Cost analysis of impacts of climate change on regional air quality.

PubMed

Liao, Kuo-Jen; Tagaris, Efthimios; Russell, Armistead G; Amar, Praveen; He, Shan; Manomaiphiboon, Kasemsan; Woo, Jung-Hun

2010-02-01

Climate change has been predicted to adversely impact regional air quality with resulting health effects. Here a regional air quality model and a technology analysis tool are used to assess the additional emission reductions required and associated costs to offset impacts of climate change on air quality. Analysis is done for six regions and five major cities in the continental United States. Future climate is taken from a global climate model simulation for 2049-2051 using the Intergovernmental Panel on Climate Change (IPCC) A1B emission scenario, and emission inventories are the same as current ones to assess impacts of climate change alone on air quality and control expenses. On the basis of the IPCC A1B emission scenario and current control technologies, least-cost sets of emission reductions for simultaneously offsetting impacts of climate change on regionally averaged 4th highest daily maximum 8-hr average ozone and yearly averaged PM2.5 (particulate matter [PM] with an aerodynamic diameter less than 2.5 microm) for the six regions examined are predicted to range from $36 million (1999$) yr(-1) in the Southeast to $5.5 billion yr(-1) in the Northeast. However, control costs to offset climate-related pollutant increases in urban areas can be greater than the regional costs because of the locally exacerbated ozone levels. An annual cost of $4.1 billion is required for offsetting climate-induced air quality impairment in 2049-2051 in the five cities alone. Overall, an annual cost of $9.3 billion is estimated for offsetting climate change impacts on air quality for the six regions and five cities examined. Much of the additional expense is to reduce increased levels of ozone. Additional control costs for offsetting the impacts everywhere in the United States could be larger than the estimates in this study. This study shows that additional emission controls and associated costs for offsetting climate impacts could significantly increase currently estimated control requirements and should be considered in developing control strategies for achieving air quality targets in the future.

Quality of life profile and correlated factors in chronic leg ulcer patients in the mid-west of São Paulo State, Brazil*

PubMed Central

Wachholz, Patrick Alexander; Masuda, Paula Yoshiko; Nascimento, Dejair Caitano; Taira, Cecilia Midori Higashi; Cleto, Norma Gondim

2014-01-01

BACKGROUND Chronic leg ulcer may have an impact on patients' quality of life. OBJECTIVES This study aimed to identify the impact of leg ulcers on patient's quality of life using the Dermatology Life Quality Index and to define the main factors correlated with this perception. METHOD Cross-sectional, non-probabilistic sampling study. We included patients with chronic leg ulcers being treated for at least 3 months. A sociodemographic and clinical survey was conducted to assess the profile of the ulcers. We administered a screening for depressive symptoms and the Dermatology Life Quality Index. We performed a descriptive statistical analysis, chi-square test and Mann-Whitney test for categorical data, Pearson for numeric variables, and multiple regression for categorical data. RESULTS Forty-one patients were assessed. Their mean age was 61.78 years. Venous ulcers (48.8%) were the most prevalent. Seventy-three percent of the sample perceived no impact/low impact on quality of life in the past week, and 26.8% perceived moderate/high impact. A multiple regression analysis identified the causes of lesion, pain related to the ulcers, time of onset, and severity of the depressive symptoms as the variables that had an influence on quality of life. CONCLUSIONS The majority of the sample perceived low or no impact of the condition on the quality of the life. The variables etiology of the lesion (p<0.001), pain related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the depressive symptoms (p<0.001) had an influence on the quality of life, suggesting the need for further studies with more robust designs to confirm the causal relationship between these characteristics and quality of life. PMID:24626651

Turning stumbling blocks into stepping stones in the analysis of cumulative impacts

Treesearch

Leslie M. Reid

2004-01-01

Federal and state legislation, such as the National Environmental Policy Act and the California Environmental Quality Act, require that responsible agency staff consider the cumulative impacts of proposed activities before permits are issued for certain kinds of public or private projects. The Council on Environmental Quality (CEQ 1997) defined a cumulative impact as...

Forest Inventory and Analysis: What it Tells Us About Water Quality in Arkansas

Treesearch

Edwin L. Miller; Hal O. Liechty

2001-01-01

Forests and forest activities have a significant impact on the amount and quality of surface water in Arkansas. Recognizing this important relationship between forests and water quality, we utilized the Forest Inventory and Analysis (FIA) data from Arkansas to better understand how forest land use in Arkansas has likely influenced the water quality in the State during...

LAND USE AS A MITIGATON STRATEGY FOR THE WATER QUALITY IMPACTS OF GLOBAL WARMING: A SCENARIO ANALYSIS ON TWO WATERSHEDS IN THE OHIO RIVER BASIN

EPA Science Inventory

This study uses an integrative approach to study the water quality impacts of future global climate and land use changes. Changing land use types was used as a nitigation strategy to reduce the adverse impacts of global climate change on water resources. The climate scenarios wer...

Incorporating Quality Scores in Meta-Analysis

ERIC Educational Resources Information Center

Ahn, Soyeon; Becker, Betsy Jane

2011-01-01

This paper examines the impact of quality-score weights in meta-analysis. A simulation examines the roles of study characteristics such as population effect size (ES) and its variance on the bias and mean square errors (MSEs) of the estimators for several patterns of relationship between quality and ES, and for specific patterns of systematic…

Analysis of Ordinary Public Fund and Its Impact on the Quality of Academic Programs in the Higher Education in the Subsystem of the Polytechnic Universities in Mexico

ERIC Educational Resources Information Center

Monroy, Pedro Salazar; Arcos-Vega, José L.; Garcia, Juan J. Sevilla

2017-01-01

In 2015, there was the need of making this study to determine the efficient and effectiveness management for making decisions in respect to the ordinary fund allocations and their impact on the quality of the academic programs into the Polytechnic engineering universities in Mexico. This analysis is very important for providing essential evidence…

Assessment of port-related air quality impacts: geographic analysis of population

EPA Science Inventory

Increased global trade has led to greater transportation by rail, road and ships to move cargo. Based upon multiple near-road and near-source monitoring studies, the busy roadways and large emission sources at ports may impact local air quality within several hundred metres of th...

LAND USE AS A MITIGATION STRATEGY FOR THE WATER QUALITY IMPACTS OF GLOBAL WARMING: A SCENARIO ANALYSIS ON TWO WATERSHEDS IN THE OHIO RIVER BASIN

EPA Science Inventory

This study uses an integrative approach to study the water quality impacts of future global climate and land use changes. In this study, changing land use types were used as a mitigation strategy to reduce the adverse impacts of global climate change on water resources. The Thorn...

LAND USE AS A MITIGATION STRATEGY FOR THE WATER QUALITY IMPACTS OF GLOBAL WARMING: A SCENARIO ANALYSIS ON TWO WATERSHEDS IN THE OHIO RIVER BASIN

EPA Science Inventory

This study uses an integrative approach to study the water quality impacts of future global climate and land use changes. In this study, changing land use types was used as a mitigation strategy to reduce the adverse impacts of global climate change on water resources. The climat...

The impact of service quality perception on patient satisfaction in Government Hospitals in Southern Saudi Arabia

PubMed Central

Alghamdi, Faris S.

2014-01-01

ABSTRACT Objectives: To examine the impact of service quality perception on patient satisfaction and determine which dimension from 5 dimensions (tangible, reliability, responsive, assurance, and empathy) has the greatest impact on patient satisfaction. Methods: A total of 183 eligible patients participated in this study. This study was conducted in Al-Baha province, Saudi Arabia from June 2013 to August 2013. We utilized the cross-sectional method, using a modified Assessment of Service Quality questionnaire to collect the data. Results: To test the study hypothesis, multiple regression analysis was carried out. Analysis of variance revealed that the overall result showed a statistically significant impact of health service quality on patient satisfaction (p=0.000). The beta-weights (beta) suggested that the empathy dimension had the greatest influence on patient satisfaction (ß=0.476), followed by tangible (ß=0.198) and responsiveness dimensions (ß=0.164). Conclusion: Patient satisfaction was influenced by health service quality, with the empathy dimension as the greatest influence on patient satisfaction. Therefore, it should be considered a priority by government hospitals to train doctors in interpersonal relationship skills to enhance the doctor-patient relationship. PMID:25316476

The impact of service quality perception on patient satisfaction in government hospitals in southern Saudi Arabia.

PubMed

Alghamdi, Faris S

2014-10-01

To examine the impact of service quality perception on patient satisfaction and determine  which dimension from 5 dimensions (tangible, reliability, responsive, assurance, and empathy) has the greatest impact on patient satisfaction. A total of 183 eligible patients participated in this study. This study was conducted in Al-Baha province, Saudi Arabia from June 2013 to August 2013. We utilized the cross-sectional method, using a modified Assessment of Service Quality questionnaire to collect the data. To test the study hypothesis, multiple regression analysis was carried out. Analysis of variance revealed that the overall result showed a statistically significant impact of health service quality on patient satisfaction (p=0.000). The beta-weights (beta) suggested that the empathy dimension had the greatest influence on patient satisfaction (beta=0.476), followed by tangible (beta=0.198) and responsiveness dimensions (beta=0.164). Patient satisfaction was influenced by health service quality, with the empathy dimension as the greatest influence on patient satisfaction. Therefore, it should be considered a priority by government hospitals to train doctors in interpersonal relationship skills to enhance the doctor-patient relationship. 

Environmental Impact Analysis Process. Supplement to Final Environmental Impact Statement Space Shuttle Program, Vandenberg AFB, California

DTIC Science & Technology

1983-07-01

problems . Six appendices offer more detailed environmental assessments for the key issues of air quality impacts, inadvertent weather modification...research studies in problem areas, and newly- acquired knowledge of the affected environment. The physical, chemi- cal, biological, and...Shuttle program, in conjunction with other projects within the county, will aggravate short-tenm problems concerning housing, and the quality and quantity

40 CFR 63.43 - Maximum achievable control technology (MACT) determinations for constructed and reconstructed...

Code of Federal Regulations, 2012 CFR

2012-07-01

... achieving such emission reduction and any non-air quality health and environmental impacts and energy..., and analysis of cost and non-air quality health environmental impacts or energy requirements for the...-day period for submittal of public comment; and (iii) A notice by prominent advertisement in the area...

40 CFR 63.43 - Maximum achievable control technology (MACT) determinations for constructed and reconstructed...

Code of Federal Regulations, 2014 CFR

2014-07-01

... achieving such emission reduction and any non-air quality health and environmental impacts and energy..., and analysis of cost and non-air quality health environmental impacts or energy requirements for the...-day period for submittal of public comment; and (iii) A notice by prominent advertisement in the area...

40 CFR 63.43 - Maximum achievable control technology (MACT) determinations for constructed and reconstructed...

Code of Federal Regulations, 2013 CFR

2013-07-01

... achieving such emission reduction and any non-air quality health and environmental impacts and energy..., and analysis of cost and non-air quality health environmental impacts or energy requirements for the...-day period for submittal of public comment; and (iii) A notice by prominent advertisement in the area...

Definition of air quality measurements for monitoring space shuttle launches

NASA Technical Reports Server (NTRS)

Thorpe, R. D.

1978-01-01

A description of a recommended air quality monitoring network to characterize the impact on ambient air quality in the Kennedy Space Center (KSC) (area) of space shuttle launch operations is given. Analysis of ground cloud processes and prevalent meteorological conditions indicates that transient HCl depositions can be a cause for concern. The system designed to monitor HCl employs an extensive network of inexpensive detectors combined with a central analysis device. An acid rain network is also recommended. A quantitative measure of projected minimal long-term impact involves the limited monitoring of NOx and particulates. All recommended monitoring is confined ti KSC property.

Regulatory Impact Analysis (RIA) for the Proposed Revisions to the Sulfur Dioxide National Ambient Air Quality Standards (NAAQS)

EPA Pesticide Factsheets

This Regulatory Impact Analysis (RIA) provides estimates of the incremental costs and monetized human health benefits of attaining a revised short‐term Sulfur Dioxide (SO2) NAAQS within the current monitoring network.

An evaluation of contaminated estuarine sites using sediment quality guidelines and ecological assessment methodologies.

PubMed

Fulton, M; Key, P; Wirth, E; Leight, A K; Daugomah, J; Bearden, D; Sivertsen, S; Scott, G

2006-10-01

Toxic contaminants may enter estuarine ecosystems through a variety of pathways. When sediment contaminant levels become sufficiently high, they may impact resident biota. One approach to predict sediment-associated toxicity in estuarine ecosystems involves the use of sediment quality guidelines (ERMs, ERLs) and site-specific contaminant chemistry while a second approach utilizes site-specific ecological sampling to assess impacts at the population or community level. The goal of this study was to utilize an integrated approach including chemical contaminant analysis, sediment quality guidelines and grass shrimp population monitoring to evaluate the impact of contaminants from industrial sources. Three impacted sites and one reference site were selected for study. Grass shrimp populations were sampled using a push-netting approach. Sediment samples were collected at each site and analyzed for metals, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and pesticides. Contaminant levels were then compared to sediment quality guidelines. In general, grass shrimp population densities at the sites decreased as the ERM quotients increased. Grass shrimp densities were significantly reduced at the impacted site that had an ERM exceedance for chromium and the highest Mean ERM quotient. Regression analysis indicated that sediment chromium concentrations were negatively correlated with grass shrimp density. Grass shrimp size was reduced at two sites with intermediate levels of contamination. These findings support the use of both sediment quality guidelines and site-specific population monitoring to evaluate the impacts of sediment-associated contaminants in estuarine systems.

Maximizing sinter plant operating flexibility through emissions trading and air modeling

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

Schewe, G.J.; Wagner, J.A.; Heron, T.

1998-12-31

This paper provides details on the dispersion modeling analysis performed to demonstrate air quality impacts associated with an emission trading scheme for a sintering operation in Youngstown, Ohio. The emission trade was proposed to allow the sinter plant to expand its current allowable sulfur dioxide (SO2) emissions while being offset with SO{sub 2} emissions from boilers at a nearby shutdown steel mill. While the emission trade itself was feasible and the emissions required for the offset were available (the boiler shutdown and their subsequent SO{sub 2} emission credits were never claimed, banked, or used elsewhere), the second criteria for determiningmore » compliance was a demonstration of minimal air quality impact. The air analysis combined the increased ambient SO{sub 2} concentrations of the relaxed sinter plant emissions with the offsetting air quality of the shutdown boilers to yield the net air quality impacts. To test this net air impact, dispersion modeling was performed treating the sinter plant SO{sub 2} emissions as positive and the shutdown boiler SO{sub 2} emissions as negative. The results of the modeling indicated that the ambient air concentrations due to the proposed emissions increase will be offset by the nearby boiler emissions to levels acceptable under EPA`s offset policy Level 2 significant impact concentrations. Therefore, the dispersion modeling demonstrated that the emission trading scheme would not result in significant air quality impacts and maximum operating flexibility was provided to the sintering facility.« less

32 CFR 989.30 - Air quality.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Air quality. 989.30 Section 989.30 National... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.30 Air quality. Section 176(c) of the Clean Air Act..., Air Quality Compliance. 10 10 See footnote 1 to § 989.1. ...

32 CFR 989.30 - Air quality.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Air quality. 989.30 Section 989.30 National... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.30 Air quality. Section 176(c) of the Clean Air Act..., Air Quality Compliance. 10 10 See footnote 1 to § 989.1. ...

32 CFR 989.30 - Air quality.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Air quality. 989.30 Section 989.30 National... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.30 Air quality. Section 176(c) of the Clean Air Act..., Air Quality Compliance. 10 10 See footnote 1 to § 989.1. ...

32 CFR 989.30 - Air quality.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Air quality. 989.30 Section 989.30 National... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.30 Air quality. Section 176(c) of the Clean Air Act..., Air Quality Compliance. 10 10 See footnote 1 to § 989.1. ...

32 CFR 989.30 - Air quality.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Air quality. 989.30 Section 989.30 National... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.30 Air quality. Section 176(c) of the Clean Air Act..., Air Quality Compliance. 10 10 See footnote 1 to § 989.1. ...

32 CFR 651.42 - Actions normally requiring an EIS.

Code of Federal Regulations, 2010 CFR

2010-07-01

... significant impacts are socioeconomic, with no significant biophysical environmental impact). (f) Training...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.42... substances that have the potential to cause significant environmental impact. (d) Land acquisition, leasing...

The Perceived Impact of Quality Audit on the Work of Academics

ERIC Educational Resources Information Center

Cheng, Ming

2011-01-01

Quality audit has become the dominant means of assessing the quality of university teaching and learning. This paper addresses this international trend through the analysis of academics' perception of quality audit. It presents a new way to understand quality audit through the interpretation of how frontline academics in England perceived and…

The Impact of Visit Frequency on the Relationship between Service Quality and Outpatient Satisfaction: A South Korean Study

PubMed Central

Cho, Woo Hyun; Lee, Hanjoon; Kim, Chankon; Lee, Sunhee; Choi, Kui-Son

2004-01-01

Objective To examine the relative impact of four service quality dimensions on outpatient satisfaction and to test the invariance of the structural relationships between the service quality dimensions and satisfaction across three patient groups of varying numbers of prior visits to the same hospital as outpatients. Data Sources/Study Setting Survey of 557 outpatients using a self-administered questionnaire over a 10-day period at a general hospital in Sungnam, South Korea. Data Collection Patients answered questions related to two main constructs, patient satisfaction and health care service quality. The health care service quality measures (30 items) were developed based on the results of three focus group interviews and the SERVQUAL scale, while satisfaction (3 items) was measured using a previously validated scale. Study Design Confirmatory factor analysis was used to assess the construct validity of the service quality scale by testing convergent and divergent validity. A structural equation model specifying the four service quality dimensions as exogenous variables and patient satisfaction as an endogenous variable was estimated to assess the relative impact of each of the service quality dimensions on satisfaction. This was followed by a multigroup LISREL analysis that tested the invariance of structural coefficients across three groups with different frequencies of outpatient visits to the hospital. Principal Findings Findings support the causal relationship between service quality and satisfaction in the context of the South Korean health care environment. The four service quality dimensions showed varying patterns of impact on patient satisfaction across the three different outpatient groups. Conclusion The hospital management needs to be aware of the relative importance of each of the service quality dimensions in satisfaction formation of outpatients, which varies across different hospital utilization groups, and use this in strategic considerations. PMID:14965075

Parametric Analysis of Surveillance Quality and Level and Quality of Intent Information and Their Impact on Conflict Detection Performance

NASA Technical Reports Server (NTRS)

Guerreiro, Nelson M.; Butler, Ricky W.; Hagen, George E.; Maddalon, Jeffrey M.; Lewis, Timothy A.

2016-01-01

A loss-of-separation (LOS) is said to occur when two aircraft are spatially too close to one another. A LOS is the fundamental unsafe event to be avoided in air traffic management and conflict detection (CD) is the function that attempts to predict these LOS events. In general, the effectiveness of conflict detection relates to the overall safety and performance of an air traffic management concept. An abstract, parametric analysis was conducted to investigate the impact of surveillance quality, level of intent information, and quality of intent information on conflict detection performance. The data collected in this analysis can be used to estimate the conflict detection performance under alternative future scenarios or alternative allocations of the conflict detection function, based on the quality of the surveillance and intent information under those conditions.Alternatively, this data could also be used to estimate the surveillance and intent information quality required to achieve some desired CD performance as part of the design of a new separation assurance system.

78 FR 23207 - Availability of an Environmental Assessment for Field Testing of a Yersinia Pestis Vaccine, Live...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-18

... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2013-0020... could have on the quality of the human environment. Based on the risk analysis and other relevant data... a significant impact on the quality of the human environment, and that an environmental impact...

The impact of endometriosis upon quality of life: a qualitative analysis.

PubMed

Jones, Georgina; Jenkinson, Crispin; Kennedy, Stephen

2004-06-01

to explore and describe the impact of endometriosis upon quality of life. Nuffield Department of Obstetrics and Gynaecology, University of Oxford. qualitative study. twenty-four women with a laparoscopic diagnosis of endometriosis. face to face, individual, in-depth interviews. analysis of the data revealed 15 descriptive categories. Pain, physical functioning, role performance, social functioning, emotional well-being, relationship with the medical profession, treatment, sexual intercourse, energy and vitality, employment and infertility were found to be a particular concern for women with endometriosis. Physical appearance, lack of control and powerlessness, feelings of social isolation and concerns that their daughters might develop endometriosis were new areas found to be negatively affected by the condition. the impact of endometriosis-associated symptoms upon quality of life is multidimensional and more complex than just negatively affecting psychosocial parameters. Conducting in-depth interviews to explore the subjective experiences of patients with endometriosis enabled the diverse areas of quality of life to be identified. Adopting a qualitative methodology is essential for item generation on disease specific health status questionnaires.

32 CFR 651.23 - Environmental impact statement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Environmental impact statement. 651.23 Section...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Records and Documents § 651.23 Environmental impact statement. An Environmental Impact statement (EIS) is a detailed written statement required...

Assessment of the emissions and air quality impacts of biomass and biogas use in California.

PubMed

Carreras-Sospedra, Marc; Williams, Robert; Dabdub, Donald

2016-02-01

It is estimated that there is sufficient in-state "technically" recoverable biomass to support nearly 4000 MW of bioelectricity generation capacity. This study assesses the emissions of greenhouse gases and air pollutants and resulting air quality impacts of new and existing bioenergy capacity throughout the state of California, focusing on feedstocks and advanced technologies utilizing biomass resources predominant in each region. The options for bioresources include the production of bioelectricity and renewable natural gas (NG). Emissions of criteria pollutants and greenhouse gases are quantified for a set of scenarios that span the emission factors for power generation and the use of renewable natural gas for vehicle fueling. Emissions are input to the Community Multiscale Air Quality (CMAQ) model to predict regional and statewide temporal air quality impacts from the biopower scenarios. With current technology and at the emission levels of current installations, maximum bioelectricity production could increase nitrogen oxide (NOx) emissions by 10% in 2020, which would cause increases in ozone and particulate matter concentrations in large areas of California. Technology upgrades would achieve the lowest criteria pollutant emissions. Conversion of biomass to compressed NG (CNG) for vehicles would achieve comparable emission reductions of criteria pollutants and minimize emissions of greenhouse gases (GHG). Air quality modeling of biomass scenarios suggest that applying technological changes and emission controls would minimize the air quality impacts of bioelectricity generation. And a shift from bioelectricity production to CNG production for vehicles would reduce air quality impacts further. From a co-benefits standpoint, CNG production for vehicles appears to provide the best benefits in terms of GHG emissions and air quality. This investigation provides a consistent analysis of air quality impacts and greenhouse gas emissions for scenarios examining increased biomass use. Further work involving economic assessment, seasonal or annual emissions and air quality modeling, and potential exposure analysis would help inform policy makers and industry with respect to further development and direction of biomass policy and bioenergy technology alternatives needed to meet energy and environmental goals in California.

Improving patient care through student leadership in team quality improvement projects.

PubMed

Tschannen, Dana; Aebersold, Michelle; Kocan, Mary Jo; Lundy, Francene; Potempa, Kathleen

2015-01-01

In partnership with a major medical center, senior-level nursing students completed a root cause analysis and implementation plan to address a unit-specific quality issue. To evaluate the project, unit leaders were asked their perceptions of the value of the projects and impact on patient care, as well as to provide exemplars depicting how the student root cause analysis work resulted in improved patient outcome and/or unit processes. Liaisons noted benefits of having an RCA team, with positive impact on patient outcomes and care processes.

PREDICTING THE RELATIVE IMPACTS OF URBAN DEVELOPMENT POLICIES AND ON-ROAD VEHICLE TECHNOLOGIES ON AIR QUALITY IN THE UNITED STATES: MODELING AND ANALYSIS OF A CASE STUDY IN AUSTIN, TEXAS

EPA Science Inventory

Urban development results in changes to land use and land cover and, consequently, to biogenic and anthropogenic emissions, meteorological processes, and processes such as dry deposition that influence future predictions of air quality. This study examines the impacts of alter...

Corruption, inequality and population perception of healthcare quality in Europe

PubMed Central

2013-01-01

Background Evaluating the quality of healthcare and patient safety using general population questionnaires is important from research and policy perspective. Using a special wave of the Eurobarometer survey, we analysed the general population’s perception of health care quality and patient safety in a cross-country setting. Methods We used ordered probit, ordinary least squares and probit analysis to estimate the determinants of health care quality, and ordered logit analysis to analyse the likelihood of being harmed by a specific medical procedure. The models used population weights as well as country-clustered standard errors. Results We found robust evidence for the impact of socio-demographic variables on the perception of quality of health care. More specifically, we found a non-linear impact of age on the perception of quality of health care and patient safety, as well as a negative impact of poverty on both perception of quality and patient safety. We also found robust evidence that countries with higher corruption levels were associated with worse perceptions of quality of health care. Finally, we found evidence that income inequality affects patients’ perception vis-à-vis safety, thus feeding into the poverty/health care quality nexus. Conclusions Socio-demographic factors and two macro variables (corruption and income inequality) explain the perception of quality of health care and likelihood of being harmed by adverse events. The results carry significant policy weight and could explain why targeting only the health care sector (without an overall reform of the public sector) could potentially be challenging. PMID:24215401

Corruption, inequality and population perception of healthcare quality in Europe.

PubMed

Nikoloski, Zlatko; Mossialos, Elias

2013-11-11

Evaluating the quality of healthcare and patient safety using general population questionnaires is important from research and policy perspective. Using a special wave of the Eurobarometer survey, we analysed the general population's perception of health care quality and patient safety in a cross-country setting. We used ordered probit, ordinary least squares and probit analysis to estimate the determinants of health care quality, and ordered logit analysis to analyse the likelihood of being harmed by a specific medical procedure. The models used population weights as well as country-clustered standard errors. We found robust evidence for the impact of socio-demographic variables on the perception of quality of health care. More specifically, we found a non-linear impact of age on the perception of quality of health care and patient safety, as well as a negative impact of poverty on both perception of quality and patient safety. We also found robust evidence that countries with higher corruption levels were associated with worse perceptions of quality of health care. Finally, we found evidence that income inequality affects patients' perception vis-à-vis safety, thus feeding into the poverty/health care quality nexus. Socio-demographic factors and two macro variables (corruption and income inequality) explain the perception of quality of health care and likelihood of being harmed by adverse events. The results carry significant policy weight and could explain why targeting only the health care sector (without an overall reform of the public sector) could potentially be challenging.

Impacts of Climate Policy on Regional Air Quality, Health, and Air Quality Regulatory Procedures

NASA Astrophysics Data System (ADS)

Thompson, T. M.; Selin, N. E.

2011-12-01

Both the changing climate, and the policy implemented to address climate change can impact regional air quality. We evaluate the impacts of potential selected climate policies on modeled regional air quality with respect to national pollution standards, human health and the sensitivity of health uncertainty ranges. To assess changes in air quality due to climate policy, we couple output from a regional computable general equilibrium economic model (the US Regional Energy Policy [USREP] model), with a regional air quality model (the Comprehensive Air Quality Model with Extensions [CAMx]). USREP uses economic variables to determine how potential future U.S. climate policy would change emissions of regional pollutants (CO, VOC, NOx, SO2, NH3, black carbon, and organic carbon) from ten emissions-heavy sectors of the economy (electricity, coal, gas, crude oil, refined oil, energy intensive industry, other industry, service, agriculture, and transportation [light duty and heavy duty]). Changes in emissions are then modeled using CAMx to determine the impact on air quality in several cities in the Northeast US. We first calculate the impact of climate policy by using regulatory procedures used to show attainment with National Ambient Air Quality Standards (NAAQS) for ozone and particulate matter. Building on previous work, we compare those results with the calculated results and uncertainties associated with human health impacts due to climate policy. This work addresses a potential disconnect between NAAQS regulatory procedures and the cost/benefit analysis required for and by the Clean Air Act.

Environmental impact of geopressure - geothermal cogeneration facility on wetland resources and socioeconomic characteristics in Louisiana Gulf Coast region. Final report, October 10, 1983-September 31, 1984

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

Smalley, A.M.; Saleh, F.M.S.; Fontenot, M.

1984-08-01

Baseline data relevant to air quality are presented. The following are also included: geology and resource assessment, design well prospects in southwestern Louisiana, water quality monitoring, chemical analysis subsidence, microseismicity, geopressure-geothermal subsidence modeling, models of compaction and subsidence, sampling handling and preparation, brine chemistry, wetland resources, socioeconomic characteristics, impacts on wetlands, salinity, toxic metals, non-metal toxicants, temperature, subsidence, and socioeconomic impacts. (MHR)

Assessment of the impact of landfill on groundwater quality: a case study of the Pirana site in western India.

PubMed

Singh, Umesh Kumar; Kumar, Manish; Chauhan, Rita; Jha, Pawan Kumar; Ramanathan, Al; Subramanian, V

2008-06-01

In present study focus has been given on estimating quality and toxicity of waste with respect to heavy metals and its impact on groundwater quality, using statistical and empirical relationships between different hydrochemical data, so that easy monitoring may be possible which in turn help the sustainable management of landfill site and municipal solid waste. Samples of solid waste, leachate and groundwater were analyzed to evaluate the impact of leachates on groundwater through the comparison of their hydrochemical nature. Results suggest the existence of an empirical relationship between some specific indicator parameters like heavy metals of all three above mentioned sample type. Further, K/Mg ratio also indicates three groundwater samples heavily impacted from leachate contamination. A good number of samples are also showing higher values for NO(3)(-) and Pb than that of World Health Organization (WHO) drinking water regulation. Predominance of Fe and Zn in both groundwater and solid waste samples may be due to metal plating industries in the area. Factor analysis is used as a tool to explain observed relation between numerous variables in term of simpler relation, which may help to deduce the strength of relation. Positive loading of most of the factors for heavy metal clearly shows landfill impact on ground water quality especially along the hydraulic gradient. Cluster analysis, further substantiates the impact of landfill. Two major groups of samples obtained from cluster analysis suggest that one group comprises samples that are severely under the influence of landfill and contaminated leachates along the groundwater flow direction while other assorted with samples without having such influence.

Water quality following extensive beetle-induced tree mortality: Interplay of aromatic carbon loading, disinfection byproducts, and hydrologic drivers.

PubMed

Brouillard, Brent M; Dickenson, Eric R V; Mikkelson, Kristin M; Sharp, Jonathan O

2016-12-01

The recent bark beetle epidemic across western North America may impact water quality as a result of elevated organic carbon release and hydrologic shifts associated with extensive tree dieback. Analysis of quarterly municipal monitoring data from 2004 to 2014 with discretization of six water treatment facilities in the Rocky Mountains by extent of beetle impact revealed a significant increasing trend in total organic carbon (TOC) and total trihalomethane (TTHM) production within high (≳50% areal infestation) beetle-impacted watersheds while no or insignificant trends were found in watersheds with lower impact levels. Alarmingly, the TTHM concentration trend in the high impact sites exceeded regulatory maximum contaminant levels during the most recent two years of analysis (2013-14). To evaluate seasonal differences, explore the interplay of water quality and hydrologic processes, and eliminate variability associated with municipal reporting, these treatment facilities were targeted for more detailed surface water sampling and characterization. Surface water samples collected from high impact watersheds exhibited significantly higher TOC, aromatic signatures, and disinfection byproduct (DBP) formation potential than watersheds with lower infestation levels. Spectroscopic analyses of surface water samples indicated that these heightened DBP precursor levels are a function of both elevated TOC loading and increased aromatic character. This association was heightened during precipitation and runoff events in high impact sites, supporting the hypothesis that altered hydrologic flow paths resulting from tree mortality mobilize organic carbon and elevate DBP formation potential for several months after runoff ceases. The historical trends found here likely underestimate the full extent of TTHM shifts due to monitoring biases with the extended seasonal release of DBP precursors increasing the potential for human exposure. Collectively, our analysis suggests that while water quality impacts continue to rise nearly one decade after infestation, significant increases in TOC mobilization and DBP precursors are limited to watersheds that experience extensive tree mortality. Copyright © 2016 Elsevier B.V. All rights reserved.

Geostationary Coastal and Air Pollution Events (GEO-CAPE) Sensitivity Analysis Experiment

NASA Technical Reports Server (NTRS)

Lee, Meemong; Bowman, Kevin

2014-01-01

Geostationary Coastal and Air pollution Events (GEO-CAPE) is a NASA decadal survey mission to be designed to provide surface reflectance at high spectral, spatial, and temporal resolutions from a geostationary orbit necessary for studying regional-scale air quality issues and their impact on global atmospheric composition processes. GEO-CAPE's Atmospheric Science Questions explore the influence of both gases and particles on air quality, atmospheric composition, and climate. The objective of the GEO-CAPE Observing System Simulation Experiment (OSSE) is to analyze the sensitivity of ozone to the global and regional NOx emissions and improve the science impact of GEO-CAPE with respect to the global air quality. The GEO-CAPE OSSE team at Jet propulsion Laboratory has developed a comprehensive OSSE framework that can perform adjoint-sensitivity analysis for a wide range of observation scenarios and measurement qualities. This report discusses the OSSE framework and presents the sensitivity analysis results obtained from the GEO-CAPE OSSE framework for seven observation scenarios and three instrument systems.

Klickitat Cogeneration Project : Final Environmental Assessment.

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

United States. Bonneville Power Administration; Klickitat Energy Partners

1994-09-01

To meet BPA`s contractual obligation to supply electrical power to its customers, BPA proposes to acquire power generated by Klickitat Cogeneration Project. BPA has prepared an environmental assessment evaluating the proposed project. Based on the EA analysis, BPA`s proposed action is not a major Federal action significantly affecting the quality of the human environment within the meaning of the National Environmental Policy Act of 1969 for the following reasons: (1)it will not have a significant impact land use, upland vegetation, wetlands, water quality, geology, soils, public health and safety, visual quality, historical and cultural resources, recreation and socioeconomics, and (2)more » impacts to fisheries, wildlife resources, air quality, and noise will be temporary, minor, or sufficiently offset by mitigation. Therefore, the preparation of an environmental impact statement is not required and BPA is issuing this FONSI (Finding of No Significant Impact).« less

Vocal parameters and voice-related quality of life in adult women with and without ovarian function.

PubMed

Ferraz, Pablo Rodrigo Rocha; Bertoldo, Simão Veras; Costa, Luanne Gabrielle Morais; Serra, Emmeliny Cristini Nogueira; Silva, Eduardo Magalhães; Brito, Luciane Maria Oliveira; Chein, Maria Bethânia da Costa

2013-05-01

To identify the perceptual and acoustic parameters of voice in adult women with and without ovarian function and its impact on quality of life related to voice. Cross-sectional and analytical study with 106 women divided into, two groups: G1, with ovarian function (n=43) and G2, without physiological ovarian function (n=63). The women were instructed to sustain the vowel "a" and the sounds of /s/ and /z/ in habitual pitch and loudness. They were also asked to classify their voices and answer the voice-related quality of life (V-RQOL) questionnaire. The perceptual analysis of the vocal samples was performed by three speech-language pathologists using the GRBASI (G: grade; R: roughness; B: breathness; A: asthenia; S: strain; I: instability) scale. The acoustic analysis was carried out with the software VoxMetria 2.7h (CTS Informatica). The data were analyzed using descriptive statistics. In the perceptual analysis, both groups showed a mild deviation for the parameters roughness, strain, and instability, but only G2 showed a mild impact for the overall degree of dysphonia. The mean of fundamental frequency was significantly lower for the G2, with a difference of 17.41Hz between the two groups. There was no impact on V-RQOL in any of the V-RQOL domains for this group. With the menopause, there is a change in women's voices, impacting on some voice parameters. However, there is no direct impact on their quality of life related to voice. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Higher Education Quality Assessment in China: An Impact Study

ERIC Educational Resources Information Center

Liu, Shuiyun

2015-01-01

This research analyses an external higher education quality assessment scheme in China, namely, the Quality Assessment of Undergraduate Education (QAUE) scheme. Case studies were conducted in three Chinese universities with different statuses. Analysis shows that the evaluated institutions responded to the external requirements of the QAUE…

Estimating Impaired Waters on a County Level for Public Health Analysis

EPA Science Inventory

Assessing the population-level impact of water quality on health can be difficult. Water quality data are measured at a watershed level and health data are organized at different levels of aggregation. To address this discrepancy and enable the consideration of water quality for ...

Using ESRI Online Mapping Tools to Support STEM Learning through Analysis of the Impact of Land Use/Land Cover Change on Water Quality

NASA Astrophysics Data System (ADS)

Powley, C.; Alian, S.; Mayer, A.

2017-12-01

In the 2004 National Water Quality Report to the Congress, the US EPA states that about 44% of the streams, 64% of lakes and 30% of estuaries that were assessed were not suitable for basic use like fishing and swimming. Pollutants from nonpoint sources are most likely the cause. The needs of landowners to use their land for other uses is enormous and most are likely willing to forgo the potential damage to achieve monetary gains. These are difficult decisions as there are many positive gains in commercialized development, although this comes with a cost. So it is imperative for all entities to work together in developing an awareness that benefits all stakeholders. We used this water quality management context to prepare lessons for high school students to map water quality problem areas in Rifle River and the West Branch in Ogemaw County, Michigan based on field samples and by using ESRI online data entry and mapping tools. The students also used Long Term Hydrologic Impact Analysis (L-THIA) to evaluate the impacts of different land use/cover types, developing an understanding of the implication of land management on surface water quality.

Malocclusion: social, functional and emotional influence on children.

PubMed

Martins-Júnior, P A; Marques, L S; Ramos-Jorge, M L

2012-01-01

To determine the association between types of malocclusion and quality of life in children between 8-10 years of age and establish correlations between the severity of the malocclusion and particular bio-psychosocial variables. The sample was made up of 102 schoolchildren aged 8-10 years. Clinical exams were performed using the criteria of the Dental Aesthetic Index (DAI) to determine the presence and severity of malocclusions. The impact on quality of life was assessed using the Child Perceptions Questionnaire (CPQ8-10). Statistical analysis involved the chi-square test, Fisher's exact test and Spearman's correlation analysis. Malocclusions affected 61% of the children examined. There was a positive correlation between total CPQ8-10 and DAI scores (P = 0.034). The following types of malocclusion had a significant effect on the quality of life of the children: upper anterior irregularity > or = 2 mm, anterior open bite > or = 2 mm and diastema > or = 2 mm. Children with malocclusion experienced a greater negative impact on quality of life in comparison to those without malocclusion. Malocclusions had a negative influence over the quality of life of children between 8-10 years of age. More severe malocclusions had a greater impact with regard to social, emotional and functional aspects.

An Exploratory Analysis of Societal Preferences for Research-Driven Quality of Life Improvements in Canada

ERIC Educational Resources Information Center

Rudd, Murray A.

2011-01-01

Research in the humanities, arts, and social sciences (HASS) tends to have impacts that enhance quality of life (QOL) but that are not amenable to pricing in established markets. If the economic value of "non-market" research impacts is ignored when making the business case for HASS research, society will under-invest in it. My goal in…

Measuring the Air Quality and Transportation Impacts of Infill Development

EPA Pesticide Factsheets

This report summarizes three case studies. The analysis shows how standard forecasting tools can be modified to capture at least some of the transportation and air quality benefits of brownfield and infill development.

CONDITIONAL PROBABILITY ANALYSIS APPROACH FOR IDENTIFYING BIOLOGICAL THRESHOLD OF IMPACT FOR SEDIMENTATION: APPICATION TO FRESHWATER STREAMS IN OREGON COAST RANGE ECOREGION

EPA Science Inventory

A conditional probability analysis (CPA) approach has been developed for identifying biological thresholds of impact for use in the development of geographic-specific water quality criteria for protection of aquatic life. This approach expresses the threshold as the likelihood ...

Separating the Air Quality Impact of a Major Highway and Nearby Sources by Nonparametric Trajectory Analysis

EPA Science Inventory

Nonparametric Trajectory Analysis (NTA), a receptor-oriented model, was used to assess the impact of local sources of air pollution at monitoring sites located adjacent to highway I-15 in Las Vegas, NV. Measurements of black carbon, carbon monoxide, nitrogen oxides, and sulfur di...

Environmental review of Potomac Electric Power Company's proposed Station H Element I

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

Not Available

1990-04-01

The report has been conducted to evaluate the potential impacts to environmental and cultural resources from the proposed construction and operation of Element I (the combustion turbine portion) of the Station H power plant facility at Potomac Electric Power Company's Dickerson site. This review also presents an evaluation of air quality impacts of Elements I and II (combustion turbine and combined cycle components of the facility) and an assessment of compliance with state and Federal air quality regulations (primarily the ambient air quality standards and the air quality impact requirements of PSD regulations). Results of the Environmental Review analysis aremore » used as the basis for establishing preliminary recommended licensing conditions for operating the proposed facility. These recommendations are also included in the report.« less

Compulsory of Malaysia’s Quality Assessment System in Construction (QLASSIC)

NASA Astrophysics Data System (ADS)

Manap, N.; Goh, YK; Syahrom, N.

2017-12-01

Nowadays, the quality in the construction industry has become very important because it contribute to the nation’s economic growth and quality of life of the house occupants. Therefore, CIDB is proposed to enforce the implementation of QLASSIC as the main element of project approval for issuance of Certificate of Fitness (CFO) or Certificate of Compliances (C.C.C) in construction industry of Malaysia. The objectives of this study are to identify the views of contractors toward the compulsory of the QLASSIC and to determine the impacts of the QLASSIC in the construction industry. The methodology used are literature review and the questionnaires. The descriptive statistic like the frequency and percentage were used for describing the respondent background. While the mean distribution analysis was used to analysis the views on the compulsory of QLASSIC and the impacts of the QLASSIC. The result of the study shows that, the views of the respondents toward the compulsory of QLASSIC and the main impacts of the QLASSIC were identified. The significance of this study is it can help contractors to understand the impacts and the important of using QLASSIC.

Genome sequence of the thermotolerant foodborne pathogen Salmonella enterica serovar Senftenberg ATCC 43845 and phylogenetic analysis of Loci encoding increased protein quality control mechanisms

USDA-ARS?s Scientific Manuscript database

Salmonella enterica subsp. enterica bacteria are important foodborne pathogens with major economic impact. Some isolates exhibit increased heat tolerance, a concern for food safety. Analysis of a finished-quality genome sequence of an isolate commonly used in heat resistance studies, S. enterica sub...

Applications notice for participation in the LANDSAT-D image data quality analysis program

NASA Technical Reports Server (NTRS)

1981-01-01

The applications notice for the LANDSAT 4 image data quality analysis program is presented. The objectives of the program are to qualify LANDSAT 4 sensor and systems performance from a user applications point of view, and to identify any malfunctions that may impact data applications. Guidelines for preparing proposals and background information are provided.

Impact of particulate air pollution on quality-adjusted life expectancy in Canada.

PubMed

Coyle, Douglas; Stieb, Dave; Burnett, Richard T; DeCivita, Paul; Krewski, Daniel; Chen, Yue; Thun, Michael J

Air pollution and premature death are important public health concerns. Analyses have repeatedly demonstrated that airborne particles are associated with increased mortality and estimates have been used to forecast the impact on life expectancy. In this analysis, we draw upon data from the American Cancer Society (ACS) cohort and literature on utility-based measures of quality of life in relation to health status to more fully quantify the effects of air pollution on mortality in terms of quality-adjusted life expectancy. The analysis was conducted within a decision analytic model using Monte Carlo simulation techniques. Outcomes were estimated based on projections of the Canadian population. A one-unit reduction in sulfate air pollution would yield a mean annual increase in Quality-Adjusted Life Years (QALYs) of 20,960, with gains being greater for individuals with lower educational status and for males compared to females. This suggests that the impact of reductions in sulfate air pollution on quality-adjusted life expectancy is substantial. Interpretation of the results is unclear. However, the potential gains in QALYs from reduced air pollutants can be contrasted to the costs of policies to bring about such reductions. Based on a tentative threshold for the value of health benefits, analysis suggests that an investment in Canada of over 1 billion dollars per annum would be an efficient use of resources if it could be demonstrated that this would reduce sulfate concentrations in ambient air by 1 microg/m(3). Further analysis can assess the efficiency of targeting such initiatives to communities that are most likely to benefit.

Impact of Asian Dust on Climate and Air Quality

NASA Technical Reports Server (NTRS)

Chin, Mian; Tan, Qian; Diehl, Thomas; Yu, Hongbin

2010-01-01

Dust generated from Asian permanent desert and desertification areas can be efficiently transported around the globe, making significant radiative impact through their absorbing and scattering solar radiation and through their deposition on snow and ice to modify the surface albedo. Asian dust is also a major concern of surface air quality not only in the source and immediate downwind regions but also areas thousands of miles away across the Pacific. We present here a global model, GOCART, analysis of data from satellite remote sensing instrument (MODIS, MISR, CALIPSO, OMI) and other observations on Asian dust sources, transport, and deposition, and use the model to assess the Asian dust impact on global climate and air quality.

The influence of childhood atopic dermatitis on health of mothers, and its impact on Asian families.

PubMed

Ho, Roger C M; Giam, Y C; Ng, T P; Mak, Anselm; Goh, Daniel; Zhang, Melvyn W B; Cheak, Alicia; Van Bever, Hugo P

2010-05-01

This study examines maternal perceptions of paediatric atopic dermatitis (AD) on family and determines risk factors including severity of AD, maternal physical and mental health (MH), quality of life of patients and sociodemographics which predict a negative family impact. A cross-sectional assessment using the Dermatitis Family Impact Questionnaire Scale to assess the impact of AD on family, Infant's Dermatitis Quality of Life Index (<5-yrs old) or Children's Dermatitis Life Quality Index (5-17 yrs old) was used to measure health-related quality of life (HRQOL) of paediatric patients with AD. A 12-item Short-Form Health Survey (SF-12) was used to assess physical and MH of their mothers. Risk factors of adverse family impact were assessed using multiple regression analysis. One hundred and four patients with AD and their mothers were studied. Their mean ages (+/-s.d.) were respectively 6.4 +/- 4.3 and 37.2 +/- 6.6 yrs. In multiple regression analysis, Severity Scoring of Atopic Dermatitis (SCORAD) appeared to be associated with negative family impact and the association remained significant after adjustment for bio-psycho-social factors and HRQOL of patients. The association remained insignificant after adjustment for physical and MH of the mothers. Our results show that the severity of paediatric AD leads to negative family impact through reduction of physical and MH of the mothers, and is independent of patients' HRQOL and sociodemographics. The current approach for managing paediatric AD in Asian society could include early multidisciplinary intervention, aiming at enhancing physical and MH of mothers while minimizing negative impact on family and social isolation. Further research will be welcomed as the results of this study mainly applied to Asian society which could be different to populations from other geographic areas.

Assessing the combined effects of urbanisation and climate change on the river water quality in an integrated urban wastewater system in the UK.

PubMed

Astaraie-Imani, Maryam; Kapelan, Zoran; Fu, Guangtao; Butler, David

2012-12-15

Climate change and urbanisation are key factors affecting the future of water quality and quantity in urbanised catchments and are associated with significant uncertainty. The work reported in this paper is an evaluation of the combined and relative impacts of climate change and urbanisation on the receiving water quality in the context of an Integrated Urban Wastewater System (IUWS) in the UK. The impacts of intervening system operational control parameters are also investigated. Impact is determined by a detailed modelling study using both local and global sensitivity analysis methods together with correlation analysis. The results obtained from the case-study analysed clearly demonstrate that climate change combined with increasing urbanisation is likely to lead to worsening river water quality in terms of both frequency and magnitude of breaching threshold dissolved oxygen and ammonium concentrations. The results obtained also reveal the key climate change and urbanisation parameters that have the largest negative impact as well as the most responsive IUWS operational control parameters including major dependencies between all these parameters. This information can be further utilised to adapt future IUWS operation and/or design which, in turn, should make these systems more resilient to future climate and urbanisation changes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development and testing of a text-mining approach to analyse patients' comments on their experiences of colorectal cancer care.

PubMed

Wagland, Richard; Recio-Saucedo, Alejandra; Simon, Michael; Bracher, Michael; Hunt, Katherine; Foster, Claire; Downing, Amy; Glaser, Adam; Corner, Jessica

2016-08-01

Quality of cancer care may greatly impact on patients' health-related quality of life (HRQoL). Free-text responses to patient-reported outcome measures (PROMs) provide rich data but analysis is time and resource-intensive. This study developed and tested a learning-based text-mining approach to facilitate analysis of patients' experiences of care and develop an explanatory model illustrating impact on HRQoL. Respondents to a population-based survey of colorectal cancer survivors provided free-text comments regarding their experience of living with and beyond cancer. An existing coding framework was tested and adapted, which informed learning-based text mining of the data. Machine-learning algorithms were trained to identify comments relating to patients' specific experiences of service quality, which were verified by manual qualitative analysis. Comparisons between coded retrieved comments and a HRQoL measure (EQ5D) were explored. The survey response rate was 63.3% (21 802/34 467), of which 25.8% (n=5634) participants provided free-text comments. Of retrieved comments on experiences of care (n=1688), over half (n=1045, 62%) described positive care experiences. Most negative experiences concerned a lack of post-treatment care (n=191, 11% of retrieved comments) and insufficient information concerning self-management strategies (n=135, 8%) or treatment side effects (n=160, 9%). Associations existed between HRQoL scores and coded algorithm-retrieved comments. Analysis indicated that the mechanism by which service quality impacted on HRQoL was the extent to which services prevented or alleviated challenges associated with disease and treatment burdens. Learning-based text mining techniques were found useful and practical tools to identify specific free-text comments within a large dataset, facilitating resource-efficient qualitative analysis. This method should be considered for future PROM analysis to inform policy and practice. Study findings indicated that perceived care quality directly impacts on HRQoL. 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/

A national-scale analysis of the impacts of drought on water quality in UK rivers

NASA Astrophysics Data System (ADS)

Coxon, G.; Howden, N. J. K.; Freer, J. E.; Whitehead, P. G.; Bussi, G.

2015-12-01

Impacts of droughts on water quality qre difficult to quanitify but are essential to manage ecosystems and maintain public water supply. During drought, river water quality is significantly changed by increased residence times, reduced dilution and enhanced biogeochemical processes. But, the impact severity varies between catchments and depends on multiple factors including the sensitivity of the river to drought conditions, anthropogenic influences in the catchment and different delivery patterns of key nutrient, contaminant and mineral sources. A key constraint is data availability for key water quality parameters such that impacts of drought periods on certain determinands can be identified. We use national-scale water quality monitoring data to investigate the impacts of drought periods on water quality in the United Kingdom (UK). The UK Water Quality Sampling Harmonised Monitoring Scheme (HMS) dataset consists of >200 UK sites with weekly to monthly sampling of many water quality variables over the past 40 years. This covers several major UK droughts in 1975-1976, 1983-1984,1989-1992, 1995 and 2003, which cover severity, spatial and temporal extent, and how this affects the temporal impact of the drought on water quality. Several key water quality parameters, including water temperature, nitrate, dissolved organic carbon, orthophosphate, chlorophyll and pesticides, are selected from the database. These were chosen based on their availability for many of the sites, high sampling resolution and importance to the drinking water function and ecological status of the river. The water quality time series were then analysed to investigate whether water quality during droughts deviated significantly from non-drought periods and examined how the results varied spatially, for different drought periods and for different water quality parameters. Our results show that there is no simple conclusion as to the effects of drought on water quality in UK rivers; impacts are diverse both in terms of timing, magnitude and duration. We consider several scenarios in which management interventions may alleviate water quality pressures, and discuss how the many interacting factors need to be better characterised to support detailed mechanistic models to improve our process understanding.

Brief alcohol intervention trials conducted by higher prestige authors and published in higher impact factor journals are cited more frequently.

PubMed

Tanner-Smith, Emily E; Polanin, Joshua R

2016-07-01

To examine the relationships between study quality, author prestige, journal impact factors, and citation rates of trials and to examine whether journal impact factors mediated the relationships between study quality and author prestige on citation rates. We used bibliometric data from 128 controlled trials included in a recent meta-analysis on brief alcohol interventions for adolescents and young adults. We obtained the number of citations from ISI Web of Knowledge and Google Scholar; journal impact factors were obtained from ISI Web of Knowledge. Linear regression models were used to examine the direct and indirect effects of interest. The results indicated that studies were published in journals with higher impact factors when first authors had higher h-indices and studies were funded, but this was largely because those studies were of higher quality. Studies were cited more frequently when first authors had higher h-indices and studies were funded, even after adjusting for study quality proxies. The observed associations between study quality and author prestige on citation rates were also partly mediated through journal impact factors. We conclude that studies conducted by more established authors and reported in more prestigious journal outlets are more likely to be cited by other scholars, even after controlling for various proxies of study quality. Copyright © 2016 Elsevier Inc. All rights reserved.

Brief Alcohol Intervention Trials Conducted by Higher Prestige Authors and Published in Higher Impact Factor Journals are Cited More Frequently

PubMed Central

Tanner-Smith, Emily E.; Polanin, Joshua R.

2016-01-01

Objective To examine the relationships between study quality, author prestige, journal impact factors, and citation rates of trials; and to examine whether journal impact factors mediated the relationships between study quality and author prestige on citation rates. Study Design and Setting We used bibliometric data from 128 controlled trials included in a recent meta-analysis on brief alcohol interventions (BAIs) for adolescents and young adults. We obtained the number of citations from ISI Web of Knowledge and Google Scholar; journal impact factors were obtained from ISI Web of Knowledge. Linear regression models were used to examine the direct and indirect effects of interest. Results The results indicated that studies were published in journals with higher impact factors when first authors had higher h-indices and studies were funded, but this was largely because those studies were of higher quality. Studies were cited more frequently when first authors had higher h-indices and studies were funded, even after adjusting for study quality proxies. The observed associations between study quality and author prestige on citation rates were also partly mediated through journal impact factors. Conclusion We conclude that studies conducted by more established authors and reported in more prestigious journal outlets are more likely to be cited by other scholars, even after controlling for various proxies of study quality. PMID:26854420

Fuzzy Clustering Analysis in Environmental Impact Assessment--A Complement Tool to Environmental Quality Index.

ERIC Educational Resources Information Center

Kung, Hsiang-Te; And Others

1993-01-01

In spite of rapid progress achieved in the methodological research underlying environmental impact assessment (EIA), the problem of weighting various parameters has not yet been solved. This paper presents a new approach, fuzzy clustering analysis, which is illustrated with an EIA case study on Baoshan-Wusong District in Shanghai, China. (Author)

A rapid response air quality analysis system for use in projects having stringent quality assurance requirements

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

Bowman, A.W.

1990-04-01

This paper describes an approach to solve air quality problems which frequently occur during iterations of the baseline change process. From a schedule standpoint, it is desirable to perform this evaluation in as short a time as possible while budgetary pressures limit the size of the staff available to do the work. Without a method in place to deal with baseline change proposal requests the environment analysts may not be able to produce the analysis results in the time frame expected. Using a concept called the Rapid Response Air Quality Analysis System (RAAS), the problems of timing and cost becomemore » tractable. The system could be adapted to assess other atmospheric pathway impacts, e.g., acoustics or visibility. The air quality analysis system used to perform the EA analysis (EA) for the Salt Repository Project (part of the Civilian Radioactive Waste Management Program), and later to evaluate the consequences of proposed baseline changes, consists of three components: Emission source data files; Emission rates contained in spreadsheets; Impact assessment model codes. The spreadsheets contain user-written codes (macros) that calculate emission rates from (1) emission source data (e.g., numbers and locations of sources, detailed operating schedules, and source specifications including horsepower, load factor, and duty cycle); (2) emission factors such as those published by the U.S. Environmental Protection Agency, and (3) control efficiencies.« less

Impacts of Energy Sector Emissions on PM2.5 Air Quality in Northern India

NASA Astrophysics Data System (ADS)

Karambelas, A. N.; Kiesewetter, G.; Heyes, C.; Holloway, T.

2015-12-01

India experiences high concentrations of fine particulate matter (PM2.5), and several Indian cities currently rank among the world's most polluted cities. With ongoing urbanization and a growing economy, emissions from different energy sectors remain major contributors to air pollution in India. Emission sectors impact ambient air quality differently due to spatial distribution (typical urban vs. typical rural sources) as well as source height characteristics (low-level vs. high stack sources). This study aims to assess the impacts of emissions from three distinct energy sectors—transportation, domestic, and electricity—on ambient PM2.5­­ in northern India using an advanced air quality analysis framework based on the U.S. EPA Community Multi-Scale Air Quality (CMAQ) model. Present air quality conditions are simulated using 2010 emissions from the Greenhouse Gas-Air Pollution Interaction and Synergies (GAINS) model. Modeled PM2.5 concentrations are compared with satellite observations of aerosol optical depth (AOD) from the Moderate Imaging Spectroradiometer (MODIS) for 2010. Energy sector emissions impacts on future (2030) PM2.5 are evaluated with three sensitivity simulations, assuming maximum feasible reduction technologies for either transportation, domestic, or electricity sectors. These simulations are compared with a business as usual 2030 simulation to assess relative sectoral impacts spatially and temporally. CMAQ is modeled at 12km by 12km and include biogenic emissions from the Community Land Model coupled with the Model of Emissions of Gases and Aerosols in Nature (CLM-MEGAN), biomass burning emissions from the Global Fires Emissions Database (GFED), and ERA-Interim meteorology generated with the Weather Research and Forecasting (WRF) model for 2010 to quantify the impact of modified anthropogenic emissions on ambient PM2.5 concentrations. Energy sector emissions analysis supports decision-making to improve future air quality and public health in India.

Quality Management in Schools: Analysis of Mediating Factors

ERIC Educational Resources Information Center

Díez, Fernando; Iraurgi, Ioseba; Sanchez, Aurelio Villa

2018-01-01

The objective of this study is to contribute to Quality Management Systems (QMS) and their impact on schools in the Basque Country, Spain. Specifically, it analyses two models: the EFQM Excellence Model, which originated in the business world, and the Integrated Quality Project (IQP) Model, which has a humanistic focus and arose from an…

ANALYSIS OF AIR QUALITY DATA NEAR ROADWAYS USING A DISPERSION MODEL

EPA Science Inventory

A dispersion model was used to analyze measurements made during a field study conducted by the U.S. EPA in July and August 2006, to estimate the impact of highway emissions on air quality at distances of tens of meters from an eight-lane highway. The air quality measurements con...

Quality Curriculum for Under-Threes: The Impact of Structural Standards

ERIC Educational Resources Information Center

Wertfein, Monika; Spies-Kofler, Anita; Becker-Stoll, Fabienne

2009-01-01

The purpose of this study conducted in 36 infant-toddler centres ("Kinderkrippen") in the city of Munich in Bavaria/Germany was to explore structural characteristics of early child care and education and their effects on child care quality. Stepwise regressions and variance analysis (Manova) examined the relation between quality of care…

Modeling the impacts of green infrastructure land use changes on air quality and meteorology case study and sensitivity analysis in Kansas City

EPA Science Inventory

Changes in vegetation cover associated with urban planning efforts may affect regional meteorology and air quality. Here we use a comprehensive coupled meteorology-air quality model (WRF-CMAQ) to simulate the influence of planned land use changes from green infrastructure impleme...

Experimental analysis of the impact of sluice regulation on water quality in the highly polluted Huai River Basin, China.

PubMed

Zuo, Qiting; Chen, Hao; Dou, Ming; Zhang, Yongyong; Li, Dongfeng

2015-07-01

Impact assessment of sluice regulation on water quality is one of the crucial tasks in the present river management. However, research difficulties remain because of insufficient in situ data and numerous influencing factors in aquatic environments. The Huaidian Sluice, the main control sluice of the Shaying River, China, was selected for this study. Three field experimental programs were designed and carried out to analyze spatial and temporal variations in water quality parameters under various sluice regulation conditions and to explore the impacts of regulation mechanisms on water quality. Monitoring data were used to simulate water quality under different scenarios by the water quality analysis simulation program (WASP). Results demonstrate that the influences of sluice regulation on permanganate index (CODMn) and ammonia nitrogen (NH4-N) concentrations (indicators of water quality) were complex and nonlinear and presented different trends of increase or decrease from different regulation modes. Gate openings of different widths and different flow rates affected CODMn and NH4-N concentrations differently. Monitoring results and numerical simulation results indicate that the sluice opening should be small. Flow discharge through the sluice should be greater than 10 m(3) s and less than 60 m(3) s to maintain low CODMn concentrations, and discharge should be low (e.g., 14 m(3) s) to maintain low NH4-N concentrations. This research provides an experimental basis for further research on the construction of water quality models and for the development of reasonable regulations on water quality and quantity.

Impacts of global change on the concentrations and dilution of combined sewer overflows in a drinking water source.

PubMed

Jalliffier-Verne, Isabelle; Leconte, Robert; Huaringa-Alvarez, Uriel; Madoux-Humery, Anne-Sophie; Galarneau, Martine; Servais, Pierre; Prévost, Michèle; Dorner, Sarah

2015-03-01

This study presents an analysis of climate change impacts on a large river located in Québec (Canada) used as a drinking water source. Combined sewer overflow (CSO) effluents are the primary source of fecal contamination of the river. An analysis of river flowrates was conducted using historical data and predicted flows from a future climate scenario. A spatio-temporal analysis of water quality trends with regard to fecal contamination was performed and the effects of changing flowrates on the dilution of fecal contaminants were analyzed. Along the river, there was a significant spatial trend for increasing fecal pollution downstream of CSO outfalls. Escherichia coli concentrations (upper 95th percentile) increased linearly from 2002 to 2012 at one drinking water treatment plant intake. Two critical periods in the current climate were identified for the drinking water intakes considering both potential contaminant loads and flowrates: local spring snowmelt that precedes river peak flow and extra-tropical storm events that occur during low flows. Regionally, climate change is expected to increase the intensity of the impacts of hydrological conditions on water quality in the studied basin. Based on climate projections, it is expected that spring snowmelt will occur earlier and extreme spring flowrates will increase and low flows will generally decrease. High and low flows are major factors related to the potential degradation of water quality of the river. However, the observed degradation of water quality over the past 10 years suggests that urban development and population growth may have played a greater role than climate. However, climate change impacts will likely be observed over a longer period. Source water protection plans should consider climate change impacts on the dilution of contaminants in addition to local land uses changes in order to maintain or improve water quality. Copyright © 2014 Elsevier B.V. All rights reserved.

Environmetric data interpretation to assess the water quality of Maritsa River catchment.

PubMed

Papazova, Petia; Simeonova, Pavlina

2013-01-01

Maritsa River is one of the largest rivers flowing on Bulgarian territory. The quality of its waters is of substantial importance for irrigation, industrial, recreation and domestic use. Besides, part of the river is flowing on Turkish territory and the control and management of the Maritsa catchment is of mutual interst for the neighboring countires. Thus, performing interpretation and modeling of the river water quality is a major environmetric problem. Two multivariate statstical methods (Cluster analysis/CA/and Principal components analysis/PCA/) were applied for model assessment of the water quality of Maritsa River on Bulgarian territory. The study used long-term monitoring data from 21 sampling sites characterized by 8 surface water quality indicators. The application of CA to the indicators results in 3 significant clusters showing the impact of biological, anthropogenic and eutrophication sources. For further assessment of the monitoring data, PCA was implemented, which identified, again,three latent factors confirming, in principle, the clustering output. The latent factors were conditionally named "biologic", "anthropogenic" and "eutrophication" source. Their identification coinside correctly to the location of real pollution sources along the Maritsa River catchment. The linkage of the sampling sites along the river flow by CA identified four special patterns separated by specific tracers levels: biological and anthropogenic major impact for pattern 1, euthrophication major impact for pattern 2, background levels for pattern 3 and eutrophication and agricultural major impact for pattern 4. The apportionment models of the pollution determined the contribution of each one of identified pollution factors to the total concentration of each one of the water quality parameters. Thus, a better risk management of the surface water quality is achieved both on local and national level.

Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes

PubMed Central

Congdon, Peter

2016-01-01

Background: Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation. Methods: This paper proposes a structural equation model for quality and access as latent variables affecting adverse outcomes, such as unplanned hospitalisations. In a case study application, quality of care (QOC) is defined in relation to diabetes, and the aim is to assess impacts of care quality and access on unplanned hospital admissions for diabetes, while allowing also for socio-economic deprivation, diabetes morbidity, and supply effects. The study involves 90 general practitioner (GP) practices in two London Clinical Commissioning Groups, using clinical quality of care indicators, and patient survey data on perceived access. Results: As a single predictor, quality of care has a significant negative impact on emergency admissions, and this significant effect remains when socio-economic deprivation and morbidity are allowed. In a full structural equation model including access, the probability that QOC negatively impacts on unplanned admissions exceeds 0.9. Furthermore, poor access is linked to deprivation, diminished QOC, and larger list sizes. Conclusions: Using a Bayesian inference methodology, the evidence from the analysis is weighted towards negative impacts of higher primary care quality and improved access on unplanned admissions. The methodology of the paper is potentially applicable to other long term conditions, and relevant when care quality and access cannot be measured directly and are better regarded as latent variables. PMID:27598184

Assessing Impacts on Unplanned Hospitalisations of Care Quality and Access Using a Structural Equation Method: With a Case Study of Diabetes.

PubMed

Congdon, Peter

2016-09-01

Enhanced quality of care and improved access are central to effective primary care management of long term conditions. However, research evidence is inconclusive in establishing a link between quality of primary care, or access, and adverse outcomes, such as unplanned hospitalisation. This paper proposes a structural equation model for quality and access as latent variables affecting adverse outcomes, such as unplanned hospitalisations. In a case study application, quality of care (QOC) is defined in relation to diabetes, and the aim is to assess impacts of care quality and access on unplanned hospital admissions for diabetes, while allowing also for socio-economic deprivation, diabetes morbidity, and supply effects. The study involves 90 general practitioner (GP) practices in two London Clinical Commissioning Groups, using clinical quality of care indicators, and patient survey data on perceived access. As a single predictor, quality of care has a significant negative impact on emergency admissions, and this significant effect remains when socio-economic deprivation and morbidity are allowed. In a full structural equation model including access, the probability that QOC negatively impacts on unplanned admissions exceeds 0.9. Furthermore, poor access is linked to deprivation, diminished QOC, and larger list sizes. Using a Bayesian inference methodology, the evidence from the analysis is weighted towards negative impacts of higher primary care quality and improved access on unplanned admissions. The methodology of the paper is potentially applicable to other long term conditions, and relevant when care quality and access cannot be measured directly and are better regarded as latent variables.

Influence of land use on water quality in a tropical landscape: a multi-scale analysis

PubMed Central

Yackulic, Charles B.; Lim, Yili; Arce-Nazario, Javier A.

2015-01-01

There is a pressing need to understand the consequences of human activities, such as land transformations, on watershed ecosystem services. This is a challenging task because different indicators of water quality and yield are expected to vary in their responsiveness to large versus local-scale heterogeneity in land use and land cover (LUC). Here we rely on water quality data collected between 1977 and 2000 from dozens of gauge stations in Puerto Rico together with precipitation data and land cover maps to (1) quantify impacts of spatial heterogeneity in LUC on several water quality indicators; (2) determine the spatial scale at which this heterogeneity influences water quality; and (3) examine how antecedent precipitation modulates these impacts. Our models explained 30–58% of observed variance in water quality metrics. Temporal variation in antecedent precipitation and changes in LUC between measurements periods rather than spatial variation in LUC accounted for the majority of variation in water quality. Urbanization and pasture development generally degraded water quality while agriculture and secondary forest re-growth had mixed impacts. The spatial scale over which LUC influenced water quality differed across indicators. Turbidity and dissolved oxygen (DO) responded to LUC in large-scale watersheds, in-stream nitrogen concentrations to LUC in riparian buffers of large watersheds, and fecal matter content and in-stream phosphorus concentration to LUC at the sub-watershed scale. Stream discharge modulated impacts of LUC on water quality for most of the metrics. Our findings highlight the importance of considering multiple spatial scales for understanding the impacts of human activities on watershed ecosystem services. PMID:26146455

DRAINMOD-GIS: a lumped parameter watershed scale drainage and water quality model

Treesearch

G.P. Fernandez; G.M. Chescheir; R.W. Skaggs; D.M. Amatya

2006-01-01

A watershed scale lumped parameter hydrology and water quality model that includes an uncertainty analysis component was developed and tested on a lower coastal plain watershed in North Carolina. Uncertainty analysis was used to determine the impacts of uncertainty in field and network parameters of the model on the predicted outflows and nitrate-nitrogen loads at the...

The Effect of Family Background, University Quality and Educational Mismatch on Wage: An Analysis Using a Young Cohort of Italian Graduates

ERIC Educational Resources Information Center

Ordine, Patrizia; Rose, Giuseppe

2015-01-01

This paper analyzes the impact of university quality, family background and mismatch on the wages of young Italian graduates. An empirical analysis is undertaken using a representative sample of graduates merged with a dataset containing information on the characteristics of universities. By utilizing quantile regression techniques, some evidence…

Incorporating health care quality into health antitrust law

PubMed Central

2008-01-01

Background Antitrust authorities treat price as a proxy for hospital quality since health care quality is difficult to observe. As the ability to measure quality improved, more research became necessary to investigate the relationship between hospital market power and patient outcomes. This paper examines the impact of hospital competition on the quality of care as measured by the risk-adjusted mortality rates with the hospital as the unit of analysis. The study separately examines the effect of competition on non-profit hospitals. Methods We use California Office of Statewide Health Planning and Development (OSHPD) data from 1997 through 2002. Empirical model is a cross-sectional study of 373 hospitals. Regression analysis is used to estimate the relationship between Coronary Artery Bypass Graft (CABG) risk-adjusted mortality rates and hospital competition. Results Regression results show lower risk-adjusted mortality rates in the presence of a more competitive environment. This result holds for all alternative hospital market definitions. Non-profit hospitals do not have better patient outcomes than investor-owned hospitals. However, they tend to provide better quality in less competitive environments. CABG volume did not have a significant effect on patient outcomes. Conclusion Quality should be incorporated into the antitrust analysis. When mergers lead to higher prices and lower quality, thus lower social welfare, the antitrust challenge of hospital mergers is warranted. The impact of lower hospital competition on quality of care delivered by non-profit hospitals is ambiguous. PMID:18430219

Coverage and quality: A comparison of Web of Science and Scopus databases for reporting faculty nursing publication metrics.

PubMed

Powell, Kimberly R; Peterson, Shenita R

Web of Science and Scopus are the leading databases of scholarly impact. Recent studies outside the field of nursing report differences in journal coverage and quality. A comparative analysis of nursing publications reported impact. Journal coverage by each database for the field of nursing was compared. Additionally, publications by 2014 nursing faculty were collected in both databases and compared for overall coverage and reported quality, as modeled by Scimajo Journal Rank, peer review status, and MEDLINE inclusion. Individual author impact, modeled by the h-index, was calculated by each database for comparison. Scopus offered significantly higher journal coverage. For 2014 faculty publications, 100% of journals were found in Scopus, Web of Science offered 82%. No significant difference was found in the quality of reported journals. Author h-index was found to be higher in Scopus. When reporting faculty publications and scholarly impact, academic nursing programs may be better represented by Scopus, without compromising journal quality. Programs with strong interdisciplinary work should examine all areas of strength to ensure appropriate coverage. Copyright © 2017 Elsevier Inc. All rights reserved.

Factor selection for service quality evaluation: a hospital case study.

PubMed

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.

Cultural and contextual analysis of quality of life among older Nepali women.

PubMed

Shrestha, Srijana; Zarit, Steven H

2012-06-01

The quality-of-life construct can be used to assess how well an individual's needs are met or being met by the society. However, in the dominant narratives of quality of life in old age, exploration of the impact of cultural differences on how older adults define and assess their quality of life has been limited. Moreover, the examination of heterogeneity within one culture and its influence on quality of life has been largely ignored. The present study compares the quality of life as defined by two samples of Nepali elderly women, those who live with their families and those who live in an old-age home, and presents data on factors associated with quality of life in the two samples. The results show that social and cultural norms, informed by religious principles that prescribe familial elder care, impact how quality of life is described by both groups of women.

The IMPACT-III (HR) questionnaire: a valid measure of health-related quality of life in Croatian children with inflammatory bowel disease.

PubMed

Abdovic, Slaven; Mocic Pavic, Ana; Milosevic, Milan; Persic, Mladen; Senecic-Cala, Irena; Kolacek, Sanja

2013-12-01

To assess the reliability and validity of IMPACT-III (HR), a disease-specific, health-related quality of life instrument in Croatian children with inflammatory bowel disease. In a multicenter study, 104 children participated in a validation study of IMPACT-III (HR) cross-culturally adapted for Croatia. Factor analysis was used to determine optimal domain structure for this cohort, analysis of Cronbach's alpha coefficients to test internal reliability, ANOVA to assess discriminant validity, and correlation with Pediatric Quality of Life Inventory, Version 4.0 (PedsQL) using Pearson correlation coefficients to assess concurrent validity. Cronbach's alpha for the IMPACT-III (HR) total score was 0.92. The most robust factor solution was a 5-domain structure: Symptoms, Concerns, Socializing, Body Image, and Worry about Stool, all of which demonstrated good internal reliability (α=0.60-0.89), but two items were dropped to achieve this. Discriminant validity was demonstrated by significant differences (P<0.001) in mean IMPACT-III (HR) scores between quiescent and mild or moderate-severe disease activity groups for total (148 vs. 139 or 125) and following factor scores: Symptoms (84 vs. 71 or 61), Socializing (91 vs. 83 or 76), and Worry about Stool (significant only between quiescent and moderate-severe groups, 90 vs. 62, respectively). Concurrent validity of IMPACT-III (HR) with PedsQL showed significant correlation, which was strongest when similar domains were compared. IMPACT-III (HR) appears to be useful tool to measure health-related quality of life in Croatian children with Crohn's disease and ulcerative colitis. Copyright © 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Longitudinal analysis of reporting and quality of systematic reviews in high-impact surgical journals.

PubMed

Chapman, S J; Drake, T M; Bolton, W S; Barnard, J; Bhangu, A

2017-02-01

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement aims to optimize the reporting of systematic reviews. The performance of the PRISMA Statement in improving the reporting and quality of surgical systematic reviews remains unclear. Systematic reviews published in five high-impact surgical journals between 2007 and 2015 were identified from online archives. Manuscripts blinded to journal, publication year and authorship were assessed according to 27 reporting criteria described by the PRISMA Statement and scored using a validated quality appraisal tool (AMSTAR, Assessing the Methodological Quality of Systematic Reviews). Comparisons were made between studies published before (2007-2009) and after (2011-2015) its introduction. The relationship between reporting and study quality was measured using Spearman's rank test. Of 281 eligible manuscripts, 80 were published before the PRISMA Statement and 201 afterwards. Most manuscripts (208) included a meta-analysis, with the remainder comprising a systematic review only. There was no meaningful change in median compliance with the PRISMA Statement (19 (i.q.r. 16-21) of 27 items before versus 19 (17-22) of 27 after introduction of PRISMA) despite achieving statistical significance (P = 0·042). Better reporting compliance was associated with higher methodological quality (r s  = 0·70, P < 0·001). The PRISMA Statement has had minimal impact on the reporting of surgical systematic reviews. Better compliance was associated with higher-quality methodology. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

Impact of Altering Various Image Parameters on Human Epidermal Growth Factor Receptor 2 Image Analysis Data Quality.

PubMed

Pantanowitz, Liron; Liu, Chi; Huang, Yue; Guo, Huazhang; Rohde, Gustavo K

2017-01-01

The quality of data obtained from image analysis can be directly affected by several preanalytical (e.g., staining, image acquisition), analytical (e.g., algorithm, region of interest [ROI]), and postanalytical (e.g., computer processing) variables. Whole-slide scanners generate digital images that may vary depending on the type of scanner and device settings. Our goal was to evaluate the impact of altering brightness, contrast, compression, and blurring on image analysis data quality. Slides from 55 patients with invasive breast carcinoma were digitized to include a spectrum of human epidermal growth factor receptor 2 (HER2) scores analyzed with Visiopharm (30 cases with score 0, 10 with 1+, 5 with 2+, and 10 with 3+). For all images, an ROI was selected and four parameters (brightness, contrast, JPEG2000 compression, out-of-focus blurring) then serially adjusted. HER2 scores were obtained for each altered image. HER2 scores decreased with increased illumination, higher compression ratios, and increased blurring. HER2 scores increased with greater contrast. Cases with HER2 score 0 were least affected by image adjustments. This experiment shows that variations in image brightness, contrast, compression, and blurring can have major influences on image analysis results. Such changes can result in under- or over-scoring with image algorithms. Standardization of image analysis is recommended to minimize the undesirable impact such variations may have on data output.

Frequency analysis of urban runoff quality in an urbanizing catchment of Shenzhen, China

NASA Astrophysics Data System (ADS)

Qin, Huapeng; Tan, Xiaolong; Fu, Guangtao; Zhang, Yingying; Huang, Yuefei

2013-07-01

This paper investigates the frequency distribution of urban runoff quality indicators using a long-term continuous simulation approach and evaluates the impacts of proposed runoff control schemes on runoff quality in an urbanizing catchment in Shenzhen, China. Four different indicators are considered to provide a comprehensive assessment of the potential impacts: total runoff depth, event pollutant load, Event Mean Concentration, and peak concentration during a rainfall event. The results obtained indicate that urban runoff quantity and quality in the catchment have significant variations in rainfall events and a very high rate of non-compliance with surface water quality regulations. Three runoff control schemes with the capacity to intercept an initial runoff depth of 5 mm, 10 mm, and 15 mm are evaluated, respectively, and diminishing marginal benefits are found with increasing interception levels in terms of water quality improvement. The effects of seasonal variation in rainfall events are investigated to provide a better understanding of the performance of the runoff control schemes. The pre-flood season has higher risk of poor water quality than other seasons after runoff control. This study demonstrates that frequency analysis of urban runoff quantity and quality provides a probabilistic evaluation of pollution control measures, and thus helps frame a risk-based decision making for urban runoff quality management in an urbanizing catchment.

Third molar removal and its impact on quality of life: systematic review and meta-analysis.

PubMed

Duarte-Rodrigues, Lucas; Miranda, Ednele Fabyene Primo; Souza, Taiane Oliveira; de Paiva, Haroldo Neves; Falci, Saulo Gabriel Moreira; Galvão, Endi Lanza

2018-05-24

The purpose of this systematic review was to assess the impact of third molar removal on patient's quality of life. To address the study purpose, investigators designed and implemented a systematic review. The primary outcome variable was the quality of life after third molar extraction. An electronic search was conducted through March, 2017, on the PUBMED, Virtual Health Library (VHL), Web of Science, and OVID, to identify relevant literatures. Research studies (randomized or non-randomized clinical trials) were included that evaluated the quality of life in individuals before and after third molar extraction, using validated measures of oral health-related quality of life with quantitative approach, besides procedures performed under local anesthesia. The R software was used to measure the mean difference on the quality of life between the preoperative period and follow-up days. A total of 1141 studies were identified. Of this total, 13 articles were selected in the present systematic review, of which six studies were included in the meta-analysis. All of these 13 articles used the OHIP-14, and 4 of this 13 used OHQoLUK-16 to evaluate the quality of life. Regarding quality assessment, four of the 13 included studies in this review received a maximum score of 9 points, according to the Newcastle-Ottawa (NOS). The OHIP-14 mean score on the first postoperative day was 17.57 (95% CI 11.84-23.30, I 2  = 96%) higher than the preoperative period. On the seventh postoperative day, the quality of life assessed by OHIP-14 got worse again. This systematic review revealed that the highest negative impact on quality of life of individuals submitted to third molar surgery was observed on the first postoperative day, decreasing over the follow-up period.

[Association between physical and psychosocial impacts of oral disorders and quality of life among the elderly].

PubMed

Martins, Andréa Maria Eleutério de Barros Lima; Jones, Kimberly Marie; Souza, João Gabriel Silva; Pordeus, Isabela Almeida

2014-08-01

This study sought to evaluate the association between the impact of oral disorders in terms of physical/psychosocial dimensions and quality of life among the elderly. It involved a cross-sectional study conducted among the elderly (65-74 years) in 2008/2009. The social impact was assessed using the Oral Health Impact Profile (OHIP 14) and the quality of life using the SF 12 Short-Form Health Survey. Descriptive, univariate and multivariate (logistic regression) analysis was conducted with correction for the design effect, using SPSS(r)18.0 software. Of the 800 individuals approached, 736 elderly individuals participated (TR = 92%), with a mean age of 67.77 years, the majority of whom showed no impact based on the measurement of the prevalence of OHIP. The functional limitation dimension of the OHIP was associated with the physical domain of the SF12, irrespective of the other variables investigated. However, the seriousness of OHIP and its psychological discomfort and disability dimensions was associated with the mental domain of the SF12. The conclusion reached is that some impacts of oral disorders were associated with unsatisfactory quality of life in the physical and mental domains.

Toward a Methodology for Conducting Social Impact Assessments Using Quality of Social Life Indicators.

ERIC Educational Resources Information Center

Olsen, Marvin E.; Merwin, Donna J.

Broadly conceived, social impacts refer to all changes in the structure and functioning of patterned social ordering that occur in conjunction with an environmental, technological, or social innovation or alteration. Departing from the usual cost-benefit analysis approach, a new methodology proposes conducting social impact assessment grounded in…

Opportunity or Exploitation? Women and Quality Assurance in Higher Education

ERIC Educational Resources Information Center

Morley, Louise

2005-01-01

Based on interviews with 18 UK women academics and managers on quality and power in higher education, this article interrogates the impact of quality assurance discourses and practices on women in higher education. Micro-level analysis of the effects of audit and the evaluative state seem to suggest that hegemonic masculinities and gendered power…

Preliminary findings on water quality of ricing lakes on White Earth Reservation, MN

USDA-ARS?s Scientific Manuscript database

Wild rice is a cultural and economic staple of the Anishinaabe People of White Earth. Changes in land use within the watershed may impact the water quality of ricing lakes on the reservation. The purpose of this discussion is to report the preliminary findings of water quality analysis of samples ta...

The Operation Mechanisms of External Quality Assurance Frameworks of Foreign Higher Education and Implications for Graduate Education

ERIC Educational Resources Information Center

Lin, Mengquan; Chang, Kai; Gong, Le

2016-01-01

The higher education quality evaluation and assurance frameworks and their operating mechanisms of countries such as the United Kingdom, France, and the United States show that higher education systems, traditional culture, and social background all impact quality assurance operating mechanisms. A model analysis of these higher education quality…

[Application of risk-based approach for determination of critical factors in technology transfer of production of medicinal products].

PubMed

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.

Analysis of weather patterns associated with air quality degradation and potential health impacts

EPA Science Inventory

Emissions from anthropogenic and natural sources into the atmosphere are determined in large measure by prevailing weather conditions through complex physical, dynamical and chemical processes. Air pollution episodes are characterized by degradation in air quality as reflected by...

Environmental cost-benefit analysis of ultra low sulfur jet fuel.

DOT National Transportation Integrated Search

2011-12-01

Aircraft emissions can reduce air quality, leading to adverse health impacts including : increased risk of premature mortality. A technically viable way to mitigate the health : impacts of aviation is the use of desulfurized jet fuel, as has been don...

Belgian guidelines for budget impact analyses.

PubMed

Neyt, M; Cleemput, I; Sande, S Van De; Thiry, N

2015-06-01

To develop methodological guidelines for budget impact analysis submitted to the Belgian health authorities as part of a reimbursement request. A review of the literature was performed and provided the basis for preliminary budget impact guidelines. These guidelines were improved after discussion with health economists from the Belgian Health Care Knowledge Centre (KCE) and different Belgian stakeholders from both government and industry. Preliminary guidelines were also discussed in a workshop with health economists from The German Institute for Quality and Efficiency in Healthcare. Finally, the guidelines were also externally validated by three external experts. The guidelines give explicit guidance for the following components of a budget impact analysis: perspective of the evaluation, target population, comparator, costs, time horizon, modeling, handling uncertainty and discount rate. Special attention is given to handling varying target population sizes over time, applying a time horizon up to the steady state instead of short-term predictions, and similarities and differences between budget impact analysis and economic evaluations. The guidelines provide a framework for both researchers and assessors to set up budget impact analyses that are transparent, relevant, of high quality and apply a consistent methodology. This might improve the extent to which such evaluations can reliably and consistently be used in the reimbursement decision making process.

Improvement of impact noise in a passenger car utilizing sound metric based on wavelet transform

NASA Astrophysics Data System (ADS)

Lee, Sang-Kwon; Kim, Ho-Wuk; Na, Eun-Woo

2010-08-01

A new sound metric for impact sound is developed based on the continuous wavelet transform (CWT), a useful tool for the analysis of non-stationary signals such as impact noise. Together with new metric, two other conventional sound metrics related to sound modulation and fluctuation are also considered. In all, three sound metrics are employed to develop impact sound quality indexes for several specific impact courses on the road. Impact sounds are evaluated subjectively by 25 jurors. The indexes are verified by comparing the correlation between the index output and results of a subjective evaluation based on a jury test. These indexes are successfully applied to an objective evaluation for improvement of the impact sound quality for cases where some parts of the suspension system of the test car are modified.

Retrospective analysis of associations between water quality and toxic blooms of golden alga (Prymnesium parvum) in Texas reservoirs: Implications for understanding dispersal mechanisms and impacts of climate change

USGS Publications Warehouse

Patino, Reynaldo; Dawson, D.; VanLandeghem, Matthew M.

2014-01-01

Toxic blooms of golden alga (GA, Prymnesium parvum) in Texas typically occur in winter or early spring. In North America, they were first reported in Texas in the 1980s, and a marked range expansion occurred in 2001. Although there is concern about the influence of climate change on the future distribution of GA, factors responsible for past dispersals remain uncertain. To better understand the factors that influence toxic bloom dispersal in reservoirs, this study characterized reservoir water quality associated with toxic GA blooms since 2001, and examined trends in water quality during a 20-year period bracketing the 2001 expansion. Archived data were analyzed for six impacted and six nonimpacted reservoirs from two major Texas basins: Brazos River and Colorado River. Data were simplified for analysis by pooling spatially (across sampling stations) and temporally (winter, December-February) within reservoirs and generating depth-corrected (1 m) monthly values. Classification tree analysis [period of record (POR), 2001-2010] using salinity-associated variables (specific conductance, chloride, sulfate), dissolved oxygen (DO), pH, temperature, total hardness, potassium, nitrate+nitrite, and total phosphorus indicated that salinity best predicts the toxic bloom occurrence. Minimum estimated salinities for toxic bloom formation were 0.59 and 1.02 psu in Brazos and Colorado River reservoirs, respectively. Principal component analysis (POR, 2001-2010) indicated that GA habitat is best defined by higher salinity relative to nonimpacted reservoirs, with winter DO and pH also being slightly higher and winter temperature slightly lower in impacted reservoirs. Trend analysis, however, did not reveal monotonic changes in winter water quality of GA-impacted reservoirs during the 20-year period (1991-2010) bracketing the 2001 dispersal. Therefore, whereas minimum levels of salinity are required for GA establishment and toxic blooms in Texas reservoirs, the lack of trends in water quality suggests that conditions favorable for toxic blooms pre-date the 2001 expansion. These observations are consistent with a climate change-independent scenario of past GA dispersals in Texas reservoirs driven by novel introductions into pre-existing favorable habitat. Reports of latent GA populations in certain nonimpacted reservoirs, however, provide a plausible scenario of future dispersals characterized by prolonged periods between colonization and toxic bloom development and driven by changes in water quality, natural, or anthropogenic.

Impact of sociodemographic attributes and dental caries on quality of life of intellectual disabled children using ECOHIS

PubMed Central

Aggarwal, Vikram Pal; Mathur, Anmol; Dileep, C.L; Batra, Manu; Makkar, Diljot Kaur

2016-01-01

Objectives To assess the impact of oral health outcomes on Oral Health-Related Quality of Life (OHRQoL) among intellectual disabled children and their families. Methodology OHRQoL based study was conducted among 150 intellectual disabled children students in the North West part of the country, Rajasthan, India. Guardians were asked to complete questionnaire on socioeconomic status and the Early Childhood Oral Health Impact Scale (ECOHIS) on their perception of the children’s OHRQoL. Clinical assessment included dental caries and OHI-S INDEX. Univariate regression analysis was fitted to assess covariates for the prevalence of impacts on OHRQoL. Results 54% of the caregivers reported that their child had an impact on at least one ECOHIS item. Negative impacts were more prevalent on items related to difficulty in eating some foods, difficulty in pronouncing any words and missed preschool, day-care or school. The univariate Poisson regression analysis showed that dental caries was significantly associated with the outcome. The prevalence of any impact on OHRQoL was approximately 1.32 and 2.84 times higher for children with low and higher severity of dental caries respectively when compared with those who were free of caries. Conclusion Patient-oriented outcomes like OHRQoL will enhance our understanding of the relationship between oral health and general health and demonstrate to clinical researchers and practitioners that improving the quality of patient’s well-being go beyond simply treating dental disease and disorders. PMID:27833512

The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis.

PubMed

Barlow, Pepita; McKee, Martin; Basu, Sanjay; Stuckler, David

2017-03-08

Regional trade agreements are major international policy instruments that shape macro-economic and political systems. There is widespread debate as to whether and how these agreements pose risks to public health. Here we perform a comprehensive systematic review of quantitative studies of the health impact of trade and investment agreements. We identified studies from searches in PubMed, Web of Science, EMBASE, and Global Health Online. Research articles were eligible for inclusion if they were quantitative studies of the health impacts of trade and investment agreements or policy. We systematically reviewed study findings, evaluated quality using the Quality Assessment Tool from the Effective Public Health Practice Project, and performed network citation analysis to study disciplinary siloes. Seventeen quantitative studies met our inclusion criteria. There was consistent evidence that implementing trade agreements was associated with increased consumption of processed foods and sugar-sweetened beverages. Granting import licenses for patented drugs was associated with increased access to pharmaceuticals. Implementing trade agreements and associated policies was also correlated with higher cardiovascular disease incidence and higher Body Mass Index (BMI), whilst correlations with tobacco consumption, under-five mortality, maternal mortality, and life expectancy were inconclusive. Overall, the quality of studies is weak or moderately weak, and co-citation analysis revealed a relative isolation of public health from economics. We identified limitations in existing studies which preclude definitive conclusions of the health impacts of regional trade and investment agreements. Few address unobserved confounding, and many possible consequences and mechanisms linking trade and investment agreements to health remain poorly understood. Results from our co-citation analysis suggest scope for greater interdisciplinary collaboration. Notwithstanding these limitations, our results find evidence that trade agreements pose some significant health risks. Health protections in trade and investment treaties may mitigate these impacts.

The impact of software quality characteristics on healthcare outcome: a literature review.

PubMed

Aghazadeh, Sakineh; Pirnejad, Habibollah; Moradkhani, Alireza; Aliev, Alvosat

2014-01-01

The aim of this study was to discover the effect of software quality characteristics on healthcare quality and efficiency indicators. Through a systematic literature review, we selected and analyzed 37 original research papers to investigate the impact of the software indicators (coming from the standard ISO 9126 quality characteristics and sub-characteristics) on some of healthcare important outcome indicators and finally ranked these software indicators. The results showed that the software characteristics usability, reliability and efficiency were mostly favored in the studies, indicating their importance. On the other hand, user satisfaction, quality of patient care, clinical workflow efficiency, providers' communication and information exchange, patient satisfaction and care costs were among the healthcare outcome indicators frequently evaluated in relation to the mentioned software characteristics. Regression Logistic Method was the most common assessment methodology, and Confirmatory Factor Analysis and Structural Equation Modeling were performed to test the structural model's fit. The software characteristics were considered to impact the healthcare outcome indicators through other intermediate factors (variables).

Are Public Libraries Improving Quality of Education? When the Provision of Public Goods Is Not Enough. Policy Research Working Paper 7429

ERIC Educational Resources Information Center

Rodriguez-Lesmes, Paul; Trujillo, Jose Daniel; Valderrama, Daniel

2015-01-01

This paper analyzes the relation between public, education-related infrastructure and the quality of education in schools. The analysis uses a case study of the establishment of two large, high-quality public libraries in low-income areas in Bogotá, Colombia. It assesses the impact of these libraries on the quality of education by comparing…

Psychosocial Interventions for Depressive and Anxiety Symptoms in Individuals with Chronic Kidney Disease: Systematic Review and Meta-Analysis

PubMed Central

Pascoe, Michaela C.; Thompson, David R.; Castle, David J.; McEvedy, Samantha M.; Ski, Chantal F.

2017-01-01

Purpose: Depressive and anxiety symptoms are common amongst individuals with chronic kidney disease and are known to affect quality of life adversely. Psychosocial interventions have been shown to decrease depressive and anxiety symptoms in various chronic diseases, but few studies have examined their efficacy in people with chronic kidney disease and no meta-analysis has been published. Thus, the aim of the present systematic review and meta-analysis was to evaluate the effects of psychosocial interventions on depressive and anxiety symptoms as well as quality of life in individuals diagnosed with chronic kidney disease and/or their carers. Methods: In this systematic review and meta-analysis, we included published randomized controlled trials comparing psychosocial interventions versus usual care for impacting depressive and anxiety symptoms and quality of life. Results: Eight studies were included in the systematic review and six of these were subjected to meta-analysis. Psychosocial interventions were associated with a medium effect size for reduction in depressive symptoms and a small effect size for improved quality of life in the in individuals with chronic-kidney-disease and their carers. Some evidence suggested a reduction in anxiety. Conclusion: Psychosocial interventions appear to reduce depressive symptoms and improve quality of life in patients with chronic-kidney-disease and their carers and to have some beneficial impact on anxiety. However, the small number of identified studies indicates a need for further research in this field. PMID:28659852

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

NASA Astrophysics Data System (ADS)

Berger, Roland; Hänze, Martin

2015-01-01

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

IMPACT OF DENTAL TRAUMA AND ESTHETIC IMPAIRMENT ON THE QUALITY OF LIFE OF PRESCHOOL CHILDREN

PubMed Central

Gonçalves, Bruna Miroski; Dias, Loraine Fernandes; Pereira, Carla da Silva; Ponte, Marcos Ximenes; Konrath, Andréa Cristina; Bolan, Michele da Silva; Cardoso, Mariane

2017-01-01

ABSTRACT Objective: To evaluate the impact of dental trauma and impaired esthetics on the quality of life (QoL) of preschool children and their relatives. Methods: Study conducted with 192 children aged 2 to 5 years in 11 preschools in Florianópolis, Santa Catarina, South of Brazil. Parents/caregivers completed a questionnaire on quality of life (Brazilian version of the Early Childhood Oral Health Impact Scales - B-ECOHIS), a socioeconomic survey, and then answered specific questions related to dental trauma. The subjects were examined by three accordant examiners (Kappa>0.7). Dental trauma was evaluated on the basis of indexes adopted by the World Health Organization, and esthetic impairment was then classified. Data were descriptively analyzed and put to bivariate analysis by chi-square and Fisher tests, with significance level at 5%. Results: The prevalence of dental trauma was 62.5% with 15.6% of esthetic impairment. Almost 12% of parents reported impact on the quality of life of their children. Dental trauma was not significantly associated with gender, age or QoL. Crown color change by trauma was associated with esthetic impairment. Also esthetic impairment had a negative impact on QoL (p<0.05) and was associated with oral limitations (p<0.05). Conclusions: Esthetic impairment had a negative impact on children’s quality of life, while dental trauma was not associated to it. PMID:28977132

Impact of sleep quality on the quality of life of patients with Parkinson's disease: a questionnaire based study.

PubMed

Pandey, Shweta; Bajaj, Bhupender Kumar; Wadhwa, Ankur; Anand, Kuljeet Singh

2016-09-01

Poor sleep quality contributes to the inferior quality of life of patients with Parkinson's disease (PD) despite appropriate treatment of motor symptoms. The literature about the impact of sleep quality on quality of life of patients with PD is as yet sparse. One hundred patients of PD diagnosed as per UK Brain Bank criteria were assessed for severity and stage of PD using UPDRS and modified Hoehn &Yahr scales. The quality of sleep was assessed by Pittsburgh Sleep Quality Index and excessive daytime somnolence (EDS) was evaluated using Epworth Sleepiness Scale. Parkinson's Disease Questionnaire -39 (PDQ-39) was used to determine quality of life of the patients. Comorbid depression and anxiety were assessed using Inventory of Depressive Symptoms-Self Rated and Hamilton Anxiety Rating Scale. Pearson's correlation and multiple linear regressions were used to analyze relation of sleep quality with quality of life of patients. Fifty patients had poor sleep quality. EDS was present in only 9 patients. Co-morbid depression and anxiety were present in 52 and 34 patients respectively. While the motor severity assessed by UPDRS-III was observed to adversely affect quality of life, it did not negatively impact quality of sleep. Higher score on UPDRS-total and UPDRS IV suggesting advanced disease correlated with poor sleep quality. Depression and anxiety were significantly more frequent in patients with poor sleep quality (p<0.01). Patients with poor sleep quality had worse quality of life (r=0.338, p<0.05). Depression and anxiety were also observed to have significant negative impact on quality of life of PD patients (p<0.01). Poor sleep quality was not found to be an independent predictor of quality of life using multiple linear regression analysis. Poor sleep quality along with comorbid depression, anxiety and advanced stage of disease is associated with poor quality of life. Copyright © 2016 Elsevier B.V. All rights reserved.

Data available on the impact of drug use on transportation safety

DOT National Transportation Integrated Search

1988-05-01

The report assesses the available data on drug use in transportation, the relevant experimental research on the impacts of drugs, and the state-of-the-art in drug analysis and toxicological quality control. The report describes and evaluates: informa...

76 FR 6376 - Approval of Air Quality Implementation Plans; Indiana and Ohio; Disapproval of Interstate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-04

... impact. EPA stated that the State's conclusion should be supported by an adequate technical analysis. EPA... technical analysis, no such analysis was provided by IDEM justifying that these measures are sufficient to... a State's [[Page 6379

Air quality and future energy system planning

NASA Astrophysics Data System (ADS)

Sobral Mourao, Zenaida; Konadu, Dennis; Lupton, Rick

2016-04-01

Ambient air pollution has been linked to an increasing number of premature deaths throughout the world. Projected increases in demand for food, energy resources and manufactured products will likely contribute to exacerbate air pollution with an increasing impact on human health, agricultural productivity and climate change. Current events such as tampering emissions tests by VW car manufacturers, failure to comply with EU Air Quality directives and WHO guidelines by many EU countries, the problem of smog in Chinese cities and new industrial emissions regulations represent unique challenges but also opportunities for regulators, local authorities and industry. However current models and practices of energy and resource use do not consider ambient air impacts as an integral part of the planing process. Furthermore the analysis of drivers, sources and impacts of air pollution is often fragmented, difficult to understand and lacks effective visualization tools that bring all of these components together. This work aims to develop a model that links impacts of air quality on human health and ecosystems to current and future developments in the energy system, industrial and agricultural activity and patterns of land use. The model will be added to the ForeseerTM tool, which is an integrated resource analysis platform that has been developed at the University of Cambridge initially with funding from BP and more recently through the EPSRC funded Whole Systems Energy Modeling (WholeSEM) project. The basis of the tool is a set of linked physical models for energy, water and land, including the technologies that are used to transform these resources into final services such as housing, food, transport and household goods. The new air quality model will explore different feedback effects between energy, land and atmospheric systems with the overarching goal of supporting better communication about the drivers of air quality and to incorporate concerns about air quality into energy system planning. Some example applications of this work are: (1) to discover conflicts and synergies between air quality regulations and future developments in the energy system and land use change; (2) to show the drivers of air quality in a given spatial context; (3) to explore effective ways to visualize impacts of different energy, land use and emissions control policies on air quality. An initial test case for the Bay Area in California will be presented, extending the scope of the existing California ForeseerTM tool to identify impacts of different policies within the water-energy-land nexus on local air quality.

The Impact Factor: Implications of Open Access on Quality

ERIC Educational Resources Information Center

Grozanick, Sara E.

2010-01-01

There has been debate about the extent to which open access affects the quality of scholarly work. At the same time, researchers have begun to look for ways to evaluate the quality of open access publications. Dating back to the growth of citation indexes during the 1960s and 1970s, citation analysis--examining citation statistics--has since been…

Relevance of Regional Hydro-Climatic Projection Data for Hydrodynamics and Water Quality Modelling of the Baltic Sea

NASA Astrophysics Data System (ADS)

Goldenberg, R.; Vigouroux, G.; Chen, Y.; Bring, A.; Kalantari, Z.; Prieto, C.; Destouni, G.

2017-12-01

The Baltic Sea, located in Northern Europe, is one of the world's largest body of brackish water, enclosed and surrounded by nine different countries. The magnitude of climate change may be particularly large in northern regions, and identifying its impacts on vulnerable inland waters and their runoff and nutrient loading to the Baltic Sea is an important and complex task. Exploration of such hydro-climatic impacts is needed to understand potential future changes in physical, ecological and water quality conditions in the regional coastal and marine waters. In this study, we investigate hydro-climatic changes and impacts on the Baltic Sea by synthesizing multi-model climate projection data from the CORDEX regional downscaling initiative (EURO- and Arctic- CORDEX domains, http://www.cordex.org/). We identify key hydro-climatic variable outputs of these models and assess model performance with regard to their projected temporal and spatial change behavior and impacts on different scales and coastal-marine parts, up to the whole Baltic Sea. Model spreading, robustness and impact implications for the Baltic Sea system are investigated for and through further use in simulations of coastal-marine hydrodynamics and water quality based on these key output variables and their change projections. Climate model robustness in this context is assessed by inter-model spreading analysis and observation data comparisons, while projected change implications are assessed by forcing of linked hydrodynamic and water quality modeling of the Baltic Sea based on relevant hydro-climatic outputs for inland water runoff and waterborne nutrient loading to the Baltic sea, as well as for conditions in the sea itself. This focused synthesis and analysis of hydro-climatically relevant output data of regional climate models facilitates assessment of reliability and uncertainty in projections of driver-impact changes of key importance for Baltic Sea physical, water quality and ecological conditions and their future evolution.

How do you perceive this author? Understanding and modeling authors’ communication quality in social media

PubMed Central

2018-01-01

In this study, we leverage human evaluations, content analysis, and computational modeling to generate a comprehensive analysis of readers’ evaluations of authors’ communication quality in social media with respect to four factors: author credibility, interpersonal attraction, communication competence, and intent to interact. We review previous research on the human evaluation process and highlight its limitations in providing sufficient information for readers to assess authors’ communication quality. From our analysis of the evaluations of 1,000 Twitter authors’ communication quality from 300 human evaluators, we provide empirical evidence of the impact of the characteristics of the reader (demographic, social media experience, and personality), author (profile and social media engagement), and content (linguistic, syntactic, similarity, and sentiment) on the evaluation of an author’s communication quality. In addition, based on the author and message characteristics, we demonstrate the potential for building accurate models that can indicate an author’s communication quality. PMID:29389979

How do you perceive this author? Understanding and modeling authors' communication quality in social media.

PubMed

Han, Kyungsik

2018-01-01

In this study, we leverage human evaluations, content analysis, and computational modeling to generate a comprehensive analysis of readers' evaluations of authors' communication quality in social media with respect to four factors: author credibility, interpersonal attraction, communication competence, and intent to interact. We review previous research on the human evaluation process and highlight its limitations in providing sufficient information for readers to assess authors' communication quality. From our analysis of the evaluations of 1,000 Twitter authors' communication quality from 300 human evaluators, we provide empirical evidence of the impact of the characteristics of the reader (demographic, social media experience, and personality), author (profile and social media engagement), and content (linguistic, syntactic, similarity, and sentiment) on the evaluation of an author's communication quality. In addition, based on the author and message characteristics, we demonstrate the potential for building accurate models that can indicate an author's communication quality.

The Effect of the Agricultural Carbon Sequestration and Agrochemical Reduction on the Regional Water Environment Quality

NASA Astrophysics Data System (ADS)

Leyi, Wang; Baoli, Zhang; Xin, Li; Juan, Du

2018-05-01

This paper analysed the impact of the agricultural carbon reduction and emission reduction measures implementation on the environmental quality of surface water and groundwater in winter and summer in Henan and Anhui Province project areas by using entropy weight fuzzy matter element analysis method. The result showed that the reduction in the application of chemical fertilizers and pesticides had a certain impact on the improvement of the water environment by using agricultural carbon sequestration technologies.

Determinants of Post-fire Water Quality in the Western United States

NASA Astrophysics Data System (ADS)

Rust, A.; Saxe, S.; Dolan, F.; Hogue, T. S.; McCray, J. E.

2015-12-01

Large wildfires are becoming increasingly common in the Western United States. Wildfires that consume greater than twenty percent of the watershed impact river water quality. The surface waters of the arid West are limited and in demand by the aquatic ecosystems, irrigated agriculture, and the region's growing human population. A range of studies, typically focused on individual fires, have observed mobilization of contaminants, nutrients (including nitrates), and sediments into receiving streams. Post-fire metal concentrations have also been observed to increase when fires were located in streams close to urban centers. The objective of this work was to assemble an extensive historical water quality database through data mining from federal, state and local agencies into a fire-database. Data from previous studies on individual fires by the co-authors was also included. The fire-database includes observations of water quality, discharge, geospatial and land characteristics from over 200 fire-impacted watersheds in the western U.S. since 1985. Water quality data from burn impacted watersheds was examined for trends in water quality response using statistical analysis. Watersheds where there was no change in water quality after fire were also examined to determine characteristics of the watershed that make it more resilient to fire. The ultimate goal is to evaluate trends in post-fire water quality response and identify key drivers of resiliency and post-fire response. The fire-database will eventually be publicly available.Large wildfires are becoming increasingly common in the Western United States. Wildfires that consume greater than twenty percent of the watershed impact river water quality. The surface waters of the arid West are limited and in demand by the aquatic ecosystems, irrigated agriculture, and the region's growing human population. A range of studies, typically focused on individual fires, have observed mobilization of contaminants, nutrients (including nitrates), and sediments into receiving streams. Post-fire metal concentrations have also been observed to increase when fires were located in streams close to urban centers. The objective of this work was to assemble an extensive historical water quality database through data mining from federal, state and local agencies into a fire-database. Data from previous studies on individual fires by the co-authors was also included. The fire-database includes observations of water quality, discharge, geospatial and land characteristics from over 200 fire-impacted watersheds in the western U.S. since 1985. Water quality data from burn impacted watersheds was examined for trends in water quality response using statistical analysis. Watersheds where there was no change in water quality after fire were also examined to determine characteristics of the watershed that make it more resilient to fire. The ultimate goal is to evaluate trends in post-fire water quality response and identify key drivers of resiliency and post-fire response. The fire-database will eventually be publicly available.

Environmental Quality and the U.S. Power Sector: Air Quality, Land Use and Environmental Justice

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

Massetti, Emanuele; Brown, Marilyn Ann; Lapsa, Melissa Voss

This baseline report summarizes key environmental quality issues associated with electricity generation, transmission, distribution, and end use in the United States. Its scope includes non-greenhouse gas air pollution (i.e., sulfur dioxide, nitrogen oxides, particulate matter and hazardous air pollutants), land use, water pollution, ecological impacts, human health, and environmental justice. The discussion characterizes both current impacts and recent trends, as well as assessments of key drivers of change. For example, the air emissions section includes a quantitative decomposition analysis of the drivers of change in sulfur dioxide emissions reductions from coal-fired power plants. The report is divided into four topicalmore » sections: air emissions, land use and ecology, water quality, and environmental justice.« less

Impact of Altering Various Image Parameters on Human Epidermal Growth Factor Receptor 2 Image Analysis Data Quality

PubMed Central

Pantanowitz, Liron; Liu, Chi; Huang, Yue; Guo, Huazhang; Rohde, Gustavo K.

2017-01-01

Introduction: The quality of data obtained from image analysis can be directly affected by several preanalytical (e.g., staining, image acquisition), analytical (e.g., algorithm, region of interest [ROI]), and postanalytical (e.g., computer processing) variables. Whole-slide scanners generate digital images that may vary depending on the type of scanner and device settings. Our goal was to evaluate the impact of altering brightness, contrast, compression, and blurring on image analysis data quality. Methods: Slides from 55 patients with invasive breast carcinoma were digitized to include a spectrum of human epidermal growth factor receptor 2 (HER2) scores analyzed with Visiopharm (30 cases with score 0, 10 with 1+, 5 with 2+, and 10 with 3+). For all images, an ROI was selected and four parameters (brightness, contrast, JPEG2000 compression, out-of-focus blurring) then serially adjusted. HER2 scores were obtained for each altered image. Results: HER2 scores decreased with increased illumination, higher compression ratios, and increased blurring. HER2 scores increased with greater contrast. Cases with HER2 score 0 were least affected by image adjustments. Conclusion: This experiment shows that variations in image brightness, contrast, compression, and blurring can have major influences on image analysis results. Such changes can result in under- or over-scoring with image algorithms. Standardization of image analysis is recommended to minimize the undesirable impact such variations may have on data output. PMID:28966838

Evaluation of the Impacts of Land Use on Water Quality: A Case Study in The Chaohu Lake Basin

PubMed Central

Yan, Haiming; Wu, Feng; Deng, Xiangzheng

2013-01-01

It has been widely accepted that there is a close relationship between the land use type and water quality. There have been some researches on this relationship from the perspective of the spatial configuration of land use in recent years. This study aims to analyze the influence of various land use types on the water quality within the Chaohu Lake Basin based on the water quality monitoring data and RS data from 2000 to 2008, with the small watershed as the basic unit of analysis. The results indicated that there was significant negative correlation between forest land and grassland and the water pollution, and the built-up area had negative impacts on the water quality, while the influence of the cultivated land on the water quality was very complex. Besides, the impacts of the landscape diversity on the indicators of water quality within the watershed were also analyzed, the result of which indicated there was a significant negative relationship between them. The results can provide important scientific reference for the local land use optimization and water pollution control and guidance for the formulation of policies to coordinate the exploitation and protection of the water resource. PMID:23970833

An appraisal of the quality of published qualitative dental research.

PubMed

Masood, Mohd; Thaliath, Ebin T; Bower, Elizabeth J; Newton, J Timothy

2011-06-01

To appraise the quality of published qualitative research in dentistry and identify aspects of quality, which require attention in future research. Qualitative research studies on dental topics were appraised using the critical appraisal skills programme (CASP) appraisal framework for qualitative research. The percentage of CASP criteria fully met during the assessment was used as an indication of the quality of each paper. Individual criteria were not weighted. Forty-three qualitative studies were identified for appraisal of which 48% had a dental public health focus. Deficiencies in detail of reporting, research design, methodological rigour, presentation of findings, reflexivity, credibility of findings and relevance of study were identified. Problems with quality were apparent irrespective of journal impact factor, although papers from low impact factor journals exhibited the most deficiencies. Journals with the highest impact factors published the least qualitative research. The quality of much of the qualitative research published on dental topics is mediocre. Qualitative methods are underutilized in oral health research. If quality guidelines such as the CASP framework are used in the context of a thorough understanding of qualitative research design and data analysis, they can promote good practice and the systematic assessment of qualitative research. © 2010 John Wiley & Sons A/S.

A study on real-time low-quality content detection on Twitter from the users' perspective.

PubMed

Chen, Weiling; Yeo, Chai Kiat; Lau, Chiew Tong; Lee, Bu Sung

2017-01-01

Detection techniques of malicious content such as spam and phishing on Online Social Networks (OSN) are common with little attention paid to other types of low-quality content which actually impacts users' content browsing experience most. The aim of our work is to detect low-quality content from the users' perspective in real time. To define low-quality content comprehensibly, Expectation Maximization (EM) algorithm is first used to coarsely classify low-quality tweets into four categories. Based on this preliminary study, a survey is carefully designed to gather users' opinions on different categories of low-quality content. Both direct and indirect features including newly proposed features are identified to characterize all types of low-quality content. We then further combine word level analysis with the identified features and build a keyword blacklist dictionary to improve the detection performance. We manually label an extensive Twitter dataset of 100,000 tweets and perform low-quality content detection in real time based on the characterized significant features and word level analysis. The results of our research show that our method has a high accuracy of 0.9711 and a good F1 of 0.8379 based on a random forest classifier with real time performance in the detection of low-quality content in tweets. Our work therefore achieves a positive impact in improving user experience in browsing social media content.

A study on real-time low-quality content detection on Twitter from the users’ perspective

PubMed Central

Yeo, Chai Kiat; Lau, Chiew Tong; Lee, Bu Sung

2017-01-01

Detection techniques of malicious content such as spam and phishing on Online Social Networks (OSN) are common with little attention paid to other types of low-quality content which actually impacts users’ content browsing experience most. The aim of our work is to detect low-quality content from the users’ perspective in real time. To define low-quality content comprehensibly, Expectation Maximization (EM) algorithm is first used to coarsely classify low-quality tweets into four categories. Based on this preliminary study, a survey is carefully designed to gather users’ opinions on different categories of low-quality content. Both direct and indirect features including newly proposed features are identified to characterize all types of low-quality content. We then further combine word level analysis with the identified features and build a keyword blacklist dictionary to improve the detection performance. We manually label an extensive Twitter dataset of 100,000 tweets and perform low-quality content detection in real time based on the characterized significant features and word level analysis. The results of our research show that our method has a high accuracy of 0.9711 and a good F1 of 0.8379 based on a random forest classifier with real time performance in the detection of low-quality content in tweets. Our work therefore achieves a positive impact in improving user experience in browsing social media content. PMID:28793347

Impact of ozone observations on the structure of a tropical cyclone using coupled atmosphere-chemistry data assimilation

NASA Astrophysics Data System (ADS)

Lim, S.; Park, S. K.; Zupanski, M.

2015-04-01

Since the air quality forecast is related to both chemistry and meteorology, the coupled atmosphere-chemistry data assimilation (DA) system is essential to air quality forecasting. Ozone (O3) plays an important role in chemical reactions and is usually assimilated in chemical DA. In tropical cyclones (TCs), O3 usually shows a lower concentration inside the eyewall and an elevated concentration around the eye, impacting atmospheric as well as chemical variables. To identify the impact of O3 observations on TC structure, including atmospheric and chemical information, we employed the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem) with an ensemble-based DA algorithm - the maximum likelihood ensemble filter (MLEF). For a TC case that occurred over the East Asia, our results indicate that the ensemble forecast is reasonable, accompanied with larger background state uncertainty over the TC, and also over eastern China. Similarly, the assimilation of O3 observations impacts atmospheric and chemical variables near the TC and over eastern China. The strongest impact on air quality in the lower troposphere was over China, likely due to the pollution advection. In the vicinity of the TC, however, the strongest impact on chemical variables adjustment was at higher levels. The impact on atmospheric variables was similar in both over China and near the TC. The analysis results are validated using several measures that include the cost function, root-mean-squared error with respect to observations, and degrees of freedom for signal (DFS). All measures indicate a positive impact of DA on the analysis - the cost function and root mean square error have decreased by 16.9 and 8.87%, respectively. In particular, the DFS indicates a strong positive impact of observations in the TC area, with a weaker maximum over northeast China.

Economic Assessment and Budgetary Impact of a Telemedicine Procedure and Spirometry Quality Control in the Primary Care Setting.

PubMed

Marina, Nuria; Bayón, Juan Carlos; López de Santa María, Elena; Gutiérrez, Asunción; Inchausti, Marta; Bustamante, Victor; Gáldiz, Juan B

2016-01-01

To evaluate the economic impact of a telemedicine procedure designed to improve the quality of lung function testing (LFT) in primary care in a public healthcare system, compared with the standard method. The economic impact of 9,039 LFTs performed in 51 health centers (2010-2013) using telespirometry (TS) compared to standard spirometry (SS) was studied. TS costs more per unit than SS (€47.80 vs. €39.70) (2013), but the quality of the TS procedure is superior (84% good quality, compared to 61% using the standard procedure). Total cost of TS was €431,974 (compared with €358,306€ for SS), generating an economic impact of €73,668 (2013). The increase in cost for good quality LFT performed using TS was €34,030 (2010) and €144,295 (2013), while the costs of poor quality tests fell by €15,525 (2010) and 70,627€ (2013). The cost-effectiveness analysis concludes that TS is 23% more expensive and 46% more effective. Healthcare costs consequently fall as the number of LFTs performed by TS rises. Avoiding poor quality, invalid LFTs generates savings that compensate for the increased costs of performing LFTs with TS, making it a cost-effective method. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Chemical and sensorial aroma characterization of freshly distilled Calvados. 1. Evaluation of quality and defects on the basis of key odorants by olfactometry and sensory analysis.

PubMed

Guichard, Hugues; Lemesle, Stéphane; Ledauphin, Jérôme; Barillier, Daniel; Picoche, Bernard

2003-01-15

Eight freshly distilled samples of Calvados, a fermented and distilled apple juice, were analyzed by sensory evaluation and direct injection GC to determine the composition of higher alcohols, esters, and aldehydes. The composition determined by direct injection was tentatively related to sensory descriptors. Esters have a probable maximum level around 500 g/hl of pure alcohol (PA). This level also corresponds to the threshold of the main ester constituent, ethyl acetate. A high ratio of esters to ethyl acetate seems to be of prime importance for good quality. Total aldehydes, with a maximum level between 8 and 11 g/hl of PA and mainly comprising acetal (maximum between 5 and 9 g/hl of PA), were related to a "green" descriptor. Higher alcohols do not have a direct impact on quality, but other volatile compounds with a positive impact on flavor should probably be present at a high level. As overall quality was not well related to sensory quality, it was necessary to perform more a precise analysis to determine the key odorants. The Calvados samples were thus extracted using pentane. Gas chromatography, employing both a flame ionization detector and an olfactometry port, was used to analyze the obtained extracts. Seventy-one odors were detected and distributed according to Calvados quality determined by sensory evaluation. Nineteen odors common to all Calvados samples constituted the "skeleton" of the aroma. Twenty-eight odors were specific to a quality class: 6 for good quality, 4 for neutral, and 18 for defective. Twenty-four other odors had either too low an odor impact or no evident specificity.

Conflict Detection Performance Analysis for Function Allocation Using Time-Shifted Recorded Traffic Data

NASA Technical Reports Server (NTRS)

Guerreiro, Nelson M.; Butler, Ricky W.; Maddalon, Jeffrey M.; Hagen, George E.; Lewis, Timothy A.

2015-01-01

The performance of the conflict detection function in a separation assurance system is dependent on the content and quality of the data available to perform that function. Specifically, data quality and data content available to the conflict detection function have a direct impact on the accuracy of the prediction of an aircraft's future state or trajectory, which, in turn, impacts the ability to successfully anticipate potential losses of separation (detect future conflicts). Consequently, other separation assurance functions that rely on the conflict detection function - namely, conflict resolution - are prone to negative performance impacts. The many possible allocations and implementations of the conflict detection function between centralized and distributed systems drive the need to understand the key relationships that impact conflict detection performance, with respect to differences in data available. This paper presents the preliminary results of an analysis technique developed to investigate the impacts of data quality and data content on conflict detection performance. Flight track data recorded from a day of the National Airspace System is time-shifted to create conflicts not present in the un-shifted data. A methodology is used to smooth and filter the recorded data to eliminate sensor fusion noise, data drop-outs and other anomalies in the data. The metrics used to characterize conflict detection performance are presented and a set of preliminary results is discussed.

Impact of traumatic dental injury on the quality of life of young children: a case-control study.

PubMed

Vieira-Andrade, Raquel Gonçalves; Siqueira, Maria Betânia Lins; Gomes, Genara Brum; D'Avila, Sérgio; Pordeus, Isabela Almeida; Paiva, Saul Martins; Granville-Garcia, Ana Flávia

2015-10-01

There are no longitudinal studies that assess the impact of traumatic dental injury (TDI) on the oral health-related quality of life (OHRQoL) of preschool children. To investigate the impact of TDI on OHRQoL among preschool children, a population-based case-control study was carried out with a representative sample of 335 children, 3-5 years of age, enrolled at public and private preschools in the city of Campina Grande, Brazil. The case group and the control group were matched for age, gender, type of preschool and monthly household income at a ratio of 1:4 (67 cases and 286 controls). Impact on the OHRQoL of children was assessed through administration of the Early Childhood Oral Health Impact Scale (ECOHIS). The occurrence of TDI was determined through clinical examinations performed by three calibrated dentists. Data analysis involved descriptive statistics, McNemar's test, the chi-square test with linear trend and conditional logistic regression analysis [P≤0.05; 95% confidence interval (95% CI)]. The most frequent responses were 'felt pain' (19.4%) and 'difficulty eating' (16.4%). The prevalence of TDI was 37.3% in the case group and 33.9% in the control group. No statistically significant differences were found between case and control groups regarding the presence of TDI (odds ratio=1.16; 95% CI: 0.66-2.02). TDI had no impact on the quality of life of preschool children. © 2015 FDI World Dental Federation.

Diabetes-related quality of life is enhanced by glycaemic improvement in older people.

PubMed

Abbatecola, A M; Spazzafumo, L; Fabbietti, P; Testa, R; Rabini, R A; Bonfigli, A R; Corsonello, A; Lattanzio, F; Paolisso, G

2015-02-01

To investigate the validity and reliability of the Audit of Diabetes-Dependent Quality of Life instrument in older Italians with diabetes and to test the association of diabetes-related quality of life with glycaemic control over time. A total of 558 outpatients with Type 2 diabetes from the Diabetic Unit of the Italian National Research Centre on Aging Hospital in Ancona were enrolled to complete questionnaires (Audit of Diabetes-Dependent Quality of Life-19 and the Short-Form-12), and to undergo clinical and biochemical testing at baseline and at 12 months of follow-up. The overall impact of diabetes using the average weighted impact score from the Audit of Diabetes-Dependent Quality of Life questionnaire was calculated. Participants were categorized according to this score as having either less or more negative diabetes-related quality of life. Participants had a mean ± SD age of 67.7 ± 9.2 years and 51.8% were male. Factor analysis and Cronbach's coefficient of internal consistency (Cronbach's α = 0.931) confirmed that the 19 domain-specific Audit of Diabetes-Dependent Quality of Life items could be combined into a single scale in this Italian population. The impact score correlated with the physical (r = 0.275; P < 0.001) and mental components (r = 0.291; P < 0.001) of the Short-Form-12 questionnaire. Significant differences were found according to diabetic complications in specific Audit of Diabetes-Dependent Quality of Life items and impact scores. Insulin use had a greater association with a more negative quality of life compared with other antidiabetic agents. A multivariate linear regression model with restricted linear spline application showed that the relationship between HbA1c and impact score was not linear and that the change in the impact score was associated with improved glycaemic control in those with a less negative diabetes-related quality of life at 12 months. The Audit of Diabetes-Dependent Quality of Life-19 is a valid tool for measuring the impact of diabetes on quality of life in older Italians. Perception of diabetes-related quality of life is associated with glycaemic control over time. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

The impact of specialized palliative care on cancer patients' health-related quality of life: a systematic review and meta-analysis.

PubMed

Kassianos, Angelos P; Ioannou, Myria; Koutsantoni, Marianna; Charalambous, Haris

2018-01-01

Specialized palliative care (SPC) is currently underutilized or provided late in cancer care. The aim of this systematic review and meta-analysis is to critically evaluate the impact of SPC on patients' health-related quality of life (HRQoL). Five databases were searched through June 2016. Randomized controlled trials (RCTs) and prospective studies using a pre- and post- assessment of HRQoL were included. The PRISMA reporting statement was followed. Criteria from available checklists were used to evaluate the studies' quality. A meta-analysis followed using random-effect models separately for RCTs and non-RCTs. Eleven studies including five RCTs and 2939 cancer patients published between 2001 and 2014 were identified. There was improved HRQoL in patients with cancer following SPC especially in symptoms like pain, nausea, and fatigue as well as improvement of physical and psychological functioning. Less or no improvements were observed in social and spiritual domains. In general, studies of inpatients showed a larger benefit from SPC than studies of outpatients whereas patients' age and treatment duration did not moderate the impact of SPC. Methodological shortcomings of included studies include high attrition rates, low precision, and power and poor reporting of control procedures. The methodological problems and publication bias call for higher-quality studies to be designed, funded, and published. However, there is a clear message that SPC is multi-disciplinary and aims at palliation of symptoms and burden in line with current recommendations.

Assessment of the Impact of Cotrimoxazole Prophylaxis on Key Outcomes Among HIV-Infected Adults in Low- and Middle-Income Countries: A Systematic Review

PubMed Central

Hassani, Ahmed Saadani; Marston, Barbara J.; Kaplan, Jonathan E.

2016-01-01

Background Cotrimoxazole (CTX) prophylaxis is among the key interventions provided to HIV-infected individuals in resource-limited settings. We conducted a systematic review of the available evidence. Methods MEDLINE, Embase, Global Health, CINAHL, SOCA, and African Index Medicus (AIM) were used to identify articles relevant to the CTX prophylaxis intervention from 1995 to 2014. Included articles addressed impact of CTX prophylaxis on the outcomes of mortality, morbidity, retention in care, quality of life, and/or prevention of ongoing HIV transmission. We rated the quality of evidence in individual articles and assessed the overall quality of the body of evidence, the expected impact, and the cost effectiveness (CE) for each outcome. Results Of the initial 1418 identified articles, 42 met all inclusion criteria. These included 9 randomized controlled trials, 26 observational studies, 2 systematic reviews with meta-analysis, 1 other systematic review, and 4 CE studies. The overall quality of evidence was rated as “good” and the expected impact “high” for both mortality and morbidity. The overall quality of evidence from the 4 studies addressing retention in care was rated as “poor,” and the expected impact on retention was rated as “uncertain.” The 4 assessed CE studies showed that provision of CTX prophylaxis is cost effective and sometimes cost saving. No studies addressed impact on quality of life or HIV transmission. Conclusions CTX prophylaxis is a cost-effective intervention with expected high impact on morbidity and mortality reduction in HIV-infected adults in resource-limited settings. Benefits are seen in both pre-antiretroviral therapy and antiretroviral therapy populations. PMID:25768865

Observation impact studies with the Mercator Ocean analysis and forecasting systems

NASA Astrophysics Data System (ADS)

Remy, E. D.; Le Traon, P. Y.; Lellouche, J. M.; Drevillon, M.; Turpin, V.; Benkiran, M.

2016-02-01

Mercator Ocean produces and delivers in real-time ocean analysis and forecasts on a daily basis. The quality of the analysis highly relies on the availability and quality of the assimilated observations.Tools are developed to estimate the impact of the present network and to help designing the future evolutions of the observing systems in the context of near real time production of ocean analysis and forecasts. OSE and OSSE are the main approaches used in this context. They allow the assessment of the efficiency of a given data set to constrain the ocean model circulation through the data assimilation process. Illustrations will mainly focus on the present and future evolution of the Argo observation network and altimetry constellation, including the potential impact of future SWOT data. Our systems show clear sensitivities to observation array changes, mainly depending on the specified observation error and regional dynamic. Impact on non observed variables can be important and are important to evaluate. Dedicated diagnostics has to be define to measure the improvements bring by each data set. Alternative approaches to OSE and OSSE are also explored: approximate computation of DFS will be presented and discussed. Limitations of each approach will be discussed in the context of real time operation.

Leadership and School Quality. Research and Theory in Educational Administration

ERIC Educational Resources Information Center

DiPaola, Michael, Ed.; Forsyth, Patrick B., Ed.

2015-01-01

"Leadership and School Quality" is the twelfth book in a series on research and theory dedicated to advancing understanding of schools through empirical study and theoretical analysis. The chapters include analyses that investigate relationships between school organizations and leadership behaviors that have an impact on teacher and…

Enhancing the Impact of Quality Points in Interteaching

ERIC Educational Resources Information Center

Rosales, Rocío; Soldner, James L.; Crimando, William

2014-01-01

Interteaching is a classroom instruction approach based on behavioral principles that offers increased flexibility to instructors. There are several components of interteaching that may contribute to its demonstrated efficacy. In a prior analysis of one of these components, the quality points contingency, no significant difference was reported in…

Comparison of methodologic quality and study/report characteristics between quantitative clinical nursing and nursing education research articles.

PubMed

Schneider, Barbara St Pierre; Nicholas, Jennifer; Kurrus, Jeffrey E

2013-01-01

To compare the methodologic quality and study/report characteristics between quantitative clinical nursing and nursing education research articles. The methodologic quality of quantitative nursing education research needs to advance to a higher level. Clinical research can provide guidance for nursing education to reach this level. One hundred quantitative clinical research articles from-high impact journals published in 2007 and 37 education research articles from high impact journals published in 2006 to 2007 were chosen for analysis. Clinical articles had significantly higher quality scores than education articles in three domains: number of institutions studied, type of data, and outcomes. The findings indicate three ways in which nursing education researchers can strengthen the methodologic quality of their quantitative research. With this approach, greater funding may be secured for advancing the science of nursing education.

Examining the links between perceived impact of pregnancy, depressive symptoms, and quality of life during adolescent pregnancy: the buffering role of social support.

PubMed

Pires, Raquel; Araújo-Pedrosa, Anabela; Canavarro, Maria Cristina

2014-05-01

The aims of the current study were to examine the indirect effect of the perceived impact of pregnancy on quality of life (QoL) through the severity of depressive symptoms among a sample of pregnant adolescents, and to explore whether adolescents' satisfaction with support from their mothers (SM) or partners (SP) was a buffer of this effect. Demographic and pregnancy-related data were collected for 395 pregnant adolescents age 12-19 and were controlled for testing the proposed indirect effect. SM and SP were tested as moderators of the links between perceived impact of pregnancy and depressive symptoms and between depressive symptoms and QoL. A computational tool for path analysis-based moderation and mediation analysis as well as their combination was used to test indirect and interaction effects (PROCESS). A significant indirect effect of the perceived impact of pregnancy on QoL through the severity of depressive symptoms was found (0.51, CI = 0.29/0.78). There was no significant direct effect of the perceived impact of pregnancy on QoL after controlling for the severity of depressive symptoms. SM and SP buffered the indirect effect by weakening the association between a negative perception of the impact of pregnancy and higher severity of depressive symptoms. Identifying adolescents with a negative perception of the impact of pregnancy, improving the quality of their relations with their mothers and partners, and promoting satisfactory support from these figures may be extremely important to prevent and treat depressive symptoms and, in so doing, improve adolescents' QoL during pregnancy.

32 CFR 651.45 - Steps in preparing and processing an EIS.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.45... alternatives, and state why the action may have unknown and/or significant environmental impacts. (3) The... delegations and committees, governors, national environmental organizations, the DOD and federal agency...

32 CFR 651.45 - Steps in preparing and processing an EIS.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.45... alternatives, and state why the action may have unknown and/or significant environmental impacts. (3) The... delegations and committees, governors, national environmental organizations, the DOD and federal agency...

32 CFR 651.45 - Steps in preparing and processing an EIS.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.45... alternatives, and state why the action may have unknown and/or significant environmental impacts. (3) The... delegations and committees, governors, national environmental organizations, the DOD and federal agency...

32 CFR 651.45 - Steps in preparing and processing an EIS.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.45... alternatives, and state why the action may have unknown and/or significant environmental impacts. (3) The... delegations and committees, governors, national environmental organizations, the DOD and federal agency...

32 CFR 651.42 - Actions normally requiring an EIS.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

32 CFR 651.42 - Actions normally requiring an EIS.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

32 CFR 651.42 - Actions normally requiring an EIS.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

32 CFR 651.6 - NEPA analysis staffing.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false NEPA analysis staffing. 651.6 Section 651.6 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY... depth of analysis required. In cases where the document addresses impacts to an environment whose...

Identifying predictors for quality and quantity restorative character of wilderness: using events as an analysis unit

Treesearch

Chad D. Pierskalla; Jason M. Siniscalchi; William E. Hammitt; David A. Smaldone; Steven J. Storck

2007-01-01

The purpose of this research is to understand whether and how trail design and resource impacts influence the quality and quantity of restorative experiences. The focus of past research has been on understanding the quality-side (what happens). What is missing is a better understanding of the quantity-side of experiences (how much happens). Gibson's environmental...

The Hong Kong Policy of Quality Education for All: A Multi-Level Analysis of Its Impacts on Newly Arrived Children

ERIC Educational Resources Information Center

Chong, Stella

2012-01-01

This paper attempts to argue that using market forces to raise education standards casts doubts to quality education, although this is seemingly an international trend, for such practice presents challenges to many issues such as equity. Using Hong Kong as a case, the paper analyses the practices of quality school education by focusing in…

Proceedings of the First National Workshop on the Global Weather Experiment: Current Achievements and Future Directions, volume 2, part 1

NASA Technical Reports Server (NTRS)

1985-01-01

Topics covered include: data systems and quality; analysis and assimilation techniques; impacts on forecasts; tropical forecasts; analysis intercomparisons; improvements in predictability; and heat sources and sinks.

Impact of leadership qualities on employee commitment in multi-project-based organizations

NASA Astrophysics Data System (ADS)

Waris, M.; Khan, A.; Ismail, I.; Adeleke, A. Q.; Panigrahi, S.

2018-04-01

The purpose of this study is to investigate the impact of multiple leadership qualities (MLQ) on employee commitment in multi-project-based organizsations. The dimensions of leadership qualities develop a healthy organizational environment which will lead to job satisfaction and, ultimately, job commitment. MLQ inspire the subordinates, as collective in nature, to get extra ordinary goals in the hyper competitive era. The main objective of this research is two fold ; firstly, to find out the impact of MLQ on employee job affectiveness and calculative commitment and secondly, to investigate the extent of the impact of MLQ on organizations. A total of 213 respondents were included in the study from different organizations. The data were analyzed through regression analysis by using the SPSS. The finding shows that all of the variables have a positive correlation with each other. The correlation of MLQ and employee job commitment was also found to be significant, which shows that MLQ have an impact on the organizations. Conceptual framework of the study is developed as MLQ an independent variables and its impact has been examined on the Employee Job Commitment. The results supported the hypothesis that MLQ have a positive and significant impact on employee job commitment.

Source apportionment of groundwater pollution around landfill site in Nagpur, India.

PubMed

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.

Quality of services and quality of life from service providers' perspectives: analysis with focus groups.

PubMed

Jenaro, C; Vega, V; Flores, N; Cruz, M

2013-06-01

Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this population. The current study aims to identify service providers' perceptions regarding the quality of life of their clients and the quality of services they provide. It also aims to identify similarities and differences of appraisals among professionals, and to identify associations between supports, quality of life and quality of services. Data were collected from 22 service providers who attended three focus groups (professionals, direct support staff, and managers) from whom 424 comments were analysed. Service providers were asked about the required support for users, the meaning of quality of life for those users, and about features that should characterise quality services. Thematic analysis was employed and transcripts of the sessions were coded according to the dimensions of models on supports, quality of life and quality of services. Chi-squared tests were utilised to test for potential differences among groups. Each professional group has its own priorities concerning required supports. Among the organisation different and potentially conflicting perceptions regarding the meaning of experiencing quality of life coexist. Concerning quality of services, only managers mentioned personal outcomes. Finally, institutionalisation has a negative impact on supports, quality of life and quality of services. It is necessary to move beyond a shared awareness of the negative impact of institutionalisation towards the transformation of services in search of personal quality outcomes. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

76 FR 43175 - Approval of Air Quality Implementation Plans; Indiana and Ohio; Disapproval of Interstate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... impact. EPA stated that the state's conclusion should be supported by an adequate technical analysis. EPA... by an adequate technical analysis. IDEM did not provide a technical analysis in its submittal, but... technical analysis and justification necessary to make that demonstration. Indiana did not provide any...

Modeling the effects of functional performance and post-transplant comorbidities on health-related quality of life after heart transplantation.

PubMed

Butler, Javed; McCoin, Nicole S; Feurer, Irene D; Speroff, Theodore; Davis, Stacy F; Chomsky, Don B; Wilson, John R; Merrill, Walter H; Drinkwater, Davis C; Pierson, Richard N; Pinson, C Wright

2003-10-01

Health-related quality of life and functional performance are important outcome measures following heart transplantation. This study investigates the impact of pre-transplant functional performance and post-transplant rejection episodes, obesity and osteopenia on post-transplant health-related quality of life and functional performance. Functional performance and health-related quality of life were measured in 70 adult heart transplant recipients. A composite health-related quality of life outcome measure was computed via principal component analysis. Iterative, multiple regression-based path analysis was used to develop an integrated model of variables that affect post-transplant functional performance and health-related quality of life. Functional performance, as measured by the Karnofsky scale, improved markedly during the first 6 months post-transplant and was then sustained for up to 3 years. Rejection Grade > or =2 was negatively associated with health-related quality of life, measured by Short Form-36 and reversed Psychosocial Adjustment to Illness Scale scores. Patients with osteopenia had lower Short Form-36 physical scores and obese patients had lower functional performance. Path analysis demonstrated a negative direct effect of obesity (beta = - 0.28, p < 0.05) on post-transplant functional performance. Post-transplant functional performance had a positive direct effect on the health-related quality of life composite score (beta = 0.48, p < 0.001), and prior rejection episodes grade > or =2 had a negative direct effect on this measure (beta = -0.29, p < 0.05). Either directly or through effects mediated by functional performance, moderate-to-severe rejection, obesity and osteopenia negatively impact health-related quality of life. These findings indicate that efforts should be made to devise immunosuppressive regimens that reduce the incidence of acute rejection, weight gain and osteopenia after heart transplantation.

Impacts of crop growth dynamics on soil quality at the regional scale

NASA Astrophysics Data System (ADS)

Gobin, Anne

2014-05-01

Agricultural land use and in particular crop growth dynamics can greatly affect soil quality. Both the amount of soil lost from erosion by water and soil organic matter are key indicators for soil quality. The aim was to develop a modelling framework for quantifying the impacts of crop growth dynamics on soil quality at the regional scale with test case Flanders. A framework for modelling the impacts of crop growth on soil erosion and soil organic matter was developed by coupling the dynamic crop cover model REGCROP (Gobin, 2010) to the PESERA soil erosion model (Kirkby et al., 2009) and to the RothC carbon model (Coleman and Jenkinson, 1999). All three models are process-based, spatially distributed and intended as a regional diagnostic tool. A geo-database was constructed covering 10 years of crop rotation in Flanders using the IACS parcel registration (Integrated Administration and Control System). Crop allometric models were developed from variety trials to calculate crop residues for common crops in Flanders and subsequently derive stable organic matter fluxes to the soil. Results indicate that crop growth dynamics and crop rotations influence soil quality for a very large percentage. soil erosion mainly occurs in the southern part of Flanders, where silty to loamy soils and a hilly topography are responsible for soil loss rates of up to 40 t/ha. Parcels under maize, sugar beet and potatoes are most vulnerable to soil erosion. Crop residues of grain maize and winter wheat followed by catch crops contribute most to the total carbon sequestered in agricultural soils. For the same rotations carbon sequestration is highest on clay soils and lowest on sandy soils. This implies that agricultural policies that impact on agricultural land management influence soil quality for a large percentage. The coupled REGCROP-PESERA-ROTHC model allows for quantifying the impact of seasonal and year-to-year crop growth dynamics on soil quality. When coupled to a multi-annual crop rotation database both spatial and temporal analysis becomes possible and allows for decision support at both farm and regional level. The framework is therefore suited for further scenario analysis and impact assessment. The research is funded by the Belgian Science Policy Organisation (Belspo) under contract nr SD/RI/03A.

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

NASA Astrophysics Data System (ADS)

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

2018-04-01

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

Modelling the cost-effectiveness of impact-absorbing flooring in Swedish residential care facilities.

PubMed

Ryen, Linda; Svensson, Mikael

2016-06-01

Fall-related injuries among the elderly, specifically hip fractures, cause significant morbidity and mortality as well as imposing a substantial financial cost on the health care system. Impact-absorbing flooring has been advocated as an effective method for preventing hip fractures resulting from falls. This study identifies the cost-effectiveness of impact-absorbing flooring compared to standard flooring in residential care facilities for the elderly in a Swedish setting. An incremental cost-effectiveness analysis was performed comparing impact-absorbing flooring to standard flooring using a Markov decision model. A societal perspective was adopted and incremental costs were compared to incremental gains in quality-adjusted life years (QALYs). Data on costs, probability transitions and health-related quality of life measures were retrieved from the published literature and from Swedish register data. Probabilistic sensitivity analysis was performed through a Monte Carlo simulation. The base-case analysis indicates that the impact-absorbing flooring reduces costs and increases QALYs. When allowing for uncertainty we find that 60% of the simulations indicate that impact-absorbing flooring is cost-saving compared to standard flooring and an additional 20% that it has a cost per QALY below a commonly used threshold value : Using a modelling approach, we find that impact-absorbing flooring is a dominant strategy at the societal level considering that it can save resources and improve health in a vulnerable population. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Variation in Estimated Ozone-Related Health Impacts of Climate Change due to Modeling Choices and Assumptions

PubMed Central

Post, Ellen S.; Grambsch, Anne; Weaver, Chris; Morefield, Philip; Leung, Lai-Yung; Nolte, Christopher G.; Adams, Peter; Liang, Xin-Zhong; Zhu, Jin-Hong; Mahoney, Hardee

2012-01-01

Background: Future climate change may cause air quality degradation via climate-induced changes in meteorology, atmospheric chemistry, and emissions into the air. Few studies have explicitly modeled the potential relationships between climate change, air quality, and human health, and fewer still have investigated the sensitivity of estimates to the underlying modeling choices. Objectives: Our goal was to assess the sensitivity of estimated ozone-related human health impacts of climate change to key modeling choices. Methods: Our analysis included seven modeling systems in which a climate change model is linked to an air quality model, five population projections, and multiple concentration–response functions. Using the U.S. Environmental Protection Agency’s (EPA’s) Environmental Benefits Mapping and Analysis Program (BenMAP), we estimated future ozone (O3)-related health effects in the United States attributable to simulated climate change between the years 2000 and approximately 2050, given each combination of modeling choices. Health effects and concentration–response functions were chosen to match those used in the U.S. EPA’s 2008 Regulatory Impact Analysis of the National Ambient Air Quality Standards for O3. Results: Different combinations of methodological choices produced a range of estimates of national O3-related mortality from roughly 600 deaths avoided as a result of climate change to 2,500 deaths attributable to climate change (although the large majority produced increases in mortality). The choice of the climate change and the air quality model reflected the greatest source of uncertainty, with the other modeling choices having lesser but still substantial effects. Conclusions: Our results highlight the need to use an ensemble approach, instead of relying on any one set of modeling choices, to assess the potential risks associated with O3-related human health effects resulting from climate change. PMID:22796531

Assessment of quality of life in patients with post kalaazar dermal leishmaniasis.

PubMed

Pal, Biplab; Murti, Krishna; Siddiqui, Niyamat Ali; Das, Pradeep; Lal, Chandra Shekhar; Babu, Rajendra; Rastogi, Manoj Kumar; Pandey, Krishna

2017-07-24

Post kala-azar dermal leishmaniasis (PKDL) is a dermatological disorder caused by protozoal parasite Leishmania donovani. PKDL cases are thought to be a reservoir of parasites and may increase cases of visceral leishmaniasis. The disease is not life threatening but cosmetic disfigurement associated with it may impair the patients' quality of life. This study aimed to assess the health related quality of life in patients with post kalaazar dermal leishmanasis for the first time. A total of 92 PKDL cases and 96 healthy participants filled out the questionnaires. The Dermatology Life Quality Index (DLQI) and SF 36 questionnaire were used to assess the quality of life. Data on socio-demographic and clinical features were also collected. The collected data were analyzed by using SPSS software (version 16), Student's t-test, analysis of variance (ANOVA) was applied for comparison of means. PKDL patients experienced very large impact on their quality of life. The mean score of DLQI was 11.41. Highest impact was found in symptoms and feelings and lowest impact was observed for personal relationship domain. Patients below 20 years age group found to have lower quality of life. There was a significant difference in mean DLQI scores with regard to age and severity of lesions (P < 0.05). No significant difference was observed with respect to gender, duration and location of lesions (p > 0.05). PKDL significantly impaired the patient's quality of life. Further studies to assess the impact of treatment on quality of life in these patients are recommended.

Health and cost impact of air pollution from biomass burning over the United States

NASA Astrophysics Data System (ADS)

Eslami, E.; Sadeghi, B.; Choi, Y.

2017-12-01

Effective assessment of health and cost effects of air pollution associated with wildfire events is critical for supporting sustainable management and policy analysis to reduce environmental damages. Since biomass burning events result in higher ozone, PM2.5, and NOx concentration values in urban regions due to long-range transport, preliminary results indicated that wildfire events cause a considerable increase in incident estimates and costs. This study aims to evaluate the health and cost impact of biomass burning events over the continental United States using combined air quality and health impact modeling. To meet this goal, a comprehensive air quality modeling scenarios containing biomass burning emissions were conducted using the Community Multiscale Air Quality (CMAQ) modeling system from 2011 to 2014 with a spatial resolution of 12 km. The modeling period includes fire seasons between April and October over the course of four years. By using modeled pollutants concentrations, the USEPA's GIS-based computer program Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) provides an inclusive figure of health and cost impact caused by changing gaseous and particulate air pollution due to fire events. The basis of BenMAP-CE is the use of a damage-function approach to estimate the health impact of an applied change in air quality by comparing a biomass burning scenario (the one that includes wildfire events) with a baseline scenario (without biomass emissions). This approach considers several factors containing population, exposure to the pollutants, adverse health effects of a particular pollutant, and economic costs. Hence, this study made it capable of showing how biomass burning across U.S. influences people's health in different months, seasons, and regions. Besides, the cost impact of the wildfire events during study periods has also been estimated at both national and regional levels. The results of this study demonstrate the BenMAP-CE can be successfully utilized as a proper tool to obtain health and cost impact of biomass burning events.

75 FR 72705 - Approval and Promulgation of Implementation Plans; Idaho

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

... other states, WG relied on an additional study entitled the ``Uinta Basin Air Quality Study (UBAQS... of a modeling analysis to assess ozone impacts prior to authorizing oil and gas development projects... Agencies on assessing impacts of oil and gas development projects.\\18\\ WG questioned why EPA's...

32 CFR 651.41 - Conditions requiring an EIS.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.41... of hazardous or toxic materials that may have significant environmental impact. (i) Be highly... 32 National Defense 4 2014-07-01 2013-07-01 true Conditions requiring an EIS. 651.41 Section 651...

32 CFR 651.41 - Conditions requiring an EIS.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.41... of hazardous or toxic materials that may have significant environmental impact. (i) Be highly... 32 National Defense 4 2012-07-01 2011-07-01 true Conditions requiring an EIS. 651.41 Section 651...

32 CFR 651.41 - Conditions requiring an EIS.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.41... of hazardous or toxic materials that may have significant environmental impact. (i) Be highly... 32 National Defense 4 2013-07-01 2013-07-01 false Conditions requiring an EIS. 651.41 Section 651...

A forecasting study on Chinese television development (1986 to 2001).

PubMed

Sun, L

1988-01-01

Given its widespread availability and impact on social values, television is expected to play an important role in China's modernization drive. Necessary to this process is a detailed analysis of the framework in which the technical aspects of television's development are related to political, economic, telecommunications, and social factors. To facilitate this analysis, a Delphi survey was conducted in 1986 as was a cross-impact analysis assisted by computer modelling. Entitled "Future Development of Chinese Television, 1986-2001," the Delphi survey sought to provide decision makers with operationally meaningful assistance in the form of information and analysis. The responses from experts suggested that, if economic growth can be sustained over the next 5 years, telecommunications development will receive top priority in state planning. Cross-impact analysis helps to clarify and promote better understanding of the complex relationships among future events and trends. This analysis tended to confirm the hypothesis that a nongovernmental television station is unlikely to emerge before 1991. Crucial to the success of any television policy (such as cable television service or videotext systems) is legislative support. The appearance of a nongovernmental television station would have a considerable impact on the private sector in China and lead to competition in programming quality, attracting audiences, and further commercialization. While the future development of Chinese television is dependent on economic factors such as purchasing power and the quality of life, its development can thus also be expected to exert a strong influence on economic life.

Investigating Drought Onset, Termination and Recovery According to Water Quality Indicators

NASA Astrophysics Data System (ADS)

Ahmadi, B.; Moradkhani, H.

2016-12-01

Frequency and severity of droughts are increasing globally. Reduced catchment runoff and river flows caused by the meteorological drivers leads to hydrological drought. Hydrological droughts have significant impacts not only on water quantity but also on water quality. In this study, first the onset of historical hydrological droughts is estimated using daily threshold-based indicators. Then drought termination and recovery period in terms of water quantity is analyzed. This is followed by examination of water quality during these detected hydrological droughts. Four water quality parameters, i.e., water temperature, dissolved oxygen, pH and turbidity are investigated over Willamette river basin located in northwestern Oregon in the United States. Drought vulnerability and resiliency are analyzed for the study period. Droughts and the recovery period are found to have significant impact on water quality parameters. Also, the results indicate a deterioration of water quality during droughts and longer drought recovery if water quality indicators are considered in the analysis.

Analysis and description of disease-specific quality of life in patients with anal fistula.

PubMed

Ferrer-Márquez, Manuel; Espínola-Cortés, Natalia; Reina-Duarte, Ángel; Granero-Molina, José; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel

2018-04-01

In patients diagnosed with anal fistula, knowing the quality of life specifically related to the disease can help coloproctology specialists to choose the most appropriate therapeutic strategy for each case. The aim of our study is to analyzse and describe the factors related to the specific quality of life in a consecutive series of patients diagnosed with anal fistula. Observational, cross-sectional study carried out from March 2015 to February 2017. All patients were assessed in the colorectal surgery unit of a hospital in southeast of Spain. After performing an initial anamnesis and a physical examination, patients diagnosed with anal fistula completed the Quality of Life in Ppatients with Anal Fistula Questionnaire (QoLAF-Q). This questionnaire specifically measures quality of life in people with anal fistula and its score range is the following: zero impact = 14 points, limited impact = 15 to 28 points, moderate impact = 29 to 42 points, high impact = 43 to 56 points, and very high impact = 57 to 70 points. A total of 80 patients were included. The median score obtained in the questionnaire for the sample studied was 34.00 (range=14-68). Statistically significant differences between patients with "primary anal fistula" (n=65) and "recurrent anal fistula" (n=15) were observed (mean rank=42.96 vs. mean rank=29.83, p=0.048). Furthermore, an inverse proportion (P=.016) between "time with clinical symptoms" and "impact on quality of life" was found (<6 months: mean rank = 45.55; 6-12 months: mean rank = 44.39; 1-2 years: mean rank = 37.83; 2-5 years: mean rank = 22; >5 years: mean rank = 19.00). There were no statistically significant differences (P=.149) between quality of life amongst patients diagnosed with complex (mean rank = 36.13) and simple fistulae (mean rank = 43.59). Anal fistulae exert moderate-high impact on patients' quality of life. "Shorter time experiencing clinical symptoms" and the "presence of primary fistula" are factors that can be associated with worse quality of life. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Sustainability analysis of bioenergy based land use change under climate change and variability

NASA Astrophysics Data System (ADS)

Raj, C.; Chaubey, I.; Brouder, S. M.; Bowling, L. C.; Cherkauer, K. A.; Frankenberger, J.; Goforth, R. R.; Gramig, B. M.; Volenec, J. J.

2014-12-01

Sustainability analyses of futuristic plausible land use and climate change scenarios are critical in making watershed-scale decisions for simultaneous improvement of food, energy and water management. Bioenergy production targets for the US are anticipated to impact farming practices through the introduction of fast growing and high yielding perennial grasses/trees, and use of crop residues as bioenergy feedstocks. These land use/land management changes raise concern over potential environmental impacts of bioenergy crop production scenarios, both in terms of water availability and water quality; impacts that may be exacerbated by climate variability and change. The objective of the study was to assess environmental, economic and biodiversity sustainability of plausible bioenergy scenarios for two watersheds in Midwest US under changing climate scenarios. The study considers fourteen sustainability indicators under nine climate change scenarios from World Climate Research Programme's (WCRP's) Coupled Model Intercomparison Project phase 3 (CMIP3). The distributed hydrological model SWAT (Soil and Water Assessment Tool) was used to simulate perennial bioenergy crops such as Miscanthus and switchgrass, and corn stover removal at various removal rates and their impacts on hydrology and water quality. Species Distribution Models (SDMs) developed to evaluate stream fish response to hydrology and water quality changes associated with land use change were used to quantify biodiversity sustainability of various bioenergy scenarios. The watershed-scale sustainability analysis was done in the St. Joseph River watershed located in Indiana, Michigan, and Ohio; and the Wildcat Creek watershed, located in Indiana. The results indicate streamflow reduction at watershed outlet with increased evapotranspiration demands for high-yielding perennial grasses. Bioenergy crops in general improved in-stream water quality compared to conventional cropping systems (maize-soybean). Water quality benefits due to land use change were generally greater than the effects of climate change variability.

Quality characterization and impact assessment of highway runoff in urban and rural area of Guangzhou, China.

PubMed

Gan, Huayang; Zhuo, Muning; Li, Dingqiang; Zhou, Yongzhang

2008-05-01

Accurate knowledge of the quality and environmental impact of the highway runoff in Pear River Delta, South China is required to assess this important non-point pollution source. This paper presents the quality characterization and environmental impact assessment of rainfall runoff from highways in urban and rural area of Guangzhou, the largest city of Pear River Delta over 1 year's investigation. Multiple regression and Pearson correlation analysis were used to determine influence of the rainfall characteristics on water quality and correlations among the constituents in highway runoff. The results and analysis indicates that the runoff water is nearly neutral with low biodegradability. Oil and grease (O&G), suspended solids (SS) and heavy metals are the dominant pollutants in contrast to the low level of nutrient constituents in runoff. Quality of highway runoff at rural site is better than that of at urban site for most constituents. Depth and antecedent dry period are the main rainfall factors influencing quality of highway runoff. The correlation patterns among constituents in highway runoff at urban site are consistent with their dominant phases in water. Strong correlations (r > or = 0.80) are found among chemical oxygen demand (COD), total phosphorus, Cu and Zn as well as conductivity, nitrate nitrogen and total nitrogen. O&G, COD, SS and Pb in highway runoff at urban site substantially exceed their concentrations in receiving water of Pear River. The soil directly discharged by highway runoff at rural site has contaminated seriously by heavy metals in surface layer accompanying with pH conversion from original acidic to alkaline at present.

Stratospheric Intrusion-Influenced Ozone Air Quality Exceedences Investigated in MERRA-2

NASA Technical Reports Server (NTRS)

Knowland, K. Emma; Ott, Lesley; Duncan, Bryan; Wargan, Krzysztof

2017-01-01

Ozone near the surface is harmful to human health and is a result of the photochemical reaction with both man-made and natural precursor pollutant sources. Therefore, in order to reduce near surface ozone concentrations, communities must reduce anthropogenic pollution sources. However, the injection of stratospheric ozone into the troposphere, known as a stratospheric intrusion, can also lead to concentrations of ground-level ozone exceeding air quality standards. Stratospheric intrusions are dynamical atmospheric features, however, these intrusions have been misrepresented in models and reanalyses until recently, as the features of a stratospheric intrusion are best identified in horizontal resolutions of approximately 50 km or smaller. NASA's Modern-Era Retrospective Analysis for Research and Applications Version-2 (MERRA-2) reanalysis is a publicly-available high-resolution dataset (50 km) with assimilated ozone that characterizes stratospheric ozone on the same spatiotemporal resolution as the meteorology. We show that stratospheric intrusions that impact surface air quality are well represented in the MERRA-2 reanalysis. This is demonstrated through a case study analysis of stratospheric intrusion events which were identified by the United States Environmental Protection Agency (EPA) to impact surface ozone air quality in spring 2012 in Colorado. The stratospheric intrusions are identified in MERRA-2 by the folding of the dynamical tropopause under the jet stream and subsequent isentropic descent of dry, O3-rich stratospheric air towards the surface where ozone air quality exceedences were observed. The MERRA-2 reanalysis can support air quality agencies for more rapid identification of the impact of stratospheric air on ground-level ozone.

Analysis of Postsurgical Health-Related Quality of Life and Quality of Voice of Patients With Laryngeal Carcinoma.

PubMed

Luo, Jie; Wu, Jieli; Lv, Kexing; Li, Kaichun; Wu, Jianhui; Wen, Yihui; Li, Xiaoling; Tang, Haocheng; Jiang, Aiyun; Wang, Zhangfeng; Wen, Weiping; Lei, Wenbin

2016-01-01

This study aims to analyze the postsurgical health-related quality of life (HRQOL) and quality of voice (QOV) of patients with laryngeal carcinoma with an expectation of improving the treatment and HRQOL of these patients. Based on the collection of information of patients with laryngeal carcinoma regarding clinical characteristics (age, TNM stage, with or without laryngeal preservation and/or neck dissection, with or without postoperative irradiation and/or chemotherapy, etc.), QOV using Voice Handicap Index (VIH) scale and HRQOL using EORTC QLQ-C30 and EORTCQLQ-H&N35 scales, the differences of postsurgical HRQOL related to their clinical characteristics were analyzed using univariate nonparametric tests, the main factors impacting the postsurgical HRQOL were analyzed using regression analyses (generalized linear models) and the correlation between QOV and HRQOL analyzed using spearman correlation analysis. A total of 92 patients were enrolled in this study, on whom the use of EORTC QLQ-C30, EORTC QLQ-H&N35 and VHI scales revealed that: the differences of HRQOL were significant among patients with different ages, TNM stages, and treatment modalities; the main factors impacting the postsurgical HRQOL were pain, speech disorder, and dry mouth; and QOV was significantly correlated with HRQOL. For the patients with laryngeal carcinoma included in our study, the quality of life after open surgeries were impacted by many factors predominated by pain, speech disorder, and dry mouth. It is suggested that doctors in China do more efforts on the patients' postoperative pain and xerostomia management and speech rehabilitation with the hope of improving the patients' quality of life.

Adapting water treatment design and operations to the impacts of global climate change

NASA Astrophysics Data System (ADS)

Clark, Robert M.; Li, Zhiwei; Buchberger, Steven G.

2011-12-01

It is anticipated that global climate change will adversely impact source water quality in many areas of the United States and will therefore, potentially, impact the design and operation of current and future water treatment systems. The USEPA has initiated an effort called the Water Resources Adaptation Program (WRAP) which is intended to develop tools and techniques that can assess the impact of global climate change on urban drinking water and wastewater infrastructure. A three step approach for assessing climate change impacts on water treatment operation and design is being persude in this effort. The first step is the stochastic characterization of source water quality, the second step is the application of the USEPA Water Treatment Plant model and the third step is the application of cost algorithms to provide a metric that can be used to assess the coat impact of climate change. A model has been validated using data collected from Cincinnati's Richard Miller Water Treatment Plant for the USEPA Information Collection Rule (ICR) database. An analysis of the water treatment processes in response to assumed perturbations in raw water quality identified TOC, pH, and bromide as the three most important parameters affecting performance of the Miller WTP. The Miller Plant was simulated using the EPA WTP model to examine the impact of these parameters on selected regulated water quality parameters. Uncertainty in influent water quality was analyzed to estimate the risk of violating drinking water maximum contaminant levels (MCLs).Water quality changes in the Ohio River were projected for 2050 using Monte Carlo simulation and the WTP model was used to evaluate the effects of water quality changes on design and operation. Results indicate that the existing Miller WTP might not meet Safe Drinking Water Act MCL requirements for certain extreme future conditions. However, it was found that the risk of MCL violations under future conditions could be controlled by enhancing existing WTP design and operation or by process retrofitting and modification.

The relationship between quality management practices and organisational performance: A structural equation modelling approach

NASA Astrophysics Data System (ADS)

Jamaluddin, Z.; Razali, A. M.; Mustafa, Z.

2015-02-01

The purpose of this paper is to examine the relationship between the quality management practices (QMPs) and organisational performance for the manufacturing industry in Malaysia. In this study, a QMPs and organisational performance framework is developed according to a comprehensive literature review which cover aspects of hard and soft quality factors in manufacturing process environment. A total of 11 hypotheses have been put forward to test the relationship amongst the six constructs, which are management commitment, training, process management, quality tools, continuous improvement and organisational performance. The model is analysed using Structural Equation Modeling (SEM) with AMOS software version 18.0 using Maximum Likelihood (ML) estimation. A total of 480 questionnaires were distributed, and 210 questionnaires were valid for analysis. The results of the modeling analysis using ML estimation indicate that the fits statistics of QMPs and organisational performance model for manufacturing industry is admissible. From the results, it found that the management commitment have significant impact on the training and process management. Similarly, the training had significant effect to the quality tools, process management and continuous improvement. Furthermore, the quality tools have significant influence on the process management and continuous improvement. Likewise, the process management also has a significant impact to the continuous improvement. In addition the continuous improvement has significant influence the organisational performance. However, the results of the study also found that there is no significant relationship between management commitment and quality tools, and between the management commitment and continuous improvement. The results of the study can be used by managers to prioritize the implementation of QMPs. For instances, those practices that are found to have positive impact on organisational performance can be recommended to managers so that they can allocate resources to improve these practices to get better performance.

Cost and impact of a quality improvement programme in mental health services.

PubMed

Beecham, Jennifer; Ramsay, Angus; Gordon, Kate; Maltby, Sophie; Walshe, Kieran; Shaw, Ian; Worrall, Adrian; King, Sarah

2010-04-01

To estimate the cost and impact of a centrally-driven quality improvement initiative in four UK mental health communities. Total costs in year 1 were identified using documentation, a staff survey, semi-structured interviews and discussion groups. Few outcome data were collected within the programme so thematic analysis was used to identify the programme's impact within its five broad underlying principles. The survey had a 40% response. Total costs ranged between pound164,000 and pound458,000 per site, plus staff time spent on workstreams. There was a very hazy view of the resources absorbed and poor recording of expenditure and activity. The initiative generated little demonstrable improvements in service quality but some participants reported changes in attitudes. Given the difficult contexts, short time-scales and capacity constraints, the programme's lack of impact is not surprising. It may, however, represent a worthwhile investment in cultural change which might facilitate improvements in how services are delivered.

Factors associated with severe impact of lipodystrophy on the quality of life of patients infected with HIV-1.

PubMed

Blanch, Jordi; Rousaud, Araceli; Martinez, Esteban; De Lazzari, Elisa; Milinkovic, Ana; Peri, Josep-Maria; Blanco, José-Luis; Jaen, Jesús; Navarro, Victor; Massana, Guillem; Gatell, Josep-Maria

2004-05-15

A standardized questionnaire was used to assess the impact of lipodystrophy (LD) on quality of life (QoL). Eighty-four consecutive asymptomatic human immunodeficiency virus type 1 (HIV-1)-infected outpatients with clinical LD completed a modified version of the Dermatology Life Quality Index (DLQI) survey to measure the impact of body fat changes on their QoL. Body changes influenced dressing for 55 patients (65%), produced feelings of shame for 41 (49%), and disrupted sexual life for 23 (27%). There was a greater impact on the DLQI due to body changes among women, injection drug users, patients with abdominal or breast lipoaccumulation, and patients with a high number of non-LD side effects. Multivariate proportional odds model analysis showed that the severity of non-LD-associated side effects and the presence of breast lipoaccumulation were associated with impaired psychosocial functioning. Specific characteristics of patients, antiretroviral-based side effects, and breast lipoaccumulation exert a greater impact on QoL in HIV-1-infected patients with LD.

The role of seasonal water scarcity on water quality: a global analysis with case study in the Magdalena, Colombia

NASA Astrophysics Data System (ADS)

Burke, Sophia; Mulligan, Mark

2017-04-01

Water scarcity is not just a problem of its own right (hydrological drought) but cascades the hydro-economic system to create problems for crop growth and livestock (agricultural drought) and thus for wellbeing and economic productivity (economic drought). One of these cascades is the impact of reduced water quantity on water quality as a result of non-point source pollutant concentration in water bodies such as rivers, lakes and wetlands. This paper investigates the impact of seasonal water shortages on the quality of supplied water to urban centres with a view to better understanding how land use management can reduce dry-season pollutant spikes. We apply a widely used spatial hydrological model (WaterWorld) and its water quality index (the human footprint on water quality, HFWQ) to examine to what extent HFWQ of water flowing into urban water intakes is affected by flow seasonality and by typical "dry year" events. A global analysis shows trends across climatic and land use gradients and is followed by a regional analysis of the Magdalena basin in Colombia: a large basin with 79% of the countries population and a mixture of intensively farmed and protected lands along a seasonality gradient from South to North. The Magdalena is a case study basin of the EartH2Observe project.

Quality of life and deglutition after total laryngectomy

PubMed Central

Pernambuco, Leandro de Araújo; Oliveira, Jabson Herber Profiro de; Régis, Renata Milena Freitas Lima; Lima, Leilane Maria de; Araújo, Ana Maria Bezerra de; Balata, Patrícia Maria Mendes; Cunha, Daniele Andrade da; Silva, Hilton Justino da

2012-01-01

Summary Introduction: Total laryngectomy creates deglutition disorders and causes a decrease in quality of life Aim: To describe the impact of swallowing and quality of life of patients after total laryngectomy. Method: A case series study. Patients completed a Swallowing and Quality of Life questionnaire composed of 44 questions assessing 11 domains related to quality of life (burden, eating duration, eating desire, frequency of symptoms, food selection, communication, fear, mental health, social functioning, sleep, and fatigue). The analysis was performed using descriptive statistics, including measures of central tendency and variability. Results: The sample comprised 15 patients who underwent total laryngectomy and adjuvant radiotherapy. Of these, 66.7% classified their health as good and 73% reported no restrictions on food consistency. The domains “communication” and “fear” represented severe impact and “eating duration” represented moderate impact on quality of life. The items with lower scores were: longer time to eat than others (domain “eating duration”), cough and cough to remove the liquid or food of the mouth when they are stopped (domain “symptom frequency”), difficulties in understanding (domain “communication”) and fear of choking and having pneumonia (domain “fear”). Conclusion: After total laryngectomy, patients report that swallowing issues have moderate to severe impact in “communication,” “fear,” and “eating duration” domains. PMID:25991974

Evaluating water management strategies with the Systems Impact Assessment Model: SIAM version 4

USGS Publications Warehouse

Bartholow, John M.; Heasley, John; Hanna, Blair; Sandelin, Jeff; Flug, Marshall; Campbell, Sharon; Henriksen, Jim; Douglas, Aaron

2005-01-01

The apparent disparity between restoration benefits and costs for the Klamath River may suggest to some that water resources on the Klamath be reallocated to environmentally friendly nonmarket uses. The economic analysis rests in part on the information made available to the survey designers by the biological, hydrologic, and water quality data incorporated in The System Impact Assessment Model (SIAM). It is our hope that SIAM can be used to improve the river's water quality and fishery, and strengthen the important regional economy.

Voice, stress, work and quality of life of soccer coaches and physical trainers.

PubMed

Penteado, Regina Zanella; Silva, Noelle Bernardi da; Montebello, Maria Imaculada de Lima

2015-01-01

To assess aspects related to work, stress and quality of life related to voice in soccer coaches (C) and physical trainers (T), comparing the categories. Qualitative and quantitative studies with 13 C and 13 T of teams competing in Phase One of the highest level (Série A ) of the 2012 Campeonato Paulista (São Paulo State Soccer Championship). The questions were open ended and related to complaints, difficulties, and/or problems regarding voice use during work and to the relations between voice, work, stress, and quality of life. Stress at work was analyzed by the Job Stress Scale (JSS) questionnaire. The perception of the impact of the voice on quality of life was evaluated by the Voice-Related Quality of Life (V-RQOL) protocol. The answers to the questions were transcribed and submitted to content analysis, and regarding the questionnaire, descriptive data and analytical statistics were used. Content analysis showed lack of preparation for voice care; voice complaints; and intense vocal use demand under stressful work, in addition to the absence of healthy habits and social/family support. The JSS dimensions showed that the Active Work situation and the high V-RQOL scores are compatible with vocal health without complaints. There were no statistical differences between the categories. Both categories reported complaints/problems linked to professional voice use and stressful workload. However, the perception of vocal impact on the quality of life was positive, and the analysis of stress at work resulted in "good" and favorable conditions. The relationship between voice, work, stress, and quality of life in both the categories require further investigations.

Land use change and conversion effects on ground water quality trends: An integration of land change modeler in GIS and a new Ground Water Quality Index developed by fuzzy multi-criteria group decision-making models.

PubMed

Shooshtarian, Mohammad Reza; Dehghani, Mansooreh; Margherita, Ferrante; Gea, Oliveri Conti; Mortezazadeh, Shima

2018-04-01

This study aggregated Land Change Modeller (LCM) as a useful model in GIS with an extended Groundwater Quality Index (GWQI) developed by fuzzy Multi-Criteria Group Decision-Making models to investigate the effect of land use change and conversion on groundwater quality being supplied for drinking. The model's performance was examined through an applied study in Shiraz, Iran, in a five year period (2011 to 2015). Four land use maps including urban, industrial, garden, and bare were employed in LCM model and the impact of change in area and their conversion to each other on GWQI changes was analysed. The correlation analysis indicated that increase in the urban land use area and conversion of bare to the residential/industrial land uses, had a relation with water quality decrease. Integration of LCM and GWQI can accurately and logically provide a numerical analysis of the possible impact of land use change and conversion, as one of the influencing factors, on the groundwater quality. Hence, the methodology could be used in urban development planning and management in macro level. Copyright © 2018. Published by Elsevier Ltd.

A guide to evaluating linkage quality for the analysis of linked data.

PubMed

Harron, Katie L; Doidge, James C; Knight, Hannah E; Gilbert, Ruth E; Goldstein, Harvey; Cromwell, David A; van der Meulen, Jan H

2017-10-01

Linked datasets are an important resource for epidemiological and clinical studies, but linkage error can lead to biased results. For data security reasons, linkage of personal identifiers is often performed by a third party, making it difficult for researchers to assess the quality of the linked dataset in the context of specific research questions. This is compounded by a lack of guidance on how to determine the potential impact of linkage error. We describe how linkage quality can be evaluated and provide widely applicable guidance for both data providers and researchers. Using an illustrative example of a linked dataset of maternal and baby hospital records, we demonstrate three approaches for evaluating linkage quality: applying the linkage algorithm to a subset of gold standard data to quantify linkage error; comparing characteristics of linked and unlinked data to identify potential sources of bias; and evaluating the sensitivity of results to changes in the linkage procedure. These approaches can inform our understanding of the potential impact of linkage error and provide an opportunity to select the most appropriate linkage procedure for a specific analysis. Evaluating linkage quality in this way will improve the quality and transparency of epidemiological and clinical research using linked data. © The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association.

Analysis of parameter sensitivity and identifiability of root zone water quality model (RZWQM) for dryland sugerbeet modeling

USDA-ARS?s Scientific Manuscript database

Sugarbeet is being considered as one of the most viable feedstock alternatives to corn for biofuel production since herbicide resistant energy beets were deregulated by USDA in 2012. Growing sugarbeets for biofuel production may have significant impacts on soil health and water quality in the north-...

Writing Week-Journals to Improve the Writing Quality of Fourth-Graders' Compositions

ERIC Educational Resources Information Center

Rosário, Pedro; Högemann, Julia; Núñez, José Carlos; Vallejo, Guillermo; Cunha, Jennifer; Oliveira, Vera; Fuentes, Sonia; Rodrigues, Celestino

2017-01-01

Students' writing problems are a global educational concern and is in need of particular attention. This study aims to examine the impact of providing extra writing opportunities (i.e., writing journals) on the quality of writing compositions. A longitudinal cluster-randomized controlled design using a multilevel modeling analysis with 182 fourth…

Bioenergy Sustainability Analysis | Bioenergy | NREL

Science.gov Websites

and bioenergy systems produce benefits and also impacts to air, water, and land locally, regionally overlap are photos of water, a tree branch with a city in the background, two children walking in a field photo and contains the text: Environmental Sustainability: Climate, Soil quality, Water quality and

The Impact of Isolation on the Job Satisfaction of New Principals

ERIC Educational Resources Information Center

Bauer, Scott C.; Brazer, S. David

2013-01-01

Professional isolation has hampered the quality of the work experience for employees inside and outside public education for decades. This study explores the role that isolation plays in predicting the quality of the work experience among new principals. The analysis tests whether isolation serves as a mediator in the relationship between factors…

(AMD) ANALYSIS OF AIR QUALITY DATA NEAR ROADWAYS USING A DISPERSION MODEL

EPA Science Inventory

We used a dispersion model to analyze measurements made during a field study conducted by the U.S. EPA in July-August 2006, to estimate the impact of traffic emissions on air quality at distances of tens of meters from an 8 lane highway located in Raleigh, North Carolina. The air...

Developing a quality by design approach to model tablet dissolution testing: an industrial case study.

PubMed

Yekpe, Ketsia; Abatzoglou, Nicolas; Bataille, Bernard; Gosselin, Ryan; Sharkawi, Tahmer; Simard, Jean-Sébastien; Cournoyer, Antoine

2018-07-01

This study applied the concept of Quality by Design (QbD) to tablet dissolution. Its goal was to propose a quality control strategy to model dissolution testing of solid oral dose products according to International Conference on Harmonization guidelines. The methodology involved the following three steps: (1) a risk analysis to identify the material- and process-related parameters impacting the critical quality attributes of dissolution testing, (2) an experimental design to evaluate the influence of design factors (attributes and parameters selected by risk analysis) on dissolution testing, and (3) an investigation of the relationship between design factors and dissolution profiles. Results show that (a) in the case studied, the two parameters impacting dissolution kinetics are active pharmaceutical ingredient particle size distributions and tablet hardness and (b) these two parameters could be monitored with PAT tools to predict dissolution profiles. Moreover, based on the results obtained, modeling dissolution is possible. The practicality and effectiveness of the QbD approach were demonstrated through this industrial case study. Implementing such an approach systematically in industrial pharmaceutical production would reduce the need for tablet dissolution testing.

Air Emissions Inventories

EPA Pesticide Factsheets

This site provides access to emissions data, regulations and guidance, electronic system access, resources and tools to support trends analysis, regional, and local scale air quality modeling, regulatory impact assessments.

Application of ICH Q9 Quality Risk Management Tools for Advanced Development of Hot Melt Coated Multiparticulate Systems.

PubMed

Stocker, Elena; Becker, Karin; Hate, Siddhi; Hohl, Roland; Schiemenz, Wolfgang; Sacher, Stephan; Zimmer, Andreas; Salar-Behzadi, Sharareh

2017-01-01

This study aimed to apply quality risk management based on the The International Conference on Harmonisation guideline Q9 for the early development stage of hot melt coated multiparticulate systems for oral administration. N-acetylcysteine crystals were coated with a formulation composing tripalmitin and polysorbate 65. The critical quality attributes (CQAs) were initially prioritized using failure mode and effects analysis. The CQAs of the coated material were defined as particle size, taste-masking efficiency, and immediate release profile. The hot melt coated process was characterized via a flowchart, based on the identified potential critical process parameters (CPPs) and their impact on the CQAs. These CPPs were prioritized using a process failure mode, effects, and criticality analysis and their critical impact on the CQAs was experimentally confirmed using a statistical design of experiments. Spray rate, atomization air pressure, and air flow rate were identified as CPPs. Coating amount and content of polysorbate 65 in the coating formulation were identified as critical material attributes. A hazard and critical control points analysis was applied to define control strategies at the critical process points. A fault tree analysis evaluated causes for potential process failures. We successfully demonstrated that a standardized quality risk management approach optimizes the product development sustainability and supports the regulatory aspects. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Urbanization in Pearl River Delta area in past 20 years: remote sensing of impact on water quality

NASA Astrophysics Data System (ADS)

Wang, Yunpeng; Fan, Fenglei; Zhang, Jinqu; Xia, Hao; Ye, Chun

2004-11-01

The Pearl River Delta of Guangdong province in China is one of the world"s largest growths in urbanization for the past 20 years. The objective of this research is to explore the relationship between urbanization and water quality in this area. Present and past remote sensing data including MSS< TM/ETM and ASTER are used to research the urbanization and its impact on water quality. Land use and water quality information are extracted from remote sensing data. Data of population, industrial and agricultural productivity indices are integrated with the thematic maps derived from remote sensing data by GIS method. Spatial analysis methods are applied on these data and the results indicate that population, waste water both from household and industrial and chemical fertilizer consumptions are main controls of the regional water quality and environment.

Can There Ever Be Enough to Impact Water Quality? Evaluating BMPs in Elliot Ditch, Indiana Using the LTHIA-LID Model

NASA Astrophysics Data System (ADS)

Rahman, M. S.; Hoover, F. A.; Bowling, L. C.

2017-12-01

Elliot Ditch is an urban/urbanizing watershed located in the city of Lafayette, IN, USA. The city continues to struggle with stormwater management and combined sewer overflow (CSO) events. Several best-management practices (BMP) such as rain gardens, green roofs, and bioswales have been implemented in the watershed, but the level of adoption needed to achieve meaningful impact is currently unknown. This study's goal is to determine what level of BMP coverage is needed to impact water quality, whether meaningful impact is determined by achieving water quality targets or statistical significance. A power analysis was performed using water quality data for total suspended solids (TSS), E.coli, total phosphorus (TP) and nitrate (NO3-N) from Elliot Ditch from 2011 to 2015. The minimum detectable difference (MDD) was calculated as the percent reduction in load needed to detect a significant change in the watershed. The water quality targets were proposed by stakeholders as part of a watershed management planning process. The water quality targets and the MDD percentages were then compared to simulated load reductions due to BMP implementation using the Long-term Hydrologic Impact Assessment-Low Impact Development (LTHIA-LID) model. Seven baseline model scenarios were simulated by implementing the maximum number of each of six types of BMPs (rain barrels, permeable patios, green roofs, grassed swale/bioswales, bioretention/rain gardens, and porous pavement), as well as all the practices combined in the watershed. These provide the baseline for targeted implementation scenarios designed to determine if statistically and physically meaningful load reductions can be achieved through BMP implementation alone.

Potential impacts of climate change on water quality in a shallow reservoir in China.

PubMed

Zhang, Chen; Lai, Shiyu; Gao, Xueping; Xu, Liping

2015-10-01

To study the potential effects of climate change on water quality in a shallow reservoir in China, the field data analysis method is applied to data collected over a given monitoring period. Nine water quality parameters (water temperature, ammonia nitrogen, nitrate nitrogen, nitrite nitrogen, total nitrogen, total phosphorus, chemical oxygen demand, biochemical oxygen demand and dissolved oxygen) and three climate indicators for 20 years (1992-2011) are considered. The annual trends exhibit significant trends with respect to certain water quality and climate parameters. Five parameters exhibit significant seasonality differences in the monthly means between the two decades (1992-2001 and 2002-2011) of the monitoring period. Non-parametric regression of the statistical analyses is performed to explore potential key climate drivers of water quality in the reservoir. The results indicate that seasonal changes in temperature and rainfall may have positive impacts on water quality. However, an extremely cold spring and high wind speed are likely to affect the self-stabilising equilibrium states of the reservoir, which requires attention in the future. The results suggest that land use changes have important impact on nitrogen load. This study provides useful information regarding the potential effects of climate change on water quality in developing countries.

Impact of Quality Improvement Educational Interventions on Documented Adherence to Quality Measures for Adults with Crohn's Disease.

PubMed

Greene, Laurence; Sapir, Tamar; Moreo, Kathleen; Carter, Jeffrey D; Patel, Barry; Higgins, Peter D R

2015-09-01

In recent years, leading organizations in inflammatory bowel disease (IBD) have developed quality measures for the care of adults with Crohn's disease or ulcerative colitis. We used chart audits to assess the impact of quality improvement educational activities on documented adherence to Physician Quality Reporting System measures for IBD. Twenty community-based gastroenterologists were recruited to participate in baseline chart audits (n = 200), a series of 4 accredited educational activities with feedback, and follow-up chart audits (n = 200). Trained abstractors reviewed randomly selected charts of adults with moderate or severe Crohn's disease. The charts were retrospectively abstracted for physicians' documented performance of the 2013 Physician Quality Reporting System IBD quality measures. We compared the physicians' baseline and posteducation rates of documented adherence with 10 of these measures. In a secondary analysis, we compared preeducation with posteducation difference scores of low-performing physicians, those whose baseline documentation rates were in the lowest quartile, and the rest of the cohort. At baseline, documentation of mean provider-level adherence to the 10 quality measures ranged from 3% to 98% (grand mean = 35.8%). In the overall analysis, baseline and posteducation rates of documented adherence did not differ significantly for any of the measures. However, for 4 measures, preeducation to posteducation difference scores were significantly greater among low performers than physicians in the highest 3 quartiles. The results of this preliminary pragmatic study indicate that quality improvement education affords the potential to improve adherence to Physician Quality Reporting System quality measures for IBD among low-performing gastroenterologists.

Assessment of predictors of the impact of fibromyalgia on health-related quality of life 12 months after the end of an interdisciplinary treatment.

PubMed

Martín, Josune; Torre, Fernando; Aguirre, Urko; Padierna, Angel; Matellanes, Begoña; Quintana, José M

2017-01-15

Fibromyalgia is a chronic pain disorder with a range of comorbid symptoms, including anxiety. We aimed to prospectively identify predictors of the long-term impact of fibromyalgia on health-related quality of life after the end of an interdisciplinary intervention. 138 patients with fibromyalgia, selected from a hospital pain management unit, participated in a 6-week interdisciplinary treatment that combined coordinated psychological, medical, educational, and physiotherapeutic interventions. Participants completed the Fibromyalgia Impact Questionnaire and the Hospital Anxiety and Depression Scale at baseline and 6 weeks, 6 months, and 12 months after the intervention. Multivariable generalized linear mixed models were developed, using the Fibromyalgia Impact Questionnaire score as a continuous variable. Variables that were significant predictors of the long-term impact of fibromyalgia on health-related quality of life in patients who completed a 6-week interdisciplinary treatment were marital status, the number of concurrent conditions, years since the onset of pain, and symptoms of anxiety. In the longitudinal analysis, patients with symptoms of anxiety had lower rates of improvement than those without symptoms of anxiety. Our results suggest that patients with lower level of anxiety have less impact on their HRQoL. The results also provide evidence that starting interventions as soon as possible is an important factor for improving health-related quality of life. Copyright © 2016 Elsevier B.V. All rights reserved.

Paediatric x-ray radiation dose reduction and image quality analysis.

PubMed

Martin, L; Ruddlesden, R; Makepeace, C; Robinson, L; Mistry, T; Starritt, H

2013-09-01

Collaboration of multiple staff groups has resulted in significant reduction in the risk of radiation-induced cancer from radiographic x-ray exposure during childhood. In this study at an acute NHS hospital trust, a preliminary audit identified initial exposure factors. These were compared with European and UK guidance, leading to the introduction of new factors that were in compliance with European guidance on x-ray tube potentials. Image quality was assessed using standard anatomical criteria scoring, and visual grading characteristics analysis assessed the impact on image quality of changes in exposure factors. This analysis determined the acceptability of gradual radiation dose reduction below the European and UK guidance levels. Chest and pelvis exposures were optimised, achieving dose reduction for each age group, with 7%-55% decrease in critical organ dose. Clinicians confirmed diagnostic image quality throughout the iterative process. Analysis of images acquired with preliminary and final exposure factors indicated an average visual grading analysis result of 0.5, demonstrating equivalent image quality. The optimisation process and final radiation doses are reported for Carestream computed radiography to aid other hospitals in minimising radiation risks to children.

Cost-effectiveness and Budget Impact of Routine Use of Fractional Exhaled Nitric Oxide Monitoring for the Management of Adult Asthma Patients in Spain.

PubMed

Sabatelli, L; Seppälä, U; Sastre, J; Crater, G

Fractional exhaled nitric oxide (FeNO) is a marker for type 2 airway inflammation. The objective of this study was to evaluate the cost-effectiveness and budget impact of FeNO monitoring for management of adult asthma in Spain. A cost-effectiveness analysis model was used to evaluate the effect on costs of adding FeNO monitoring to asthma management. Over a 1-year period, the model estimated the incremental cost per quality-adjusted life year and incremental number of exacerbations avoided when FeNO monitoring was added to standard guideline-driven asthma care compared with standard care alone. Univariate and multivariate sensitivity analyses were applied to explore uncertainty in the model. A budget impact model was used to examine the impact of FeNO monitoring on primary care costs across the Spanish health system. The results showed that adding FeNO to standard asthma care saved €62.53 per patient-year in the adult population and improved quality-adjusted life years by 0.026 per patient-year. The budget impact analysis revealed a potential net yearly saving of €129 million if FeNO monitoring had been used in primary care settings in Spain. The present economic model shows that adding FeNO to the treatment algorithm can considerably reduce costs and improve quality of life when used to manage asthma in combination with current treatment guidelines.

Malocclusion and oral health-related quality of life in Brazilian school children.

PubMed

Sardenberg, Fernanda; Martins, Milene T; Bendo, Cristiane B; Pordeus, Isabela A; Paiva, Saul M; Auad, Sheyla M; Vale, Miriam P

2013-01-01

To test the hypothesis that malocclusion and its impact on quality of life has no effect on 8- to 10-year-old Brazilian schoolchildren as measured by an oral health-related quality of life (OHRQoL) instrument. A cross-sectional study was carried out with a population-based sample of 1204 8- to 10-year-old children attending elementary schools in Belo Horizonte, Brazil. Dental examinations were carried out by two calibrated examiners. OHRQoL was assessed using the Brazilian version of the Child Perceptions Questionnaire. The Dental Aesthetic Index was used for the clinical assessment of malocclusion. Dental caries and socioeconomic factors were used as controlling variables. Bivariate analysis involved the chi-square test and the Fisher exact test. A Poisson regression model was employed for the multivariate analysis (P < .05). Anterior segment spacing and anterior mandibular overjet were significantly associated with impact on OHRQoL (P < .05). Schoolchildren with malocclusion were 1.30-fold (95% CI: 1.15-1.46; P < 0.001) more likely to experience a negative impact on OHRQoL than those without malocclusion. Children belonging to families with an income less than or equal to two times the minimum wage were 1.59-fold (95% CI: 1.35-1.88; P < 0.001) more likely to experience a negative impact on OHRQoL than those belonging to families with the highest income. Schoolchildren with malocclusion from lower-income families experience a greater negative impact on OHRQoL.

Could Expanded Freight Rail Reduce Air Pollution from Trucks?

NASA Astrophysics Data System (ADS)

Bickford, E. E.; Holloway, T.; Johnston, M.

2010-12-01

Cars, trucks and trains are a significant source of emissions that impact both climate and air quality on regional to global scales. Diesel vehicles, most used for freight transport, account for 42% of on-road nitrogen oxide emissions, 58% of on-road fine particulate emissions, and 21% of on-road carbon dioxide emissions. With freight tonnage projected to increase 28% by 2018, and freight trucks the fastest growing source of transportation emissions, we evaluate the potential for increased rail capacity to reduce the environmental impacts of trucks. Most widely available mobile source emissions inventories contain insufficient spatial detail to quantify realistic emission scenario options, and none to date have been linked with commodity flow information in a manner appropriate to consider the true potential of rail substitution. To support a truck-to-rail analysis, and other policy assessments requiring roadway-by-roadway analysis, we have developed a freight emissions inventory for the Upper Midwest based on the Federal Highway Administration’s Freight Analysis Framework version 2.2 and the Environmental Protection Agency’s on-road emissions model, Mobile6.2. Using a Geographical Information System (GIS), we developed emissions scenarios for truck-to-rail modal shifts where 95% of freight tonnage on trips longer than 400 miles is shifted off of trucks and onto railways. Scenarios will be analyzed with the Community Multiscale Air Quality (CMAQ) regional model to assess air quality impacts of associated changes. By using well-respected transportation data and realistic assumptions, results from this study have the potential to inform decisions on transportation sustainability, carbon management, public health, and air quality.

Community Near-Port Modeling System (C-PORT): Briefing for ...

EPA Pesticide Factsheets

What C-PORT is: Screening level tool for assessing port activities and exploring the range of potential impacts that changes to port operations might have on local air quality; Analysis of decision alternatives through mapping of the likely pattern of potential pollutant dispersion and an estimated change in pollutant concentrations for user-designated scenarios; Designed primarily to evaluate the local air quality impacts of proposed port expansion or modernization, as well as to identify options for mitigating any impacts; Currently includes data from 21 US seaports and features a map-based interface similar to the widely used Google Earth; Still under development, C-PORT is designed as an easy-to-use computer modeling tool for users, such as state air quality managers and planners. This is part of our product outreach prior to model public release and to solicit for additional beta testers.

A Novel Patient-Derived Conceptual Model of the Impact of Celiac Disease in Adults: Implications for Patient-Reported Outcome and Health-Related Quality-of-Life Instrument Development.

PubMed

Leffler, Daniel A; Acaster, Sarah; Gallop, Katy; Dennis, Melinda; Kelly, Ciarán P; Adelman, Daniel C

2017-04-01

Celiac disease is a chronic inflammatory condition with wide ranging effects on individual's lives caused by a combination of symptoms and the burden of adhering to a gluten-free diet (GFD). To further understand patients' experience of celiac disease, the impact it has on health-related quality of life (HRQOL), and to develop a conceptual model describing this impact. Adults with celiac disease on a GFD reporting symptoms within the previous 3 months were included; patients with refractory celiac disease and confounding medical conditions were excluded. A semistructured discussion guide was developed exploring celiac disease symptoms and impact on patients' HRQOL. An experienced interviewer conducted in-depth interviews. The data set was coded and analyzed using thematic analysis to identify concepts, themes, and the inter-relationships between them. Data saturation was monitored and concepts identified formed the basis of the conceptual model. Twenty-one participants were recruited, and 32 distinct gluten-related symptoms were reported and data saturation was reached. Analysis identified several themes impacting patients' HRQOL: fears and anxiety, day-to-day management of celiac disease, physical functioning, sleep, daily activities, social activities, emotional functioning, and relationships. The conceptual model highlights the main areas of impact and the relationships between concepts. Both symptoms and maintaining a GFD have a substantial impact on patient functioning and HRQOL in adults with celiac disease. The conceptual model derived from these data may help to design future patient-reported outcomes as well as interventions to improve the quality of life in an individual with celiac disease. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Structural equation model of factors related to quality of life for community-dwelling schizophrenic patients in Japan

PubMed Central

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

Library and information services: impact on patient care quality.

PubMed

Marshall, Joanne Gard; Morgan, Jennifer Craft; Thompson, Cheryl A; Wells, Amber L

2014-01-01

The purpose of this paper is to explore library and information service impact on patient care quality. A large-scale critical incident survey of physicians and residents at 56 library sites serving 118 hospitals in the USA and Canada. Respondents were asked to base their answers on a recent incident in which they had used library resources to search for information related to a specific clinical case. Of 4,520 respondents, 75 percent said that they definitely or probably handled patient care differently using information obtained through the library. In a multivariate analysis, three summary clinical outcome measures were used as value and impact indicators: first, time saved; second, patient care changes; and third, adverse events avoided. The outcomes were examined in relation to four information access methods: first, asking librarian for assistance; second, performing search in a physical library; third, searching library's web site; or fourth, searching library resources on an institutional intranet. All library access methods had consistently positive relationships with the clinical outcomes, providing evidence that library services have a positive impact on patient care quality. Electronic collections and services provided by the library and the librarian contribute to patient care quality.

76 FR 43128 - Approval and Promulgation of Air Quality Implementation Plan; Alabama; Disapproval of Interstate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

..., if so, address the impact. The state's conclusion must be supported by an adequate technical analysis...'' provisions, the state's SIP revision must be supported by an adequate technical analysis, including, but not... disapproval where the Agency states: ``* * *without an adequate technical analysis EPA does not believe that...

Determining Water Quality Trends in the Sacramento-San Joaquin Delta Watershed in the Face of Climate Change

NASA Astrophysics Data System (ADS)

Kynett, K.; Azimi-Gaylon, S.; Doidic, C.

2014-12-01

The Sacramento-San Joaquin Delta and Suisun Marsh (Delta) is the largest estuary on the West Coast of the Americas and is a resource of local, State, and national significance. The Delta is simultaneously the most critical component of California's water supply, a primary focus of the state's ecological conservation measures, and a vital resource deeply imperiled by degraded water quality. Delta waterbodies are identified as impaired by salinity, excess nutrients, low dissolved oxygen, pathogens, pesticides, heavy metals, and other contaminants. Climate change is expected to exacerbate the impacts of existing stressors in the Delta and magnify the challenges of managing this natural resource. A clear understanding of the current state of the watershed is needed to better inform scientists, decision makers, and the public about potential impacts from climate change. The Delta Watershed Initiative Network (Delta WIN) leverages the ecological benefits of healthy watersheds, and enhances, expands and creates opportunities for greater watershed health by coordinating with agencies, established programs, and local organizations. At this critical junction, Delta WIN is coordinating data integration and analysis to develop better understanding of the existing and emerging water quality concerns. As first steps, Delta WIN is integrating existing water quality data, analyzing trends, and monitoring to fill data gaps and to evaluate indicators of climate change impacts. Available data will be used for trend analysis; Delta WIN will continue to monitor where data is incomplete and new questions arise. Understanding how climate change conditions may affect water quality will be used to inform efforts to build resilience and maintain water quality levels which sustain aquatic life and human needs. Assessments of historical and new data will aid in recognition of potential climate change impacts and in initiating implementation of best management practices in collaboration with State and local agencies. Ultimately, Delta WIN can inform responsive science and adaptive management in other estuaries and critical natural resource areas facing times of change.

From Autonomy to Quality Management: NPM Impacts on School Governance in Switzerland

ERIC Educational Resources Information Center

Hangartner, Judith; Svaton, Carla Jana

2013-01-01

This article reviews the impact of discourses on "New Public Management" (NPM) on compulsory schooling in Switzerland during the last two decades and traces its implementation in the Canton of Bern. The analysis suggests that while NPM reformers initially promoted increased school autonomy, the introduction of market elements and school…

The impact of SNP fingerprinting and parentage analysis on the effectiveness of variety recommendations in cacao

USDA-ARS?s Scientific Manuscript database

Evidence for the impact of mislabeling and/or pollen contamination on consistency of field performance has been lacking to reinforce the need for strict adherence to quality control protocols in cacao seed garden and germplasm plot management. The present study used SNP fingerprinting at 64 loci to ...

Quality of life in ostomy patients: a qualitative study.

PubMed

Dabirian, Aazam; Yaghmaei, Farideh; Rassouli, Maryam; Tafreshi, Mansoureh Zagheri

2010-12-21

Therapeutic procedures may not only treat disease but also affect patient quality of life. Therefore, quality of life should be measured in order to assess the impact of disease and therapeutic procedures. To identify clients' problems, it is necessary to assess several dimensions of quality of life, including physical, spiritual, economic, and social aspects. In this regard, we conducted a qualitative study to explore quality of life and its dimensions in ostomy patients referred to the Iranian Ostomy Association. Fourteen patients were interviewed about their quality of life dimensions by purposeful sampling. Data were gathered by semistructured interviews and analyzed using the content analysis method. Nine main themes emerged using this approach, including physical problems related to colostomy, impact of colostomy on psychological functioning, social and family relationships, travel, nutrition, physical activity, and sexual function, as well as religious and economic issues. The findings of the study identified a number of challenges in quality of life for patients with ostomy. The results can be used by health care providers to create a supportive environment that promotes better quality of life for their ostomy patients.

Quality of life in ostomy patients: a qualitative study

PubMed Central

Dabirian, Aazam; Yaghmaei, Farideh; Rassouli, Maryam; Tafreshi, Mansoureh Zagheri

2011-01-01

Purpose Therapeutic procedures may not only treat disease but also affect patient quality of life. Therefore, quality of life should be measured in order to assess the impact of disease and therapeutic procedures. To identify clients’ problems, it is necessary to assess several dimensions of quality of life, including physical, spiritual, economic, and social aspects. In this regard, we conducted a qualitative study to explore quality of life and its dimensions in ostomy patients referred to the Iranian Ostomy Association. Methods Fourteen patients were interviewed about their quality of life dimensions by purposeful sampling. Data were gathered by semistructured interviews and analyzed using the content analysis method. Results Nine main themes emerged using this approach, including physical problems related to colostomy, impact of colostomy on psychological functioning, social and family relationships, travel, nutrition, physical activity, and sexual function, as well as religious and economic issues. Conclusion The findings of the study identified a number of challenges in quality of life for patients with ostomy. The results can be used by health care providers to create a supportive environment that promotes better quality of life for their ostomy patients. PMID:21311696

Assessing the environmental impacts of aircraft noise and emissions

NASA Astrophysics Data System (ADS)

Mahashabde, Anuja; Wolfe, Philip; Ashok, Akshay; Dorbian, Christopher; He, Qinxian; Fan, Alice; Lukachko, Stephen; Mozdzanowska, Aleksandra; Wollersheim, Christoph; Barrett, Steven R. H.; Locke, Maryalice; Waitz, Ian A.

2011-01-01

With the projected growth in demand for commercial aviation, many anticipate increased environmental impacts associated with noise, air quality, and climate change. Therefore, decision-makers and stakeholders are seeking policies, technologies, and operational procedures that balance environmental and economic interests. The main objective of this paper is to address shortcomings in current decision-making practices for aviation environmental policies. We review knowledge of the noise, air quality, and climate impacts of aviation, and demonstrate how including environmental impact assessment and quantifying uncertainties can enable a more comprehensive evaluation of aviation environmental policies. A comparison is presented between the cost-effectiveness analysis currently used for aviation environmental policy decision-making and an illustrative cost-benefit analysis. We focus on assessing a subset of the engine NO X emissions certification stringency options considered at the eighth meeting of the International Civil Aviation Organization’s Committee on Aviation Environmental Protection. The FAA Aviation environmental Portfolio Management Tool (APMT) is employed to conduct the policy assessments. We show that different conclusions may be drawn about the same policy options depending on whether benefits and interdependencies are estimated in terms of health and welfare impacts versus changes in NO X emissions inventories as is the typical practice. We also show that these conclusions are sensitive to a variety of modeling uncertainties. While our more comprehensive analysis makes the best policy option less clear, it represents a more accurate characterization of the scientific and economic uncertainties underlying impacts and the policy choices.

Oral health-related quality of life of Portuguese adults with mild intellectual disabilities

PubMed Central

Pereira, Paulo Almeida; Nunes, Manuel; Mendes, Rui Amaral

2018-01-01

Individuals with disabilities are regarded as a highly vulnerable population group, particularly as far as oral health is concern. However, few studies have assessed the impact of the oral condition on the quality of life of these individuals. Therefore, the aim of this study is to expand knowledge on the oral health status of the Portuguese adults with mild intellectual disability, and to assess how the patient’s oral health is related to their quality of life. A sample of 240 adults with mild intellectual disabilities linked to the Portuguese Federation for Intellectual Disability, were interviewed using a previously validated version of the Oral Health Impact Profile. An oral health examination was also conducted using three oral health indexes: Clinical Oral Health Index (COHI); Clinical Oral Care Needs Index (COCNI) and the Clinical Oral Prevention Index (COPI). Sociodemographic characteristics and dental health factors were also collected, following statistical analysis. More than half of the individuals (54,9%) presented one or more problems of major to severe impact on health (COHI level 2); only 4,6% of the individuals do not need treatment or examination (COCNI level 0) and 85% of the study sample needs measures of educational or preventive action (COPI level 1). In 76,9% of the participants, oral health had impact on the quality of life. The most affected dimensions of life were physical pain with 61,9%, followed by psychological discomfort and psychological disability with 45,1% and 45%, respectively. With relation to oral health factors and sociodemographic variables it was verified that fewer teeth and higher self-perception of need for dental treatment had a negative impact on the quality of life. On the other hand, institutionalization and an increase in at least one category in the self-perception of the oral health status had a positive impact on the quality of life. Given the high burden of oral disease and the considerable impact on quality of life found in this study, the establishment of guidelines to improve the oral health and quality of life of these individuals should be regarded as imperative. PMID:29561892

A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation

PubMed Central

Samsa, Greg; Matchar, David B; Dolor, Rowena J; Wiklund, Ingela; Hedner, Ewa; Wygant, Gail; Hauch, Ole; Marple, Cheryl Beadle; Edwards, Roger

2004-01-01

Background Anticoagulation can reduce quality of life, and different models of anticoagulation management might have different impacts on satisfaction with this component of medical care. Yet, to our knowledge, there are no scales measuring quality of life and satisfaction with anticoagulation that can be generalized across different models of anticoagulation management. We describe the development and preliminary validation of such an instrument – the Duke Anticoagulation Satisfaction Scale (DASS). Methods The DASS is a 25-item scale addressing the (a) negative impacts of anticoagulation (limitations, hassles and burdens); and (b) positive impacts of anticoagulation (confidence, reassurance, satisfaction). Each item has 7 possible responses. The DASS was administered to 262 patients currently receiving oral anticoagulation. Scales measuring generic quality of life, satisfaction with medical care, and tendency to provide socially desirable responses were also administered. Statistical analysis included assessment of item variability, internal consistency (Cronbach's alpha), scale structure (factor analysis), and correlations between the DASS and demographic variables, clinical characteristics, and scores on the above scales. A follow-up study of 105 additional patients assessed test-retest reliability. Results 220 subjects answered all items. Ceiling and floor effects were modest, and 25 of the 27 proposed items grouped into 2 factors (positive impacts, negative impacts, this latter factor being potentially subdivided into limitations versus hassles and burdens). Each factor had a high degree of internal consistency (Cronbach's alpha 0.78–0.91). The limitations and hassles factors consistently correlated with the SF-36 scales measuring generic quality of life, while the positive psychological impact scale correlated with age and time on anticoagulation. The intra-class correlation coefficient for test-retest reliability was 0.80. Conclusions The DASS has demonstrated reasonable psychometric properties to date. Further validation is ongoing. To the degree that dissatisfaction with anticoagulation leads to decreased adherence, poorer INR control, and poor clinical outcomes, the DASS has the potential to help identify reasons for dissatisfaction (and positive satisfaction), and thus help to develop interventions to break this cycle. As an instrument designed to be applicable across multiple models of anticoagulation management, the DASS could be crucial in the scientific comparison between those models of care. PMID:15132746

32 CFR 651.45 - Steps in preparing and processing an EIS.

Code of Federal Regulations, 2010 CFR

2010-07-01

... technical analyses are balanced with environmental analysis, the agency preferred alternative will not...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.45... alternatives based on relevant factors including environmental, economic, and technical considerations and...

Air Pollution and Quality of Sperm: A Meta-Analysis

PubMed Central

Fathi Najafi, Tahereh; Latifnejad Roudsari, Robab; Namvar, Farideh; Ghavami Ghanbarabadi, Vahid; Hadizadeh Talasaz, Zahra; Esmaeli, Mahin

2015-01-01

Context: Air pollution is common in all countries and affects reproductive functions in men and women. It particularly impacts sperm parameters in men. This meta-analysis aimed to examine the impact of air pollution on the quality of sperm. Evidence Acquisition: The scientific databases of Medline, PubMed, Scopus, Google scholar, Cochrane Library, and Elsevier were searched to identify relevant articles published between 1978 to 2013. In the first step, 76 articles were selected. These studies were ecological correlation, cohort, retrospective, cross-sectional, and case control ones that were found through electronic and hand search of references about air pollution and male infertility. The outcome measurement was the change in sperm parameters. A total of 11 articles were ultimately included in a meta-analysis to examine the impact of air pollution on sperm parameters. The authors applied meta-analysis sheets from Cochrane library, then data extraction, including mean and standard deviation of sperm parameters were calculated and finally their confidence interval (CI) were compared to CI of standard parameters. Results: The CI for pooled means were as follows: 2.68 ± 0.32 for ejaculation volume (mL), 62.1 ± 15.88 for sperm concentration (million per milliliter), 39.4 ± 5.52 for sperm motility (%), 23.91 ± 13.43 for sperm morphology (%) and 49.53 ± 11.08 for sperm count. Conclusions: The results of this meta-analysis showed that air pollution reduces sperm motility, but has no impact on the other sperm parameters of spermogram. PMID:26023349

Air pollution and quality of sperm: a meta-analysis.

PubMed

Fathi Najafi, Tahereh; Latifnejad Roudsari, Robab; Namvar, Farideh; Ghavami Ghanbarabadi, Vahid; Hadizadeh Talasaz, Zahra; Esmaeli, Mahin

2015-04-01

Air pollution is common in all countries and affects reproductive functions in men and women. It particularly impacts sperm parameters in men. This meta-analysis aimed to examine the impact of air pollution on the quality of sperm. The scientific databases of Medline, PubMed, Scopus, Google scholar, Cochrane Library, and Elsevier were searched to identify relevant articles published between 1978 to 2013. In the first step, 76 articles were selected. These studies were ecological correlation, cohort, retrospective, cross-sectional, and case control ones that were found through electronic and hand search of references about air pollution and male infertility. The outcome measurement was the change in sperm parameters. A total of 11 articles were ultimately included in a meta-analysis to examine the impact of air pollution on sperm parameters. The authors applied meta-analysis sheets from Cochrane library, then data extraction, including mean and standard deviation of sperm parameters were calculated and finally their confidence interval (CI) were compared to CI of standard parameters. The CI for pooled means were as follows: 2.68 ± 0.32 for ejaculation volume (mL), 62.1 ± 15.88 for sperm concentration (million per milliliter), 39.4 ± 5.52 for sperm motility (%), 23.91 ± 13.43 for sperm morphology (%) and 49.53 ± 11.08 for sperm count. The results of this meta-analysis showed that air pollution reduces sperm motility, but has no impact on the other sperm parameters of spermogram.

The distribution of outcomes research papers across clinical journals.

PubMed

Goldsack, Jennifer; McLaughlin, Chris; Bristol, Mirar N; Loeb, Alex; Bergey, Meredith; Sonnad, Seema S

2011-06-01

This study examines the distribution of health outcomes research (HOR) studies in the clinical literature by clinical areas and journal impact factor. The authors reviewed 535 journals and divided the sample into higher and lower impact journals across four clinical area. Mann-Whitney and Kruskal-Wallis tests were used to examine differences across four categories of outcomes research articles published, specifically the incidence of articles in higher versus lower impact journals and differences across clinical areas. All high-impact journals published more safety and quality articles than process assessment, quality of life, or cost analysis studies. The number of each type of outcomes research study published was highly variable across all clinical areas. Only arthritis and outcomes research journals showed statistically significant differences between higher versus lower impact journals. Authors may benefit from considering these differences in their clinical specialty area when deciding where to submit HOR studies.

Follow-Up of External Quality Controls for PCR-Based Diagnosis of Whooping Cough in a Hospital Laboratory Network (Renacoq) and in Other Hospital and Private Laboratories in France.

PubMed

Guillot, Sophie; Guiso, Nicole

2016-08-01

The French National Reference Centre (NRC) for Whooping Cough carried out an external quality control (QC) analysis in 2010 for the PCR diagnosis of whooping cough. The main objective of the study was to assess the impact of this QC in the participating laboratories through a repeat analysis in 2012. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Metrics for the Evaluation the Utility of Air Quality Forecasting

NASA Astrophysics Data System (ADS)

Sumo, T. M.; Stockwell, W. R.

2013-12-01

Global warming is expected to lead to higher levels of air pollution and therefore the forecasting of both long-term and daily air quality is an important component for the assessment of the costs of climate change and its impact on human health. Some of the risks associated with poor air quality days (where the Air Pollution Index is greater than 100), include hospital visits and mortality. Accurate air quality forecasting has the potential to allow sensitive groups to take appropriate precautions. This research builds metrics for evaluating the utility of air quality forecasting in terms of its potential impacts. Our analysis of air quality models focuses on the Washington, DC/Baltimore, MD region over the summertime ozone seasons between 2010 and 2012. The metrics that are relevant to our analysis include: (1) The number of times that a high ozone or particulate matter (PM) episode is correctly forecasted, (2) the number of times that high ozone or PM episode is forecasted when it does not occur and (3) the number of times when the air quality forecast predicts a cleaner air episode when the air was observed to have high ozone or PM. Our evaluation of the performance of air quality forecasts include those forecasts of ozone and particulate matter and data available from the U.S. Environmental Protection Agency (EPA)'s AIRNOW. We also examined observational ozone and particulate matter data available from Clean Air Partners. Overall the forecast models perform well for our region and time interval.

An Exploration of the Impact of Reform-Based Science Instruction on Second Graders' Academic Achievement

ERIC Educational Resources Information Center

Ellis, Valeisha Michelle

2013-01-01

The purpose of this study was to examine whether possible relationships might exist between the quality of reform-based science instruction and science and reading achievement in second grade. The study also examined separately possible interactions between quality of instruction and gender and race. The study involved an analysis of data…

Perspectives on Social Network Analysis for Observational Scientific Data

NASA Astrophysics Data System (ADS)

Singh, Lisa; Bienenstock, Elisa Jayne; Mann, Janet

This chapter is a conceptual look at data quality issues that arise during scientific observations and their impact on social network analysis. We provide examples of the many types of incompleteness, bias and uncertainty that impact the quality of social network data. Our approach is to leverage the insights and experience of observational behavioral scientists familiar with the challenges of making inference when data are not complete, and suggest avenues for extending these to relational data questions. The focus of our discussion is on network data collection using observational methods because they contain high dimensionality, incomplete data, varying degrees of observational certainty, and potential observer bias. However, the problems and recommendations identified here exist in many other domains, including online social networks, cell phone networks, covert networks, and disease transmission networks.

Spatio-Temporal Trends and Identification of Correlated Variables with Water Quality for Drinking-Water Reservoirs

PubMed Central

Gu, Qing; Wang, Ke; Li, Jiadan; Ma, Ligang; Deng, Jinsong; Zheng, Kefeng; Zhang, Xiaobin; Sheng, Li

2015-01-01

It is widely accepted that characterizing the spatio-temporal trends of water quality parameters and identifying correlated variables with water quality are indispensable for the management and protection of water resources. In this study, cluster analysis was used to classify 56 typical drinking water reservoirs in Zhejiang Province into three groups representing different water quality levels, using data of four water quality parameters for the period 2006–2010. Then, the spatio-temporal trends in water quality were analyzed, assisted by geographic information systems (GIS) technology and statistical analysis. The results indicated that the water quality showed a trend of degradation from southwest to northeast, and the overall water quality level was exacerbated during the study period. Correlation analysis was used to evaluate the relationships between water quality parameters and ten independent variables grouped into four categories (land use, socio-economic factors, geographical features, and reservoir attributes). According to the correlation coefficients, land use and socio-economic indicators were identified as the most significant factors related to reservoir water quality. The results offer insights into the spatio-temporal variations of water quality parameters and factors impacting the water quality of drinking water reservoirs in Zhejiang Province, and they could assist managers in making effective strategies to better protect water resources. PMID:26492263

Spatio-Temporal Trends and Identification of Correlated Variables with Water Quality for Drinking-Water Reservoirs.

PubMed

Gu, Qing; Wang, Ke; Li, Jiadan; Ma, Ligang; Deng, Jinsong; Zheng, Kefeng; Zhang, Xiaobin; Sheng, Li

2015-10-20

It is widely accepted that characterizing the spatio-temporal trends of water quality parameters and identifying correlated variables with water quality are indispensable for the management and protection of water resources. In this study, cluster analysis was used to classify 56 typical drinking water reservoirs in Zhejiang Province into three groups representing different water quality levels, using data of four water quality parameters for the period 2006-2010. Then, the spatio-temporal trends in water quality were analyzed, assisted by geographic information systems (GIS) technology and statistical analysis. The results indicated that the water quality showed a trend of degradation from southwest to northeast, and the overall water quality level was exacerbated during the study period. Correlation analysis was used to evaluate the relationships between water quality parameters and ten independent variables grouped into four categories (land use, socio-economic factors, geographical features, and reservoir attributes). According to the correlation coefficients, land use and socio-economic indicators were identified as the most significant factors related to reservoir water quality. The results offer insights into the spatio-temporal variations of water quality parameters and factors impacting the water quality of drinking water reservoirs in Zhejiang Province, and they could assist managers in making effective strategies to better protect water resources.

Potential Impacts of Future Climate Change on Regional Air Quality and Public Health over China

NASA Astrophysics Data System (ADS)

Hong, C.; Zhang, Q.; Zhang, Y.; He, K.

2017-12-01

Future climate change would affect public health through changing air quality. Climate extremes and poor weather conditions are likely to occur at a higher frequency in China under a changing climate, but the air pollution-related health impacts due to future climate change remain unclear. Here the potential impacts of future climate change on regional air quality and public health over China is projected using a coupling of climate, air quality and epidemiological models. We present the first assessment of China's future air quality in a changing climate under the Representative Concentration Pathway 4.5 (RCP4.5) scenario using the dynamical downscaling technique. In RCP4.5 scenario, we estimate that climate change from 2006-2010 to 2046-2050 is likely to adversely affect air quality covering more than 86% of population and 55% of land area in China, causing an average increase of 3% in O3 and PM2.5 concentrations, which are found to be associated with the warmer climate and the more stable atmosphere. Our estimate of air pollution-related mortality due to climate change in 2050 is 26,000 people per year in China. Of which, the PM2.5-related mortality is 18,700 people per year, and the O3-related mortality is 7,300 people per year. The climate-induced air pollution and health impacts vary spatially. The climate impacts are even more pronounced on the urban areas where is densely populated and polluted. 90% of the health loss is concentrated in 20% of land areas in China. We use a simple statistical analysis method to quantify the contributions of climate extremes and find more intense climate extremes play an important role in climate-induced air pollution-related health impacts. Our results indicate that global climate change will likely alter the level of pollutant management required to meet future air quality targets as well as the efforts to protect public health in China.

A Spatial and Temporal Assessment of Non-Point Groundwater Pollution Sources, Tutuila Island, American Samoa

NASA Astrophysics Data System (ADS)

Shuler, C. K.; El-Kadi, A. I.; Dulaiova, H.; Glenn, C. R.; Fackrell, J.

2015-12-01

The quality of municipal groundwater supplies on Tutuila, the main island in American Samoa, is currently in question. A high vulnerability for contamination from surface activities has been recognized, and there exists a strong need to clearly identify anthropogenic sources of pollution and quantify their influence on the aquifer. This study examines spatial relationships and time series measurements of nutrients and other tracers to identify predominant pollution sources and determine the water quality impacts of the island's diverse land uses. Elevated groundwater nitrate concentrations are correlated with areas of human development, however, the mixture of residential and agricultural land use in this unique village based agrarian setting makes specific source identification difficult using traditional geospatial analysis. Spatial variation in anthropogenic impact was assessed by linking NO3- concentrations and δ15N(NO3) from an extensive groundwater survey to land-use types within well capture zones and groundwater flow-paths developed with MODFLOW, a numerical groundwater model. Land use types were obtained from high-resolution GIS data and compared to water quality results with multiple-regression analysis to quantify the impact that different land uses have on water quality. In addition, historical water quality data and new analyses of δD and δ18O in precipitation, groundwater, and mountain-front recharge waters were used to constrain the sources and mechanisms of contamination. Our analyses indicate that groundwater nutrient levels on Tutuila are controlled primarily by residential, not agricultural activity. Also a lack of temporal variation suggests that episodic pollution events are limited to individual water sources as opposed to the entire aquifer. These results are not only valuable for water quality management on Tutuila, but also provide insight into the sustainability of groundwater supplies on other islands with similar hydrogeology and land use history.

Impact of STROBE statement publication on quality of observational study reporting: interrupted time series versus before-after analysis.

PubMed

Bastuji-Garin, Sylvie; Sbidian, Emilie; Gaudy-Marqueste, Caroline; Ferrat, Emilie; Roujeau, Jean-Claude; Richard, Marie-Aleth; Canoui-Poitrine, Florence

2013-01-01

In uncontrolled before-after studies, CONSORT was shown to improve the reporting of randomised trials. Before-after studies ignore underlying secular trends and may overestimate the impact of interventions. Our aim was to assess the impact of the 2007 STROBE statement publication on the quality of observational study reporting, using both uncontrolled before-after analyses and interrupted time series. For this quasi-experimental study, original articles reporting cohort, case-control, and cross-sectional studies published between 2004 and 2010 in the four dermatological journals having the highest 5-year impact factors (≥ 4) were selected. We compared the proportions of STROBE items (STROBE score) adequately reported in each article during three periods, two pre STROBE period (2004-2005 and 2006-2007) and one post STROBE period (2008-2010). Segmented regression analysis of interrupted time series was also performed. Of the 456 included articles, 187 (41%) reported cohort studies, 166 (36.4%) cross-sectional studies, and 103 (22.6%) case-control studies. The median STROBE score was 57% (range, 18%-98%). Before-after analysis evidenced significant STROBE score increases between the two pre-STROBE periods and between the earliest pre-STROBE period and the post-STROBE period (median score2004-05 48% versus median score2008-10 58%, p<0.001) but not between the immediate pre-STROBE period and the post-STROBE period (median score2006-07 58% versus median score2008-10 58%, p = 0.42). In the pre STROBE period, the six-monthly mean STROBE score increased significantly, by 1.19% per six-month period (absolute increase 95%CI, 0.26% to 2.11%, p = 0.016). By segmented analysis, no significant changes in STROBE score trends occurred (-0.40%; 95%CI, -2.20 to 1.41; p = 0.64) in the post STROBE statement publication. The quality of reports increased over time but was not affected by STROBE. Our findings raise concerns about the relevance of uncontrolled before-after analysis for estimating the impact of guidelines.

Impact of STROBE Statement Publication on Quality of Observational Study Reporting: Interrupted Time Series versus Before-After Analysis

PubMed Central

Bastuji-Garin, Sylvie; Sbidian, Emilie; Gaudy-Marqueste, Caroline; Ferrat, Emilie; Roujeau, Jean-Claude; Richard, Marie-Aleth; Canoui-Poitrine, Florence

2013-01-01

Background In uncontrolled before-after studies, CONSORT was shown to improve the reporting of randomised trials. Before-after studies ignore underlying secular trends and may overestimate the impact of interventions. Our aim was to assess the impact of the 2007 STROBE statement publication on the quality of observational study reporting, using both uncontrolled before-after analyses and interrupted time series. Methods For this quasi-experimental study, original articles reporting cohort, case-control, and cross-sectional studies published between 2004 and 2010 in the four dermatological journals having the highest 5-year impact factors (≥4) were selected. We compared the proportions of STROBE items (STROBE score) adequately reported in each article during three periods, two pre STROBE period (2004–2005 and 2006–2007) and one post STROBE period (2008–2010). Segmented regression analysis of interrupted time series was also performed. Results Of the 456 included articles, 187 (41%) reported cohort studies, 166 (36.4%) cross-sectional studies, and 103 (22.6%) case-control studies. The median STROBE score was 57% (range, 18%–98%). Before-after analysis evidenced significant STROBE score increases between the two pre-STROBE periods and between the earliest pre-STROBE period and the post-STROBE period (median score2004–05 48% versus median score2008–10 58%, p<0.001) but not between the immediate pre-STROBE period and the post-STROBE period (median score2006–07 58% versus median score2008–10 58%, p = 0.42). In the pre STROBE period, the six-monthly mean STROBE score increased significantly, by 1.19% per six-month period (absolute increase 95%CI, 0.26% to 2.11%, p = 0.016). By segmented analysis, no significant changes in STROBE score trends occurred (−0.40%; 95%CI, −2.20 to 1.41; p = 0.64) in the post STROBE statement publication. Interpretation The quality of reports increased over time but was not affected by STROBE. Our findings raise concerns about the relevance of uncontrolled before-after analysis for estimating the impact of guidelines. PMID:23990867

Urban-rural variations in air quality and health impacts in northern India

NASA Astrophysics Data System (ADS)

Karambelas, A. N.; Holloway, T.; Fiore, A. M.; Kinney, P.; DeFries, R. S.; Kiesewetter, G.; Heyes, C.

2017-12-01

Ambient air pollution in India is a severe problem, contributing to negative health impacts and early death. Ground-based monitors often used to quantify health impacts are often located in urban regions, however approximately 70% of India's population resides in rural areas. We use high-resolution concentrations from the regional Community Multi-scale Air Quality (CMAQ) model over densely-populated northern India to estimate air quality and health impacts due to anthropogenic emission sectors separately for urban and rural regions. Modeled concentrations inform relative risk calculations and exposure estimates as performed in the Global Burden of Disease. Anthropogenic emissions from the International Institute for Applied Systems Analysis (IIASA) Greenhouse Gas-Air Pollution Interactions and Synergies (GAINS) model following version 5a of the Evaluating the Climate and Air Quality Impacts of Short-Lived Pollutants project gridding structure are updated to reflect urban- and rural-specific activity information for transportation and residential combustion, and industrial and electrical generating unit location and magnitude information. We estimate 314,000 (95% Confidence Interval: 304,000—323,000) and 58,000 (CI: 39,000—70,000) adults (25 years or older) die prematurely each year from PM2.5 and O3 respectively in northern India, with the greatest impacts along the Indo-Gangetic Plain. Using urban and rural population distributions, we estimate that the majority of premature deaths resulting from PM2.5 and O3 are in rural (292,000) as opposed to urban (79,000) regions. These findings indicate the need for designing monitoring networks and ground-based health studies in rural areas of India to more accurately quantify the true health implications of ambient air pollution, in addition to supporting model evaluation. Using this urban-versus-rural emissions framework, we are assessing anthropogenic contributions to regional air quality and health impacts, and examining mitigation strategies to reduce anthropogenic emissions, improve air quality, and reduce PM2.5 and O3 attributable premature death in the near-term.

Regulatory Impact Analysis of the Final Revisions to the National Ambient Air Quality Standards for Ground-Level Ozone

EPA Pesticide Factsheets

The EPA performed an illustrative analysis of the potential costs, human health benefits, and welfare benefits of nationally attaining a revised primary ozone standard of 70 ppb and a primary alternative ozone standard level of 65 ppb.

The impact of response measurement error on the analysis of designed experiments

DOE PAGES

Anderson-Cook, Christine Michaela; Hamada, Michael Scott; Burr, Thomas Lee

2016-11-01

This study considers the analysis of designed experiments when there is measurement error in the true response or so-called response measurement error. We consider both additive and multiplicative response measurement errors. Through a simulation study, we investigate the impact of ignoring the response measurement error in the analysis, that is, by using a standard analysis based on t-tests. In addition, we examine the role of repeat measurements in improving the quality of estimation and prediction in the presence of response measurement error. We also study a Bayesian approach that accounts for the response measurement error directly through the specification ofmore » the model, and allows including additional information about variability in the analysis. We consider the impact on power, prediction, and optimization. Copyright © 2015 John Wiley & Sons, Ltd.« less

The impact of response measurement error on the analysis of designed experiments

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

Anderson-Cook, Christine Michaela; Hamada, Michael Scott; Burr, Thomas Lee

This study considers the analysis of designed experiments when there is measurement error in the true response or so-called response measurement error. We consider both additive and multiplicative response measurement errors. Through a simulation study, we investigate the impact of ignoring the response measurement error in the analysis, that is, by using a standard analysis based on t-tests. In addition, we examine the role of repeat measurements in improving the quality of estimation and prediction in the presence of response measurement error. We also study a Bayesian approach that accounts for the response measurement error directly through the specification ofmore » the model, and allows including additional information about variability in the analysis. We consider the impact on power, prediction, and optimization. Copyright © 2015 John Wiley & Sons, Ltd.« less

Project ATLANTA (Atlanta Land use Analysis: Temperature and Air Quality): Use of Remote Sensing and Modeling to Analyze How Urban Land Use Change Affects Meteorology and Air Quality Through Time

NASA Technical Reports Server (NTRS)

Quattrochi, Dale A.; Luvall, Jeffrey C.; Estes, Maurice G., Jr.

1999-01-01

This paper presents an overview of Project ATLANTA (ATlanta Land use ANalysis: Temperature and Air-quality) which is an investigation that seeks to observe, measure, model, and analyze how the rapid growth of the Atlanta, Georgia metropolitan area since the early 1970's has impacted the region's climate and air quality. The primary objectives for this research effort are: (1) To investigate and model the relationships between land cover change in the Atlanta metropolitan, and the development of the urban heat island phenomenon through time; (2) To investigate and model the temporal relationships between Atlanta urban growth and land cover change on air quality; and (3) To model the overall effects of urban development on surface energy budget characteristics across the Atlanta urban landscape through time. Our key goal is to derive a better scientific understanding of how land cover changes associated with urbanization in the Atlanta area, principally in transforming forest lands to urban land covers through time, has, and will, effect local and regional climate, surface energy flux, and air quality characteristics. Allied with this goal is the prospect that the results from this research can be applied by urban planners, environmental managers and other decision-makers, for determining how urbanization has impacted the climate and overall environment of the Atlanta area. Multiscaled remote sensing data, particularly high resolution thermal infrared data, are integral to this study for the analysis of thermal energy fluxes across the Atlanta urban landscape.

The influence of obesity and weight gain on quality of life according to the SF-36 for individuals of the dynamic follow-up cohort of the University of Navarra.

PubMed

Barcones-Molero, M F; Sánchez-Villegas, A; Martínez-González, M A; Bes-Rastrollo, M; Martínez-Urbistondo, M; Santabárbara, J; Martínez, J A

2018-06-26

The health-related quality of life is an important element for the comprehensive assessment of overweight and obesity. To assess the impact of obesity and weight gain on the health-related quality of life of the dynamic cohort of the Follow-up Program of the University of Navarra. The analysis included 10,033 participants of the prospective dynamic cohort of the Follow-up Project of the University of Navarra, with a response rate of approximately 90%. The quality of life was measured with the Short Form 36 Health Survey (SF-36) (0, worst quality of life; 100, best quality of life). The statistical analysis was performed with generalized lineal models (mean of each SF-36 domain and 95% CI). A difference of 3 points was considered clinically relevant. The SF-36 analysis showed that physical function, general health and the physical component summary were inferior in individuals with excess weight and obesity at the start of the study, compared with individuals with normal weight. The study population with unchanged excess weight or obesity after 2 years of follow-up presented lower scores on the SF-36 domains corresponding to physical function, body pain, physical component summary and general health than individuals who maintained the normal weight category according to BMI (kg/m 2 ). Obesity appears to be associated with a negative impact on health-related quality of life, affecting the physical area more significantly than the psychosocial. Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Preferred drug lists: potential impact on healthcare economics.

PubMed

Ovsag, Kimberly; Hydery, Sabrina; Mousa, Shaker A

2008-01-01

To analyze the implementation of Medicaid preferred drug lists (PDLs) in a number of states and determine its impact on quality of care and cost relative to other segments of healthcare. We reviewed research and case studies found by searching library databases, primarily MEDLINE and EBSCOHost, and searching pertinent journals. Keywords initially included "drug lists," "prior authorization," "prior approval," and "Medicaid." We added terms such as "influence use of other healthcare services," "quality of care," and "overall economic impact." We mainly used primary sources. Based on our literature review, we determined that there are a number of issues regarding Medicaid PDLs that need to be addressed. Some issues include: (a) the potential for PDLs to influence the utilization of other healthcare services, (b) criteria used by Medicaid for determining acceptance of drugs onto a PDL, (c) the effect of PDL implementation on compliance to new regimens, (d) the potential effects of restricting medication availability on quality of care, (e) administrative costs associated with PDLs, and (f) satisfaction rates among patients and medical providers. This review highlighted expected short-term cost savings with limited degree of compromised quality of PDL implementation, but raised the concern about the potential long-term decline in quality of care and overall economic impact. The number of concerns raised indicates that further studies are warranted regarding both short-term cost benefits as well as potential long-term effects of Medicaid PDL implementation. Objective analysis of these effects is necessary to ensure cost-effectiveness and quality of care.

Meta-analysis of quality of life in children and adolescents with ADHD: By both parent proxy-report and child self-report using PedsQL™.

PubMed

Lee, Yi-chen; Yang, Hao-Jan; Chen, Vincent Chin-Hung; Lee, Wan-Ting; Teng, Ming-Jen; Lin, Chung-Hui; Gossop, Michael

2016-01-01

Attention deficit hyperactivity disorder (ADHD) is a prevalent developmental disorder that seriously and negatively impacts a child's health-related quality of life (HRQOL). However, no meta-analysis has been conducted to examine the magnitude of impact, domains affected and factors moderating the impact. This review included nine studies that compared HRQOL of children or adolescents with ADHD with those with typical development using both child self-reports and parent proxy-reports. Seven among nine studies were meta-analytically synthesized to examine the degree of impact of ADHD on children and adolescents, parent-child discrepancy, and the moderators. The results indicate that ADHD impact a child's or adolescent's HRQOL negatively with a moderate effect in physical and a severe effect in psychosocial (i.e., emotional, social, and school) domains. Parental ratings of overall HRQOL in children or adolescents with ADHD were not significantly different from child's ratings when compared with typically developing children and adolescents. Age was negatively associated with all domains of HRQOL in children and adolescents with ADHD both by parent- and child-ratings, and the strongest effect was found in parental ratings of child's emotional HRQOL, with a moderate correlation. This meta-analysis suggests that HRQOL may be assessed in children and adolescents with ADHD both by parent proxy- and child self-reports, and that interventions may be planned accordingly. Future meta-analysis may explore how measures of HRQOL and other factors including child, parental, familiar and school characteristics influence the impact of ADHD and the parent-child agreement in children and adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

An Empirical Study of the Impact of Service Quality on Patient Satisfaction in Private Hospitals, Iran

PubMed Central

Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

2015-01-01

Objective: Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. Method: This cross-sectional study was conducted in the year 2010. The study’s sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. Result: this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Conclusions: Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers. PMID:25560338

The economic impact of poor sample quality in clinical chemistry laboratories: results from a global survey.

PubMed

Erdal, Erik P; Mitra, Debanjali; Khangulov, Victor S; Church, Stephen; Plokhoy, Elizabeth

2017-03-01

Background Despite advances in clinical chemistry testing, poor blood sample quality continues to impact laboratory operations and the quality of results. While previous studies have identified the preanalytical causes of lower sample quality, few studies have examined the economic impact of poor sample quality on the laboratory. Specifically, the costs associated with workarounds related to fibrin and gel contaminants remain largely unexplored. Methods A quantitative survey of clinical chemistry laboratory stakeholders across 10 international regions, including countries in North America, Europe and Oceania, was conducted to examine current blood sample testing practices, sample quality issues and practices to remediate poor sample quality. Survey data were used to estimate costs incurred by laboratories to mitigate sample quality issues. Results Responses from 164 participants were included in the analysis, which was focused on three specific issues: fibrin strands, fibrin masses and gel globules. Fibrin strands were the most commonly reported issue, with an overall incidence rate of ∼3%. Further, 65% of respondents indicated that these issues contribute to analyzer probe clogging, and the majority of laboratories had visual inspection and manual remediation practices in place to address fibrin- and gel-related quality problems (55% and 70%, respectively). Probe maintenance/replacement, visual inspection and manual remediation were estimated to carry significant costs for the laboratories surveyed. Annual cost associated with lower sample quality and remediation related to fibrin and/or gel globules for an average US laboratory was estimated to be $100,247. Conclusions Measures to improve blood sample quality present an important step towards improved laboratory operations.

An empirical study of the impact of service quality on patient satisfaction in private hospitals, Iran.

PubMed

Zarei, Ehsan; Daneshkohan, Abbas; Pouragha, Behrouz; Marzban, Sima; Arab, Mohammad

2014-07-29

Perceived service quality is the most important predictor of patient satisfaction. The purpose of this study was to investigate the impact of the service quality on the overall satisfaction of patients in private hospitals of Tehran, Iran. This cross-sectional study was conducted in the year 2010. The study's sample consisted of 969 patients who were recruited from eight private general hospitals in Tehran, Iran using consecutive sampling. A questionnaire was used for data collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers.

Impact of oral immunotherapy on quality of life in children with cow milk allergy: a pilot study.

PubMed

Carraro, S; Frigo, A C; Perin, M; Stefani, S; Cardarelli, C; Bozzetto, S; Baraldi, E; Zanconato, S

2012-01-01

Quality of life is negatively affected in children with food allergy. Oral immunotherapy is an approach to food allergy that leads to patient desensitization by administering gradually increasing amounts of a given food allergen. The aim of this pilot study is to evaluate how oral immunotherapy affects quality of life in children allergic to cow milk proteins. Thirty children (aged 3-12 years) with cow milk allergy were recruited. Their parents were provided with a validated disease specific quality of life questionnaire (the food allergy quality of life questionnaire -- parent form, FAQLQ-PF) before and again 2 months after completing an oral immunotherapy protocol with cow milk. A significant improvement in all the investigated domains -- emotional impact, food anxiety and social and dietary limitations -- was found. The separate analysis of the different age groups demonstrated that the emotional impact and the food-related anxiety improved in children older than 4, while the social domains improved in each age group. In this pilot experience, oral immunotherapy significantly improves quality of life in children with cow milk allergy. The improvement seems particularly evident in children over 4 years old, who are most likely to benefit from the oral immunotherapy approach. Further placebo-controlled studies are needed to confirm these preliminary results.

Geospatial Modeling of Watershed Quality as an Indicator for Environmental Health

NASA Astrophysics Data System (ADS)

Archer, R.

2016-12-01

The impact of urbanization of rural Tennessee counties on environmental quality and human health and wellbeing has not been well studied, especially in the context of water quality. Between 2015 and 2025, Williamson County, TN is projected to see the strongest rate of population growth in the region, expanding by 33.7 percent. Water quality directly affects the condition of soils, vegetation, and other life forms that depend on water for survival, and therefore is a valid indicator of environmental health. Current reliable data is available on less than half (47%) of waterways in Tennessee. GIS is applied to model the impact of urbanization on rural communities within the Mill Creek watershed in Williamson County, Tennessee. Water quality measurements are integrated with data identifying urbanization and other land development influences assessed over a previous decades in order to identify influences of environmental change impacts on the watershed. The study examines the threat of urbanization to soils, vegetation and other related natural resources as well as the distance of farm areas, pasture grazing, cattle access and manure runoff, construction and landscaping to collection systems leading into the watershed. Combining spatial analysis with water quality interpretation helped to identify and display potential causes and sources of Mill Creek Watershed pollution as well as vulnerable locations susceptible to risk of declining environmental health.

Impact on quality of life in teachers after educational actions for prevention of voice disorders: a longitudinal study.

PubMed

Pizolato, Raquel Aparecida; Rehder, Maria Inês Beltrati Cornacchioni; Meneghim, Marcelo de Castro; Ambrosano, Glaucia Maria Bovi; Mialhe, Fábio Luiz; Pereira, Antonio Carlos

2013-02-27

Voice problems are more common in teachers due to intensive voice use during routine at work. There is evidence that occupational disphonia prevention programs are important in improving the quality voice and consequently the quality of subjects' lives. To investigate the impact of educational voice interventions for teachers on quality of life and voice. A longitudinal interventional study involving 70 teachers randomly selected from 11 public schools, 30 to receive educational intervention with vocal training exercises and vocal hygiene habits (experimental group) and 40 to receive guidance on vocal hygiene habits (control group control). Before the process of educational activities, the Voice-Related Quality of Life instrument (V-RQOL) was applied, and 3 months after conclusion of the activities, the subjects were interviewed again, using the same instrument. For data analysis, Prox MIXED were applied, with a level of significance α < 0.05. Teachers showed significantly higher domain and overall V-RQOL scores after preventive intervention, in both control and experimental groups. Nevertheless, there was no statistical difference in scores between the groups. Educational actions for vocal health had a positive impact on the quality of life of the participants, and the incorporation of permanent educational actions at institutional level is suggested.

Impact on quality of life in teachers after educational actions for prevention of voice disorders: a longitudinal study

PubMed Central

2013-01-01

Background Voice problems are more common in teachers due to intensive voice use during routine at work. There is evidence that occupational disphonia prevention programs are important in improving the quality voice and consequently the quality of subjects’ lives. Aim To investigate the impact of educational voice interventions for teachers on quality of life and voice. Methods A longitudinal interventional study involving 70 teachers randomly selected from 11 public schools, 30 to receive educational intervention with vocal training exercises and vocal hygiene habits (experimental group) and 40 to receive guidance on vocal hygiene habits (control group control). Before the process of educational activities, the Voice-Related Quality of Life instrument (V-RQOL) was applied, and 3 months after conclusion of the activities, the subjects were interviewed again, using the same instrument. For data analysis, Prox MIXED were applied, with a level of significance α < 0.05. Results: Teachers showed significantly higher domain and overall V-RQOL scores after preventive intervention, in both control and experimental groups. Nevertheless, there was no statistical difference in scores between the groups. Conclusion Educational actions for vocal health had a positive impact on the quality of life of the participants, and the incorporation of permanent educational actions at institutional level is suggested. PMID:23445566

The dual threat of urbanisation and climate change in urbanising catchments - integrated science to meet future challenges - a case study of the Thames catchment, United Kingdom.

NASA Astrophysics Data System (ADS)

Miller, J.; Hutchins, M.; McGrane, S. J.; Kjeldsen, T. R.; Rowland, C.; Hagen-Zanker, A.; Rickards, N. J.; Fidal, J.; Vesuviano, G.; Hitt, O.

2016-12-01

Rapid urbanisation coupled with climate change poses a significant threat of increased flooding in urban locations around the world. In the UK there is a lack of joined up science and monitoring data to support model development and management decisions required for a rapidly growing population. Here, we present the findings from a multi-disciplinary research project entitled POLLCURB involving a combination of both monitoring and modelling approaches, including participatory citizen science, to evaluate impacts of urbanisation and climate change on flooding and water quality in the Thames basin, United Kingdom. Empirical analysis of five years of monitoring data in intensely monitored sub-catchments reveals the degree to which urban land-use impacts upon hydrological and water quality response. Analysis reveals hydrological impacts do not always follow the expected urban gradient due to intra-catchment differences in hydraulic functions. Statistical detection and attribution techniques are used to assess long-term river data, highlighting strong signals of urban growth after climate variability is accounted for. Historical land-use change mapping of the Thames basin using remote sensing shows growth in urban coverage from around 13% (1980's) to 15% (2015) and was used to develop and train a cellular automata model. Projections of a business-as-usual scenario indicates future growth of 12% by 2035. Future potential changes to flooding and water quality are assessed under urbanisation and climate scenarios for the Thames region to provide comparative and cumulative analysis of how these drivers will affect existing and new urban areas within the Thames basin. Results show the relative and cumulative impacts that both urbanisation and climate change have on basin hydrology and water quality, and highlight the improvements in modelling accuracy when utilising high-resolution data. Discussion is made of results in relation to modelling, policy, mitigation options, and implications for further scientific research.

Quality of life in children with adverse drug reactions: a narrative and systematic review.

PubMed

Del Pozzo-Magaña, Blanca R; Rieder, Michael J; Lazo-Langner, Alejandro

2015-10-01

Adverse drug reactions are a common problem affecting adults and children. The economic impact of the adverse drug reactions has been widely evaluated; however, studies of the impact on the quality of life of children with adverse drug reactions are scarce. The aim was to evaluate studies assessing the health-related quality of life of children with adverse drug reactions. We conducted a systematic review that included the following electronic databases: MEDLINE, EMBASE and the Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Cochrane Controlled Trials Register and the Health Technology Assessment Databases). Nine studies were included. Four of the studies were conducted in children with epilepsy; the rest of them involved children with chronic viral hepatitis, Crohn's disease, paediatric cancer and multiple adverse drug reactions compared with healthy children. Based on their findings, authors of all studies concluded that adverse drug reactions had a negative impact on the quality of life of children. No meta-analysis was conducted given the heterogeneous nature of the studies. To date, there is no specific instrument that measures quality of life of children with adverse drug reactions, and the information available is poor and variable. In general, adverse drug reactions have a negative impact on the quality of life of affected children. For those interested in this area, more work needs to be done to improve tools that help to evaluate efficiently the health-related quality of life of children with adverse drug reactions and chronic diseases. © 2014 The British Pharmacological Society.

Impact of two early treatment protocols for anterior dental crossbite on children's quality of life.

PubMed

Miamoto, Cristina Batista; Marques, Leandro Silva; Abreu, Lucas Guimarães; Paiva, Saul Martins

2018-01-01

To assess the impact of two early treatment protocols for anterior dental crossbite on children's quality of life. Thirty children, 8 to 10 years of age, with anterior dental crossbite, participated in this study. Individuals were divided into two groups: Group 1 - 15 children undergoing treatment with an upper removable appliance with digital springs; Group 2 - 15 children undergoing treatment with resin-reinforced glass ionomer cement bite pads on the lower first molars. Quality of life was evaluated using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10), which contains four subscales: oral symptoms (OS), functional limitations (FL), emotional well-being (EW), and social well-being (SW). A higher score denotes a greater negative impact on children's quality of life. Children answered the questionnaire before treatment (T1) and twelve months after orthodontic treatment onset (T2). Descriptive statistics, the Wilcoxon test and analysis of covariance (ANCOVA) were performed. Children's mean age was 9.07 ± 0.79 years in Group 1 and 9.00 ± 0.84 years in Group 2. For Group 1, the FL and EW subscale scores and the overall CPQ8-10 were significantly higher in T1 as compared to T2 (p= 0.004, p= 0.012 and p= 0.015, respectively). For Group 2, there were no statistically significant differences. The ANCOVA showed no significant difference regarding quality of life at T2 between groups, after controlling for quality of life measures at T1. The difference regarding the impact on quality of life between groups is not related to the protocol used.

Quality of life in children with adverse drug reactions: a narrative and systematic review

PubMed Central

Del Pozzo-Magaña, Blanca R; Rieder, Michael J; Lazo-Langner, Alejandro

2015-01-01

Aims Adverse drug reactions are a common problem affecting adults and children. The economic impact of the adverse drug reactions has been widely evaluated; however, studies of the impact on the quality of life of children with adverse drug reactions are scarce. The aim was to evaluate studies assessing the health-related quality of life of children with adverse drug reactions. Methods We conducted a systematic review that included the following electronic databases: MEDLINE, EMBASE and the Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Cochrane Controlled Trials Register and the Health Technology Assessment Databases). Results Nine studies were included. Four of the studies were conducted in children with epilepsy; the rest of them involved children with chronic viral hepatitis, Crohn’s disease, paediatric cancer and multiple adverse drug reactions compared with healthy children. Based on their findings, authors of all studies concluded that adverse drug reactions had a negative impact on the quality of life of children. No meta-analysis was conducted given the heterogeneous nature of the studies. Conclusions To date, there is no specific instrument that measures quality of life of children with adverse drug reactions, and the information available is poor and variable. In general, adverse drug reactions have a negative impact on the quality of life of affected children. For those interested in this area, more work needs to be done to improve tools that help to evaluate efficiently the health-related quality of life of children with adverse drug reactions and chronic diseases. PMID:24833305

Data Quality- and Master Data Management - A Hospital Case.

PubMed

Arthofer, Klaus; Girardi, Dominic

2017-01-01

Poor data quality prevents the analysis of data for decisions which are critical for business. It also has a negative impact on business processes. Nevertheless the maturity level of data quality- and master data management is still insufficient in many organizations nowadays. This article discusses the corresponding maturity of companies and a management cycle integrating data quality- and master data management in a case dealing with benchmarking in hospitals. In conclusion if data quality and master data are not properly managed, structured data should not be acquired in the first place due to the added expense and complexity.

Impact of geostationary satellite water vapor channel data on weather analysis and forecasting

NASA Technical Reports Server (NTRS)

Velden, Christopher S.

1995-01-01

Preliminary results from NWP impact studies are indicating that upper-tropospheric wind information provided by tracking motions in sequences of geostationary satellite water vapor imagery can positively influence forecasts on regional scales, and possibly on global scales as well. The data are complimentary to cloud-tracked winds by providing data in cloud-free regions, as well as comparable in quality. First results from GOES-8 winds are encouraging, and further efforts and model impacts will be directed towards optimizing these data in numerical weather prediction (NWP). Assuming successful launches of GOES-J and GMS-5 satellites in 1995, high quality and resolution water vapor imagers will be available to provide nearly complete global upper-tropospheric wind coverage.

Integrated analysis of numerical weather prediction and computational fluid dynamics for estimating cross-ventilation effects on inhaled air quality inside a factory

NASA Astrophysics Data System (ADS)

Murga, Alicia; Sano, Yusuke; Kawamoto, Yoichi; Ito, Kazuhide

2017-10-01

Mechanical and passive ventilation strategies directly impact indoor air quality. Passive ventilation has recently become widespread owing to its ability to reduce energy demand in buildings, such as the case of natural or cross ventilation. To understand the effect of natural ventilation on indoor environmental quality, outdoor-indoor flow paths need to be analyzed as functions of urban atmospheric conditions, topology of the built environment, and indoor conditions. Wind-driven natural ventilation (e.g., cross ventilation) can be calculated through the wind pressure coefficient distributions of outdoor wall surfaces and openings of a building, allowing the study of indoor air parameters and airborne contaminant concentrations. Variations in outside parameters will directly impact indoor air quality and residents' health. Numerical modeling can contribute to comprehend these various parameters because it allows full control of boundary conditions and sampling points. In this study, numerical weather prediction modeling was used to calculate wind profiles/distributions at the atmospheric scale, and computational fluid dynamics was used to model detailed urban and indoor flows, which were then integrated into a dynamic downscaling analysis to predict specific urban wind parameters from the atmospheric to built-environment scale. Wind velocity and contaminant concentration distributions inside a factory building were analyzed to assess the quality of the human working environment by using a computer simulated person. The impact of cross ventilation flows and its variations on local average contaminant concentration around a factory worker, and inhaled contaminant dose, were then discussed.

Impacts of Early Childhood Education on Medium- and Long-Term Educational Outcomes

ERIC Educational Resources Information Center

McCoy, Dana Charles; Yoshikawa, Hirokazu; Ziol-Guest, Kathleen M.; Duncan, Greg J.; Schindler, Holly S.; Magnuson, Katherine; Yang, Rui; Koepp, Andrew; Shonkoff, Jack P.

2017-01-01

Despite calls to expand early childhood education (ECE) in the United States, questions remain regarding its medium- and long-term impacts on educational outcomes. We use meta-analysis of 22 high-quality experimental and quasi-experimental studies conducted between 1960 and 2016 to find that on average, participation in ECE leads to statistically…

Impact of Ozone Radiative Feedbacks on Global Weather Forecasting

NASA Astrophysics Data System (ADS)

Ivanova, I.; de Grandpré, J.; Rochon, Y. J.; Sitwell, M.

2017-12-01

A coupled Chemical Data Assimilation system for ozone is being developed at Environment and Climate Change Canada (ECCC) with the goals to improve the forecasting of UV index and the forecasting of air quality with the Global Environmental Multi-scale (GEM) Model for Air quality and Chemistry (MACH). Furthermore, this system provides an opportunity to evaluate the benefit of ozone assimilation for improving weather forecasting with the ECCC Global Deterministic Prediction System (GDPS) for Numerical Weather Prediction (NWP). The present UV index forecasting system uses a statistical approach for evaluating the impact of ozone in clear-sky and cloudy conditions, and the use of real-time ozone analysis and ozone forecasts is highly desirable. Improving air quality forecasting with GEM-MACH further necessitates the development of integrated dynamical-chemical assimilation system. Upon its completion, real-time ozone analysis and ozone forecasts will also be available for piloting the regional air quality system, and for the computation of ozone heating rates, in replacement of the monthly mean ozone distribution currently used in the GDPS. Experiments with ozone radiative feedbacks were run with the GDPS at 25km resolution and 84 levels with a lid at 0.1 hPa and were initialized with ozone analysis that has assimilated total ozone column from OMI, OMPS, and GOME satellite instruments. The results show that the use of prognostic ozone for the computation of the heating/cooling rates has a significant impact on the temperature distribution throughout the stratosphere and upper troposphere regions. The impact of ozone assimilation is especially significant in the tropopause region, where ozone heating in the infrared wavelengths is important and ozone lifetime is relatively long. The implementation of the ozone radiative feedback in the GDPS requires addressing various issues related to model biases (temperature and humidity) and biases in equilibrium state (ozone mixing ratio, air temperature and overhead column ozone) used for the calculation of the linearized photochemical production and loss of ozone. Furthermore the radiative budget in the tropopause region is strongly affected by water vapor cooling, which impact requires further evaluation for the use in chemically coupled operational NWP systems.

[The experience of implementation of system of quality management in the Department of Laboratory Diagnostic of the N.V. Sklifosofskiy Research Institute of Emergency Care of Moscow Health Department: a lecture].

PubMed

Zenina, L P; Godkov, M A

2013-08-01

The article presents the experience of implementation of system of quality management into the practice of multi-field laboratory of emergency medical care hospital. The analysis of laboratory errors is applied and the modes of their prevention are demonstrated. The ratings of department of laboratory diagnostic of the N. V. Sklifosofskiy research institute of emergency care in the program EQAS (USA) Monthly Clinical Chemistry from 2007 are presented. The implementation of the system of quality management of laboratory analysis into department of laboratory diagnostic made it possible to support physicians of clinical departments with reliable information. The confidence of clinicians to received results increased. The effectiveness of laboratory diagnostic increased due to lowering costs of analysis without negative impact to quality of curative process.

[Establishment and application of "multi-dimensional structure and process dynamic quality control technology system" in preparation products of traditional Chinese medicine (I)].

PubMed

Gu, Jun-Fei; Feng, Liang; Zhang, Ming-Hua; Wu, Chan; Jia, Xiao-Bin

2013-11-01

Safety is an important component of the quality control of traditional Chinese medicine (TCM) preparation products, as well as an important guarantee for clinical application. Currently, the quality control of TCMs in Chinese Pharmacopoeia mostly focuses on indicative compounds for TCM efficacy. TCM preparations are associated with multiple links, from raw materials to products, and each procedure may have impacts on the safety of preparation. We make a summary and analysis on the factors impacting safety during the preparation of TCM products, and then expound the important role of the "multi-dimensional structure and process dynamic quality control technology system" in the quality safety of TCM preparations. Because the product quality of TCM preparation is closely related to the safety, the control over safety-related material basis is an important component of the product quality control of TCM preparations. The implementation of the quality control over the dynamic process of TCM preparations from raw materials to products, and the improvement of the TCM quality safety control at the microcosmic level help lay a firm foundation for the development of the modernization process of TCM preparations.

Biofilm composition in the Olt River (Romania) reservoirs impacted by a chlor-alkali production plant.

PubMed

Dranguet, P; Cosio, C; Le Faucheur, S; Hug Peter, D; Loizeau, J-L; Ungureanu, V-Gh; Slaveykova, V I

2017-05-24

Freshwater biofilms can be useful indicators of water quality and offer the possibility to assess contaminant effects at the community level. The present field study examines the effects of chlor-alkali plant effluents on the community composition of biofilms grown in the Olt River (Romania) reservoirs. The relationship between ambient water quality variables and community composition alterations was explored. Amplicon sequencing revealed a significant modification of the composition of microalgal, bacterial and fungal communities in the biofilms collected in the impacted reservoirs in comparison with those living in the uncontaminated control reservoir. The abundance corrected Simpson index showed lower richness and diversity in biofilms collected in the impacted reservoirs than in the control reservoir. The biofilm bacterial communities of the impacted reservoirs were characterized by the contaminant-tolerant Cyanobacteria and Bacteroidetes, whereas microalgal communities were predominantly composed of Bacillariophyta and fungal communities of Lecanoromycetes and Paraglomycetes. A principal component analysis revealed that major contaminants present in the waste water of the chlor-alkali production plant, i.e. Na + , Ca 2+ , Cl - and Hg, were correlated with the alteration of biofilm community composition in the impacted reservoirs. However, the biofilm composition was also influenced by water quality variables such as NO 3 - , SO 4 2- , DOC and Zn from unknown sources. The results of the present study imply that, even when below the environmental quality standards, typical contaminants of chlor-alkali plant releases may affect biofilm composition and that their impacts on the microbial biodiversity might be currently overlooked.

Effect of Isothermal Bainitic Quenching on Rail Steel Impact Strength and Wear Resistance

NASA Astrophysics Data System (ADS)

Çakir, Fatih Hayati; Çelik, Osman Nuri

2017-09-01

The effect of heat treatment regimes on hardness, impact strength, and wear resistance of rail steel for high-speed tracks (rail quality category R350HT) is studied. Analysis of steel properties with a different structure is compared: pearlitic, and upper and lower bainite. It is shown that the steel with bainitic structure has the best impact strength, but wear resistance is better for steel with a lower bainite structure.

Capturing Budget Impact Considerations Within Economic Evaluations: A Systematic Review of Economic Evaluations of Rotavirus Vaccine in Low- and Middle-Income Countries and a Proposed Assessment Framework.

PubMed

Carvalho, Natalie; Jit, Mark; Cox, Sarah; Yoong, Joanne; Hutubessy, Raymond C W

2018-01-01

In low- and middle-income countries, budget impact is an important criterion for funding new interventions, particularly for large public health investments such as new vaccines. However, budget impact analyses remain less frequently conducted and less well researched than cost-effectiveness analyses. The objective of this study was to fill the gap in research on budget impact analyses by assessing (1) the quality of stand-alone budget impact analyses, and (2) the feasibility of extending cost-effectiveness analyses to capture budget impact. We developed a budget impact analysis checklist and scoring system for budget impact analyses, which we then adapted for cost-effectiveness analyses, based on current International Society for Pharmacoeconomics and Outcomes Research Task Force recommendations. We applied both budget impact analysis and cost-effectiveness analysis checklists and scoring systems to examine the extent to which existing economic evaluations provide sufficient evidence about budget impact to enable decision making. We used rotavirus vaccination as an illustrative case in which low- and middle-income countries uptake has been limited despite demonstrated cost effectiveness. A systematic literature review was conducted to identify economic evaluations of rotavirus vaccine in low- and middle-income countries published between January 2000 and February 2017. We critically appraised the quality of budget impact analyses, and assessed the extension of cost-effectiveness analyses to provide useful budget impact information. Six budget impact analyses and 60 cost-effectiveness analyses were identified. Budget impact analyses adhered to most International Society for Pharmacoeconomics and Outcomes Research recommendations, with key exceptions being provision of undiscounted financial streams for each budget period and model validation. Most cost-effectiveness analyses could not be extended to provide useful budget impact information; cost-effectiveness analyses also rarely presented undiscounted annual costs, or estimated financial streams during the first years of programme scale-up. Cost-effectiveness analyses vastly outnumber budget impact analyses of rotavirus vaccination, despite both being critical for policy decision making. Straightforward changes to the presentation of cost-effectiveness analyses results could facilitate their adaptation into budget impact analyses.

Reduced-form air quality modeling for community-scale ...

EPA Pesticide Factsheets

Transportation plays an important role in modern society, but its impact on air quality has been shown to have significant adverse effects on public health. Numerous reviews (HEI, CDC, WHO) summarizing findings of hundreds of studies conducted mainly in the last decade, conclude that exposures to traffic emissions near roads are a public health concern. The Community LINE Source Model (C-LINE) is a web-based model designed to inform the community user of local air quality impacts due to roadway vehicles in their region of interest using a simplified modeling approach. Reduced-form air quality modeling is a useful tool for examining what-if scenarios of changes in emissions, such as those due to changes in traffic volume, fleet mix, or vehicle speed. Examining various scenarios of air quality impacts in this way can identify potentially at-risk populations located near roadways, and the effects that a change in traffic activity may have on them. C-LINE computes dispersion of primary mobile source pollutants using meteorological conditions for the region of interest and computes air-quality concentrations corresponding to these selected conditions. C-LINE functionality has been expanded to model emissions from port-related activities (e.g. ships, trucks, cranes, etc.) in a reduced-form modeling system for local-scale near-port air quality analysis. This presentation describes the Community modeling tools C-LINE and C-PORT that are intended to be used by local gove

Interdisciplinary study of atmospheric processes and constituents of the mid-Atlantic coastal region

NASA Technical Reports Server (NTRS)

Kindle, E. C.

1976-01-01

Progress is reported in the following areas: analysis of the air quality of Plymouth Park, Chesapeake, Virginia; background analysis and impact assessment for the proposed expansion of Busch Gardens; application of remote sensing and atmospheric interaction; and biosphere interaction. Plans for further study are included.

Trend analysis of stressors and ecological responses, particularly nutrients, in the Narragansett Bay Watershed.

EPA Science Inventory

Current and historic impacts of nitrogen on water quality were evaluated and relationships between nutrients and ecosystem structure and function were developed for Narragansett Bay, RI. Land use land cover change analysis from 1985 thru 2005 resulted in a 7% increase in urban la...

40 CFR 260.11 - References.

Code of Federal Regulations, 2012 CFR

2012-07-01

...). (7) ASTM E 168-88, “Standard Practices for General Techniques of Infrared Quantitative Analysis,” IBR...-Visible Quantitative Analysis,” IBR approved for § 264.1063. (9) ASTM E 260-85, “Standard Practice for..., Research Triangle Park, NC. (1) “Screening Procedures for Estimating the Air Quality Impact of Stationary...

40 CFR 260.11 - References.

Code of Federal Regulations, 2014 CFR

2014-07-01

...). (7) ASTM E 168-88, “Standard Practices for General Techniques of Infrared Quantitative Analysis,” IBR...-Visible Quantitative Analysis,” IBR approved for § 264.1063. (9) ASTM E 260-85, “Standard Practice for..., Research Triangle Park, NC. (1) “Screening Procedures for Estimating the Air Quality Impact of Stationary...

40 CFR 260.11 - References.

Code of Federal Regulations, 2013 CFR

2013-07-01

...). (7) ASTM E 168-88, “Standard Practices for General Techniques of Infrared Quantitative Analysis,” IBR...-Visible Quantitative Analysis,” IBR approved for § 264.1063. (9) ASTM E 260-85, “Standard Practice for..., Research Triangle Park, NC. (1) “Screening Procedures for Estimating the Air Quality Impact of Stationary...

Oral health-related quality of life of implant-supported overdentures versus conventional complete prostheses: Retrospective study of a cohort of edentulous patients.

PubMed

Fernandez-Estevan, Lucia; Selva-Otaolaurruchi, Eduardo J; Montero, Javier; Sola-Ruiz, Fernanda

2015-07-01

This work aims to confirm if implant-supported overdentures are a good treatment option for edentulous patients and offer an improvement in quality of life compared with traditional complete prostheses (dentures). This retrospective clinical descriptive study included three evaluation groups: validation group (n=57); control group of patients with complete removeable prostheses (n=56); study group of patients with implant-supported overdentures retained with the Locator® system (n=80). The study also validated the Oral Health Impact Profile-20 questionnaire. Individual protocols were created that included socio-demographic data, the Oral Health Impact Profile-20 (OHIP-20) questionnaire and Oral Satisfaction Scale (OSS). Descriptive and bivariate statistical analysis was carried out applying χ², Pearson, Kruskal-Wallis, and Student t tests, transferring data into SPSS-Windows® software from a Microsoft® Excel spreadsheet. The OHIP-20 proved to be a valid instrument and provided reliable assessment of health-related quality of life among both the Spanish general population and edentulous patients. The control and study groups proved comparable, showing socio-demographic homogeneity. For patients with overdentures retained by means of the Locator® system, these restorations had significantly lower impact on quality of life (19 vs 33), both generally and for each individual questionnaire item, and much higher satisfaction with the state of their oral cavities (8.3 vs 5.3) than patients wearing dentures; both sets of data showed a direct linear relationship, so that as the level of impact on quality of life increased, perceived oral satisfaction worsened. Patients rehabilitated with implant supported overdentures retained by the Locator® system, presented significantly lower levels of impact on their quality of life and significantly higher oral satisfaction than patients with conventional complete prostheses.

Methodological reporting of randomized clinical trials in respiratory research in 2010.

PubMed

Lu, Yi; Yao, Qiuju; Gu, Jie; Shen, Ce

2013-09-01

Although randomized controlled trials (RCTs) are considered the highest level of evidence, they are also subject to bias, due to a lack of adequately reported randomization, and therefore the reporting should be as explicit as possible for readers to determine the significance of the contents. We evaluated the methodological quality of RCTs in respiratory research in high ranking clinical journals, published in 2010. We assessed the methodological quality, including generation of the allocation sequence, allocation concealment, double-blinding, sample-size calculation, intention-to-treat analysis, flow diagrams, number of medical centers involved, diseases, funding sources, types of interventions, trial registration, number of times the papers have been cited, journal impact factor, journal type, and journal endorsement of the CONSORT (Consolidated Standards of Reporting Trials) rules, in RCTs published in 12 top ranking clinical respiratory journals and 5 top ranking general medical journals. We included 176 trials, of which 93 (53%) reported adequate generation of the allocation sequence, 66 (38%) reported adequate allocation concealment, 79 (45%) were double-blind, 123 (70%) reported adequate sample-size calculation, 88 (50%) reported intention-to-treat analysis, and 122 (69%) included a flow diagram. Multivariate logistic regression analysis revealed that journal impact factor ≥ 5 was the only variable that significantly influenced adequate allocation sequence generation. Trial registration and journal impact factor ≥ 5 significantly influenced adequate allocation concealment. Medical interventions, trial registration, and journal endorsement of the CONSORT statement influenced adequate double-blinding. Publication in one of the general medical journal influenced adequate sample-size calculation. The methodological quality of RCTs in respiratory research needs improvement. Stricter enforcement of the CONSORT statement should enhance the quality of RCTs.

An Integrated Modeling Framework Forecasting Ecosystem Exposure-- A Systems Approach to the Cumulative Impacts of Multiple Stressors

NASA Astrophysics Data System (ADS)

Johnston, J. M.

2013-12-01

Freshwater habitats provide fishable, swimmable and drinkable resources and are a nexus of geophysical and biological processes. These processes in turn influence the persistence and sustainability of populations, communities and ecosystems. Climate change and landuse change encompass numerous stressors of potential exposure, including the introduction of toxic contaminants, invasive species, and disease in addition to physical drivers such as temperature and hydrologic regime. A systems approach that includes the scientific and technologic basis of assessing the health of ecosystems is needed to effectively protect human health and the environment. The Integrated Environmental Modeling Framework 'iemWatersheds' has been developed as a consistent and coherent means of forecasting the cumulative impact of co-occurring stressors. The Framework consists of three facilitating technologies: Data for Environmental Modeling (D4EM) that automates the collection and standardization of input data; the Framework for Risk Assessment of Multimedia Environmental Systems (FRAMES) that manages the flow of information between linked models; and the Supercomputer for Model Uncertainty and Sensitivity Evaluation (SuperMUSE) that provides post-processing and analysis of model outputs, including uncertainty and sensitivity analysis. Five models are linked within the Framework to provide multimedia simulation capabilities for hydrology and water quality processes: the Soil Water Assessment Tool (SWAT) predicts surface water and sediment runoff and associated contaminants; the Watershed Mercury Model (WMM) predicts mercury runoff and loading to streams; the Water quality Analysis and Simulation Program (WASP) predicts water quality within the stream channel; the Habitat Suitability Index (HSI) model scores physicochemical habitat quality for individual fish species; and the Bioaccumulation and Aquatic System Simulator (BASS) predicts fish growth, population dynamics and bioaccumulation of toxic substances. The capability of the Framework to address cumulative impacts will be demonstrated for freshwater ecosystem services and mountaintop mining.

Implementation of Programmatic Quality and the Impact on Safety

NASA Technical Reports Server (NTRS)

Huls, Dale Thomas; Meehan, Kevin

2005-01-01

The purpose of this paper is to discuss the implementation of a programmatic quality assurance discipline within the International Space Station Program and the resulting impact on safety. NASA culture has continued to stress safety at the expense of quality when both are extremely important and both can equally influence the success or failure of a Program or Mission. Although safety was heavily criticized in the media after Colimbiaa, strong case can be made that it was the failure of quality processes and quality assurance in all processes that eventually led to the Columbia accident. Consequently, it is possible to have good quality processes without safety, but it is impossible to have good safety processes without quality. The ISS Program quality assurance function was analyzed as representative of the long-term manned missions that are consistent with the President s Vision for Space Exploration. Background topics are as follows: The quality assurance organizational structure within the ISS Program and the interrelationships between various internal and external organizations. ISS Program quality roles and responsibilities with respect to internal Program Offices and other external organizations such as the Shuttle Program, JSC Directorates, NASA Headquarters, NASA Contractors, other NASA Centers, and International Partner/participants will be addressed. A detailed analysis of implemented quality assurance responsibilities and functions with respect to NASA Headquarters, the JSC S&MA Directorate, and the ISS Program will be presented. Discussions topics are as follows: A comparison of quality and safety resources in terms of staffing, training, experience, and certifications. A benchmark assessment of the lessons learned from the Columbia Accident Investigation (CAB) Report (and follow-up reports and assessments), NASA Benchmarking, and traditional quality assurance activities against ISS quality procedures and practices. The lack of a coherent operational and sustaining quality assurance strategy for long-term manned space flight. An analysis of the ISS waiver processes and the Problem Reporting and Corrective Action (PRACA) process implemented as quality functions. Impact of current ISS Program procedures and practices with regards to operational safety and risk A discussion regarding a "defense-in-depth" approach to quality functions will be provided to address the issue of "integration vs independence" with respect to the roles of Programs, NASA Centers, and NASA Headquarters. Generic recommendations are offered to address the inadequacies identified in the implementation of ISS quality assurance. A reassessment by the NASA community regarding the importance of a "quality culture" as a component within a larger "safety culture" will generate a more effective and value-added functionality that will ultimately enhance safety.

Impact of Climate Change on Lake Erie Drinking Water Quality—An Initial Assessment with Remote Sensing

NASA Astrophysics Data System (ADS)

Liou, L.

2012-12-01

A changing climate in the Lake Erie region appears to be having direct impacts on the quality of Lake Erie's drinking water. A dramatic increase in the size and duration of harmful algal blooms (HABs), changes in chlorophyll (Chl) levels and related primary production (PP), prominent sediment plumes, and nearshore production of submerged aquatic vegetation (SAV) are likely being impacted by warmer winters, more intense storms, and reduced ice extent, amongst other meteorological factors. Hypoxia, another major drinking water issue in the lake, is exacerbated by HABs and nearshore SAV. A Michigan Tech research team (Shuchman, Sayers, Brooks) has recently been developing algorithms to derive HAB extents, Chl levels, PP, sediment plume extents, and nearshore SAV maps for the Great Lakes. Inputs have primarily been derived from MODIS Aqua imagery from the NASA Oceancolor website; investigations in the capability of VIIRS imagery to provide the same critical data are being pursued. Remote sensing-derived ice extent and thickness spatial data are also being analyzed. Working with Liou and Lekki of the NASA Glenn Research Center, the study team is deriving algorithms specifically for Lake Erie and integrating them into an analysis of the lake's changing trends over the last 10 years (2002-2012) to improve understanding of how they are impacting the area's water quality, especially for customers dependent on Lake Erie drinking water. This analysis is tying these remote sensing-derived products to climate-driven meteorological factors to enable an initial assessment of how future changes could continue to impact the region's drinking water quality.

Evaluating the Success of Educational Policy in Mexican Higher Education

ERIC Educational Resources Information Center

Sagarra, Marti; Mar-Molinero, Cecilio; Rodríguez-Regordosa, Herberto

2015-01-01

State support in higher education (HE) is often justified on the grounds that HE is important for the development of the country. However, little analysis is normally done in order to assess the impact of education quality initiatives. The Mexican government has been engaging in a policy of HE quality improvement that can be traced to 1989. In…

Climate, Clams, and a Changing Watershed: A time series analysis to quantify the impact of management and climate on water quality in the Potomac Estuary

EPA Science Inventory

The Potomac River is the largest tributary of the Chesapeake Bay and has been a key study site in water quality research, beginning with work to address public health concerns such as safe drinking water and waterborne disease during periods of population growth and urbanization ...

Temporal and spatial variations in the relationship between urbanization and water quality.

PubMed

Ren, Lijun; Cui, Erqian; Sun, Haoyu

2014-12-01

With the development of economy, most of Chinese cities are at the stage of rapid urbanization in recent years, which has caused many environmental problems, especially the serious deterioration of water quality. Therefore, the research of the relationship between urbanization and water quality has important theoretical and practical significance, and it is also the main restriction factor in the urbanization advancement. In this work, we investigated the impact of urbanization on the water quality of the nearby river. We established a comprehensive environmental assessment framework by combining urbanization and water quality, and one model was designed to examine the impact of urbanization on the water quality in Jinan from 2001 to 2010 with factor component analysis. The assessment of urbanization level was accomplished using a comprehensive index system, which was based on four aspects: demographic urbanization, economic urbanization, land urbanization, and social urbanization. In addition, synthetic pollution index method was utilized to assess the water pollution of Xiaoqing River in the study area. Through the analysis of regression curves, we conclude that (1) when the urbanization level is below 25 %, the relationship is low and irregular; (2) if the urbanization level varies between 25 and 40 %, there will be an irreversible degradation of stream water quality; (3) there is a positive correlation between urbanization and pollution levels of urban river after the adjustment period; and (4) land and demographic aspects have the highest independent contribution. This study is a useful reference for policymakers in terms of economic and environmental management.

Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis.

PubMed

Ng, G K B; Leung, G K K; Johnston, J M; Cowling, B J

2013-10-01

The objectives of this review were to identify factors that influence implementation of hospital accreditation programmes and to assess the impact of the accreditation process on quality improvement in public hospitals. Two electronic databases, Medline (OvidSP) and PubMed, were systematically searched. "Public hospital", "hospital accreditation", and "quality improvement" were used as the search terms. A total of 348 citations were initially identified. After critical appraisal and study selection, 26 articles were included in the review. The data were extracted and analysed using a SWOT (strengths, weaknesses, opportunities, threats) analysis. Increased staff engagement and communication, multidisciplinary team building, positive changes in organisational culture, and enhanced leadership and staff awareness of continuous quality improvement were identified as strengths. Weaknesses included organisational resistance to change, increased staff workload, lack of awareness about continuous quality improvement, insufficient staff training and support for continuous quality improvement, lack of applicable accreditation standards for local use, and lack of performance outcome measures. Opportunities included identification of improvement areas, enhanced patient safety, additional funding, public recognition, and market advantage. Threats included opportunistic behaviours, funding cuts, lack of incentives for participation, and a regulatory approach to mandatory participation. By relating the findings to the operational issues of accreditation, this review discussed the implications for successful implementation and how accreditation may drive quality improvement. These findings have implications for various stakeholders (government, the public, patients and health care providers), when it comes to embarking on accreditation exercises.

The Impact of an Integrated Electronic Health Record Adoption on Nursing Care Quality.

PubMed

Walker-Czyz, AnneMarie

2016-01-01

The purpose of this study was to measure the impact of an integrated electronic health record (EHR) innovation adoption on the quality of nursing care delivered, including hospital-acquired falls, hospital-acquired pressure ulcers, ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and costs measured in nursing hours. The impact on quality, cost, and nurse satisfaction measured in turnover rates before, during, and after implementation of EHR tools was also investigated. Little is known about the adoption patterns of computerized documentation by nursing and the effects on the practice environment. A quantitative, retrospective analysis using interrupted time series model of a large data set was conducted in a 431-bed urban hospital, with 10 medical surgical units and 2 critical care units. The research was constructed using the Diffusion of Innovations (DOI) theory. Incorporating electronic, evidenced-based practice (EBP) tools into bedside nurse's workflow promotes decision making at the point of care that may improve quality with no negative impact on direct cost. The data revealed that total falls, CAUTI, and CLABSI rates were positively impacted after the implementation of an integrated EHR. Hospital-acquired pressure ulcer and VAP rates were negatively impacted at the implementation period followed by a significant positive rate reduction that surpassed the preimplementation period. Cost indicators, measured in hours per patient day and overtime, were negatively impacted during the implementation period followed by a return to baseline. Nurse turnover had a significant increase from the preimplementation to postimplementation period and failed to return to baseline. This study confirms that nurses have the ability to positively impact the quality of patient care through successful innovation adoption related to the use of EBP computerized documentation tools at the bedside. This study further clarified the practice environment of nurses during DOI.

Rasch analysis of the Multiple Sclerosis Impact Scale (MSIS-29)

PubMed Central

Ramp, Melina; Khan, Fary; Misajon, Rose Anne; Pallant, Julie F

2009-01-01

Background Multiple Sclerosis (MS) is a degenerative neurological disease that causes impairments, including spasticity, pain, fatigue, and bladder dysfunction, which negatively impact on quality of life. The Multiple Sclerosis Impact Scale (MSIS-29) is a disease-specific health-related quality of life (HRQoL) instrument, developed using the patient's perspective on disease impact. It consists of two subscales assessing the physical (MSIS-29-PHYS) and psychological (MSIS-29-PSYCH) impact of MS. Although previous studies have found support for the psychometric properties of the MSIS-29 using traditional methods of scale evaluation, the scale has not been subjected to a detailed Rasch analysis. Therefore, the objective of this study was to use Rasch analysis to assess the internal validity of the scale, and its response format, item fit, targeting, internal consistency and dimensionality. Methods Ninety-two persons with definite MS residing in the community were recruited from a tertiary hospital database. Patients completed the MSIS-29 as part of a larger study. Rasch analysis was undertaken to assess the psychometric properties of the MSIS-29. Results Rasch analysis showed overall support for the psychometric properties of the two MSIS-29 subscales, however it was necessary to reduce the response format of the MSIS-29-PHYS to a 3-point response scale. Both subscales were unidimensional, had good internal consistency, and were free from item bias for sex and age. Dimensionality testing indicated it was not appropriate to combine the two subscales to form a total MSIS score. Conclusion In this first study to use Rasch analysis to fully assess the psychometric properties of the MSIS-29 support was found for the two subscales but not for the use of the total scale. Further use of Rasch analysis on the MSIS-29 in larger and broader samples is recommended to confirm these findings. PMID:19545445

Implementation of Quality Systems in Nuclear Medicine: Why It Matters. An Outcome Analysis (Quality Management Audits in Nuclear Medicine Part III).

PubMed

Dondi, Maurizio; Paez, Diana; Torres, Leonel; Marengo, Mario; Delaloye, Angelika Bischof; Solanki, Kishor; Van Zyl Ellmann, Annare; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Giammarile, Francesco; Pascual, Thomas

2018-05-01

The International Atomic Energy Agency (IAEA) developed a comprehensive program-Quality Management Audits in Nuclear Medicine (QUANUM). This program covers all aspects of nuclear medicine practices including, but not limited to, clinical practice, management, operations, and services. The QUANUM program, which includes quality standards detailed in relevant checklists, aims at introducing a culture of comprehensive quality audit processes that are patient oriented, systematic, and outcome based. This paper will focus on the impact of the implementation of QUANUM on daily routine practices in audited centers. Thirty-seven centers, which had been externally audited by experts under IAEA auspices at least 1 year earlier, were invited to run an internal audit using the QUANUM checklists. The external audits also served as training in quality management and the use of QUANUM for the local teams, which were responsible of conducting the internal audits. Twenty-five out of the 37 centers provided their internal audit report, which was compared with the previous external audit. The program requires that auditors score each requirement within the QUANUM checklists on a scale of 0-4, where 0-2 means nonconformance and 3-4 means conformance to international regulations and standards on which QUANUM is based. Our analysis covering both general and clinical areas assessed changes on the conformance status on a binary manner and the level of conformance scores. Statistical analysis was performed using nonparametric statistical tests. The evaluation of the general checklists showed a global improvement on both the status and the levels of conformances (P < 0.01). The evaluation of the requirements by checklist also showed a significant improvement in all, with the exception of Hormones and Tumor marker determinations, where changes were not significant. Of the 25 evaluated institutions, 88% (22 of 25) and 92% (23 of 25) improved their status and levels of conformance, respectively. Fifty-five requirements, on average, increased from nonconformance to conformance status. In 8 key areas, the number of improved requirements was well above the average: Administration & Management (checklist 2); Radiation Protection & Safety (checklist 4); General Quality Assurance system (checklist 6); Imaging Equipment Quality Assurance or Quality Control (checklist 7); General Diagnostic (checklist 9); General Therapeutic (checklist 12); Radiopharmacy Level 1 (checklist 14); and Radiopharmacy Level 2 (checklist 15). Analysis of results related to clinical activities showed an overall positive impact on both the status and the level of conformance to international standards. Similar results were obtained for the most frequently performed clinical imaging and therapeutic procedures. Our study shows that the implementation of a comprehensive quality management system through the IAEA QUANUM program has a positive impact on nuclear medicine practices. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Regional impacts of oil and gas development on ozone formation in the western United States.

PubMed

Rodriguez, Marco A; Barna, Michael G; Moore, Tom

2009-09-01

The Intermountain West is currently experiencing increased growth in oil and gas production, which has the potential to affect the visibility and air quality of various Class I areas in the region. The following work presents an analysis of these impacts using the Comprehensive Air Quality Model with extensions (CAMx). CAMx is a state-of-the-science, "one-atmosphere" Eulerian photochemical dispersion model that has been widely used in the assessment of gaseous and particulate air pollution (ozone, fine [PM2.5], and coarse [PM10] particulate matter). Meteorology and emissions inventories developed by the Western Regional Air Partnership Regional Modeling Center for regional haze analysis and planning are used to establish an ozone baseline simulation for the year 2002. The predicted range of values for ozone in the national parks and other Class I areas in the western United States is then evaluated with available observations from the Clean Air Status and Trends Network (CASTNET). This evaluation demonstrates the model's suitability for subsequent planning, sensitivity, and emissions control strategy modeling. Once the ozone baseline simulation has been established, an analysis of the model results is performed to investigate the regional impacts of oil and gas development on the ozone concentrations that affect the air quality of Class I areas. Results indicate that the maximum 8-hr ozone enhancement from oil and gas (9.6 parts per billion [ppb]) could affect southwestern Colorado and northwestern New Mexico. Class I areas in this region that are likely to be impacted by increased ozone include Mesa Verde National Park and Weminuche Wilderness Area in Colorado and San Pedro Parks Wilderness Area, Bandelier Wilderness Area, Pecos Wilderness Area, and Wheeler Peak Wilderness Area in New Mexico.

The Impact of Long-Term Climate Change on Nitrogen Runoff at the Watershed Scale.

NASA Astrophysics Data System (ADS)

Dorley, J.; Duffy, C.; Arenas Amado, A.

2017-12-01

The impact of agricultural runoff is a major concern for water quality of mid-western streams. This concern is largely due to excessive use of agricultural fertilizer, a major source of nutrients in many Midwestern watersheds. In order to improve water quality in these watersheds, understanding the long-term trends in nutrient concentration and discharge is an important water quality problem. This study attempts to analyze the role of long-term temperature and precipitation on nitrate runoff in an agriculturally dominated watershed in Iowa. The approach attempts to establish the concentration-discharge (C-Q) signature for the watershed using time series analysis, frequency analysis and model simulation. The climate data is from the Intergovernmental Panel on Climate Change (IPCC), model GFDL-CM3 (Geophysical Fluid Dynamic Laboratory Coupled Model 3). The historical water quality data was made available by the IIHR-Hydroscience & Engineering at the University of Iowa for the clear creek watershed (CCW). The CCW is located in east-central Iowa. The CCW is representative of many Midwestern watersheds with humid-continental climate with predominantly agricultural land use. The study shows how long-term climate changes in temperature and precipitation affects the C-Q dynamics and how a relatively simple approach to data analysis and model projections can be applied to best management practices at the site.

Environmental analysis of waste foundry sand via life cycle assessment.

PubMed

Mitterpach, Jozef; Hroncová, Emília; Ladomerský, Juraj; Balco, Karol

2017-01-01

The aim of this manuscript is to provide an environmental assessment of the creation and use of waste foundry sand (WFS) via an LCA in a foundry for grey cast iron. A life cycle impact assessment was carried out using SimaPro 8. This environmental analysis assessed the impact of creating waste foundry sand (WFS) in a foundry, Hronec (Slovakia, Central Europe). According to BREF, this foundry is classified as an iron foundry with a production capacity greater than 20 t/day with processes typical for grey cast iron foundries. Molten metal is poured into single-use sand moulds. We identified those factors influencing the creation and use of WFS which significantly affect the quality of the environment. The use of WFS from the production of cores in regenerated moulding mixtures with installed circuits brings marked minimisation of material and energy inputs in the processes of creating WFS and it positively influences the consumption of resources and the quality of the ecosystem. Space for lessening the impact of WFS processes upon the consumption of resources and ecosystem quality is mainly found in recycling WFS in the building sector. In the next step, it is necessary to thoroughly verify the eco-toxicological properties of not only the created WFS and other foundry waste, but mainly the building products for which this waste is used. In terms of transportation, it is important that waste is recycled at local level. The processes of creating WFS have a marked influence upon all the selected waste categories (consumption of resources, ecosystem quality, human health). By minimising material inputs into processes and the effective adjustment of production technology, a foundry can significantly lessen the impacts of processes for creating WFS upon the environment.

Air quality and climate impacts due to CNG conversion of motor vehicles in Dhaka, Bangladesh.

PubMed

Wadud, Zia; Khan, Tanzila

2013-12-17

Dhaka had recently experienced rapid conversion of its motor vehicle fleet to run on compressed natural gas (CNG). This paper quantifies ex-post the air quality and climate benefits of the CNG conversion policy, including monetary valuations, through an impact pathway approach. Around 2045 (1665) avoided premature deaths in greater Dhaka (City Corporation) can be attributed to air quality improvements from the CNG conversion policy in 2010, resulting in a saving of around USD 400 million. Majority of these health benefits resulted from the conversion of high-emitting diesel vehicles. CNG conversion was clearly detrimental from climate change perspective using the changes in CO2 and CH4 only (CH4 emissions increased); however, after considering other global pollutants (especially black carbon), the climate impact was ambiguous. Uncertainty assessment using input distributions and Monte Carlo simulation along with a sensitivity analysis show that large uncertainties remain for climate impacts. For our most likely estimate, there were some climate costs, valued at USD 17.7 million, which is an order of magnitude smaller than the air quality benefits. This indicates that such policies can and should be undertaken on the grounds of improving local air pollution alone and that precautions should be taken to reduce the potentially unintended increases in GHG emissions or other unintended effects.

The Impact of Nursing Home Pay-for-Performance on Quality and Medicare Spending: Results from the Nursing Home Value-Based Purchasing Demonstration.

PubMed

Grabowski, David C; Stevenson, David G; Caudry, Daryl J; O'Malley, A James; Green, Lisa H; Doherty, Julia A; Frank, Richard G

2017-08-01

To evaluate the impact of the Nursing Home Value-Based Purchasing demonstration on quality of care and Medicare spending. Administrative and qualitative data from Arizona, New York, and Wisconsin nursing homes over the base-year (2008-2009) and 3-year (2009-2012) demonstration period. Nursing homes were randomized to the intervention in New York, while the comparison facilities were constructed via propensity score matching in Arizona and Wisconsin. We used a difference-in-difference analysis to compare outcomes across the base-year relative to outcomes in each of the three demonstration years. To provide context and assist with interpretation of results, we also interviewed staff members at participating facilities. Medicare savings were observed in Arizona in the first year only and Wisconsin for the first 2 years; no savings were observed in New York. The demonstration did not systematically impact any of the quality measures. Discussions with nursing home administrators suggested that facilities made few, if any, changes in response to the demonstration, leading us to conclude that the observed savings likely reflected regression to the mean rather than true savings. The Federal nursing home pay-for-performance demonstration had little impact on quality or Medicare spending. © Health Research and Educational Trust.

Validation of the Kohnen Restless Legs Syndrome-Quality of Life instrument.

PubMed

Kohnen, Ralf; Martinez-Martin, Pablo; Benes, Heike; Trenkwalder, Claudia; Högl, Birgit; Dunkl, Elmar; Walters, Arthur S

2016-08-01

Due to the symptoms and the sleep disturbances it causes, Restless Legs Syndrome (RLS) has a negative impact on quality of life. Measurement of such impact can be performed by means of questionnaires, such as the Kohnen Restless Legs Syndrome-Quality of Life questionnaire (KRLS-QoL), a specific 12-item instrument that is self-applied by patients. The present study is aimed at performing a first formal validation study of this instrument. Eight hundred ninety-one patients were included for analysis. RLS severity was assessed by the International Restless Legs Scale (IRLS), Restless Legs Syndrome-6 scales (RLS-6), and Clinical Global Impression of Severity. In addition the Epworth Sleepiness Scale (ESS) was assessed. Acceptability, dimensionality, scaling assumptions, reliability, precision, hypotheses-related validity, and responsiveness were tested. There were missing data in 3.58% patients. Floor and ceiling effects were low for the subscales, global evaluation, and summary index derived from items 1 to 11 after checking that scaling assumptions were met. Exploratory parallel factor analysis showed that the KRLS-QoL may be deemed unidimensional, ie, that all components of the scale are part of one overall general quality of life factor. Indexes of internal consistency (alpha = 0.88), item-total correlation (r S  = 0.32-0.71), item homogeneity coefficient (0.41), and scale stability (ICC = 0.73) demonstrated a satisfactory reliability of the KRLS-QoL. Moderate or high correlations were obtained between KRLS-QoL scores and the IRLS, some components of the RLS-6, inter-KRLS-QoL domains, and global evaluations. Known-groups validity for severity levels grouping and responsiveness analysis results were satisfactory, the latter showing higher magnitudes of response for treated than for placebo arms. The KRLS-QoL was proven an acceptable, reliable, valid, and responsive measure to assess the impact of the RLS on quality of life. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Managing future air quality in megacities: A case study for Delhi

NASA Astrophysics Data System (ADS)

Amann, Markus; Purohit, Pallav; Bhanarkar, Anil D.; Bertok, Imrich; Borken-Kleefeld, Jens; Cofala, Janusz; Heyes, Chris; Kiesewetter, Gregor; Klimont, Zbigniew; Liu, Jun; Majumdar, Dipanjali; Nguyen, Binh; Rafaj, Peter; Rao, Padma S.; Sander, Robert; Schöpp, Wolfgang; Srivastava, Anjali; Vardhan, B. Harsh

2017-07-01

Megacities in Asia rank high in air pollution at the global scale. In many cities, ambient concentrations of fine particulate matter (PM2.5) have been exceeding both the WHO interim targets as well as respective national air quality standards. This paper presents a systems analytical perspective on management options that could efficiently improve air quality at the urban scale, having Delhi as a case study. We employ the newly developed GAINS-City policy analysis framework, consisting of a bottom up emission calculation combined with atmospheric chemistry-transport calculation, to derive innovative insights into the current sources of pollution and their impacts on ambient PM2.5, both from emissions of primary PM as well as precursors of secondary inorganic and organic aerosols. We outline the likely future development of these sources, quantify the related ambient PM2.5 concentrations and health impacts, and explore potential policy interventions that could effectively reduce environmental pollution and resulting health impacts in the coming years. The analysis demonstrates that effective improvement of Delhi's air quality requires collaboration with neighboring States and must involve sources that are less relevant in industrialized countries. At the same time, many of the policy interventions will have multiple co-benefits on development targets in Delhi and its neighboring States. Outcomes of this study, as well as the modelling tools used herein, are applicable to other urban areas and fast growing metropolitan zones in the emerging Asian regions.

Assessment of physico-chemical characteristics of water in Tamilnadu.

PubMed

Udhayakumar, R; Manivannan, P; Raghu, K; Vaideki, S

2016-12-01

Water is an important component to human life. The major aims of the present work are to assess the quality of the ground water and its impact in Villupuram District of Tamilnadu. The present study focus to bring an awareness among the people about the quality of ground water by taking water samples from various locations for Physico - Chemical analysis of the ground water. This analysis result was compared with the WHO, ICMR, USPH and European standards of drinking water quality parameters with the following water quality parameters namely pH, Electrical conductivity, Cl, , Na, K, Ca , Mg, Total dissolved solids, Total hardness, Dissolved oxygen, Fluoride etc. Various chemical methods have been employed to investigate the extent level of pollution in ground water. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of city effluents on water quality of Indus River: assessment of temporal and spatial variations in the southern region of Khyber Pakhtunkhwa, Pakistan.

PubMed

Khan, Ilham; Khan, Azim; Khan, Muhammad Sohail; Zafar, Shabnam; Hameed, Asma; Badshah, Shakeel; Rehman, Shafiq Ur; Ullah, Hidayat; Yasmeen, Ghazala

2018-04-04

The impact of city effluents on water quality of Indus River was assessed in the southern region of Khyber Pakhtunkhwa, Pakistan. Water samples were collected in dry (DS) and wet (WS) seasons from seven sampling zones along Indus River and the physical, bacteriological, and chemical parameters determining water quality were quantified. There were marked temporal and spatial variations in the water quality of Indus River. The magnitude of pollution was high in WS compared with DS. The quality of water varied across the sampling zones, and it greatly depended upon the nature of effluents entering the river. Water samples exceeded the WHO permissible limits for pH, EC, TDS, TS, TSS, TH, DO, BOD, COD, total coliforms, Escherichia coli, Ca 2+ , Mg 2+ , NO 3 - , and PO 4 2- . Piper analysis indicated that water across the seven sampling zones along Indus River was alkaline in nature. Correlation analyses indicated that EC, TDS, TS, TH, DO, BOD, and COD may be considered as key physical parameters, while Na + , K + , Ca 2+ , Mg 2+ , Cl - , F - , NO 3 - , PO 4 2- , and SO 4 2- as key chemical parameters determining water quality, because they were strongly correlated (r > 0.70) with most of the parameters studied. Cluster analysis indicated that discharge point at Shami Road is the major source of pollution impairing water quality of Indus River. Wastewater treatment plants must be installed at all discharge points along Indus River for protecting the quality of water of this rich freshwater resource in Pakistan.

40 CFR 93.160 - Mitigation of air quality impacts.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Mitigation of air quality impacts. 93... quality impacts. (a) Any measures that are intended to mitigate air quality impacts must be identified and..., the revised text is set forth as follows: § 93.160 Mitigation of air quality impacts. (e) When...

The Influence of God and Providence on Happiness and the Quality of Life of Patients Benefiting from Aesthetic Medicine Treatments in Poland.

PubMed

Galęba, Anna; Bajurna, Beata

2015-08-01

The research reveals the impact of a belief in god and god's Providence on the happiness and quality of life of patients benefiting from aesthetic medicine treatments in Poland (country where over 90 % of society declare to be deeply devout). The work also examines age and sex of the patients benefiting from beauty treatments (botulinum toxin, fillers, medical peels and needle mesotherapy), their quality of life and also the impact of various factors, including God and Divine Providence on their happiness. The research shows the analysis of factors influencing the successes or failures in the past year and presents the comparison of patients who have benefited from the aesthetic medicine treatments (cosmetic medicine) to the common average Polish citizens.

Menstrual Cycle Maintenance and Quality of Life After Breast Cancer Treatment: A Prospective Study.

DTIC Science & Technology

1997-10-01

quality of life of these young patients may be compromised by premature menopause with symptoms such as hot flashes, sleep disturbances, decreased libido, and vagina dryness. Very little is known about the incidence, onset, time course, and symptomatology of premature menopause induced by breast cancer therapy and virtually nothing is known about its impact on the young survivor’s quality of life . No prospective study heretofore exists. A comprehensive analysis on a large prospective study cohort as proposed herein will

Impact of the codec and various QoS methods on the final quality of the transferred voice in an IP network

NASA Astrophysics Data System (ADS)

Slavata, Oldřich; Holub, Jan

2015-02-01

This paper deals with an analysis of the relation between the codec that is used, the QoS method, and the final voice transmission quality. The Cisco 2811 router is used for adjusting QoS. VoIP client Linphone is used for adjusting the codec. The criterion for transmission quality is the MOS parameter investigated with the ITU-T P.862 PESQ and P.863 POLQA algorithms.

Impact of commercial housing systems and nutrient and energy intake on laying hen performance and egg quality parameters1

PubMed Central

Karcher, D. M.; Jones, D. R.; Abdo, Z.; Zhao, Y.; Shepherd, T. A.; Xin, H.

2015-01-01

The US egg industry is exploring alternative housing systems for laying hens. However, limited published research related to cage-free aviary systems and enriched colony cages exists related to production, egg quality, and hen nutrition. The laying hen's nutritional requirements and resulting productivity are well established with the conventional cage system, but diminutive research is available in regards to alternative housing systems. The restrictions exist with limited availability of alternative housing systems in research settings and the considerable expense for increased bird numbers in a replicate due to alternative housing system design. Therefore, the objective of the current study was to evaluate the impact of nutrient and energy intake on production and egg quality parameters from laying hens housed at a commercial facility. Lohmann LSL laying hens were housed in three systems: enriched colony cage, cage-free aviary, and conventional cage at a single commercial facility. Daily production records were collected along with dietary changes during 15 production periods (28-d each). Eggs were analyzed for shell strength, shell thickness, Haugh unit, vitelline membrane properties, and egg solids each period. An analysis of covariance (ANCOVA) coupled with a principal components analysis (PCA) approach was utilized to assess the impact of nutritional changes on production parameters and monitored egg quality factors. The traits of hen-day production and mortality had a response only in the PCA 2 direction. This finds that as house temperature and Met intake increases, there is an inflection point at which hen-day egg production is negatively effected. Dietary changes more directly influenced shell parameters, vitelline membrane parameters, and egg total solids as opposed to laying hen housing system. Therefore, further research needs to be conducted in controlled research settings on laying hen nutrient and energy intake in the alternative housing systems and resulting impact on egg quality measures. PMID:25630672

Impact of commercial housing systems and nutrient and energy intake on laying hen performance and egg quality parameters.

PubMed

Karcher, D M; Jones, D R; Abdo, Z; Zhao, Y; Shepherd, T A; Xin, H

2015-03-01

The US egg industry is exploring alternative housing systems for laying hens. However, limited published research related to cage-free aviary systems and enriched colony cages exists related to production, egg quality, and hen nutrition. The laying hen's nutritional requirements and resulting productivity are well established with the conventional cage system, but diminutive research is available in regards to alternative housing systems. The restrictions exist with limited availability of alternative housing systems in research settings and the considerable expense for increased bird numbers in a replicate due to alternative housing system design. Therefore, the objective of the current study was to evaluate the impact of nutrient and energy intake on production and egg quality parameters from laying hens housed at a commercial facility. Lohmann LSL laying hens were housed in three systems: enriched colony cage, cage-free aviary, and conventional cage at a single commercial facility. Daily production records were collected along with dietary changes during 15 production periods (28-d each). Eggs were analyzed for shell strength, shell thickness, Haugh unit, vitelline membrane properties, and egg solids each period. An analysis of covariance (ANCOVA) coupled with a principal components analysis (PCA) approach was utilized to assess the impact of nutritional changes on production parameters and monitored egg quality factors. The traits of hen-day production and mortality had a response only in the PCA 2 direction. This finds that as house temperature and Met intake increases, there is an inflection point at which hen-day egg production is negatively effected. Dietary changes more directly influenced shell parameters, vitelline membrane parameters, and egg total solids as opposed to laying hen housing system. Therefore, further research needs to be conducted in controlled research settings on laying hen nutrient and energy intake in the alternative housing systems and resulting impact on egg quality measures. © The Author 2015. Published by Oxford University Press on behalf of Poultry Science Association.

Impacts of agricultural land use on biological integrity: A causal analysis

USGS Publications Warehouse

Riseng, C.M.; Wiley, M.J.; Black, R.W.; Munn, M.D.

2011-01-01

Agricultural land use has often been linked to nutrient enrichment, habitat degradation, hydrologic alteration, and loss of biotic integrity in streams. The U.S. Geological Survey's National Water Quality Assessment Program sampled 226 stream sites located in eight agriculture-dominated study units across the United States to investigate the geographic variability and causes of agricultural impacts on stream biotic integrity. In this analysis we used structural equation modeling (SEM) to develop a national and set of regional causal models linking agricultural land use to measured instream conditions. We then examined the direct, indirect, and total effects of agriculture on biotic integrity as it acted through multiple water quality and habitat pathways. In our nation-wide model, cropland affected benthic communities by both altering structural habitats and by imposing water quality-related stresses. Regionspecific modeling demonstrated that geographic context altered the relative importance of causal pathways through which agricultural activities affected stream biotic integrity. Cropland had strong negative total effects on the invertebrate community in the national, Midwest, and Western models, but a very weak effect in the Eastern Coastal Plain model. In theWestern Arid and Eastern Coastal Plain study regions, cropland impacts were transmitted primarily through dissolved water quality contaminants, but in the Midwestern region, they were transmitted primarily through particulate components of water quality. Habitat effects were important in the Western Arid model, but negligible in the Midwest and Eastern Coastal Plain models. The relative effects of riparian forested wetlands also varied regionally, having positive effects on biotic integrity in the Eastern Coastal Plain andWestern Arid region models, but no statistically significant effect in the Midwest. These differences in response to cropland and riparian cover suggest that best management practices and planning for the mitigation of agricultural land use impacts on stream ecosystems should be regionally focused. ?? 2011 by the Ecological Society of America.

A Model of Risk Analysis in Analytical Methodology for Biopharmaceutical Quality Control.

PubMed

Andrade, Cleyton Lage; Herrera, Miguel Angel De La O; Lemes, Elezer Monte Blanco

2018-01-01

One key quality control parameter for biopharmaceutical products is the analysis of residual cellular DNA. To determine small amounts of DNA (around 100 pg) that may be in a biologically derived drug substance, an analytical method should be sensitive, robust, reliable, and accurate. In principle, three techniques have the ability to measure residual cellular DNA: radioactive dot-blot, a type of hybridization; threshold analysis; and quantitative polymerase chain reaction. Quality risk management is a systematic process for evaluating, controlling, and reporting of risks that may affects method capabilities and supports a scientific and practical approach to decision making. This paper evaluates, by quality risk management, an alternative approach to assessing the performance risks associated with quality control methods used with biopharmaceuticals, using the tool hazard analysis and critical control points. This tool provides the possibility to find the steps in an analytical procedure with higher impact on method performance. By applying these principles to DNA analysis methods, we conclude that the radioactive dot-blot assay has the largest number of critical control points, followed by quantitative polymerase chain reaction, and threshold analysis. From the analysis of hazards (i.e., points of method failure) and the associated method procedure critical control points, we conclude that the analytical methodology with the lowest risk for performance failure for residual cellular DNA testing is quantitative polymerase chain reaction. LAY ABSTRACT: In order to mitigate the risk of adverse events by residual cellular DNA that is not completely cleared from downstream production processes, regulatory agencies have required the industry to guarantee a very low level of DNA in biologically derived pharmaceutical products. The technique historically used was radioactive blot hybridization. However, the technique is a challenging method to implement in a quality control laboratory: It is laborious, time consuming, semi-quantitative, and requires a radioisotope. Along with dot-blot hybridization, two alternatives techniques were evaluated: threshold analysis and quantitative polymerase chain reaction. Quality risk management tools were applied to compare the techniques, taking into account the uncertainties, the possibility of circumstances or future events, and their effects upon method performance. By illustrating the application of these tools with DNA methods, we provide an example of how they can be used to support a scientific and practical approach to decision making and can assess and manage method performance risk using such tools. This paper discusses, considering the principles of quality risk management, an additional approach to the development and selection of analytical quality control methods using the risk analysis tool hazard analysis and critical control points. This tool provides the possibility to find the method procedural steps with higher impact on method reliability (called critical control points). Our model concluded that the radioactive dot-blot assay has the larger number of critical control points, followed by quantitative polymerase chain reaction and threshold analysis. Quantitative polymerase chain reaction is shown to be the better alternative analytical methodology in residual cellular DNA analysis. © PDA, Inc. 2018.

Groundwater Quality: Analysis of Its Temporal and Spatial Variability in a Karst Aquifer.

PubMed

Pacheco Castro, Roger; Pacheco Ávila, Julia; Ye, Ming; Cabrera Sansores, Armando

2018-01-01

This study develops an approach based on hierarchical cluster analysis for investigating the spatial and temporal variation of water quality governing processes. The water quality data used in this study were collected in the karst aquifer of Yucatan, Mexico, the only source of drinking water for a population of nearly two million people. Hierarchical cluster analysis was applied to the quality data of all the sampling periods lumped together. This was motivated by the observation that, if water quality does not vary significantly in time, two samples from the same sampling site will belong to the same cluster. The resulting distribution maps of clusters and box-plots of the major chemical components reveal the spatial and temporal variability of groundwater quality. Principal component analysis was used to verify the results of cluster analysis and to derive the variables that explained most of the variation of the groundwater quality data. Results of this work increase the knowledge about how precipitation and human contamination impact groundwater quality in Yucatan. Spatial variability of groundwater quality in the study area is caused by: a) seawater intrusion and groundwater rich in sulfates at the west and in the coast, b) water rock interactions and the average annual precipitation at the middle and east zones respectively, and c) human contamination present in two localized zones. Changes in the amount and distribution of precipitation cause temporal variation by diluting groundwater in the aquifer. This approach allows to analyze the variation of groundwater quality controlling processes efficiently and simultaneously. © 2017, National Ground Water Association.

STAPOL: A Simulation of the Impact of Policy, Values, and Technological and Societal Developments upon the Quality of Life.

ERIC Educational Resources Information Center

Little, Dennis; Feller, Richard

The Institute for the Future has been conducting research in technological and societal forecasting, social indicators, value change, and simulation gaming. This paper describes an effort to bring together parts of that research into a simulation game ("State Policy," or STAPOL) for analysis of the impact of government policy, social values, and…

78 FR 4879 - Nine Mile Point 3 Nuclear Project, LLC and UniStar Nuclear Operating Services, LLC Combined...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-23

... Analysis Report (FSAR). On December 1, 2009, UniStar Nuclear Energy (UNE), acting on behalf of the COL... Exclusion From Environmental Review With respect to the exemption's impact on the quality of the human... relation to security issues. Therefore, the common defense and security is not impacted by this exemption...

Desktop microsimulation: a tool to improve efficiency in the medical office practice.

PubMed

Montgomery, James B; Linville, Beth A; Slonim, Anthony D

2013-01-01

Because the economic crisis in the United States continues to have an impact on healthcare organizations, industry leaders must optimize their decision making. Discrete-event computer simulation is a quality tool with a demonstrated track record of improving the precision of analysis for process redesign. However, the use of simulation to consolidate practices and design efficiencies into an unfinished medical office building was a unique task. A discrete-event computer simulation package was used to model the operations and forecast future results for four orthopedic surgery practices. The scenarios were created to allow an evaluation of the impact of process change on the output variables of exam room utilization, patient queue size, and staff utilization. The model helped with decisions regarding space allocation and efficient exam room use by demonstrating the impact of process changes in patient queues at check-in/out, x-ray, and cast room locations when compared to the status quo model. The analysis impacted decisions on facility layout, patient flow, and staff functions in this newly consolidated practice. Simulation was found to be a useful tool for process redesign and decision making even prior to building occupancy. © 2011 National Association for Healthcare Quality.

Separating the air quality impact of a major highway and nearby sources by nonparametric trajectory analysis.

PubMed

Henry, Ronald C; Vette, Alan; Norris, Gary; Vedantham, Ram; Kimbrough, Sue; Shores, Richard C

2011-12-15

Nonparametric Trajectory Analysis (NTA), a receptor-oriented model, was used to assess the impact of local sources of air pollution at monitoring sites located adjacent to highway I-15 in Las Vegas, NV. Measurements of black carbon, carbon monoxide, nitrogen oxides, and sulfur dioxide concentrations were collected from December 2008 to December 2009. The purpose of the study was to determine the impact of the highway at three downwind monitoring stations using an upwind station to measure background concentrations. NTA was used to precisely determine the contribution of the highway to the average concentrations measured at the monitoring stations accounting for the spatially heterogeneous contributions of other local urban sources. NTA uses short time average concentrations, 5 min in this case, and constructed local back-trajectories from similarly short time average wind speed and direction to locate and quantify contributions from local source regions. Averaged over an entire year, the decrease of concentrations with distance from the highway was found to be consistent with previous studies. For this study, the NTA model is shown to be a reliable approach to quantify the impact of the highway on local air quality in an urban area with other local sources.

An integrated assessment of two decades of air pollution policy making in Spain: Impacts, costs and improvements.

PubMed

Vedrenne, Michel; Borge, Rafael; Lumbreras, Julio; Conlan, Beth; Rodríguez, María Encarnación; de Andrés, Juan Manuel; de la Paz, David; Pérez, Javier; Narros, Adolfo

2015-09-15

This paper analyses the effects of policy making for air pollution abatement in Spain between 2000 and 2020 under an integrated assessment approach with the AERIS model for number of pollutants (NOx/NO2, PM10/PM2.5, O3, SO2, NH3 and VOC). The analysis of the effects of air pollution focused on different aspects: compliance with the European limit values of Directive 2008/50/EC for NO2 and PM10 for the Spanish air quality management areas; the evaluation of impacts caused by the deposition of atmospheric sulphur and nitrogen on ecosystems; the exceedance of critical levels of NO2 and SO2 in forest areas; the analysis of O3-induced crop damage for grapes, maize, potato, rice, tobacco, tomato, watermelon and wheat; health impacts caused by human exposure to O3 and PM2.5; and costs on society due to crop losses (O3), disability-related absence of work staff and damage to buildings and public property due to soot-related soiling (PM2.5). In general, air quality policy making has delivered improvements in air quality levels throughout Spain and has mitigated the severity of the impacts on ecosystems, health and vegetation in 2020 as target year. The findings of this work constitute an appropriate diagnosis for identifying improvement potentials for further mitigation for policy makers and stakeholders in Spain. Copyright © 2015 Elsevier B.V. All rights reserved.

Integrated analysis considered mitigation cost, damage cost and adaptation cost in Northeast Asia

NASA Astrophysics Data System (ADS)

Park, J. H.; Lee, D. K.; Kim, H. G.; Sung, S.; Jung, T. Y.

2015-12-01

Various studies show that raising the temperature as well as storms, cold snap, raining and drought caused by climate change. And variety disasters have had a damage to mankind. The world risk report(2012, The Nature Conservancy) and UNU-EHS (the United Nations University Institute for Environment and Human Security) reported that more and more people are exposed to abnormal weather such as floods, drought, earthquakes, typhoons and hurricanes over the world. In particular, the case of Korea, we influenced by various pollutants which are occurred in Northeast Asian countries, China and Japan, due to geographical meteorological characteristics. These contaminants have had a significant impact on air quality with the pollutants generated in Korea. Recently, around the world continued their effort to reduce greenhouse gas and to improve air quality in conjunction with the national or regional development goals priority. China is also working on various efforts in accordance with the international flows to cope with climate change and air pollution. In the future, effect of climate change and air quality in Korea and Northeast Asia will be change greatly according to China's growth and mitigation policies. The purpose of this study is to minimize the damage caused by climate change on the Korean peninsula through an integrated approach taking into account the mitigation and adaptation plan. This study will suggest a climate change strategy at the national level by means of a comprehensive economic analysis of the impacts and mitigation of climate change. In order to quantify the impact and damage cost caused by climate change scenarios in a regional scale, it should be priority variables selected in accordance with impact assessment of climate change. The sectoral impact assessment was carried out on the basis of selected variables and through this, to derive the methodology how to estimate damage cost and adaptation cost. And then, the methodology was applied in Korea. Finally, we build an integrated analysis considered mitigation cost, damage cost, and adaptation cost by climate change

Reporting quality of randomised controlled trial abstracts among high-impact general medical journals: a review and analysis

PubMed Central

Hays, Meredith; Andrews, Mary; Wilson, Ramey; Callender, David; O'Malley, Patrick G; Douglas, Kevin

2016-01-01

Objective The aim of this study was to assess adherence to the Consolidated Standards of Reporting Trials (CONSORT) for Abstracts by five high-impact general medical journals and to assess whether the quality of reporting was homogeneous across these journals. Design This is a descriptive, cross-sectional study. Setting Randomised controlled trial (RCT) abstracts in five high-impact general medical journals. Participants We used up to 100 RCT abstracts published between 2011 and 2014 from each of the following journals: The New England Journal of Medicine (NEJM), the Annals of Internal Medicine (Annals IM), The Lancet, the British Medical Journal (The BMJ) and the Journal of the American Medical Association (JAMA). Main outcome The primary outcome was per cent overall adherence to the 19-item CONSORT for Abstracts checklist. Secondary outcomes included per cent adherence in checklist subcategories and assessing homogeneity of reporting quality across the individual journals. Results Search results yielded 466 abstracts, 3 of which were later excluded as they were not RCTs. Analysis was performed on 463 abstracts (97 from NEJM, 66 from Annals IM, 100 from The Lancet, 100 from The BMJ, 100 from JAMA). Analysis of all scored items showed an overall adherence of 67% (95% CI 66% to 68%) to the CONSORT for Abstracts checklist. The Lancet had the highest overall adherence rate (78%; 95% CI 76% to 80%), whereas NEJM had the lowest (55%; 95% CI 53% to 57%). Adherence rates to 8 of the checklist items differed by >25% between journals. Conclusions Among the five highest impact general medical journals, there is variable and incomplete adherence to the CONSORT for Abstracts reporting checklist of randomised trials, with substantial differences between individual journals. Lack of adherence to the CONSORT for Abstracts reporting checklist by high-impact medical journals impedes critical appraisal of important studies. We recommend diligent assessment of adherence to reporting guidelines by authors, reviewers and editors to promote transparency and unbiased reporting of abstracts. PMID:27470506

Influence of trabecular bone quality and implantation direction on press-fit mechanics.

PubMed

Damm, Niklas B; Morlock, Michael M; Bishop, Nicholas E

2017-02-01

Achieving primary stability of uncemented press-fit prostheses in patients with poor quality bone can involve axial implantation forces large enough to cause bone fracture. Radial implantation eliminates intraoperative impaction forces and could prevent this damage. Platens of two commercial implant surfaces ("Beaded" and "Flaked") were implanted onto trabecular bone specimens of varying quality in a press-fit simulator. Samples were implanted with varying interference, either axially (shear) or radially (normal). Push-in and pull-out forces were measured to assess stability. Microstructural changes in the bone were determined from μCT analysis. For force-defined implantation analysis, push-in and pull-out forces both increased proportionally with increasing radial force, independent of implantation direction, bone quality or implant surface. For position-defined implantation analysis, pull-out forces were generally found to increase with interference and to be greater for radial than axial implantation direction, and to be lower for poor quality bone. Bone density increased locally at the tested interface due to implantation, in particular for the Beaded surface under axial implantation. If a safe radial stress can be determined for cortical bone in a particular patient, the associated implantation force, and pull-out force which represents primary stability, can be directly derived, regardless of implantation direction, bone quality or implant surface. Radial implantation delivers primary stability that is no worse than that for axial implantation and may eliminate potentially damaging impaction forces. Development of implant designs based on this principal might improve implant fixation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:224-233, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Impact of two early treatment protocols for anterior dental crossbite on children’s quality of life

PubMed Central

Miamoto, Cristina Batista; Marques, Leandro Silva; Abreu, Lucas Guimarães; Paiva, Saul Martins

2018-01-01

ABSTRACT Objective: To assess the impact of two early treatment protocols for anterior dental crossbite on children’s quality of life. Methods: Thirty children, 8 to 10 years of age, with anterior dental crossbite, participated in this study. Individuals were divided into two groups: Group 1 - 15 children undergoing treatment with an upper removable appliance with digital springs; Group 2 - 15 children undergoing treatment with resin-reinforced glass ionomer cement bite pads on the lower first molars. Quality of life was evaluated using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10), which contains four subscales: oral symptoms (OS), functional limitations (FL), emotional well-being (EW), and social well-being (SW). A higher score denotes a greater negative impact on children’s quality of life. Children answered the questionnaire before treatment (T1) and twelve months after orthodontic treatment onset (T2). Descriptive statistics, the Wilcoxon test and analysis of covariance (ANCOVA) were performed. Results: Children’s mean age was 9.07 ± 0.79 years in Group 1 and 9.00 ± 0.84 years in Group 2. For Group 1, the FL and EW subscale scores and the overall CPQ8-10 were significantly higher in T1 as compared to T2 (p= 0.004, p= 0.012 and p= 0.015, respectively). For Group 2, there were no statistically significant differences. The ANCOVA showed no significant difference regarding quality of life at T2 between groups, after controlling for quality of life measures at T1. Conclusions: The difference regarding the impact on quality of life between groups is not related to the protocol used. PMID:29791690

Top Nurse-Management Staffing Collapse and Care Quality in Nursing Homes

PubMed Central

Hunt, Selina R.; Corazzini, Kirsten; Anderson, Ruth A.

2014-01-01

Director of nursing turnover is linked to staff turnover and poor quality of care in nursing homes; however the mechanisms of these relationships are unknown. Using a complexity science framework, we examined how nurse management turnover impacts system capacity to produce high quality care. This study is a longitudinal case analysis of a nursing home (n = 97 staff) with 400% director of nursing turnover during the study time period. Data included 100 interviews, observations and documents collected over 9 months and were analyzed using immersion and content analysis. Turnover events at all staff levels were nonlinear, socially mediated and contributed to dramatic care deficits. Federal mandated, quality assurance mechanisms failed to ensure resident safety. High multilevel turnover should be elevated to a sentinel event for regulators. Suggestions to magnify positive emergence in extreme conditions and to improve quality are provided. PMID:24652943

Preferred drug lists: Potential impact on healthcare economics

PubMed Central

Ovsag, Kimberly; Hydery, Sabrina; Mousa, Shaker A

2008-01-01

Objectives To analyze the implementation of Medicaid preferred drug lists (PDLs) in a number of states and determine its impact on quality of care and cost relative to other segments of healthcare. Methods We reviewed research and case studies found by searching library databases, primarily MEDLINE and EBSCOHost, and searching pertinent journals. Keywords initially included “drug lists,” “prior authorization,” “prior approval,” and “Medicaid.” We added terms such as “influence use of other healthcare services,” “quality of care,” and “overall economic impact.” We mainly used primary sources. Results Based on our literature review, we determined that there are a number of issues regarding Medicaid PDLs that need to be addressed. Some issues include: (a) the potential for PDLs to influence the utilization of other healthcare services, (b) criteria used by Medicaid for determining acceptance of drugs onto a PDL, (c)the effect of PDL implementation on compliance to new regimens, (d) the potential effects of restricting medication availability on quality of care, (e) administrative costs associated with PDLs, and (f) satisfaction rates among patients and medical providers. This review highlighted expected short-term cost savings with limited degree of compromised quality of PDL implementation, but raised the concern about the potential long-term decline in quality of care and overall economic impact. Conclusions The number of concerns raised indicates that further studies are warranted regarding both short-term cost benefits as well as potential long-term effects of Medicaid PDL implementation. Objective analysis of these effects is necessary to ensure cost-effectiveness and quality of care. PMID:18561515

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

PubMed Central

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

2017-01-01

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

Surgery and Trauma Care Providers’ Perception of the Impact of Dual-Practice Employment on Quality of Care Provided in an Andean Country

PubMed Central

LaGrone, Lacey N.; Isquith-Dicker, Leah N.; Egoavil, Eduardo Huaman; Herrera-Matta, Juan Jaime; Fuhs, Amy K.; Checa, David Ortega; Revoredo, Fernando; Rodriguez Castro, Manuel J.A.; Mock, Charles N.

2017-01-01

Background Dual practice, simultaneous employment by healthcare workers in the public and private sector, is pervasive worldwide. Although an estimated 30% of the global burden of disease is surgical, the implications of dual practice on surgical care are not well studied. Methods We conducted anonymous in-depth individual interviews on trauma quality improvement practices with healthcare providers who participate in the care of the injured at ten large hospitals in Peru’s capital city, Lima. A grounded theory approach to qualitative data analysis was employed to identify salient themes. Results Fifty interviews were conducted. A group of themes that emerged related to the perceived negative and positive impacts of dual practice on the quality of surgical care. Participants asserted that the majority of physicians in Lima working in the public sector also worked in the private sector. Dual practice has negative impacts on physicians’ time, the quality of care in the public sector, and surgical education. Dual practice positively affects patient care by allowing physicians to acquire management and quality improvement skills and providing incentives for research and academic productivity. In addition, dual practice provides opportunities for clinical innovations and raises the economic status of the physician. Conclusions Surgeons in Peru report that dual practice negatively impacts patient care by creating time and human resource conflicts. Participants assert that these conflicts widen the gap in quality of care between rich and poor. This practice warrants redirection through national-level regulation of physician schedules and reorganization of public investment in health via physician remuneration. PMID:28251600

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

PubMed

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

2017-01-01

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

Body image and college women's quality of life: The importance of being self-compassionate.

PubMed

Duarte, Cristiana; Ferreira, Cláudia; Trindade, Inês A; Pinto-Gouveia, José

2015-06-01

This study explored self-compassion as a mediator between body dissatisfaction, social comparison based on body image and quality of life in 662 female college students. Path analysis revealed that while controlling for body mass index, self-compassion mediated the impact of body dissatisfaction and unfavourable social comparisons on psychological quality of life. The path model accounted for 33 per cent of psychological quality of life variance. Findings highlight the importance of self-compassion as a mechanism that may operate on the association between negative body image evaluations and young women's quality of life. © The Author(s) 2015.

Analysis of air quality management with emphasis on transportation sources

NASA Technical Reports Server (NTRS)

English, T. D.; Divita, E.; Lees, L.

1980-01-01

The current environment and practices of air quality management were examined for three regions: Denver, Phoenix, and the South Coast Air Basin of California. These regions were chosen because the majority of their air pollution emissions are related to mobile sources. The impact of auto exhaust on the air quality management process is characterized and assessed. An examination of the uncertainties in air pollutant measurements, emission inventories, meteorological parameters, atmospheric chemistry, and air quality simulation models is performed. The implications of these uncertainties to current air quality management practices is discussed. A set of corrective actions are recommended to reduce these uncertainties.

Response of benthic macroinvertebrate communities to highway construction in an Appalachian watershed

USGS Publications Warehouse

Hedrick, Lara B.; Welsh, S.A.; Anderson, James T.; Lin, L.-S.; Chen, Y.; Wei, X.

2010-01-01

Highway construction in mountainous areas can result in sedimentation of streams, negatively impacting stream habitat, water quality, and biotic communities. We assessed the impacts of construction of a segment of Corridor H, a four-lane highway, in the Lost River watershed, West Virginia, by monitoring benthic macroinvertebrate communities and water quality, before, during, and after highway construction and prior to highway use at upstream and downstream sites from 1997 through 2007. Data analysis of temporal impacts of highway construction followed a Before-After-Control-Impact (BACI) study design. Highway construction impacts included an increase in stream sedimentation during the construction phase. This was indicated by an increase in turbidity and total suspended solids. Benthic macroinvertebrate metrics indicated a community more tolerant during and after construction than in the period before construction. The percent of Chironomidae and the Hilsenhoff Biotic Index (HBI) increased, while percent of Ephemeroptera, Plecoptera, and Trichoptera (EPT) decreased. Our 10-year study addressed short-term impacts of highway construction and found that impacts were relatively minimal. A recovery of the number of EPT taxa collected after construction indicated that the benthic macroinvertebrate community may be recovering from impacts of highway construction. However, this study only addressed a period of 3 years before, 3 years during, and 4 years post construction. Inferences cannot be made concerning the long-term impacts of the highway, highway traffic, runoff, and other factors associated with highway use. Continual monitoring of the watershed is necessary to determine if the highway has a continual impact on stream habitat, water quality, and biotic integrity. ?? 2010 Springer Science+Business Media B.V.

SU-F-P-64: The Impact of Plan Complexity Parameters On the Plan Quality and Deliverability of Volumetric Modulated Arc Therapy with Canonical Correlation Analysis

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

Jin, X; Yi, J; Xie, C

Purpose: To evaluate the impact of complexity indices on the plan quality and deliverability of volumetric modulated arc therapy (VMAT), and to determine the most significant parameters in the generation of an ideal VMAT plan. Methods: A multi-dimensional exploratory statistical method, canonical correlation analysis (CCA) was adopted to study the correlations between VMAT parameters of complexity, quality and deliverability, as well as their contribution weights with 32 two-arc VMAT nasopharyngeal cancer (NPC) patients and 31 one-arc VMAT prostate cancer patients. Results: The MU per arc (MU/Arc) and MU per control point (MU/CP) of NPC were 337.8±25.2 and 3.7±0.3, respectively, whichmore » were significantly lower than those of prostate cancer patients (MU/Arc : 506.9±95.4, MU/CP : 5.6±1.1). The plan complexity indices indicated that two-arc VMAT plans were more complex than one-arc VMAT plans. Plan quality comparison confirmed that one-arc VMAT plans had a high quality than two-arc VMAT plans. CCA results implied that plan complexity parameters were highly correlated with plan quality with the first two canonical correlations of 0.96, 0.88 (both p<0.001) and significantly correlated with deliverability with the first canonical correlation of 0.79 (p<0.001), plan quality and deliverability was also correlated with the first canonical correlation of 0.71 (p=0.02). Complexity parameters of MU/CP, segment area (SA) per CP, percent of MU/CP less 3 and planning target volume (PTV) were weighted heavily in correlation with plan quality and deliveability . Similar results obtained from individual NPC and prostate CCA analysis. Conclusion: Relationship between complexity, quality, and deliverability parameters were investigated with CCA. MU, SA related parameters and PTV volume were found to have strong effect on the plan quality and deliverability. The presented correlation among different quantified parameters could be used to improve the plan quality and the efficiency of the radiotherapy process when creating a complex VMAT plan.« less

Wavelet based de-noising of breath air absorption spectra profiles for improved classification by principal component analysis

NASA Astrophysics Data System (ADS)

Kistenev, Yu. V.; Shapovalov, A. V.; Borisov, A. V.; Vrazhnov, D. A.; Nikolaev, V. V.; Nikiforova, O. Yu.

2015-11-01

The comparison results of different mother wavelets used for de-noising of model and experimental data which were presented by profiles of absorption spectra of exhaled air are presented. The impact of wavelets de-noising on classification quality made by principal component analysis are also discussed.

77 FR 21896 - Approval and Promulgation of Air Quality Implementation Plans; State of Nevada; Regional Haze...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-12

... proposed approval, including specific comments on NDEP's modeling and cost analysis of the RGGS BART Determination for NO X . See Modeling for the Reid Gardner Generating Station: Visibility Impacts in Class I... independent modeling analysis to evaluate the incremental visibility improvement attributable to the NO X...

A two-stage approach for estimating a statewide truck trip table.

DOT National Transportation Integrated Search

2014-05-01

Statewide models, including passenger and freight movements, are frequently used for : supporting numerous statewide planning activities. Many states use them for traffic impact : studies, air quality conformity analysis, freight planning, economic d...

Short-term effects of air quality and thermal stress on non-accidental morbidity-a multivariate meta-analysis comparing indices to single measures.

PubMed

Lokys, Hanna Leona; Junk, Jürgen; Krein, Andreas

2018-01-01

Air quality and thermal stress lead to increased morbidity and mortality. Studies on morbidity and the combined impact of air pollution and thermal stress are still rare. To analyse the correlations between air quality, thermal stress and morbidity, we used a two-stage meta-analysis approach, consisting of a Poisson regression model combined with distributed lag non-linear models (DLNMs) and a meta-analysis investigating whether latitude or the number of inhabitants significantly influence the correlations. We used air pollution, meteorological and hospital admission data from 28 administrative districts along a north-south gradient in western Germany from 2001 to 2011. We compared the performance of the single measure particulate matter (PM10) and air temperature to air quality indices (MPI and CAQI) and the biometeorological index UTCI. Based on the Akaike information criterion (AIC), it can be shown that using air quality indices instead of single measures increases the model strength. However, using the UTCI in the model does not give additional information compared to mean air temperature. Interaction between the 3-day average of air quality (max PM10, max CAQI and max MPI) and meteorology (mean air temperature and mean UTCI) did not improve the models. Using the mean air temperature, we found immediate effects of heat stress (RR 1.0013, 95% CI: 0.9983-1.0043) and by 3 days delayed effects of cold stress (RR: 1.0184, 95% CI: 1.0117-1.0252). The results for air quality differ between both air quality indices and PM10. CAQI and MPI show a delayed impact on morbidity with a maximum RR after 2 days (MPI 1.0058, 95% CI: 1.0013-1.0102; CAQI 1.0068, 95% CI: 1.0030-1.0107). Latitude was identified as a significant meta-variable, whereas the number of inhabitants was not significant in the model.

Short-term effects of air quality and thermal stress on non-accidental morbidity—a multivariate meta-analysis comparing indices to single measures

NASA Astrophysics Data System (ADS)

Lokys, Hanna Leona; Junk, Jürgen; Krein, Andreas

2018-01-01

Air quality and thermal stress lead to increased morbidity and mortality. Studies on morbidity and the combined impact of air pollution and thermal stress are still rare. To analyse the correlations between air quality, thermal stress and morbidity, we used a two-stage meta-analysis approach, consisting of a Poisson regression model combined with distributed lag non-linear models (DLNMs) and a meta-analysis investigating whether latitude or the number of inhabitants significantly influence the correlations. We used air pollution, meteorological and hospital admission data from 28 administrative districts along a north-south gradient in western Germany from 2001 to 2011. We compared the performance of the single measure particulate matter (PM10) and air temperature to air quality indices (MPI and CAQI) and the biometeorological index UTCI. Based on the Akaike information criterion (AIC), it can be shown that using air quality indices instead of single measures increases the model strength. However, using the UTCI in the model does not give additional information compared to mean air temperature. Interaction between the 3-day average of air quality (max PM10, max CAQI and max MPI) and meteorology (mean air temperature and mean UTCI) did not improve the models. Using the mean air temperature, we found immediate effects of heat stress (RR 1.0013, 95% CI: 0.9983-1.0043) and by 3 days delayed effects of cold stress (RR: 1.0184, 95% CI: 1.0117-1.0252). The results for air quality differ between both air quality indices and PM10. CAQI and MPI show a delayed impact on morbidity with a maximum RR after 2 days (MPI 1.0058, 95% CI: 1.0013-1.0102; CAQI 1.0068, 95% CI: 1.0030-1.0107). Latitude was identified as a significant meta-variable, whereas the number of inhabitants was not significant in the model.

An Overview of Key Indicators and Evaluation Tools for Assessing Housing Quality: A Literature Review

NASA Astrophysics Data System (ADS)

Sinha, Rajan Chandra; Sarkar, Satyaki; Mandal, Nikhil Ranjan

2017-09-01

The issue of the housing quality has been addressed for various stakeholders at different levels. There exist varied opinion about its measurability and possible applications. Thus the study is carried out to have an insight into the concept of housing quality and its relevance in the changing demographics, technological, socio-economic and socio-cultural conditions. This study attempts to summarize the literature that addresses past research concerned with factors related to housing quality, its measurement methodology and critically examines the broad key indicators identified to have impact upon enhancing the housing quality. This work discusses the recent techniques which are extensively used for analysis of housing quality.

Quality assessment of genetic counseling process in the context of presymptomatic testing for late-onset disorders: a thematic analysis of three review articles.

PubMed

Paneque, Milena; Sequeiros, Jorge; Skirton, Heather

2012-01-01

Presymptomatic testing (PST) is available for a range of late-onset disorders. Health practitioners generally follow guidelines regarding appropriate number of counseling sessions, involvement of multidisciplinary teams, topics for pretest discussion, and follow-up sessions; however, more understanding is needed about what helps consultands effectively and the impact of amount and quality of genetic counseling on the psychosocial sequelae of PST for late-onset disorders. We conducted a thematic analysis of three review articles on quality of the genetic counseling process, aiming at (1) exploring current evidence; (2) identifying quality assessment indicators; and (3) making recommendations for genetic counseling practice in late-onset disorders. We undertook a systematic search of 6 relevant databases: 38 articles were identified and 3 fitted our inclusion criteria; after quality appraisal, all were included in the review. The number of sessions, time spent, consultation environment, follow-up, and multidisciplinarity were identified as variables for quality assessment. Research on counseling in the context of genetic testing in familial cancer tends to be related to outcomes and indicators for quality assessment, while research concerning other late-onset diseases is mainly focused on the psychological impact of the test results. The quality and content of the overall process in noncancer late-onset diseases is insufficiently articulated. Despite the fact that PST for Huntington disease and other degenerative conditions has been offered for more than 20 years, good methodological approaches to assess quality of genetic counseling in that context remain elusive. This restricts improvement of the protocols for genetic services and, in general, healthcare for the at-risk population.

Investigating the organisational impacts of quality improvement: a protocol for a realist evaluation of improvement approaches drawing on the Resource Based View of the Firm

PubMed Central

Burton, Christopher R; Rycroft Malone, Jo; Robert, Glenn; Willson, Alan; Hopkins, Angela

2014-01-01

Introduction Little is understood about the role of quality improvement in enabling health organisations to survive and thrive in the contemporary context of financial and economic challenges. We will draw on the theoretical foundations of the ‘Resource Based View of the Firm’ (RBV) to develop insights into why health organisations engage in improvement work, how impacts are conceptualised, and ‘what works’ in delivering these impacts. Specifically, RBV theorises that the mix and use of resources across different organisations may explain differences in performance. Whether improvement work influences these resources is unclear. Methods and analysis Case study research will be conducted across health organisations participating in four approaches to improvement, including: a national improvement programme; a multiorganisational partnership around implementation; an organisational strategy for quality improvement; and a coproduction project designed to enhance the experience of a clinical service from the perspective of patients. Data will comprise in-depth interviews with key informants, observation of key events and documents; analysed within and then across cases. Adopting a realist perspective, the core tenets of RBV will be evaluated as a programme theory, focusing on the interplay between organisational conditions and behavioural or resource responses that are reported through engagement in improvement. Ethics and dissemination The study has been approved by Bangor University Ethics Committee. The investigation will not judge the relative merits of different approaches to healthcare quality improvement. Rather, we will develop unique insights into the organisational consequences, and dependencies of quality improvement, providing an opportunity to add to the explanatory potential of RBV in this and other contexts. In addition to scientific and lay reports of the study findings, research outputs will include a framework for constructing the economic impacts of quality improvement and practical guidance for health service managers that maximises the impacts of investment in quality improvement. PMID:25082421

Evaluating Water Quality Response and Controlling Variables for Burned Watersheds in the Western United States

NASA Astrophysics Data System (ADS)

Rust, A.; Saxe, S.; Hogue, T. S.; McCray, J. E.

2016-12-01

Increasing wildfire size and frequency in the Western United States creates short-term and long-term impacts on water quality. Surface water in forested watersheds provides water for municipal water supplies and aquatic ecosystems. After fire, increased runoff and erosion lead to elevated loading of nutrients, sediment, and metals. Studies on individual fires have observed mobilization of contaminants, nutrients, metals and sediments into receiving waters. Other studies focused on individual fires over a short period, 1-3 years after fire. The objective of this study is to utilize an extensive historical water quality database, assembled by the authors, to identify trends in post-fire water quality response for the ten years following a significant fire. Specifically, we investigate the variability of post-fire water quality response and determine the key drivers impacting the immediate contaminant flux, recovery over the longer-term and ultimate resiliency of impacted watersheds and municipal water supplies. Results show that the most common post-fire response was increased nutrient loading. Thirty-two western watersheds experienced significant increases in NO3-, NO2-, NH3, and total nitrogen loading for the first five years after fire and remained elevated ten years after fire. Dissolved and total phosphorous significantly increased in 32 western watersheds for the first five years after fire. The majority of these water bodies returned to normal loading after 10 years. Dissolved ions such as calcium, magnesium, and chloride were also exported from over 32 watersheds for the first five years after fire. Using multiple linear regression analysis, we also identify the key physical watershed characteristics that drive post-fire water quality response and recovery. Burn severity, burn area and aridity index all influence the degree of water quality response. Our work provides managers with critical information to evaluate water supply impacts, including short-term treatment needs, as well as the potential long-term resiliency of impacted watersheds.

Oral health-related quality of life of implant-supported overdentures versus conventional complete prostheses: Retrospective study of a cohort of edentulous patients

PubMed Central

Selva-Otaolaurruchi, Eduardo J.; Montero, Javier; Sola-Ruiz, Fernanda

2015-01-01

Background This work aims to confirm if implant-supported overdentures are a good treatment option for edentulous patients and offer an improvement in quality of life compared with traditional complete prostheses (dentures). Material and Methods This retrospective clinical descriptive study included three evaluation groups: validation group (n=57); control group of patients with complete removeable prostheses (n=56); study group of patients with implant-supported overdentures retained with the Locator® system (n=80). The study also validated the Oral Health Impact Profile-20 questionnaire. Individual protocols were created that included socio-demographic data, the Oral Health Impact Profile-20 (OHIP-20) questionnaire and Oral Satisfaction Scale (OSS). Descriptive and bivariate statistical analysis was carried out applying χ², Pearson, Kruskal-Wallis, and Student t tests, transferring data into SPSS-Windows® software from a Microsoft® Excel spreadsheet. Results The OHIP-20 proved to be a valid instrument and provided reliable assessment of health-related quality of life among both the Spanish general population and edentulous patients. The control and study groups proved comparable, showing socio-demographic homogeneity. For patients with overdentures retained by means of the Locator® system, these restorations had significantly lower impact on quality of life (19 vs 33), both generally and for each individual questionnaire item, and much higher satisfaction with the state of their oral cavities (8.3 vs 5.3) than patients wearing dentures; both sets of data showed a direct linear relationship, so that as the level of impact on quality of life increased, perceived oral satisfaction worsened. Conclusions Patients rehabilitated with implant supported overdentures retained by the Locator® system, presented significantly lower levels of impact on their quality of life and significantly higher oral satisfaction than patients with conventional complete prostheses. Key words: Oral health-related quality of life, OHIP-20, OSS, overdentures, dental implants, complete prostheses, Locator® system. PMID:26034930

Identifying/Quantifying Environmental Trade-offs Inherent in GHG Reduction Strategies for Coal-Fired Power.

PubMed

Schivley, Greg; Ingwersen, Wesley W; Marriott, Joe; Hawkins, Troy R; Skone, Timothy J

2015-07-07

Improvements to coal power plant technology and the cofired combustion of biomass promise direct greenhouse gas (GHG) reductions for existing coal-fired power plants. Questions remain as to what the reduction potentials are from a life cycle perspective and if it will result in unintended increases in impacts to air and water quality and human health. This study provides a unique analysis of the potential environmental impact reductions from upgrading existing subcritical pulverized coal power plants to increase their efficiency, improving environmental controls, cofiring biomass, and exporting steam for industrial use. The climate impacts are examined in both a traditional-100 year GWP-method and a time series analysis that accounts for emission and uptake timing over the life of the power plant. Compared to fleet average pulverized bed boilers (33% efficiency), we find that circulating fluidized bed boilers (39% efficiency) may provide GHG reductions of about 13% when using 100% coal and reductions of about 20-37% when cofiring with 30% biomass. Additional greenhouse gas reductions from combined heat and power are minimal if the steam coproduct displaces steam from an efficient natural gas boiler. These upgrades and cofiring biomass can also reduce other life cycle impacts, although there may be increased impacts to water quality (eutrophication) when using biomass from an intensely cultivated source. Climate change impacts are sensitive to the timing of emissions and carbon sequestration as well as the time horizon over which impacts are considered, particularly for long growth woody biomass.

Correlation between the Voice Handicap and Swallowing Quality of Life in patients with laryngeal cancer submitted to chemoradiotherapy.

PubMed

Rosa, Maria Eduarda da; Mituuti, Cláudia Tiemi; Ghirardi, Ana Carolina de Assis Moura

2018-01-01

Purpose To verify the correlation between the voice handicap and swallowing quality of life in individuals submitted to chemoradiotherapy for laryngeal cancer treatment. Methods Cross-sectional, observational and quantitative study. Fourteen male individuals diagnosed with laryngeal cancer were submitted to exclusive chemoradiotherapy treatment. The individuals completed the Voice Handicap Index (VHI) and the Swallowing Quality of Life (SWAL-QOL) questionnaires. Data were submitted to descriptive and inferential analysis using Spearman's Correlation Test to verify possible correlations among the scores of these instruments. Values of p ≤ 0.05 were considered statistically significant. Results No significant correlation was found between the total VHI and overall SWAL-QOL scores. However, there was significant correlation between the domain Functional of the VHI and the domains Fatigue and Social of the SWAL-QOL, between the domain Organic in the VHI and the SWAL-QOL domain Social, and total VHI score and SWAL-QOL domain Swallowing as a burden. Furthermore, chemoradiotherapy treatment had a greater impact on the voice than on the swallowing for the studied individuals. Conclusion The data showed a significant correlation between voice handicap and the impact of quality of life involving swallowing in individuals with laryngeal cancer submitted to chemoradiotherapy. This may affect individuals' emotional and social aspects, impacting their overall quality of life.

Exploring the Relationship Between Online Social Network Site Usage and the Impact on Quality of Life for Older and Younger Users: An Interaction Analysis

PubMed Central

Chen, Liming; Mulvenna, Maurice D; Bond, Raymond

2016-01-01

Background Analyzing content generated by users of social network sites has been shown to be beneficial across a number of disciplines. Such analysis has revealed the precise behavior of users that details their distinct patterns of engagement. An issue is evident whereby without direct engagement with end users, the reasoning for anomalies can only be the subject of conjecture. Furthermore, the impact of engaging in social network sites on quality of life is an area which has received little attention. Of particular interest is the impact of online social networking on older users, which is a demographic that is specifically vulnerable to social isolation. A review of the literature reveals a lack of knowledge concerning the impact of these technologies on such users and even less is known regarding how this impact varies across different demographics. Objective The objective of our study was to analyze user interactions and to survey the attitudes of social network users directly, capturing data in four key areas: (1) functional usage, (2) behavioral patterns, (3) technology, and (4) quality of life. Methods An online survey was constructed, comprising 32 questions. Each question directly related to a research question. Respondents were recruited through a variety of methods including email campaigns, Facebook advertisements, and promotion from related organizations. Results In total, data was collected from 919 users containing 446 younger and 473 older users. In comparison to younger users, a greater proportion of older users (289/473, 61.1% older vs 218/446, 48.9% younger) (P<.001) stated that Facebook had either a positive or huge impact on their quality of life. Furthermore, a greater percentage of older users strongly agreed that Facebook strengthened their relationship with other people (64/473, 13.5% older vs 40/446, 9.0%younger) (P=.02). In comparison to younger users, a greater proportion of older users had more positive emotions—classified as slightly better or very good—during their engagement with Facebook (186/473, 39.3% older vs 120/446, 26.9% younger) (P<.001). Conclusions The results reveal that despite engaging at considerably lower rates with significantly fewer connections, older users gain a greater quality-of-life benefit. Results disclose how both cohorts vary in their use, interactions, and rationale for engaging with Facebook. PMID:27687745

Exploring the Relationship Between Online Social Network Site Usage and the Impact on Quality of Life for Older and Younger Users: An Interaction Analysis.

PubMed

Quinn, Darren; Chen, Liming; Mulvenna, Maurice D; Bond, Raymond

2016-09-29

Analyzing content generated by users of social network sites has been shown to be beneficial across a number of disciplines. Such analysis has revealed the precise behavior of users that details their distinct patterns of engagement. An issue is evident whereby without direct engagement with end users, the reasoning for anomalies can only be the subject of conjecture. Furthermore, the impact of engaging in social network sites on quality of life is an area which has received little attention. Of particular interest is the impact of online social networking on older users, which is a demographic that is specifically vulnerable to social isolation. A review of the literature reveals a lack of knowledge concerning the impact of these technologies on such users and even less is known regarding how this impact varies across different demographics. The objective of our study was to analyze user interactions and to survey the attitudes of social network users directly, capturing data in four key areas: (1) functional usage, (2) behavioral patterns, (3) technology, and (4) quality of life. An online survey was constructed, comprising 32 questions. Each question directly related to a research question. Respondents were recruited through a variety of methods including email campaigns, Facebook advertisements, and promotion from related organizations. In total, data was collected from 919 users containing 446 younger and 473 older users. In comparison to younger users, a greater proportion of older users (289/473, 61.1% older vs 218/446, 48.9% younger) (P<.001) stated that Facebook had either a positive or huge impact on their quality of life. Furthermore, a greater percentage of older users strongly agreed that Facebook strengthened their relationship with other people (64/473, 13.5% older vs 40/446, 9.0%younger) (P=.02). In comparison to younger users, a greater proportion of older users had more positive emotions-classified as slightly better or very good-during their engagement with Facebook (186/473, 39.3% older vs 120/446, 26.9% younger) (P<.001). The results reveal that despite engaging at considerably lower rates with significantly fewer connections, older users gain a greater quality-of-life benefit. Results disclose how both cohorts vary in their use, interactions, and rationale for engaging with Facebook.

Occidental Geothermal, Inc. , Oxy geothermal power plant No. 1. Final environmental impact report

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

Not Available

1981-12-01

The project-specific environmental analysis covers the following: geology, soils, water resources, biology, air quality, noise, waste management, health, safety, transportation, energy and material resources, cultural resources, socioeconomics, public services, land use, and aesthetics. Other topics covered are: the cumulative envionmental analysis; unavoidable significant adverse environmental effects; irreversible environmental changes and irretrievable commitments of energy and materials; the relationship between local short-term uses of man's environment and the maintenance and enhancement of long-term productivity; growth-inducing impacts; and alternatives to the proposed action. (MHR)

Applying air pollution modelling within a multi-criteria decision analysis framework to evaluate UK air quality policies

NASA Astrophysics Data System (ADS)

Chalabi, Zaid; Milojevic, Ai; Doherty, Ruth M.; Stevenson, David S.; MacKenzie, Ian A.; Milner, James; Vieno, Massimo; Williams, Martin; Wilkinson, Paul

2017-10-01

A decision support system for evaluating UK air quality policies is presented. It combines the output from a chemistry transport model, a health impact model and other impact models within a multi-criteria decision analysis (MCDA) framework. As a proof-of-concept, the MCDA framework is used to evaluate and compare idealized emission reduction policies in four sectors (combustion in energy and transformation industries, non-industrial combustion plants, road transport and agriculture) and across six outcomes or criteria (mortality, health inequality, greenhouse gas emissions, biodiversity, crop yield and air quality legal compliance). To illustrate a realistic use of the MCDA framework, the relative importance of the criteria were elicited from a number of stakeholders acting as proxy policy makers. In the prototype decision problem, we show that reducing emissions from industrial combustion (followed very closely by road transport and agriculture) is more advantageous than equivalent reductions from the other sectors when all the criteria are taken into account. Extensions of the MCDA framework to support policy makers in practice are discussed.

Relating health and climate impacts to grid-scale emissions using adjoint sensitivity modeling for the Climate and Clean Air Coalition

NASA Astrophysics Data System (ADS)

Henze, D. K.; Lacey, F.; Seltzer, M.; Vallack, H.; Kuylenstierna, J.; Bowman, K. W.; Anenberg, S.; Sasser, E.; Lee, C. J.; Martin, R.

2013-12-01

The Climate and Clean Air Coalition (CCAC) was initiated in 2012 to develop, understand and promote measures to reduce short lived climate forcers such as aerosol, ozone and methane. The Coalition now includes over 30 nations, and as a service to these nations is committed to providing a decision support toolkit that allows member nations to explore the benefits of a range of emissions mitigation measures in terms of the combined impacts on air quality and climate and so help in the development of their National Action Plans. Here we will present recent modeling work to support the development of the CCAC National Action Plans toolkit. Adjoint sensitivity analysis is presented as a means of efficiently relating air quality, climate and crop impacts back to changes in emissions from each species, sector and location at the grid-scale resolution of typical global air quality model applications. The GEOS-Chem adjoint model is used to estimate the damages per ton of emissions of PM2.5 related mortality, the impacts of ozone precursors on crops and ozone-related health effects, and the combined impacts of these species on regional surface temperature changes. We show how the benefits-per-emission vary spatially as a function of the surrounding environment, and how this impacts the overall benefit of sector-specific control strategies. We present initial findings for Bangladesh, as well as Mexico, Ghana and Colombia, some of the first countries to join the CCAC, and discuss general issues related to adjoint-based metrics for quantifying air quality and climate co-benefits.

The combination matters - distinct impact of lifestyle factors on sperm quality: a study on semen analysis of 1683 patients according to MSOME criteria

PubMed Central

2012-01-01

Background Poor sperm quality can negatively affect embryonic development and IVF outcome. This study is aimed at investigating the influence of various lifestyle factors on semen quality according to MSOME (motile sperm organelle morphology examination) criteria. Methods 1683 male patients undergoing assisted reproductive technologies (ART) in our clinic were surveyed about their age, BMI (body mass index), ejaculation frequency, nutrition, sports, sleeping habits and social behavior. Semen samples were collected and evaluation of semen parameters according to MSOME and WHO criteria was performed. Results were grouped and statistically analyzed. Results Although single parameters had minor effects on sperm parameter, the combination of age, BMI, coffee intake, ejaculatory frequency and duration of sexual abstinence were identified as factors having a negative effect on sperm motility. Additionally, we could demonstrate that MSOME quality was reduced. The negative impact of age, BMI and coffee intake on sperm quality could be compensated if patients had a high ejaculation frequency and shorter periods of sexual abstinence. Conclusions Combinations of adverse lifestyle factors could have a detrimental impact on sperm, not only in terms of motility and sperm count but also in terms of sperm head vacuolization. This negative impact was shown to be compensated by higher ejaculation frequency and a shorter period of sexual abstinence. The compensation is most likely due to a shorter storage time in the male gonads, thus reducing the duration of sperms’ exposure to reactive oxygen species (ROS). PMID:23265183

Impact of syncope on quality of life: validation of a measure in patients undergoing tilt testing.

PubMed

Nave-Leal, Elisabete; Oliveira, Mário; Pais-Ribeiro, José; Santos, Sofia; Oliveira, Eunice; Alves, Teresa; Cruz Ferreira, Rui

2015-03-01

Recurrent syncope has a significant impact on quality of life. The development of measurement scales to assess this impact that are easy to use in clinical settings is crucial. The objective of the present study is a preliminary validation of the Impact of Syncope on Quality of Life questionnaire for the Portuguese population. The instrument underwent a process of translation, validation, analysis of cultural appropriateness and cognitive debriefing. A population of 39 patients with a history of recurrent syncope (>1 year) who underwent tilt testing, aged 52.1 ± 16.4 years (21-83), 43.5% male, most in active employment (n=18) or retired (n=13), constituted a convenience sample. The resulting Portuguese version is similar to the original, with 12 items in a single aggregate score, and underwent statistical validation, with assessment of reliability, validity and stability over time. With regard to reliability, the internal consistency of the scale is 0.9. Assessment of convergent and discriminant validity showed statistically significant results (p<0.01). Regarding stability over time, a test-retest of this instrument at six months after tilt testing with 22 patients of the sample who had not undergone any clinical intervention found no statistically significant changes in quality of life. The results indicate that this instrument is of value for assessing quality of life in patients with recurrent syncope in Portugal. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Effect of age and carcass weight on quality traits of m. rectus abdominis from Charolais heifers.

PubMed

Ellies-Oury, M P; Dumont, R; Perrier, G; Roux, M; Micol, D; Picard, B

2017-04-01

In practice cattle may be slaughtered at different combinations of age and weight. As each of these factors could affect meat quality traits, the present work aimed to identify which combination can be expected to increase overall meat quality of m. rectus abdominis of Charolais heifers. Totally, 40 heifers were slaughtered either at 26±1 or at 36±1 months of age. Young heifers were sampled at two different carcass weights (349±12 and 394±8 kg). Old heifers were also sampled at two different carcass weights (397±6 and 451±9 kg). The m. rectus abdominis was excised 24 h postmortem to determine metabolic enzyme activities, myosin heavy-chain isoform proportions, lipid contents, collagen content and collagen solubility. Shear force measurements were evaluated on raw and broiled meat after 14 days of ageing. Meat quality traits scored between 0 and 10 by sensory analysis. Increasing slaughter age from 26 to 36 months had no impact on either raw/broiled shear force (0.31⩽P⩽0.47) and/or meat quality traits (0.62⩽P⩽0.91) or on physicochemical properties of heifer's meat samples. Increasing carcass weight for a similar slaughter age of 26 months had also impact neither on meat quality traits (0.52⩽P⩽0.91) nor on muscular properties. On the contrary, increasing carcass weight for a similar slaughter age of 36 months had induced a decrease of muscular shear force (raw muscle; P=0.009) and a concomitant decrease of total collagen content (P=0.03). Nevertheless, no significant impact on meat quality traits was revealed by the sensorial panel (0.13⩽P⩽0.49). Metabolic enzyme activities (0.13⩽P⩽0.86) and myosin heavy-chain proportions (0.13⩽P⩽0.96) were not significantly impacted by slaughter age and carcass weight. Thus, the impact of increasing carcass weight and/or slaughter age in young Charolais heifers has a limited impact on meat quality traits and associated muscular characteristics. Modulating heifer's cycles (age and/or carcass weight in the studied range) appears to be a way to answer to the numerous marketing chains, without penalising meat quality traits.

Good-quality social care for people with Parkinson’s disease: a qualitative study

PubMed Central

Kennedy, Fiona; Stocks, Amanda-Jayne; McDonnell, Ann; Ramaswamy, Bhanu; Wood, Brendan; Whitfield, Malcolm

2016-01-01

Objectives The study examines the meaning of good-quality social care for people with Parkinson's disease and their carers. It identifies, from their perspective, the impact of good-quality social care on health and well-being. Design Qualitative case study methodology, interview and framework analysis techniques were used. Setting: community locations in the north and midlands of England. Participants Data were collected from 43 participants including individual interviews with people with Parkinson's disease (n=4), formal and informal social care providers (n=13), 2 focus groups, 1 with people with Parkinson's disease and their carers (n=17), and 1 with professionals (n=8), plus a telephone interview with a former commissioner. Findings Good-quality social care, delivered in a timely fashion, was reported to have a positive impact on health. Furthermore, there is an indication that good-quality social care can prevent untoward events, such as infections, symptom deterioration and deterioration in mental health. The concept of the ‘Impact Gap’ developed from the findings, illustrates how the costs of care may be reduced by delivering good-quality social care. Control, choice and maintaining independence emerged as indicators of good-quality social care, irrespective of clinical condition. Participants identified characteristics indicative of good-quality social care specific to Parkinson's disease, including understanding Parkinson's disease, appropriate administration of medication, timing of care and reassessment. ‘Parkinson's aware’ social care was seen to generate psychological, physical and social benefits that were inter-related. Conclusions The findings indicate how maximising quality in social care delivery for people with Parkinson's disease can impact on health and well-being. Long-term or short-term benefits may result in prevented events and reductions in health and social care resource. Health professionals can be instrumental in early detection of and signposting to social care. PMID:26883233

Workplace interventions to improve work ability: A systematic review and meta-analysis of their effectiveness.

PubMed

Oakman, Jodi; Neupane, Subas; Proper, Karin I; Kinsman, Natasha; Nygård, Clas-Håkan

2018-03-01

Objective Extended working lives due to an ageing population will necessitate the maintenance of work ability across the life course. This systematic review aimed to analyze whether workplace interventions positively impact work ability. Methods We searched Medline, PsycINFO, CINAHL and Embase databases using relevant terms. Work-based interventions were those focused on individuals, the workplace, or multilevel (combination). Work ability - measured using the work ability index (WAI) or the single-item work ability score (WAS) - was the outcome measure. Grading of Recommendations Assessment, Development & Evaluation (GRADE) criteria was used to assess evidence quality, and impact statements were developed to synthesize the results. Meta-analysis was undertaken where appropriate. Results We reviewed 17 randomized control trials (comprising 22 articles). Multilevel interventions (N=5) included changes to work arrangements and liaisons with supervisors, whilst individual-focused interventions (N=12) involved behavior change or exercise programs. We identified only evidence of a moderate quality for either individual or multilevel interventions aiming to improve work ability. The meta-analysis of 13 studies found a small positive significant effect for interventions on work ability [overall pooled mean 0.12, 95% confidence interval (CI) 0.03-0.21] with no heterogeneity for the effect size (Chi 2 =11.28, P=0.51; I 2 =0%). Conclusions The meta-analysis showed a small positive effect, suggesting that workplace interventions might improve work ability. However, the quality of the evidence base was only moderate, precluding any firm conclusion. Further high quality studies are require to establish the role of interventions on work ability.

Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors.

PubMed

Singh, Rupali; Teel, Cynthia; Sabus, Carla; McGinnis, Patricia; Kluding, Patricia

2016-01-01

Fatigue is a persistent symptom, impacting quality of life (QoL) and functional status in people with type 2 diabetes, yet the symptom of fatigue has not been fully explored. The purpose of this study was to explore the relationship between fatigue, QoL functional status and to investigate the predictors of fatigue. These possible predictors included body mass index (BMI), Hemoglobin A1C (HbA1C), sleep quality, pain, number of complications from diabetes, years since diagnosis and depression. Forty-eight individuals with type 2 diabetes (22 females, 26 males; 59.66±7.24 years of age; 10.45 ±7.38 years since diagnosis) participated in the study. Fatigue was assessed by using Multidimensional Fatigue Inventory (MFI-20). Other outcomes included: QoL (Audit of Diabetes Dependent QoL), and functional status (6 minute walk test), BMI, HbA1c, sleep (Pittsburg sleep quality index, PSQI), pain (Visual Analog Scale), number of complications, years since diagnosis, and depression (Beck's depression Inventory-2). The Pearson correlation analysis followed by multivariable linear regression model was used. Fatigue was negatively related to quality of life and functional status. Multivariable linear regression analysis revealed sleep, pain and BMI as the independent predictors of fatigue signaling the presence of physiological (sleep, pain, BMI) phenomenon that could undermine health outcomes.

Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors

PubMed Central

Teel, Cynthia; Sabus, Carla; McGinnis, Patricia; Kluding, Patricia

2016-01-01

Fatigue is a persistent symptom, impacting quality of life (QoL) and functional status in people with type 2 diabetes, yet the symptom of fatigue has not been fully explored. The purpose of this study was to explore the relationship between fatigue, QoL functional status and to investigate the predictors of fatigue. These possible predictors included body mass index (BMI), Hemoglobin A1C (HbA1C), sleep quality, pain, number of complications from diabetes, years since diagnosis and depression. Forty-eight individuals with type 2 diabetes (22 females, 26 males; 59.66±7.24 years of age; 10.45 ±7.38 years since diagnosis) participated in the study. Fatigue was assessed by using Multidimensional Fatigue Inventory (MFI-20). Other outcomes included: QoL (Audit of Diabetes Dependent QoL), and functional status (6 minute walk test), BMI, HbA1c, sleep (Pittsburg sleep quality index, PSQI), pain (Visual Analog Scale), number of complications, years since diagnosis, and depression (Beck’s depression Inventory-2). The Pearson correlation analysis followed by multivariable linear regression model was used. Fatigue was negatively related to quality of life and functional status. Multivariable linear regression analysis revealed sleep, pain and BMI as the independent predictors of fatigue signaling the presence of physiological (sleep, pain, BMI) phenomenon that could undermine health outcomes. PMID:27824886

Potential impact of particulate matter less than 10 micron (PM10) to ambient air quality of Jakarta and Palembang

NASA Astrophysics Data System (ADS)

Agustine, I.; Yulinawati, H.; Gunawan, D.; Suswantoro, E.

2018-01-01

Particulate is a main urban air pollutant affects the environment and human wellbeing. The purpose of this study is to analyze the impact of particulate matter less than 10 micron (PM10) to ambient air quality of Jakarta and Palembang. The analysis is done with calendarPlot Function of openair model, which is based on the calculation of Pollutant Standards Index (PSI) or better known as Air Quality Index (AQI). The AQI category of “moderate” dominates Jakarta’s calendar from 2015 to 2016, which indicates the impact of PM10 is the visibility reduction. There was one day with category “unhealthy” that indicates the impact of dust exposure everywhere in Jakarta during 2015. Similar to Jakarta, the AQI category “moderate” also dominates Palembang’s calendar during 2015. However, the AQI category “hazardous” happened for few days in September and October 2015 during forest fires, which indicates the more harmful impacts of PM10, such as reduced visibility, dust exposure everywhere, increased sensitivity in patients with asthma and bronchitis to respiratory illness in all exposed populations. During 2016, AQI category of Jakarta mostly “moderate”, while in Palembang was “good”. Dominant AQI category from 2015 to 2016 shows higher PM10 concentration occurred in Jakarta compared to Palembang.

Water quality assessment of the ecologically stressed Hooghly River Estuary, India: A multivariate approach.

PubMed

Mitra, Soumita; Ghosh, Swayambhu; Satpathy, Kamala Kanta; Bhattacharya, Bhaskar Deb; Sarkar, Santosh Kumar; Mishra, Pravakar; Raja, P

2018-01-01

Spatio-temporal and seasonal variation of the water quality characteristics of the Hooghly River Estuary, India were studied considering eight stations of diverse eco-hydrological characteristics. Wide variations in turbidity, total dissolved solids and fecal coliform exceeded the permissible BIS drinking water level limit. The estuary is observed to be relatively low-oxygenated, mesotropic and phosphate limiting. Spatial heterogeneity and impact of the southwest monsoon were remarkably pronounced in the distribution of the inorganic nutrients revealing the following values (expressed in μgatml -1 ): nitrate+nitrite (2.42-37.19), phosphate (0.41-1.52) and silicate (38.5-187.75). Water Quality Index (WQI) values confirmed the prevailing 'bad' condition, detrimental for sustenance of aquatic biota. Results of Principal Component Analysis identified the major factors liable for water quality deterioration while cluster analysis categorized the stations on the basis of similar water quality status. The authors recommend adopting preventive measures for water quality improvement linked to biodiversity conservation. Copyright © 2017 Elsevier Ltd. All rights reserved.

An Analysis of How Building a Collaborative Community of Professional Social Studies Teachers through Targeted Ambient Professional Development Impacts Social Studies Classroom Practices

ERIC Educational Resources Information Center

Thomas-Brown, Karen; Shaffer, LaShorage; Werner, Sharon

2016-01-01

This study examined the impact of a yearlong ambient professional development (PD) program-The Wayne Schools Global Geography Project (WSGG-project)-that focused on improving teacher quality through PD and classroom observations for in-service social studies teachers. The project targeted middle and high school social studies teachers and used…

A Survey of the Freshwater Mussel Fauna of the Little Kanawha River Basin,

DTIC Science & Technology

Mussels, * Aquatic biology, Surveys, Rivers, Basins(Geographic), Natural resources, Population, Distribution, Sampling, Environmental impact...Chemical analysis, Pesticides, Metals, Water quality, Waste water , Waste management, Decision making, West Virginia, Fresh water , Workshops

Identification of High Performance, Low Environmental Impact Materials and Processes Using Systematic Substitution (SyS)

NASA Technical Reports Server (NTRS)

Dhooge, P. M.; Nimitz, J. S.

2001-01-01

Process analysis can identify opportunities for efficiency improvement including cost reduction, increased safety, improved quality, and decreased environmental impact. A thorough, systematic approach to materials and process selection is valuable in any analysis. New operations and facilities design offer the best opportunities for proactive cost reduction and environmental improvement, but existing operations and facilities can also benefit greatly. Materials and processes that have been used for many years may be sources of excessive resource use, waste generation, pollution, and cost burden that should be replaced. Operational and purchasing personnel may not recognize some materials and processes as problems. Reasons for materials or process replacement may include quality and efficiency improvements, excessive resource use and waste generation, materials and operational costs, safety (flammability or toxicity), pollution prevention, compatibility with new processes or materials, and new or anticipated regulations.

Quality Evaluation and Chemical Markers Screening of Salvia miltiorrhiza Bge. (Danshen) Based on HPLC Fingerprints and HPLC-MSn Coupled with Chemometrics.

PubMed

Liang, Wenyi; Chen, Wenjing; Wu, Lingfang; Li, Shi; Qi, Qi; Cui, Yaping; Liang, Linjin; Ye, Ting; Zhang, Lanzhen

2017-03-17

Danshen, the dried root of Salvia miltiorrhiza Bge., is a widely used commercially available herbal drug, and unstable quality of different samples is a current issue. This study focused on a comprehensive and systematic method combining fingerprints and chemical identification with chemometrics for discrimination and quality assessment of Danshen samples. Twenty-five samples were analyzed by HPLC-PAD and HPLC-MS n . Forty-nine components were identified and characteristic fragmentation regularities were summarized for further interpretation of bioactive components. Chemometric analysis was employed to differentiate samples and clarify the quality differences of Danshen including hierarchical cluster analysis, principal component analysis, and partial least squares discriminant analysis. Consistent results were that the samples were divided into three categories which reflected the difference in quality of Danshen samples. By analyzing the reasons for sample classification, it was revealed that the processing method had a more obvious impact on sample classification than the geographical origin, it induced the different content of bioactive compounds and finally lead to different qualities. Cryptotanshinone, trijuganone B, and 15,16-dihydrotanshinone I were screened out as markers to distinguish samples by different processing methods. The developed strategy could provide a reference for evaluation and discrimination of other traditional herbal medicines.

What affects the quality of economic analysis for life-saving investments?

PubMed

Hahn, Robert W; Kosec, Katrina; Neumann, Peter J; Wallsten, Scott

2006-06-01

Economic analysis of life-saving investments in both the public and private sectors has the potential to dramatically improve longevity and the quality of life, but only if the analyses on which decisions are based are done well. In this article, we analyze a data set that provides information on the content and quality of journal articles that measure the cost-effectiveness of life-saving investments. Our study is the first to provide a detailed multivariate analysis of factors affecting objective measures of quality. We also explore whether a series of recommendations by an expert panel convened by the U.S. Public Health Service affect the way analyses of specific life-saving investments are done. Our results suggest that four factors are positively correlated with an index we construct to measure analytical quality: (1) having at least one author affiliated with a university, (2) publication in a journal that has experience in publishing these analyses, (3) if the life-saving investment is located in the United States, and (4) if the analysis considers a measure of social costs or benefits. Somewhat surprisingly, a study's funding source and whether it is affiliated with industry are not significantly correlated with the quality index. Finally, neither time nor the panel guidelines had an impact on the index.

Urbanization and carbon dioxide emissions in Singapore: evidence from the ARDL approach.

PubMed

Ali, Hamisu Sadi; Abdul-Rahim, A S; Ribadu, Mohammed Bashir

2017-01-01

The main aim of this article is to examine empirically the impact of urbanization on carbon dioxide emissions in Singapore from 1970 to 2015. The autoregressive distributed lags (ARDL) approach is applied within the analysis. The main finding reveals a negative and significant impact of urbanization on carbon emissions in Singapore, which means that urban development in Singapore is not a barrier to the improvement of environmental quality. Thus, urbanization enhances environmental quality by reducing carbon emissions in the sample country. The result also highlighted that economic growth has a positive and significant impact on carbon emissions, which suggests that economic growth reduces environmental quality through its direct effect of increasing carbon emissions in the country. Despite the high level of urbanization in Singapore, which shows that 100 % of the populace is living in the urban center, it does not lead to more environmental degradation. Hence, urbanization will not be considered an obstacle when initiating policies that will be used to reduce environmental degradation in the country. Policy makers should consider the country's level of economic growth instead of urbanization when formulating policies to reduce environmental degradation, due to its direct impact on increasing carbon dioxide emissions.

Outcomes associated with community-based research projects in teaching undergraduate public health.

PubMed

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.

Impact of statins on cognitive deficits in adult male rodents after traumatic brain injury: a systematic review.

PubMed

Peng, Weijun; Yang, Jingjing; Yang, Bo; Wang, Lexing; Xiong, Xin-gui; Liang, Qinghua

2014-01-01

The efficacy of statin treatment on cognitive decline is controversial, and the effect of statins on cognitive deficits in individuals with traumatic brain injury (TBI) has yet to be investigated. Therefore, we systematically reviewed the effect of statins on cognitive deficits in adult male rodents after TBI. After identifying eligible studies by searching four electronic databases on February 28, 2014, we assessed study quality, evaluated the efficacy of statin treatment, and performed stratified metaregression and metaregression to assess the influence of study design on statin efficacy. Eleven studies fulfilled our inclusion criteria from a total of 183 publications. The overall methodological quality of these studies was poor. Meta-analysis showed that statins exert statistically significant positive effects on cognitive performance after TBI. Stratified analysis showed that atorvastatin has the greatest effect on acquisition memory, simvastatin has the greatest effect on retention memory, and statin effects on acquisition memory are higher in closed head injury models. Metaregression analysis further showed that that animal species, study quality, and anesthetic agent impact statin effects on retention memory. We conclude that statins might reduce cognitive deficits after TBI. However, additional well-designed and well-reported animal studies are needed to inform further clinical study.

Impact of interventions to improve the quality of peer review of biomedical journals: a systematic review and meta-analysis.

PubMed

Bruce, Rachel; Chauvin, Anthony; Trinquart, Ludovic; Ravaud, Philippe; Boutron, Isabelle

2016-06-10

The peer review process is a cornerstone of biomedical research. We aimed to evaluate the impact of interventions to improve the quality of peer review for biomedical publications. We performed a systematic review and meta-analysis. We searched CENTRAL, MEDLINE (PubMed), Embase, Cochrane Database of Systematic Reviews, and WHO ICTRP databases, for all randomized controlled trials (RCTs) evaluating the impact of interventions to improve the quality of peer review for biomedical publications. We selected 22 reports of randomized controlled trials, for 25 comparisons evaluating training interventions (n = 5), the addition of a statistical peer reviewer (n = 2), use of a checklist (n = 2), open peer review (i.e., peer reviewers informed that their identity would be revealed; n = 7), blinded peer review (i.e., peer reviewers blinded to author names and affiliation; n = 6) and other interventions to increase the speed of the peer review process (n = 3). Results from only seven RCTs were published since 2004. As compared with the standard peer review process, training did not improve the quality of the peer review report and use of a checklist did not improve the quality of the final manuscript. Adding a statistical peer review improved the quality of the final manuscript (standardized mean difference (SMD), 0.58; 95 % CI, 0.19 to 0.98). Open peer review improved the quality of the peer review report (SMD, 0.14; 95 % CI, 0.05 to 0.24), did not affect the time peer reviewers spent on the peer review (mean difference, 0.18; 95 % CI, -0.06 to 0.43), and decreased the rate of rejection (odds ratio, 0.56; 95 % CI, 0.33 to 0.94). Blinded peer review did not affect the quality of the peer review report or rejection rate. Interventions to increase the speed of the peer review process were too heterogeneous to allow for pooling the results. Despite the essential role of peer review, only a few interventions have been assessed in randomized controlled trials. Evidence-based peer review needs to be developed in biomedical journals.

Pesticides used in forest nursery management in the United States and the impact of the Food Quality Protection Act and other regulatory actions

Treesearch

Jesus A. Cota

2002-01-01

The Food Quality Protection Act (FQPA) of 1996 has placed new standards on the registration and regulation of pesticides intended to protect children. The most significant changed mandated by FQPA relate to the registration process termed the "Risk Cup." This approach to risk analysis has resulted in greater restrictions on the application of pesticides used...

Team Performance Improvement: Mediating Roles of Employee Job Autonomy and Quality of Team Leader-Member Relations in Supportive Organizations in the Korean Business Context

ERIC Educational Resources Information Center

Song, Ji Hoon

2011-01-01

The purpose of this research was to examine the mediating roles of job autonomy and the quality of the leader-member relationship to explain the impact of organizational support on team performance. A total of 228 cases collected from Korean business organizations were used for data analysis. Hierarchical multiple regression, Type 1 SS-based…

Image quality enhancement for skin cancer optical diagnostics

NASA Astrophysics Data System (ADS)

Bliznuks, Dmitrijs; Kuzmina, Ilona; Bolocko, Katrina; Lihachev, Alexey

2017-12-01

The research presents image quality analysis and enhancement proposals in biophotonic area. The sources of image problems are reviewed and analyzed. The problems with most impact in biophotonic area are analyzed in terms of specific biophotonic task - skin cancer diagnostics. The results point out that main problem for skin cancer analysis is the skin illumination problems. Since it is often not possible to prevent illumination problems, the paper proposes image post processing algorithm - low frequency filtering. Practical results show diagnostic results improvement after using proposed filter. Along that, filter do not reduces diagnostic results' quality for images without illumination defects. Current filtering algorithm requires empirical tuning of filter parameters. Further work needed to test the algorithm in other biophotonic applications and propose automatic filter parameter selection.

The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: a systematic review.

PubMed

Jennings, Natasha; Clifford, Stuart; Fox, Amanda R; O'Connell, Jane; Gardner, Glenn

2015-01-01

To provide the best available evidence to determine the impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department for adult patients. The delivery of quality care in the emergency department is emerging as one of the most important service indicators in health delivery. Increasing service pressures in the emergency department have resulted in the adoption of service innovation models: the most common and rapidly expanding of these is emergency nurse practitioner services. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this service model in terms of outcomes related to safety and quality of patient care. Previous research is now outdated and not commensurate with the changing domain of delivering emergency care with nurse practitioner services. A comprehensive search of four electronic databases from 2006 to 2013 was conducted to identify research evaluating nurse practitioner service impact in the emergency department. English language articles were sought using MEDLINE, CINAHL, Embase and Cochrane and included two previous systematic reviews completed five and seven years ago. A three step approach was used. Following a comprehensive search, two reviewers assessed all identified studies against the inclusion criteria. From the original 1013 studies, 14 papers were retained for critical appraisal on methodological quality by two independent reviewers and data were extracted using standardised tools. Narrative synthesis was conducted to summarise and report the findings as insufficient data was available for meta-analysis of results. This systematic review has shown that emergency nurse practitioner service has a positive impact on quality of care, patient satisfaction and waiting times. There was insufficient evidence to draw conclusions regarding outcomes of a cost benefit analysis. Synthesis of the available research attempts to provide an evidence base for emergency nurse practitioner service to guide healthcare leaders, policy makers and clinicians in reform of emergency service provision. The findings suggest that further high quality research is required for comparative measures of clinical and service effectiveness of emergency nurse practitioner service. In the context of increased health service demand and the need to provide timely and effective care to patients, such measures will assist in evidence based health service planning. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ready, Steady, Go! Program, Italy: a Program Impact Pathways (PIP) analysis.

PubMed

Veracini, Giordana; Leonardi, Elisabetta; Girotti, Rita; Thrasher, Erika Willumsen

2014-09-01

Ready, Steady, Go! promotes proper nutrition and physical activity among people of all ages in targeted neighborhoods and encourages social integration and children's participation in decisions that affect their lives. It also seeks to involve parents in activities so that they can influence their children's attitudes toward lifestyles and personal development. This partnership has reached 70,000 Italian children and adults with new opportunities for physical activities and social experiences that help them improve nutritional behaviors while having fun with their peers. To assess the Ready, Steady, Go! Program logic and to identify Critical Quality Control Points (CCPs) and a core suite of impact indicators based on a Program Impact Pathways (PIP) analysis. The PIP analysis team reviewed the key activities and processes that form Ready, Steady, Go! and then identified key CCPs for the project. The findings were presented at the Healthy Lifestyles Program Evaluation Workshop held in Granada, Spain, 13-14 September 2013, under the auspices of the Mondelēz International Foundation. The PIP analysis confirmed that Ready, Steady, Go! has a structure that is likely to support the primary aims of the program. The CCPs identified are training of teachers in healthy lifestyles, teachers' active participation in the program, access to remodeled and well-equipped sports and recreational centers, participation of parents and grandparents, and involvement of local institutions and networks. A suite of impact indicators for changes in healthy lifestyle knowledge, attitudes, and behavior was identified. Project staff are now more aware of the importance of carefully monitoring the CCPs and have decided to conduct quarterly PIP-informed quality control evaluations.

Impact of Advanced Practice Registered Nurses on Quality Measures: The Missouri Quality Initiative Experience.

PubMed

Rantz, Marilyn J; Popejoy, Lori; Vogelsmeier, Amy; Galambos, Colleen; Alexander, Greg; Flesner, Marcia; Murray, Cathy; Crecelius, Charles; Ge, Bin; Petroski, Gregory

2018-06-01

The purpose of this article is to review the impact of advanced practice registered nurses (APRNs) on the quality measure (QM) scores of the 16 participating nursing homes of the Missouri Quality Initiative (MOQI) intervention. The MOQI was one of 7 program sites in the US, with specific interventions unique to each site tested for the Centers for Medicaid and Medicare Services Innovations Center. While the goals of the MOQI for long-stay nursing home residents did not specifically include improvement of the QM scores, it was anticipated that improvement most likely would occur. Primary goals of the MOQI were to reduce the frequency of avoidable hospital admissions and readmissions; improve resident health outcomes; improve the process of transitioning between inpatient hospitals and nursing facilities; and reduce overall healthcare spending without restricting access to care or choice of providers. A 2-group comparison analysis was conducted using statewide QMs; a matched comparison group was selected from facilities in the same counties as the intervention homes, similar baseline QM scores, similar size and ownership. MOQI nursing homes each had an APRN embedded full-time to improve care and help the facility achieve MOQI goals. Part of their clinical work with residents and staff was to focus on quality improvement strategies with potential to influence healthcare outcomes. Trajectories of QM scores for the MOQI intervention nursing homes and matched comparison group homes were tested with nonparametric tests to examine for change in the desired direction between the 2 groups from baseline to 36 months. A composite QM score for each facility was constructed, and baseline to 36-month average change scores were examined using nonparametric tests. Then, adjusting for baseline, a repeated measures analysis using analysis of covariance as conducted. Composite QM scores of the APRN intervention group were significantly better (P = .025) than the comparison group. The repeated measures analysis identified statistically significant group by time interaction (P = .012). Then group comparisons were made at each of the 6-month intervals and statistically significant differences were found at 24 months (P = .042) and 36 months (P = .002), and nearly significant at 30 months (P = .11). APRNs working full time in nursing homes can positively influence quality of care, and their impact can be measured on improving QMs. As more emphasis is placed on quality and outcomes for nursing home services, providers need to find successful strategies to improve their QMs. Results of these analyses reveal the positive impact on QM outcomes for the majority of the MOQI nursing homes, indicating budgeting for APRN services can be a successful strategy. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Impacts of climate change and variability on European agriculture: results of inventory analysis in COST 734 countries.

PubMed

Orlandini, Simone; Nejedlik, Pavol; Eitzinger, Josef; Alexandrov, Vesselin; Toulios, Leonidas; Calanca, Pierluigi; Trnka, Miroslav; Olesen, Jørgen E

2008-12-01

Climate plays a fundamental role in agriculture because of to its influence on production. All processes are regulated by specific climatic requirements. Furthermore, European agriculture, based on highly developed farming techniques, is mainly oriented to high quality food production that is more susceptible to meteorological hazards. These hazards can modify environment-genotype interactions, which can affect the quality of production. The COST 734 Action (Impacts of Climate Change and Variability on European Agriculture), launched in 2006, is composed of 28 signature countries and is funded by the European Commission. The main objective of the Action is the evaluation of possible impacts arising from climate change and variability on agriculture and the assessment of critical thresholds for various European areas. The Action will concentrate on four different tasks: agroclimatic indices and simulation models, including review and assessment of tools used to relate climate and agricultural processes; evaluation of the current trends of agroclimatic indices and model outputs, including remote sensing; developing and assessing future regional and local scenarios of agroclimatic conditions; and risk assessment and foreseen impacts on agriculture. The work will be carried out by respective Working Groups. This paper presents the results of the analysis of the first phase of inventory activity. Specific questionnaires were disseminated among COST 734 countries to collect information on climate change analysis, studies, and impact at the European level. The results were discussed with respect to their spatial distribution in Europe and to identify possible common long- and short-term strategies for adaptation.

Impact of childhood trauma on functionality and quality of life in HIV-infected women.

PubMed

Troeman, Zyrhea C E; Spies, Georgina; Cherner, Mariana; Archibald, Sarah L; Fennema-Notestine, Christine; Theilmann, Rebecca J; Spottiswoode, Bruce; Stein, Dan J; Seedat, Soraya

2011-09-30

While there are many published studies on HIV and functional limitations, there are few in the context of early abuse and its impact on functionality and Quality of Life (QoL) in HIV. The present study focused on HIV in the context of childhood trauma and its impact on functionality and Quality of Life (QoL) by evaluating 85 HIV-positive (48 with childhood trauma and 37 without) and 52 HIV-negative (21 with childhood trauma and 31 without) South African women infected with Clade C HIV. QoL was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), the Patient's Assessment of Own Functioning Inventory (PAOFI), the Activities of Daily Living (ADL) scale and the Sheehan Disability Scale (SDS). Furthermore, participants were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Childhood Trauma Questionnaire (CTQ). Subjects had a mean age of 30.1 years. After controlling for age, level of education and CES-D scores, analysis of covariance (ANCOVA) demonstrated significant individual effects of HIV status and childhood trauma on self-reported QoL. No significant interactional effects were evident. Functional limitation was, however, negatively correlated with CD4 lymphocyte count. In assessing QoL in HIV-infected women, we were able to demonstrate the impact of childhood trauma on functional limitations in HIV.

Data Analysis Tools and Methods for Improving the Interaction Design in E-Learning

ERIC Educational Resources Information Center

Popescu, Paul Stefan

2015-01-01

In this digital era, learning from data gathered from different software systems may have a great impact on the quality of the interaction experience. There are two main directions that come to enhance this emerging research domain, Intelligent Data Analysis (IDA) and Human Computer Interaction (HCI). HCI specific research methodologies can be…

Reinterpretations of the northern Nectaris Basin, part F

NASA Technical Reports Server (NTRS)

Wilhelms, D. E.

1972-01-01

Photogeologic analysis was attempted on a strip of Apollo 16 metric photographs; the superior quality and stereographic properties of the photography permitted this reevaluation. Geologic contacts, as redrawn closely resemble those of earlier maps, but some differences resulted because of improved photographic quality and a conscious attempt to test fully the impact hypothesis. All or most of the nonmare material of the region of the northern Nectaris Basin rim can be explained by the formation of impact basins. This interpretation seems strained only for some irregular and clustered craters north of Mare Nectaris and for the southern facies of the Descartes material. If the latter material is shown to have been sampled and to be of impact origin, then extensive hill and crater-forming volcanic material of Imbrian or younger age probably does not exist on the lunar terra.

Changes in dark chocolate volatiles during storage.

PubMed

Nightingale, Lia M; Cadwallader, Keith R; Engeseth, Nicki J

2012-05-09

Chocolate storage is critical to the quality of the final product. Inadequate storage, especially with temperature fluctuations, may lead to a change in crystal structure, which may eventually cause fat bloom. Bloom is the main cause of quality loss in the chocolate industry. The impact of various storage conditions on the flavor quality of dark chocolate was determined. Dark chocolate was stored in different conditions leading to either fat or sugar bloom and analyzed at 0, 4, and 8 weeks of storage. Changes in chocolate flavor were determined by volatile analysis and descriptive sensory evaluation. Results were analyzed by analysis of variance (ANOVA), cluster analysis, principal component analysis (PCA), and linear partial least-squares regression analysis (PLS). Volatile concentration and loss were significantly affected by storage conditions. Chocolates stored at high temperature were the most visually and texturally compromised, but volatile concentrations were affected the least, whereas samples stored at ambient, frozen, and high relative humidity conditions had significant volatile loss during storage. It was determined that high-temperature storage caused a change in crystal state due to the polymorphic shift to form VI, leading to an increase in sample hardness. Decreased solid fat content (SFC) during high-temperature storage increased instrumentally determined volatile retention, although no difference was detected in chocolate flavor during sensory analysis, possibly due to instrumental and sensory sampling techniques. When all instrumental and sensory data had been taken into account, the storage condition that had the least impact on texture, surface roughness, grain size, lipid polymorphism, fat bloom formation, volatile concentrations, and sensory attributes was storage at constant temperature and 75% relative humidity.

Quality: performance improvement, teamwork, information technology and protocols.

PubMed

Coleman, Nana E; Pon, Steven

2013-04-01

Using the Institute of Medicine framework that outlines the domains of quality, this article considers four key aspects of health care delivery which have the potential to significantly affect the quality of health care within the pediatric intensive care unit. The discussion covers: performance improvement and how existing methods for reporting, review, and analysis of medical error relate to patient care; team composition and workflow; and the impact of information technologies on clinical practice. Also considered is how protocol-driven and standardized practice affects both patients and the fiscal interests of the health care system.

RNA-seq analysis of stress response in rainbow trout

USDA-ARS?s Scientific Manuscript database

Fish under intensive rearing conditions experience various stress conditions, which have negative impacts on survival, growth and fillet quality. Understanding the molecular mechanisms underlying stress responses will facilitate improvement of animal welfare and production efficiency. Our objective ...

Monitoring Diffuse Impacts: Australian Tourism Developments.

PubMed

Warnken; Buckley

2000-04-01

/ The scientific quality of monitoring for diffuse environmental impacts has rarely been quantified. This paper presents an analysis of all formal environmental monitoring programs for Australian tourism developments over a 15-year period from 1980 to 1995. The tourism sector provides a good test bed for this study because tourism developments are (1) often adjacent to or even within conservation reserves and other relatively undisturbed natural environments, and (2) often clustered, with resulting cumulative impacts that require detection at an early stage. Here we analyze the precision and reliability with which monitoring programs as actually implemented can detect diffuse environmental impacts against natural variation. Of 175 Australian tourism developments subject to EIA from 1980 to 1993 inclusive, only 13 were subject to formal monitoring. Only 44 individual parameters, in total, were monitored for all these developments together. No baseline monitoring was conducted for nine of the 44 parameters. For the remaining 35, only one was monitored for a full year. Before, after, control, impact, paired sampling (BACIP) monitoring designs were used for 24 of the 44 parameters, and power analysis in 10. The scientific quality of monitoring was significantly better for developments subject to control by the Great Barrier Reef Marine Park Authority (GBRMPA). The key factor appears to be the way in which GBRMPA uses external referees and manages external consultants. The GBRMPA model merits wider adoption.

A comparison of quality measures between for-profit and nonprofit medicare-certified home health agencies in Michigan.

PubMed

Haldiman, Kathryn L; Tzeng, Huey-Ming

2010-04-01

This exploratory study investigated the differences in the means of quality measures between for-profit and nonprofit Medicare-certified home health agencies in Michigan. The research question was: Do nonprofit agencies provide higher quality of care than for-profit agencies? Twelve publicly available quality measures were retrieved in May 2009 and used for analysis. Independent t tests found significant differences between for-profit and nonprofit agencies on 6 of the 12 measures, with for-profit agencies performing better on 5 measures. The relative value of both types of ownership should be recognized. Future research may focus on using standardized quality measures to explore further the impact of profit orientation on home health quality of care.

Impact of Disclosure of HIV Infection on Health-Related Quality of Life Among Children and Adolescents With HIV Infection

PubMed Central

Butler, Anne M.; Williams, Paige L.; Howland, Lois C.; Storm, Deborah; Hutton, Nancy; Seage, George R.

2009-01-01

Background Little is known concerning the impact of HIV status disclosure on quality of life, leaving clinicians and families to rely on research of children with other terminal illnesses. Objectives The purpose of this work was to examine the impact of HIV disclosure on pediatric quality of life and to describe the distribution of age at disclosure in a perinatally infected pediatric population. Methods A longitudinal analysis was conducted of perinatally HIV-infected youth ≥5 years of age enrolled in a prospective cohort study, Pediatric AIDS Clinical Trials Group 219C, with ≥1 study visit before and after HIV disclosure. Age-specific quality-of-life instruments were completed by primary caregivers at routine study visits. The distribution of age at disclosure was summarized. Six quality-of-life domains were assessed, including general health perception, symptom distress, psychological status, health care utilization, physical functioning, and social/role functioning. For each domain, mixed-effects models were fit to estimate the effect of disclosure on quality of life. Results A total of 395 children with 2423 study visits were analyzed (1317 predisclosure visits and 1106 postdisclosure visits). The median age at disclosure was estimated to be 11 years. Older age at disclosure was associated with earlier year of birth. Mean domain scores were not significantly different at the last undisclosed visit compared with the first disclosed visit, with the exception of general health perception. When all of the visits were considered, 5 of 6 mean domain scores were lower after disclosure, although the differences were not significant. In mixed-effects models, disclosure did not significantly impact quality of life for any domain. Conclusions Age at disclosure decreased significantly over time. There were no statistically significant differences between predisclosure and postdisclosure quality of life; therefore, disclosure should be encouraged at an appropriate time. PMID:19255023

Experimental investigation on the effects of cooling system on surface quality in high speed milling of an aluminium alloy

NASA Astrophysics Data System (ADS)

Chirita, B.; Tampu, N. C.; Brabie, G.; Radu, M. C.

2016-08-01

Surface quality is often an important feature of industrial products, not only from the impact it has on the aesthetic aspect but also for the functional role of the parts. High quality surface increases corrosion resistance, assures a longer life cycle for the product and lowers the wear. For a machined part, surface quality is influenced by a series of factors such as the material of the part, the process type, tool geometry, cutting parameters or the cooling system. The choice of the cooling system is especially important, taking into account that the proper conditions will not only assure a superior surface quality, but will also lower the costs and reduce the environmental impact and health risks. The present study aims to investigate the performance of the cooling system and the effect of the cutting parameters on the characteristics of the surfaces resulted from high speed face milling of some parts made of Al 7050-T7451 aluminium alloy. Dry cutting conditions and minimum quantity lubrication (MQL) where used. The results were analysed using analysis of variance (ANOVA).

Sociodemographic aspects and quality of life of patients with sickle cell anemia

PubMed Central

dos Santos, Juliana Pereira; Gomes Neto, Mansueto

2013-01-01

Background Sickle cell anemia is a chronic inherited disease, widespread in the Brazilian population due to the high degree of miscegenation in the country. Despite the high prevalence, there are few studies describing the characteristics of patients and the impact of the disease on quality of life. Objective To describe the sociodemographic profile and the impact of the disease on the quality of life of sickle cell anemia patients. Methods Over 18-year-old patients with sickle cell anemia who attended meetings held by the Associação Baiana de Portadores de Doenças Falciformes, an association for sickle cell anemia patients in Bahia, were interviewed. Sociodemographic data were collected and the generic the Medical Outcomes 36-Item Short-Form Health Survey (SF-36) questionnaire, which is used to assess quality of life, was applied. The analysis of the descriptive statistics was performed using the Statistics Program for the Social Sciences software. Results Thirty-two mostly female (65.6%) patients were interviewed. The mean age was 31.9 ± 12.67 years, 50.0% considered themselves black, 68.8% did not work and 87.5% had per capita income below the poverty line (up to one and a half minimum wages). The SF-36 scores were: limitation by physical aspects 26.56, functional capacity 28.9, emotional aspects 30.20, social aspects, 50.0, pain 50.31, mental health 54.62, general health status 56.09 and vitality 56.71. This shows that the disease has a huge impact on the patients' quality of life. Conclusion The disease interferes in the working capacity of individuals, who mostly have low incomes and impaired access to healthcare services and significantly impacts on their quality of life. PMID:24106440

Defining process design space for a hydrophobic interaction chromatography (HIC) purification step: application of quality by design (QbD) principles.

PubMed

Jiang, Canping; Flansburg, Lisa; Ghose, Sanchayita; Jorjorian, Paul; Shukla, Abhinav A

2010-12-15

The concept of design space has been taking root under the quality by design paradigm as a foundation of in-process control strategies for biopharmaceutical manufacturing processes. This paper outlines the development of a design space for a hydrophobic interaction chromatography (HIC) process step. The design space included the impact of raw material lot-to-lot variability and variations in the feed stream from cell culture. A failure modes and effects analysis was employed as the basis for the process characterization exercise. During mapping of the process design space, the multi-dimensional combination of operational variables were studied to quantify the impact on process performance in terms of yield and product quality. Variability in resin hydrophobicity was found to have a significant influence on step yield and high-molecular weight aggregate clearance through the HIC step. A robust operating window was identified for this process step that enabled a higher step yield while ensuring acceptable product quality. © 2010 Wiley Periodicals, Inc.

Development of a protocol to optimize electric power consumption and life cycle environmental impacts for operation of wastewater treatment plant.

PubMed

Piao, Wenhua; Kim, Changwon; Cho, Sunja; Kim, Hyosoo; Kim, Minsoo; Kim, Yejin

2016-12-01

In wastewater treatment plants (WWTPs), the portion of operating costs related to electric power consumption is increasing. If the electric power consumption decreased, however, it would be difficult to comply with the effluent water quality requirements. A protocol was proposed to minimize the environmental impacts as well as to optimize the electric power consumption under the conditions needed to meet the effluent water quality standards in this study. This protocol was comprised of six phases of procedure and was tested using operating data from S-WWTP to prove its applicability. The 11 major operating variables were categorized into three groups using principal component analysis and K-mean cluster analysis. Life cycle assessment (LCA) was conducted for each group to deduce the optimal operating conditions for each operating state. Then, employing mathematical modeling, six improvement plans to reduce electric power consumption were deduced. The electric power consumptions for suggested plans were estimated using an artificial neural network. This was followed by a second round of LCA conducted on the plans. As a result, a set of optimized improvement plans were derived for each group that were able to optimize the electric power consumption and life cycle environmental impact, at the same time. Based on these test results, the WWTP operating management protocol presented in this study is deemed able to suggest optimal operating conditions under which power consumption can be optimized with minimal life cycle environmental impact, while allowing the plant to meet water quality requirements.

Impact of early childhood caries on oral health-related quality of life of preschool children.

PubMed

Li, M Y; Zhi, Q H; Zhou, Y; Qiu, R M; Lin, H C

2015-03-01

Child oral health-related quality of life (COHRQoL) has been assessed in developed areas; however, it remains unstudied in mainland China. Studies on COHRQoL would benefit a large number of children in China suffering from oral health problems such as dental caries. This study explored the relationship between COHRQoL and early childhood caries, adjusted by socioeconomic factors, in 3- to 4-year-old children in a region of southern China. In this study, 1062 children aged 3-4 years were recruited by cluster sampling and their oral health statuses were examined by a trained dentist. The Chinese version of the Early Childhood Oral Health Impact Scale (ECOHIS) and questions about the children's socioeconomic conditions were completed by the children's parents. A negative binomial regression analysis was used to assess the prevalence of early childhood caries among the children and its influence on COHRQoL. The total ECOHIS scores of the returned scale sets ranged from 0 to 31, and their average scores was 3.1±5.1. The negative binomial analysis showed that the dmfs indices were significantly associated with the ECOHIS score and subscale scores (P<0.05). The multivariate adjusted model showed that a higher dmft index was associated with greater negative impact on COHRQoL (RR = 1.10; 95% CI = 1.07, 1.13; P < 0.05). However, demographic and socioeconomic factors were not associated with COHRQoL (P>0.05). The severity of early childhood caries has a negative impact on the oral health-related quality of life of preschool children and their parents.

Requirements and Their Impact Downstream: Improving Casual Analysis Processes Through Measurement and Analysis of Textual Information

DTIC Science & Technology

2008-09-01

re-considered for future use in the PCRs. Its reintroduction should be accompanied with more adequate support for selecting appropriate quality...cnr.it/Papers/ODBASE- CONTEXT.pdf. [Goethert 2007] Goethert, Wolf & Goldenson, Dennis. "Implementing CMMI® Measurement & Analysis Using Goal-Driven...9th Annual Practical Software and Systems Measurement Users’ Group Conference. Keystone, Colorado , July 2005. [Monarch 1995] Ira A. Monarch. An

MEGAPOLI: concept and first results of multi-scale modelling of megacity impacts

NASA Astrophysics Data System (ADS)

Baklanov, A. A.; Lawrence, M.; Pandis, S.

2009-09-01

The European FP7 project MEGAPOLI: ‘Megacities: Emissions, urban, regional and Global Atmospheric POLlution and climate effects, and Integrated tools for assessment and mitigation' (http://megapoli.info), started in October 2008, brings together 27 leading European research groups from 11 countries, state-of-the-art scientific tools and key players from countries outside Europe to investigate the interactions among megacities, air quality and climate. MEGAPOLI bridges the spatial and temporal scales that connect local emissions, air quality and weather with global atmospheric chemistry and climate. The main MEGAPOLI objectives are: 1. to assess impacts of megacities and large air-pollution hot-spots on local, regional and global air quality, 2. to quantify feedbacks among megacity air quality, local and regional climate, and global climate change, 3. to develop improved integrated tools for prediction of air pollution in megacities. In order to achieve these objectives the following tasks are realizing: • Develop and evaluate integrated methods to improve megacity emission data, • Investigate physical and chemical processes starting from the megacity street level, continuing to the city, regional and global scales, • Assess regional and global air quality impacts of megacity plumes, • Determine the main mechanisms of regional meteorology/climate forcing due to megacity plumes, • Assess global megacity pollutant forcing on climate, • Examine feedback mechanisms including effects of climate change on megacity air quality, • Develop integrated tools for prediction of megacity air quality, • Evaluate these integrated tools and use them in case studies, • Develop a methodology to estimate the impacts of different scenarios of megacity development on human health and climate change, • Propose and assess mitigation options to reduce the impacts of megacity emissions. We follow a pyramid strategy of undertaking detailed measurements in one European major city, Paris, performing detailed analysis for 12 megacities with existing air quality datasets and investigate the effects of all megacities on climate and global atmospheric chemistry. The project focuses on the multi-scale modelling of interacting meteorology and air quality, spanning the range from emissions to air quality, effects on climate, and feedbacks and mitigation potentials. Our hypothesis is that megacities around the world have an impact on air quality not only locally, but also regionally and globally and therefore can also influence the climate of our planet. Some of the links between megacities, air quality and climate are reasonably well-understood. However, a complete quantitative picture of these interactions is clearly missing. Understanding and quantifying these missing links is the focus of MEGAPOLI. The current status and modeling results after the first project year on examples of Paris and other European megacities are discussed.

The differential impact of scientific quality, bibliometric factors, and social media activity on the influence of systematic reviews and meta-analyses about psoriasis.

PubMed

Ruano, Juan; Aguilar-Luque, Macarena; Gómez-Garcia, Francisco; Alcalde Mellado, Patricia; Gay-Mimbrera, Jesus; Carmona-Fernandez, Pedro J; Maestre-López, Beatriz; Sanz-Cabanillas, Juan Luís; Hernández Romero, José Luís; González-Padilla, Marcelino; Vélez García-Nieto, Antonio; Isla-Tejera, Beatriz

2018-01-01

Researchers are increasingly using on line social networks to promote their work. Some authors have suggested that measuring social media activity can predict the impact of a primary study (i.e., whether or not an article will be highly cited). However, the influence of variables such as scientific quality, research disclosures, and journal characteristics on systematic reviews and meta-analyses has not yet been assessed. The present study aims to describe the effect of complex interactions between bibliometric factors and social media activity on the impact of systematic reviews and meta-analyses about psoriasis (PROSPERO 2016: CRD42016053181). Methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool. Altmetrics, which consider Twitter, Facebook, and Google+ mention counts as well as Mendeley and SCOPUS readers, and corresponding article citation counts from Google Scholar were obtained for each article. Metadata and journal-related bibliometric indices were also obtained. One-hundred and sixty-four reviews with available altmetrics information were included in the final multifactorial analysis, which showed that social media and impact factor have less effect than Mendeley and SCOPUS readers on the number of cites that appear in Google Scholar. Although a journal's impact factor predicted the number of tweets (OR, 1.202; 95% CI, 1.087-1.049), the years of publication and the number of Mendeley readers predicted the number of citations in Google Scholar (OR, 1.033; 95% CI, 1.018-1.329). Finally, methodological quality was related neither with bibliometric influence nor social media activity for systematic reviews. In conclusion, there seems to be a lack of connectivity between scientific quality, social media activity, and article usage, thus predicting scientific success based on these variables may be inappropriate in the particular case of systematic reviews.

Revalidation and quality assurance: the application of the MUSIQ framework in independent verification visits to healthcare organisations

PubMed Central

Griffin, Ann; Viney, Rowena; Welland, Trevor; Gafson, Irene

2017-01-01

Objectives We present a national evaluation of the impact of independent verification visits (IVVs) performed by National Health Service (NHS) England as part of quality assuring medical revalidation. Organisational visits are central to NHS quality assurance. They are costly, yet little empirical research evidence exists concerning their impact, and what does exist is conflicting. Setting The focus was on healthcare providers in the NHS (in secondary care) and private sector across England, who were designated bodies (DBs). DBs are healthcare organisations that have a statutory responsibility, via the lead clinician, the responsible officer (RO), to implement medical revalidation. Participants All ROs who had undergone an IVV in England in 2014 and 2015 were invited to participate. 46 ROs were interviewed. Ethnographic data were gathered at 18 observations of the IVVs and 20 IVV post visit reports underwent documentary analysis. Primary and secondary outcome measures Primary outcomes were the findings pertaining to the effectiveness of the IVV system in supporting the revalidation processes at the DBs. Secondary outcomes were methodological, relating to the Model for Understanding Success in Quality (MUSIQ) and how its application to the IVV reveals the relevance of contextual factors described in the model. Results The impact of the IVVs varied by DB according to three major themes: the personal context of the RO; the organisational context of the DB; and the visit and its impact. ROs were largely satisfied with visits which raised the status of appraisal within their organisations. Inadequate or untimely feedback was associated with dissatisfaction. Conclusions Influencing teams whose prime responsibility is establishing processes and evaluating progress was crucial for internal quality improvement. Visits acted as a nudge, generating internal quality review, which was reinforced by visit teams with relevant expertise. Diverse team membership, knowledge transfer and timely feedback made visits more impactful. PMID:28196952

Revalidation and quality assurance: the application of the MUSIQ framework in independent verification visits to healthcare organisations.

PubMed

Griffin, Ann; McKeown, Alex; Viney, Rowena; Rich, Antonia; Welland, Trevor; Gafson, Irene; Woolf, Katherine

2017-02-14

We present a national evaluation of the impact of independent verification visits (IVVs) performed by National Health Service (NHS) England as part of quality assuring medical revalidation. Organisational visits are central to NHS quality assurance. They are costly, yet little empirical research evidence exists concerning their impact, and what does exist is conflicting. The focus was on healthcare providers in the NHS (in secondary care) and private sector across England, who were designated bodies (DBs). DBs are healthcare organisations that have a statutory responsibility, via the lead clinician, the responsible officer (RO), to implement medical revalidation. All ROs who had undergone an IVV in England in 2014 and 2015 were invited to participate. 46 ROs were interviewed. Ethnographic data were gathered at 18 observations of the IVVs and 20 IVV post visit reports underwent documentary analysis. Primary outcomes were the findings pertaining to the effectiveness of the IVV system in supporting the revalidation processes at the DBs. Secondary outcomes were methodological, relating to the Model for Understanding Success in Quality (MUSIQ) and how its application to the IVV reveals the relevance of contextual factors described in the model. The impact of the IVVs varied by DB according to three major themes: the personal context of the RO; the organisational context of the DB; and the visit and its impact. ROs were largely satisfied with visits which raised the status of appraisal within their organisations. Inadequate or untimely feedback was associated with dissatisfaction. Influencing teams whose prime responsibility is establishing processes and evaluating progress was crucial for internal quality improvement. Visits acted as a nudge, generating internal quality review, which was reinforced by visit teams with relevant expertise. Diverse team membership, knowledge transfer and timely feedback made visits more impactful. 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/.

The differential impact of scientific quality, bibliometric factors, and social media activity on the influence of systematic reviews and meta-analyses about psoriasis

PubMed Central

Gómez-Garcia, Francisco; Alcalde Mellado, Patricia; Gay-Mimbrera, Jesus; Carmona-Fernandez, Pedro J.; Maestre-López, Beatriz; Sanz-Cabanillas, Juan Luís; Hernández Romero, José Luís; González-Padilla, Marcelino; Vélez García-Nieto, Antonio; Isla-Tejera, Beatriz

2018-01-01

Researchers are increasingly using on line social networks to promote their work. Some authors have suggested that measuring social media activity can predict the impact of a primary study (i.e., whether or not an article will be highly cited). However, the influence of variables such as scientific quality, research disclosures, and journal characteristics on systematic reviews and meta-analyses has not yet been assessed. The present study aims to describe the effect of complex interactions between bibliometric factors and social media activity on the impact of systematic reviews and meta-analyses about psoriasis (PROSPERO 2016: CRD42016053181). Methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool. Altmetrics, which consider Twitter, Facebook, and Google+ mention counts as well as Mendeley and SCOPUS readers, and corresponding article citation counts from Google Scholar were obtained for each article. Metadata and journal-related bibliometric indices were also obtained. One-hundred and sixty-four reviews with available altmetrics information were included in the final multifactorial analysis, which showed that social media and impact factor have less effect than Mendeley and SCOPUS readers on the number of cites that appear in Google Scholar. Although a journal’s impact factor predicted the number of tweets (OR, 1.202; 95% CI, 1.087–1.049), the years of publication and the number of Mendeley readers predicted the number of citations in Google Scholar (OR, 1.033; 95% CI, 1.018–1.329). Finally, methodological quality was related neither with bibliometric influence nor social media activity for systematic reviews. In conclusion, there seems to be a lack of connectivity between scientific quality, social media activity, and article usage, thus predicting scientific success based on these variables may be inappropriate in the particular case of systematic reviews. PMID:29377889

Impact of a Novel, Anti-microbial Dressing on In Vivo, Pseudomonas aeruginosa Wound Biofilm: Quantitative Comparative Analysis using a Rabbit Ear Model

DTIC Science & Technology

2014-12-01

previously pub- lished in vivo, wound biofilm model.19 Rabbits were anesthe- tized with intramuscular injection of a ketamine (22.5 mg/kg) and xylazine (3.5...22: 12–16. 3. Krasner D. Painful venous ulcers: themes and stories about their impact on quality of life. Ostomy Wound Manage 1998; 44: 38–49. 4

Understanding Acquisition Cycle Time: Focusing the Research Problem

DTIC Science & Technology

2013-11-01

Browning, Tyson R., and Steven D. Eppinger. “Modeling Impacts of Process Architecture on Cost and Schedule Risk in Product Development.” IEEE...2009. Clark, Kim, and Steven Wheelwright. Revolutionizing Development: Quantum Leaps in Speed, Efficiency and Quality. New York, NY: The Free Press...1992. Cross, Steven M. Data Analysis and its Impact on Predicting Schedule and Cost Risk. AFIT/GIR/ENC/06M-01. Wright-Patterson AFB OH: AFIT

The impact of article length on the number of future citations: a bibliometric analysis of general medicine journals.

PubMed

Falagas, Matthew E; Zarkali, Angeliki; Karageorgopoulos, Drosos E; Bardakas, Vangelis; Mavros, Michael N

2013-01-01

The number of citations received is considered an index of study quality and impact. We aimed to examine the factors associated with the number of citations of published articles, focusing on the article length. Original human studies published in the first trimester of 2006 in 5 major General Medicine journals were analyzed with regard to the number of authors and of author-affiliated institutions, title and abstract word count, article length (number of print pages), number of bibliographic references, study design, and 2006 journal impact factor (JIF). A multiple linear regression model was employed to identify the variables independently associated with the number of article citations received through January 2012. On univariate analysis the JIF, number of authors, article length, study design (interventional/observational and prospective/retrospective), title and abstract word count, number of author-affiliated institutions, and number of references were all associated with the number of citations received. On multivariate analysis with the logarithm of citations as the dependent variable, only article length [regression coefficient: 14.64 (95% confidence intervals: (5.76-23.50)] and JIF [3.37 (1.80-4.948)] independently predicted the number of citations. The variance of citations explained by these parameters was 51.2%. In a sample of articles published in major General Medicine journals, in addition to journal impact factors, article length and number of authors independently predicted the number of citations. This may reflect a higher complexity level and quality of longer and multi-authored studies.

40 CFR 93.160 - Mitigation of air quality impacts.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Mitigation of air quality impacts. 93.160 Section 93.160 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality impacts. (a) Any measures that are intended to mitigate air quality impacts must be identified and...

40 CFR 93.160 - Mitigation of air quality impacts.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Mitigation of air quality impacts. 93.160 Section 93.160 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality impacts. (a) Any measures that are intended to mitigate air quality impacts must be identified and...

40 CFR 93.160 - Mitigation of air quality impacts.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Mitigation of air quality impacts. 93.160 Section 93.160 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality impacts. (a) Any measures that are intended to mitigate air quality impacts must be identified and...

40 CFR 93.160 - Mitigation of air quality impacts.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Mitigation of air quality impacts. 93.160 Section 93.160 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... quality impacts. (a) Any measures that are intended to mitigate air quality impacts must be identified and...

The impact of child's severity on quality-of-life among parents of children with autism spectrum disorder: the mediating role of optimism.

PubMed

Wisessathorn, Manika; Chanuantong, Tanasugarn; Fisher, Edwin B

2013-10-01

Investigate the impact of child severity and optimism on quality-of-life in parents of children with Autism Spectrum Disorder (ASD). Additionally, the role of optimism as mediator between child's severity and parental quality-of-life was also evaluated Three hundred three parents of children with ASD were recruited from the local autistic centers and schools in Bangkok, Thailand. A set of demographic information sheet, the Childhood Autism Rating Scale (CARS), the Life Oriented Test-Revised (LOT-R), and the WHOQOL-BREF test were submitted for collecting parental information. Using Pearson Correlation, a significant negative association was found between child's severity and parental quality-of-life while optimism was found to correlate positively with parental outcomes. The finding from path-analysis confirmed that impairment of language and repetitive behavior of an ASD child associated with optimism that, in turn, predicted level of parental quality-of-life in all domains. The current findings assured a role of optimism as mediator between child's severity and parental quality-of-life. Implications for the development of intervention focused on enhancing parent's optimism were recommended.

Impact of Blood Pressure Dysregulation on Health-Related Quality of Life in Persons With Spinal Cord Injury: Development of a Conceptual Model

PubMed Central

Carlozzi, Noelle E.; Fyffe, Denise; Morin, Kel G.; Byrne, Rachel; Tulsky, David S.; Victorson, David; Lai, Jin-Shei; Wecht, Jill M.

2015-01-01

Objectives To identify medically relevant aspects of blood pressure dysregulation (BPD) related to quality of life in individuals with spinal cord injury (SCI), and to propose an integrated conceptual framework based on input from both individuals with SCI and their clinical providers. This framework will serve as a guide for the development of a patient-reported outcome (PRO) measure specifically related to BPD. Design Three focus groups with individuals with SCI and 3 groups with SCI providers were analyzed using grounded-theory based qualitative analysis to ascertain how blood pressure impacts health-related quality of life (HRQOL) in individuals with SCI. Setting Focus groups were conducted at 2 Veterans Affairs medical centers and a research center. Participants Individuals with SCI (n=27) in 3 focus groups and clinical providers (n=25) in 3 focus groups. Interventions Not applicable. Main Outcome Measures Not applicable. Results Qualitative analysis indicated that all focus groups spent the highest percentage of time discussing symptoms of BPD (39%), followed by precipitators/causes of BPD (16%), preventative actions (15%), corrective actions (12%), and the impact that BPD has on social or emotional functioning (8%). While patient/consumer focus groups and provider focus groups raised similar issues, providers spent more time discussing precipitators/causes of BPD and preventative actions (38%) than patient/consumer groups (24%). Conclusions These results suggest that BPD uniquely and adversely impacts HRQOL in persons with SCI. While both individuals with SCI and their providers highlighted the relevant symptoms of BPD, the SCI providers offered additional detailed information regarding the precipitators/causes and what can be done to prevent/treat BPD. Further, the results suggest that persons with SCI are aware of how BPD impacts their HRQOL and are able to distinguish between subtle signs and symptoms. These findings exemplify the need for a validated and sensitive clinical measurement tool that can assess the extent to which BPD impacts HRQOL in patients with SCI. PMID:23499779

Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship: Results From the Randomized PORTEC-2 Trial

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

Boer, Stephanie M. de, E-mail: s.m.de_boer.ONCO@lumc.nl; Nout, Remi A.; Jürgenliemk-Schulz, Ina M.

Purpose: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC) survivors. Patients and Methods: In the PORTEC-2 trial, 427 patients with stage I high–intermediate-risk EC were randomly allocated to EBRT or VBT. The 7- and 10-year HRQL questionnaires consisted of EORTC QLQ-C30; subscales for bowel and bladder symptoms; the Impact of Cancer Questionnaire; and 14 questions on comorbidities, walking aids, and incontinence pads. Analysis was done using linear mixed modelsmore » for subscales and (ordinal) logistic regression with random effects for single items. A two-sided P value <.01 was considered statistically significant. Results: Longitudinal HRQL analysis showed persisting higher rates of bowel symptoms with EBRT, without significant differences in global health or any of the functioning scales. At 7 years, clinically relevant fecal leakage was reported by 10.6% in the EBRT group, versus 1.8% for VBT (P=.03), diarrhea by 8.4% versus 0.9% (P=.04), limitations due to bowel symptoms by 10.5% versus 1.8% (P=.001), and bowel urgency by 23.3% versus 6.6% (P<.001). Urinary urgency was reported by 39.3% of EBRT patients, 25.5% for VBT, P=.05. No difference in sexual activity was seen between treatment arms. Long-term impact of cancer scores was higher among the patients who had an EC recurrence or second cancer. Conclusions: More than 7 years after treatment, EBRT patients reported more bowel symptoms with impact on daily activities, and a trend for more urinary symptoms, without impact on overall quality of life or difference in cancer survivorship issues.« less

Quality of life and emotional functioning in youth with chronic migraine and juvenile fibromyalgia.

PubMed

Kashikar-Zuck, Susmita; Zafar, Marium; Barnett, Kimberly A; Aylward, Brandon S; Strotman, Daniel; Slater, Shalonda K; Allen, Janelle R; Lecates, Susan L; Kabbouche, Marielle A; Ting, Tracy V; Hershey, Andrew D; Powers, Scott W

2013-12-01

Chronic pain in children is associated with significant negative impact on social, emotional, and school functioning. Previous studies on the impact of pain on children's functioning have primarily used mixed samples of pain conditions or single pain conditions (eg, headache and abdominal pain) with relatively small sample sizes. As a result, the similarities and differences in the impact of pain in subgroups of children with chronic pain have not been closely examined. To compare pain characteristics, quality of life, and emotional functioning among youth with pediatric chronic migraine (CM) and juvenile fibromyalgia (JFM). We combined data obtained during screening of patients for 2 relatively large intervention studies of youth (age range, 10 to 18 y) with CM (N=153) and JFM (N=151). Measures of pain intensity, quality of life (Pediatric Quality of Life; PedsQL, child and parent-proxy), depressive symptoms (Children's Depression Inventory), and anxiety symptoms (Adolescent Symptom Inventory-4-Anxiety subscale) were completed by youth and their parent. A multivariate analysis of covariance controlling for effects of age and sex was performed to examine differences in quality of life and emotional functioning between the CM and JFM groups. Youth with JFM had significantly higher anxiety and depressive symptoms, and lower quality of life in all domains. Among children with CM, overall functioning was higher but school functioning was a specific area of concern. Results indicate important differences in subgroups of pediatric pain patients and point to the need for more intensive multidisciplinary intervention for JFM patients.

Surgery-first orthognathic approach vs traditional orthognathic approach: Oral health-related quality of life assessed with 2 questionnaires.

PubMed

Pelo, Sandro; Gasparini, Giulio; Garagiola, Umberto; Cordaro, Massimo; Di Nardo, Francesco; Staderini, Edoardo; Patini, Romeo; de Angelis, Paolo; D'Amato, Giuseppe; Saponaro, Gianmarco; Moro, Alessandro

2017-08-01

The purposes of the study were to investigate and evaluate the differences detected by the patients between the traditional orthognathic approach and the surgery-first one in terms of level of satisfaction and quality of life. A total of 30 patients who underwent orthognathic surgery for correction of malocclusions were selected and included in this study. Fifteen patients were treated with the conventional orthognathic surgery approach, and 15 patients with the surgery-first approach. Variables were assessed through the Orthognathic Quality of Life Questionnaire and the Oral Health Impact Profile questionnaire and analyzed with 2-way repeated-measures analysis of variance. The results showed significant differences in terms of the Orthognathic Quality of Life Questionnaire (P <0.001) and the Oral Health Impact Profile (P <0.001) scores within groups between the first and last administrations of both questionnaires. Differences in the control group between first and second administrations were also significant. Questionnaire scores showed an immediate increase of quality of life after surgery in the surgery-first group and an initial worsening during orthodontic treatment in the traditional approach group followed by postoperative improvement. This study showed that the worsening of the facial profile during the traditional orthognathic surgery approach decompensation phase has a negative impact on the perception of patients' quality of life. Surgeons should consider the possibility of a surgery-first approach to prevent this occurrence. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Disability and quality of life in patients with fibromyalgia

PubMed Central

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

Bottom-up perspectives of extreme event and climate change threats to water quality: Drinking water utilities in California

NASA Astrophysics Data System (ADS)

Ekstrom, J.; Klasic, M.; Fencl, A.; Lubell, M.; Bedsworth, L. W.; Baker, E.

2016-12-01

Extreme events impact water quality, which pose serious challenges for drinking water systems. Such extreme events, including wildfire, storm surge, and other weather-related extremes, are projected to increase under a changing climate. It remains unclear what climate change information can support water managers in preparing for more extreme events. Exploring this topic requires understanding the larger question: What is the role of scientific information in adapting to climate change? We present two parts of a three-year study geared to understand whether, where, why and in what way climate information (or the lack of) is used or needed to support long term water quality planning for extreme events. In 2015 we surveyed California drinking water utilities and found a wide range of extreme event/water quality issues, perspectives on the severity of climate change threats, drought impacts and trusted information sources relating to water quality concerns. Approximately 70% of 259 respondents had recently experienced extreme weather-related events that worsen or trigger water quality. Survey results informed development of a case study analysis to gain a more in-depth understanding of what type of - or when - extreme events information could support climate adaptation. Projections of extreme events are often not in a form that is useable for water quality planning. Relative to supply-related projections, water quality has received much less scientific attention, leaving it an assumed scientific information gap and need for management. The question remains whether filling this gap would help adaptation, whom it would help, and in what way. Based on interviews with water systems in Summer 2016, our case study analyses reinforce that extreme events threaten water quality in many ways; largely as secondary impacts of climate change. Secondary impacts involve disinfection byproducts, increasing salinity in the Delta, and the use of lower quality sources. The most common barriers impeding effective adaptation were not related to information. Instead, respondents frequently expressed the obstacles of external institutions not coordinating with their needs. This demonstrates why climate adaptation must simultaneously occur at multiple levels of governance in order for water systems to successfully advance.

Stormwater management impacts on urban stream water quality and quantity during and after development in Clarksburg, MD

NASA Astrophysics Data System (ADS)

Loperfido, J. V.; Noe, G. B.; Jarnagin, S.; Mohamoud, Y. M.; Van Ness, K.; Hogan, D. M.

2012-12-01

Urbanization and urban land use leads to degradation of local stream habitat and 'urban stream syndrome.' Best Management Practices (BMPs) are often used in an attempt to mitigate the impact of urban land use on stream water quality and quantity. Traditional development has employed stormwater BMPs that were placed in a centralized manner located either in the stream channel or near the riparian zone to treat stormwater runoff from large drainage areas; however, urban streams have largely remained impaired. Recently, distributed placement of BMPs throughout the landscape has been implemented in an attempt to detain, treat, and infiltrate stormwater runoff from smaller drainage areas near its source. Despite increasing implementation of distributed BMPs, little has been reported on the catchment-scale (1-10 km^2) performance of distributed BMPs and how they compare to centralized BMPs. The Clarksburg Special Protection Area (CSPA), located in the Washington, DC exurbs within the larger Chesapeake Bay watershed, is undergoing rapid urbanization and employs distributed BMPs on the landscape that treat small drainage areas with the goal of preserving high-quality stream resources in the area. In addition, the presence of a nearby traditionally developed (centralized BMPs) catchment and an undeveloped forested catchment makes the CSPA an ideal setting to understand how the best available stormwater management technology implemented during and after development affects stream water quality and quantity through a comparative watershed analysis. The Clarksburg Integrated Monitoring Partnership is a consortium of local and federal agencies and universities that conducts research in the CSPA including: monitoring of stream water quality, geomorphology, and biology; analysis of stream hydrological and water quality data; and GIS mapping and analysis of land cover, elevation change and BMP implementation data. Here, the impacts of urbanization on stream water quantity, geomorphology, and biology during development while implementing advanced sediment and erosion control BMPs are discussed. Also, effects of centralized versus distributed stormwater BMPs and land cover on stream water quantity and quality following suburban development are presented. This includes stream response to precipitation events, baseflow and stormflow export of water, and water chemistry data. Results from this work have informed land use planning at the local level and are being incorporated through adaptive management to maintain the high-quality stream resources in the CSPA. More generally, results from this work could inform urban development stakeholders on effective strategies to curtail urban stream syndrome.

Probabilistic analysis of the eight-hour-averaged CO impacts of highways.

DOT National Transportation Integrated Search

1980-01-01

This report describes a method for estimating the probability that a highway facility will violate the eight hour National Ambient Air Quality Standard (NAAQS) for carbon monoxide (CO). The method is predicated on the assumption that overlapping eigh...

Impact of National Ambient Air Quality Standards Nonattainment Designations on Particulate Pollution and Health.

PubMed

Zigler, Corwin M; Choirat, Christine; Dominici, Francesca

2018-03-01

Despite dramatic air quality improvement in the United States over the past decades, recent years have brought renewed scrutiny and uncertainty surrounding the effectiveness of specific regulatory programs for continuing to improve air quality and public health outcomes. We employ causal inference methods and a spatial hierarchical regression model to characterize the extent to which a designation of "nonattainment" with the 1997 National Ambient Air Quality Standard for ambient fine particulate matter (PM2.5) in 2005 causally affected ambient PM2.5 and health outcomes among over 10 million Medicare beneficiaries in the Eastern United States in 2009-2012. We found that, on average across all retained study locations, reductions in ambient PM2.5 and Medicare health outcomes could not be conclusively attributed to the nonattainment designations against the backdrop of other regional strategies that impacted the entire Eastern United States. A more targeted principal stratification analysis indicates substantial health impacts of the nonattainment designations among the subset of areas where the designations are estimated to have actually reduced ambient PM2.5 beyond levels achieved by regional measures, with noteworthy reductions in all-cause mortality, chronic obstructive pulmonary disorder, heart failure, ischemic heart disease, and respiratory tract infections. These findings provide targeted evidence of the effectiveness of local control measures after nonattainment designations for the 1997 PM2.5 air quality standard.

Visual acuity and quality of life in dry eye disease: Proceedings of the OCEAN group meeting.

PubMed

Benítez-Del-Castillo, José; Labetoulle, Marc; Baudouin, Christophe; Rolando, Maurizio; Akova, Yonca A; Aragona, Pasquale; Geerling, Gerd; Merayo-Lloves, Jesús; Messmer, Elisabeth M; Boboridis, Kostas

2017-04-01

Dry eye disease (DED) results in tear film instability and hyperosmolarity, inflammation of the ocular surface and, ultimately, visual disturbance that can significantly impact a patient's quality of life. The effects on visual acuity result in difficulties with driving, reading and computer use and negatively impact psychological health. These effects also extend to the workplace, with a loss of productivity and quality of work causing substantial economic losses. The effects of DED and the impact on vision experienced by patients may not be given sufficient importance by ophthalmologists. Functional visual acuity (FVA) is a measure of visual acuity after sustained eye opening without blinking for at least 10 s and mimics the sustained visual acuity of daily life. Measuring dynamic FVA allows the detection of impaired visual function in patients with DED who may display normal conventional visual acuity. There are currently several tests and methods that can be used to measure dynamic visual function: the SSC-350 FVA measurement system, assessment of best-corrected visual acuity decay using the interblink visual acuity decay test, serial measurements of ocular and corneal higher order aberrations, and measurement of dynamic vision quality using the Optical Quality Analysis System. Although the equipment for these methods may be too large or unaffordable for use in clinical practice, FVA testing is an important assessment for DED. Copyright © 2016 Elsevier Inc. All rights reserved.

Understanding Intention to Use Electronic Information Resources: A Theoretical Extension of the Technology Acceptance Model (TAM)

PubMed Central

Tao, Donghua

2008-01-01

This study extended the Technology Acceptance Model (TAM) by examining the roles of two aspects of e-resource characteristics, namely, information quality and system quality, in predicting public health students’ intention to use e-resources for completing research paper assignments. Both focus groups and a questionnaire were used to collect data. Descriptive analysis, data screening, and Structural Equation Modeling (SEM) techniques were used for data analysis. The study found that perceived usefulness played a major role in determining students’ intention to use e-resources. Perceived usefulness and perceived ease of use fully mediated the impact that information quality and system quality had on behavior intention. The research model enriches the existing technology acceptance literature by extending TAM. Representing two aspects of e-resource characteristics provides greater explanatory information for diagnosing problems of system design, development, and implementation. PMID:18999300

Understanding intention to use electronic information resources: A theoretical extension of the technology acceptance model (TAM).

PubMed

Tao, Donghua

2008-11-06

This study extended the Technology Acceptance Model (TAM) by examining the roles of two aspects of e-resource characteristics, namely, information quality and system quality, in predicting public health students' intention to use e-resources for completing research paper assignments. Both focus groups and a questionnaire were used to collect data. Descriptive analysis, data screening, and Structural Equation Modeling (SEM) techniques were used for data analysis. The study found that perceived usefulness played a major role in determining students' intention to use e-resources. Perceived usefulness and perceived ease of use fully mediated the impact that information quality and system quality had on behavior intention. The research model enriches the existing technology acceptance literature by extending TAM. Representing two aspects of e-resource characteristics provides greater explanatory information for diagnosing problems of system design, development, and implementation.

The Impact of Different Types of Resource Transfers on Individual Wellbeing: An Analysis of Quality of Life Using CASP-12

ERIC Educational Resources Information Center

Ateca-Amestoy, Victoria; Ugidos, Arantza

2013-01-01

This paper uses data for Spain from the Survey of Health, Ageing and Retirement in Europe (release 2.3.1) to model the determinants of the quality of life of the elderly, paying special attention to their intergenerational relations. The aim is to study CASP-12 (a social functional index) and explore the effect of interdependency in terms of the…

Numerical simulation of deformation and figure quality of precise mirror

NASA Astrophysics Data System (ADS)

Vit, Tomáš; Melich, Radek; Sandri, Paolo

2015-01-01

The presented paper shows results and a comparison of FEM numerical simulations and optical tests of the assembly of a precise Zerodur mirror with a mounting structure for space applications. It also shows how the curing of adhesive film can impact the optical surface, especially as regards deformations. Finally, the paper shows the results of the figure quality analysis, which are based on data from FEM simulation of optical surface deformations.

Future of lignite resources: a life cycle analysis.

PubMed

Wang, Qingsong; Liu, Wei; Yuan, Xueliang; Zheng, Xiaoning; Zuo, Jian

2016-12-01

Lignite is a low-quality energy source which accounts for 13 % of China's coal reserves. It is imperative to improve the quality of lignite for large-scale utilization. To further explore and analyze the influence of various key processes on the environment and economic costs, a lignite drying and compression technology is evaluated using an integrated approach of life cycle assessment and life cycle costs. Results showed that lignite mining, direct air emissions, and electricity consumption have most significant impacts on the environment. An integrated evaluation of life cycle assessment and life cycle costs showed that the most significant contributor to the environmental impacts and economic costs was the lignite mining process. The impact of transportation and wastewater treatment process on the environment and economic costs was small enough to be ignored. Critical factors were identified for reducing the environmental and economic impacts of lignite drying and compression technology. These findings provide useful inputs for both industrial practice and policy making for exploitation, processing, and utilization of lignite resources.

The impact of on-site wastewater from high density cluster developments on groundwater quality

NASA Astrophysics Data System (ADS)

Morrissey, P. J.; Johnston, P. M.; Gill, L. W.

2015-11-01

The net impact on groundwater quality from high density clusters of unsewered housing across a range of hydro(geo)logical settings has been assessed. Four separate cluster development sites were selected, each representative of different aquifer vulnerability categories. Groundwater samples were collected on a monthly basis over a two year period for chemical and microbiological analysis from nested multi-horizon sampling boreholes upstream and downstream of the study sites. The field results showed no statistically significant difference between upstream and downstream water quality at any of the study areas, although there were higher breakthroughs in contaminants in the High and Extreme vulnerability sites linked to high intensity rainfall events; these however, could not be directly attributed to on-site effluent. Linked numerical models were then built for each site using HYDRUS 2D to simulate the attenuation of contaminants through the unsaturated zone from which the resulting hydraulic and contaminant fluxes at the water table were used as inputs into MODFLOW MT3D models to simulate the groundwater flows. The results of the simulations confirmed the field observations at each site, indicating that the existing clustered on-site wastewater discharges would only cause limited and very localised impacts on groundwater quality, with contaminant loads being quickly dispersed and diluted downstream due to the relatively high groundwater flow rates. Further simulations were then carried out using the calibrated models to assess the impact of increasing cluster densities revealing little impact at any of the study locations up to a density of 6 units/ha with the exception of the Extreme vulnerability site.

Air quality impacts of distributed power generation in the South Coast Air Basin of California 1: Scenario development and modeling analysis

NASA Astrophysics Data System (ADS)

Rodriguez, M. A.; Carreras-Sospedra, M.; Medrano, M.; Brouwer, J.; Samuelsen, G. S.; Dabdub, D.

Distributed generation (DG) is generally defined as the operation of many small stationary power generators throughout an urban air basin. Although DG has the potential to supply a significant portion of the increased power demands in California and the rest of the United States, it may lead to increased levels of in-basin pollutants and adversely impact urban air quality. This study focuses on two main objectives: (1) the systematic characterization of DG installation in urban air basins, and (2) the simulation of potential air quality impacts using a state-of-the-art three-dimensional computational model. A general and systematic approach is devised to construct five realistic and 21 spanning scenarios of DG implementation in the South Coast Air Basin (SoCAB) of California. Realistic scenarios reflect an anticipated level of DG deployment in the SoCAB by the year 2010. Spanning scenarios are developed to determine the potential impacts of unexpected outcomes. Realistic implementations of DG in the SoCAB result in small differences in ozone and particulate matter concentrations in the basin compared to the baseline simulations. The baseline accounts for population increase, but does not consider any future emissions control measures. Model results for spanning implementations with extra high DG market penetration show that domain-wide ozone peak concentrations increase significantly. Also, air quality impacts of spanning implementations when DG operate during a 6-h period are larger than when the same amount of emissions are introduced during a 24-h period.

Urinary Incontinence Symptoms and Impact on Quality of Life in Patients Seeking Outpatient Physical Therapy Services

PubMed Central

Alappattu, Meryl; Neville, Cynthia; Beneciuk, Jason; Bishop, Mark

2016-01-01

Objective The objective of this study was to examine the frequency and types of urinary incontinence (UI) in patients seeking outpatient physical therapy for neuro-musculoskeletal conditions. Design Retrospective cross-sectional analysis. Patients A convenience sample of patients that positively responded to a UI screening question were included in this study. Methods Data were collected for age, sex, and primary treatment condition classified into one of the following (i.e. urinary dysfunction; fecal dysfunction; pelvic pain; spine; neurological disorders; or extremity disorders); UI type (i.e. mixed, urge, stress, or insensible); UI symptom severity; and quality of life impact. Main Outcome Measures Frequency of UI type, symptom severity, health-related quality of life (HRQoL) impact, and pad use were compared between treatment groups. Results The mean age of the sample (n=599) was 49.8 years (SD=18.5) and 94.7% were female. The urinary dysfunction group comprised 44.2% of the total sample, followed by the spine group with 25.7%, and pelvic pain with 17.2%. The urinary dysfunction group scored significantly higher on UI symptom severity and impact on quality of life compared to the pelvic pain and spine groups, but not compared to the extremity disorders, fecal dysfunction, or neurological disorders group. Conclusion These preliminary data indicate that UI is a condition afflicting many individuals who present to outpatient physical therapy beyond those seeking care for UI. We recommend using a simple screening measure for UI and its impact on HRQoL as part of a routine initial evaluation in outpatient physical therapy settings. PMID:26863987

Efficient bibliographic searches on allergy using ISI databases.

PubMed

Sáez Gómez, J M; Annan, J W; Negro Alvarez, J M; Guillen-Grima, F; Bozzola, C M; Ivancevich, J C; Aguinaga Ontoso, E

2008-01-01

The aim of this article is to provide an introduction to using databases from the Thomson ISI Web of Knowledge, with special reference to Citation Indexes as an analysis tool for publications, and also to explain the meaning of the well-known Impact Factor. We present the partially modified new Consultation Interface to enhance information search routines of these databases. It introduces distinctive methods in search bibliography, including the correct application of analysis tools, paying particular attention to Journal Citation Reports and Impact Factor. We finish this article with comment on the consequences of using the Impact Factor as a quality indicator for the assessment of journals and publications, and how to ensure measures for indexing in the Thomson ISI Databases.

Tamoxifen for breast cancer risk reduction: impact of alternative approaches to quality-of-life adjustment on cost-effectiveness analysis.

PubMed

Melnikow, Joy; Birch, Stephen; Slee, Christina; McCarthy, Theodore J; Helms, L Jay; Kuppermann, Miriam

2008-09-01

In cost-effectiveness analysis (CEA), the effects of health-care interventions on multiple health dimensions typically require consideration of both quantity and quality of life. To explore the impact of alternative approaches to quality-of-life adjustment using patient preferences (utilities) on the outcome of a CEA on use of tamoxifen for breast cancer risk reduction. A state transition Markov model tracked hypothetical cohorts of women who did or did not take 5 years of tamoxifen for breast cancer risk reduction. Incremental quality-adjusted effectiveness and cost-effectiveness ratios (ICERs) for models including and excluding a utility adjustment for menopausal symptoms were compared with each other and to a global utility model. Two hundred fifty-five women aged 50 and over with estimated 5-year breast cancer risk >or=1.67% participated in utility assessment interviews. Standard gamble utilities were assessed for specified tamoxifen-related health outcomes, current health, and for a global assessment of possible outcomes of tamoxifen use. Inclusion of a utility for menopausal symptoms in the outcome-specific models substantially increased the ICER; at the threshold 5-year breast cancer risk of 1.67%, tamoxifen was dominated. When a global utility for tamoxifen was used in place of outcome-specific utilities, tamoxifen was dominated under all circumstances. CEAs may be profoundly affected by the types of outcomes considered for quality-of-life adjustment and how these outcomes are grouped for utility assessment. Comparisons of ICERs across analyses must consider effects of different approaches to using utilities for quality-of-life adjustment.

Context matters: the impact of unit leadership and empowerment on nurses' organizational commitment.

PubMed

Laschinger, Heather K Spence; Finegan, Joan; Wilk, Piotr

2009-05-01

The aim of this study was to test a multilevel model linking unit-level leader-member exchange quality and structural empowerment to nurses' psychological empowerment and organizational commitment at the individual level of analysis. Few studies have examined the contextual effects of unit leadership on individual nurse outcomes. Workplace empowerment has been related to retention outcomes such as organizational commitment in several studies, but few have studied the impact of specific unit characteristics within which nurses work on these outcomes. We surveyed 3,156 nurses in 217 hospital units to test the multilevel model. A multilevel path analysis revealed significant individual and contextual effects on nurses' organizational commitment. Both unit-level leader-member exchange quality and structural empowerment had significant direct effects on individual-level psychological empowerment and organizational commitment. Psychological empowerment mediated the relationship between core self-evaluations and organizational commitment at the individual level of analysis. The contextual effects of positive supervisor relationships and their influence on empowering working conditions at the unit level and, subsequently, nurses' organizational commitment highlight the importance of leadership for creating conditions that result in a committed nursing workforce.

Classroom Response Systems: Effects on the Critical Analysis Skills of Students in Introductory Science Courses

ERIC Educational Resources Information Center

Adams, Cindy Chesworth; Columba, Lynn

2014-01-01

College instructors often teach scientific thinking by asking students to review and analyze a primary research article. The main purpose of this study was to explore how classroom response systems (CRS) could help impact the quality of written analysis papers submitted for this assignment by students taking 100-level biology courses at a…

The Impact of Tier 1 Reading Instruction on Reading Outcomes for Students in Grades 4-12: A Meta-Analysis

ERIC Educational Resources Information Center

Swanson, Elizabeth; Stevens, Elizabeth A.; Scammacca, Nancy K.; Capin, Philip; Stewart, Alicia A.; Austin, Christy R.

2017-01-01

Understanding the efficacy of evidence-based reading practices delivered in the Tier 1 (i.e. general classroom) setting is critical to successful implementation of multi-tiered systems, meeting a diverse range of student learning needs, and providing high quality reading instruction across content areas. This meta-analysis presents evidence on the…

Dental pain, use of dental services and oral health-related quality of life in southern Brazil.

PubMed

Cavalheiro, Charles Henrique; Abegg, Claides; Fontanive, Victor Nascimento; Davoglio, Rosane Silvia

2016-08-18

This study aimed at assessing the relationship between dental pain and the reason for using dental services and oral health quality of life in people aged 50 to 74 years in southern Brazil. A cross-sectional population-based study was conducted with 720 individuals aged 50 to 74 years, living in three health districts in the city of Porto Alegre. Dental impacts on daily life and sociodemographic data were assessed using structured interviews. The Oral Impacts on Daily Performance - OIDP instrument was used to measure oral impacts. The information was analyzed by Poisson regression with robust variance adjustment, taking into account cluster sampling. Dental pain was present in 32.5% of those reporting an oral impact on their daily activities. Dental pain most frequently affected talking (37.6%), cleaning teeth and gums (37.0%) and enjoying the companionship of people (36.5%). After adjustments to the multivariate analysis, the reason for dental visits due to dental pain was found to have a high impact on daily activities [RP 1.68 (1.11 - 2.54].

Quality Control of RNA Preservation and Extraction from Paraffin-Embedded Tissue: Implications for RT-PCR and Microarray Analysis

PubMed Central

Pichler, Martin; Zatloukal, Kurt

2013-01-01

Analysis of RNA isolated from fixed and paraffin-embedded tissues is widely used in biomedical research and molecular pathological diagnostics. We have performed a comprehensive and systematic investigation of the impact of factors in the pre-analytical workflow, such as different fixatives, fixation time, RNA extraction method and storage of tissues in paraffin blocks, on several downstream reactions including complementary DNA (cDNA) synthesis, quantitative reverse transcription polymerase chain reaction (qRT-PCR) and microarray hybridization. We compared the effects of routine formalin fixation with the non-crosslinking, alcohol-based Tissue Tek Xpress Molecular Fixative (TTXMF, Sakura Finetek), and cryopreservation as gold standard for molecular analyses. Formalin fixation introduced major changes into microarray gene expression data and led to marked gene-to-gene variations in delta-ct values of qRT-PCR. We found that qRT-PCR efficiency and gene-to-gene variations were mainly attributed to differences in the efficiency of cDNA synthesis as the most sensitive step. These differences could not be reliably detected by quality assessment of total RNA isolated from formalin-fixed tissues by electrophoresis or spectrophotometry. Although RNA from TTXMF fixed samples was as fragmented as RNA from formalin fixed samples, much higher cDNA yield and lower ct-values were obtained in qRT-PCR underlining the negative impact of crosslinking by formalin. In order to better estimate the impact of pre-analytical procedures such as fixation on the reliability of downstream analysis, we applied a qRT-PCR-based assay using amplicons of different length and an assay measuring the efficiency of cDNA generation. Together these two assays allowed better quality assessment of RNA extracted from fixed and paraffin-embedded tissues and should be used to supplement quality scores derived from automated electrophoresis. A better standardization of the pre-analytical workflow, application of additional quality controls and detailed sample information would markedly improve the comparability and reliability of molecular studies based on formalin-fixed and paraffin-embedded tissue samples. PMID:23936242

40 CFR 51.860 - Mitigation of air quality impacts.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Mitigation of air quality impacts. 51... Federal Actions to State or Federal Implementation Plans § 51.860 Mitigation of air quality impacts. Link... mitigate air quality impacts must be identified and the process for implementation and enforcement of such...

The Effect of Cuts in Medicare Reimbursement on Hospital Mortality

PubMed Central

Seshamani, Meena; Schwartz, J Sanford; Volpp, Kevin G

2006-01-01

Objective To determine if patients treated at hospitals under different levels of financial strain from the Balanced Budget Act (BBA) of 1997 had differential changes in 30-day mortality, and whether vulnerable patient populations such as the uninsured were disproportionately affected. Data Source Hospital discharge data from all general acute care hospitals in Pennsylvania from 1997 to 2001. Study Design A multivariate regression analysis was performed retrospectively on 30-day mortality rates, using hospital discharge data, hospital financial data, and death certificate information from Pennsylvania. Data Collection We used 370,017 hospital episodes with one of four conditions identified by the Agency for Healthcare Research and Quality as inpatient quality indicators were extracted. Principal Findings The average magnitude of Medicare payment reduction on overall net revenues was estimated at 1.8 percent for hospitals with low BBA impact and 3.6 percent for hospitals with a high impact in 1998, worsening to 2 and 4.8 percent, respectively, by 2001. Operating margins decreased significantly over the time period for all hospitals (p<.05). While unadjusted mortality rates demonstrated a disproportionate rise in mortality for patients from high impact hospitals from 1997 to 2000, adjusted analyses show no consistent, significant difference in the rate of change in mortality between high-impact and low-impact hospitals (p = .04–.94). Similarly, uninsured patients did not experience greater increases in mortality in high-impact hospitals relative to low-impact hospitals. Conclusions An analysis of hospitalizations in the Commonwealth of Pennsylvania did not find an adverse impact of increased financial strain from the BBA on patient mortality either among all patients or among the uninsured. PMID:16704507

A Screening Assessment of the Potential Impacts of Climate ...

EPA Pesticide Factsheets

EPA has released this draft document solely for the purpose of pre-dissemination peer review under applicable information quality guidelines. This document has not been formally disseminated by EPA. It does not represent and should not be construed to represent any Agency policy or determination. EPA will consider any public comments submitted in accordance with this notice when revising the document. The report is a screening level analysis intended to determine the scope and magnitude of global change impacts rather than a detailed assessment of specific impacts and adaptation measures.

Informing the NCA: EPA's Climate Change Impact and Risk Analysis Framework

NASA Astrophysics Data System (ADS)

Sarofim, M. C.; Martinich, J.; Kolian, M.; Crimmins, A. R.

2017-12-01

The Climate Change Impact and Risk Analysis (CIRA) framework is designed to quantify the physical impacts and economic damages in the United States under future climate change scenarios. To date, the framework has been applied to 25 sectors, using scenarios and projections developed for the Fourth National Climate Assessment. The strength of this framework has been in the use of consistent climatic, socioeconomic, and technological assumptions and inputs across the impact sectors to maximize the ease of cross-sector comparison. The results of the underlying CIRA sectoral analyses are informing the sustained assessment process by helping to address key gaps related to economic valuation and risk. Advancing capacity and scientific literature in this area has created opportunity to consider future applications and strengthening of the framework. This presentation will describe the CIRA framework, present results for various sectors such as heat mortality, air & water quality, winter recreation, and sea level rise, and introduce potential enhancements that can improve the utility of the framework for decision analysis.

Teachers' dispositional mindfulness and the quality of their relationships with children in Head Start classrooms.

PubMed

Becker, Brandon D; Gallagher, Kathleen C; Whitaker, Robert C

2017-12-01

The quality of teachers' relationships with children is a key predictor of children's later social emotional competence and academic achievement. Interventions to increase mindfulness among teachers have focused primarily on the impacts on teachers' subjective well-being, but not on the quality of their relationships with children. Furthermore, none of these interventions have involved preschool teachers. To consider the potential of mindfulness-based interventions to improve the quality of teachers' relationships with preschool-aged children, we examined data from an online survey of 1001 classroom teachers in 37 Pennsylvania Head Start Programs. Using path analysis we investigated the association between teachers' dispositional mindfulness and the quality of their relationships with children (conflict and closeness). We further examined whether this association was mediated by teacher depressive symptoms and moderated by perceived workplace stress. Higher levels of dispositional mindfulness among teachers were associated with higher quality relationships with children (less conflict and greater closeness). The association between greater dispositional mindfulness and less conflict was partially mediated by lower depressive symptoms, and the conditional direct effect of mindfulness on conflict was stronger when perceived workplace stress was lower. These findings suggest that preschool teachers who have higher levels of dispositional mindfulness may experience higher quality relationships with children in their classrooms. Interventions to increase levels of dispositional mindfulness among early childhood educators may improve their well-being along with the quality of their relationships with children, potentially impacting children's educational outcomes. The potential impacts of such interventions may be even stronger if structural and systemic changes are also made to reduce workplace stress. Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Facies analysis, diagenesis and sequence stratigraphy of the carbonate-evaporite succession of the Upper Jurassic Surmeh Formation: Impacts on reservoir quality (Salman Oil Field, Persian Gulf, Iran)

NASA Astrophysics Data System (ADS)

Beigi, Maryam; Jafarian, Arman; Javanbakht, Mohammad; Wanas, H. A.; Mattern, Frank; Tabatabaei, Amin

2017-05-01

This study aims to determine the depositional facies, diagenetic processes and sequence stratigraphic elements of the subsurface carbonate-evaporite succession of the Upper Jurassic (Kimmeridgian-Tithonian) Surmeh Formation of the Salman Oil Field (the Persian Gulf, Iran), in an attempt to explore their impacts on reservoir quality. The Surmeh Formation consists mainly of carbonate rocks, intercalated with evaporite layers. Petrographically, the Surmeh Formation consists of nine microfacies (MF1-MF9). These microfacies are grouped into three facies associations related to three depositional environments (peritidal flat, lagoon and high-energy shoal) sited on the inner part of a homoclinal carbonate ramp. The recorded diagenetic processes include dolomitization, anhydritization, compaction, micritization, neomorphism, dissolution and cementation. Vertical stacking patterns of the studied facies reveal the presence of three third-order depositional sequences, each of which consists of transgressive systems tract (TST) and highstand systems tract (HST). The TSTs comprise intertidal and lagoon facies whereas the HSTs include supratidal and shoal facies. In terms of their impacts on reservoir quality, the shoal facies represent the best reservoir quality, whereas the peritidal and lagoonal facies exhibit moderate to lowest reservoir quality. Also, poikilotopic anhydrite cement played the most significant role in declining the reservoir quality, whereas the widespread dissolution of labile grains and formation of moldic and vuggy pores contributed in enhancing the reservoir quality. In addition, the HSTs have a better reservoir quality than the TSTs. This study represents an approach to use the depositional facies, diagenetic alterations and sequence stratigraphic framework of carbonate -evaporite succession for a more successful reservoir characterization.

A longitudinal study of clinical peer review's impact on quality and safety in U.S. hospitals.

PubMed

Edwards, Marc T

2013-01-01

Clinical peer review is the dominant method of event analysis in U.S. hospitals. It is pivotal to medical staff efforts to improve quality and safety, yet the quality assurance process model that has prevailed for the past 30 years evokes fear and is fundamentally antithetical to a culture of safety. Two prior national studies characterized a quality improvement model that corrects this dysfunction but failed to demonstrate progress toward its adoption despite a high rate of program change between 2007 and 2009. This study's online survey of 470 organizations participating in either of the prior studies further assessed relationships between clinical peer review program factors, including the degree of conformance to the quality improvement model (the QI model score), and subjectively measured program impact variables. Among the 300 hospitals (64%) that responded, the median QI model score was only 60 on a 100-point scale. Scores increased somewhat for the 2007 cohort (mean pair-wise difference of 5.9 [2-10]), but not for the 2009 cohort. The QI model is expanded as the result of the finding that self-reporting of adverse events, near misses, and hazardous conditions--an essential practice in high-reliability organizations--is no longer rare in hospitals. Self-reporting and the quality of case review are additional multivariate predictors of the perceived ongoing impact of clinical peer review on quality and safety, medical staff perceptions of the program, and medical staff engagement in quality and safety initiatives. Hospital leaders and trustees who seek to improve patient outcomes should facilitate the adoption of this best practice model for clinical peer review.

Family Impacts among Children with Autism Spectrum Disorder: The Role of Health Care Quality

PubMed Central

Zuckerman, Katharine E.; Lindly, Olivia J.; Bethell, Christina D.; Kuhlthau, Karen

2014-01-01

Objectives To compare health care quality and family employment and financial impacts among children with special health care needs (CSHCN) with autism spectrum disorder (CSHCN+ASD), CSHCN with functional limitations (CSHCN+FL), and CSHCN lacking these conditions (other CSHCN). To test whether high health care quality was associated with reduced family impacts among CSHCN+ASD. Methods Data from the 2009-2010 National Survey of CSHCN were used to compare 3025 CSHCN+ASD, 6505 CSHCN+FL, and 28 296 other CSHCN. Weighted multivariate logistic regression analyses examined six age-relevant, federally-defined health care quality indicators and five family financial and employment impact indicators. Two composite measures were additionally used: (1) receipt of care that met all age-relevant quality indicators; and (2) had ≥ two of the five adverse family impacts. Results Across all health care quality indicators CSHCN+ASD fared poorly, with only 7.4% meeting all age-relevant indicators. CSHCN+ASD had worse health care quality than other CSHCN, including CSHCN+FL. CSHCN+ASD also had high rates of adverse family impact, with over half experiencing two or more adverse impacts. Rates of adverse family impact were higher in CSHCN+ASD than other CSHCN, including CSHCN+FL. Among CSHCN+ASD, those whose health care that met federal quality standards were less likely to have multiple adverse family impacts than CSHCN+ASD whose health care did not meet federal quality standards. Conclusions CSHCN+ASD are more prone to experience poor health care quality and family impacts than other CSHCN, even CSHCN+FL. Receipt of care meeting federal quality standards may potentially lessen adverse family impacts for CSHCN+ASD. PMID:24976352

Land use change and effects on water quality and ecosystem health in the Lake Tahoe basin, Nevada and California

USGS Publications Warehouse

Forney, William; Richards, Lora; Adams, Kenneth D.; Minor, Timothy B.; Rowe, Timothy G.; Smith, J. LaRue; Raumann, Christian G.

2001-01-01

Human activity in the Lake Tahoe Basin has increased substantially in the past four decades, causing significant impacts on the quality and clarity of the lake's famous deep, clear water. Protection of Lake Tahoe and the surrounding environment has become an important activity in recent years. A variety of agencies, including the Tahoe Regional Planning Agency, Tahoe Research Group of the University of California at Davis, Desert Research Institute of the University and Community College System of Nevada, U.S. Geological Survey (USGS), and a host of State (both Nevada and California) and local agencies have been monitoring and conducting research in the Basin in order to understand how the lake functions and to what extent humans have affected its landscape and ecosystem processes. In spite of all of these activities, there remains a lack of comprehensive land use change data and analysis for the Basin. A project is underway that unites the land cover mapping expertise of the USGS National Mapping Discipline with the hydrologic expertise of the Water Resources Discipline to assess the impacts of urban growth and land use change in the Lake Tahoe Basin. Three activities are planned over the next 3 years: (1) mapping the current and historic state of the land surface, (2) conducting analysis to document patterns, rates, and trends in urbanization, land use change, and ecosystem health, and (3) assessing the causes and consequences of land use change with regard to water quality and ecosystem health. We hypothesize that changes in the extent of urban growth and the corresponding increases in impervious surfaces and decreases in natural vegetation have resulted in severe impacts on ecosystem health and integrity, riparian zones and water quality over time. We are acting on multiple fronts to test this hypothesis through the quantification of landscape disturbances and impacts.

Quality of life for post-polio syndrome: a patient derived, Rasch standard scale.

PubMed

Young, Carolyn A; Quincey, Anne-Marie C; Wong, Samantha M; Tennant, Alan

2018-03-01

To design a disease-specific quality of life (QoL) questionnaire for people with post-polio syndrome (PPS). Qualitative interviews were conducted with 45 people with PPS to identify themes and derive potential items reflecting impact upon QoL. After cognitive debriefing, these were made into a questionnaire pack along with comparative questionnaires and posted to 319 patients. The 271 (85%) returned questionnaires were subjected to exploratory factor analysis (EFA) and Rasch analysis. A 25 item scale, the post-polio quality of life scale (PP-QoL), showed good fit to the Rasch model (conditional chi-square p = 0.156), unidimensionality (% t-tests 2.0: CI 0.7-3.8), and Cronbach's alpha of 0.87. With the latent estimate transformed to a 0-100 scale, the mean score was 56.9 (SD 18.5) with only 3.3% of respondents at the floor or ceiling of the scale. Test-retest reliability showed an intraclass correlation coefficient (ICC) (2.1) of 0.916, and correlation of 0.85. The disease-specific PP-QoL demonstrated excellent reliability, appropriate concurrent validity, and satisfied the standards of the Rasch model. It enables examination of the impact of health status upon perceived QoL, and the impact of rehabilitation interventions. The scale is freely available for academic or not-for-profit users to improve research in this neglected, disabling condition. Implications for Rehabilitation In post-polio syndrome (PPS), existing work examines aspects of health-related quality of life (HRQoL), such as activity limitations. A disease-specific QoL measure would enable researchers to model the impact of health status, such as fatigue or mobility restrictions, upon QoL in PPS. The post-polio quality of life scale (PP-QoL) is based on the patients' lived experience, meets Rasch standards and is free for use for academic and not-for-profit researchers. The raw score is reliable for individual use in clinical settings, and interval scale transformation is available for parametric applications and the calculation of change scores.

Psychological wellbeing and quality-of-life among siblings of paediatric CFS/ME patients: A mixed-methods study

PubMed Central

Velleman, Sophie; Collin, Simon M; Beasant, Lucy; Crawley, Esther

2015-01-01

Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a disabling condition known to have a negative impact on all aspects of a child’s life. However, little is understood about the impact of CFS/ME on siblings. A total of 34 siblings completed questionnaires measuring depression (Hospital Anxiety and Depression Scale (HADS)), anxiety (HADS and Spence Children’s Anxiety Scale (SCAS)) and European Quality-of-life-Youth (EQ-5D-Y). These scores were compared with scores from normative samples. Siblings had higher levels of anxiety on the SCAS than adolescents of the same age recruited from a normative sample; however, depression and quality-of-life were similar. Interviews were undertaken with nine siblings of children with CFS/ME who returned questionnaires. Interview data were analysed using a framework approach to thematic analysis. Siblings identified restrictions on family life, ‘not knowing’ and lack of communication as negative impacts on their family, and change of role/focus, emotional reactions and social stigma as negative impacts on themselves. They also described positive communication, social support and extra activities as protective factors. Paediatric services should be aware of the impact of CFS/ME on the siblings of children with CFS/ME, understand the importance of assessing paediatric CFS/ME patients within the context of their family and consider providing information for siblings about CFS/ME. PMID:26395764

Psychological wellbeing and quality-of-life among siblings of paediatric CFS/ME patients: A mixed-methods study.

PubMed

Velleman, Sophie; Collin, Simon M; Beasant, Lucy; Crawley, Esther

2016-10-01

Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a disabling condition known to have a negative impact on all aspects of a child's life. However, little is understood about the impact of CFS/ME on siblings. A total of 34 siblings completed questionnaires measuring depression (Hospital Anxiety and Depression Scale (HADS)), anxiety (HADS and Spence Children's Anxiety Scale (SCAS)) and European Quality-of-life-Youth (EQ-5D-Y). These scores were compared with scores from normative samples. Siblings had higher levels of anxiety on the SCAS than adolescents of the same age recruited from a normative sample; however, depression and quality-of-life were similar. Interviews were undertaken with nine siblings of children with CFS/ME who returned questionnaires. Interview data were analysed using a framework approach to thematic analysis. Siblings identified restrictions on family life, 'not knowing' and lack of communication as negative impacts on their family, and change of role/focus, emotional reactions and social stigma as negative impacts on themselves. They also described positive communication, social support and extra activities as protective factors. Paediatric services should be aware of the impact of CFS/ME on the siblings of children with CFS/ME, understand the importance of assessing paediatric CFS/ME patients within the context of their family and consider providing information for siblings about CFS/ME. © The Author(s) 2015.

Integrating prior information into microwave tomography part 2: Impact of errors in prior information on microwave tomography image quality.

PubMed

Kurrant, Douglas; Fear, Elise; Baran, Anastasia; LoVetri, Joe

2017-12-01

The authors have developed a method to combine a patient-specific map of tissue structure and average dielectric properties with microwave tomography. The patient-specific map is acquired with radar-based techniques and serves as prior information for microwave tomography. The impact that the degree of structural detail included in this prior information has on image quality was reported in a previous investigation. The aim of the present study is to extend this previous work by identifying and quantifying the impact that errors in the prior information have on image quality, including the reconstruction of internal structures and lesions embedded in fibroglandular tissue. This study also extends the work of others reported in literature by emulating a clinical setting with a set of experiments that incorporate heterogeneity into both the breast interior and glandular region, as well as prior information related to both fat and glandular structures. Patient-specific structural information is acquired using radar-based methods that form a regional map of the breast. Errors are introduced to create a discrepancy in the geometry and electrical properties between the regional map and the model used to generate the data. This permits the impact that errors in the prior information have on image quality to be evaluated. Image quality is quantitatively assessed by measuring the ability of the algorithm to reconstruct both internal structures and lesions embedded in fibroglandular tissue. The study is conducted using both 2D and 3D numerical breast models constructed from MRI scans. The reconstruction results demonstrate robustness of the method relative to errors in the dielectric properties of the background regional map, and to misalignment errors. These errors do not significantly influence the reconstruction accuracy of the underlying structures, or the ability of the algorithm to reconstruct malignant tissue. Although misalignment errors do not significantly impact the quality of the reconstructed fat and glandular structures for the 3D scenarios, the dielectric properties are reconstructed less accurately within the glandular structure for these cases relative to the 2D cases. However, general agreement between the 2D and 3D results was found. A key contribution of this paper is the detailed analysis of the impact of prior information errors on the reconstruction accuracy and ability to detect tumors. The results support the utility of acquiring patient-specific information with radar-based techniques and incorporating this information into MWT. The method is robust to errors in the dielectric properties of the background regional map, and to misalignment errors. Completion of this analysis is an important step toward developing the method into a practical diagnostic tool. © 2017 American Association of Physicists in Medicine.

Acne in adolescents: quality of life, self-esteem, mood, and psychological disorders.

PubMed

Dunn, Lauren K; O'Neill, Jenna L; Feldman, Steven R

2011-01-15

Acne is a significant adolescent problem and may precipitate emotional and psychological effects. The impact of acne on psychological parameters and implications for acne treatment are not fully understood. We performed a MEDLINE search using the terms "acne" and "adolescent" along with "psychological," "depression," or "psychiatric," which yielded 16 reviewed studies. Qualitative review of the selected articles revealed that the presence of acne has a significant impact on self-esteem and quality of life. Depression and other psychological disorders are more prevalent in acne patients and acne treatment may improve symptoms of these disorders. The reviewed studies were semi-quantitative analyses utilizing various standardized surveys or questionnaires. Therefore, quantitative analysis of selected studies was not possible. The presence of co-morbid psychological disorders should be considered in the treatment of acne patients and future prospective trials are needed to assess the impact of treatment on psychological outcomes.

Air quality concerns of unconventional oil and natural gas production.

PubMed

Field, R A; Soltis, J; Murphy, S

2014-05-01

Increased use of hydraulic fracturing ("fracking") in unconventional oil and natural gas (O & NG) development from coal, sandstone, and shale deposits in the United States (US) has created environmental concerns over water and air quality impacts. In this perspective we focus on how the production of unconventional O & NG affects air quality. We pay particular attention to shale gas as this type of development has transformed natural gas production in the US and is set to become important in the rest of the world. A variety of potential emission sources can be spread over tens of thousands of acres of a production area and this complicates assessment of local and regional air quality impacts. We outline upstream activities including drilling, completion and production. After contrasting the context for development activities in the US and Europe we explore the use of inventories for determining air emissions. Location and scale of analysis is important, as O & NG production emissions in some US basins account for nearly 100% of the pollution burden, whereas in other basins these activities make up less than 10% of total air emissions. While emission inventories are beneficial to quantifying air emissions from a particular source category, they do have limitations when determining air quality impacts from a large area. Air monitoring is essential, not only to validate inventories, but also to measure impacts. We describe the use of measurements, including ground-based mobile monitoring, network stations, airborne, and satellite platforms for measuring air quality impacts. We identify nitrogen oxides, volatile organic compounds (VOC), ozone, hazardous air pollutants (HAP), and methane as pollutants of concern related to O & NG activities. These pollutants can contribute to air quality concerns and they may be regulated in ambient air, due to human health or climate forcing concerns. Close to well pads, emissions are concentrated and exposure to a wide range of pollutants is possible. Public health protection is improved when emissions are controlled and facilities are located away from where people live. Based on lessons learned in the US we outline an approach for future unconventional O & NG development that includes regulation, assessment and monitoring.

Accountability studies of air pollution and health effects: lessons learned and recommendations for future natural experiment opportunities.

PubMed

Rich, David Q

2017-03-01

To address limitations of observational epidemiology studies of air pollution and health effects, including residual confounding by temporal and spatial factors, several studies have taken advantage of 'natural experiments', where an environmental policy or air quality intervention has resulted in reductions in ambient air pollution concentrations. Researchers have examined whether the population impacted by these air quality improvements, also experienced improvements in various health indices (e.g. reduced morbidity/mortality). In this paper, I review key accountability studies done previously and new studies done over the past several years in Beijing, Atlanta, London, Ireland, and other locations, describing study design and analysis strengths and limitations of each. As new 'natural experiment' opportunities arise, several lessons learned from these studies should be applied when planning a new accountability study. Comparison of health outcomes during the intervention to both before and after the intervention in the population of interest, as well as use of a control population to assess whether any temporal changes in the population of interest were also seen in populations not impacted by air quality improvements, should aid in minimizing residual confounding by these long term time trends. Use of either detailed health records for a population, or prospectively collected data on relevant mechanistic biomarkers coupled with such morbidity/mortality data may provide a more thorough assessment of if the intervention beneficially impacted the health of the community, and if so by what mechanism(s). Further, prospective measurement of a large suite of air pollutants may allow a more thorough understanding of what pollutant source(s) is/are responsible for any health benefit observed. The importance of using multiple statistical analysis methods in each paper and the difference in how the timing of the air pollution/outcome association may impact which of these design features is most important is also discussed. Based on these and other lessons learned, researchers may provide a more epidemiologically rigorous evaluation of cause-specific health impacts of an air quality intervention or action. Copyright © 2016 Elsevier Ltd. All rights reserved.

Accountability studies of air pollution and health effects: lessons learned and recommendations for future natural experiment opportunities

PubMed Central

Rich, David Q.

2017-01-01

To address limitations of observational epidemiology studies of air pollution and health effects, including residual confounding by temporal and spatial factors, several studies have taken advantage of ‘natural experiments’, where an environmental policy or air quality intervention has resulted in reductions in ambient air pollution concentrations. Researchers have examined whether the population impacted by these air quality improvements, also experienced improvements in various health indices (e.g. reduced morbidity/mortality). In this paper, I review key accountability studies done previously and new studies done over the past several years in Beijing, Atlanta, London, Ireland, and other locations, describing study design and analysis strengths and limitations of each. As new ‘natural experiment’ opportunities arise, several lessons learned from these studies should be applied when planning a new accountability study. Comparison of health outcomes during the intervention to both before and after the intervention in the population of interest, as well as use of a control population to assess whether any temporal changes in the population of interest were also seen in populations not impacted by air quality improvements, should aid in minimizing residual confounding by these long term time trends. Use of either detailed health records for a population, or prospectively collected data on relevant mechanistic biomarkers coupled with such morbidity/mortality data may provide a more thorough assessment of if the intervention beneficially impacted the health of the community, and if so by what mechanism(s). Further, prospective measurement of a large suite of air pollutants may allow a more thorough understanding of what pollutant source(s) is/are responsible for any health benefit observed. The importance of using multiple statistical analysis methods in each paper and the difference in how the timing of the air pollution/outcome association may impact which of these design features is most important is also discussed. Based on these and other lessons learned, researchers may provide a more epidemiologically rigorous evaluation of cause-specific health impacts of an air quality intervention or action. PMID:28089581

Sector-wise midpoint characterization factors for impact assessment of regional consumptive and degradative water use.

PubMed

Lin, Chia-Chun; Lin, Jia-Yu; Lee, Mengshan; Chiueh, Pei-Te

2017-12-31

Water availability, resulting from either a lack of water or poor water quality is a key factor contributing to regional water stress. This study proposes a set of sector-wise characterization factors (CFs), namely consumptive and degradative water stresses, to assess the impact of water withdrawals with a life cycle assessment approach. These CFs consider water availability, water quality, and competition for water between domestic, agricultural and industrial sectors and ecosystem at the watershed level. CFs were applied to a case study of regional water management of industrial water withdrawals in Taiwan to show that both regional or seasonal decrease in water availability contributes to a high consumptive water stress, whereas water scarcity due to degraded water quality not meeting sector standards has little influence on increased degradative water stress. Degradative water stress was observed more in the agricultural sector than in the industrial sector, which implies that the agriculture sector may have water quality concerns. Reducing water intensity and alleviating regional scale water stresses of watersheds are suggested as approaches to decrease the impact of both consumptive and degradative water use. The results from this study may enable a more detailed sector-wise analysis of water stress and influence water resource management policies. Copyright © 2017 Elsevier B.V. All rights reserved.

Packaging and transportation of radioactive materials

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

None

The following topics are discussed in this volume: shielding and criticality; transportation accidents; physical security in transit; transport forecasting and logistics; transportation experience, operations and planning; regulation; standards and quality assurance; risk analysis; and environmental impacts. Separate abstracts are prepared for individual items. (DC)

Final Regulatory Impact Analysis (RIA) for the NO2 National Ambient Air Quality Standards (NAAQS)

EPA Pesticide Factsheets

This RIA provides illustrative estimates, as of January 2010, of the incremental costs and monetized human health benefits of attaining the revised NO2 NAAQS within the the existing community-wide monitoring network of 409 monitors.

Multi-scale trends analysis of landscape stressors in an urbanizing coastal watershed

EPA Science Inventory

Anthropogenic land based stressors within a watershed can deliver major impacts to downstream and adjacent coastal waterways affecting water quality and estuarine habitats. Our research focused on a subset of non-point sources of watershed stressors specifically, human population...

BACTERIA SOURCE TRACKING AND HOST SPECIES SPECIFICITY ANALYSIS

EPA Science Inventory

Point and non-point pollution sources of fecal pollution on a watershed adversely impact the quality of drinking source waters and recreational waters. States are required to develop total maximum daily loads (TMDLs) and devise best management practices (BMPs) to reduce the pollu...

Fate and Effects of Leachate Contamination on Alaska's Tribal Drinking Water Sources

EPA Science Inventory

EPA and Alaskan tribal communities identified and selected five representative Alaskan tribal landfills/dump sites and performed water quality sampling and analysis to identify chemical and microbial contaminants of concern (COCs) that could potentially impact the local drinking ...

A Sustainable Early Warning System for Climate Change Impacts on Water Quality Management

NASA Astrophysics Data System (ADS)

Lee, T.; Tung, C.; Chung, N.

2007-12-01

In this era of rapid social and technological change leading to interesting life complexity and environmental displacement, both positive and negative effects among ecosystems call for a balance in which there are impacts by climate changes. Early warning systems for climate change impacts are necessary in order to allow society as a whole to properly and usefully assimilate the masses of new information and knowledge. Therefore, our research addresses to build up a sustainable early warning mechanism. The main goal is to mitigate the cumulative impacts on the environment of climate change and enhance adaptive capacities. An effective early warning system has been proven for protection. However, there is a problem that estimate future climate changes would be faced with high uncertainty. In general, take estimations for climate change impacts would use the data from General Circulation Models and take the analysis as the Intergovernmental Panel on Climate Change declared. We follow the course of the method for analyzing climate change impacts and attempt to accomplish the sustainable early warning system for water quality management. Climate changes impact not only on individual situation but on short-term variation and long-term gradually changes. This kind characteristic should adopt the suitable warning system for long-term formulation and short- term operation. To continue the on-going research of the long-term early warning system for climate change impacts on water quality management, the short-term early warning system is established by using local observation data for reappraising the warning issue. The combination of long-term and short-term system can provide more circumstantial details. In Taiwan, a number of studies have revealed that climate change impacts on water quality, especially in arid period, the concentration of biological oxygen demand may turn into worse. Rapid population growth would also inflict injury on its assimilative capacity to degenerate. To concern about those items, the sustainable early warning system is established and the initiative fall into the following categories: considering the implications for policies, applying adaptive strategies and informing the new climate changes. By setting up the framework of early warning system expectantly can defend stream area from impacts damaging and in sure the sustainable development.

Impact of Requirements Quality on Project Success or Failure

NASA Astrophysics Data System (ADS)

Tamai, Tetsuo; Kamata, Mayumi Itakura

We are interested in the relationship between the quality of the requirements specifications for software projects and the subsequent outcome of the projects. To examine this relationship, we investigated 32 projects started and completed between 2003 and 2005 by the software development division of a large company in Tokyo. The company has collected reliable data on requirements specification quality, as evaluated by software quality assurance teams, and overall project performance data relating to cost and time overruns. The data for requirements specification quality were first converted into a multiple-dimensional space, with each dimension corresponding to an item of the recommended structure for software requirements specifications (SRS) defined in IEEE Std. 830-1998. We applied various statistical analysis methods to the SRS quality data and project outcomes.

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

Chen, Longgao; Yang, Xiaoyan; School of Environmental Science and Spatial Informatics, China University of Mining and Technology, Xuzhou 221116

The implementation of land use planning (LUP) has a large impact on environmental quality. There lacks a widely accepted and consolidated approach to assess the LUP environmental impact using Strategic Environmental Assessment (SEA). In this paper, we developed a state-impact-state (SIS) model employed in the LUP environmental impact assessment (LUPEA). With the usage of Matter-element (ME) and Extenics method, the methodology based on the SIS model was established and applied in the LUPEA of Zoucheng County, China. The results show that: (1) this methodology provides an intuitive and easy understanding logical model for both the theoretical analysis and application ofmore » LUPEA; (2) the spatial multi-temporal assessment from base year, near-future year to planning target year suggests the positive impact on the environmental quality in the whole County despite certain environmental degradation in some towns; (3) besides the spatial assessment, other achievements including the environmental elements influenced by land use and their weights, the identification of key indicators in LUPEA, and the appropriate environmental mitigation measures were obtained; and (4) this methodology can be used to achieve multi-temporal assessment of LUP environmental impact of County or Town level in other areas. - Highlights: • A State-Impact-State model for Land Use Planning Environmental Assessment (LUPEA). • Matter-element (ME) and Extenics methods were embedded in the LUPEA. • The model was applied to the LUPEA of Zoucheng County. • The assessment shows improving environment quality since 2000 in Zoucheng County. • The method provides a useful tool for the LUPEA in the county level.« less

Association of overjet and overbite with esthetic impairments of oral health-related quality of life.

PubMed

Sierwald, Ira; John, Mike T; Schierz, Oliver; Jost-Brinkmann, Paul-Georg; Reissmann, Daniel R

2015-09-01

Esthetics is an important part of quality of life and a frequent reason for orthodontic treatment demand. It was the aim of this study to investigate whether esthetic impairments, related to overjet and overbite, can be assessed with an established oral health-related quality of life instrument. Data from 1968 participants (age: 16-90 years; 69.8% female) from three German surveys were analyzed. Esthetic impairments of oral health-related quality of life were measured with four questions of the Oral Health Impact profile (OHIP), which comprise esthetic aspects of oral health-related quality of life. Higher values represent greater esthetic impairment (sum score: 0-16). Overbite and overjet values were categorized (≤ - 1 mm, 0-1 mm, 2-3 mm, 4-5 mm, ≥ 6 mm). The specific impact of each category on esthetic impairment, in relation to the reference category (2-3 mm), was calculated in linear regression analyses. The type of relationship and the specific impact of overbite and overjet were evaluated in regression analyses with fractional polynomials. Overbite ranged from - 5 to 15 mm (mean: 3.2 mm) and overjet from - 7 to 19 mm (mean: 3.1 mm). Both an increase and a decrease in overjet, in relation to the reference category, resulted in more esthetic-related oral health-related quality of life impairments. However, in this model, only the effect for increased overjet was statistically significant (4-5 mm: + 0.4 OHIP points; ≥ 6 mm: + 0.9 OHIP points). In the regression analysis with fractional polynomials, both an increase and a decrease in overjet resulted in more esthetic impairments, characterized by a U-shaped relationship. No association could be verified for overbite. A substantial increase or decrease of overjet from the reference values is associated with esthetic impairments of oral health-related quality of life, whereas the extent of overbite seems to have no impact on esthetics.

Reporting quality of randomised controlled trial abstracts among high-impact general medical journals: a review and analysis.

PubMed

Hays, Meredith; Andrews, Mary; Wilson, Ramey; Callender, David; O'Malley, Patrick G; Douglas, Kevin

2016-07-28

The aim of this study was to assess adherence to the Consolidated Standards of Reporting Trials (CONSORT) for Abstracts by five high-impact general medical journals and to assess whether the quality of reporting was homogeneous across these journals. This is a descriptive, cross-sectional study. Randomised controlled trial (RCT) abstracts in five high-impact general medical journals. We used up to 100 RCT abstracts published between 2011 and 2014 from each of the following journals: The New England Journal of Medicine (NEJM), the Annals of Internal Medicine (Annals IM), The Lancet, the British Medical Journal (The BMJ) and the Journal of the American Medical Association (JAMA). The primary outcome was per cent overall adherence to the 19-item CONSORT for Abstracts checklist. Secondary outcomes included per cent adherence in checklist subcategories and assessing homogeneity of reporting quality across the individual journals. Search results yielded 466 abstracts, 3 of which were later excluded as they were not RCTs. Analysis was performed on 463 abstracts (97 from NEJM, 66 from Annals IM, 100 from The Lancet, 100 from The BMJ, 100 from JAMA). Analysis of all scored items showed an overall adherence of 67% (95% CI 66% to 68%) to the CONSORT for Abstracts checklist. The Lancet had the highest overall adherence rate (78%; 95% CI 76% to 80%), whereas NEJM had the lowest (55%; 95% CI 53% to 57%). Adherence rates to 8 of the checklist items differed by >25% between journals. Among the five highest impact general medical journals, there is variable and incomplete adherence to the CONSORT for Abstracts reporting checklist of randomised trials, with substantial differences between individual journals. Lack of adherence to the CONSORT for Abstracts reporting checklist by high-impact medical journals impedes critical appraisal of important studies. We recommend diligent assessment of adherence to reporting guidelines by authors, reviewers and editors to promote transparency and unbiased reporting of abstracts. 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/

Impact of clinical status and salivary conditions on xerostomia and oral health-related quality of life of adolescents with type 1 diabetes mellitus.

PubMed

Busato, Ivana Maria Saes; Ignácio, Sérgio Aparecido; Brancher, João Armando; Moysés, Simone Tetu; Azevedo-Alanis, Luciana Reis

2012-02-01

To investigate the influence of clinical status and salivary conditions on the presence of xerostomia on adolescents with and without type 1 diabetes mellitus (DM1), and further to investigate the influence of clinical status, salivary conditions and xerostomia on oral health-related quality of life (OHQoL) of those with DM1. A cross-sectional study was performed on 102 adolescents, 51 with DM1 and 51 nondiabetics. Xerostomia was detected by asking a question about the sensation of having 'dry mouth', and Oral Health Impact Profile-14 was used to measure the impact of xerostomia on OHQoL. The clinical status was assessed by using decayed, missing or filled and Community Periodontal indices, and by evaluating oral manifestations; and the following salivary conditions were evaluated: stimulated salivary flow, pH, buffer capacity, total protein, amylase, urea, calcium, and glucose salivary concentrations. Multiple logistic regression analysis was used to evaluate the influence of clinical status and salivary conditions on xerostomia and the impact of xerostomia on the OHQoL of adolescents with DM1. Clinical status and salivary conditions was shown to have no influence on the presence of xerostomia. Bivariate (P = 0.00) and logistic regression (P = 0.01) analysis showed a significant association between DM1 and xerostomia. Logistic regression analysis showed association between xerostomia (P = 0.00) and OHQoL, and caries experience (P = 0.03) and OHQoL. DM1 showed to be predictive of a high prevalence of xerostomia in adolescents. Caries experience and xerostomia showed to have a negative impact on the OHQoL of adolescents with DM1. © 2011 John Wiley & Sons A/S.

Alternate approaches for assessing impacts of oil sands development on air quality: A case study using the First Nation Community of Fort McKay.

PubMed

Davidson, Carla; Spink, David

2018-04-01

Previous analyses of continuously measured compounds in Fort McKay, an indigenous community in the Athabasca Oil Sands, have detected increasing concentrations of nitrogen dioxide (NO 2 ) and total hydrocarbons (THC), but not of sulfur dioxide (SO 2 ), ozone (O 3 ), total reduced sulfur compounds (TRS), or particulate matter (aerodynamic diameter <2.5 μm; PM 2.5 ). Yet the community frequently experiences odors, dust, and reduced air quality. The authors used Fort McKay's continuously monitored air quality data (1998-2014) as a case study to assess techniques for air quality analysis that make no assumptions regarding type of change. Linear trend analysis detected increasing concentrations of higher percentiles of NO 2 , nitric oxide (NO), and nitrogen oxides (NO x ), and THC. However, comparisons of all compounds between an early industrial expansion period (1998-2001) and current day (2011-2014) show that concentrations of NO 2 , SO 2 , THC, TRS, and PM 2.5 have significantly increased, whereas concentrations of O 3 are significantly lower. An assessment of the frequency and duration of periods when concentrations of each compound were above a variety of thresholds indicated that the frequency of air quality events is increasing for NO 2 and THC. Assessment of change over time with odds ratios of the 25th, 50th, 75th, and 90th percentile concentrations for each compound compared with an estimate of natural background variability showed that concentrations of TRS, SO 2 , and THC are dynamic, higher than background, and changes are nonlinear and nonmonotonic. An assessment of concentrations as a function of wind direction showed a clear and generally increasing influence of industry on air quality. This work shows that evaluating air quality without assumptions of linearity reveals dynamic changes in air quality in Fort McKay, and that it is increasingly being affected by oil sands operations. Understanding the nature and types of air quality changes occurring in a community or region is essential for the development of appropriate air quality management policies. Time-series trending of air quality data is a common tool for assessing air quality changes and is often used to assess the effectiveness of current emission management programs. The use of this tool, in the context of oil sands development, has significant limitations, and alternate air quality change analysis approaches need to be applied to ensure that the impact of this development on air quality is fully understood so that appropriate emission management actions can be taken.

Linking Spatial Variations in Water Quality with Water and Land Management using Multivariate Techniques.

PubMed

Wan, Yongshan; Qian, Yun; Migliaccio, Kati White; Li, Yuncong; Conrad, Cecilia

2014-03-01

Most studies using multivariate techniques for pollution source evaluation are conducted in free-flowing rivers with distinct point and nonpoint sources. This study expanded on previous research to a managed "canal" system discharging into the Indian River Lagoon, Florida, where water and land management is the single most important anthropogenic factor influencing water quality. Hydrometric and land use data of four drainage basins were uniquely integrated into the analysis of 25 yr of monthly water quality data collected at seven stations to determine the impact of water and land management on the spatial variability of water quality. Cluster analysis (CA) classified seven monitoring stations into four groups (CA groups). All water quality parameters identified by discriminant analysis showed distinct spatial patterns among the four CA groups. Two-step principal component analysis/factor analysis (PCA/FA) was conducted with (i) water quality data alone and (ii) water quality data in conjunction with rainfall, flow, and land use data. The results indicated that PCA/FA of water quality data alone was unable to identify factors associated with management activities. The addition of hydrometric and land use data into PCA/FA revealed close associations of nutrients and color with land management and storm-water retention in pasture and citrus lands; total suspended solids, turbidity, and NO + NO with flow and Lake Okeechobee releases; specific conductivity with supplemental irrigation supply; and dissolved O with wetland preservation. The practical implication emphasizes the importance of basin-specific land and water management for ongoing pollutant loading reduction and ecosystem restoration programs. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Impact assessment of GPS radio occultation data on Antarctic analysis and forecast using WRF 3DVAR

NASA Astrophysics Data System (ADS)

Zhang, H.; Wee, T. K.; Liu, Z.; Lin, H. C.; Kuo, Y. H.

2016-12-01

This study assesses the impact of Global Positioning System (GPS) Radio Occultation (RO) refractivity data on the analysis and forecast in the Antarctic region. The RO data are continuously assimilated into the Weather Research and Forecasting (WRF) Model using the WRF 3DVAR along with other observations that were operationally available to the National Center for Environmental Prediction (NCEP) during a month period, October 2010, including the Advance Microwave Sounding Unit (AMSU) radiance data. For the month-long data assimilation experiments, three RO datasets are used: 1) The actual operational dataset, which was produced by the near real-time RO processing at that time and provided to weather forecasting centers; 2) a post-processed dataset with posterior clock and orbit estimates, and with improved RO processing algorithms; and, 3) another post-processed dataset, produced with a variational RO processing. The data impact is evaluated with comparing the forecasts and analyses to independent driftsonde observations that are made available through the Concordiasi field campaign, in addition to utilizing other traditional means of verification. A denial of RO data (while keeping all other observations) resulted in a remarkable quality degradation of analysis and forecast, indicating the high value of RO data over the Antarctic area. The post-processed RO data showed a significantly larger positive impact compared to the near real-time data, due to extra RO data from the TerraSAR-X satellite (unavailable at the time of the near real-time processing) as well as the supposedly improved data quality as a result of the post-processing. This strongly suggests that the future polar constellation of COSMIC-2 is vital. The variational RO processing further reduced the systematic and random errors in both analysis and forecasts, for instance, leading to a smaller background departure of AMSU radiance. This indicates that the variational RO processing provides an improved reference for the bias correction of satellite radiance, making the bias correction more effective. This study finds that advanced RO data processing algorithms may further enhance the high quality of RO data in high Southern latitudes.

"Cooking and Active Leisure" TAS Program, Spain: a Program Impact Pathways (PIP) analysis.

PubMed

Roura, Elena; Pareja, Sara Lucía; Milá, Raimon; Cinca, Núria

2014-09-01

The "Cooking and Active Leisure" Tu y Alícia por la Salud (CAL-TAS) Program is a school-based pilot that addresses healthy lifestyle needs of Spanish secondary school students with initiatives that research has proven to improve dietary and physical activity behaviors. The objectives were to perform a Program Impact Pathways (PIP) analysis to describe key activities and processes of the CAL-TAS Program, identify Critical Quality Control Points (CCPs), and identify a suite of common indicators of healthy lifestyles to be applied across participant schools. The CAL-TAS Program designers and implementation team developed this PIP analysis through an iterative process and presented the results for feedback at the seven-country Healthy Lifestyles Program Evaluation Workshop held in Granada, Spain, 13-14 September 2013, under the auspices of the Mondelēz International Foundation. The team identified three PIP CCPs: teachers' motivation and training, changes in students' knowledge of healthy lifestyles, and changes in students' healthy lifestyle behavior. The selected indicators of the program's impact on healthy lifestyles are adequacy of food intake, level of knowledge of healthy lifestyles gained, and adequacy of physical activity level according to World Health Organization recommendations. A clear definition of impact indicators, as well as collection of accurate data on healthy lifestyle behaviors and knowledge, is essential to understanding the effectiveness of this program before it can be scaled up. CAL-TAS is an effective secondary school-based program encouraging healthy lifestyles. The PIP analysis was instrumental in identifying CCPs to sustain and improve the quality of the program. The team hopes to sustain and improve the program through these program evaluation recommendations.

Vaccines are different: A systematic review of budget impact analyses of vaccines.

PubMed

Loze, Priscilla Magalhaes; Nasciben, Luciana Bertholim; Sartori, Ana Marli Christovam; Itria, Alexander; Novaes, Hillegonda Maria Dutilh; de Soárez, Patrícia Coelho

2017-05-15

Several countries require manufacturers to present a budget impact analysis (BIA), together with a cost-effectiveness analysis, to support national funding requests. However, guidelines for conducting BIA of vaccines are scarce. To analyze the methodological approaches used in published budget impact analysis (BIA) of vaccines, discussing specific methodological issues related to vaccines. This systematic review of the literature on BIA of vaccines was carried out in accordance with the Centre for Reviews and Dissemination - CRD guidelines. We searched multiple databases: MedLine, Embase, Biblioteca Virtual de Saúde (BVS), Cochrane Library, DARE Database, NHS Economic Evaluation Database (NHS EED), HTA Database (via Centre for Reviews and Dissemination - CRD), and grey literature. Two researchers, working independently, selected the studies and extracted the data. The methodology quality of individual studies was assessed using the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. A qualitative narrative synthesis was conducted. Twenty-two studies were reviewed. The most frequently evaluated vaccines were pneumococcal (41%), influenza (23%) and rotavirus (18%). The target population was stated in 21 studies (95%) and the perspective was clear in 20 (91%). Only 36% reported the calculations used to complete the BIA, 27% informed the total and disaggregated costs for each time period, and 9% showed the change in resource use for each time period. More than half of the studies (55%, n=12) reported less than 50% of the items recommended in the checklist. The production of BIA of vaccines has increased from 2009. The report of the methodological steps was unsatisfactory, making it difficult to assess the validity of the results presented. Vaccines specific issues should be discussed in international guidelines for BIA of vaccines, to improve the quality of the studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

A rapid review of the impact of commissioning on service use, quality, outcomes and value for money: implications for Australian policy.

PubMed

Gardner, Karen; Davies, G Powell; Edwards, Karen; McDonald, Julie; Findlay, Terry; Kearns, Rachael; Joshi, Chandni; Harris, Mark

2016-01-01

The aim of this systematic review was to assess evidence of the impact of commissioning on health service use, quality, outcomes and value for money and to consider findings in the Australian context. Systematic searches of the literature identified 444 papers and, after exclusions, 36 were subject to full review. The commissioning cycle (planning, contracting, monitoring) formed a framework for analysis and impacts were assessed at individual, subpopulation and population levels. Little evidence of the effectiveness of commissioning at any level was available and observed impacts were highly context-dependent. There was insufficient evidence to identify a preferred model. Lack of skills and capacity were cited as major barriers to the implementation of commissioning. Successful commissioning requires a clear policy framework of national and regional priorities that define agreed targets for commissioning agencies. Engagement of consumers and providers, especially physicians, was considered to be critically important but is time consuming and has proven difficult to sustain. Adequate information on the cost, volume and quality of healthcare services is critically important for setting priorities, and for contracting and monitoring performance. Lack of information resulted in serious problems. High-quality nationally standardised performance measures and data requirements need to be built into contracts and ongoing monitoring and evaluation. In Australia, there is significant work to be done in areas of policy and governance, funding systems and incentives, patient enrolment or registration, information systems, individual and organisational capacity, community engagement and experience in commissioning.

[Self-rating of oral health according to the Oral Health Impact Profile and associated factors: a systematic review].

PubMed

Gabardo, Marilisa Carneiro Leão; Moysés, Simone Tetu; Moysés, Samuel Jorge

2013-06-01

To systematically evaluate the literature to investigate associations between social, demographic, economic, psychosocial, and behavioral factors and the self-perception of oral health measured using the Oral Health Impact Profile (OHIP). In this systematic review of the literature, the Preferred Reporting Items for Systematic Reviews (PRISMA) were adapted for the performance of a qualitative metasummary, without meta-analysis. Articles about oral health and associated factors with implications for quality of life were selected, with a focus on the tool for self-rating of the oral health-disease process, the OHIP. Pubmed/National Library of Medicine (NLM) and the Virtual Health Library (Biblioteca Virtual em Saúde - BVS/BIREME) were searched. Articles published between 2001 and 2011 were included. The following Medical Subject Headings (MeSH) were employed: oral health, quality of life, sickness impact profile, and socioeconomic factors. Of 57 articles identified, 20 met the inclusion criteria. The metasummary revealed that a poor self-perception of oral health was associated with unfavorable social, economic, demographic, and psychosocial factors, as well as with undesirable habits and poor clinical oral conditions. There is consensus in the literature about the influence of the investigated factors on the self-perception of oral health and on quality of life. The OHIP is an important aid for determining oral health needs and for developing strategies to control/reduce disease and promote oral health, with a consequent positive impact on quality of life.

Publications by doctoral candidates at Charité University Hospital, Berlin, from 1998-2008.

PubMed

Ziemann, Esther; Oestmann, Jörg-Wilhelm

2012-05-01

One quality parameter of medical theses is the number of articles published by the doctoral candidates. Over the course of the past decade the Charité-Universitätsmedizin Berlin has taken steps to improve the quality of the theses completed by its doctoral students in medicine and increase their publication activity. This study was designed to verify the efficacy of these measures and to detect general trends. Medical theses completed in 1998, 2004 and 2008 (sample size >250 for each year) were retrospectively analyzed with regard to associated publications within a 7-year period (from 5 years before completion to 2 years thereafter). Quality and quantity were recorded. Publications found in the PubMed database were evaluated; the impact factor of the publishing journal was used as quality parameter. The sample sizes were 264 for 1998, 316 for 2004, and 316 for 2008. The number of publications per doctoral student increased from 0.78 to 1.39 over the course of the study period, and the average impact factor rose from 2.42 to 3.62. Analysis using the current impact factors of the publishing journals showed an increase from 3.13 to 3.85. The proportion of case reports fell from 12.7% to 8%. The proportion of first authorships remained about the same. The past decade has seen an increase in the number of publications by doctoral students at the Charité and a rise in the average impact factor of the journals concerned.

The prevalence and impact of Fusarium head blight pathogens and mycotoxins on malting barley quality in UK

PubMed Central

Nielsen, L.K.; Cook, D.J.; Edwards, S.G.; Ray, R.V.

2014-01-01

Fusarium head blight (FHB) caused by Fusarium and Microdochium species can significantly affect the yield of barley grain as well as the quality and safety of malt and beer. The present study provides new knowledge on the impacts of the FHB pathogen complex on the malting and brewing quality parameters of naturally infected barley. Quantitative real-time PCR and liquid chromatography double mass spectrometry were used to quantify the predominant FHB pathogens and Fusarium mycotoxins, respectively, in commercially grown UK malting barley samples collected between 2007 and 2011. The predominant Fusarium species identified across the years were F. poae, F. tricinctum and F. avenaceum. Microdochium majus was the predominant Microdochium species in 2007, 2008, 2010 and 2011 whilst Microdochium nivale predominated in 2009. Deoxynivalenol and zearalenone quantified in samples collected between 2007 and 2009 were associated with F. graminearum and F. culmorum, whilst HT-2 and T-2, and nivalenol in samples collected between 2010 and 2011 correlated positively with F. langsethiae and F. poae, respectively. Analysis of the regional distribution and yearly variation in samples from 2010 to 2011 showed significant differences in the composition of the FHB species complex. In most regions (Scotland, the South and North of England) the harvest in 2010 had higher concentrations of Fusarium spp. than in 2011, although no significant difference was observed in the Midlands between the two years. Microdochium DNA was significantly higher in 2011 and in the North of England and Scotland compared to the South or Midlands regions. Pathogens of the FHB complex impacted negatively on grain yield and quality parameters. Thousand grain weight of malting barley was affected significantly by M. nivale and M. majus whilst specific weight correlated negatively with F. avenaceum and F. graminearum. To determine the impact of sub-acute infections of the identified Fusarium and Microdochium species on malting and brewing quality of naturally infected samples, selected malting barley cultivars (Optic, Quench and Tipple) were micromalted and subjected to malt and wort analysis of key quality parameters. F. poae and M. nivale decreased germinative energy and increased water sensitivity of barley. The fungal biomass of F. poae and F. langsethiae correlated with increased wort free amino nitrogen and with decreased extract of malt. DNA of M. nivale correlated with increased malt friability as well as decreased wort filtration volume. The findings of this study indicate that the impact of species such as the newly emerging F. langsethiae, as well as F. poae and the two non-toxigenic Microdochium species should be considered when evaluating the quality of malting barley. PMID:24727381

High Spatial Resolution Thermal Infrared Remote Sensing Data for Analysis of the Atlanta, Georgia, Urban Heat Island Effect and Its Impacts on the Environment

NASA Technical Reports Server (NTRS)

Quattrochi, Dale A.

2007-01-01

The twenty-first century is the first "urban century" according to the United Nations Development Program. The focus of cities reflects awareness of the growing percentage of the world's population that lives in urban areas. In environmental terms, cities are the original producers of many of the global problems related to waste disposal, air and water pollution, and associated environmental and ecological challenges. Expansion of cities, both in population and areal extent, is a relentless process. In 2000, approximately 3 billion people representing about 40% of the global population, resided in urban areas. Urban population will continue to rise substantially over the next several decades according to UN estimates, and most of this growth will Occur in developing countries. The UN estimates that by 2025, 60% of the world's population will live in urban areas. As a consequence, the number of"megacities" (those cities with populations of 10 million inhabitants or more) will increase by 100 by 2025. Thus, there is a critical need to understand urban areas and what their impacts are on environmental, ecological and hydrologic resources, as well as on the local, regional, and even global climate. One of the more egregious side effects of urbanization is the increase in surface and air temperatures that lead to deterioration in air quality. In the United States, under the more stringent air quality guidelines established by the U.S. Environmental Protection Agency in 1997, nearly 300 counties in 34 states will not meet these new air quality standards for ground level ozone. Mitigation of the urban heat island (UHI) effect is actively being evaluated as a possible way to reduce ground ozone levels in cities and assist states in improving air quality. Foremost in the analysis of how the UHI affects air quality and other environmental factors is the use of remote sensing technology and data to characterize urban land covers in sufficient detail to quantifiably measure the impact of increased urban heating on air quality. The urban landscape impacts surface thermal energy exchanges that determine development of the UHI. This paper will illustrate how we are using high spatial remote sensing data collected over the Atlanta, Georgia metropolitan area in conjunction with other geographic information, to perform a detailed urban land cover classification and to determine the contribution of these land covers to the urban heat island effect. Also, the spatial arrangement of the land covers and the impact on urban heating from these selected patterns of development are evaluated. Additionally, this paper will show how these data are being used as inputs to improve air quality modeling for Atlanta, including potential benefits from UHI mitigation.

Framework Design and Influencing Factor Analysis of a Water Environmental Functional Zone-Based Effluent Trading System.

PubMed

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.

Framework Design and Influencing Factor Analysis of a Water Environmental Functional Zone-Based Effluent Trading System

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.

Evaluation of an immunosuppressant side effect instrument.

PubMed

Winsett, Rebecca P; Arheart, Kris; Stratta, Robert J; Alloway, Rita; Wicks, Mona N; Gaber, A Osama; Hathaway, Donna K

2004-09-01

Clinicians continue to be compelled to evaluate the impact of immunosuppressive medication side effects on the quality of life of transplant recipients. We Were asked to develop an instrument to measure side effects in immunosuppressed transplant recipients. To construct an instrument that measures the impact and severity of side effects of immunosuppressive medications used in transplantation and to assess the reliability and validity of the newly developed instrument called the Memphis Survey. The instrument was constructed by a panel of physicians, nurses, and pharmacists with experience in treating transplant recipients. A small group of kidney transplant recipients (n= 13) provided pilot data for refining and testing the instrument. A national sample of kidney, liver, and heart transplant recipients (n = 505) provided data that were used to further develop the instrument. Factor analysis was used to determine the psychological dimensions underlying the instrument and to guide the construction of scales from the survey items. The instrument scales were then computed from the dataset of 505 transplant recipients to quantify the impact of immunosuppressant side effects on the quality of life of transplant recipients. Analyses showed the final instrument scales to be valid and reliable. Exploratory analysis suggests the need for further testing of the instrument to determine gender differences.

Impact of fresh tailing deposition on the evolution of groundwater hydrogeochemistry at the abandoned Manitou mine site, Quebec, Canada.

PubMed

Maqsoud, Abdelkabir; Neculita, Carmen Mihaela; Bussière, Bruno; Benzaazoua, Mostafa; Dionne, Jean

2016-05-01

The abandoned Manitou mine site has produced acid mine drainage (AMD) for several decades. In order to limit the detrimental environmental impacts of AMD, different rehabilitation scenarios were proposed and analyzed. The selected rehabilitation scenario was to use fresh tailings from the neighboring Goldex gold mine as monolayer cover and to maintain an elevated water table. In order to assess the impact of the Goldex tailing deposition on the hydrogeochemistry of the Manitou mine site, a network of 30 piezometers was installed. These piezometers were used for continuous measurement of the groundwater level, as well as for water sampling campaigns for chemical quality monitoring, over a 3-year period. Hydrochemical data were analyzed using principal component analysis. Results clearly showed the benefic impact of fresh tailing deposition on the groundwater quality around the contaminated area. These findings were also confirmed by the evolution of electrical conductivity. In addition to the improvement of the physicochemical quality of water on the Manitou mine site, new tailing deposition induced an increase of water table level. However, at this time, the Manitou reactive tailings are not completely submerged and possible oxidation might still occur, especially after ceasing of the fresh tailing deposition. Therefore, complementary rehabilitation scenarios should still be considered.

Health impact of sport and exercise in emerging adult men: a prospective study.

PubMed

Henchoz, Yves; Baggio, Stéphanie; N'Goran, Alexandra A; Studer, Joseph; Deline, Stéphane; Mohler-Kuo, Meichun; Daeppen, Jean-Bernard; Gmel, Gerhard

2014-10-01

Health benefits of sport and exercise are well documented in children, adolescents and adults, but little is known about emerging adulthood-a period of life characterized by significant demographic and developmental changes. The present study aimed to assess the health impact of changes in sport and exercise levels during that specific period of life. The analysis used baseline and 15-month follow-up data (N = 4,846) from the cohort study on substance use risk factors. Associations between baseline exercise levels or changes in exercise levels and health indicators (i.e., health-related quality of life, depression, body mass index, alcohol dependence, nicotine dependence and cannabis use disorder) were measured using chi-squared tests and ANOVA. Direction of effects was tested using cross-lagged analysis. At baseline, all health indicator scores were observed to be better for regular exercisers than for other exercise levels. At follow-up, participants who had maintained regular exercise over time had better scores than those who had remained irregular exercisers or had discontinued, but their scores for health-related quality of life and depression were close to those of participants who had adopted regular exercise after the baseline questionnaire. Cross-lagged analysis indicated that regular exercise at baseline was a significant predictor of health-related quality of life and substance use dependence at follow-up, but was itself predicted only by health-related quality of life. From a health promotion perspective, this study emphasizes how important it is for emerging adult men to maintain, or adopt, regular sport and exercise.

Impacts of South East Biomass Burning on local air quality in South China Sea

NASA Astrophysics Data System (ADS)

Wai-man Yeung, Irene; Fat Lam, Yun; Eniolu Morakinyo, Tobi

2016-04-01

Biomass burning is a significant source of carbon monoxide and particulate matter, which is not only contribute to the local air pollution, but also regional air pollution. This study investigated the impacts of biomass burning emissions from Southeast Asia (SEA) as well as its contribution to the local air pollution in East and South China Sea, including Hong Kong and Taiwan. Three years (2012 - 2014) of the Hybrid Single Particle Lagrangian-Integrated Trajectory (HYSPLIT) with particles dispersion analyses using NCEP (Final) Operational Global Analysis data (FNL) data (2012 - 2014) were analyzed to track down all possible long-range transport from SEA with a sinking motion that worsened the surface air quality (tropospheric downwash from the free troposphere). The major sources of SEA biomass burning emissions were first identified using high fire emissions from the Global Fire Emission Database (GFED), followed by the HYSPLIT backward trajectory dispersion modeling analysis. The analyses were compared with the local observation data from Tai Mo Shan (1,000 msl) and Tap Mun (60 msl) in Hong Kong, as well as the data from Lulin mountain (2,600 msl) in Taiwan, to assess the possible impacts of SEA biomass burning on local air quality. The correlation between long-range transport events from the particles dispersion results and locally observed air quality data indicated that the background concentrations of ozone, PM2.5 and PM10 at the surface stations were enhanced by 12 μg/m3, 4 μg/m3 and 7 μg/m3, respectively, while the long-range transport contributed to enhancements of 4 μg/m3, 4 μg/m3 and 8 μg/m3 for O3, PM2.5 and PM10, respectively at the lower free atmosphere.

Spatial-Temporal Variations of Water Quality and Its Relationship to Land Use and Land Cover in Beijing, China

PubMed Central

Chen, Xiang; Zhou, Weiqi; Pickett, Steward T. A.; Li, Weifeng; Han, Lijian

2016-01-01

Rapid urbanization with intense land use and land cover (LULC) change and explosive population growth has a great impact on water quality. The relationship between LULC characteristics and water quality provides important information for non-point sources (NPS) pollution management. In this study, we first quantified the spatial-temporal patterns of five water quality variables in four watersheds with different levels of urbanization in Beijing, China. We then examined the effects of LULC on water quality across different scales, using Pearson correlation analysis, redundancy analysis, and multiple regressions. The results showed that water quality was improved over the sampled years but with no significant difference (p > 0.05). However, water quality was significantly different among nonurban and both exurban and urban sites (p < 0.05). Forest land was positively correlated with water quality and affected water quality significantly (p < 0.05) within a 200 m buffer zone. Impervious surfaces, water, and crop land were negatively correlated with water quality. Crop land and impervious surfaces, however, affected water quality significantly (p < 0.05) for buffer sizes greater than 800 m. Grass land had different effects on water quality with the scales. The results provide important insights into the relationship between LULC and water quality, and thus for controlling NPS pollution in urban areas. PMID:27128934

Scientometric analysis: A technical need for medical science researchers either as authors or as peer reviewers.

PubMed

Masic, Izet

2016-01-01

The nature of performing a scientific research is a process that has several different components which consist of identifying the key research question(s), choices of scientific approach for the study and data collection, data analysis, and finally reporting on results. Generally, peer review is a series of procedures in the evaluation of a creative work or performance by other people, who work in the same or related field, with the aim of maintaining and improving the quality of work or performance in that field. The assessment of the achievement of every scientist, and thus indirectly determining his reputation in the scientific community of these publications, especially journals, is done through the so-called impact factor index. The impact factor predicts or estimates that how many annual citations article may receive after its publication. Evaluation of scientific productivity and assessment of the published articles of researchers and scientists can be made through the so-called H-index. The quality of published results of scientific work largely depends on knowledge sources that are used in the preparation, which means that it should be considered to serve the purpose and the very relevance of the information used. Scientometrics as a field of science covers all aforementioned issues, and scientometric analysis is obligatory for quality assessment of the scientific validity of published articles and other type of publications.

Scientometric analysis: A technical need for medical science researchers either as authors or as peer reviewers

PubMed Central

Masic, Izet

2016-01-01

The nature of performing a scientific research is a process that has several different components which consist of identifying the key research question(s), choices of scientific approach for the study and data collection, data analysis, and finally reporting on results. Generally, peer review is a series of procedures in the evaluation of a creative work or performance by other people, who work in the same or related field, with the aim of maintaining and improving the quality of work or performance in that field. The assessment of the achievement of every scientist, and thus indirectly determining his reputation in the scientific community of these publications, especially journals, is done through the so-called impact factor index. The impact factor predicts or estimates that how many annual citations article may receive after its publication. Evaluation of scientific productivity and assessment of the published articles of researchers and scientists can be made through the so-called H-index. The quality of published results of scientific work largely depends on knowledge sources that are used in the preparation, which means that it should be considered to serve the purpose and the very relevance of the information used. Scientometrics as a field of science covers all aforementioned issues, and scientometric analysis is obligatory for quality assessment of the scientific validity of published articles and other type of publications. PMID:26985429

Evaluation of air quality zone classification methods based on ambient air concentration exposure.

PubMed

Freeman, Brian; McBean, Ed; Gharabaghi, Bahram; Thé, Jesse

2017-05-01

Air quality zones are used by regulatory authorities to implement ambient air standards in order to protect human health. Air quality measurements at discrete air monitoring stations are critical tools to determine whether an air quality zone complies with local air quality standards or is noncompliant. This study presents a novel approach for evaluation of air quality zone classification methods by breaking the concentration distribution of a pollutant measured at an air monitoring station into compliance and exceedance probability density functions (PDFs) and then using Monte Carlo analysis with the Central Limit Theorem to estimate long-term exposure. The purpose of this paper is to compare the risk associated with selecting one ambient air classification approach over another by testing the possible exposure an individual living within a zone may face. The chronic daily intake (CDI) is utilized to compare different pollutant exposures over the classification duration of 3 years between two classification methods. Historical data collected from air monitoring stations in Kuwait are used to build representative models of 1-hr NO 2 and 8-hr O 3 within a zone that meets the compliance requirements of each method. The first method, the "3 Strike" method, is a conservative approach based on a winner-take-all approach common with most compliance classification methods, while the second, the 99% Rule method, allows for more robust analyses and incorporates long-term trends. A Monte Carlo analysis is used to model the CDI for each pollutant and each method with the zone at a single station and with multiple stations. The model assumes that the zone is already in compliance with air quality standards over the 3 years under the different classification methodologies. The model shows that while the CDI of the two methods differs by 2.7% over the exposure period for the single station case, the large number of samples taken over the duration period impacts the sensitivity of the statistical tests, causing the null hypothesis to fail. Local air quality managers can use either methodology to classify the compliance of an air zone, but must accept that the 99% Rule method may cause exposures that are statistically more significant than the 3 Strike method. A novel method using the Central Limit Theorem and Monte Carlo analysis is used to directly compare different air standard compliance classification methods by estimating the chronic daily intake of pollutants. This method allows air quality managers to rapidly see how individual classification methods may impact individual population groups, as well as to evaluate different pollutants based on dosage and exposure when complete health impacts are not known.

Quality of governance, public spending on health and health status in Sub Saharan Africa: a panel data regression analysis.

PubMed

Makuta, Innocent; O'Hare, Bernadette

2015-09-21

The population in Sub Saharan Africa (SSA) suffers poor health as manifested in high mortality rates and low life expectancy. Economic growth has consistently been shown to be a major determinant of health outcomes. However, even with good economic growth rates, it is not possible to achieve desired improvements in health outcomes. Public spending on health (PSH) has long been viewed as a potential complement to economic growth in improving health. However, the relationship between PSH and health outcomes is inconclusive and this inconclusiveness may, in part, be explained by governance-related factors which mediate the impact of the former on the latter. Little empirical work has been done in this regard on SSA. This paper investigates whether or not the quality of governance (QoG) has a modifying effect on the impact of public health spending on health outcomes, measured by under-five mortality (U5M) and life expectancy at birth (LE), in SSA. Using two staged least squares regression technique on panel data from 43 countries in SSA over the period 1996-2011, we estimated the effect of public spending on health and quality of governance U5M and LE, controlling for GDP per capita and other socio-economic factors. We also interacted PSH and QoG to find out if the latter has a modifying effect on the former's impact on U5M and LE. Public spending on health has a statistically significant impact in improving health outcomes. Its direct elasticity with respect to under-five mortality is between -0.09 and -0.11 while its semi-elasticity with respect to life expectancy is between 0.35 and 0.60. Allowing for indirect effect of PSH spending via interaction with quality of governance, we find that an improvement in QoG enhances the overall impact of PSH. In countries with higher quality of governance, the overall elasticity of PSH with respect to under-five mortality is between -0.17 and -0.19 while in countries with lower quality of governance, it is about -0.09. The corresponding semi elasticities with respect to life expectancy are about 6 in countries with higher QoG and about 3 in countries with lower QoG. Public spending on health improves health outcomes. Its impact is mediated by quality of governance, having the higher impact on health outcomes in countries with higher quality of governance and lower impact in countries with lower quality of governance. This may be due to increased efficiency in the use of available resources and better allocation of the same as QoG improves. Improving QoG would improve health outcomes in SSA. The same increase in PSH is twice as effective in reducing U5M and increasing LE in countries with good QoG when compared with countries with poor QoG.

A Comparative Analysis of Health-Related Quality of Life and Family Impact between Children with ADHD Treated in a General Pediatric Clinic and a Psychiatric Clinic Utilizing the PedsQL

ERIC Educational Resources Information Center

Limbers, Christine A.; Ripperger-Suhler, Jane; Boutton, Kelly; Ransom, Daniel; Varni, James W.

2011-01-01

Objective: To evaluate health-related quality of life (HRQOL) from the perspective of children with ADHD and their parents being seen in a Pediatric Clinic in comparison to healthy children and children with ADHD being seen in a Psychiatric Clinic. Method: Participants were children with a physician diagnosis of ADHD ages 5-18 years and their…

Final Environmental Impact Statement for Proposed Implementation of the Base Realignment and Closure (BRAC) Final Recommendations and Associated Actions for the 104th Fighter Wing, Massachusetts Air National Guard at Westfield-Barnes Airport, Westfield, Massachusetts. Volume 1: Executive Summary through Chapter 9.0, and Volume 2: Appendices

DTIC Science & Technology

2007-10-01

there was a likelihood of a significant impact on air quality. The nature and extent of such an analysis would depend on the specific circumstances...resources, biological resources, and cultural resources. For the Proposed Action, findings indicate that there will be significant impacts to the noise...the rate of peak discharge. This impact will be minimal given the developed nature of the site. No projects are sited within floodplains. The rate of

Effectively teaching self-assessment: preparing the dental hygiene student to provide quality care.

PubMed

Jackson, Sarah C; Murff, Elizabeth J Tipton

2011-02-01

Literature on self-assessment presents substantial evidence regarding the impact of self-assessment on dental practitioners and quality of care. Related dental hygiene research documents a need to enhance self-assessment curricula; however, no published curriculum module exists to effectively teach self-assessment. The purpose of this study was to explore the impact of a self-assessment educational module for dental hygiene curricula designed using adult learning principles. This module was implemented with thirty-three dental hygiene students in their junior year using a one-group, pretest-posttest design. Results analyzed using matched pairs Wilcoxon signed-rank test indicated the self-assessment module was effective (p<0.01 corresponding to a Bonferroni FWER of 0.20) in improving some aspects of the students' perceptions and voluntary clinical application of self-assessment. No statistically significant relationship was found between the students' perceptions and their application of self-assessment using Pearson's correlation. The quality of self-assessment comments on the students' daily clinical evaluation forms was also enhanced after module implementation (p<0.05). This change in quality after module implementation was demonstrated by a quantitative analysis using a self-designed rubric and a qualitative thematic analysis of student comments to identify predominant themes. Students also were surveyed to determine which module components were most effective. Findings indicate a self-assessment educational module enhanced these dental hygiene students' self-assessment perceptions and skills.

Survey of editors and reviewers of high-impact psychology journals: statistical and research design problems in submitted manuscripts.

PubMed

Harris, Alex; Reeder, Rachelle; Hyun, Jenny

2011-01-01

The authors surveyed 21 editors and reviewers from major psychology journals to identify and describe the statistical and design errors they encounter most often and to get their advice regarding prevention of these problems. Content analysis of the text responses revealed themes in 3 major areas: (a) problems with research design and reporting (e.g., lack of an a priori power analysis, lack of congruence between research questions and study design/analysis, failure to adequately describe statistical procedures); (b) inappropriate data analysis (e.g., improper use of analysis of variance, too many statistical tests without adjustments, inadequate strategy for addressing missing data); and (c) misinterpretation of results. If researchers attended to these common methodological and analytic issues, the scientific quality of manuscripts submitted to high-impact psychology journals might be significantly improved.

Quality of life and treatment adherence in hypertensive patients: systematic review with meta-analysis

PubMed Central

de Souza, Ana Célia Caetano; Borges, José Wicto Pereira; Moreira, Thereza Maria Magalhães

2016-01-01

ABSTRACT OBJECTIVE To verify the effects of antihypertensive treatment (pharmacological and non-pharmacological) on the health-related quality of life of individuals with hypertension. METHODS We conducted a systematic review with meta-analysis using the following databases: IBECS, LILACS, SciELO, Medline, Cochrane, Science Direct, Scopus and the Brazilian Capes Theses and Dissertations Database. The statistical analysis was performed using Review Manager, version 5.2. The average difference was used for the summarization of meta-analytic effect by the fixed-effect model. Twenty studies were included. RESULTS The summarization of the effect showed an average increase of 2.45 points (95%CI 1.02–3.87; p < 0.0008) in the quality of life of individuals adhering to non-pharmacological treatment for arterial hypertension. Adherence to pharmacological treatment indicated an average increase of 9.24 points (95%CI 8.16–10.33; p < 0.00001) in the quality of life of individuals with arterial hypertension. CONCLUSIONS Non-pharmacological treatment improves the overall quality of life and physical domain of people with arterial hypertension. Adherence to pharmacological treatment has a positive impact on the mental and physical domains of patients, as it did on the overall quality of life score. PMID:28099657

A proposed aquatic plant community biotic index for Wisconsin lakes

USGS Publications Warehouse

Nichols, S.; Weber, S.; Shaw, B.

2000-01-01

The Aquatic Macrophyte Community Index (AMCI) is a multipurpose tool developed to assess the biological quality of aquatic plant communities in lakes. It can be used to specifically analyze aquatic plant communities or as part of a multimetric system to assess overall lake quality for regulatory, planning, management, educational, or research purposes. The components of the index are maximum depth of plant growth; percentage of the littoral zone vegetated; Simpson's diversity index; the relative frequencies of submersed, sensitive, and exotic species; and taxa number. Each parameter was scaled based on data distributions from a statewide database, and scaled values were totaled for the AMCI value. AMCI values were grouped and tested by ecoregion and lake type (natural lakes and impoundments) to define quality on a regional basis. This analysis suggested that aquatic plant communities are divided into four groups: (1) Northern Lakes and Forests lakes and impoundments, (2) North-Central Hardwood Forests lakes and impoundments, (3) Southeastern Wisconsin Till Plains lakes, and (4) Southeastern Wisconsin Till Plains impoundments, Driftless Area Lakes, and Mississippi River Backwater lakes. AMCI values decline from group 1 to group 4 and reflect general water quality and human use trends in Wisconsin. The upper quartile of AMCI values in any region are the highest quality or benchmark plant communities. The interquartile range consists of normally impacted communities for the region and the lower quartile contains severely impacted or degraded plant communities. When AMCI values were applied to case studies, the values reflected known impacts to the lakes. However, quality criteria cannot be used uncritically, especially in lakes that initially have low nutrient levels.The Aquatic Macrophyte Community Index (AMCI) is a multipurpose tool developed to assess the biological quality of aquatic plant communities in lakes. It can be used to specifically analyze aquatic plant communities or as part of a multimetric system to assess overall lake quality for regulatory, planning, management, educational, or research purposes. The components of the index are maximum depth of plant growth; percentage of the littoral zone vegetated; Simpson's diversity index; the relative frequencies of submersed, sensitive, and exotic species; and taxa number. Each parameter was scaled based on data distributions from a statewide database, and scaled values were totaled for the AMCI value, AMCI values were grouped and tested by ecoregion and lake type (natural lakes and impoundments) to define quality on a regional basis. This analysis suggested that aquatic plant communities are divided into four groups: (1) Northern Lakes and Forests lakes and impoundments, (2) North-Central Hardwood Forests lakes and impoundments, (3) Southeastern Wisconsin Till Plains lakes, and (4) Southeastern Wisconsin Till Plains impoundments, Driftless Area Lakes, and Mississippi River Backwater lakes. AMCI values decline from group 1 to group 4 and reflect general water quality and human use trends in Wisconsin. The upper quartile of AMCI values in any region are the highest quality or benchmark plant communities. The interquartile range consists of normally impacted communities for the region and the lower quartile contains severely impacted or degraded plant communities. When AMCI values were applied to case studies, the values reflected known impacts to the lakes. However, quality criteria cannot be used uncritically, especially in lakes that initially have low nutrient levels.In Wisconsin, the Aquatic Macrophyte Community Index (AMCI) was developed and used to define the quality of aquatic macrophyte communities in northern Wisconsin flowages. In this study, the AMCI concept was expanded to lakes and impoundments on a statewide basis. The parameters selected were the maximum depth of plant growth, percentage of littoral area vegetated, Simpson's diversity index, relative frequen

TU-EF-BRD-04: Summing It Up: The Future of Quality and Safety Research

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

Ford, E.

Research related to quality and safety has been a staple of medical physics academic activities for a long time. From very early on, medical physicists have developed new radiation measurement equipment and analysis techniques, created ever increasingly accurate dose calculation models, and have vastly improved imaging, planning, and delivery techniques. These and other areas of interest have improved the quality and safety of radiotherapy for our patients. With the advent of TG-100, quality and safety is an area that will garner even more research interest in the future. As medical physicists pursue quality and safety research in greater numbers, itmore » is worthwhile to consider what actually constitutes research on quality and safety. For example, should the development of algorithms for real-time EPID-based in-vivo dosimetry be defined as “quality and safety” research? How about the clinical implementation of such as system? Surely the application of failure modes and effects analysis to a clinical process would be considered quality and safety research, but is this type of research that should be included in the medical physics peer-reviewed literature? The answers to such questions are of critical importance to set researchers in a direction that will provide the greatest benefit to our field and the patients we serve. The purpose of this symposium is to consider what constitutes research in the arena of quality and safety and differentiate it from other research directions. The key distinction here is developing the tool itself (e.g. algorithms for EPID dosimetry) vs. studying the impact of the tool with some quantitative metric. Only the latter would I call quality and safety research. Issues of ‘basic’ versus ‘applied’ quality and safety research will be covered as well as how the research results should be structured to provide increasing levels of support that a quality and safety intervention is effective and sustainable. Examples from existing peer-reviewed research will be used to highlight the main points. Historical, medical physicists have leveraged many areas of applied physics, engineering and biology to improve radiotherapy. Research on quality and safety is another area where physicists can have an impact. The key to further progress is to clearly define what constitutes quality and safety research for those interested in doing such research and the reviewers of that research. Learning Objectives: List several tools of quality and safety with references to peer-reviewed literature. Describe effects of mental workload on performance. Outline research in quality and safety indicators and technique analysis. Understand what quality and safety research needs to be going forward. Understand the links between cooperative group trials and quality and safety research.« less

TU-EF-BRD-01: Topics in Quality and Safety Research and Level of Evidence

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

Pawlicki, T.

Research related to quality and safety has been a staple of medical physics academic activities for a long time. From very early on, medical physicists have developed new radiation measurement equipment and analysis techniques, created ever increasingly accurate dose calculation models, and have vastly improved imaging, planning, and delivery techniques. These and other areas of interest have improved the quality and safety of radiotherapy for our patients. With the advent of TG-100, quality and safety is an area that will garner even more research interest in the future. As medical physicists pursue quality and safety research in greater numbers, itmore » is worthwhile to consider what actually constitutes research on quality and safety. For example, should the development of algorithms for real-time EPID-based in-vivo dosimetry be defined as “quality and safety” research? How about the clinical implementation of such as system? Surely the application of failure modes and effects analysis to a clinical process would be considered quality and safety research, but is this type of research that should be included in the medical physics peer-reviewed literature? The answers to such questions are of critical importance to set researchers in a direction that will provide the greatest benefit to our field and the patients we serve. The purpose of this symposium is to consider what constitutes research in the arena of quality and safety and differentiate it from other research directions. The key distinction here is developing the tool itself (e.g. algorithms for EPID dosimetry) vs. studying the impact of the tool with some quantitative metric. Only the latter would I call quality and safety research. Issues of ‘basic’ versus ‘applied’ quality and safety research will be covered as well as how the research results should be structured to provide increasing levels of support that a quality and safety intervention is effective and sustainable. Examples from existing peer-reviewed research will be used to highlight the main points. Historical, medical physicists have leveraged many areas of applied physics, engineering and biology to improve radiotherapy. Research on quality and safety is another area where physicists can have an impact. The key to further progress is to clearly define what constitutes quality and safety research for those interested in doing such research and the reviewers of that research. Learning Objectives: List several tools of quality and safety with references to peer-reviewed literature. Describe effects of mental workload on performance. Outline research in quality and safety indicators and technique analysis. Understand what quality and safety research needs to be going forward. Understand the links between cooperative group trials and quality and safety research.« less

Comparing Parents’ and Children’s Views of Children’s Quality of Life after Heart Transplant

PubMed Central

Green, Angela L.; McSweeney, Jean; Ainley, Kathy; Bryant, Janet

2012-01-01

Purpose The purpose of this focused ethnographic study was to explore the quality of life (QOL) of school-age heart-transplant recipients. Design and Methods Semi-structured interviews were conducted with 11 parent-child dyads. Data were analyzed using content analysis and constant comparison. Results Participants identified key factors impacting the children’s QOL including: participation in normal activities, normalcy, staying healthy, sources of strength and support, and struggles (parents’ perspectives) and doing what kids do, being with family and friends, and being a heart transplant kid (children’s perspectives). Practice Implications Interventions focusing on the key factors identified by participants may impact the QOL of school-age heart-transplant recipients. PMID:19161575

Service quality that improves customer satisfaction in a university: a case study in Institut Teknologi Indonesia

NASA Astrophysics Data System (ADS)

Theresia, L.; Bangun, R.

2017-12-01

Universities should provide better service quality to get more customers. The purpose of this study was to find service quality which has impact on the increasing of customer satisfaction in a university. This study is a case study in Institut Teknologi Indonesia (ITI). The result of the study will help ITI to improve its service quality to increase customer satisfaction. This study employs path analysis technique. The data were collected through questionnaires developed from the literature. Questionnaires have two parts namely 1) service quality and 2) customer satisfaction. Service quality is measured through 22 questions with five service quality dimensions: 1) Tangibles, 2) Reliability, 3) Responsiveness, 4) Assurance and 5) Empathy. Customer Satisfaction is measured through 4 questions. The data then are processed by SPSS. The results showed that the students preferred to tangible quality improvement than intangible aspect.

Data Quality Monitoring in Clinical Trials: Has It Been Worth It? An Evaluation and Prediction of the Future by All Stakeholders

PubMed Central

Kalali, Amir; West, Mark; Walling, David; Hilt, Dana; Engelhardt, Nina; Alphs, Larry; Loebel, Antony; Vanover, Kim; Atkinson, Sarah; Opler, Mark; Sachs, Gary; Nations, Kari; Brady, Chris

2016-01-01

This paper summarizes the results of the CNS Summit Data Quality Monitoring Workgroup analysis of current data quality monitoring techniques used in central nervous system (CNS) clinical trials. Based on audience polls conducted at the CNS Summit 2014, the panel determined that current techniques used to monitor data and quality in clinical trials are broad, uncontrolled, and lack independent verification. The majority of those polled endorse the value of monitoring data. Case examples of current data quality methodology are presented and discussed. Perspectives of pharmaceutical companies and trial sites regarding data quality monitoring are presented. Potential future developments in CNS data quality monitoring are described. Increased utilization of biomarkers as objective outcomes and for patient selection is considered to be the most impactful development in data quality monitoring over the next 10 years. Additional future outcome measures and patient selection approaches are discussed. PMID:27413584

Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren.

PubMed

Dantas-Neta, Neusa Barros; Moura, Lúcia de Fátima Almeida de Deus; Cruz, Priscila Figueiredo; Moura, Marcoeli Silva; Paiva, Saul Martins; Martins, Carolina Castro; Lima, Marina de Deus Moura de

2016-10-24

This study evaluated the impact of molar-incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perceptions of schoolchildren and their parents/caregivers. This cross-sectional study consisted of a sample of 594 schoolchildren between 11 and 14 years of age and their parents/caregivers who answered the questionnaires CPQ11-14ISF:16 and P-CPQ, respectively. The main independent variable of this study was MIH of the schoolchildren. Experience of dental caries, malocclusion, and socioeconomic status were treated as confounding variables. Statistical analysis used descriptive analysis and Poisson regression with robust variance. The prevalence of MIH was 18.9%. The overall P-CPQ score ranged from 0 to 35 (average = 7.26 ± 6.84), and the overall CPQ11-14ISF:16 score ranged from 0 to 47 (average = 11.92 ± 7.98). Severe MIH was associated with a greater negative impact of the "functional limitation" domain (RR = 1.41; 95%CI = 1.01-1.97), according to parents'/caregivers' perceptions. Severe MIH was associated with a greater negative impact of the "oral symptom" domain (RR = 1.30; 95%CI = 1.06-1.60) and functional limitation domain (RR = 1.42; 95%CI = 1.08-1.86), according to the schoolchildren's perceptions. Schoolchildren with severe MIH had a greater negative impact on the oral symptom and functional limitation domains than those without MIH. According to parents'/caregivers' perceptions, schoolchildren with severe MIH had a greater negative impact on the functional limitation domain than those without MIH.

Health-related quality of life and stages of behavioural change for exercise in overweight/obese individuals.

PubMed

Romain, A J; Bernard, P; Attalin, V; Gernigon, C; Ninot, G; Avignon, A

2012-10-01

Stages of change in exercise behaviour have been shown to be associated with health-related quality of life (HRQoL) in overweight/obese adults. However, studies examining this relationship have not used questionnaires specifically designed for such a population. The present study assessed the impact of stages of change (SOC) for exercise, using the transtheoretical model, on the HRQoL, using the quality of life, obesity and dietetics (QOLOD) scale, an obesity-specific QoL questionnaire. Our hypothesis was that the more people are in the advanced stages of behavioural change, the better their HRQoL. A total of 214 consecutive obese individuals (148 women/66 men, mean age 47.4 ± 14.0 years, BMI 37.2 ± 8.4 kg/m2) were included in the cross-sectional study, and all completed SOC and QOLOD questionnaires. Multivariate analysis of covariance (MANCOVA) established significant effects on the overall composite of the five dimensions of the QOLOD (P < 0.001). Analysis of covariance (ANCOVA) further determined the significant effect of SOC in terms of physical impact (P < 0.001) and psychosocial impact (P < 0.01), with marginally significant effects on sex life (P = 0.07), but no impact on comfort with food (P = 0.13) or on the dieting experience (P = 0.13), two dimensions evaluating attitudes toward food. In obese/overweight individuals, the HRQoL varies with the SOC, with those in the more advanced behavioural stages reporting better HRQoL. However, dimensions related to food showed no differences according to SOC, confirming the complexity of the relationship between exercise and nutrition, and the need for further studies to acquire a more complete understanding of their underlying mechanisms. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Cost-effectiveness analysis of oral fentanyl formulations for breakthrough cancer pain treatment

PubMed Central

Cortesi, Paolo Angelo; D’Angiolella, Lucia Sara; Vellucci, Renato; Allegri, Massimo; Casale, Giuseppe; Favaretti, Carlo; Kheiraoui, Flavia; Cesana, Giancarlo; Mantovani, Lorenzo Giovanni

2017-01-01

Breakthrough cancer Pain (BTcP) has a high prevalence in cancer population. Patients with BTcP reported relevant health care costs and poor quality of life. The study assessed the cost-effectiveness of the available Oral Fentanyl Formulations (OFFs) for BTcP in Italy. A decision-analytical model was developed to estimate costs and benefits associated with treatments, from the Italian NHS perspective. Expected reductions in pain intensity per BTcP episodes were translated into, percentage of BTcP reduction, resource use and Quality-Adjusted-Life-Years (QALYs). Relative efficacy, resources used and unit costs data were derived from the literature and validated by clinical experts. Probabilistic and deterministic sensitivity analyses were performed. At base-case analysis, Sublingual Fentanyl Citrate (FCSL) compared to other oral formulations reported a lower patient’s cost (€1,960.8) and a higher efficacy (18.7% of BTcP avoided and 0.0507 QALYs gained). The sensitivity analyses confirmed the main results in all tested scenarios, with the highest impact reported by BTcP duration and health care resources consumption parameters. Between OFFs, FCSL is the cost-effective option due to faster reduction of pain intensity. However, new research is needed to better understand the economic and epidemiologic impact of BTcP, and to collect more robust data on economic and quality of life impact of the different fentanyl formulations. Different fentanyl formulations are available to manage BTcP in cancer population. The study is the first that assesses the different impact in terms of cost and effectiveness of OFFs, providing new information to better allocate the resources available to treat BTcP and highlighting the need of better data. PMID:28654672

Towards health impact assessment of drinking-water privatization--the example of waterborne carcinogens in North Rhine-Westphalia (Germany).

PubMed Central

Fehr, Rainer; Mekel, Odile; Lacombe, Martin; Wolf, Ulrike

2003-01-01

Worldwide there is a tendency towards deregulation in many policy sectors - this, for example, includes liberalization and privatization of drinking-water management. However, concerns about the negative impacts this might have on human health call for prospective health impact assessment (HIA) on the management of drinking-water. On the basis of an established generic 10-step HIA procedure and on risk assessment methodology, this paper aims to produce quantitative estimates concerning health effects from increased exposure to carcinogens in drinking-water. Using data from North Rhine-Westphalia in Germany, probabilistic estimates of excess lifetime cancer risk, as well as estimates of additional cases of cancer from increased carcinogen exposure levels are presented. The results show how exposure to contaminants that are strictly within current limits could increase cancer risks and case-loads substantially. On the basis of the current analysis, we suggest that with uniform increases in pollutant levels, a single chemical (arsenic) is responsible for a large fraction of expected additional risk. The study also illustrates the uncertainty involved in predicting the health impacts of changes in water quality. Future analysis should include additional carcinogens, non-cancer risks including those due to microbial contamination, and the impacts of system failures and of illegal action, which may be increasingly likely to occur under changed management arrangements. If, in spite of concerns, water is privatized, it is particularly important to provide adequate surveillance of water quality. PMID:12894324

A cost-efficiency and health benefit approach to improve urban air quality.

PubMed

Miranda, A I; Ferreira, J; Silveira, C; Relvas, H; Duque, L; Roebeling, P; Lopes, M; Costa, S; Monteiro, A; Gama, C; Sá, E; Borrego, C; Teixeira, J P

2016-11-01

When ambient air quality standards established in the EU Directive 2008/50/EC are exceeded, Member States are obliged to develop and implement Air Quality Plans (AQP) to improve air quality and health. Notwithstanding the achievements in emission reductions and air quality improvement, additional efforts need to be undertaken to improve air quality in a sustainable way - i.e. through a cost-efficiency approach. This work was developed in the scope of the recently concluded MAPLIA project "Moving from Air Pollution to Local Integrated Assessment", and focuses on the definition and assessment of emission abatement measures and their associated costs, air quality and health impacts and benefits by means of air quality modelling tools, health impact functions and cost-efficiency analysis. The MAPLIA system was applied to the Grande Porto urban area (Portugal), addressing PM10 and NOx as the most important pollutants in the region. Four different measures to reduce PM10 and NOx emissions were defined and characterized in terms of emissions and implementation costs, and combined into 15 emission scenarios, simulated by the TAPM air quality modelling tool. Air pollutant concentration fields were then used to estimate health benefits in terms of avoided costs (external costs), using dose-response health impact functions. Results revealed that, among the 15 scenarios analysed, the scenario including all 4 measures lead to a total net benefit of 0.3M€·y(-1). The largest net benefit is obtained for the scenario considering the conversion of 50% of open fire places into heat recovery wood stoves. Although the implementation costs of this measure are high, the benefits outweigh the costs. Research outcomes confirm that the MAPLIA system is useful for policy decision support on air quality improvement strategies, and could be applied to other urban areas where AQP need to be implemented and monitored. Copyright © 2016. Published by Elsevier B.V.

Association between quality of sleep and health-related quality of life in persons with diabetes mellitus type 2.

PubMed

Bani-Issa, Wegdan; Al-Shujairi, Arwa M; Patrick, Linda

2018-04-01

To estimate the relationship of sleep quality with health-related quality of life (HRQOL) in persons with diabetes mellitus type 2 (DMT2) living in the United Arab Emirates (UAE). DMT2 is an epidemic health condition in the UAE that has enormous impacts on heath, and consequent effects on HRQOL. However, because of an absence of screening for quality of sleep, people with DMT2 who experience poor sleep are likely to go untreated, which may compound the distressing impacts of DMT2 on their HRQOL. This is a cross-sectional quantitative research design. A sample of 268 participants with DMT2 were recruited from community healthcare settings in the UAE using cluster sampling. Participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI) and the World Health Organization HRQOL. Data analysis used descriptive and correlational statistics. Of the 268 participants, 34% identified as "poor sleepers" and 55% had poor HRQOL. Poor sleepers showed significantly lower scores for HRQOL than good sleepers. The global PSQI scores were found to be independently predictive of global HRQOL. Subjective perceptions of sleep quality, the use of sleep medications and impaired daytime functioning were the variables found to have the highest correlations with global HRQOL and its four domains. This study found that people with DMT2 who indicate experiencing poor quality sleep are more likely to show a negative correlation with HRQOL. Additional research is needed to investigate how poor sleep may impact the health of people with DMT2. Findings suggest that assessment of sleep quality should be an essential component of diabetes care. Understanding sleep practices may aid public health practitioners and other healthcare providers in the design of culturally appropriate interventions to improve sleep quality in persons with DMT2. © 2017 John Wiley & Sons Ltd.

Air Quality, Climate and Economic Impacts of Biogas Management Technologies

EPA Science Inventory

Anaerobically digested organic waste (e.g. manure, sewage, and municipal solid waste) produces biogas, a source of renewable energy. A recent analysis indicates that the technical resource in California could produce nearly 93 billion cubic feet per year of biomethane from availa...

Environmental Impact Analysis Process. Environmental Assessment for NAVSTAR Global Positioning System, Block IIR, and Medium Launch Vehicle III, Cape Canaveral Air Station, Florida

DTIC Science & Technology

1994-11-01

59 10 Solid Rocket Motor Combustion Products ...60 11 Core Vehicle First Stage Combustion Products ......................................................60 12 Health Hazard...Qualities of Hazardous Launch Emissions......................................61 13 Atlas II Combustion Products

Investigation of the environmental impacts of sedimentation in Anzali Pond

NASA Astrophysics Data System (ADS)

Barmal, Milad; Neshaei, Seyed Ahmad; Farzan, Niloofar

2016-04-01

Anzali harbor is the most essential transportation pole between Iran and other countries of the Caspian Sea basin. Anzali pond is an important ecosystem in the region due to its unique plant and animal species. In order to determine the effects of interaction between pond and sea, a series of in-depth studies and analysis on the pattern of sedimentation in Anzali harbor and pond were performed. The study area is Anzali harbor and pond which is located in southwest of the Caspian Sea in Iran. In recent years the economical importance and improvement program of this region has devoted many scientists and authorities attention to itself. In this paper, researches on environmental impact by sediment and pollution in this zone are performed. Analysis indicates that by disposal of sediment and pollution in this area, the physical and chemical quality of water has declined. Some practical suggestions are made to improve the quality of the studied region in terms of environmental aspects.

Applying the ICF framework to study changes in quality-of-life for youth with chronic conditions

PubMed Central

McDougall, Janette; Wright, Virginia; Schmidt, Jonathan; Miller, Linda; Lowry, Karen

2011-01-01

Objective The objective of this paper is to describe how the ICF framework was applied as the foundation for a longitudinal study of changes in quality-of-life (QoL) for youth with chronic conditions. Method This article will describe the study’s aims, methods, measures and data analysis techniques. It will point out how the ICF framework was used—and expanded upon—to provide a model for studying the impact of factors on changes in QoL for youth with chronic conditions. Further, it will describe the instruments that were chosen to measure the components of the ICF framework and the data analysis techniques that will be used to examine the impact of factors on changes in youths’ QoL. Conclusions Qualitative and longitudinal designs for studying QoL based on the ICF framework can be useful for unraveling the complex ongoing inter-relationships among functioning, contextual factors and individuals’ perceptions of their QoL. PMID:21034288

Impacts of land use and population density on seasonal surface water quality using a modified geographically weighted regression.

PubMed

Chen, Qiang; Mei, Kun; Dahlgren, Randy A; Wang, Ting; Gong, Jian; Zhang, Minghua

2016-12-01

As an important regulator of pollutants in overland flow and interflow, land use has become an essential research component for determining the relationships between surface water quality and pollution sources. This study investigated the use of ordinary least squares (OLS) and geographically weighted regression (GWR) models to identify the impact of land use and population density on surface water quality in the Wen-Rui Tang River watershed of eastern China. A manual variable excluding-selecting method was explored to resolve multicollinearity issues. Standard regression coefficient analysis coupled with cluster analysis was introduced to determine which variable had the greatest influence on water quality. Results showed that: (1) Impact of land use on water quality varied with spatial and seasonal scales. Both positive and negative effects for certain land-use indicators were found in different subcatchments. (2) Urban land was the dominant factor influencing N, P and chemical oxygen demand (COD) in highly urbanized regions, but the relationship was weak as the pollutants were mainly from point sources. Agricultural land was the primary factor influencing N and P in suburban and rural areas; the relationship was strong as the pollutants were mainly from agricultural surface runoff. Subcatchments located in suburban areas were identified with urban land as the primary influencing factor during the wet season while agricultural land was identified as a more prevalent influencing factor during the dry season. (3) Adjusted R 2 values in OLS models using the manual variable excluding-selecting method averaged 14.3% higher than using stepwise multiple linear regressions. However, the corresponding GWR models had adjusted R 2 ~59.2% higher than the optimal OLS models, confirming that GWR models demonstrated better prediction accuracy. Based on our findings, water resource protection policies should consider site-specific land-use conditions within each watershed to optimize mitigation strategies for contrasting land-use characteristics and seasonal variations. Copyright © 2016 Elsevier B.V. All rights reserved.

Stress, health and quality of life of female migrant domestic workers in Singapore: a cross-sectional study.

PubMed

Anjara, S G; Nellums, L B; Bonetto, C; Van Bortel, T

2017-10-10

There is a global increase in migrant workers. In Singapore, there are over 230,000 migrant domestic workers (MDWs). Female MDWs may experience high levels of stress and social isolation, which may negatively impact on their health and quality of life. There have also been documented cases of abuse and exploitation. However, there is a lack of empirical research with this population. This study aimed to investigate factors impacting on the health and quality of life of female MDWs in Singapore, including socio-demographic and job related characteristics, stress, social isolation, and working management style. A cross-sectional survey was carried out with 182 female MDWs in Singapore. The survey examined health and quality of life (WHOQoL-Bréf), social connectedness (the Friendship Scale), and preferred and experienced working management style (the Theory X and Theory Y Questionnaire). Descriptive analyses were carried out in addition to ANOVA, t-tests, and chi-square tests, followed by a multivariate analysis using linear regression. Participants were found to have good overall quality of life and satisfaction with health. Age and working experience were found to be significantly (p < 0.05) associated with overall quality of life and three domains (psychological, social, and environmental health). Agreement between experienced and preferred working management style was also found to be associated with higher quality of life scores (with the exception of the social relationships domain). Though women reported relatively good overall quality of life, more than half of participants reported feeling stressed. In addition, nearly 20% of participants reported being isolated or very isolated. Stress was identified to be associated with isolation. In the multivariate analysis, stress was found to contribute to worse quality of life in all domains except social relationships, after adjusting for confounders. Social connectedness was positively associated with all domains of quality of life, and agreement of working management style was positively associated with physical health, psychological health and environmental quality of life. The findings serve as an evidence-base pointing to the need for policies aimed at decreasing stress and social isolation among female MDWs in order to improve their health and quality of life.

Using multilevel modeling to assess case-mix adjusters in consumer experience surveys in health care.

PubMed

Damman, Olga C; Stubbe, Janine H; Hendriks, Michelle; Arah, Onyebuchi A; Spreeuwenberg, Peter; Delnoij, Diana M J; Groenewegen, Peter P

2009-04-01

Ratings on the quality of healthcare from the consumer's perspective need to be adjusted for consumer characteristics to ensure fair and accurate comparisons between healthcare providers or health plans. Although multilevel analysis is already considered an appropriate method for analyzing healthcare performance data, it has rarely been used to assess case-mix adjustment of such data. The purpose of this article is to investigate whether multilevel regression analysis is a useful tool to detect case-mix adjusters in consumer assessment of healthcare. We used data on 11,539 consumers from 27 Dutch health plans, which were collected using the Dutch Consumer Quality Index health plan instrument. We conducted multilevel regression analyses of consumers' responses nested within health plans to assess the effects of consumer characteristics on consumer experience. We compared our findings to the results of another methodology: the impact factor approach, which combines the predictive effect of each case-mix variable with its heterogeneity across health plans. Both multilevel regression and impact factor analyses showed that age and education were the most important case-mix adjusters for consumer experience and ratings of health plans. With the exception of age, case-mix adjustment had little impact on the ranking of health plans. On both theoretical and practical grounds, multilevel modeling is useful for adequate case-mix adjustment and analysis of performance ratings.

Reporting quality of statistical methods in surgical observational studies: protocol for systematic review.

PubMed

Wu, Robert; Glen, Peter; Ramsay, Tim; Martel, Guillaume

2014-06-28

Observational studies dominate the surgical literature. Statistical adjustment is an important strategy to account for confounders in observational studies. Research has shown that published articles are often poor in statistical quality, which may jeopardize their conclusions. The Statistical Analyses and Methods in the Published Literature (SAMPL) guidelines have been published to help establish standards for statistical reporting.This study will seek to determine whether the quality of statistical adjustment and the reporting of these methods are adequate in surgical observational studies. We hypothesize that incomplete reporting will be found in all surgical observational studies, and that the quality and reporting of these methods will be of lower quality in surgical journals when compared with medical journals. Finally, this work will seek to identify predictors of high-quality reporting. This work will examine the top five general surgical and medical journals, based on a 5-year impact factor (2007-2012). All observational studies investigating an intervention related to an essential component area of general surgery (defined by the American Board of Surgery), with an exposure, outcome, and comparator, will be included in this systematic review. Essential elements related to statistical reporting and quality were extracted from the SAMPL guidelines and include domains such as intent of analysis, primary analysis, multiple comparisons, numbers and descriptive statistics, association and correlation analyses, linear regression, logistic regression, Cox proportional hazard analysis, analysis of variance, survival analysis, propensity analysis, and independent and correlated analyses. Each article will be scored as a proportion based on fulfilling criteria in relevant analyses used in the study. A logistic regression model will be built to identify variables associated with high-quality reporting. A comparison will be made between the scores of surgical observational studies published in medical versus surgical journals. Secondary outcomes will pertain to individual domains of analysis. Sensitivity analyses will be conducted. This study will explore the reporting and quality of statistical analyses in surgical observational studies published in the most referenced surgical and medical journals in 2013 and examine whether variables (including the type of journal) can predict high-quality reporting.

The Impact of a Teaching or Singing Career on the Female Vocal Quality at the Mean Age of 67 Years: A Pilot Study.

PubMed

D'haeseleer, Evelien; Claeys, Sofie; Bettens, Kim; Leemans, Laura; Van Calster, Ann-Sophie; Van Damme, Nina; Thijs, Zoë; Daelman, Julie; Leyns, Clara; Van Lierde, Kristiane

2017-07-01

The purpose of this study was to measure the objective and subjective vocal quality in women aged between 60 and 75 years. Secondly, the impact of a teaching or singing career on the vocal quality was investigated by comparing the vocal quality of retired women with different careers. This is a case-control study. Seventy-three retired women between 60 and 75 years (mean age: 67 years, standard deviation: 4.49) participated in the study and were divided into three groups: women with a teaching career (n = 21), choir singers with a singing career (n = 12), and women with a non-vocal career (n = 40). All subjects underwent the same assessment protocol consisting of objective (aerodynamic, maximum performance, vocal range, acoustic measurements, and the Dysphonia Severity Index) and subjective (the Voice Handicap Index, auditory-perceptual evaluations by three listeners) voice measurements. In all three groups, objective and perceptual voice analysis showed a mild dysphonia. No differences in the Dysphonia Severity Index were found between the three groups. The voices of choir singers with a singing career were perceived significantly less rough than voices of the women with a non-vocal career. Additionally, the lowest frequency of the frequency range was significantly lower in the retired teachers and choir singers than in the controls. The results of this study prudently suggest that a singing or a teaching career compared with a non-vocal career has a positive impact on the vocal frequency range, and that singing has a positive impact on the perceptual vocal quality of the older female voice. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

TU-EF-BRD-03: Mental Workload and Performance

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

Mazur, L.

Research related to quality and safety has been a staple of medical physics academic activities for a long time. From very early on, medical physicists have developed new radiation measurement equipment and analysis techniques, created ever increasingly accurate dose calculation models, and have vastly improved imaging, planning, and delivery techniques. These and other areas of interest have improved the quality and safety of radiotherapy for our patients. With the advent of TG-100, quality and safety is an area that will garner even more research interest in the future. As medical physicists pursue quality and safety research in greater numbers, itmore » is worthwhile to consider what actually constitutes research on quality and safety. For example, should the development of algorithms for real-time EPID-based in-vivo dosimetry be defined as “quality and safety” research? How about the clinical implementation of such as system? Surely the application of failure modes and effects analysis to a clinical process would be considered quality and safety research, but is this type of research that should be included in the medical physics peer-reviewed literature? The answers to such questions are of critical importance to set researchers in a direction that will provide the greatest benefit to our field and the patients we serve. The purpose of this symposium is to consider what constitutes research in the arena of quality and safety and differentiate it from other research directions. The key distinction here is developing the tool itself (e.g. algorithms for EPID dosimetry) vs. studying the impact of the tool with some quantitative metric. Only the latter would I call quality and safety research. Issues of ‘basic’ versus ‘applied’ quality and safety research will be covered as well as how the research results should be structured to provide increasing levels of support that a quality and safety intervention is effective and sustainable. Examples from existing peer-reviewed research will be used to highlight the main points. Historical, medical physicists have leveraged many areas of applied physics, engineering and biology to improve radiotherapy. Research on quality and safety is another area where physicists can have an impact. The key to further progress is to clearly define what constitutes quality and safety research for those interested in doing such research and the reviewers of that research. Learning Objectives: List several tools of quality and safety with references to peer-reviewed literature. Describe effects of mental workload on performance. Outline research in quality and safety indicators and technique analysis. Understand what quality and safety research needs to be going forward. Understand the links between cooperative group trials and quality and safety research.« less

Development of a new methodology for the creation of water temperature scenarios using frequency analysis tool.

PubMed

Val, Jonatan; Pino, María Rosa; Chinarro, David

2018-03-15

Thermal quality in river ecosystems is a fundamental property for the development of biological processes and many of the human activities linked to the aquatic environment. In the future, this property is going to be threatened due to global change impacts, and basin managers will need useful tools to evaluate these impacts. Currently, future projections in temperature modelling are based on the historical data for air and water temperatures, and the relationship with past temperature scenarios; however, this represents a problem when evaluating future scenarios with new thermal impacts. Here, we analysed the thermal impacts produced by several human activities, and linked them with the decoupling degree of the thermal transfer mechanism from natural systems measured with frequency analysis tools (wavelet coherence). Once this relationship has been established we develop a new methodology for simulating different thermal impacts scenarios in order to project them into future. Finally, we validate this methodology using a site that changed its thermal quality during the studied period due to human impacts. Results showed a high correlation (r 2 =0.84) between the decoupling degree of the thermal transfer mechanisms and the quantified human impacts, obtaining 3 thermal impact scenarios. Furthermore, the graphic representation of these thermal scenarios with its wavelet coherence spectrums showed the impacts of an extreme drought period and the agricultural management. The inter-conversion between the scenarios gave high morphological similarities in the obtained wavelet coherence spectrums, and the validation process clearly showed high efficiency of the developed model against old methodologies when comparing with Nash-Stucliffe criterion. Although there is need for further investigation with different climatic and anthropic management conditions, the developed frequency models could be useful in decision-making processes by managers when faced with future global change impacts. Copyright © 2017 Elsevier B.V. All rights reserved.

The impact of accreditation of primary healthcare centers: successes, challenges and policy implications as perceived by healthcare providers and directors in Lebanon

PubMed Central

2014-01-01

Background In 2009, the Lebanese Ministry of Public Health (MOPH) launched the Primary Healthcare (PHC) accreditation program to improve quality across the continuum of care. The MOPH, with the support of Accreditation Canada, conducted the accreditation survey in 25 PHC centers in 2012. This paper aims to gain a better understanding of the impact of accreditation on quality of care as perceived by PHC staff members and directors; how accreditation affected staff and patient satisfaction; key enablers, challenges and strategies to improve implementation of accreditation in PHC. Methods The study was conducted in 25 PHC centers using a cross-sectional mixed methods approach; all staff members were surveyed using a self-administered questionnaire whereas semi-structured interviews were conducted with directors. Results The scales measuring Management and Leadership had the highest mean score followed by Accreditation Impact, Human Resource Utilization, and Customer Satisfaction. Regression analysis showed that Strategic Quality Planning, Customer Satisfaction and Staff Involvement were associated with a perception of higher Quality Results. Directors emphasized the benefits of accreditation with regards to documentation, reinforcement of quality standards, strengthened relationships between PHC centers and multiple stakeholders and improved staff and patient satisfaction. Challenges encountered included limited financial resources, poor infrastructure, and staff shortages. Conclusions To better respond to population health needs, accreditation is an important first step towards improving the quality of PHC delivery arrangement system. While there is a need to expand the implementation of accreditation to cover all PHC centers in Lebanon, considerations should be given to strengthening their financial arrangements as well. PMID:24568632

Modeling Source Water Threshold Exceedances with Extreme Value Theory

NASA Astrophysics Data System (ADS)

Rajagopalan, B.; Samson, C.; Summers, R. S.

2016-12-01

Variability in surface water quality, influenced by seasonal and long-term climate changes, can impact drinking water quality and treatment. In particular, temperature and precipitation can impact surface water quality directly or through their influence on streamflow and dilution capacity. Furthermore, they also impact land surface factors, such as soil moisture and vegetation, which can in turn affect surface water quality, in particular, levels of organic matter in surface waters which are of concern. All of these will be exacerbated by anthropogenic climate change. While some source water quality parameters, particularly Total Organic Carbon (TOC) and bromide concentrations, are not directly regulated for drinking water, these parameters are precursors to the formation of disinfection byproducts (DBPs), which are regulated in drinking water distribution systems. These DBPs form when a disinfectant, added to the water to protect public health against microbial pathogens, most commonly chlorine, reacts with dissolved organic matter (DOM), measured as TOC or dissolved organic carbon (DOC), and inorganic precursor materials, such as bromide. Therefore, understanding and modeling the extremes of TOC and Bromide concentrations is of critical interest for drinking water utilities. In this study we develop nonstationary extreme value analysis models for threshold exceedances of source water quality parameters, specifically TOC and bromide concentrations. In this, the threshold exceedances are modeled as Generalized Pareto Distribution (GPD) whose parameters vary as a function of climate and land surface variables - thus, enabling to capture the temporal nonstationarity. We apply these to model threshold exceedance of source water TOC and bromide concentrations at two locations with different climate and find very good performance.