Broken symmetry dielectric resonators for high quality factor Fano metasurfaces
Campione, Salvatore; Liu, Sheng; Basilio, Lorena I.; ...
2016-10-25
We present a new approach to dielectric metasurface design that relies on a single resonator per unit cell and produces robust, high quality factor Fano resonances. Our approach utilizes symmetry breaking of highly symmetric resonator geometries, such as cubes, to induce couplings between the otherwise orthogonal resonator modes. In particular, we design perturbations that couple “bright” dipole modes to “dark” dipole modes whose radiative decay is suppressed by local field effects in the array. Our approach is widely scalable from the near-infrared to radio frequencies. We first unravel the Fano resonance behavior through numerical simulations of a germanium resonator-based metasurfacemore » that achieves a quality factor of ~1300 at ~10.8 μm. Then, we present two experimental demonstrations operating in the near-infrared (~1 μm): a silicon-based implementation that achieves a quality factor of ~350; and a gallium arsenide-based structure that achieves a quality factor of ~600, the highest near-infrared quality factor experimentally demonstrated to date with this kind of metasurface. Importantly, large electromagnetic field enhancements appear within the resonators at the Fano resonant frequencies. Here, we envision that combining high quality factor, high field enhancement resonances with nonlinear and active/gain materials such as gallium arsenide will lead to new classes of active optical devices.« less
Broken symmetry dielectric resonators for high quality factor Fano metasurfaces
DOE Office of Scientific and Technical Information (OSTI.GOV)
Campione, Salvatore; Liu, Sheng; Basilio, Lorena I.
We present a new approach to dielectric metasurface design that relies on a single resonator per unit cell and produces robust, high quality factor Fano resonances. Our approach utilizes symmetry breaking of highly symmetric resonator geometries, such as cubes, to induce couplings between the otherwise orthogonal resonator modes. In particular, we design perturbations that couple “bright” dipole modes to “dark” dipole modes whose radiative decay is suppressed by local field effects in the array. Our approach is widely scalable from the near-infrared to radio frequencies. We first unravel the Fano resonance behavior through numerical simulations of a germanium resonator-based metasurfacemore » that achieves a quality factor of ~1300 at ~10.8 μm. Then, we present two experimental demonstrations operating in the near-infrared (~1 μm): a silicon-based implementation that achieves a quality factor of ~350; and a gallium arsenide-based structure that achieves a quality factor of ~600, the highest near-infrared quality factor experimentally demonstrated to date with this kind of metasurface. Importantly, large electromagnetic field enhancements appear within the resonators at the Fano resonant frequencies. Here, we envision that combining high quality factor, high field enhancement resonances with nonlinear and active/gain materials such as gallium arsenide will lead to new classes of active optical devices.« less
Study on the quality of FRP fishing vessel based on improved Fishbone Chart
NASA Astrophysics Data System (ADS)
Sui, J. H.; Yu, Y. F.; Du, Q. F.; Jiang, D. W.
2018-01-01
The construction quality of FRP fishing vessels influences their production, use and industry development. In order to explore the factors that affect the construction quality of FRP fishing vessels, key factors affecting the construction quality of FRP fishing vessels are determined based on the quality problems of FRP fishing vessels constructed. The improved Fishbone Chart is used to analyze the eight factors of “human, machine, material, process, environment, inspection, design and information”. Taking the factors that affect the construction quality of FRP fishing vessels as the central target, the eight influencing factors were condensed into five aspects and a composite Fishbone Chart is drawn. The Fishbone Chart is used as the basic model, the influencing factors are sorted, screened and discriminated, and the system model convenient for construction site management and control is established. Finally, the causes of poor construction of FRP fishing vessels are analyzed and discussed, and relevant suggestions are put forward.
Factor selection for service quality evaluation: a hospital case study.
Ameryoun, Ahmad; Najafi, Seyedvahid; Nejati-Zarnaqi, Bayram; Khalilifar, Seyed Omid; Ajam, Mahdi; Ansarimoghadam, Ahmad
2017-02-13
Purpose The purpose of this paper is to develop a systematic approach to predict service quality dimension's influence on service quality using a novel analysis based on data envelopment and SERVQUAL. Design/methodology/approach To assess hospital service quality in Tehran, expectation and perception of those who received the services were evaluated using SERVQUAL. The hospital service quality dimensions were found by exploratory factor analysis (EFA). To compare customer expectation and perception, perceived service quality index (PSQI) was measured using a new method based on common weights. A novel sensitivity approach was used to test the service quality factor's impact on the PSQI. Findings A new service quality dimension named "trust in services" was found using EFA, which is not an original SERVQUAL factor. The approach was applied to assess the hospital's service quality. Since the PSQI value was 0.76 it showed that improvements are needed to meet customer expectations. The results showed the factor order that affect PSQI. "Trust in services" has the strongest influence on PSQI followed by "tangibles," "assurance," "empathy," and "responsiveness," respectively. Practical implications This work gives managers insight into service quality by following a systematic method; i.e., measuring perceived service quality from the customer viewpoint and service factors' impact on customer perception. Originality/value The procedure helps managers to select the required service quality dimensions which need improvement and predict their effects on customer perception.
[Ecological environmental quality assessment of Hangzhou urban area based on RS and GIS].
Xu, Pengwei; Zhao, Duo
2006-06-01
In allusion to the shortage of traditional ecological environmental quality assessment, this paper studied the spatial distribution of assessing factors at a mid-small scale, and the conversion of integer character to girding assessing cells. The main assessing factors including natural environmental condition, environmental quality, natural landscape and urbanization pressure, which were classified into four types with about eleven assessing factors, were selected from RS images and GIS-spatial analyzing environmental quality vector graph. Based on GIS, a comprehensive assessment model for the ecological environmental quality in Hangzhou urban area was established. In comparison with observed urban heat island effects, the assessment results were in good agreement with the ecological environmental quality in the urban area of Hangzhou.
Kang, Chuan-Zhi; Zhou, Tao; Jiang, Wei-Ke; Guo, Lan-Ping; Zhang, Xiao-Bo; Xiao, Cheng-Hong; Zhao, Dan
2016-07-01
Maxent model was applied in the study to filtering the climate factors layer by layer. Polysaccharides and pseudostellarin B the two internal quality evaluation index were combined to analyse the interlinkages between climate factors and chemical constituents in order to search for the critical climate factors of Pseudostellaria heterophylla. Then based on the key climate factors to explicit the quality spatial distribution of P. heterophylla. The results showed that polysaccharides and climatic factors had no significant correlation, suggesting that the indicator was not climate-driven metabolites. Pseudostellarin B could construct regression model with the precipitation. And quality regionalization results showed that pseudostellarin B content presented firstly increased and then decreased trend from southeast to northwest, which was the consistent change with precipitation. It clearly proposed that precipitation was the key climate factor, which affected the accumulation of cyclopeptide compound for Pseudostellariae Radix. Copyright© by the Chinese Pharmaceutical Association.
NASA Astrophysics Data System (ADS)
Haiyang, Yu; Yanmei, Liu; Guijun, Yang; Xiaodong, Yang; Dong, Ren; Chenwei, Nie
2014-03-01
To achieve dynamic winter wheat quality monitoring and forecasting in larger scale regions, the objective of this study was to design and develop a winter wheat quality monitoring and forecasting system by using a remote sensing index and environmental factors. The winter wheat quality trend was forecasted before the harvest and quality was monitored after the harvest, respectively. The traditional quality-vegetation index from remote sensing monitoring and forecasting models were improved. Combining with latitude information, the vegetation index was used to estimate agronomy parameters which were related with winter wheat quality in the early stages for forecasting the quality trend. A combination of rainfall in May, temperature in May, illumination at later May, the soil available nitrogen content and other environmental factors established the quality monitoring model. Compared with a simple quality-vegetation index, the remote sensing monitoring and forecasting model used in this system get greatly improved accuracy. Winter wheat quality was monitored and forecasted based on the above models, and this system was completed based on WebGIS technology. Finally, in 2010 the operation process of winter wheat quality monitoring system was presented in Beijing, the monitoring and forecasting results was outputted as thematic maps.
ERIC Educational Resources Information Center
Pippen, Rebecca Gintz
2016-01-01
For decades, accountability for student results has been at the forefront of school reform. While many school-based factors have influence, teacher quality has consistently been identified as the most important school-based factor related to student achievement (Rivkin, Hanushek, & Kain, 2000; Stronge, 2007). Research also suggests that a…
Hwang, Jee-In; Park, Hyeoun-Ae
2015-07-01
This study investigated individual and work-related factors associated with nurses' perceptions of evidence-based practice (EBP) and quality improvement (QI), and the relationships between evidence-based practice, quality improvement and clinical errors. Understanding the factors affecting evidence-based practice and quality improvement activities and their relationships with clinical errors is important for designing strategies to promote evidence-based practice, quality improvement and patient safety. A cross-sectional survey was conducted with 594 nurses in two Korean teaching hospitals using the evidence-based practice Questionnaire and quality improvement scale developed in this study. Four hundred and forty-three nurses (74.6%) returned the completed survey. Nurses' ages and educational levels were significantly associated with evidence-based practice scores whereas age and job position were associated with quality improvement scores. There were positive, moderate correlations between evidence-based practice and quality improvement scores. Nurses who had not made any clinical errors during the past 12 months had significantly higher quality improvement skills scores than those who had. The findings indicated the necessity of educational support regarding evidence-based practice and quality improvement for younger staff nurses who have no master degrees. Enhancing quality improvement skills may reduce clinical errors. Nurse managers should consider the characteristics of their staff when implementing educational and clinical strategies for evidence-based practice and quality improvement. © 2013 John Wiley & Sons Ltd.
Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane
2014-01-01
Considerable conceptual and operational complexities related to service quality measurements and variability in delivery contexts of scaled-up medical male circumcision, pose real challenges to monitoring implementation of quality and safety. Clarifying latent factors of the quality instruments can enhance contextual applicability and the likelihood that observed service outcomes are appropriately assessed. To explore factors underlying SYMMACS service quality assessment tool (adopted from the WHO VMMC quality toolkit) and; determine service quality performance using composite quality index derived from the latent factors. Using a comparative process evaluation of Voluntary Medical Male Circumcision Scale-Up in Kenya site level data was collected among health facilities providing VMMC over two years. Systematic Monitoring of the Medical Male Circumcision Scale-Up quality instrument was used to assess availability of guidelines, supplies and equipment, infection control, and continuity of care services. Exploratory factor analysis was performed to clarify quality structure. Fifty four items and 246 responses were analyzed. Based on Eigenvalue >1.00 cut-off, factors 1, 2 & 3 were retained each respectively having eigenvalues of 5.78; 4.29; 2.99. These cumulatively accounted for 29.1% of the total variance (12.9%; 9.5%; 6.7%) with final communality estimates being 13.06. Using a cut-off factor loading value of ≥0.4, fifteen items loading on factor 1, five on factor 2 and one on factor 3 were retained. Factor 1 closely relates to preparedness to deliver safe male circumcisions while factor two depicts skilled task performance and compliance with protocols. Of the 28 facilities, 32% attained between 90th and 95th percentile (excellent); 45% between 50th and 75th percentiles (average) and 14.3% below 25th percentile (poor). the service quality assessment instrument may be simplified to have nearly 20 items that relate more closely to service outcomes. Ranking of facilities and circumcision procedure using a composite index based on these items indicates that majority performed above average.
ERIC Educational Resources Information Center
Rosadi, Kemas Imron
2015-01-01
Development of education in Indonesia is based on three aspects, namely equity and expansion, quality and relevance, as well as good governance. Quality education is influenced by several factors related to quality education managerial leaders, limited funds, facilities, educational facilities, media, learning resources, tools and training…
Quality of Mental Health Care for Nursing Home Residents: A Literature Review
Grabowski, David C.; Aschbrenner, Kelly A.; Rome, Vincent F.; Bartels, Stephen J.
2010-01-01
Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors. PMID:20223943
Neutrons in proton pencil beam scanning: parameterization of energy, quality factors and RBE
NASA Astrophysics Data System (ADS)
Schneider, Uwe; Hälg, Roger A.; Baiocco, Giorgio; Lomax, Tony
2016-08-01
The biological effectiveness of neutrons produced during proton therapy in inducing cancer is unknown, but potentially large. In particular, since neutron biological effectiveness is energy dependent, it is necessary to estimate, besides the dose, also the energy spectra, in order to obtain quantities which could be a measure of the biological effectiveness and test current models and new approaches against epidemiological studies on cancer induction after proton therapy. For patients treated with proton pencil beam scanning, this work aims to predict the spatially localized neutron energies, the effective quality factor, the weighting factor according to ICRP, and two RBE values, the first obtained from the saturation corrected dose mean lineal energy and the second from DSB cluster induction. A proton pencil beam was Monte Carlo simulated using GEANT. Based on the simulated neutron spectra for three different proton beam energies a parameterization of energy, quality factors and RBE was calculated. The pencil beam algorithm used for treatment planning at PSI has been extended using the developed parameterizations in order to calculate the spatially localized neutron energy, quality factors and RBE for each treated patient. The parameterization represents the simple quantification of neutron energy in two energy bins and the quality factors and RBE with a satisfying precision up to 85 cm away from the proton pencil beam when compared to the results based on 3D Monte Carlo simulations. The root mean square error of the energy estimate between Monte Carlo simulation based results and the parameterization is 3.9%. For the quality factors and RBE estimates it is smaller than 0.9%. The model was successfully integrated into the PSI treatment planning system. It was found that the parameterizations for neutron energy, quality factors and RBE were independent of proton energy in the investigated energy range of interest for proton therapy. The pencil beam algorithm has been extended using the developed parameterizations in order to calculate the neutron energy, quality factor and RBE.
Neutrons in proton pencil beam scanning: parameterization of energy, quality factors and RBE.
Schneider, Uwe; Hälg, Roger A; Baiocco, Giorgio; Lomax, Tony
2016-08-21
The biological effectiveness of neutrons produced during proton therapy in inducing cancer is unknown, but potentially large. In particular, since neutron biological effectiveness is energy dependent, it is necessary to estimate, besides the dose, also the energy spectra, in order to obtain quantities which could be a measure of the biological effectiveness and test current models and new approaches against epidemiological studies on cancer induction after proton therapy. For patients treated with proton pencil beam scanning, this work aims to predict the spatially localized neutron energies, the effective quality factor, the weighting factor according to ICRP, and two RBE values, the first obtained from the saturation corrected dose mean lineal energy and the second from DSB cluster induction. A proton pencil beam was Monte Carlo simulated using GEANT. Based on the simulated neutron spectra for three different proton beam energies a parameterization of energy, quality factors and RBE was calculated. The pencil beam algorithm used for treatment planning at PSI has been extended using the developed parameterizations in order to calculate the spatially localized neutron energy, quality factors and RBE for each treated patient. The parameterization represents the simple quantification of neutron energy in two energy bins and the quality factors and RBE with a satisfying precision up to 85 cm away from the proton pencil beam when compared to the results based on 3D Monte Carlo simulations. The root mean square error of the energy estimate between Monte Carlo simulation based results and the parameterization is 3.9%. For the quality factors and RBE estimates it is smaller than 0.9%. The model was successfully integrated into the PSI treatment planning system. It was found that the parameterizations for neutron energy, quality factors and RBE were independent of proton energy in the investigated energy range of interest for proton therapy. The pencil beam algorithm has been extended using the developed parameterizations in order to calculate the neutron energy, quality factor and RBE.
NASA Astrophysics Data System (ADS)
Gao, Yuanci; Charles, Jones R.; Yu, Guofen; Jyotsna, Dutta M.
2012-03-01
A long loop phase locked backward-wave oscillator (BWO) for a high quality factor resonator system operating at D-band frequencies (130-170GHz) was described, the phase noise of the phased locked BWO was analyzed and measured at typical frequencies. When it used with a high quality factor open resonator for measuring the quality factor of simple harmonic resonators based on the magnitude transfer characteristic, this system has proven to be capable of accurate measuring the quality factor as high as 0.8 million with an uncertainty of less than 1.3% (Lorentzian fitting) at typical frequencies in the range of 130GHz-170GHz.
Analysis of psychological factors for quality assessment of interactive multimodal service
NASA Astrophysics Data System (ADS)
Yamagishi, Kazuhisa; Hayashi, Takanori
2005-03-01
We proposed a subjective quality assessment model for interactive multimodal services. First, psychological factors of an audiovisual communication service were extracted by using the semantic differential (SD) technique and factor analysis. Forty subjects participated in subjective tests and performed point-to-point conversational tasks on a PC-based TV phone that exhibits various network qualities. The subjects assessed those qualities on the basis of 25 pairs of adjectives. Two psychological factors, i.e., an aesthetic feeling and a feeling of activity, were extracted from the results. Then, quality impairment factors affecting these two psychological factors were analyzed. We found that the aesthetic feeling is mainly affected by IP packet loss and video coding bit rate, and the feeling of activity depends on delay time and video frame rate. We then proposed an opinion model derived from the relationships among quality impairment factors, psychological factors, and overall quality. The results indicated that the estimation error of the proposed model is almost equivalent to the statistical reliability of the subjective score. Finally, using the proposed model, we discuss guidelines for quality design of interactive audiovisual communication services.
Grimbergen, T W; van Dijk, E; de Vries, W
1998-11-01
A new method is described for the determination of x-ray quality dependent correction factors for free-air ionization chambers. The method is based on weighting correction factors for mono-energetic photons, which are calculated using the Monte Carlo method, with measured air kerma spectra. With this method, correction factors for electron loss, scatter inside the chamber and transmission through the diaphragm and front wall have been calculated for the NMi free-air chamber for medium-energy x-rays for a wide range of x-ray qualities in use at NMi. The newly obtained correction factors were compared with the values in use at present, which are based on interpolation of experimental data for a specific set of x-ray qualities. For x-ray qualities which are similar to this specific set, the agreement between the correction factors determined with the new method and those based on the experimental data is better than 0.1%, except for heavily filtered x-rays generated at 250 kV. For x-ray qualities dissimilar to the specific set, differences up to 0.4% exist, which can be explained by uncertainties in the interpolation procedure of the experimental data. Since the new method does not depend on experimental data for a specific set of x-ray qualities, the new method allows for a more flexible use of the free-air chamber as a primary standard for air kerma for any x-ray quality in the medium-energy x-ray range.
Altena, Astrid M; Beijersbergen, Mariëlle D; Vermunt, Jeroen K; Wolf, Judith R L M
2018-04-17
It is important to gain more insight into specific subgroups of homeless young adults (HYA) to enable the development of tailored interventions that adequately meet their diverse needs and to improve their quality of life. Within a heterogeneous sample of HYA, we investigated whether subgroups are distinguishable based on risk- and protective factors for quality of life. In addition, differences between subgroups were examined regarding the socio-demographic characteristics, the use of cognitive coping strategies and quality of life. A total of 393 HYA using shelter facilities in the Netherlands were approached to participate, between December 2011 and March 2013. Structured face-to-face interviews were administered approximately 2 weeks after shelter admission by trained research assistants. A latent class analysis was conducted to empirically distinguish 251 HYA in subgroups based on common risk factors (former abuse, victimisation, psychological symptoms and substance use) and protective factors (resilience, family and social support and perceived health status). Additional analysis of variance and chi-square tests were used to compare subgroups on socio-demographic characteristics, the use of cognitive coping strategies and quality of life. The latent class analysis yielded four highly interpretable subgroups: the at-risk subgroup, the high-risk and least protected subgroup, the low-risk subgroup and the higher functioning and protected subgroup. Subgroups of HYA with lower scores in risk factors showed higher scores in protective factors, the adaptive cognitive coping strategies and quality of life. Our findings confirm the need for targeted and tailored interventions for specific subgroups of HYA. Social workers need to be attentive to the pattern of risk- and protective factors in each individual to determine which risk factors are prominent and need to be targeted and which protective factors need to be enhanced to improve the quality of life of HYA. © 2018 John Wiley & Sons Ltd.
Rural Teacher Identity and Influencing Factors in Western China
ERIC Educational Resources Information Center
Mingren, Zhao; Shiquan, Fu
2018-01-01
The quality of rural teachers is a key factor affecting the quality of rural education. A better understanding of rural teachers is the basis for strengthening their development. It is possible to obtain a more holistic understanding of rural teachers' work and life through their identity. Based on a wealth of case-based information, rural teacher…
Image quality metrics for volumetric laser displays
NASA Astrophysics Data System (ADS)
Williams, Rodney D.; Donohoo, Daniel
1991-08-01
This paper addresses the extensions to the image quality metrics and related human factors research that are needed to establish the baseline standards for emerging volume display technologies. The existing and recently developed technologies for multiplanar volume displays are reviewed with an emphasis on basic human visual issues. Human factors image quality metrics and guidelines are needed to firmly establish this technology in the marketplace. The human visual requirements and the display design tradeoffs for these prototype laser-based volume displays are addressed and several critical image quality issues identified for further research. The American National Standard for Human Factors Engineering of Visual Display Terminal Workstations (ANSIHFS-100) and other international standards (ISO, DIN) can serve as a starting point, but this research base must be extended to provide new image quality metrics for this new technology for volume displays.
Development of cotton gin PM10 emission factors for EPA’s AP-42
USDA-ARS?s Scientific Manuscript database
The Compilation of Air Pollution Emission Factors (AP-42) emission factors are assigned ratings, from A (Excellent) to E (Poor), based on the quality of data used to develop them. All current PM10 cotton gin emission factors received quality ratings of D or lower. In an effort to improve these ratin...
Evaluation of thermal effects on the beam quality of disk laser with unstable resonator
NASA Astrophysics Data System (ADS)
Shayganmanesh, Mahdi; Beirami, Reza
2017-01-01
In this paper thermal effects of the disk active medium and associated effects on the beam quality of laser are investigated. Using Collins integral and iterative method, transverse mode of an unstable resonator including a Yb:YAG active medium in disk geometry is calculated. After that the beam quality of the laser is calculated based on the generalized beam characterization method. Thermal lensing of the disk is calculated based on the OPD (Optical Path Difference) concept. Five factors influencing the OPD including temperature gradient, disk thermal expansion, photo-elastic effect, electronic lens and disk deformation are considered in our calculations. The calculations show that the effect of disk deformation factor on the quality of laser beam in the resonator is strong. However the total effect of all the thermal factors on the internal beam quality is fewer. Also it is shown that thermal effects degrade the output power, beam profile and beam quality of the output laser beam severely. As well the magnitude of each of affecting factors is evaluated distinctly.
Identifying key hospital service quality factors in online health communities.
Jung, Yuchul; Hur, Cinyoung; Jung, Dain; Kim, Minki
2015-04-07
The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. We defined social media-based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea's two biggest online portals were used to test the effectiveness of detection of social media-based key quality factors for hospitals. To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and classification performance still has room for improvement, but the extraction results are applicable to more detailed analysis. Further analysis of the extracted information reveals that there are differences in the details of social media-based key quality factors for hospitals according to the regions in Korea, and the patterns of change seem to accurately reflect social events (eg, influenza epidemics). These findings could be used to provide timely information to caregivers, hospital officials, and medical officials for health care policies.
Xie, Anping; Carayon, Pascale
2015-01-01
Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines how human factors and ergonomics (HFE) is applied to redesign healthcare work systems and processes and improve quality and safety of care. We identified 12 projects representing 23 studies and addressing different physical, cognitive and organisational HFE issues in a variety of healthcare systems and care settings. Some evidence exists for the effectiveness of HFE-based healthcare system redesign in improving process and outcome measures of quality and safety of care. We assessed risk of bias in 16 studies reporting the impact of HFE-based healthcare system redesign and found varying quality across studies. Future research should further assess the impact of HFE on quality and safety of care, and clearly define the mechanisms by which HFE-based system redesign can improve quality and safety of care.
NASA Astrophysics Data System (ADS)
KIM, M.; Kim, J.; Baek, J.; Kim, C.; Shin, H.
2013-12-01
It has being happened as flush flood or red/green tide in various natural phenomena due to climate change and indiscreet development of river or land. Especially, water being very important to man should be protected and managed from water quality pollution, and in water resources management, real-time watershed monitoring system is being operated with the purpose of keeping watch and managing on rivers. It is especially important to monitor and forecast water quality in watershed. A study area selected Nak_K as one site among TMDL unit watershed in Nakdong River. This study is to develop a water quality forecasting model connected with making full use of observed data of 8 day interval from Nakdong River Environment Research Center. When forecasting models for each of the BOD, DO, COD, and chlorophyll-a are established considering correlation of various water quality factors, it is needed to select water quality factors showing highly considerable correlation with each water quality factor which is BOD, DO, COD, and chlorophyll-a. For analyzing the correlation of the factors (reservoir discharge, precipitation, air temperature, DO, BOD, COD, Tw, TN, TP, chlorophyll-a), in this study, self-organizing map was used and cross correlation analysis method was also used for comparing results drawn. Based on the results, each forecasting model for BOD, DO, COD, and chlorophyll-a was developed during the short period as 8, 16, 24, 32 days at 8 day interval. The each forecasting model is based on neural network with back propagation algorithm. That is, the study is connected with self-organizing map for analyzing correlation among various factors and neural network model for forecasting of water quality. It is considerably effective to manage the water quality in plenty of rivers, then, it specially is possible to monitor a variety of accidents in water quality. It will work well to protect water quality and to prevent destruction of the environment becoming more and more serious before occurring.
Xie, Anping; Carayon, Pascale
2014-01-01
Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines how Human Factors and Ergonomics (HFE) is applied to redesign healthcare work systems and processes and improve quality and safety of care. We identified twelve projects representing 23 studies and addressing different physical, cognitive and organizational HFE issues in a variety of healthcare systems and care settings. Some evidence exists for the effectiveness of HFE-based healthcare system redesign in improving process and outcome measures of quality and safety of care. We assessed risk of bias in 16 studies reporting the impact of HFE-based healthcare system redesign and found varying quality across studies. Future research should further assess the impact of HFE on quality and safety of care, and clearly define the mechanisms by which HFE-based system redesign can improve quality and safety of care. Practitioner Summary Existing evidence shows that HFE-based healthcare system redesign has the potential to improve quality of care and patient safety. Healthcare organizations need to recognize the importance of HFE-based healthcare system redesign to quality of care and patient safety, and invest resources to integrate HFE in healthcare improvement activities. PMID:25323570
Development of cotton gin PM10 emission factors for EPA’s AP-42-DUPLICATE DO NOT USE
USDA-ARS?s Scientific Manuscript database
The Compilation of Air Pollution Emission Factors (AP-42) emission factors are assigned ratings, from A (Excellent) to E (Poor), based on the quality of data used to develop them. All current PM10 cotton gin emission factors received quality ratings of D or lower. In an effort to improve these ratin...
Energy efficiency in wireless communication systems
Caffrey, Michael Paul; Palmer, Joseph McRae
2012-12-11
Wireless communication systems and methods utilize one or more remote terminals, one or more base terminals, and a communication channel between the remote terminal(s) and base terminal(s). The remote terminal applies a direct sequence spreading code to a data signal at a spreading factor to provide a direct sequence spread spectrum (DSSS) signal. The DSSS signal is transmitted over the communication channel to the base terminal which can be configured to despread the received DSSS signal by a spreading factor matching the spreading factor utilized to spread the data signal. The remote terminal and base terminal can dynamically vary the matching spreading factors to adjust the data rate based on an estimation of operating quality over time between the remote terminal and base terminal such that the amount of data being transmitted is substantially maximized while providing a specified quality of service.
Factors Affecting Success of Training Companies
ERIC Educational Resources Information Center
Rogala, Piotr; Batko, Roman; Wawak, Slawomir
2017-01-01
This study aims to identify the key factors which influence the functioning quality and success of training companies. Based on an analysis of the requirements included in the quality management system standards for providers of education and training services, a set of twenty factors has been developed. This was followed by a survey for…
Assessment of Factors Influencing Communication in Clinical Pharmacy.
Yao, Dongning; Jiang, Liang; Huang, Yuankai; Chen, Lei; Wang, Yitao; Xi, Xiaoyu
2018-01-01
This study aimed to identify and assess the factors that influence communication quality between clinical pharmacists and patients using a structural equation model based on the predisposing, reinforcing, and enabling constructs in educational/environmental diagnosis and evaluation-policy, regulatory, and organizational constructs in educational and ecological development model to identify the most effective path to increase their communication quality. A survey was conducted at 253 Class-A tertiary hospitals in China from March to December 2016. During on-site observations, verbal communications between clinical pharmacists ( n = 752) and patients were audio recorded, and communication quality was rated by an expert panel on an 8-item Quality of Communication Rating Scale. Clinical pharmacists completed questionnaires that examined the predisposing, enabling, and reinforcing factors that influenced communication quality. Finally, AMOS was employed to examine the relationships between the three factors and communication quality. The results indicated that all three factors positively affected communication quality, with correlation coefficients of .26, .13, and .17, respectively. The most influential predisposing factor was attitude (.77), the most influential enabling factors were self-efficacy (.71) and confidence (.72), and the most influential reinforcing factor was rewards (.74). The findings suggest that pharmacists' attitudes toward, perceived knowledge of, and skill and confidence in communication, and the rewards offered by pharmacy management are the most influential factors that influence communication quality.
Huijg, Johanna M; Dusseldorp, Elise; Gebhardt, Winifred A; Verheijden, Marieke W; van der Zouwe, Nicolette; Middelkoop, Barend J C; Duijzer, Geerke; Crone, Mathilde R
2015-04-01
Physical therapists play an important role in the promotion of physical activity (PA) and the effectiveness of PA interventions. However, little is known about the extent to which they implement PA interventions following the intervention protocol and about the factors influencing their implementation behaviors. The study objective was to investigate physical therapists' implementation fidelity regarding PA interventions, including completeness and quality of delivery, and influencing factors with a Theoretical Domains Framework-based questionnaire. The study was based on a cross-sectional design. A total of 268 physical therapists completed the Determinants of Implementation Behavior Questionnaire. Questions about completeness and quality of delivery were based on components and tasks of PA interventions as described by the Royal Dutch Society for Physical Therapy. Multilevel regression analyses were used to identify factors associated with completeness and quality of delivery. High implementation fidelity was found for the physical therapists, with higher scores for completeness of delivery than for quality of delivery. Physical therapists' knowledge, skills, beliefs about capabilities and consequences, positive emotions, behavioral regulation, and the automaticity of PA intervention delivery were the most important predictors of implementation fidelity. Together, the Theoretical Domains Framework accounted for 23% of the variance in both total completeness and total quality scores. The cross-sectional design precluded the determination of causal relationships. Also, the use of a self-report measure to assess implementation fidelity could have led to socially desirable responses, possibly resulting in more favorable ratings for completeness and quality. This study enhances the understanding of how physical therapists implement PA interventions and which factors influence their behaviors. Knowledge about these factors may assist in the development of strategies to improve physical therapists' implementation behaviors. © 2015 American Physical Therapy Association.
Nejad, Mina Motaghi; Nejad, Ghodratollah Shakeri; Tavakol, Heshmatollah; Cheraghi, Maria
2017-06-01
The aim of the study was to determine the effect of the training program based on the Precede model and its main components on improving the quality of life in patients with asthma. It was a randomized quasi-experimental study done on 120 patients with asthma who were referred to the Imam Khomeini hospital in Ahvaz who were selected using the convenience sampling method and were randomly divided into intervention and control groups. The data collection tool consisted of two questionnaires. The first questionnaire evaluated the quality of life in patients with asthma and the other one was developed by the researcher based on the structures of the Precede model. Training intervention was conducted during four sessions twice a week and each session was carried out for an hour based on the structures of the Precede model. In order to achieve the results, SPSS software, even t -test, and χ 2 were used. The results showed that after the training intervention in the experimental group, the mean scores of predisposing factors ( p < 0.001), enabling factors, reinforcing factors and behavioral factors were significantly increased ( p < 0.001) as compared to the control group. A significant difference was observed in the mean scores of quality of life in two groups after the intervention ( p < 0.001), and the quality of life of patients in the experimental group was improved after the training intervention. The design and implementation of the training program based on the Precede model can have a positive effect on the improvement of quality of life in patients with asthma.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 2 2010-01-01 2010-01-01 false Quality. 29.2291 Section 29.2291 Agriculture... Quality. A division of a group or the second factor of a grade based on the relative degree of one or more elements of quality. ...
NASA Astrophysics Data System (ADS)
Alseddiqi, M.; Mishra, R.; Pislaru, C.
2012-05-01
The paper presents the results from a quality framework to measure the effectiveness of a new engineering course entitled 'school-based learning (SBL) to work-based learning (WBL) transition module' in the Technical and Vocational Education (TVE) system in Bahrain. The framework is an extended version of existing information quality frameworks with respect to pedagogical and technological contexts. It incorporates specific pedagogical and technological dimensions as per the Bahrain modern industry requirements. Users' views questionnaire on the effectiveness of the new transition module was distributed to various stakeholders including TVE teachers and students. The aim was to receive critical information in diagnosing, monitoring and evaluating different views and perceptions about the effectiveness of the new module. The analysis categorised the quality dimensions by their relative importance. This was carried out using the principal component analysis available in SPSS. The analysis clearly identified the most important quality dimensions integrated in the new module for SBL-to-WBL transition. It was also apparent that the new module contains workplace proficiencies, prepares TVE students for work placement, provides effective teaching and learning methodologies, integrates innovative technology in the process of learning, meets modern industrial needs, and presents a cooperative learning environment for TVE students. From the principal component analysis finding, to calculate the percentage of relative importance of each factor and its quality dimensions, was significant. The percentage comparison would justify the most important factor as well as the most important quality dimensions. Also, the new, re-arranged quality dimensions from the finding with an extended number of factors tended to improve the extended version of the quality information framework to a revised quality framework.
NASA Astrophysics Data System (ADS)
Xiao, Dingbang; Su, Jianbin; Chen, Zhihua; Hou, Zhanqiang; Wang, Xinghua; Wu, Xuezhong
2013-04-01
In order to improve its structural sensitivity, a vibratory microgyroscope is commonly sealed in high vacuum to increase the drive mode quality factor. The sense mode quality factor of the microgyroscope will also increase simultaneously after vacuum sealing, which will lead to a long decay time of free response and even self-oscillation of the sense mode. As a result, the mechanical performance of the microgyroscope will be seriously degraded. In order to solve this problem, a closed-loop control technique is presented to adjust and optimize the sense mode quality factor. A velocity feedback loop was designed to increase the electric damping of the sense mode vibration. A circuit was fabricated based on this technique, and experimental results indicate that the sense mode quality factor of the microgyroscope was adjusted from 8052 to 428. The decay time of the sense mode free response was shortened from 3 to 0.5 s, and the vibration-rejecting ability of the microgyroscope was improved obviously without sensitivity degradation.
Identifying Key Hospital Service Quality Factors in Online Health Communities
Jung, Yuchul; Hur, Cinyoung; Jung, Dain
2015-01-01
Background The volume of health-related user-created content, especially hospital-related questions and answers in online health communities, has rapidly increased. Patients and caregivers participate in online community activities to share their experiences, exchange information, and ask about recommended or discredited hospitals. However, there is little research on how to identify hospital service quality automatically from the online communities. In the past, in-depth analysis of hospitals has used random sampling surveys. However, such surveys are becoming impractical owing to the rapidly increasing volume of online data and the diverse analysis requirements of related stakeholders. Objective As a solution for utilizing large-scale health-related information, we propose a novel approach to identify hospital service quality factors and overtime trends automatically from online health communities, especially hospital-related questions and answers. Methods We defined social media–based key quality factors for hospitals. In addition, we developed text mining techniques to detect such factors that frequently occur in online health communities. After detecting these factors that represent qualitative aspects of hospitals, we applied a sentiment analysis to recognize the types of recommendations in messages posted within online health communities. Korea’s two biggest online portals were used to test the effectiveness of detection of social media–based key quality factors for hospitals. Results To evaluate the proposed text mining techniques, we performed manual evaluations on the extraction and classification results, such as hospital name, service quality factors, and recommendation types using a random sample of messages (ie, 5.44% (9450/173,748) of the total messages). Service quality factor detection and hospital name extraction achieved average F1 scores of 91% and 78%, respectively. In terms of recommendation classification, performance (ie, precision) is 78% on average. Extraction and classification performance still has room for improvement, but the extraction results are applicable to more detailed analysis. Further analysis of the extracted information reveals that there are differences in the details of social media–based key quality factors for hospitals according to the regions in Korea, and the patterns of change seem to accurately reflect social events (eg, influenza epidemics). Conclusions These findings could be used to provide timely information to caregivers, hospital officials, and medical officials for health care policies. PMID:25855612
Shieh, Chun-Chien; Kipritidis, John; O’Brien, Ricky T.; Kuncic, Zdenka; Keall, Paul J.
2014-01-01
Purpose: Respiratory signal, binning method, and reconstruction algorithm are three major controllable factors affecting image quality in thoracic 4D cone-beam CT (4D-CBCT), which is widely used in image guided radiotherapy (IGRT). Previous studies have investigated each of these factors individually, but no integrated sensitivity analysis has been performed. In addition, projection angular spacing is also a key factor in reconstruction, but how it affects image quality is not obvious. An investigation of the impacts of these four factors on image quality can help determine the most effective strategy in improving 4D-CBCT for IGRT. Methods: Fourteen 4D-CBCT patient projection datasets with various respiratory motion features were reconstructed with the following controllable factors: (i) respiratory signal (real-time position management, projection image intensity analysis, or fiducial marker tracking), (ii) binning method (phase, displacement, or equal-projection-density displacement binning), and (iii) reconstruction algorithm [Feldkamp–Davis–Kress (FDK), McKinnon–Bates (MKB), or adaptive-steepest-descent projection-onto-convex-sets (ASD-POCS)]. The image quality was quantified using signal-to-noise ratio (SNR), contrast-to-noise ratio, and edge-response width in order to assess noise/streaking and blur. The SNR values were also analyzed with respect to the maximum, mean, and root-mean-squared-error (RMSE) projection angular spacing to investigate how projection angular spacing affects image quality. Results: The choice of respiratory signals was found to have no significant impact on image quality. Displacement-based binning was found to be less prone to motion artifacts compared to phase binning in more than half of the cases, but was shown to suffer from large interbin image quality variation and large projection angular gaps. Both MKB and ASD-POCS resulted in noticeably improved image quality almost 100% of the time relative to FDK. In addition, SNR values were found to increase with decreasing RMSE values of projection angular gaps with strong correlations (r ≈ −0.7) regardless of the reconstruction algorithm used. Conclusions: Based on the authors’ results, displacement-based binning methods, better reconstruction algorithms, and the acquisition of even projection angular views are the most important factors to consider for improving thoracic 4D-CBCT image quality. In view of the practical issues with displacement-based binning and the fact that projection angular spacing is not currently directly controllable, development of better reconstruction algorithms represents the most effective strategy for improving image quality in thoracic 4D-CBCT for IGRT applications at the current stage. PMID:24694143
The use of citation indicators to identify and support high-quality research in Poland.
Pilc, Andrzej
2008-01-01
In large, mostly English-speaking countries, where the "critical mass" of scientists working in different subfields of science is achieved, the peer review system may be sufficient to assess the quality of scientific research. However, in smaller countries, outside the Anglo-American circle, it is important to introduce different systems to identify research of high quality. In Poland, a parametric system for assessing the quality of research has been introduced. It was largely based on the impact factor of scientific journals. While the use of this indicator to assess research quality is highly questionable, the implementation of the system in the Polish reality is even worse. Therefore it is important to change and improve the system currently used by the Ministry of Science and Higher Education to both evaluate and, more importantly, finance science in Poland. Here, a system based on three factors, i.e. the impact factor, the institutional h-index, and the institutional number of citations, is proposed. The scientific quality of institutions in Division VI: Medical Sciences of the Polish Academy of Sciences were evaluated and the results were compared with the existing system. Moreover, a method to identify high-quality researchers and institutions at the national level based on the quantity of highly cited papers is shown. Additionally, an attempt to identify the highest quality Polish research on an international level is proposed. This is based on the number of individual citations, the individual h-index, the number of publications, and the priority of the discovery.
Factors affecting success of an integrated community-based telehealth system.
Hsieh, Hui-Lung; Tsai, Chung-Hung; Chih, Wen-Hai; Lin, Huei-Hsieh
2015-01-01
The rise of chronic and degenerative diseases in developed countries has become one critical epidemiologic issue. Telehealth can provide one viable way to enhance health care, public health, and health education delivery and support. The study aims to empirically examine and evaluate the success factors of community-based telehealth system adoption. The valid 336 respondents are the residents of a rural community in Taiwan. The structural equation modeling (SEM) was used to assess the proposed model applied to telehealth. The findings showed the research model had good explanatory power and fitness. Also, the findings indicated that system quality exerted the strongest overall effect on intention to use. Furthermore, service quality exerted the strongest overall effect on user satisfaction. The findings also illustrated that the joint effects of three intrinsic qualities (system quality, information quality, and service quality) on use were mediated by user satisfaction and intention to use. The study implies that community-based telehealth service providers should improve three intrinsic qualities to enhance user satisfaction and intention to use, which in turn can lead to increase the usage of the telehealth equipment. The integrated community-based telehealth system may become an innovative and suitable way to deliver better care to the residents of communities.
Cohen-Mansfield, Jiska; Sela, Adi Hannah; Iecovich, Esther; Golander, Hava
2017-11-02
As more older persons opt to age in place, there is a growing trend to hire migrant workers as live-in caregivers to care for them. This raises the need to examine the quality of care they receive within this unique care setting. The objective of this pilot study was to establish the components of quality of care as provided by migrant live-in caregivers. We interviewed a convenience sample of older persons cared for by migrant live-in caregivers and their relatives. When relatives reported that older persons could not be interviewed due to advanced dementia, only relatives were interviewed. Overall, 72 older persons and 117 relatives were interviewed. We used the Quality of Care Questionnaire (QuCQ) developed for this study to examine the main components of quality of care in this population. Factor analysis using older persons' data revealed two factors. In the first factor, "caretaking," items concerning provision of prompt care exhibited the highest loadings. Items measuring interpersonal aspects of the care dynamic had the highest loadings in the second factor, thus labeled "relationship." The factor analysis based on relatives' data yielded similarities and differences with the one based on older persons' data. Yet, there were significant correlations between relative and older persons' responses when using the older persons' factor structure. According to older persons and relatives, quality of care depends on the extent to which older persons' care-related needs, as well as social ones, are addressed. Appropriate evaluation of quality of care in the live-in setting is important for its improvement.
Lin, Fen-Fang; Wang, Ke; Yang, Ning; Yan, Shi-Guang; Zheng, Xin-Yu
2012-02-01
In this paper, some main factors such as soil type, land use pattern, lithology type, topography, road, and industry type that affect soil quality were used to precisely obtain the spatial distribution characteristics of regional soil quality, mutual information theory was adopted to select the main environmental factors, and decision tree algorithm See 5.0 was applied to predict the grade of regional soil quality. The main factors affecting regional soil quality were soil type, land use, lithology type, distance to town, distance to water area, altitude, distance to road, and distance to industrial land. The prediction accuracy of the decision tree model with the variables selected by mutual information was obviously higher than that of the model with all variables, and, for the former model, whether of decision tree or of decision rule, its prediction accuracy was all higher than 80%. Based on the continuous and categorical data, the method of mutual information theory integrated with decision tree could not only reduce the number of input parameters for decision tree algorithm, but also predict and assess regional soil quality effectively.
Yu, Wen-Kang; Dong, Ling; Pei, Wen-Xuan; Sun, Zhi-Rong; Dai, Jun-Dong; Wang, Yun
2017-12-01
The whole process quality control and management of traditional Chinese medicine (TCM) decoction pieces is a system engineering, involving the base environment, seeds and seedlings, harvesting, processing and other multiple steps, so the accurate identification of factors in TCM production process that may induce the quality risk, as well as reasonable quality control measures are very important. At present, the concept of quality risk is mainly concentrated in the aspects of management and regulations, etc. There is no comprehensive analysis on possible risks in the quality control process of TCM decoction pieces, or analysis summary of effective quality control schemes. A whole process quality control and management system for TCM decoction pieces based on TCM quality tree was proposed in this study. This system effectively combined the process analysis method of TCM quality tree with the quality risk management, and can help managers to make real-time decisions while realizing the whole process quality control of TCM. By providing personalized web interface, this system can realize user-oriented information feedback, and was convenient for users to predict, evaluate and control the quality of TCM. In the application process, the whole process quality control and management system of the TCM decoction pieces can identify the related quality factors such as base environment, cultivation and pieces processing, extend and modify the existing scientific workflow according to their own production conditions, and provide different enterprises with their own quality systems, to achieve the personalized service. As a new quality management model, this paper can provide reference for improving the quality of Chinese medicine production and quality standardization. Copyright© by the Chinese Pharmaceutical Association.
Research on Air Quality Evaluation based on Principal Component Analysis
NASA Astrophysics Data System (ADS)
Wang, Xing; Wang, Zilin; Guo, Min; Chen, Wei; Zhang, Huan
2018-01-01
Economic growth has led to environmental capacity decline and the deterioration of air quality. Air quality evaluation as a fundamental of environmental monitoring and air pollution control has become increasingly important. Based on the principal component analysis (PCA), this paper evaluates the air quality of a large city in Beijing-Tianjin-Hebei Area in recent 10 years and identifies influencing factors, in order to provide reference to air quality management and air pollution control.
Selecting islands and shoals for conservation based on biological and aesthetic criteria
Knutson, M.G.; Leopold, D.J.; Smardon, R.C.
1993-01-01
Consideration of biological quality has long been an important component of rating areas for conservation. Often these same areas are highly valued by people for aesthetic reasons, creating demands for housing and recreation that may conflict with protection plans for these habitats. Most methods of selecting land for conservation purposes use biological factors alone. For some land areas, analysis of aesthetic qualities is also important in describing the scenic value of undisturbed land. A method for prioritizing small islands and shoals based on both biological and visual quality factors is presented here. The study included 169 undeveloped islands and shoals a??0.8 ha in the Thousand Islands Region of the St. Lawrence River, New York. Criteria such as critical habitat for uncommon plant and animal species were considered together with visual quality and incorporated into a rating system that ranked the islands and shoals according to their priority for conservation management and protection from development. Biological factors were determined based on previous research and a field survey. Visual quality was determined by visual diagnostic criteria developed from public responses to photographs of a sample of islands. Variables such as elevation, soil depth, and type of plant community can be used to classify islands into different categories of visual quality but are unsuccessful in classifying islands into categories of overall biological quality.
Exploring Factors That Influence Quality Literature Circles
ERIC Educational Resources Information Center
Young, Chase; Mohr, Kathleen A. J.
2018-01-01
Research indicates that literature circles are an authentic means for literacy development that students typically enjoy. To better understand the potential value and to add to the research base regarding literature circles, this study, involving 17 fourth graders, explores factors that may influence the quality of literature discussions,…
High quality factor single-crystal diamond mechanical resonators
NASA Astrophysics Data System (ADS)
Ovartchaiyapong, P.; Pascal, L. M. A.; Myers, B. A.; Lauria, P.; Bleszynski Jayich, A. C.
2012-10-01
Single-crystal diamond is a promising material for microelectromechanical systems (MEMs) because of its low mechanical loss, compatibility with extreme environments, and built-in interface to high-quality spin centers. But its use has been limited by challenges in processing and growth. We demonstrate a wafer bonding-based technique to form diamond on insulator, from which we make single-crystal diamond micromechanical resonators with mechanical quality factors as high as 338 000 at room temperature. Variable temperature measurements down to 10 K reveal a nonmonotonic dependence of quality factor on temperature. These resonators enable integration of single-crystal diamond into MEMs technology for classical and quantum applications.
Technology usage, quality management system, and service quality in Thailand.
Sivabrovornvatana, Nilubon; Siengthai, Sununta; Krairit, Donyaprueth; Paul, Himangshu
2005-01-01
This article aims to explore the relationship between technology and quality management for enhancing Thai hospital service quality. The paper presents the findings of an exploratory study that investigates service quality from the customer and service provider perception. In-depth interviews were conducted with respondents in Thai hospitals. The interviews explored service-related factors that patients and service providers perceive to be important for hospital services. The first interview group consisted of professionals as internal customers in direct contact with external customers, while the second group consisted of external customers of the same hospitals. The study's outcomes clearly suggest factors that make significant contribution to service quality. These factors can be categorized according to five SERVQUAL dimensions (reliability, responsiveness, assurance, empathy, and tangibility), although some factors required slightly different interpretation. The findings suggest that hospitals can develop an appropriate approach to their advantage, which can yield sustainable improvement in service quality as perceived by patients and professionals. Hospitals can make better quality decisions based on structured measurement and knowledge. It is recommended that managers apply this knowledge for successful implementation of activities related to service quality in their organizations.
Pay for performance: will dentistry follow?
Voinea-Griffin, Andreea; Fellows, Jeffrey L; Rindal, Donald B; Barasch, Andrei; Gilbert, Gregg H; Safford, Monika M
2010-04-28
"Pay for performance" is an incentive system that has been gaining acceptance in medicine and is currently being considered for implementation in dentistry. However, it remains unclear whether pay for performance can effect significant and lasting changes in provider behavior and quality of care. Provider acceptance will likely increase if pay for performance programs reward true quality. Therefore, we adopted a quality-oriented approach in reviewing those factors which could influence whether it will be embraced by the dental profession. The factors contributing to the adoption of value-based purchasing were categorized according to the Donabedian quality of care framework. We identified the dental insurance market, the dental profession position, the organization of dental practice, and the dental patient involvement as structural factors influencing the way dental care is practiced and paid for. After considering variations in dental care and the early stage of development for evidence-based dentistry, the scarcity of outcome indicators, lack of clinical markers, inconsistent use of diagnostic codes and scarcity of electronic dental records, we concluded that, for pay for performance programs to be successfully implemented in dentistry, the dental profession and health services researchers should: 1) expand the knowledge base; 2) increase considerably evidence-based clinical guidelines; and 3) create evidence-based performance measures tied to existing clinical practice guidelines. In this paper, we explored factors that would influence the adoption of value-based purchasing programs in dentistry. Although none of these factors were essential deterrents for the implementation of pay for performance programs in medicine, the aggregate seems to indicate that significant changes are needed before this type of program could be considered a realistic option in dentistry.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 2 2010-01-01 2010-01-01 false Quality. 29.6032 Section 29.6032 Agriculture... INSPECTION Standards Definitions § 29.6032 Quality. A division of a group or the second factor of a grade based on the relative degree of one or more elements of quality. ...
Domitrovich, Celene E; Pas, Elise T; Bradshaw, Catherine P; Becker, Kimberly D; Keperling, Jennifer P; Embry, Dennis D; Ialongo, Nicholas
2015-11-01
Evidence-based interventions are being disseminated broadly in schools across the USA, but the implementation levels achieved in community settings vary considerably. The current study examined the extent to which teacher and school factors were associated with implementation dosage and quality of the PAX Good Behavior Game (PAX GBG), a universal classroom-based preventive intervention designed to improve student social-emotional competence and behavior. Specifically, dosage (i.e., number of games and duration of games) across the school year and quality (i.e., how well the game is delivered) of PAX GBG implementation across four time points in a school year were examined. Hierarchical linear modeling was used to examine the association between teacher-level factors (e.g., demographics, self-reports of personal resources, attitudes toward the intervention, and workplace perceptions) and longitudinal implementation data. We also accounted for school-level factors, including demographic characteristics of the students and ratings of the schools' organizational health. Findings indicated that only a few teacher-level factors were significantly related to variation in implementation. Teacher perceptions (e.g., fit with teaching style, emotional exhaustion) were generally related to dosage, whereas demographic factors (e.g., teachers' age) were related to quality. These findings highlight the importance of school contextual and proximal teacher factors on the implementation of classroom-based programs.
Building conservation base on assessment of facade quality on Basuki Rachmat Street, Malang
NASA Astrophysics Data System (ADS)
Kurniawan, E. B.; Putri, R. Y. A.; Wardhani, D. K.
2017-06-01
Visual quality covers aspects of imageability which is associated with visual system and the element of distinction. Within a visual system of specific area, the physical quality may lead to a strong image. Here, the physical quality is one of important that make urban aesthetic. Build a discussion toward visual system of urban area, this paper aim is to identify the influencing factors in defining the façade’s visual quality of heritage buildings at Jend. Basuki Rahmat Street, Malang City, East Java-Indonesia. This Street is a main road of Malang city center that was built by Dutch colonial government. It was designed by IR. Thomas Kartsten. It was known as one of Malang area that have good visual quality. In order to idenfity the influencing factors, this paper conducts Multiple linear regression as a tools of analysis. The examined potential factors are resulted from of architecture and urban design expert’s assessment to each building’s segment at Jend. Basuki Rahmat. Finally, this paper reveals that the influencing factors are color, rhythm, and proportion. This is demonstrated by the results model: Visual quality (Y) = 0.304 + 0.21 Colors(X5) + 0.221 rhythm (X6) + 0.304 proportion (X7). Furthermore, the recommendation of the building facade will be made based on this model and study of historical and typology building in Basuki Rachmat Street.
Development of cotton gin PM2.5 emission factors for EPA’S AP-42
USDA-ARS?s Scientific Manuscript database
The Compilation of Air Pollution Emission Factors (AP-42) emission factors are assigned ratings, from A (Excellent) to E (Poor), based on the quality of data used to develop them. AP-42 currently contains no PM2.5 cotton gin emission factors. In an effort to develop science-based data for regulating...
Factors associated with quality of life in active childhood epilepsy: a population-based study.
Reilly, Colin; Atkinson, Patricia; Das, Krishna B; Chin, Richard F M; Aylett, Sarah E; Burch, Victoria; Gillberg, Christopher; Scott, Rod C; Neville, Brian G R
2015-05-01
Improving health-related quality of life (HRQOL), rather than just reducing seizures, should be the principal goal in comprehensive management of childhood epilepsy. There is a lack of population-based data on predictors of HRQOL in childhood epilepsy. The Children with Epilepsy in Sussex Schools (CHESS) study is a prospective, population-based study involving school-aged children (5-15 years) with active epilepsy (on one or more AED and/or had a seizure in the last year) in a defined geographical area in the UK. Eighty-five of 115 (74% of eligible population) children underwent comprehensive psychological assessment including measures of cognition, behaviour, and motor functioning. Parents of the children completed the Quality of Life in Childhood Epilepsy (QOLCE).Clinical data on eligible children was extracted using a standardised pro forma. Linear regression analysis was undertaken to identify factors significantly associated with total Quality of Life in this population. Factors independently significantly associated (p < .05) with total QOLCE scores were seizures before 24 months, cognitive impairment (IQ < 85), anxiety, and parent reported school attendance difficulty. These factors were also significantly associated with total QOLCE when children with IQ < 50 were excluded from analysis. The majority of factors associated with parent reported HRQOL in active childhood epilepsy are related to neurobehavioural and/or psychosocial aspects of the condition. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Yi, Hyun Sook; Lee, Yuree
2017-01-01
Teachers' classroom behaviors and their effects on student learning have received significant attention from educators, because the quality of instruction is a critical factor closely tied to students' learning experiences. Based on a theoretical model conceptualizing the quality of instruction, this study examined the characteristics of…
34 CFR 222.189 - What funding priority does the Secretary give to applications?
Code of Federal Regulations, 2012 CFR
2012-07-01
... OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION IMPACT AID PROGRAMS Impact Aid..., priority is given to applications based on a rank order of the application quality factors referenced in... application quality factors referenced in § 222.190, including the severity of the emergency. (3) Third...
34 CFR 222.189 - What funding priority does the Secretary give to applications?
Code of Federal Regulations, 2010 CFR
2010-07-01
... OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION IMPACT AID PROGRAMS Impact Aid..., priority is given to applications based on a rank order of the application quality factors referenced in... application quality factors referenced in § 222.190, including the severity of the emergency. (3) Third...
34 CFR 222.189 - What funding priority does the Secretary give to applications?
Code of Federal Regulations, 2014 CFR
2014-07-01
... OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION IMPACT AID PROGRAMS Impact Aid..., priority is given to applications based on a rank order of the application quality factors referenced in... application quality factors referenced in § 222.190, including the severity of the emergency. (3) Third...
Patterns of Student Employment in Russia
ERIC Educational Resources Information Center
Roshchin, Sergey; Rudakov, Victor
2017-01-01
This paper analyses the factors of combining study and work and the factors explaining intensity of work during study in Russia, based on cross-sectional survey data. The issue of how Russian students combine work and study is analysed through the set of financial, academic, social and demographic predictors, quality of university and quality of…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Shieh, Chun-Chien; Kipritidis, John; O’Brien, Ricky T.
Purpose: Respiratory signal, binning method, and reconstruction algorithm are three major controllable factors affecting image quality in thoracic 4D cone-beam CT (4D-CBCT), which is widely used in image guided radiotherapy (IGRT). Previous studies have investigated each of these factors individually, but no integrated sensitivity analysis has been performed. In addition, projection angular spacing is also a key factor in reconstruction, but how it affects image quality is not obvious. An investigation of the impacts of these four factors on image quality can help determine the most effective strategy in improving 4D-CBCT for IGRT. Methods: Fourteen 4D-CBCT patient projection datasets withmore » various respiratory motion features were reconstructed with the following controllable factors: (i) respiratory signal (real-time position management, projection image intensity analysis, or fiducial marker tracking), (ii) binning method (phase, displacement, or equal-projection-density displacement binning), and (iii) reconstruction algorithm [Feldkamp–Davis–Kress (FDK), McKinnon–Bates (MKB), or adaptive-steepest-descent projection-onto-convex-sets (ASD-POCS)]. The image quality was quantified using signal-to-noise ratio (SNR), contrast-to-noise ratio, and edge-response width in order to assess noise/streaking and blur. The SNR values were also analyzed with respect to the maximum, mean, and root-mean-squared-error (RMSE) projection angular spacing to investigate how projection angular spacing affects image quality. Results: The choice of respiratory signals was found to have no significant impact on image quality. Displacement-based binning was found to be less prone to motion artifacts compared to phase binning in more than half of the cases, but was shown to suffer from large interbin image quality variation and large projection angular gaps. Both MKB and ASD-POCS resulted in noticeably improved image quality almost 100% of the time relative to FDK. In addition, SNR values were found to increase with decreasing RMSE values of projection angular gaps with strong correlations (r ≈ −0.7) regardless of the reconstruction algorithm used. Conclusions: Based on the authors’ results, displacement-based binning methods, better reconstruction algorithms, and the acquisition of even projection angular views are the most important factors to consider for improving thoracic 4D-CBCT image quality. In view of the practical issues with displacement-based binning and the fact that projection angular spacing is not currently directly controllable, development of better reconstruction algorithms represents the most effective strategy for improving image quality in thoracic 4D-CBCT for IGRT applications at the current stage.« less
NASA Astrophysics Data System (ADS)
Santos, J. T.; Holz, T.; Fernandes, A. J. S.; Costa, F. M.; Chu, V.; Conde, J. P.
2015-02-01
Diamond-based microelectromechanical resonators have the potential of enhanced performance due to the chemical inertness of the diamond structural layer and its high Young’s modulus, high wear resistance, low thermal expansion coefficient, and very high thermal conductivity. In this work, the resonance frequency and quality factor of MEMS resonators based on nanocrystalline diamond films are characterized under different air pressures. The dynamic behavior of 50-300 μm long linear bridges and double ended tuning forks, with resonance frequencies between 0.5 and 15 MHz and quality factors as high as 50 000 are described as a function of measurement pressure from high vacuum(~10 mTorr) up to atmospheric conditions. The resonance frequencies and quality factors in vacuum show good agreement with the theoretical models including anchor and thermoelastic dissipation (TED). The Young’s moduli for nanocrystalline diamond films extrapolated from experimental data are between 840-920 GPa. The critical pressure values, at which the quality factor starts decreasing due to dissipation in air, are dependent on the resonator length. Longer structures, with quality factors limited by TED and lower resonance frequencies, have low critical pressures, of the order of 1-10 Torr and go from an intrinsic dissipation, to a molecular dissipation regime and finally to a region of viscous dissipation. Shorter resonators, with higher resonance frequencies and quality factors limited by anchor losses, have higher critical pressures, some higher than atmospheric pressure, and enter directly into the viscous dissipation regime from the intrinsic region.
Klassen, Anne F; Anthony, Samantha J; Khan, Aalia; Sung, Lillian; Klaassen, Robert
2011-09-01
This paper describes a systematic review conducted to identify factors that have been investigated as explanations of variability in the quality of life of children with cancer and childhood cancer survivors. Our purpose was to build an evidence base that could be used to guide and direct future research. MEDLINE, CINAHL, EMBASE, PsycINFO, Cancerlit, and Sociological Abstracts were searched from the inception of each database to June 15, 2009 using the following search terms: "quality of life," "health-related quality of life," "quality adjusted life years," "health status," "functional status," "well-being," or "patient-reported outcome." Sample characteristics and information about the relationship between a quality of life domain or total scale score and at least one factor (e.g., child gender or age, coping skills, family income) were extracted from eligible studies. Nine cancer-specific and nine generic QOL questionnaires were used in 58 publications described 239 factors (50 unique factors). The large number of cancer, treatment, child, and family variables considered indicates that extensive research activity has occurred. However, most of the variables identified were examined in only a few studies and most represent medical and treatment variables with less research attention paid to child and family variables. Our study has compiled evidence about determinants of QOL for children with cancer and childhood cancer survivors from the existing literature. Future research can build on this evidence base to expand the range of factors studied as most research to date has focused on medical and treatment factors.
Targeting Environmental Quality to Improve Population Health ...
Key goals of health care reform are to stimulate innovative approaches to improve healthcare quality and clinical outcomes while holding down costs. To achieve these goals value-based payment places the needs of the patient first and encourages multi-stakeholder cooperation. Yet, the stakeholders are typically all within the healthcare system, e.g. the Accountable Care Organization or Patient-Centered Medical Home, leaving important contributors to the health of the population such as the public health and environmental health systems absent. And rarely is the quality of the environment regarded as a modifiable factor capable of imparting a health benefit. Underscoring this point, a PubMed search of the search terms “environmental quality” with “value-based payment”, “value-based healthcare” or “value-based reimbursement” returned no relevant articles, providing further evidence that the healthcare industry largely disregards the quality of the environment as a significant determinant of wellbeing and an actionable risk factor for clinical disease management and population health intervention. Yet, the quality of the environment is unequivocally related to indicators of population health including all-cause mortality. The EPA’s Environmental Quality Index (EQI) composed of five different domains (air, land use, water, built environment and social) has provided new estimates of the associations between environmental quality and health stat
An assessment system for rating scientific journals in the field of ergonomics and human factors.
Dul, Jan; Karwowski, Waldemar
2004-05-01
A method for selecting and rating scientific and professional journals representing the discipline of ergonomics and human factors is proposed. The method is based upon the journal list, impact factors and citations provided by the Institute of Scientific Information (ISI), and the journal list published in the Ergonomics Abstracts. Three groups of journals were distinguished. The 'ergonomics journals' focus exclusively on ergonomics and human factors. The 'related journals' focus on other disciplines than ergonomics and human factors, but regularly publish ergonomics/human factors papers. The 'basic journals' focus on other technical, medical or social sciences than ergonomics, but are important for the development of ergonomics/human factors. Journal quality was rated using a maximum of four categories: top quality (A-level), high quality (B-level), good quality (C-level)) and professional (P-level). The above methods were applied to develop the Ergonomics Journal List 2004. A total of 25 'ergonomics journals', 58 'related journals' and 142 'basic journals' were classified.
Public health laboratory quality management in a developing country.
Wangkahat, Khwanjai; Nookhai, Somboon; Pobkeeree, Vallerut
2012-01-01
The article aims to give an overview of the system of public health laboratory quality management in Thailand and to produce a strengths, weaknesses, opportunities and threats (SWOT) analysis that is relevant to public health laboratories in the country. The systems for managing laboratory quality that are currently employed were described in the first component. The second component was a SWOT analysis, which used the opinions of laboratory professionals to identify any areas that could be improved to meet quality management systems. Various quality management systems were identified and the number of laboratories that met both international and national quality management requirements was different. The SWOT analysis found the opportunities and strengths factors offered the best chance to improve laboratory quality management in the country. The results are based on observations and brainstorming with medical laboratory professionals who can assist laboratories in accomplishing quality management. The factors derived from the analysis can help improve laboratory quality management in the country. This paper provides viewpoints and evidence-based approaches for the development of best possible practice of services in public health laboratories.
[Temporal variation of water quality and driving factors in Yanghe watershed of Zhangjiakou].
Pang, Bo; Wang, Tie-Yu; Lü, Yong-Long; Du, Li-Yu; Luo, Wei
2013-01-01
Yanghe is an important water source for Guanting Reservoir, which once supplied the Beijing city with drinking water, industrial process water and water-use in landscape. Based on the data of water quality monitored by Yanghe watershed monitoring stations from 1992 to 2009, 11 pollutants were selected for analysis. The trends of changes in water quality were figured out, and the major pollutants and driving factors were measured by the integrated standard index and grey correlation analytical methods. The results showed that there were two stages of water quality change in Yanghe watershed of Zhangjiakou. Firstly, the water was polluted seriously but recovered rapidly from 1992 to 1996. Secondly, although light pollution occurred in the watershed from 1997 to 2009, the pollution factors were still above the limits. The main pollution factors are ammonia nitrogen, petroleum, permanganate index, BOD5, Cr6+ and Cd. The main driving factor of water quality is the change of land use type, and the agricultural land showed less impact on water quality than the industrial land.
Kramers-Kronig based quality factor for shear wave propagation in soft tissue
Urban, M W; Greenleaf, J F
2009-01-01
Shear wave propagation techniques have been introduced for measuring the viscoelastic material properties of tissue, but assessing the accuracy of these measurements is difficult for in vivo measurements in tissue. We propose using the Kramers-Kronig relationships to assess the consistency and quality of the measurements of shear wave attenuation and phase velocity. In ex vivo skeletal muscle we measured the wave attenuation at different frequencies, and then applied finite bandwidth Kramers-Kronig equations to predict the phase velocities. We compared these predictions with the measured phase velocities and assessed the mean square error (MSE) as a quality factor. An algorithm was derived for computing a quality factor using the Kramers-Kronig relationships. PMID:19759409
Initial investigation of dietitian perception of plant-based protein quality.
Hughes, Glenna J; Kress, Kathleen S; Armbrecht, Eric S; Mukherjea, Ratna; Mattfeldt-Beman, Mildred
2014-07-01
Interest in plant-based diets is increasing, evidenced by scientific and regulatory recommendations, including Dietary Guidelines for Americans. Dietitians provide guidance in dietary protein selection but little is known about how familiar dietitians are with the quality of plant versus animal proteins or methods for measuring protein quality. Likewise, there is a need to explore their beliefs related to dietary recommendations. The aim of this study was to assess dietitians' perceptions of plant-based protein quality and to determine if these are affected by demographic factors such as age and dietary practice group (DPG) membership. This was a cross-sectional design using an online survey. The survey was sent to all members of the Missouri Dietetic Association. All completed surveys (136) were analyzed. The main outcome measures were responses to belief and knowledge questions about the protein quality of plant-based diets, along with demographic information including age and DPG membership. Descriptive statistics and frequencies were determined, and chi-square analysis was used to determine the associations between belief and knowledge responses and demographic characteristics. Responses to belief statements suggested a high level of support for plant-based diets. No associations were found between any of the belief questions and demographic factors. A majority of respondents were not familiar with protein quality determination methods that are currently recognized by global regulatory and advisory agencies. Potential barriers identified in shifting to a more plant-based diet were lack of interest and perceived difficulty. Knowledge among dietitians of plant-based protein quality in general, and methods of protein quality measurement more specifically, needs to be addressed to enhance their knowledge base for making dietary protein recommendations. Two potential avenues for training are university curricula and continuing education opportunities provided to practitioners who provide dietary advice.
Xiong, Zong-Wei; Gu, Sheng-Hao; Mao, Li-Li; Wang, Xue-Jiao; Zhang, Li-Zhen; Zhou, Zhi-Guo
2012-12-01
By using geographical information system (GIS), the cotton fiber quality data from 2005 to 2011 and the daily meteorological data from 1981 to 2010 at 82 sites (counties and cities) in China major cotton production regions were collected and treated with spatial interpolation. The spatial information system of cotton fiber quality in China major cotton production regions was established based on GIS, and the spatial distribution characteristics of the cotton fiber quality and their relationships with the local climatic factors were analyzed. In the northwest region (especially Xinjiang) of China, due to the abundant sunlight, low precipitation, and low relative humidity, the cotton fiber length, micronaire, and grade ranked the first. In the Yangtze River region and Yellow River region, the specific strength of cotton fiber was higher, and in the Yangtze River region, the cotton fiber length and specific strength were higher, while the micronaire and grade were lower than those in the Yellow River region. The cotton fiber quality was closely related to the climate factors such as temperature, sunlight, rainfall, and humidity.
Error function attack of chaos synchronization based encryption schemes.
Wang, Xingang; Zhan, Meng; Lai, C-H; Gang, Hu
2004-03-01
Different chaos synchronization based encryption schemes are reviewed and compared from the practical point of view. As an efficient cryptanalysis tool for chaos encryption, a proposal based on the error function attack is presented systematically and used to evaluate system security. We define a quantitative measure (quality factor) of the effective applicability of a chaos encryption scheme, which takes into account the security, the encryption speed, and the robustness against channel noise. A comparison is made of several encryption schemes and it is found that a scheme based on one-way coupled chaotic map lattices performs outstandingly well, as judged from quality factor. Copyright 2004 American Institute of Physics.
Factors Associated with Teacher Delivery of a Classroom-Based Tier 2 Prevention Program
ERIC Educational Resources Information Center
Sutherland, Kevin S; Conroy, Maureen A; McLeod, Bryce D; Algina, James; Kunemund, Rachel L
2018-01-01
Teachers sometimes struggle to deliver evidence based programs designed to prevent and ameliorate chronic problem behaviors of young children with integrity. Identifying factors associated with variations in the quantity and quality of delivery is thus an important goal for the field. This study investigated factors associated with teacher…
Personal and macro-systemic factors as predictors of quality of life in chronic schizophrenia.
Fontanil-Gómez, Yolanda; Alcedo Rodríguez, María A; Gutiérrez López, María I
2017-05-01
The goal of this research was to establish possible predictive factors for both subjective and externally assessed quality of life in people with chronic schizophrenia. Sixty-eight people with schizophrenia took part in the study and were assessed using the World Health Organisation Quality of Life Assessment - Brief Version (WHOQOL-BREF), the Quality of Life Scale (QLS), the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), the Global Assessment of Functioning (GAF), the Social Functioning Scale (SFS) tests. Correlations and multiple regression analysis were conducted to determine possible predictors of quality of life. The residential environment (rural/urban), diagnosis, age at onset of disorder, global functioning and social functioning explained 68% of the total variance based on proxies’ assessment quality of life. Living arrangements and social functioning emerged as predictor variables for subjective quality of life, explaining a 47.3% of the total variance. Socio-cultural factors, such as social integration or the quality of interpersonal relationships, have more influence on these peoples’ physical and psychological health than certain personal factors, such as psychopathology. It is therefore advisable to pay attention to the environment and macro-systemic variables when developing intervention plans to improve their quality of life.
Collett, David; Friend, Peter J; Watson, Christopher J E
2017-04-01
A measure of donor liver quality, the donor liver index, was developed and validated for the UK population of transplant recipients. Unlike previously proposed measures, this index is only based on variables that are available at the point of retrieval, and so does not include cold ischemic time. Indices of liver quality were based on data from the UK Transplant Registry on all 7929 liver transplants between January 2000 and December 2014. The donor liver index (DLI) was based on factors shown to affect graft survival, which included donor age, sex, height, type (donor after brain death or circulatory death), bilirubin, smoking history, and whether the liver was split. A separate index (DLI1) looking at 1-year survival showed donor cardiac disease, black ethnicity, and steatosis to be additional risk factors. A strong association was found between DLI and whether or not a surgeon accepts an offered liver for transplant, with a marked fall in acceptance rates for livers with an index greater than 1.31. Since 2000, there has been a notable reduction in the quality of livers transplanted, coupled with variation between the 7 UK liver transplant centers in risk appetite. The DLI is an index of liver quality which enables analysis of the changing trends in liver quality and center behavior. DLI1 enables identification of factors affecting shorter-term survival, and perhaps identifies a cohort of livers that may benefit from novel preservation technologies.
Resident attractiveness: an influential factor in the quality of care in nursing homes.
Campbell, Sara L
2005-08-01
Studying the characteristics considered attractive in residents in long-term care can provide an innovative picture of how nursing staff may perceive and inadvertently respond to residents based on those characteristics. It may be difficult to believe that attractiveness can affect the quality of residents' care. However, being open to the discovery of all factors that may influence the quality of care is important to promote positive changes in resident outcomes in nursing homes.
Environmental Health Standards for Human Spacecraft
NASA Technical Reports Server (NTRS)
James John T.
2010-01-01
The discussion of air and water quality standards includes evidence-based standards, factors unique to spaceflight, effects from exposures to combinations of compounds, contingency versus nominal standards, tables of ISO standards for air quality (ppm) and water quality (mg/L), and updating of standards.
ERIC Educational Resources Information Center
Byers, E. Sandra; Sears, Heather A.; Foster, Lyndsay R.
2013-01-01
This paper examines factors associated with middle school students' perceptions of the quality of the sexual health education (SHE) they received at school. Participants were 478 predominately White young people (256 girls, 222 boys) in grades 6-8 who completed a survey assessing their demographic characteristics; dating and sexual experience; and…
Factors Influencing Quality of Life of Hungarian Postmenopausal Women Screened by Osteodensitometry
ERIC Educational Resources Information Center
Maroti-Nagy, Agnes; Paulik, Edit
2011-01-01
The aim of our study was to evaluate factors influencing health related quality of life in Hungarian postmenopausal women who underwent osteodensitometry. A questionnaire-based cross-sectional study was carried out; 359 women aged over 40 years were involved, attending the outpatient Bone Densitometry Centre of Szeged. Two kinds of tools were…
Influence of fundamental mode fill factor on disk laser output power and laser beam quality
NASA Astrophysics Data System (ADS)
Cheng, Zhiyong; Yang, Zhuo; Shao, Xichun; Li, Wei; Zhu, Mengzhen
2017-11-01
An three-dimensional numerical model based on finite element method and Fox-Li method with angular spectrum diffraction theoy is developed to calculate the output power and power density distribution of Yb:YAG disk laser. We invest the influence of fundamental mode fill factor(the ratio of fundamental mode size and pump spot size) on the output power and laser beam quality. Due to aspherical aberration and soft aperture effect in laser disk, high beam quality can be achieve with relative lower efficiency. The highest output power of fundamental laser mode is influenced by the fundamental mode fill factor. Besides we find that optimal mode fill factor increase with pump spot size.
NASA Astrophysics Data System (ADS)
Lin, Chang-Yu; Huang, I.-Yu; Lan, Je-Wei
2013-01-01
Conventional flexural plate-wave (FPW) transducers have limited applications in biomedical sensing due to their disadvantages such as high insertion loss and low quality factor. To overcome these shortcomings, we propose a FPW transducer on a low phase velocity insulator membrane (5-μm-thick SiO2) with a novel groove-type reflective grating structure design. Additionally, a cystamine self-assembly monolayer and a glutaraldehyde cross-linking layer are implemented on the backside of the FPW device to immobilize alpha-fetoprotein (AFP) antibody. A FPW-based AFP biosensor with low detection limit (5 ng/mL) can be achieved and used to measure the extreme low concentration of AFP antigen in human serum for early detection of hepatocellular carcinoma. The proposed FPW-based AFP biosensor also demonstrates a very high quality factor (206), low insertion loss (-40.854 dB), low operating frequency (6.388 MHz), and high sensing linearity (90.7%).
Objective quality assessment for multiexposure multifocus image fusion.
Hassen, Rania; Wang, Zhou; Salama, Magdy M A
2015-09-01
There has been a growing interest in image fusion technologies, but how to objectively evaluate the quality of fused images has not been fully understood. Here, we propose a method for objective quality assessment of multiexposure multifocus image fusion based on the evaluation of three key factors of fused image quality: 1) contrast preservation; 2) sharpness; and 3) structure preservation. Subjective experiments are conducted to create an image fusion database, based on which, performance evaluation shows that the proposed fusion quality index correlates well with subjective scores, and gives a significant improvement over the existing fusion quality measures.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 2 2010-01-01 2010-01-01 false Quality. 29.3050 Section 29.3050 Agriculture... Quality. A division of a group or the second factor of a grade, based on the relative degree of one or more elements of quality in tobacco. [24 FR 8771, Oct. 29, 1959. Redesignated at 47 FR 51722, Nov. 17...
Ishibashi, Midori
2015-01-01
The cost, speed, and quality are the three important factors recently indicated by the Ministry of Health, Labour and Welfare (MHLW) for the purpose of accelerating clinical studies. Based on this background, the importance of laboratory tests is increasing, especially in the evaluation of clinical study participants' entry and safety, and drug efficacy. To assure the quality of laboratory tests, providing high-quality laboratory tests is mandatory. For providing adequate quality assurance in laboratory tests, quality control in the three fields of pre-analytical, analytical, and post-analytical processes is extremely important. There are, however, no detailed written requirements concerning specimen collection, handling, preparation, storage, and shipping. Most laboratory tests for clinical studies are performed onsite in a local laboratory; however, a part of laboratory tests is done in offsite central laboratories after specimen shipping. As factors affecting laboratory tests, individual and inter-individual variations are well-known. Besides these factors, standardizing the factors of specimen collection, handling, preparation, storage, and shipping, may improve and maintain the high quality of clinical studies in general. Furthermore, the analytical method, units, and reference interval are also important factors. It is concluded that, to overcome the problems derived from pre-analytical processes, it is necessary to standardize specimen handling in a broad sense.
NASA Astrophysics Data System (ADS)
Wang, Zhenghua; Tian, Zhihui
2018-01-01
In recent years, the problem of air pollution becomes more and more serious. Based on the geographic and seasonal climatic characteristics of Xuchang City, this paper studies the temporal and spatial distribution characteristics of air quality index. The results show that: from the time point of view, air quality index shows seasonal difference. Air quality index is highest in winter and is lowest in summer. From the space point of view, there are differences between the north and the south to a certain extent. Changge City, Yuzhou city and central Xuchang county is higher than the southeast of Xiangcheng county and Yanling county. The spatial and temporal variation characteristics of air quality index in Xuchang are influenced by natural factors and human activities, and the economic development and population are the important factors affecting the urban air quality.
Quality evaluation on an e-learning system in continuing professional education of nurses.
Lin, I-Chun; Chien, Yu-Mei; Chang, I-Chiu
2006-01-01
Maintaining high quality in Web-based learning is a powerful means of increasing the overall efficiency and effectiveness of distance learning. Many studies have evaluated Web-based learning but seldom evaluate from the information systems (IS) perspective. This study applied the famous IS Success model in measuring the quality of a Web-based learning system using a Web-based questionnaire for data collection. One hundred and fifty four nurses participated in the survey. Based on confirmatory factor analysis, the variables of the research model fit for measuring the quality of a Web-based learning system. As Web-based education continues to grow worldwide, the results of this study may assist the system adopter (hospital executives), the learner (nurses), and the system designers in making reasonable and informed judgments with regard to the quality of Web-based learning system in continuing professional education.
Muñoz-Pareja, Maritza; Loch, Mathias Roberto; Dos Santos, Hellen Geremias; Sakay Bortoletto, Maira Sayuri; Durán González, Alberto; Maffei de Andrade, Selma
The prevalence of poor sleep quality in men and women ≥ 40 years old from the VIGICARDIO Study was determined, and sociodemographic, health, lifestyle and social capital factors associated with poor sleep quality were identified. A population-based study conducted in 2011 among 1,058 non-institutionalised individuals randomly selected from Cambé, Paraná State, Brazil. Logistic regression was used to evaluate the association between sleep quality and sociodemographic, health, lifestyle and social capital factors in men and women. The prevalence of poor sleep quality was 34% in men and 44% in women. Having bad/regular self-rated health status was a factor associated with poor sleep quality in men (OR: 1.79; 95% CI: 1.17-2.72) and women (OR: 2.43; 95% CI: 1.68-3.53). Being obese (OR: 1.67; 95% CI: 1.13-2.46), having depression (OR: 2.09; 95% CI: 1.41-3.13) and presenting temporal orientation difficulties (OR: 1.95; 95% CI: 1.08-3.52) were associated factors in women. Difficulty to understand what is explained (OR: 2.18; 95% CI: 1.16-4.09) and alcohol abuse (OR: 1.85; 95% CI: 1.21-2.83) were associated factors in men. Factors affecting sleep quality are different for men and for women. These factors should be taken into consideration when devising activities that promote good sleep quality, with a view to improving their effectiveness. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Diani, Christopher A; Rock, Angie; Moll, Phil
2017-12-01
Background Risk-based monitoring is a concept endorsed by the Food and Drug Administration to improve clinical trial data quality by focusing monitoring efforts on critical data elements and higher risk investigator sites. BIOTRONIK approached this by implementing a comprehensive strategy that assesses risk and data quality through a combination of operational controls and data surveillance. This publication demonstrates the effectiveness of a data-driven risk assessment methodology when used in conjunction with a tailored monitoring plan. Methods We developed a data-driven risk assessment system to rank 133 investigator sites comprising 3442 subjects and identify those sites that pose a potential risk to the integrity of data collected in implantable cardiac device clinical trials. This included identification of specific risk factors and a weighted scoring mechanism. We conducted trend analyses for risk assessment data collected over 1 year to assess the overall impact of our data surveillance process combined with other operational monitoring efforts. Results Trending analyses of key risk factors revealed an improvement in the quality of data collected during the observation period. The three risk factors follow-up compliance rate, unavailability of critical data, and noncompliance rate correspond closely with Food and Drug Administration's risk-based monitoring guidance document. Among these three risk factors, 100% (12/12) of quantiles analyzed showed an increase in data quality. Of these, 67% (8/12) of the improving trends in worst performing quantiles had p-values less than 0.05, and 17% (2/12) had p-values between 0.05 and 0.06. Among the poorest performing site quantiles, there was a statistically significant decrease in subject follow-up noncompliance rates, protocol noncompliance rates, and incidence of missing critical data. Conclusion One year after implementation of a comprehensive strategy for risk-based monitoring, including a data-driven risk assessment methodology to target on-site monitoring visits, statistically significant improvement was seen in a majority of measurable risk factors at the worst performing site quantiles. For the three risk factors which are most critical to the overall compliance of cardiac rhythm management medical device studies: follow-up compliance rate, unavailability of critical data, and noncompliance rate, we measured significant improvement in data quality. Although the worst performing site quantiles improved but not significantly in some risk factors such as subject attrition, the data-driven risk assessment highlighted key areas on which to continue focusing both on-site and centralized monitoring efforts. Data-driven surveillance of clinical trial performance provides actionable observations that can improve site performance. Clinical trials utilizing risk-based monitoring by leveraging a data-driven quality assessment combined with specific operational procedures may lead to an improvement in data quality and resource efficiencies.
Eating practices and diet quality: a population study of four Nordic countries.
Holm, L; Lund, T B; Niva, M
2015-07-01
Daily practices related to eating are embedded in the social and cultural contexts of everyday life. How are such factors associated with diet quality relative to motivational factors? And, are associations universal or context-specific? We analyze the relationship between diet quality and the following practices: social company while eating, the regularity and duration of eating and the activity of watching TV while eating. A cross-sectional, questionnaire-based internet survey was conducted in April 2012 with stratified random samples of the populations (aged 15-80 years) in Denmark, Finland, Norway and Sweden (N=7531, completion rate 9-13%). The questionnaire elicited detailed accounts of one day of eating focusing on social and practical aspects of eating events. The validated Dietary Quality Score was the dependent variable. This measure is based on eight food frequency questions focusing on fats, vegetables, fruits and fish in the diet. Eating activities were associated with diet quality even when motivation to eat healthily and sociodemographic factors were controlled for. The number of daily eating events and eating main meals was positively correlated with diet quality in all countries. Beyond that, activities that were significantly associated with diet quality varied with country. When measured separately, the association between each activity and diet quality was weaker than motivation to eat healthily, but in combinations that are found in parts of the populations, the association was substantial. Daily practices related to eating are correlated with diet quality. Practices that are important are in part universal but also country-specific. Efforts to promote healthy eating should address not only cognitive factors but also everyday contexts of eating that facilitate or hamper healthy practices.
van Engen-Verheul, Mariëtte M; Peek, Niels; Haafkens, Joke A; Joukes, Erik; Vromen, Tom; Jaspers, Monique W M; de Keizer, Nicolette F
2017-01-01
Evidence on successful quality improvement (QI) in health care requires quantitative information from randomized clinical trials (RCTs) on the effectiveness of QI interventions, but also qualitative information from professionals to understand factors influencing QI implementation. Using a structured qualitative approach, concept mapping, this study determines factors identified by cardiac rehabilitation (CR) teams on what is needed to successfully implement a web-based audit and feedback (A&F) intervention with outreach visits to improve the quality of CR care. Participants included 49 CR professionals from 18 Dutch CR centres who had worked with the A&F system during a RCT. In three focus group sessions participants formulated statements on factors needed to implement QI successfully. Subsequently, participants rated all statements for importance and feasibility and grouped them thematically. Multi dimensional scaling was used to produce a final concept map. Forty-two unique statements were formulated and grouped into five thematic clusters in the concept map. The cluster with the highest importance was QI team commitment, followed by organisational readiness, presence of an adequate A&F system, access to an external quality assessor, and future use and functionalities of the A&F system. Concept mapping appeared efficient and useful to understand contextual factors influencing QI implementation as perceived by healthcare teams. While presence of a web-based A&F system and external quality assessor were seen as instrumental for gaining insight into performance and formulating QI actions, QI team commitment and organisational readiness were perceived as essential to actually implement and carry out these actions. These two sociotechnical factors should be taken into account when implementing and evaluating the success of QI implementations in future research. Copyright © 2016. Published by Elsevier Ireland Ltd.
Web-based Factors Affecting Online Purchasing Behaviour
NASA Astrophysics Data System (ADS)
Ariff, Mohd Shoki Md; Sze Yan, Ng; Zakuan, Norhayati; Zaidi Bahari, Ahamad; Jusoh, Ahmad
2013-06-01
The growing use of internet and online purchasing among young consumers in Malaysia provides a huge prospect in e-commerce market, specifically for B2C segment. In this market, if E-marketers know the web-based factors affecting online buyers' behaviour, and the effect of these factors on behaviour of online consumers, then they can develop their marketing strategies to convert potential customers into active one, while retaining existing online customers. Review of previous studies related to the online purchasing behaviour in B2C market has point out that the conceptualization and empirical validation of the online purchasing behaviour of Information and Communication Technology (ICT) literate users, or ICT professional, in Malaysia has not been clearly addressed. This paper focuses on (i) web-based factors which online buyers (ICT professional) keep in mind while shopping online; and (ii) the effect of web-based factors on online purchasing behaviour. Based on the extensive literature review, a conceptual framework of 24 items of five factors was constructed to determine web-based factors affecting online purchasing behaviour of ICT professional. Analysis of data was performed based on the 310 questionnaires, which were collected using a stratified random sampling method, from ICT undergraduate students in a public university in Malaysia. The Exploratory factor analysis performed showed that five factors affecting online purchase behaviour are Information Quality, Fulfilment/Reliability/Customer Service, Website Design, Quick and Details, and Privacy/Security. The result of Multiple Regression Analysis indicated that Information Quality, Quick and Details, and Privacy/Security affect positively online purchase behaviour. The results provide a usable model for measuring web-based factors affecting buyers' online purchase behaviour in B2C market, as well as for online shopping companies to focus on the factors that will increase customers' online purchase.
Key factors for a high-quality VR experience
NASA Astrophysics Data System (ADS)
Champel, Mary-Luc; Doré, Renaud; Mollet, Nicolas
2017-09-01
For many years, Virtual Reality has been presented as a promising technology that could deliver a truly new experience to users. The media and entertainment industry is now investigating the possibility to offer a video-based VR 360 experience. Nevertheless, there is a substantial risk that VR 360 could have the same fate as 3DTV if it cannot offer more than just being the next fad. The present paper aims at presenting the various quality factors required for a high-quality VR experience. More specifically, this paper will focus on the main three VR quality pillars: visual, audio and immersion.
Weighing in on the Teacher Merit Pay Debate. Notes
ERIC Educational Resources Information Center
Froese-Germain, Bernie
2011-01-01
First the good news. There's a growing consensus that the quality of teachers and teaching is a major factor--some would say the most important school-based factor--in the quality of student learning. In sum (and this comes as no surprise to the teaching profession), good teaching matters. The bad news is that, in this highly charged climate of…
ERIC Educational Resources Information Center
Oredein, Afolakemi O.; Durojaye, Toluwase G.
2012-01-01
This study is based on lecturers' and students' perception on educational policy implementation factors and quality education in Nigerian universities. Educational policies have always been formulated purposely to guide the present and future thinking, actions and decisions of managers. The potency of policy is not in formulation but in its proper…
Gu, Qing; Deng, Jinsong; Wang, Ke; Lin, Yi; Li, Jun; Gan, Muye; Ma, Ligang; Hong, Yang
2014-01-01
Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources. PMID:24919129
Gu, Qing; Deng, Jinsong; Wang, Ke; Lin, Yi; Li, Jun; Gan, Muye; Ma, Ligang; Hong, Yang
2014-06-10
Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources.
Carnegie Knowledge Network Concluding Recommendations. What We Know Series
ERIC Educational Resources Information Center
Goldhaber, Dan; Harris Douglas N.; Loeb, Susanna; McCaffrey, Daniel F.; Raudenbush, Stephen W.
2015-01-01
It is common knowledge that teacher quality is a key in-school factor affecting student achievement. While the quality of teaching clearly matters for how much students learn, this quality is challenging to measure. Evaluating teacher quality based on the level of their students' end-of-year test scores has been one method of assessing…
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 2 2010-01-01 2010-01-01 false Quality. 29.3539 Section 29.3539 Agriculture... Type 95) § 29.3539 Quality. A division of a group or the second factor of a grade based on the relative degree of one or more elements of quality in tobacco. [30 FR 9207, July 23, 1965. Redesignated at 49 FR...
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 2 2010-01-01 2010-01-01 false Quality. 29.2542 Section 29.2542 Agriculture...-Cured Tobacco (u.s. Types 22, 23, and Foreign Type 96) § 29.2542 Quality. A division of a group or the second factor of a grade based on the relative degree of one or more elements of quality. [37 FR 13626...
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 2 2010-01-01 2010-01-01 false Quality. 29.1051 Section 29.1051 Agriculture... Type 92) § 29.1051 Quality. A division of a group or the second factor of a grade based on the relative degree of one or more elements of quality. [42 FR 21092, Apr. 25, 1977. Redesignated at 47 FR 51721, Nov...
Comans, Tracy A; Currin, Michelle L; Brauer, Sandra G; Haines, Terry P
2011-01-01
To identify factors contributing to reduced quality of life and increased caregiver strain in an older population referred to a community rehabilitation team and to recommend service delivery models. Analytical cross-sectional study arising from baseline assessments from 107 subjects drawn from a randomised controlled trial of community rehabilitation service delivery models. A community rehabilitation team based in Brisbane, Queensland, Australia. Primary outcome variables include quality of life (EQ-5D & VAS) and Carer Strain Index. Predictor variables include participation in functional activities, history of falls, number of medications, number of co-morbidities, depression, environmental hazards, physical function and nutrition. Association between variables assessed using linear regression. Major factors contributing to reduced quality of life were having reduced participation in daily activities, depression, and having poor vision. Having poor nutrition and no longer driving also contributed to poor quality of life. The major factor contributing to increased caregiver strain was reduced participation in daily activities by the older person. Community rehabilitation services working with older populations must adopt models of care that screen for and address a wide range of factors that contribute to poor quality of life and caregiver strain.
Nabizadeh, Ramin; Valadi Amin, Maryam; Alimohammadi, Mahmood; Naddafi, Kazem; Mahvi, Amir Hossein; Yousefzadeh, Samira
2013-04-26
Developing a water quality index which is used to convert the water quality dataset into a single number is the most important task of most water quality monitoring programmes. As the water quality index setup is based on different local obstacles, it is not feasible to introduce a definite water quality index to reveal the water quality level. In this study, an innovative software application, the Iranian Water Quality Index Software (IWQIS), is presented in order to facilitate calculation of a water quality index based on dynamic weight factors, which will help users to compute the water quality index in cases where some parameters are missing from the datasets. A dataset containing 735 water samples of drinking water quality in different parts of the country was used to show the performance of this software using different criteria parameters. The software proved to be an efficient tool to facilitate the setup of water quality indices based on flexible use of variables and water quality databases.
Effects-based monitoring of water quality is a proven approach to monitoring the status of a water source. Only biological material can integrate factors which dictate toxicity. Online Toxicity Monitors (OTMs) provide a means to digitize sentinel organism responses to dynamic wa...
Dimensions of service quality in healthcare: a systematic review of literature.
Fatima, Iram; Humayun, Ayesha; Iqbal, Usman; Shafiq, Muhammad
2018-06-13
Various dimensions of healthcare service quality were used and discussed in literature across the globe. This study presents an updated meaningful review of the extensive research that has been conducted on measuring dimensions of healthcare service quality. Systematic review method in current study is based on PRISMA guidelines. We searched for literature using databases such as Google, Google Scholar, PubMed and Social Science, Citation Index. In this study, we screened 1921 identified papers using search terms/phrases. Snowball strategies were adopted to extract published articles from January 1997 till December 2016. Two-hundred and fourteen papers were identified as relevant for data extraction; completed by two researchers, double checked by the other two to develop agreement in discrepancies. In total, 74 studies fulfilled our pre-defined inclusion and exclusion criteria for data analysis. Service quality is mainly measured as technical and functional, incorporating many sub-dimensions. We synthesized the information about dimensions of healthcare service quality with reference to developed and developing countries. 'Tangibility' is found to be the most common contributing factor whereas 'SERVQUAL' as the most commonly used model to measure healthcare service quality. There are core dimensions of healthcare service quality that are commonly found in all models used in current reviewed studies. We found a little difference in these core dimensions while focusing dimensions in both developed and developing countries, as mostly SERVQUAL is being used as the basic model to either generate a new one or to add further contextual dimensions. The current study ranked the contributing factors based on their frequency in literature. Based on these priorities, if factors are addressed irrespective of any context, may lead to contribute to improve healthcare quality and may provide an important information for evidence-informed decision-making.
NASA Astrophysics Data System (ADS)
Kuo, Yi-Ming; Liu, Wen-Wen
2015-04-01
The Han River basin is one of the most important industrial and grain production bases in the central China. A lot of factories and towns have been established along the river where large farmlands are located nearby. In the last few decades the water quality of the Han River, specifically in middle and lower reaches, has gradually declined. The agricultural nonpoint pollution and municipal and industrial point pollution significantly degrade the water quality of the Han River. Factor analysis can be applied to reduce the dimensionality of a data set consisting of a large number of inter-related variables. Cluster analysis can classify the samples according to their similar characters. In this study, factor analysis is used to identify major pollution indicators, and cluster analysis is employed to classify the samples based on the sample locations and hydrochemical variables. Water samples were collected from 12 sample sites collected from Xiangyang City (middle Han River) to Wuhan City (lower Han River). Correlations among 25 hydrochemical variables are statistically examined. The important pollutants are determined by factor analysis. A three-factor model is determined and explains over 85% of the total river water quality variation. Factor 1, including SS, Chl-a, TN and TP, can be considered as the nonpoint source pollution. Factor 2, including Cl-, Br-, SO42-, Ca2+, Mg2+, K+, Fe2+ and PO43-, can be treated as the industrial pollutant pollution. Factor 3, including F- and NO3-, reflects the influence of the groundwater or self-purification capability of the river water. The various land uses along the Han River correlate well with the pollution types. In addition, the result showed that the water quality of Han River deteriorated gradually from middle to lower Han River. Some tributaries have been seriously polluted and significantly influence the mainstream water quality of the Han River. Finally, the result showed that the nonpoint pollution and the point pollution both significantly influence water quality in the middle and lower Han River. This study provides an effective method for watershed management and pollution control in Han River.
Determinants of perceived sleep quality in normal sleepers.
Goelema, M S; Regis, M; Haakma, R; van den Heuvel, E R; Markopoulos, P; Overeem, S
2017-09-20
This study aimed to establish the determinants of perceived sleep quality over a longer period of time, taking into account the separate contributions of actigraphy-based sleep measures and self-reported sleep indices. Fifty participants (52 ± 6.6 years; 27 females) completed two consecutive weeks of home monitoring, during which they kept a sleep-wake diary while their sleep was monitored using a wrist-worn actigraph. The diary included questions on perceived sleep quality, sleep-wake information, and additional factors such as well-being and stress. The data were analyzed using multilevel models to compare a model that included only actigraphy-based sleep measures (model Acti) to a model that included only self-reported sleep measures to explain perceived sleep quality (model Self). In addition, a model based on the self-reported sleep measures and extended with nonsleep-related factors was analyzed to find the most significant determinants of perceived sleep quality (model Extended). Self-reported sleep measures (model Self) explained 61% of the total variance, while actigraphy-based sleep measures (model Acti) only accounted for 41% of the perceived sleep quality. The main predictors in the self-reported model were number of awakenings during the night, sleep onset latency, and wake time after sleep onset. In the extended model, the number of awakenings during the night and total sleep time of the previous night were the strongest determinants of perceived sleep quality, with 64% of the variance explained. In our cohort, perceived sleep quality was mainly determined by self-reported sleep measures and less by actigraphy-based sleep indices. These data further stress the importance of taking multiple nights into account when trying to understand perceived sleep quality.
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.
A paradigm shift for bone quality in dentistry: A literature review.
Kuroshima, Shinichiro; Kaku, Masaru; Ishimoto, Takuya; Sasaki, Muneteru; Nakano, Takayoshi; Sawase, Takashi
2017-10-01
The aim of this study was to present the current concept of bone quality based on the proposal by the National Institutes of Health (NIH) and some of the cellular and molecular factors that affect bone quality. This is a literature review which focuses on collagen, biological apatite (BAp), and bone cells such as osteoblasts and osteocytes. In dentistry, the term "bone quality" has long been considered to be synonymous with bone mineral density (BMD) based on radiographic and sensible evaluations. In 2000, the NIH proposed the concept of bone quality as "the sum of all characteristics of bone that influence the bone's resistance to fracture," which is completely independent of BMD. The NIH defines bone quality as comprising bone architecture, bone turnover, bone mineralization, and micro-damage accumulation. Moreover, our investigations have demonstrated that BAp, collagen, and bone cells such as osteoblasts and osteocytes play essential roles in controlling the current concept of bone quality in bone around hip and dental implants. The current concept of bone quality is crucial for understanding bone mechanical functions. BAp, collagen and osteocytes are the main factors affecting bone quality. Moreover, mechanical loading dynamically adapts bone quality. Understanding the current concept of bone quality is required in dentistry. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Factors associated with quality of life in patients undergoing coronary angioplasty
Darvishpour, Azar; Javadi-Pashaki, Nazila; Salari, Arsalan; Sadeghi, Tahere; Taleshan-Nejad, Marayam
2017-01-01
Objective: Percutaneous coronary intervention has been effective in increasing longevity of patients with cardiovascular disease. However, the evidence shows that the quality of life after the intervention is still lower than optimal level. The quality of life can be affected by various factors. The aim of this study is to determine the quality of life and its related factors in patients undergoing coronary angioplasty. Methods: This cross-sectional study was performed on 106 patients undergoing coronary angioplasty during 2015-2016. This study population included all patients who referred to a cardiac clinic in Rasht, Iran, were passed 3 months after their angioplasty. Research samples met the inclusion criteria and were willing to participate to the study, were selected gradually (continually). Research tools were a self-structured questionnaire regarding factors associated with the quality of life and the MacNew quality of life questionnaire. Data were collected through asking patients questions and using patient’s medical records. Data analysis was conducted using descriptive and inferential statistics. Results: The results of multivariate linear regression analysis showed that independent variables of age (P = 0.0001), the number of diseased vessels (P = 0.0001), and the number of comorbidities (P < 0.05) were the most important factors associated with the quality of life. Conclusion: Health-care professionals can play an effective role in promoting the quality of life of patients undergoing coronary angioplasty by modifying lifestyle based on the related factors and to provide comprehensive care programs, especially for elderly. PMID:29085266
Hedayat, Kosar; Karbakhsh, Mojgan; Ghiasi, Maryam; Goodarzi, Azadeh; Fakour, Yousef; Akbari, Zahra; Ghayoumi, Afsaneh; Ghandi, Narges
2016-06-07
Vitiligo is a multi-factorial pigmentary skin disorder. Recently, the importance of emotional and psychological issues is proposed in incidence, progression, relapse and remission of vitiligo. There are limited studies conducted in developing countries, which assess life quality of patients with vitiligo. The aim of this study was the application and evaluation of a disease-specific quality of life index in Iranian patients, for the first time. This cross-sectional biphasic study was conducted on 25 patients as a pilot and another 173 patients as the main study group, in Razi Hospital, Tehran, Iran, 2013-2014. Persian version of Vitiligo Quality of Life index (VitiQoL) was developed with backward-forward method. Based on the pilot study, the validity and reliability were assessed. The Vitiligo Area and Score Index (VASI), VitiQoL, and their relationship, demographic and clinical characteristic of patients were measured. The Mean and standard deviation of the VitiQoL score was 30.5 ± 14.5 (range 0-60 in Persian version). There was a significant relationship between VASI score and VitiQoL (p = 0.015, r = 0.187). Confirmatory factor analysis revealed three important factors within VitiQoL: participation limitation, stigma, and behavior. In subscale analysis based on behavior factor, female patients had poorer quality of life (p = 0.02). Concomitant psychiatric problems, e.g. anxiety and depression, were not associated with QOL; however, they were near to being meaningful (p = 0.06, r = 0.14). VitiQoL is a valid index in estimating life quality of vitiligo patients and has proper relation to disease severity. Focusing on patient's life quality is an important entity in the management of vitiligo patients; relevant supportive group-based consultations and therapies are also important arms when approaching vitiligo.
Mello, Aline Veroneze de; Sarti, Flávia Mori; Pereira, Jaqueline Lopes; Goldbaum, Moisés; Cesar, Chester Luiz Galvão; Alves, Maria Cecilia Goi Porto; Fisberg, Regina Mara
2018-06-07
Recent studies have explored the influence of socioeconomic inequalities on the diet quality. However, there is lack of evidence regarding the level of inequalities in dietary quality and its main contributing factors from population-based follow-up studies. The primary objective of this study was to investigate the level and the determinants of inequalities in diet quality in a representative sample of adolescents, adults and older adults resident in São Paulo, Brazil. Data from the Health Survey of São Paulo (ISA-Capital) were analyzed for 2003 (n = 2398), 2008 (n = 1662) and 2015 (n = 1742) surveys. Information on food consumption was obtained through 24-h dietary recall, and diet quality was assessed based on the Revised Brazilian Healthy Eating Index (BHEI-R). The descriptive variables were compared using 95% confidence interval. The scores of BHEI-R and its components were compared across age groups and year. The association between socioeconomic inequalities and diet quality was based on the estimation of concentration index. We observed that the BHEI-R scores gradually improved over 12-years, with older adults showing the greatest improvement. The increase in overall population score was observed for total fruits, whole fruits, whole grains, oils and sodium. The main contributor to socioeconomic inequality in diet quality in 2003 was ethnic group, and in 2008 and 2015, it was per capita household income; age was a persistent factor of inequality in the population over the years. Concentration indices indicated that lower income individuals had higher BHEI-R scores in 2003; however, there was a shift in favor of higher income individuals in 2008 and 2015. Changes in the patterns of determination of inequalities according to age, ethnic group or income during the period analyzed show the existence of ongoing process of contribution of demographic and socioeconomic factors in the diet quality of individuals in a large urban center.
Research-Based Options for Education Policymaking: Preschool Education
ERIC Educational Resources Information Center
Mathis, William
2012-01-01
Publicly supported, high-quality preschool education is among the most successful and well-documented of education reforms. There is near-universal agreement that high-quality preschool programs more than pay for themselves in economic and social benefits. Program quality is absolutely critical. While no one factor can be considered determinative,…
Klimov, Victor I.; Baker, Thomas A.; Lim, Jaehoon; ...
2016-05-09
In this study, luminescent solar concentrators (LSCs) can be utilized as both large-area collectors of solar radiation supplementing traditional photovoltaic cells as well as semitransparent “solar windows” that provide a desired degree of shading and simultaneously serve as power-generation units. An important characteristic of an LSC is a concentration factor (C) that can be thought of as a coefficient of effective enlargement (or contraction) of the area of a solar cell when it is coupled to the LSC. Here we use analytical and numerical Monte Carlo modeling in addition to experimental studies of quantum-dot-based LSCs to analyze the factors thatmore » influence optical concentration in practical devices. Our theoretical model indicates that the maximum value of C achievable with a given fluorophore is directly linked to the LSC quality factor (Q LSC) defined as the ratio of absorption coefficients at the wavelengths of incident and reemitted light. In fact, we demonstrate that the ultimate concentration limit (C 0) realized in large-area devices scales linearly with the LSC quality factor and in the case of perfect emitters and devices without back reflectors is approximately equal to Q LSC. To test the predictions of this model, we conduct experimental studies of LSCs based on visible-light emitting II–VI core/shell quantum dots with two distinct LSC quality factors. We also investigate devices based on near-infrared emitting CuInSe xS 2–x quantum dots for which the large emission bandwidth allows us to assess the impact of varied Q LSC on the concentration factor by simply varying the detection wavelength. In all cases, we find an excellent agreement between the model and the experimental observations, suggesting that the developed formalism can be utilized for express evaluation of prospective LSC performance based on the optical spectra of LSC fluorophores, which should facilitate future efforts on the development of high-performance devices based on quantum dots as well as other types of emitters.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Klimov, Victor I.; Baker, Thomas A.; Lim, Jaehoon
In this study, luminescent solar concentrators (LSCs) can be utilized as both large-area collectors of solar radiation supplementing traditional photovoltaic cells as well as semitransparent “solar windows” that provide a desired degree of shading and simultaneously serve as power-generation units. An important characteristic of an LSC is a concentration factor (C) that can be thought of as a coefficient of effective enlargement (or contraction) of the area of a solar cell when it is coupled to the LSC. Here we use analytical and numerical Monte Carlo modeling in addition to experimental studies of quantum-dot-based LSCs to analyze the factors thatmore » influence optical concentration in practical devices. Our theoretical model indicates that the maximum value of C achievable with a given fluorophore is directly linked to the LSC quality factor (Q LSC) defined as the ratio of absorption coefficients at the wavelengths of incident and reemitted light. In fact, we demonstrate that the ultimate concentration limit (C 0) realized in large-area devices scales linearly with the LSC quality factor and in the case of perfect emitters and devices without back reflectors is approximately equal to Q LSC. To test the predictions of this model, we conduct experimental studies of LSCs based on visible-light emitting II–VI core/shell quantum dots with two distinct LSC quality factors. We also investigate devices based on near-infrared emitting CuInSe xS 2–x quantum dots for which the large emission bandwidth allows us to assess the impact of varied Q LSC on the concentration factor by simply varying the detection wavelength. In all cases, we find an excellent agreement between the model and the experimental observations, suggesting that the developed formalism can be utilized for express evaluation of prospective LSC performance based on the optical spectra of LSC fluorophores, which should facilitate future efforts on the development of high-performance devices based on quantum dots as well as other types of emitters.« less
Quality factor concept in piezoceramic transformer performance description.
Mezheritsky, Alex V
2006-02-01
A new general approach based on the quality factor concept to piezoceramic transformer (PT) performance description is proposed. The system's quality factor, material elastic anisotropy, and coupling factors of the input and output sections of an electrically excited and electrically loaded PT fully characterize its resonance and near-resonance behavior. The PT efficiency, transformation ratio, and input and output power were analytically analyzed and simulated as functions of the load and frequency for the simplest classical Langevin-type and Rosen-type PT designs. A new formulation of the electrical input impedance allows one to separate the power consumed by PT from the power transferred into the load. The system's PT quality factor takes into account losses in each PT "input-output-load" functional components. The loading process is changing PT input electrical impedance on the way that under loading the minimum series impedance is increasing and the maximum parallel impedance is decreasing coincidentally. The quality-factors ratio, between the states of fully loaded and nonloaded PT, is one of the best measures of PTs dynamic performance--practically, the lower the ratio is, the better PT efficiency. A simple and effective method for the loaded PT quality factor determination is proposed. As was found, a piezoceramic with low piezoelectric anisotropy is required to provide maximum PT efficiency and higher corresponding voltage gain. Limitations on the PT output voltage and power, caused by nonlinear effects in piezoceramics, were established.
Systematic uncertainties in RF-based measurement of superconducting cavity quality factors
Holzbauer, J. P.; Pischalnikov, Yu.; Sergatskov, D. A.; ...
2016-05-10
Q 0 determinations based on RF power measurements are subject to at least three potentially large systematic effects that have not been previously appreciated. Here, instrumental factors that can systematically bias RF based measurements of Q 0 are quantified and steps that can be taken to improve the determination of Q 0 are discussed.
NASA Astrophysics Data System (ADS)
Gholami, V.; Khaleghi, M. R.; Sebghati, M.
2017-11-01
The process of water quality testing is money/time-consuming, quite important and difficult stage for routine measurements. Therefore, use of models has become commonplace in simulating water quality. In this study, the coactive neuro-fuzzy inference system (CANFIS) was used to simulate groundwater quality. Further, geographic information system (GIS) was used as the pre-processor and post-processor tool to demonstrate spatial variation of groundwater quality. All important factors were quantified and groundwater quality index (GWQI) was developed. The proposed model was trained and validated by taking a case study of Mazandaran Plain located in northern part of Iran. The factors affecting groundwater quality were the input variables for the simulation, whereas GWQI index was the output. The developed model was validated to simulate groundwater quality. Network validation was performed via comparison between the estimated and actual GWQI values. In GIS, the study area was separated to raster format in the pixel dimensions of 1 km and also by incorporation of input data layers of the Fuzzy Network-CANFIS model; the geo-referenced layers of the effective factors in groundwater quality were earned. Therefore, numeric values of each pixel with geographical coordinates were entered to the Fuzzy Network-CANFIS model and thus simulation of groundwater quality was accessed in the study area. Finally, the simulated GWQI indices using the Fuzzy Network-CANFIS model were entered into GIS, and hence groundwater quality map (raster layer) based on the results of the network simulation was earned. The study's results confirm the high efficiency of incorporation of neuro-fuzzy techniques and GIS. It is also worth noting that the general quality of the groundwater in the most studied plain is fairly low.
NASA Astrophysics Data System (ADS)
Kaienburg, Pascal; Rau, Uwe; Kirchartz, Thomas
2016-08-01
Understanding the fill factor in organic solar cells remains challenging due to its complex dependence on a multitude of parameters. By means of drift-diffusion simulations, we thoroughly analyze the fill factor of such low-mobility systems and demonstrate its dependence on a collection coefficient defined in this work. We systematically discuss the effect of different recombination mechanisms, space-charge regions, and contact properties. Based on these findings, we are able to interpret the thickness dependence of the fill factor for different experimental studies from the literature. The presented model provides a facile method to extract the photoactive layer's electronic quality which is of particular importance for the fill factor. We illustrate that over the past 15 years, the electronic quality has not been continuously improved, although organic solar-cell efficiencies increased steadily over the same period of time. Only recent reports show the synthesis of polymers for semiconducting films of high electronic quality that are able to produce new efficiency records.
Correlation of neonatal intensive care unit performance across multiple measures of quality of care.
Profit, Jochen; Zupancic, John A F; Gould, Jeffrey B; Pietz, Kenneth; Kowalkowski, Marc A; Draper, David; Hysong, Sylvia J; Petersen, Laura A
2013-01-01
To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance. We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations. Twenty-two regional NICUs in California. In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007. Pneumothorax, growth velocity, health care-associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk. The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations, 6 were significant (ρ < .05). Correlations between pairs of measures of quality of care were strong (ρ ≥ .5) for 1 pair, moderate (range, ρ ≥ .3 to ρ < .5) for 8 pairs, weak (range, ρ ≥ .1 to ρ < .3) for 5 pairs, and negligible (ρ < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care-associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4. In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest.
Correlation of Neonatal Intensive Care Unit Performance Across Multiple Measures of Quality of Care
Profit, J; Zupancic, JAF; Gould, JB; Pietz, K; Kowalkowski, MA; Draper, D; Hysong, SJ; Petersen, LA
2014-01-01
Objectives To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance. Design We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations. Setting Twenty-two regional NICUs in California. Patients In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007. Main Outcomes Measures Pneumothorax, growth velocity, health care–associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk. Results The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations only 6 were significant (P < .05). Correlations between pairs of quality measures were strong (ρ > .5) for 1 pair, moderate (.3 < |ρ| < .5) for 8 pairs, weak (.1 < |ρ| < .3) for 5 pairs and negligible (|ρ| < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care–associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4. Conclusion In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest. PMID:23403539
Quality assurance and the need to evaluate interventions and audit programme outcomes.
Zhao, Min; Vaartjes, Ilonca; Klipstein-Grobusch, Kerstin; Kotseva, Kornelia; Jennings, Catriona; Grobbee, Diederick E; Graham, Ian
2017-06-01
Evidence-based clinical guidelines provide standards for the provision of healthcare. However, these guidelines have been poorly implemented in daily practice. Clinical audit is a quality improvement tool to promote quality of care in daily practice and to improve outcomes through the systematic review of care delivery and implementation of changes. A major priority in the management of subjects with cardiovascular disease (CVD) management is secondary prevention by controlling cardiovascular risk factors and providing appropriate medical treatment. Clinical audits can be applied to monitor modifiable risk factors and evaluate quality improvements of CVD management in daily practice. Existing clinical audits have provided an overview of the burden of risk factors in subjects with CVD and reflect real-world risk factor recording and management. However, consistent and representative data from clinic audits are still insufficient to fully monitor quality improvement of CVD management. Data are lacking in particular from low- and middle-income countries, limiting the evaluation of CVD management quality by clinical audit projects in many settings. To support the development of clinical standards, monitor daily practice performance, and improve quality of care in CVD management at national and international levels, more widespread clinical audits are warranted.
Hasan, Haroon; Muhammed, Taaha; Yu, Jennifer; Taguchi, Kelsi; Samargandi, Osama A; Howard, A Fuchsia; Lo, Andrea C; Olson, Robert; Goddard, Karen
2017-10-01
The objective of our study was to evaluate the methodological quality of systematic reviews and meta-analyses in Radiation Oncology. A systematic literature search was conducted for all eligible systematic reviews and meta-analyses in Radiation Oncology from 1966 to 2015. Methodological characteristics were abstracted from all works that satisfied the inclusion criteria and quality was assessed using the critical appraisal tool, AMSTAR. Regression analyses were performed to determine factors associated with a higher score of quality. Following exclusion based on a priori criteria, 410 studies (157 systematic reviews and 253 meta-analyses) satisfied the inclusion criteria. Meta-analyses were found to be of fair to good quality while systematic reviews were found to be of less than fair quality. Factors associated with higher scores of quality in the multivariable analysis were including primary studies consisting of randomized control trials, performing a meta-analysis, and applying a recommended guideline related to establishing a systematic review protocol and/or reporting. Systematic reviews and meta-analyses may introduce a high risk of bias if applied to inform decision-making based on AMSTAR. We recommend that decision-makers in Radiation Oncology scrutinize the methodological quality of systematic reviews and meta-analyses prior to assessing their utility to inform evidence-based medicine and researchers adhere to methodological standards outlined in validated guidelines when embarking on a systematic review. Copyright © 2017 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Lin, Jin-Ding; Hu, Jung; Yen, Chia-Feng; Hsu, Shang-Wei; Lin, Lan-Ping; Loh, Ching-Hui; Chen, Mei-Hua; Wu, Sheng-Ru; Chu, Cordia M.; Wu, Jia-Ling
2009-01-01
The present study based on World Health Organization quality of life (WHOQOL-BREF) scale to examine quality of life of the caregivers caring for their children/adolescents with intellectual disabilities in Taiwan, and the factors contributing to their quality of life. Structured interviews were conducted with 597 caregivers of children/adolescents…
Tessema, Gizachew Assefa; Streak Gomersall, Judith; Mahmood, Mohammad Afzal; Laurence, Caroline O.
2016-01-01
Background Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa. Methods Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings. Results From 4334 records, 11 studies (eight quantitative, three qualitative) met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client’s waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as ‘pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers’ behaviour. Conclusion There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking contraceptive methods are important to improve the quality of care in family planning services. Strategies to improve provider behavior and competency are important. Moreover, strategies that minimize client waiting time and ensure client confidentiality should be implemented to ensure quality of care in family planning services. However, no strong evidence based conclusions and recommendations may be drawn from the evidence. Future studies are needed to identify the most important factors associated with quality of care in family planning services in a wider range of African countries. PMID:27812124
Assessment of Soil Environmental Quality in Huangguoshu Waterfalls Scenic Area
NASA Astrophysics Data System (ADS)
Luo, Rongbin; Feng, Kaiyu; Gu, Bo; Xu, Chengcheng
2018-03-01
This paper concentrates on five major heavy metal pollutants as soil environmental quality evaluation factors, respectively Lead (Pb), Cadmium (Cd), Mercury (Hg), Arsenic (As), Chromium (Cr), based on the National Soil Environmental Quality Standards (GB15618 - 1995), we used single factor index evaluation model of soil environmental quality and comprehensive index evaluation model to analyze surface soil environmental quality in the Huangguoshu Waterfalls scenic area. Based on surface soil analysis, our results showed that the individual contamination index, Pb, Hg, As and Cr in the Huangguoshu Waterfalls scenic area met class I according to requirements of National Soil Environmental Quality Standards, which indicated that Pb, Hg, As and Cr were not main heavy metal pollutants in this area, but the individual contamination index of Cd in soil was seriously exceeded National Soil Environmental Quality Standards’ requirement. Soil environmental quality in Shitouzhai, Luoshitan, Langgong Hongyan Power Plant have exceeded the requirement of National Soil Environmental Quality Standards “0.7< Pc≤ 1.0” (Alert Level), these soils had been slightly polluted; the classification of soil environmental quality assessment in Longgong downstream area was above “Alert Level”, it indicated that soil in this area was not polluted. Above all, relevant measures for soil remediation are put forward.
ERIC Educational Resources Information Center
Kauppila, Osmo; Mursula, Anu; Harkonen, Janne; Kujala, Jaakko
2015-01-01
The growth in university-industry collaboration has resulted in an increasing demand for methods to evaluate it. This paper presents one way to evaluate an organization's collaborative activities based on the European Foundation of Quality Management excellence model. Success factors of collaboration are derived from literature and compared…
ERIC Educational Resources Information Center
Salajan, Florin D.; Welch, Anita G.; Ray, Chris M.; Peterson, Claudette
2015-01-01
This study's primary investigation is the impact of "peer influence" and "perceived quality of teaching" on faculty members' usage of web-based learning management systems within the Technology Acceptance Model (TAM) framework. These factors are entered into an extended TAM as external variables impacting on the core constructs…
Consumer perception of bread quality.
Gellynck, Xavier; Kühne, Bianka; Van Bockstaele, Filip; Van de Walle, Davy; Dewettinck, Koen
2009-08-01
Bread contains a wide range of important nutritional components which provide a positive effect on human health. However, the consumption of bread is declining during the last decades. This is due to factors such as changing eating patterns and an increasing choice of substitutes like breakfast cereals and fast foods. The aim of this study is to investigate consumer's quality perception of bread towards sensory, health and nutrition attributes. Four consumer segments are identified based on these attributes. The different consumer segments comprise consumers being positive to all three quality aspects of bread ("enthusiastic") as wells as consumers perceiving bread strongly as "tasteless", "non-nutritious" or "unhealthy". Moreover, factors are identified which influence the consumers' quality perception of bread. The results of our study may help health professionals and policy makers to systematically inform consumers about the positive effects of bread based on its components. Furthermore, firms can use the results to build up tailor-made marketing strategies.
Impact of weak social ties and networks on poor sleep quality: A case study of Iranian employees.
Masoudnia, Ebrahim
2015-12-01
The poor sleep quality is one of the major risk factors of somatic, psychiatric and social disorders and conditions as well as the major predictors of quality of employees' performance. The previous studies in Iran had neglected the impacts of social factors including social networks and ties on adults sleep quality. Thus, the aim of the current research was to determine the relationship between social networks and adult employees' sleep quality. This study was conducted with a correlational and descriptive design. Data were collected from 360 participants (183 males and 177 females) who were employed in Yazd public organizations in June and July of 2014. These samples were selected based on random sampling method. In addition, the measuring tools were the Pittsburgh Sleep Quality Index (PSQI) and Social Relations Inventory (SRI). Based on the results, the prevalence rate of sleep disorder among Iranian adult employees was 63.1% (total PSQI>5). And, after controlling for socio-demographic variables, there was significant difference between individuals with strong and poor social network and ties in terms of overall sleep quality (p<.01), subjective sleep quality (p<.01), habitual sleep efficiency (p<.05), and daytime dysfunction (p<.01). The results also revealed that the employees with strong social network and ties had better overall sleep quality, had the most habitual sleep efficiency, and less daytime dysfunction than employees with poor social network and ties. It can be implied that the weak social network and ties serve as a risk factor for sleep disorders or poor sleep quality for adult employees. Therefore, the social and behavioral interventions seem essential to improve the adult's quality sleep. Copyright © 2015 Elsevier B.V. All rights reserved.
Wood, Tim J; Moore, Craig S; Horsfield, Carl J; Saunderson, John R; Beavis, Andrew W
2015-01-01
The purpose of this study was to develop size-based radiotherapy kilovoltage cone beam CT (CBCT) protocols for the pelvis. Image noise was measured in an elliptical phantom of varying size for a range of exposure factors. Based on a previously defined "small pelvis" reference patient and CBCT protocol, appropriate exposure factors for small, medium, large and extra-large patients were derived which approximate the image noise behaviour observed on a Philips CT scanner (Philips Medical Systems, Best, Netherlands) with automatic exposure control (AEC). Selection criteria, based on maximum tube current-time product per rotation selected during the radiotherapy treatment planning scan, were derived based on an audit of patient size. It has been demonstrated that 110 kVp yields acceptable image noise for reduced patient dose in pelvic CBCT scans of small, medium and large patients, when compared with manufacturer's default settings (125 kVp). Conversely, extra-large patients require increased exposure factors to give acceptable images. 57% of patients in the local population now receive much lower radiation doses, whereas 13% require higher doses (but now yield acceptable images). The implementation of size-based exposure protocols has significantly reduced radiation dose to the majority of patients with no negative impact on image quality. Increased doses are required on the largest patients to give adequate image quality. The development of size-based CBCT protocols that use the planning CT scan (with AEC) to determine which protocol is appropriate ensures adequate image quality whilst minimizing patient radiation dose.
Approaches to improve the quality of maternal and newborn health care: an overview of the evidence.
Austin, Anne; Langer, Ana; Salam, Rehana A; Lassi, Zohra S; Das, Jai K; Bhutta, Zulfiqar A
2014-09-04
Despite progress in recent years, an estimated 273,500 women died as a result of maternal causes in 2010. The burden of these deaths is disproportionately bourne by women who reside in low income countries or belong to the poorest sectors of the population of middle or high income ones, and it is particularly acute in regions where access to and utilization of facility-based services for childbirth and newborn care is lowest. Evidence has shown that poor quality of facility-based care for these women and newborns is one of the major contributing factors for their elevated rates of morbidity and mortality. In addition, women who perceive the quality of facilty-based care to be poor,may choose to avoid facility-based deliveries, where life-saving interventions could be availble. In this context, understanding the underlying factors that impact the quality of facility-based services and assessing the effectiveness of interventions to improve the quality of care represent critical inputs for the improvement of maternal and newborn health. This series of five papers assesses and summarizes information from relevant systematic reviews on the impact of various approaches to improve the quality of care for women and newborns. The first paper outlines the conceptual framework that guided this study and the methodology used for selecting the reviews and for the analysis. The results are described in the following three papers, which highlight the evidence of interventions to improve the quality of maternal and newborn care at the community, district, and facility level. In the fifth and final paper of the series, the overall findings of the review are discussed, research gaps are identified, and recommendations proposed to impove the quality of maternal and newborn health care in resource-poor settings.
Source apportionment of groundwater pollution around landfill site in Nagpur, India.
Pujari, Paras R; Deshpande, Vijaya
2005-12-01
The present work attempts statistical analysis of groundwater quality near a Landfill site in Nagpur, India. The objective of the present work is to figure out the impact of different factors on the quality of groundwater in the study area. Statistical analysis of the data has been attempted by applying Factor Analysis concept. The analysis brings out the effect of five different factors governing the groundwater quality in the study area. Based on the contribution of the different parameters present in the extracted factors, the latter are linked to the geological setting, the leaching from the host rock, leachate of heavy metals from the landfill as well as the bacterial contamination from landfill site and other anthropogenic activities. The analysis brings out the vulnerability of the unconfined aquifer to contamination.
Strong Photoluminescence Enhancement in All-Dielectric Fano Metasurface with High Quality Factor.
Yuan, Shuai; Qiu, Xingzhi; Cui, Chengcong; Zhu, Liangqiu; Wang, Yuxi; Li, Yi; Song, Jinwen; Huang, Qingzhong; Xia, Jinsong
2017-11-28
All-dielectric metamaterials offer great flexibility for controlling light-matter interaction, owing to their strong electric and magnetic resonances with negligible loss at wavelengths above the material bandgap. Here, we propose an all-dielectric asymmetric metasurface structure exhibiting high quality factor and prominent Fano line shape. Over three-orders photoluminescence enhancement is demonstrated in the fabricated all-dielectric metasurface with record-high quality factor of 1011. We find this strong emission enhancement is attributed to the coherent Fano resonances, which originate from the destructive interferences of antisymmetric displacement currents in the asymmetric all-dielectric metasurface. Our observations show a promising approach to realize light emitters based on all-dielectric metasurfaces.
40 CFR Appendix B to Part 132 - Great Lakes Water Quality Initiative
Code of Federal Regulations, 2011 CFR
2011-07-01
... WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132, App. B Appendix B to Part 132—Great Lakes Water Quality Initiative Methodology for Deriving Bioaccumulation Factors Great Lakes States and Tribes... system. For log KOW, the log of the octanol-water partition coefficient is a base 10 logarithm. Uptake...
40 CFR Appendix B to Part 132 - Great Lakes Water Quality Initiative
Code of Federal Regulations, 2010 CFR
2010-07-01
... WATER QUALITY GUIDANCE FOR THE GREAT LAKES SYSTEM Pt. 132, App. B Appendix B to Part 132—Great Lakes Water Quality Initiative Methodology for Deriving Bioaccumulation Factors Great Lakes States and Tribes... system. For log KOW, the log of the octanol-water partition coefficient is a base 10 logarithm. Uptake...
ERIC Educational Resources Information Center
Azkiyah, Siti Nurul; Mukminin, Amirul
2017-01-01
This study was intended to investigate the teaching quality of student teachers when they conducted their teaching practicum. Teaching quality is conceptualised based on eight classroom factors (orientation, structuring, modelling, application, questioning, building classroom as a learning environment, assessment, and time management) of the…
Developing a Scale for Quality of Using Learning Strategies
ERIC Educational Resources Information Center
Tasci, Guntay; Yurdugul, Halil
2016-01-01
This study aims to develop a measurement tool to measure the quality of using learning strategies. First, the quality of using learning strategies was described based on the literature. The 32 items in the 5-point Likert scale were then administered to 320 prospective teachers, and they were analysed with exploratory factor analysis using…
Heisig, Paul M.; Phillips, Patrick J.
2004-01-01
The implications of this study are that seasonal and more frequent base-flow surveys of water chemistry from small stream basins can help refine the understanding of local hydrogeologic systems and define the effects of nonpointsource contamination on base-flow water quality. The concentration of most nonpoint sources in valley-bottom or lower-hillside areas helped indicate the relative contributions of water from hillside and valley-bottom areas at different times of year. The positive correlations between the intensity of nonpoint-source activities and nonpoint-source constituents in base flow underscores the link between land use (nonpoint sources), ground-water quality, and surface-water quality.
Quench-induced degradation of the quality factor in superconducting resonators
DOE Office of Scientific and Technical Information (OSTI.GOV)
Checchin, M.; Martinello, M.; Romanenko, A.
Quench of superconducting radio-frequency cavities frequently leads to the lowered quality factor Q 0, which had been attributed to the additional trapped magnetic flux. Here we demonstrate that the origin of this magnetic flux is purely extrinsic to the cavity by showing no extra dissipation (unchanged Q 0) after quenching in zero magnetic field, which allows us to rule out intrinsic mechanisms of flux trapping such as generation of thermal currents or trapping of the rf field. We also show the clear relation of dissipation introduced by quenching to the orientation of the applied magnetic field and the possibility tomore » fully recover the quality factor by requenching in the compensated field. We discover that for larger values of the ambient field, the Q-factor degradation may become irreversible by this technique, likely due to the outward flux migration beyond the normal zone opening during quench. Lastly, our findings are of special practical importance for accelerators based on low- and medium-beta accelerating structures residing close to focusing magnets, as well as for all high-Q cavity-based accelerators.« less
Quench-induced degradation of the quality factor in superconducting resonators
Checchin, M.; Martinello, M.; Romanenko, A.; ...
2016-04-28
Quench of superconducting radio-frequency cavities frequently leads to the lowered quality factor Q 0, which had been attributed to the additional trapped magnetic flux. Here we demonstrate that the origin of this magnetic flux is purely extrinsic to the cavity by showing no extra dissipation (unchanged Q 0) after quenching in zero magnetic field, which allows us to rule out intrinsic mechanisms of flux trapping such as generation of thermal currents or trapping of the rf field. We also show the clear relation of dissipation introduced by quenching to the orientation of the applied magnetic field and the possibility tomore » fully recover the quality factor by requenching in the compensated field. We discover that for larger values of the ambient field, the Q-factor degradation may become irreversible by this technique, likely due to the outward flux migration beyond the normal zone opening during quench. Lastly, our findings are of special practical importance for accelerators based on low- and medium-beta accelerating structures residing close to focusing magnets, as well as for all high-Q cavity-based accelerators.« less
Quench-Induced Degradation of the Quality Factor in Superconducting Resonators
NASA Astrophysics Data System (ADS)
Checchin, M.; Martinello, M.; Romanenko, A.; Grassellino, A.; Sergatskov, D. A.; Posen, S.; Melnychuk, O.; Zasadzinski, J. F.
2016-04-01
Quench of superconducting radio-frequency cavities frequently leads to the lowered quality factor Q0 , which had been attributed to the additional trapped magnetic flux. Here we demonstrate that the origin of this magnetic flux is purely extrinsic to the cavity by showing no extra dissipation (unchanged Q0) after quenching in zero magnetic field, which allows us to rule out intrinsic mechanisms of flux trapping such as generation of thermal currents or trapping of the rf field. We also show the clear relation of dissipation introduced by quenching to the orientation of the applied magnetic field and the possibility to fully recover the quality factor by requenching in the compensated field. We discover that for larger values of the ambient field, the Q -factor degradation may become irreversible by this technique, likely due to the outward flux migration beyond the normal zone opening during quench. Our findings are of special practical importance for accelerators based on low- and medium-β accelerating structures residing close to focusing magnets, as well as for all high-Q cavity-based accelerators.
Kleinknecht-Dolf, Michael; Spichiger, Elisabeth; Frei, Irena Anna; Müller, Marianne; Martin, Jacqueline S; Spirig, Rebecca
2015-04-01
The adoption of DRG-based payment systems has narrowed hospitals' financial margins, necessitating streamlining and process optimization. The experience of other countries shows that this restructuring can influence context factors essential to the delivery of nursing care. As a result, nursing care quality and patient safety may be impacted. The Sinergia Project aims to develop a monitoring model and related instruments to continuously monitor the impact of DRG-based reimbursement on central nursing service context factors. The descriptive, quantitative results were collected within the framework of a study with a mixed methods design by means of an online survey in which nurses from five hospitals participated. The results show that the nursing service context factors examined (nursing care complexity, quality of the work environment, management, moral distress and job satisfaction), have relevance in all practice areas as regards practice setting and nursing care delivery. Patterns can be recognized that are consistent with those found in the literature and which could be an indication of the relationships between the context factors above, as was hypothesized in the model. The study has provided the participating hospitals with useful data upon which to base discussions on ensuring quality of nursing care and practice development, in addition to information important to the further development of the model and the instruments employed.
Left Handed Materials Based on Magnetic Nanocomposites
2006-10-18
theory that unifies DNMs and SNMs as a function of two flmdamental material parameters: quality factors for permittivity (Qe=e’/e") and permeability (Qu...simultaneously negative effective permeability/uff and permittivity Seff to form LHM or only single negative parameter (SNM) to form negative indexed...developed a theory that unifies DNMs and SNMs as a function of two fundamental material parameters: quality factors for permittivity (Q, = -’/ 6") and
Jin, Xiaowei; Wang, Zijian; Wang, Yeyao; Lv, Yibing; Rao, Kaifeng; Jin, Wei; Giesy, John P; Leung, Kenneth M Y
2015-08-01
The potential use of toxicity data for nonnative species to derive water quality criteria is controversial because it is sometimes questioned whether criteria based on species from one geographical region provide appropriate protection for species in a different region. However, this is an important concept for the development of Chinese water quality criteria or standards. Data were assembled on 38 chemicals for which values were available for both native and nonnative species. Sensitivities of these organisms were compared based on the 5% hazardous concentration values and the species sensitivity distribution from a literature review. Results of the present study's analysis showed that there is approximately 74% certainty that use of nonnative species to generate water quality criteria would be sufficiently protective of aquatic ecosystems in China. Without applying any assessment factor to the water quality criteria generated from nonnative species, the uncertainty would be 26% when the native Chinese species might be under protection. Applying an assessment factor of 10 would offer adequate protection to native Chinese species for approximately 90% of tested chemicals and thus reduce the uncertainty from 26% to 10%. © 2015 SETAC.
Evaluation of diet quality of the elderly and associated factors.
Pinto de Souza Fernandes, Dalila; Duarte, Maria Sônia Lopes; Pessoa, Milene Cristine; Franceschini, Sylvia do Carmo Castro; Ribeiro, Andréia Queiroz
2017-09-01
Observational studies suggest healthy dietary patterns are associated with risk reduction and better control of various chronic diseases. However, few Brazilian studies have focused on evaluating the quality of the elderly diet and its relationship with diseases. This study aimed to estimate the association between diet quality and socioeconomic factors, health and nutrition of the elderly. This is a cross-sectional population-based study whose target population were non-institutionalized elderly residents in the city of Viçosa, Brazil. Anthropometric, socioeconomic, health conditions, lifestyle and food consumption variables were obtained from a semi-structured questionnaire. The quality of the diet was assessed by the revised Healthy Eating Index classified into tertiles, considering the first tertile as "Poor diet quality," the second as 'Intermediate diet quality' and the third as "Better diet quality." To identify factors independently associated with diet quality model, the works used multinomial logistic regression. In the results of the multivariate analysis, the factors independently associated with "better diet quality" included female gender, higher education, history of one to five medical visits in the past year, history of diabetes mellitus, dyslipidemia and the use of polypharmacy. Our results show that most seniors need to improve the quality of their diet and those of male gender with no or little education, and those who do not seek medical services constitute the group that needs attention concerning the measures to improve the quality of their diet. Copyright © 2017 Elsevier B.V. All rights reserved.
2013-01-01
Background Developing a water quality index which is used to convert the water quality dataset into a single number is the most important task of most water quality monitoring programmes. As the water quality index setup is based on different local obstacles, it is not feasible to introduce a definite water quality index to reveal the water quality level. Findings In this study, an innovative software application, the Iranian Water Quality Index Software (IWQIS), is presented in order to facilitate calculation of a water quality index based on dynamic weight factors, which will help users to compute the water quality index in cases where some parameters are missing from the datasets. Conclusion A dataset containing 735 water samples of drinking water quality in different parts of the country was used to show the performance of this software using different criteria parameters. The software proved to be an efficient tool to facilitate the setup of water quality indices based on flexible use of variables and water quality databases. PMID:24499556
Litman, Leib; Robinson, Jonathan; Rosenzweig, Cheskie
2015-06-01
In this study, we examined data quality among Amazon Mechanical Turk (MTurk) workers based in India, and the effect of monetary compensation on their data quality. Recent studies have shown that work quality is independent of compensation rates, and that compensation primarily affects the quantity but not the quality of work. However, the results of these studies were generally based on compensation rates below the minimum wage, and far below a level that was likely to play a practical role in the lives of workers. In this study, compensation rates were set around the minimum wage in India. To examine data quality, we developed the squared discrepancy procedure, which is a task-based quality assurance approach for survey tasks whose goal is to identify inattentive participants. We showed that data quality is directly affected by compensation rates for India-based participants. We also found that data were of a lesser quality among India-based than among US participants, even when optimal payment strategies were utilized. We additionally showed that the motivation of MTurk users has shifted, and that monetary compensation is now reported to be the primary reason for working on MTurk, among both US- and India-based workers. Overall, MTurk is a constantly evolving marketplace where multiple factors can contribute to data quality. High-quality survey data can be acquired on MTurk among India-based participants when an appropriate pay rate is provided and task-specific quality assurance procedures are utilized.
Outcomes associated with community-based research projects in teaching undergraduate public health.
Bouhaimed, Manal; Thalib, Lukman; Doi, Suhail A R
2008-01-01
Community based research projects have been widely used in teaching public health in many institutions. Nevertheless, there is a paucity of information on the learning outcomes of such a teaching strategy. We therefore attempted to evaluate our experience with such a project based teaching process. The objective of this study was to evaluate the factors related to quality, impact and relevance of a 6-week student project for teaching public health in the faculty of medicine at Kuwait University. Interactive sessions familiarized students with research methods. Concurrently, they designed and completed a participatory project with a Community Medicine mentor. Questionnaires were used to assess quality, impact and relevance of the project, and these were correlated with multiple demographic, statistical and research design factors. We evaluated a total of 104 projects that were completed during the period of September 2001 to June 2006. Three dimensions of outcome were assessed: quality; impact and relevance. The average (mean + SE; maximum of 5) scores across all projects were 2.6 + 0.05 (range 1.7-3.7) for quality, 2.8 + 0.06 (range 1.7-4.3) for impact and 3.3 + 0.08 (range 1.3-5) for relevance. The analysis of the relationship between various factors and the scores on each dimension of assessment revealed that various factors were associated with improved quality, impact or relevance to public health practice. We conclude that use of more objective measurement instruments with better a priori conceptualization along with appropriate use of statistics and a more developed study design were likely to result in more meaningful research outcomes. We also found that a biostatistics or epidemiology mentor improved the research outcome.
Venturelli, Massimo; Cè, Emiliano; Limonta, Eloisa; Schena, Federico; Caimi, Barbara; Carugo, Stefano; Veicsteinas, Arsenio; Esposito, Fabio
2015-10-01
Recommendations for prevention of cardiovascular diseases (CVDs) risk factors among older adults highlighted the importance of exercise-based interventions, including endurance training (ET). However, the evidence of efficacy of other interventions based on short-bouts of exercise (circuit training, CT), and the practice of breath-control and meditation (relaxing training, RT) is growing. The aim of this study was to elucidate if CT or RT are equally effective in CVD risk factors reduction compared to ET. To this purpose, in 40 elderly participants, with clinically diagnosed grade 1 hypertension, resting blood pressure, blood glucose, and cholesterol levels, peak oxygen uptake ([Formula: see text]), mechanical efficiency and quality of life were evaluated before and after 12 weeks of ET, CT, and RT treatments. Resting blood pressure reduced significantly in all groups by ∼11 %. In ET, blood cholesterol levels (-18 %), [Formula: see text] (+8 %), mechanical efficiency (+9 %), and quality of life scores (+36 %) ameliorated. In CT blood glucose levels (-11 %), [Formula: see text] (+7 %) and quality of life scores (+35 %) were bettered. Conversely, in RT, the lower blood pressure went along only with an improvement in the mental component of quality of life (+42 %). ET and CT were both appropriate interventions to reduce CVDs risk factors, because blood pressure reduction was accompanied by decreases in blood glucose and cholesterol levels, increases in [Formula: see text], mechanical efficiency, and quality of life. Although RT influenced only blood pressure and quality of life, this approach would be an attractive alternative for old individuals unable or reluctant to carry out ET or CT.
Robertson, Dale M.
1998-01-01
The variability in water quality throughout the WMIC Study Unit during base-flow conditions could be described very well by subdividing the area into Relatively Homogeneous Units and sampling a few streams with drainage basins completely within these homogeneous units. This subdivision and sampling scheme enabled the differences in water quality to be directly related to the differences in the environmental characteristics that exist throughout the Study Unit.
Comparison quality of life patients treated with insulin and oral hypoglycemic drugs
NASA Astrophysics Data System (ADS)
Harahap, A. W.; Nasution, M. S.
2018-03-01
Diabetes mellitus (DM) is a group of chronic metabolic diseases with characteristic hyperglycemia that occurs due to abnormalities in insulin secretion, insulin action or both. Improved quality of life is one of the goals of DM management. This study aims to compare thequality of life in40 patients with type 2 diabetes using insulin therapy and 40 patients using oral hypoglycemic drugs in H. Adam Malik Hospital year 2015. This study is an observational study with cross-sectionalstudy designand consecutive sampling method. Evaluation of the patient’s quality of life taken through interviews and questionnaires using the Short Form-36 questionnaire consistingof8 domains of quality of life. Statistical analysis using unpaired t-test and Mann-Whitney test. Results of the quality of life-based on patient characteristics showed significant differences in education factor (p=0.005) and employment factor (p=0.001). Quality of life-based on therapy showed significant differences in domain role of physical (p=0.005) and domain role of emotional (p=0.038).The quality of life of patients with type 2 diabetes using insulin better than using hypoglycemic drug significantly in domain role of physical and domain role of emotions.
[Thinking on designation of sham acupuncture in clinical research].
Pan, Li-Jia; Chen, Bo; Zhao, Xue; Guo, Yi
2014-01-01
Randomized controlled trials (RCT) is the source of the raw data of evidence-based medicine. Blind method is adopted in most of the high-quality RCT. Sham acupuncture is the main form of blinded in acupuncture clinical trial. In order to improve the quality of acupuncture clinical trail, based on the necessity of sham acupuncture in clinical research, the current situation as well as the existing problems of sham acupuncture, suggestions were put forward from the aspects of new way and new designation method which can be adopted as reference, and factors which have to be considered during the process of implementing. Various subjective and objective factors involving in the process of trial should be considered, and used of the current international standards, try to be quantification, and carry out strict quality monitoring.
NASA Astrophysics Data System (ADS)
Priyono, Wena, Made; Rahardjo, Boedi
2017-09-01
Experts and practitioners agree that the quality of higher education in Indonesia needs to be improved significantly and continuously. The low quality of university graduates is caused by many factors, one of which is the poor quality of learning. Today's instruction process tends to place great emphasis only on delivering knowledge. To avoid the pitfalls of such instruction, e.g. passive learning, thus Civil Engineering students should be given more opportunities to interact with others and actively participate in the learning process. Based on a number of theoretical and empirical studies, one appropriate strategy to overcome the aforementioned problem is by developing and implementing activity-based learning approach.
Factors Associated With Marital Satisfaction in Infertile Couple: A Comprehensive Literature Review
Samadaee-Gelehkolaee, Keshvar; McCarthy, Barry W; Khalilian, Alireza; Hamzehgardeshi, Zeinab; Peyvandi, Sepideh; Elyasi, Forouza; Shahidi, Maryam
2016-01-01
Background: Many factors impact on marital satisfaction. Related factors include demographic factors, assisted reproductive techniques, psychological health, quality of life, psychological, socioeconomic and family support, and sexual function. Methods: This study is a literature review of research studies conducted on factors associated with marital satisfaction in infertile couples. The current literature review search was undertaken using multiple databases selected from articles pertinent to the study. The selection of subjects was undertaken from1990 through 2015. The methodological quality was analyzed based on a checklist adopted from a systematic review. Quality assessment of full text studies was finally carried out by two reviewers. Results: The initial search yielded a list of 445 papers, and then reviewers studied titles and abstracts. Thereafter, 69 papers were incorporated, and researchers reviewed summaries of all of the searched articles. Finally, the researchers utilized the data gained from 64 full articles so as to compile this review paper. Reviewing the studies conducted on marital satisfaction, they classified related findings into 6 categories: demographic factors, using fertility assisting methods, psychological health, life quality, economic, social, and family support, and sexual function. Conclusion: The results of this review article depicted that various factors play role in creating marriage life satisfaction in an infertile couple, so that paying attention to them can play an important role in continuing their treatment. Thus, to identify such factors is considered essential in their treatment protocol highly based on culture. Of the drawbacks of this research is that it has tried at best to employ the studies belonging to diverse countries with different cultures. Also, the number of the papers was considerably limited. PMID:26652079
Xie, Yanfei; Szeto, Grace; Dai, Jie
2017-03-01
This systematic review aimed at evaluating the prevalence and risk factors for musculoskeletal complaints associated with mobile handheld device use. Pubmed, Medline, Web of Science, CINAHL and Embase were searched. The methodological quality of included studies was assessed. Strength of evidence for risk factors was determined based on study designs, methodological quality and consistency of results. Five high-quality, eight acceptable-quality and two low-quality peer-reviewed articles were included. This review demonstrates that the prevalence of musculoskeletal complaints among mobile device users ranges from 1.0% to 67.8% and neck complaints have the highest prevalence rates ranging from 17.3% to 67.8%. This study also finds some evidence for neck flexion, frequency of phone calls, texting and gaming in relation to musculoskeletal complaints among mobile device users. Inconclusive evidence is shown for other risk factors such as duration of use and human-device interaction techniques due to inconsistent results or a limited number of studies. Copyright © 2016 Elsevier Ltd. All rights reserved.
Sharafi, Mastaneh; Rawal, Shristi; Fernandez, Maria Luz; Huedo-Medina, Tania B; Duffy, Valerie B
2018-05-08
Sensations from foods and beverages drive dietary choices, which in turn, affect risk of diet-related diseases. Perception of these sensation varies with environmental and genetic influences. This observational study aimed to examine associations between chemosensory phenotype, diet and cardiovascular disease (CVD) risk. Reportedly healthy women (n = 110, average age 45 ± 9 years) participated in laboratory-based measures of chemosensory phenotype (taste and smell function, propylthiouracil (PROP) bitterness) and CVD risk factors (waist circumference, blood pressure, serum lipids). Diet variables included preference and intake of sweet/high-fat foods, dietary restraint, and diet quality based on reported preference (Healthy Eating Preference Index-HEPI) and intake (Healthy Eating Index-HEI). We found that females who reported high preference yet low consumption of sweet/high-fat foods had the highest dietary restraint and depressed quinine taste function. PROP nontasters were more likely to report lower diet quality; PROP supertasters more likely to consume but not like a healthy diet. Multivariate structural models were fitted to identify predictors of CVD risk factors. Reliable latent taste (quinine taste function, PROP tasting) and smell (odor intensity) variables were identified, with taste explaining more variance in the CVD risk factors. Lower bitter taste perception was associated with elevated risk. In multivariate models, the HEPI completely mediated the taste-adiposity and taste-HDL associations and partially mediated the taste-triglyceride or taste-systolic blood pressure associations. The taste-LDL pathway was significant and direct. The HEI could not replace HEPI in adequate models. However, using a latent diet quality variable with HEPI and HEI, increased the strength of association between diet quality and adiposity or CVD risk factors. In conclusion, bitter taste phenotype was associated with CVD risk factors via diet quality, particularly when assessed by level of food liking/disliking. Copyright © 2018 Elsevier Inc. All rights reserved.
Anders, Markus P; Breckenkamp, Jürgen; Blettner, Maria; Schlehofer, Brigitte; Berg-Beckhoff, Gabriele
2014-12-01
Good sleep quality is essential for recovery. The risk factors of sleep disorders have been extensively investigated, but there is sparse information on the association of socioeconomic factors with a person's sleep quality. The aim of the present analysis is to investigate this association, taking particularly the effect of health confounders into consideration. The data were extracted from the cross-sectional QUEBEB Study. In total, the study sample consisted of 3281 participants (1817 women and 1464 men, aged 16-72 years). Here socioeconomic status (SES) was collected from the baseline survey taken in 2004. Sleep quality for the same participants was measured with in-depth personal interviews in 2006 using the Pittsburgh Sleep Quality Index, together with other relevant characteristics (e.g. anxiety, depression and health status). Multiple logistic regression analyses were performed. People living in an urban environment with a high or medium SES have a greater probability of good sleep quality (odds ratio 1.65, 95% confidence interval 1.27-2.14; odds ratio 1.40, 95% confidence interval 1.16-1.69) than persons with a low SES. Anxiety and depression, but also health status, are also associated with sleep quality and can influence in part the socioeconomic levels seen in sleep quality. SES and sleep quality are associated. However, there are important additional determinants that influence the level of association between SES and sleep quality. Several factors, such as anxiety, depression and health status, are associated with poorer sleep quality, but at the same time, these factors occur more often within lower social classes. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Rapert, M I; Babakus, E
1996-01-01
Many organizations are not convinced a quality orientation pays off and are looking for ways to link quality with performance. The authors' exploratory study found that a quality orientation is a differentiating factor between low-performing and high-performing general service hospitals. They also developed a quality scale to assess the performance implications of quality-based strategies in the health care industry. Successful health care organizations (1) develop a strategic quality orientation at the management level, (2) support the pursuit of quality at the contact level, and (3) monitor external customers' perceptions of quality.
Li, Hong-Jiao; He, Li-Yun; Liu, Zhi-Shun; Sun, Ya-Nan; Yan, Shi-Yan; Liu, Jia; Zhao, Ye; Liu, Bao-Yan
2014-02-01
To effectively guarantee quality of randomized controlld trial (RCT) of acupuncture and develop reasonable content and checklist of on-site quality control, influencing factors on quality of acupuncture RCT are analyzed and scientificity of quality control content and feasibility of on-site manipulation are put into overall consideration. Based on content and checklist of on-site quality control in National 11th Five-Year Plan Project Optimization of Comprehensive Treatment Plan for TCM in Prevention and Treatment of Serious Disease and Clinical Assessment on Generic Technology and Quality Control Research, it is proposed that on-site quality control of acupuncture RCT should be conducted with PICOST (patient, intervention, comparison, out come, site and time) as core, especially on quality control of interveners' skills and outcome assessment of blinding, and checklist of on-site quality control is developed to provide references for undertaking groups of the project.
Liu, Yong; Wang, Limin; Pang, Richard; Mo, Nanxun; Hu, Yan; Deng, Qian; Hu, Zhaohui
2015-05-01
The aim of this paper is to describe the designing and implementation of a web-based plasma glucose measurement quality monitoring system to assess the analytical quality of plasma glucose measurements in multicenter population study and provide evidence for the future studies. In the chronic non-communicable disease and related factor surveillance in China, a web based quality monitoring system for plasma glucose measurement was established to conduct evaluation on plasma glucose monitoring quality and effectiveness in 302 surveillance centers, including quality control data entry, transmission and feedback. The majority of the surveillance centers met the quality requirements and passed the evaluation of reproducibility and precision of plasma glucose measurement, only a few centers required intensive training and re-assessment. In order to ensure the completeness and reliability of plasma glucose measurement in the surveillance centers, the establishment of web-based plasma glucose measurement quality control system can facilitate the identification of the qualified surveillance centers and evaluation of plasma glucose measurement quality in different regions. Communication and training are important in ensuring plasma glucose measurement quality. It is necessary to further improve this web-based plasma glucose measurement quality monitoring system in the future to reduce the method specific plasma glucose measurement bias.
ERIC Educational Resources Information Center
Õun, Tiia; Tuul, Maire; Tera, Signe; Sagen, Kelli; Mägi, Helena
2018-01-01
Various factors of the quality of preschool child care institutions influence the development of children and their future success in school. The activities of preschool child care institutions in Estonia are based on the national curriculum. Several indicators of structural quality have been determined on the national level. The aim of the…
Hyperspectral remote sensing for the assessment of inland water quality can be used in enhancing the capabilities of resource managers to monitor water bodies in a timely and cost-effective manner. The key factor in assessing the accuracy of water quality assessments based on re...
Factors affecting dental service quality.
Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia
2015-01-01
Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.
USDA-ARS?s Scientific Manuscript database
The objective of the present study was to assess the relationship between lifestyle factors and abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in a community-based setting. Cross-sectional associations between lifestyle factors (dietary quality, physical activity, smo...
Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura
2016-01-01
Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be satisfied when the TPS-QC tool generated re-optimized plans without sacrificing other dosimetric endpoints. In addition to its feasibility and accuracy, the proposed TPS-QC tool is also user-friendly and easy to operate, both of which are necessary characteristics for clinical use.
Physical and sensory quality of Java Arabica green coffee beans
NASA Astrophysics Data System (ADS)
Sunarharum, W. B.; Yuwono, S. S.; Pangestu, N. B. S. W.; Nadhiroh, H.
2018-03-01
Demand on high quality coffee for consumption is continually increasing not only in the consuming countries (importers) but also in the producing countries (exporters). Coffee quality could be affected by several factors from farm to cup including the post-harvest processing methods. This research aimed to investigate the influence of different post-harvest processing methods on physical and sensory quality of Java Arabica green coffee beans. The two factors being evaluated were three different post-harvest processing methods to produce green coffee beans (natural/dry, semi-washed and fully-washed processing) under sun drying. Physical quality evaluation was based on The Indonesian National Standard (SNI 01-2907-2008) while sensory quality was evaluated by five expert judges. The result shows that less defects observed in wet processed coffee as compared to the dry processing. The mechanical drying was also proven to yield a higher quality green coffee beans and minimise losses.
Palma, Gisele Carla Dos Santos; Freitas, Tatiana Beline; Bonuzzi, Giordano Márcio Gatinho; Soares, Marcos Antonio Arlindo; Leite, Paulo Henrique Wong; Mazzini, Natália Araújo; Almeida, Murilo Ruas Groschitz; Pompeu, José Eduardo; Torriani-Pasin, Camila
2017-05-01
This review determines the effects of virtual reality interventions for stroke subjects based on the International Classification of Functioning, Disability,and Health (ICF) framework. Virtual reality is a promising tool for therapy for stroke rehabilitation, but the effects of virtual reality interventions on post-stroke patients based on the specific ICF domains (Body Structures, Body Functions, Activity, and Participation) have not been investigated. A systematic review was conducted, including trials with adults with a clinical diagnosis of a chronic, subacute, or acute stroke. Eligible trials had to include studies with an intervention protocol and follow-up, with a focus on upper limbs and/or lower limbs and/or balance. The Physiotherapy Evidence Database (PEDro) was used to assess the methodological quality of randomized controlled trials. Each trial was separated according to methodological quality into a high-quality trial (PEDro ≥ 6) and a low-quality trial (PEDro ≤ 6). Only high-quality trials were analyzed specifically based on the outcome of these trials. In total, 54 trials involving 1811 participants were included. Of the papers included and considered high quality, 14 trials evaluated areas of the Body Structures component, 20 trials of the Body Functions domain, 17 trials of the Activity component, and 8 trials of the Participation domain. In relation to ICF Part 2, four trials evaluated areas of the Personal Factors component and one trial evaluated domains of the Environmental Factors component. The effects of virtual reality on stroke rehabilitation based on the ICF framework are positive in Body Function and Body Structure. However, the results in the domains Activity and Participation are inconclusive. More high-quality clinical trials are needed to confirm the effectiveness of virtual reality in the domains of Activity and Participation.
Indoor air quality: A psychosocial perspective
DOE Office of Scientific and Technical Information (OSTI.GOV)
Boxer, P.A.
1990-05-01
The incidence of indoor air quality problems has increased dramatically over the past decade. Investigation of these problems has yielded a definitive cause in only one third of the cases. Psychosocial factors may play a key role in the development and propagation of symptoms attributed to poor indoor air quality. Guidelines for managing indoor air quality problems from the organizational perspective are based upon psychosocial principles and elements of risk perception.
Azar, Farbod Ebadifard; Solhi, Mahnaz; Nejhaddadgar, Nazila; Amani, Firoz
2017-08-01
Poor quality of life is common among diabetic patients, and educational intervention is one of the most effective strategies to improve the quality of life for chronic patients. To determine the effect of an educational intervention based on PRECEDE-PROCEED in quality of life of diabetic patients, in 2016. In this quasi-experimental study, 86 patients referred to diabetic centers of Ardabil participated. We used the components PRECEDE-PROCEED model for planning, implementation and evaluation of the program. Data collection tools were Diabetes Quality of Life questionnaire (DQOL) and a researcher-made questionnaire. Eight training sessions were conducted for the intervention group for self-efficiency, self- management, attitude, knowledge, and enabling reinforcing factors. Quality of life was followed one and three months after intervention. Data were analyzed through SPSS 16 software using descriptive and analytical tests. The mean age of patients was 55.88 (±12.1) years. The result showed that before intervention, no significant difference was observed among the mean scores of quality of life, self-management, knowledge, attitude, enabling and reinforcing factors, and self-efficiency in two groups. But one and three months after intervention a significant difference was observed (p<0.001). Educational intervention with PRECEDE-PROCEED model improved the diabetic patient's quality of life.
The lack of theoretical support for using person trade-offs in QALY-type models.
Østerdal, Lars Peter
2009-10-01
Considerable support for the use of person trade-off methods to assess the quality-adjustment factor in quality-adjusted life years (QALY) models has been expressed in the literature. The WHO has occasionally used similar methods to assess the disability weights for calculation of disability-adjusted life years (DALYs). This paper discusses the theoretical support for the use of person trade-offs in QALY-type measurement of (changes in) population health. It argues that measures of this type based on such quality-adjustment factors almost always violate the Pareto principle, and so lack normative justification.
Predictive factors for work capacity in patients with musculoskeletal disorders.
Lydell, Marie; Baigi, Amir; Marklund, Bertil; Månsson, Jörgen
2005-09-01
To identify predictive factors for work capacity in patients with musculoskeletal disorders. A descriptive, evaluative, quantitative study. The study was based on 385 patients who participated in a rehabilitation programme. Patients were divided into 2 groups depending on their ability to work. The groups were compared with each other with regard to sociodemographic factors, diagnoses, disability pension and number of sick days. The patient's level of exercise habits, ability to undertake activities, physical capacity, pain and quality of life were compared further using logistic regression analysis. Predictive factors for work capacity, such as ability to undertake activities, quality of life and fitness on exercise, were identified as important independent factors. Other well-known factors, i.e. gender, age, education, pain and earlier sickness certification periods, were also identified. Factors that were not significantly different between the groups were employment status, profession, diagnosis and levels of exercise habits. Identifying predictors for ability to return to work is an essential task for deciding on suitable individual rehabilitation. This study identified new predictive factors, such as ability to undertake activities, quality of life and fitness on exercise.
Moore, Craig S; Horsfield, Carl J; Saunderson, John R; Beavis, Andrew W
2015-01-01
Objective: The purpose of this study was to develop size-based radiotherapy kilovoltage cone beam CT (CBCT) protocols for the pelvis. Methods: Image noise was measured in an elliptical phantom of varying size for a range of exposure factors. Based on a previously defined “small pelvis” reference patient and CBCT protocol, appropriate exposure factors for small, medium, large and extra-large patients were derived which approximate the image noise behaviour observed on a Philips CT scanner (Philips Medical Systems, Best, Netherlands) with automatic exposure control (AEC). Selection criteria, based on maximum tube current–time product per rotation selected during the radiotherapy treatment planning scan, were derived based on an audit of patient size. Results: It has been demonstrated that 110 kVp yields acceptable image noise for reduced patient dose in pelvic CBCT scans of small, medium and large patients, when compared with manufacturer's default settings (125 kVp). Conversely, extra-large patients require increased exposure factors to give acceptable images. 57% of patients in the local population now receive much lower radiation doses, whereas 13% require higher doses (but now yield acceptable images). Conclusion: The implementation of size-based exposure protocols has significantly reduced radiation dose to the majority of patients with no negative impact on image quality. Increased doses are required on the largest patients to give adequate image quality. Advances in knowledge: The development of size-based CBCT protocols that use the planning CT scan (with AEC) to determine which protocol is appropriate ensures adequate image quality whilst minimizing patient radiation dose. PMID:26419892
Cotton harvesting emission factors based on source sampling
USDA-ARS?s Scientific Manuscript database
Air quality regulation across the U.S. is intensifying due to increasing public concern for environmental protection. Non-attainment status with Federal particulate matter (PM) air quality standards has forced air pollution regulators in some states to focus emission reduction efforts on previously ...
Ejaz, Aslam; Kim, Yuhree; Winner, Megan; Page, Andrew; Tisnado, Diana; Dy, Sydney E Morss; Pawlik, Timothy M
2016-04-01
The objective of the current study was to analyze various patient-related factors related to patient-reported quality of overall and surgical care following surgical resection of lung or colorectal cancer. Between 2003 and 2005, 3,954 patients who underwent cancer-directed surgery for newly diagnosed lung (30.3%) or colorectal (69.7%) cancer were identified from a population- and health system-based survey of participants from multiple US regions. Factors associated with patient-perceived quality of overall and surgical care were analyzed with multivariable logistic regression models. Overall, 56.7% of patients reported excellent quality of overall care and 67.9% of patients reported excellent quality of surgical care; there was no difference by cancer type (P > 0.05). Factors associated with lower likelihood to report excellent quality of overall and surgical care included female sex, minority race, and the presence of multiple comorbidities (all odds ratio [OR] <1, all P < 0.05). Patients who had higher levels of education (overall quality: OR 1.62; surgical quality: OR 1.26), higher annual income (overall quality: OR 1.29; surgical quality: OR 1.23), and good physical function (overall quality: OR 1.35; surgical quality: OR 1.24) were all more likely to report excellent quality of overall and surgical care (all P < 0.05). Furthermore, patients who reported their physician as having excellent communication skills (overall quality: OR 6.49; surgical quality: OR 3.74) as well as patients who perceived their cancer as likely curable (overall quality: OR 1.17; surgical quality: OR 1.11) were more likely to report excellent quality of overall and surgical care (all P < 0.05). Patient-reported quality of care is associated with several factors including race, income, and educational status, as well as physician communication and patient perception of likelihood of cure. Future studies are needed to more closely examine patient-physician relationships and communication barriers, particularly among minority patients and those with lower income and educational status.
Silicon nano-membrane based photonic crystal microcavities for high sensitivity bio-sensing.
Lai, Wei-Cheng; Chakravarty, Swapnajit; Zou, Yi; Chen, Ray T
2012-04-01
We experimentally demonstrated photonic crystal microcavity based resonant sensors coupled to photonic crystal waveguides in silicon nano-membrane on insulator for chemical and bio-sensing. Linear L-type microcavities are considered. In contrast to cavities with small mode volumes, but low quality factors for bio-sensing, we showed increasing the length of the microcavity enhances the quality factor of the resonance by an order of magnitude and increases the resonance wavelength shift while retaining compact device characteristics. Q~26760 and sensitivity down to 15 ng/ml and ~110 pg/mm2 in bio-sensing was experimentally demonstrated on silicon-on-insulator devices.
[Factors Influencing Quality of Life of Alcoholics Anonymous Members in Korea].
Yoo, Jae Soon; Lee, Jongeun; Park, Woo Young
2016-04-01
The purpose of this study was to determine quality of life (QOL) related factors in Alcoholics Anonymous (AA) members based on PRECEDE Model. A cross sectional survey was conducted with participants (N =203) from AA meeting in 11 alcohol counsel centers all over South Korea. Data were collected using a specially designed questionnaire based on the PRECEDE model and including QOL, epidemiological factors (including depression and perceived health status), behavioral factors (continuous abstinence and physical health status and practice), predisposing factors (abstinence self-efficacy and self-esteem), reinforcing factors (social capital and family functioning), and enabling factors. Data were analyzed using t-test, one way ANOVA, Tukey HSD test and hierarchical multiple regression analysis with SPSS (ver. 21.0). Of the educational diagnostic variables, self-esteem (β=.23), family functioning (β=.12), abstinence self-efficacy (β=.12) and social capital (β=.11) were strong influential factors in AA members' QOL. In addition, epidemiological diagnostic variables such as depression (β=-.44) and perceived health status (β=.35) were the main factors in QOL. Also, physical health status and practice (β=.106), one of behavioral diagnostic variables was a beneficial factor in QOL. Hierarchical multiple regression analysis showed the determinant variables accounted for 44.0% of the variation in QOL (F=25.76, p<.001). The finding of the study can be used as a framework for planning interventions in order to promote the quality of life of AA members. It is necessary to develop nursing intervention strategies for strengthening educational and epidemiological diagnostic variables in order to improve AA members' QOL.
Xia, Jiang-Bao; Liu, Yu-Ting; Zhu, Jin-Fang; Xu, Jing-Wei; Lu, Zhao-Hua; Liu, Jing-Tao; Liu, Qing
2013-06-01
Taking the Tamarix chinensis secondary shrubs in Laizhou Bay of Yellow River Delta as test objects, and by using synthetic factor method, this paper studied the main factors causing the lowly efficiency of T. chinensis secondary shrubs as well as the main parameters for the classification of lowly efficient T. chinensis secondary shrubs. A total of 24 indices including shrubs growth and soil physical and chemical properties were selected to determine the main affecting factors and parameters in evaluating and classifying the lowly efficient shrubs. There were no obvious correlations between the indices reflecting the shrubs growth and soil quality, and thus, only using shrub growth index to reflect the lowly efficiency level of T. chinensis was not enough, and it would be necessary to combine with soil quality factors to make a comprehensive evaluation. The principal factors reflecting the quality level of lowly efficient T. chinensis shrubs included soil salt content and moisture content, stand age, single tree's aboveground stem, leaf biomass, and basal diameter, followed by soil density, porosity, and soil nutrient status. The lowly efficient T. chinensis shrubs in the Bay could be classified into five types, namely, shrub with growth potential, slightly low quality shrub, moderately lowly efficient shrub, moderately low quality and lowly efficient shrub, and seriously low quality and lowly efficient shrub. The main features, low efficiency causes, and management measures of these shrubs were discussed based on the mean cluster value.
Alkerwi, Ala'a; Vernier, Céderic; Sauvageot, Nicolas; Crichton, Georgina E; Elias, Merrill F
2015-01-01
Objectives This study aimed to examine the most important demographic and socioeconomic factors associated with diet quality, evaluated in terms of compliance with national dietary recommendations, selection of healthy and unhealthy food choices, energy density and food variety. We hypothesised that different demographic and socioeconomic factors may show disparate associations with diet quality. Study design A nationwide, cross-sectional, population-based study. Participants A total of 1352 apparently healthy and non-institutionalised subjects, aged 18–69 years, participated in the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study in 2007–2008. The participants attended the nearest study centre after a telephone appointment, and were interviewed by trained research staff. Outcome measures Diet quality as measured by 5 dietary indicators, namely, recommendation compliance index (RCI), recommended foods score (RFS), non-recommended foods score (non-RFS), energy density score (EDS), and dietary diversity score (DDS). The novel Correlated Component Regression (CCR) technique was used to determine the importance and magnitude of the association of each socioeconomic factor with diet quality, in a global analytic approach. Results Increasing age, being male and living below the poverty threshold were predominant factors associated with eating a high energy density diet. Education level was an important factor associated with healthy and adequate food choices, whereas economic resources were predominant factors associated with food diversity and energy density. Conclusions Multiple demographic and socioeconomic circumstances were associated with different diet quality indicators. Efforts to improve diet quality for high-risk groups need an important public health focus. PMID:25967988
Schroeder, R.L.
2006-01-01
It is widely accepted that plans for restoration projects should contain specific, measurable, and science-based objectives to guide restoration efforts. The United States Fish and Wildlife Service (USFWS) is in the process of developing Comprehensive Conservation Plans (CCPs) for more than 500 units in the National Wildlife Refuge System (NWRS). These plans contain objectives for biological and ecosystem restoration efforts on the refuges. Based on USFWS policy, a system was developed to evaluate the scientific quality of such objectives based on three critical factors: (1) Is the objective specific, measurable, achievable, results-oriented, and time-fixed? (2) What is the extent of the rationale that explains the assumptions, logic, and reasoning for the objective? (3) How well was available science used in the development of the objective? The evaluation system scores each factor on a scale of 1 (poor) to 4 (excellent) according to detailed criteria. The biological and restoration objectives from CCPs published as of September 2004 (60 total) were evaluated. The overall average score for all biological and restoration objectives was 1.73. Average scores for each factor were: Factor 1-1.97; Factor 2-1.86; Factor 3-1.38. The overall scores increased from 1997 to 2004. Future restoration efforts may benefit by using this evaluation system during the process of plan development, to ensure that biological and restoration objectives are of the highest scientific quality possible prior to the implementation of restoration plans, and to allow for improved monitoring and adaptive management.
Depression and associated factors in older adults in South Africa.
Peltzer, Karl; Phaswana-Mafuya, Nancy
2013-01-18
Late-life depression is an important public health problem because of its devastating consequences. The study aims to investigate the prevalence and associated factors of self-reported symptom-based depression in a national sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE wave 1) in 2008. We conducted a national population-based cross-sectional study with a probability sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The questionnaire included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements as well as questions on depression symptoms in the past 12 months. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables, and depression. The overall prevalence of symptom-based depression in the past 12 months was 4.0%. In multivariable analysis, functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems) were associated with self-reported depression symptoms in the past 12 months. Self-reported depression in older South Africans seems to be a public health problem calling for appropriate interventions to reduce occurrence. Factors identified to be associated with depression, including functional disability, lack of quality of life, and chronic conditions (angina, asthma, arthritis, and nocturnal sleep problems), can be used to guide interventions. The identified protective and risk factors can help in formulating public health care policies to improve quality of life among older adults.
30 CFR 1206.174 - How do I value gas production when an index-based method cannot be used?
Code of Federal Regulations, 2011 CFR
2011-07-01
... dispositions of like-quality gas in the same field (or, if necessary to obtain a reasonable sample, from the..., quality of gas, residue gas, or gas plant products, volume, and such other factors as may be appropriate... consideration of other information relevant in valuing like-quality gas, residue gas, or gas plant products...
Validation of smoke plume rise models using ground based lidar
Cyle E. Wold; Shawn Urbanski; Vladimir Kovalev; Alexander Petkov; Wei Min Hao
2010-01-01
Biomass fires can significantly degrade regional air quality. Plume rise height is one of the critical factors determining the impact of fire emissions on air quality. Plume rise models are used to prescribe the vertical distribution of fire emissions which are critical input for smoke dispersion and air quality models. The poor state of model evaluation is due in...
Exploring nursing e-learning systems success based on information system success model.
Chang, Hui-Chuan; Liu, Chung-Feng; Hwang, Hsin-Ginn
2011-12-01
E-learning is thought of as an innovative approach to enhance nurses' care service knowledge. Extensive research has provided rich information toward system development, courses design, and nurses' satisfaction with an e-learning system. However, a comprehensive view in understanding nursing e-learning system success is an important but less focused-on topic. The purpose of this research was to explore net benefits of nursing e-learning systems based on the updated DeLone and McLean's Information System Success Model. The study used a self-administered questionnaire to collected 208 valid nurses' responses from 21 of Taiwan's medium- and large-scale hospitals that have implemented nursing e-learning systems. The result confirms that the model is sufficient to explore the nurses' use of e-learning systems in terms of intention to use, user satisfaction, and net benefits. However, while the three exogenous quality factors (system quality, information quality, and service quality) were all found to be critical factors affecting user satisfaction, only information quality showed a direct effect on the intention to use. This study provides useful insights for evaluating nursing e-learning system qualities as well as an understanding of nurses' intentions and satisfaction related to performance benefits.
[Informatics data quality and management].
Feng, Rung-Chuang
2009-06-01
While the quality of data affects every aspect of business, it is frequently overlooked in terms of customer data integration, data warehousing, business intelligence and enterprise applications. Regardless of which data terms are used, a high level of data quality is a critical base condition essential to satisfy user needs and facilitate the development of effective applications. In this paper, the author introduces methods, a management framework and the major factors involved in data quality assessment. Author also integrates expert opinions to develop data quality assessment tools.
NASA Astrophysics Data System (ADS)
Wu, Z.; Luo, Z.; Zhang, Y.; Guo, F.; He, L.
2018-04-01
A Modulation Transfer Function (MTF)-based fuzzy comprehensive evaluation method was proposed in this paper for the purpose of evaluating high-resolution satellite image quality. To establish the factor set, two MTF features and seven radiant features were extracted from the knife-edge region of image patch, which included Nyquist, MTF0.5, entropy, peak signal to noise ratio (PSNR), average difference, edge intensity, average gradient, contrast and ground spatial distance (GSD). After analyzing the statistical distribution of above features, a fuzzy evaluation threshold table and fuzzy evaluation membership functions was established. The experiments for comprehensive quality assessment of different natural and artificial objects was done with GF2 image patches. The results showed that the calibration field image has the highest quality scores. The water image has closest image quality to the calibration field, quality of building image is a little poor than water image, but much higher than farmland image. In order to test the influence of different features on quality evaluation, the experiment with different weights were tested on GF2 and SPOT7 images. The results showed that different weights correspond different evaluating effectiveness. In the case of setting up the weights of edge features and GSD, the image quality of GF2 is better than SPOT7. However, when setting MTF and PSNR as main factor, the image quality of SPOT7 is better than GF2.
Assessment of medical care by elderly people: general satisfaction and physician quality.
Lee, Y; Kasper, J D
1998-01-01
OBJECTIVE: To identify personal characteristics and factors related to health and patterns of healthcare utilization associated with the elderly people's satisfaction with medical care. DATA SOURCES/STUDY SETTING: Data from the 1991 Medicare Current Beneficiary Survey (MCBS) on 8,859 persons age 65 and over living in the community. STUDY DESIGN: Items reflecting general satisfaction with care and views of physician quality are examined and, based on factor analysis, grouped in dimensions of two (global quality, access) and three (technical skills, interpersonal manner, information-giving), respectively. The relationship of high levels of satisfaction in each dimension to personal characteristics of elderly people, and to measures of access and utilization, is assessed using logistic regression. PRINCIPAL FINDINGS: While satisfaction is high, with over 90 percent surveyed expressing some satisfaction, there is substantial variation with less likelihood of high satisfaction among those 80 or older, with less education and income and in poorer health. Longer waiting time at visits and less frequent visits are factors in lower satisfaction as well. A favorable perception of physician quality, especially regarding technical skills, appears to play a significant role in satisfaction with global quality of care. CONCLUSIONS: Studies of patient satisfaction in elderly people are rare. Some factors expected to be related to positive assessment based on earlier studies, were, e.g., better health and shorter waiting time, while others were not, e.g., increasing age. Elderly people appear to place greater importance on physician technical skills, as opposed to interpersonal dimensions, in assessing global quality. These findings suggest the need for a better understanding of how elderly people evaluate care and what they value in interactions with the healthcare system. Images Figure 1 PMID:9460484
Human action quality evaluation based on fuzzy logic with application in underground coal mining.
Ionica, Andreea; Leba, Monica
2015-01-01
The work system is defined by its components, their roles and the relationships between them. Any work system gravitates around the human resource and the interdependencies between human factor and the other components of it. Researches in this field agreed that the human factor and its actions are difficult to quantify and predict. The objective of this paper is to apply a method of human actions evaluation in order to estimate possible risks and prevent possible system faults, both at human factor level and at equipment level. In order to point out the importance of the human factor influence on all the elements of the working systems we propose a fuzzy logic based methodology for quality evaluation of human actions. This methodology has a multidisciplinary character, as it gathers ideas and methods from: quality management, ergonomics, work safety and artificial intelligence. The results presented refer to a work system with a high degree of specificity, namely, underground coal mining and are valuable for human resources risk evaluation pattern. The fuzzy logic evaluation of the human actions leads to early detection of possible dangerous evolutions of the work system and alarm the persons in charge.
Keyser, Donna J; Pincus, Harold Alan
2010-01-01
A community-based collaborative conducted a 2-year pilot study to inform efforts for improving maternal and child health care practice and policy in Allegheny County, Pennsylvania. (1) To test whether three small-scale versions of an evidence-based, systems improvement approach would be workable in local community settings and (2) to identify specific policy/infrastructure reforms for sustaining improvements. A mixed methods approach was used, including quantitative performance measurement supplemented with qualitative data about factors related to outcomes of interest, as well as key stakeholder interviews and a literature review/Internet search. Quantitative performance results varied; qualitative data revealed critical factors for the success and failure of the practices tested. Policy/infrastructure recommendations were developed to address specific practice barriers. This information was important for designing a region-wide quality improvement initiative focused on maternal depression. The processes and outcomes provide valuable insights for other communities interested in conducting similar quality improvement initiatives.
Poultry Meat Quality in Relation to Muscle Growth and Muscle Fiber Characteristics
Ismail, Ishamri; Joo, Seon-Tea
2017-01-01
Variations in the definition of poultry meat quality exist because the quality traits are not solely based on intrinsic and extrinsic factors but also consumers’ preference. Appearance quality traits (AQT), eating quality traits (EQT), and reliance quality traits (RQT) are the major factors focused by the consumer before buying good quality of poultry meat. AQT and EQT of poultry meat are controlled by physical and biochemical characteristics of muscle fibers which can be categorized into a total number of fibers (TNF), cross-sectional area of fibers (CSAF), and fiber type composition (FTC). In poultry meat, it has been shown that muscle fiber properties play a key role in meat quality because numerous studies have reported the relationships between quality traits and fiber characteristics. Despite intensive research has been carried out to manipulate the muscle fiber to improve poultry meat quality, demand in a rapid growth of poultry muscle has correlated to the deterioration in the meat quality. The present paper reviews the definition of poultry meat quality, meat quality traits, and variations of meat quality. Also, this review presents recent knowledge underlying the relationship between poultry meat quality traits and muscle fiber characteristics. PMID:29725209
Suda, Hiromi Kimura
2015-10-01
Bone quality, which was defined as "the sum total of characteristics of the bone that influence the bone's resistance to fracture" at the National Institute of Health (NIH) conference in 2001, contributes to bone strength in combination with bone mass. Bone mass is often measured as bone mineral density (BMD) and, consequently, can be quantified easily. On the other hand, bone quality is composed of several factors such as bone structure, bone matrix, calcification degree, microdamage, and bone turnover, and it is not easy to obtain data for the various factors. Therefore, it is difficult to quantify bone quality. We are eager to develop new measurement methods for bone quality that make it possible to determine several factors associated with bone quality at the same time. Analytic methods based on Raman and FTIR spectroscopy have attracted a good deal of attention as they can provide a good deal of chemical information about hydroxyapatite and collagen, which are the main components of bone. A lot of studies on bone quality using Raman and FTIR imaging have been reported following the development of the two imaging systems. Thus, both Raman and FTIR imaging appear to be promising new bone morphometric techniques.
Determinants of quality management systems implementation in hospitals.
Wardhani, Viera; Utarini, Adi; van Dijk, Jitse Pieter; Post, Doeke; Groothoff, Johan Willem
2009-03-01
To identify the problems and facilitating factors in the implementation of quality management system (QMS) in hospitals through a systematic review. A search strategy was performed on the Medline database for articles written in English published between 1992 and early 2006. Using the thesaurus terms 'Total Quality Management' and 'Quality Assurance Health Care', combined with the term 'hospital' and 'implement*', we identified 533 publications. The screening process was based on empirical articles describing organization-wide QMS implementation. Fourteen empirical articles fulfilled the inclusion criteria and were reviewed in this paper. An organization culture emphasizing standards and values associated with affiliation, teamwork and innovation, assumption of change and risk taking, play as the key success factor in QMS implementation. This culture needs to be supported by sufficient technical competence to apply a scientific problem-solving approach. A clear distribution of QMS function within the organizational structure is more important than establishing a formal quality structure. In addition to management leadership, physician involvement also plays an important role in implementing QMS. Six supporting and limiting factors determining QMS implementation are identified in this review. These are the organization culture, design, leadership for quality, physician involvement, quality structure and technical competence.
Parts-based stereoscopic image assessment by learning binocular manifold color visual properties
NASA Astrophysics Data System (ADS)
Xu, Haiyong; Yu, Mei; Luo, Ting; Zhang, Yun; Jiang, Gangyi
2016-11-01
Existing stereoscopic image quality assessment (SIQA) methods are mostly based on the luminance information, in which color information is not sufficiently considered. Actually, color is part of the important factors that affect human visual perception, and nonnegative matrix factorization (NMF) and manifold learning are in line with human visual perception. We propose an SIQA method based on learning binocular manifold color visual properties. To be more specific, in the training phase, a feature detector is created based on NMF with manifold regularization by considering color information, which not only allows parts-based manifold representation of an image, but also manifests localized color visual properties. In the quality estimation phase, visually important regions are selected by considering different human visual attention, and feature vectors are extracted by using the feature detector. Then the feature similarity index is calculated and the parts-based manifold color feature energy (PMCFE) for each view is defined based on the color feature vectors. The final quality score is obtained by considering a binocular combination based on PMCFE. The experimental results on LIVE I and LIVE Π 3-D IQA databases demonstrate that the proposed method can achieve much higher consistency with subjective evaluations than the state-of-the-art SIQA methods.
Sun, Hong-bing; Sun, Hui; Jiang, Shun-yuan; Zhou, Yi; Cao, Wen-long; Ji, Ming-chang; Zhy, Wen-tao; Yan, Han-jing
2015-03-01
Growth suitability as assessment indicators for medicinal plants cultivation was proposed based on chemical quality determination and ecological factors analysis by Maxent and ArcGIS model. Notopterygium incisum, an endangered Chinese medicinal plant, was analyzed as a case, its potential distribution areas at different suitability grade and regionalization map were formulated based on growth suitability theory. The results showed that the most suitable habitats is Sichuan province, and more than 60% of the most suitable areawas located in the western Sichuan such as Aba and Ganzi prefectures for N. incisum. The results indicated that habitat altitude, average air temperature in September, and vegetation types were the dominant factors contributing to the grade of plant growth, precipitation and slope were the major factors contributing to notopterol accumulation in its underground parts, while isoimperatorin in its underground parts was negatively corelated with precipitation and slope of its habitat. However, slope as a factor influencing chemical components seemed to be a pseudo corelationship. Therefore, there were distinguishing differences between growth suitability and quality suitability for medicinal plants, which was helpful to further research and practice of cultivation regionalization, wild resource monitoring and large-scale cultivation of traditional Chinese medicine plants.
Taguchi experimental design to determine the taste quality characteristic of candied carrot
NASA Astrophysics Data System (ADS)
Ekawati, Y.; Hapsari, A. A.
2018-03-01
Robust parameter design is used to design product that is robust to noise factors so the product’s performance fits the target and delivers a better quality. In the process of designing and developing the innovative product of candied carrot, robust parameter design is carried out using Taguchi Method. The method is used to determine an optimal quality design. The optimal quality design is based on the process and the composition of product ingredients that are in accordance with consumer needs and requirements. According to the identification of consumer needs from the previous research, quality dimensions that need to be assessed are the taste and texture of the product. The quality dimension assessed in this research is limited to the taste dimension. Organoleptic testing is used for this assessment, specifically hedonic testing that makes assessment based on consumer preferences. The data processing uses mean and signal to noise ratio calculation and optimal level setting to determine the optimal process/composition of product ingredients. The optimal value is analyzed using confirmation experiments to prove that proposed product match consumer needs and requirements. The result of this research is identification of factors that affect the product taste and the optimal quality of product according to Taguchi Method.
Through the Lens of Culture: Quality of Life Among Latina Breast Cancer Survivors
Graves, Kristi D.; Jensen, Roxanne E.; Cañar, Janet; Perret-Gentil, Monique; Leventhal, Kara-Grace; Gonzalez, Florencia; Caicedo, Larisa; Jandorf, Lina; Kelly, Scott; Mandelblatt, Jeanne
2012-01-01
BACKGROUND Latinas have lower quality of life than Caucasian cancer survivors but we know little about factors associated with quality of life in this growing population. METHODS Bilingual staff conducted interviews with a national cross-sectional sample of 264 Latina breast cancer survivors. Quality of life was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B). Regression models evaluated associations between culture, social and medical context and overall quality of life and its subdomains. RESULTS Latina survivors were 1-5 years post-diagnosis and reported a lower mean quality of life score compared to other published reports of non-Latina survivors (M=105; SD=19.4 on the FACT-B). Culturally-based feelings of breast cancer-related stigma and shame were consistently related to lower overall quality of life and lower well-being in each quality of life domain. Social and medical contextual factors were independently related to quality of life; together cultural, social and medical context factors uniquely accounted for 62% of the explained model variance of overall quality of life (Adjusted R2=0.53, P<.001). Similar relationships were seen for quality of life subdomains in which cultural, social and medical contextual variables independently contributed to the overall variance of each final model: physical well-being (Adjusted R2=0.23, P <.001), social well-being (Adjusted R2=0.51, P<.001), emotional well-being (Adjusted R2=0.28, P<.001), functional well-being (Adjusted R2=0.41, P<.001) and additional breast concerns (Adjusted R2=0.40, P<.001). CONCLUSIONS Efforts to improve Latinas’ survivorship experiences should consider cultural, social and medical contextual factors to close existing quality of life gaps between Latinas and other survivors. PMID:23085764
Genetic and environmental influences on sleep quality in middle-aged men: a twin study.
Genderson, Margo R; Rana, Brinda K; Panizzon, Matthew S; Grant, Michael D; Toomey, Rosemary; Jacobson, Kristen C; Xian, Hong; Cronin-Golomb, Alice; Franz, Carol E; Kremen, William S; Lyons, Michael J
2013-10-01
Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (mean age = 55.4 years; range 51-60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 [SD = 3.6; range 0-20]. Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep-a dichotomous measure based on the cut-off of global PSQI>5-was 31%, with no contribution of the common environment. Heritability of six of the seven PSQI component scores (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, and daytime dysfunction) ranged from 0.15 to 0.31, whereas no genetic influences contributed to the use of sleeping medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step towards examination of the genetic relationship between sleep and other facets of aging. © 2013 European Sleep Research Society.
Genetic and Environmental Influences on Sleep Quality in Middle-Aged Men: A Twin Study
Genderson, Margo R.; Rana, Brinda K.; Panizzon, Matthew S.; Grant, Michael D.; Toomey, Rosemary; Jacobson, Kristen C.; Xian, Hong; Cronin-Golomb, Alice; Franz, Carol E.; Kremen, William S.; Lyons, Michael J.
2013-01-01
SUMMARY Poor sleep quality is a risk factor for a number of cognitive and physiological age-related disorders. Identifying factors underlying sleep quality are important in understanding the etiology of these age-related health disorders. We investigated the extent to which genes and the environment contribute to subjective sleep quality in middle-aged male twins using the classical twin design. We used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality in 1218 middle-aged twin men from the Vietnam Era Twin Study of Aging (VETSA)(mean age=55.4 years; range 51–60; 339 monozygotic twin pairs, 257 dizygotic twin pairs, 26 unpaired twins). The mean PSQI global score was 5.6 (SD=3.6; range 0–20). Based on univariate twin models, 34% of variability in the global PSQI score was due to additive genetic effects (heritability) and 66% was attributed to individual-specific environmental factors. Common environment did not contribute to the variability. Similarly, the heritability of poor sleep—a dichotomous measure based on the cut-off of global PSQI>5--was 31% with no contribution of the common environment. Heritability of six of the seven PSQI component scores (Subjective Sleep Quality, Sleep Latency, Sleep Duration, Habitual Sleep Efficiency, Sleep Disturbances, and Daytime Dysfunction) ranged from .15 to .31, where as no genetic influences contributed to Use of Sleeping Medication. Additive genetic influences contribute to approximately one-third of the variability of global subjective sleep quality. Our results in middle-aged men constitute a first step toward examination of the genetic relationship between sleep and other facets of aging. PMID:23509903
Kim, Chang Eun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Choi, Areum; Park, Ki Byung; Lee, Ho-Joo; Ha, In-Hyuk
2017-03-28
Treatment effectiveness holds considerable importance in the association between service quality and satisfaction in medical service studies. While complementary and alternative medicine (CAM) use grows more prominent, comprehensive evaluations of the quality of medical service at CAM-oriented hospitals are scarce. This study assesses the quality of medical services provided at a CAM-oriented hospital of Korean medicine using the service encounter system approach and analyzes the influence of treatment effectiveness on patient loyalty. A survey study using one-on-one interviews was conducted using a cross-sectional design in outpatients visiting one of fifteen Korean medicine facilities located throughout Korea. A total of 880 surveys were completed from June to July, 2014, and 728 surveys were included in the final analysis after excluding incomplete or incorrect questionnaires. The reliability and validity of the surveys was confirmed using Cronbach's alpha coefficient and confirmatory factor analysis, and a structural equation modeling analysis was performed to verify causality and association between factors (quality of medical service, treatment effectiveness, patient satisfaction, and intent to revisit). The measured factors of physician performance and quality of service procedures had a positive effect on treatment effectiveness. The impression of the facilities and environment directly impacted satisfaction rates for interpersonal-based medical service encounters, while treatment effectiveness positively affected satisfaction regarding quality of medical service. However, treatment effectiveness had a more significant effect on satisfaction compared to facilities and environment, and it indirectly affected satisfaction and directly influenced intent to revisit. Treatment effectiveness and satisfaction both positively influenced intent to revisit. The importance of treatment effectiveness should be recognized when examining quality of medical services, and we hope that these findings may contribute to future studies.
Microfilm Permanence and Archival Quality
ERIC Educational Resources Information Center
Avedon, Don M.
1972-01-01
The facts about microfilm permanence and archival quality are presented in simple terms. The major factors, including the film base material, the film emulsion, processing, and storage conditions are reviewed. The designations on the edge of the film are explained and a list of refernces provided. (14 references) (Author)
Waddimba, Anthony C; Burgess, James F; Young, Gary J; Beckman, Howard B; Meterko, Mark
2013-01-01
Physician's dissatisfaction is reported to be increasing, especially in primary care. The transition from fee-for-service to outcome-based reimbursements may make matters worse. To investigate influences of provider attitudes and practice settings on job satisfaction/dissatisfaction during transition to quality-based payment models, we assessed self-reported satisfaction/dissatisfaction with practice in a Rochester (New York)-area physician practice association in the process of implementing pay-for-performance. We linked cross-sectional data for 215 survey respondents on satisfaction ratings and behavioral attitudes with medical record data on their clinical behavior and practices, and census data on their catchment population. Factors associated with the odds of being satisfied or dissatisfied were determined via predictive multivariable logistic regression modeling. Dissatisfied physicians were more likely to have larger-than-average patient panels, lower autonomy and/or control, and beliefs that quality incentives were hindering patient care. Satisfied physicians were more likely to have a higher sense of autonomy and control, smaller patient volumes, and a less complex patient mix. Efforts to maintain or improve satisfaction among physicians should focus on encouraging professional autonomy during transitions from volume-based to quality/outcomes-based payment systems. An optimum balance between accountability and autonomy/control might maximize both health care quality and job satisfaction.
Iwasaki, Yoshitaka; Coyle, Catherine P.; Shank, John W.
2010-01-01
SUMMARY Globally, the mental health system is being transformed into a strengths-based, recovery-oriented system of care, to which the concept of active living is central. Based on an integrative review of the literature, this paper presents a heuristic conceptual framework of the potential contribution that enjoyable and meaningful leisure experiences can have in active living, recovery, health and life quality among persons with mental illness. This framework is holistic and reflects the humanistic approach to mental illness endorsed by the United Nations and the World Health Organization. It also includes ecological factors such as health care systems and environmental factors as well as cultural influences that can facilitate and/or hamper recovery, active living and health/life quality. Unique to this framework is our conceptualization of active living from a broad-based and meaning-oriented perspective rather than the traditional, narrower conceptualization which focuses on physical activity and exercise. Conceptualizing active living in this manner suggests a unique and culturally sensitive potential for leisure experiences to contribute to recovery, health and life quality. In particular, this paper highlights the potential of leisure engagements as a positive, strengths-based and potentially cost-effective means for helping people better deal with the challenges of living with mental illness. PMID:20543204
ANALYSIS OF MOTOR VEHICLE EMISSIONS IN A HOUSTON TUNNEL DURING THE TEXAS AIR QUALITY STUDY 2000
Measurements from a Houston tunnel were used to develop fuel consumption based emission factors for CO, NOx, and Non-Methane Organic Compound (NMOC) for on-road gasoline vehicles. The Houston NOx emission factor was at the low range of emission factors reported in previous (pr...
Zhang, Sha; Meng, Long; Qiu, Feng; Yang, Jia-Dan; Sun, Shusen
2018-01-01
Previous studies have demonstrated that medication adherence has an impact on health-related quality of life (HRQoL). However, other medication-related factors that may influence HRQoL have not been extensively studied, especially factors based on the Medication-Risk Questionnaire (MRQ), and such studies are mostly done in Western countries. Our objective was to explore risk factors associated with HRQoL among community-dwelling elderly with chronic diseases in mainland China, especially the medication-related risk factors regarding MRQ. The study was conducted in a community health service center through surveys to eligible patients. The main outcomes of HRQoL were assessed by the EuroQol-5D (EQ-5D) scale and EQ-visual analog scale (EQ-VAS). Medication-related risk factors according to MRQ associated with HRQoL were identified using a multiple linear regression. A total of 311 patients were analyzed, averaging 71.19±5.33 years, and 68.8% were female. The mean EQ-5D index was 0.72±0.09, and the mean EQ-VAS score was 71.37±11.97. The most prevalent problem was pain/discomfort, and 90.0% believed that they could take care of themselves without any problems. Sex, age, educational level, frailty, function status, and certain medication-related factors regarding MRQ were found to be significant factors impacting the HRQoL. A multivariate analysis showed that MRQ factors of polypharmacy, multimorbidity, feeling difficultly with taking medicines as prescribed, and taking medicines with narrow therapeutic index had negative impacts on the quality of life. Patient's internal characteristics and medication-related risk factors according to MRQ were associated with quality of life. The results of the MRQ is an indicator of quality of life that can identify patients who need interventions.
NASA Astrophysics Data System (ADS)
Vanrolleghem, Peter A.; Mannina, Giorgio; Cosenza, Alida; Neumann, Marc B.
2015-03-01
Sensitivity analysis represents an important step in improving the understanding and use of environmental models. Indeed, by means of global sensitivity analysis (GSA), modellers may identify both important (factor prioritisation) and non-influential (factor fixing) model factors. No general rule has yet been defined for verifying the convergence of the GSA methods. In order to fill this gap this paper presents a convergence analysis of three widely used GSA methods (SRC, Extended FAST and Morris screening) for an urban drainage stormwater quality-quantity model. After the convergence was achieved the results of each method were compared. In particular, a discussion on peculiarities, applicability, and reliability of the three methods is presented. Moreover, a graphical Venn diagram based classification scheme and a precise terminology for better identifying important, interacting and non-influential factors for each method is proposed. In terms of convergence, it was shown that sensitivity indices related to factors of the quantity model achieve convergence faster. Results for the Morris screening method deviated considerably from the other methods. Factors related to the quality model require a much higher number of simulations than the number suggested in literature for achieving convergence with this method. In fact, the results have shown that the term "screening" is improperly used as the method may exclude important factors from further analysis. Moreover, for the presented application the convergence analysis shows more stable sensitivity coefficients for the Extended-FAST method compared to SRC and Morris screening. Substantial agreement in terms of factor fixing was found between the Morris screening and Extended FAST methods. In general, the water quality related factors exhibited more important interactions than factors related to water quantity. Furthermore, in contrast to water quantity model outputs, water quality model outputs were found to be characterised by high non-linearity.
Nekouei, Zohreh Khayyam; Yousefy, Alireza; Doost, Hamid Taher Neshat; Manshaee, Gholamreza; Sadeghei, Masoumeh
2014-01-01
Background: Conducted researches show that psychological factors may have a very important role in the etiology, continuity and consequences of coronary heart diseases. This study has drawn the psychological risk and protective factors and their effects in patients with coronary heart diseases (CHD) in a structural model. It aims to determine the structural relations between psychological risk and protective factors with quality of life in patients with coronary heart disease. Materials and Methods: The present cross-sectional and correlational studies were conducted using structural equation modeling. The study sample included 398 patients of coronary heart disease in the university referral Hospital, as well as other city health care centers in Isfahan city. They were selected based on random sampling method. Then, in case, they were executed the following questionnaires: Coping with stressful situations (CISS- 21), life orientation (LOT-10), general self-efficacy (GSE-10), depression, anxiety and stress (DASS-21), perceived stress (PSS-14), multidimensional social support (MSPSS-12), alexithymia (TAS-20), spiritual intelligence (SQ-23) and quality of life (WHOQOL-26). Results: The results showed that protective and risk factors could affect the quality of life in patients with CHD with factor loadings of 0.35 and −0.60, respectively. Moreover, based on the values of the framework of the model such as relative chi-square (CMIN/DF = 3.25), the Comparative Fit Index (CFI = 0.93), the Parsimony Comparative Fit Index (PCFI = 0.68), the Root Mean Square Error of Approximation (RMSEA = 0.07) and details of the model (significance of the relationships) it has been confirmed that the psychocardiological structural model of the study is the good fitting model. Conclusion: This study was among the first to research the different psychological risk and protective factors of coronary heart diseases in the form of a structural model. The results of this study have emphasized the necessity of noticing the psychological factors in primary prevention by preventive programs and in secondary prevention by rehabilitation centers to improve the quality of life of the people with heart diseases. PMID:24778660
Vernik, N V; Ivantsova, M A; Yashin, D I
2015-01-01
To evaluate the ways of reduction complications during endoscopic procedures based on principals of professional ethics and improving the quality of working area. Data of fundamental literature, evidence based medicine, science publications and internet portals. Deontology is the fundamental principle of medical practice and one of the main factors of professional effectiveness. Complications in endoscopy are often the investigations of deviation from the deontological principals. The whole number of psychological factors influences on professional activity of endoscopists, where the emotional "burn-out" syndrome (EBS) occupies one of the main places. Prophylactic and timely relief of EBS serves improvement of the practical work quality. Creation of favorable working area is the strategically important task in prophylactics of endoscopy complications. The questions of practical realization of deontological principles in endoscopy are the subject of further discussion.
2013-01-01
Background With the increasing prevalence of Picture Archiving and Communication Systems (PACS) in healthcare institutions, there is a growing need to measure their success. However, there is a lack of published literature emphasizing the technical and social factors underlying a successful PACS. Methods An updated Information Systems Success Model was utilized by radiology technologists (RTs) to evaluate the success of PACS at a large medical center in Taiwan. A survey, consisting of 109 questionnaires, was analyzed by Structural Equation Modeling. Results Socio-technical factors (including system quality, information quality, service quality, perceived usefulness, user satisfaction, and PACS dependence) were proven to be effective measures of PACS success. Although the relationship between service quality and perceived usefulness was not significant, other proposed relationships amongst the six measurement parameters of success were all confirmed. Conclusions Managers have an obligation to improve the attributes of PACS. At the onset of its deployment, RTs will have formed their own subjective opinions with regards to its quality (system quality, information quality, and service quality). As these personal concepts are either refuted or reinforced based on personal experiences, RTs will become either satisfied or dissatisfied with PACS, based on their perception of its usefulness or lack of usefulness. A satisfied RT may play a pivotal role in the implementation of PACS in the future. PMID:24053458
Factors Affecting Quality Discourse and Knowledge Construction in an Online University Course
ERIC Educational Resources Information Center
Sutton, Lourdes M.
2012-01-01
Asynchronous discussion boards are an important element of online courses in higher education settings. Currently, questions persist about the quality of online interaction and discussions in which students are engaged. In addition, online instructors may not be utilizing instructional strategies that are appropriate for web-based learning…
In 1998, EPA published its draft revision to the methodology for deriving ambient water quality criteria to protect human health. Four methods were proposed to determine lipid-normalized bioaccumulation factors based on freely-dissolved water concentrations (BAFs) for nonpolar or...
A low-threshold high-index-contrast grating (HCG)-based organic VCSEL
NASA Astrophysics Data System (ADS)
Shayesteh, Mohammad Reza; Darvish, Ghafar; Ahmadi, Vahid
2015-12-01
We propose a low-threshold high-index-contrast grating (HCG)-based organic vertical-cavity surface-emitting laser (OVCSEL). The device has the feasibility to apply both electrical and optical excitation. The microcavity of the laser is a hybrid photonic crystal (HPC) in which the top distributed Bragg reflector (DBR) is replaced by a sub-wavelength high-contrast-grating layer, and provides a high-quality factor. The simulated quality factor of the microcavity is shown to be as high as 282,000. We also investigate the threshold behavior and the dynamics of the OVCSEL optically pumped with sub-picosecond pulses. Results from numerical simulation show that lasing threshold is 75 nJ/cm2.
Jeon, Kwon Chan; Chen, Lei-Shih; Goodson, Patricia
2012-01-01
We performed a systematic review of factors affecting parental decisions to continue or terminate a pregnancy after prenatal diagnosis of a sex chromosome abnormality, as reported in published studies from 1987 to May 2011. Based on the Matrix Method for systematic reviews, 19 studies were found in five electronic databases, meeting specific inclusion/exclusion criteria. Abstracted data were organized in a matrix. Alongside the search for factors influencing parental decisions, each study was judged on its methodological quality and assigned a methodological quality score. Decisions either to terminate or to continue a sex chromosome abnormality-affected pregnancy shared five similar factors: specific type of sex chromosome abnormality, gestational week at diagnosis, parents' age, providers' genetic expertise, and number of children/desire for (more) children. Factors unique to termination decisions included parents' fear/anxiety and directive counseling. Factors uniquely associated with continuation decisions were parents' socioeconomic status and ethnicity. The studies' average methodological quality score was 10.6 (SD = 1.67; range, 8-14). Findings from this review can be useful in adapting and modifying guidelines for genetic counseling after prenatal diagnosis of a sex chromosome abnormality. Moreover, improving the quality of future studies on this topic may allow clearer understanding of the most influential factors affecting parental decisions.
High-quality JPEG compression history detection for fake uncompressed images
NASA Astrophysics Data System (ADS)
Zhang, Rong; Wang, Rang-Ding; Guo, Li-Jun; Jiang, Bao-Chuan
2017-05-01
Authenticity is one of the most important evaluation factors of images for photography competitions or journalism. Unusual compression history of an image often implies the illicit intent of its author. Our work aims at distinguishing real uncompressed images from fake uncompressed images that are saved in uncompressed formats but have been previously compressed. To detect the potential image JPEG compression, we analyze the JPEG compression artifacts based on the tetrolet covering, which corresponds to the local image geometrical structure. Since the compression can alter the structure information, the tetrolet covering indexes may be changed if a compression is performed on the test image. Such changes can provide valuable clues about the image compression history. To be specific, the test image is first compressed with different quality factors to generate a set of temporary images. Then, the test image is compared with each temporary image block-by-block to investigate whether the tetrolet covering index of each 4×4 block is different between them. The percentages of the changed tetrolet covering indexes corresponding to the quality factors (from low to high) are computed and used to form the p-curve, the local minimum of which may indicate the potential compression. Our experimental results demonstrate the advantage of our method to detect JPEG compressions of high quality, even the highest quality factors such as 98, 99, or 100 of the standard JPEG compression, from uncompressed-format images. At the same time, our detection algorithm can accurately identify the corresponding compression quality factor.
Quality assessment of urban environment
NASA Astrophysics Data System (ADS)
Ovsiannikova, T. Y.; Nikolaenko, M. N.
2015-01-01
This paper is dedicated to the research applicability of quality management problems of construction products. It is offered to expand quality management borders in construction, transferring its principles to urban systems as economic systems of higher level, which qualitative characteristics are substantially defined by quality of construction product. Buildings and structures form spatial-material basis of cities and the most important component of life sphere - urban environment. Authors justify the need for the assessment of urban environment quality as an important factor of social welfare and life quality in urban areas. The authors suggest definition of a term "urban environment". The methodology of quality assessment of urban environment is based on integrated approach which includes the system analysis of all factors and application of both quantitative methods of assessment (calculation of particular and integrated indicators) and qualitative methods (expert estimates and surveys). The authors propose the system of indicators, characterizing quality of the urban environment. This indicators fall into four classes. The authors show the methodology of their definition. The paper presents results of quality assessment of urban environment for several Siberian regions and comparative analysis of these results.
The effects of gardening on quality of life in people with stroke.
Ho, Sui-Hua; Lin, Chiuhsiang Joe; Kuo, Fen-Ling
2016-06-27
Compared with traditional rehabilitation, gardening has been viewed as a more occupation-based intervention to help patients improve functional performance. However, there is still a need for evidence-based research into what factors interact to create the beneficial effects of gardening for people who have sustained a cerebral vascular accident (CVA). To explore how plant, gender, and the time after stroke onset influenced improvements in the quality of life of patients in a gardening program. One treatment of tending short-term plants, and another treatment of tending long-term plants were compared. Quality of life improvement was evaluated according to three factors: plant, gender, and the time after stroke onset. The data were analyzed with 2k replicated factorial designs. The 2k factorial design with replication indicated significant effects on both the social role and the family role. For the social role, the interaction of plant and gender difference was significant. For the family role, the significant effects were found on interaction of plant with both gender and the time after stroke onset. Tending plants with different life cycles has varied effects on the quality of life of people who have sustained a CVA. Factors related to gender and the time after stroke onset influenced role competency in this sample.
Engel, Lidia; Mortimer, Duncan; Bryan, Stirling; Lear, Scott A; Whitehurst, David G T
2017-07-01
The ICEpop CAPability measure for Adults (ICECAP-A) is a measure of capability wellbeing developed for use in economic evaluations. It was designed to overcome perceived limitations associated with existing preference-based instruments, where the explicit focus on health-related aspects of quality of life may result in the failure to capture fully the broader benefits of interventions and treatments that go beyond health. The aim of this study was to investigate the extent to which preference-based health-related quality of life (HRQoL) instruments are able to capture aspects of capability wellbeing, as measured by the ICECAP-A. Using data from the Multi Instrument Comparison project, pairwise exploratory factor analyses were conducted to compare the ICECAP-A with five preference-based HRQoL instruments [15D, Assessment of Quality of Life 8-dimension (AQoL-8D), EQ-5D-5L, Health Utilities Index Mark 3 (HUI-3), and SF-6D]. Data from 6756 individuals were used in the analyses. The ICECAP-A provides information above that garnered from most commonly used preference-based HRQoL instruments. The exception was the AQoL-8D; more common factors were identified between the ICECAP-A and AQoL-8D compared with the other pairwise analyses. Further investigations are needed to explore the extent and potential implications of 'double counting' when applying the ICECAP-A alongside health-related preference-based instruments.
Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura
2016-01-01
Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be satisfied when the TPS-QC tool generated re-optimized plans without sacrificing other dosimetric endpoints. In addition to its feasibility and accuracy, the proposed TPS-QC tool is also user-friendly and easy to operate, both of which are necessary characteristics for clinical use. PMID:26930204
Sleep and Depression in Postpartum Women: A Population-Based Study
Dørheim, Signe Karen; Bondevik, Gunnar Tschudi; Eberhard-Gran, Malin; Bjorvatn, Bjørn
2009-01-01
Study Objectives: (1) To describe the prevalence of and risk factors for postpartum maternal sleep problems and depressive symptoms simultaneously, (2) identify factors independently associated with either condition, and (3) explore associations between specific postpartum sleep components and depression. Design: Cross-sectional. Setting: Population-based. Participants: All women (n = 4191) who had delivered at Stavanger University Hospital from October 2005 to September 2006 were mailed a questionnaire seven weeks postpartum. The response rate was 68% (n = 2830). Interventions: None. Measurements and results: Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI), and depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS). The prevalence of sleep problems, defined as PSQI > 5, was 57.7%, and the prevalence of depression, defined as EPDS ≥ 10, was 16.5%. The mean self-reported nightly sleep duration was 6.5 hours and sleep efficiency 73%. Depression, previous sleep problems, being primiparous, not exclusively breastfeeding, or having a younger or male infant were factors associated with poor postpartum sleep quality. Poor sleep was also associated with depression when adjusted for other significant risk factors for depression, such as poor partner relationship, previous depression, depression during pregnancy and stressful life events. Sleep disturbances and subjective sleep quality were the aspects of sleep most strongly associated with depression. Conclusions: Poor sleep was associated with depression independently of other risk factors. Poor sleep may increase the risk of depression in some women, but as previously known risk factors were also associated, mothers diagnosed with postpartum depression are not merely reporting symptoms of chronic sleep deprivation. Citation: Dørheim SK; Bondevik GT; Eberhard-Gran M; Bjorvatn B. Sleep and depression in postpartum women: a population-based study. SLEEP 2009;32(7):847-855. PMID:19639747
Hajizade-Valokolaee, Maryam; Khani, Soghra; Fooladi, Ensieh; Peivandi, Sepideh
2017-01-01
Background and aim Infertility as a global problem, affects the different aspects of women’s health. Also, violence against infertile women affects their psychological wellbeing and treatment consequence. This study aimed at reviewing related factors to violence against infertile women, based on an ecological approach. Methods In this systematic review, the researchers conducted their search in electronic databases such as Google Scholar, and then in more specialized ones such as Medline via PubMed, Science Direct, Up-to-date, Springer, SID, Magiran, Iranmedex and Irandoc with the key words violence, infertility, women, risk factors, social environment, and individuality, from 1988 to 2016. The selection of papers was undertaken from 20–27 January 2017. The articles were selected based on the following criteria: 1), the articles focused on the research question 2), infertility and violence were included in the title of the articles, and 3) articles were published in online journals. Exclusion criteria were articles which focused on violence against the general population, pregnant women and female sex workers and articles that were not available in full text form or written in other languages (Not Persian or English). The quality of selected studies was appraised using a 16-item checklist adapted from Tao. This checklist consisted of 16 items which used a 0 or 1 scoring system (not eligible or eligible). If an article received a score of 75% (12–16 points), it was of high quality. A score of 50% to 74% (8–12 points) indicated moderate quality, and less than 50% (8 points) indicated low quality. The process of titles, abstracts and full-texts’ appraisal led to the selection of 16 articles, which were used to write this article Results Two of the articles based on 16-items of the check list had high quality score, 8 of them had moderate and the remaining articles had low quality score. Our findings were classified under three categories corresponding with the ecological approach: (1) Microsystem level “individual sociodemographic and infertility characteristics”, (2) Mesosystem level “interpersonal’ and husband sociodemographic characteristics” and (3) Macro system level considered ethnicity and cultural factors. Conclusion Violence against infertile women and the stress caused by it, would affect the consequences of infertility treatment. It is noted that various cultural-contextual factors cause violence in different societies. There is a need for the development of screening tools and applying counselors to identify infertile women at the risk of violence, and provide clinical services, counseling and social support. PMID:29403627
DOSIMETRIC response of a REM-500 in low energy neutron fields typical of nuclear power plants.
Aslam; Matysiak, W; Atanackovic, J; Waker, A J
2012-06-01
This study investigates the response of a REM-500 to assess neutron quality factor and dose equivalent in low energy neutron fields, which are commonly encountered in the workplace environment of nuclear power stations. The McMaster University 3 MV Van de Graaff accelerator facility was used to measure the response of the instrument in monoenergetic neutron fields in the energy range 51 to 727 keV by bombarding a thin LiF target with 1.93-2.50 MeV protons. The energy distribution of the neutron fields produced in the facility was measured by a (3)He filled gas ionization chamber. The MCA mode of the REM-500 instrument was used to collect lineal energy distributions at varying neutron energies and to calculate the frequency and dose-mean lineal energies. The effective quality factor, Q-, was also calculated using the values of Q(y)listed in the REM-500 operation manual and compared with those of ICRP 60. The authors observed a continuously increasing trend in y - F, y-D, and Q-with an increase in neutron energy. It is interesting to note that standard tissue equivalent proportional counters (TEPCs) filled with tissue equivalent(TE) gas give rise to a similar trend for these microdosimetric quantities of interest in the same energy range; however, the averages calculated in this study are larger by about 15%compared to a TEPC filled with propane-based TE gas probably because of the larger stopping power of protons in propane compared to TE gas. These somewhat larger event sizes did not result in any significant increase in the Q-compared to those obtained from a TEPC filled with TE gas and were found to be in good agreement with other measurements reported earlier at corresponding neutron energies. The instrument quality factor response, R(Q), defined as the ratio of measured quality factor to the calculated quality factor in an ICRU tissue sphere,was found to vary with neutron energy. The instrument response,R(Q), was ~0.6 at 727 keV, which deteriorates further to ~0.3 at 51 keV neutron energy. The counter response based on ICRP 60 was comparable to an ideal response of 1.0 above 600 keV, which dropped to ~0.8 at 159 keV and ~0.4 at 51 keV neutron energy. The decline in counter quality factor response based on ICRP 60 was found to be much steeper than that when using the instrument’s built-in function for quality factor.The REM-500 measures a dose equivalent at 727 keV,which is 60% of the ambient dose equivalent, 40% at 159 keV,and 15% at 51 keV. Two algorithms have been developed, one for real time measurement and another to be used post measurement,and their efficacy is demonstrated in determining the quality factor and the ambient dose equivalent in low energy neutron fields, which are typical for the workplace environment in CANDU® nuclear power generating stations.
Bienvenu, B; Cozon, G; Hoarau, C; Pasquet, M; Cherin, P; Clerson, P; Hachulla, E; Crave, J C; Delain, J C; Jaussaud, R
2016-06-22
IgG replacement therapy (IgRT) in primary immunodeficiencies (PID) is a lifelong treatment which may be administered intravenously (IVIg) or subcutaneously (SCIg), at hospital or at home. The objective of the VISAGE study was to investigate if route and/or place for IgRT impact patients' satisfaction regarding IgRT and quality of life (QoL) in real-life conditions. The study enrolled PID patients at least 15 years old receiving IgRT for at least 3 months. Satisfaction and QoL were evaluated at enrollment and over a 12-month follow-up period by Life Quality Index (LQI) which measures 3 dimensions of satisfaction: treatment interference, therapy related problems and therapy settings (factors I, II and III) and SF-36 v2 questionnaire. The study included 116 PID patients (mean age 42 ± 18 years, 44 % males, 58 % with scholar or professional occupation) receiving IgRT for a mean of 8.5 ± 8.4 years. At enrollment they were receiving either home-based SCIg (51 %), hospital-based IVIg (40 %) or home-based IVIg (9 %). Patients exhibited a high degree of satisfaction regarding IgRT whatever the route and place for administration. LQI factor I was higher for home-based SCIg (86 ± 2) than for hospital-based IVIg (81 ± 3) and home-based IVIg (73 ± 5; p = 0.02 versus home-based SCIg); no difference was found for LQI factor II; LQI factor III was higher for home-based SCIg (92 ± 2) than for hospital-based IVIg (87 ± 5) and hospital-based IVIg (82 ± 3; p = 0.005 versus home-based SCIg). By contrast, every dimension of QoL was impaired. Over the follow-up period, 10 patients switched from hospital-based IVIg to home-based SCIg and improved LQI factor I (p = 0.004) and factor III (p = 0.02), while no change was noticed in LQI factors II and QoL. Meanwhile, no change in satisfaction or QoL was found in patients with stable route of IgRT. When asked on their preferred place of treatment all but one patient with home-based treatment would choose to be treated at home and 29 % of patients treated at hospital would prefer home-based IgRT. PID patients expressed a high degree of satisfaction regarding IgRT, contrasting with impaired QoL. In real-life conditions awareness of patient's expectations regarding the route or place of IgRT may be associated with further improvement of satisfaction.
Osonoi, Yusuke; Mita, Tomoya; Osonoi, Takeshi; Saito, Miyoko; Tamasawa, Atsuko; Nakayama, Shiho; Someya, Yuki; Ishida, Hidenori; Kanazawa, Akio; Gosho, Masahiko; Fujitani, Yoshio; Watada, Hirotaka
2015-06-18
While poor sleep quality can worsen cardiovascular risk factors such as glucose and lipid profiles in patients with type 2 diabetes mellitus (T2DM), the relationship between sleep quality and atherosclerosis remains largely unknown. The aim of this study was to examine this relationship. The study participants comprised 724 Japanese T2DM outpatients free of history of cardiovascular diseases. The relationships between sleep quality (assessed by the Pittsburgh Sleep Quality Index (PSQI)) and various clinical and laboratory parameters were investigated. The mean PSQI was 5.1 ± 3.0 (±SD). Patients were divided into three groups based on the total PSQI score; subjects with good sleep quality (n = 462), average sleep quality (n = 185), and poor sleep quality (n = 77). In the age/gender-adjusted model, patients with poor sleep quality tended to be obese, evening type and depressed. However, other lifestyles showed no significant trends. Alanine aminotransferase, fasting blood glucose, HbA1c, systolic blood pressure, urinary albumin excretion, and brachial-ankle pulse wave velocity (baPWV) tended to be higher in patients with poor sleep quality. High baPWV was the only parameter that correlated with poor sleep in a model adjusted for several other lifestyle factors. Our study indicates that poor sleep quality in T2DM patients correlates with increased arterial wall stiffness, a marker of atherosclerosis and a risk factor for cardiovascular diseases.
Photodiode area effect on performance of X-ray CMOS active pixel sensors
NASA Astrophysics Data System (ADS)
Kim, M. S.; Kim, Y.; Kim, G.; Lim, K. T.; Cho, G.; Kim, D.
2018-02-01
Compared to conventional TFT-based X-ray imaging devices, CMOS-based X-ray imaging sensors are considered next generation because they can be manufactured in very small pixel pitches and can acquire high-speed images. In addition, CMOS-based sensors have the advantage of integration of various functional circuits within the sensor. The image quality can also be improved by the high fill-factor in large pixels. If the size of the subject is small, the size of the pixel must be reduced as a consequence. In addition, the fill factor must be reduced to aggregate various functional circuits within the pixel. In this study, 3T-APS (active pixel sensor) with photodiodes of four different sizes were fabricated and evaluated. It is well known that a larger photodiode leads to improved overall performance. Nonetheless, if the size of the photodiode is > 1000 μm2, the degree to which the sensor performance increases as the photodiode size increases, is reduced. As a result, considering the fill factor, pixel-pitch > 32 μm is not necessary to achieve high-efficiency image quality. In addition, poor image quality is to be expected unless special sensor-design techniques are included for sensors with a pixel pitch of 25 μm or less.
A quality function deployment framework for the service quality of health information websites.
Chang, Hyejung; Kim, Dohoon
2010-03-01
This research was conducted to identify both the users' service requirements on health information websites (HIWs) and the key functional elements for running HIWs. With the quality function deployment framework, the derived service attributes (SAs) are mapped into the suppliers' functional characteristics (FCs) to derive the most critical FCs for the users' satisfaction. Using the survey data from 228 respondents, the SAs, FCs and their relationships were analyzed using various multivariate statistical methods such as principal component factor analysis, discriminant analysis, correlation analysis, etc. Simple and compound FC priorities were derived by matrix calculation. Nine factors of SAs and five key features of FCs were identified, and these served as the basis for the house of quality model. Based on the compound FC priorities, the functional elements pertaining to security and privacy, and usage support should receive top priority in the course of enhancing HIWs. The quality function deployment framework can improve the FCs of the HIWs in an effective, structured manner, and it can also be utilized for critical success factors together with their strategic implications for enhancing the service quality of HIWs. Therefore, website managers could efficiently improve website operations by considering this study's results.
Infrared machine vision system for the automatic detection of olive fruit quality.
Guzmán, Elena; Baeten, Vincent; Pierna, Juan Antonio Fernández; García-Mesa, José A
2013-11-15
External quality is an important factor in the extraction of olive oil and the marketing of olive fruits. The appearance and presence of external damage are factors that influence the quality of the oil extracted and the perception of consumers, determining the level of acceptance prior to purchase in the case of table olives. The aim of this paper is to report on artificial vision techniques developed for the online estimation of olive quality and to assess the effectiveness of these techniques in evaluating quality based on detecting external defects. This method of classifying olives according to the presence of defects is based on an infrared (IR) vision system. Images of defects were acquired using a digital monochrome camera with band-pass filters on near-infrared (NIR). The original images were processed using segmentation algorithms, edge detection and pixel value intensity to classify the whole fruit. The detection of the defect involved a pixel classification procedure based on nonparametric models of the healthy and defective areas of olives. Classification tests were performed on olives to assess the effectiveness of the proposed method. This research showed that the IR vision system is a useful technology for the automatic assessment of olives that has the potential for use in offline inspection and for online sorting for defects and the presence of surface damage, easily distinguishing those that do not meet minimum quality requirements. Crown Copyright © 2013 Published by Elsevier B.V. All rights reserved.
Lovato, Nicole; Lack, Leon; Wright, Helen; Kennaway, David J
2013-09-01
Cognitive behavior therapy is an effective nonpharmacologic treatment for insomnia. However, individualized administration is costly and often results in substantial variability in treatment response across individual patients, particularly so for older adults. Group-based administration has demonstrated impressive potential for a brief and inexpensive answer to the effective treatment of insomnia in the older population. It is important to identify potential predictors of response to such a treatment format to guide clinicians when selecting the most suitable treatment for their patients. The aim of our study was to identify factors that predict subjective sleep quality of older adults following group-based administration of cognitive behavior therapy for insomnia (CBT-I). Eighty-six adults (41 men; mean age, 64.10 y; standard deviation [SD], 6.80) with sleep maintenance or early morning awakening insomnia were selected from a community-based sample to participate in a 4-week group-based treatment program of CBT-I. Participants were required to complete 7-day sleep diaries and a comprehensive battery of questionnaires related to sleep quality and daytime functioning. Hierarchical multiple regression analyses were used to identify factors predicting subjective sleep quality immediately following treatment and at 3-month follow-up. Sleep diaries reported average nightly sleep efficiency (SE), which was used as the outcome measure of sleep quality. Participants with the greatest SE following treatment while controlling for pretreatment SE were relatively younger and had more confidence in their ability to sleep at pretreatment. These characteristics may be useful to guide clinicians when considering the use of a group-based CBT-I for sleep maintenance or early morning awakening insomnia in older adults. Copyright © 2013 Elsevier B.V. All rights reserved.
The consumer quality index anthroposophic healthcare: a construction and validation study.
Koster, Evi B; Ong, Rob R S; Heybroek, Rachel; Delnoij, Diana M J; Baars, Erik W
2014-04-02
Accounting for the patients' perspective on quality of care has become increasingly important in the development of Evidence Based Medicine as well as in governmental policies. In the Netherlands the Consumer Quality (CQ) Index has been developed to measure the quality of care from the patients' perspective in different healthcare sectors in a standardized manner. Although the scientific accountability of anthroposophic healthcare as a form of integrative medicine is growing, patient experiences with anthroposophic healthcare have not been measured systematically. In addition, the specific anthroposophic aspects are not measured by means of existing CQ Indexes. To enable accountability of quality of the anthroposophic healthcare from the patients' perspective the aim of this study is the construction and validation of a CQ Index for anthroposophic healthcare. Construction in three phases: Phase 1. Determining anthroposophic quality aspects: literature study and focus groups. Phase 2. Adding new questions and validating the new questionnaire. Research population: random sample from 7910 patients of 22 anthroposophic GPs. survey, mixed mode by means of the Dillman method. Measuring instrument: experience questionnaire: CQ Index General Practice (56 items), added with 27 new anthroposophic items added and an item-importance questionnaire (anthroposophic items only). Factor analysis, scale construction, internal consistency (Chronbach's Alpha), inter-item-correlation, discriminative ability (Intra Class Correlation) and inter-factor-correlations. Phase 3. Modulation and selection of new questions based on results. Criteria of retaining items: general: a limited amount of items, statistical: part of a reliable scale and inter-item-correlation <0,7, and theoretical. Phase 1. 27 anthroposophic items. Phase 2. Two new anthroposophic scales: Scale AntroposophicTreatmentGP: seven items, Alpha=0,832, ICC=4,2 Inter-factor-correlation with existing GP-scales range from r=0,24 (Accessibility) to r=0,56 (TailoredCare). Scale InteractionalStyleGP: five items, Alpha=0,810, ICC=5,8, Inter-factor-correlation with existing GP-scales range from r=0,32 (Accessibility) to r=0,76 (TailoredCare). Inter-factor-correlation between new scales: r=0,50. Phase 3: Adding both scales and four single items. Removing eleven items and reformulating two items. The CQ Index Anthroposophic Healthcare measures patient experiences with anthroposophic GP's validly and reliably. Regarding the inter-factor-correlations anthroposophic quality aspects from the patients' perspective are mostly associated with individually tailored care and patient centeredness.
Information Quality Evaluation of C2 Systems at Architecture Level
2014-06-01
based on architecture models of C2 systems, which can help to identify key factors impacting information quality and improve the system capability at the stage of architecture design of C2 system....capability evaluation of C2 systems at architecture level becomes necessary and important for improving the system capability at the stage of architecture ... design . This paper proposes a method for information quality evaluation of C2 system at architecture level. First, the information quality model is
Dosimetry for Small and Nonstandard Fields
NASA Astrophysics Data System (ADS)
Junell, Stephanie L.
The proposed small and non-standard field dosimetry protocol from the joint International Atomic Energy Agency (IAEA) and American Association of Physicist in Medicine working group introduces new reference field conditions for ionization chamber based reference dosimetry. Absorbed dose beam quality conversion factors (kQ factors) corresponding to this formalism were determined for three different models of ionization chambers: a Farmer-type ionization chamber, a thimble ionization chamber, and a small volume ionization chamber. Beam quality correction factor measurements were made in a specially developed cylindrical polymethyl methacrylate (PMMA) phantom and a water phantom using thermoluminescent dosimeters (TLDs) and alanine dosimeters to determine dose to water. The TLD system for absorbed dose to water determination in high energy photon and electron beams was fully characterized as part of this dissertation. The behavior of the beam quality correction factor was observed as it transfers the calibration coefficient from the University of Wisconsin Accredited Dosimetry Calibration Laboratory (UWADCL) 60Co reference beam to the small field calibration conditions of the small field formalism. TLD-determined beam quality correction factors for the calibration conditions investigated ranged from 0.97 to 1.30 and had associated standard deviations from 1% to 3%. The alanine-determined beam quality correction factors ranged from 0.996 to 1.293. Volume averaging effects were observed with the Farmer-type ionization chamber in the small static field conditions. The proposed small and non-standard field dosimetry protocols new composite-field reference condition demonstrated its potential to reduce or remove ionization chamber volume dependancies, but the measured beam quality correction factors were not equal to the standard CoP's kQ, indicating a change in beam quality in the small and non-standard field dosimetry protocols new composite-field reference condition relative to the standard broad beam reference conditions. The TLD- and alanine-determined beam quality correction factors in the composite-field reference conditions were approximately 3% greater and differed by more than one standard deviation from the published TG-51 kQ values for all three chambers.
Nosrati, Kazem
2013-04-01
Soil degradation associated with soil erosion and land use is a critical problem in Iran and there is little or insufficient scientific information in assessing soil quality indicator. In this study, factor analysis (FA) and discriminant analysis (DA) were used to identify the most sensitive indicators of soil quality for evaluating land use and soil erosion within the Hiv catchment in Iran and subsequently compare soil quality assessment using expert opinion based on soil surface factors (SSF) form of Bureau of Land Management (BLM) method. Therefore, 19 soil physical, chemical, and biochemical properties were measured from 56 different sampling sites covering three land use/soil erosion categories (rangeland/surface erosion, orchard/surface erosion, and rangeland/stream bank erosion). FA identified four factors that explained for 82 % of the variation in soil properties. Three factors showed significant differences among the three land use/soil erosion categories. The results indicated that based upon backward-mode DA, dehydrogenase, silt, and manganese allowed more than 80 % of the samples to be correctly assigned to their land use and erosional status. Canonical scores of discriminant functions were significantly correlated to the six soil surface indices derived of BLM method. Stepwise linear regression revealed that soil surface indices: soil movement, surface litter, pedestalling, and sum of SSF were also positively related to the dehydrogenase and silt. This suggests that dehydrogenase and silt are most sensitive to land use and soil erosion.
Factors Influencing Implementation of a Preschool-Based Physical Activity Intervention
ERIC Educational Resources Information Center
Lau, Erica Y.; Saunders, Ruth P.; Beets, Michael W.; Cai, Bo; Pate, Russell R.
2017-01-01
Examining factors that influence implementation of key program components that underlie an intervention's success provides important information to inform the development of effective dissemination strategies. We examined direct and indirect effects of preschool capacity, quality of prevention support system and teacher characteristics on…
NASA Astrophysics Data System (ADS)
Hsieh, M.; Zhao, L.; Ma, K.
2010-12-01
Finite-frequency approach enables seismic tomography to fully utilize the spatial and temporal distributions of the seismic wavefield to improve resolution. In achieving this goal, one of the most important tasks is to compute efficiently and accurately the (Fréchet) sensitivity kernels of finite-frequency seismic observables such as traveltime and amplitude to the perturbations of model parameters. In scattering-integral approach, the Fréchet kernels are expressed in terms of the strain Green tensors (SGTs), and a pre-established SGT database is necessary to achieve practical efficiency for a three-dimensional reference model in which the SGTs must be calculated numerically. Methods for computing Fréchet kernels for seismic velocities have long been established. In this study, we develop algorithms based on the finite-difference method for calculating Fréchet kernels for the quality factor Qμ and seismic boundary topography. Kernels for the quality factor can be obtained in a way similar to those for seismic velocities with the help of the Hilbert transform. The effects of seismic velocities and quality factor on either traveltime or amplitude are coupled. Kernels for boundary topography involve spatial gradient of the SGTs and they also exhibit interesting finite-frequency characteristics. Examples of quality factor and boundary topography kernels will be shown for a realistic model for the Taiwan region with three-dimensional velocity variation as well as surface and Moho discontinuity topography.
NASA Astrophysics Data System (ADS)
Wei, Ke; Fan, Xiaoguang; Zhan, Mei; Meng, Miao
2018-03-01
Billet optimization can greatly improve the forming quality of the transitional region in the isothermal local loading forming (ILLF) of large-scale Ti-alloy ribweb components. However, the final quality of the transitional region may be deteriorated by uncontrollable factors, such as the manufacturing tolerance of the preforming billet, fluctuation of the stroke length, and friction factor. Thus, a dual-response surface method (RSM)-based robust optimization of the billet was proposed to address the uncontrollable factors in transitional region of the ILLF. Given that the die underfilling and folding defect are two key factors that influence the forming quality of the transitional region, minimizing the mean and standard deviation of the die underfilling rate and avoiding folding defect were defined as the objective function and constraint condition in robust optimization. Then, the cross array design was constructed, a dual-RSM model was established for the mean and standard deviation of the die underfilling rate by considering the size parameters of the billet and uncontrollable factors. Subsequently, an optimum solution was derived to achieve the robust optimization of the billet. A case study on robust optimization was conducted. Good results were attained for improving the die filling and avoiding folding defect, suggesting that the robust optimization of the billet in the transitional region of the ILLF was efficient and reliable.
ERIC Educational Resources Information Center
Thompson, Terrie Lynn; MacDonald, Colla J.
2005-01-01
Given the extraordinary interest and growth in eLearning as a learning tool and as an industry, it is not surprising there is lively debate on quality. A research-based and tested eLearning model was used to design and evaluate an online M.Ed. course in order to study factors that influence the quality of an eLearning event. Several data…
Measurement of M²-Curve for Asymmetric Beams by Self-Referencing Interferometer Wavefront Sensor.
Du, Yongzhao
2016-11-29
For asymmetric laser beams, the values of beam quality factor M x 2 and M y 2 are inconsistent if one selects a different coordinate system or measures beam quality with different experimental conditionals, even when analyzing the same beam. To overcome this non-uniqueness, a new beam quality characterization method named as M²-curve is developed. The M²-curve not only contains the beam quality factor M x 2 and M y 2 in the x -direction and y -direction, respectively; but also introduces a curve of M x α 2 versus rotation angle α of coordinate axis. Moreover, we also present a real-time measurement method to demonstrate beam propagation factor M²-curve with a modified self-referencing Mach-Zehnder interferometer based-wavefront sensor (henceforth SRI-WFS). The feasibility of the proposed method is demonstrated with the theoretical analysis and experiment in multimode beams. The experimental results showed that the proposed measurement method is simple, fast, and a single-shot measurement procedure without movable parts.
Measurement of M2-Curve for Asymmetric Beams by Self-Referencing Interferometer Wavefront Sensor
Du, Yongzhao
2016-01-01
For asymmetric laser beams, the values of beam quality factor Mx2 and My2 are inconsistent if one selects a different coordinate system or measures beam quality with different experimental conditionals, even when analyzing the same beam. To overcome this non-uniqueness, a new beam quality characterization method named as M2-curve is developed. The M2-curve not only contains the beam quality factor Mx2 and My2 in the x-direction and y-direction, respectively; but also introduces a curve of Mxα2 versus rotation angle α of coordinate axis. Moreover, we also present a real-time measurement method to demonstrate beam propagation factor M2-curve with a modified self-referencing Mach-Zehnder interferometer based-wavefront sensor (henceforth SRI-WFS). The feasibility of the proposed method is demonstrated with the theoretical analysis and experiment in multimode beams. The experimental results showed that the proposed measurement method is simple, fast, and a single-shot measurement procedure without movable parts. PMID:27916845
Adoption of Smart Structures for Prevention of Health Hazards in Buildings
NASA Astrophysics Data System (ADS)
Oke, Ayodeji; Aigbavboa, Clinton; Ngema, Wiseman
2017-11-01
The importance of building quality to the health and well-being of occupants and surrounding neighbors cannot be overemphasized. Smart structures were construed to proffer solution to various issues of sustainable development including social factors that is concerned with health and safety of people. Based on existing literature materials on building quality, smart structures and general aspect of sustainable developments, this study examined the benefits of smart structures in the prevention of various health issues in infrastructural buildings, which has been a concern for stakeholders in the architecture, engineering and construction industry. The criterion for indoor environmental quality was adopted and various health and bodily issues related to building quality were explained. The adoption of smart structure concept will help to manage physical, chemical, biological and psychological factors of building with a view to enhancing better quality of life of occupants.
Measuring quality in community based housing support - the QPC-H instrument.
Lundqvist, Lars-Olov; Rask, Mikael; Brunt, David; Ivarsson, Ann-Britt; Schröder, Agneta
2016-04-18
Purpose - The purpose of this paper is to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care-Housing (QPC-H) and briefly describe the residents' perception of quality of housing support. Design/methodology/approach - A sample of 174 residents from 22 housing support services in nine Swedish municipalities participated in the study. Confirmatory factor analysis (CFA) revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the Quality in Psychiatric Care (QPC) family of instruments. Findings - CFA revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the QPC family of instruments. The internal consistency of the factors was acceptable except in the case of secure and secluded environment, probably due to few numbers of items. With this exception, the QPC-H shows adequate psychometric properties. Social implications - The residents' ratings of quality of housing service were generally high; the highest rating was for secluded environment and the lowest for participation. This dimension would thus seem to indicate an important area for improvement. Originality/value - The QPC-H includes important aspects of residents' assessment of quality of housing service and offers a simple and inexpensive way to evaluate housing support services from the residents' perspective.
The effects of RN staffing hours on nursing home quality: a two-stage model.
Lee, Hyang Yuol; Blegen, Mary A; Harrington, Charlene
2014-03-01
Based on structure-process-outcome approach, this study examined the association of registered nurse (RN) staffing hours and five quality indicators, including two process measures (catheter use and antipsychotic drug use) and three outcome measures (pressure ulcers, urinary tract infections, and weight loss). We used data on resident assessments, RN staffing, organizational characteristics, and market factors to examine the quality of 195 nursing homes operating in a rural state of United States - Colorado. Two-stage least squares regression models were performed to address the endogenous relationships between RN staffing and the outcome-related quality indicators, and ordinary least squares regression was used for the process-related ones. This analysis focused on the relationship of RN staffing to nursing home quality indicators, controlling for organizational characteristics, resources, resident casemix, and market factors with clustering to control for geographical differences. Higher RN hours were associated with fewer pressure ulcers, but RN hours were not related to the other quality indicators. The study finding shows the importance of understanding the role of 'nurse staffing' under nursing home care, as well as the significance of associated/contextual factors with nursing home quality even in a small rural state. Copyright © 2013 Elsevier Ltd. All rights reserved.
Flatland, Bente; Freeman, Kathy P; Friedrichs, Kristen R; Vap, Linda M; Getzy, Karen M; Evans, Ellen W; Harr, Kendal E
2010-09-01
Owing to lack of governmental regulation of veterinary laboratory performance, veterinarians ideally should demonstrate a commitment to self-monitoring and regulation of laboratory performance from within the profession. In response to member concerns about quality management in veterinary laboratories, the American Society for Veterinary Clinical Pathology (ASVCP) formed a Quality Assurance and Laboratory Standards (QAS) committee in 1996. This committee recently published updated and peer-reviewed Quality Assurance Guidelines on the ASVCP website. The Quality Assurance Guidelines are intended for use by veterinary diagnostic laboratories and veterinary research laboratories that are not covered by the US Food and Drug Administration Good Laboratory Practice standards (Code of Federal Regulations Title 21, Chapter 58). The guidelines have been divided into 3 reports on 1) general analytic factors for veterinary laboratory performance and comparisons, 2) hematology and hemostasis, and 3) clinical chemistry, endocrine assessment, and urinalysis. This report documents recommendations for control of general analytical factors within veterinary clinical laboratories and is based on section 2.1 (Analytical Factors Important In Veterinary Clinical Pathology, General) of the newly revised ASVCP QAS Guidelines. These guidelines are not intended to be all-inclusive; rather, they provide minimum guidelines for quality assurance and quality control for veterinary laboratory testing. It is hoped that these guidelines will provide a basis for laboratories to assess their current practices, determine areas for improvement, and guide continuing professional development and education efforts. ©2010 American Society for Veterinary Clinical Pathology.
Jain, Meha; Lim, Yili; Arce-Nazario, Javier A; Uriarte, María
2014-01-01
Identifying which factors influence household water management can help policy makers target interventions to improve drinking water quality for communities that may not receive adequate water quality at the tap. We assessed which perceptional and socio-demographic factors are associated with household drinking water management strategies in rural Puerto Rico. Specifically, we examined which factors were associated with household decisions to boil or filter tap water before drinking, or to obtain drinking water from multiple sources. We find that households differ in their management strategies depending on the institution that distributes water (i.e. government PRASA vs community-managed non-PRASA), perceptions of institutional efficacy, and perceptions of water quality. Specifically, households in PRASA communities are more likely to boil and filter their tap water due to perceptions of low water quality. Households in non-PRASA communities are more likely to procure water from multiple sources due to perceptions of institutional inefficacy. Based on informal discussions with community members, we suggest that water quality may be improved if PRASA systems improve the taste and odor of tap water, possibly by allowing for dechlorination prior to distribution, and if non-PRASA systems reduce the turbidity of water at the tap, possibly by increasing the degree of chlorination and filtering prior to distribution. Future studies should examine objective water quality standards to identify whether current management strategies are effective at improving water quality prior to consumption.
Acoustic Quality Levels of Mosques in Batu Pahat
NASA Astrophysics Data System (ADS)
Azizah Adnan, Nor; Nafida Raja Shahminan, Raja; Khair Ibrahim, Fawazul; Tami, Hannifah; Yusuff, M. Rizal M.; Murniwaty Samsudin, Emedya; Ismail, Isham
2018-04-01
Every Friday, Muslims has been required to perform a special prayer known as the Friday prayers which involve the delivery of a brief lecture (Khutbah). Speech intelligibility in oral communications presented by the preacher affected all the congregation and determined the level of acoustic quality in the interior of the mosque. Therefore, this study intended to assess the level of acoustic quality of three public mosques in Batu Pahat. Good acoustic quality is essential in contributing towards appreciation in prayers and increasing khusyu’ during the worship, which is closely related to the speech intelligibility corresponding to the actual function of the mosque according to Islam. Acoustic parameters measured includes noise criteria (NC), reverberation time (RT) and speech transmission index (STI), and was performed using the sound level meter and sound measurement instruments. This test is carried out through the physical observation with the consideration of space and volume design as a factor affecting acoustic parameters. Results from all 3 mosques as the showed that the acoustic quality level inside these buildings are slightly poor which is at below 0.45 coefficients based on the standard. Among the factors that influencing the low acoustical quality are location, building materials, installation of sound absorption material and the number of occupants inside the mosque. As conclusion, the acoustic quality level of a mosque is highly depends on physical factors of the mosque such as the architectural design and space volume besides other factors as been identified by this study.
Jain, Meha; Lim, Yili; Arce-Nazario, Javier A.; Uriarte, María
2014-01-01
Identifying which factors influence household water management can help policy makers target interventions to improve drinking water quality for communities that may not receive adequate water quality at the tap. We assessed which perceptional and socio-demographic factors are associated with household drinking water management strategies in rural Puerto Rico. Specifically, we examined which factors were associated with household decisions to boil or filter tap water before drinking, or to obtain drinking water from multiple sources. We find that households differ in their management strategies depending on the institution that distributes water (i.e. government PRASA vs community-managed non-PRASA), perceptions of institutional efficacy, and perceptions of water quality. Specifically, households in PRASA communities are more likely to boil and filter their tap water due to perceptions of low water quality. Households in non-PRASA communities are more likely to procure water from multiple sources due to perceptions of institutional inefficacy. Based on informal discussions with community members, we suggest that water quality may be improved if PRASA systems improve the taste and odor of tap water, possibly by allowing for dechlorination prior to distribution, and if non-PRASA systems reduce the turbidity of water at the tap, possibly by increasing the degree of chlorination and filtering prior to distribution. Future studies should examine objective water quality standards to identify whether current management strategies are effective at improving water quality prior to consumption. PMID:24586302
Knoll, Gabriella; Schunk, Michaela; Meisinger, Christa; Huth, Cornelia; Holle, Rolf
2016-01-01
Objective Little is known about the development of the quality of diabetes care in Germany. The aim of this study is to analyze time trends in patient self-management, physician-delivered care, medication, risk factor control, complications and quality of life from 2000 to 2014. Methods Analyses are based on data from individuals with type 2 diabetes of the population-based KORA S4 (1999–2001, n = 150), F4 (2006–2008, n = 203), FF4 (2013/14, n = 212) cohort study. Information on patient self-management, physician-delivered care, medication, risk factor control and quality of life were assessed in standardized questionnaires and examinations. The 10-year coronary heart disease (CHD) risk was calculated using the UKPDS risk engine. Time trends were analyzed using multivariable linear and logistic regression models adjusted for age, sex, education, diabetes duration, and history of cardiovascular disease. Results From 2000 to 2014 the proportion of participants with type 2 diabetes receiving oral antidiabetic/cardio-protective medication and of those reaching treatment goals for glycemic control (HbA1c<7%, 60% to 71%, p = 0.09), blood pressure (<140/80 mmHg, 25% to 69%, p<0.001) and LDL cholesterol (<2.6 mmol/l, 13% to 27%, p<0.001) increased significantly. However, improvements were generally smaller from 2007 to 2014 than from 2000 to 2007. Modeled 10-year CHD risk decreased from 30% in 2000 to 24% in 2007 to 19% in 2014 (p<0.01). From 2007 to 2014, the prevalence of microvascular complications decreased and quality of life increased, but no improvements were observed for the majority of indicators of self-management. Conclusion Despite improvements, medication and risk factor control has remained suboptimal. The flattening of improvements and deteriorations in quality of (self-) care since 2007 indicate that more effort is needed to improve quality of care and patient self-management. Due to selection or lead time bias an overestimation of quality of care improvements cannot be ruled out. PMID:27749939
Improved RF Measurements of SRF Cavity Quality Factors
DOE Office of Scientific and Technical Information (OSTI.GOV)
Holzbauer, J. P.; Contreras, C.; Pischalnikov, Y.
SRF cavity quality factors can be accurately measured using RF-power based techniques only when the cavity is very close to critically coupled. This limitation is from systematic errors driven by non-ideal RF components. When the cavity is not close to critically coupled, these systematic effects limit the accuracy of the measurements. The combination of the complex base-band envelopes of the cavity RF signals in combination with a trombone in the circuit allow the relative calibration of the RF signals to be extracted from the data and systematic effects to be characterized and suppressed. The improved calibration allows accurate measurements tomore » be made over a much wider range of couplings. Demonstration of these techniques during testing of a single-spoke resonator with a coupling factor of near 7 will be presented, along with recommendations for application of these techniques.« less
Beregovykh, V V; Spitskiy, O R
2014-01-01
Risk-based approach is used for examination of impact of different factors on quality of medicinal products in technology transfer. A general diagram is offered for risk analysis execution in technology transfer from pharmaceutical development to production. When transferring technology to full- scale commercial production it is necessary to investigate and simulate production process application beforehand in new real conditions. The manufacturing process is the core factorfor risk analysis having the most impact on quality attributes of a medicinal product. Further importantfactors are linked to materials and products to be handled and manufacturing environmental conditions such as premises, equipment and personnel. Usage of risk-based approach in designing of multipurpose production facility of medicinal products is shown where quantitative risk analysis tool RAMM (Risk Analysis and Mitigation Matrix) was applied.
Contribution of Fermentation Yeast to Final Amino Acid Profile in DDGS
USDA-ARS?s Scientific Manuscript database
One major factor affecting DDGS quality and market values is amino acid (AA) composition. DDGS proteins come from corn and yeast. Yet, the effect of fermentation yeast on DDGS protein quantity and quality (AA profile) has not been well documented. Based on literature review, there are at least 4 met...
ERIC Educational Resources Information Center
Downey, Thomas E.
Continuous quality improvement (CQI) models, which were first applied in business, are critical to making new technology-based learning paradigms and flexible learning environments a reality. The following are among the factors that have facilitated CQI's application in education: increased operating costs; increased competition from private…
[Issues in the use of medical oxygen generator with molecular sieve].
Xu, Junfeng; Yang, Xiaoling; Zhao, Xiaolei; Bai, Jiefang; Wang, Chaojie
2014-07-01
There are some existing problems in controlling the quality of oxygen. In order to improve quality, efficiency and safety in the use of oxygen, we presented some factors which may give rise to variations in concentration of oxygen and proposed some suggestions based on the investigation and analysis of such problems.
Joe, Yun Haeng; Woo, Kyoungja; Hwang, Jungho
2014-09-15
In this study, SiO2 nanoparticles surface coated with Ag nanoparticles (SA particles) were fabricated to coat a medium air filter. The pressure drop, filtration efficiency, and anti-viral ability of the filter were evaluated against aerosolized bacteriophage MS2 in a continuous air flow condition. A mathematical approach was developed to measure the anti-viral ability of the filter with various virus deposition times. Moreover, two quality factors based on the anti-viral ability of the filter, and a traditional quality factor based on filtration efficiency, were calculated. The filtration efficiency and pressure drop increased with decreasing media velocity and with increasing SA particle coating level. The anti-viral efficiency also increased with increasing SA particle coating level, and decreased by with increasing virus deposition time. Consequently, SA particle coating on a filter does not have significant effects on filtration quality, and there is an optimal coating level to produce the highest anti-viral quality. Copyright © 2014 Elsevier B.V. All rights reserved.
Li, Qing-na; Huang, Xiu-ling; Gao, Rui; Lu, Fang
2012-08-01
Data management has significant impact on the quality control of clinical studies. Every clinical study should have a data management plan to provide overall work instructions and ensure that all of these tasks are completed according to the Good Clinical Data Management Practice (GCDMP). Meanwhile, the data management plan (DMP) is an auditable document requested by regulatory inspectors and must be written in a manner that is realistic and of high quality. The significance of DMP, the minimum standards and the best practices provided by GCDMP, the main contents of DMP based on electronic data capture (EDC) and some key factors of DMP influencing the quality of clinical study were elaborated in this paper. Specifically, DMP generally consists of 15 parts, namely, the approval page, the protocol summary, role and training, timelines, database design, creation, maintenance and security, data entry, data validation, quality control and quality assurance, the management of external data, serious adverse event data reconciliation, coding, database lock, data management reports, the communication plan and the abbreviated terms. Among them, the following three parts are regarded as the key factors: designing a standardized database of the clinical study, entering data in time and cleansing data efficiently. In the last part of this article, the authors also analyzed the problems in clinical research of traditional Chinese medicine using the EDC system and put forward some suggestions for improvement.
Castiello, Luciano; Sabatino, Marianna; Zhao, Yingdong; Tumaini, Barbara; Ren, Jiaqiang; Ping, Jin; Wang, Ena; Wood, Lauren V; Marincola, Francesco M; Puri, Raj K; Stroncek, David F
2013-02-01
Cell-based immunotherapies are among the most promising approaches for developing effective and targeted immune response. However, their clinical usefulness and the evaluation of their efficacy rely heavily on complex quality control assessment. Therefore, rapid systematic methods are urgently needed for the in-depth characterization of relevant factors affecting newly developed cell product consistency and the identification of reliable markers for quality control. Using dendritic cells (DCs) as a model, we present a strategy to comprehensively characterize manufactured cellular products in order to define factors affecting their variability, quality and function. After generating clinical grade human monocyte-derived mature DCs (mDCs), we tested by gene expression profiling the degrees of product consistency related to the manufacturing process and variability due to intra- and interdonor factors, and how each factor affects single gene variation. Then, by calculating for each gene an index of variation we selected candidate markers for identity testing, and defined a set of genes that may be useful comparability and potency markers. Subsequently, we confirmed the observed gene index of variation in a larger clinical data set. In conclusion, using high-throughput technology we developed a method for the characterization of cellular therapies and the discovery of novel candidate quality assurance markers.
Irwin, Jessica L; Beeghly, Marjorie; Rosenblum, Katherine L; Muzik, Maria
2016-12-01
The postpartum period brings a host of biopsychosocial, familial, and economic changes, which may be challenging for new mothers, especially those with trauma histories. Trauma-exposed women are at heightened risk for psychiatric symptomatology and reduced quality of life. The current study sought to evaluate whether a set of hypothesized promotive factors assessed during the first 18 months postpartum (positive parenting, family cohesion, and maternal resilience) are associated with life satisfaction in this population, after controlling for income and postpartum psychiatric symptoms. Analyses were based on data collected for 266 mother-infant dyads from a longitudinal cohort study, Maternal Anxiety during the Childbearing Years (MACY), of women oversampled for childhood maltreatment history. Hierarchical linear regression was used to evaluate the study hypotheses. Consistent with prior work, greater postpartum psychiatric symptoms and less income predicted poor perceptions of life quality. In hierarchical regressions controlling for income and psychiatric symptoms, positive parenting and family cohesion predicted unique variance in mothers' positive perceptions of life quality, and resilience was predictive beyond all other factors. Factors from multiple levels of analysis (maternal, dyadic, and familial) may serve as promotive factors predicting positive perceptions of life quality among women with childhood trauma histories, even those struggling with high levels of psychiatric or economic distress.
Kayiga, Herbert; Ajeani, Judith; Kiondo, Paul; Kaye, Dan K
2016-07-11
Obstructed labour remains a major cause of maternal morbidity and mortality whose complications can be reduced with improved quality of obstetric care. The objective was to assess whether criteria-based audit improves quality of obstetric care provided to women with obstructed labour in Mulago hospital, Uganda. Using criteria-based audit, management of obstructed labour was analyzed prospectively in two audits. Six standards of care were compared. An initial audit of 180 patients was conducted in September/October 2013. The Audit results were shared with key stakeholders. Gaps in patient management were identified and recommendations for improving obstetric care initiated. Six standards of care (intravenous fluids, intravenous antibiotics, monitoring of maternal vital signs, bladder catheterization, delivery within two hours, and blood grouping and cross matching) were implemented. A re-audit of 180 patients with obstructed labour was conducted four months later to evaluate the impact of these recommendations. The results of the two audits were compared. In-depth interviews and focus group discussions were conducted among healthcare providers to identify factors that could have influenced the audit results. There was improvement in two standards of care (intravenous fluids and intravenous antibiotic administration) 58.9 % vs. 86.1 %; p < 0.001 and 21.7 % vs. 50.5 %; P < 0.001 respectively after the second audit. There was no improvement in vital sign monitoring, delivery within two hours or blood grouping and cross matching. There was a decline in bladder catheterization (94 % vs. 68.9 %; p < 0.001. The overall mean care score in the first and second audits was 55.1 and 48.2 % respectively, p = 0.19. Healthcare factors (negative attitude, low numbers, poor team work, low motivation), facility factors (poor supervision, stock-outs of essential supplies, absence of protocols) and patient factors (high patient load, poor compliance to instructions) contributed to poor quality of care. Introduction of criteria based audit in the management of obstructed labour led to measurable improvements in only two out of six standards of care. The extent to which criteria based audit may improve quality of obstetric care depends on having basic effective healthcare systems in place.
Hydrologic and water-quality rehabilitation of environments for suitable fish habitat
NASA Astrophysics Data System (ADS)
Zhao, C. S.; Yang, S. T.; Xiang, H.; Liu, C. M.; Zhang, H. T.; Yang, Z. L.; Zhang, Y.; Sun, Y.; Mitrovic, S. M.; Yu, Q.; Lim, R. P.
2015-11-01
Aquatic ecological rehabilitation is attracting increasing public and research attention, but without knowledge of the responses of aquatic species to their habitats the success of habitat restoration is uncertain. Thus efficient study of species response to habitat, through which to prioritize the habitat factors influencing aquatic ecosystems, is highly important. However many current models have too high requirement for assemblage information and have great bias in results due to consideration of only the species' attribute of presence/absence, abundance or biomass, thus hindering the wider utility of these models. This paper, using fish as a case, presents a framework for identification of high-priority habitat factors based on the responses of aquatic species to their habitats, using presence/absence, abundance and biomass data. This framework consists of four newly developed sub-models aiming to determine weightings for the evaluation of species' contributions to their communities, to quantitatively calculate an integrated habitat suitability index for multi-species based on habitat factors, to assess the suitable probability of habitat factors and to assess the rehabilitation priority of habitat factors. The framework closely links hydrologic, physical and chemical habitat factors to fish assemblage attributes drawn from monitoring datasets on hydrology, water quality and fish assemblages at a total of 144 sites, where 5084 fish were sampled and tested. Breakpoint identification techniques based on curvature in cumulated dominance along with a newly developed weighting calculation model based on theory of mass systems were used to help identify the dominant fish, based on which the presence and abundance of multiple fish were normalized to estimate the integrated habitat suitability index along gradients of various factors, based on their variation with principal habitat factors. Then, the appropriate probability of every principal habitat factor was estimated and graded, and the priority of habitat factors for rehabilitation was determined. Application of the model to Jinan City, a pilot city for the construction of a civilized and ecological city in China, proved effective, revealing that carbonate is the poorest habitat factor and has the highest priority for ecological rehabilitation. This was tested using two methods: alternative priority models and a dataset of all habitat factors in place of only the principal habitat factors. We also found that hydrological factors have higher priority than the water quality factors at the levels of both the whole city and its subordinate eco-regions and therefore that hydrological factors deserve special attention in the future ecosystem rehabilitation. Further, the current habitat state makes nearly half of the habitats in Jinan City undesirable for fish communities, largely due to long-term agricultural practices. Spatially, rivers in the mountainous region south of Jinan city and adjacent to the urban area and rivers in the agricultural region north of the city should be emphasized in future habitat rehabilitation. All of these findings have substantial ramifications for the rehabilitation of aquatic ecosystems in Jinan City as a reference for river ecological remediation in rivers with scarce ecological data worldwide.
Eklund, Mona
2015-01-01
Findings from quality of life studies are often inconclusive for reasons such as: i) estimates may address different aspects of quality of life and thus produce different outcomes; ii) quality of life is largely determined by self-factors; and iii) people with a long-term condition rate their quality of life better than those who have had their condition for a short duration. This makes quality of life a complex phenomenon to measure. The above explanations served as hypotheses for this methodologically oriented paper, based on a longitudinal study on women with stress-related disorders receiving work rehabilitation. Eighty-four women participating in a lifestyle intervention or care as usual were compared. Self-ratings of "general quality of life" and a summarized "satisfaction with different life domains" index (according to Manchester Short Assessment of Quality of Life) and two self-factors (self-esteem and self-mastery) were administered at admission and a 6-month follow-up. Participant age and amount of months on sick leave prior to rehabilitation were used as two proxies of duration of the condition. General quality of life distinguished between the groups, whereas satisfaction with life domains did not. Self-esteem and self-mastery were related to both quality of life aspects. Age was related to both estimates of quality of life, whereas duration of sick leave was unrelated to both. General quality of life and satisfaction with life domains produced different results. Outcome studies should apply more than one operationalization of quality of life and self-factors should be considered as important determinants of quality of life. Duration of the condition needs to be acknowledged as well when interpreting levels of quality of life, although the current study could not present any clear-cut findings in this respect.
Promoting Students' Attention to Argumentative Reasoning Patterns
ERIC Educational Resources Information Center
Cavagnetto, Andy R.; Kurtz, Kenneth J.
2016-01-01
Argument-based interventions in science education have largely been motivated by the perspective that students lack knowledge of argument. Recent studies, however, suggest that contextual factors influence students' argument quality. The authors hypothesize that a key limiting factor lies in students' abilities to recognize when to employ…
An Energy Saving Green Plug Device for Nonlinear Loads
NASA Astrophysics Data System (ADS)
Bloul, Albe; Sharaf, Adel; El-Hawary, Mohamed
2018-03-01
The paper presents a low cost a FACTS Based flexible fuzzy logic based modulated/switched tuned arm filter and Green Plug compensation (SFC-GP) scheme for single-phase nonlinear loads ensuring both voltage stabilization and efficient energy utilization. The new Green Plug-Switched filter compensator SFC modulated LC-Filter PWM Switched Capacitive Compensation Devices is controlled using a fuzzy logic regulator to enhance power quality, improve power factor at the source and reduce switching transients and inrush current conditions as well harmonic contents in source current. The FACTS based SFC-GP Device is a member of family of Green Plug/Filters/Compensation Schemes used for efficient energy utilization, power quality enhancement and voltage/inrush current/soft starting control using a dynamic error driven fuzzy logic controller (FLC). The device with fuzzy logic controller is validated using the Matlab / Simulink Software Environment for enhanced power quality (PQ), improved power factor and reduced inrush currents. This is achieved using modulated PWM Switching of the Filter-Capacitive compensation scheme to cope with dynamic type nonlinear and inrush cyclical loads..
Variation in cooking and eating quality traits in Japanese rice germplasm accessions
Hori, Kiyosumi; Suzuki, Keitaro; Iijima, Ken; Ebana, Kaworu
2016-01-01
The eating quality of cooked rice is important and determines its market price and consumer acceptance. To comprehensively describe the variation of eating quality in 183 rice germplasm accessions, we evaluated 33 eating-quality traits including amylose and protein contents, pasting properties of rice flour, and texture of cooked rice grains. All eating-quality traits varied widely in the germplasm accessions. Principal-components analysis (PCA) revealed that allelic differences in the Wx gene explained the largest proportion of phenotypic variation of the eating-quality traits. In 146 accessions of non-glutinous temperate japonica rice, PCA revealed that protein content and surface texture of the cooked rice grains significantly explained phenotypic variations of the eating-quality traits. An allelic difference based on simple sequence repeats, which was located near a quantitative trait locus (QTL) on the short arm of chromosome 3, was associated with differences in the eating quality of non-glutinous temperate japonica rice. These results suggest that eating quality is controlled by genetic factors, including the Wx gene and the QTL on chromosome 3, in Japanese rice accessions. These genetic factors have been consciously selected for eating quality during rice breeding programs in Japan. PMID:27162502
Variation in cooking and eating quality traits in Japanese rice germplasm accessions.
Hori, Kiyosumi; Suzuki, Keitaro; Iijima, Ken; Ebana, Kaworu
2016-03-01
The eating quality of cooked rice is important and determines its market price and consumer acceptance. To comprehensively describe the variation of eating quality in 183 rice germplasm accessions, we evaluated 33 eating-quality traits including amylose and protein contents, pasting properties of rice flour, and texture of cooked rice grains. All eating-quality traits varied widely in the germplasm accessions. Principal-components analysis (PCA) revealed that allelic differences in the Wx gene explained the largest proportion of phenotypic variation of the eating-quality traits. In 146 accessions of non-glutinous temperate japonica rice, PCA revealed that protein content and surface texture of the cooked rice grains significantly explained phenotypic variations of the eating-quality traits. An allelic difference based on simple sequence repeats, which was located near a quantitative trait locus (QTL) on the short arm of chromosome 3, was associated with differences in the eating quality of non-glutinous temperate japonica rice. These results suggest that eating quality is controlled by genetic factors, including the Wx gene and the QTL on chromosome 3, in Japanese rice accessions. These genetic factors have been consciously selected for eating quality during rice breeding programs in Japan.
Safety considerations in providing allergen immunotherapy in the office.
Mattos, Jose L; Lee, Stella
2016-06-01
This review highlights the risks of allergy immunotherapy, methods to improve the quality and safety of allergy treatment, the current status of allergy quality metrics, and the future of quality measurement. In the current healthcare environment, the emphasis on outcomes measurement is increasing, and providers must be better equipped in the development, measurement, and reporting of safety and quality measures. Immunotherapy offers the only potential cure for allergic disease and asthma. Although well tolerated and effective, immunotherapy can be associated with serious consequence, including anaphylaxis and death. Many predisposing factors and errors that lead to serious systemic reactions are preventable, and the evaluation and implementation of quality measures are crucial to developing a safe immunotherapy practice. Although quality metrics for immunotherapy are in their infancy, they will become increasingly sophisticated, and providers will face increased pressure to deliver safe, high-quality, patient-centered, evidence-based, and efficient allergy care. The establishment of safety in the allergy office involves recognition of potential risk factors for anaphylaxis, the development and measurement of quality metrics, and changing systems-wide practices if needed. Quality improvement is a continuous process, and although national allergy-specific quality metrics do not yet exist, they are in development.
2014-01-01
Background This study aimed to clarify how community mental healthcare systems can be improved. Methods We included 79 schizophrenic patients, aged 20 to 80 years, residing in the Tokyo metropolitan area who regularly visited rehabilitation facilities offering assistance to psychiatric patients and were receiving treatment on an outpatient basis. No subjects had severe cognitive disorders or were taking medication with side effects that could prevent the completion of questionnaires. Questionnaires included items related to quality of life, self-efficacy, self-esteem, psychosis based on the Behavior and Symptom Identification Scale, health locus of control, and socio-demographic factors. We performed multiple linear regression analysis with quality of life as the dependent variable and, based on covariance structural analysis, evaluated the goodness of fit of the resulting structural equations models. Results Self-efficacy, self-esteem, and degree of psychosis significantly impacted quality of life. Marital status, age, and types of medications also influenced quality of life. Multiple linear regression analysis revealed psychiatric symptoms (Behavior and Symptom Identification Scale-32 [daily living and role functioning] (Beta = −0.537, p < 0.001) and self-efficacy (Beta = 0.249, p < 0.05) to be predictors of total quality of life score. Based on covariance structural analysis, the resulting model was found to exhibit reasonable goodness of fit. Conclusions Self-efficacy had an especially strong and direct impact on QOL. Therefore, it is important to provide more positive feedback to patients, provide social skills training based on cognitive behavioral therapy, and engage patients in role playing to improve self-efficacy and self-concept. PMID:25101143
Comprehensive model for predicting perceptual image quality of smart mobile devices.
Gong, Rui; Xu, Haisong; Luo, M R; Li, Haifeng
2015-01-01
An image quality model for smart mobile devices was proposed based on visual assessments of several image quality attributes. A series of psychophysical experiments were carried out on two kinds of smart mobile devices, i.e., smart phones and tablet computers, in which naturalness, colorfulness, brightness, contrast, sharpness, clearness, and overall image quality were visually evaluated under three lighting environments via categorical judgment method for various application types of test images. On the basis of Pearson correlation coefficients and factor analysis, the overall image quality could first be predicted by its two constituent attributes with multiple linear regression functions for different types of images, respectively, and then the mathematical expressions were built to link the constituent image quality attributes with the physical parameters of smart mobile devices and image appearance factors. The procedure and algorithms were applicable to various smart mobile devices, different lighting conditions, and multiple types of images, and performance was verified by the visual data.
A Study on Fitts' Law Based Gait Symmetric Evaluation and It's Clinic Application.
Rencheng, Wang; Meiqin, Zhang; Xiaonan, Deng; Dewen, Jin; Maobin, Wang; Guangqing, Li
2005-01-01
Symmetry, one of the prominent characters of normal human gait, could be destroyed by some special or abnormal factors such as barrier spanning, walking impediment, etc. Therefore, it becomes an important factor used to evaluate qualities and functions of walking. In this paper, the fitts' law based symmetry index calculation is introduced and its application in clinic test is also reported. The results show that the fitts' law based index is effective in clinic evaluation.
How to measure the QoS of a web-based EHRs system: development of an instrument.
de la Torre-Díez, Isabel; López-Coronado, Miguel; Rodrigues, Joel J P C
2012-12-01
The quality of service (QoS) can be treated as a set of concepts whose satisfaction/dissatisfaction generates a global positive/negative vision about the service provided by any application. The different nature of the services and its features require an analysis of the factors that have the greatest influence on the users' opinion and, therefore, measuring the quality of service in each application requires a specific instrument. This paper will introduce an instrument to measure the QoS offered to users by a general Web application for Electronic Health Records (EHRs). The collection of opinions from a pilot sample and the performance of an explanatory factor analysis will bring together the factors that best sum up the quality of an EHRs application. Subsequently, a confirmatory factor analysis will be performed to make the study reliable and, as its name suggests, to confirm that indeed the structure of the instrument developed measures the QoS in accordance with the requirements of the users.
Cho, Kyoung Won; Bae, Sung-Kwon; Ryu, Ji-Hye; Kim, Kyeong Na; An, Chang-Ho; Chae, Young Moon
2015-01-01
This study was to evaluate the performance of the newly developed information system (IS) implemented on July 1, 2014 at three public hospitals in Korea. User satisfaction scores of twelve key performance indicators of six IS success factors based on the DeLone and McLean IS Success Model were utilized to evaluate IS performance before and after the newly developed system was introduced. All scores increased after system introduction except for the completeness of medical records and impact on the clinical environment. The relationships among six IS factors were also analyzed to identify the important factors influencing three IS success factors (Intention to Use, User Satisfaction, and Net Benefits). All relationships were significant except for the relationships among Service Quality, Intention to Use, and Net Benefits. The results suggest that hospitals should not only focus on systems and information quality; rather, they should also continuously improve service quality to improve user satisfaction and eventually reach full the potential of IS performance.
Recent progress in opto-electronic oscillator
NASA Technical Reports Server (NTRS)
Maleki, Lute
2005-01-01
The optoelectronic oscillator (OEO) is a unique device based on photonics techniques to generate highly spectrally pure microwave signals [1]. The development of the OEO was motivated by the need for high performance oscillators in the frequency range larger than 10 GHz, where conventional electronic oscillators have a number of limitations. These limitations typically stem from the product of fQ, where f is the oscillator frequency and Q is the quality factor of the resonator in the oscillator. In conventional resonators, whether electromagnetic or piezoelectric, this product is usually a constant. Thus, as the oscillator frequency is pushed higher, the quality factor degrades, resulting in degradation of the phase noise of the oscillator. An approach to mitigate the problem is to start with a very high quality signal in the 5 to 100 MHz range generated by a quartz oscillator and multiply the frequency to achieve the desired microwave signal. Here again, frequency multiplication also results in an increase of the phase noise by a factor of 2010gN, where N is the multiplication factor.
Reporting and methodological quality of meta-analyses in urological literature.
Xia, Leilei; Xu, Jing; Guzzo, Thomas J
2017-01-01
To assess the overall quality of published urological meta-analyses and identify predictive factors for high quality. We systematically searched PubMed to identify meta-analyses published from January 1st, 2011 to December 31st, 2015 in 10 predetermined major paper-based urology journals. The characteristics of the included meta-analyses were collected, and their reporting and methodological qualities were assessed by the PRISMA checklist (27 items) and AMSTAR tool (11 items), respectively. Descriptive statistics were used for individual items as a measure of overall compliance, and PRISMA and AMSTAR scores were calculated as the sum of adequately reported domains. Logistic regression was used to identify predictive factors for high qualities. A total of 183 meta-analyses were included. The mean PRISMA and AMSTAR scores were 22.74 ± 2.04 and 7.57 ± 1.41, respectively. PRISMA item 5, protocol and registration, items 15 and 22, risk of bias across studies, items 16 and 23, additional analysis had less than 50% adherence. AMSTAR item 1, " a priori " design, item 5, list of studies and item 10, publication bias had less than 50% adherence. Logistic regression analyses showed that funding support and " a priori " design were associated with superior reporting quality, following PRISMA guideline and " a priori " design were associated with superior methodological quality. Reporting and methodological qualities of recently published meta-analyses in major paper-based urology journals are generally good. Further improvement could potentially be achieved by strictly adhering to PRISMA guideline and having " a priori " protocol.
Optical microresonator for application to an opto-electronic oscillator
NASA Astrophysics Data System (ADS)
Wu, Yu-Mei; Vivien, Laurent; Cassan, Eric; Luong, Vu Hai Nam; Nguyen, Lam Duy; Journet, Bernard
2010-02-01
Optoelectronic oscillators are classically based on a feedback fiber loop acting as a delay line for high spectral purity. One of the problems due to long fiber loops is the size and the requirement of temperature control. Going toward integrated solutions requires the introduction of optical resonators with a very high quality factor. A structure based on silicon on insulator material has been designed for application to an oscillator working at 8 GHz. The micro-resonator has a stadium shape with a ridge of 30 nm height, 1 μm width, a millimetric radius and a gap of some microns in agreement with the required free spectral range. A quality factor of 500000 can be achieved leading to an equivalent fiber loop of 2 km.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Serafimovich, P. G.; Stepikhova, M. V., E-mail: mst@ipm.sci-nnov.ru; Kazanskiy, N. L.
2016-08-15
The production technology of a photonic-crystal cavity formed as a group of holes in a silicon strip waveguide by ion-beam etching is described. The parasitic effect associated with hole conicity which develops upon hole formation by the given technology is studied. Numerical simulation shows that the hole-conicity induced decrease in the cavity quality factor can be compensated with consideration for the hole volume. The influence of the waveguide thickness on the resonance wavelength and quality factor of the photonic-crystal cavity is analyzed.
Chen, Lei; Han, Zhaoxing; Li, Shuang; Shen, Zhenyao
2016-10-01
The efficacy of traditional effluent trading systems is questionable due to their neglect of seasonal hydrological variation and the creation of upstream hot spots within a watershed. Besides, few studies have been conducted to distinguish the impacts of each influencing factor on effluent trading systems outputs. In this study, a water environmental functional zone-based effluent trading systems framework was configured and a comprehensive analysis of its influencing factors was conducted. This proposed water environmental functional zone-based effluent trading systems was then applied for the control of chemical oxygen demand in the Beiyun River watershed, Beijing, China. Optimal trading results highlighted the integration of water quality constraints and different hydrological seasons, especially for downstream dischargers. The optimal trading of each discharger, in terms of pollutant reduction load and abatement cost, is greatly influenced by environmental and political factors such as background water quality, the location of river assessment points, and tradable discharge permits. In addition, the initial permit allowance has little influence on the market as a whole but does impact the individual discharger. These results provide information that is critical to understanding the impact of policy design on the functionality of an effluent trading systems.
NASA Astrophysics Data System (ADS)
Chen, Lei; Han, Zhaoxing; Li, Shuang; Shen, Zhenyao
2016-10-01
The efficacy of traditional effluent trading systems is questionable due to their neglect of seasonal hydrological variation and the creation of upstream hot spots within a watershed. Besides, few studies have been conducted to distinguish the impacts of each influencing factor on effluent trading systems outputs. In this study, a water environmental functional zone-based effluent trading systems framework was configured and a comprehensive analysis of its influencing factors was conducted. This proposed water environmental functional zone-based effluent trading systems was then applied for the control of chemical oxygen demand in the Beiyun River watershed, Beijing, China. Optimal trading results highlighted the integration of water quality constraints and different hydrological seasons, especially for downstream dischargers. The optimal trading of each discharger, in terms of pollutant reduction load and abatement cost, is greatly influenced by environmental and political factors such as background water quality, the location of river assessment points, and tradable discharge permits. In addition, the initial permit allowance has little influence on the market as a whole but does impact the individual discharger. These results provide information that is critical to understanding the impact of policy design on the functionality of an effluent trading systems.
Liu, Yu; Maier, Manfred; Hao, Yufang; Chen, Yan; Qin, Yuelan; Huo, Ran
2013-01-01
To explore the factors related to quality of life for patients with type 2 diabetes with or without depressive symptoms in China. In patients with type 2 diabetes with or without depressive symptoms, different factors such as gender, social context or regional setting may affect their quality of life. This was a cross-sectional study. Of 791 registered patients with type 2 diabetes from four communities in Beijing, cluster sampling was used to recruit patients for participation. Self-rating depression scale was used to screen for depressive symptoms; demographic and clinical data were collected, and quality of life and social support were assessed using appropriate tools. The factors associated with quality of life were tested using multivariate linear regression. The prevalence of depressive symptoms in 667 patients with diabetes was 44·2%. Quality of life of patients with depressive symptoms was worse than that of patients without depressive symptoms, and this was associated negatively with history of diabetic complications, usage of hypoglycaemic agents or insulin and self-rating depression scale scores and positively with salary and subjective social support. The factors related to quality of life for patients with or without depressive symptoms are different. For patients with depressive symptoms, better salary and subjective social support are associated positively with their quality of life, while the presence of diabetic complications, a higher score for depressive symptoms and need for hypoglycaemic agents or insulin are negatively associated with quality of life. It is suggested that the nurse should screen depression for patients with diabetes, especially for those with diabetic complications or low social support. This should be done in the community regularly in order to find diabetic patients with depression in time. In addition, the results can provide a reference to clinical nursing care for patients with diabetes in hospitals. © 2012 Blackwell Publishing Ltd.
Optimized adipose tissue engineering strategy based on a neo-mechanical processing method.
He, Yunfan; Lin, Maohui; Wang, Xuecen; Guan, Jingyan; Dong, Ziqing; Feng, Lu; Xing, Malcolm; Feng, Chuanbo; Li, Xiaojian
2018-05-26
Decellularized adipose tissue (DAT) represents a promising scaffold for adipose tissue engineering. However, the unique and prolonged lipid removal process required for adipose tissue can damage extracellular matrix (ECM) constituents. Moreover, inadequate vascularization limits the recellularization of DAT in vivo. We proposed a neo-mechanical protocol for rapidly breaking adipocytes and removing lipid content from adipose tissue. The lipid-depleted adipose tissue was then subjected to a fast and mild decellularization to fabricate high-quality DAT (M-DAT). Adipose liquid extract (ALE) derived from this mechanical process was collected and incorporated into M-DAT to further optimize in vivo recellularization. Ordinary DAT was fabricated and served as a control. This developed strategy was evaluated based on decellularization efficiency, ECM quality, and recellularization efficiency. Angiogenic factor components and angiogenic potential of ALE were evaluated in vivo and in vitro. M-DAT achieved the same decellularization efficiency, but exhibited better retention of ECM components and recellularization, compared to those with ordinary DAT. Protein quantification revealed considerable levels of angiogenic factors (basic fibroblast growth factor, epidermal growth factor, transforming growth factor-β1, and vascular endothelial growth factor) in ALE. ALE promoted tube formation in vitro and induced intense angiogenesis in M-DAT in vivo; furthermore, higher expression of the adipogenic factor PPARγ and greater numbers of adipocytes were evident following ALE treatment, compared to those in the M-DAT group. Mechanical processing of adipose tissue led to the production of high-quality M-DAT and angiogenic factor-enriched ALE. The combination of ALE and M-DAT could be a promising strategy for engineered adipose tissue construction. This article is protected by copyright. All rights reserved. © 2018 by the Wound Healing Society.
Factors determining yield and quality of illicit indoor cannabis (Cannabis spp.) production.
Vanhove, Wouter; Van Damme, Patrick; Meert, Natalie
2011-10-10
Judiciary currently faces difficulties in adequately estimating the yield of illicit indoor cannabis plantations. The latter data is required in penalization which is based on the profits gained. A full factorial experiment in which two overhead light intensities, two plant densities and four varieties were combined in the indoor cultivation of cannabis (Cannabis spp.) was used to reveal cannabis drug yield and quality under each of the factor combinations. Highest yield was found for the Super Skunk and Big Bud varieties which also exhibited the highest concentrations of Δ(9)-tetrahydrocannabinol (THC). Results show that plant density and light intensity are additive factors whereas the variety factor significantly interacts with both plant density and light intensity factors. Adequate estimations of yield of illicit, indoor cannabis plantations can only be made if upon seizure all factors considered in this study are accounted for. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
[Colonoscopy quality control as a requirement of colorectal cancer screening].
Quintero, Enrique; Alarcón-Fernández, Onofre; Jover, Rodrigo
2013-11-01
The strategies used in population-based colorectal screening strategies culminate in colonoscopy and consequently the success of these programs largely depends on the quality of this diagnostic test. The main factors to consider when evaluating quality are scientific-technical quality, safety, patient satisfaction, and accessibility. Quality indicators allow variability among hospitals, endoscopy units and endoscopists to be determined and can identify those not achieving recommended standards. In Spain, the working group for colonoscopy quality of the Spanish Society of Gastroenterology and the Spanish Society of Gastrointestinal Endoscopy have recently drawn up a Clinical Practice Guideline that contains the available evidence on the quality of screening colonoscopy, as well as the basic requirements that must be met by endoscopy units and endoscopists carrying out this procedure. The implementation of training programs and screening colonoscopy quality controls are strongly recommended to guarantee the success of population-based colorectal cancer screening. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.
RISK FACTORS FOR PRESSURE INJURIES AMONG CRITICAL-CARE PATIENTS: A SYSTEMATIC REVIEW
Alderden, Jenny; Rondinelli, June; Pepper, Ginette; Cummins, Mollie; Whitney, JoAnne
2017-01-01
Objective To identify risk factors independently predictive of pressure injury (also known as pressure ulcer) development among critical-care patients Design We undertook a systematic review of primary research based on standardized criteria set forth by the Institute of Medicine. Data Sources We searched the following databases: CINAHL (EBSCOhost), the Cochrane Library (Wilson), Dissertations & Theses Global (ProQuest), PubMed (National Library of Medicine), and Scopus. There was no language restriction. Method A research librarian coordinated the search strategy. Articles that potentially met inclusion criteria were screened by two investigators. Among the articles that met selection criteria, one investigator extracted data and a second investigator reviewed the data for accuracy. Based on a literature search, we developed a tool for assessing study quality using a combination of currently available tools and expert input. We used the method developed by Coleman and colleagues in 2014 to generate evidence tables and a summary narrative synthesis by domain and subdomain. Results Of 1753 abstracts reviewed, 158 were identified as potentially eligible and 18 fulfilled eligibility criteria. Five studies were classified as high quality, two were moderate quality, nine were low quality, and two were of very low quality. Age, mobility/activity, perfusion, and vasopressor infusion emerged as important risk factors for pressure injury development, whereas results for risk categories that are theoretically important, including nutrition, and skin/pressure injury status, were mixed. Methodological limitations across studies limited the generalizability of the results, and future research is needed, particularly to evaluate risk conferred by altered nutrition and skin/pressure injury status, and to further elucidate the effects of perfusion-related variables. Conclusions Results underscore the importance of avoiding overinterpretation of a single study, and the importance of taking study quality into consideration when reviewing risk factors. Maximal pressure injury prevention efforts are particularly important among critical-care patients who are older, have altered mobility, experience poor perfusion, or who are receiving a vasopressor infusion. PMID:28384533
48 CFR 5215.605 - Evaluation factors.
Code of Federal Regulations, 2012 CFR
2012-10-01
... REGULATIONS CONTRACTING BY NEGOTIATION Source Selection 5215.605 Evaluation factors. (S-90)(1) When a cost... the proposed costs may be adjusted, for purposes of evaluation, based upon the results of the cost... minimally acceptable approach or a cost/benefit approach. When the quality desired is that necessary to meet...
Green, Carolyn J; Fortin, Patricia; Maclure, Malcolm; Macgregor, Art; Robinson, Sylvia
2006-12-01
Improvement of chronic disease management in primary care entails monitoring indicators of quality over time and across patients and practices. Informatics tools are needed, yet implementing them remains challenging. To identify critical success factors enabling the translation of clinical and operational knowledge about effective and efficient chronic care management into primary care practice. A prospective case study of positive deviants using key informant interviews, process observation, and document review. A chronic disease management (CDM) collaborative of primary care physicians with documented improvement in adherence to clinical practice guidelines using a web-based patient registry system with CDM guideline-based flow sheet. Thirty community-based physician participants using predominantly paper records, plus a project management team including the physician lead, project manager, evaluator and support team. A critical success factor (CSF) analysis of necessary and sufficient pathways to the translation of knowledge into clinical practice. A web-based CDM 'toolkit' was found to be a direct CSF that allowed this group of physicians to improve their practice by tracking patient care processes using evidence-based clinical practice guideline-based flow sheets. Moreover, the information and communication technology 'factor' was sufficient for success only as part of a set of seven direct CSF components including: health delivery system enhancements, organizational partnerships, funding mechanisms, project management, practice models, and formal knowledge translation practices. Indirect factors that orchestrated success through the direct factor components were also identified. A central insight of this analysis is that a comprehensive quality improvement model was the CSF that drew this set of factors into a functional framework for successful knowledge translation. In complex primary care settings environment where physicians have low adoption rates of electronic tools to support the care of patients with chronic conditions, successful implementation may require a set of interrelated system and technology factors.
Comparison of CIGS solar cells made with different structures and fabrication techniques
Mansfield, Lorelle M.; Garris, Rebekah L.; Counts, Kahl D.; ...
2016-11-03
Cu(In, Ga)Se2 (CIGS)-based solar cells from six fabricators were characterized and compared. The devices had differing substrates, absorber deposition processes, buffer materials, and contact materials. The effective bandgaps of devices varied from 1.05 to 1.22 eV, with the lowest optical bandgaps occurring in those with metal-precursor absorber processes. Devices with Zn(O, S) or thin CdS buffers had quantum efficiencies above 90% down to 400 nm. Most voltages were 250-300 mV below the Shockley-Queisser limit for their bandgap. Electroluminescence intensity tracked well with the respective voltage deficits. Fill factor (FF) was as high as 95% of the maximum for each device'smore » respective current and voltage, with higher FF corresponding to lower diode quality factors (~1.3). An in-depth analysis of FF losses determined that diode quality reflected in the quality factor, voltage-dependent photocurrent, and, to a lesser extent, the parasitic resistances are the limiting factors. As a result, different absorber processes and device structures led to a range of electrical and physical characteristics, yet this investigation showed that multiple fabrication pathways could lead to high-quality and high-efficiency solar cells.« less
Wholey, Douglas R; Finch, Michael; Kreiger, Rob; Reeves, David
2018-01-03
Performance measurement and public reporting are increasingly being used to compare clinic performance. Intended consequences include quality improvement, value-based payment, and consumer choice. Unintended consequences include reducing access for riskier patients and inappropriately labeling some clinics as poor performers, resulting in tampering with stable care processes. Two analytic steps are used to maximize intended and minimize unintended consequences. First, risk adjustment is used to reduce the impact of factors outside providers' control. Second, performance categorization is used to compare clinic performance using risk-adjusted measures. This paper examines the effects of methodological choices, such as risk adjusting for sociodemographic factors in risk adjustment and accounting for patients clustering by clinics in performance categorization, on clinic performance comparison for diabetes care, vascular care, asthma, and colorectal cancer screening. The population includes all patients with commercial and public insurance served by clinics in Minnesota. Although risk adjusting for sociodemographic factors has a significant effect on quality, it does not explain much of the variation in quality. In contrast, taking into account the nesting of patients within clinics in performance categorization has a substantial effect on performance comparison.
Comparison of CIGS solar cells made with different structures and fabrication techniques
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mansfield, Lorelle M.; Garris, Rebekah L.; Counts, Kahl D.
Cu(In, Ga)Se2 (CIGS)-based solar cells from six fabricators were characterized and compared. The devices had differing substrates, absorber deposition processes, buffer materials, and contact materials. The effective bandgaps of devices varied from 1.05 to 1.22 eV, with the lowest optical bandgaps occurring in those with metal-precursor absorber processes. Devices with Zn(O, S) or thin CdS buffers had quantum efficiencies above 90% down to 400 nm. Most voltages were 250-300 mV below the Shockley-Queisser limit for their bandgap. Electroluminescence intensity tracked well with the respective voltage deficits. Fill factor (FF) was as high as 95% of the maximum for each device'smore » respective current and voltage, with higher FF corresponding to lower diode quality factors (~1.3). An in-depth analysis of FF losses determined that diode quality reflected in the quality factor, voltage-dependent photocurrent, and, to a lesser extent, the parasitic resistances are the limiting factors. As a result, different absorber processes and device structures led to a range of electrical and physical characteristics, yet this investigation showed that multiple fabrication pathways could lead to high-quality and high-efficiency solar cells.« less
NASA Technical Reports Server (NTRS)
Vajingortin, L. D.; Roisman, W. P.
1991-01-01
The problem of ensuring the required quality of products and/or technological processes often becomes more difficult due to the fact that there is not general theory of determining the optimal sets of value of the primary factors, i.e., of the output parameters of the parts and units comprising an object and ensuring the correspondence of the object's parameters to the quality requirements. This is the main reason for the amount of time taken to finish complex vital article. To create this theory, one has to overcome a number of difficulties and to solve the following tasks: the creation of reliable and stable mathematical models showing the influence of the primary factors on the output parameters; finding a new technique of assigning tolerances for primary factors with regard to economical, technological, and other criteria, the technique being based on the solution of the main problem; well reasoned assignment of nominal values for primary factors which serve as the basis for creating tolerances. Each of the above listed tasks is of independent importance. An attempt is made to give solutions for this problem. The above problem dealing with quality ensuring an mathematically formalized aspect is called the multiple inverse problem.
Human Factors Affecting the Patient's Acceptance of Wireless Biomedical Sensors
NASA Astrophysics Data System (ADS)
Fensli, Rune; Boisen, Egil
In monitoring arrhythmia, the quality of medical data from the ECG sensors may be enhanced by being based on everyday life situations. Hence, the development of wireless biomedical sensors is of growing interest, both to diagnose the heart patient, as well as to adjust the regimen. However, human factors such as emotional barriers and stigmatization, may affect the patient's behavior while wearing the equipment, which in turn may influence quality of data. The study of human factors and patient acceptance is important both in relation to the development of such equipment, as well as in evaluating the quality of data gathered from the individual patient. In this paper, we highlight some important aspects in patient acceptance by comparing results from a preliminary clinical trial with patients using a wireless ECG sensor for three days out-of-hospital service, to available published results from telehomecare projects, and discuss important aspects to be taken into account in future investigations.
Molybdenum-rhenium alloy based high-Q superconducting microwave resonators
DOE Office of Scientific and Technical Information (OSTI.GOV)
Singh, Vibhor, E-mail: v.singh@tudelft.nl; Schneider, Ben H.; Bosman, Sal J.
2014-12-01
Superconducting microwave resonators (SMRs) with high quality factors have become an important technology in a wide range of applications. Molybdenum-Rhenium (MoRe) is a disordered superconducting alloy with a noble surface chemistry and a relatively high transition temperature. These properties make it attractive for SMR applications, but characterization of MoRe SMR has not yet been reported. Here, we present the fabrication and characterization of SMR fabricated with a MoRe 60–40 alloy. At low drive powers, we observe internal quality-factors as high as 700 000. Temperature and power dependence of the internal quality-factors suggest the presence of the two level systems from themore » dielectric substrate dominating the internal loss at low temperatures. We further test the compatibility of these resonators with high temperature processes, such as for carbon nanotube chemical vapor deposition growth, and their performance in the magnetic field, an important characterization for hybrid systems.« less
Chang, Hsin Hsin; Chang, Ching Sheng
2008-01-01
Background Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters. Methods This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54) to analyze and evaluate the data. Results The findings are as follows: (1) Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2) After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3) Network security contributes a positive moderating effect on service quality and patient satisfaction. Conclusion It revealed that the impact of electronic workflow (online appointment system service) on service quality was greater than electronic facilities (electronic medical record systems) in technology-based service encounters. Convenience and credibility are the most important factors of service quality in technology-based service encounters that patients demand. Due to the openness of networks, patients worry that transaction information could be intercepted; also, the credibility of the hospital involved is even a bigger concern, as patients have a strong sense of distrust. Therefore, in the operation of technology-based service encounters, along with providing network security, it is essential to build an atmosphere of psychological trust. PMID:18419820
Chang, Hsin Hsin; Chang, Ching Sheng
2008-04-17
Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters. This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54) to analyze and evaluate the data. The findings are as follows: (1) Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2) After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3) Network security contributes a positive moderating effect on service quality and patient satisfaction. It revealed that the impact of electronic workflow (online appointment system service) on service quality was greater than electronic facilities (electronic medical record systems) in technology-based service encounters. Convenience and credibility are the most important factors of service quality in technology-based service encounters that patients demand. Due to the openness of networks, patients worry that transaction information could be intercepted; also, the credibility of the hospital involved is even a bigger concern, as patients have a strong sense of distrust. Therefore, in the operation of technology-based service encounters, along with providing network security, it is essential to build an atmosphere of psychological trust.
Wang, Ning; Yu, Ping; Hailey, David
2015-08-01
The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. To describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. A nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. There was a tendency to omit 'nursing problem' or 'nursing diagnosis' in the nursing process by changing these terms (used in the paper-based care plan) to 'observation' in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, P<0.01), but had a lower total mean quality score. The electronic care plan contained fewer problem or diagnosis statements, contributing factors and resident outcomes than the paper-based system (P<0.01). Both types of nursing care plan were weak in documenting measurable and concrete resident outcomes. The overall quality of documentation content for the nursing process was no better in the electronic system than in the paper-based system. Omission of the nursing problem or diagnosis from the nursing process may reflect a range of factors behind the practice that need to be understood. Further work is also needed on qualitative aspects of the nurse care plan, nurses' attitudes towards standardized terminologies and the effect of different documentation practice on care quality and resident outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Larson, E B
1999-09-01
Evidence-based medicine (EBM) and practice guidelines have been embraced by increasing numbers of scholars, administrators, and medical journalists as an intellectually attractive solution to the dilemma of improving health care quality while reducing costs. However, certain factors have thus far limited the role that EBM might play in resolving cost-quality trade-offs. Beyond the quality of the guideline and the evidence base itself, critical factors for success include local clinician involvement, a unified or closed medical staff, protocols that minimize use of clinical judgment and that call for involvement of so-called physician extenders (such as nurse practitioners and physician assistants), and financial incentive. TROUBLESOME ISSUES RELATED TO COST-QUALITY TRADE-OFFS: Rationing presents many dilemmas, but for physicians one critical problem is determining what is the physician's responsibility. Is the physician to be the patient's advocate, or should the physician be the advocate of all patients (the patients' advocate)? How do we get physicians out of potentially conflicted roles? EBM guidelines are needed to help minimize the number of instances physicians are asked to ration care at the bedside. If the public can decide to share and limit resources--presumably based on shared priorities--physicians would have a basis to act as advocates for all patients. Although EBM alone is not a simple solution to the problems of increasing costs and public expectations, it can be an important source of input and information in relating the value of service and medical technology to public priorities.
Opto-electronic oscillator: moving toward solutions based on polymer materials
NASA Astrophysics Data System (ADS)
Nguyên, Lâm Duy; Journet, Bernard; Zyss, Joseph
2008-02-01
Optoelectronic oscillators have been studied since many years now, their high spectral purity being one of their most interesting quality for photonics signal processing, communication or radio over fiber systems. One part of the structure is a long fiber optic feedback loop acting as a delay line. Different techniques have been introduced such as multiple loops in order to get very narrow spectral lines and large mode spacing. One of the problems due to long fiber loops is the size and the requirement of temperature control. In order to go toward integrated solutions it is also possible to introduce optical resonators instead of a delay line structure (as for classical electronic oscillators). But such resonators should present very high quality factor. In this paper we demonstrate solutions using resonators based on polymer materials such as PMMA-DCM. Structures such as micro-rings, micro-disks or stadium-shaped resonator have been realized at the laboratory. Quality factor of 6000 have already been achieved leading to an equivalent fiber loop of 19 m for an oscillator at 10 GHz. But it has been already theoretically proved that quality factor greater than one thousand hundred could be obtained. These resonators can be directly implemented with Mach-Zehnder optical modulators based on electro-optic polymer such as PMMA-DR1 leading to integrated solutions. And in the future it should be also possible to add a laser made with polymer material, with a structure as stadium-shape polymer micro-laser. The fully integrated photonic chip is not so far. The last important function to be implemented is the tuning of the oscillation frequency.
Peltner, Jonas; Thiele, Silke
2018-02-01
The present study aimed to derive food purchase patterns considering the convenience level of foods. Associations between identified patterns and dietary quality were analysed, as well as household characteristics associated with the dietary patterns. A Convenience Food Classification Scheme (CFCS) was developed. After classifying basic food groups into the CFCS, the formed groups were used to apply a factor analysis to identify convenience-based food purchase patterns. For these patterns nutrient and energy densities were examined. Using regression analysis, associations between the adherence to the patterns and household characteristic and attitude variables were analysed. The study used representative German food purchase data from 2011. Approximately 12 million purchases of 13 131 households were recorded in these data. Three convenience-based patterns were identified: a low-convenience, a semi-convenience and a ready-to-eat food pattern. Tighter adherence to the semi-convenience pattern was shown to result in the lowest nutrient and highest energy densities. Important factors influencing adherence to the patterns were household size, presence of children and attitudes. Working full-time was negatively associated with adherence to the low-convenience pattern and positively with the ready-to-eat pattern. Convenience foods were an important part of households' food baskets which in some cases led to lower nutritional quality. Therefore, it is important to offer convenience foods higher in nutrient density and lower in energy density. Interventions targeted on enhancing cooking skills could be an effective strategy to increase purchases of unprocessed foods, which, in turn, could also contribute to an improved diet quality.
Wagner, Daniel J; Durbin, Janet; Barnsley, Jan; Ivers, Noah M
2017-12-02
Despite its popularity, the effectiveness of audit and feedback in support quality improvement efforts is mixed. While audit and feedback-related research efforts have investigated issues relating to feedback design and delivery, little attention has been directed towards factors which motivate interest and engagement with feedback interventions. This study explored the motivating factors that drove primary care teams to participate in a voluntary audit and feedback initiative. Interviews were conducted with leaders of primary care teams who had participated in at least one iteration of the audit and feedback program. This intervention was developed by an organization which advocates for high-quality, team-based primary care in Ontario, Canada. Interview transcripts were coded using the Consolidated Framework for Implementation Research and the resulting framework was analyzed inductively to generate key themes. Interviews were completed with 25 individuals from 18 primary care teams across Ontario. The majority were Executive Directors (14), Physician leaders (3) and support staff for Quality Improvement (4). A range of motivations for participating in the audit and feedback program beyond quality improvement were emphasized. Primarily, informants believed that the program would eventually become a best-in-class audit and feedback initiative. This reflected concerns regarding existing initiatives in terms of the intervention components and intentions as well as the perception that an initiative by primary care, for primary care would better reflect their own goals and better support desired patient outcomes. Key enablers included perceived obligations to engage and provision of support for the work involved. No teams cited an evidence base for A&F as a motivating factor for participation. A range of motivating factors, beyond quality improvement, contributed to participation in the audit and feedback program. Findings from this study highlight that efforts to understand how and when the intervention works best cannot be limited to factors within developers' control. Clinical teams may more readily engage with initiatives with the potential to address their own long-term system goals. Aligning motivations for participation with the goals of the audit and feedback initiative may facilitate both engagement and impact.
Böker, J; Völzke, H; Nauck, M; Hannemann, A; Friedrich, N
2018-03-01
Growth hormone (GH) and its main mediator, insulin-like growth factor-I (IGF-I), play a significant role in bone metabolism. The relations between IGF-I and bone mineral density (BMD) or osteoporosis have been assessed in previous studies but whether the associations are sex-specific remains uncertain. Moreover, only a few studies examined bone quality assessed by quantitative ultrasound (QUS). We aimed to investigate these associations in the general population of north-east Germany. Data from 1759 men and 1784 women who participated in the baseline examination of the Study of Health in Pomerania (SHIP)-Trend were used. IGF-I and IGF-binding protein-3 (IGFBP-3) concentrations were measured on the IDS-iSYS multidiscipline automated analyser (Immunodiagnostic Systems Limited). QUS measurements were performed at the heel (Achilles InSight, GE Healthcare). Sex-specific linear and multinomial logistic regression models adjusted for potential confounders were calculated. Linear regression analyses revealed significant positive associations between IGF-I and IGF-I/IGFBP-3 ratio, a marker for free IGF-I, with all QUS parameters in men. Among women, we found an inverse association between IGF-I and the QUS-based fracture risk but no association with any other QUS parameter. There was no association between IGFBP-3 and the QUS-based fracture risk. Our data suggest an important role of IGF-I on bone quality in men. The observed association of IGF-I with the QUS-based stiffness index and QUS-based fracture risk in this study might animate clinicians to refer patients with low IGF-I levels, particularly men, to a further evaluation of risk factors for osteoporosis and a detailed examination of the skeletal system. © 2018 John Wiley & Sons Ltd.
Local environmental quality positively predicts breastfeeding in the UK’s Millennium Cohort Study
Sear, Rebecca
2017-01-01
ABSTRACT Background and Objectives: Breastfeeding is an important form of parental investment with clear health benefits. Despite this, rates remain low in the UK; understanding variation can therefore help improve interventions. Life history theory suggests that environmental quality may pattern maternal investment, including breastfeeding. We analyse a nationally representative dataset to test two predictions: (i) higher local environmental quality predicts higher likelihood of breastfeeding initiation and longer duration; (ii) higher socioeconomic status (SES) provides a buffer against the adverse influences of low local environmental quality. Methodology: We ran factor analysis on a wide range of local-level environmental variables. Two summary measures of local environmental quality were generated by this analysis—one ‘objective’ (based on an independent assessor’s neighbourhood scores) and one ‘subjective’ (based on respondent’s scores). We used mixed-effects regression techniques to test our hypotheses. Results: Higher objective, but not subjective, local environmental quality predicts higher likelihood of starting and maintaining breastfeeding over and above individual SES and area-level measures of environmental quality. Higher individual SES is protective, with women from high-income households having relatively high breastfeeding initiation rates and those with high status jobs being more likely to maintain breastfeeding, even in poor environmental conditions. Conclusions and Implications: Environmental quality is often vaguely measured; here we present a thorough investigation of environmental quality at the local level, controlling for individual- and area-level measures. Our findings support a shift in focus away from individual factors and towards altering the landscape of women’s decision making contexts when considering behaviours relevant to public health. PMID:29354262
Local environmental quality positively predicts breastfeeding in the UK's Millennium Cohort Study.
Brown, Laura J; Sear, Rebecca
2017-01-01
Background and Objectives: Breastfeeding is an important form of parental investment with clear health benefits. Despite this, rates remain low in the UK; understanding variation can therefore help improve interventions. Life history theory suggests that environmental quality may pattern maternal investment, including breastfeeding. We analyse a nationally representative dataset to test two predictions: (i) higher local environmental quality predicts higher likelihood of breastfeeding initiation and longer duration; (ii) higher socioeconomic status (SES) provides a buffer against the adverse influences of low local environmental quality. Methodology: We ran factor analysis on a wide range of local-level environmental variables. Two summary measures of local environmental quality were generated by this analysis-one 'objective' (based on an independent assessor's neighbourhood scores) and one 'subjective' (based on respondent's scores). We used mixed-effects regression techniques to test our hypotheses. Results: Higher objective, but not subjective, local environmental quality predicts higher likelihood of starting and maintaining breastfeeding over and above individual SES and area-level measures of environmental quality. Higher individual SES is protective, with women from high-income households having relatively high breastfeeding initiation rates and those with high status jobs being more likely to maintain breastfeeding, even in poor environmental conditions. Conclusions and Implications: Environmental quality is often vaguely measured; here we present a thorough investigation of environmental quality at the local level, controlling for individual- and area-level measures. Our findings support a shift in focus away from individual factors and towards altering the landscape of women's decision making contexts when considering behaviours relevant to public health.
2013-01-01
Introduction In 2004, a community-based health insurance (CBI) scheme was introduced in Nouna health district, Burkina Faso, with the objective of improving financial access to high quality health services. We investigate the role of CBI enrollment in the quality of care provided at primary-care facilities in Nouna district, and measure differences in objective and perceived quality of care and patient satisfaction between enrolled and non-enrolled populations who visit the facilities. Methods We interviewed a systematic random sample of 398 patients after their visit to one of the thirteen primary-care facilities contracted with the scheme; 34% (n = 135) of the patients were currently enrolled in the CBI scheme. We assessed objective quality of care as consultation, diagnostic and counselling tasks performed by providers during outpatient visits, perceived quality of care as patient evaluations of the structures and processes of service delivery, and overall patient satisfaction. Two-sample t-tests were performed for group comparison and ordinal logistic regression (OLR) analysis was used to estimate the association between CBI enrollment and overall patient satisfaction. Results Objective quality of care evaluations show that CBI enrollees received substantially less comprehensive care for outpatient services than non-enrollees. In contrast, CBI enrollment was positively associated with overall patient satisfaction (aOR = 1.51, p = 0.014), controlling for potential confounders such as patient socio-economic status, illness symptoms, history of illness and characteristics of care received. Conclusions CBI patients perceived better quality of care, while objectively receiving worse quality of care, compared to patients who were not enrolled in CBI. Systematic differences in quality of care expectations between CBI enrollees and non-enrollees may explain this finding. One factor influencing quality of care may be the type of provider payment used by the CBI scheme, which has been identified as a leading factor in reducing provider motivation to deliver high quality care to CBI enrollees in previous studies. Based on this study, it is unlikely that perceived quality of care and patient satisfaction explain the low CBI enrollment rates in this community. PMID:23680066
Scholte, Marijn; Calsbeek, Hilly; Nijhuis-van der Sanden, Maria W G; Braspenning, Jozé
2014-06-18
Assessing quality of care from the patient's perspective has changed from patient satisfaction to the more general term patient experience, as satisfaction measures turned out to be less discriminative due to high scores. Literature describes four to ten dimensions of patient experience, tailored to specific conditions or types of care. Given the administrative burden on patients, less dimensions and items could increase feasibility. Ten dimensions of patient experiences with physical therapy (PT) were proposed in the Netherlands in a consensus-based process with patients, physical therapists, health insurers, and policy makers. The aim of this paper is to detect the number of dimensions from data of a field study using factor analysis at item level. A web-based survey yielded data of 2,221 patients from 52 PT practices on 41 items. Principal component factor analysis at item level was used to assess the proposed distinction between the ten dimensions. Factor analysis revealed two dimensions: 'personal interaction' and 'practice organisation'. The dimension 'patient reported outcome' was artificially established. The three dimensions 'personal interaction' (14 items) (median(practice level) = 91.1; IQR = 2.4), 'practice organisation' (9 items) (median(practice level) = 88.9; IQR = 6.0) and 'outcome' (3 items) (median(practice level) = 80.6; IQR = 19.5) reduced the number of dimensions from ten to three and the number of items by more than a third. Factor analysis revealed three dimensions and achieved an item reduction of more than a third. It is a relevant step in the development process of a quality measurement tool to reduce respondent burden, increase clarity, and promote feasibility.
Gong, Yin-Xi; He, Cheng; Yan, Fei; Feng, Zhong-Ke; Cao, Meng-Lei; Gao, Yuan; Miao, Jie; Zhao, Jin-Long
2013-10-01
Multispectral remote sensing data containing rich site information are not fully used by the classic site quality evaluation system, as it merely adopts artificial ground survey data. In order to establish a more effective site quality evaluation system, a neural network model which combined remote sensing spectra factors with site factors and site index relations was established and used to study the sublot site quality evaluation in the Wangyedian Forest Farm in Inner Mongolia Province, Chifeng City. Based on the improved back propagation artificial neural network (BPANN), this model combined multispectral remote sensing data with sublot survey data, and took larch as example, Through training data set sensitivity analysis weak or irrelevant factor was excluded, the size of neural network was simplified, and the efficiency of network training was improved. This optimal site index prediction model had an accuracy up to 95.36%, which was 9.83% higher than that of the neural network model based on classic sublot survey data, and this shows that using multi-spectral remote sensing and small class survey data to determine the status of larch index prediction model has the highest predictive accuracy. The results fully indicate the effectiveness and superiority of this method.
Yang, Yuanmu; Kravchenko, Ivan I.; Briggs, Dayrl P.; ...
2014-12-16
Fano-resonant plasmonic metamaterials and nanostructures have become a major focus of the nanophotonics fields over the past several years due their ability to produce high quality factor (Q-factor) resonances. The origin of such resonances is the interference between a broad and narrow resonance, ultimately allowing suppression of radiative damping. However, Fano-resonant plasmonic structures still suffer non-radiative damping due to Ohmic loss, ultimately limiting the achievable Q-factors to values less than ~10. Here, we report experimental demonstration of Fano-resonant silicon-based metamaterials that have a response that mimics the electromagnetically induced transparency (EIT) found in atomic systems. Due to extremely low absorptionmore » loss, a record-high quality factor (Q-factor) of 306 was experimentally observed. Furthermore, the unit cell of the metamaterial was designed with a feed-gap which results in strong local field enhancement in the surrounding medium resulting in strong light-matter interaction. This allows the metamaterial to serve as a refractive index sensor with a figure-of-merit (FOM) of 101, far exceeding the performance of previously demonstrated localized surface plasmon resonance sensors.« less
Influence of natural factors on the quality of midwestern streams and rivers
Porter, Stephen D.; Harris, Mitchell A.; Kalkhoff, Stephen J.
2001-01-01
Streams flowing through cropland in the Midwestern Corn Belt differ considerably in their chemical and ecological characteristics, even though agricultural land use is highly intensive throughout the entire region. These differences likely are attributable to differences in riparian vegetation, soil properties, and hydrology. This conclusion is based on results from a study of the upper Midwest region conducted during seasonally low-flow conditions in August 1997 by the U.S. Geological Survey (USGS) National Water Quality Assessment (NAWQA) Program. This report summarizes significant results from the study and presents some implications for the design and interpretation of water-quality monitoring and assessment studies based on these results.
Bingefors, Kerstin; Lindberg, Magnus; Isacson, Dag
2011-06-01
Hand eczema is common and has an adverse impact on the lives of patients. There is a need for population-based surveys on the pharmacoepidemiological aspects, quality of life and impact of socioeconomic factors in hand eczema. The aim of this cross-sectional study was to investigate these factors. A questionnaire-based nationwide survey of health was performed, including questions on hand eczema, use of pharmaceuticals and socioeconomic factors. Quality of life was estimated with the generic instrument Short Form 36 (SF-36). The questionnaire was sent to 7,985 persons (age range 18-84 years), response rate 61.1% (n = 4,875). The 1-year prevalence of hand eczema in the study population was 7.5%. In this group, quality of life was lower. All dimensions of SF-36 were affected, most markedly general health and those dimensions reporting on mental health. In the group with self-reported hand eczema, 51% reported using topical pharmaceuticals. Hand eczema was more common among women (9.1%, n = 2,630) than among men (5.6%, n = 2,245) and in the age group below 65 years (8.5%, n = 3,274) compared with those aged 65 years and over (4.3%, n = 1,151). This survey clearly demonstrates the impact of hand eczema on several dimensions of life and also highlights age, gender and socioeconomic differences.
Weighing the impact (factor) of publishing in veterinary journals.
Christopher, Mary M
2015-06-01
The journal in which you publish your research can have a major influence on the perceived value of your work and on your ability to reach certain audiences. The impact factor, a widely used metric of journal quality and prestige, has evolved into a benchmark of quality for institutions and graduate programs and, inappropriately, as a proxy for the quality of individual authors and articles, affecting tenure, promotion, and funding decisions. As a result, despite its many limitations, publishing decisions by authors often are based solely on a journal's impact factor. This can disadvantage journals in small disciplines, such as veterinary medicine, and limit the ability of authors to reach key audiences. In this article, factors that can influence the impact factor of a journal and its applicability, including precision, citation practices, article type, editorial policies, and size of the research community will be reviewed. The value and importance of veterinary journals such as the Journal of Veterinary Cardiology for reaching relevant audiences and for helping shape disciplinary specialties and influence clinical practice will also be discussed. Lastly, the efforts underway to develop alternative measures to assess the scientific quality of individual authors and articles, such as article-level metrics, as well as institutional measures of the economic and social impact of biomedical research will be considered. Judicious use of the impact factor and the implementation of new metrics for assessing the quality and societal relevance of veterinary research articles will benefit both authors and journals. Copyright © 2015 Elsevier B.V. All rights reserved.
ERIC Educational Resources Information Center
Leask, Marilyn; Younie, Sarah
2013-01-01
If teacher quality is the most critical factor in improving educational outcomes, then why is so little attention drawn to the knowledge and evidence base available to support teachers in improving the quality of their professional knowledge? This paper draws together findings from a range of sources to propose national models for continuing…
Assessing the Quality of Academic Libraries on the Web: The Development and Testing of Criteria.
ERIC Educational Resources Information Center
Chao, Hungyune
2002-01-01
This study develops and tests an instrument useful for evaluating the quality of academic library Web sites. Discusses criteria for print materials and human-computer interfaces; user-based perspectives; the use of factor analysis; a survey of library experts; testing reliability through analysis of variance; and regression models. (Contains 53…
A Comparison of Factors that Influence the Quality of PEPs in Title I Schools
ERIC Educational Resources Information Center
Williams, Connie Jean
2009-01-01
The purpose of this study was to investigate the relationship between school-based organizational structures that support teachers' development of Personalized Education Plans (PEPs) and their quality as written for third through fifth grade students in each of two Title I schools. A causal comparative design was implemented. Teachers' responses…
ERIC Educational Resources Information Center
Conway, Laura J.; Levickis, Penny A.; Smith, Jodie; Mensah, Fiona; Wake, Melissa; Reilly, Sheena
2018-01-01
Background: Identifying risk and protective factors for language development informs interventions for children with developmental language disorder (DLD). Maternal responsive and intrusive communicative behaviours are associated with language development. Mother-child interaction quality may influence how children use these behaviours in language…
The Influence of First Impressions on Subsequent Ratings within an OSCE Station
ERIC Educational Resources Information Center
Wood, Timothy J.; Chan, James; Humphrey-Murto, Susan; Pugh, Debra; Touchie, Claire
2017-01-01
Competency-based assessment is placing increasing emphasis on the direct observation of learners. For this process to produce valid results, it is important that raters provide quality judgments that are accurate. Unfortunately, the quality of these judgments is variable and the roles of factors that influence the accuracy of those judgments are…
Taylor, Natalie; Clay-Williams, Robyn; Hogden, Emily; Pye, Victoria; Li, Zhicheng; Groene, Oliver; Suñol, Rosa; Braithwaite, Jeffrey
2015-01-01
Introduction Despite the growing body of research on quality and safety in healthcare, there is little evidence of the association between the way hospitals are organised for quality and patient factors, limiting our understanding of how to effect large-scale change. The ‘Deepening our Understanding of Quality in Australia’ (DUQuA) study aims to measure and examine relationships between (1) organisation and department-level quality management systems (QMS), clinician leadership and culture, and (2) clinical treatment processes, clinical outcomes and patient-reported perceptions of care within Australian hospitals. Methods and analysis The DUQuA project is a national, multilevel, cross-sectional study with data collection at organisation (hospital), department, professional and patient levels. Sample size calculations indicate a minimum of 43 hospitals are required to adequately power the study. To allow for rejection and attrition, 70 hospitals across all Australian jurisdictions that meet the inclusion criteria will be invited to participate. Participants will consist of hospital quality management professionals; clinicians; and patients with stroke, acute myocardial infarction and hip fracture. Organisation and department-level QMS, clinician leadership and culture, patient perceptions of safety, clinical treatment processes, and patient outcomes will be assessed using validated, evidence-based or consensus-based measurement tools. Data analysis will consist of simple correlations, linear and logistic regression and multilevel modelling. Multilevel modelling methods will enable identification of the amount of variation in outcomes attributed to the hospital and department levels, and the factors contributing to this variation. Ethics and dissemination Ethical approval has been obtained. Results will be disseminated to individual hospitals in de-identified national and international benchmarking reports with data-driven recommendations. This ground-breaking national study has the potential to influence decision-making on the implementation of quality and safety systems and processes in Australian and international hospitals. PMID:26644128
Kaplan, Heather C; Provost, Lloyd P; Froehle, Craig M; Margolis, Peter A
2012-01-01
BACKGROUND Quality improvement (QI) efforts have become widespread in healthcare, however there is significant variability in their success. Differences in context are thought to be responsible for some of the variability seen. To develop a conceptual model that can be used by organisations and QI researchers to understand and optimise contextual factors affecting the success of a QI project. 10 QI experts were provided with the results of a systematic literature review and then participated in two rounds of opinion gathering to identify and define important contextual factors. The experts subsequently met in person to identify relationships among factors and to begin to build the model. The Model for Understanding Success in Quality (MUSIQ) is organised based on the level of the healthcare system and identifies 25 contextual factors likely to influence QI success. Contextual factors within microsystems and those related to the QI team are hypothesised to directly shape QI success, whereas factors within the organisation and external environment are believed to influence success indirectly. The MUSIQ framework has the potential to guide the application of QI methods in healthcare and focus research. The specificity of MUSIQ and the explicit delineation of relationships among factors allows a deeper understanding of the mechanism of action by which context influences QI success. MUSIQ also provides a foundation to support further studies to test and refine the theory and advance the field of QI science.
Dimensional Precision Research of Wax Molding Rapid Prototyping based on Droplet Injection
NASA Astrophysics Data System (ADS)
Mingji, Huang; Geng, Wu; yan, Shan
2017-11-01
The traditional casting process is complex, the mold is essential products, mold quality directly affect the quality of the product. With the method of rapid prototyping 3D printing to produce mold prototype. The utility wax model has the advantages of high speed, low cost and complex structure. Using the orthogonal experiment as the main method, analysis each factors of size precision. The purpose is to obtain the optimal process parameters, to improve the dimensional accuracy of production based on droplet injection molding.
NASA Astrophysics Data System (ADS)
Shen, Xia; Bai, Yan-Feng; Qin, Tao; Han, Shen-Sheng
2008-11-01
Factors influencing the quality of lensless ghost imaging are investigated. According to the experimental results, we find that the imaging quality is determined by the number of independent sub light sources on the imaging plane of the reference arm. A qualitative picture based on advanced wave optics is presented to explain the physics behind the experimental phenomena. The present results will be helpful to provide a basis for improving the quality of ghost imaging systems in future works.
Ke, Quan; Luo, Weijie; Yan, Guozheng; Yang, Kai
2016-04-01
A wireless power transfer system based on the weakly inductive coupling makes it possible to provide the endoscope microrobot (EMR) with infinite power. To facilitate the patients' inspection with the EMR system, the diameter of the transmitting coil is enlarged to 69 cm. Due to the large transmitting range, a high quality factor of the Litz-wire transmitting coil is a necessity to ensure the intensity of magnetic field generated efficiently. Thus, this paper builds an analytical model of the transmitting coil, and then, optimizes the parameters of the coil by enlarging the quality factor. The lumped model of the transmitting coil includes three parameters: ac resistance, self-inductance, and stray capacitance. Based on the exact two-dimension solution, the accurate analytical expression of ac resistance is derived. Several transmitting coils of different specifications are utilized to verify this analytical expression, being in good agreements with the measured results except the coils with a large number of strands. Then, the quality factor of transmitting coils can be well predicted with the available analytical expressions of self- inductance and stray capacitance. Owing to the exact estimation of quality factor, the appropriate coil turns of the transmitting coil is set to 18-40 within the restrictions of transmitting circuit and human tissue issues. To supply enough energy for the next generation of the EMR equipped with a Ø9.5×10.1 mm receiving coil, the coil turns of the transmitting coil is optimally set to 28, which can transfer a maximum power of 750 mW with the remarkable delivering efficiency of 3.55%.
A Quality Function Deployment Framework for the Service Quality of Health Information Websites
Kim, Dohoon
2010-01-01
Objectives This research was conducted to identify both the users' service requirements on health information websites (HIWs) and the key functional elements for running HIWs. With the quality function deployment framework, the derived service attributes (SAs) are mapped into the suppliers' functional characteristics (FCs) to derive the most critical FCs for the users' satisfaction. Methods Using the survey data from 228 respondents, the SAs, FCs and their relationships were analyzed using various multivariate statistical methods such as principal component factor analysis, discriminant analysis, correlation analysis, etc. Simple and compound FC priorities were derived by matrix calculation. Results Nine factors of SAs and five key features of FCs were identified, and these served as the basis for the house of quality model. Based on the compound FC priorities, the functional elements pertaining to security and privacy, and usage support should receive top priority in the course of enhancing HIWs. Conclusions The quality function deployment framework can improve the FCs of the HIWs in an effective, structured manner, and it can also be utilized for critical success factors together with their strategic implications for enhancing the service quality of HIWs. Therefore, website managers could efficiently improve website operations by considering this study's results. PMID:21818418
Modification of spermatozoa quality in mature small ruminants.
Martin, G B; de St Jorre, T Jorre; Al Mohsen, F A; Malecki, I A
2011-01-01
This review is based largely, but not entirely, on the assumption that gamete quality is directly linked to sperm output and thus testicular mass, an approach made necessary by the absence of a large body of data on factors that affect gamete quality in ruminants. On the other hand, there is a change in the efficiency of sperm production per gram of testicular tissue when the testis is growing or shrinking, a clear indicator of changes in the rates of cell loss during the process of spermatogenesis, probably through apoptosis. We therefore postulate that the spermatozoa that do survive when the testis is shrinking are of a lower quality than those that are produced when the testis is growing and the rate of sperm survival is increasing. In adult small ruminants in particular, testicular mass and sperm production are highly labile and can be manipulated by management of photoperiod (melatonin), nutrition, genetics and behaviour ('mating pressure'). Importantly, these factors do not act independently of each other - rather, the outcomes in terms of sperm production are dictated by interactions. It therefore seems likely that spermatozoa quality will be affected by these same factors, but definitive answers await detailed studies.
Influence of non-Kolmogorov atmospheric turbulence on the beam quality of vortex beams.
Li, Jinhong; Wang, Weiwei; Duan, Meiling; Wei, Jinlin
2016-09-05
Based on the extended Huygens-Fresnel principle and the definition of second-order moments of the Wigner distribution function (WDF), the analytical expressions for the propagation factors (M2-factors) and Strehl ratio SR of the Gaussian Schell-model (GSM) vortex beams and GSM non-vortex beams propagation through non-Kolmogorov atmospheric turbulence are derived, and used to study the influence of non-Kolmogorov atmospheric turbulence on beam quality of the GSM vortex beams. It is shown that the smaller the generalized structure constant and the outer scale of turbulence are, and the bigger the inner scale of turbulence is, the smaller the normalized propagation factor is, the bigger the Strehl ratio is, and the better the beam quality of GSM vortex beams in atmospheric turbulence is. The variation of beam quality with the generalized exponent α is nonmonotonic, when α = 3.11, the beam quality of the GSM vortex beams is the poorest through non-Kolmogorov atmospheric turbulence. GSM vortex beams is less affected by turbulence than GSM non-vortex beams under certain condition, and will be useful in long-distance free-space optical communications.
Perceptions of drinking water quality and risk and its effect on behaviour: a cross-national study.
Doria, Miguel de França; Pidgeon, Nick; Hunter, Paul R
2009-10-15
There is a growing effort to provide drinking water that has the trust of consumers, but the processes underlying the perception of drinking water quality and risks are still not fully understood. This paper intends to explore the factors involved in public perception of the quality and risks of drinking water. This purpose was addressed with a cross-national mixed-method approach, based on quantitative (survey) and qualitative (focus groups) data collected in the UK and Portugal. The data were analysed using several methods, including structural equation models and generalised linear models. Results suggest that perceptions of water quality and risk result from a complex interaction of diverse factors. The estimation of water quality is mostly influenced by satisfaction with organoleptic properties (especially flavour), risk perception, contextual cues, and perceptions of chemicals (lead, chlorine, and hardness). Risk perception is influenced by organoleptics, perceived water chemicals, external information, past health problems, and trust in water suppliers, among other factors. The use of tap and bottled water to drink was relatively well explained by regression analysis. Several cross-national differences were found and the implications are discussed. Suggestions for future research are provided.
Home Telehealth Video Conferencing: Perceptions and Performance
Morris, Greg; Pech, Joanne; Rechter, Stuart; Carati, Colin; Kidd, Michael R
2015-01-01
Background The Flinders Telehealth in the Home trial (FTH trial), conducted in South Australia, was an action research initiative to test and evaluate the inclusion of telehealth services and broadband access technologies for palliative care patients living in the community and home-based rehabilitation services for the elderly at home. Telehealth services at home were supported by video conferencing between a therapist, nurse or doctor, and a patient using the iPad tablet. Objective The aims of this study are to identify which technical factors influence the quality of video conferencing in the home setting and to assess the impact of these factors on the clinical perceptions and acceptance of video conferencing for health care delivery into the home. Finally, we aim to identify any relationships between technical factors and clinical acceptance of this technology. Methods An action research process developed several quantitative and qualitative procedures during the FTH trial to investigate technology performance and users perceptions of the technology including measurements of signal power, data transmission throughput, objective assessment of user perceptions of videoconference quality, and questionnaires administered to clinical users. Results The effectiveness of telehealth was judged by clinicians as equivalent to or better than a home visit on 192 (71.6%, 192/268) occasions, and clinicians rated the experience of conducting a telehealth session compared with a home visit as equivalent or better in 90.3% (489/540) of the sessions. It was found that the quality of video conferencing when using a third generation mobile data service (3G) in comparison to broadband fiber-based services was concerning as 23.5% (220/936) of the calls failed during the telehealth sessions. The experimental field tests indicated that video conferencing audio and video quality was worse when using mobile data services compared with fiber to the home services. As well, statistically significant associations were found between audio/video quality and patient comfort with the technology as well as the clinician ratings for effectiveness of telehealth. Conclusions These results showed that the quality of video conferencing when using 3G-based mobile data services instead of broadband fiber-based services was less due to failed calls, audio/ video jitter, and video pixilation during the telehealth sessions. Nevertheless, clinicians felt able to deliver effective services to patients at home using 3G-based mobile data services. PMID:26381104
Wang, Tieyu; Zhou, Yunqiao; Bi, Cencen; Lu, Yonglong; He, Guizhen; Giesy, John P
2017-07-01
There is a need to formulate water environment standards (WESs) from the current water quality criteria (WQC) in China. To this end, we briefly summarize typical mechanisms applied in several countries with longer histories of developing WESs, and three limitations to formulating WESs in China were identified. After analyzing the feasibility factors including economic development, scientific support capability and environmental policies, we realized that China is still not ready for a complete change from its current nation-wide unified WES system to a local-standard-based system. Thus, we proposed a framework for transformation from WQC to WESs in China. The framework consists of three parts, including responsibilities, processes and policies. The responsibilities include research authorization, development of guidelines, and collection of information, at both national and local levels; the processes include four steps and an impact factor system to establish water quality standards; and the policies include seven specific proposals. Copyright © 2016. Published by Elsevier B.V.
Thin-slice vision: inference of confidence measure from perceptual video quality
NASA Astrophysics Data System (ADS)
Hameed, Abdul; Balas, Benjamin; Dai, Rui
2016-11-01
There has been considerable research on thin-slice judgments, but no study has demonstrated the predictive validity of confidence measures when assessors watch videos acquired from communication systems, in which the perceptual quality of videos could be degraded by limited bandwidth and unreliable network conditions. This paper studies the relationship between high-level thin-slice judgments of human behavior and factors that contribute to perceptual video quality. Based on a large number of subjective test results, it has been found that the confidence of a single individual present in all the videos, called speaker's confidence (SC), could be predicted by a list of features that contribute to perceptual video quality. Two prediction models, one based on artificial neural network and the other based on a decision tree, were built to predict SC. Experimental results have shown that both prediction models can result in high correlation measures.
MapReduce Based Parallel Bayesian Network for Manufacturing Quality Control
NASA Astrophysics Data System (ADS)
Zheng, Mao-Kuan; Ming, Xin-Guo; Zhang, Xian-Yu; Li, Guo-Ming
2017-09-01
Increasing complexity of industrial products and manufacturing processes have challenged conventional statistics based quality management approaches in the circumstances of dynamic production. A Bayesian network and big data analytics integrated approach for manufacturing process quality analysis and control is proposed. Based on Hadoop distributed architecture and MapReduce parallel computing model, big volume and variety quality related data generated during the manufacturing process could be dealt with. Artificial intelligent algorithms, including Bayesian network learning, classification and reasoning, are embedded into the Reduce process. Relying on the ability of the Bayesian network in dealing with dynamic and uncertain problem and the parallel computing power of MapReduce, Bayesian network of impact factors on quality are built based on prior probability distribution and modified with posterior probability distribution. A case study on hull segment manufacturing precision management for ship and offshore platform building shows that computing speed accelerates almost directly proportionally to the increase of computing nodes. It is also proved that the proposed model is feasible for locating and reasoning of root causes, forecasting of manufacturing outcome, and intelligent decision for precision problem solving. The integration of bigdata analytics and BN method offers a whole new perspective in manufacturing quality control.
Cross-Cultural Perspectives of Service Quality and Risk in Air Transportation
NASA Technical Reports Server (NTRS)
Cunningham, Lawrence F.; Young, Clifford E.; Lee, Moonkyu
2002-01-01
This study compares US and Korean customers in terms of their perceptions of airline service quality based on SERVPERF and industry-based measures, as well as their perceptions of risks involved in the airline choice. SERVPERF is a set of multi-dimensional measures of customer evaluations of service quality. The results indicate that: (1) US passengers are generally more satisfied with their airline service than Korean customers on most of the SERVPERF dimensions; (2) Koreans are generally more satisfied with the bumping procedures whereas US participants feel more satisfied with the airline's baggage handling, operations/safety, and connections; and (3) US participants perceive higher levels of performance and financial risks whereas Koreans feel greater social risk in choosing an airline. This study also examines the SERVPERF, industry-based measure, and perceived risk in predicting customer satisfaction with, and intention to repatronize the airline. The results suggest that US customers consider service reliability, in-flight comfort, and connections as the key factors determining satisfaction with airline service whereas Korean passengers generally regard reliability, assurance, and risk factors as predictors of satisfaction. The determining factors of customer intention to repatronize the airline are reliability and empathy for US, and reliability and overall risk for Korean customers. The study demonstrates the applicability of SERVPERF as a cross-cultural tool and indicates the importance of perceived risk in cross-cultural studies.
Kam, Chi-Ming; Greenberg, Mark T; Walls, Carla T
2003-03-01
In order for empirically validated school-based prevention programs to "go to scale," it is important to understand the processes underlying program dissemination. Data collected in effectiveness trials, especially those measuring the quality of program implementation and administrative support, are valuable in explicating important factors influencing implementation. This study describes findings regarding quality of implementation in a recent effectiveness trial conducted in a high-risk, American urban community. This delinquency prevention trial is a locally owned intervention, which used the Promoting Alternative THinking Skills Curriculum as its major program component. The intervention involved 350 first graders in 6 inner-city public schools. Three schools implemented the intervention and the other 3 were comparison schools from the same school district. Although intervention effects were not found for all the intervention schools, the intervention was effective in improving children's emotional competence and reducing their aggression in schools which effectively supported the intervention. This study, utilizing data from the 3 intervention schools (13 classrooms and 164 students), suggested that 2 factors contributed to the success of the intervention: (a) adequate support from school principals and (b) high degree of classroom implementation by teachers. These findings are discussed in light of the theory-driven models in program evaluation that emphasized the importance of the multiple factors influencing the implementation of school-based interventions.
Feasibility model study for Blumbangreksa product model based on lean startup method
NASA Astrophysics Data System (ADS)
Pakpahan, A. K.; Dewobroto, W. S.; Pratama, R. Y.
2017-12-01
Based on the data from Ministry of Maritime Affairs and Fisheries in 2015, the productivity of shrimp farmers in Indonesia is still below China, India and Thailand, because of the low survival rate of shrimp seeds were planted in Indonesia. Water quality factors become a significant factor that increasesthe survival rate of shrimp seeds plantation, therefore team of PT. Atnic EkoteknoWicaksana create a tool called Blumbangreksa that able to monitor water quality of shrimp farms, measure temperature, salinity, pH, DO (dissolved oxygen), TDS (total dissolve solid) in water and moist air over the surface of the water and GSM -based and Internet of things. Based on the research results, unique value proposition of Blumbangreksa products is the measurement result of water quality are accurate, real-time measurements, based on Internet of things and have the ability measurements at once. Based on the feasibility study using the opportunity assessment of Marty Cagan, it can be seen that the product has fulfilled ten elements of assessment opportunity, so Blumbangreksa products are considered feasible. Initial investment fund of Blumbangreksa products is Rp 1,369,856,574, with profitability index of 1:51 and average breakeven products each year as many as 18 products are sold, and the payback period for 4 years and 2 months, therefore the business of Blumbangreksa product is feasible.
[Risk-adjusted assessment: late-onset infection in neonates].
Gmyrek, Dieter; Koch, Rainer; Vogtmann, Christoph; Kaiser, Annette; Friedrich, Annette
2011-01-01
The weak point of the countrywide perinatal/neonatal quality surveillance is the ignorance of interhospital differences in the case mix of patients. As a result, this approach does not produce reliable benchmarking. The objective of this study was to adjust the result of the late-onset infection incidence of different hospitals according to their risk profile of patients by multivariate analysis. The perinatal/neonatal database of 41,055 newborns of the Saxonian quality surveillance from 1998 to 2004 was analysed. Based on 18 possible risk factors, a logistic regression model was used to develop a specific risk predictor for the quality indicator "late-onset infection". The developed risk predictor for the incidence of late-onset infection could be described by 4 of the 18 analysed risk factors, namely gestational age, admission from home, hypoxic ischemic encephalopathy and B-streptococcal infection. The AUC(ROC) value of this quality indicator was 83.3%, which demonstrates its reliability. The hospital ranking based on the adjusted risk assessment was very different from hospital rankings before this adjustment. The average correction of ranking position was 4.96 for 35 clinics. The application of the risk adjustment method proposed here allows for a more objective comparison of the incidence of the quality indicator "late onset infection" among different hospitals. Copyright © 2011. Published by Elsevier GmbH.
Carmichael, Suzan L; Yang, Wei; Gilboa, Suzanne; Ailes, Elizabeth; Correa, Adolfo; Botto, Lorenzo D; Feldkamp, Marcia L; Shaw, Gary M
2016-03-01
We examined whether risks of 32 birth defects were higher than expected in the presence of overweight or obese body mass index (BMI) and low diet quality, based on estimating individual and joint effects of these factors and calculating relative excess risk due to interaction. Analyses included mothers of 20,250 cases with birth defects and 8617 population-based controls without birth defects born from 1997 to 2009 and interviewed for the National Birth Defects Prevention Study. We used logistic regression to generate adjusted odds ratios (AORs) reflecting the combined effects of BMI and diet quality. We focused analyses on 16 birth defects (n = 11,868 cases, 8617 controls) for which initial results suggested an association with BMI or diet quality. Relative to the reference group (normal weight women with not low diet quality, i.e., >lowest quartile), AORs for low diet quality among normal weight women tended to be >1, and AORs for overweight and obese women tended to be stronger among women who had low diet quality than not low diet quality. For 9/16 birth defects, AORs for obese women who had low diet quality-the group we hypothesized to have highest risk-were higher than other stratum-specific AORs. Most relative excess risk due to interactions were positive but small (<0.5), with confidence intervals that included zero. These findings provide evidence for the hypothesis of highest birth defect risks among offspring to women who are obese and have low diet quality but insufficient evidence for an interaction of these factors in their contribution to risk. © 2015 Wiley Periodicals, Inc.
Experienced quality factors: qualitative evaluation approach to audiovisual quality
NASA Astrophysics Data System (ADS)
Jumisko-Pyykkö, Satu; Häkkinen, Jukka; Nyman, Göte
2007-02-01
Subjective evaluation is used to identify impairment factors of multimedia quality. The final quality is often formulated via quantitative experiments, but this approach has its constraints, as subject's quality interpretations, experiences and quality evaluation criteria are disregarded. To identify these quality evaluation factors, this study examined qualitatively the criteria participants used to evaluate audiovisual video quality. A semi-structured interview was conducted with 60 participants after a subjective audiovisual quality evaluation experiment. The assessment compared several, relatively low audio-video bitrate ratios with five different television contents on mobile device. In the analysis, methodological triangulation (grounded theory, Bayesian networks and correspondence analysis) was applied to approach the qualitative quality. The results showed that the most important evaluation criteria were the factors of visual quality, contents, factors of audio quality, usefulness - followability and audiovisual interaction. Several relations between the quality factors and the similarities between the contents were identified. As a research methodological recommendation, the focus on content and usage related factors need to be further examined to improve the quality evaluation experiments.
Wong, William CW; Cheung, Catherine SK; Hart, Graham J
2008-01-01
Background Systematic reviews based on the critical appraisal of observational and analytic studies on HIV prevalence and risk factors for HIV transmission among men having sex with men are very useful for health care decisions and planning. Such appraisal is particularly difficult, however, as the quality assessment tools available for use with observational and analytic studies are poorly established. Methods We reviewed the existing quality assessment tools for systematic reviews of observational studies and developed a concise quality assessment checklist to help standardise decisions regarding the quality of studies, with careful consideration of issues such as external and internal validity. Results A pilot version of the checklist was developed based on epidemiological principles, reviews of study designs, and existing checklists for the assessment of observational studies. The Quality Assessment Tool for Systematic Reviews of Observational Studies (QATSO) Score consists of five items: External validity (1 item), reporting (2 items), bias (1 item) and confounding factors (1 item). Expert opinions were sought and it was tested on manuscripts that fulfil the inclusion criteria of a systematic review. Like all assessment scales, QATSO may oversimplify and generalise information yet it is inclusive, simple and practical to use, and allows comparability between papers. Conclusion A specific tool that allows researchers to appraise and guide study quality of observational studies is developed and can be modified for similar studies in the future. PMID:19014686
Solhi, Mahnaz; Shabani Hamedan, Marziyeh; Salehi, Masoud
2016-01-01
Background: Women-headed households are more exposed to social damages than other women. Such condition remarkably influences the women's health-related life quality. The present study is aimed to investigate the effect of an educational intervention in quality of life of women-headed households under protection of Tehran Welfare Organization, in 2015. Methods: In this quasi-experimental study with control group, 180 women-headed households participated. Sampling method was random allocation. Data collection tools were Life Quality standard questionnaire (WHOQOL-BREF) and a researcher-made questionnaire about structures of ecological and educational diagnosis phase of PRECEDE-PROCEED model. Validity and reliability of the questionnaire approved in a primary study. Based on the results obtained from the primary study, the intervention was performed in the case group only. Participants were followed one and three months after intervention. Data were analyzed through SPSS v. 15 software using descriptive and analytical tests. Results: Before intervention no significant difference was observed among the mean scores of life quality, behavioral factors, and knowledge, enabling, and reinforcing factors in the two groups. But, one month and three months after intervention a significant difference was observed between the mean scores of these variables (in five instances p<0.001). Conclusion: Intervention through the PRECEDE-PROCEED model improved the women-headed households' quality of life. The innovation of this study is using such intervention on quality of life in women-headed households for the first time.
Kuwaiti Science Teachers' Beliefs and Intentions Regarding the Use of Inquiry-Based Instruction
ERIC Educational Resources Information Center
Alhendal, Dalal; Marshman, Margaret; Grootenboer, Peter
2016-01-01
To improve the quality of education, the Kuwaiti Ministry of Education has encouraged schools to implement inquiry-based instruction. This study identifies psychosocial factors that predict teachers' intention to use inquiry-based instruction in their science classrooms. An adapted model of Ajzen's (1985) theory of planned behaviour--the Science…
Nikolian, Vahagn C; Kamdar, Neil S; Regenbogen, Scott E; Morris, Arden M; Byrn, John C; Suwanabol, Pasithorn A; Campbell, Darrell A; Hendren, Samantha
2017-06-01
Anastomotic leak is a major source of morbidity in colorectal operations and has become an area of interest in performance metrics. It is unclear whether anastomotic leak is associated primarily with surgeons' technical performance or explained better by patient characteristics and institutional factors. We sought to establish if anastomotic leak could serve as a valid quality metric in colorectal operations by evaluating provider variation after adjusting for patient factors. We performed a retrospective cohort study of colorectal resection patients in the Michigan Surgical Quality Collaborative. Clinically relevant patient and operative factors were tested for association with anastomotic leak. Hierarchical logistic regression was used to derive risk-adjusted rates of anastomotic leak. Of 9,192 colorectal resections, 244 (2.7%) had a documented anastomotic leak. The incidence of anastomotic leak was 3.0% for patients with pelvic anastomoses and 2.5% for those with intra-abdominal anastomoses. Multivariable analysis showed that a greater operative duration, male sex, body mass index >30 kg/m 2 , tobacco use, chronic immunosuppressive medications, thrombocytosis (platelet count >400 × 10 9 /L), and urgent/emergency operations were independently associated with anastomotic leak (C-statistic = 0.75). After accounting for patient and procedural risk factors, 5 hospitals had a significantly greater incidence of postoperative anastomotic leak. This population-based study shows that risk factors for anastomotic leak include male sex, obesity, tobacco use, immunosuppression, thrombocytosis, greater operative duration, and urgent/emergency operation; models including these factors predict most of the variation in anastomotic leak rates. This study suggests that anastomotic leak can serve as a valid metric that can identify opportunities for quality improvement. Copyright © 2017 Elsevier Inc. All rights reserved.
A MEMS disk resonator-based band pass filter electrical equivalent circuit simulation
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sundaram, G. M.; Angira, Mahesh; Gupta, Navneet
In this paper, coupled beam bandpass Disk filter is designed for 1 MHz bandwidth. Filter electrical equivalent circuit simulation is performed using circuit simulators. Important filter parameters such as insertion loss, shape factor and Q factor aresetimated using coventorware simulation. Disk resonator based radial contour mode filter provides 1.5 MHz bandwidth and unloaded quality factor of resonator and filter as 233480, 21797 respectively. From the simulation result it’s found that insertion loss minimum is 151.49 dB, insertion loss maximum is 213.94 dB, and 40 dB shape factor is 4.17.
A novel, fuzzy-based air quality index (FAQI) for air quality assessment
NASA Astrophysics Data System (ADS)
Sowlat, Mohammad Hossein; Gharibi, Hamed; Yunesian, Masud; Tayefeh Mahmoudi, Maryam; Lotfi, Saeedeh
2011-04-01
The ever increasing level of air pollution in most areas of the world has led to development of a variety of air quality indices for estimation of health effects of air pollution, though the indices have their own limitations such as high levels of subjectivity. Present study, therefore, aimed at developing a novel, fuzzy-based air quality index (FAQI ) to handle such limitations. The index developed by present study is based on fuzzy logic that is considered as one of the most common computational methods of artificial intelligence. In addition to criteria air pollutants (i.e. CO, SO 2, PM 10, O 3, NO 2), benzene, toluene, ethylbenzene, xylene, and 1,3-butadiene were also taken into account in the index proposed, because of their considerable health effects. Different weighting factors were then assigned to each pollutant according to its priority. Trapezoidal membership functions were employed for classifications and the final index consisted of 72 inference rules. To assess the performance of the index, a case study was carried out employing air quality data at five different sampling stations in Tehran, Iran, from January 2008 to December 2009, results of which were then compared to the results obtained from USEPA air quality index (AQI). According to the results from present study, fuzzy-based air quality index is a comprehensive tool for classification of air quality and tends to produce accurate results. Therefore, it can be considered useful, reliable, and suitable for consideration by local authorities in air quality assessment and management schemes. Fuzzy-based air quality index (FAQI).
Resilience in Wives of persons with Alcoholism: An Indian exploration
Johnson, Pradeep R; Britto, Carl; Sudevan, Kevin Jude; Bosco, Ashish; Sreedaran, Priya; Ashok, Mysore V
2018-01-01
Context: Mental health has currently shifted focus from “deficit” to strength-based approaches such as Resilience. Coping styles and personality factors have been well studied in Wives of persons with Alcoholism (WopA) but not Resilience. Alcohol dependence in spouse is seen as an adversity. Aims: To evaluate Resilience in the WopA and explore its relationship with marital quality and clinical variables of Alcohol Dependence in their husbands. Settings and Design: A cross-sectional study in a tertiary care hospital in Bangalore, Karnataka. Subjects and Methods: WopA (n=34) between 25–55 years, were assessed for Resilience using Resilience Scale for Adults (RSA), while marital quality was assessed using Marital Quality Scale (MQS). The Severity of Alcohol Dependence, Age of onset of Initiation, Age of onset of Problem Drinking, and Age of onset of Dependence were evaluated in their husbands. Statistical Analysis: Independent sample t-test, Chi-square test, and Pearson's correlation were used. Results: Majority of the WopA (82%) scored low on the RSA. Low Resilience (LR) WopA scored significantly lower on all factors of RSA except the perception of future; in comparison to High Resilience (HR) WopA. Additionally, the LR WopA reported significantly poorer marital quality. Conclusions: Most WopA had low Resilience. LR WopA also had significantly poor marital quality. These findings need to be studied further in a larger population with culturally appropriate scales. The low scoring Resilience factors amongst WopA may be utilized in strength-based psychotherapeutic approaches. There is a need to improve the understanding of Resilience and its assessment in this population.
Resilience in Wives of persons with Alcoholism: An Indian exploration.
Johnson, Pradeep R; Britto, Carl; Sudevan, Kevin Jude; Bosco, Ashish; Sreedaran, Priya; Ashok, Mysore V
2018-01-01
Mental health has currently shifted focus from "deficit" to strength-based approaches such as Resilience. Coping styles and personality factors have been well studied in Wives of persons with Alcoholism (WopA) but not Resilience. Alcohol dependence in spouse is seen as an adversity. To evaluate Resilience in the WopA and explore its relationship with marital quality and clinical variables of Alcohol Dependence in their husbands. A cross-sectional study in a tertiary care hospital in Bangalore, Karnataka. WopA (n=34) between 25-55 years, were assessed for Resilience using Resilience Scale for Adults (RSA), while marital quality was assessed using Marital Quality Scale (MQS). The Severity of Alcohol Dependence, Age of onset of Initiation, Age of onset of Problem Drinking, and Age of onset of Dependence were evaluated in their husbands. Independent sample t -test, Chi-square test, and Pearson's correlation were used. Majority of the WopA (82%) scored low on the RSA. Low Resilience (LR) WopA scored significantly lower on all factors of RSA except the perception of future; in comparison to High Resilience (HR) WopA. Additionally, the LR WopA reported significantly poorer marital quality. Most WopA had low Resilience. LR WopA also had significantly poor marital quality. These findings need to be studied further in a larger population with culturally appropriate scales. The low scoring Resilience factors amongst WopA may be utilized in strength-based psychotherapeutic approaches. There is a need to improve the understanding of Resilience and its assessment in this population.
Disability and quality of life in patients with fibromyalgia
Verbunt, Jeanine A; Pernot, Dia HFM; Smeets, Rob JEM
2008-01-01
Background Patients with fibromyalgia often feel disabled in the performance of daily activities. Psychological factors seem to play a pronounced disabling role in fibromyalgia. The objectives of the study are: Firstly, to investigate contributing factors for disability in fibromyalgia. Secondly, to study psychological distress in patients with fibromyalgia as compared to other nonspecific pain syndromes. And finally, to explore the impact of fibromyalgia on a patient's quality of life. Methods In this cross sectional study, explaining factors for disability were studied based on a regression analysis with gender, mental health, physical and social functioning as independent variables. For the assessment of disability in fibromyalgia the FIQ was used. The levels of psychological distress in patients with fibromyalgia, Complex Regional Pain Syndrome (CRPS) and chronic low back pain (CLBP) were compared based on scores on the Symptom Checklist (SCL90). Quality of life of patients with fibromyalgia was compared with scores (SF36) of both patients with fibromyalgia and other health conditions as derived from the literature. Results Disability in fibromyalgia seemed best explained by a patients mental health condition (β = -0.360 p = 0.02). The level of psychological distress was higher in patients with fibromyalgia as compared to patients with CRPS or CLBP (p < 0.01). The impact of fibromyalgia on quality of life appeared to be high as compared to the impact of other health conditions. Conclusion Patients with fibromyalgia report a considerable impact on their quality of life and their perceived disability level seems influenced by their mental health condition. In comparison with patients with other pain conditions psychological distress is higher. PMID:18211701
Lee, Minyoung; Kim, Min Joo; Suh, Dongwon; Kim, Jungjin; Jo, Eunkyoung; Yoon, BumChul
2016-01-01
Little is known about the effectiveness of self-determination theory (SDT), a representative motivational theory, on exercise domain in older adults. This feasibility study used quantitative and qualitative approaches to evaluate the effectiveness of a 13-month group exercise program applying SDT-based motivational strategies on exercise adherence, physical fitness, and quality of life, and to explore factors affecting exercise adherence in South Korean older adults (N = 18). Exercise attendance rate was high (82.52%). There were significant differences in aerobic endurance (p < .001), lower body strength (p < .05), dynamic balance (p < .001), and perceived social functioning (p < .05) at 13 months compared with baseline. Factors affecting exercise adherence were related to the SDT-based motivational strategies. These results support the importance of health professionals applying SDT-based motivational strategies to exercise programs to help facilitate motivation for participation and to promote physical fitness and quality of life in older adults.
Ring, Adele; Jacoby, Ann; Baker, Gus A; Marson, Anthony; Whitehead, Margaret M
2016-03-01
A significant body of research highlights negative impacts of epilepsy for individual quality of life (QOL). Poor seizure control is frequently associated with reporting of poor QOL and good seizure control with good QOL; however, this is not a universal finding. Evidence suggests that some people enjoy good QOL despite ongoing seizures while others report poor QOL despite good seizure control. Understanding the factors that influence QOL for people with epilepsy and the processes via which such factors exert their influence is central to the development of interventions to support people with epilepsy to experience the best possible QOL. We present findings of a qualitative investigation exploring influences and processes on QOL for people with epilepsy. We describe the clinical, psychological, and social factors contributing to QOL. In particular, we focus on the value of the concept of resilience for understanding quality of life in epilepsy. Based on our analysis, we propose a model of resilience wherein four key component sets of factors interact to determine QOL. This model reflects the fluid nature of resilience that, we suggest, is subject to change based on shifts within the individual components and the interactions between them. The model offers a representation of the complex influences that act and interact to either mitigate or further compound the negative impacts of epilepsy on individual QOL. Copyright © 2016 Elsevier Inc. All rights reserved.
2D/3D video content adaptation decision engine based on content classification and user assessment
NASA Astrophysics Data System (ADS)
Fernandes, Rui; Andrade, M. T.
2017-07-01
Multimedia adaptation depends on several factors, such as the content itself, the consumption device and its characteristics, the transport and access networks and the user. An adaptation decision engine, in order to provide the best possible Quality of Experience to a user, needs to have information about all variables that may influence its decision. For the aforementioned factors, we implement content classification, define device classes, consider limited bandwidth scenarios and categorize user preferences based on a subjective quality evaluation test. The results of these actions generate vital information to pass to the adaptation decision engine so that its operation may provide the indication of the most suitable adaptation to perform that delivers the best possible outcome for the user under the existing constraints.
Factors That Promote Motivation and Academic Engagement in a Career Technical Education Context
ERIC Educational Resources Information Center
Loera, Gustavo; Nakamoto, Jonathan; Oh, Youn Joo; Rueda, Robert
2013-01-01
Drawing on social cognitive theory, this study examined the relationship between student and school-based factors (e.g., educational aspirations, quality of the program of study, and adults' impact on college enrollment) and students' academic engagement and satisfaction with student life in a career technical education (CTE) setting. This study…
Associations of Psychosocial Factors with the Stress of Infertility Treatment
ERIC Educational Resources Information Center
Schneider, Myra G.; Forthofer, Melinda S.
2005-01-01
This study investigated psychosocial factors thought to be associated with perceived stress over the course of infertility treatment. The research was based on secondary analysis of data from the Study of Marriage, Family, and Life Quality with a sample of 128 people who completed an infertility-related stress instrument at all three measurement…
An Examination of the Factors Affecting Stakeholder's Assessment of School Decentralization.
ERIC Educational Resources Information Center
Jenni, Roger W.; Mauriel, John J.
Factors that influence the perceptions held by school site council members and others about the quality of site-based management (SBM) are examined in this study. Specifically, the relationships among a group's assessment of SBM, perceived level of influence on council decision making, perceived level of support from other groups, and perceived…
Evaluating the Relationship between Productivity and Quality in Emergency Departments
Bastian, Nathaniel D.; Riordan, John P.
2017-01-01
Background In the United States, emergency departments (EDs) are constantly pressured to improve operational efficiency and quality in order to gain financial benefits and maintain a positive reputation. Objectives The first objective is to evaluate how efficiently EDs transform their input resources into quality outputs. The second objective is to investigate the relationship between the efficiency and quality performance of EDs and the factors affecting this relationship. Methods Using two data sources, we develop a data envelopment analysis (DEA) model to evaluate the relative efficiency of EDs. Based on the DEA result, we performed multinomial logistic regression to investigate the relationship between ED efficiency and quality performance. Results The DEA results indicated that the main source of inefficiencies was working hours of technicians. The multinomial logistic regression result indicated that the number of electrocardiograms and X-ray procedures conducted in the ED and the length of stay were significantly associated with the trade-offs between relative efficiency and quality. Structural ED characteristics did not influence the relationship between efficiency and quality. Conclusions Depending on the structural and operational characteristics of EDs, different factors can affect the relationship between efficiency and quality. PMID:29065673
Bond, Gary R; Drake, Robert E; Rapp, Charles A; McHugo, Gregory J; Xie, Haiyi
2009-09-01
Fidelity scales have been widely used to assess program adherence to the principles of an evidence-based practice, but they do not measure important aspects of quality of care. Pragmatic scales measuring clinical quality of services are needed to complement fidelity scales measuring structural aspects of program implementation. As part of the instrumentation developed for the National Implementing Evidence-Based Practices Project, we piloted a new instrument with two 5-item quality scales, Individualization (a client-level quality scale) and Quality Improvement (an organizational-level quality scale). Pairs of independent fidelity assessors conducted fidelity reviews in 49 sites in 8 states at baseline and at four subsequent 6-month intervals over a 2-year follow-up period. The assessors followed a standardized protocol to administer these quality scales during daylong site visits; during these same visits they assessed programs on fidelity to the evidence-based practice that the site was seeking to implement. Assessors achieved acceptable interrater reliability for both Individualization and Quality Improvement. Principal components factor analysis confirmed the 2-scale structure. The two scales were modestly correlated with each other and with the evidence-based practice fidelity scales. Over the first year, Individualization and Quality Improvement improved, but showed little or no improvement during the last year of follow-up. The two newly developed scales showed adequate psychometric properties in this preliminary study, but further research is needed to assess their validity and utility in routine clinical practice.
Yoon, Ju Young; Lee, Ji Yun; Bowers, Barbara J; Zimmerman, David R
2012-12-01
With the rapid increase in the number of long-term care hospitals in Korea, care quality has become an important issue. Urinary incontinence is an important condition affecting many residents' quality of life. Thus, it is important that urinary incontinence be amenable to improving conditions with appropriate interventions, since a change in urinary incontinence status can reflect care quality in long-term care facilities if patient level factors are adjusted. We aim to examine the impact of organizational factors on urinary incontinence care quality defined as the improvement of urinary incontinence status or maintenance of continent status post-admission to Korean long-term care hospitals. DESIGN AND DATA: This is a longitudinal correlation study. Data came from two sources: monthly patient assessment reports using the Patient Assessment Instrument and the hospital information system from the Health Insurance Review and Assessment Services. The final analysis includes 5271 elderly adults without indwelling urinary catheter or urostomy who were admitted to 534 Korean long-term care hospitals in April 2008. Multi-level logistic analysis was used to explore the organizational factors that influence urinary incontinence care quality controlling for patient level factors. With respect to the organizational factors, the findings showed that location and RN/total nursing staff ratio variables were statistically significant, controlling for risk factors at the patient level. The odds of urinary incontinence improvement from admission in urban long-term care hospitals were 1.28 times higher than rural long-term care hospitals. In addition, when a long-term care hospital increased one standard deviation (0.19) in the RN ratio, the odds of urinary incontinence status improvement or maintenance of continence status from admission increased about 1.8 times. The most significant finding was that a higher RN to patient ratio and urban location were associated with better resident outcomes of urinary incontinence among organizational factors. For a better understanding of how these significant organizational factors influence positive care outcomes and provide more practical implications, studies should examine concrete care process measures as well as structure and outcome measures based on systematic conceptual models. Copyright © 2012 Elsevier Ltd. All rights reserved.
Johnson, Peter; Fogarty, Linda; Fullerton, Judith; Bluestone, Julia; Drake, Mary
2013-08-28
With decreasing global resources, a pervasive critical shortage of skilled health workers, and a growing disease burden in many countries, the need to maximize the effectiveness and efficiency of pre-service education in low-and middle-income countries has never been greater. We performed an integrative review of the literature to analyse factors contributing to quality pre-service education and created a conceptual model that shows the links between essential elements of quality pre-service education and desired outcomes. The literature contains a rich discussion of factors that contribute to quality pre-service education, including the following: (1) targeted recruitment of qualified students from rural and low-resource settings appears to be a particularly effective strategy for retaining students in vulnerable communities after graduation; (2) evidence supports a competency-based curriculum, but there is no clear evidence supporting specific curricular models such as problem-based learning; (3) the health workforce must be well prepared to address national health priorities; (4) the role of the preceptor and preceptors' skills in clinical teaching, identifying student learning needs, assessing student learning, and prioritizing and time management are particularly important; (5) modern, Internet-enabled medical libraries, skills and simulation laboratories, and computer laboratories to support computer-aided instruction are elements of infrastructure meriting strong consideration; and (6) all students must receive sufficient clinical practice opportunities in high-quality clinical learning environments in order to graduate with the competencies required for effective practice. Few studies make a link between PSE and impact on the health system. Nevertheless, it is logical that the production of a trained and competent staff through high-quality pre-service education and continuing professional development activities is the foundation required to achieve the desired health outcomes. Professional regulation, deployment practices, workplace environment upon graduation and other service delivery contextual factors were analysed as influencing factors that affect educational outcomes and health impact. Our model for pre-service education reflects the investments that must be made by countries into programmes capable of leading to graduates who are competent for the health occupations and professions at the time of their entry into the workforce.
2010-01-01
Background Children and adults with impairments such as cerebral palsy have lower participation in life situations than able-bodied people. Less is known about their subjective perception of their lives, called their quality of life. During adolescence, rapid physical and psychological changes occur; although these may be more difficult for disabled than for able-bodied adolescents, little research has examined the lives of disabled adolescents. In 2003-4 a European Union funded project, SPARCLE, visited 818 children aged 8-12 years with cerebral palsy, sampled from population-based registers in nine European regions. The quality of life reported by these disabled children was similar to that of the general population but their participation was lower; levels of participation varied between countries even for children with similar severity of cerebral palsy. We are currently following up these children, now aged 13-17 years, to identify (i) to what extent contemporaneous factors (pain, impairment, psychological health and parental stress) predict their participation and quality of life, (ii) what factors modify how participation and quality of life at age 8-12 years are associated with participation and quality of life in adolescence, and (iii) whether differences between European countries in participation and quality of life can be explained by variations in environmental factors. Methods/Design Trained researchers will visit families to administer questionnaires to capture the adolescents' type and severity of impairment, socio-demographic characteristics, participation, quality of life, psychological health, pain, environmental access and parental stress. We will use multivariable models (linear, logistic or ordinal) to assess how adolescent participation, quality of life, psychological health, pain, environmental access and parental stress, vary with impairment and socio-demographic characteristics and, where possible, how these outcomes compare with general population data. For participation and quality of life, longitudinal analyses will assess to what extent these are predicted by corresponding levels in childhood and what factors modify this relationship. Structural equation modelling will be used to identify indirect relationships mediated by other factors. PMID:20504349
Xie, Qiuju; Ni, Ji-Qin; Su, Zhongbin
2017-10-15
In confined swine buildings, temperature, humidity, and air quality are all important for animal health and productivity. However, the current swine building environmental control is only based on temperature; and evaluation and control methods based on multiple environmental factors are needed. In this paper, fuzzy comprehensive evaluation (FCE) theory was adopted for multi-factor assessment of environmental quality in two commercial swine buildings using real measurement data. An assessment index system and membership functions were established; and predetermined weights were given using analytic hierarchy process (AHP) combined with knowledge of experts. The results show that multi-factors such as temperature, humidity, and concentrations of ammonia (NH 3 ), carbon dioxide (CO 2 ), and hydrogen sulfide (H 2 S) can be successfully integrated in FCE for swine building environment assessment. The FCE method has a high correlation coefficient of 0.737 compared with the method of single-factor evaluation (SFE). The FCE method can significantly increase the sensitivity and perform an effective and integrative assessment. It can be used as part of environmental controlling and warning systems for swine building environment management to improve swine production and welfare. Copyright © 2017 Elsevier B.V. All rights reserved.
Reporting and methodological quality of meta-analyses in urological literature
Xu, Jing
2017-01-01
Purpose To assess the overall quality of published urological meta-analyses and identify predictive factors for high quality. Materials and Methods We systematically searched PubMed to identify meta-analyses published from January 1st, 2011 to December 31st, 2015 in 10 predetermined major paper-based urology journals. The characteristics of the included meta-analyses were collected, and their reporting and methodological qualities were assessed by the PRISMA checklist (27 items) and AMSTAR tool (11 items), respectively. Descriptive statistics were used for individual items as a measure of overall compliance, and PRISMA and AMSTAR scores were calculated as the sum of adequately reported domains. Logistic regression was used to identify predictive factors for high qualities. Results A total of 183 meta-analyses were included. The mean PRISMA and AMSTAR scores were 22.74 ± 2.04 and 7.57 ± 1.41, respectively. PRISMA item 5, protocol and registration, items 15 and 22, risk of bias across studies, items 16 and 23, additional analysis had less than 50% adherence. AMSTAR item 1, “a priori” design, item 5, list of studies and item 10, publication bias had less than 50% adherence. Logistic regression analyses showed that funding support and “a priori” design were associated with superior reporting quality, following PRISMA guideline and “a priori” design were associated with superior methodological quality. Conclusions Reporting and methodological qualities of recently published meta-analyses in major paper-based urology journals are generally good. Further improvement could potentially be achieved by strictly adhering to PRISMA guideline and having “a priori” protocol. PMID:28439452
Charlton, Peter H; Bonnici, Timothy; Tarassenko, Lionel; Alastruey, Jordi; Clifton, David A; Beale, Richard; Watkinson, Peter J
2017-05-01
Breathing rate (BR) can be estimated by extracting respiratory signals from the electrocardiogram (ECG) or photoplethysmogram (PPG). The extracted respiratory signals may be influenced by several technical and physiological factors. In this study, our aim was to determine how technical and physiological factors influence the quality of respiratory signals. Using a variety of techniques 15 respiratory signals were extracted from the ECG, and 11 from PPG signals collected from 57 healthy subjects. The quality of each respiratory signal was assessed by calculating its correlation with a reference oral-nasal pressure respiratory signal using Pearson's correlation coefficient. Relevant results informing device design and clinical application were obtained. The results informing device design were: (i) seven out of 11 respiratory signals were of higher quality when extracted from finger PPG compared to ear PPG; (ii) laboratory equipment did not provide higher quality of respiratory signals than a clinical monitor; (iii) the ECG provided higher quality respiratory signals than the PPG; (iv) during downsampling of the ECG and PPG significant reductions in quality were first observed at sampling frequencies of <250 Hz and <16 Hz respectively. The results informing clinical application were: (i) frequency modulation-based respiratory signals were generally of lower quality in elderly subjects compared to young subjects; (ii) the qualities of 23 out of 26 respiratory signals were reduced at elevated BRs; (iii) there were no differences associated with gender. Recommendations based on the results are provided regarding device designs for BR estimation, and clinical applications. The dataset and code used in this study are publicly available.
Investigating the CO 2 laser cutting parameters of MDF wood composite material
NASA Astrophysics Data System (ADS)
Eltawahni, H. A.; Olabi, A. G.; Benyounis, K. Y.
2011-04-01
Laser cutting of medium density fibreboard (MDF) is a complicated process and the selection of the process parameters combinations is essential to get the highest quality cut section. This paper presents a means for selecting the process parameters for laser cutting of MDF based on the design of experiments (DOE) approach. A CO 2 laser was used to cut three thicknesses, 4, 6 and 9 mm, of MDF panels. The process factors investigated are: laser power, cutting speed, air pressure and focal point position. In this work, cutting quality was evaluated by measuring the upper kerf width, the lower kerf width, the ratio between the upper kerf width to the lower kerf width, the cut section roughness and the operating cost. The effect of each factor on the quality measures was determined. The optimal cutting combinations were presented in favours of high quality process output and in favours of low cutting cost.
Waßmuth, Ralf
2015-01-01
Certification of conformity in health care should provide assurance of compliance with quality standards. This also includes risk management and patient safety. Based on a comprehensive definition of quality, beneficial effects on the management of risks and the enhancement of patient safety can be expected from certification of conformity. While these effects have strong face validity, they are currently not sufficiently supported by evidence from health care research. Whether this relates to a lack of evidence or a lack of investigation remains open. Advancing safety culture and "climate", as well as learning from adverse events rely in part on quality management and are at least in part reflected in the certification of healthcare quality. However, again, evidence of the effectiveness of such measures is limited. Moreover, additional factors related to personality, attitude and proactive action of healthcare professionals are crucial factors in advancing risk management and patient safety which are currently not adequately reflected in certification of conformity programs.
Enhancing the Value of Population-Based Risk Scores for Institutional-Level Use.
Raza, Sajjad; Sabik, Joseph F; Rajeswaran, Jeevanantham; Idrees, Jay J; Trezzi, Matteo; Riaz, Haris; Javadikasgari, Hoda; Nowicki, Edward R; Svensson, Lars G; Blackstone, Eugene H
2016-07-01
We hypothesized that factors associated with an institution's residual risk unaccounted for by population-based models may be identifiable and used to enhance the value of population-based risk scores for quality improvement. From January 2000 to January 2010, 4,971 patients underwent aortic valve replacement (AVR), either isolated (n = 2,660) or with concomitant coronary artery bypass grafting (AVR+CABG; n = 2,311). Operative mortality and major morbidity and mortality predicted by The Society of Thoracic Surgeons (STS) risk models were compared with observed values. After adjusting for patients' STS score, additional and refined risk factors were sought to explain residual risk. Differences between STS model coefficients (risk-factor strength) and those specific to our institution were calculated. Observed operative mortality was less than predicted for AVR (1.6% [42 of 2,660] vs 2.8%, p < 0.0001) and AVR+CABG (2.6% [59 of 2,311] vs 4.9%, p < 0.0001). Observed major morbidity and mortality was also lower than predicted for isolated AVR (14.6% [389 of 2,660] vs 17.5%, p < 0.0001) and AVR+CABG (20.0% [462 of 2,311] vs 25.8%, p < 0.0001). Shorter height, higher bilirubin, and lower albumin were identified as additional institution-specific risk factors, and body surface area, creatinine, glomerular filtration rate, blood urea nitrogen, and heart failure across all levels of functional class were identified as refined risk-factor variables associated with residual risk. In many instances, risk-factor strength differed substantially from that of STS models. Scores derived from population-based models can be enhanced for institutional level use by adjusting for institution-specific additional and refined risk factors. Identifying these and measuring differences in institution-specific versus population-based risk-factor strength can identify areas to target for quality improvement initiatives. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Properties of Superconducting Mo, Mo2n and Trilayer Mo2n-Mo-Mo2n Thin Films
NASA Technical Reports Server (NTRS)
Barrentine, E. M.; Stevenson, T. R.; Brown, A. D.; Lowitz, A. E.; Noroozian, O.; U-Yen, K.; Eshan, N.; Hsieh, W. T.; Moseley, S. H.; Wollack, E. J.
2014-01-01
We present measurements of the properties of thin film superconducting Mo, Mo2N and Mo2N/Mo/Mo2N trilayers of interest for microwave kinetic inductance detector (MKID) applications. Using microwave resonator devices, we investigate the transition temperature, energy gaps, kinetic inductance, and internal quality factors of these materials. We present an Usadel-based interpretation of the trilayer transition temperature as a function of trilayer thicknesses, and a 2-gap interpretation to understand the change in kinetic inductance and internal resonance quality factor (Q) as a function of temperature.
Testing of qubit materials and fabrication using superconducting resonators
NASA Astrophysics Data System (ADS)
Kumar, Shwetank; Steffen, Matthias; Divincenzo, David; Keefe, George; Rothwell, Mary Beth; Farinelli, Matthew; Rozen, Jim; Milliken, Frank; Ketchen, Mark
2009-03-01
We will present the results of measurements made on superconducting resonators fabricated using different substrates and superconducting metals. Specifically, the quality factor of these resonators will be shown to be closely related to not only the purity of the substrates and metals used in the process but also to the details of the fabrication. We will demonstrate the change in quality factor of a bare resonator when subjected to the qubit process. Based on our measurements we propose that superconducting resonators may form a test bed for troubleshooting the fabrication process for minimizing the materials related dissipation in the qubits.
An Improved Power Quality Based Sheppard-Taylor Converter Fed BLDC Motor Drive
NASA Astrophysics Data System (ADS)
Singh, Bhim; Bist, Vashist
2015-12-01
This paper deals with the design and analysis of a power factor correction based Sheppard-Taylor converter fed brushless dc motor (BLDCM) drive. The speed of the BLDCM is controlled by adjusting the dc link voltage of the voltage source inverter (VSI) feeding BLDCM. Moreover, a low frequency switching of the VSI is used for electronically commutating the BLDCM for reduced switching losses. The Sheppard-Taylor converter is designed to operate in continuous conduction mode to achieve an improved power quality at the ac mains for a wide range of speed control and supply voltage variation. The BLDCM drive is designed and its performance is simulated in a MATLAB/Simulink environment to achieve the power quality indices within the limits of the international power quality standard IEC-61000-3-2.
Quality assurance in mammography: College of Radiology Survey in Malaysia.
Ho, E L M; Ng, K H; Wong, J H D; Wang, H B
2006-06-01
Malaysia's mammography QA practice was surveyed based on the Malaysian Ministry of Health and the American College of Radiology (ACR) requirements. Data on mammography unit, processor, image receptor, exposure factors, mean glandular dose (MGD), sensitometry, image quality and viewbox luminance were obtained. Mean developer temperature and cycle time were 34.1 +/- 1.8degreesC and 107.7 +/- 33.2 seconds. Mean base+fog level, speed index and contrast index were 0.20+/-0.01, 1.20+/-0.01 and 1.33+/-0.26 respectively. Eighty-six percent of the fifty centres passed the image quality test while 12.5% complied with ACR recommended viewbox luminance. Average MGD was 1.0+/-0.4 mGy. Malaysia is on the right track for QA but with room for total quality improvement.
Human factors and safety in emergency medicine
NASA Technical Reports Server (NTRS)
Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.
1994-01-01
A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.
Exposure to sulfur dioxide (SO2) during weeks three through eight of pregnancy increased risk for ventricular septal defects in a population-based case-control study of air quality and birth defects in seven Texas counties between 1997 and 2000. As a follow-back, a computer-assi...
A Taxonomy of Factors to Promote Quality Web-Supported Learning
ERIC Educational Resources Information Center
Fresen, Jill
2007-01-01
This article reports on a case study of the e-learning production unit at the University of Pretoria, South Africa. Phase 1 of the study, completed in 2003, was the design and development of a process-based quality management system for web-supported learning (WSL) using a basic ISO 9000 approach (University of Pretoria, 2003). The second phase,…
ERIC Educational Resources Information Center
Heneveld, Ward
This report is based on the conviction that improvements in the quality of education must focus on the school as the unit of change. Through a review of the qualitative research literature on school improvement and the more quantitative literature on school effectiveness, a conceptual framework that identifies generic factors that determine school…
NASA Astrophysics Data System (ADS)
Desai, Bhagyashree; Mokashi, Pavani; Anand, R. L.; Burli, S. B.; Khandal, S. V.
2016-09-01
The experimental study aims to underseek the effect of various additives on the green sand molding properties as a particular combination of additives could yield desired sand properties. The input parameters (factors) selected were water and powder (Fly ash, Coconut shell and Tamarind) in three levels. Experiments were planned using design of experiments (DOE). On the basis of plans, experiments were conducted to understand the behavior of sand mould properties such as compression strength, shear strength, permeability number with various additives. From the experimental results it could be concluded that the factors have significant effect on the sand properties as P-value found to be less than 0.05 for all the cases studied. The optimization based on quality loss function was also performed. The study revealed that the quality loss associated with the tamarind powder was lesser compared to other additives selected for the study. The optimization based on quality loss function and the parametric analysis using ANOVA suggested that the tamarind powder of 8 gm per Kg of molding sand and moisture content of 7% yield better properties to obtain sound castings.
Development and testing of a fast conceptual river water quality model.
Keupers, Ingrid; Willems, Patrick
2017-04-15
Modern, model based river quality management strongly relies on river water quality models to simulate the temporal and spatial evolution of pollutant concentrations in the water body. Such models are typically constructed by extending detailed hydrodynamic models with a component describing the advection-diffusion and water quality transformation processes in a detailed, physically based way. This approach is too computational time demanding, especially when simulating long time periods that are needed for statistical analysis of the results or when model sensitivity analysis, calibration and validation require a large number of model runs. To overcome this problem, a structure identification method to set up a conceptual river water quality model has been developed. Instead of calculating the water quality concentrations at each water level and discharge node, the river branch is divided into conceptual reservoirs based on user information such as location of interest and boundary inputs. These reservoirs are modelled as Plug Flow Reactor (PFR) and Continuously Stirred Tank Reactor (CSTR) to describe advection and diffusion processes. The same water quality transformation processes as in the detailed models are considered but with adjusted residence times based on the hydrodynamic simulation results and calibrated to the detailed water quality simulation results. The developed approach allows for a much faster calculation time (factor 10 5 ) without significant loss of accuracy, making it feasible to perform time demanding scenario runs. Copyright © 2017 Elsevier Ltd. All rights reserved.
[Environmental quality assessment of regional agro-ecosystem in Loess Plateau].
Wang, Limei; Meng, Fanping; Zheng, Jiyong; Wang, Zhonglin
2004-03-01
Based on the detection and analysis of the contamination status of agro-ecosystem with apple-crops intercropping as the dominant cropping model in Loess Plateau, the individual factor and comprehensive environmental quality were assessed by multilevel fuzzy synthetic evaluation model, analytical hierarchy process(AHP), and improved standard weight deciding method. The results showed that the quality of soil, water and agricultural products was grade I, the social economical environmental quality was grade II, the ecological environmental quality was grade III, and the comprehensive environmental quality was grade I. The regional agro-ecosystem dominated by apple-crops intercropping was not the best model for the ecological benefits, but had the better social economical benefits.
Quality transitivity and traceability system of herbal medicine products based on quality markers.
Liu, Changxiao; Guo, De-An; Liu, Liang
2018-05-15
Due to a variety of factors to affect the herb quality, the existing quality management model is unable to evaluate the process control. The development of the concept of "quality marker" (Q-marker) lays basis for establishing an independent process quality control system for herbal products. To ensure the highest degree of safety, effectiveness and quality process control of herbal products, it is aimed to establish a quality transitivity and traceability system of quality and process control from raw materials to finished herbal products. Based on the key issues and challenges of quality assessment, the current status of quality and process controls from raw materials to herbal medicinal products listed in Pharmacopoeia were analyzed and the research models including discovery and identification of Q-markers, analysis and quality management of risk evaluation were designed. Authors introduced a few new technologies and methodologies, such as DNA barcoding, chromatographic technologies, fingerprint analysis, chemical markers, bio-responses, risk management and solution for quality process control. The quality and process control models for herbal medicinal products were proposed and the transitivity and traceability system from raw materials to the finished products was constructed to improve the herbal quality from the entire supply and production chain. The transitivity and traceability system has been established based on quality markers, especially on how to control the production process under Good Engineering Practices, as well as to implement the risk management for quality and process control in herbal medicine production. Copyright © 2018 Elsevier GmbH. All rights reserved.
Call-Center Based Disease Management of Pediatric Asthmatics
2006-04-01
This study will measure the impact of CBDMP, which promotes patient education and empowerment, on multiple factors to include; patient/caregiver quality...Prepare and reproduce patient education materials, and informed consent work sheets. Contract Oracle data base administrator to establish database for... Patient education materials and informed consent documents were reproduced. A web-based Oracle data-base was determined to be both prohibitively
Risk Analysis of Underestimate Cost Offer to The Project Quality in Aceh Province
NASA Astrophysics Data System (ADS)
Rani, Hafnidar A.
2016-11-01
The possibility of errors in the process of offer price determination could be enormous, so it can affect the possibility of project underestimate cost which can impact and reduce the profit if being implementing. Government Equipment/Service Procurement Policy Institution (LKPP) assesses that the practices of cheaper price in the government equipment/service procurement are still highly found and can be potential to decrease the project quality. This study aimed to analyze the most dominant factors happened in underestimate cost offer practice, to analyze the relationship of underestimate cost offer risk factors to road construction project quality in Aceh Province and to analyze the most potential factors of underestimate cost offer risk affecting road construction project quality in Aceh Province. Road construction projects observed the projects which have been implemented in Aceh Province since 2013 - 2015. This study conducted by interviewing Government Budget Authority (KPA), and distributing the questionnaire to the road construction contractors with the qualification of K1, K2, K3, M1, M2 and B1. Based on the data from Construction Service Development Institution (LPJK) of Aceh Province on 2016, the populations obtained are 2,717 constructors. By using Slovin Equation, the research samples obtained are 97 contractors. The most dominant factors in underestimate cost offer risk of the road construction projects in Aceh Province is Contingency Cost Factor which the mean is 4.374.
Bassler, A W; Arnould, C; Butterworth, A; Colin, L; De Jong, I C; Ferrante, V; Ferrari, P; Haslam, S; Wemelsfelder, F; Blokhuis, H J
2013-11-01
The objectives of this study were to 1) identify determinants of poor welfare in commercial broiler chicken flocks by studying the associations between selected resource-based measures (RBM, potential risk factors), such as litter quality and dark period, and animal-based welfare indicators (ABM), such as foot pad dermatitis and lameness, and 2) establish the breadth of effect of a risk factor by determining the range of animal welfare indicators associated with each of the risk factors (i.e., the number of ABM related to a specific RBM). Eighty-nine broiler flocks were inspected in 4 European countries (France, Italy, the United Kingdom, and the Netherlands) in a cross-sectional study. The ABM were contact dermatitis (measured using scores of foot-pad dermatitis and hock burn, respectively), lameness (measured as gait score), fear of humans (measured by the avoidance distance test and the touch test), and negative emotional state (measured using qualitative behavior assessment, QBA). In a first step, risk factors were identified by building a multiple linear regression model for each ABM. Litter quality was identified as a risk factor for contact dermatitis. Length of dark period at 3 wk old (DARK3) was a risk factor for the touch test result. DARK3 and flock age were risk factors for lameness, and the number of different stockmen and DARK3 were risk factors for QBA results. Next, the ABM were grouped according to risk factor and counted. Then, in a second step, associations between the ABM were investigated using common factor analysis. The breadth of a risk factor's effect was judged by combining the number (count) of ABM related to this factor and the strength of association between these ABM. Flock age and DARK3 appeared to affect several weakly correlated ABM, thus indicating a broad range of effects. Our findings suggest that manipulation of the predominant risk factors identified in this study (DARK3, litter quality, and slaughter age) could generate improvements in the related ABM and thereby enhance the birds' overall welfare status.
Factors Affecting Medical Service Quality.
Mosadeghrad, Ali Mohammad
2014-02-01
A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Quality of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Differences in internal and external factors such as availability of resources, patient cooperation and collaboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding factors that influence medical services quality.
Bases of Marital Satisfaction among Men and Women.
ERIC Educational Resources Information Center
Rhyne, Darla
1981-01-01
Investigated possible gender differences in bases of marital satisfaction. Data indicated that marital quality of men and women differ in degree rather than in kind. Suggests men may be more satisfied with their marriages than women but the same factors are important in their assessments. (Author/RC)
Theoretical approach to society-wide environmental quality control
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ayano, K.
1982-01-01
The study outlines the basis for a theory of societal control of environmental quality in the US based on the concepts and philosophy of company-wide quality control which has developed in Japan as a cross-disciplinary approach to problem-solving in the industrial realm. The basic concepts are: 1) every member of society, as a producer of environmental products and services for future generations, in principle has the responsibility to control the quality of his output; 2) environment quality is the quality of life, or the fitness of use of environment for humans; and 3) societal control is any activity necessary formore » quality production of environmental products and services continuously or in the long run. A motivator-hygiene theory of environmental quality is identified, and a proposal is made that the policy provision must be formulated differently between those aimed at hygiene factors of environmental quality and those aimed at motivators, the former in a collectivistic manner, the latter as an individual problem. The concept of societal cost of environmental quality is introduced. Based on the motivator-hygiene theory of environmental quality, the collectivistic and individual approaches are differentiated and discussed.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Balcazar, Mario D.; Yonehara, Katsuya; Moretti, Alfred
Intense neutrino beam is a unique probe for researching beyond the standard model. Fermilab is the main institution to produce the most powerful and widespectrum neutrino beam. From that respective, a radiation robust beam diagnostic system is a critical element in order to maintain the quality of the neutrino beam. Within this context, a novel radiation-resistive beam profile monitor based on a gasfilled RF cavity is proposed. The goal of this measurement is to study a tunable Qfactor RF cavity to determine the accuracy of the RF signal as a function of the quality factor. Specifically, measurement error of themore » Q-factor in the RF calibration is investigated. Then, the RF system will be improved to minimize signal error.« less
Whittaker, Jackie L; Booysen, Nadine; de la Motte, Sarah; Dennett, Liz; Lewis, Cara L; Wilson, Dave; McKay, Carly; Warner, Martin; Padua, Darin; Emery, Carolyn A; Stokes, Maria
2017-04-01
Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. 5 electronic databases were systematically searched. Studies selected included original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. 2 independent authors assessed the quality (Downs and Black (DB) criteria) and level of evidence (Oxford Centre of Evidence-Based Medicine model). Of 4361 potential studies, 17 were included. The majority were low-quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3-15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). 4 studies considered inter-relationships between risk factors, 7 reported diagnostic accuracy and none tested an intervention programme targeting individuals identified as high risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations. Future research should focus on high-quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating preparticipation screening and LE injury prevention programmes through high-quality randomised controlled trials targeting individuals at greater risk of injury based on screening tests with validated test properties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Whittaker, Jackie L; Booysen, Nadine; de la Motte, Sarah; Dennett, Liz; Lewis, Cara L.; Wilson, Dave; McKay, Carly; Warner, Martin; Padua, Darin; Emery, Carolyn A; Stokes, Maria
2017-01-01
Background Identification of risk factors for lower extremity (LE) injury in sport and military/first-responder occupations is required to inform injury prevention strategies. Objective To determine if poor movement quality is associated with LE injury in sport and military/first-responder occupations. Material and methods Five electronic databases were systematically searched. Studies selected included: original data; analytic design; movement quality outcome (qualitative rating of functional compensation, asymmetry, impairment or efficiency of movement control); LE injury sustained with sport or military/first-responder occupation. The PRISMA guidelines were followed. Two independent authors assessed the quality [Downs and Black (DB) criteria] and level of evidence (Oxford Centre of Evidence-Based Medicine model). Results Of 4361 potential studies, 17 were included. The majority were low quality cohort studies (level 4 evidence). Median DB score was 11/33 (range 3–15). Heterogeneity in methodology and injury definition precluded meta-analyses. The Functional Movement Screen was the most common outcome investigated (15/17 studies). Four studies considered interrelationships between risk factors, seven reported diagnostic accuracy and none tested an intervention program targeting individuals identified as high-risk. There is inconsistent evidence that poor movement quality is associated with increased risk of LE injury in sport and military/first-responder occupations. Conclusions Future research should focus on high quality cohort studies to identify the most relevant movement quality outcomes for predicting injury risk followed by developing and evaluating pre-participation screening and LE injury prevention programs through high quality randomized controlled trials targeting individuals at greater risk of injury based upon screening tests with validated test properties. PMID:27935483
Liu, Jian; Torres, F A; Ma, Yubo; Zhao, C; Ju, L; Blair, D G; Chao, S; Roch-Jeune, I; Flaminio, R; Michel, C; Liu, K-Y
2014-02-10
Three-mode optoacoustic parametric amplifiers (OAPAs), in which a pair of photon modes are strongly coupled to an acoustic mode, provide a general platform for investigating self-cooling, parametric instability and very sensitive transducers. Their realization requires an optical cavity with tunable transverse modes and a high quality-factor mirror resonator. This paper presents the design of a table-top OAPA based on a near-self-imaging cavity design, using a silicon torsional microresonator. The design achieves a tuning coefficient for the optical mode spacing of 2.46 MHz/mm. This allows tuning of the mode spacing between amplification and self-cooling regimes of the OAPA device. Based on demonstrated resonator parameters (frequencies ∼400 kHz and quality-factors ∼7.5×10(5) we predict that the OAPA can achieve parametric instability with 1.6 μW of input power and mode cooling by a factor of 1.9×10(4) with 30 mW of input power.
Oliveira-Maia, Albino J; Mendonça, Carina; Pessoa, Maria J; Camacho, Marta; Gago, Joaquim
2016-01-01
Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective well-being in patients suffering from SMI.
Oliveira-Maia, Albino J.; Mendonça, Carina; Pessoa, Maria J.; Camacho, Marta; Gago, Joaquim
2016-01-01
Within clinical psychiatry, recovery from severe mental illness (SMI) has classically been defined according to symptoms and function (service-based recovery). However, service-users have argued that recovery should be defined as the process of overcoming mental illness, regaining self-control and establishing a meaningful life (customer-based recovery). Here, we aimed to compare customer-based and service-based recovery and clarify their differential relationship with other constructs, namely needs and quality of life. The study was conducted in 101 patients suffering from SMI, recruited from a rural community mental health setting in Portugal. Customer-based recovery and function-related service-based recovery were assessed, respectively, using a shortened version of the Mental Health Recovery Measure (MHRM-20) and the Global Assessment of Functioning score. The Camberwell Assessment of Need scale was used to objectively assess needs, while subjective quality of life was measured with the TL-30s scale. Using multiple linear regression models, we found that the Global Assessment of Functioning score was incrementally predictive of the MHRM-20 score, when added to a model including only clinical and demographic factors, and that this model was further incremented by the score for quality of life. However, in an alternate model using the Global Assessment of Functioning score as the dependent variable, while the MHRM-20 score contributed significantly to the model when added to clinical and demographic factors, the model was not incremented by the score for quality of life. These results suggest that, while a more global concept of recovery from SMI may be assessed using measures for service-based and customer-based recovery, the latter, namely the MHRM-20, also provides information about subjective well-being. Pending confirmation of these findings in other populations, this instrument could thus be useful for comprehensive assessment of recovery and subjective well-being in patients suffering from SMI. PMID:27857698
Error Sources in Proccessing LIDAR Based Bridge Inspection
NASA Astrophysics Data System (ADS)
Bian, H.; Chen, S. E.; Liu, W.
2017-09-01
Bridge inspection is a critical task in infrastructure management and is facing unprecedented challenges after a series of bridge failures. The prevailing visual inspection was insufficient in providing reliable and quantitative bridge information although a systematic quality management framework was built to ensure visual bridge inspection data quality to minimize errors during the inspection process. The LiDAR based remote sensing is recommended as an effective tool in overcoming some of the disadvantages of visual inspection. In order to evaluate the potential of applying this technology in bridge inspection, some of the error sources in LiDAR based bridge inspection are analysed. The scanning angle variance in field data collection and the different algorithm design in scanning data processing are the found factors that will introduce errors into inspection results. Besides studying the errors sources, advanced considerations should be placed on improving the inspection data quality, and statistical analysis might be employed to evaluate inspection operation process that contains a series of uncertain factors in the future. Overall, the development of a reliable bridge inspection system requires not only the improvement of data processing algorithms, but also systematic considerations to mitigate possible errors in the entire inspection workflow. If LiDAR or some other technology can be accepted as a supplement for visual inspection, the current quality management framework will be modified or redesigned, and this would be as urgent as the refine of inspection techniques.
12 CFR 614.4160 - Differential interest rate programs.
Code of Federal Regulations, 2012 CFR
2012-01-01
... loans based on a variety of factors that may include type, purpose, amount, quality, funding or... rate programs, institutions may consider, among other things, the effect that such interest rate...
12 CFR 614.4160 - Differential interest rate programs.
Code of Federal Regulations, 2010 CFR
2010-01-01
... loans based on a variety of factors that may include type, purpose, amount, quality, funding or... rate programs, institutions may consider, among other things, the effect that such interest rate...
12 CFR 614.4160 - Differential interest rate programs.
Code of Federal Regulations, 2011 CFR
2011-01-01
... loans based on a variety of factors that may include type, purpose, amount, quality, funding or... rate programs, institutions may consider, among other things, the effect that such interest rate...
12 CFR 614.4160 - Differential interest rate programs.
Code of Federal Regulations, 2013 CFR
2013-01-01
... loans based on a variety of factors that may include type, purpose, amount, quality, funding or... rate programs, institutions may consider, among other things, the effect that such interest rate...
Capacity and readiness for quality improvement among home and community-based service providers.
Abrahamson, Kathleen; Myers, Jaclyn; Arling, Greg; Davila, Heather; Mueller, Christine; Abery, Brian; Cai, Yun
2016-01-01
The objective of this study was to explore home and community-based service (HCBS) providers' perspectives of organizational readiness for quality improvement (QI). Data were obtained from a survey of participants (N = 56) in a state-sponsored HCBS QI initiative. Quality improvement challenges included lack of time and resources, staff apprehension or resistance, resistance from consumers and families, and project sustainability. Support from leadership was viewed as an important factor in participating organizations' decision to engage in QI. Internal resources available to support QI varied widely between participating organizations, with differences observed between smaller and larger agencies, as well as between provider types and populations served.
Study on Quality Indicator System of Rhythmic Gymnasts in Analytic Hierarchy Process
NASA Astrophysics Data System (ADS)
Luo, Lin
2017-08-01
The rhythmic gymnastics (RG) is a sport item with the direct aim of winning as well as a good ornamental value. The scientific selection by the rhythmic gymnasts is necessary for the success, and also the beginning for the scientific training of the gymnasts in their special training stage. According to RG characteristics and the physical characteristics of the gymnasts, also in combination with the investigations & interviews to the coaches who have years of training experience in RG, the experts & scholars on RG study & teaching in universities, and by referring to relevant documents, this paper established the quality indicator system in analytic hierarchy process (AHP). We summarized and selected several indicators obviously influencing the RG training and divided them into the three types of factors: physical factors, flexibility & strength factors, and speed & dexterity factors, according to which 12 specific indicators, their weights and comprehensive evaluation coefficients. Based on these indicators, we established the quality indicator system of the gymnasts, and developed corresponding software system, providing scientific theoretical basis & practical application basis for the selection & evaluation of the gymnasts.
Dreiling, Katharina; Montano, Diego; Poinstingl, Herbert; Müller, Tjark; Schiekirka-Schwake, Sarah; Anders, Sven; von Steinbüchel, Nicole; Raupach, Tobias
2017-08-01
Evaluation is an integral part of curriculum development in medical education. Given the peculiarities of bedside teaching, specific evaluation tools for this instructional format are needed. Development of these tools should be informed by appropriate frameworks. The purpose of this study was to develop a specific evaluation tool for bedside teaching based on the Stanford Faculty Development Program's clinical teaching framework. Based on a literature review yielding 47 evaluation items, an 18-item questionnaire was compiled and subsequently completed by undergraduate medical students at two German universities. Reliability and validity were assessed in an exploratory full information item factor analysis (study one) and a confirmatory factor analysis as well as a measurement invariance analysis (study two). The exploratory analysis involving 824 students revealed a three-factor structure. Reliability estimates of the subscales were satisfactory (α = 0.71-0.84). The model yielded satisfactory fit indices in the confirmatory factor analysis involving 1043 students. The new questionnaire is short and yet based on a widely-used framework for clinical teaching. The analyses presented here indicate good reliability and validity of the instrument. Future research needs to investigate whether feedback generated from this tool helps to improve teaching quality and student learning outcome.
Linley, Warren G; Hughes, Dyfrig A
2012-09-01
There have been several explorations of factors influencing the reimbursement decisions of the National Institute for Health and Clinical Excellence (NICE) but not of other UK-based health technology assessment (HTA) organizations. This study aimed to explore the factors influencing the recommendations of the All Wales Medicines Strategy Group (AWMSG) on the use of new medicines in Wales. Based on public data, logistic regression models were developed to evaluate the influence of cost effectiveness, the quality and quantity of clinical evidence, disease characteristics (including rarity), budget impact, and a range of other factors on the recommendations of AWMSG and its subcommittee, the New Medicines Group (NMG). Multivariate analyses of 47 AWMSG appraisals between 2007-9 correctly predicted 87% of decisions. The results are suggestive of a positive influence on recommendations of the presence of probabilistic sensitivity analyses (PSAs) but, counter-intuitively, a statistically significant negative influence of evidence from high-quality randomized controlled trials (RCTs) [odds ratio 0.059; 95% CI 0.005, 0.699]. This latter observation may be attributed to our strict definition of high quality, which excluded the use of surrogate endpoints. Putative explanatory variables, including cost effectiveness, budget impact, underlying disease characteristics and 'ultra'-orphan drug status were not statistically significant predictors of final AWMSG decisions based on our dataset. Univariate analyses indicate that medicines with negative recommendations had significantly higher incremental cost-effectiveness ratios than those with positive recommendations, consistent with the pursuit of economic efficiency. There is also evidence that AWMSG considers equity issues via an ultra-orphan drugs policy. Consideration of decision uncertainty via PSA appears to positively influence the reimbursement decisions of AWMSG. The significant negative impact of the presence of high-quality RCTs, and the lack of a significant positive impact of other expected factors, may reflect issues in the plausibility of supporting evidence for medicines that received negative recommendations. Furthermore, it serves to emphasize the difficulties in applying the usual hierarchies of evidence to the HTA process, and in particular to the appraisal of high-cost specialist medicines close to market launch.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Renaud, James, E-mail: james.renaud@mail.mcgill.ca; Seuntjens, Jan; Sarfehnia, Arman
Purpose: In this work, the authors describe an electron sealed water calorimeter (ESWcal) designed to directly measure absorbed dose to water in clinical electron beams and its use to derive electron beam quality conversion factors for two ionization chamber types. Methods: A functioning calorimeter prototype was constructed in-house and used to obtain reproducible measurements in clinical accelerator-based 6, 9, 12, 16, and 20 MeV electron beams. Corrections for the radiation field perturbation due to the presence of the glass calorimeter vessel were calculated using Monte Carlo (MC) simulations. The conductive heat transfer due to dose gradients and nonwater materials wasmore » also accounted for using a commercial finite element method software package. Results: The relative combined standard uncertainty on the ESWcal dose was estimated to be 0.50% for the 9–20 MeV beams and 1.00% for the 6 MeV beam, demonstrating that the development of a water calorimeter-based standard for electron beams over such a wide range of clinically relevant energies is feasible. The largest contributor to the uncertainty was the positioning (Type A, 0.10%–0.40%) and its influence on the perturbation correction (Type B, 0.10%–0.60%). As a preliminary validation, measurements performed with the ESWcal in a 6 MV photon beam were directly compared to results derived from the National Research Council of Canada (NRC) photon beam standard water calorimeter. These two independent devices were shown to agree well within the 0.43% combined relative uncertainty of the ESWcal for this beam type and quality. Absorbed dose electron beam quality conversion factors were measured using the ESWcal for the Exradin A12 and PTW Roos ionization chambers. The photon-electron conversion factor, k{sub ecal}, for the A12 was also experimentally determined. Nonstatistically significant differences of up to 0.7% were found when compared to the calculation-based factors listed in the AAPM’s TG-51 protocol. General agreement between the relative electron energy dependence of the PTW Roos data measured in this work and a recent MC-based study are also shown. Conclusions: This is the first time that water calorimetry has been successfully used to measure electron beam quality conversion factors for energies as low as 6 MeV (R{sub 50} = 2.25 cm)« less
Bouya, Salehoddin; Koochakzai, Maryam; Rafiemanesh, Hosein; Balouchi, Abbas; Taheri, Safiyeh; Badakhsh, Mahin; Didehvar, Mahnaz
2018-07-01
Quality of life is the most important psychological factor affecting breast cancer patients. This study aimed to examine the health related quality of life of breast cancer patients in Iran. International (PubMed, Web of science, Scopus and Google scholar) and national (SID, Magiran) databases were searched for related studies to September 2017. The quality of the articles was evaluated using the Hoy tool. Out of 232 initial studies, 18 studies performed on 2263 people were included in the final stage of the study. Based on the EORTC-QLQ-C30 and random effect method, the pooled mean score of quality of life in 1073 people was 57.88 (95% CI 48.26-67.41, I 2 = 97.90%) and the pooled mean score of quality of life based on WHOQOL-BREF in 357 people was 66.79 (95% CI 45.96-87.62, I 2 = 99.50%). According to the results of the study, a moderate level of quality of life in women with breast cancer was indicated. Therefore, the use of multidimensional approaches can improve their quality of life.
Vavken, P; Culen, G; Dorotka, R
2008-01-01
The demand to routinely apply evidence-based methods in orthopedic surgery increases steadily. In order to do so, however, the validity and reliability of the "evidence" has to be scrutinized. The object of this study was to assess the quality of the most recent orthopedic evidence and to determine variables that have an influence on quality. All 2006 controlled trials from orthopedic journals with high impact factors were analysed in a cross-sectional study. A score based on the CONSORT statement was used to assess study quality. Selected variables were tested for their influence on the quality of the study. Two independent blinded observers reviewed 126 studies. The overall quality was moderate to high. The most neglected parameters were power analysis, intention-to-treat, and concealment. The participation of a methodologically trained investigator increases study quality significantly. There was no difference in study quality irrespective of whether or not there was statistically significant result. Using our quality score we were able show fairly good results for recent orthopedic studies. The most frequently neglected issues in orthopedic research are blinding, power analysis, and intention-to-treat. This may distort the results of clinical investigations considerably and, especially, lack of concealment causes false-positive findings. Our data show furthermore that participation of a methodologist significantly increases quality of the study and consequently strengthens the reliability of results.
NASA Astrophysics Data System (ADS)
Brochu, Christine; Larouche, André; Hark, Robert
Shell thickness is an important quality factor for lithographic and anodizing quality aluminum alloys. Increasing pressure is placed on casting plants to produce a thinner shell zone for these alloys. This study, based on plant trials and mathematical modelling highlights the most significant parameters influencing shell zone formation. Results obtained show the importance of metal temperature and distribution and mould metal level on shell zone formation. As an answer to specific plant problems, this study led to the development of improved metal distribution systems for DC casting of litho and anodizing quality alloys.
Andersen, Johan H; Fallentin, Nils; Thomsen, Jane F; Mikkelsen, Sigurd
2011-05-12
To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers. PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented.
Silage review: Unique challenges of silages made in hot and cold regions.
Bernardes, T F; Daniel, J L P; Adesogan, A T; McAllister, T A; Drouin, P; Nussio, L G; Huhtanen, P; Tremblay, G F; Bélanger, G; Cai, Y
2018-05-01
Silage making can be conveniently divided into field, ensiling, storage, and feed-out phases. In all of these stages, controllable and uncontrollable components can affect silage quality. For instance, silages produced in hot or cold regions are strongly influenced by uncontrollable climate-related factors. In hot regions, crops for silage are influenced by (1) high temperatures negatively affecting corn yield (whole-crop and grain) and nutritive value, (2) butyric and alcoholic fermentations in warm-season grasses (Panicum, Brachiaria, and Pennisetum genera) and sugarcane, respectively, and (3) accelerated aerobic deterioration of silages. Ensiling expertise and economic factors that limit mechanization also impair silage production and utilization in hot environments. In cold regions, a short and cool growing season often limits the use of crops sensitive to cool temperature, such as corn. The fermentation triggered by epiphytic and inoculated microorganisms can also be functionally impaired at lower temperature. Although the use of silage inoculants has increased in Northern Europe, acid-based additives are still a good option in difficult weather conditions to ensure good fermentation quality, nutritive value, and high intake potential of silages. Acid-based additives have enhanced the quality of round bale silage, which has become a common method of forage preservation in Northern Europe. Although all abiotic factors can affect silage quality, the ambient temperature is a factor that influences all stages of silage making from production in the field to utilization at the feed bunk. This review identifies challenges and obstacles to producing silages under hot and cold conditions and discusses strategies for addressing these challenges. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Understanding Peer Review of Scientific Research
ERIC Educational Resources Information Center
Association of American Universities, 2011
2011-01-01
An important factor in the success of America's national research system is that federal funds for university-based research are awarded primarily through peer review, which uses panels of scientific experts, or "peers," to evaluate the quality of grant proposals. In this competitive process, proposals compete for resources based on their…
Baldwin, Richard; Chenoweth, Lynnette; Dela Rama, Marie; Wang, Alex Y
Theory suggests that structural factors such as aged care facility size (bed numbers) will influence service quality. There have been no recent published studies in support of this theory, and consequently, the available literature has not been useful in assisting decision makers with investment decisions on facility size. The study aimed to address that deficit by reviewing the international literature on the relationships between the size of residential aged care facilities, measured by number of beds, and service quality. A systematic review identified 30 studies that reported a relationship between facility size and quality and provided sufficient details to enable comparison. There are three groups of studies based on measurement of quality-those measuring only resident outcomes, those measuring care and resident outcomes using composite tools, and those focused on regulatory compliance. The overall findings support the posited theory to a large extent, that size is a factor in quality and smaller facilities yield the most favorable results. Studies using multiple indicators of service quality produced more consistent results in favor of smaller facilities, as did most studies of regulatory compliance. The theory that aged care facility size (bed numbers) will influence service quality was supported by 26 of the 30 studies reviewed. The review findings indicate that aged care facility size (number of beds) may be one important factor related to service quality. Smaller facilities are more likely to result in higher quality and better outcomes for residents than larger facilities. This has implications for those who make investment decisions concerning aged care facilities. The findings also raise implications for funders and policy makers to ensure that regulations and policies do not encourage the building of facilities inconsistent with these findings.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Huang, Chuan, E-mail: chuan.huang@stonybrookmedicine.edu; Department of Radiology, Harvard Medical School, Boston, Massachusetts 02115; Departments of Radiology, Psychiatry, Stony Brook Medicine, Stony Brook, New York 11794
2015-02-15
Purpose: Degradation of image quality caused by cardiac and respiratory motions hampers the diagnostic quality of cardiac PET. It has been shown that improved diagnostic accuracy of myocardial defect can be achieved by tagged MR (tMR) based PET motion correction using simultaneous PET-MR. However, one major hurdle for the adoption of tMR-based PET motion correction in the PET-MR routine is the long acquisition time needed for the collection of fully sampled tMR data. In this work, the authors propose an accelerated tMR acquisition strategy using parallel imaging and/or compressed sensing and assess the impact on the tMR-based motion corrected PETmore » using phantom and patient data. Methods: Fully sampled tMR data were acquired simultaneously with PET list-mode data on two simultaneous PET-MR scanners for a cardiac phantom and a patient. Parallel imaging and compressed sensing were retrospectively performed by GRAPPA and kt-FOCUSS algorithms with various acceleration factors. Motion fields were estimated using nonrigid B-spline image registration from both the accelerated and fully sampled tMR images. The motion fields were incorporated into a motion corrected ordered subset expectation maximization reconstruction algorithm with motion-dependent attenuation correction. Results: Although tMR acceleration introduced image artifacts into the tMR images for both phantom and patient data, motion corrected PET images yielded similar image quality as those obtained using the fully sampled tMR images for low to moderate acceleration factors (<4). Quantitative analysis of myocardial defect contrast over ten independent noise realizations showed similar results. It was further observed that although the image quality of the motion corrected PET images deteriorates for high acceleration factors, the images were still superior to the images reconstructed without motion correction. Conclusions: Accelerated tMR images obtained with more than 4 times acceleration can still provide relatively accurate motion fields and yield tMR-based motion corrected PET images with similar image quality as those reconstructed using fully sampled tMR data. The reduction of tMR acquisition time makes it more compatible with routine clinical cardiac PET-MR studies.« less
Ng, Chew Lip; Liu, Xuan Dao; Murali Govind, Renuka; Tan, Jonathan Wei Jian; Ooi, Shirley Beng Suat; Archuleta, Sophia
2018-03-16
Postgraduate medical education in Singapore underwent major transition recently, from a British-style system and accreditation to a competency-based residency programme modelled after the American system. We aimed to identify the relative importance of factors influencing the choice of residency sponsoring institutions (SIs) among medical students during this transition period. A questionnaire-based cross-sectional study of Singaporean undergraduate medical students across all years of study was performed in 2011. Participants rated 45 factors (including research, academia and education, marketing, reputation of faculty, working conditions, posting experience and influence by peers/seniors) for degree of importance to their choice of SIs on a five-point Likert scale. Differences with respect to gender and seniority were compared. 705 of 1,274 students completed the survey (response rate 55.3%). The top five influencing factors were guidance by mentor (4.48 ± 0.74), reputation for good teaching (4.46 ± 0.76), personal overall experience in SIs (4.41 ± 0.88), quality of mentorship and supervision (4.41 ± 0.75), and quality and quantity of teaching (4.37 ± 0.78). The five lowest-rated factors were social networking (2.91 ± 1.00), SI security (3.01 ± 1.07), open house impact (3.15 ± 0.96), advertising paraphernalia (3.17 ± 0.95) and research publications (3.21 ± 1.00). Female students attributed more importance to security and positive work environment. Preclinical students rated research and marketing aspects more highly while clinical students valued positive work environment more. Quality of education, mentorship, experiences during clerkship and positive working environment were the most important factors influencing the choice of SIs.
Trapskin, Kari; Johnson, Curtis; Cory, Patrick; Sorum, Sarah; Decker, Chris
2009-01-01
To describe the Wisconsin Pharmacy Quality Collaborative (WPQC), a quality-based network of pharmacies and payers with the common goals of improving medication use and safety, reducing health care costs for payers and patients, and increasing professional recognition and compensation for pharmacist-provided services. Wisconsin between 2006 and 2009. Community (independent, chain, and health-system) pharmacies and private and public health care payers/purchasers with support from the McKesson Corporation. This initiative aligns incentives for pharmacies and payers through implementation of 12 quality-based pharmacy requirements as conditions of pharmacy participation in a practice-advancement pilot. Payers compensate network pharmacies that meet the quality-based requirements for two levels of pharmacy professional services (level 1, intervention-based services; level 2, comprehensive medication review and assessment services). The pilot project is designed to measure the following outcomes: medication-use quality improvements, frequency and types of services provided, drug therapy problems, patient safety, cost savings, identification of factors that facilitate pharmacist participation, and patient satisfaction. The Pharmacy Society of Wisconsin created the WPQC network, which consists of 53 pharmacies, 106 trained pharmacists, 45 student pharmacists, 6 pharmacy technicians, and 2 initial payers. A quality assurance process is followed approximately quarterly to audit the 12 network quality requirements. An evaluation of this collaboration is being conducted. This program demonstrates that collaboration among payers and pharmacists is possible and can result in the development of an incentive-aligned program that stresses quality patient care, standardized services, and professional service compensation for pharmacists. This combination of a quality-based credentialing process with a professional services reimbursement schedule is unique and has the promise to enhance the ambulatory pharmacy practice model.
Quality of Diabetes Management in Saudi Arabia: A Review of Existing Barriers.
Almutairi, Khalid M
2015-12-01
Diabetes mellitus is a complex disorder that requires continuous management and medical care. The purpose of this review is to identify and summarize the barriers that affect diabetes management in Saudi Arabia. Studies that have examined the quality of diabetes management in Saudi Arabia were identified through online and manual literature searches. Two researchers independently searched and assessed for inclusion/exclusion criteria. All studies were screened by a specialist for the significance of the review. Studies that were included were evaluated for relevance, methodological rigor, and credibility by giving a quality score based on Russell and Gregory's criteria. This review presents an overview of the quality of diabetes management and issues and barriers concerning the improvement of diabetes care in Saudi Arabia. The online literature search yielded 11 studies which met the inclusion criteria. Factors affecting the quality of diabetes care can be categorized into patient factors (such as adherence, compliance, attitudes, beliefs, knowledge, financial resources and co-morbidities) and healthcare providers' factors (including beliefs, attitudes and knowledge, patient - provider interaction and communication). The identified barriers, both from patients and healthcare providers, will help healthcare authorities to improve diabetes management in Saudi Arabia. Improvement of health awareness about disease and disease management should be tailored through continuous patient education. Continuous training and seminars will also expand providers' knowledge that will ensure quality and effective diabetes management.
[Spanish versus English as a language of publication and impact factor of Neurologia].
Aleixandre-Benavent, R; Valderrama Zurián, J C; Alonso-Arroyo, A; Miguel-Dasit, A; González de Dios, J; de Granda Orive, Ji
2007-01-01
Although the English language is considered nowadays as the international language of medical publications, some important Spanish journals with impact factor in the Journal Citation Reports as Neurologia, they bet for the publication in Spanish. Neurologia is the official publication of the Sociedad Española de Neurología and there is the conviction that you can have a Spanish language journal with a high quality and a strong impact. Its presence in the most important international data bases and the possibility of free access to its contents through Internet guarantees its proper diffusion around the world. From the point of view of citation, the repercussion of the language for Neurologia, is reflected in the fact that the 46,8 % of the citations that receive are from journals that are published in Spanish. The main factor to improve the impact of the journal is the quality of their papers, as well as the fulfillment of the international rules about periodical publications, the punctuality in its edition and distribution, the presence in national and international bibliographical data bases, its free diffusion in Internet, the training of its researchers and their sensitivity to consult and cite articles that have been published in quality Spanish journals, when necessary.
Considerations for the design of safe and effective consumer health IT applications in the home.
Zayas-Cabán, Teresa; Dixon, Brian E
2010-10-01
Consumer health IT applications have the potential to improve quality, safety and efficiency of consumers' interactions with the healthcare system. Yet little attention has been paid to human factors and ergonomics in the design of consumer health IT, potentially limiting the ability of health IT to achieve these goals. This paper presents the results of an analysis of human factors and ergonomics issues encountered by five projects during the design and implementation of home-based consumer health IT applications. Agency for Healthcare Research and Quality-funded consumer health IT research projects, where patients used the IT applications in their homes, were reviewed. Project documents and discussions with project teams were analysed to identify human factors and ergonomic issues considered or addressed by project teams. The analysis focused on system design and design processes used as well as training, implementation and use of the IT intervention. A broad range of consumer health IT applications and diverse set of human factors and ergonomics issues were identified. The design and implementation processes used resulted in poor fit with some patients' healthcare tasks and the home environment and, in some cases, resulted in lack of use. Clinician interaction with patients and the information provided through health IT applications appeared to positively influence adoption and use. Consumer health IT application design would benefit from the use of human factors and ergonomics design and evaluation methods. Considering the context in which home-based consumer health IT applications are used will likely affect the ability of these applications to positively impact the quality, safety and efficiency of patient care.
ERIC Educational Resources Information Center
Bondarenko, Natal'ia
2015-01-01
This article analyzes the characteristics of the existing and expected deficit of professional skills and qualities of workers employed by Russian companies. Analyzed factors include generic skills, soft or behavioral skills, the influence of the qualification, and shortage on the effectiveness of the companies as a whole. The data is based on a…
ERIC Educational Resources Information Center
Felce, David
1998-01-01
Draws together the results of seven studies that investigated factors influencing the effects of service quality in community-based residential services for people with severe mental retardation. Results found that quality of staff and resident activity is dependent on an interaction between the structure, orientation, and procedures followed…
ERIC Educational Resources Information Center
Freixa Niella, Montse; Vilà Baños, Ruth; Rubio Hurtado, M. José
2015-01-01
The aim of this research was to identify the factors that could be used for quality assessments of the placement centres used by the University of Barcelona's Faculty of Education. To achieve this, a multiple case study method (bachelor's degrees in Education, Social Education and Social Work) was used, which was based on a survey methodology. A…
Kim, Miji; Ryu, Eunjung
2015-12-01
The purpose of this study was to construct and test a structural equation model of quality of work life for clinical nurses based on Peterson and Wilson's Culture-Work-Health model (CWHM). A structured questionnaire was completed by 523 clinical nurses to analyze the relationships between concepts of CWHM-organizational culture, social support, employee health, organizational health, and quality of work life. Among these conceptual variables of CWHM, employee health was measured by perceived health status, and organizational health was measured by presenteeism. SPSS21.0 and AMOS 21.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting quality of work life among clinical nurses. The goodness-of-fit statistics of the final modified hypothetical model are as follows: χ²=586.03, χ²/df=4.19, GFI=.89, AGFI=.85, CFI=.91, TLI=.90, NFI=.89, and RMSEA=.08. The results revealed that organizational culture, social support, organizational health, and employee health accounted for 69% of clinical nurses' quality of work life. The major findings of this study indicate that it is essential to create a positive organizational culture and provide adequate organizational support to maintain a balance between the health of clinical nurses and the organization. Further repeated and expanded studies are needed to explore the multidimensional aspects of clinical nurses' quality of work life in Korea, including various factors, such as work environment, work stress, and burnout.
Hoefelmann, Luana Peter; Lopes, Adair da Silva; da Silva, Kelly Samara; Moritz, Pablo; Nahas, Markus Vinicius
2013-10-01
We aimed to identify and compare the sociodemographic and economic factors associated with perceived sleep quality and sleep duration in high school students from Santa Catarina, Brazil (2001 and 2011). Our study used a school-based, cross-sectional survey administered in 2001 and 2011 to high school students aged 15-19 years (n=5028 in 2001; n=6529 in 2011) enrolled in public schools in Santa Catarina, Brazil. The students responded to a questionnaire that asked about the number of hours slept on school days (insufficient, <8 h; sufficient, > or = 8 h), perceived sleep quality (adequate or poor), sociodemographic characteristics (gender, age, and area), economic factors (work and family income), and school-related variables (grade and shift). The prevalence of poor sleep quality and insufficient sleep increased by 31.2% and 45.9%, respectively, between 2001 and 2011. Remunerated employment, urban environment, male gender, and high family income were strongly associated with these outcomes. There was a notable increase in insufficient sleep and the perception of poor sleep quality among the students in Santa Catarina in the last decade. Public policies are needed to ameliorate this situation, which has disastrous consequences for the health of adolescents. Copyright © 2013 Elsevier B.V. All rights reserved.
Ahlborg, Tone; Strandmark, Margaretha
2006-09-01
The aim of this study was to describe and analyze first-time parents' experiences of factors that affect the quality of their intimate relationship and the way they cope with their situation six months after delivery. The method used was inductive qualitative content analysis of two open questions in a larger questionnaire. The data is based on 535 respondents' statements. The factors affecting the quality of the intimate relationship were available or missing and could be classified into four categories. 1. 'Coping by adjustment to parental role', e.g., mutual support as new parents, 2. 'The couple's 'intimacy', i.e., togetherness and love, 3. 'Coping by communication', i.e., verbal and non-verbal mutual confirmation, and 4. 'Coping with external conditions', e.g., by seeking social support. The results are described in a model, which could constitute a basis for the promotion of health in family health care, with the aim, if possible, of preventing unnecessary separations/divorces after couples become parents.
Determinants of health-related quality of life in psoriasis patients in Malaysia.
Nyunt, Wint Wint Thu; Low, Wah Yun; Ismail, Rokiah; Sockalingam, Sargunan; Min, Aung Ko Ko
2015-03-01
Psoriasis is a chronic dermatological disorder that has a negative impact on quality of life (QoL). This hospital-based cross-sectional study determined factors associated with health-related QoL (HRQoL) impairment in adult psoriasis patients. HRQoL was assessed using the Dermatology Life Quality Index (DLQI). Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). A total of 223 patients, aged 18 to 83 years, were recruited. For 67 (30%) patients, psoriasis had very large to extremely large effect on their life (DLQI score = 11-30). The median DLQI score was 7 (interquartile range = 7). Factors significantly associated with severe impact on HRQoL (DLQI ≥ 10) were disease severity, single status, working status, sports activities, nail dystrophy, exposed area involvement, itch, disturbed sleep, stress, and infection. The factor predictive of severe impact of psoriasis on HRQoL was disease severity. A holistic approach in the management, including psychosocial issues, is absolutely crucial for the optimal care of psoriasis patients. © 2013 APJPH.
NASA Astrophysics Data System (ADS)
Yu, Yingying; Sun, Bo
2018-07-01
We investigate the multi-resonance coupling of inverted quadrangular frustum pyramid (IQFP) groove metal arrays at terahertz frequencies. The surface plasmon resonance (SPR) and groove resonance are induced, resulting in resonance coupling. The dipole of the groove resonance drives the quadrupole of the SPR and creates a sharp Fano-like resonance. The effects of geometry parameters including the width (at the bottom) and height are analyzed in detail. The results show that with the decrease in the sidewall slope of the groove, the confinement of the groove region on the electromagnetic field decreases, thereby increasing the resonance coupling. The Fano-like resonance is enhanced. The sensitivity and quality factor are discussed. The results show that the Fano-like resonance has high sensitivity and quality factor. With the increase in the sidewall slope of the groove, the sensitivity increases, and the quality factor decreases. The results show that the Fano-like resonance of IQFP groove metal arrays has a significant potential for biological monitoring and sensing.
Quality improvement in physiotherapy services.
Boak, George; Sephton, Ruth; Hough, Elaine; Ten Hove, Ruth
2017-06-12
Purpose The purpose of this paper is to evaluate a process change in physiotherapy services and to explore factors that may have influenced the outcomes. Design/methodology/approach This is a multiple case study and information was gathered from eight physiotherapy teams over 24 months. Findings The process change was successfully implemented in six teams. It had a clear, positive effect on service quality provided to patients in three teams. Whilst quality also improved in three other teams, other issues make changes difficult to assess. Factors that enabled process change to be effective are suggested. Research limitations/implications The findings are based on results achieved by only eight English teams. Practical implications This process change may be appropriate for other teams providing therapy services if attention is paid to potential enabling factors, and a learning approach is adopted to designing and introducing the change. Originality/value To the best of the authors' knowledge, no other longitudinal process change study in therapy services has been published.
A Steel Ball Surface Quality Inspection Method Based on a Circumferential Eddy Current Array Sensor.
Zhang, Huayu; Xie, Fengqin; Cao, Maoyong; Zhong, Mingming
2017-07-01
To efficiently inspect surface defects on steel ball bearings, a new method based on a circumferential eddy current array (CECA) sensor was proposed here. The best probe configuration, in terms of the coil quality factor (Q-factor), magnetic field intensity, and induced eddy current density on the surface of a sample steel ball, was determined using 3-, 4-, 5-, and 6-coil probes, for analysis and comparison. The optimal lift-off from the measured steel ball, the number of probe coils, and the frequency of excitation current suitable for steel ball inspection were obtained. Using the resulting CECA sensor to inspect 46,126 steel balls showed a miss rate of ~0.02%. The sensor was inspected for surface defects as small as 0.05 mm in width and 0.1 mm in depth.
Shen, Nelson; Yufe, Shira; Saadatfard, Omid; Sockalingam, Sanjeev; Wiljer, David
2017-01-01
Information system research has stressed the importance of theory in understanding how user perceptions can motivate the use and adoption of technology such as web-based continuing professional development programs for interprofessional education (WCPD-IPE). A systematic review was conducted to provide an information system perspective on the current state of WCPD-IPE program evaluation and how current evaluations capture essential theoretical constructs in promoting technology adoption. Six databases were searched to identify studies evaluating WCPD-IPE. Three investigators determined eligibility of the articles. Evaluation items extracted from the studies were assessed using the Kirkpatrick-Barr framework and mapped to the Benefits Evaluation Framework. Thirty-seven eligible studies yielded 362 evaluation items for analysis. Most items (n = 252) were assessed as Kirkpatrick-Barr level 1 (reaction) and were mainly focused on the quality (information, service, and quality) and satisfaction dimensions of the Benefits Evaluation. System quality was the least evaluated quality dimension, accounting for 26 items across 13 studies. WCPD-IPE use was reported in 17 studies and its antecedent factors were evaluated in varying degrees of comprehensiveness. Although user reactions were commonly evaluated, greater focus on user perceptions of system quality (ie, functionality and performance), usefulness, and usability of the web-based platform is required. Surprisingly, WCPD-IPE use was reported in less than half of the studies. This is problematic as use is a prerequisite to realizing any individual, organizational, or societal benefit of WCPD-IPE. This review proposes an integrated framework which accounts for these factors and provides a theoretically grounded guide for future evaluations.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kinoshita, N; Kita, A; Yoshioka, C
Purpose: Several clinical reference dosimetry protocols for absorbed-dose to water have recently been published: The American Association of Physicists in Medicine (AAPM) published an Addendum to the AAPM’s TG-51 (Addendum TG-51) in April 2014, and the Japan Society of Medical Physics (JSMP) published the Japan Society of Medical Physics 12 (JSMP12), a clinical reference dosimetry protocol, in September 2012. This investigation compared and evaluated the absorbed-dose to water of high-energy photon beams according to Addendum TG-51, International Atomic Energy Agency Technical Report Series No. 398 (TRS-398), and JSMP12. Methods: Differences in the respective beam quality conversion factors with Addendum TG-51,more » TRS-398, and JSMP12 were analyzed and the absorbed-dose to water using 6- and 10-MV photon beams was measured according to the protocols recommended in Addendum TG-51, TRS-398, and JSMP12. The measurements were conducted using two Farmer-type ionization chambers, Exradin A12 and PTW 30013. Results: The beam quality conversion factors for both the 6- and 10-MV photon beams with Addendum TG-51 were within 0.6%, in agreement with the beam quality conversion factors with TRS-398 and JSMP12. The Exradin A12 provided an absorbed-dose to water ratio from 1.003 to 1.006 with TRS-398 / Addendum TG-51 and from 1.004 to 1.005 with JSMP 12 / Addendum TG-51, whereas the PTW 30013 provided a ratio of 1.001 with TRS-398 / Addendum TG-51 and a range from 0.997 to 0.999 with JSMP 12 / Addendum TG-51. Conclusion: Despite differences in the beam quality conversion factor, no major differences were seen in the absorbed-dose to water with Addendum TG-51, TRS-398, and JSMP12. However, Addendum TG-51 provides the most recent data for beam quality conversion factors based on Monte Carlo simulation and greater detail for the measurement protocol. Therefore, the absorbed-dose to water measured with Addendum TG-51 is an estimate with less uncertainty.« less
Bouzid, Maha; Kintz, Erica; Hunter, Paul R
2018-06-07
Cryptosporidium infection causes gastrointestinal disease and has a worldwide distribution. The highest burden is in developing countries. We sought to conduct a systematic review and meta-analysis to identify Cryptosporidium risk factors in Low and Middle Income countries (LMICs). Medline Ovid and Scopus databases were searched with no restriction on year or language of publication. All references were screened independently in duplicate and were included if they presented data on at least 3 risk factors. Meta-analyses using random effects models were used to calculate overall estimates for each exposure. The most frequently reported risk factors in the 15 included studies were overcrowding, household diarrhoea, poor quality drinking water, animal contact, open defecation/ lack of toilet and breastfeeding. The combined odds ratio for animal contact was 1.98 (95%CI: 1.11-3.54) based on 11 studies and for diarrhoea in the household 1.98 (95%CI: 1.13-3.49) based on 4 studies. Open defecation was associated with a pooled odds ratio of 1.82 (95%CI: 1.19-2.8) based on 5 studies. Poor drinking water quality was not associated with a significant Cryptosporidium risk, odds ratio 1.06 (95%CI: 0.77-1.47). Breastfeeding was protective with pooled odds ratio 0.4 (95%CI: 0.13-1.22), which was not statistically significant. Based on the included studies, crowded living conditions, animal contact and open defecation are responsible for the majority of Cryptosporidium cases in LMICs. Future studies investigating Cryptosporidium risk factors should have a good study design and duration, include appropriate number of cases, select suitable controls, investigate multiple relevant risk factors, fully report data and perform multivariate analysis.
NASA Astrophysics Data System (ADS)
Borris, Matthias; Leonhardt, Günther; Marsalek, Jiri; Österlund, Heléne; Viklander, Maria
2016-08-01
The assessment of future trends in urban stormwater quality should be most helpful for ensuring the effectiveness of the existing stormwater quality infrastructure in the future and mitigating the associated impacts on receiving waters. Combined effects of expected changes in climate and socio-economic factors on stormwater quality were examined in two urban test catchments by applying a source-based computer model (WinSLAMM) for TSS and three heavy metals (copper, lead, and zinc) for various future scenarios. Generally, both catchments showed similar responses to the future scenarios and pollutant loads were generally more sensitive to changes in socio-economic factors (i.e., increasing traffic intensities, growth and intensification of the individual land-uses) than in the climate. Specifically, for the selected Intermediate socio-economic scenario and two climate change scenarios (RSP = 2.6 and 8.5), the TSS loads from both catchments increased by about 10 % on average, but when applying the Intermediate climate change scenario (RCP = 4.5) for two SSPs, the Sustainability and Security scenarios (SSP1 and SSP3), the TSS loads increased on average by 70 %. Furthermore, it was observed that well-designed and maintained stormwater treatment facilities targeting local pollution hotspots exhibited the potential to significantly improve stormwater quality, however, at potentially high costs. In fact, it was possible to reduce pollutant loads from both catchments under the future Sustainability scenario (on average, e.g., TSS were reduced by 20 %), compared to the current conditions. The methodology developed in this study was found useful for planning climate change adaptation strategies in the context of local conditions.
Managing Chronic Disease in Ontario Primary Care: The Impact of Organizational Factors
Russell, Grant M.; Dahrouge, Simone; Hogg, William; Geneau, Robert; Muldoon, Laura; Tuna, Meltem
2009-01-01
PURPOSE New approaches to chronic disease management emphasize the need to improve the delivery of primary care services to meet the needs of chronically ill patients. This study (1) assessed whether chronic disease management differed among 4 models of primary health care delivery and (2) identified which practice organizational factors were independently associated with high-quality care. METHODS We undertook a cross-sectional survey with nested qualitative case studies (2 practices per model) in 137 randomly selected primary care practices from 4 delivery models in Ontario Canada: fee for service, capitation, blended payment, and community health centers (CHCs). Practice and clinician surveys were based on the Primary Care Assessment Tool. A chart audit assessed evidence-based care delivery for patients with diabetes, congestive heart failure, and coronary artery disease. Intermediate outcomes were calculated for patients with diabetes and hypertension. Multiple linear regression identified those organizational factors independently associated with chronic disease management. RESULTS Chronic disease management was superior in CHCs. Clinicians in CHCs found it easier than those in the other models to promote high-quality care through longer consultations and interprofessional collaboration. Across the whole sample and independent of model, high-quality chronic disease management was associated with the presence of a nurse-practitioner. It was also associated with lower patient-family physician ratios and when practices had 4 or fewer full-time-equivalent family physicians. CONCLUSIONS The study adds to the literature supporting the value of nurse-practitioners within primary care teams and validates the contributions of Ontario’s CHCs. Our observation that quality of care decreased in larger, busier practices suggests that moves toward larger practices and greater patient-physician ratios may have unanticipated negative effects on processes of care quality. PMID:19597168
Borris, Matthias; Leonhardt, Günther; Marsalek, Jiri; Österlund, Heléne; Viklander, Maria
2016-08-01
The assessment of future trends in urban stormwater quality should be most helpful for ensuring the effectiveness of the existing stormwater quality infrastructure in the future and mitigating the associated impacts on receiving waters. Combined effects of expected changes in climate and socio-economic factors on stormwater quality were examined in two urban test catchments by applying a source-based computer model (WinSLAMM) for TSS and three heavy metals (copper, lead, and zinc) for various future scenarios. Generally, both catchments showed similar responses to the future scenarios and pollutant loads were generally more sensitive to changes in socio-economic factors (i.e., increasing traffic intensities, growth and intensification of the individual land-uses) than in the climate. Specifically, for the selected Intermediate socio-economic scenario and two climate change scenarios (RSP = 2.6 and 8.5), the TSS loads from both catchments increased by about 10 % on average, but when applying the Intermediate climate change scenario (RCP = 4.5) for two SSPs, the Sustainability and Security scenarios (SSP1 and SSP3), the TSS loads increased on average by 70 %. Furthermore, it was observed that well-designed and maintained stormwater treatment facilities targeting local pollution hotspots exhibited the potential to significantly improve stormwater quality, however, at potentially high costs. In fact, it was possible to reduce pollutant loads from both catchments under the future Sustainability scenario (on average, e.g., TSS were reduced by 20 %), compared to the current conditions. The methodology developed in this study was found useful for planning climate change adaptation strategies in the context of local conditions.
Alexander, Jeffrey A; Hearld, Larry R; Jiang, H Joanna; Fraser, Irene
2007-01-01
Evidence-based management assumes that available research evidence is consistent with the problems and decision-making conditions faced by those who will utilize this evidence in practice. This article attempts to identify how hospital leaders view key determinants of hospital quality and costs, as well as the fundamental ways these leaders "think" about solutions to quality and cost issues in their organizations. The objective of this analysis is to better inform the research agenda and approaches pursued by health services research so that this research reflects the "realities" of practice in hospitals. We conducted a series of semistructured interviews with a convenience sample of eight hospital and three health system leaders. Questions focused on current and future challenges facing hospitals as they relate to hospital quality, costs, and efficiency, and potential solutions to those challenges. Nine major organizational and managerial factors emerged from the interviews, including staffing, evidence-based practice, information technology, data availability and benchmarking, and leadership. Hospital leaders tend to think about these factors systemically and consider process-related factors as the important drivers of cost and quality. The results suggest a need to expand the methods utilized by health services researchers to make their research more relevant to health care managers. Expanding research methods to reflect the systemic way that managers view the challenges and solutions facing their organizations may enhance the application of research findings into management practice. Finally, better communication is needed between the research and practice communities. Researchers must learn to think more like managers if their research is to be relevant, and managers must learn to more effectively communicate their issues with the research community and frame their problems in researchable terms.
An Improved Power Quality BIBRED Converter-Based VSI-Fed BLDC Motor Drive
NASA Astrophysics Data System (ADS)
Singh, Bhim; Bist, Vashist
2014-01-01
This paper presents an IHQRR (integrated high-quality rectifier regulator) BIBRED (boost integrated buck rectifier energy storage DC-DC) converter-based VSI (voltage source inverter)-fed BLDC (brushless DC) motor drive. The speed control of BLDC motor is achieved by controlling the DC link voltage of the VSI using a single voltage sensor. This allows VSI to operate in fundamental frequency switching mode for electronic commutation of BLDC motor which reduces the switching losses due to high-frequency switching used in conventional approach of PWM (pulse width modulation)-based VSI-fed BLDC motor drive. A BIBRED converter is operated in a dual-DCM (discontinuous conduction mode) thus using a voltage follower approach for PFC (power factor correction) and DC link voltage control. The performance of the proposed drive is evaluated for improved power quality over a wide range of speed control and supply voltage variation for demonstrating the behavior of proposed drive. The power quality indices thus obtained are within the recommended limits by international PQ (power quality) standards such as IEC 61000-3-2.
NASA Astrophysics Data System (ADS)
Sevcik, L.; Uhrin, D.; Frnda, J.; Voznak, M.; Toral-Cruz, Homer; Mikulec, M.; Jakovlev, Sergej
2015-05-01
Nowadays, the interest in real-time services, like audio and video, is growing. These services are mostly transmitted over packet networks, which are based on IP protocol. It leads to analyses of these services and their behavior in such networks which are becoming more frequent. Video has become the significant part of all data traffic sent via IP networks. In general, a video service is one-way service (except e.g. video calls) and network delay is not such an important factor as in a voice service. Dominant network factors that influence the final video quality are especially packet loss, delay variation and the capacity of the transmission links. Analysis of video quality concentrates on the resistance of video codecs to packet loss in the network, which causes artefacts in the video. IPsec provides confidentiality in terms of safety, integrity and non-repudiation (using HMAC-SHA1 and 3DES encryption for confidentiality and AES in CBC mode) with an authentication header and ESP (Encapsulating Security Payload). The paper brings a detailed view of the performance of video streaming over an IP-based network. We compared quality of video with packet loss and encryption as well. The measured results demonstrated the relation between the video codec type and bitrate to the final video quality.
2012-01-01
Background Quality improvement collaboratives (QICs) bring together groups of healthcare professionals to work in a structured manner to improve the quality of healthcare delivery within particular domains. We explored which characteristics of the composition, participation, functioning, and organization of these collaboratives related to changes in the healthcare for patients with anxiety disorders, dual diagnosis, or schizophrenia. Methods We studied three QICs involving 29 quality improvement (QI) teams representing a number of mental healthcare organizations in the Netherlands. The aims of the three QICs were the implementation of multidisciplinary practice guidelines in the domains of anxiety disorders, dual diagnosis, and schizophrenia, respectively. We used eight performance indicators to assess the impact of the QI teams on self-reported patient outcomes and process of care outcomes for 1,346 patients. The QI team members completed a questionnaire on the characteristics of the composition, participation in a national program, functioning, and organizational context for their teams. It was expected that an association would be found between these team characteristics and the quality of care for patients with anxiety disorders, dual diagnosis, and schizophrenia. Results No consistent patterns of association emerged. Theory-based factors did not perform better than practice-based factors. However, QI teams that received support from their management and both active and inspirational team leadership showed better results. Rather surprisingly, a lower average level of education among the team members was associated with better results, although less consistently than the management and leadership characteristics. Team views with regard to the QI goals of the team and attitudes towards multidisciplinary practice guidelines did not correlate with team success. Conclusions No general conclusions about the impact of the characteristics of QI teams on the quality of healthcare can be drawn, but support of the management and active, inspirational team leadership appear to be important. Not only patient outcomes but also the performance indicators of monitoring and screening/assessment showed improvement in many but not all of the QI teams with such characteristics. More studies are needed to identify factors associated with the impact of multidisciplinary practice guidelines in mental healthcare. PMID:22230594
Nguyen, Lemai; Bellucci, Emilia; Nguyen, Linh Thuy
2014-11-01
This paper provides a review of EHR (electronic health record) implementations around the world and reports on findings including benefits and issues associated with EHR implementation. A systematic literature review was conducted from peer-reviewed scholarly journal publications from the last 10 years (2001-2011). The search was conducted using various publication collections including: Scopus, Embase, Informit, Medline, Proquest Health and Medical Complete. This paper reports on our analysis of previous empirical studies of EHR implementations. We analysed data based on an extension of DeLone and McLean's information system (IS) evaluation framework. The extended framework integrates DeLone and McLean's dimensions, including information quality, system quality, service quality, intention of use and usage, user satisfaction and net benefits, together with contingent dimensions, including systems development, implementation attributes and organisational aspects, as identified by Van der Meijden and colleagues. A mix of evidence-based positive and negative impacts of EHR was found across different evaluation dimensions. In addition, a number of contingent factors were found to contribute to successful implementation of EHR. This review does not include white papers or industry surveys, non-English papers, or those published outside the review time period. This review confirms the potential of this technology to aid patient care and clinical documentation; for example, in improved documentation quality, increased administration efficiency, as well as better quality, safety and coordination of care. Common negative impacts include changes to workflow and work disruption. Mixed observations were found on EHR quality, adoption and satisfaction. The review warns future implementers of EHR to carefully undertake the technology implementation exercise. The review also informs healthcare providers of contingent factors that potentially affect EHR development and implementation in an organisational setting. Our findings suggest a lack of socio-technical connectives between the clinician, the patient and the technology in developing and implementing EHR and future developments in patient-accessible EHR. In addition, a synthesis of DeLone and McLean's framework and Van der Meijden and colleagues' contingent factors has been found useful in comprehensively understanding and evaluating EHR implementations. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.
Review of NASA approach to space radiation risk assessments for Mars exploration.
Cucinotta, Francis A
2015-02-01
Long duration space missions present unique radiation protection challenges due to the complexity of the space radiation environment, which includes high charge and energy particles and other highly ionizing radiation such as neutrons. Based on a recommendation by the National Council on Radiation Protection and Measurements, a 3% lifetime risk of exposure-induced death for cancer has been used as a basis for risk limitation by the National Aeronautics and Space Administration (NASA) for low-Earth orbit missions. NASA has developed a risk-based approach to radiation exposure limits that accounts for individual factors (age, gender, and smoking history) and assesses the uncertainties in risk estimates. New radiation quality factors with associated probability distribution functions to represent the quality factor's uncertainty have been developed based on track structure models and recent radiobiology data for high charge and energy particles. The current radiation dose limits are reviewed for spaceflight and the various qualitative and quantitative uncertainties that impact the risk of exposure-induced death estimates using the NASA Space Cancer Risk (NSCR) model. NSCR estimates of the number of "safe days" in deep space to be within exposure limits and risk estimates for a Mars exploration mission are described.
Hu, Peifeng; Herningtyas, Elizabeth H.; Kale, Varsha; Crimmins, Eileen M.; Risbud, Arun R.; McCreath, Heather; Lee, Jinkook; Strauss, John; O’Brien, Jennifer C.; Bloom, David E.; Seeman, Teresa E.
2015-01-01
Measurement of C-reactive protein, a marker of inflammation, in dried blood spots has been increasingly incorporated in community-based social surveys internationally. Although the dried blood spot based CRP assay protocol has been validated in the United States, it remains unclear whether laboratories in other less developed countries can generate C-reactive protein results of similar quality. We therefore conducted external quality monitoring for dried blood spot based C-reactive protein measurement for the Indonesia Family Life Survey and the Longitudinal Aging Study in India. Our results show that dried blood spot based C-reactive protein results in these two countries have excellent and consistent correlations with serum-based values and dried blood spot based results from the reference laboratory in the United States. Even though the results from duplicate samples may have fluctuations in absolute values over time, the relative order of C-reactive protein levels remains similar and the estimates are reasonably precise for population-based studies that investigate the association between socioeconomic factors and health. PMID:25879265
The pattern space factor and quality factor of cylindrical source antennas
NASA Astrophysics Data System (ADS)
Jarem, John M.
1982-09-01
For the first time the quality factor of cylindrical source antennas is derived by a plane wave expansion. The evanescent energy (and therefore the quality factor) as defined by a plane wave expansion is shown to be different from Collin and Rothschild's [IEEE Trans. Antennas Propagation AP-12, 23 (1964)] quality factor.
Rates of urbanisation and the resiliency of air and water quality.
Duh, Jiunn-Der; Shandas, Vivek; Chang, Heejun; George, Linda A
2008-08-01
Global human population and urban development are increasing at unprecedented rates and creating tremendous stress on local, regional, and global air and water quality. However, little is known about how urban areas vary in their capacity to address effectively air and water quality impacts associated to urban development. There exists a need to better understanding the factors that mediate the interactions between urbanisation and variations of environmental quality. By synthesizing literatures on the relationship between urban development and air and water quality, we assess the amount of scholarship for each of these cities, characterize population growth rates in one hundred of the largest global cities, and link growth trends to changes in air and water quality. Our results suggest that, while there is a growing literature linking urbanisation and environmental quality, some regions of the globe are better represented than others, and that these trends are consistent with our characterization of population growth rates. In addition, the comparison between population growth rates and air and water quality suggest that multiple factors affect the environmental quality, and that approaching rates of urbanisation through the lens of 'resiliency' can be an effective integrative concept for studying the capacity of urban areas to respond to rapid rates of change. Based on these results we offer a framework for systematically assessing changes in air and water quality in megacities.
Lee, Sang Myeon; Park, Kwang Hyun; Jung, Seungon; Park, Hyesung; Yang, Changduk
2018-05-14
For a given π-conjugated polymer, the batch-to-batch variations in molecular weight (M w ) and polydispersity index (Ð) can lead to inconsistent process-dependent material properties and consequent performance variations in the device application. Using a stepwise-heating protocol in the Stille polycondensation in conjunction with optimized processing, we obtained an ultrahigh-quality PTB7 polymer having high M w and very narrow Ð. The resulting ultrahigh-quality polymer-based solar cells demonstrate up to 9.97% power conversion efficiencies (PCEs), which is over 24% enhancement from the control devices fabricated with commercially available PTB7. Moreover, we observe almost negligible batch-to-batch variations in the overall PCE values from ultrahigh-quality polymer-based devices. The proposed stepwise polymerization demonstrates a facile and effective strategy for synthesizing high-quality semiconducting polymers that can significantly improve device yield in polymer-based solar cells, an important factor for the commercialization of organic solar cells, by mitigating device-to-device variations.
Weinstein, Dana; Bhave, Sunil A
2010-04-14
This paper introduces the resonant body transistor (RBT), a silicon-based dielectrically transduced nanoelectromechanical (NEM) resonator embedding a sense transistor directly into the resonator body. Combining the benefits of FET sensing with the frequency scaling capabilities and high quality factors (Q) of internal dielectrically transduced bar resonators, the resonant body transistor achieves >10 GHz frequencies and can be integrated into a standard CMOS process for on-chip clock generation, high-Q microwave circuits, fundamental quantum-state preparation and observation, and high-sensitivity measurements. An 11.7 GHz bulk-mode RBT is demonstrated with a quality factor Q of 1830, marking the highest frequency acoustic resonance measured to date on a silicon wafer.
Storrs, Mark J; Alexander, Heather; Sun, Jing; Kroon, Jeroen; Evans, Jane L
2015-03-01
Previous research on interprofessional education (IPE) assessment has shown the need to evaluate the influence of team-based processes on the quality of clinical education. This study aimed to develop a valid and reliable instrument to evaluate the effectiveness of interprofessional team-based treatment planning (TBTP) on the quality of clinical education at the Griffith University School of Dentistry and Oral Health, Queensland, Australia. A scale was developed and evaluated to measure interprofessional student team processes and their effect on the quality of clinical education for dental, oral health therapy, and dental technology students (known more frequently as intraprofessional education). A face validity analysis by IPE experts confirmed that items on the scale reflected the meaning of relevant concepts. After piloting, 158 students (61% response rate) involved with TBTP participated in a survey. An exploratory factor analysis using the principal component method retained 23 items with a total variance of 64.6%, suggesting high content validity. Three subscales accounted for 45.7%, 11.4%, and 7.5% of the variance. Internal consistency of the scale (α=0.943) and subscales 1 (α=0.953), 2 (α=0.897), and 3 (α=0.813) was high. A reliability analysis yielded moderate (rs=0.43) to high correlations (0.81) with the remaining scale items. Confirmatory factor analyses verified convergent validity and confirmed that this structure had a good model fit. This study suggests that the instrument might be useful in evaluating interprofessional or intraprofessional team-based processes and their influence on the quality of clinical education in academic dental institutions.
Taylor, Natalie; Clay-Williams, Robyn; Hogden, Emily; Pye, Victoria; Li, Zhicheng; Groene, Oliver; Suñol, Rosa; Braithwaite, Jeffrey
2015-12-07
Despite the growing body of research on quality and safety in healthcare, there is little evidence of the association between the way hospitals are organised for quality and patient factors, limiting our understanding of how to effect large-scale change. The 'Deepening our Understanding of Quality in Australia' (DUQuA) study aims to measure and examine relationships between (1) organisation and department-level quality management systems (QMS), clinician leadership and culture, and (2) clinical treatment processes, clinical outcomes and patient-reported perceptions of care within Australian hospitals. The DUQuA project is a national, multilevel, cross-sectional study with data collection at organisation (hospital), department, professional and patient levels. Sample size calculations indicate a minimum of 43 hospitals are required to adequately power the study. To allow for rejection and attrition, 70 hospitals across all Australian jurisdictions that meet the inclusion criteria will be invited to participate. Participants will consist of hospital quality management professionals; clinicians; and patients with stroke, acute myocardial infarction and hip fracture. Organisation and department-level QMS, clinician leadership and culture, patient perceptions of safety, clinical treatment processes, and patient outcomes will be assessed using validated, evidence-based or consensus-based measurement tools. Data analysis will consist of simple correlations, linear and logistic regression and multilevel modelling. Multilevel modelling methods will enable identification of the amount of variation in outcomes attributed to the hospital and department levels, and the factors contributing to this variation. Ethical approval has been obtained. Results will be disseminated to individual hospitals in de-identified national and international benchmarking reports with data-driven recommendations. This ground-breaking national study has the potential to influence decision-making on the implementation of quality and safety systems and processes in Australian and international hospitals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
NASA Astrophysics Data System (ADS)
Taylan, Osman
2017-02-01
High ozone concentration is an important cause of air pollution mainly due to its role in the greenhouse gas emission. Ozone is produced by photochemical processes which contain nitrogen oxides and volatile organic compounds in the lower atmospheric level. Therefore, monitoring and controlling the quality of air in the urban environment is very important due to the public health care. However, air quality prediction is a highly complex and non-linear process; usually several attributes have to be considered. Artificial intelligent (AI) techniques can be employed to monitor and evaluate the ozone concentration level. The aim of this study is to develop an Adaptive Neuro-Fuzzy inference approach (ANFIS) to determine the influence of peripheral factors on air quality and pollution which is an arising problem due to ozone level in Jeddah city. The concentration of ozone level was considered as a factor to predict the Air Quality (AQ) under the atmospheric conditions. Using Air Quality Standards of Saudi Arabia, ozone concentration level was modelled by employing certain factors such as; nitrogen oxide (NOx), atmospheric pressure, temperature, and relative humidity. Hence, an ANFIS model was developed to observe the ozone concentration level and the model performance was assessed by testing data obtained from the monitoring stations established by the General Authority of Meteorology and Environment Protection of Kingdom of Saudi Arabia. The outcomes of ANFIS model were re-assessed by fuzzy quality charts using quality specification and control limits based on US-EPA air quality standards. The results of present study show that the ANFIS model is a comprehensive approach for the estimation and assessment of ozone level and is a reliable approach to produce more genuine outcomes.
Service quality of hospital outpatient departments: patients' perspective.
Zarei, Ehsan
2015-01-01
Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients' perspective. This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications. Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients' perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor. Practical implications - The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction. According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.
NASA Astrophysics Data System (ADS)
Mohamed, N.; Saman, M. Z. M.; Sharif, S.; Hamzah, H. S.
2018-03-01
While the concept of remanufacturing is gaining popularity globally, literature and theory on strategic decision-making on certifying for warranty in this area remain limited. A strategic and establish concept flow is developed based on extensive literature review and surveys with experienced experts who are dealing with remanufactured, reconditioned, rebuilt and reused components. The remanufacturing research on evaluating quality assurance of remanufactured component targets macro-level parameters and the indicators which must be confirmed for evaluation. The strategic remanufacturing factors identified from the literature review are discussed in a brainstorming session with a number of remanufacturing researchers and academic experts. The study is further broadened by industrial surveys and case studies to justify the inputs on developing a framework to certify remanufactured components. Preliminary results have established the key factors of remanufacturing quality control that might lead to the strict quality assurance of remanufactured components. Later, the developed framework can be used as a benchmarking tool to certify remanufactured components and warranty issuance. The findings serve as the foundation for further research concerning Original Equipment Manufacturer (OEM) or Original Equipment Remanufacturer (OER) and Independent Equipment Remanufacturer (IER) in the Malaysian Remanufacturing Industry.
Hogg, Lori Hoffman
2014-01-01
Prioritizing personalized, proactive, patient-driven health care is among the Veterans Health Administration's (VHA's) transformational initiatives. As one of the largest integrated healthcare systems, the VHA sets standards for performance measures and outcomes achieved in quality of care. Evidence-based practice (EBP) is a hallmark in oncology nursing care. EBP can be linked to positive outcomes and improving quality that can be influenced directly by nursing interventions. VHA oncology nurses had the opportunity to partner with the Oncology Nursing Society (ONS), ONS Foundation, and the Joint Commission in the multiyear development of a comprehensive approach to quality cancer care. Building on a platform of existing measures and refining measurement sets culminated in testing evidence-based, nursing-sensitive quality measures for reliability through the ONS Foundation-supported Breast Cancer Care (BCC) Quality Measures Set. The BCC Measures afforded the VHA to have its many sites collectively assess documentation of the symptoms of patients with breast cancer, the use of colony-stimulating factors, and education about neutropenia precautions provided. Parallel paths of the groups, seeking evidence-based measures, led to the perfect partnership in the VHA's journey in pilot testing the BCC Measures in veterans with breast cancer. This generated further quality assessments and continuous improvement projects for spread and sustainability throughout the VHA.
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
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.
ERIC Educational Resources Information Center
Øye, Christine; Mekki, Tone Elin; Skaar, Randi; Dahl, Hellen; Forland, Oddvar; Jacobsen, Frode F.
2015-01-01
Knowledge utilization is politically "hot" because it informs decisions on improving the quality of care in nursing homes (NHs). The difficulties encountered in implementing evidence-based knowledge into practice may be explained by contextual factors. Contextual factors are crucial to understanding the process of knowledge utilization;…
Rotation to a Partially Specified Target Matrix in Exploratory Factor Analysis: How Many Targets?
ERIC Educational Resources Information Center
Myers, Nicholas D.; Ahn, Soyeon; Jin, Ying
2013-01-01
The purpose of this study was to explore the influence of the number of targets specified on the quality of exploratory factor analysis solutions with a complex underlying structure and incomplete substantive measurement theory. Three Monte Carlo studies were performed based on the ratio of the number of observed variables to the number of…
Gelaye, Bizu; Lohsoonthorn, Vitool; Lertmeharit, Somrat; Pensuksan, Wipawan C; Sanchez, Sixto E; Lemma, Seblewengel; Berhane, Yemane; Zhu, Xiaotong; Vélez, Juan Carlos; Barbosa, Clarita; Anderade, Asterio; Tadesse, Mahlet G; Williams, Michelle A
2014-01-01
The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) are questionnaires used to assess sleep quality and excessive daytime sleepiness in clinical and population-based studies. The present study aimed to evaluate the construct validity and factor structure of the PSQI and ESS questionnaires among young adults in four countries (Chile, Ethiopia, Peru and Thailand). A cross-sectional study was conducted among 8,481 undergraduate students. Students were invited to complete a self-administered questionnaire that collected information about lifestyle, demographic, and sleep characteristics. In each country, the construct validity and factorial structures of PSQI and ESS questionnaires were tested through exploratory and confirmatory factor analyses (EFA and CFA). The largest component-total correlation coefficient for sleep quality as assessed using PSQI was noted in Chile (r = 0.71) while the smallest component-total correlation coefficient was noted for sleep medication use in Peru (r = 0.28). The largest component-total correlation coefficient for excessive daytime sleepiness as assessed using ESS was found for item 1 (sitting/reading) in Chile (r = 0.65) while the lowest item-total correlation was observed for item 6 (sitting and talking to someone) in Thailand (r = 0.35). Using both EFA and CFA a two-factor model was found for PSQI questionnaire in Chile, Ethiopia and Thailand while a three-factor model was found for Peru. For the ESS questionnaire, we noted two factors for all four countries. Overall, we documented cross-cultural comparability of sleep quality and excessive daytime sleepiness measures using the PSQI and ESS questionnaires among Asian, South American and African young adults. Although both the PSQI and ESS were originally developed as single-factor questionnaires, the results of our EFA and CFA revealed the multi- dimensionality of the scales suggesting limited usefulness of the global PSQI and ESS scores to assess sleep quality and excessive daytime sleepiness.
Influence of Socioeconomic Factors on Daily Life Activities and Quality of Life of Thai Elderly
Somrongthong, Ratana; Wongchalee, Sunanta; Ramakrishnan, Chandrika; Hongthong, Donnapa; Yodmai, Korravarn; Wongtongkam, Nualnong
2017-01-01
Background The increasing number of older people is a significant issue in Thailand, resulted in growing demands of health and social welfare services. The study aim was to explore the influence of socioeconomic factors on activities of daily living and quality of life of Thai seniors. Design and methods Using randomised cluster sampling, one province was sampled from each of the Central, North, Northeast and South regions, then one subdistrict sampled in each province, and a household survey used to identify the sample of 1678 seniors aged 60 years and over. The Mann-Whitney U-test and binary logistic regression were used to compare and determine the association of socioeconomic variables on quality of life and activities of daily living. Results The findings showed that sociodemographic and socioeconomic factors were significantly related to functional capacity of daily living. Education levels were strongly associated with daily life activities, with 3.55 adjusted ORs for respondents with secondary school education. Gender was important, with females comprising 61% of dependent respondents but only 47% of independent respondents. Seniors with low incomes were more likely to be anxious in the past, present and future and less likely to accept death in the late stage, with 1.40 Adjusted ORs (95%CI: 1.02-1.92), and 0.72 (95%CI: 0.53-0.98), respectively. However, they were more likely to engage in social activities. Conclusions While socioeconomic factors strongly indicated the functional capacity to live independently, a good quality of life also required other factors leading to happiness and life satisfaction. Significance for public health Increasing numbers of ageing population raise a public health concern in Thai society due to the increasing demands of medical and health services regarding chronic diseases and disability. Unfortunately, few studies have mentioned socioeconomic factors on daily living activities and quality of life and none has taken place across regions in Thailand. Epidemiological population-based studies are necessary to identify social determinants and potential contributing factors that influence quality of life and disability which in turn, may utilise information shaping the policy through better support and care. PMID:28785548
KIPS: An Evidence-Based Tool for Assessing Parenting Strengths and Needs in Diverse Families
ERIC Educational Resources Information Center
Comfort, Marilee; Gordon, Philip R.; Naples, Denise
2011-01-01
The movement toward evidence-based practices has stimulated greater interest in assessing parenting outcomes. The purpose of these studies was to further validate the Keys to Interactive Parenting Scale (KIPS), a structured observational assessment of parenting quality, with 397 diverse families. Factor analysis demonstrated that the 12 KIPS items…
Depression among the urban poor in Peninsular Malaysia: a community based cross-sectional study.
Tan, Kok Leong; Yadav, Hematram
2013-01-01
This community based cross-sectional study examined the prevalence and factors associated with depression among urban poor in Peninsular Malaysia. The Patient Health Questionnaire (PHQ-9) was used to determine the presence or absence of depression. The prevalence of depression among the urban poor was 12.3%. Factors significantly associated with depression included respondents under 25 years old, male gender, living in the area for less than four years and those who do not exercise regularly. It is important to identify individuals with depression and its associated factors early because depression can severely affect the quality of life.
Grosse, Scott D; Chaugule, Shraddha S; Hay, Joel W
2015-01-01
Estimates of preference-weighted health outcomes or health state utilities are needed to assess improvements in health in terms of quality-adjusted life-years. Gains in quality-adjusted life-years are used to assess the cost–effectiveness of prophylactic use of clotting factor compared with on-demand treatment among people with hemophilia, a congenital bleeding disorder. Published estimates of health utilities for people with hemophilia vary, contributing to uncertainty in the estimates of cost–effectiveness of prophylaxis. Challenges in estimating utility weights for the purpose of evaluating hemophilia treatment include selection bias in observational data, difficulty in adjusting for predictors of health-related quality of life and lack of preference-based data comparing adults with lifetime or primary prophylaxis versus no prophylaxis living within the same country and healthcare system. PMID:25585817
NASA Astrophysics Data System (ADS)
Chitrakar, S.; Miller, S. N.; Liu, T.; Caffrey, P. A.
2015-12-01
Water quality data have been collected from three representative stream reaches in a coalbed methane (CBM) development area for over five years to improve the understanding of salt loading in the system. These streams are located within Atlantic Rim development area of the Muddy Creek in south-central Wyoming. Significant development of CBM wells is ongoing in the study area. Three representative sampling stream reaches included the Duck Pond Draw and Cow Creek, which receive co-produced water, and; South Fork Creek, and upstream Cow Creek which do not receive co-produced water. Water samples were assayed for various parameters which included sodium, calcium, magnesium, fluoride, chlorine, nitrate, O-phosphate, sulfate, carbonate, bicarbonates, and other water quality parameters such as pH, conductivity, and TDS. Based on these water quality parameters we have investigated various hydrochemical and geochemical processes responsible for the high variability in water quality in the region. However, effective interpretation of complex databases to understand aforementioned processes has been a challenging task due to the system's complexity. In this work we applied multivariate statistical techniques including cluster analysis (CA), principle component analysis (PCA) and discriminant analysis (DA) to analyze water quality data and identify similarities and differences among our locations. First, CA technique was applied to group the monitoring sites based on the multivariate similarities. Second, PCA technique was applied to identify the prevalent parameters responsible for the variation of water quality in each group. Third, the DA technique was used to identify the most important factors responsible for variation of water quality during low flow season and high flow season. The purpose of this study is to improve the understanding of factors or sources influencing the spatial and temporal variation of water quality. The ultimate goal of this whole research is to develop coupled salt loading and GIS-based hydrological modelling tool that will be able to simulate the salt loadings under various user defined scenarios in the regions undergoing CBM development. Therefore, the findings from this study will be used to formulate the predominant processes responsible for solute loading.
Health-related quality of life in the Brazilian Amazon: a population-based cross-sectional study.
Silva, Marcus Tolentino; Caicedo Roa, Monica; Galvao, Tais Freire
2017-08-14
To analyze perceptions of health-related quality of life and associated factors in populations from the Manaus Metropolitan Region. We conducted a population-based cross-sectional study from May to August 2015. Adults aged 18 years and older were selected using probabilistic three-phase cluster sampling and stratified by sex and age, based on official estimates. Quality of life data were collected using the European Quality of Life 5-Dimensions 3-Levels (EQ-5D-3L) along with socioeconomic, demographic, and health perception data. Utility scores were calculated using the Brazilian version of the EQ-5D-3L. Descriptive statistics were derived, and a multivariate Tobit regression model with correction for complex sampling was performed to identify the variables that influence utility levels. A total of 4001 participants were included. The average utility score was 0.886 (95% confidence interval [CI]: 0.881-0.890) with significant differences according to living area (the capital (0.882 ± 0.144) or inner cities (0.908 ± 0.122; p < 0.001)). The dimension for which the highest proportion of people reported moderate to severe problems was pain/discomfort (39%), followed by anxiety/depression (18%). Men had a higher quality of life than women (β = 0.041, p < 0.001). Not working was a factor that increased quality of life compared with being formally employed (β = 0.031, p = 0.037). The poorest people had a lower quality of life than the richest people (β = -0.118, p < 0.001). Better health perceptions increased utility scores (p < 0.001), while being separated decreased the scores (β = -0.052, p = 0.001). Health-related quality of life in the Manaus Metropolitan Region was high, as expected for the general population, and was higher among individuals who lived in the inner cities, men and those in higher social classes. Gender discrepancies and differences in quality of life between the capital and inner cities should be further investigated.
Meteorological and urban landscape factors on severe air pollution in Beijing.
Han, Lijian; Zhou, Weiqi; Li, Weifeng; Meshesha, Derege T; Li, Li; Zheng, Mingqing
2015-07-01
Air pollution gained special attention with the rapid development in Beijing. In January 2013, Beijing experienced extreme air pollution, which was not well examined. We thus examine the magnitude of air quality in the particular month by applying the air quality index (AQI), which is based on the newly upgraded Chinese environmental standard. Our finding revealed that (1) air quality has distinct spatial heterogeneity and relatively better air quality was observed in the northwest while worse quality happened in the southeast part of the city; (2) the wind speed is the main determinant of air quality in the city-when wind speed is greater than 4 m/sec, air quality can be significantly improved; and (3) urban impervious surface makes a contribution to the severity of air pollution-that is, with an increase in the fraction of impervious surface in a given area, air pollution is more severe. The results from our study demonstrated the severe pollution in Beijing and its meteorological and landscape factors. Also, the results of this work suggest that very strict air quality management should be conducted when wind speed less than 4 m/sec, especially at places with a large fraction of urban impervious surface. Prevention of air pollution is rare among methods with controls on meteorological and urban landscape conditions. We present research that utilizes the latest air quality index (AQI) to compare air pollution with meteorological and landscape conditions. We found that wind is the major meteorological factor that determines the air quality. For a given wind speed greater than 4 m/sec, the air quality improved significantly. Urban impervious surface also contributes to the severe air pollution: that is, when the fraction of impervious surface increases, there is more severe air pollution. These results suggest that air quality management should be conducted when wind speed is less than 4 m/sec, especially at places with a larger fraction of urban impervious surface.
Bennett, George L.; Fram, Miranda S.; Belitz, Kenneth
2014-01-01
Groundwater quality in the Klamath Mountains (KLAM) study unit was investigated as part of the Priority Basin Project of the California Groundwater Ambient Monitoring and Assessment (GAMA) Program. The study unit is located in Del Norte, Humboldt, Shasta, Siskiyou, Tehama, and Trinity Counties. The GAMA Priority Basin Project is being conducted by the California State Water Resources Control Board in collaboration with the U.S. Geological Survey (USGS) and the Lawrence Livermore National Laboratory. The GAMA Priority Basin Project was designed to provide a spatially unbiased, statistically robust assessment of the quality of untreated (raw) groundwater in the primary aquifer system. The assessment is based on water-quality data and explanatory factors for groundwater samples collected in 2010 by the USGS from 39 sites and on water-quality data from the California Department of Public Health (CDPH) water-quality database. The primary aquifer system was defined by the depth intervals of the wells listed in the CDPH water-quality database for the KLAM study unit. The quality of groundwater in the primary aquifer system may be different from that in the shallower or deeper water-bearing zones; shallow groundwater may be more vulnerable to surficial contamination. This study included two types of assessments: (1) a status assessment, which characterized the status of the current quality of the groundwater resource by using data from samples analyzed for volatile organic compounds, pesticides, and naturally occurring inorganic constituents, such as major ions and trace elements, and (2) an understanding assessment, which evaluated the natural and human factors potentially affecting the groundwater quality. The assessments were intended to characterize the quality of groundwater resources in the primary aquifer system of the KLAM study unit, not the quality of treated drinking water delivered to consumers by water purveyors. Relative-concentrations (sample concentrations divided by the health- or aesthetic-based benchmark concentrations) were used for evaluating groundwater quality for those constituents that have Federal or California regulatory or non-regulatory benchmarks for drinking-water quality. A relative-concentration greater than (>) 1.0 indicates a concentration greater than a benchmark, and a relative-concentration less than or equal to (≤) 1.0 indicates a concentration less than or equal to a benchmark. Relative-concentrations of organic constituents were classified as “high” (relative-concentration > 1.0), “moderate” (0.1 Aquifer-scale proportion was used in the status assessment as the primary metric for evaluating regional-scale groundwater quality. High aquifer-scale proportion is defined as the percentage of the area of the primary aquifer system with a relative-concentration greater than 1.0 for a particular constituent or class of constituents; percentage is based on an areal rather than a volumetric basis. Moderate and low aquifer-scale proportions were defined as the percentages of the primary aquifer system with moderate and low relative-concentrations, respectively. The KLAM study unit includes more than 8,800 square miles (mi2), but only those areas near the sampling sites, about 920 mi2, are included in the areal assessment of the study unit. Two statistical approaches—grid-based and spatially weighted—were used to evaluate aquifer-scale proportions for individual constituents and classes of constituents. To confirm this methodology, 90 percent confidence intervals were calculated for the grid-based high aquifer-scale proportions and were compared to the spatially weighted results, which were found to be within these confidence intervals in all cases. Grid-based results were selected for use in the status assessment unless, as was observed in a few cases, a grid-based result was zero and the spatially weighted result was not zero, in which case, the spatially weighted result was used. The status assessment showed that inorganic constituents with human-health benchmarks were detected at high relative-concentrations in 2.6 percent of the primary aquifer system and at moderate relative-concentrations in 10 percent of the system. The high aquifer-scale proportion for inorganic constituents mainly reflected the high aquifer-scale proportions of boron. Inorganic constituents with secondary maximum contaminant levels were detected at high relative-concentrations in 13 percent of the primary aquifer system and at moderate relative-concentrations in 10 percent of the system. The constituents present at high relative-concentrations included iron and manganese. Organic constituents with human-health benchmarks were not detected at high relative-concentrations, but were detected at moderate relative-concentrations in 1.9 percent of the primary aquifer system. The 1.9 percent reflected a spatially weighted moderate aquifer-scale proportion for the gasoline additive methyl tert-butyl ether. Of the 148 organic constituents analyzed, 14 constituents were detected. Only one organic constituent had a detection frequency of greater than 10 percent—the trihalomethane, chloroform. The second component of this study, the understanding assessment, identified the natural and human factors that may have affected the groundwater quality in the KLAM study unit by evaluating statistical correlations between water-quality constituents and potential explanatory factors. The potential explanatory factors evaluated were aquifer lithology, land use, hydrologic conditions, depth, groundwater age, and geochemical conditions. Results of the statistical evaluations were used to explain the occurrence and distribution of constituents in the KLAM study unit. Groundwater age distribution (modern, mixed, or pre-modern), redox class (oxic, mixed, or anoxic), and dissolved oxygen concentration were the explanatory factors that best explained occurrence patterns of the inorganic constituents. High concentrations of boron were found to be associated with groundwater classified as mixed or pre-modern with respect to groundwater age. Boron was also negatively correlated to dissolved oxygen and positively correlated to specific conductance. Iron and manganese concentrations were strongly associated with low dissolved oxygen concentrations, anoxic and mixed redox classifications, and pre-modern groundwater. Specific conductance concentrations were found to be related to pre-modern groundwater, low dissolved oxygen concentrations, and high pH. Chloroform was selected for additional evaluation in the understanding assessment because it was detected in more than 10 percent of wells sampled in the KLAM study unit. Septic tank density was the only explanatory factor that was found to relate to chloroform concentrations.
Binary phase plates cannot improve laser beam quality.
Siegman, A E
1993-05-01
Binary phase plates are often suggested as a means for improving the far-field brightness of beams coming from antiphased laser arrays or waveguide lasers operating in higher-order modes. Somewhat surprisingly, however, binary phase plates actually cannot improve at all the second-moment-based beam quality factor M(2) as usually defined for such beams. Even from a power-in-the-bucket viewpoint, their usefulness is debatable.
Methodology for designing psychological habitability for the space station.
Komastubara, A
2000-09-01
Psychological habitability is a critical quality issue for the International Space Station because poor habitability degrades performance shaping factors (PSFs) and increases human errors. However, habitability often receives rather limited design attention based on someone's superficial tastes because systematic design procedures lack habitability quality. To improve design treatment of psychological habitability, this paper proposes and discusses a design methodology for designing psychological habitability for the International Space Station.
Hoshikawa, Masako; Uchida, Sunao; Hirano, Yuichi
2018-02-26
The amount, quality, and timing of sleep are considered important for athletes' ability to train, maximize training responses, and recover. However, some research has shown that elite athletes do not obtain sufficient sleep. Based on this background, researchers recently started to assess and manage sleep in elite athletes. The purpose of this study was to clarify the prevalence of poor sleep quality and its associated factors amongst elite Japanese athletes. Eight hundred and ninety-one candidates for the 17th Asian Games Incheon 2014, who were over 20 years old, participated in this study. They completed a questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, two-question case-finding instruments, and a checklist for sleep hygiene. Data from 817 of the 891 athletes (91.7%) with no missing values were analyzed. The mean time in bed was 7 h and 29 min. Two hundred and twenty-nine (28.0%) athletes showed a PSQI global score above the clinical criteria. A multiple logistic analysis revealed that sleep quality was significantly associated with five factors: "time in bed," "eating breakfast every morning," "avoiding the use of electronic devices (PC, smartphone, etc.) just before bedtime," "depressive mood", and "not thinking about troubles while in bed." Forty percent of athletes reported they had been informed by someone about "snoring loudly" and/or "leg twitching or jerking during sleep." The results of this study demonstrate that 28% of the athletes showed the PSQI score above the cutoff for poor sleep quality (> 5.5), which suggests that there may be a high prevalence of poor sleep quality in this population of athletes. To improve athletes' sleep, the five factors associated with sleep quality should be emphasized in athletes' sleep education. Furthermore, in medical evaluations of athletes, it may be desirable to include screening for sleep disorders.
NASA Astrophysics Data System (ADS)
Shoudong, Zhu; Huasheng, Peng; Lanping, Guo; Tongren, Xu; Yan, Zhang; Meilan, Chen; Qingxiu, Hao; Liping, Kang; Luqi, Huang
2017-02-01
Atractylodes is an East-Asiatic endemic genera that distributed in China, Japan and Russian Far Eastern. As an important resource of medicinal plant, atractylodes has long been used as herbal medicine. To example the significant features in its trueborn quality and geographical distribution, we explored the relationships between medicine quality and habitat suitability in two classifications-lower atractylodin content than the standard of Chinese Pharmacopoeia (2010) and the other has higher content. We found that the atractylodin content is negatively related to the habitat suitability for atractylodes with lower atractylodin, while the atractylodin content is positively related to the habitat suitability for those with higher atractylodin. By analyzing the distribution of atractylodeswith lower atractylodin content than the standard of Pharmacopeia, we discovered that the main ecological factors that could inhibit the accumulation of atractylodin were soil type (39.7%), soil clay content (26.7%), mean temperature in December (22.3%), Cation-exchange capacity (6%), etc. And these ecological factors promoted the accumulation of atractylodin for the atractylodes with higher atractylodin. By integrating the two classifications, we finally predicted the distribution of atractylodin content in China.Our results realized the query of atractylodes quality in arbitrary coordinates, and satisfied the actually cultivation demands of “Planting area based on atractylodin quality”.
El-Shahat, M F; Sadek, M A; Mostafa, W M; Hagagg, K H
2016-04-01
The present investigation has been conducted to delineate the hydrogeochemical and environmental factors that control the water quality of the groundwater resources in the north-east of Cairo. A complementary approach based on hydrogeochemistry and a geographical information system (GIS) based protectability index has been employed for conducting this work. The results from the chemical analysis revealed that the groundwater of the Quaternary aquifer is less saline than that of the Miocene aquifer and the main factors that control the groundwater salinity in the studied area are primarily related to the genesis of the original recharging water modified after by leaching, dissolution, cation exchange, and fertilizer leachate. The computed groundwater quality index (WQI) falls into two categories: fair for almost all the Miocene groundwater samples, while the Quaternary groundwater samples are all have a good quality. The retarded flow and non-replenishment of the Miocene aquifer compared to the renewable active recharge of the Quaternary aquifer can explain this variation of WQI. The index and overlay approach exemplified by the DUPIT index has been used to investigate the protectability of the study aquifers against diffuse pollutants. Three categories (highly protectable less vulnerable, moderately protectable moderately vulnerable and less protectable highly vulnerable) have been determined and areally mapped.
Quantitative assessment of desertification in south of Iran using MEDALUS method.
Sepehr, A; Hassanli, A M; Ekhtesasi, M R; Jamali, J B
2007-11-01
The main aim of this study was the quantitative assessment of desertification process in the case study area of the Fidoye-Garmosht plain (Southern Iran). Based on the MEDALUS approach and the characteristics of study area a regional model developed using GIS. Six main factors or indicators of desertification including: soil, climate, erosion, plant cover, groundwater and management were considered for evaluation. Then several sub-indicators affecting the quality of each main indicator were identified. Based on the MEDALUS approach, each sub-indicator was quantified according to its quality and given a weighting of between 1.0 and 2.0. ArcGIS 9 was used to analyze and prepare the layers of quality maps using the geometric mean to integrate the individual sub-indicator maps. In turn the geometric mean of all six quality maps was used to generate a single desertification status map. Results showed that 12% of the area is classified as very severe, 81% as severe and 7% as moderately affected by desertification. In addition the plant cover and groundwater indicators were the most important factors affecting desertification process in the study area. The model developed may be used to assess desertification process and distinguish the areas sensitive to desertification in the study region and in regions with the similar characteristics.
Methodology of quality improvement projects for the Texas Medicare population.
Pendergrass, P W; Abel, R L; Bing, M; Vaughn, R; McCauley, C
1998-07-01
The Texas Medical Foundation, the quality improvement organization for the state of Texas, develops local quality improvement projects for the Medicare population. These projects are developed as part of the Health Care Quality Improvement Program undertaken by the Health Care Financing Administration. The goal of a local quality improvement project is to collaborate with providers to identify and reduce the incidence of unintentional variations in the delivery of care that negatively impact outcomes. Two factors are critical to the success of a quality improvement project. First, as opposed to peer review that is based on implicit criteria, quality improvement must be based on explicit criteria. These criteria represent key steps in the delivery of care that have been shown to improve outcomes for a specific disease. Second, quality improvement must be performed in partnership with the health care community. As such, the health care community must play an integral role in the design and evaluation of a quality improvement project and in the design and implementation of the resulting quality improvement plan. Specifically, this article provides a historical perspective for the transition from peer review to quality improvement. It discusses key steps used in developing and implementing local quality improvement projects including topic selection, quality indicator development, collaborator recruitment, and measurement of performance/improvement. Two Texas Medical Foundation projects are described to highlight the current methodology and to illustrate the impact of quality improvement projects.
2014-01-01
Background New clinical research findings may require clinicians to change their behaviour to provide high-quality care to people with type 2 diabetes, likely requiring them to change multiple different clinical behaviours. The present study builds on findings from a UK-wide study of theory-based behavioural and organisational factors associated with prescribing, advising, and examining consistent with high-quality diabetes care. Aim To develop and evaluate the effectiveness and cost of an intervention to improve multiple behaviours in clinicians involved in delivering high-quality care for type 2 diabetes. Design/methods We will conduct a two-armed cluster randomised controlled trial in 44 general practices in the North East of England to evaluate a theory-based behaviour change intervention. We will target improvement in six underperformed clinical behaviours highlighted in quality standards for type 2 diabetes: prescribing for hypertension; prescribing for glycaemic control; providing physical activity advice; providing nutrition advice; providing on-going education; and ensuring that feet have been examined. The primary outcome will be the proportion of patients appropriately prescribed and examined (using anonymised computer records), and advised (using anonymous patient surveys) at 12 months. We will use behaviour change techniques targeting motivational, volitional, and impulsive factors that we have previously demonstrated to be predictive of multiple health professional behaviours involved in high-quality type 2 diabetes care. We will also investigate whether the intervention was delivered as designed (fidelity) by coding audiotaped workshops and interventionist delivery reports, and operated as hypothesised (process evaluation) by analysing responses to theory-based postal questionnaires. In addition, we will conduct post-trial qualitative interviews with practice teams to further inform the process evaluation, and a post-trial economic analysis to estimate the costs of the intervention and cost of service use. Discussion Consistent with UK Medical Research Council guidance and building on previous development research, this pragmatic cluster randomised trial will evaluate the effectiveness of a theory-based complex intervention focusing on changing multiple clinical behaviours to improve quality of diabetes care. Trial registration ISRCTN66498413. PMID:24886606
Flabouris, Arthas; Nocera, Antony; Garner, Alan
2004-01-01
Multiple casualty incidents (MCI) are infrequent events for medical systems. This renders audit and quality improvement of the medical responses difficult. Quality tools and use of such tools for improvement is necessary to ensure that the design of medical systems facilitates the best possible response to MCI. To describe the utility of incident reporting as a quality monitoring and improvement tool during the deployment of medical teams for mass gatherings and multiple casualty incidents. Voluntary and confidential reporting of incidents was provided by members of the disaster medical response teams during the period of disaster medical team deployment for the 2000 Sydney Olympic Games. Qualitative evaluations were conducted of reported incidents. The main outcome measures included the nature of incident and associated contributing factors, minimization factors, harm potential, and comparison with the post-deployment, cold debriefings. A total of 53 incidents were reported. Management-based decisions, poor or non-existent protocols, and equipment and communication-related issues were the principal contributing factors. Eighty nine percent of the incidents were considered preventable. A potential for harm to patients and/or team members was documented in 58% of reports, of which 76% were likely to cause at least significant harm. Of equipment incidents, personal protective equipment (33%), medical equipment (27%), provision of equipment (22%), and communication equipment (17%) predominated. Personal protective equipment (50%) was reported as the most frequent occupational health and safety incident followed by fatigue (25%). Pre-deployment planning was the most important factor for future incident impact minimization. Incident monitoring was efficacious as a quality tool in identifying incident contributing factors. Incident monitoring allowed for greater systems evaluation. Further evaluation of this quality tool within different disaster settings is required.
Meyer, Eric C; Frankfurt, Sheila B; Kimbrel, Nathan A; DeBeer, Bryann B; Gulliver, Suzy B; Morrisette, Sandra B
2018-07-01
Posttraumatic stress disorder (PTSD) strongly predicts greater disability and lower quality of life (QOL). Mindfulness-based and other third-wave behavior therapy interventions improve well-being by enhancing mindfulness, self-compassion, and psychological flexibility. We hypothesized that these mechanisms of therapeutic change would comprise a single latent factor that would predict disability and QOL after accounting for PTSD symptom severity. Iraq and Afghanistan war veterans (N = 117) completed a study of predictors of successful reintegration. Principal axis factor analysis tested whether mindfulness, self-compassion, and psychological flexibility comprised a single latent factor. Hierarchical regression tested whether this factor predicted disability and QOL 1 year later. Mindfulness, self-compassion, and psychological flexibility comprised a single factor that predicted disability and QOL after accounting for PTSD symptom severity. PTSD symptoms remained a significant predictor of disability but not QOL. Targeting these mechanisms may help veterans achieve functional recovery, even in the presence of PTSD symptoms. © 2018 Wiley Periodicals, Inc.
Glurich, Ingrid; Nycz, Gregory; Acharya, Amit
2017-06-01
Escalating prevalence of both diabetes and periodontal disease, two diseases associated with bi-directional exacerbation, has been reported. Periodontal disease represents a modifiable risk factor that may reduce diabetes onset or progression, and integrated models of cross-disciplinary care are needed to establish and manage glycemic control in affected patients. An ad-hoc environmental scan of current literature and media sought to characterize factors impacting status of integrated care models based on review of the existing evidence base in literature and media surrounding: (1) current cross-disciplinary practice patterns, (2) epidemiological updates, (3) status on risk assessment and screening for dysglycemia in the dental setting, (4) status on implementation of quality metrics for oral health, (5) care model pilots, and (6) public health perspectives. The survey revealed: escalating prevalence of diabetes and periodontitis globally; greater emphasis on oral health assessment for diabetic patients in recent medical clinical practice guidelines; high knowledgeability surrounding oral-systemic impacts on diabetes and growing receptivity to medical-dental integration among medical and dental providers; increasing numbers of programs/studies reporting on positive impact of emerging integrated dental-medical care models on diabetic patient healthcare access and health outcomes; a growing evidence base for clinically significant rates of undiagnosed dysglycemia among dental patients reported by point-of-care pilot studies; no current recommendation for population-based screening for dysglycemia in dental settings pending a stronger evidence base; improved definition of true periodontitis prevalence in (pre)/diabetics; emerging recognition of the need for oral health quality indicators and tracking; evidence of persistence in dental access disparity; updated status on barriers to integration. The potential benefit of creating clinically-applicable integrated care models to support holistic management of an escalating diabetic population by targeting modifiable risk factors including periodontitis is being recognized by the health industry. Cross-disciplinary efforts supported by high quality research are needed to mitigate previously- and newly-defined barriers of care integration and expedite development and implementation of integrated care models in various practice settings. Implementation of quality monitoring in the dental setting will support definition of the impact and efficacy of interventional clinical care models on patient outcomes. © 2017 Marshfield Clinic.
Formaldehyde substitute fixatives: effects on nucleic acid preservation.
Moelans, Cathy B; Oostenrijk, Daphne; Moons, Michiel J; van Diest, Paul J
2011-11-01
In surgical pathology, formalin-fixed paraffin-embedded tissues are increasingly being used as a source of DNA and RNA for molecular assays in addition to histopathological evaluation. However, the commonly used formalin fixative is carcinogenic, and its crosslinking impairs DNA and RNA quality. The suitability of three new presumably less toxic, crosslinking (F-Solv) and non-crosslinking (FineFIX, RCL2) alcohol-based fixatives was tested for routine molecular pathology in comparison with neutral buffered formalin (NBF) as gold standard. Size ladder PCR, epidermal growth factor receptor sequence analysis, microsatellite instability (MSI), chromogenic (CISH), fluorescence in situ hybridisation (FISH) and qPCR were performed. The alcohol-based non-crosslinking fixatives (FineFIX and RCL2) resulted in a higher DNA yield and quality compared with crosslinking fixatives (NBF and F-Solv). Size ladder PCR resulted in a shorter amplicon size (300 bp) for both crosslinking fixatives compared with the non-crosslinking fixatives (400 bp). All four fixatives were directly applicable for MSI and epidermal growth factor receptor sequence analysis. All fixatives except F-Solv showed clear signals in CISH and FISH. RNA yield and quality were superior after non-crosslinking fixation. qPCR resulted in lower Ct values for RCL2 and FineFIX. The alcohol-based non-crosslinking fixatives performed better than crosslinking fixatives with regard to DNA and RNA yield, quality and applicability in molecular diagnostics. Given the higher yield, less starting material may be necessary, thereby increasing the applicability of biopsies for molecular studies.
Low quality of life and depressive symptoms are connected with an unhealthy lifestyle.
Savolainen, Jorma; Kautiainen, Hannu; Miettola, Juhani; Niskanen, Leo; Mäntyselkä, Pekka
2014-03-01
The Lapinlahti 2005 study was carried out to explore cardiovascular disease risk factors, lifestyle and quality of life in Lapinlahti residents in eastern Finland. Our aim was to study the association between lifestyle and health-related quality of life (HRQoL) in the community. The present study is based on the baseline data of the followed up (2005-2010) population-based cohort (N = 376, n of males = 184). A trained research nurse measured weight, height, waist circumference and blood pressure. Self-reported HRQoL was measured using a 15D questionnaire. A BDI-21 inventory was used to assess the presence of self-reported depressive symptoms. Lifestyle factors (nutrition, exercise, smoking and alcohol use) were examined with a structured questionnaire. Each lifestyle item was valued as -1, 0 or 1, depending on how well it corresponded to the recommendations. Based on the index the participants were divided into three lifestyle sum tertiles: I = unhealthy, II = neutral and III = healthy. The age- and sex-adjusted linear trend between the tertiles was tested. The 15D score had a positive linear relationship with the lifestyle tertiles (P = .0048 for linearity, age- and sex-adjusted). Respectively, self-reported depressive symptoms were less frequent among subjects with a healthier lifestyle (P = .038). People who are expected to strive most to change their lifestyle have the lowest quality of life and psychological welfare, which should be taken into account in both clinical work and health promotion.
Sustainability of quality improvement following removal of pay-for-performance incentives.
Benzer, Justin K; Young, Gary J; Burgess, James F; Baker, Errol; Mohr, David C; Charns, Martin P; Kaboli, Peter J
2014-01-01
Although pay-for-performance (P4P) has become a central strategy for improving quality in US healthcare, questions persist about the effectiveness of these programs. A key question is whether quality improvement that occurs as a result of P4P programs is sustainable, particularly if incentives are removed. To investigate sustainability of performance levels following removal of performance-based incentives. Observational cohort study that capitalized on a P4P program within the Veterans Health Administration (VA) that included adoption and subsequent removal of performance-based incentives for selected inpatient quality measures. The study sample comprised 128 acute care VA hospitals where performance was assessed between 2004 and 2010. VA system managers set annual performance goals in consultation with clinical leaders, and report performance scores to medical centers on a quarterly basis. These scores inform performance-based incentives for facilities and their managers. Bonuses are distributed based on the attainment of these performance goals. Seven quality of care measures for acute coronary syndrome, heart failure, and pneumonia linked to performance-based incentives. Significant improvements in performance were observed for six of seven quality of care measures following adoption of performance-based incentives and were maintained up to the removal of the incentive; subsequently, the observed performance levels were sustained. This is a quasi-experimental study without a comparison group; causal conclusions are limited. The maintenance of performance levels after removal of a performance-based incentive has implications for the implementation of Medicare's value-based purchasing initiative and other P4P programs. Additional research is needed to better understand human and system-level factors that mediate sustainability of performance-based incentives.
Sohn, Minsung; Choi, Mankyu
2017-10-01
The environment of long-term care hospitals (LTCHs) is critical to the management of the quality of their services and to patient safety, as highlighted by international studies. However, there is a lack of evidence on this topic in South Korea. This study aimed to examine the factors affecting healthcare quality in LTCHs and to explore the effectiveness of their quality management. This study used a mixed methods approach with quantitative data collected in a national survey and qualitative data from semi-structured interviews with practice-based managers. The samples included 725 nationally representative LTCHs in South Korea for the quantitative analysis and 15 administrators for the in-depth interviews. A higher installation rate of patient-safety and hygiene-related facilities and staff with longer-tenures, especially nurses, were more likely to have better healthcare quality and education for both employees and patients. The need for patient-safety- and hygiene-related facilities in LTCHs that serve older adults reflects their vulnerability to certain adverse events (e.g., infections). Consistent and skillful nursing care to improve the quality of LTCHs can be achieved by developing relevant educational programs for staff and patients, thereby strengthening the relationships between them.
Relationship factors and quality among mixed-orientation couples.
Kays, Jill L; Yarhouse, Mark A; Ripley, Jennifer S
2014-01-01
Mixed-orientation couples are defined as a heterosexual couple in which 1 partner experiences same-sex attraction and the other does not. Despite the fact that there is a sizable number of mixed-orientation couples in the U.S. adult population, few researchers have studied this population, and thus, there is limited understanding of these relationships. The authors examined the degree to which relationship commitment, partner-focused forgivingness, and marital values were associated with relationship quality, and how these variables predicted relationship quality. The total sample (N = 265) consisted of 2 independent samples-105 sexual minorities (i.e., the spouse who experiences same-sex attraction) and 160 heterosexual spouses. The data were not dyadic. Together, commitment, partner-focused forgivingness, and marital values accounted for roughly 43% of the variance in relationship quality. Relationship commitment was found to be the largest single predictor of relationship quality, followed by partner-focused forgivingness. Research and clinical implications are discussed. This study significantly adds to the current research base by quantitatively measuring various variables in these relationships, as well as expanding our understanding of relationship quality in mixed-orientation couples and factors that may play a role.
A study on the sleep quality of incoming university students.
Cheng, Shu Hui; Shih, Chi-Chen; Lee, I Hui; Hou, Yi-Wen; Chen, Kao Chin; Chen, Kow-Tong; Yang, Yen Kuang; Yang, Yi Ching
2012-05-30
This study was designed to examine the prevalence and the risk factors of poor sleep quality in 4318 incoming university students in Taiwan. The test battery comprised a self-administered structured questionnaire, including items related to personal medical history and lifestyle habits, the Measurement of Support Functions (MSF), Pittsburgh Sleep Quality Index (PSQI), Chinese Internet Addiction Scale-Revision (CIAS-R), neuroticism subscale of the Maudsley Personality Inventory (MPI), and the 12-item Chinese Health Questionnaire (CHQ-12). Of the total study population, 2360 students (54.7%) were classified into the poor sleep quality group, as defined by a PSQI score ≥6. Based on the results of multivariate logistic regression analysis, poor sleep quality was significantly associated with undergraduate students, female gender, skipping breakfast, tea drinking, a higher tendency toward internet addition, poor social support, higher neuroticism, and higher CHQ scores. Poor sleep quality is prevalent among incoming university students in Taiwan, and more work is needed on the identification of the factors influencing poor sleep, and in providing systematic education in the importance of sleep and time management skills to university students. Copyright © 2012 Elsevier Ltd. All rights reserved.
Teubner, Diana; Paulus, Martin; Veith, Michael; Klein, Roland
2015-02-01
Piscifaunal health depends upon the state and quality of the aquatic environment. Variations in physical condition of fish may therefore be attributed to changes in environmental quality. Based on time series of up to 20 years of biometric data of bream from multiple sampling sites of the German environmental specimen bank (ESB), this study assessed whether changes in biometric parameters are able to indicate long-term alterations in fish health and environmental quality. Evaluated biometric parameters of fish health comprised length and weight of individuals of a defined age class, the condition factor, lipid content and hepatosomatic index (HSI). Although there are negative trends of the HSI, the overall development of health parameters can be interpreted as positive. This seems to suggest that health parameters conclusively mirror the long-term improvement of water quality in the selected rivers. However, the applicability of the condition factor as well as lipid content as indicators for fish health remained subject to restrictions. Altogether, the results from the ESB confirmed the high value of biometric parameters for monitoring of long-term changes in state and quality of aquatic ecosystems.
The Impact of Operative Approach on Postoperative Complications Following Colectomy for Colon Caner.
Mungo, Benedetto; Papageorge, Christina M; Stem, Miloslawa; Molena, Daniela; Lidor, Anne O
2017-08-01
Colectomy is one of the most common major abdominal procedures performed in the USA. A better understanding of risk factors and the effect of operative approach on adverse postoperative outcomes may significantly improve quality of care. Adult patients with a primary diagnosis of colon cancer undergoing colectomy were selected from the National Surgical Quality Improvement Program 2013-2015 targeted colectomy database. Patients were stratified into five groups based on specific operative approach. Univariate and multivariate analyses were used to compare the five groups and identify risk factors for 30-day anastomotic leak, readmission, and mortality. In total, 25,097 patients were included in the study, with a 3.32% anastomotic leak rate, 1.20% mortality rate, and 9.57% readmission rate. After adjusting for other factors, open surgery and conversion to open significantly increased the odds for leak, mortality, and readmission compared to laparoscopy. Additionally, smoking and chemotherapy increased the risk for leak and readmission, while total resection was associated with increased mortality and leak. Operative approach and several other potentially modifiable perioperative factors have a significant impact on risk for adverse postoperative outcomes following colectomy. To improve quality of care for these patients, efforts should be made to identify and minimize the influence of such risk factors.
Bio-implantable passive on-chip RF-MEMS strain sensing resonators for orthopaedic applications
NASA Astrophysics Data System (ADS)
Melik, Rohat; Kosku Perkgoz, Nihan; Unal, Emre; Puttlitz, Christian; Demir, Hilmi Volkan
2008-11-01
One out of ten bone fractures does not heal properly due to improper load distribution and strain profiles during the healing process. To provide implantable tools for the assessment of bone fractures, we have designed novel, bio-implantable, passive, on-chip, RF-MEMS strain sensors that rely on the resonance frequency shift with mechanical deformation. For this purpose, we modeled, fabricated and experimentally characterized two on-chip sensors with high quality factors for in vivo implantation. One of the sensors has an area of ~0.12 mm2 with a quality factor of ~60 and the other has an area of ~0.07 mm2 with a quality factor of ~70. To monitor the mechanical deformation by measuring the change in the resonance frequencies with the applied load, we employed a controllable, point load applying experimental setup designed and constructed for in vitro characterization. In the case of the sensor with the larger area, when we apply a load of 3920 N, we obtain a frequency shift of ~330 MHz and a quality factor of ~76. For the smaller sensor, the frequency shift and the quality factor are increased to 360 MHz and 95, respectively. These data demonstrate that our sensor chips have the capacity to withstand relatively high physiologic loads, and that the concomitant and very large resonant frequency shift with the applied load is achieved while maintaining a high signal quality factor. These experiments demonstrate that these novel sensors have the capacity for producing high sensitivity strain readout, even when the total device area is considerably small. Also, we have demonstrated that our bio-implantable, passive sensors deliver a telemetric, real-time readout of the strain on a chip. Placing two more resonators on the sides of the sensor to serve as transmitter and receiver antennas, we achieved to transfer contactless power and read out loads in the absence of direct wiring to the sensor. With this model, where telemetric measurements become simpler due to the fact that all sensor system is built on the same chip, we obtain a frequency shift of ~190 MHz with an increase in the quality factor from ~38 to ~46 when a load of 3920 N is applied. Therefore, as a first proof of concept, we have demonstrated the feasibility of our on-chip strain sensors for monitoring the mechanical deformation using telemetry-based systems.
Disentangling natural and anthropogenic influences on Patagonian pond water quality.
Epele, Luis B; Manzo, Luz M; Grech, Marta G; Macchi, Pablo; Claverie, Alfredo Ñ; Lagomarsino, Leonardo; Miserendino, M Laura
2018-02-01
The water quality of wetlands is governed not only by natural variability in hydrology and other factors, but also by anthropogenic activities. Patagonia is a vast sparsely-populated in which ponds are a key component of rural and urban landscapes because they provide several ecosystem services such as habitat for wildlife and watering for livestock. Integrating field-based and geospatial data of 109 ponds sampled across the region, we identified spatial trends and assessed the effects of anthropogenic and natural factors in pond water quality. The studied ponds were generally shallow, well oxygenated, with maximum nutrient values reported in sites used for livestock breeding. TN:TP ratio values were lower than 14 in >90% of the ponds, indicating nitrogen limitation. Water conductivity decreased from de east to the west, meanwhile pH and dissolved oxygen varied associated with the latitude. To assess Patagonian ponds water status we recommend the measure of total suspended solids and total nitrogen in the water, and evaluate the mallín (wetland vegetation) coverage in a 100m radius from the pond, since those features were significantly influenced by livestock land use. To evaluate the relative importance of natural variability and anthropogenic influences as driving factors of water quality we performed three generalized linear models (GLM) that encompassed the hydrology, hydroperiod and biome (to represent natural influences), and land use (to represent anthropogenic influences) as fixed effects. Our results revealed that at the Patagonian scale, ponds water quality would be strongly dependent on natural gradients. We synthetized spatial patterns of Patagonian pond water quality, and disentangled natural and anthropic factors finding that the dominant environmental influence is rainfall gradient. Copyright © 2017 Elsevier B.V. All rights reserved.
Quality Teaching in Science: an Emergent Conceptual Framework
NASA Astrophysics Data System (ADS)
Jordens, J. Zoe; Zepke, Nick
2017-09-01
Achieving quality in higher education is a complex task involving the interrelationship of many factors. The influence of the teacher is well established and has led to some general principles of good teaching. However, less is known about the extent that specific disciplines influence quality teaching. The purposes of the paper are to investigate how quality teaching is perceived in the sciences and from these perceptions to develop for discussion a framework for teaching practice in the sciences. A New Zealand study explored the views of national teaching excellence award winners in science on quality teaching in undergraduate science. To capture all possible views from this expert panel, a dissensus-recognising Delphi method was used together with sensitising concepts based on complexity and wickedity. The emergent conceptual framework for quality teaching in undergraduate science highlighted areas of consensus and areas where there were a variety of views. About the purposes of science and its knowledge base, there was relative consensus, but there was more variable support for values underpinning science teaching. This highlighted the complex nature of quality teaching in science. The findings suggest that, in addition to general and discipline-specific influences, individual teacher values contribute to an understanding of quality in undergraduate science teaching.
Indoor air quality analysis based on Hadoop
NASA Astrophysics Data System (ADS)
Tuo, Wang; Yunhua, Sun; Song, Tian; Liang, Yu; Weihong, Cui
2014-03-01
The air of the office environment is our research object. The data of temperature, humidity, concentrations of carbon dioxide, carbon monoxide and ammonia are collected peer one to eight seconds by the sensor monitoring system. And all the data are stored in the Hbase database of Hadoop platform. With the help of HBase feature of column-oriented store and versioned (automatically add the time column), the time-series data sets are bulit based on the primary key Row-key and timestamp. The parallel computing programming model MapReduce is used to process millions of data collected by sensors. By analysing the changing trend of parameters' value at different time of the same day and at the same time of various dates, the impact of human factor and other factors on the room microenvironment is achieved according to the liquidity of the office staff. Moreover, the effective way to improve indoor air quality is proposed in the end of this paper.
Owlia, P; Vasei, M; Goliaei, B; Nassiri, I
2011-04-01
The interests in journal impact factor (JIF) in scientific communities have grown over the last decades. The JIFs are used to evaluate journals quality and the papers published therein. JIF is a discipline specific measure and the comparison between the JIF dedicated to different disciplines is inadequate, unless a normalization process is performed. In this study, normalized impact factor (NIF) was introduced as a relatively simple method enabling the JIFs to be used when evaluating the quality of journals and research works in different disciplines. The NIF index was established based on the multiplication of JIF by a constant factor. The constants were calculated for all 54 disciplines of biomedical field during 2005, 2006, 2007, 2008 and 2009 years. Also, ranking of 393 journals in different biomedical disciplines according to the NIF and JIF were compared to illustrate how the NIF index can be used for the evaluation of publications in different disciplines. The findings prove that the use of the NIF enhances the equality in assessing the quality of research works produced by researchers who work in different disciplines. Copyright © 2010 Elsevier Inc. All rights reserved.
Martin, P; Caci, H; Azorin, J M; Daléry, J; Hardy-Baylé, M C; Etienne, D; Gérard, D; Peretti, C S
2005-01-01
RATIONALE/OBJECTIVE: Quality of Life (QOL) has been recognized as an important measure of the outcome of patients by clinicians and policy makers in Mental Health. The emerging consensus in the health field that personal values and the patient's preferences are important in monitoring the quality of medical care outcomes makes it even more important to assess the patient's perspectives. Unfortunately, there is little consensus about what constitutes QOL or how to measure it, particularly in psychotic patients. The objective of this study is to report the stages of development and validation of a QOL questionnaire based on issues pertinent to patients with schizophrenia. During a first phase, identical pattern were identified among interviews (conducted by psychologists) of schizophrenic patients (DSM IV, n = 100), mental health staff (n = 20) and families (n = 20). The data gathered in the first phase were discussed and organized, by 25 experts, into a structure that made up the skeleton of the scale (133 items, 17 factors). Based on a prospective epidemiological study conducted with 337 French psychiatrists, a validation analysis of structural and psychometric proprieties was performed. Finally reliability of the scale was assessed by a second test/retest (D0, D7) study (n = 100). A total of 686 schizophrenic, schizophreniform or schizoaffective patients (DSM IV) were included. Internal consistency analysis identified 14 factors (74 items), all with a Cronbach's alpha of at least 0.75: professional life (0.95), affective and sexual life (0.92), illness knowledge (0.90), relationship (0.92), life satisfaction, (0.87), coping with drugs (0.79), drugs impact on the body (0.87), daily life (0.83), family relationship (0.81), future (0.88), security feeling (0.84), leisure (0.87), money management (0.76) and autonomy (0.75). Construct validity was confirmed (Pearson test) using established clinical (Brief Psychiatry Rating Scale and Clinical Global Improvement), social (Psychological Aptitude Rating Scale) and generic quality of life (Functional Status questionnaire) measures, correlation coefficient was significant for all factors but 2 in the BPRS (illness knowledge and coping with drugs) and 3 in the CGI (illness knowledge, coping with drugs and life satisfaction). Lastly, test/retest indicated high reliability for each factor (p < 0.001), the lower correlation coefficient (r) was 0.526. The Schizophrenia Quality Of Life-scale (SOL), based on a patient's point of view approach, is an efficient, multidimensional instrument designed for the measurement of the consequences of schizophrenia on individuals' lives.
Implementation of Quality by Design for Formulation of Rebamipide Gastro-retentive Tablet.
Ha, Jung-Myung; Seo, Jeong-Woong; Kim, Su-Hyeon; Kim, Ju-Young; Park, Chun-Woong; Rhee, Yun-Seok; Park, Eun-Seok
2017-11-01
The purpose of the present study was to develop a rebamipide (RBM) gastro-retentive (GR) tablet by implementing quality by design (QbD). RBM GR tablets were prepared using a sublimation method. Quality target product profile (QTPP) and critical quality attributes (CQAs) of the RBM GR tablets were defined according to the preliminary studies. Factors affecting the CQAs were prioritized using failure mode and effects analysis (FMEA). Design space and optimum formulation were established through a mixture design. The validity of the design space was confirmed using runs within the area. The QTPP of the RBM GR tablets was the orally administered GR tablet containing 300 mg of RBM taken once daily. Based on the QTPP, dissolution rate, tablet friability, and floating property were chosen as CQAs. According to the risk assessment, the amount of sustained-release agent, sublimating material, and diluent showed high-risk priority number (RPN) values above 40. Based on the RPN, these factors were further investigated using mixture design methodology. Design space of formulations was depicted as an overlaid contour plot and the optimum formulation to satisfy the desired responses was obtained by determining the expected value of each response. The similarity factor (f2) of the release profile between predicted response and experimental response was 89.463, suggesting that two release profiles are similar. The validity of the design space was also confirmed. Consequently, we were able to develop the RBM GR tablets by implementing the QbD concept. These results provide useful information for development of tablet formulations using the QbD.
Innovative and Successful Approaches to Improving Care Transitions From Hospital to Home
Labson, Margherita C.
2015-01-01
Abstract Effective transitions to home care have been identified as among the factors leading to reducing hospital readmissions within 30 days of discharge and improvements on various other quality measures. Innovative applications of published evidence-based models and best practices designed to improve care transitions have been implemented in various settings across the country in an effort to enhance quality performance. For this article, The Joint Commission collected a series of case examples to examine how evidence-based innovations in care transitions are reducing readmissions and improving other quality outcomes. The organizations providing the case examples were interviewed and asked to provide performance data demonstrating quality improvement, as well as information about their care processes and data-gathering techniques. Their innovative approaches are reducing hospital readmissions; improving patient safety, satisfaction, and engagement; and contributing to other positive outcomes. PMID:25654457
How product trial changes quality perception of four new processed beef products.
Saeed, Faiza; Grunert, Klaus G; Therkildsen, Margrethe
2013-01-01
The purpose of this paper is the quantitative analysis of the change in quality perception of four new processed beef products from pre to post trial phases. Based on the Total Food Quality Model, differences in pre and post-trial phases were measured using repeated measures technique for cue evaluation, quality evaluation and purchase motive fulfillment. For two of the tested products, trial resulted in a decline of the evaluation of cues, quality and purchase motive fulfillment compared to pre-trial expectations. For these products, positive expectations were created by giving information about ingredients and ways of processing, which were not confirmed during trial. For the other two products, evaluations on key sensory dimensions based on trial exceeded expectations, whereas the other evaluations remained unchanged. Several demographic factors influenced the pattern of results, notably age and gender, which may be due to underlying differences in previous experience. The study gives useful insights for testing of new processed meat products before market introduction. Copyright © 2012 Elsevier Ltd. All rights reserved.
The advantages of absorbed-dose calibration factors.
Rogers, D W
1992-01-01
A formalism for clinical external beam dosimetry based on use of ion chamber absorbed-dose calibration factors is outlined in the context and notation of the AAPM TG-21 protocol. It is shown that basing clinical dosimetry on absorbed-dose calibration factors ND leads to considerable simplification and reduced uncertainty in dose measurement. In keeping with a protocol which is used in Germany, a quantity kQ is defined which relates an absorbed-dose calibration factor in a beam of quality Q0 to that in a beam of quality Q. For 38 cylindrical ion chambers, two sets of values are presented for ND/NX and Ngas/ND and for kQ for photon beams with beam quality specified by the TPR20(10) ratio. One set is based on TG-21's protocol to allow the new formalism to be used while maintaining equivalence to the TG-21 protocol. To demonstrate the magnitude of the overall error in the TG-21 protocol, the other set uses corrected versions of the TG-21 equations and the more consistent physical data of the IAEA Code of Practice. Comparisons are made to procedures based on air-kerma or exposure calibration factors and it is shown that accuracy and simplicity are gained by avoiding the determination of Ngas from NX. It is also shown that the kQ approach simplifies the use of plastic phantoms in photon beams since kQ values change by less than 0.6% compared to those in water although an overall correction factor of 0.973 is needed to go from absorbed dose in water calibration factors to those in PMMA or polystyrene. Values of kQ calculated using the IAEA Code of Practice are presented but are shown to be anomalous because of the way the effective point of measurement changes for 60Co beams. In photon beams the major difference between the IAEA Code of Practice and the corrected AAPM TG-21 protocol is shown to be the Prepl correction factor. Calculated kQ curves and three parameter equations for them are presented for each wall material and are shown to represent accurately the kQ curve for all ion chambers in this study with a wall of that specified material and a thickness less than 0.25 g/cm2. Values of kQ can be measured using the primary standards for absorbed dose in photon beams.
Dwivedi, Dipankar; Mohanty, Binayak P.; Lesikar, Bruce J.
2013-01-01
Microbes have been identified as a major contaminant of water resources. Escherichia coli (E. coli) is a commonly used indicator organism. It is well recognized that the fate of E. coli in surface water systems is governed by multiple physical, chemical, and biological factors. The aim of this work is to provide insight into the physical, chemical, and biological factors along with their interactions that are critical in the estimation of E. coli loads in surface streams. There are various models to predict E. coli loads in streams, but they tend to be system or site specific or overly complex without enhancing our understanding of these factors. Hence, based on available data, a Bayesian Neural Network (BNN) is presented for estimating E. coli loads based on physical, chemical, and biological factors in streams. The BNN has the dual advantage of overcoming the absence of quality data (with regards to consistency in data) and determination of mechanistic model parameters by employing a probabilistic framework. This study evaluates whether the BNN model can be an effective alternative tool to mechanistic models for E. coli loads estimation in streams. For this purpose, a comparison with a traditional model (LOADEST, USGS) is conducted. The models are compared for estimated E. coli loads based on available water quality data in Plum Creek, Texas. All the model efficiency measures suggest that overall E. coli loads estimations by the BNN model are better than the E. coli loads estimations by the LOADEST model on all the three occasions (three-fold cross validation). Thirteen factors were used for estimating E. coli loads with the exhaustive feature selection technique, which indicated that six of thirteen factors are important for estimating E. coli loads. Physical factors included temperature and dissolved oxygen; chemical factors include phosphate and ammonia; biological factors include suspended solids and chlorophyll. The results highlight that the LOADEST model estimates E. coli loads better in the smaller ranges, whereas the BNN model estimates E. coli loads better in the higher ranges. Hence, the BNN model can be used to design targeted monitoring programs and implement regulatory standards through TMDL programs. PMID:24511166
Comparison of fluence-to-dose conversion coefficients for deuterons, tritons and helions.
Copeland, Kyle; Friedberg, Wallace; Sato, Tatsuhiko; Niita, Koji
2012-02-01
Secondary radiation in aircraft and spacecraft includes deuterons, tritons and helions. Two sets of fluence-to-effective dose conversion coefficients for isotropic exposure to these particles were compared: one used the particle and heavy ion transport code system (PHITS) radiation transport code coupled with the International Commission on Radiological Protection (ICRP) reference phantoms (PHITS-ICRP) and the other the Monte Carlo N-Particle eXtended (MCNPX) radiation transport code coupled with modified BodyBuilder™ phantoms (MCNPX-BB). Also, two sets of fluence-to-effective dose equivalent conversion coefficients calculated using the PHITS-ICRP combination were compared: one used quality factors based on linear energy transfer; the other used quality factors based on lineal energy (y). Finally, PHITS-ICRP effective dose coefficients were compared with PHITS-ICRP effective dose equivalent coefficients. The PHITS-ICRP and MCNPX-BB effective dose coefficients were similar, except at high energies, where MCNPX-BB coefficients were higher. For helions, at most energies effective dose coefficients were much greater than effective dose equivalent coefficients. For deuterons and tritons, coefficients were similar when their radiation weighting factor was set to 2.
Sauwen, Nicolas; Acou, Marjan; Bharath, Halandur N; Sima, Diana M; Veraart, Jelle; Maes, Frederik; Himmelreich, Uwe; Achten, Eric; Van Huffel, Sabine
2017-01-01
Non-negative matrix factorization (NMF) has become a widely used tool for additive parts-based analysis in a wide range of applications. As NMF is a non-convex problem, the quality of the solution will depend on the initialization of the factor matrices. In this study, the successive projection algorithm (SPA) is proposed as an initialization method for NMF. SPA builds on convex geometry and allocates endmembers based on successive orthogonal subspace projections of the input data. SPA is a fast and reproducible method, and it aligns well with the assumptions made in near-separable NMF analyses. SPA was applied to multi-parametric magnetic resonance imaging (MRI) datasets for brain tumor segmentation using different NMF algorithms. Comparison with common initialization methods shows that SPA achieves similar segmentation quality and it is competitive in terms of convergence rate. Whereas SPA was previously applied as a direct endmember extraction tool, we have shown improved segmentation results when using SPA as an initialization method, as it allows further enhancement of the sources during the NMF iterative procedure.
Skyttberg, Niclas; Vicente, Joana; Chen, Rong; Blomqvist, Hans; Koch, Sabine
2016-06-04
Vital sign data are important for clinical decision making in emergency care. Clinical Decision Support Systems (CDSS) have been advocated to increase patient safety and quality of care. However, the efficiency of CDSS depends on the quality of the underlying vital sign data. Therefore, possible factors affecting vital sign data quality need to be understood. This study aims to explore the factors affecting vital sign data quality in Swedish emergency departments and to determine in how far clinicians perceive vital sign data to be fit for use in clinical decision support systems. A further aim of the study is to provide recommendations on how to improve vital sign data quality in emergency departments. Semi-structured interviews were conducted with sixteen physicians and nurses from nine hospitals and vital sign documentation templates were collected and analysed. Follow-up interviews and process observations were done at three of the hospitals to verify the results. Content analysis with constant comparison of the data was used to analyse and categorize the collected data. Factors related to care process and information technology were perceived to affect vital sign data quality. Despite electronic health records (EHRs) being available in all hospitals, these were not always used for vital sign documentation. Only four out of nine sites had a completely digitalized vital sign documentation flow and paper-based triage records were perceived to provide a better mobile workflow support than EHRs. Observed documentation practices resulted in low currency, completeness, and interoperability of the vital signs. To improve vital sign data quality, we propose to standardize the care process, improve the digital documentation support, provide workflow support, ensure interoperability and perform quality control. Vital sign data quality in Swedish emergency departments is currently not fit for use by CDSS. To address both technical and organisational challenges, we propose five steps for vital sign data quality improvement to be implemented in emergency care settings.
Alkerwi, Ala'a; Vernier, Cédric; Crichton, Georgina E; Sauvageot, Nicolas; Shivappa, Nitin; Hébert, James R
2015-01-28
The scientific community has become increasingly interested in the overall quality of diets rather than in single food-based or single nutrient-based approaches to examine diet-disease relationships. Despite the plethora of indices used to measure diet quality, there still exist questions as to which of these can best predict health outcomes. The present study aimed to compare the ability of five diet quality indices, namely the Recommendation Compliance Index (RCI), Diet Quality Index-International (DQI-I), Dietary Approaches to Stop Hypertension (DASH), Mediterranean Diet Score (MDS), and Dietary Inflammatory Index (DII), to detect changes in chronic disease risk biomarkers. Nutritional data from 1352 participants, aged 18-69 years, of the Luxembourg nationwide cross-sectional ORISCAV-LUX (Observation of Cardiovascular Risk Factors in Luxembourg) study, 2007-8, were used to calculate adherence to the diet quality index. General linear modelling was performed to assess trends in biomarkers according to adherence to different dietary patterns, after adjustment for age, sex, education level, smoking status, physical activity and energy intake. Among the five selected diet quality indices, the MDS exhibited the best ability to detect changes in numerous risk markers and was significantly associated with lower levels of LDL-cholesterol, apo B, diastolic blood pressure, renal function indicators (creatinine and uric acid) and liver enzymes (serum γ-glutamyl-transpeptidase and glutamate-pyruvate transaminase). Compared with other dietary patterns, higher adherence to the Mediterranean diet is associated with a favourable cardiometabolic, hepatic and renal risk profile. Diets congruent with current universally accepted guidelines may be insufficient to prevent chronic diseases. Clinicians and public health decision makers should be aware of needs to improve the current dietary guidelines.
Rusch, Heather L.; Guardado, Pedro; Baxter, Tristin; Mysliwiec, Vincent; Gill, Jessica M.
2015-01-01
Study Objectives: One-third of deployed military personnel will be diagnosed with insomnia, placing them at high risk for comorbid depression, posttraumatic stress disorder (PTSD), and medical conditions. The disruption of trophic factors has been implicated in these comorbid conditions, which can impede postdeployment recovery. This study determined if improved sleep quality is associated with (1) reductions in depression and posttraumatic symptoms, as well as enrichments in health-related quality of life (HRQOL), and (2) changes in plasma concentrations of brain derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1). Methods: Forty-four military personnel diagnosed with insomnia underwent clinical evaluations and blood draws at pretreatment and at posttreatment following cognitive behavioral therapy for insomnia and automatic positive airway pressure treatment. Participants were classified as sleep improved (n = 28) or sleep declined (n = 16) based on their change in pretreatment to posttreatment Pittsburgh Sleep Quality Index (PSQI) score. Both groups were compared on outcomes of depression, PTSD, HRQOL, BDNF, and IGF-1. Results: Paired t-tests of the sleep improved group revealed significant declines in depression (p = 0.005) and posttraumatic arousal (p = 0.006) symptoms, and a significant increase in concentrations of IGF-1 (p = 0.009). The sleep declined group had no relevant change in psychiatric symptoms or trophic factors, and had further declines on five of eight dimensions of HRQOL. Between-group change score differences were significant at p < 0.05. Conclusions: These findings suggest that interventions, which successfully improve sleep quality, are an effective means to reduce the depression and posttraumatic arousal symptoms common to military personnel, as well as increase protective trophic factors implicated in these conditions. Citation: Rusch HL, Guardado P, Baxter T, Mysliwiec V, Gill JM. Improved sleep quality is associated with reductions in depression and PTSD arousal symptoms and increases in IGF-1 concentrations. J Clin Sleep Med 2015;11(6):615–623. PMID:25766717
Wang, Huifen; Livingston, Kara A.; Fox, Caroline S.; Meigs, James B.; Jacques, Paul F.
2013-01-01
The evidence-based Dietary Guidelines for Americans recommends increasing the intake of fat-free or low-fat milk and milk products. However, yogurt, a nutrient-dense milk product, has been understudied. This cross-sectional study examined whether yogurt consumption was associated with better diet quality and metabolic profile among adults (n = 6526) participating in the Framingham Heart Study Offspring (1998-2001) and Third Generation (2002-2005) cohorts. A validated food frequency questionnaire was used to assess dietary intake, and the Dietary Guidelines Adherence Index (DGAI) was used to measure overall diet quality. Standardized clinical examinations and laboratory tests were conducted. Generalized estimating equations examined the associations of yogurt consumption with diet quality and levels of metabolic factors. Approximately 64% of women (vs 41% of men) were yogurt consumers (ie, consumed >0 servings/week). Yogurt consumers had a higher DGAI score (ie, better diet quality) than nonconsumers. Adjusted for demographic and lifestyle factors and DGAI, yogurt consumers, compared with nonconsumers, had higher potassium intakes (difference, 0.12 g/d) and were 47%, 55%, 48%, 38%, and 34% less likely to have inadequate intakes (based on Dietary Reference Intake) of vitamins B2 and B12, calcium, magnesium, and zinc, respectively (all P ≤ .001). In addition, yogurt consumption was associated with lower levels of circulating triglycerides, glucose, and lower systolic blood pressure and insulin resistance (all P < .05). Yogurt is a good source of several micronutrients and may help to improve diet quality and maintain metabolic well-being as part of a healthy, energy-balanced dietary pattern. PMID:23351406
Abernethy, Amy P; Wheeler, Jane L; Bull, Janet
2011-05-01
Few hospice and palliative care organizations use health information technology (HIT) for data collection and management; the feasibility and utility of a HIT-based approach in this multi-faceted, interdisciplinary context is unclear. To develop a HIT-based data infrastructure that serves multiple hospice and palliative care sites, meeting clinical and administrative needs with data, technical, and analytic support. Through a multi-site academic/community partnership, a data infrastructure was collaboratively developed, pilot-tested at a community-based site, refined, and demonstrated for data collection and preliminary analysis. Additional sites, which participated in system development, became prepared to contribute data to the growing aggregate database. Electronic data collection proved feasible in community-based hospice and palliative care. The project highlighted "success factors" for implementing HIT in this field: engagement of site-based project "champions" to promote the system from within; involvement of stakeholders at all levels of the organization, to promote culture change and buy-in; attention to local needs (e.g., data for quality reporting) and requirements (e.g., affordable cost, efficiency); consideration of practical factors (e.g., potential to interfere with clinical flow); provision of adequate software, technical, analytic, and statistical support; availability of flexible HIT options (e.g., different data-collection platforms); and adoption of a consortium approach in which sites can support one another, learn from each others' experiences, pool data, and benefit from economies of scale. In hospice and palliative care, HIT-based data collection/management has potential to generate better understanding of populations and outcomes, support quality assessment/quality improvement, and prepare sites to participate in research. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
A research review of quality assessment for software
NASA Technical Reports Server (NTRS)
1991-01-01
Measures were recommended to assess the quality of software submitted to the AdaNet program. The quality factors that are important to software reuse are explored and methods of evaluating those factors are discussed. Quality factors important to software reuse are: correctness, reliability, verifiability, understandability, modifiability, and certifiability. Certifiability is included because the documentation of many factors about a software component such as its efficiency, portability, and development history, constitute a class for factors important to some users, not important at all to other, and impossible for AdaNet to distinguish between a priori. The quality factors may be assessed in different ways. There are a few quantitative measures which have been shown to indicate software quality. However, it is believed that there exists many factors that indicate quality and have not been empirically validated due to their subjective nature. These subjective factors are characterized by the way in which they support the software engineering principles of abstraction, information hiding, modularity, localization, confirmability, uniformity, and completeness.
Postacute rehabilitation quality of care: toward a shared conceptual framework.
Jesus, Tiago Silva; Hoenig, Helen
2015-05-01
There is substantial interest in mechanisms for measuring, reporting, and improving the quality of health care, including postacute care (PAC) and rehabilitation. Unfortunately, current activities generally are either too narrow or too poorly specified to reflect PAC rehabilitation quality of care. In part, this is caused by a lack of a shared conceptual understanding of what construes quality of care in PAC rehabilitation. This article presents the PAC-rehab quality framework: an evidence-based conceptual framework articulating elements specifically pertaining to PAC rehabilitation quality of care. The widely recognized Donabedian structure, process, and outcomes (SPO) model furnished the underlying structure for the PAC-rehab quality framework, and the International Classification of Functioning, Disability and Health (ICF) framed the functional outcomes. A comprehensive literature review provided the evidence base to specify elements within the SPO model and ICF-derived framework. A set of macrolevel-outcomes (functional performance, quality of life of patient and caregivers, consumers' experience, place of discharge, health care utilization) were defined for PAC rehabilitation and then related to their (1) immediate and intermediate outcomes, (2) underpinning care processes, (3) supportive team functioning and improvement processes, and (4) underlying care structures. The role of environmental factors and centrality of patients in the framework are explicated as well. Finally, we discuss why outcomes may best measure and reflect the quality of PAC rehabilitation. The PAC-rehab quality framework provides a conceptually sound, evidence-based framework appropriate for quality of care activities across the PAC rehabilitation continuum. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Nutrition and physical activity for the prevention and treatment of age-related sarcopenia.
Bosaeus, Ingvar; Rothenberg, Elisabet
2016-05-01
Sarcopenia, defined as loss of skeletal muscle mass and function, is associated with adverse outcomes such as physical disability, impaired quality of life and increased mortality. Several mechanisms are involved in the development of sarcopenia. Potentially modifiable factors include nutrition and physical activity. Protein metabolism is central to the nutritional issues, along with other potentially modifying nutritional factors as energy balance and vitamin D status. An increasing but still incomplete knowledge base has generated recent recommendations on an increased protein intake in the elderly. Several factors beyond the total amount of protein consumed emerge as potentially important in this context. A recent summit examined three hypotheses: (1) A meal threshold; habitually consuming 25-30 g protein at breakfast, lunch and dinner provides sufficient protein to effectively stimulate muscle protein anabolism; (2) Protein quality; including high-quality protein at each meal improves postprandial muscle protein synthesis; and (3) performing physical activity in close temporal proximity to a high-quality protein meal enhances muscle anabolism. Optimising the potential for muscle protein anabolism by consuming an adequate amount of high-quality protein at each meal, in combination with physical activity, appears as a promising strategy to prevent or delay the onset of sarcopenia. However, results of interventions are inconsistent, and well-designed, standardised studies evaluating exercise or nutrition interventions are needed before guidelines can be developed for the prevention and treatment of age-related sarcopenia.
Willems, Elise; Smismans, Annick; Cartuyvels, Reinoud; Coppens, Guy; Van Vaerenbergh, Kristien; Van den Abeele, Anne-Marie; Frans, Johan
2012-05-01
Bloodstream infections remain a major challenge in medicine. Optimal detection of pathogens is only possible if the quality of preanalytical factors is thoroughly controlled. Since the laboratory is responsible for this preanalytical phase, the quality control of critical factors should be integrated in its quality control program. The numerous recommendations regarding blood culture collection contain controversies. Only an unambiguous guideline permits standardization and interlaboratory quality control. We present an evidence-based concise guideline of critical preanalytical determinants for blood culture collection and summarize key performance indicators with their concomitant target values. In an attempt to benchmark, we compared the true-positive rate, contamination rate, and collected blood volume of blood culture bottles in 5 Belgian hospital laboratories. The true-positive blood culture rate fell within previously defined acceptation criteria by Baron et al. (2005) in all 5 hospitals, whereas the contamination rate exceeded the target value in 4 locations. Most unexpected, in each of the 5 laboratories, more than one third of the blood culture bottles were incorrectly filled, irrespective of the manufacturer of the blood culture vials. As a consequence of this shortcoming, one manufacturer recently developed an automatic blood volume monitoring system. In conclusion, clear recommendations for standardized blood culture collection combined with quality control of critical factors of the preanalytical phase are essential for diagnostic blood culture improvement. Copyright © 2012 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Sondkar, Pravin B.
The severity of combined aerodynamics and power transmission response in high-speed, high power density systems such as a rotorcraft is still a major cause of annoyance in spite of recent advancement in passive, semi-active and active control. With further increase in the capacity and power of this class of machinery systems, the acoustic noise levels are expected to increase even more. To achieve further improvements in sound quality, a more refined understanding of the factors and attributes controlling human perception is needed. In the case of rotorcraft systems, the perceived quality of the interior sound field is a major determining factor of passenger comfort. Traditionally, this sound quality factor is determined by measuring the response of a chosen set of juries who are asked to compare their qualitative reactions to two or more sounds based on their subjective impressions. This type of testing is very time-consuming, costly, often inconsistent, and not useful for practical design purposes. Furthermore, there is no known universal model for sound quality. The primary aim of this research is to achieve significant improvements in quantifying the sound quality of combined aerodynamic and power transmission response in high-speed, high power density machinery systems such as a rotorcraft by applying relevant objective measures related to the spectral characteristics of the sound field. Two models have been proposed in this dissertation research. First, a classical multivariate regression analysis model based on currently known sound quality metrics as well some new metrics derived in this study is presented. Even though the analysis resulted in the best possible multivariate model as a measure of the acoustic noise quality, it lacks incorporation of human judgment mechanism. The regression model can change depending on specific application, nature of the sounds and types of juries used in the study. Also, it predicts only the averaged preference scores and does not explain why two jury members differ in their judgment. To address the above shortcoming of applying regression analysis, a new human judgment model is proposed to further improve the ability to predict the degree of subjective annoyance. The human judgment model involves extraction of subjective attributes and their values using a proposed artificial jury processor. In this approach, a set of ear transfer functions are employed to compute the characteristics of sound pressure waves as perceived subjectively by human. The resulting basilar membrane displacement data from this proposed model is then applied to analyze the attribute values. Using this proposed human judgment model, the human judgment mechanism, which is highly sophisticated, will be examined. Since the human judgment model is essentially based on jury attributes that are not expected to change significantly with application or nature of the sound field, it gives a more common basis to evaluate sound quality. This model also attempts to explain the inter-juror differences in opinion, which is critical in understanding the variability in human response.
Nguyen, Kim-Huong; Mulhern, Brendan; Kularatna, Sanjeewa; Byrnes, Joshua; Moyle, Wendy; Comans, Tracy
2017-01-25
With an ageing population, the number of people with dementia is rising. The economic impact on the health care system is considerable and new treatment methods and approaches to dementia care must be cost effective. Economic evaluation requires valid patient reported outcome measures, and this study aims to develop a dementia-specific health state classification system based on the Quality of Life for Alzheimer's disease (QOL-AD) instrument (nursing home version). This classification system will subsequently be valued to generate a preference-based measure for use in the economic evaluation of interventions for people with dementia. We assessed the dimensionality of the QOL-AD to develop a new classification system. This was done using exploratory and confirmatory factor analysis and further assessment of the structure of the measure to ensure coverage of the key areas of quality of life. Secondly, we used Rasch analysis to test the psychometric performance of the items, and select item(s) to describe each dimension. This was done on 13 items of the QOL-AD (excluding two general health items) using a sample of 284 residents living in long-term care facilities in Australia who had a diagnosis of dementia. A five dimension classification system is proposed resulting from the three factor structure (defined as 'interpersonal environment', 'physical health' and 'self-functioning') derived from the factor analysis and two factors ('memory' and 'mood') from the accompanying review. For the first three dimensions, Rasch analysis selected three questions of the QOL-AD ('living situation', 'physical health', and 'do fun things') with memory and mood questions representing their own dimensions. The resulting classification system (AD-5D) includes many of the health-related quality of life dimensions considered important to people with dementia, including mood, global function and skill in daily living. The development of the AD-5D classification system is an important step in the future application of the widely used QOL-AD in economic evaluations. Future valuation studies will enable this tool to be used to calculate quality adjusted life years to evaluate treatments and interventions for people diagnosed with mild to moderate dementia.
The Health and Functioning ICF-60: Development and Psychometric Properties
Tutelyan, V A; Chatterji, S; Baturin, A K; Pogozheva, A V; Kishko, O N; Akolzina, S E
2014-01-01
Background This paper describes the development and psychometric properties of the Health and Functioning ICF-60 (HF-ICF-60) measure, based on the World Health Organization (WHO) ‘International Classification of Functioning, Disability and Health: ICF’ (2001). The aims of the present study were to test psychometric properties of the HF-ICF-60, developed as a measure that would be responsive to change in functioning through changes in health and nutritional status, as a prospective measure to monitor health and nutritional status of populations and to explore the relationship of the HF-ICF-60 with quality of life measures such as the World Health Organization WHOQOL-BREF quality of life assessment in relation to non-communicable diseases. Methods The HF-ICF-60 measure consists of 60 items selected from the ICF by an expert panel, which included 18 items that cover Body Functions, 21 items that cover Activities and Participation, rated on five-point scales, and 21 items that cover Environmental Factors (seven items cover Individual Environmental Factors and 14 items cover Societal Environmental Factors), rated on nine-point scales. The HF-ICF-60 measure was administered to the Russian nationally representative sample within the Russian National Population Quality of Life, Health and Nutrition Survey, in 2004 (n = 9807) and 2005 (n = 9560), as part of the two waves of the Russian Longitudinal Monitoring Survey (RLMS). The statistical analyses were carried out with the use of both classical and modern psychometric methods, such as factor analysis, and based on Item Response Theory, respectively. Results The HF-ICF-60 questionnaire is a new measure derived directly from the ICF and covers the ICF components as follows: Body Functions, Activities and Participation, and Environmental Factors (Individual Environmental Factors and Societal Environmental Factors). The results from the factor analyses (both Exploratory Factor Analyses and Confirmatory Factor Analyses) show good support for the proposed structure together with an overall higher-order factor for each scale of the measure. The measure has good reliability and validity, and sensitivity to change in the health and nutritional status of respondents over time. Normative values were developed for the Russian adult population. Conclusions The HF-ICF-60 has shown good psychometric properties in the two waves of the nationally representative RLMS, which provided considerable support to using the HF-ICF-60 data as the normative health and functioning values for the Russian population. Similarly, the administration of the WHOQOL-BREF in the same two waves of the nationally representative RLMS has allowed the normative quality of life values for the Russian population to be obtained. Therefore, the objective assessment of health and functioning of the HF-ICF-60 could be mapped onto the subjective evaluation of quality of life of the WHOQOL-BREF to increase the potential usefulness of the surveys in relation to non-communicable diseases. © 2014 The Authors. Clinical Psychology & Psychotherapy. Published by John Wiley & Sons, Ltd. Key Practitioner Message The HF-ICF-60 offers a new perspective in measuring change in functioning through changes in lifestyle and diet. The HF-ICF-60 can be combined with the WHOQOL-BREF to map the objective assessment of health and functioning onto the subjective evaluation of quality of life. Combined use of the HF-ICF-60 and the WHOQOL-BREF can be especially useful for national and global monitoring and surveillance of implementation of measures to reduce risk factors of non-communicable diseases and to promote healthy lifestyles and healthy diets. PMID:24931300
ERIC Educational Resources Information Center
Mahmoud, Ali Bassam; Khalifa, Bayan
2015-01-01
Purpose: The purpose of this paper is to confirm the factorial structure of SERVPERF based on an exploration of its dimensionality among Syrian universities' students. It also aimed at assessing the perceived service quality offered at these universities. Design/methodology/approach: A cross-sectional survey was conducted targeting students at…
ERIC Educational Resources Information Center
Aalborg, Annette E.; Miller, Brenda A.; Husson, Gail; Byrnes, Hilary F.; Bauman, Karl E.; Spoth, Richard L.
2012-01-01
Objective: To examine factors that influence the effectiveness and quality of implementation of evidence-based family-focused adolescent substance use prevention programmes delivered in health care settings and to assess the effects of programme choice versus programme assignment on programme delivery. Design: Strengthening Families Program: For…
1987-01-01
profession in the quality of its judgments, there is not that much of a research base on which to base a defense ( Feyerabend , 1975; Morgan et al., 1981...Feather, N. T. 1982 Expectancy, Incentive, and Action. Hillsdale, NJ. Feyerabend , P. 1975 Against Method. London: Verso. Fischhoff, B. 1975
Implementation of Innovations in Higher Education: The Case of Competency-Based Training in Ghana
ERIC Educational Resources Information Center
Boahin, Peter; Hofman, W. H. Adriaan
2012-01-01
A notable trend in recent years has been the introduction of competency-based training (CBT) in vocational education and training systems in many countries. Several CBT training programmes in Ghana have been accredited and quality assured. This article explores the perception of both students and lecturers towards CBT and examines factors that…
Development of rational pay factors based on concrete compressive strength data
DOT National Transportation Integrated Search
2008-06-01
This research project addresses the opportunity to contain the escalating costs of concrete materials in construction projects. Both statistical process control and rational acceptance criteria show that quality improvement and cost savings can be ac...
Piloting a generic cancer consumer quality index in six European countries.
Wind, Anke; Roeling, Mark Patrick; Heerink, Jana; Sixma, Herman; Presti, Pietro; Lombardo, Claudio; van Harten, Wim
2016-09-02
Accounting for patients' perspective has become increasingly important. Based on the Consumer Quality Index method (founded on Consumer Assessment of Healthcare Providers and Systems) a questionnaire was recently developed for Dutch cancer patients. As a next step, this study aimed to adapt and pilot this questionnaire for international comparison of cancer patients experience and satisfaction with care in six European countries. The Consumer Quality Index was translated into the local language at the participating pilot sites using cross-translation. A minimum of 100 patients per site were surveyed through convenience sampling. Data from seven pilot sites in six countries was collected through an online and paper-based survey. Internal consistency was tested by calculating Cronbach's alpha and validity by means of cognitive interviews. Demographic factors were compared as possible influencing factors. A total of 698 patients from six European countries filled the questionnaire. Cronbach's alpha was good or satisfactory in 8 out of 10 categories. Patient satisfaction significantly differed between the countries. We observed no difference in patient satisfaction for age, gender, education, and tumor type, but satisfaction was significantly higher in patients with a higher level of activation. This European Cancer Consumer Quality Index(ECCQI) showed promising scores on internal consistency (reliability) and a good internal validity. The ECCQI is to our knowledge the first to measure and compare experiences and satisfaction of cancer patients on an international level, it may enable healthcare providers to improve the quality of cancer care.
NASA Astrophysics Data System (ADS)
Chen, Xuying; Liu, Xinxin; Wang, Tao; Le, Xianhao; Ma, Fangyi; Lee, Chengkuo; Xie, Jin
2018-05-01
Thermoelastic dissipation is one of the main dissipative mechanisms in piezoelectric micromachined ultrasonic transducers (pMUTs). In this paper, we firstly propose pMUTs with etching holes to decrease thermoelastic dissipation and enhance quality factor (Q). The etching holes effectively disturb heat flow, and thus reduce thermoelastic loss. Working mechanism based on the Zener’s model is interpreted. The experiment results show that the Q of pMUT with three rows of holes is increased by 139% from 2050 to 4909 compared with the traditional one. Temperature coefficient of frequency (TCF) and vibration performance are also improved. The enhanced pMUT can be widely used in measurement of Doppler shift and relative high power applications.
Historical and social aspects of halitosis.
Elias, Marina Sá; Ferriani, Maria das Graças Carvalho
2006-01-01
Buccal odors have always been a factor of concern for society. This study aims to investigate the historical and social base of halitosis, through systematized research in the database BVS (biblioteca virtual em saúde - virtual library in health) and also in books. Lack of knowledge on how to prevent halitosis allows for its occurrence, limiting quality of life. As social relationships are one of the pillars of the quality of life concept, halitosis needs to be considered a factor of negative interference. Education in health should be accomplished with a view to a dynamic balance, involving human beings' physical and psychological aspects, as well as their social interactions, so that individuals do not become jigsaw puzzles of sick parts.
Szadzińska, Justyna; Łechtańska, Joanna; Kowalski, Stefan Jan; Stasiak, Marcin
2017-01-01
The effectiveness of hybrid drying based on convective drying with application of ultrasound and microwave enhancement is the main subject of the studies. The drying kinetics, energy consumption as well as the quality aspect of green pepper is analysed. It was shown that hybrid drying methods shorten significantly the drying time, reduce the energy consumption and affect positively the quality factors. Each of the analysed aspects depend on combination of the convective-ultrasound-microwave drying programs. Besides, based on the drying model elaborated earlier by one of the authors, the effects of ultrasound on convective drying assessed by such phenomena as "heating effect", "vibration effect" and "synergistic effect" are presented. Copyright © 2016 Elsevier B.V. All rights reserved.
Resilience in family caregivers of persons with acquired brain injury.
Las Hayas, Carlota; López de Arroyabe, Elena; Calvete, Esther
2015-08-01
The authors' purpose was to develop the Questionnaire of Resilience in Caregivers of Acquired Brain Injury (QRC-ABI) and explore its psychometric properties The QRC-ABI was developed to measure the process of resilience, including resilient factors that, according to the literature, are the most relevant for caregivers. This is a cross-sectional study of Spanish primary caregivers of individuals with ABI. It included 237 caregivers (77.6% women and 21.1% men) who completed the QRC-ABI, the Posttraumatic Growth Inventory (Weiss & Berger, 2006), the World Health Organization Quality of Life-BREF (Skevington, Lotfy, O'Connell, & the WHOQOL Group, 2004) assessment, and the Positive Aspects of Caregiving (Tarlow et al., 2004) assessment. An item pool of 36 items was developed, from which 17 were finally selected based on a consensus among researchers and adequate symmetry indexes and kurtoses. Confirmatory factor analysis of the QRC-ABI confirmed a hierarchical solution in which 4 resilience dimensions were explained by a broader general resilience factor. The internal consistency of each scale was >.80. Convergent validity was supported through positive correlations of the QRC-ABI with quality of life, positive aspects of caregiving, and posttraumatic growth, and a negative correlation with perceived burden. The new QRC-ABI showed good reliability and validity. Our results are consistent with previous studies that have argued that resilient qualities are important for a healthy and positive adaptation to the challenging adversities faced by caregivers of individuals with ABI. Future interventions based on resilience should promote these factors in caregivers. (c) 2015 APA, all rights reserved).
Reducing Falls After Electroconvulsive Therapy: A Quality Improvement Project.
Brown, Allana Marie
2017-07-01
Falls after electroconvulsive therapy (ECT) in patients 60 and older have been long recognized as a major clinical care issue across many mental health care settings. The evidence base for fall prevention strategies after receiving ECT is sparse. The risk factors for falls after ECT are vast and complex in nature, especially considering existing comorbid medical conditions. The dearth of research in guiding practitioners on fall reduction interventions for this patient population illuminates a gap in mental health care quality and safety. The purpose of the current nurse-led quality improvement project was to reduce falls in patients undergoing ECT by enhancing safety measures through education and a post-ECT treatment protocol. The project did not prove to be as efficacious as anticipated as measured by fall rate outcomes. Several factors that may account for the project's findings are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 55(7), 20-29.]. Copyright 2017, SLACK Incorporated.
Islam, Abu Reza Md Towfiqul; Ahmed, Nasir; Bodrud-Doza, Md; Chu, Ronghao
2017-12-01
Drinking water is susceptible to the poor quality of contaminated water affecting the health of humans. Thus, it is an essential study to investigate factors affecting groundwater quality and its suitability for drinking uses. In this paper, the entropy theory, multivariate statistics, spatial autocorrelation index, and geostatistics are applied to characterize groundwater quality and its spatial variability in the Sylhet district of Bangladesh. A total of 91samples have been collected from wells (e.g., shallow, intermediate, and deep tube wells at 15-300-m depth) from the study area. The results show that NO 3 - , then SO 4 2- , and As are the most contributed parameters influencing the groundwater quality according to the entropy theory. The principal component analysis (PCA) and correlation coefficient also confirm the results of the entropy theory. However, Na + has the highest spatial autocorrelation and the most entropy, thus affecting the groundwater quality. Based on the entropy-weighted water quality index (EWQI) and groundwater quality index (GWQI) classifications, it is observed that 60.45 and 53.86% of water samples are classified as having an excellent to good qualities, while the remaining samples vary from medium to extremely poor quality domains for drinking purposes. Furthermore, the EWQI classification provides the more reasonable results than GWQIs due to its simplicity, accuracy, and ignoring of artificial weight. A Gaussian semivariogram model has been chosen to the best fit model, and groundwater quality indices have a weak spatial dependence, suggesting that both geogenic and anthropogenic factors play a pivotal role in spatial heterogeneity of groundwater quality oscillations.
Risk factors for injury in sport climbing and bouldering: a systematic review of the literature.
Woollings, Kaikanani Y; McKay, Carly D; Emery, Carolyn A
2015-09-01
Rock climbing is an increasingly popular sport worldwide, as a recreational activity and a competitive sport. Several disciplines including sport climbing and bouldering have developed, each employing specific movements and techniques, leading to specific injuries. To examine risk factors and prevention measures for injury in sport climbing and bouldering, and to assess the methodological quality of existing studies. 12 electronic databases and several other sources were searched systematically using predetermined inclusion and exclusion criteria. Eligible articles were peer-reviewed, based on primary research using original data; outcome measures included injury, morbidity or mortality in rock climbing, and included one or more potential risk factor or injury prevention strategy. Two independent reviewers assessed the methodology of research in each study using the Downs and Black Quality Index. The data extracted is summarised, and appraisals of the articles are presented with respect to the quality of evidence presented. 19 studies met the inclusion criteria, and introduced 35 possible risk factors or injury prevention measures in climbing. Age, increasing years of climbing experience, highest climbing grade achieved (skill level), high climbing intensity score (CIS) and participating in lead climbing are potential risk factors. Results regarding injury prevention measures remain inconclusive. This field is relatively new and, as such, the data are not as robust as for more established sports with a larger research foundation. The key need is establishing modifiable risk factors using prospective studies and high quality methodology, such that injury prevention strategies can be developed. The CIS may be a useful measure in this field of research. 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.
Nesterko, Yuriy; Braehler, Elmar; Grande, Gesine; Glaesmer, Heide
2013-06-01
There is a lack of population-based studies on health-related quality of life (HRQoL) and satisfaction with life (SWL) of immigrants compared to the native populations. Findings of previous research are inconclusive. Our study compares HRQoL and SWL in immigrants and native-born Germans, investigating immigration-related factors as suspected determinants of HRQoL and SWL in immigrants. In the German Socio-economic panel from 2006, HRQoL (measured with the SF-12v2) and SWL as well as immigration-related factors were assessed in 21,079 subjects (including 2,971 immigrants). Analyses of variance were applied as statistical tests in our study. Native-born Germans report a higher amount of SWL and of HRQoL on the physical health component compared to the immigrants. With effect sizes ranging from E² = 0.001 to 0.111, these findings are of minimal practical relevance. In immigrants, the physical health component of HRQoL is significantly associated with younger age at migration and with country of origin. As the effect sizes are extremely low, these findings have limited practical relevance. There are small differences in SWL and HRQoL of immigrants and native-born Germans. Some immigration-related factors are related to HRQoL, but not to SWL. As immigrants are a quite heterogeneous group, it seems useful to focus on immigration-related factors, not simply comparing immigrants and the native-born. Our findings suggest that research on the association of immigration-related factors with quality of life in immigrants seems a promising approach to better identify subgroups of immigrants with lower levels of quality of life.
Impact of quality of evidence on the strength of recommendations: an empirical study
Djulbegovic, Benjamin; Trikalinos, Thomas A; Roback, John; Chen, Ren; Guyatt, Gordon
2009-01-01
Background Evidence is necessary but not sufficient for decision-making, such as making recommendations by clinical practice guideline panels. However, the fundamental premise of evidence-based medicine (EBM) rests on the assumed link between the quality of evidence and "truth" and/or correctness in making guideline recommendations. If this assumption is accurate, then the quality of evidence ought to play a key role in making guideline recommendations. Surprisingly, and despite the widespread penetration of EBM in health care, there has been no empirical research to date investigating the impact of quality of evidence on the strength of recommendations made by guidelines panels. Methods The American Association of Blood Banking (AABB) has recently convened a 12 member panel to develop clinical practice guidelines (CPG) for the use of fresh-frozen plasma (FFP) for 6 different clinical indications. The panel was instructed that 4 factors should play a role in making recommendation: quality of evidence, uncertainty about the balance between desirable (benefits) and undesirable effects (harms), uncertainty or variability in values and preferences, and uncertainty about whether the intervention represents a wise use of resources (costs). Each member of the panel was asked to make his/her final judgments on the strength of recommendation and the overall quality of the body of evidence. "Voting" was anonymous and was based on the use of GRADE (Grading quality of evidence and strength of recommendations) system, which clearly distinguishes between quality of evidence and strength of recommendations. Results Despite the fact that many factors play role in formulating CPG recommendations, we show that when the quality of evidence is higher, the probability of making a strong recommendation for or against an intervention dramatically increases. Probability of making strong recommendation was 62% when evidence is "moderate", while it was only 23% and 13% when evidence was "low" or "very low", respectively. Conclusion We report the first empirical evaluation of the relationship between quality of evidence pertinent to a clinical question and strength of the corresponding guideline recommendations. Understanding the relationship between quality of evidence and probability of making (strong) recommendation has profound implications for the science of quality measurement in health care. PMID:19622148