of 3 kGy irradiation reduced the initial total viable counts (TVC) and psychrophiles, and increased the initial b * and thiobarbituric acid reactive substance (TBARS) values. During storage, TBARS, TVC and psychrophiles of nonirradiated samples increased faster and were higher than those irradiated. Regardless of irradiation treatment, samples coated with chitosan containing rose polyphenols had lower TBARS, pH and bacteria than that in no coating or chitosan coating batches. Carp treated with combined treatment could preserve an acceptable sensory quality at the end of storage. The result indicated that polyphenol-chitosan coating combined with irradiation can maintain fish quality by preventing bacterial growth, oxidation, and changes in color and sensory acceptability. © 2017 Institute of Food Technologists®.

Fruit growing in areas of air pollution by sulfur dioxide (in German)

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

Guderian, R.

1969-01-01

A review is presented dealing with leaf injuries and reductions in growth, yield, and fruit quality in pome fruits, stone fruits, bush fruits, vines, strawberries, and walnuts caused by sulfur dioxide. References to varietal resistance and the effects of manuring on resistance are provided. 11 references.

Fertilizer intensification and its impacts in China's HHH Plains

USDA-ARS?s Scientific Manuscript database

The accomplishment of China’s food security by application of high rates of fertilizers has generated several controversies regarding the quality of soil and water resources. Thus, the objective of this article is to assess the effects and causes of the fertilizer intensification in the Huang Huai ...

Tools for Measuring and Improving Performance.

ERIC Educational Resources Information Center

Jurow, Susan

1993-01-01

Explains the need for meaningful performance measures in libraries and the Total Quality Management (TQM) approach to data collection. Five tools representing different stages of a TQM inquiry are covered (i.e., the Shewhart Cycle, flowcharts, cause-and-effect diagrams, Pareto charts, and control charts), and benchmarking is addressed. (Contains…

Effects of biochar amendment and fertilizer sources on serrano chili pepper yield, uptake, and nitrogen fate

USDA-ARS?s Scientific Manuscript database

Efficient nitrogen (N) management strategies are a key approach in addressing the increase of food demand and environmental protection. Failing to achieve adequate nitrogen use efficiency (NUE) in agricultural systems can cause damaging outcomes including degradative water quality, increase in green...

Effects of Stormwater Pipe Size and Rainfall on Sediment and Nutrients Delivered to a Coastal Bayou

EPA Science Inventory

Pollutants discharged from stormwater pipes can cause water quality and ecosystem problems in coastal bayous. A study was conducted to characterize sediment and nutrients discharged by small and large (, 20 cm and .20 cm in internal diameters, respectively) pipes under different ...

Meta-Analysis of Lost Ecosystem Attributes in Urban Streams and the Effectiveness of Out-of-Channel Management Practices

EPA Science Inventory

Watershed development is a leading cause of stream impairment, and it increasingly threatens the availability, quality, and sustainability of freshwater resources as human populations continue to grow and migrate. Most efforts have focused on trying to improve ecological conditio...

Effects of Friction Reduction on Fiber Damage in a Saw-Type Lint Cleaner

USDA-ARS?s Scientific Manuscript database

U.S. cotton is at a competitive disadvantage from a fiber-quality standpoint, because lint cleaning is required for mechanically harvested cotton, and lint cleaning causes fiber damage. Lint-cleaning research has focused mainly on modifying saw-type lint cleaners, but the work reported here focuses...

The Magnitude of Lost Ecosystem Structure and Function in Urban Streams and the Effectiveness of Watershed-Based Management

EPA Science Inventory

Watershed development is a leading cause of stream impairment and increasingly threatens the availability, quality, and sustainability of freshwater resources. In a recent global meta-analysis, we found that measures of desirable ecological structure (e.g., algal, macroinvertebra...

Temperature and nutrient effects on periphyton associated bacterial communities in continuous flow-through estuarine mesocosms

EPA Science Inventory

Nutrient pollution is a leading cause of water quality impairments and degraded aquatic ecosystem condition. Reliable and reproducible indicators of ecosystem condition are needed to help manage nutrient pollution. The diatom component of periphyton has been used as a water qua...

THE ROLE OF STORMWATER BMPS IN MITIGATING THE EFFECTS OF NUTRIENT OVERENRICHMENT IN THE URBAN WATERSHED

EPA Science Inventory

Nutrient overenrichment from agricultural and urban point and nonpoint sources, including urban stormwter, is a leading cause of impairment to our nation's rivers, lakes, and coastal waters. For waters that do not currently meet existing water quality standards, The USEPA's TMDL ...

A SIMPLE MODEL FOR FORECASTING THE EFFECTS OF NITROGEN LOADS ON CHESAPEAKE BAY HYPOXIA

EPA Science Inventory

The causes and consequences of oxygen depletion in Chesapeake Bay have been the focus of research, assessment, and policy action over the past several decades. An ongoing scientific re-evaluation of what nutrients load reductions are necessary to meet the water quality goals is ...

Analysis of laser pumping and thermal effects based on element analysis

NASA Astrophysics Data System (ADS)

Cui, Li; Liu, Zhijia; Zhang, Yizhuo; Han, Juan

2018-03-01

Thermal effect is a plateau that limits the output of high-power, high beam quality laser, and thermal effects become worse with the increase of pump power. We can reduce the effects caused by thermal effects from pumping, laser medium shape, cooling method and other aspects. In this article, by using finite element analysis software, the thermal effects between Nd:Glass and Nd:YAG laser crystal was analyzed and compared. The causes of generation for thermal effects, and factors that influence the distribution in laser medium were analyzed, including the light source, the laser medium shape and the working mode. Nd:Glass is more suitable for low repetition frequency, high energy pulsed laser output, due to its large size, line width and so on, and Nd:YAG is more suitable for continue or high repetition rate laser output, due to its higher thermal conductivity.

Associations between environmental quality and mortality in ...

EPA Pesticide Factsheets

BACKGROUND: Assessing cumulative effects of the multiple environmental factors influencing mortality remains a challenging task. OBJECTIVES: This study aimed to examine the associations between cumulative environmental quality and all-cause and leading cause-specific (heart disease, cancer, and stroke) mortality rates. METHODS: We used the overall Environmental Quality Index (EQI) and its five domain indices (air, water, land, built, and sociodemographic) to represent environmental exposure. Associations between the EQI and mortality rates (CDC WONDER) for counties in the contiguous United States (n = 3,109) were investigated using multiple linear regression models and random intercept and random slope hierarchical models. Urbanicity, climate, and a combination of the two were used to explore the spatial patterns in the associations. RESULTS: We found 1 standard deviation increase in the overall EQI (worse environment) was associated with a mean 3.22% (95% Cl:2.80%, 3.64%) increase in all-cause mortality, a 0.54% (95% Cl: -0.17%, 1.25%) increase in heart disease mortality, a 2.71% (95% Cl: 2.21%, 3.22%) increase in cancer mortality, and a 2.25% (95% Cl: 1.11%, 3.39%) increase in stroke mortality. Among the environmental domains, the associations ranged from -1.27% (95% Cl: -1.70%,-0.84%) to 3.37% (95% Cl:2.90%, 3.84%),for all-cause mortality, -2.62% (95% Cl: -3.52%, -1.73%) to 4.50% (95% Cl:3.73%, 5.27%) for heart disease mortality, -0.88% (95% Cl:-2.12%, 0.36%)

Beam quality improvement by population-dynamic-coupled combined guiding effect in end-pumped Nd:YVO4 laser oscillator

NASA Astrophysics Data System (ADS)

Shen, Yijie; Gong, Mali; Fu, Xing

2018-05-01

Beam quality improvement with pump power increasing in an end-pumped laser oscillator is experimentally realized for the first time, to the best of our knowledge. The phenomenon is caused by the population-dynamic-coupled combined guiding effect, a comprehensive theoretical model of which has been well established, in agreement with the experimental results. Based on an 888 nm in-band dual-end-pumped oscillator using four tandem Nd:YVO4 crystals, the output beam quality of M^2= 1.1/1.1 at the pump power of 25 W is degraded to M^2 = 2.5/1.8 at 75 W pumping and then improved to M^2= 1.8/1.3 at 150 W pumping. The near-TEM_{00} mode is obtained with the highest continuous-wave output power of 72.1 W and the optical-to-optical efficiency of 48.1%. This work demonstrates great potential to further scale the output power of end-pumped laser oscillator while keeping good beam quality.

Increasing viscosity and inertia using a robotically-controlled pen improves handwriting in children

PubMed Central

Ben-Pazi, Hilla; Ishihara, Abraham; Kukke, Sahana; Sanger, Terence D

2010-01-01

The aim of this study was to determine the effect of mechanical properties of the pen on the quality of handwriting in children. Twenty two school aged children, ages 8–14 years wrote in cursive using a pen attached to a robot. The robot was programmed to increase the effective weight (inertia) and stiffness (viscosity) of the pen. Speed, frequency, variability, and quality of the two handwriting samples were compared. Increased inertia and viscosity improved handwriting quality in 85% of children (p<0.05). Handwriting quality did not correlate with changes in speed, suggesting that improvement was not due to reduced speed. Measures of movement variability remained unchanged, suggesting that improvement was not due to mechanical smoothing of pen movement by the robot. Since improvement was not explained by reduced speed or mechanical smoothing, we conclude that children alter handwriting movements in response to pen mechanics. Altered movement could be caused by changes in proprioceptive sensory feedback. PMID:19794098

Investigation into the effect of some additives on the mechanical strength, quality and thermal conductivity of clay bricks

NASA Astrophysics Data System (ADS)

Zaid, Adnan I. O.; Qandil, A.; Qattous, M. A. A.

2016-08-01

It was repeatedly reported that the clay bricks industry in Jordan is facing both weak mechanical strength and poor quality which caused marketing problems where it is expected to serve the increasing demand of housing in the country especially after the political crises in the neighboring countries Iraq and Syria. It is therefore anticipated that improvement of the mechanical strength and quality of the produced clay evaluation of the brick industry in Jordan is worth investigating. In this paper, theoretical and experimental investigation obtained from field visits to the factories producing clay bricks were carried out. Furthermore, the effect of using some additives from locally available materials namely: Battn El-Ghoul Clay, Suweileh sand and Olive extracts on the mechanical strength, thermal conductivity and surface quality of the produced bricks is investigated and discussed. The experimental results indicated that thermal conductivity, color and durability were all enhanced and the ultimate compressive strength was reduced but remained higher than the acceptable value for brickwork.

Investigation of Mechanism of Action of Modifying Admixtures Based on Products of Petrochemical Synthesis on Concrete Structure

NASA Astrophysics Data System (ADS)

Tukhareli, V. D.; Tukhareli, A. V.; Cherednichenko, T. F.

2017-11-01

The creation of composite materials for generating structural elements with the desired properties has always been and still remains relevant. The basis of a modern concrete technology is the creation of a high-quality artificial stone characterized by low defectiveness and structure stability. Improving the quality of concrete compositions can be achieved by using chemical admixtures from local raw materials which is a very promising task of modern materials’ science for creation of a new generation of concretes. The new generation concretes are high-tech, high-quality, multicomponent concrete mixes and compositions with admixtures that preserve the required properties in service under all operating conditions. The growing complexity of concrete caused by systemic effects that allow you to control the structure formation at all stages of the technology ensures the obtaining of composites with "directional" quality, compositions, structure and properties. The possibility to use the organic fraction of oil refining as a multifunctional hydrophobic-plasticizing admixture in the effective cement concrete is examined.

Ground-water quality in the Santa Rita, Buellton, and Los Olivos hydrologic subareas of the Santa Ynez River basin, Santa Barbara County, California

USGS Publications Warehouse

Hamlin, S.N.

1985-01-01

Groundwater quality in the upper Santa Ynez River Valley in Santa Barbara County has degraded due to both natural and anthropogenic causes. The semiarid climate and uneven distribution of rainfall has limited freshwater recharge and caused salt buildup in water supplies. Tertiary rocks supply mineralized water. Agricultural activities (irrigation return flow containing fertilizers and pesticides, cultivation, feedlot waste disposal) are a primary cause of water quality degradation. Urban development, which also causes water quality degradation (introduced contaminants, wastewater disposal, septic system discharge, and land fill disposal of waste), has imposed stricter requirements on water supply quality. A well network was designed to monitor changes in groundwater quality related to anthropogenic activities. Information from this network may aid in efficient management of the groundwater basins as public water supplies, centered around three basic goals. First is to increase freshwater recharge to the basins by conjunctive surface/groundwater use and surface-spreading techniques. Second is to optimize groundwater discharge by efficient timing and spacing of pumping. Third is to control and reduce sources of groundwater contamination by regulating wastewater quality and distribution and, preferably, by exporting wastewaters from the basin. (USGS)

Defense Logistics Agency Can Improve Its Product Quality Deficiency Report Processing

DTIC Science & Technology

2015-07-01

Contracts for M2 Machine Gun Spare Parts in Support of Operations in Southwest Asia,” January 11, 2010 Appendixes DODIG-2015-140 │ 29 Appendix B...personnel are adequately processing product quality deficiency reports and identifying the root cause for defective spare parts . This is the first...quality deficiency report program and prevents meaningful analysis of the primary causes of spare- part quality deficiencies. In addition, the

Effect of Simultaneous Water Deficit Stress and Meloidogyne incognita Infection on Cotton Yield and Fiber Quality

PubMed Central

Davis, R. F.; Earl, H. J.; Timper, P.

2014-01-01

Both water deficit stress and Meloidogyne incognita infection can reduce cotton growth and yield, and drought can affect fiber quality, but the effect of nematodes on fiber quality is not well documented. To determine whether nematode parasitism affects fiber quality and whether the combined effects of nematode and drought stress on yield and quality are additive (independent effects), synergistic, or antagonistic, we conducted a study for 7 yr in a field infested with M. incognita. A split-plot design was used with the main plot factor as one of three irrigation treatments (low [nonirrigated], moderate irrigation, and high irrigation [water-replete]) and the subplot factor as 0 or 56 l/ha 1,3-dichloropropene. We prevented water deficit stress in plots designated as water-replete by supplementing rainfall with irrigation. Plots receiving moderate irrigation received half the water applied to the water-replete treatment. The severity of root galling was greater in nonfumigated plots and in plots receiving the least irrigation, but the amount of irrigation did not influence the effect of fumigation on root galling (no irrigation × fumigation interaction). The weights of lint and seed harvested were reduced in nonfumigated plots and also decreased as the level of irrigation decreased, but fumigation did not influence the effect of irrigation. Nematodes affected fiber quality by increasing micronaire readings but typically had little or no effect on percent lint, fiber length (measured by HVI), uniformity, strength, elongation, length (based on weight or number measured by AFIS), upper quartile length, or short fiber content (based on weight or number). Micronaire also was increased by water deficit stress, but the effects from nematodes and water stress were independent. We conclude that the detrimental effects caused to cotton yield and quality by nematode parasitism and water deficit stress are independent and therefore additive. PMID:24987162

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

PubMed Central

Osaro, Erhabor; Chima, Njemanze

2014-01-01

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the “engine room” of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness. PMID:25182941

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England.

PubMed

Osaro, Erhabor; Chima, Njemanze

2014-06-01

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

Use of enzymes to minimize the rheological dough problems caused by high levels of damaged starch in starch-gluten systems.

PubMed

Barrera, Gabriela N; León, Alberto E; Ribotta, Pablo D

2016-05-01

During wheat milling, starch granules can experience mechanical damage, producing damaged starch. High levels of damaged starch modify the physicochemical properties of wheat flour, negatively affecting the dough behavior as well as the flour quality and cookie and bread making quality. The aim of this work was to evaluate the effect of α-amylase, maltogenic amylase and amyloglucosidase on dough rheology in order to propose alternatives to reduce the issues related to high levels of damaged starch. The dough with a high level of damaged starch became more viscous and resistant to deformations as well as less elastic and extensible. The soluble fraction of the doughs influenced the rheological behavior of the systems. The α-amylase and amyloglucosidase reduced the negative effects of high damaged starch contents, improving the dough rheological properties modified by damaged starch. The rheological behavior of dough with the higher damaged-starch content was related to a more open gluten network arrangement as a result of the large size of the swollen damaged starch granules. We can conclude that the dough rheological properties of systems with high damaged starch content changed positively as a result of enzyme action, particularly α-amylase and amyloglucosidase additions, allowing the use of these amylases and mixtures of them as corrective additives. Little information was reported about amyloglucosidase activity alone or combined with α-amylase. The combinations of these two enzymes are promising to minimize the negative effects caused by high levels of damaged starch on product quality. More research needs to be done on bread quality combining these two enzymes. © 2015 Society of Chemical Industry. © 2015 Society of Chemical Industry.

[Experimental research of turbidity influence on water quality monitoring of COD in UV-visible spectroscopy].

PubMed

Tang, Bin; Wei, Biao; Wu, De-Cao; Mi, De-Ling; Zhao, Jing-Xiao; Feng, Peng; Jiang, Shang-Hai; Mao, Ben-Jiang

2014-11-01

Eliminating turbidity is a direct effect spectroscopy detection of COD key technical problems. This stems from the UV-visible spectroscopy detected key quality parameters depend on an accurate and effective analysis of water quality parameters analytical model, and turbidity is an important parameter that affects the modeling. In this paper, we selected formazine turbidity solution and standard solution of potassium hydrogen phthalate to study the turbidity affect of UV--visible absorption spectroscopy detection of COD, at the characteristics wavelength of 245, 300, 360 and 560 nm wavelength point several characteristics with the turbidity change in absorbance method of least squares curve fitting, thus analyzes the variation of absorbance with turbidity. The results show, In the ultraviolet range of 240 to 380 nm, as the turbidity caused by particle produces compounds to the organics, it is relatively complicated to test the turbidity affections on the water Ultraviolet spectra; in the visible region of 380 to 780 nm, the turbidity of the spectrum weakens with wavelength increases. Based on this, this paper we study the multiplicative scatter correction method affected by the turbidity of the water sample spectra calibration test, this method can correct water samples spectral affected by turbidity. After treatment, by comparing the spectra before, the results showed that the turbidity caused by wavelength baseline shift points have been effectively corrected, and features in the ultraviolet region has not diminished. Then we make multiplicative scatter correction for the three selected UV liquid-visible absorption spectroscopy, experimental results shows that on the premise of saving the characteristic of the Ultraviolet-Visible absorption spectrum of water samples, which not only improve the quality of COD spectroscopy detection SNR, but also for providing an efficient data conditioning regimen for establishing an accurate of the chemical measurement methods.

Identification of Important Parameter from Leachate Solid Waste Landfill on Water Quality, Case Study of Pesanggrahan River

NASA Astrophysics Data System (ADS)

Yanidar, R.; Hartono, D. M.; Moersidik, S. S.

2018-03-01

Cipayung Landfill takes waste generation from Depok City approximately ± 750 tons/day of solid waste. The south and west boundaries of the landfill is Pesanggarahan River which 200m faraway. The objectives of this study are to indicate an important parameter which greatly affects the water quality of Pesanggrahan River and purpose the dynamic model for improving our understanding of the dynamic behavior that captures the interactions and feedbacks important parameter in river in order to identify and assess the effects of the treated leachate from final solid waste disposal activity as it responds to changes over time in the river. The high concentrations of BOD and COD are not the only cause significantly affect the quality of the pesanggrahan water, it also because the river has been contaminated in the upstream area. It need the water quality model to support the effectiveness calculation of activities for preventing a selected the pollutant sources the model should be developed for simulating and predicting the trend of water quality performance in Pesanggrahan River which can potentially be used by policy makers in strategic management to sustain river water quality as raw drinking water.

Working conditions and effects of ISO 9000 in six furniture-making companies: implementation and processes.

PubMed

Karltun, J; Axelsson, J; Eklund, J

1998-08-01

What effects will the implementation of the quality standard ISO 9000 have regarding working conditions and competitive advantages? Which are the most important change process characteristics for assuring improved working conditions and other desired effects? These are the main questions behind this study of six furniture-making companies which implemented ISO 9000 during the period 1991-1994. The results show that customer requirement was the dominant goal to implement ISO 9000. Five of the six companies succeeded in gaining certification. The influence on working conditions was limited, but included better order and housekeeping, more positive attitudes towards discussing quality shortcomings, a few workplace improvements, work enrichment caused by additional tasks within the quality system and a better understanding of external customer demands. Among the negative effects were new, apparently meaningless, tasks for individual workers as well as more stress and more physically strenuous work. The effects on the companies included a decrease in external quality-related costs and improved delivery precision. The study confirms the importance for efficient change of the design of the change process, and identifies 'improvement methodology' as the most important process characteristic. Improved working conditions are enhanced by added relevant strategic goals and by a participative implementation process.

Oral Mucositis: Melatonin Gel an Effective New Treatment

PubMed Central

Abdel Moneim, Ahmed Esmat; Guerra-Librero, Ana; Florido, Javier; Shen, Ying-Qiang; Fernández-Gil, Beatriz; Acuña-Castroviejo, Darío; Escames, Germaine

2017-01-01

The current treatment for cervico-facial cancer involves radio and/or chemotherapy. Unfortunately, cancer therapies can lead to local and systemic complications such as mucositis, which is the most common dose-dependent complication in the oral cavity and gastrointestinal tract. Mucositis can cause a considerably reduced quality of life in cancer patients already suffering from physical and psychological exhaustion. However, the role of melatonin in the treatment of mucositis has recently been investigated, and offers an effective alternative therapy in the prevention and/or management of radio and/or chemotherapy-induced mucositis. This review focuses on the pathobiology and management of mucositis in order to improve the quality of cancer patients’ lives. PMID:28481279

Remote quality monitoring in the banana chain

PubMed Central

Jedermann, Reiner; Praeger, Ulrike; Geyer, Martin; Lang, Walter

2014-01-01

Quality problems occurring during or after sea transportation of bananas in refrigerated containers are mainly caused by insufficient cooling and non-optimal atmospheric conditions, but also by the heat generated by respiration activity. Tools to measure and evaluate these effects can largely help to reduce losses along the banana supply chain. The presented green life model provides a tool to predict the effect of deviating temperature, relative humidity, and CO2 and O2 gas concentrations on the storage stability of bananas. A second thermal model allows evaluation of the cooling efficiency, the effect of changes in packaging and stowage and the amount of respiration heat from the measured temperature curves. Spontaneous ripening causes higher respiration heat and CO2 production rate. The resulting risk for creation of hot spots increases in positions in which the respiration heat exceeds the available cooling capacity. In case studies on the transport of bananas from Costa Rica to Europe, we validated the models and showed how they can be applied to generate automated warning messages for containers with reduced banana green life or with temperature problems and also for remote monitoring of the ripening process inside the container. PMID:24797132

Remote quality monitoring in the banana chain.

PubMed

Jedermann, Reiner; Praeger, Ulrike; Geyer, Martin; Lang, Walter

2014-06-13

Quality problems occurring during or after sea transportation of bananas in refrigerated containers are mainly caused by insufficient cooling and non-optimal atmospheric conditions, but also by the heat generated by respiration activity. Tools to measure and evaluate these effects can largely help to reduce losses along the banana supply chain. The presented green life model provides a tool to predict the effect of deviating temperature, relative humidity, and CO2 and O2 gas concentrations on the storage stability of bananas. A second thermal model allows evaluation of the cooling efficiency, the effect of changes in packaging and stowage and the amount of respiration heat from the measured temperature curves. Spontaneous ripening causes higher respiration heat and CO2 production rate. The resulting risk for creation of hot spots increases in positions in which the respiration heat exceeds the available cooling capacity. In case studies on the transport of bananas from Costa Rica to Europe, we validated the models and showed how they can be applied to generate automated warning messages for containers with reduced banana green life or with temperature problems and also for remote monitoring of the ripening process inside the container.

TU-AB-BRD-04: Development of Quality Management Program

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

Thomadsen, B.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

Examples of, reasons for, and consequences of the poor quality of wind data from ships for the marine boundary layer: Implications for remote sensing

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

Pierson, W.J. Jr.

1990-08-15

Wind reports by data buoys are used to demonstrate that these reports have in the past provided useful values for the synoptic scale winds and that at present these reports provide very reliable values for the synoptic scale winds. Past studies of wind reports by ships have revealed that the data are of poor quality, but the causes for this poor quality are not identified. Examples of the poor quality of wind data from ships are obtained by comparing ship reports with buoy reports and comparing reports of different kinds of ships with each other. These comparisons identify many differentmore » reasons for the poor quality of wind data from ships. Suggestions are made for improving the quality of ship data. The consequences of the poor quality of ship winds are described in terms of the effects on weather and wave forecasts. The implications for remotely sensed winds are discussed.« less

Assessing the impacts of sediments from dredging on corals.

PubMed

Jones, Ross; Bessell-Browne, Pia; Fisher, Rebecca; Klonowski, Wojciech; Slivkoff, Matthew

2016-01-15

There is a need to develop water quality thresholds for dredging near coral reefs that can relate physical pressures to biological responses and define exposure conditions above which effects could occur. Water quality characteristics during dredging have, however, not been well described. Using information from several major dredging projects, we describe sediment particle sizes in the water column/seabed, suspended sediment concentrations at different temporal scales during natural and dredging-related turbidity events, and changes in light quantity/quality underneath plumes. These conditions differ considerably from those used in past laboratory studies of the effects of sediments on corals. The review also discusses other problems associated with using information from past studies for developing thresholds such as the existence of multiple different and inter-connected cause-effect pathways (which can confuse/confound interpretations), the use of sediment proxies, and the reliance on information from sediment traps to justify exposure regimes in sedimentation experiments. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Interference Mitigation Effects on Synthetic Aperture Radar Coherent Data Products

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

Musgrove, Cameron

2014-05-01

For synthetic aperture radar image products interference can degrade the quality of the images while techniques to mitigate the interference also reduce the image quality. Usually the radar system designer will try to balance the amount of mitigation for the amount of interference to optimize the image quality. This may work well for many situations, but coherent data products derived from the image products are more sensitive than the human eye to distortions caused by interference and mitigation of interference. This dissertation examines the e ect that interference and mitigation of interference has upon coherent data products. An improvement tomore » the standard notch mitigation is introduced, called the equalization notch. Other methods are suggested to mitigation interference while improving the quality of coherent data products over existing methods.« less

Decomposition of birch leaves in heavily polluted industrial barrens: relative importance of leaf quality and site of exposure.

PubMed

Kozlov, Mikhail V; Zvereva, Elena L

2015-07-01

The decrease in litter decomposition rate in polluted habitats is well documented, but the factors that explain the observed variation in the magnitude of this pollution effect on litter decomposition remain poorly understood. We explored effects of environmental conditions and leaf quality on decomposition rate of mountain birch (Betula pubescens ssp. czerepanovii) leaves in a heavily polluted industrial barren near the nickel-copper smelter at Monchegorsk. Litter bags filled with leaves collected from two heavily polluted barren sites and from two control forest sites were buried at 2.5-cm depth and exposed for 2 and 4 years at each of these four sites. The relative mass loss of native leaves in the industrial barren during 2 years of exposure was reduced to 49% of the loss observed in the unpolluted forest. We found a similar reduction in mass loss when leaves from control sites were exposed to polluted sites and when leaves from polluted sites were exposed to control sites. We conclude that the reduction in leaf litter decomposition in an industrial barren is caused by pollution-induced changes in both environmental conditions and leaf quality. This reduction is much smaller than expected, given the four-fold decrease in soil microbial activity and nearly complete extinction of saprophagous invertebrates in the polluted soil. We suggest that a longer snowless period and higher spring and summer temperatures at the barren sites have partially counterbalanced the adverse effects caused by the toxicity of metal pollutants.

Treatment of xerostomia and hyposalivation in the elderly: A systematic review

PubMed Central

Gil-Montoya, José-Antonio; Silvestre, Francisco-Javier; Barrios, Rocío

2016-01-01

Background Therapeutic strategies for xerostomia, regardless of etiology, have so far not had definitive or clearly effective results. Objectives. To systematically revise the latest scientific evidence available regarding the treatment of dry mouth, regardless of the cause of the problem. Material and Methods The literature search was conducted in March 2015, using the Medline and Embase databases. The “Clinical Trial”, from 2006 to March 2015, was carried out in English and only on human cases. The draft of the systematic review and assessment of the methodological quality of the trials was carried out following the criteria of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the “Oxford Quality Scale”. Results Finally, a total of 26 trials were identified that met the previously defined selection and quality criteria; 14 related to drug treatments for dry mouth, 10 with non-pharmacological treatment and 2 with alternative treatments. Conclusions Pilocarpine continues to be the best performing sialogogue drug for subjects with xerostomia due to radiation on head and neck cancer or diseases such as Sjogren’s Syndrome. For patients with dry mouth caused solely by medication, there are some positive indications from the use of malic acid, along with other elements that counteract the harmful effect on dental enamel. In general, lubrication of oral mucous membrane reduces the symptoms, although the effects are short-lived. Key words:Systematic review, xerostomia, clinical trial, hyposalivation. PMID:27031061

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

PubMed

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

2018-01-01

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

Measuring quality in anatomic pathology.

PubMed

Raab, Stephen S; Grzybicki, Dana Marie

2008-06-01

This article focuses mainly on diagnostic accuracy in measuring quality in anatomic pathology, noting that measuring any quality metric is complex and demanding. The authors discuss standardization and its variability within and across areas of care delivery and efforts involving defining and measuring error to achieve pathology quality and patient safety. They propose that data linking error to patient outcome are critical for developing quality improvement initiatives targeting errors that cause patient harm in addition to using methods of root cause analysis, beyond those traditionally used in cytologic-histologic correlation, to assist in the development of error reduction and quality improvement plans.

Tidal Influence on Water Quality of Kapuas Kecil River Downstream

NASA Astrophysics Data System (ADS)

Purnaini, Rizki; Sudarmadji; Purwono, Suryo

2018-02-01

The Kapuas Kecil River is strongly influenced by tidal, in the dry season the intrusion of surface water is often a problem for the WTP because it causes the change of raw water quality to be processed. The purpose of this study was to examine the effect of sea tides on water quality of the Kapuas Kecil River. The study was conducted in Kapuas River downstream along ± 30 km from the upper boundary to the estuary. Water sampling is carried out during the dry and rainy season, when the tidal conditions at 7 (seven) locations of the monitoring station. Descriptive analysis methods and regression-correlation statistics are used to determine the effect of tides on water quality in Kapuas River downstream. In general, the water quality of the Kapuas Kecil River has exceeded the criteria of first class water quality, ie water that can be used for drinking water. The status of water quality of the Kapuas Kecil River based on the pollution index calculation shows the condition of the river is "mild to medium pollutants". The result of multiple linear regression analysis got the value of coefficient of determination (adjusted R square) = 0,760, which in whole show that independent variable (tidal and distance) influence to dependent variable (value of TDS) equal to 76%.

Using multivariate techniques to assess the effects of urbanization on surface water quality: a case study in the Liangjiang New Area, China.

PubMed

Luo, Kun; Hu, Xuebin; He, Qiang; Wu, Zhengsong; Cheng, Hao; Hu, Zhenlong; Mazumder, Asit

2017-04-01

Rapid urbanization in China has been causing dramatic deterioration in the water quality of rivers and threatening aquatic ecosystem health. In this paper, multivariate techniques, such as factor analysis (FA) and cluster analysis (CA), were applied to analyze the water quality datasets for 19 rivers in Liangjiang New Area (LJNA), China, collected in April (dry season) and September (wet season) of 2014 and 2015. In most sampling rivers, total phosphorus, total nitrogen, and fecal coliform exceeded the Class V guideline (GB3838-2002), which could thereby threaten the water quality in Yangtze and Jialing Rivers. FA clearly identified the five groups of water quality variables, which explain majority of the experimental data. Nutritious pollution, seasonal changes, and construction activities were three key factors influencing rivers' water quality in LJNA. CA grouped 19 sampling sites into two clusters, which located at sub-catchments with high- and low-level urbanization, respectively. One-way ANOVA showed the nutrients (total phosphorus, soluble reactive phosphorus, total nitrogen, ammonium nitrogen, and nitrite), fecal coliform, and conductivity in cluster 1 were significantly greater than in cluster 2. Thus, catchment urbanization degraded rivers' water quality in Liangjiang New Area. Identifying effective buffer zones at riparian scale to weaken the negative impacts of catchment urbanization was recommended.

Dysphagia is a common and serious problem for adults with mental illness: a systematic review.

PubMed

Aldridge, Kristy J; Taylor, Nicholas F

2012-03-01

Adults with mental illness may experience a higher incidence of dysphagia and choking due to factors such as medication side effects and behavioural abnormalities. The aim of this study was to determine the frequency of dysphagia and the most effective interventions for this population. Studies published up to August 2010 were sought via a comprehensive electronic database search (CINAHL, PsycINFO, MEDLINE, PubMed, Cochrane, and Embase). Studies reporting dysphagia frequency or dysphagia intervention outcomes in adults with mental illness were included. Two reviewers independently assessed study eligibility and quality, and the results were synthesised descriptively. Ten studies were identified, each describing dysphagia frequency or death due to choking asphyxiation. No studies evaluating intervention effectiveness were identified. Study quality was limited by subjective assessment of outcomes. Six studies presented dysphagia frequencies ranging from 9 to 42% in varying subgroups. Four studies presented the frequency of choking asphyxiation death, including a large survey that concluded that adults with organic mental illness were 43 times more likely to die of this cause than the general population. Dysphagia is a common and significant cause of morbidity and mortality in adults with mental illness and our review found that there is a lack of studies evaluating the effectiveness of intervention techniques.

[Benefits and risks for primary prevention with statins in the elderly].

PubMed

Joseph, Jean-Philippe; Afonso, Mélanie; Berdaï, Driss; Salles, Nathalie; Bénard, Antoine; Gay, Bernard; Bonnet, Fabrice

2015-12-01

Statins in primary prevention before 75 years old reduce cardiovascular events from 20 to 30% and mortality from 10% with acceptable side effects. We investigated whether these results persisted for patients aged 75 and older taking statin. Methodic review of large randomized clinical trials and meta-analyzes that included patients 75 years and older treated with statins in primary prevention. Since the 1990s, a score of randomized controlled trials studying statins versus placebo in primary prevention were published and studied in meta-analyses. Exclusion criteria, including persons older than 70 years, are often restrictive. The impact on all-cause mortality in the four main studies and meta-analyses in over 75 years has not been demonstrated. On the other hand, a recent meta-analyses of observational studies including subjects between 70 and 89 years treated with statins found that low total cholesterol was associated with a moderate decrease in cardiovascular mortality, with no decrease in all-cause mortality. Moreover, in a common context of comorbidities in this age group, statins may be responsible for many adverse effects, drug interactions and impaired quality of life. Given the lack of formal evidence of effectiveness in terms of all-cause mortality and a high level of adverse effects, the benefit/risk of primary prevention with statins is not established in the elderly. The economic weight of statin prescriptions and their possible impact on quality of life justify an economic analysis of discontinuing statin therapy for people 75 years and older. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Environmental Assessment: Construct Mass/Mobility Parking Lot at Grand Forks AFB, North Dakota

DTIC Science & Technology

2004-02-13

Water: Surface water quality could be degraded, both in the short-term, during actual construction, and over the long-term due to reduced storm water quality caused...term, during actual construction, and over the long-term due to reduced storm water quality caused by the increase of exposed soil. The short-term

A Guide to Medications Inducing Salivary Gland Dysfunction, Xerostomia, and Subjective Sialorrhea: A Systematic Review Sponsored by the World Workshop on Oral Medicine VI.

PubMed

Wolff, Andy; Joshi, Revan Kumar; Ekström, Jörgen; Aframian, Doron; Pedersen, Anne Marie Lynge; Proctor, Gordon; Narayana, Nagamani; Villa, Alessandro; Sia, Ying Wai; Aliko, Ardita; McGowan, Richard; Kerr, Alexander Ross; Jensen, Siri Beier; Vissink, Arjan; Dawes, Colin

2017-03-01

Medication-induced salivary gland dysfunction (MISGD), xerostomia (sensation of oral dryness), and subjective sialorrhea cause significant morbidity and impair quality of life. However, no evidence-based lists of the medications that cause these disorders exist. Our objective was to compile a list of medications affecting salivary gland function and inducing xerostomia or subjective sialorrhea. Electronic databases were searched for relevant articles published until June 2013. Of 3867 screened records, 269 had an acceptable degree of relevance, quality of methodology, and strength of evidence. We found 56 chemical substances with a higher level of evidence and 50 with a moderate level of evidence of causing the above-mentioned disorders. At the first level of the Anatomical Therapeutic Chemical (ATC) classification system, 9 of 14 anatomical groups were represented, mainly the alimentary, cardiovascular, genitourinary, nervous, and respiratory systems. Management strategies include substitution or discontinuation of medications whenever possible, oral or systemic therapy with sialogogues, administration of saliva substitutes, and use of electro-stimulating devices. While xerostomia was a commonly reported outcome, objectively measured salivary flow rate was rarely reported. Moreover, xerostomia was mostly assessed as an adverse effect rather than the primary outcome of medication use. This study may not include some medications that could cause xerostomia when administered in conjunction with others or for which xerostomia as an adverse reaction has not been reported in the literature or was not detected in our search. We compiled a comprehensive list of medications with documented effects on salivary gland function or symptoms that may assist practitioners in assessing patients who complain of dry mouth while taking medications. The list may also prove useful in helping practitioners anticipate adverse effects and consider alternative medications.

Statins for aortic valve stenosis.

PubMed

Thiago, Luciana; Tsuji, Selma Rumiko; Nyong, Jonathan; Puga, Maria Eduarda Dos Santos; Góis, Aécio Flávio Teixeira de; Macedo, Cristiane Rufino; Valente, Orsine; Atallah, Álvaro Nagib

2016-01-01

Aortic valve stenosis is the most common type of valvular heart disease in the USA and Europe. Aortic valve stenosis is considered similar to atherosclerotic disease. Some studies have evaluated statins for aortic valve stenosis. To evaluate the effectiveness and safety of statins in aortic valve stenosis. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, LILACS - IBECS, Web of Science and CINAHL Plus. These databases were searched from their inception to 24 November 2015. We also searched trials in registers for ongoing trials. We used no language restrictions.Selection criteria: Randomized controlled clinical trials (RCTs) comparing statins alone or in association with other systemic drugs to reduce cholesterol levels versus placebo or usual care. Data collection and analysis: Primary outcomes were severity of aortic valve stenosis (evaluated by echocardiographic criteria: mean pressure gradient, valve area and aortic jet velocity), freedom from valve replacement and death from cardiovascular cause. Secondary outcomes were hospitalization for any reason, overall mortality, adverse events and patient quality of life.Two review authors independently selected trials for inclusion, extracted data and assessed the risk of bias. The GRADE methodology was employed to assess the quality of result findings and the GRADE profiler (GRADEPRO) was used to import data from Review Manager 5.3 to create a 'Summary of findings' table. We included four RCTs with 2360 participants comparing statins (1185 participants) with placebo (1175 participants). We found low-quality evidence for our primary outcome of severity of aortic valve stenosis, evaluated by mean pressure gradient (mean difference (MD) -0.54, 95% confidence interval (CI) -1.88 to 0.80; participants = 1935; studies = 2), valve area (MD -0.07, 95% CI -0.28 to 0.14; participants = 127; studies = 2), and aortic jet velocity (MD -0.06, 95% CI -0.26 to 0.14; participants = 155; study = 1). Moderate-quality evidence showed no effect on freedom from valve replacement with statins (risk ratio (RR) 0.93, 95% CI 0.81 to 1.06; participants = 2360; studies = 4), and no effect on muscle pain as an adverse event (RR 0.91, 95% CI 0.75 to 1.09; participants = 2204; studies = 3; moderate-quality evidence). Low- and very low-quality evidence showed uncertainty around the effect of statins on death from cardiovascular cause (RR 0.80, 95% CI 0.56 to 1.15; participants = 2297; studies = 3; low-quality evidence) and hospitalization for any reason (RR 0.84, 95% CI 0.39 to 1.84; participants = 155; study = 1; very low-quality evidence). None of the four included studies reported on overall mortality and patient quality of life. Result findings showed uncertainty surrounding the effect of statins for aortic valve stenosis. The quality of evidence from the reported outcomes ranged from moderate to very low. These results give support to European and USA guidelines (2012 and 2014, respectively) that so far there is no clinical treatment option for aortic valve stenosis.

Oral direct thrombin inhibitors or oral factor Xa inhibitors for the treatment of pulmonary embolism.

PubMed

Robertson, Lindsay; Kesteven, Patrick; McCaslin, James E

2015-12-04

Pulmonary embolism is a potentially life-threatening condition in which a clot can travel from the deep veins, most commonly in the leg, up to the lungs. Previously, a pulmonary embolism was treated with the anticoagulants heparin and vitamin K antagonists. Recently, however, two forms of direct oral anticoagulants (DOACs) have been developed: oral direct thrombin inhibitors (DTI) and oral factor Xa inhibitors. The new drugs have characteristics that may be favourable over conventional treatment, including oral administration, a predictable effect, lack of frequent monitoring or re-dosing and few known drug interactions. To date, no Cochrane review has measured the effectiveness and safety of these drugs in the long-term treatment (minimum duration of three months) of pulmonary embolism. To assess the effectiveness of oral DTIs and oral factor Xa inhibitors for the long-term treatment of pulmonary embolism. The Cochrane Vascular Trials Search Co-ordinator searched the Specialised Register (last searched January 2015) and the Cochrane Register of Studies (last searched January 2015). Clinical trials databases were also searched for details of ongoing or unpublished studies. We searched the reference lists of relevant articles retrieved by electronic searches for additional citations. We included randomised controlled trials in which patients with a pulmonary embolism confirmed by standard imaging techniques were allocated to receive an oral DTI or an oral factor Xa inhibitor for the long-term (minimum duration three months) treatment of pulmonary embolism. Two review authors (LR, JM) independently extracted the data and assessed the risk of bias in the trials. Any disagreements were resolved by discussion with the third author (PK). We used meta-analyses when we considered heterogeneity low. The two primary outcomes were recurrent venous thromboembolism and pulmonary embolism. Other outcomes included all-cause mortality and major bleeding. We calculated all outcomes using an odds ratio (OR) with a 95% confidence interval (CI). We included five randomised controlled trials with a total of 7897 participants. Two studies tested oral DTIs (dabigatran) and three studies tested oral factor Xa inhibitors (one rivaroxaban, one edoxaban and one apixaban).Analysis showed no difference in the effectiveness of oral DTIs and standard anticoagulation in preventing recurrent pulmonary embolism (OR 1.02, 95% CI 0.50 to 2.04; two studies; 1602 participants; high quality evidence), recurrent venous thromboembolism (OR 0.93, 95% CI 0.52 to 1.66; two studies; 1602 participants; high quality evidence), deep vein thrombosis (DVT) (OR 0.79, 95% CI 0.29 to 2.13; two studies; 1602 participants; high quality evidence) and major bleeding (OR 0.50, 95% CI 0.15 to 1.68; two studies; 1527 participants; high quality evidence).For oral factor Xa inhibitors, when we combined the three included studies together in meta-analyses, there was significant heterogeneity for recurrent pulmonary embolism (OR 1.08, 95% CI 0.46 to 2.56; two studies; 4509 participants; I(2) = 58%; moderate quality evidence). The oral factor Xa inhibitors were no more or less effective in the prevention of recurrent venous thromboembolism (OR 0.85, 95% CI 0.63 to 1.15; three studies; 6295 participants; high quality evidence), DVT (OR 0.72, 95% CI 0.39 to 1.32; two studies; 4509 participants; high quality evidence), all-cause mortality (OR 1.16, 95% CI 0.79 to 1.70; one study; 4817 participants; moderate quality evidence) or major bleeding (OR 0.97, 95% CI 0.59 to 1.62; two studies; 4507 participants; high quality evidence). None of the studies measured quality of life. Moderate to high quality evidence suggests that there are no differences between DOACs and standard anticoagulation for the long-term treatment of pulmonary embolism, for the outcomes recurrent pulmonary embolism, recurrent venous thromboembolism, DVT, all-cause mortality and major bleeding.

Sleep and optimism: A longitudinal study of bidirectional causal relationship and its mediating and moderating variables in a Chinese student sample.

PubMed

Lau, Esther Yuet Ying; Hui, C Harry; Lam, Jasmine; Cheung, Shu-Fai

2017-01-01

While both sleep and optimism have been found to be predictive of well-being, few studies have examined their relationship with each other. Neither do we know much about the mediators and moderators of the relationship. This study investigated (1) the causal relationship between sleep quality and optimism in a college student sample, (2) the role of symptoms of depression, anxiety, and stress as mediators, and (3) how circadian preference might moderate the relationship. Internet survey data were collected from 1,684 full-time university students (67.6% female, mean age = 20.9 years, SD = 2.66) at three time-points, spanning about 19 months. Measures included the Attributional Style Questionnaire, the Pittsburgh Sleep Quality Index, the Composite Scale of Morningness, and the Depression Anxiety Stress Scale-21. Moderate correlations were found among sleep quality, depressive mood, stress symptoms, anxiety symptoms, and optimism. Cross-lagged analyses showed a bidirectional effect between optimism and sleep quality. Moreover, path analyses demonstrated that anxiety and stress symptoms partially mediated the influence of optimism on sleep quality, while depressive mood partially mediated the influence of sleep quality on optimism. In support of our hypothesis, sleep quality affects mood symptoms and optimism differently for different circadian preferences. Poor sleep results in depressive mood and thus pessimism in non-morning persons only. In contrast, the aggregated (direct and indirect) effects of optimism on sleep quality were invariant of circadian preference. Taken together, people who are pessimistic generally have more anxious mood and stress symptoms, which adversely affect sleep while morningness seems to have a specific protective effect countering the potential damage poor sleep has on optimism. In conclusion, optimism and sleep quality were both cause and effect of each other. Depressive mood partially explained the effect of sleep quality on optimism, whereas anxiety and stress symptoms were mechanisms bridging optimism to sleep quality. This was the first study examining the complex relationships among sleep quality, optimism, and mood symptoms altogether longitudinally in a student sample. Implications on prevention and intervention for sleep problems and mood disorders are discussed.

Effect of different pretreatments on dried chilli (Capsicum annum L.) quality

NASA Astrophysics Data System (ADS)

Anoraga, S. B.; Sabarisman, I.; Ainuri, M.

2018-03-01

Chilli (Capsicum annum L.) has significant price fluctuation. When the chilli price is declined, it causes food waste from unsold chilli. Therefore, drying chilli is a solution for this condition. Futhermore, it can be processed for various product like chilli powder, chilli sauce, etc. The aim of this study was to investigate the effect of different pretreatments on dried chilli quality. Chilli was blenched with hot water and steam before drying. The purpose of this pretreatments is to inactivate enzyme that prevents color and vitamin C losses. The quality parameters were moisture content, colour, vitamin C content, and capsaicin. Changes were observed by gravimetri method for moisture content, chromameter in L* a * b * colour model, and iodine titration for vitamin C. After drying for 20 hours at 60°C, chilli with steam blanching pretreatment dried rapidly than other samples. Unpretreated chilli had higher vitamin C content and better color than blanched chilli.

Evidence for the adverse effect of starvation on bone quality: a review of the literature.

PubMed

Kueper, Janina; Beyth, Shaul; Liebergall, Meir; Kaplan, Leon; Schroeder, Josh E

2015-01-01

Malnutrition and starvation's possible adverse impacts on bone health and bone quality first came into the spotlight after the horrors of the Holocaust and the ghettos of World War II. Famine and food restrictions led to a mean caloric intake of 200-800 calories a day in the ghettos and concentration camps, resulting in catabolysis and starvation of the inhabitants and prisoners. Severely increased risks of fracture, poor bone mineral density, and decreased cortical strength were noted in several case series and descriptive reports addressing the medical issues of these individuals. A severe effect of severely diminished food intake and frequently concomitant calcium- and Vitamin D deficiencies was subsequently proven in both animal models and the most common cause of starvation in developed countries is anorexia nervosa. This review attempts to summarize the literature available on the impact of the metabolic response to Starvation on overall bone health and bone quality.

Aircraft and satellite monitoring of water quality in Lake Superior near Duluth

NASA Technical Reports Server (NTRS)

Scherz, J. P.; Sydor, M.; Vandomelen, J. F.

1974-01-01

Satellite images and low altitude aerial photographs often show vivid discolorations in water bodies. Extensive laboratory analysis shows that water reflectance, which causes brightness on aerial images, positively correlates to the water quality parameter of turbidity, which on a particular day correlates to suspended solids. Work with low altitude photography on three overcast days and with ERTS images on five clear days provides positive correlation of image brightness to the high turbidity and solids which are present in Lake Superior near Duluth over 50% of the time. Proper use of aerial images would have shown that an $8,000,000 drinking water intake constructed in the midst of this unpotable, turbid water should have been located 6 miles north in clear, usable water. Noise effects such as skylight reflection, atmospheric effects, and depth penetration also must be understood for operational use of remote sensing for water quality monitoring and are considered in the paper.

Rain events and their effect on effluent quality studied at a full scale activated sludge treatment plant.

PubMed

Wilén, B M; Lumley, D; Mattsson, A; Mino, T

2006-01-01

The effect of rain events on effluent quality dynamics was studied at a full scale activated sludge wastewater treatment plant which has a process solution incorporating pre-denitrification in activated sludge with post-nitrification in trickling filters. The incoming wastewater flow varies significantly due to a combined sewer system. Changed flow conditions have an impact on the whole treatment process since the recirculation to the trickling filters is set by the hydraulic limitations of the secondary settlers. Apart from causing different hydraulic conditions in the plant, increased flow due to rain or snow-melting, changes the properties of the incoming wastewater which affects process performance and effluent quality, especially the particle removal efficiency. A comprehensive set of on-line and laboratory data were collected and analysed to assess the impact of rain events on the plant performance.

Predicting effects of environmental change on river inflows to ...

EPA Pesticide Factsheets

Estuarine river watersheds provide valued ecosystem services to their surrounding communities including drinking water, fish habitat, and regulation of estuarine water quality. However, the provisioning of these services can be affected by changes in the quantity and quality of river water, such as those caused by altered landscapes or shifting temperatures or precipitation. We used the ecohydrology model, VELMA, in the Trask River watershed to simulate the effects of environmental change scenarios on estuarine river inputs to Tillamook Bay (OR) estuary. The Trask River watershed is 453 km2 and contains extensive agriculture, silviculture, urban, and wetland areas. VELMA was parameterized using existing spatial datasets of elevation, soil type, land use, air temperature, precipitation, river flow, and water quality. Simulated land use change scenarios included alterations in the distribution of the nitrogen-fixing tree species Alnus rubra, and comparisons of varying timber harvest plans. Scenarios involving spatial and temporal shifts in air temperature and precipitation trends were also simulated. Our research demonstrates the utility of ecohydrology models such as VELMA to aid in watershed management decision-making. Model outputs of river water flow, temperature, and nutrient concentrations can be used to predict effects on drinking water quality, salmonid populations, and estuarine water quality. This modeling effort is part of a larger framework of

Intertidal foraminifera (Protista) and carbon-nitrogen cycling: combined effects of temperature and diet quality

NASA Astrophysics Data System (ADS)

Wukovits, Julia; Enge, Annekatrin Julie; Oberrauch, Max; Watzka, Margarete; Wanek, Wolfgang; Heinz, Petra

2017-04-01

Benthic foraminifera (eukaryotic protists) are to a large extent acting as detrivores, feeding on microalgal detritus. Phytodetritus constitutes a main component of the intertidal carbon (C) and nitrogen (N) pool, thus making foraminifera important players in intertidal nutrient fluxes. These fluxes are strongly dependent on interactions between biotic and abiotic environmental factors, as e.g. the energetic value or the quality of phytodetritus that depends on environmental nutrient availability. Increased inorganic C concentrations in coastal water bodies (e.g. due to increased atmospheric CO2) can have a negative effect on the phytodetrital quality by increasing microalgal C:N ratios. Simultanous warming of the environment can cause increased metabolic rates of exposed heterotrophic organisms, like foraminifera. The combination of lower food quality and increased metabolic rates is supposed to cause cascading effects on organismic C cycling, potentially diminishing the role of detrivorous food as a C sink in marine food webs by increased discharge of excess C. In this study, the above described scenario was tested in laboratory feeding experiments on a common and abundant intertidal foraminiferal species (Haynesina germanica, collected in the German Wadden Sea). Two batches of artificially produced and dual isotope labeled (13C and 15N) chlorophyte detritus (1.5 gDW m-2) with different C:N ratios (5.5 and 7.6) and one batch of isotopically labelled diatom detritus (C:N 5.6) were fed under controlled conditions at three different temperatures. Results were extrapolated to the in situ abundance of live H. germanica individuals in the sampling area (sediment core data), to estimate the magnitude of the effect on an areal basis within the natural habitat. The study revealed significant, temperature induced variations in the carbon and nitrogen processing of H. germanica. The food source with an increased C:N ratio doubled the release of carbon from the H. germanica community at 20°C in relation to 15°C, causing a theoretical carbon loss of 1000 μg m-2 within 24 hours. The uptake of diatom detritus was higher relative to chlorophyte detritus uptake, though the carbon release did not differ from the chlorophyte food source of similar C:N (C:N 5.5). The results illustrate the impact of altered environmental factors on benthic nutrient fluxes in foraminiferal communities, an important but often overlooked component of intertidal microfauna associations.

Irregular analytical errors in diagnostic testing - a novel concept.

PubMed

Vogeser, Michael; Seger, Christoph

2018-02-23

In laboratory medicine, routine periodic analyses for internal and external quality control measurements interpreted by statistical methods are mandatory for batch clearance. Data analysis of these process-oriented measurements allows for insight into random analytical variation and systematic calibration bias over time. However, in such a setting, any individual sample is not under individual quality control. The quality control measurements act only at the batch level. Quantitative or qualitative data derived for many effects and interferences associated with an individual diagnostic sample can compromise any analyte. It is obvious that a process for a quality-control-sample-based approach of quality assurance is not sensitive to such errors. To address the potential causes and nature of such analytical interference in individual samples more systematically, we suggest the introduction of a new term called the irregular (individual) analytical error. Practically, this term can be applied in any analytical assay that is traceable to a reference measurement system. For an individual sample an irregular analytical error is defined as an inaccuracy (which is the deviation from a reference measurement procedure result) of a test result that is so high it cannot be explained by measurement uncertainty of the utilized routine assay operating within the accepted limitations of the associated process quality control measurements. The deviation can be defined as the linear combination of the process measurement uncertainty and the method bias for the reference measurement system. Such errors should be coined irregular analytical errors of the individual sample. The measurement result is compromised either by an irregular effect associated with the individual composition (matrix) of the sample or an individual single sample associated processing error in the analytical process. Currently, the availability of reference measurement procedures is still highly limited, but LC-isotope-dilution mass spectrometry methods are increasingly used for pre-market validation of routine diagnostic assays (these tests also involve substantial sets of clinical validation samples). Based on this definition/terminology, we list recognized causes of irregular analytical error as a risk catalog for clinical chemistry in this article. These issues include reproducible individual analytical errors (e.g. caused by anti-reagent antibodies) and non-reproducible, sporadic errors (e.g. errors due to incorrect pipetting volume due to air bubbles in a sample), which can both lead to inaccurate results and risks for patients.

Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive Pulmonary Disease (COPD)

PubMed Central

Sikich, N

2012-01-01

Executive Summary In July 2010, the Medical Advisory Secretariat (MAS) began work on a Chronic Obstructive Pulmonary Disease (COPD) evidentiary framework, an evidence-based review of the literature surrounding treatment strategies for patients with COPD. This project emerged from a request by the Health System Strategy Division of the Ministry of Health and Long-Term Care that MAS provide them with an evidentiary platform on the effectiveness and cost-effectiveness of COPD interventions. After an initial review of health technology assessments and systematic reviews of COPD literature, and consultation with experts, MAS identified the following topics for analysis: vaccinations (influenza and pneumococcal), smoking cessation, multidisciplinary care, pulmonary rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation for acute and chronic respiratory failure, hospital-at-home for acute exacerbations of COPD, and telehealth (including telemonitoring and telephone support). Evidence-based analyses were prepared for each of these topics. For each technology, an economic analysis was also completed where appropriate. In addition, a review of the qualitative literature on patient, caregiver, and provider perspectives on living and dying with COPD was conducted, as were reviews of the qualitative literature on each of the technologies included in these analyses. The Chronic Obstructive Pulmonary Disease Mega-Analysis series is made up of the following reports, which can be publicly accessed at the MAS website at: http://www.hqontario.ca/en/mas/mas_ohtas_mn.html. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework Influenza and Pneumococcal Vaccinations for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Smoking Cessation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Long-term Oxygen Therapy for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Home Telehealth for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease Using an Ontario Policy Model Experiences of Living and Dying With COPD: A Systematic Review and Synthesis of the Qualitative Empirical Literature For more information on the qualitative review, please contact Mita Giacomini at: http://fhs.mcmaster.ca/ceb/faculty_member_giacomini.htm. For more information on the economic analysis, please visit the PATH website: http://www.path-hta.ca/About-Us/Contact-Us.aspx. The Toronto Health Economics and Technology Assessment (THETA) collaborative has produced an associated report on patient preference for mechanical ventilation. For more information, please visit the THETA website: http://theta.utoronto.ca/static/contact. Objective The objective of this evidence-based analysis was to determine the effectiveness and cost-effectiveness of multidisciplinary care (MDC) compared with usual care (UC, single health care provider) for the treatment of stable chronic obstructive pulmonary disease (COPD). Clinical Need: Condition and Target Population Chronic obstructive pulmonary disease is a progressive disorder with episodes of acute exacerbations associated with significant morbidity and mortality. Cigarette smoking is linked causally to COPD in more than 80% of cases. Chronic obstructive pulmonary disease is among the most common chronic diseases worldwide and has an enormous impact on individuals, families, and societies through reduced quality of life and increased health resource utilization and mortality. The estimated prevalence of COPD in Ontario in 2007 was 708,743 persons. Technology Multidisciplinary care involves professionals from a range of disciplines, working together to deliver comprehensive care that addresses as many of the patient’s health care and psychosocial needs as possible. Two variables are inherent in the concept of a multidisciplinary team: i) the multidisciplinary components such as an enriched knowledge base and a range of clinical skills and experiences, and ii) the team components, which include but are not limited to, communication and support measures. However, the most effective number of team members and which disciplines should comprise the team for optimal effect is not yet known. Research Question What is the effectiveness and cost-effectiveness of MDC compared with UC (single health care provider) for the treatment of stable COPD? Research Methods Literature Search Search Strategy A literature search was performed on July 19, 2010 using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published from January 1, 1995 until July 2010. Abstracts were reviewed by a single reviewer and, for those studies meeting the eligibility criteria, full-text articles were obtained. Reference lists were also examined for any additional relevant studies not identified through the search. Inclusion Criteria health technology assessments, systematic reviews, or randomized controlled trials studies published between January 1995 and July 2010; COPD study population studies comparing MDC (2 or more health care disciplines participating in care) compared with UC (single health care provider) Exclusion Criteria grey literature duplicate publications non-English language publications study population less than 18 years of age Outcomes of Interest hospital admissions emergency department (ED) visits mortality health-related quality of life lung function Quality of Evidence The quality of each included study was assessed, taking into consideration allocation concealment, randomization, blinding, power/sample size, withdrawals/dropouts, and intention-to-treat analyses. The quality of the body of evidence was assessed as high, moderate, low, or very low according to the GRADE Working Group criteria. The following definitions of quality were used in grading the quality of the evidence: High Further research is very unlikely to change confidence in the estimate of effect. Moderate Further research is likely to have an important impact on confidence in the estimate of effect and may change the estimate. Low Further research is very likely to have an important impact on confidence in the estimate of effect and is likely to change the estimate. Very Low Any estimate of effect is very uncertain. Summary of Findings Six randomized controlled trials were obtained from the literature search. Four of the 6 studies were completed in the United States. The sample size of the 6 studies ranged from 40 to 743 participants, with a mean study sample between 66 and 71 years of age. Only 2 studies characterized the study sample in terms of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPD stage criteria, and in general the description of the study population in the other 4 studies was limited. The mean percent predicted forced expiratory volume in 1 second (% predicted FEV1) among study populations was between 32% and 59%. Using this criterion, 3 studies included persons with severe COPD and 2 with moderate COPD. Information was not available to classify the population in the sixth study. Four studies had MDC treatment groups which included a physician. All studies except 1 reported a respiratory specialist (i.e., respiratory therapist, specialist nurse, or physician) as part of the multidisciplinary team. The UC group was comprised of a single health care practitioner who may or may not have been a respiratory specialist. A meta-analysis was completed for 5 of the 7 outcome measures of interest including: health-related quality of life, lung function, all-cause hospitalization, COPD-specific hospitalization, and mortality. There was only 1 study contributing to the outcome of all-cause and COPD-specific ED visits which precluded pooling data for these outcomes. Subgroup analyses were not completed either because heterogeneity was not significant or there were a small number of studies that were meta-analysed for the outcome. Quality of Life Three studies reported results of quality of life assessment based on the St. George’s Respiratory Questionnaire (SGRQ). A mean decrease in the SGRQ indicates an improvement in quality of life while a mean increase indicates deterioration in quality of life. In all studies the mean change score from baseline to the end time point in the MDC treatment group showed either an improvement compared with the control group or less deterioration compared with the control group. The mean difference in change scores between MDC and UC groups was statistically significant in all 3 studies. The pooled weighted mean difference in total SGRQ score was −4.05 (95% confidence interval [CI], −6.47 to 1.63; P = 0.001). The GRADE quality of evidence was assessed as low for this outcome. Lung Function Two studies reported results of the FEV1 % predicted as a measure of lung function. A negative change from baseline infers deterioration in lung function and a positive change from baseline infers an improvement in lung function. The MDC group showed a statistically significant improvement in lung function up to 12 months compared with the UC group (P = 0.01). However this effect is not maintained at 2-year follow-up (P = 0.24). The pooled weighted mean difference in FEV1 percent predicted was 2.78 (95% CI, −1.82 to −7.37). The GRADE quality of evidence was assessed as very low for this outcome indicating that an estimate of effect is uncertain. Hospital Admissions All-Cause Four studies reported results of all-cause hospital admissions in terms of number of persons with at least 1 admission during the follow-up period. Estimates from these 4 studies were pooled to determine a summary estimate. There is a statistically significant 25% relative risk (RR) reduction in all-cause hospitalizations in the MDC group compared with the UC group (P < 0.001). The index of heterogeneity (I2) value is 0%, indicating no statistical heterogeneity between studies. The GRADE quality of evidence was assessed as moderate for this outcome, indicating that further research may change the estimate of effect. COPD-Specific Hospitalization Three studies reported results of COPD-specific hospital admissions in terms of number of persons with at least 1 admission during the follow-up period. Estimates from these 3 studies were pooled to determine a summary estimate. There is a statistically significant 33% RR reduction in all-cause hospitalizations in the MDC group compared with the UC group (P = 0.002). The I2 value is 0%, indicating no statistical heterogeneity between studies. The GRADE quality of evidence was assessed as moderate for this outcome, indicating that further research may change the estimate of effect. Emergency Department Visits All-Cause Two studies reported results of all-cause ED visits in terms of number of persons with at least 1 visit during the follow-up period. There is a statistically nonsignificant reduction in all-cause ED visits when data from these 2 studies are pooled (RR, 0.64; 95% CI, 0.31 to −1.33; P = 0.24). The GRADE quality of evidence was assessed as very low for this outcome indicating that an estimate of effect is uncertain. COPD-Specific One study reported results of COPD-specific ED visits in terms of number of persons with at least 1 visit during the follow-up period. There is a statistically significant 41% reduction in COPD-specific ED visits when the data from these 2 studies are pooled (RR, 0.59; 95% CI, 0.43−0.81; P < 0.001). The GRADE quality of evidence was assessed as moderate for this outcome. Mortality Three studies reported the mortality during the study follow-up period. Estimates from these 3 studies were pooled to determine a summary estimate. There is a statistically nonsignificant reduction in mortality between treatment groups (RR, 0.81; 95% CI, 0.52−1.27; P = 0.36). The I2 value is 19%, indicating low statistical heterogeneity between studies. All studies had a 12-month follow-up period. The GRADE quality of evidence was assessed as low for this outcome. Conclusions Significant effect estimates with moderate quality of evidence were found for all-cause hospitalization, COPD-specific hospitalization, and COPD-specific ED visits (Table ES1). A significant estimate with low quality evidence was found for the outcome of quality of life (Table ES2). All other outcome measures were nonsignificant and supported by low or very low quality of evidence. Table ES1: Summary of Dichotomous Data Outcome Number ofStudies(n) Relative Risk(95% CI) GRADE Hospitalizations             All-cause (number of persons) 4(1121) 0.75 (0.64−0.87) Moderate       COPD-specific (number of persons) 3(916) 0.67 (0.52−0.87) Moderate Emergency Department Visits             All-cause (number of persons) 2(223) 0.64 (0.31−1.33) Very Low       COPD-specific (number of persons) 2(783) 0.59 (0.43−0.81) Moderate Mortality         3(1033) 0.81 (0.52−1.27) Low * Abbreviations: CI, confidence intervals; COPD, chronic obstructive pulmonary disease; n, number. Table ES2: Summary of Continuous Data Outcome Number ofStudies(n) Weighted Mean Difference (95% CI) GRADE Quality of Life (SGRQ) 2(942) −4.05 (−6.47 to −1.63) Low Lung Function (FEV1% predicted) 2(316) 2.78 (−1.82−7.37) Very Low * Abbreviations: CI, confidence intervals; FEV1, forced expiratory volume in 1 second; n, number; SGRQ, St. George’s Respiratory Questionnaire. PMID:23074433

The effects of urine concentration, and cushion centrifugation to remove urine, on the quality of cool-stored stallion sperm.

PubMed

Voge, Jared; Varner, Dickson D; Blanchard, Terry L; Meschini, Marika; Turner, Carly; Teague, Sheila R; Brinsko, Steven P; Love, Charles C

2016-09-15

Urine-contaminated stallion semen is a clinical problem due to a variety of causes. The effect of the level of urine contamination on the longevity of sperm quality has not been evaluated. The aim of this study was to determine the effects of urine concentration level (0%, 10%, 20%, 30%, and 40%) and cushioned centrifugation and resuspension of the sperm pellet in fresh extender, on measures of sperm quality, immediately after semen collection (T0), after 1 hour of storage at room temperature (T1), and after 24 hours of cooled storage (T24). In general, most sperm quality measures declined with increasing urine concentration starting at T0. Cushioned centrifugation (CC), but not simple dilution, generally maintained sperm quality at T24 as compared with T1. At T24, total sperm motility was higher in all urine-contaminated CC samples compared with uncentrifuged samples (P < 0.05); sperm viability was lower in CC than uncentrifuged at a urine concentration of 20%, but higher at 30% and 40% (P < 0.05); and DNA quality was decreased (higher % cells outside the main population) in all urine concentrations (P < 0.05). Immediate extension in semen extender, followed by cushioned centrifugation and resuspension of the sperm pellet in fresh extender, provided the best option for preserving sperm quality of urospermic semen. Copyright © 2016 Elsevier Inc. All rights reserved.

A quality-of-life study of cutaneous lupus erythematosus.

PubMed

Batalla, A; García-Doval, I; Peón, G; de la Torre, C

2013-11-01

The study of quality of life in patients with skin disorders has become more important in recent decades. In the case of lupus erythematosus, most quality-of-life studies have focused on the systemic form of the disease, with less attention being paid to the cutaneous form. The main objective of this study was to evaluate quality of life in patients with cutaneous lupus erythematosus (CLE) using a dermatology-specific questionnaire: the Dermatology Life Quality Index (DLQI). Our secondary objective was to investigate associations between DLQI scores and other aspects of the disease. Thirty-six patients with CLE completed the DLQI questionnaire. Other factors assessed were disease severity (measured using the Cutaneous Lupus Erythematosus Disease Area and Severity Index), time since diagnosis, body surface area affected, previous and current treatments, and the presence of criteria for systemic lupus erythematosus (SLE). According to the DLQI, CLE had a moderate, very large, or extremely large effect on quality of life in 50% of the patients analyzed (18/36). No significant associations were found between DLQI scores and disease severity, time since diagnosis, body surface area affected, number, type, or duration of pharmacologic treatments, or the presence or absence of SLE criteria. CLE has a significant and lasting effect on patient quality of life. This effect is probably primarily due to multiple factors, including the chronic nature of the disease, the visibility of the lesions, and the fact that they can cause disfigurement. Copyright © 2012 Elsevier España, S.L. and AEDV. All rights reserved.

Effects of childhood experience with nature on tolerance of urban residents toward hornets and wild boars in Japan.

PubMed

Hosaka, Tetsuro; Sugimoto, Koun; Numata, Shinya

2017-01-01

Urban biodiversity conservation often aims to promote the quality of life for urban residents by providing ecosystem services as well as habitats for diverse wildlife. However, biodiversity inevitably brings some disadvantages, including problems and nuisances caused by wildlife. Although some studies have reported that enhancement of nature interaction among urban children promotes their affective attitude toward of favorable animals, its effect on tolerance toward problem-causing wildlife is unknown. In this study, we assessed the tolerance of 1,030 urban residents in Japan toward hornets and wild boar, and analyzed the effects of childhood experience with nature on tolerance using a structural equation model. The model used sociodemographic factors and childhood nature experience as explanatory variables, affective attitude toward these animals as a mediator, and tolerance as a response variable. The public tolerance toward hornets and boars was low; over 60% of the respondents would request the removal of hornets and wild boar from nearby green spaces by government services, even when the animals had not caused any damage. Tolerance was lower in females and elderly respondents. Childhood experience with nature had a greater influence on tolerance than did sociodemographic factors in the scenario where animals have not caused any problems; however, its effect was only indirect via promoting positive affective attitude toward wildlife when the animals have caused problems. Our results suggest that increasing people's direct experience with nature is important to raise public tolerance, but its effect is limited to cases where wildlife does not cause any problems. To obtain wider support for conservation in urban areas, conservationists, working together with municipal officials, educators and the media, should provide relevant information on the ecological functions performed by problem-causing wildlife and strategies for avoiding the problems that wildlife can cause.

In pursuit of high-value healthcare: the case for improving quality and achieving equity in a time of healthcare transformation.

PubMed

Betancourt, Joseph R

2014-01-01

The passage of the Patient Protection and Affordable Care Act and current efforts in payment reform signal the beginning of a significant transformation for the US healthcare system. As we embark on this transformation, disparities have emerged as the hallmark of low-value healthcare--care that does not meet quality standards, is inefficient, and is usually of high cost. A new set of structures is being developed to facilitate increased access to care that is cost-effective and high in quality--otherwise known as high-value healthcare. Addressing disparities and achieving equity are the perfect target areas for recouping value, and doing so will pave the way for high-value healthcare. As healthcare leaders make difficult choices, they should consider the realities of healthcare equity. First, racial and ethnic disparities in healthcare persist and are a clear sign of poor-quality, low-value healthcare. Second, the root causes of these disparities are complex, but a well-developed set of evidence-based approaches is available to help leaders address healthcare inequity. Third, evidence suggests that being inattentive to the root causes of disparities adversely affects efficiency and an organization's bottom line. Finally, if healthcare organizations are progressive, thoughtful, and prepared for success in such an environment, a new healthcare system that offers accessible, high-value, equitable, culturally competent, and high-quality care to all is well within reach.

Quality of life and chemotherapy-related symptoms of Turkish cancer children undergoing chemotherapy.

PubMed

Arslan, Fatma Tas; Basbakkal, Zumrut; Kantar, Mehmet

2013-01-01

This cross-sectional and descriptive study was designed to determine symptoms emerging due to chemotherapy treatment and their effects on children's quality of life. The research was carried out between February 2008 and February 2009 at the pediatric oncology clinics in four hospitals, focusing on 93 patients receiving chemotherapy. A survey form, the Pediatric Quality of Life Inventory (PedsQL 4.0) and the Memorial Symptom Assessment Scale (MSAS) were used as data collection tools. Chi-square and Student t tests were performed for data analysis. Some 51.6% of the children were aged 13-15 years old, and 51.8% were boys and 50.5% were diagnosed as having solid tumors. There were significant relations between: antimetabolite chemotherapeutics and feeling irritable and worrying (p=0.001, p=0.030); vinkoalkaloid and numbness/tingling in hands/feet (p=0.043); antracyclines and lack of energy and skin changes (p=0.021, p=0.004); and corticosteroids and lack of appetite, nausea and sadness (p=0.008, p=0.009, p=0.009). Several symptoms such as feeling sad, worrying and feeling irritable caused a significant decrease in the total domain of quality of life scores (p=0.034, p=0.012, p=0.010, respectively). Chemotherapeutic drugs can cause symptoms that can seriously affect quality of life in children.

Processing speed and memory mediate age-related differences in decision making.

PubMed

Henninger, Debra E; Madden, David J; Huettel, Scott A

2010-06-01

Decision making under risk changes with age. Increases in risk aversion with age have been most commonly characterized, although older adults may be risk seeking in some decision contexts. An important, and unanswered, question is whether these changes in decision making reflect a direct effect of aging or, alternatively, an indirect effect caused by age-related changes in specific cognitive processes. In the current study, older adults (M = 71 years) and younger adults (M = 24 years) completed a battery of tests of cognitive capacities and decision-making preferences. The results indicated systematic effects of age upon decision quality-with both increased risk seeking and increased risk aversion observed in different tasks-consistent with prior studies. Path analyses, however, revealed that age-related effects were mediated by individual differences in processing speed and memory. When those variables were included in the model, age was no longer a significant predictor of decision quality. The authors conclude that the reduction in decision quality and associated changes in risk preferences commonly ascribed to aging are instead mediated by age-related changes in underlying cognitive capacities. (c) 2010 APA, all rights reserved

Effect of the Combination Hot Water - Calcium Chloride on the In Vitro Growth of Colletotrichum gloeosporioides and the Postharvest Quality of Infected Papaya

PubMed Central

Ayón-Reyna, Lidia Elena; López-Valenzuela, José Ángel; Delgado-Vargas, Francisco; López-López, Martha Edith; Molina-Corral, Francisco Javier; Carrillo-López, Armando; Vega-García, Misael Odín

2017-01-01

Anthracnose of papaya fruit caused by the fungus Colletotrichum gloeosporioides is one of the most economically important postharvest diseases. Hot water immersion (HW) and calcium chloride (Ca) treatments have been used to control papaya postharvest diseases; however, the effect of the combination HW-Ca on the pathogen growth and the development of the disease in infected papaya fruit has been scarcely studied. The aim of this study was to evaluate the effect of the HW-Ca treatment on the in vitro growth of C. gloesporioides conidia and the quality of infected papaya. In vitro, the HW-Ca treated conidia showed reduced mycelial growth and germination. In vivo, the HW-Ca treatment of infected papaya delayed for 5 days the onset of the anthracnose symptoms and improved the papaya postharvest quality. The combined treatment HW-Ca was better than any of the individual treatments to inhibit the in vitro development of C. gloeosporioides and to reduce the negative effects of papaya anthracnose. PMID:29238280

Global Burden of Skin Disease: Inequities and Innovations.

PubMed

Seth, Divya; Cheldize, Khatiya; Brown, Danielle; Freeman, Esther F

2017-09-01

We review the current understanding of the burden of dermatological disease through the lens of the Global Burden of Disease project, evaluate the impact of skin disease on quality of life in a global context, explore socioeconomic implications, and finally summarize interventions towards improving quality of dermatologic care in resource-poor settings. The Global Burden of Disease project has shown that skin diseases continue to be the 4 th leading cause of nonfatal disease burden world-wide. However, research efforts and funding do not match with the relative disability of skin diseases. International and national efforts, such as the WHO List of Essential Medicines, are critical towards reducing the socioeconomic burden of skin diseases and increasing access to care. Recent innovations such as teledermatology, point-of-care diagnostic tools, and task-shifting help to provide dermatological care to underserved regions in a cost-effective manner. Skin diseases cause significant non-fatal disability worldwide, especially in resource-poor regions. Greater impetus to study the burden of skin disease in low resource settings and policy efforts towards delivering high quality care are essential in improving the burden of skin diseases.

Interactive effect of supplemental ultraviolet B and elevated ozone on seed yield and oil quality of two cultivars of linseed (Linum usitatissimum L.) carried out in open top chambers.

PubMed

Tripathi, Ruchika; Agrawal, Shashi B

2013-03-30

Current scenarios of global climate change predict a significant increase in ultraviolet B (UV-B) and tropospheric ozone (O₃) in the near future. Both UV-B and O₃ can have detrimental effects on the productivity and yield quality of important agricultural crops. The present study was conducted to investigate the individual and interactive effects of supplemental UV-B (sUV-B) (ambient + 7.2 kJ m⁻² day⁻¹) and O₃ (ambient + 10 ppb) on the yield and oil quality of two cultivars of linseed (Linum usitatissimum L.). The mean monthly ambient O₃ concentration varied from 27.7 to 59.0 ppb during the experimental period. O₃ affected fruit formation, while sUV-B was mainly responsible for ovule abortion. Seed sugar and protein contents showed maximum reduction in O₃-treated plants, while mineral nutrient levels were most affected by sUV-B + O₃ treatment. Rancid oil of low nutritional quality and containing long-chain fatty acids was favoured along with a decrease in oil content. sUV-B and O₃ individually as well as in combination caused deterioration of the yield and quality of oil and seeds of linseed. However, the individual effect of O₃ was more damaging than the effect of sUV-B or sUV-B + O₃, and cultivar T-397 performed better than Padmini. © 2012 Society of Chemical Industry.

Effects of manure storage additivies on manure composition and greenhouse gas and ammonia emissions

USDA-ARS?s Scientific Manuscript database

Abstract: Storage of dairy manure slurry allows for flexibility in the timing of land application of manure to reduce environmental impacts related to water quality. Yet, manure storage can increase greenhouse gas (GHG) and ammonia emissions and cause operational issues due to the buildup of slurry ...

Medical makeup: the correction of hyperpigmentation disorders.

PubMed

Nonni, J

2012-12-01

Medical makeup corrects skin tone imperfections with dermocosmetic products, which bring together tolerance efficacy, colour neutralization and sun protection. Highly suitable for imperfections caused by hyperpigmentation, it allows patients affected by these disorders to cover them up effectively and discretely, giving them a better quality of life. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Algorithm for employing physical forces in metabolic bone diseases.

PubMed

Massari, Leo

2011-04-01

Metabolic bone diseases, especially osteoporosis, demand a multidisciplinary approach. The physical forces find a rationale in the treatment of local alterations in bone-cartilage metabolism. In integrated treatment of vertebral fractures caused by fragility, stimulation with electrical fields has been observed to be effective in reducing pain and improving patients' quality of life.

Evaluating soybean breeding lines developed from differenct sources of resistance to phomopsis seed decay

USDA-ARS?s Scientific Manuscript database

Phomopsis seed decay (PSD) causes poor soybean seed quality worldwide. The primary causal agent of PSD is Phomopsis longicolla (syn. Diaporthe longicolla). Breeding for PSD-resistance is the most effective long-term strategy to control this disease. To develop soybean lines with resistance to PSD, m...

Effect of high flow events on spatiotemporal variation of E. coli concentrations in creek sediments

USDA-ARS?s Scientific Manuscript database

Sediments can harbor large populations of Escherichia coli often times in greater amounts than the overlying water column. Resuspension of sediments during storm events causes the release of E. coli which drastically changes microbial water quality metrics. It is not well known how populations of E....

78 FR 17902 - Approval and Promulgation of Implementation Plans and Designation of Areas for Air Quality...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-25

... health (``primary'' NAAQS) and welfare (``secondary'' NAAQS). In 1978, EPA designated the San Diego Air... on scientific evidence demonstrating that ozone causes adverse health effects at lower ozone... was set. EPA determined that the 1997 ozone standard would be more protective of human health...

76 FR 38334 - Approval and Promulgation of Air Quality Implementation Plans; District of Columbia, Maryland...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... health, especially children and adults who are active outdoors, and individuals with a pre-existing... Order Reviews I. What is the background of this action? In 1997, EPA revised the health-based NAAQS for... ozone standard based on scientific evidence demonstrating that ozone causes adverse health effects at...

Effects of forest harvest on biogeochemical processes in the Caspar Creek watershed

Treesearch

Randy A. Dahlgren

1998-01-01

Water quality and long-term sustainability are major components addressed within the ecosystem approach to forest management. Forest harvest practices are often implicated as having adverse impacts on sensitive aquatic communities and on the long-term sustainability of forest ecosystems. While careless harvest practices can certainly cause adverse impacts, proper...

Geochemical Impacts to Groundwater from Geologic Carbon Sequestration: Controls on pH and Inorganic Carbon Concentrations from Reaction Path and Kinetic Modeling

EPA Science Inventory

Geologic carbon sequestration has the potential to cause long-term reductions in global emissions of carbon dioxide to the atmosphere. Safe and effective application of carbon sequestration technology requires an understanding of the potential risks to the quality of underground...

Does Cultural Capital Matter?: Cultural Divide and Quality of Life

ERIC Educational Resources Information Center

Kim, Seoyong; Kim, Hyesun

2009-01-01

Since the remarkable work of Pierre Bourdieu, the concept of cultural capital has gained wide popularity along with theoretical and conceptual debates. This trend represents the social-structural change from materialism to postmaterialism. However, there are few empirical studies which find the cause and effect of cultural capital. Based on…

Grain biodeterioration of sorghum converted lines inoculated with a mixture of Fusarium thapsinum and Curvularia lunata

USDA-ARS?s Scientific Manuscript database

Globally, grain mold is a major hurdle affecting sorghum productivity and quality. This disease is caused by complex fungal pathogens, among them Fusarium thapsinum and Curvularia lunata are the major fungi prevalent in many sorghum growing regions. This study examined the effect of inoculating a ...

How to Create Healthy Indoor Environments in Schools

ERIC Educational Resources Information Center

Rhodes, Diane; Di Nella, Frank

2012-01-01

A green and healthy indoor environment should be a fundamental concern in the place where kids learn and grow. Good indoor air quality (IAQ) has been shown to have positive effects on student and staff productivity, performance, comfort and attendance. Conversely, poor IAQ in classrooms--caused by mold and moisture issues, problems with HVAC…

The Casual Approach to Teacher Education: What Effect Does Casualisation Have for Australian University Teaching?

ERIC Educational Resources Information Center

Klopper, Christopher J.; Power, Bianca M.

2014-01-01

Universities in many countries are struggling to adapt to the competing forces of globalisation, new managerialism, entrepreneurialism and new technologies and quality agenda demands. Diminishing resources caused by restricted funding and an aging and diminishing academic workforce pose barriers. One solution to staffing shortages is the…

Top 10 Research Questions Related to Physical Activity and Cancer Survivorship

ERIC Educational Resources Information Center

Courneya, Kerry S.; Rogers, Laura Q.; Campbell, Kristin L.; Vallance, Jeff K.; Friedenreich, Christine M.

2015-01-01

In the United States, there are more than 14 million cancer survivors. Many of these survivors have been treated with multimodal therapy including surgery, radiation therapy, chemotherapy, and targeted therapies. These therapies improve survival; however, they also cause acute and chronic side effects that can undermine health and quality of life.…

Video surveillance with speckle imaging

DOEpatents

Carrano, Carmen J [Livermore, CA; Brase, James M [Pleasanton, CA

2007-07-17

A surveillance system looks through the atmosphere along a horizontal or slant path. Turbulence along the path causes blurring. The blurring is corrected by speckle processing short exposure images recorded with a camera. The exposures are short enough to effectively freeze the atmospheric turbulence. Speckle processing is used to recover a better quality image of the scene.

Microbial safety and overall quality of cantaloupe fresh-cut pieces prepared from whole cantaloupe after wet steam treatment

USDA-ARS?s Scientific Manuscript database

Fresh-cut cantaloupes have been associated with outbreaks of Salmonelosis disease and the minimally processed fresh-cut fruits have a limited shelf life because of deterioration caused by spoilage microflora and physiological processes. In this study, we evaluated the effect of minimal wet steam t...

Influence of microwave vacuum drying on glass transition temperature, gelatinization temperature, physical and chemical qualities of lotus seeds.

PubMed

Zhao, Yingting; Jiang, Yajun; Zheng, Baodong; Zhuang, Weijing; Zheng, Yafeng; Tian, Yuting

2017-08-01

This study investigated the effects of microwave power density on effective moisture diffusion coefficient (D eff ), glass transition temperature (T g ), gelatinization temperature (T P ), physical and chemical qualities of lotus seeds during microwave vacuum drying. D eff increased by 42% and 127% at 15W/g and 20W/g, respectively, when compared with 10W/g. T P was negatively correlated with the relaxation times of T 21 and T 22 , while T g was negatively correlated with the relative areas A 22 . The rates of change of color were observed to be divided roughly into two periods, consisting of a rapid change caused by enzymatic browning and a slow change caused by non-enzymatic browning. An equation is provided to illustrate the relationship of k 1 and k 2 of Peleg's model depending on power density during rehydration kinetics. The samples at 20W/g exhibited the higher content of amino acid (540.19mg/100gd.b.) while lower starch (17.53g/100gd.b.). Copyright © 2017 Elsevier Ltd. All rights reserved.

Short-Term Effect of Two Semi-Occluded Vocal Tract Training Programs on the Vocal Quality of Future Occupational Voice Users: "Resonant Voice Training Using Nasal Consonants" Versus "Straw Phonation".

PubMed

Meerschman, Iris; Van Lierde, Kristiane; Peeters, Karen; Meersman, Eline; Claeys, Sofie; D'haeseleer, Evelien

2017-09-18

The purpose of this study was to determine the short-term effect of 2 semi-occluded vocal tract training programs, "resonant voice training using nasal consonants" versus "straw phonation," on the vocal quality of vocally healthy future occupational voice users. A multigroup pretest-posttest randomized control group design was used. Thirty healthy speech-language pathology students with a mean age of 19 years (range: 17-22 years) were randomly assigned into a resonant voice training group (practicing resonant exercises across 6 weeks, n = 10), a straw phonation group (practicing straw phonation across 6 weeks, n = 10), or a control group (receiving no voice training, n = 10). A voice assessment protocol consisting of both subjective (questionnaire, participant's self-report, auditory-perceptual evaluation) and objective (maximum performance task, aerodynamic assessment, voice range profile, acoustic analysis, acoustic voice quality index, dysphonia severity index) measurements and determinations was used to evaluate the participants' voice pre- and posttraining. Groups were compared over time using linear mixed models and generalized linear mixed models. Within-group effects of time were determined using post hoc pairwise comparisons. No significant time × group interactions were found for any of the outcome measures, indicating no differences in evolution over time among the 3 groups. Within-group effects of time showed a significant improvement in dysphonia severity index in the resonant voice training group, and a significant improvement in the intensity range in the straw phonation group. Results suggest that the semi-occluded vocal tract training programs using resonant voice training and straw phonation may have a positive impact on the vocal quality and vocal capacities of future occupational voice users. The resonant voice training caused an improved dysphonia severity index, and the straw phonation training caused an expansion of the intensity range in this population.

Conventional vs. e-learning in nursing education: A systematic review and meta-analysis.

PubMed

Voutilainen, Ari; Saaranen, Terhi; Sormunen, Marjorita

2017-03-01

By and large, in health professions training, the direction of the effect of e-learning, positive or negative, strongly depends on the learning outcome in question as well as on learning methods which e-learning is compared to. In nursing education, meta-analytically generated knowledge regarding the comparisons between conventional and e-learning is scarce. The aim of this review is to discover the size of the effect of e-learning on learning outcomes in nursing education and to assess the quality of studies in which e-learning has been compared to conventional learning. A systematic search of six electronic databases, PubMed, Ovid MEDLINE®, CINAHL (EBSCOhost), Cochrane Library, PsycINFO, and ERIC, was conducted in order to identify relevant peer-reviewed English language articles published between 2011 and 2015. The quality of the studies included as well as the risk of bias in each study was assessed. A random-effects meta-analysis was performed to generate a pooled mean difference in the learning outcome. Altogether, 10 studies were eligible for the quality assessment and meta-analysis. Nine studies were evaluated as good quality studies, but not without a risk of bias. Performance bias caused a high risk in nearly all the studies. In the meta-analysis, an e-learning method resulted in test scores that were, on average, five points higher than a conventional method on a 0-100 scale. Heterogeneity between the studies was very large. The size and direction of the effect of a learning method on learning outcomes appeared to be strongly situational. We suggest that meta-regressions should be performed instead of basic meta-analyses in order to reveal factors that cause variation in the learning outcomes of nursing education. It might be necessary to perform separate meta-analyses between e-learning interventions aimed at improving nursing knowledge and those aimed at improving nursing skills. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

PubMed Central

Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio

2015-01-01

Introduction Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. Methods We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Results Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Conclusion Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to improve cause-of-death reporting and use linked discharge data to monitor data quality. PMID:25590598

Absorbent products for incontinence: 'treatment effects' and impact on quality of life.

PubMed

Getliffe, Kathryn; Fader, Mandy; Cottenden, Alan; Jamieson, Katharine; Green, Nicholas

2007-10-01

This study aimed to determine how the use and characteristics of absorbent products for incontinence impact on women's quality of life, and to examine the concept of 'treatment effects' in the context of pad use. Key pad performance characteristics were identified from the literature and focus group work. Semi-structured interviews with 99 women with light incontinence were used to investigate the impact of pad use on women's quality of life, including both positive and negative 'treatment effects', and to rank pad characteristics by their importance. Achieving effective and discrete containment of urine was the dominant factor impacting on women's lives. Sub-themes embraced physical effects, psychological impact and social functioning. The five pad characteristics ranked most important for day time use were: 'to hold urine, to contain smell, to stay in place, discreteness, and comfort when wet. For night use discreteness was replaced by to keep skin dry'. High levels of reported anxiety were associated with perceived risk of poor pad performance, lack of discreteness and need for complex regimes for pad management. Insufficient attention has been paid to the balance between the beneficial and negative treatment effects of absorbent pads to date. Existing continence-related quality of life measures are not designed for conditions where change in symptoms is not an outcome measure. The study findings provide the basis for developing a more sensitive, patient-oriented, quality of life measure for pad-users which can aid product selection, new product development and inform future evaluative comparisons between products/products and treatments. This paper illustrates the complex influence on quality of life caused by using absorbent pads to contain incontinence. It raises awareness of the importance of careful selection of the most appropriate pad for each individual to minimize unfavourable side effects, and the need for a new quality of life measure designed for pad-users.

Calculation and simulation of atmospheric refraction effects in maritime environments

NASA Astrophysics Data System (ADS)

Dion, Denis, Jr.; Gardenal, Lionel; Lahaie, P.; Forand, J. Luc

2001-01-01

Near the sea surface, atmospheric refraction and turbulence affect both IR transmission and image quality. This produces an impact on both the detection and classification/identification of targets. With the financial participation of the U.S. Office of Naval Research (ONR), Canada's Defence Research Establishment Valcartier (DREV) is developing PRIME (Propagation Resources In the Maritime Environment), a computer model aimed at describing the overall atmospheric effects on IR imagery systems in the marine surface layer. PRIME can be used as a complement to MODTRAN to compute the effective transmittance in the marine surface layer, taking into account the lens effects caused by refraction. It also provides information on image degradation caused by both refraction and turbulence. This paper reviews the refraction phenomena that take place in the surface layer and discusses their effects on target detection and identification. We then show how PRIME can benefit detection studies and image degradation simulations.

Vaccines for women for preventing neonatal tetanus.

PubMed

Demicheli, Vittorio; Barale, Antonella; Rivetti, Alessandro

2015-07-06

Tetanus is an acute, often fatal, disease caused by an exotoxin produced by Clostridium tetani. It occurs in newborn infants born to mothers who do not have sufficient circulating antibodies to protect the infant passively, by transplacental transfer. Prevention may be possible by the vaccination of pregnant or non-pregnant women, or both, with tetanus toxoid, and the provision of clean delivery services. Tetanus toxoid consists of a formaldehyde-treated toxin that stimulates the production of antitoxin. To assess the effectiveness of tetanus toxoid, administered to women of reproductive age or pregnant women, to prevent cases of, and deaths from, neonatal tetanus. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015), CENTRAL (The Cochrane Library 2015, Issue 1), PubMed (1966 to 28 January 2015), EMBASE (1974 to 28 January 2015) and reference lists of retrieved studies. Randomised or quasi-randomised trials evaluating the effects of tetanus toxoid in pregnant women or women of reproductive age on numbers of neonatal tetanus cases and deaths. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two effectiveness trials (9823 infants) and one safety trial (48 mothers) were included. The main outcomes were measured on infants born to a subset of those randomised women who became pregnant during the course of the studies. For our primary outcomes, there was no high-quality evidence according to GRADE assessments.One study (1182 infants) assessed the effectiveness of tetanus toxoid in comparison with influenza vaccine in preventing neonatal tetanus deaths. A single dose did not provide significant protection against neonatal tetanus deaths, (risk ratio (RR) 0.57, 95% confidence interval (CI) 0.26 to 1.24; 494 infants; GRADE: low-quality evidence). However, a two- or three-dose course did provide protection against neonatal deaths, (RR 0.02, 95% CI 0.00 to 0.30; 688 infants; GRADE: moderate-quality evidence). Administration of a two- or three-dose course resulted in significant protection when all causes of death are considered as an outcome (RR 0.31, 95% CI 0.17 to 0.55; 688 infants; GRADE: moderate-quality evidence). No effect was detected on causes of death other than tetanus. Cases of neonatal tetanus after at least one dose of tetanus toxoid were reduced in the tetanus toxoid group, (RR 0.20, 95% CI 0.10 to 0.40; 1182 infants; GRADE: moderate-quality evidence).Another study, involving 8641 children, assessed the effectiveness of tetanus-diphtheria toxoid in comparison with cholera toxoid in preventing neonatal mortality after one or two doses. Neonatal mortality was reduced in the tetanus-diphtheria toxoid group (RR 0.68, 95% CI 0.56 to 0.82). In preventing deaths at four to 14 days, neonatal mortality was reduced again in the tetanus-diphtheria toxoid group (RR 0.38, 95% CI 0.27 to 0.55). The quality of evidence as assessed using GRADE was found to be low.The third small trial assessed that pain at injection site was reported more frequently among pregnant women who received tetanus diphtheria acellular pertussis than placebo (RR 5.68, 95% CI 1.54 to 20.94; GRADE: moderate-quality evidence). Available evidence supports the implementation of immunisation practices on women of reproductive age or pregnant women in communities with similar, or higher, levels of risk of neonatal tetanus, to the two study sites.

Lactose intolerance.

PubMed

Vandenplas, Yvan

2015-01-01

Lactose is the main carbohydrate in infant feeding, but its impact decreases as the child gets older and consumes less milk and dairy products. Congenital lactose intolerance is a very rare condition. However, lactase activity may be low and need to mature during the first weeks of life in many infants. However, the evidence that unabsorbed lactose is causing infantile crying and colic is contradictory. Unabsorbed lactose has a bifidogenic effect and improves calcium absorption. Lactose malabsorption may occur secondary and thus temporally to other etiologies such as infectious gastroenteritis, cow's milk allergy and celiac disease. One the cause is treated, lactase activity will gradually return to normal. The vast majority of Asian children will develop late onset congenital lactase deficiency. However, this entity only exceptionally causes symptoms before the age of 4-5 years. Symptoms are abdominal cramps, flatulence and watery, acid stools, and decrease the quality of life but lactose intolerance is not associated with "true disease". The diagnosis is made on clinical grounds and confirmed with a lactose breath test, if needed. These patients need to have a lifetime long reduced lactose intake to improve their quality of life.

SU-E-T-420: Failure Effects Mode Analysis for Trigeminal Neuralgia Frameless Radiosurgery

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

Howe, J

2015-06-15

Purpose: Functional radiosurgery has been used successfully in the treatment of trigeminal neuralgia but presents significant challenges to ensuring the high prescription dose is delivered accurately. A review of existing practice should help direct the focus of quality improvement for this treatment regime. Method: Failure modes and effects analysis was used to identify the processes in preparing radiosurgery treatment for TN. The map was developed by a multidisciplinary team including: neurosurgeon, radiation oncology, physicist and therapist. Potential failure modes were identified for each step in the process map as well as potential causes and end effect. A risk priority numbermore » was assigned to each cause. Results: The process map identified 66 individual steps (see attached supporting document). Corrective actions were developed for areas of high risk priority number. Wrong site treatment is at higher risk for trigeminal neuralgia treatment due to the lack of site specific pathologic imaging on MR and CT – additional site specific checks were implemented to minimize the risk of wrong site treatment. Failed collision checks resulted from an insufficient collision model in the treatment planning system and a plan template was developed to address this problem. Conclusion: Failure modes and effects analysis is an effective tool for developing quality improvement in high risk radiotherapy procedures such as functional radiosurgery.« less

Hepatitis C virus infection and health-related quality of life

PubMed Central

Amodio, Piero; Salari, Laura; Montagnese, Sara; Schiff, Sami; Neri, Daniele; Bianco, Tonino; Minazzato, Lina

2012-01-01

Hepatitis C virus (HCV) hepatitis and other diseases related to HCV, such as cryoglobulinemia, lymphoma and renal failure, impair health-related quality of life (HRQoL). In addition, HCV per se might directly influence HRQoL via colonization of microglia in the brain or, indirectly, via the effect of systemic inflammatory cytokines which, in turn, can trigger brain interleukin production. The treatment of HCV-related disorders with interferon (IFN) has an effect on HRQoL. Initially, IFN causes a transient deterioration of HRQoL, due to the induction of depression and other side effects of treatment. Subsequently, the subjects who obtain a sustained virologic response experience an improvement in HRQoL. Only rarely does interferon treatment causes permanent detrimental effects on HRQoL, due to residual psychiatric or neurologic side effects. Liver transplantation is the only treatment for end-stage HCV-related liver disease. HRQoL generally improves massively a few months after transplantation, except in the case of serious complications of the transplant procedure. Furthermore, high levels of anxiety and neuroticism pre-transplant are associated with lower HRQoL one year after transplant. Additionally, six months after transplant, patients with HCV who experience virologic recurrence show significantly greater depression, anxiety, phobic anxiety, and paranoid ideation than anti-HCV-negative patients. In conclusion, optimal care for the overall well-being of patients with HCV infection requires adequate knowledge of their neurological and psychological status. PMID:22654420

Fluvial sediment in the environment: a national challenge

USGS Publications Warehouse

Larsen, Matthew C.; Gellis, Allen C.; Glysson, G. Douglas; Gray, John R.; Horowitz, Arthur J.

2010-01-01

Sediment and sediment-associated constituents can contribute substantially to water-quality impairment. In the past, sediment was viewed mainly as an engineering problem that affected reservoir storage capacity, shipping channel maintenance, and bridge scour, as well as the loss of agricultural soil. Sediment is now recognized as a major cause of aquatic system degradation in many rivers and streams as a result of light attenuation, loss of spawning substrate due to fine-grained sediment infilling, reduction in primary productivity, decreases in biotic diversity, and effects from sediment-associated chemical constituents. Recent advances in sediment measurement, assessment, source-identification, and analytical protocols provide new capabilities to quantify sediment and solid-phase chemical fluxes in aquatic systems. Developing, maintaining, and augmenting current sediment- and water-quality-monitoring networks is essential for determining the health of U.S. waterways and for evaluating the effectiveness of management actions in reducing sediment-related problems. The application of new scientific capabilities that address the adverse effects of sediment and sediment- associated constituents represents a major step in managing the Nation’s water quality. A robust Federal, national-scale eff rt, in collaboration with vested stakeholders, is needed to address these sediment-related water-quality issues across the United States.

Effects of a silica-based feed supplement on performance, health, and litter quality of growing turkeys.

PubMed

Tran, S T; Bowman, M E; Smith, T K

2015-08-01

Poor litter quality is a potential challenge to footpad health as well as the primary cause of ammonia volatilization. High ambient ammonia concentration is one of the most significant factors negatively affecting poultry production today. Some minerals have been reported to reduce ammonia release from poultry litter. Silicon dioxide, a highly pure and natural mineral, shows promise in decreasing ammonia volatilization and improving litter quality. The objective of the current study was to investigate the effects of feed-borne silicon dioxide on litter quality and how this impacts bird performance, general health and footpad health throughout a 12-wk posthatching turkey study. Supplementing the diet with silicon dioxide was found to significantly improve turkey BW gain and the efficiency of feed conversion. The severity of footpad dermatitis was monitored throughout the experimental period but no significant effect of diet was seen. The feeding of silicon dioxide reduced litter pH which decreased the conversion of NH4⁺ to NH3 thereby reducing nitrogen losses from litter. It was concluded that, under our study conditions, the feeding of 0.02% silicon dioxide offers potential economic benefits to turkey producers. © 2015 Poultry Science Association Inc.

Handling Qualities Flight Testing of the Stratospheric Observatory for Infrared Astronomy (SOFIA)

NASA Technical Reports Server (NTRS)

Glaser, Scott T.; Strovers, Brian K.

2011-01-01

Airborne infrared astronomy has a long successful history, albeit relatively unknown outside of the astronomy community. A major problem with ground based infrared astronomy is the absorption and scatter of infrared energy by water in the atmosphere. Observing the universe from above 40,000 ft puts the observation platform above 99% of the water vapor in the atmosphere, thereby addressing this problem at a fraction of the cost of space based systems. The Stratospheric Observatory For Infrared Astronomy (SOFIA) aircraft is the most ambitious foray into the field of airborne infrared astronomy in history. Using a 747SP (The Boeing Company, Chicago, Illinois) aircraft modified with a 2.5m telescope located in the aft section of the fuselage, the SOFIA endeavors to provide views of the universe never before possible and at a fraction of the cost of space based systems. The modification to the airplane includes moveable doors and aperture that expose the telescope assembly. The telescope assembly is aimed and stabilized using a multitude of on board systems. This modification has the potential to cause aerodynamic anomalies that could induce undesired forces either at the cavity itself or indirectly due to interference with the empennage, both of which could cause handling qualities issues. As a result, an extensive analysis and flight test program was conducted from December 2009 through March 2011. Several methods, including a Lower Order Equivalent Systems analysis and pilot assessment, were used to ascertain the effects of the modification. The SOFIA modification was found to cause no adverse handling qualities effects and the aircraft was cleared for operational use. This paper discusses the history and modification to the aircraft, development of test procedures and analysis, results of testing and analysis, lessons learned for future projects and justification for operational certification.

Development of an Assessment Tool for Agricultural Best Management Practice Iimplementation in the Great Lakes Restoration Initiative Priority Watersheds—Alger Creek, Tributary to Saginaw River, Michigan

USGS Publications Warehouse

Merriman, Katherine R.

2015-11-19

The Great Lakes face a number of serious challenges that cause damage to water quality, habitat, ecology, and coastal health. Excess nutrients from point and nonpoint sources have a history of causing harmful algal blooms (HABs); since the late 1990s, a resurgence of HABs have forced beach closures and resulted in water quality impairments across the Great Lakes. Studies increasingly point to phosphorus (P) runoff from agricultural lands as the cause of these HABs. In 2010, the Great Lakes Restoration Initiative (GLRI) was launched to revitalize the Great Lakes. The GLRI aims to address the challenges facing the Great Lakes and provide a framework for restoration and protection. As part of this effort, the Priority Watersheds Work Group (PWWG), cochaired by the U.S. Environmental Protection Agency (EPA) and the U.S. Department of Agriculture-Natural Resources Conservation Service (USDA–NRCS), is targeting Priority Watersheds (PWs) to reduce the amount of P reaching the Great Lakes. Within the PWs, USDA–NRCS identifies small-scale subbasins with high concentrations of agriculture for coordinated nutrient reduction efforts and enhanced monitoring and modeling. The USDA–NRCS supplies financial and/or technical assistance to producers to install or implement best management practices (BMPs) to lessen the negative effects of agriculture to water quality; additional funding is provided by the GLRI through USDA–NRCS to saturate the small-scale subbasins with BMPs. The watershed modeling component, introduced in this fact sheet, assesses the effectiveness of USDA–NRCS funded BMPs, and nutrient reductions because of GLRI or other funding programs are differentiated. Modeling scenarios consider BMPs that have already been applied and those planned to be implemented across the small-scale subbasins.

Development of an Assessment Tool for Agricultural Best Management Practice Implementation in the Great Lakes Restoration Initiative Priority Watersheds—Eagle Creek, Tributary to Maumee River, Ohio

USGS Publications Warehouse

Merriman, Katherine R.

2015-11-19

The Great Lakes face a number of serious challenges that cause damage to water quality, habitat, ecology, and coastal health. Excess nutrients from point and nonpoint sources have a history of causing harmful algal blooms (HABs); since the late 1990s, a resurgence of HABs have forced beach closures and resulted in water quality impairments across the Great Lakes. Studies increasingly point to phosphorus (P) runoff from agricultural lands as the cause of these HABs. In 2010, the Great Lakes Restoration Initiative (GLRI) was launched to revitalize the Great Lakes. The GLRI aims to address the challenges facing the Great Lakes and provide a framework for restoration and protection. As part of this effort, the Priority Watersheds Work Group (PWWG), cochaired by the U.S. Environmental Protection Agency (EPA) and the U.S. Department of Agriculture-Natural Resources Conservation Service (USDA–NRCS), is targeting Priority Watersheds (PWs) to reduce the amount of P reaching the Great Lakes. Within the PWs, USDA–NRCS identifies small-scale subbasins with high concentrations of agriculture for coordinated nutrient reduction efforts and enhanced monitoring and modeling. The USDA–NRCS supplies financial and/or technical assistance to producers to install or implement best management practices (BMPs) to lessen the negative effects of agriculture to water quality; additional funding is provided by the GLRI through USDA–NRCS to saturate the small-scale subbasins with BMPs. The watershed modeling component, introduced in this fact sheet, assesses the effectiveness of USDA–NRCS funded BMPs, and nutrient reductions because of GLRI or other funding programs are differentiated. Modeling scenarios consider BMPs that have already been applied and those planned to be implemented across the small-scale subbasins.

Development of an Assessment Tool for Agricultural Best Management Practice Implementation in the Great Lakes Restoration Initiative Priority Watersheds—Upper East River, Tributary to Green Bay, Wisconsin

USGS Publications Warehouse

Merriman, Katherine R.

2015-11-19

The Great Lakes face a number of serious challenges that cause damage to water quality, habitat, ecology, and coastal health. Excess nutrients from point and nonpoint sources have a history of causing harmful algal blooms (HABs); since the late 1990s, a resurgence of HABs have forced beach closures and resulted in water quality impairments across the Great Lakes. Studies increasingly point to phosphorus (P) runoff from agricultural lands as the cause of these HABs. In 2010, the Great Lakes Restoration Initiative (GLRI) was launched to revitalize the Great Lakes. The GLRI aims to address the challenges facing the Great Lakes and provide a framework for restoration and protection. As part of this effort, the Priority Watersheds Work Group (PWWG), cochaired by the U.S. Environmental Protection Agency (EPA) and the U.S. Department of Agriculture-Natural Resources Conservation Service (USDA–NRCS), is targeting Priority Watersheds (PWs) to reduce the amount of P reaching the Great Lakes. Within the PWs, USDA–NRCS identifies small-scale subbasins with high concentrations of agriculture for coordinated nutrient reduction efforts and enhanced monitoring and modeling. The USDA–NRCS supplies financial and/or technical assistance to producers to install or implement best management practices (BMPs) to lessen the negative effects of agriculture to water quality; additional funding is provided by the GLRI through USDA–NRCS to saturate the small-scale subbasins with BMPs. The watershed modeling component, introduced in this fact sheet, assesses the effectiveness of USDA–NRCS funded BMPs, and nutrient reductions because of GLRI or other funding programs are differentiated. Modeling scenarios consider BMPs that have already been applied and those planned to be implemented across the small-scale subbasins.

Cardiovascular, respiratory, and total mortality attributed to PM2.5 in Mashhad, Iran.

PubMed

Bonyadi, Ziaeddin; Ehrampoush, Mohammad Hasan; Ghaneian, Mohammad Taghi; Mokhtari, Mehdi; Sadeghi, Abbas

2016-10-01

Poor air quality is one of the most important environmental problems in many large cities of the world, which can cause a wide range of acute and chronic health effects, including partial physiological disorders and cardiac death due to respiratory and cardiovascular diseases. According to the latest edition of the national standard for air quality, maximum contamination level is 15 μg/m(3) per year and 35 μg/m(3) per day. The aim of this study was to evaluate cardiovascular, respiratory, and total mortality attributed to PM2.5 in the city of Mashhad during 2013. To this end, the Air Q model was used to assess health impacts of PM2.5 and human exposure to it. In this model, the attributable proportion of health outcome, annual number of excess cases of mortality for all causes, and cardiovascular and respiratory diseases were estimated. The results showed that the number of excess cases of mortality for all causes and cardiovascular and respiratory diseases attributable to PM2.5 was 32, 263, and 332 μg/m(3), respectively. Moreover, the annual average of PM2.5 in Mashhad was obtained to be 37.85 μg/m(3). This study demonstrated that a high percentage of mortality resulting from this pollutant could be due to the high average concentration of PM2.5 in the city during 2013. In this case, using the particle control methods, such as optimal use of fuel, management of air quality in urban areas, technical inspection of vehicles, faster development of public transport, and use of industrial technology can be effective in reducing air pollution in cities and turning existing situations into preferred ones.

The effects of certain enzymes on the rheology of dough and the quality characteristics of bread prepared from wheat meal.

PubMed

Altınel, Burak; Ünal, S Sezgin

2017-05-01

This study was carried out to evaluate the effects of amyloglucosidase, glucose oxidase, hemicellulase (mainly consist of endo-1,4-β-xylanase), cellulase, lipase, and the combination of phospholipase and hemicellulase (phospholipase + hemicellulase) on the extensographic properties of dough and the quality characteristics of bread prepared from wheat meal. The enzymes were added separately in two different amounts. The addition of glucose oxidase (at 0.0003-0.001%) caused a significant decrease in the resistance to extension, ratio of resistance to extensibility and energy values of the wheat meal dough compared with the control dough. The addition of hemicellulase (at 0.001-0.005%) and phospholipase + hemicellulase (at 0.0006-0.0009%) also improved the wheat meal dough rheology by reducing the resistance to extension and the ratio of resistance to extensibility. Glucose oxidase (at 0.0003-0.001%), hemicellulase (at 0.001-0.005%) and phospholipase + hemicellulase (at 0.0006-0.0009%) addition improved the specific volume of wheat meal bread compared with the control bread. Increasing the dosage of glucose oxidase from 0.0003 to 0.001% caused a further increase in the specific volume of wheat meal bread. The addition of hemicellulase (at 0.001-0.005%) caused a significant decrease in the baking loss and an increase in the moisture content of wheat meal bread compared with the control bread. The addition of amyloglucosidase (at 0.000875-0.001%), lipase (at 0.0002-0.001%) and cellulase (at 0.0003-0.0005%) did not considerably affected the dough rheological and the quality characteristics of wheat meal bread.

Trends and comparison of water quality and bottom material of northeastern Arkansas streams, 1974-85, and effects of planned diversions

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

Petersen, J.C.

1990-01-01

Water quality of several rivers in Arkansas was compared using median values at individual water quality stations. Differences were detected in several properties, including common dissolved constituents, alkalinity, nutrients, fecal coliform bacteria, trace metals, pesticides, and sediment. In bottom material, organochlorine pesticides were detected much more frequently than organophosphorus pesticides and were higher in rivers with beds of fine-gradient particles. Time trends were examined using the Seasonal Kendall test. Trends in conductance, sodium adsorption ratio, chloride, phosphorus, and ammonia were usually not detectable. Sulfate concentrations were increasing at approximately one-half of the stations studied while fecal-coliform bacteria concentrations decreased atmore » approximately one-half of the stations. The most potentially detrimental effects upon water quality resulting from surface water diversions were related to increases of common dissolved constituents. From available data, the largest of these increases would be caused by diversion from the Arkansas River. Potential effects not specifically examined include resuspension of bottom materials resulting from construction and operation of the diversion system. Use of some surface waters for artificial recharge of the alluvial aquifer may adversely affect the recharge systems or the aquifer. Possible effects include plugging of the injection well and the aquifer.« less

[Effect of inspiratory muscle training on muscle strength and quality of life in patients with chronic airflow limitation: a randomized controlled trial].

PubMed

Serón, P; Riedemann, P; Muñoz, S; Doussoulin, A; Villarroel, P; Cea, X

2005-11-01

Chronic airflow limitation (CAL) is a significant cause of illness and death. Inspiratory muscle training has been described as a technique for managing CAL. The aim of the present study was to evaluate the effectiveness of inspiratory muscle training on improving physiological and functional variables. Randomized controlled trial in which 35 patients with CAL were assigned to receive either an experimental (n=17) or control (n=18) intervention. The experimental intervention consisted of 2 months of inspiratory muscle training using a device that administered a resistive load of 40% of maximal static inspiratory mouth pressure (PImax). Inspiratory muscle strength, exercise tolerance, respiratory function, and quality of life were assessed. Significant improvement in inspiratory muscle strength was observed in the experimental training group (P=.02). All patients improved over time in both groups (P<.001). PImax increased by 8.9 cm H2O per month of training. Likewise, the health-related quality of life scores improved by 0.56 points. Use of a threshold loading device is effective for strengthening inspiratory muscles as measured by PImax after the first month of training in patients with CAL. The long-term effectiveness of such training and its impact on quality of life should be studied in a larger number of patients.

Pharmacological interventions for sleepiness and sleep disturbances caused by shift work.

PubMed

Liira, Juha; Verbeek, Jos H; Costa, Giovanni; Driscoll, Tim R; Sallinen, Mikael; Isotalo, Leena K; Ruotsalainen, Jani H

2014-08-12

Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and quality. To evaluate the effects of pharmacological interventions to reduce sleepiness or to improve alertness at work and decrease sleep disturbances whilst off work, or both, in workers undertaking shift work in their present job and to assess their cost-effectiveness. We searched CENTRAL, MEDLINE, EMBASE, PubMed and PsycINFO up to 20 September 2013 and ClinicalTrials.gov up to July 2013. We also screened reference lists of included trials and relevant reviews. We included all eligible randomised controlled trials (RCTs), including cross-over RCTs, of pharmacological products among workers who were engaged in shift work (including night shifts) in their present jobs and who may or may not have had sleep problems. Primary outcomes were sleep length and sleep quality while off work, alertness and sleepiness, or fatigue at work. Two authors independently selected studies, extracted data and assessed risk of bias in included trials. We performed meta-analyses where appropriate. We included 15 randomised placebo-controlled trials with 718 participants. Nine trials evaluated the effect of melatonin and two the effect of hypnotics for improving sleep problems. One trial assessed the effect of modafinil, two of armodafinil and one examined caffeine plus naps to decrease sleepiness or to increase alertness.Melatonin (1 to 10 mg) after the night shift may increase sleep length during daytime sleep (mean difference (MD) 24 minutes, 95% confidence interval (CI) 9.8 to 38.9; seven trials, 263 participants, low quality evidence) and night-time sleep (MD 17 minutes, 95% CI 3.71 to 30.22; three trials, 234 participants, low quality evidence) compared to placebo. We did not find a dose-response effect. Melatonin may lead to similar sleep latency times as placebo (MD 0.37minutes, 95% CI - 1.55 to 2.29; five trials, 74 participants, low quality evidence).Hypnotic medication, zopiclone, did not result in significantly longer daytime sleep length compared to placebo in one low quality trial and we could not use the data from the study on lormetazepam.Armodafinil taken before the night shift probably reduces sleepiness by one point on the Karolinska Sleepiness Scale (KSS) (MD -0.99, 95% CI -1.32 to -0.67; range 1 to 10; two trials, 572 participants, moderate quality evidence) and increases alertness by 50 ms in a simple reaction time test (MD -50.0, 95% CI -85.5 to -15.5) at three months' follow-up in shift work sleep disorder patients. Modafinil probably has similar effects on sleepiness (KSS) (MD -0.90, 95% CI -1.45 to -0.35; one trial, 183 participants, moderate quality evidence) and alertness in the psychomotor vigilance test in the same patient group. Post-marketing, severe skin reactions have been reported. Adverse effects reported by trial participants were headache, nausea and a rise in blood pressure. There were no trials in non-patient shift workers.Based on one trial, caffeine plus pre-shift naps taken before the night shift decreased sleepiness (KSS) (MD -0.63, 95% CI -1.09 to -0.17).We judged most trials to have a low risk of bias even though the randomisation method and allocation concealment were often not described. There is low quality evidence that melatonin improves sleep length after a night shift but not other sleep quality parameters. Both modafinil and armodafinil increase alertness and reduce sleepiness to some extent in employees who suffer from shift work sleep disorder but they are associated with adverse events. Caffeine plus naps reduces sleepiness during the night shift, but the quality of evidence is low. Based on one low quality trial, hypnotics did not improve sleep length and quality after a night shift.We need more and better quality trials on the beneficial and adverse effects and costs of all pharmacological agents that induce sleep or promote alertness in shift workers both with and without a diagnosis of shift work sleep disorder. We also need systematic reviews of their adverse effects.

Do self-management interventions in COPD patients work and which patients benefit most? An individual patient data meta-analysis.

PubMed

Jonkman, Nini H; Westland, Heleen; Trappenburg, Jaap Ca; Groenwold, Rolf Hh; Bischoff, Erik Wma; Bourbeau, Jean; Bucknall, Christine E; Coultas, David; Effing, Tanja W; Epton, Michael J; Gallefoss, Frode; Garcia-Aymerich, Judith; Lloyd, Suzanne M; Monninkhof, Evelyn M; Nguyen, Huong Q; van der Palen, Job; Rice, Kathryn L; Sedeno, Maria; Taylor, Stephanie Jc; Troosters, Thierry; Zwar, Nicholas A; Hoes, Arno W; Schuurmans, Marieke J

2016-01-01

Self-management interventions are considered effective in patients with COPD, but trials have shown inconsistent results and it is unknown which patients benefit most. This study aimed to summarize the evidence on effectiveness of self-management interventions and identify subgroups of COPD patients who benefit most. Randomized trials of self-management interventions between 1985 and 2013 were identified through a systematic literature search. Individual patient data of selected studies were requested from principal investigators and analyzed in an individual patient data meta-analysis using generalized mixed effects models. Fourteen trials representing 3,282 patients were included. Self-management interventions improved health-related quality of life at 12 months (standardized mean difference 0.08, 95% confidence interval [CI] 0.00-0.16) and time to first respiratory-related hospitalization (hazard ratio 0.79, 95% CI 0.66-0.94) and all-cause hospitalization (hazard ratio 0.80, 95% CI 0.69-0.90), but had no effect on mortality. Prespecified subgroup analyses showed that interventions were more effective in males (6-month COPD-related hospitalization: interaction P=0.006), patients with severe lung function (6-month all-cause hospitalization: interaction P=0.016), moderate self-efficacy (12-month COPD-related hospitalization: interaction P=0.036), and high body mass index (6-month COPD-related hospitalization: interaction P=0.028 and 6-month mortality: interaction P=0.026). In none of these subgroups, a consistent effect was shown on all relevant outcomes. Self-management interventions exert positive effects in patients with COPD on respiratory-related and all-cause hospitalizations and modest effects on 12-month health-related quality of life, supporting the implementation of self-management strategies in clinical practice. Benefits seem similar across the subgroups studied and limiting self-management interventions to specific patient subgroups cannot be recommended.

B-type natriuretic peptide-guided treatment for heart failure.

PubMed

McLellan, Julie; Heneghan, Carl J; Perera, Rafael; Clements, Alison M; Glasziou, Paul P; Kearley, Karen E; Pidduck, Nicola; Roberts, Nia W; Tyndel, Sally; Wright, F Lucy; Bankhead, Clare

2016-12-22

Heart failure is a condition in which the heart does not pump enough blood to meet all the needs of the body. Symptoms of heart failure include breathlessness, fatigue and fluid retention. Outcomes for patients with heart failure are highly variable; however on average, these patients have a poor prognosis. Prognosis can be improved with early diagnosis and appropriate use of medical treatment, use of devices and transplantation. Patients with heart failure are high users of healthcare resources, not only due to drug and device treatments, but due to high costs of hospitalisation care. B-type natriuretic peptide levels are already used as biomarkers for diagnosis and prognosis of heart failure, but could offer to clinicians a possible tool to guide drug treatment. This could optimise drug management in heart failure patients whilst allaying concerns over potential side effects due to drug intolerance. To assess whether treatment guided by serial BNP or NT-proBNP (collectively referred to as NP) monitoring improves outcomes compared with treatment guided by clinical assessment alone. Searches were conducted up to 15 March 2016 in the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library; MEDLINE (OVID), Embase (OVID), the Database of Abstracts of Reviews of Effects (DARE) and the NHS Economic Evaluation Database in the Cochrane Library. Searches were also conducted in the Science Citation Index Expanded, the Conference Proceedings Citation Index on Web of Science (Thomson Reuters), World Health Organization International Clinical Trials Registry and ClinicalTrials.gov. We applied no date or language restrictions. We included randomised controlled trials of NP-guided treatment of heart failure versus treatment guided by clinical assessment alone with no restriction on follow-up. Adults treated for heart failure, in both in-hospital and out-of-hospital settings, and trials reporting a clinical outcome were included. Two review authors independently selected studies for inclusion, extracted data and evaluated risk of bias. Risk ratios (RR) were calculated for dichotomous data, and pooled mean differences (MD) (with 95% confidence intervals (CI)) were calculated for continuous data. We contacted trial authors to obtain missing data. Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, we assessed the quality of the evidence and GRADE profiler (GRADEPRO) was used to import data from Review Manager to create a 'Summary of findings' table. We included 18 randomised controlled trials with 3660 participants (range of mean age: 57 to 80 years) comparing NP-guided treatment with clinical assessment alone. The evidence for all-cause mortality using NP-guided treatment showed uncertainty (RR 0.87, 95% CI 0.76 to 1.01; patients = 3169; studies = 15; low quality of the evidence), and for heart failure mortality (RR 0.84, 95% CI 0.54 to 1.30; patients = 853; studies = 6; low quality of evidence).The evidence suggested heart failure admission was reduced by NP-guided treatment (38% versus 26%, RR 0.70, 95% CI 0.61 to 0.80; patients = 1928; studies = 10; low quality of evidence), but the evidence showed uncertainty for all-cause admission (57% versus 53%, RR 0.93, 95% CI 0.84 to 1.03; patients = 1142; studies = 6; low quality of evidence).Six studies reported on adverse events, however the results could not be pooled (patients = 1144; low quality of evidence). Only four studies provided cost of treatment results, three of these studies reported a lower cost for NP-guided treatment, whilst one reported a higher cost (results were not pooled; patients = 931, low quality of evidence). The evidence showed uncertainty for quality of life data (MD -0.03, 95% CI -1.18 to 1.13; patients = 1812; studies = 8; very low quality of evidence).We completed a 'Risk of bias' assessment for all studies. The impact of risk of bias from lack of blinding of outcome assessment and high attrition levels was examined by restricting analyses to only low 'Risk of bias' studies. In patients with heart failure low-quality evidence showed a reduction in heart failure admission with NP-guided treatment while low-quality evidence showed uncertainty in the effect of NP-guided treatment for all-cause mortality, heart failure mortality, and all-cause admission. Uncertainty in the effect was further shown by very low-quality evidence for patient's quality of life. The evidence for adverse events and cost of treatment was low quality and we were unable to pool results.

The prevalence and association with health-related quality of life of tungiasis and scabies in schoolchildren in southern Ethiopia

PubMed Central

Lebas, Eglantine; De Sario, Valentina; Deyasso, Zeleke; Doni, Shimelis N.; Marks, Michael; Roberts, Chrissy H.; Lambert, Saba M.

2017-01-01

Background The prevalence of skin disease in low and middle income countries is high and communicable skin diseases are a significant public health problem. Tungiasis is an ectoparasite infestation caused by the flea Tunga penetrans, which has a widespread geographical distribution. Tungiasis causes painful skin lesions and may affect activities of daily living. Objective We wished to determine the prevalence and impact of tungiasis and scabies in schoolchildren in southern Ethiopia. Methods A cross-sectional study was performed in which students were examined by dermatologists and the skin disorders recorded. Individuals with pyogenic skin infections, scabies and tungiasis were also invited to complete the Children’s Dermatology Life Quality Index. Results There was a high burden of skin disease amongst this cohort with more than 40% having an ectodermal parasitic skin disease. The majority of these were due to tungiasis. Tungiasis was evident in more than a third of children and was associated with onychodystophy. There was a significant association between wearing “closed” footwear and a greater number of tungiasis lesions but not tungiasis per se. Dermatophyte infections, acne and plantar maceration secondary to occlusive footwear were also common. Scabies and tungiasis appeared to have a significant negative effect on quality of life. Conclusion Tungiasis is highly prevalent in schoolchildren in the part of Ethiopia where the study was conducted and is associated with a deleterious effect on quality of life. The role of footwear in both preventing and possibly exacerbating cutaneous ailments in this setting requires further study. PMID:28771469

Environmental impact assessment of cottage industries of Kashmir, India.

PubMed

Wani, Khursheed Ahmad; Jaiswal, Y K

2011-07-01

Our objective was to carry out environmental impact assessment of small scale industries in Kashmir (India). A prepared questionnaire was circulated among the workers, owners and residents to assess the pros and cons of the small scale industries in Kashmir. The study revealed that most of the small scale industries in Kashmir valley have an impact on the quality of the environment and may cause discomfort to the people living very close to these industries. It has been observed that small scale industries lack efficient waste management system. However, the generated wastes from these units may be used effectively, as a raw material in various ways when managed properly and may minimize the impact on the quality of the environment and may also contribute in improving the economy of the State. The proliferation of small scale industries has caused an irreversible damage to the agricultural land of the area studied.

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

PubMed

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

2013-10-01

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

Deprivation amblyopia and congenital hereditary cataract.

PubMed

Mansouri, Behzad; Stacy, Rebecca C; Kruger, Joshua; Cestari, Dean M

2013-01-01

Amblyopia is a neurodevelopmental disorder of vision associated with decreased visual acuity, poor or absent stereopsis, and suppression of information from one eye.(1,2) Amblyopia may be caused by strabismus (strabismic amblyopia), refractive error (anisometropic amblyopia), or deprivation from obstructed vision (deprivation amblyopia). 1 In the developed world, amblyopia is the most common cause of childhood visual impairment, 3 which reduces quality of life 4 and also almost doubles the lifetime risk of legal blindness.(5, 6) Successful treatment of amblyopia greatly depends on early detection and treatment of predisposing disorders such as congenital cataract, which is the most common cause of deprivational amblyopia. Understanding the genetic causes of congenital cataract leads to more effective screening tests, early detection and treatment of infants and children who are at high risk for hereditary congenital cataract.

Analysis of factors affecting the quality of life of those suffering from Crohn's disease.

PubMed

Chrobak-Bień, Joanna; Gawor, Anna; Paplaczyk, Małgorzata; Małecka-Panas, Ewa; Gąsiorowska, Anita

2017-08-31

Crohn's disease is an inflammatory bowel disease of unknown etiology. Its chronic nature, as well as symptoms of intestinal and overall significantly impedes the daily functioning of patients. Alternately occurring periods of exacerbation and remission are the cause of reduced quality of life of patients. Understanding the factors that caused the decrease in the quality of life, it allows us to understand the behavior and the situation of the patient and the ability to cope with stress caused by the disease. The aim of the study was to analyze the factors affecting the quality of life of people with Crohn's disease. The study group consisted of 50 people diagnosed with Crohn's disease. Respondents were treated at the Department of General Surgery and Colorectal Medical University of Lodz and Gastroenterological Clinic at the University Clinical Hospital No. 1 in Lodz. Quality of Life Survey was carried out by a diagnostic survey using a research tool SF-36v2 and surveys of its own design. Analysis of the results demonstrated that the quality of life of patients with Crohn's disease was reduced, especially during exacerbations. Evaluation of the quality of life of respondents in physical terms was slightly higher than in the mental aspect. Higher education subjects and the lack of need for surgical treatment significantly improves the quality of life. The occurrence of chronic disease reduces the quality of life of respondents. Elderly patients are better able to adapt to the difficult situation caused by the disease. The quality of life of women and men is at a similar level and patients in remission of the disease have a better quality of life of patients during exacerbations.

Magnetic Ureteral Stent Removal Without Cystoscopy: A Randomized Controlled Trial.

PubMed

Rassweiler, Marie-Claire; Michel, Maurice-Stephan; Ritter, Manuel; Honeck, Patrick

2017-08-01

Ureteral stenting is a common procedure in urology. The cystoscopic removal of Double-J stents (DJ) causes unpleasant side effects with a negative impact on patient's quality of life. The aim of our study was to evaluate this newly developed magnetic DJ and compare it with a standard DJ regarding quality of life with indwelling DJs as well as discomfort during the removal. The magnetic DJ (Blackstar, Urotech [Achenmühle, Germany]) is a standard 7F ureteral stent with a small magnetic cube fixed through a string on the loop of the distal part of the stent. For DJ removal, a special catheter-like retrieval instrument with a magnetic tip is inserted, the two magnets connect and the retrieval instrument is removed with the DJ. We first tested this DJ in 20 cases. Afterward we evaluated 40 consecutive cases that required a DJ placement after ureterorenoscopy in a prospective randomized manner. The quality of life was assessed by the ureteral stent symptom questionnaire. A visual analogue scale was used to document the pain by DJ removal. There was a significant difference regarding the pain location with the indwelling DJ (p = 0.038). The maximum pain was located in the lower abdomen and/or around the bladder (48%) with the magnetic DJ, whereas the standard DJ caused flank pain in 54% of the patients. The mean time for the magnetic DJ removal including preparation and cleaning as for a transurethral catheter insertion was 9.55 [7-14] minutes, whereas the mean time for the cystoscopic DJ removal was 21.35 [18-30] minutes. The pain caused by the removal of the magnetic DJ was significantly less than that caused by the cystoscopic DJ removal (p = 0.019). The discomfort caused by the indwelling magnetic DJ is comparable with that caused by the standard DJ. However, the magnetic DJ removal is less painful and faster.

Improving Quality of Shoe Soles Product using Six Sigma

NASA Astrophysics Data System (ADS)

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

2018-03-01

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

Power Quality Improvement in Induction Furnace by Harmonic Reduction Using Dynamic Voltage Restorer

NASA Astrophysics Data System (ADS)

Saggu, Tejinder Singh; Singh, Lakhwinder

2016-06-01

Induction furnaces are used in wide quantity under different capacities for annual production of around 25 million tons of iron and steel in India. It plays a vital role in various manufacturing processes around the world for melting different types of metal scraps i. e. Copper, Cast Iron, Aluminium, Steel, Brass, Bronze, Silicon, Gold, Silver etc. which are further used in many other industrial applications. The induction furnace causes a huge disturbance to the utility and nearby consumers during its operation due to its non-linear characteristics. This is a serious phenomenon responsible for power quality degradation in the power system. This paper presents methodology to improve the power quality degradation caused by induction furnace using Dynamic Voltage Restorer (DVR) which is a type of custom power device. The real time data has been taken from an industry employing induction furnace for production of ingots from scrap material. The experimental readings are measured using power quality analyser equipment. The simulation of whole plant is done by analysing this same data and the simulation results are compared with actual onsite results. Then, solution methodology using DVR is presented which revealed that the implementation of DVR is an effective solution for voltage sag mitigation and harmonics improvement in induction furnace.

Relations between hydrology, water quality, and taste-and-odor causing organisms and compounds in Lake Houston, Texas, April 2006-September 2008

USGS Publications Warehouse

Beussink, Amy M.; Graham, Jennifer L.

2011-01-01

Lake Houston is a surface-water-supply reservoir and an important recreational resource for the city of Houston, Texas. Growing concerns over water quality in Lake Houston prompted a detailed assessment of water quality in the reservoir. The assessment focused on water-quality constituents that affect the aesthetic quality of drinking water. The hydrologic and water-quality conditions influencing the occurrence of taste-and-odor causing organisms and compounds in Lake Houston were assessed using discrete and continuously monitored water-quality data collected during April 2006– September 2008. The hydrology of Lake Houston is characterized by rapidly changing conditions. During inflow events, water residence time can change by orders of magnitude within a matter of hours. Likewise, the reservoir can stratify and destratify over a period of several hours, even during non-summer and at relatively short water residence times, given extended periods with warm temperatures and little wind. The rapidly changing hydrology likely influences all other aspects of water quality in Lake Houston, including the occurrence of taste-and-odor causing organisms and compounds. Water quality in Lake Houston varied with respect to season and water residence time but typically was indicative of turbid, eutrophic to hypereutrophic conditions. In general, turbidity and nutrient concentrations were largest during non-summer (October–May) and when water residence times were relatively short (less than 100 days), which reflects the influence of inflow events on water-quality conditions. Large inflow events can cause substantial changes in water-quality conditions over relatively short periods of time (hours). The taste-and-odor causing organisms cyanobacteria and actinomycetes bacteria were always present in Lake Houston. Cyanobacterial biovolume was largest during summer (June– September) and when water residence time was greater than 100 days. Annual maxima in cyanobacterial biovolume occurred during July-September of each year, when temperatures were larger than 27 degrees Celsius and water residence times were longer than 400 days. In contrast, actinomycetes bacteria were most abundant during non-summer and when water residence times were less than 100 days, reflecting the close association between these organisms and transport of suspended sediments. Geosmin and 2-methylisoborneol are the taste-and-odor causing compounds most commonly produced by cyanobacteria and actinomycetes bacteria. Geosmin was detected more frequently (62 percent of samples) than 2-methylisoborneol (29 percent of samples) in Lake Houston. Geosmin exceeded the human detection threshold (10 nanograms per liter) only once during the study period and 2-methylisoborneol exceeded the human detection threshold twice. Manganese is a naturally occurring trace element that can occasionally cause taste-andodor problems in drinking water. Manganese concentrations exceeded the human detection threshold (about 50 micrograms per liter) in about 50 percent of samples collected near the surface and 84 percent of samples collected near the bottom. The cyanotoxin microcystin was detected relatively infrequently (16 percent of samples) and at small concentrations (less than or equal to 0.2 micrograms per liter). The abundance of the taste-and-odor causing organisms cyanobacteria and actinomycetes bacteria in Lake Houston was coupled with inflow events and subsequent changes in water-quality conditions. Cyanobacterial biovolume (biomass) in Lake Houston was largest during warm periods with little inflow and relatively small turbidity values. In contrast, actinomycetes bacteria were most abundant following inflow events when turbidity was relatively large. Severe taste-and-odor problems were not observed during the study period, precluding quantification of the hydrologic and water-quality conditions associated with large concentrations of taste-and-odor causing compounds and development of predictive models. Reservoir inflow (water residence time) and turbidity, variables related to the abundance of potential taste-andodor causing organisms, are currently (2011) continuously measured in Lake Houston, and predictive models could be developed in the future when the hydrologic and water-quality conditions associated with taste-and-odor problems have been better quantified. Seasonal and water residence time influences on water-quality conditions altered relations between hydrologic and water-quality conditions and taste-and-odor causing organisms and compounds. Future data collection and development of predictive models need to account for the variability associated with season and water residence time. 

Effects of home telemonitoring interventions on patients with chronic heart failure: an overview of systematic reviews.

PubMed

Kitsiou, Spyros; Paré, Guy; Jaana, Mirou

2015-03-12

Growing interest on the effects of home telemonitoring on patients with chronic heart failure (HF) has led to a rise in the number of systematic reviews addressing the same or very similar research questions with a concomitant increase in discordant findings. Differences in the scope, methods of analysis, and methodological quality of systematic reviews can cause great confusion and make it difficult for policy makers and clinicians to access and interpret the available evidence and for researchers to know where knowledge gaps in the extant literature exist. This overview aims to collect, appraise, and synthesize existing evidence from multiple systematic reviews on the effectiveness of home telemonitoring interventions for patients with chronic heart failure (HF) to inform policy makers, practitioners, and researchers. A comprehensive literature search was performed on MEDLINE, EMBASE, CINAHL, and the Cochrane Library to identify all relevant, peer-reviewed systematic reviews published between January 1996 and December 2013. Reviews were searched and screened using explicit keywords and inclusion criteria. Standardized forms were used to extract data and the methodological quality of included reviews was appraised using the AMSTAR (assessing methodological quality of systematic reviews) instrument. Summary of findings tables were constructed for all primary outcomes of interest, and quality of evidence was graded by outcome using the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system. Post-hoc analysis and subgroup meta-analyses were conducted to gain further insights into the various types of home telemonitoring technologies included in the systematic reviews and the impact of these technologies on clinical outcomes. A total of 15 reviews published between 2003 and 2013 were selected for meta-level synthesis. Evidence from high-quality reviews with meta-analysis indicated that taken collectively, home telemonitoring interventions reduce the relative risk of all-cause mortality (0.60 to 0.85) and heart failure-related hospitalizations (0.64 to 0.86) compared with usual care. Absolute risk reductions ranged from 1.4%-6.5% and 3.7%-8.2%, respectively. Improvements in HF-related hospitalizations appeared to be more pronounced in patients with stable HF: hazard ratio (HR) 0.70 (95% credible interval [Crl] 0.34-1.5]). Risk reductions in mortality and all-cause hospitalizations appeared to be greater in patients who had been recently discharged (≤28 days) from an acute care setting after a recent HF exacerbation: HR 0.62 (95% CrI 0.42-0.89) and HR 0.67 (95% CrI 0.42-0.97), respectively. However, quality of evidence for these outcomes ranged from moderate to low suggesting that further research is very likely to have an important impact on our confidence in the observed estimates of effect and may change these estimates. The post-hoc analysis identified five main types of non-invasive telemonitoring technologies included in the systematic reviews: (1) video-consultation, with or without transmission of vital signs, (2) mobile telemonitoring, (3) automated device-based telemonitoring, (4) interactive voice response, and (5) Web-based telemonitoring. Of these, only automated device-based telemonitoring and mobile telemonitoring were effective in reducing the risk of all-cause mortality and HF-related hospitalizations. More research data are required for interactive voice response systems, video-consultation, and Web-based telemonitoring to provide robust conclusions about their effectiveness. Future research should focus on understanding the process by which home telemonitoring works in terms of improving outcomes, identify optimal strategies and the duration of follow-up for which it confers benefits, and further investigate whether there is differential effectiveness between chronic HF patient groups and types of home telemonitoring technologies.

Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews

PubMed Central

Paré, Guy; Jaana, Mirou

2015-01-01

Background Growing interest on the effects of home telemonitoring on patients with chronic heart failure (HF) has led to a rise in the number of systematic reviews addressing the same or very similar research questions with a concomitant increase in discordant findings. Differences in the scope, methods of analysis, and methodological quality of systematic reviews can cause great confusion and make it difficult for policy makers and clinicians to access and interpret the available evidence and for researchers to know where knowledge gaps in the extant literature exist. Objective This overview aims to collect, appraise, and synthesize existing evidence from multiple systematic reviews on the effectiveness of home telemonitoring interventions for patients with chronic heart failure (HF) to inform policy makers, practitioners, and researchers. Methods A comprehensive literature search was performed on MEDLINE, EMBASE, CINAHL, and the Cochrane Library to identify all relevant, peer-reviewed systematic reviews published between January 1996 and December 2013. Reviews were searched and screened using explicit keywords and inclusion criteria. Standardized forms were used to extract data and the methodological quality of included reviews was appraised using the AMSTAR (assessing methodological quality of systematic reviews) instrument. Summary of findings tables were constructed for all primary outcomes of interest, and quality of evidence was graded by outcome using the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system. Post-hoc analysis and subgroup meta-analyses were conducted to gain further insights into the various types of home telemonitoring technologies included in the systematic reviews and the impact of these technologies on clinical outcomes. Results A total of 15 reviews published between 2003 and 2013 were selected for meta-level synthesis. Evidence from high-quality reviews with meta-analysis indicated that taken collectively, home telemonitoring interventions reduce the relative risk of all-cause mortality (0.60 to 0.85) and heart failure-related hospitalizations (0.64 to 0.86) compared with usual care. Absolute risk reductions ranged from 1.4%-6.5% and 3.7%-8.2%, respectively. Improvements in HF-related hospitalizations appeared to be more pronounced in patients with stable HF: hazard ratio (HR) 0.70 (95% credible interval [Crl] 0.34-1.5]). Risk reductions in mortality and all-cause hospitalizations appeared to be greater in patients who had been recently discharged (≤28 days) from an acute care setting after a recent HF exacerbation: HR 0.62 (95% CrI 0.42-0.89) and HR 0.67 (95% CrI 0.42-0.97), respectively. However, quality of evidence for these outcomes ranged from moderate to low suggesting that further research is very likely to have an important impact on our confidence in the observed estimates of effect and may change these estimates. The post-hoc analysis identified five main types of non-invasive telemonitoring technologies included in the systematic reviews: (1) video-consultation, with or without transmission of vital signs, (2) mobile telemonitoring, (3) automated device-based telemonitoring, (4) interactive voice response, and (5) Web-based telemonitoring. Of these, only automated device-based telemonitoring and mobile telemonitoring were effective in reducing the risk of all-cause mortality and HF-related hospitalizations. More research data are required for interactive voice response systems, video-consultation, and Web-based telemonitoring to provide robust conclusions about their effectiveness. Conclusions Future research should focus on understanding the process by which home telemonitoring works in terms of improving outcomes, identify optimal strategies and the duration of follow-up for which it confers benefits, and further investigate whether there is differential effectiveness between chronic HF patient groups and types of home telemonitoring technologies. PMID:25768664

Clinical profile and quality of life of patients with occupational contact dermatitis from New Delhi, India.

PubMed

Bhatia, Riti; Sharma, Vinod K; Ramam, M; Sethuraman, Gomathy; Yadav, Chander P

2015-09-01

Data regarding occupational contact dermatitis (OCD) and its effect on quality of life (QOL) in India are limited. To evaluate patients with OCD and record the outcome of treatment. All patients with OCD were evaluated for severity of disease (by the use of physician global assessment) and its effect on QOL (by use of the Dermatology Life Quality Index) questionnaire) at the first visit and after 3 months of treatment. Among 117 patients with OCD, hand eczema was present in 81.2%. Positive patch test reactions were found in 76%. The most common allergens were Parthenium hysterophorus and potassium dichromate. The most frequent diagnosis was occupational allergic contact dermatitis (OACD) (57%), caused by farming and construction work, followed by occupational irritant contact dermatitis (OICD) (24%), caused by wet work. Severe psychosocial distress was recorded in 62.5% of patients. After 3 months of treatment, 83% improved significantly, and 54% had improvement in QOL. Farmers were most frequently affected, followed by construction workers and housewives. OACD was found at a higher frequency than OICD. The most frequent allergens were Parthenium hysterophorus in farmers, potassium dichromate in construction workers, and vegetables in housewives. OCD has a significant impact on QOL. Patch testing, in addition to standard treatment, improves the outcome considerably. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Medical hydrogeology is an independent interdisciplinary branch of the science about groundwater].

PubMed

Elpiner, L I

The use of groundwater in population water supply systems gains more and more importance because of increasing degradation of the quality of surface water sources. At the same time there are changed concepts on ubiquitous high quality of groundwater. The executed analysis offoreign and domestic literature allowed authors to determine the character and causes of negative changes in the composition of groundwater. In the large body of investigations there were established cause-and-effect relationships between a number of noninfectious (including cardiovascular and cancer) and infectious diseases and anthropogenic pollution and the natural composition of groundwater. In the article there is substantiated the formation of a new interdisciplinary scientific direction - medical hydrogeology. On the basis of current data on the medical and ecological significance of the quality, quantity and regime of the groundwater, geological conditions of the shaping of their composition, there was shown the need of the consideration of the hydrological situation in making water supply management solutions safe for the health of the population. In this regard, there were considered the interrelationship and interdependence of allied disciplines - hygiene, ecological toxicology and epidemiology, hydrogeochemistry, hydrogeology. There was pointed the importance of the acquisition of based on hydrogeology medical specialists of the water supply profile for sharing with hygienists of the effective solution of tasks of the management of groundwater sources.

Evolution of quality characteristics of minimally processed asparagus during storage in different lighting conditions.

PubMed

Sanz, S; Olarte, C; Ayala, F; Echávarri, J F

2009-08-01

The effect of different types of lighting (white, green, red, and blue light) on minimally processed asparagus during storage at 4 degrees C was studied. The gas concentrations in the packages, pH, mesophilic counts, and weight loss were also determined. Lighting caused an increase in physiological activity. Asparagus stored under lighting achieved atmospheres with higher CO(2) and lower O(2) content than samples kept in the dark. This activity increase explains the greater deterioration experienced by samples stored under lighting, which clearly affected texture and especially color, accelerating the appearance of greenish hues in the tips and reddish-brown hues in the spears. Exposure to light had a negative effect on the quality parameters of the asparagus and it caused a significant reduction in shelf life. Hence, the 11 d shelf life of samples kept in the dark was reduced to only 3 d in samples kept under red and green light, and to 7 d in those kept under white and blue light. However, quality indicators such as the color of the tips and texture showed significantly better behavior under blue light than with white light, which allows us to state that it is better to use this type of light or blue-tinted packaging film for the display of minimally processed asparagus to consumers.

Identifying regions vulnerable to habitat degradation under future irrigation scenarios

NASA Astrophysics Data System (ADS)

Terrado, Marta; Sabater, Sergi; Acuña, Vicenç

2016-11-01

The loss and degradation of natural habitats is a primary cause of biodiversity decline. The increasing impacts of climate and land use change affect water availability, ultimately decreasing agricultural production. Areas devoted to irrigation have been increased to compensate this reduction, causing habitat and biodiversity losses, especially in regions undergoing severe water stress. These effects might intensify under global change, probably contributing to a decrease in habitat quality. We selected four European river basins across a gradient of water scarcity and irrigation agriculture. The habitat quality in the basins was assessed as a function of habitat suitability and threats under current and future global change scenarios of irrigation. Results revealed that the most threatened regions under future scenarios of global change were among those suffering of water scarcity and with bigger areas devoted to irrigation. Loss of habitat quality reached 10% in terrestrial and 25% in aquatic ecosystems under climate change scenarios involving drier conditions. The aquatic habitats were the most degraded in all scenarios, since they were affected by threats from both the terrestrial and the aquatic parts of the basin. By identifying in advance the regions most vulnerable to habitat and biodiversity loss, our approach can assist decision makers in deciding the conservation actions to be prioritized for mitigation and adaptation to the effects of climate change, particularly front the development of irrigation plans.

Innovative Use of Quality Management Methods for Product Improvement

NASA Astrophysics Data System (ADS)

Midor, Katarzyna; Žarnovský, Jozef

2016-12-01

Organisations constantly look for new, innovative solutions and methods which could be used to improve their efficiency and increase the quality of their products. Identifying the causes for returns is an important issue for modern companies, as returns are the cause for the increase in production costs and, most importantly, the loss of credibility in the eyes of the client. Therefore, for the company to be able to sustain or strengthen its position on the market, it has to follow the rules of quality management. Especially important is the rule of constant improvement. This rule is primarily connected with preventing errors and defects from occurring at all the stages of the production process. To achieve that, one must, among other things, use quality management tools. The article presents an analysis of causes for returns of a vibrating screen produced by a company which manufactures machinery and equipment for the extractive industry, using quality management tools such as the Ishikawa diagram and Pareto analysis. The analysis allowed for the identification of the causes of client returns which could not be previously identified, and proposing solutions for them.

Structured telephone support or non-invasive telemonitoring for patients with heart failure.

PubMed

Inglis, Sally C; Clark, Robyn A; Dierckx, Riet; Prieto-Merino, David; Cleland, John G F

2015-10-31

Specialised disease management programmes for heart failure aim to improve care, clinical outcomes and/or reduce healthcare utilisation. Since the last version of this review in 2010, several new trials of structured telephone support and non-invasive home telemonitoring have been published which have raised questions about their effectiveness. To review randomised controlled trials (RCTs) of structured telephone support or non-invasive home telemonitoring compared to standard practice for people with heart failure, in order to quantify the effects of these interventions over and above usual care. We updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Health Technology AsseFssment Database (HTA) on the Cochrane Library; MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), Science Citation Index Expanded (SCI-EXPANDED), Conference Proceedings Citation Index- Science (CPCI-S) on Web of Science (Thomson Reuters), AMED, Proquest Theses and Dissertations, IEEE Xplore and TROVE in January 2015. We handsearched bibliographies of relevant studies and systematic reviews and abstract conference proceedings. We applied no language limits. We included only peer-reviewed, published RCTs comparing structured telephone support or non-invasive home telemonitoring to usual care of people with chronic heart failure. The intervention or usual care could not include protocol-driven home visits or more intensive than usual (typically four to six weeks) clinic follow-up. We present data as risk ratios (RRs) with 95% confidence intervals (CIs). Primary outcomes included all-cause mortality, all-cause and heart failure-related hospitalisations, which we analysed using a fixed-effect model. Other outcomes included length of stay, health-related quality of life, heart failure knowledge and self care, acceptability and cost; we described and tabulated these. We performed meta-regression to assess homogeneity (the null hypothesis) in each subgroup analysis and to see if the effect of the intervention varied according to some quantitative variable (such as year of publication or median age). We include 41 studies of either structured telephone support or non-invasive home telemonitoring for people with heart failure, of which 17 were new and 24 had been included in the previous Cochrane review. In the current review, 25 studies evaluated structured telephone support (eight new studies, plus one study previously included but classified as telemonitoring; total of 9332 participants), 18 evaluated telemonitoring (nine new studies; total of 3860 participants). Two of the included studies trialled both structured telephone support and telemonitoring compared to usual care, therefore 43 comparisons are evident.Non-invasive telemonitoring reduced all-cause mortality (RR 0.80, 95% CI 0.68 to 0.94; participants = 3740; studies = 17; I² = 24%, GRADE: moderate-quality evidence) and heart failure-related hospitalisations (RR 0.71, 95% CI 0.60 to 0.83; participants = 2148; studies = 8; I² = 20%, GRADE: moderate-quality evidence). Structured telephone support reduced all-cause mortality (RR 0.87, 95% CI 0.77 to 0.98; participants = 9222; studies = 22; I² = 0%, GRADE: moderate-quality evidence) and heart failure-related hospitalisations (RR 0.85, 95% CI 0.77 to 0.93; participants = 7030; studies = 16; I² = 27%, GRADE: moderate-quality evidence).Neither structured telephone support nor telemonitoring demonstrated effectiveness in reducing the risk of all-cause hospitalisations (structured telephone support: RR 0.95, 95% CI 0.90 to 1.00; participants = 7216; studies = 16; I² = 47%, GRADE: very low-quality evidence; non-invasive telemonitoring: RR 0.95, 95% CI 0.89 to 1.01; participants = 3332; studies = 13; I² = 71%, GRADE: very low-quality evidence).Seven structured telephone support studies reported length of stay, with one reporting a significant reduction in length of stay in hospital. Nine telemonitoring studies reported length of stay outcome, with one study reporting a significant reduction in the length of stay with the intervention. One telemonitoring study reported a large difference in the total number of hospitalisations for more than three days, but this was not an analysis of length of stay per hospitalisation. Nine of 11 structured telephone support studies and five of 11 telemonitoring studies reported significant improvements in health-related quality of life. Nine structured telephone support studies and six telemonitoring studies reported costs of the intervention or cost effectiveness. Three structured telephone support studies and one telemonitoring study reported a decrease in costs and two telemonitoring studies reported increases in cost, due both to the cost of the intervention and to increased medical management. Adherence was rated between 55.1% and 98.5% for those structured telephone support and telemonitoring studies which reported this outcome. Participant acceptance of the intervention was reported in the range of 76% to 97% for studies which evaluated this outcome. Seven of nine studies that measured these outcomes reported significant improvements in heart failure knowledge and self-care behaviours. For people with heart failure, structured telephone support and non-invasive home telemonitoring reduce the risk of all-cause mortality and heart failure-related hospitalisations; these interventions also demonstrated improvements in health-related quality of life and heart failure knowledge and self-care behaviours. Studies also demonstrated participant satisfaction with the majority of the interventions which assessed this outcome.

Effect of periodontal treatment on preterm birth rate: a systematic review of meta-analyses.

PubMed

López, Néstor J; Uribe, Sergio; Martinez, Benjamín

2015-02-01

Preterm birth is a major cause of neonatal morbidity and mortality in both developed and developing countries. Preterm birth is a highly complex syndrome that includes distinct clinical subtypes in which many different causes may be involved. The results of epidemiological, molecular, microbiological and animal-model studies support a positive association between maternal periodontal disease and preterm birth. However, the results of intervention studies carried out to determine the effect of periodontal treatment on reducing the risk of preterm birth are controversial. This systematic review critically analyzes the methodological issues of meta-analyses of the studies to determine the effect of periodontal treatment to reduce preterm birth. The quality of the individual randomized clinical trials selected is of highest relevance for a systematic review. This article describes the methodological features that should be identified a priori and assessed individually to determine the quality of a randomized controlled trial performed to evaluate the effect of periodontal treatment on pregnancy outcomes. The AMSTAR and the PRISMA checklist tools were used to assess the quality of the six meta-analyses selected, and the bias domain of the Cochrane Collaboration's Tool was applied to evaluate each of the trials included in the meta-analyses. In addition, the methodological characteristics of each clinical trial were assessed. The majority of the trials included in the meta-analyses have significant methodological flaws that threaten their internal validity. The lack of effect of periodontal treatment on preterm birth rate concluded by four meta-analyses, and the positive effect of treatment for reducing preterm birth risk concluded by the remaining two meta-analyses are not based on consistent scientific evidence. Well-conducted randomized controlled trials using rigorous methodology, including appropriate definition of the exposure, adequate control of confounders for preterm birth and application of effective periodontal interventions to eliminate periodontal infection, are needed to confirm the positive association between periodontal disease and preterm birth. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Practical Insight to Monitor Home NIV in COPD Patients.

PubMed

Arnal, Jean-Michel; Texereau, Joëlle; Garnero, Aude

2017-08-01

Home noninvasive ventilation (NIV) is used in COPD patients with concomitant chronic hypercapnic respiratory failure in order to correct nocturnal hypoventilation and improve sleep quality, quality of life, and survival. Monitoring of home NIV is needed to assess the effectiveness of ventilation and adherence to therapy, resolve potential adverse effects, reinforce patient knowledge, provide maintenance of the equipment, and readjust the ventilator settings according to the changing condition of the patient. Clinical monitoring is very informative. Anamnesis focuses on the improvement of nocturnal hypoventilation symptoms, sleep quality, and side effects of NIV. Side effects are major cause of intolerance. Screening side effects leads to modification of interface, gas humidification, or ventilator settings. Home care providers maintain ventilator and interface and educate patients for correct use. However, patient's education should be supervised by specialized clinicians. Blood gas measurement shows a significant decrease in PaCO 2 when NIV is efficient. Analysis of ventilator data is very useful to assess daily use, unintentional leaks, upper airway obstruction, and patient ventilator synchrony. Nocturnal oximetry and capnography are additional monitoring tools to assess the impact of NIV on gas exchanges. In the near future, telemonitoring will reinforce and change the organization of home NIV for COPD patients.

TU-AB-BRD-00: Task Group 100

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

NONE

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

TU-AB-BRD-03: Fault Tree Analysis

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

Dunscombe, P.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

TU-AB-BRD-01: Process Mapping

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

Palta, J.

2015-06-15

Current quality assurance and quality management guidelines provided by various professional organizations are prescriptive in nature, focusing principally on performance characteristics of planning and delivery devices. However, published analyses of events in radiation therapy show that most events are often caused by flaws in clinical processes rather than by device failures. This suggests the need for the development of a quality management program that is based on integrated approaches to process and equipment quality assurance. Industrial engineers have developed various risk assessment tools that are used to identify and eliminate potential failures from a system or a process before amore » failure impacts a customer. These tools include, but are not limited to, process mapping, failure modes and effects analysis, fault tree analysis. Task Group 100 of the American Association of Physicists in Medicine has developed these tools and used them to formulate an example risk-based quality management program for intensity-modulated radiotherapy. This is a prospective risk assessment approach that analyzes potential error pathways inherent in a clinical process and then ranks them according to relative risk, typically before implementation, followed by the design of a new process or modification of the existing process. Appropriate controls are then put in place to ensure that failures are less likely to occur and, if they do, they will more likely be detected before they propagate through the process, compromising treatment outcome and causing harm to the patient. Such a prospective approach forms the basis of the work of Task Group 100 that has recently been approved by the AAPM. This session will be devoted to a discussion of these tools and practical examples of how these tools can be used in a given radiotherapy clinic to develop a risk based quality management program. Learning Objectives: Learn how to design a process map for a radiotherapy process Learn how to perform failure modes and effects analysis analysis for a given process Learn what fault trees are all about Learn how to design a quality management program based upon the information obtained from process mapping, failure modes and effects analysis and fault tree analysis. Dunscombe: Director, TreatSafely, LLC and Center for the Assessment of Radiological Sciences; Consultant to IAEA and Varian Thomadsen: President, Center for the Assessment of Radiological Sciences Palta: Vice President of the Center for the Assessment of Radiological Sciences.« less

Relationship Among Signal Fidelity, Hearing Loss, and Working Memory for Digital Noise Suppression.

PubMed

Arehart, Kathryn; Souza, Pamela; Kates, James; Lunner, Thomas; Pedersen, Michael Syskind

2015-01-01

This study considered speech modified by additive babble combined with noise-suppression processing. The purpose was to determine the relative importance of the signal modifications, individual peripheral hearing loss, and individual cognitive capacity on speech intelligibility and speech quality. The participant group consisted of 31 individuals with moderate high-frequency hearing loss ranging in age from 51 to 89 years (mean = 69.6 years). Speech intelligibility and speech quality were measured using low-context sentences presented in babble at several signal-to-noise ratios. Speech stimuli were processed with a binary mask noise-suppression strategy with systematic manipulations of two parameters (error rate and attenuation values). The cumulative effects of signal modification produced by babble and signal processing were quantified using an envelope-distortion metric. Working memory capacity was assessed with a reading span test. Analysis of variance was used to determine the effects of signal processing parameters on perceptual scores. Hierarchical linear modeling was used to determine the role of degree of hearing loss and working memory capacity in individual listener response to the processed noisy speech. The model also considered improvements in envelope fidelity caused by the binary mask and the degradations to envelope caused by error and noise. The participants showed significant benefits in terms of intelligibility scores and quality ratings for noisy speech processed by the ideal binary mask noise-suppression strategy. This benefit was observed across a range of signal-to-noise ratios and persisted when up to a 30% error rate was introduced into the processing. Average intelligibility scores and average quality ratings were well predicted by an objective metric of envelope fidelity. Degree of hearing loss and working memory capacity were significant factors in explaining individual listener's intelligibility scores for binary mask processing applied to speech in babble. Degree of hearing loss and working memory capacity did not predict listeners' quality ratings. The results indicate that envelope fidelity is a primary factor in determining the combined effects of noise and binary mask processing for intelligibility and quality of speech presented in babble noise. Degree of hearing loss and working memory capacity are significant factors in explaining variability in listeners' speech intelligibility scores but not in quality ratings.

Effectiveness of Remote Patient Monitoring After Discharge of Hospitalized Patients With Heart Failure: The Better Effectiveness After Transition -- Heart Failure (BEAT-HF) Randomized Clinical Trial.

PubMed

Ong, Michael K; Romano, Patrick S; Edgington, Sarah; Aronow, Harriet U; Auerbach, Andrew D; Black, Jeanne T; De Marco, Teresa; Escarce, Jose J; Evangelista, Lorraine S; Hanna, Barbara; Ganiats, Theodore G; Greenberg, Barry H; Greenfield, Sheldon; Kaplan, Sherrie H; Kimchi, Asher; Liu, Honghu; Lombardo, Dawn; Mangione, Carol M; Sadeghi, Bahman; Sadeghi, Banafsheh; Sarrafzadeh, Majid; Tong, Kathleen; Fonarow, Gregg C

2016-03-01

It remains unclear whether telemonitoring approaches provide benefits for patients with heart failure (HF) after hospitalization. To evaluate the effectiveness of a care transition intervention using remote patient monitoring in reducing 180-day all-cause readmissions among a broad population of older adults hospitalized with HF. We randomized 1437 patients hospitalized for HF between October 12, 2011, and September 30, 2013, to the intervention arm (715 patients) or to the usual care arm (722 patients) of the Better Effectiveness After Transition-Heart Failure (BEAT-HF) study and observed them for 180 days. The dates of our study analysis were March 30, 2014, to October 1, 2015. The setting was 6 academic medical centers in California. Participants were hospitalized individuals 50 years or older who received active treatment for decompensated HF. The intervention combined health coaching telephone calls and telemonitoring. Telemonitoring used electronic equipment that collected daily information about blood pressure, heart rate, symptoms, and weight. Centralized registered nurses conducted telemonitoring reviews, protocolized actions, and telephone calls. The primary outcome was readmission for any cause within 180 days after discharge. Secondary outcomes were all-cause readmission within 30 days, all-cause mortality at 30 and 180 days, and quality of life at 30 and 180 days. Among 1437 participants, the median age was 73 years. Overall, 46.2% (664 of 1437) were female, and 22.0% (316 of 1437) were African American. The intervention and usual care groups did not differ significantly in readmissions for any cause 180 days after discharge, which occurred in 50.8% (363 of 715) and 49.2% (355 of 722) of patients, respectively (adjusted hazard ratio, 1.03; 95% CI, 0.88-1.20; P = .74). In secondary analyses, there were no significant differences in 30-day readmission or 180-day mortality, but there was a significant difference in 180-day quality of life between the intervention and usual care groups. No adverse events were reported. Among patients hospitalized for HF, combined health coaching telephone calls and telemonitoring did not reduce 180-day readmissions. clinicaltrials.gov Identifier: NCT01360203.

Effect of irradiation on the biochemical and organoleptic changes during the ripening of papaya and mango fruits

NASA Astrophysics Data System (ADS)

Lacroix, Monique; Bernard, Linda; Jobin, Michele; Milot, Sylvain; Gagnon, Marcel

Papaya and mango rot caused by fungi is a major problem during storage and marketing. Gamma irradiation treatment was used to determine its effect on the quality of papayas and mangoes irradiated at 0,5 to 0,95 kGy. The level of respiration, soluble solids, texture, vitamin C and the sensorial evaluation were effectuated. The results indicate that irradiation treatment reduces significantly (p ⪕ 0,001) the level of respiration and significantly (p ⪕ 0,001) weakens the texture of mangoes. The content of soluble solids and vitamin C are not significantly affected by the irradiation. The sensory evaluation indicates that up to 0,95 kGy the sensorial quality is not changed.

Pain, Itch, Quality of Life, and Costs after Herpes Zoster.

PubMed

van Wijck, Albert J M; Aerssens, Yannick R

2017-07-01

Herpes zoster (HZ) and postherpetic neuralgia are known to have a profound effect on the patient's quality of life, but the incidence and severity of itch and its relation with pain and quality of life in the long term are still relatively unknown. The aim of this study was to measure the presence and severity of pain and itch and impact on quality of life in patients over 50 years old with HZ. We enrolled 661 patients with HZ in this 12-month observational study. Patient data were collected via a web-based questionnaire. Outcomes were pain, itch, burden of illness, impact on patient's daily life, impact on quality of life, and healthcare costs. At inclusion, 94% of patients reported any pain, 74.3% significant pain, and 26% severe pain. After 3 months, 18.8% of patients suffered from postherpetic neuralgia. At inclusion, 70.8% of patients had any itch, 39.2% significant itch, and 7.3% severe itch. The occurrence of pain increases costs and has a high impact on the quality of life, lowering EQ-5D scores by an average of 18%. In contrast, itch has little effect on the quality of life. Pain and itch are highly prevalent months after HZ. Pain caused by HZ has a large impact on quality of life, burden of illness, impact on daily life, and health care costs for these patients. The impact of itch on quality of life is relatively small. © 2016 World Institute of Pain.

Poor sleep quality is associated with increased cortical atrophy in community-dwelling adults.

PubMed

Sexton, Claire E; Storsve, Andreas B; Walhovd, Kristine B; Johansen-Berg, Heidi; Fjell, Anders M

2014-09-09

To examine the relationship between sleep quality and cortical and hippocampal volume and atrophy within a community-based sample, explore the influence of age on results, and assess the possible confounding effects of physical activity levels, body mass index (BMI), and blood pressure. In 147 community-dwelling adults (92 female; age 53.9 ± 15.5 years), sleep quality was measured using the Pittsburgh Sleep Quality Index and correlated with cross-sectional measures of volume and longitudinal measures of atrophy derived from MRI scans separated by an average of 3.5 years. Exploratory post hoc analysis compared correlations between different age groups and included physical activity, BMI, and blood pressure as additional covariates. Poor sleep quality was associated with reduced volume within the right superior frontal cortex in cross-sectional analyses, and an increased rate of atrophy within widespread frontal, temporal, and parietal regions in longitudinal analyses. Results were largely driven by correlations within adults over the age of 60, and could not be explained by variation in physical activity, BMI, or blood pressure. Sleep quality was not associated with hippocampal volume or atrophy. We found that longitudinal measures of cortical atrophy were widely correlated with sleep quality. Poor sleep quality may be a cause or a consequence of brain atrophy, and future studies examining the effect of interventions that improve sleep quality on rates of atrophy may hold key insights into the direction of this relationship. © 2014 American Academy of Neurology.

Accountability and Other CAUSES of Total Quality Management.

ERIC Educational Resources Information Center

Aamot, Karen; Piotrowski, Craig

1995-01-01

Describes Total Quality Management (TQM) techniques implemented at Waukesha County Technical College (Wisconsin). The CAUSES program focuses on customers, accountability, understanding, self-improvement, education, and searching. Describes application of TQM to the fixed-asset team project. Four figures are included. (LMI)

The effect of singing training on voice quality for people with quadriplegia.

PubMed

Tamplin, Jeanette; Baker, Felicity A; Buttifant, Mary; Berlowitz, David J

2014-01-01

Despite anecdotal reports of voice impairment in quadriplegia, the exact nature of these impairments is not well described in the literature. This article details objective and subjective voice assessments for people with quadriplegia at baseline and after a respiratory-targeted singing intervention. Randomized controlled trial. Twenty-four participants with quadriplegia were randomly assigned to a 12-week program of either a singing intervention or active music therapy control. Recordings of singing and speech were made at baseline, 6 weeks, 12 weeks, and 6 months postintervention. These deidentified recordings were used to measure sound pressure levels and assess voice quality using the Multidimensional Voice Profile and the Perceptual Voice Profile. Baseline voice quality data indicated deviation from normality in the areas of breathiness, strain, and roughness. A greater percentage of intervention participants moved toward more normal voice quality in terms of jitter, shimmer, and noise-to-harmonic ratio; however, the improvements failed to achieve statistical significance. Subjective and objective assessments of voice quality indicate that quadriplegia may have a detrimental effect on voice quality; in particular, causing a perception of roughness and breathiness in the voice. The results of this study suggest that singing training may have a role in ameliorating these voice impairments. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

The relationship between corn particle size and thermoregulation of laying hens in an equatorial semi-arid environment.

PubMed

de Souza, João Batista Freire; de Morais Oliveira, Vanessa Raquel; de Arruda, Alex Martins Varela; de Melo Silva, Aurora; de Macedo Costa, Leonardo Lelis

2015-01-01

Heat stress is one of the main factors affecting egg production. One way to improve egg production is physical processing of the feed ingredients, allowing for better utilization of nutrients. In this study, the relationship between the corn particle size, measured as the geometric mean diameter (GMD), and thermoregulation was evaluated by determining the effect of the GMD on performance, egg quality, and physiological responses. Feed intake, eggshell quality (weight and thickness), rectal temperature (T R), respiratory rate (R R), and surface temperature (T S) were recorded in sixty 20-week-old naked neck laying hens that were fed corn of different particle sizes. Ambient temperature (T A) was also recorded during the trial. The GMD of corn particles was determined using a screens granulometer, resulting in sizes of 605, 1,030, and 2,280 μm. The analysis of variance (ANOVA) of a completely randomized design showed a significant effect (P < 0.05) of GMD on feed intake, shell weight, and shell thickness. The ANOVA performed by the least squares method showed a highly significant effect (P < 0.01) of GMD on T R and R R. T A, categorized into three classes (24.0-26, 26.1-28.9, and 29.0-31.0 °C), had a significant effect (P < 0.01) on T R and T S. The interaction between the GMD of corn particles and the T A classes was not statistically significant. Coarser corn particles cause an increase in the rectal temperature of naked neck hens, and these birds increase their respiratory rate to dissipate excess metabolic heat. This increase in the respiratory rate causes a decrease in the eggshell quality.

The relationship between corn particle size and thermoregulation of laying hens in an equatorial semi-arid environment

NASA Astrophysics Data System (ADS)

de Souza, João Batista Freire; de Morais Oliveira, Vanessa Raquel; de Arruda, Alex Martins Varela; de Melo Silva, Aurora; de Macedo Costa, Leonardo Lelis

2015-01-01

Heat stress is one of the main factors affecting egg production. One way to improve egg production is physical processing of the feed ingredients, allowing for better utilization of nutrients. In this study, the relationship between the corn particle size, measured as the geometric mean diameter (GMD), and thermoregulation was evaluated by determining the effect of the GMD on performance, egg quality, and physiological responses. Feed intake, eggshell quality (weight and thickness), rectal temperature ( T R), respiratory rate ( R R), and surface temperature ( T S) were recorded in sixty 20-week-old naked neck laying hens that were fed corn of different particle sizes. Ambient temperature ( T A) was also recorded during the trial. The GMD of corn particles was determined using a screens granulometer, resulting in sizes of 605, 1,030, and 2,280 μm. The analysis of variance (ANOVA) of a completely randomized design showed a significant effect ( P < 0.05) of GMD on feed intake, shell weight, and shell thickness. The ANOVA performed by the least squares method showed a highly significant effect ( P < 0.01) of GMD on T R and R R. T A, categorized into three classes (24.0-26, 26.1-28.9, and 29.0-31.0 °C), had a significant effect ( P < 0.01) on T R and T S. The interaction between the GMD of corn particles and the T A classes was not statistically significant. Coarser corn particles cause an increase in the rectal temperature of naked neck hens, and these birds increase their respiratory rate to dissipate excess metabolic heat. This increase in the respiratory rate causes a decrease in the eggshell quality.

Hard-to-cook phenomenon in chickpeas (Cicer arietinum L): effect of accelerated storage on quality.

PubMed

Reyes-Moreno, C; Okamura-Esparza, J; Armienta-Rodelo, E; Gómez-Garza, R M; Milán-Carrillo, J

2000-01-01

Storage, at high temperature (> or = 25 degrees C) and high relative humidity (> or = 65%), causes development of hard to cook (HTC) phenomenon in grain legumes. The objective of this work was to study the effect of storage simulating tropical conditions on chickpeas quality. The hardening of the Surutato 77, Mocorito 88, and Blanco Sinaloa 92 chickpea varieties was produced using adverse storage (32 +/- 1 degrees C, RH = 75%, 160 days) conditions. For all samples, the Hunter 'L' values decreased and deltaE values increased during storage, meaning a loss of color lightness and development of darkening. Accelerated storage caused a significant decrease in the water absorption capacities and cooking times of whole seeds, cotyledons and seed coats of all samples, being more pronounced in The Blanco Sinaloa 92 variety. Furthermore, storage produced significant decreases in the seed coat tannin content of the three materials; this parameter increased significantly in the cotyledon. In all samples, the levels of phytic acid decreased significantly with the seed hardness. Hardening of chickpea grains caused a decrease in the in vitro protein digestibilities of all varieties. These results suggest that both the cotyledon and seed coat play a significant role in the process of chickpea hardening. Blanco Sinaloa 92 and Mocorito 88 might be classified as varieties with high and low proneness, respectively, to the development of the HTC condition.

High pressure, temperature and time-dependent effects on enzymatic and microbial properties of fresh sugarcane juice.

PubMed

Chauhan, O P; Ravi, N; Roopa, N; Kumar, Sumeet; Raju, P S

2017-11-01

Efficacy of variable high pressure, temperature and time on the browning causing enzymes and microbial activities, which are major spoilage factors during preservation of sugarcane juice, was studied. The juice was processed at 200-600 MPa pressure for 2-8 min at 40 and 60 °C and their effect on polyphenol oxidase and peroxidase as well as microbiological quality in terms of total plate count, yeast and molds and total coliforms was studied. Application of high pressures were found to cause significant decrease in enzymatic and microbial activities. The effects were found to be significantly more pronounced at 60 °C as compared to 40 °C. Process time also caused significant ( p  < 0.05) negative effect on microbial and enzyme activities. The sugarcane juice treated at 600 MPa for 6 min at 60 °C was found sufficient to inactivate the microbial counts completely. Whereas, enzymes were found to be completely inactivated in the samples processed at 600 MPa for 8 min at 60 °C. A pressure of 600 MPa at 60 °C for 8 min could be applied during commercial preservation of sugarcane juice for getting complete inactivation of browning causing enzymes and spoilage causing microorganisms.

Evaluating the effectiveness of smoking cessation in the management of COPD.

PubMed

Temitayo Orisasami, Isimat; Ojo, Omorogieva

2016-07-28

The aim of this literature review is to assess the effectiveness of smoking cessation in managing patients with chronic obstructive pulmonary disease (COPD). COPD is the fifth leading cause of death in the world and smoking leads to COPD in more than 80% of cases. Smoking cessation aids are considered the most effective intervention to improve quality of life and prevent further deterioration in COPD. Evidence based on the use of pharmacotherapies, patient support and motivation as part of smoking cessation strategies were evaluated and discussed. The findings demonstrate that pharmacotherapies, support and counselling in smoking cessation help reduce hospital stay and hospitalisation and improve symptoms and quality of life. In addition, nurses need more education on how to use open-ended questions and motivation when giving advice on smoking cessation to patients with COPD.

Side-gate modulation effects on high-quality BN-Graphene-BN nanoribbon capacitors

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

Wang, Yang; Chen, Xiaolong; Ye, Weiguang

High-quality BN-Graphene-BN nanoribbon capacitors with double side-gates of graphene have been experimentally realized. The double side-gates can effectively modulate the electronic properties of graphene nanoribbon capacitors. By applying anti-symmetric side-gate voltages, we observed significant upward shifting and flattening of the V-shaped capacitance curve near the charge neutrality point. Symmetric side-gate voltages, however, only resulted in tilted upward shifting along the opposite direction of applied gate voltages. These modulation effects followed the behavior of graphene nanoribbons predicted theoretically for metallic side-gate modulation. The negative quantum capacitance phenomenon predicted by numerical simulations for graphene nanoribbons modulated by graphene side-gates was not observed,more » possibly due to the weakened interactions between the graphene nanoribbon and side-gate electrodes caused by the Ga{sup +} beam etching process.« less

Benefit transfer protocol for long-term health risk valuation: A case of surface water contamination

NASA Astrophysics Data System (ADS)

Kask, Susan B.; Shogren, Jason F.

1994-10-01

In response to scarce financial resources, economists have promoted the concept of benefit transfer as a cost-effective alternative to new nonmarket valuation studies. Recent discussion on benefit transfer for improved water quality has focused on recreational benefits. While useful, the discussion must now be expanded to include another key benefit from improved water quality: the reduction in risk to public health. This paper develops a protocol for benefit transfer of long-term health risk reduction and presents a case study for surface water contamination. Challenges such as the multiple sources of risk, the mortality and morbidity effects indicated by a variety of symptoms, the long latency period between cause and effect, and an individual's ability to privately or collectively reduce the probability or severity of the risk are discussed.

Effect of ambiguities on SAR picture quality

NASA Technical Reports Server (NTRS)

Korwar, V. N.; Lipes, R. G.

1978-01-01

The degradation of picture quality is studied for a high-resolution, large-swath SAR mapping system subjected to speckle, additive white Gaussian noise, and range and azimuthal ambiguities occurring because of the non-finite antenna pattern produced by a square aperture antenna. The effect of the azimuth antenna pattern was accounted for by calculating the aximuth ambiguity function. Range ambiguities were accounted for by adding appropriate pixels at a range separation corresponding to one pulse repetition period, but attenuated by the antenna pattern. A method of estimating the range defocussing effect which arises from the azimuth matched filter being a function of range is shown. The resulting simulated picture was compared with one degraded by speckle and noise but no ambiguities. It is concluded that azimuth ambiguities don't cause any noticeable degradation but range ambiguities might.

A recursive linear predictive vocoder

NASA Astrophysics Data System (ADS)

Janssen, W. A.

1983-12-01

A non-real time 10 pole recursive autocorrelation linear predictive coding vocoder was created for use in studying effects of recursive autocorrelation on speech. The vocoder is composed of two interchangeable pitch detectors, a speech analyzer, and speech synthesizer. The time between updating filter coefficients is allowed to vary from .125 msec to 20 msec. The best quality was found using .125 msec between each update. The greatest change in quality was noted when changing from 20 msec/update to 10 msec/update. Pitch period plots for the center clipping autocorrelation pitch detector and simplified inverse filtering technique are provided. Plots of speech into and out of the vocoder are given. Formant versus time three dimensional plots are shown. Effects of noise on pitch detection and formants are shown. Noise effects the voiced/unvoiced decision process causing voiced speech to be re-constructed as unvoiced.

TH-E-19A-01: Quality and Safety in Radiation Therapy

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

Ford, E; Ezzell, G; Miller, B

2014-06-15

Clinical radiotherapy data clearly demonstrate the link between the quality and safety of radiation treatments and the outcome for patients. The medical physicist plays an essential role in this process. To ensure the highest quality treatments, the medical physicist must understand and employ modern quality improvement techniques. This extends well beyond the duties traditionally associated with prescriptive QA measures. This session will review the current best practices for improving quality and safety in radiation therapy. General elements of quality management will be reviewed including: what makes a good quality management structure, the use of prospective risk analysis such as FMEA,more » and the use of incident learning. All of these practices are recommended in society-level documents and are incorporated into the new Practice Accreditation program developed by ASTRO. To be effective, however, these techniques must be practical in a resource-limited environment. This session will therefore focus on practical tools such as the newly-released radiation oncology incident learning system, RO-ILS, supported by AAPM and ASTRO. With these general constructs in mind, a case study will be presented of quality management in an SBRT service. An example FMEA risk assessment will be presented along with incident learning examples including root cause analysis. As the physicist's role as “quality officer” continues to evolve it will be essential to understand and employ the most effective techniques for quality improvement. This session will provide a concrete overview of the fundamentals in quality and safety. Learning Objectives: Recognize the essential elements of a good quality management system in radiotherapy. Understand the value of incident learning and the AAPM/ASTRO ROILS incident learning system. Appreciate failure mode and effects analysis as a risk assessment tool and its use in resource-limited environments. Understand the fundamental principles of good error proofing that extends beyond traditional prescriptive QA measures.« less

Learning from Adverse Events in Obstetrics: Is a Standardized Computer Tool an Effective Strategy for Root Cause Analysis?

PubMed

Murray-Davis, Beth; McDonald, Helen; Cross-Sudworth, Fiona; Ahmed, Rashid; Simioni, Julia; Dore, Sharon; Marrin, Michael; DeSantis, Judy; Leyland, Nicholas; Gardosi, Jason; Hutton, Eileen; McDonald, Sarah

2015-08-01

Adverse events occur in up to 10% of obstetric cases, and up to one half of these could be prevented. Case reviews and root cause analysis using a structured tool may help health care providers to learn from adverse events and to identify trends and recurring systems issues. We sought to establish the reliability of a root cause analysis computer application called Standardized Clinical Outcome Review (SCOR). We designed a mixed methods study to evaluate the effectiveness of the tool. We conducted qualitative content analysis of five charts reviewed by both the traditional obstetric quality assurance methods and the SCOR tool. We also determined inter-rater reliability by having four health care providers review the same five cases using the SCOR tool. The comparative qualitative review revealed that the traditional quality assurance case review process used inconsistent language and made serious, personalized recommendations for those involved in the case. In contrast, the SCOR review provided a consistent format for recommendations, a list of action points, and highlighted systems issues. The mean percentage agreement between the four reviewers for the five cases was 75%. The different health care providers completed data entry and assessment of the case in a similar way. Missing data from the chart and poor wording of questions were identified as issues affecting percentage agreement. The SCOR tool provides a standardized, objective, obstetric-specific tool for root cause analysis that may improve identification of risk factors and dissemination of action plans to prevent future events.

Application Research of Quality Control Technology of Asphalt Pavement based on GPS Intelligent

NASA Astrophysics Data System (ADS)

Wang, Min; Gao, Bo; Shang, Fei; Wang, Tao

2017-10-01

Due to the difficulty of steel deck pavement asphalt layer compaction caused by the effect of the flexible supporting system (orthotropic steel deck plate), it is usually hard and difficult to control for the site compactness to reach the design goal. The intelligent compaction technology is based on GPS control technology and real-time acquisition of actual compaction tracks, and then forms a cloud maps of compaction times, which guide the roller operator to do the compaction in accordance with the design requirement to ensure the deck compaction technology and compaction quality. From the actual construction situation of actual bridge and checked data, the intelligent compaction technology is significant in guaranteeing the steel deck asphalt pavement compactness and quality stability.

Effect of processing on nutritive values of milk protein.

PubMed

Borad, Sanket G; Kumar, Anuj; Singh, Ashish K

2017-11-22

Milk is an essential source of nutritionally excellent quality protein in human, particularly in vegan diet. Before consumption, milk is invariably processed depending upon final product requirement. This processing may alter the nutritive value of protein in a significant manner. The processing operations like thermal treatment, chemical treatment, biochemical processing, physical treatments, nonconventional treatments, etc. may exert positive or negative influence on nutritional quality of milk proteins. On one side, processing enhances the nutritive and therapeutic values of protein while on other side intermediate or end products generated during protein reactions may cause toxicity and/or antigenicity upon consumption at elevated level. The review discusses the changes occurring in nutritive quality of milk proteins under the influence of various processing operations.

7 CFR 1901.202 - Nondiscrimination in FmHA or its successor agency under Public Law 103-354 programs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... person or cause any person to be subjected to discrimination on the ground of race, color, or national... unequal treatment in priority, quality, quantity, methods, or charges for service, use, occupancy or... criteria or methods of administration that have the effect of subjecting a person to discrimination with...

7 CFR 1901.202 - Nondiscrimination in FmHA or its successor agency under Public Law 103-354 programs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... person or cause any person to be subjected to discrimination on the ground of race, color, or national... unequal treatment in priority, quality, quantity, methods, or charges for service, use, occupancy or... criteria or methods of administration that have the effect of subjecting a person to discrimination with...

7 CFR 1901.202 - Nondiscrimination in FmHA or its successor agency under Public Law 103-354 programs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... person or cause any person to be subjected to discrimination on the ground of race, color, or national... unequal treatment in priority, quality, quantity, methods, or charges for service, use, occupancy or... criteria or methods of administration that have the effect of subjecting a person to discrimination with...

7 CFR 1901.202 - Nondiscrimination in FmHA or its successor agency under Public Law 103-354 programs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... person or cause any person to be subjected to discrimination on the ground of race, color, or national... unequal treatment in priority, quality, quantity, methods, or charges for service, use, occupancy or... criteria or methods of administration that have the effect of subjecting a person to discrimination with...

7 CFR 1901.202 - Nondiscrimination in FmHA or its successor agency under Public Law 103-354 programs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... person or cause any person to be subjected to discrimination on the ground of race, color, or national... unequal treatment in priority, quality, quantity, methods, or charges for service, use, occupancy or... criteria or methods of administration that have the effect of subjecting a person to discrimination with...

Modulation of estrogenic exposure effects via alterations in salinity and dissolved oxygen in male fathead minnows, Pimephales promelas

USDA-ARS?s Scientific Manuscript database

Laboratory exposure data indicate that estrogens and estrogen mimics can cause endocrine disruption in male fathead minnows (Pimephales promelas). In the wild, conditions are not static as is often the case in the laboratory. Changes in water quality parameters, such as salinity influx due to road s...

78 FR 27071 - Approval and Promulgation of Air Quality Implementation Plans; Alaska: Mendenhall Valley...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... lungs and cause serious adverse health effects. People with heart or lung diseases, children and older...) submitted with the Mendenhall Valley NAA PM 10 LMP, for base year 2004 and projected year 2018, identifies... projected to remain close to that level through 2018. Fugitive dust emissions from travel on unpaved roads...

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

Akbari, H.; Davis, S.; Huang, J.

This book is a practical guide that presents the current state of knowledge on potential environmental and economic benefits of strategic landscaping and altering surface colors in our communities. The guidebook, reviews the causes, magnitude, and impacts of increased urban warming, then focuses on actions by citizens and communities that can be undertaken to improve the quality of our homes and towns in cost-effective ways.

[Medical makeup: the correction of hyperpigmentation disorders].

PubMed

Nonni, J

2012-11-01

Medical makeup corrects skin tone imperfections with dermo-cosmetic products, which bring together tolerance efficacy, colour neutralization and sun protection. Highly suitable for imperfections caused by hyperpigmentation, it allows patients affected by these disorders to cover them up effectively and discretely, giving them a better quality of life. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Chapter 7 - Climate effects on lichen indicators for nitrogen

Treesearch

Sarah Jovan

2014-01-01

The Lichen Communities Indicator is a sensitive indicator of forest health changes caused by air quality, climate change, and other stressors. To date, more than 8,000 epiphytic lichen surveys have been collected across the Nation by the Forest Inventory Analysis (FIA) and Forest Health Monitoring (FHM) Programs and their partners (table 7.1; Phelan and others 2012)....

Swine manure application effects on ammonia volatilization, forage quality, and yield in the Pre-Amazon Region of Brazil

USDA-ARS?s Scientific Manuscript database

The use of swine manure as a nutrient source for pastures is increasingly common in Brazil, due to its low cost. However, this practice can cause nitrogen (N) losses in agricultural soil, where ammonia volatilization may be the main drawback, generating undesirable economic and environmental consequ...

Comparison of matrix effects on phytate analysis in Mehlich-3 and Alkaline-EDTA extracts by ICP, NMR, Chromatography and (HRAM) Mass Spectrometry.

USDA-ARS?s Scientific Manuscript database

Phosphorus (P) is a leading cause of water quality degradation in impaired fresh water systems. Although substantial progress has been made in understanding the fate and transport of P from nonpoint agricultural sources based on measures of total P and orthophosphate-P, a comprehensive understanding...

Evaluation of soybean breeding lines for resistance to phomopsis seed decay in stoneville mississippi 2014

USDA-ARS?s Scientific Manuscript database

Phomopsis seed decay (PSD) of soybean is a major cause of poor seed quality in most soybean production areas, especially in the mid-southern region of the United States. Breeding for PSD-resistance is the most effective long-term strategy to control this disease. To breed soybean lines with resistan...

75 FR 958 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; 2002 Base Year Emission...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-07

... standard would be more protective of human health, especially children and adults who are active outdoors... 1997, EPA revised the health-based NAAQS for ozone, setting it at 0.08 parts per million (ppm) averaged... that ozone causes adverse health effects at lower ozone concentrations and over longer periods of time...

77 FR 50966 - Approval and Promulgation of Air Quality Implementation Plans; Maryland; Attainment Demonstration...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... moderate 8-hour ozone nonattainment area? In 1997, EPA revised the health-based NAAQS for ozone, setting it... standard based on scientific evidence demonstrating that ozone causes adverse health effects at lower ozone... was set. EPA determined that the 1997 8-hour standard would be more protective of human health...

78 FR 17161 - Approval and Promulgation of Air Quality Implementation Plans; District of Columbia, Maryland and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-20

... 1997 ozone NAAQS which revised the health-based NAAQS for ozone by setting the NAAQS at 0.08 parts per... evidence demonstrating that ozone causes adverse health effects at lower ozone concentrations and over... determined that the 1997 ozone NAAQS would be more protective of human health, especially for children and...

Effects of fire severity on nitrate mobilization in watersheds subject to chronic atmospheric deposition

Treesearch

P.J. Riggan; R.N. Lockwood; P.M. Jacks; C.G. Colver; F. Weirich; L.F. DeBano; J.A. Brass

1994-01-01

Severe fires in chaparral watersheds subject to air pollution from metropolitan Los Angeles mobilized accumulated nitrogen and caused streamwater to be polluted with nitrate at concentrations exceeding the Federal Water Quality Standard. Streamwater NO3- concentrations were elevated during peak flows, the largest of which was a debris flow that...

Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: Synopsis of the 2013 ACC/AHA cholesterol guideline

USDA-ARS?s Scientific Manuscript database

Atherosclerotic cardiovascular disease (ASCVD) is the leading U.S. cause of death, lost quality of life and medical costs. Nearly one in three Americans die from heart disease and stroke. Most ASCVD is preventable through a healthy lifestyle and effective treatment of cholesterol and blood pressure...

Trends in Private Higher Education in Asia

ERIC Educational Resources Information Center

Tilak, Jandhyala B. G.

2009-01-01

There has been rapid growth in private higher education in most countries, including in Asia, during the last two-three decades. This growth, mostly motivated by profit, has had an effect on education and development in general and caused loss of equity--both social and economic, an increase in regional disparities, an erosion in quality, a change…

Predicting the impacts of new technology aircraft on international air transportation demand

NASA Technical Reports Server (NTRS)

Ausrotas, R. A.

1981-01-01

International air transportation to and from the United States was analyzed. Long term and short term effects and causes of travel are described. The applicability of econometric methods to forecast passenger travel is discussed. A nomograph is developed which shows the interaction of economic growth, airline yields, and quality of service in producing international traffic.

High cortisol levels are associated with low quality food choice in type 2 diabetes.

PubMed

Duong, Michelle; Cohen, Jessica I; Convit, Antonio

2012-02-01

Hypothalamic-pituitary-adrenal (HPA) axis control may be impaired in type 2 diabetes (T2DM). Glucocorticoids increase consumption of low quality foods high in calories, sugar, and fat. We explored the relationship between cortisol levels, poor blood glucose control, and food quality choice in T2DM. Twenty-seven healthy controls were age-, gender- and education-matched to 27 T2DM participants. Standard clinical blood tests and cortisol values were measured from fasting blood samples. Participants recorded all consumed food and drink items in a consecutive 3-day food diary. Diaries were analyzed for "high quality" and "low quality" foods using a standardized method with high reliability (0.97 and 0.86, respectively). Controlling for education, body mass index (BMI) and hemoglobin A1C (HbA1C), log-transformed cortisol (LogC) predicted the percent of low quality foods (R (2) = 0.092, β = 0.360, P < 0.05), but not the percent of high quality foods chosen. Controlling for education, BMI, and LogC, HbA1C significantly predicted both the percent of low quality foods (ΔR (2) = 0.079, β = 0.348, P = 0.024) and high quality foods chosen (ΔR (2) = 0.085, β = -0.362, P = 0.022). The relationship between HbA1C and low quality food choice may be mediated by cortisol, controlling for BMI and education (P < 0.01). HbA1C displayed both an indirect (cortisol-mediated) effect (P < 0.05) and direct effect on low quality food choice (P < 0.05). The relationship between HbA1C and low quality food choice may be partially mediated by cortisol. Poor blood glucose control may cause HPA axis disruption, increased consumption of low quality foods.

40 CFR 264.93 - Hazardous constituents.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the ground-water quality; (vii) The potential for health risks caused by human exposure to waste... quality; (viii) The potential for health risks caused by human exposure to waste constituents; (ix) The... 264.93 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED...

An agent-based simulation model to study accountable care organizations.

PubMed

Liu, Pai; Wu, Shinyi

2016-03-01

Creating accountable care organizations (ACOs) has been widely discussed as a strategy to control rapidly rising healthcare costs and improve quality of care; however, building an effective ACO is a complex process involving multiple stakeholders (payers, providers, patients) with their own interests. Also, implementation of an ACO is costly in terms of time and money. Immature design could cause safety hazards. Therefore, there is a need for analytical model-based decision-support tools that can predict the outcomes of different strategies to facilitate ACO design and implementation. In this study, an agent-based simulation model was developed to study ACOs that considers payers, healthcare providers, and patients as agents under the shared saving payment model of care for congestive heart failure (CHF), one of the most expensive causes of sometimes preventable hospitalizations. The agent-based simulation model has identified the critical determinants for the payment model design that can motivate provider behavior changes to achieve maximum financial and quality outcomes of an ACO. The results show nonlinear provider behavior change patterns corresponding to changes in payment model designs. The outcomes vary by providers with different quality or financial priorities, and are most sensitive to the cost-effectiveness of CHF interventions that an ACO implements. This study demonstrates an increasingly important method to construct a healthcare system analytics model that can help inform health policy and healthcare management decisions. The study also points out that the likely success of an ACO is interdependent with payment model design, provider characteristics, and cost and effectiveness of healthcare interventions.

Application of gamma radiation for the reduction of norovirus and the quality stability in optimally ripened cabbage kimchi.

PubMed

Park, Shin Young; Ha, Sang-Do

2017-10-01

Optimally ripened commercial cabbage kimchi is considered the main cause of enteric norovirus (NoV) outbreaks in Korea. This study investigated the effect of 1-10kGy gamma radiation on the inactivation of murine norovirus-1 (MNV-1; initial inoculum of 5-6log 10 PFU/ml), used as a human NoV surrogate, in kimchi. The effects of gamma radiation on the pH and acidity were also examined to address the index of quality and fermentation, respectively. Titers of MNV-1 significantly reduced (p<0.05) in kimchi subjected to increasing gamma radiation doses: MNV-1 titers in kimchi after 1, 3, 5, 7, and 10kGy were 4.82 (0.34-log 10 reduction), 4.45 (0.71-log 10 reduction), 4.18 (0.98-log 10 reduction), 3.71 (1.45-log 10 reduction), and 3.40 (1.76-log 10 reduction) log 10 PFU/ml, respectively. However, the values of pH (4.5-4.6) and acidity (0.6-0.7%) were not significantly different between non-irradiated and irradiated kimchi (p>0.05). The D-value (1-log reduction) for MNV-1 in kimchi, calculated using first-order kinetics, was 5.75kGy (R 2 =0.98, RMSE=0.10). Therefore, this study suggests that the use of ≥5.75kGy gamma radiation in the kimchi manufacturing industry could be very effective in reducing NoV contamination by >90% (1 log), without causing changes in quality and fermentation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Water quality limits for Atlantic salmon (Salmo salar L.) exposed to short term reductions in pH and increased aluminum simulating episodes

NASA Astrophysics Data System (ADS)

Kroglund, F.; Rosseland, B. O.; Teien, H.-C.; Salbu, B.; Kristensen, T.; Finstad, B.

2007-09-01

Acidification has caused the loss or reduction of numerous Atlantic salmon (Salmo salar L.) populations on both sides of the North Atlantic. Acid deposition peaked in the 1980's and resulted in both chronically and episodically acidified rivers. At present, water quality is improving in all affected rivers due to reduced acid deposition. However, spring snow melt, heavy rainfall and sea salt episodes can still cause short term drops in pH and elevated concentrations of bioavailable aluminum. Technical malfunction in lime dozers will cause short termed episodic spates in the limed rivers. The current situation has prompted a need for dose-response relationships based on short term exposures of Atlantic salmon to assess the potential population effects of episodic acidification. Water quality guidelines for salmon have been lacking, despite a large number of experiments, all demonstrating dose-response relationships between water chemistry and fish health. We have summarized results from 347 short-term (<14 days) exposures of salmon parr and smolt performed between 1990 and 2003 in Norway. The experiments have been performed as bioassays, where fish have been exposed in tanks fed river water, in tanks where the river water quality has been manipulated (added H+ and Al) and as Carlin-tagged smolt releases after preexposure to moderately acidic waters. The results from the various bioassays are compared to water quality limits proposed on basis of the relationship between water quality and population status/health in Norwegian rivers. The focus of this article is placed on chemical-biological interactions that can be drawn across experiments and exposure protocols. We propose dose-response relationships for acid neutralizing capacity (ANC), pH, cationic Al and gill accumulated Al, versus mortality in freshwater, effects on hypo-osmoregulatory capacity in seawater challenge tests and on smolt to adult survival in release experiments. The "no effect" dose depends on the life history stage tested and on the sensitivity of the biomarkers. Parr are more tolerant than smolt. Concentrations of Al that have no significant impact on freshwater life history stages can still have major population effects if they occur prior to smolt migration. While smolt can survive in freshwater for a prolonged period of time (>10 days) at an Al dose resulting in a gill Al concentration of up to 300 μg Alg-1 dw, a 3 day exposure resulting in a gill Al accumulation in the range of 25 to 60 μg Alg-1 dw reduces smolt to adult survival in a dose related manner by 20 to 50%. For smolt to adult survival, the biological significant response is delayed relative to the dose and occurs first after the fish enters the marine environment. In addition to exposure intensity and timing, exposure duration is important for the setting of critical limits.

Water quality limits for Atlantic salmon (Salmo salar L.) exposed to short term reductions in pH and increased aluminum simulating episodes

NASA Astrophysics Data System (ADS)

Kroglund, F.; Rosseland, B. O.; Teien, H.-C.; Salbu, B.; Kristensen, T.; Finstad, B.

2008-03-01

Acidification has caused the loss or reduction of numerous Atlantic salmon (Salmo salar L.) populations on both sides of the North Atlantic. Acid deposition peaked in the 1980's and resulted in both chronically and episodically acidified rivers. At present, water quality is improving in all affected rivers due to reduced acid deposition. However, spring snow melt, heavy rainfall and sea salt episodes can still cause short term drops in pH and elevated concentrations of bioavailable aluminum. Technical malfunction in lime dozers will cause short termed episodic spates in the limed rivers. The current situation has prompted a need for dose-response relationships based on short term exposures of Atlantic salmon to assess the potential population effects of episodic acidification. Water quality guidelines for salmon have been lacking, despite a large number of experiments, all demonstrating dose-response relationships between water chemistry and fish health. We have summarized results from 347 short-term (<14 days) exposures of salmon parr and smolt performed between 1990 and 2003 in Norway. The experiments have been performed as bioassays, where fish have been exposed in tanks fed river water, in tanks where the river water quality has been manipulated (added H+ and Al) and as Carlin-tagged smolt releases after preexposure to moderately acidic waters. The results from the various bioassays are compared to water quality limits proposed on basis of the relationship between water quality and population status/health in Norwegian rivers. The focus of this article is placed on chemical-biological interactions that can be drawn across experiments and exposure protocols. We propose dose-response relationships for acid neutralizing capacity (ANC), pH, cationic Al and gill accumulated Al, versus mortality in freshwater, effects on hypo-osmoregulatory capacity in seawater challenge tests and on smolt to adult survival in release experiments. The "no effect" dose depends on the life history stage tested and on the sensitivity of the biomarkers. Parr are more tolerant than smolt. Concentrations of Al that have no significant impact on freshwater life history stages can still have major population effects if they occur prior to smolt migration. While smolt can survive in freshwater for a prolonged period of time (>10 days) at an Al dose resulting in a gill Al concentration of up to 300 µg Alg-1 dw, a 3 day exposure resulting in a gill Al accumulation in the range of 25 to 60 µg Alg-1 dw reduces smolt to adult survival in a dose related manner by 20 to 50%. For smolt to adult survival, the biological significant response is delayed relative to the dose and occurs first after the fish enters the marine environment. In addition to exposure intensity and timing, exposure duration is important for the setting of critical limits.

Health related quality of life for stone formers.

PubMed

Bryant, Michael; Angell, Jordan; Tu, Huakang; Goodman, Michael; Pattaras, John; Ogan, Kenneth

2012-08-01

Urolithiasis is a common urological condition that causes significant pain and suffering. Until recently few studies had been done to examine how quality of life is affected in stone formers. We hypothesized that patients with multiple recurrent episodes of urolithiasis have worse health related quality of life. Thus, we identified specific factors that impact health related quality of life in patients with urolithiasis. In an institutional review board approved study we recruited 386 patients through mailings and through the outpatient clinic who were evaluated at our institution for urolithiasis in the last 5 years. Each patient was asked to answer questionnaires on stone disease, including SF-36®, a validated 36-item health care quality of life survey. Of the 386 patients recruited for study 115 responded to our inquiry. Variables such as surgical complications, time from last stone episode, number of emergency room visits and number of surgeries correlated with the SF-36 domains. Urolithiasis is associated with severe physical and psychological effects that lead to clinically significant impairment in quality of life. Our findings confirm and expand the findings of previous groups showing the many ways in which stone formation can affect patient quality of life. Appreciation of these effects in the acute and chronic treatment settings may change the way that the disease is approached. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Effectiveness of Positive Thinking Training Program on Nurses' Quality of Work Life through Smartphone Applications

PubMed Central

Dehghan, Azizallah

2017-01-01

Aim Job stress is a part of nurses' professional life that causes the decrease of the nurses' job satisfaction and quality of work life. This study aimed to determine the effect of positive thinking via social media applications on the nurses' quality of work life. Methods This was a pretest-posttest quasi-experimental study design with a control group. The samples were selected among the nurses in two hospitals in Fasa University of Medical Sciences and divided randomly into two interventional (n = 50) and control (n = 50) groups. Positive thinking training through telegrams was sent to the intervention group during a period of 3 months. Data were collected by using Brooks and Anderson's questionnaire of work life quality and analyzed by SPSS 18. Results The mean total scores of pretest and posttest in the intervention group improved noticeably and there were significant differences between mean scores of quality of work life in pretest and posttest scores in interventional groups (p < 0.001) and in dimensions of work life quality, home life (p < 0.001), work design (p < 0.001), work context (p < 0.001), and work world (p = 0.003). Conclusion This study concluded that positive thinking training via social media application enhanced nurses' quality of work life. This study is necessary to carry out on a larger sample size for generalizing findings better. PMID:28589174

Effectiveness of Positive Thinking Training Program on Nurses' Quality of Work Life through Smartphone Applications.

PubMed

Motamed-Jahromi, Mohadeseh; Fereidouni, Zhila; Dehghan, Azizallah

2017-01-01

Job stress is a part of nurses' professional life that causes the decrease of the nurses' job satisfaction and quality of work life. This study aimed to determine the effect of positive thinking via social media applications on the nurses' quality of work life. This was a pretest-posttest quasi-experimental study design with a control group. The samples were selected among the nurses in two hospitals in Fasa University of Medical Sciences and divided randomly into two interventional ( n = 50) and control ( n = 50) groups. Positive thinking training through telegrams was sent to the intervention group during a period of 3 months. Data were collected by using Brooks and Anderson's questionnaire of work life quality and analyzed by SPSS 18. The mean total scores of pretest and posttest in the intervention group improved noticeably and there were significant differences between mean scores of quality of work life in pretest and posttest scores in interventional groups ( p < 0.001) and in dimensions of work life quality, home life ( p < 0.001), work design ( p < 0.001), work context ( p < 0.001), and work world ( p = 0.003). This study concluded that positive thinking training via social media application enhanced nurses' quality of work life. This study is necessary to carry out on a larger sample size for generalizing findings better.

Bidirectional relationship between sleep and optimism with depressive mood as a mediator: A longitudinal study of Chinese working adults.

PubMed

Lau, Esther Yuet Ying; Harry Hui, C; Cheung, Shu-Fai; Lam, Jasmine

2015-11-01

Sleep and optimism are important psycho-biological and personality constructs, respectively. However, very little work has examined the causal relationship between them, and none has examined the potential mechanisms operating in the relationship. This study aimed to understand whether sleep quality was a cause or an effect of optimism, and whether depressive mood could explain the relationship. Internet survey data were collected from 987 Chinese working adults (63.4% female, 92.4% full-time workers, 27.0% married, 90.2% Hong Kong residents, mean age=32.59 at three time-points, spanning about 19 months). Measures included a Chinese attributional style questionnaire, the Pittsburgh Sleep Quality Index, and the Depression Anxiety Stress Scale. Cross-sectional analyses revealed moderate correlations among sleep quality, depressive mood, and optimism. Cross-lagged analyses showed a bidirectional causality between optimism and sleep. Path analysis demonstrated that depressive mood fully mediated the influence of optimism on sleep quality, and it partially mediated the influence of sleep quality on optimism. Optimism improves sleep. Poor sleep makes a pessimist. The effects of sleep quality on optimism could not be fully explained by depressive mood, highlighting the unique role of sleep on optimism. Understanding the mechanisms of the feedback loop of sleep quality, mood, and optimism may provide insights for clinical interventions for individuals presented with mood-related problems. Copyright © 2015 Elsevier Inc. All rights reserved.

Endourologic management of malignant ureteral obstruction: indications, results, and quality-of-life issues.

PubMed

Sountoulides, Petros; Pardalidis, Nikolaos; Sofikitis, Nikolaos

2010-01-01

Obstruction of the upper urinary tract is a problem commonly faced by practicing urologists. The constant evolution in endourology has effectively facilitated minimally invasive management of upper-tract obstruction. In a case in which malignancy is the cause of obstruction, however, the situation significantly changes. Questions arise regarding the need for relieving the obstruction, the means to accomplish this, and the benefits and drawbacks of each technique regarding both their efficacy and their impact on the patients well-being and the crucial issue of quality of life in the face of malignancy.

Statistical process control: a practical application for hospitals.

PubMed

VanderVeen, L M

1992-01-01

A six-step plan based on using statistics was designed to improve quality in the central processing and distribution department of a 223-bed hospital in Oakland, CA. This article describes how the plan was implemented sequentially, starting with the crucial first step of obtaining administrative support. The QI project succeeded in overcoming beginners' fear of statistics and in training both managers and staff to use inspection checklists, Pareto charts, cause-and-effect diagrams, and control charts. The best outcome of the program was the increased commitment to quality improvement by the members of the department.

The effect of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills rate of nurses in hospitals of tabriz, iran.

PubMed

Khodadadi, Esmail; Ebrahimi, Hossein; Moghaddasian, Sima; Babapour, Jalil

2013-03-01

Having an effective relationship with the patient in the process of treatment is essential. Nurses must have communication skills in order to establish effective relationships with the patients. This study evaluated the impact of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills of nurses. This is an experimental study with a control group that has been done in 2012. The study sample consisted of 73 nurses who work in hospitals of Tabriz; they were selected by proportional randomizing method. The intervention was only conducted on the experimental group. In order to measure the quality of care 160 patients, who had received care by nurses, participated in this study. The Data were analyzed by SPSS (ver.13). Comparing the mean scores of communication skills showed a statistically significant difference between control and experimental groups after intervention. The paired t-test showed a statistically significant difference in the experimental group before and after the intervention. Independent t-test showed a statistically significant difference between the rate of quality of care in patients of control and experimental groups after the intervention. The results showed that the training of communication skills can increase the nurse's rate of communication skills and cause elevation in quality of nursing care. Therefore, in order to improve the quality of nursing care it is recommended that communication skills be established and taught as a separate course in nursing education.

Premenstrual Syndrome in Turkish college students and its effects on life quality.

PubMed

Pinar, Gul; Colak, Meric; Oksuz, Ergun

2011-01-01

The purpose of this research is to analyze the frequency of Premenstrual Syndrome (PMS) in college students, the factors affecting Premenstrual Syndrome and the effect of Premenstrual Syndrome on life quality. The research was performed on 316 students who study at Medical Sciences Faculty of Başkent University and accepted to take part in the research. The data of the research was compiled by using "Questionnaire Form", "PMS Rating Scale" and "Life Quality Scale" developed by the researchers. In the analysis of the data; Percentage distribution, Chi-square test, One Way Anova test, Logistic regression, Multi nominal regression analysis were used. PMS was detected in 72.1% of the students. The most frequent symptoms are mainly low back pain, stress-discomfort, nervous-anger, distention and breast tenderness. PMS was found significantly high in those students who have menstrual irregularity, who have dysmenorrhea, who consume 2 cups of coffee or above per day and who smoke and drink alcohol (p<0.05). When the relation of PMS with life quality was evaluated, it was determined that the life quality decreases as PMS score average increases (p<0.05). PMS rate is high in college students and this adversely affects the life quality. It was revealed that the preventive, instructive and consultancy roles of the medical staff became more of an issue in reducing the effect of the factors causing and/or aggravating these symptoms in order to decrease PMS incidence and to improve the life quality of the students. Copyright © 2010. Published by Elsevier B.V.

Comparison of the Effects of Vaginal Royal Jelly and Vaginal Estrogen on Quality of Life, Sexual and Urinary Function in Postmenopausal Women.

PubMed

Seyyedi, Fatemeh; Rafiean-Kopaei, Mahmoud; Miraj, Sepideh

2016-05-01

Several causes can disturb the quality of life in postmenopausal women. Stress, urinary incontinence is one of the factors that can influence the quality of life of women, since they evade social activities and limit their behavior. Vulvovaginal disorders adversely impacts sexual action, psychosocial health, and partner relationships. The aim of this study was to examine the therapeutic properties of vaginal cream of royal jelly and estrogen on quality of life, sexual and urinary problems in postmenopausal women. This study was a randomized controlled clinical trial that was done on 90 married postmenopausal women 50 to 65-year-old. A total of 90 women were randomly distributed to three groups and were treated with vaginal cream of royal jelly 15%, lubricant, and conjugated estrogens for three months. Before and after intervention, quality of life and vaginal cytology were evaluated. Data was analysed by SPSS 16 using ANOVA and Tukey tests. The results expressed that vaginal royal jelly is considerably more effective than conjugated estrogens and lubricant in the improvement of quality of life, sexual and urinary function in postmenopausal women (p<0.05). Results of Pap smear showed that improvement of vaginal atrophy in conjugated estrogens group was better than other groups (p<0.001), and there was no significant difference between lubricant and royal jelly groups (p=0.89). The effectiveness of vaginal royal jelly in treatment of sexual and urinary problems of postmenopausal women is related to its estrogenic properties and could be suitable in promotion of life quality in postmenopausal women.

Voluntary Compliance, Pollution Levels, and Infant Mortality in Mexico.

PubMed

Foster, Andrew; Gutierrez, Emilio; Kumar, Naresh

2009-05-01

The increasing body of evidence from high income countries linking pollution to health outcomes (Ken Chay and Michael Greenstone 2003; Janet Currie and Matthew Neidell 2004), has raised concerns about the health impact of adverse air quality in developing countries, where, in general, environmental regulation is less stringent and health monitoring and treatment are less accessible. These concerns have, in turn, encouraged consideration of the effectiveness of alternative mechanisms for improving air quality while limiting the adverse impact on economic growth. However, the analysis of both the effects of pollution on health and the effectiveness of pollution abatement policies faces particular empirical challenges in low- and middle-income contexts, given the scarcity of reliable measures of pollution concentrations. The primary source of good quality data on air quality, ground monitoring, tends to be limited to larger metropolitan areas with monitors placed at sentinel sites that may or may not yield a representative picture of population exposure. This paper calls attention to, and makes use of, newly available procedures for extracting measures of air quality from satellite imagery. In particular, satellite-based measures of aerosol optical depth (AOD) are used to obtain estimates of air quality for the whole Mexican territory at a detailed geographic scale, and these estimates are related to measures of participation in a voluntary certification program at the level of the county. The resulting estimates are then combined with estimates of the relationship between participation in the certification program and infant mortality due to respiratory causes to obtain a rough estimate of the relationship between air quality and infant health in Mexico.

Effect of self-care education on the quality of life in patients with breast cancer

PubMed Central

Shahsavari, Hooman; Matory, Pegah; Zare, Zahra; Taleghani, Fariba; Kaji, Mohammad Akbari

2015-01-01

Context: Breast cancer is the most common cancer among Iranian women. Although survival rate of breast cancer patients has been increased some distresses affect the patients’ quality of life negatively. the effectiveness of self-care education, particularly in the sociocultural context of Iran, has not been adequately investigated. Aims: This study aims at evaluating the effectiveness of nurse-led self-care education program on quality of life in this patients. Settings and Design: A controlled trial as pretest and posttest design was conducted in Sayyed-Al-Shohada Hospital in Isfahan in 2012. Materials and Methods: Sixty patients with breast cancer were assigned to either the nurse-led self-care education program (n = 30), or to routine care (n = 30). Quality of life was measured at the time of recruitment and also 3 months after the intervention by the instrument of the National Medical Center and Beckman Research Institute. Statistical Analysis Used: Data were analyzed by SPSS (version 16) software using T-independent, T-paired and χ2, and Fisher's exact tests. Results: The intervention group had significantly greater improvements in quality of life status (P < 0.05). Furthermore, self-care education caused a significant increase in the quality of life score related to physical (P = 0.00), psychological (P = 0.00), social (P = 0.00), and emotional (P = 0.00) dimensions. Conclusions: Quality of life in patients with breast cancer can be improved by participating in a nurse-led self-care education program. It is suggested that self-care education to be added to the routine nursing care delivered to these patients. PMID:27462612

Little Evidence That Time in Child Care Causes Externalizing Problems During Early Childhood in Norway

PubMed Central

Zachrisson, Henrik Daae; Dearing, Eric; Lekhal, Ratib; Toppelberg, Claudio O.

2012-01-01

Associations between maternal reports of hours in child care and children’s externalizing problems at 18 and 36 months of age were examined in a population-based Norwegian sample (n = 75,271). Within a sociopolitical context of homogenously high-quality child care, there was little evidence that high quantity of care causes externalizing problems. Using conventional approaches to handling selection bias and listwise deletion for substantial attrition in this sample, more hours in care predicted higher problem levels, yet with small effect sizes. The finding, however, was not robust to using multiple imputation for missing values. Moreover, when sibling and individual fixed-effects models for handling selection bias were used, no relation between hours and problems was evident. PMID:23311645

Water quality of Cisadane River based on watershed segmentation

NASA Astrophysics Data System (ADS)

Effendi, Hefni; Ayu Permatasari, Prita; Muslimah, Sri; Mursalin

2018-05-01

The growth of population and industrialization combined with land development along river cause water pollution and environmental deterioration. Cisadane River is one of the river in Indonesia where urbanization, industrialization, and agricultural are extremely main sources of pollution. Cisadane River is an interesting case for investigating the effect of land use to water quality and comparing water quality in every river segment. The main objectives with this study were to examine if there is a correlation between land use and water quality in Cisadane River and there is a difference in water quality between the upstream section of Cisadane River compared with its downstream section. This study compared water quality with land use condition in each segment of river. Land use classification showed that river segment that has more undeveloped area has better water quality compared to river segment with developed area. in general, BOD and COD values have increased from upstream to downstream. However, BOD and COD values do not show a steady increase in each segment Water quality is closely related to the surrounding land use.Therefore, it can not be concluded that the water quality downstream is worse than in the upstream area.

Physical activity and quality of life of amputees in southern Brazil.

PubMed

da Silva, Rudney; Rizzo, Julia Ghazel; Gutierres Filho, Paulo José Barbosa; Ramos, Valmor; Deans, Sarah

2011-12-01

Physical activity is a positive component of human health. Its effects are associated with improvement in physical, psychological and social aspects of quality of life. Physical activity is therefore an important factor in the rehabilitation of amputees. To analyse the relationship between physical activity and quality of life for amputees in southern Brazil. Descriptive, cross-sectional design with nonrandomized sample. A total of 40 questionnaire instruments were distributed to subjects who met the inclusion criteria, with a response rate of 55% (22 individuals, n = 15 males, n = 7 females). Outcome measurements were obtained through the International Physical Activity Questionnaire and World Health Organization Quality of Life-Bref. The sample was characterized by physically active adult male prosthetic users with positive quality of life, and amputation below the right knee caused by mechanical trauma related to traffic accidents with motorcycles. Significant correlations were identified between all domains of quality of life and between level of physical activity and psychological quality of life. No correlation was identified between gender and quality of life variables or physical activity levels. This study showed that in very active amputees of both genders, level of physical activity is not associated with quality of life except for the psychological domain.

Synergistic effects of Mo and F doping on the quality factor of ZnO thin films prepared by a fully automated home-made nebulizer spray technique

NASA Astrophysics Data System (ADS)

Ravichandran, K.; Dineshbabu, N.; Arun, T.; Manivasaham, A.; Sindhuja, E.

2017-01-01

Transparent conducting oxide films of undoped, Mo doped, Mo + F co-doped ZnO were deposited using a facile homemade nebulizer spray pyrolysis technique. The effects of Mo and F doping on the structural, optical, electrical and surface morphological properties were investigated using XRD, UV-vis-NIR spectroscopy, I-V and Hall probe techniques, FESEM and AFM, and XPS, respectively. The XRD analysis confirms that all the films are well crystallized with hexagonal wurtzite structure. All the synthesized samples exhibit high transmittance (above 85%) in the visible region. The current-voltage (I-V) characteristics show the ohmic conduction nature of the films. The Hall probe measurements show that the synergistic effects of Mo and F doping cause desirable improvements in the quality factor of the ZnO films. A minimum resistivity of 5.12 × 10-3 Ω cm with remarkably higher values of mobility and carrier concentration is achieved for Mo (2 at.%) + F (15 at.%) co-doped ZnO films. A considerable variation in the intensity of deep level emission caused by Mo and F doping is observed in the photoluminescence (PL) studies. The presence of the constituent elements in the samples is confirmed by XPS analysis.

Community-wide assessment of pollen limitation in hummingbird-pollinated plants of a tropical montane rain forest

PubMed Central

Wolowski, Marina; Ashman, Tia-Lynn; Freitas, Leandro

2013-01-01

Background and Aims Although pollen limitation of reproduction (PL) has been widely studied, our understanding of its occurrence in tropical communities, especially for bird-pollinated plants, is underdeveloped. In addition, inclusion of both quantity and quality aspects in studies of PL are generally lacking. Within hummingbird-pollinated plants, a prediction was made for higher PL for the quality than quantity aspects and a minor effect of temporal variation because hummingbirds are constant and efficient pollen vectors but they may transfer low quality pollen. Methods Field hand and open pollination experiments were conducted on 21 species in a tropical montane rain forest over 2 years. The quantity (fruit set and seeds per fruit) and quality (seed weight and germination) aspects of reproduction were assessed as the response to open pollination relative to outcross hand pollination. The relationships between the effect size of quantity and quality aspects of reproduction and predictive plant features (self-incompatibility, autogamy, density and pollinator specialization level) were assessed with phylogenetic generalized linear models. Key Results Just over half of all the species expressed PL for one or more response variables. On average, the severity of PL was strong for one quality variable (seed germination; 0·83), but insignificant for another (seed weight; –0·03), and low to moderate for quantity variables (0·31 for seeds per fruit and 0·39 for fruit set). There was only a minor contribution of temporal variation to PL within the studied species. Common predictors of PL, i.e. phylogenetic relatedness, self-incompatibility, autogamy, plant density and pollinator specialization level, did not adequately explain variation in PL within this community. Conclusions Despite the measurable degree of PL within these hummingbird-pollinated plants, the causes of pollen quality and quantity insufficiency are not clear. Variables other than those tested may contribute to PL or causes of PL may vary among species and cannot adequately be accounted for when assessed from the within-community perspective. PMID:23845434

Using antibrowning agents to enhance quality and safety of fresh-cut avocado treated with intense light pulses.

PubMed

Ramos-Villarroel, Ana Y; Martín-Belloso, Olga; Soliva-Fortuny, Robert

2011-01-01

The effect of antibrowning compounds on the color and firmness of fresh-cut avocado treated with intense light pulses (ILP), as well as their impact on the survival of Listeria innocua, was investigated in this study. Dipping solutions containing 2% (w/v) L-cysteine without ascorbic acid and combined with 1% (w/v) citric acid and 1% w/v calcium lactate most effectively preserved the initial color and texture of ILP-treated fresh-cut avocado. On the other hand, ILP treatments caused a reduction of more than 3 log cycles in the populations of L. innocua inoculated on fresh-cut avocado. Log reduction levels increased when antibrowning agents were combined with ILP treatments. In conclusion, the use of quality-stabilizing agents is a good option to guarantee both the microbiological safety of fresh-cut avocado treated with ILP as well as to improve its physical and chemical quality. Intense light pulses (ILP) have received considerable attention during the last years after its approval by the U.S. Food and Drug Administration (FDA) in 1996 as a decontamination method for food or food surfaces. This article presents relevant information regarding the effect of ILP treatments combined with quality-stabilizing compounds as a feasible alternative to improve the physical and chemical quality of fresh-cut avocado as well as to guarantee its microbiological safety. © 2011 Institute of Food Technologists®

Hospital catering systems and their impact on the sensorial profile of foods provided to older patients in the UK.

PubMed

Mavrommatis, Yiannis; Moynihan, Paula J; Gosney, Margot A; Methven, Lisa

2011-08-01

Impaired sensorial perception is very common in older people and low sensorial quality of foods is associated with decreased appetite and dietary intake. Hospital undernutrition in older patients could be linked to sensorial quality of hospital food if the quality were low or inappropriate for older people. The aim of this study was to examine changes in the sensorial quality of different foods that occur as a result of the food journey (i.e. freezing, regeneration, etc.) in the most common hospital catering systems in the UK. A trained sensory panel assessed sensorial descriptors of certain foods with and without the hospital food journey as it occurs in the in-house and cook/freeze systems. The results showed effects of the food journey on a small number of sensorial descriptors related to flavour, appearance and mouthfeel. The majority of these effects were due to temperature changes, which caused accumulation of condensation. A daily variation in sensorial descriptors was also detected and in some cases it was greater than the effect of the food journey. This study has shown that changes occur in the sensory quality of meals due to hospital food journeys, however these changes were small and are not expected to substantially contribute to acceptability or have a major role in hospital malnutrition. Copyright © 2011 Elsevier Ltd. All rights reserved.

Visual acuity and quality of life in dry eye disease: Proceedings of the OCEAN group meeting.

PubMed

Benítez-Del-Castillo, José; Labetoulle, Marc; Baudouin, Christophe; Rolando, Maurizio; Akova, Yonca A; Aragona, Pasquale; Geerling, Gerd; Merayo-Lloves, Jesús; Messmer, Elisabeth M; Boboridis, Kostas

2017-04-01

Dry eye disease (DED) results in tear film instability and hyperosmolarity, inflammation of the ocular surface and, ultimately, visual disturbance that can significantly impact a patient's quality of life. The effects on visual acuity result in difficulties with driving, reading and computer use and negatively impact psychological health. These effects also extend to the workplace, with a loss of productivity and quality of work causing substantial economic losses. The effects of DED and the impact on vision experienced by patients may not be given sufficient importance by ophthalmologists. Functional visual acuity (FVA) is a measure of visual acuity after sustained eye opening without blinking for at least 10 s and mimics the sustained visual acuity of daily life. Measuring dynamic FVA allows the detection of impaired visual function in patients with DED who may display normal conventional visual acuity. There are currently several tests and methods that can be used to measure dynamic visual function: the SSC-350 FVA measurement system, assessment of best-corrected visual acuity decay using the interblink visual acuity decay test, serial measurements of ocular and corneal higher order aberrations, and measurement of dynamic vision quality using the Optical Quality Analysis System. Although the equipment for these methods may be too large or unaffordable for use in clinical practice, FVA testing is an important assessment for DED. Copyright © 2016 Elsevier Inc. All rights reserved.

Assessment of water quality of Sembilang River receiving effluent from controlled municipal solid waste (MSW) landfill in Selangor

NASA Astrophysics Data System (ADS)

Tengku Ibrahim, T. N. B.; Othman, F.; Mahmood, N. Z.

2017-06-01

Most of the landfills in Malaysia are situated near to the main river basin that supplies almost 90% of water requirement. This includes landfills in Selangor where a total of 20 landfill sites are situated in 5 main river basins and the highest number of operating landfills (three) are at the Selangor River Basin (Jeram, Bukit Tagar and Kuang Inert landfills). This situation has caused wide concern over the water safety, even the leachate has been treated. The leachate itself still contains contaminants that are difficult to treat. The main objective of this study is to investigate the effect on water quality of Sembilang River that receives effluent from the nearby landfill. In this study, we analyzed samples of water from ten sampling stations starting from the upstream to downstream of Sembilang River. The water quality was evaluated by the Water Quality Index (WQI) depending on in-situ and laboratory analysis. 11 water quality variables are selected for the quality assessment; temperature, pH, turbidity, salinity, dissolved oxygen, biochemical oxygen demand, chemical oxygen demand, total suspended solid, ammoniacal nitrogen, phosphate and nitrate. The result indicated that, when the effluent mixed with the river water, the water quality decreased gradually and was found to be lower at a few stations. The water quality of Sembilang River falls under Class III of Water Quality Index with ranges between 68.03 to 43.46 mg/L. It is revealed that the present scenario of water quality of Sembilang River is due to the effect of effluent from the landfill.

The NRL (Naval Research Laboratory) Phase-Locked Gyrotron Oscillator Program for SDIO/IST

DTIC Science & Technology

1988-07-11

are neglected as are space - charge effects . The cold cavity eigenfrequency for the TE6 2 1 mode is 35.08 GHz. The calculated efficiency, output power...improved beam quality on the gyrotron operation, and to eliminate the unknown space charge effects present in the original experiment, in which a...substantial fraction of the diode current is reflected before reaching the gyrotron cavity and may cause space charge problems before being collected on