On the Role of Impact Evaluation of Quality Assurance from the Strategic Perspective of Quality Assurance Agencies in the European Higher Education Area

ERIC Educational Resources Information Center

Damian, Radu; Grifoll, Josep; Rigbers, Anke

2015-01-01

In this paper the current national legislations, the quality assurance approaches and the activities of impact analysis of three quality assurance agencies from Romania, Spain and Germany are described from a strategic perspective. The analysis shows that the general methodologies (comprising, for example, self-evaluation reports, peer reviews,…

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

The Impact of External Quality Assessment on Universities: The Estonian Experience

ERIC Educational Resources Information Center

Vilgats, Birgit; Heidmets, Mati

2011-01-01

This article seeks to establish what impact external quality assessment had on universities in Estonia between 1997 and 2009. It is based on a study of the analysis of experts' reports of curricula accreditation and interviews with university and programme managers, undertaken between 2007 and 2009. The study included an analysis of 12 curricula…

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

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...

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...

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

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.

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

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.

Impact Analysis | Energy Analysis | NREL

Science.gov Websites

Impact Analysis Impact Analysis Our impact analysis work addresses the impacts of markets and Portfolio Standards We are engaged in a multi-year project to examine the costs, benefits, and other impacts

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.

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.

Sources of Virginia meteorological and air quality data for use in highway air quality analysis with comments on their usefulness.

DOT National Transportation Integrated Search

1975-01-01

The preparation of accurate air quality analysis portions of highway environmental impact statements requires valid meteorological and air quality data. These data are needed, in part, to determine the regional and local wind patterns on which pollut...

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

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

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

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.

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).

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

Quality Assurance and Its Impact from Higher Education Institutions' Perspectives: Methodological Approaches, Experiences and Expectations

ERIC Educational Resources Information Center

Bejan, Stelian Andrei; Janatuinen, Tero; Jurvelin, Jouni; Klöpping, Susanne; Malinen, Heikki; Minke, Bernhard; Vacareanu, Radu

2015-01-01

This paper reports on methodological approaches, experiences and expectations referring to impact analysis of quality assurance from the perspective of three higher education institutions (students, teaching staff, quality managers) from Germany, Finland and Romania. The presentations of the three sample institutions focus on discussing the core…

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

[Impact of tooth loss in quality of life].

PubMed

Silva, Maria Elisa de Souza E; Villaça, Enio Lacerda; Magalhães, Cláudia Silami de; Ferreira, Efigênia Ferreira E

2010-05-01

In order to evaluate the impact of tooth loss in patient's quality of life, 50 volunteers were selected among patients who use the Public Health Services in treatment for their complete denture's placement or replacement. The Oral Health Impact Profile (OHIP-14) and a socio-demographic data collection were applied before treatment. The values were founded through the weight of each question in association with Likert's Scale. As higher was the score, higher was the impact in the quality of life. In this survey 82% were female, 52% of patients between 41 and 60 years old (average: 59.1), and 34% married. The higher values of OHIP-14 dimensions in patient's quality of life were: Psychological Discomfort (122), Physical Pain (121), Psychological Disability (113), Physical Disability (109), Functional Limitation (93), Handicap (82) and Social Disability (76). As it could be observed, the lost of teeth or the use of inadequate prosthesis could bring negative impacts in life's quality, especially regarding preoccupation, stress with mouth problems and shame, although people perceive minor impacts in social relationships and development of their daily activities. This information can be relevant to prepare dentists to raise their knowledge about edentulous people and how to work with them.

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.

Impacts of wildfire smoke plumes on regional air quality

EPA Science Inventory

Background: Recent trends in increased frequency and severity of large fires necessitate an improved understanding of smoke plume impacts on regional-scale air quality and public health. Objective: We examine the impact of fire smoke on regional air quality between 2006 and 2013 ...

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. 

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

Understanding Land Use Impacts on Groundwater Quality Using Chemical Analysis

NASA Astrophysics Data System (ADS)

Nitka, A.; Masarik, K.; Masterpole, D.; Johnson, B.; Piette, S.

2017-12-01

Chippewa County, in western Wisconsin, has a unique historical set of groundwater quality data. The county conducted extensive groundwater sampling of private wells in 1985 (715 wells) and 2007 (800 wells). In 2016, they collaborated with UW-Extension and UW-Stevens Point to evaluate the current status of groundwater quality in Chippewa County by sampling of as many of the previously studied wells as possible. Nitrate was a primary focus of this groundwater quality inventory. Of the 744 samples collected, 60 were further analyzed for chemical indicators of agricultural and septic waste, two major sources of nitrate contamination. Wells for nitrate source analysis were selected from the 2016 participants based upon certain criteria. Only wells with a Wisconsin Unique Well Number were considered to ensure well construction information was available. Next, an Inverse Distance Weighting tool in ESRI ArcMap was used to assign values categorizing septic density. Two-thirds of the wells were selected in higher density areas and one-third in lower density areas. Equally prioritized was an even distribution of nitrate - N concentrations, with 28 of the wells having nitrate - N concentrations higher than the drinking water standard of 10 mg/L and 32 wells with concentrations between 2 and 10 mg/L. All wells with WUWN and nitrate - N concentrations greater than 20 mg/L were selected. The results of the nitrate source analyses will aid in determining temporal changes and spatial relationships of groundwater quality to soils, geology and land use in Chippewa County.

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...

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.

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.

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.

The Role of Classroom Quality in Explaining Head Start Impacts

ERIC Educational Resources Information Center

Connors, Maia C.; Friedman-Krauss, Allison H.; Morris, Pamela A.; Page, Lindsay C.; Feller, Avi

2014-01-01

This study seeks to answer the following question: Are impacts on Head Start classroom quality associated with impacts of Head Start on children's learning and development? This study employs a variety of descriptive and quasi-experimental methods to explore the role of classroom quality as a mediator or mechanism of Head Start impacts. This…

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

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

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.

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.

Potential future impacts on visual air quality for Class I areas

Treesearch

Gurule Nochumson; Mona J. Wecksung

1979-01-01

Visual air quality is most sensitive to degradation by air pollution in areas with good visibility. The protection of visual air quality in mandatory Class I Federal areas has been declared a national goal by Congress. Impacts on visual air quality are calculated for 154 Class I areas where visual air quality is considered an important value. These impacts are...

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

Does glycemic variability impact mood and quality of life?

PubMed

Penckofer, Sue; Quinn, Lauretta; Byrn, Mary; Ferrans, Carol; Miller, Michael; Strange, Poul

2012-04-01

Diabetes is a chronic condition that significantly impacts quality of life. Poor glycemic control is associated with more diabetes complications, depression, and worse quality of life. The impact of glycemic variability on mood and quality of life has not been studied. A descriptive exploratory design was used. Twenty-three women with type 2 diabetes wore a continuous glucose monitoring system for 72 h and completed a series of questionnaires. Measurements included (1) glycemic control shown by glycated hemoglobin and 24-h mean glucose, (2) glycemic variability shown by 24-h SD of the glucose readings, continuous overall net glycemic action (CONGA), and Fourier statistical models to generate smoothed curves to assess rate of change defined as "energy," and (3) mood (depression, anxiety, anger) and quality of life by questionnaires. Women with diabetes and co-morbid depression had higher anxiety, more anger, and lower quality of life than those without depression. Certain glycemic variability measures were associated with mood and quality of life. The 24-h SD of the glucose readings and the CONGA measures were significantly associated with health-related quality of life after adjusting for age and weight. Fourier models indicated that certain energy components were significantly associated with depression, trait anxiety, and overall quality of life. Finally, subjects with higher trait anxiety tended to have steeper glucose excursions. Data suggest that greater glycemic variability may be associated with lower quality of life and negative moods. Implications include replication of the study in a larger sample for the assessment of blood glucose fluctuations as they impact mood and quality of life.

Using Water Quality Models in Management - A Multiple Model Assessment, Analysis of Confidence, and Evaluation of Climate Change Impacts

NASA Astrophysics Data System (ADS)

Irby, Isaac David

Human impacts on the Chesapeake Bay through increased nutrient run-off as a result of land-use change, urbanization, and industrialization, have resulted in a degradation of water quality over the last half-century. These direct impacts, compounded with human-induced climate changes such as warming, rising sea-level, and changes in precipitation, have elevated the conversation surrounding the future of water quality in the Bay. The overall goal of this dissertation project is to use a combination of models and data to better understand and quantify the impact of changes in nutrient loads and climate on water quality in the Chesapeake Bay. This research achieves that goal in three parts. First, a set of eight water quality models is used to establish a model mean and assess model skill. All models were found to exhibit similar skill in resolving dissolved oxygen concentrations as well as a number of dissolved oxygen-influencing variables (temperature, salinity, stratification, chlorophyll and nitrate) and the model mean exhibited the highest individual skill. The location of stratification within the water column was found to be a limiting factor in the models' ability to adequately simulate habitat compression resulting from low-oxygen conditions. Second, two of the previous models underwent the regulatory Chesapeake Bay pollution diet mandated by the Environmental Protection Agency. Both models exhibited a similar relative improvement in dissolved oxygen concentrations as a result of the reduction of nutrients stipulated in the pollution diet. A Confidence Index was developed to identify the locations of the Bay where the models are in agreement and disagreement regarding the impacts of the pollution diet. The models were least certain in the deep part of the upper main stem of the Bay and the uncertainty primarily stemmed from the post-processing methodology. Finally, by projecting the impacts of climate change in 2050 on the Bay, the potential success of the

An integrated bioinformatics approach to improve two-color microarray quality-control: impact on biological conclusions.

PubMed

van Haaften, Rachel I M; Luceri, Cristina; van Erk, Arie; Evelo, Chris T A

2009-06-01

Omics technology used for large-scale measurements of gene expression is rapidly evolving. This work pointed out the need of an extensive bioinformatics analyses for array quality assessment before and after gene expression clustering and pathway analysis. A study focused on the effect of red wine polyphenols on rat colon mucosa was used to test the impact of quality control and normalisation steps on the biological conclusions. The integration of data visualization, pathway analysis and clustering revealed an artifact problem that was solved with an adapted normalisation. We propose a possible point to point standard analysis procedure, based on a combination of clustering and data visualization for the analysis of microarray data.

An In-Depth Study on the Impact of External Quality Assurance

ERIC Educational Resources Information Center

Stensaker, Bjorn; Langfeldt, Liv; Harvey, Lee; Huisman, Jeroen; Westerheijden, Don

2011-01-01

After more than two decades of external quality assurance, there is an increasing interest in questions concerning the impact and effects of this activity. Following an external evaluation of NOKUT--the Norwegian quality assurance agency, this article studies the impact of external quality assurance in detail by analysing quantitative and…

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

NASA Astrophysics Data System (ADS)

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

2018-03-01

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

Transportation impact analysis gets a failing grade when it comes to climate change and smart growth

DOT National Transportation Integrated Search

2008-12-01

Transportation impact analysis performed to comply with environmental impact laws (i.e., the : California Environmental Quality Act or the National Environmental Policy Act) often focuses : on only one perspective about potential impacts. That perspe...

Does Glycemic Variability Impact Mood and Quality of Life?

PubMed Central

Quinn, Lauretta; Byrn, Mary; Ferrans, Carol; Miller, Michael; Strange, Poul

2012-01-01

Abstract Background Diabetes is a chronic condition that significantly impacts quality of life. Poor glycemic control is associated with more diabetes complications, depression, and worse quality of life. The impact of glycemic variability on mood and quality of life has not been studied. Methods A descriptive exploratory design was used. Twenty-three women with type 2 diabetes wore a continuous glucose monitoring system for 72 h and completed a series of questionnaires. Measurements included (1) glycemic control shown by glycated hemoglobin and 24-h mean glucose, (2) glycemic variability shown by 24-h SD of the glucose readings, continuous overall net glycemic action (CONGA), and Fourier statistical models to generate smoothed curves to assess rate of change defined as “energy,” and (3) mood (depression, anxiety, anger) and quality of life by questionnaires. Results Women with diabetes and co-morbid depression had higher anxiety, more anger, and lower quality of life than those without depression. Certain glycemic variability measures were associated with mood and quality of life. The 24-h SD of the glucose readings and the CONGA measures were significantly associated with health-related quality of life after adjusting for age and weight. Fourier models indicated that certain energy components were significantly associated with depression, trait anxiety, and overall quality of life. Finally, subjects with higher trait anxiety tended to have steeper glucose excursions. Conclusions Data suggest that greater glycemic variability may be associated with lower quality of life and negative moods. Implications include replication of the study in a larger sample for the assessment of blood glucose fluctuations as they impact mood and quality of life. PMID:22324383

Impact of urban sprawl on water quality in eastern Massachusetts, USA.

PubMed

Tu, Jun; Xia, Zong-Guo; Clarke, Keith C; Frei, Allan

2007-08-01

A study of water quality, land use, and population variations over the past three decades was conducted in eastern Massachusetts to examine the impact of urban sprawl on water quality using geographic information system and statistical analyses. Since 1970, eastern Massachusetts has experienced pronounced urban sprawl, which has a substantial impact on water quality. High spatial correlations are found between water quality indicators (especially specific conductance, dissolved ions, including Ca, Mg, Na, and Cl, and dissolved solid) and urban sprawl indicators. Urbanized watersheds with high population density, high percentage of developed land use, and low per capita developed land use tended to have high concentrations of water pollutants. The impact of urban sprawl also shows clear spatial difference between suburban areas and central cities: The central cities experienced lower increases over time in specific conductance concentration, compared to suburban and rural areas. The impact of urban sprawl on water quality is attributed to the combined effects of population and land-use change. Per capita developed land use is a very important indicator for studying the impact of urban sprawl and improving land use and watershed management, because inclusion of this indicator can better explain the temporal and spatial variations of more water quality parameters than using individual land use or/and population density.

Impact of periodontal disease on quality of life: a systematic review.

PubMed

Ferreira, M C; Dias-Pereira, A C; Branco-de-Almeida, L S; Martins, C C; Paiva, S M

2017-08-01

The diagnosis of periodontal disease is commonly based on objective evaluations of the patient's medical/dental history as well as clinical and radiographic examinations. However, periodontal disease should also be evaluated subjectively through measures that quantify its impact on oral health-related quality of life. The aim of this study was to evaluate the impact of periodontal disease on quality of life among adolescents, adults and older adults. A systematic search of the literature was performed for scientific articles published up to July 2015 using electronic databases and a manual search. Two independent reviewers performed the selection of the studies, extracted the data and assessed the methodological quality. Thirty-four cross-sectional studies involving any age group, except children, and the use of questionnaires for the assessment of the impact of periodontal disease on quality of life were included. Twenty-five studies demonstrated that periodontal disease was associated with a negative impact on quality of life, with severe periodontitis exerting the most significant impact by compromising aspects related to function and esthetics. Unlike periodontitis, gingivitis was associated with pain as well as difficulties performing oral hygiene and wearing dentures. Gingivitis was also negatively correlated with comfort. The results indicate that periodontal disease may exert an impact on quality of life of individuals, with greater severity of the disease related to greater impact. Longitudinal studies with representative samples are needed to ensure validity of the findings. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

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

[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.

Impacts of iron and steelmaking facilities on soil quality.

PubMed

Strezov, Vladimir; Chaudhary, Chandrakant

2017-12-01

Iron and steel are highly important materials used in a wide range of products with important contribution to the economic development. The processes for making iron and steel are energy intensive and known to contribute to local pollution. Deposition of the metals may also have adverse impacts on soil quality, which requires detailed assessment. The aim of this study was to investigate the impacts of iron and steelmaking facilities on the local soil quality. Soil samples were collected in the vicinity of two steelmaking sites in Australia, one based on blast furnace steelmaking operation, while the second site was based on electric arc furnace steel recycling. The soil samples were compared to a background site where no industrial impact is expected. The soil collected near industrial facilities contained larger toxic metal contents, however this concentration for all priority metals was within the Australian National Environmental Protection Measure guidelines for the acceptable recreational soil quality. When compared to the international soil quality guidelines, some of the soils collected near the industrial sites, particularly near the blast furnace operated steelmaking, exceeded the arsenic, iron and manganese (according to United States Environmental Protection Agency guidelines) and chromium, copper and nickel concentrations (according to the Canadian guidelines). The work further provided a novel environmental assessment model taking into consideration the environmental and health impacts of each element. The environmental assessment revealed most significant contribution of manganese, followed by titanium, zinc, chromium and lead. Titanium was the second most important contributor to the soil quality, however this metal is currently not included in any of the international soil quality guidelines. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

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…

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.

OVERVIEW OF THE CLIMATE IMPACT ON REGIONAL AIR QUALITY (CIRAQ) PROJECT

EPA Science Inventory

The Climate Impacts on Regional Air Quality (CIRAQ) project will develop model-estimated impacts of global climate changes on ozone and particulate matter (PM) in direct support of the USEPA Global Change Research Program's (GCRP) national air quality assessment. EPA's urban/reg...

Measuring Quality in High-Impact Practices

ERIC Educational Resources Information Center

Zilvinskis, John

2017-01-01

High-Impact Practices (HIPs), such as participating in undergraduate research, completing an internship, and creating a senior-capstone project, are becoming prominent within the academy. Scholars have surmised that aspects of HIP quality (e.g., student effort, peer collaboration, and faculty interaction) lead to greater desired outcomes for…

‘In the Moment’: An Analysis of Facilitator Impact During a Quality Improvement Process

PubMed Central

Shaw, Erik; Looney, Anna; Chase, Sabrina; Navalekar, Rohini; Stello, Brian; Lontok, Oliver; Crabtree, Benjamin

2010-01-01

Facilitators frequently act ‘in the moment’ – deciding if, when and how to intervene into group process discussions. This paper offers a unique look at how facilitators impacted eleven primary care teams engaged in a 12-week quality improvement (QI) process. Participating in a federally funded QI trial, primary care practices in New Jersey and Pennsylvania formed practice-based teams comprised of physicians, nurses, administrative staff, and patients. External facilitators met with each team to help them identify and implement changes aimed at improving the organization, work relationships, office functions, and patient care. Audio-recordings of the meetings and descriptive field notes were collected. These qualitative data provided information on how facilitators acted ‘in the moment’ and how their interventions impacted group processes over time. Our findings reveal that facilitators impacted groups in multiple ways throughout the QI process, rather than through a linear progression of stages or events. We present five case examples that show what acting ‘in the moment’ looked like during the QI meetings and how these facilitator actions/interventions impacted the primary care teams. These accounts provide practical lessons learned and insights into effective facilitation that may encourage others in their own facilitation work and offer beneficial strategies to facilitators in other contexts. PMID:22557936

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

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

WATERSHED BOUNDARY CONDITIONS FOR GLOBAL CHANGE IMPACT ANALYSIS

EPA Science Inventory

The US Global Change Research Program (USGCRP) studies (among other issues) the impact of global change on water quality. This field study evaluates the impact of global changes (land-use change and climate change) on source water quality. Changes in source water quality change...

Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

PubMed

Shortell, S M; O'Brien, J L; Carman, J M; Foster, R W; Hughes, E F; Boerstler, H; O'Connor, E J

1995-06-01

This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals. Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions. The study involved cross-sectional examination of the named relationships. Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care. A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation. What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult challenges in this regard.

Quantifying Impact of Biofeedstock Production on Hydrology/Water Quality in Midwest USA

NASA Astrophysics Data System (ADS)

Chaubey, Indrajeet; Engel, Bernard; Thomas, Mark; Raj, Cibin; Saraswat, Dharmendra

2010-05-01

The production of biofeedstocks for biofuels is likely to impact the hydrology and water quality of watersheds. Communities potentially impacted are increasingly concerned, and at present, little is known regarding the magnitude of impacts of biofeedstock production on hydrology and water quality. We have initiated a national facilitation project to answer the following questions: What are the unintended environmental consequences of increased corn production to meet biofuel demands? What are the environmental impacts of various second generation biofeedstock production systems to meet cellulosic ethanol demands? Would the management of cropping systems involving corn silage meet cellulosic ethanol demands with minimal environmental impact? What are the broad-scale water quality implications of energy crops, such as switchgrass, grown for bioenergy production on highly erodible soils? This presentation will discuss development of multi-regional agricultural land management practices that can be implemented to mitigate potential negative environmental impacts associated with biofeedstock production while meeting the biofuel production demand. Specifically, we will discuss how watershed scale modeling can be utilized to evaluate the environmental impacts of various biofeedstock production strategies. We will also discuss regional differences in alternative biofeedstock production and associated hydrologic/water quality impacts.

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.

Multiobjective Policy Analysis to Evaluate Air Quality Impacts of Oil and Gas Regulations

NASA Astrophysics Data System (ADS)

Alongi, M.; Kasprzyk, J. R.; Milford, J.; Ryan, J. N.; Estep, M.

2016-12-01

Unconventional oil and gas development (UOGD) using hydraulic fracturing and horizontal drilling has recently fostered an unprecedented acceleration in energy development. Regulations seek to protect the public health of communities in proximity to UOGD and the environmental quality of these regions, while maintaining economic benefits. One such regulation is the setback distance, which dictates the minimum distance between an oil and gas well and an occupied structure, such as a residential or commercial building, or an area of special concern. This presentation discusses a new policy analysis framework for UOGD regulations, using the Borg multiobjective evolutionary algorithm (MOEA) coupled with AERMOD, a regulatory air dispersion model. The initial results explore how setback distance and well density regulations could impact the number of wells that can be drilled, based on a set of performance objectives that model potential increases in benzene, a hazardous air pollutant that has been linked to cancer and other detrimental health effects. The simulation calculates daily benzene averages using meteorological data from Greeley, CO. An important aspect of this work is to define representative quantitative objectives that accurately capture salient characteristics of the pollutant time series. For example, our framework will characterize the maximum concentration found over the entire spatial domain and over the duration of the simulation. Frequency-based objectives will also be explored, such as the number of exceedances of the benchmark annual average benzene concentration corresponding to a given level of cancer risk. The multiobjective analysis can also be expanded to integrate other objectives that represent performance-based outcomes on UOGD such as energy development profits, increases in noise pollution and decreases in property value. This research represents one application of how MOEAs can be used to inform policymaking for environmental regulations.

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.

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.

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

Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

PubMed Central

Shortell, S M; O'Brien, J L; Carman, J M; Foster, R W; Hughes, E F; Boerstler, H; O'Connor, E J

1995-01-01

OBJECTIVE: This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals. DATA SOURCES AND STUDY SETTING: Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions. STUDY DESIGN: The study involved cross-sectional examination of the named relationships. DATA COLLECTION/EXTRACTION METHODS: Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care. PRINCIPAL FINDINGS: A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation. CONCLUSIONS: What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult

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.

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.

The impact of food allergies on quality of life.

PubMed

Bacal, Liane R

2013-07-01

CME EDUCATIONAL OBJECTIVES 1. Recognize and appreciate the impact of food allergies on psychosocial health. 2. List the factors that have been shown to negatively affect health-related quality of life. 3. Understand how physicians can directly help to improve a child's quality of life while living with food allergies. Food allergy is a serious problem affecting a growing number of children worldwide. There is a large body of evidence supporting the detrimental effects that food allergy can have on a child's quality of life. With validated tools, we can identify these children and focus on how to protect, guide, and help them to live a safe life. Recent research articulates how food allergies impact health-related quality of life (HRQL). There are studies reported from the child's perspective, as well as studies reported from the parent's perspective. With the development of validated disease and age-specific questionnaires, researchers can reliably gather data on the psychological aspect of children with food allergies. The purpose of this article is to provide a review of the literature examining the psycho-social impact of food allergies on children. This article was designed to outline suggestions to help physicians care for the whole child - both mind and body. Copyright 2013, SLACK Incorporated.

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.

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.

Air quality impacts from prescribed forest fires under different management practices.

PubMed

Tian, Di; Wang, Yuhang; Bergin, Michelle; Hu, Yongtao; Liu, Yongqiang; Russell, Armistead G

2008-04-15

Large amounts of air pollutants are emitted during prescribed forest fires. Such emissions and corresponding air quality impacts can be modulated by different forest management practices. The impacts of changing burning seasons and frequencies and of controlling emissions during smoldering on regional air quality in Georgia are quantified using source-oriented air quality modeling, with modified emissions from prescribed fires reflecting effects of each practice. Equivalent fires in the spring and winter are found to have a greater impact on PM2.5 than those in summer, though ozone impacts are larger from spring and summer fires. If prescribed fires are less frequent more biofuel is burnt in each fire, leading to larger emissions and air quality impacts per fire. For example, emissions from a fire with a 5-year fire return interval (FRI) are 72% larger than those from a fire of the same acreage with a 2-year FRI. However, corresponding long-term regional impacts are reduced with the longer FRI since the annual burned area is reduced. Total emissions for fires in Georgia with a 5-year FRI are 32% less than those with a 2-year FRI. Smoldering emissions can lead to approximately 1.0 or 1.9 microg/m3 of PM2.5 in the Atlanta PM2.5 nonattainment area during March 2002.

Assessing air quality impacts of managed lanes.

DOT National Transportation Integrated Search

2010-12-01

Impacts on transit bus performance and air quality were investigated for a case study high-occupancy / toll (HOT) lane project on a corridor of I-95 near Miami. Trends in air pollutant concentration monitoring data in the study area first were analyz...

Assessing air quality impacts of managed lanes

DOT National Transportation Integrated Search

2010-12-01

Impacts on transit bus performance and air quality were investigated for a case study high-occupancy / : toll (HOT) lane project on a corridor of I-95 near Miami. Trends in air pollutant concentration : monitoring data in the study area first were an...

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.

Water Quality Analysis Simulation

EPA Pesticide Factsheets

The Water Quality analysis simulation Program, an enhancement of the original WASP. This model helps users interpret and predict water quality responses to natural phenomena and man-made pollution for variious pollution management decisions.

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

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

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

Impacts of swine manure pits on groundwater quality

USGS Publications Warehouse

Krapac, I.G.; Dey, W.S.; Roy, W.R.; Smyth, C.A.; Storment, E.; Sargent, S.L.; Steele, J.D.

2002-01-01

Manure deep-pits are commonly used to store manure at confined animal feeding operations. However, previous to this study little information had been collected on the impacts of deep-pits on groundwater quality to provide science-based guidance in formulating regulations and waste management strategies that address risks to human health and the environment. Groundwater quality has been monitored since January 1999 at two hog finishing facilities in Illinois that use deep-pit systems for manure storage. Groundwater samples were collected on a monthly basis and analyzed for inorganic and bacteriological constituent concentrations. The two sites are located in areas with geologic environments representing different vulnerabilities for local groundwater contamination. One site is underlain by more than 6 m of clayey silt, and 7-36 m of shale. Concentrations of chloride, ammonium, phosphate, and potassium indicated that local groundwater quality had not been significantly impacted by pit leakage from this facility. Nitrate concentrations were elevated near the pit, often exceeding the 10 mg N/l drinking water standard. Isotopic nitrate signatures suggested that the nitrate was likely derived from soil organic matter and fertilizer applied to adjacent crop fields. At the other site, sandstone is located 4.6-6.1 m below land surface. Chloride concentrations and ??15N and ??18O values of dissolved nitrate indicated that this facility may have limited and localized impacts on groundwater. Other constituents, including ammonia, potassium, phosphate, and sodium were generally at or less than background concentrations. Trace- and heavy-metal concentrations in groundwater samples collected from both facilities were at concentrations less than drinking water standards. The concentration of inorganic constituents in the groundwater would not likely impact human health. Fecal streptococcus bacteria were detected at least once in groundwater from all monitoring wells at both sites

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 flying qualities on mission effectiveness for helicopter air combat

NASA Technical Reports Server (NTRS)

Harris, T. M.; Beerman, D. A.; Bivens, C. C.

1984-01-01

Battlefield nap-of-the-earth (NOE) helicopter operations are vital for a use of the helicopter in a high-threat environment. As the pilot's workload in this flight regime is very high, the helicopter's handling qualities become an important factor. The present investigation is concerned with overall mission effectiveness, flying qualities, and their interaction with other parameters. A description is presented of a study which generated a significant amount of date relating the importance of flying qualities to the ability to perform several specific mission tasks. It was found that flying qualities do have a major impact on the ability to perform a specific mission. The impact of flying qualities on Scout helicopter mission effectiveness is mainly related to the probability of being detected. The flying qualities effect most critical to the Scout mission was found to be precision of hover control.

Food fortification: issues on quality assurance and impact evaluation in developing countries.

PubMed

Florentino, R

2003-01-01

Quality assurance and impact evaluation are essential components of a food fortification program and should be integrated in the fortification process. Quality assurance will ensure that the micronutrient meant to be delivered is indeed reaching the target population at the correct level. Impact evaluation will determine the effectiveness of food fortification as a strategy in controlling micronutrient deficiency and enable program planners to make decisions on the future of the program. In developing countries, both quality assurance and impact evaluation are often constrained not only by inadequacy of facilities as well as financial and manpower resources, but by unclear definition of objectives and inappropriate design. It is therefore necessary to consider the target audience for the quality assurance monitoring and impact evaluation in order to clearly define their objectives and in turn suit the design to these objectives, at the same time as the limitations in financial and manpower resources are considered.

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

PubMed

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

2012-05-01

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

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

Identification and assessment of potential water quality impact factors for drinking-water reservoirs.

PubMed

Gu, Qing; Deng, Jinsong; Wang, Ke; Lin, Yi; Li, Jun; Gan, Muye; Ma, Ligang; Hong, Yang

2014-06-10

Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources.

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

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

Does capitation matter? Impacts on access, use, and quality.

PubMed

Zuvekas, Samuel H; Hill, Steven C

2004-01-01

Provider capitation may constrain costs, but it also may reduce access and quality of care. We examine the impacts of capitating the usual source of care of enrollees in health maintenance organizations (HMOs). We account for the endogeneity of capitation and other characteristics using generalized methods of moments (GMM) estimation on a sample from the Medical Expenditure Panel Survey for 1996 and 1997. Being organized as a group/staff HMO generally has stronger impact on access and quality than capitation. Capitation by itself may increase access to consumers' usual sources of care, improve primary preventive care, and reduce coordination, but estimates with GMM were not statistically significant.

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.

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.

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 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.

Identification and Assessment of Potential Water Quality Impact Factors for Drinking-Water Reservoirs

PubMed Central

Gu, Qing; Deng, Jinsong; Wang, Ke; Lin, Yi; Li, Jun; Gan, Muye; Ma, Ligang; Hong, Yang

2014-01-01

Various reservoirs have been serving as the most important drinking water sources in Zhejiang Province, China, due to the uneven distribution of precipitation and severe river pollution. Unfortunately, rapid urbanization and industrialization have been continuously challenging the water quality of the drinking-water reservoirs. The identification and assessment of potential impacts is indispensable in water resource management and protection. This study investigates the drinking water reservoirs in Zhejiang Province to better understand the potential impact on water quality. Altogether seventy-three typical drinking reservoirs in Zhejiang Province encompassing various water storage levels were selected and evaluated. Using fifty-two reservoirs as training samples, the classification and regression tree (CART) method and sixteen comprehensive variables, including six sub-sets (land use, population, socio-economy, geographical features, inherent characteristics, and climate), were adopted to establish a decision-making model for identifying and assessing their potential impacts on drinking-water quality. The water quality class of the remaining twenty-one reservoirs was then predicted and tested based on the decision-making model, resulting in a water quality class attribution accuracy of 81.0%. Based on the decision rules and quantitative importance of the independent variables, industrial emissions was identified as the most important factor influencing the water quality of reservoirs; land use and human habitation also had a substantial impact on water quality. The results of this study provide insights into the factors impacting the water quality of reservoirs as well as basic information for protecting reservoir water resources. PMID:24919129

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.

The impact of water quality in Narragansett Bay on housing prices

NASA Astrophysics Data System (ADS)

Liu, Tingting; Opaluch, James J.; Uchida, Emi

2017-08-01

We examine the impact of water quality in Narragansett Bay on housing prices in coastal towns and cities using a hedonic housing-price model. Unlike other hedonic studies of water quality, we test whether housing market responds to average water quality or more to extreme events. We also test the spatial and temporal extent of effects of water quality on housing prices. We find that poor coastal water quality, measured in terms of the concentration of chlorophyll, has a negative impact on housing prices that diminishes with distance from the shoreline. Furthermore, our finding suggests that housing prices are most influenced by the extreme environmental conditions, which may be accompanied by unpleasant odors, discoloration, and even fish kills. We further predict potential increases in home values associated under water quality improvement scenarios and find an increase in the values of homes in coastal communities along Narragansett Bay of about 18 million up to 136 million.

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.

Assuring quality in narrative analysis.

PubMed

Bailey, P H

1996-04-01

Many nurse-researchers using qualitative strategies have been concerned with assuring quality in their work. The early literature reveals that the concepts of validity and reliability, as understood from the positivist perspective, are somehow inappropriate and inadequate when applied to interpretive research. More recent literature suggests that because of the positivist and interpretive paradigms are epistemologically divergent, the transfer of quality criteria from one perspective to the other is not automatic or even reasonable. The purpose of this article, therefore, is to clarify what the terms quality, trustworthiness, credibility, authenticity, and goodness mean in qualitative research findings. The process of assuring quality, validation, in qualitative research will be discussed within the context of the interpretive method, narrative analysis. A brief review of quality in narrative analysis nursing research will also be presented.

Impacts of climate change on surface water quality in relation to drinking water production.

PubMed

Delpla, I; Jung, A-V; Baures, E; Clement, M; Thomas, O

2009-11-01

Besides climate change impacts on water availability and hydrological risks, the consequences on water quality is just beginning to be studied. This review aims at proposing a synthesis of the most recent existing interdisciplinary literature on the topic. After a short presentation about the role of the main factors (warming and consequences of extreme events) explaining climate change effects on water quality, the focus will be on two main points. First, the impacts on water quality of resources (rivers and lakes) modifying parameters values (physico-chemical parameters, micropollutants and biological parameters) are considered. Then, the expected impacts on drinking water production and quality of supplied water are discussed. The main conclusion which can be drawn is that a degradation trend of drinking water quality in the context of climate change leads to an increase of at risk situations related to potential health impact.

An educational intervention impact on the quality of nursing records.

PubMed

Linch, Graciele Fernanda da Costa; Lima, Ana Amélia Antunes; Souza, Emiliane Nogueira de; Nauderer, Tais Maria; Paz, Adriana Aparecida; da Costa, Cíntia

2017-10-30

to evaluate the impact of an educational intervention on the quality of nursing records. quasi-experimental study with before-and-after design conducted in a hospital. All the nurses in the cardiac intensive care unit of the hospital received the intervention, which consisted of weekly meetings during five months. To collect data, the instrument Quality of Diagnoses, Interventions and Outcomes was applied to the patients' charts in two moments: baseline and after intervention. the educational intervention had an impact on the quality of the records, since most of the items presented a significant increase in their mean values after the intervention, despite the low values in the two moments. the educational intervention proved to be effective at improving the quality of nursing records and a lack of quality was identified in the evaluated records, revealed by the low mean values and by the weakness of some questions presented in the items, which did not present a significant increase. Therefore, educational actions focused on real clinical cases may have positive implications for nursing practice.

Immediate impact of smoke-free laws on indoor air quality.

PubMed

Lee, Kiyoung; Hahn, Ellen J; Riker, Carol; Head, Sara; Seithers, Peggy

2007-09-01

Smoke-free laws significantly impact indoor air quality. However, the temporal effects of these laws on indoor air pollution have not been determined. This paper assesses the temporal impact of one smoke-free law on indoor air quality. This quasi-experimental study compared the indoor air quality of nine hospitality venues and one bingo hall in Georgetown, Kentucky, before and after implementation of a 100% smoke-free workplace law. We made real-time measurements of particulate matter with 2.5 microm aerodynamic diameter or smaller (PM2.5). Among the nine Georgetown hospitality venues, the average indoor PM2.5 concentration was 84 microg/m3 before the law took effect. The average indoor PM2.5 concentrations in nine compliant venues significantly decreased to 18 microg/m3 one week after the law took effect. Three venues having 82 microg/m3 before the law had significantly lower levels from the first day the law was implemented, and the low level was maintained. Compliance with the law is critical to achieving clean indoor air. Indoor air pollution in the bingo hall was not reduced until the establishment decided to comply with the law. The smoke-free law showed immediate impact on indoor air quality.

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

Impact of fuel quality regulation and speed reductions on shipping emissions: implications for climate and air quality.

PubMed

Lack, Daniel A; Cappa, Christopher D; Langridge, Justin; Bahreini, Roya; Buffaloe, Gina; Brock, Charles; Cerully, Kate; Coffman, Derek; Hayden, Katherine; Holloway, John; Lerner, Brian; Massoli, Paola; Li, Shao-Meng; McLaren, Robert; Middlebrook, Ann M; Moore, Richard; Nenes, Athanasios; Nuaaman, Ibraheem; Onasch, Timothy B; Peischl, Jeff; Perring, Anne; Quinn, Patricia K; Ryerson, Tom; Schwartz, Joshua P; Spackman, Ryan; Wofsy, Steven C; Worsnop, Doug; Xiang, Bin; Williams, Eric

2011-10-15

Atmospheric emissions of gas and particulate matter from a large ocean-going container vessel were sampled as it slowed and switched from high-sulfur to low-sulfur fuel as it transited into regulated coastal waters of California. Reduction in emission factors (EFs) of sulfur dioxide (SO₂), particulate matter, particulate sulfate and cloud condensation nuclei were substantial (≥ 90%). EFs for particulate organic matter decreased by 70%. Black carbon (BC) EFs were reduced by 41%. When the measured emission reductions, brought about by compliance with the California fuel quality regulation and participation in the vessel speed reduction (VSR) program, are placed in a broader context, warming from reductions in the indirect effect of SO₄ would dominate any radiative changes due to the emissions changes. Within regulated waters absolute emission reductions exceed 88% for almost all measured gas and particle phase species. The analysis presented provides direct estimations of the emissions reductions that can be realized by California fuel quality regulation and VSR program, in addition to providing new information relevant to potential health and climate impact of reduced fuel sulfur content, fuel quality and vessel speed reductions.

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.

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.

Assessing air quality impacts of managed lanes : summary.

DOT National Transportation Integrated Search

2010-01-01

Researchers at the National Center for Transit Research, University of South Florida, recently studied a segment of I-95 between Ft. Lauderdale and Miami to investigate the impacts of high-occupancy/toll (HOT) lanes on air quality. The project simula...

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

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.

Impacts of extreme flooding on riverbank filtration water quality.

PubMed

Ascott, M J; Lapworth, D J; Gooddy, D C; Sage, R C; Karapanos, I

2016-06-01

Riverbank filtration schemes form a significant component of public water treatment processes on a global level. Understanding the resilience and water quality recovery of these systems following severe flooding is critical for effective water resources management under potential future climate change. This paper assesses the impact of floodplain inundation on the water quality of a shallow aquifer riverbank filtration system and how water quality recovers following an extreme (1 in 17 year, duration >70 days, 7 day inundation) flood event. During the inundation event, riverbank filtrate water quality is dominated by rapid direct recharge and floodwater infiltration (high fraction of surface water, dissolved organic carbon (DOC) >140% baseline values, >1 log increase in micro-organic contaminants, microbial detects and turbidity, low specific electrical conductivity (SEC) <90% baseline, high dissolved oxygen (DO) >400% baseline). A rapid recovery is observed in water quality with most floodwater impacts only observed for 2-3 weeks after the flooding event and a return to normal groundwater conditions within 6 weeks (lower fraction of surface water, higher SEC, lower DOC, organic and microbial detects, DO). Recovery rates are constrained by the hydrogeological site setting, the abstraction regime and the water quality trends at site boundary conditions. In this case, increased abstraction rates and a high transmissivity aquifer facilitate rapid water quality recoveries, with longer term trends controlled by background river and groundwater qualities. Temporary reductions in abstraction rates appear to slow water quality recoveries. Flexible operating regimes such as the one implemented at this study site are likely to be required if shallow aquifer riverbank filtration systems are to be resilient to future inundation events. Development of a conceptual understanding of hydrochemical boundaries and site hydrogeology through monitoring is required to assess the

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.

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.

Persistent Urban Impacts on Surface Water Quality Mediated by Stormwater Recharge

NASA Astrophysics Data System (ADS)

Gabor, R. S.; Brooks, P. D.; Neilson, B. T.; Bowen, G. J.; Jameel, M. Y.; Hall, S. J.; Eiriksson, D.; Millington, M. R.; Gelderloos, A.

2016-12-01

Growing population centers along mountain watersheds put added stress on sensitive hydrologic systems and create water quality impacts downstream. We examined the mountain-to-urban transition in watersheds on Utah's Wasatch Front to identify mechanisms by which urbanization impacts water resources. Rivers in the Wasatch flow from the mountains directly into an urban landscape, where they are subject to channelization, stormwater runoff systems, and urban inputs to water quality from sources such as road salt and fertilizer. As part of an interdisciplinary effort within the iUTAH project, multiple synoptic surveys were performed and a variety of measurements were made, including basic water chemistry along with discharge, water isotopes, and nutrients. Red Butte Creek, a stream in Salt Lake City, does not show significant urban impact to water quality until several kilometers after it enters the city where concentrations of solutes such as chloride and nitrate more than triple in a gaining reach. Groundwater springs discharging to this gaining section demonstrate urban-impacted water chemistry, suggesting that during baseflow a contaminated alluvial aquifer significantly controls stream chemistry. By combining hydrometric and hydrochemical observations we were able to estimate that these groundwater springs were 17-20% urban runoff. We were then able to predict the chemistry of urban runoff that feeds into the alluvial aquifer. Samples collected from storm culverts, roofs, and asphalt during storms had chemistry values within the range of those predicted by the mixing model. This evidence that urbanization affects the water quality of baseflow through impacted groundwater suggests that stormwater mitigation may not be sufficient for protecting urban watersheds, and quantifying these persistent groundwater mediated impacts is necessary to evaluate the success of restoration efforts. By comparing these results from Red Butte Creek with similar studies from other

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

Methodological quality and scientific impact of quantitative nursing education research over 18 months.

PubMed

Yucha, Carolyn B; Schneider, Barbara St Pierre; Smyer, Tish; Kowalski, Susan; Stowers, Eva

2011-01-01

The methodological quality of nursing education research has not been rigorously studied. The purpose of this study was to evaluate the methodological quality and scientific impact of nursing education research reports. The methodological quality of 133 quantitative nursing education research articles published between July 2006 and December 2007 was evaluated using the Medical Education Research Study Quality Instrument (MERSQI).The mean (+/- SD) MERSQI score was 9.8 +/- 2.2. It correlated (p < .05) with several scientific impact indicators: citation counts from Scopus (r = .223), Google Scholar (r = .224), and journal impact factor (r = .216); it was not associated with Web of Science citation count, funding, or h Index. The similarities between this study's MERSQI ratings for nursing literature and those reported for the medical literature, coupled with the association with citation counts, suggest that the MERSQI is an appropriate instrument to evaluate the quality of nursing education research.

Impact of medical director certification on nursing home quality of care.

PubMed

Rowland, Frederick N; Cowles, Mick; Dickstein, Craig; Katz, Paul R

2009-07-01

This study tests the research hypothesis that certified medical directors are able to use their training, education, and knowledge to positively influence quality of care in US nursing homes. F-tag numbers were identified within the State Operations Manual that reflect dimensions of quality thought to be impacted by the medical director. A weighting system was developed based on the "scope and severity" level at which the nursing homes were cited for these specific tag numbers. Then homes led by certified medical directors were compared with homes led by medical directors not known to be certified. DATA/PARTICIPANTS: Data were obtained from the Centers for Medicare & Medicaid Services' Online Survey Certification and Reporting database for nursing homes. Homes with a certified medical director (547) were identified from the database of the American Medical Directors Association. The national survey database was used to compute a "standardized quality score" (zero representing best possible score and 1.0 representing average score) for each home, and the homes with certified medical directors compared with the other homes in the database. Regression analysis was then used to attempt to identify the most important contributors to measured quality score differences between the homes. The standardized quality score of facilities with certified medical directors (n=547) was 0.8958 versus 1.0037 for facilities without certified medical directors (n=15,230) (lower number represents higher quality). When nursing facility characteristics were added to the regression equation, the presence of a certified medical director accounted for up to 15% improvement in quality. The presence of certified medical directors is an independent predictor of quality in US nursing homes.

The impact of cannabis and cannabinoids for medical conditions on health-related quality of life: A systematic review and meta-analysis.

PubMed

Goldenberg, Matthew; Reid, Mark William; IsHak, Waguih William; Danovitch, Itai

2017-05-01

The use of cannabis or cannabinoids to treat medical conditions and/or alleviate symptoms is increasingly common. However, the impact of this use on patient reported outcomes, such as health-related quality of life (HRQoL), remains unclear. We conducted a systematic review and meta-analysis, employing guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We categorized studies based on design, targeted disease condition, and type of cannabis or cannabinoid used. We scored studies based on quality and risk of bias. After eliminating some studies because of poor quality or insufficient data, we conducted meta-analyses of remaining studies based on design. Twenty studies met our pre-defined selection criteria. Eleven studies were randomized controlled trials (RCTs; 2322 participants); the remaining studies were of cohort and cross-sectional design. Studies of cannabinoids were mostly RCTs of higher design quality than studies of cannabis, which utilized smaller self-selected samples in observational studies. Although we did not uncover a significant association between cannabis and cannabinoids for medical conditions and HRQoL, some patients who used them to treat pain, multiple sclerosis, and inflammatory bower disorders have reported small improvements in HRQoL, whereas some HIV patients have reported reduced HRQoL. The relationship between HRQoL and the use of cannabis or cannabinoids for medical conditions is inconclusive. Some patient populations report improvements whereas others report reductions in HRQoL. In order to inform users, practitioners, and policymakers more clearly, future studies should adhere to stricter research quality guidelines and more clearly report patient outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

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

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)

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.

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.

Transfer of knowledge from sound quality measurement to noise impact evaluation

NASA Astrophysics Data System (ADS)

Genuit, Klaus

2004-05-01

It is well known that the measurement and analysis of sound quality requires a complex procedure with consideration of the physical, psychoacoustical and psychological aspects of sound. Sound quality cannot be described only by a simple value based on A-weighted sound pressure level measurements. The A-weighted sound pressure level is sufficient to predict the probabilty that the human ear could be damaged by sound but the A-weighted level is not the correct descriptor for the annoyance of a complex sound situation given by several different sound events at different and especially moving positions (soundscape). On the one side, the consideration of the spectral distribution and the temporal pattern (psychoacoustics) is requested and, on the other side, the subjective attitude with respect to the sound situation, the expectation and experience of the people (psychology) have to be included in context with the complete noise impact evaluation. This paper describes applications of the newest methods of sound quality measurements-as it is well introduced at the car manufacturers-based on artifical head recordings and signal processing comparable to the human hearing used in noisy environments like community/traffic noise.

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 hand eczema severity on quality of life

PubMed Central

Charan, Ujwala Priya; Peter, C. V. Dincy; Pulimood, Susanne A.

2013-01-01

Background: Hand eczema is a common disease seen in dermatological practice comprising of a spectrum ranging from mild disease to a severe distressing and chronic course with a negative impact on the quality of life. Aim: To assess the impact of hand eczema severity on quality of life. Materials and Methods: Patients with hand eczema were enrolled in a prospective study. Disease severity was assessed by hand eczema severity index (HECSI) score and quality of life by dermatology life quality index (DLQI) questionnaire. Results: Forty-six patients participated of which 22 (47.8%) were males and 24 (52.2%) females. The commonest age group affected among men and women was 50-59 years (31.8%) and 40-49 years (41.7%) respectively. History of atopy was found in 23.9% and 63% had persistent disease. In 28 (60.9%), the trigger was washing soaps and detergents of which 21 (87.5%) were housewives. Of those employed, 27.7% reported loss of work days. The mean HECSI score was 14.46 (S.D = 20.98) and mean DLQI score was 9.54 (S.D = 5.62). Gender, age, occupation and duration of disease did not significantly affect the quality of life or disease severity. Increased episodes of eczema (>4 episodes/year) showed a statistically significant correlation with DLQI (P value = 0.021). There was no significant correlation between HECSI score and DLQI in this study. Conclusion: Majority of the patients with hand eczema had a significant impairment of their quality of life. The impairment of quality of life in this study was mainly dependent on increased frequency of the eruptions and not on hand eczema severity. PMID:23741665

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.

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.

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

Air quality impacts of projections of natural gas-fired distributed generation

NASA Astrophysics Data System (ADS)

Horne, Jeremy R.; Carreras-Sospedra, Marc; Dabdub, Donald; Lemar, Paul; Nopmongcol, Uarporn; Shah, Tejas; Yarwood, Greg; Young, David; Shaw, Stephanie L.; Knipping, Eladio M.

2017-11-01

This study assesses the potential impacts on emissions and air quality from the increased adoption of natural gas-fired distributed generation of electricity (DG), including displacement of power from central power generation, in the contiguous United States. The study includes four major tasks: (1) modeling of distributed generation market penetration; (2) modeling of central power generation systems; (3) modeling of spatially and temporally resolved emissions; and (4) photochemical grid modeling to evaluate the potential air quality impacts of increased DG penetration, which includes both power-only DG and combined heat and power (CHP) units, for 2030. Low and high DG penetration scenarios estimate the largest penetration of future DG units in three regions - New England, New York, and California. Projections of DG penetration in the contiguous United States estimate 6.3 GW and 24 GW of market adoption in 2030 for the low DG penetration and high DG penetration scenarios, respectively. High DG penetration (all of which is natural gas-fired) serves to offset 8 GW of new natural gas combined cycle (NGCC) units, and 19 GW of solar photovoltaic (PV) installations by 2030. In all scenarios, air quality in the central United States and the northwest remains unaffected as there is little to no DG penetration in those states. California and several states in the northeast are the most impacted by emissions from DG units. Peak increases in maximum daily 8-h average ozone concentrations exceed 5 ppb, which may impede attainment of ambient air quality standards. Overall, air quality impacts from DG vary greatly based on meteorological conditions, proximity to emissions sources, the number and type of DG installations, and the emissions factors used for DG units.

Determination of trigger levels for groundwater quality in landfills located in historically human-impacted areas.

PubMed

Stefania, Gennaro A; Zanotti, Chiara; Bonomi, Tullia; Fumagalli, Letizia; Rotiroti, Marco

2018-05-01

Landfills are one of the most recurrent sources of groundwater contamination worldwide. In order to limit their impacts on groundwater resources, current environmental regulations impose the adoption of proper measures for the protection of groundwater quality. For instance, in the EU member countries, the calculation of trigger levels for identifying significant adverse environmental effects on groundwater generated by landfills is required by the Landfill Directive 99/31/EC. Although the derivation of trigger levels could be relatively easy when groundwater quality data prior to the construction of a landfill are available, it becomes challenging when these data are missing and landfills are located in areas that are already impacted by historical contamination. This work presents a methodology for calculating trigger levels for groundwater quality in landfills located in areas where historical contaminations have deteriorated groundwater quality prior to their construction. This method is based on multivariate statistical analysis and involves 4 steps: (a) implementation of the conceptual model, (b) landfill monitoring data collection, (c) hydrochemical data clustering and (d) calculation of the trigger levels. The proposed methodology was applied on a case study in northern Italy, where a currently used lined landfill is located downstream of an old unlined landfill and others old unmapped waste deposits. The developed conceptual model stated that groundwater quality deterioration observed downstream of the lined landfill is due to a degrading leachate plume fed by the upgradient unlined landfill. The methodology led to the determination of two trigger levels for COD and NH 4 -N, the former for a zone representing the background hydrochemistry (28 and 9 mg/L for COD and NH 4 -N, respectively), the latter for the zone impacted by the degrading leachate plume from the upgradient unlined landfill (89 and 83 mg/L for COD and NH 4 -N, respectively). Copyright �

The impact of database quality on keystroke dynamics authentication

NASA Astrophysics Data System (ADS)

Panasiuk, Piotr; Rybnik, Mariusz; Saeed, Khalid; Rogowski, Marcin

2016-06-01

This paper concerns keystroke dynamics, also partially in the context of touchscreen devices. The authors concentrate on the impact of database quality and propose their algorithm to test database quality issues. The algorithm is used on their own as well as the well-known . Following specific problems were researched: classification accuracy, development of user typing proficiency, time precision during sample acquisition, representativeness of training set, sample length.

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.

Family Medicine Panel Size with Care Teams: Impact on Quality.

PubMed

Angstman, Kurt B; Horn, Jennifer L; Bernard, Matthew E; Kresin, Molly M; Klavetter, Eric W; Maxson, Julie; Willis, Floyd B; Grover, Michael L; Bryan, Michael J; Thacher, Tom D

2016-01-01

The demand for comprehensive primary health care continues to expand. The development of team-based practice allows for improved capacity within a collective, collaborative environment. Our hypothesis was to determine the relationship between panel size and access, quality, patient satisfaction, and cost in a large family medicine group practice using a team-based care model. Data were retrospectively collected from 36 family physicians and included total panel size of patients, percentage of time spent on patient care, cost of care, access metrics, diabetic quality metrics, patient satisfaction surveys, and patient care complexity scores. We used linear regression analysis to assess the relationship between adjusted physician panel size, panel complexity, and outcomes. The third available appointments (P < .01) and diabetic quality (P = .03) were negatively affected by increased panel size. Patient satisfaction, cost, and percentage fill rate were not affected by panel size. A physician-adjusted panel size larger than the current mean (2959 patients) was associated with a greater likelihood of poor-quality rankings (≤25th percentile) compared with those with a less than average panel size (odds ratio [OR], 7.61; 95% confidence interval [CI], 1.13-51.46). Increased panel size was associated with a longer time to the third available appointment (OR, 10.9; 95% CI, 1.36-87.26) compared with physicians with panel sizes smaller than the mean. We demonstrated a negative impact of larger panel size on diabetic quality results and available appointment access. Evaluation of a family medicine practice parameters while controlling for panel size and patient complexity may help determine the optimal panel size for a practice. © Copyright 2016 by the American Board of Family Medicine.

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.

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.

Allergic rhinitis-induced nasal congestion: its impact on sleep quality.

PubMed

Storms, William

2008-03-01

Allergic rhinitis (AR) is an extremely common health problem affecting 20 to 40 million Americans and between 10-25% of the world's population. Patients with AR suffer from both nasal symptoms (congestion, rhinorrhea, itching, and sneezing) and ocular symptoms (itching, redness, and tearing). The negative impact on sleep quality and quantity, and consequently on various aspects of the patient's life, is an under-recognised and under-treated component of AR morbidity. Nasal congestion, which is one of the most bothersome and prevalent symptoms of AR, is thought to be the leading symptom responsible for rhinitis-related sleep problems. In addition to reducing clinical symptoms, pharmacologic therapies for AR that specifically reduce inflammatory cells and mediators - and therefore nasal congestion and other symptoms - should also improve sleep quality and overall quality of life (QOL). Intranasal corticosteroids (INS) are the current mainstay of therapy for AR. Results of a number of clinical trials demonstrate that INS effectively reduce nasal congestion and ocular symptoms, improve sleep quality, and decrease daytime somnolence. Intranasal corticosteroids have also proved to be effective in reducing symptoms of acute rhinosinusitis and nasal polyposis, both of which also negatively impact on sleep quality. Intranasal corticosteroids are considered safe due to their low systemic bioavailability.

Impact of image quality on OCT angiography based quantitative measurements.

PubMed

Al-Sheikh, Mayss; Ghasemi Falavarjani, Khalil; Akil, Handan; Sadda, SriniVas R

2017-01-01

To study the impact of image quality on quantitative measurements and the frequency of segmentation error with optical coherence tomography angiography (OCTA). Seventeen eyes of 10 healthy individuals were included in this study. OCTA was performed using a swept-source device (Triton, Topcon). Each subject underwent three scanning sessions 1-2 min apart; the first two scans were obtained under standard conditions and for the third session, the image quality index was reduced using application of a topical ointment. En face OCTA images of the retinal vasculature were generated using the default segmentation for the superficial and deep retinal layer (SRL, DRL). Intraclass correlation coefficient (ICC) was used as a measure for repeatability. The frequency of segmentation error, motion artifact, banding artifact and projection artifact was also compared among the three sessions. The frequency of segmentation error, and motion artifact was statistically similar between high and low image quality sessions (P = 0.707, and P = 1 respectively). However, the frequency of projection and banding artifact was higher with a lower image quality. The vessel density in the SRL was highly repeatable in the high image quality sessions (ICC = 0.8), however, the repeatability was low, comparing the high and low image quality measurements (ICC = 0.3). In the DRL, the repeatability of the vessel density measurements was fair in the high quality sessions (ICC = 0.6 and ICC = 0.5, with and without automatic artifact removal, respectively) and poor comparing high and low image quality sessions (ICC = 0.3 and ICC = 0.06, with and without automatic artifact removal, respectively). The frequency of artifacts is higher and the repeatability of the measurements is lower with lower image quality. The impact of image quality index should be always considered in OCTA based quantitative measurements.

Statistical quality control through overall vibration analysis

NASA Astrophysics Data System (ADS)

Carnero, M. ^a. Carmen; González-Palma, Rafael; Almorza, David; Mayorga, Pedro; López-Escobar, Carlos

2010-05-01

The present study introduces the concept of statistical quality control in automotive wheel bearings manufacturing processes. Defects on products under analysis can have a direct influence on passengers' safety and comfort. At present, the use of vibration analysis on machine tools for quality control purposes is not very extensive in manufacturing facilities. Noise and vibration are common quality problems in bearings. These failure modes likely occur under certain operating conditions and do not require high vibration amplitudes but relate to certain vibration frequencies. The vibration frequencies are affected by the type of surface problems (chattering) of ball races that are generated through grinding processes. The purpose of this paper is to identify grinding process variables that affect the quality of bearings by using statistical principles in the field of machine tools. In addition, an evaluation of the quality results of the finished parts under different combinations of process variables is assessed. This paper intends to establish the foundations to predict the quality of the products through the analysis of self-induced vibrations during the contact between the grinding wheel and the parts. To achieve this goal, the overall self-induced vibration readings under different combinations of process variables are analysed using statistical tools. The analysis of data and design of experiments follows a classical approach, considering all potential interactions between variables. The analysis of data is conducted through analysis of variance (ANOVA) for data sets that meet normality and homoscedasticity criteria. This paper utilizes different statistical tools to support the conclusions such as chi squared, Shapiro-Wilks, symmetry, Kurtosis, Cochran, Hartlett, and Hartley and Krushal-Wallis. The analysis presented is the starting point to extend the use of predictive techniques (vibration analysis) for quality control. This paper demonstrates the existence

How does study quality affect the results of a diagnostic meta-analysis?

PubMed Central

Westwood, Marie E; Whiting, Penny F; Kleijnen, Jos

2005-01-01

Background The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Although the primary diagnostic literature is extensive, studies are often of low methodological quality or poorly reported. There has been no rigorously evaluated, evidence based tool to assess the methodological quality of diagnostic studies. The primary objective of this study was to determine the extent to which variations in the quality of primary studies impact the results of a diagnostic meta-analysis and whether this differs with diagnostic test type. A secondary objective was to contribute to the evaluation of QUADAS, an evidence-based tool for the assessment of quality in diagnostic accuracy studies. Methods This study was conducted as part of large systematic review of tests used in the diagnosis and further investigation of urinary tract infection (UTI) in children. All studies included in this review were assessed using QUADAS, an evidence-based tool for the assessment of quality in systematic reviews of diagnostic accuracy studies. The impact of individual components of QUADAS on a summary measure of diagnostic accuracy was investigated using regression analysis. The review divided the diagnosis and further investigation of UTI into the following three clinical stages: diagnosis of UTI, localisation of infection, and further investigation of the UTI. Each stage used different types of diagnostic test, which were considered to involve different quality concerns. Results Many of the studies included in our review were poorly reported. The proportion of QUADAS items fulfilled was similar for studies in different sections of the review. However, as might be expected, the individual items fulfilled differed between the three clinical stages. Regression analysis found that different items showed a strong association with test performance for the different tests evaluated. These differences were observed both within and between the three

Hydrologic and water quality impacts of biofuel feedstock production in the Ohio River Basin

DOE PAGES

Demissie, Yonas; Yan, Eugene; Wu, May

2017-07-10

Our study addresses the uncertainties related to potential changes in land use and management and associated impacts on hydrology and water quality resulting from increased production of biofuel from the conventional and cellulosic feedstock. The Soil Water Assessment Tool (SWAT) was then used to assess the impacts on regional and field scale evapotranspiration, soil moisture content, stream flow, sediment, and nutrient loadings in the Ohio River Basin. The model incorporates spatially and temporally detailed hydrologic, climate and agricultural practice data that are pertinent to simulate biofuel feedstock production, watershed hydrology and water quality. Three future biofuel production scenarios in themore » region were considered, including a feedstock projection from the DOE Billion-Ton (BT2) Study, a change in corn rotations to continuous corn, and harvest of 50% corn stover. The impacts were evaluated on the basis of relative changes in hydrology and water quality from historical baseline and future business-as-usual conditions of the basin. The overall impact on water quality is an order of magnitude higher than the impact on hydrology. For all the three future scenarios, the sub-basin results indicated an overall increase in annual evapotranspiration of up to 6%, a decrease in runoff up to 10% and minimal change in soil moisture. The sediment and phosphorous loading at both regional and field levels increased considerably (up to 40–90%) for all the biofuel feedstock scenario considered, while the nitrogen loading increased up to 45% in some regions under the BT2 Study scenario, decreased up to 10% when corn are grown continuously instead of in rotations, and changed minimally when 50% of the stover are harvested. Field level analyses revealed significant variability in hydrology and water quality impacts that can further be used to identify suitable locations for the feedstock productions without causing major impacts on water quantity and quality.« less

Hydrologic and water quality impacts of biofuel feedstock production in the Ohio River Basin

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

Demissie, Yonas; Yan, Eugene; Wu, May

Our study addresses the uncertainties related to potential changes in land use and management and associated impacts on hydrology and water quality resulting from increased production of biofuel from the conventional and cellulosic feedstock. The Soil Water Assessment Tool (SWAT) was then used to assess the impacts on regional and field scale evapotranspiration, soil moisture content, stream flow, sediment, and nutrient loadings in the Ohio River Basin. The model incorporates spatially and temporally detailed hydrologic, climate and agricultural practice data that are pertinent to simulate biofuel feedstock production, watershed hydrology and water quality. Three future biofuel production scenarios in themore » region were considered, including a feedstock projection from the DOE Billion-Ton (BT2) Study, a change in corn rotations to continuous corn, and harvest of 50% corn stover. The impacts were evaluated on the basis of relative changes in hydrology and water quality from historical baseline and future business-as-usual conditions of the basin. The overall impact on water quality is an order of magnitude higher than the impact on hydrology. For all the three future scenarios, the sub-basin results indicated an overall increase in annual evapotranspiration of up to 6%, a decrease in runoff up to 10% and minimal change in soil moisture. The sediment and phosphorous loading at both regional and field levels increased considerably (up to 40–90%) for all the biofuel feedstock scenario considered, while the nitrogen loading increased up to 45% in some regions under the BT2 Study scenario, decreased up to 10% when corn are grown continuously instead of in rotations, and changed minimally when 50% of the stover are harvested. Field level analyses revealed significant variability in hydrology and water quality impacts that can further be used to identify suitable locations for the feedstock productions without causing major impacts on water quantity and quality.« less

Influence of air quality model resolution on uncertainty associated with health impacts

NASA Astrophysics Data System (ADS)

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

2012-06-01

We use regional air quality modeling to evaluate the impact of model resolution on uncertainty associated with the human health benefits resulting from proposed air quality regulations. Using a regional photochemical model (CAMx), we ran a modeling episode with meteorological inputs representing conditions as they occurred during August through September 2006, and two emissions inventories (a 2006 base case and a 2018 proposed control scenario, both for Houston, Texas) at 36, 12, 4 and 2 km resolution. The base case model performance was evaluated for each resolution against daily maximum 8-h averaged ozone measured at monitoring stations. Results from each resolution were more similar to each other than they were to measured values. Population-weighted ozone concentrations were calculated for each resolution and applied to concentration response functions (with 95% confidence intervals) to estimate the health impacts of modeled ozone reduction from the base case to the control scenario. We found that estimated avoided mortalities were not significantly different between 2, 4 and 12 km resolution runs, but 36 km resolution may over-predict some potential health impacts. Given the cost/benefit analysis requirements of the Clean Air Act, the uncertainty associated with human health impacts and therefore the results reported in this study, we conclude that health impacts calculated from population weighted ozone concentrations obtained using regional photochemical models at 36 km resolution fall within the range of values obtained using fine (12 km or finer) resolution modeling. However, in some cases, 36 km resolution may not be fine enough to statistically replicate the results achieved using 2 and 4 km resolution. On average, when modeling at 36 km resolution, 7 deaths per ozone month were avoided because of ozone reductions resulting from the proposed emissions reductions (95% confidence interval was 2-9). When modeling at 2, 4 or 12 km finer scale resolution, on

Impacts on water quality by hydraulic fracturing in Pennsylvania

NASA Astrophysics Data System (ADS)

Yan, B.; Stute, M.; Chillrud, S. N.; Ross, J. M.; Howarth, M.; Panettieri, R.; Saberi, P.

2015-12-01

Shale gas development, including drilling and hydraulic fracturing, is rapidly increasing throughout the United States and, indeed, the rest of the world. Systematic surveys of water quality both pre- and post drilling/production are sparse. To examine the impacts of shale gas production on water quality, pilot studies have been conducted in adjacent counties of western NY (Chemung, Tioga, Broome, and Delaware) and northern PA (Bradford, Susquehanna, and Wayne). These 7 counties along the border of NY and PA share similar geology and demographic compositions and have been identified as a key area to develop shale gas with the key difference that active fracking is occurring in PA but there is no fracking yet in NY. Measurements include a suite of major and trace elements, methane and its stable isotopes, noble gases and tritium for dating purposes, and the primary radioactive elements of potential concern, radon and radium. We found elevated methane levels on both sides of the border. Higher levels of major ions were observed in PA samples close to the gas wells in the valley, possibly from hydraulic fracturing activities. The lab analysis of samples collected in recently launched 100 Bottom Project is ongoing and the results will be presented in this conference.

Episodic air quality impacts of plug-in electric vehicles

NASA Astrophysics Data System (ADS)

Razeghi, Ghazal; Carreras-Sospedra, Marc; Brown, Tim; Brouwer, Jack; Dabdub, Donald; Samuelsen, Scott

2016-07-01

In this paper, the Spatially and Temporally Resolved Energy and Environment Tool (STREET) is used in conjunction with University of California Irvine - California Institute of Technology (UCI-CIT) atmospheric chemistry and transport model to assess the impact of deploying plug-in electric vehicles and integrating wind energy into the electricity grid on urban air quality. STREET is used to generate emissions profiles associated with transportation and power generation sectors for different future cases. These profiles are then used as inputs to UCI-CIT to assess the impact of each case on urban air quality. The results show an overall improvement in 8-h averaged ozone and 24-h averaged particulate matter concentrations in the South Coast Air Basin (SoCAB) with localized increases in some cases. The most significant reductions occur northeast of the region where baseline concentrations are highest (up to 6 ppb decrease in 8-h-averaged ozone and 6 μg/m3 decrease in 24-h-averaged PM2.5). The results also indicate that, without integration of wind energy into the electricity grid, the temporal vehicle charging profile has very little to no effect on urban air quality. With the addition of wind energy to the grid mix, improvement in air quality is observed while charging at off-peak hours compared to the business as usual scenario.

Modeling prescribed burning experiments and assessing the fire impacts on local to regional air quality

NASA Astrophysics Data System (ADS)

Zhou, L.; Baker, K. R.; Napelenok, S. L.; Elleman, R. A.; Urbanski, S. P.

2016-12-01

Biomass burning, including wildfires and prescribed burns, strongly impact the global carbon cycle and are of increasing concern due to the potential impacts on ambient air quality. This modelling study focuses on the evolution of carbonaceous compounds during a prescribed burning experiment and assesses the impacts of burning on local to regional air quality. The Community Multiscale Air Quality (CMAQ) model is used to conduct 4 and 2 km grid resolution simulations of prescribed burning experiments in southeast Washington state and western Idaho state in summer 2013. The ground and airborne measurements from the field experiment are used to evaluate the model performance in capturing surface and aloft impacts from the burning events. Phase partitioning of organic compounds in the plume are studied as it is a crucial step towards understanding the fate of carbonaceous compounds. The sensitivities of ambient concentrations and deposition to emissions are conducted for organic carbon, elemental carbon and ozone to estimate the impacts of fire on air quality.

Influence of air quality model resolution on uncertainty associated with health impacts

NASA Astrophysics Data System (ADS)

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

2012-10-01

We use regional air quality modeling to evaluate the impact of model resolution on uncertainty associated with the human health benefits resulting from proposed air quality regulations. Using a regional photochemical model (CAMx), we ran a modeling episode with meteorological inputs simulating conditions as they occurred during August through September 2006 (a period representative of conditions leading to high ozone), and two emissions inventories (a 2006 base case and a 2018 proposed control scenario, both for Houston, Texas) at 36, 12, 4 and 2 km resolution. The base case model performance was evaluated for each resolution against daily maximum 8-h averaged ozone measured at monitoring stations. Results from each resolution were more similar to each other than they were to measured values. Population-weighted ozone concentrations were calculated for each resolution and applied to concentration response functions (with 95% confidence intervals) to estimate the health impacts of modeled ozone reduction from the base case to the control scenario. We found that estimated avoided mortalities were not significantly different between the 2, 4 and 12 km resolution runs, but the 36 km resolution may over-predict some potential health impacts. Given the cost/benefit analysis requirements motivated by Executive Order 12866 as it applies to the Clean Air Act, the uncertainty associated with human health impacts and therefore the results reported in this study, we conclude that health impacts calculated from population weighted ozone concentrations obtained using regional photochemical models at 36 km resolution fall within the range of values obtained using fine (12 km or finer) resolution modeling. However, in some cases, 36 km resolution may not be fine enough to statistically replicate the results achieved using 2, 4 or 12 km resolution. On average, when modeling at 36 km resolution, an estimated 5 deaths per week during the May through September ozone season are avoided

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.

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.

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.

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

Are extreme hydro-meteorological events a prerequisite for extreme water quality impacts? Exploring climate impacts on inland and coastal waters

NASA Astrophysics Data System (ADS)

Michalak, A. M.; Balaji, V.; Del Giudice, D.; Sinha, E.; Zhou, Y.; Ho, J. C.

2017-12-01

Questions surrounding water sustainability, climate change, and extreme events are often framed around water quantity - whether too much or too little. The massive impacts of extreme water quality impairments are equally compelling, however. Recent years have provided a host of compelling examples, with unprecedented harmful algal blooms developing along the West coast, in Utah Lake, in Lake Erie, and off the Florida coast, and huge hypoxic dead zones continuing to form in regions such as Lake Erie, the Chesapeake Bay, and the Gulf of Mexico. Linkages between climate change, extreme events, and water quality impacts are not well understood, however. Several factors explain this lack of understanding, including the relative complexity of underlying processes, the spatial and temporal scale mismatch between hydrologists and climatologists, and observational uncertainty leading to ambiguities in the historical record. Here, we draw on a number of recent studies that aim to quantitatively link meteorological variability and water quality impacts to test the hypothesis that extreme water quality impairments are the result of extreme hydro-meteorological events. We find that extreme hydro-meteorological events are neither always a necessary nor a sufficient condition for the occurrence of extreme water quality impacts. Rather, extreme water quality impairments often occur in situations where multiple contributing factors compound, which complicates both attribution of historical events and the ability to predict the future incidence of such events. Given the critical societal importance of water quality projections, a concerted program of uncertainty reduction encompassing observational and modeling components will be needed to examine situations where extreme weather plays an important, but not solitary, role in the chain of cause and effect.

Financial and quality impacts of the Medicare physician group practice demonstration.

PubMed

Pope, Gregory; Kautter, John; Leung, Musetta; Trisolini, Michael; Adamache, Walter; Smith, Kevin

2014-01-01

To examine the impact of the Medicare Physician Group Practice (PGP) demonstration on expenditure, utilization, and quality outcomes. Secondary data analysis of 2001-2010 Medicare claims for 1,776,387 person years assigned to the ten participating provider organizations and 1,579,080 person years in the corresponding local comparison groups. We used a pre-post comparison group observational design consisting of four pre-demonstration years (1/01-12/04) and five demonstration years (4/05-3/10). We employed a propensity-weighted difference-in-differences regression model to estimate demonstration effects, adjusting for demographics, health status, geographic area, and secular trends. The ten demonstration sites combined saved $171 (2.0%) per assigned beneficiary person year (p<0.001) during the five-year demonstration period. Medicare paid performance bonuses to the participating PGPs that averaged $102 per person year. The net savings to the Medicare program were $69 (0.8%) per person year. Demonstration savings were achieved primarily from the inpatient setting. The demonstration improved quality of care as measured by six of seven claims-based process quality indicators. The PGP demonstration, which used a payment model similar to the Medicare Accountable Care Organization (ACO) program, resulted in small reductions in Medicare expenditures and inpatient utilization, and improvements in process quality indicators. Judging from this demonstration experience, it is unlikely that Medicare ACOs will initially achieve large savings. Nevertheless, ACOs paid through shared savings may be an important first step toward greater efficiency and quality in the Medicare fee-for-service program.

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.

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

Water Quality Analysis Simulation Program (WASP)

EPA Pesticide Factsheets

The Water Quality Analysis Simulation Program (WASP) model helps users interpret and predict water quality responses to natural phenomena and manmade pollution for various pollution management decisions.

Absorbent products for incontinence: 'treatment effects' and impact on quality of life.

PubMed

Getliffe, Kathryn; Fader, Mandy; Cottenden, Alan; Jamieson, Katharine; Green, Nicholas

2007-10-01

This study aimed to determine how the use and characteristics of absorbent products for incontinence impact on women's quality of life, and to examine the concept of 'treatment effects' in the context of pad use. Key pad performance characteristics were identified from the literature and focus group work. Semi-structured interviews with 99 women with light incontinence were used to investigate the impact of pad use on women's quality of life, including both positive and negative 'treatment effects', and to rank pad characteristics by their importance. Achieving effective and discrete containment of urine was the dominant factor impacting on women's lives. Sub-themes embraced physical effects, psychological impact and social functioning. The five pad characteristics ranked most important for day time use were: 'to hold urine, to contain smell, to stay in place, discreteness, and comfort when wet. For night use discreteness was replaced by to keep skin dry'. High levels of reported anxiety were associated with perceived risk of poor pad performance, lack of discreteness and need for complex regimes for pad management. Insufficient attention has been paid to the balance between the beneficial and negative treatment effects of absorbent pads to date. Existing continence-related quality of life measures are not designed for conditions where change in symptoms is not an outcome measure. The study findings provide the basis for developing a more sensitive, patient-oriented, quality of life measure for pad-users which can aid product selection, new product development and inform future evaluative comparisons between products/products and treatments. This paper illustrates the complex influence on quality of life caused by using absorbent pads to contain incontinence. It raises awareness of the importance of careful selection of the most appropriate pad for each individual to minimize unfavourable side effects, and the need for a new quality of life measure designed for pad-users.

Oral mucosal lesions' impact on oral health-related quality of life in preschool children.

PubMed

de Oliveira, Luísa Jardim Corrêa; Torriani, Dione Dias; Correa, Marcos Britto; Peres, Marco Aurélio; Peres, Karen Glazer; Matijasevich, Alicia; Dos Santos, Iná da Silva; Barros, Aluisio J D; Demarco, Flávio Fernando; Tarquinio, Sandra Beatriz Chaves

2015-12-01

The aim of this study was to assess the prevalence of oral mucosal lesions and their impact on oral health-related quality of life (OHRQoL) in children aged 5 years. A sample of 1118 children from Pelotas' birth cohort, born in 2004 (response rate of 85.8%), were selected to participate in the study. Data were collected using a questionnaire applied to mothers and from the oral examinations of the children. OML were identified by type, site, and size. Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess caregivers' perception on children's OHRQoL. Descriptive, bivariate, and multivariate Poisson regression analyses were carried out, considering the impact on OHRQoL (total ECOHIS score) as the outcome. The prevalence of the OML was 30.1% (95% CI 27.5-32.9). Ulcers were the more prevalent type of lesion (29.4%), and the most affected site was the gums (31.0%). In bivariate analysis, there was a positive association between the presence of OML and OHRQoL impact measured by the following: mean overall score of ECOHIS (P < 0.001); extent (P < 0.001); prevalence (P = 0.030); and intensity (P = 0.010). After adjustments for sociodemographic and oral health variables, children with OML presented higher impact on OHRQoL [rate ratio (RR) 1.38 95% CI 1.11; 1.72] comparing with their counterparts. Analyzing specific domains, children with OML also presented higher impact on children symptoms (RR 1.46 95% CI 1.20; 1.66) and family functional (RR 3.14 95% CI 1.59; 6.22) domains. Almost one-third of children presented with oral mucosal lesions, and these lesions impaired children's oral health-related quality of life. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of Arsenic Treatment Techniques on Distribution Water Quality

EPA Science Inventory

This presentation will summarize the results of the distribution water quality studies (arsenic, lead, and copper) of the demonstration program. The impact of the treatment systems by type of system (adsorptive media, coagulation/filtration, ion exchange, etc) will be shown by co...

EPA Research Evaluating CAFO Impacts on Ground Water Quality

EPA Science Inventory

An overview of several projects will be presented on a research program currently underway at ORD’s Ground Water and Ecosystems Restoration Division (GWERD) to evaluate CAFO impacts on ground water quality. The overall research objectives are to characterize the potential for gro...

The impact of Dupuytren disease on patient activity and quality of life.

PubMed

Wilburn, J; McKenna, S P; Perry-Hinsley, D; Bayat, A

2013-06-01

To explore the impact of Dupuytren disease (DD) from the patients' perspective. Audio-recorded interviews were conducted for patients with Dupuytren disease (DD) attending outpatient clinics. The interviews were transcribed and subjected to content analysis. This analysis highlighted key impact areas and common themes in individuals' personal experiences. These were then allocated to categories specified by the World Health Organization International Classification of Functioning, Disability, and Health (impairments and activity limitations) and the needs-based model of quality of life (QoL). Qualitative unstructured interviews were conducted with 34 patients (74% men; age, 41-80 y; mean [SD], 64 [13] y). The sample had a wide range of severity and duration of DD (range, 0.5-40; mean [SD], 13 [10] y). Nine hundred fifty-three statements relating to the impact of DD were identified from the interview transcripts. These statements fell into 2 major categories of impact: activity limitations (10 themes including problems with dressing, gripping, and personal care) and QoL (6 need categories: physiological, safety and security, social, affection, esteem, and cognitive needs). Findings from the interviews suggest that DD affects both performance of activities and QoL. To determine accurately the effectiveness of DD interventions from the patients' perspective, it is important to determine their impacts on both activity limitations and QoL. We intend to develop valid, reproducible, and responsive DD-specific scales for this purpose. The study identifies key issues specific to DD that influence patients' functioning and QoL. The information reported will form the basis of DD-specific patient-reported outcomes measures for use in clinical practice and evaluations of interventions. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Protein Aggregation and Its Impact on Product Quality

PubMed Central

Roberts, Christopher J.

2014-01-01

Protein pharmaceutical products are typically active as folded monomers that are composed of one or more protein chains, such as the heavy and light chains in monoclonal antibodies that are a mainstay of current drug pipelines. There are numerous possible aggregated states for a given protein, some of which are potentially useful, while most of which are considered deleterious from the perspective of pharmaceutical product quality and performance. This review provides an overview of how and why different aggregated states of proteins occur, how this potentially impacts product quality and performance, fundamental approaches to control aggregate formation, and the practical approaches that are currently used in the pharmaceutical industry. PMID:25173826

Analysis and Application of Quality Economics Based on Input-Output

NASA Astrophysics Data System (ADS)

Lu, Qiang; Li, Xin

2018-01-01

Quality economics analysis is an important research area in the current economic frontier, which has a huge role in promoting the quality-benefit type road development in China. Through the study of quality economics analysis and application, economics of quality and quality economics management are summarized, and theoretical framework of quality economics analysis is constructed. Finally, the quality economics analysis of aerospace equipment is taken as an example to carry on the application research.

Disasters and Impact of Sleep Quality and Quantity on National Guard Medical Personnel

DTIC Science & Technology

2018-04-30

Impact of Sleep Quality & Quantity on National Guard Medical Personnel Sb. GRANT NUMBER Sc. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Sd. PROJECT NUMBER...Std. 239.18 Adobe Professional 7 .0 Approved for Public Release ~••Unlmlted Disasters & Impact of Sleep Quality & Quantity on National Guard...College of Nursing 4/11/2018 6 Methods • Measures • Critical skills questions • Medication calculations +Licensed • Basic Life Support (BLS

Interactive multi-mode blade impact analysis

NASA Technical Reports Server (NTRS)

Alexander, A.; Cornell, R. W.

1978-01-01

The theoretical methodology used in developing an analysis for the response of turbine engine fan blades subjected to soft-body (bird) impacts is reported, and the computer program developed using this methodology as its basis is described. This computer program is an outgrowth of two programs that were previously developed for the purpose of studying problems of a similar nature (a 3-mode beam impact analysis and a multi-mode beam impact analysis). The present program utilizes an improved missile model that is interactively coupled with blade motion which is more consistent with actual observations. It takes into account local deformation at the impact area, blade camber effects, and the spreading of the impacted missile mass on the blade surface. In addition, it accommodates plate-type mode shapes. The analysis capability in this computer program represents a significant improvement in the development of the methodology for evaluating potential fan blade materials and designs with regard to foreign object impact resistance.

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

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.

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

A tool to determine financial impact of adverse events in health care: healthcare quality calculator.

PubMed

Yarbrough, Wendell G; Sewell, Andrew; Tickle, Erin; Rhinehardt, Eric; Harkleroad, Rod; Bennett, Marc; Johnson, Deborah; Wen, Li; Pfeiffer, Matthew; Benegas, Manny; Morath, Julie

2014-12-01

Hospital leaders lack tools to determine the financial impact of poor patient outcomes and adverse events. To provide health-care leaders with decision support for investments to improve care, we created a tool, the Healthcare Quality Calculator (HQCal), which uses institution-specific financial data to calculate impact of poor patient outcomes or quality improvement on present and future margin. Excel and Web-based versions of the HQCal were based on a cohort study framework and created with modular components including major drivers of cost and reimbursement. The Healthcare Quality Calculator (HQCal) compares payment, cost, and profit/loss for patients with and without poor outcomes or quality issues. Cost and payment information for groups with and without quality issues are used by the HQCal to calculate profit or loss. Importantly, institution-specific payment and cost data are used to calculate financial impact and attributable cost associated with poor patient outcomes, adverse events, or quality issues. Because future cost and reimbursement changes can be forecast, the HQCal incorporates a forward-looking component. The flexibility of the HQCal was demonstrated using surgical site infections after abdominal surgery and postoperative surgical airway complications. The Healthcare Quality Calculator determines financial impact of poor patient outcomes and the benefit of initiatives to improve quality. The calculator can identify quality issues that would provide the largest financial benefit if improved; however, it cannot identify specific interventions. The calculator provides a tool to improve transparency regarding both short- and long-term financial consequences of funding, or failing to fund, initiatives to close gaps in quality or improve patient outcomes.

The Impact of Globalization on a Country's Quality of Life: Toward an Integrated Model

ERIC Educational Resources Information Center

Sirgy, M. Joseph; Lee, Dong-Jin; Miller, Chad; Littlefield, James E.

2004-01-01

The purpose of the paper is to develop a set of theoretical propositions to explain the impact of globalization on a country's quality of life (QOL). In this paper, we describe how globalization impacts the quality of life of residents of a country by first articulating the globalization construct (in terms of inflows and outflows of goods,…

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.

Impacts of Noise Barriers on Near-Road Air Quality

EPA Science Inventory

Numerous health studies show an increase in adverse health effects for populations near large roadways. A study was designed to assess traffic emission impacts on air quality near a heavily traveled highway. The portion of highway studied included a section of open field and a se...

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…

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

From Design and Implementation to Impact of Quality Assurance: An Overview of Some Studies into What Impacts Improvement

ERIC Educational Resources Information Center

Westerheijden, Don F.; Hulpiau, Veerle; Waeytens, Kim

2007-01-01

Attention shifted in recent years from design and implementation to use and usefulness of quality assurance. Scientific studies focus increasingly on quality assurance's impact on curricula and individual teachers. Which factors influence follow-up activities and what is their relation to improvement of education? One factor that we single out is…

Impact of indoor surface material on perceived air quality.

PubMed

Senitkova, I

2014-03-01

The material combination impact on perceived indoor air quality for various surface interior materials is presented in this paper. The chemical analysis and sensory assessments identifies health adverse of indoor air pollutants (TVOCs). In this study, emissions and odors from different common indoor surface materials were investigated in glass test chamber under standardized conditions. Chemical measurements (TVOC concentration) and sensory assessments (odor intensity, air acceptability) were done after building materials exposure to standardized conditions. The results of the chemical and sensory assessment of individual materials and their combinations are compared and discussed within the paper. The using possibility of individual material surface sorption ability was investigated. The knowledge of targeted sorption effects can be used in the interior design phase. The results demonstrate the various sorption abilities of various indoor materials as well as the various sorption abilities of the same indoor material in various combinations. Copyright © 2013 Elsevier B.V. All rights reserved.

Periodontitis impacts quality of life in postmenopausal women.

PubMed

DeBaz, C; Shamia, H; Hahn, J; Mithani, S; Sadeghi, G; Palomo, L

2015-01-01

Interrelationships between traditional dental variables are becoming more evident in far-reaching aspects of life such as psychosocial interaction, self-esteem, overall health and even occupational performance. This study compares quality of life in postmenopausal women with chronic periodontitis with that of healthy postmenopausal women. A total of 128 randomly recruited postmenopausal women received a comprehensive periodontal evaluation and completed the Utian Quality of Life Survey. The participants were divided into healthy and periodontitis groups based on comprehensive periodontal examination. Mean scores were calculated for each quality-of-life item, domain and the overall summary score. Periodontitis patients' quality-of-life outcomes were compared to those of healthy patients using the t-test with threshold of significance at p < 0.05. Quality-of-life scores in all fields measured were significantly poorer in the periodontitis patients compared to the healthy patients, occupational (25.74 ± 8.25 vs. 21.40 ± 9.19), health (26.46 ± 5.93 vs. 19.64 ± 10.24), emotional (21.04 ± 10.20 vs. 16.40 ± 10.84), sexual (9.23 ± 4.92 vs. 5.96 ± 5.20), and total score (82.48 ± 23.74 vs. 63.69 ± 26.61). This study has identified that postmenopausal women with chronic periodontitis report significantly poorer quality of life than healthy patients. Clinicians caring for postmenopausal women should be aware that periodontitis also impacts quality of life when making referral decisions for oral health care.

[Xerostomia and its impact on oral health-related quality of life].

PubMed

Herrmann, Gianna; Müller, Karolina; Behr, Michael; Hahnel, Sebastian

2017-02-01

Dry mouth is a frequently occurrence in elderly people and causes numerous clinical and social problems. To investigate the quality of life in geriatric patients living in nursing homes depending on the subjective sensation of dry mouth and associated oral parameters. A total of 62 male and female elderly patients living in 7 cooperating nursing homes were interviewed employing questionnaires with regard to their oral health-related quality of life (GOHAI) and their subjective perception of dry mouth (sXI-D). Dental status, drinking habits and current medication were documented. The mean GOHAI score was 53.6 and the mean sXI-D score was 7.9. Oral health-related quality of life was significantly influenced by the subjective sensation of dry mouth (p < 0.001), whereas no significant impact of the number of residual teeth or implants or the character of prosthetic restorations could be identified. Xerostomia was significantly influenced by the number of medications consumed (p = 0.039). Xerostomia has a significant impact on the oral health-related quality of life of elderly people living in nursing homes. Thus, dental treatment should focus on the alleviation of xerostomia to improve the oral health-related quality of life in the elderly population.

Conservation Tillage Impacts on Soil Quality

NASA Astrophysics Data System (ADS)

Hake, K.

2012-04-01

As recent as the 1970's in University lecture halls cotton production was vilified for being "hard on the soil". This stigma is still perpetuated today in the popular press, deserving a close scrutiny of its origin and its reality as soil quality is an essential but unappreciated component of cotton's unique tolerance to heat and drought. The objective of expanding food, feed and fiber production to meet the global demand, during forecast climate disruption requires that scientists improve both the above and below ground components of agriculture. The latter has been termed the "final frontier" for its inaccessibility and complexity. The shift to conservation tillage in the U.S.A. over the previous three decades has been dramatic in multiple crops. Cotton and its major rotation crops (corn, soybean, and wheat) can be grown for multiple years without tillage using herbicides instead to control weeds. Although pesticide resistant insects and weeds (especially to Bt proteins and glyphosate) are a threat to Integrated Pest Management and conservation tillage that need vigilance and proactive management, the role of modern production tools in meeting agricultural objectives to feed and clothe the world is huge. The impact of these tools on soil quality will be reviewed. In addition ongoing research efforts to create production practices to further improve soil quality and meet the growing challenges of heat and drought will be reviewed.

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.

Corn stover harvest and tillage impacts on near-surface soil physical quality

USDA-ARS?s Scientific Manuscript database

Excessive harvest of corn (Zea mays L.) stover for ethanol production has raised concerns regarding negative consequences on soil physical quality. Our objective was to quantify the impact of two tillage practices and three levels of corn stover harvest on near-surface soil physical quality through ...

Impact Evaluation of Quality Assurance in Higher Education: Methodology and Causal Designs

ERIC Educational Resources Information Center

Leiber, Theodor; Stensaker, Bjørn; Harvey, Lee

2015-01-01

In this paper, the theoretical perspectives and general methodological elements of impact evaluation of quality assurance in higher education institutions are discussed, which should be a cornerstone of quality development in higher education and contribute to improving the knowledge about the effectiveness (or ineffectiveness) of quality…

Atopic dermatitis: impact on the quality of life of patients and their partners.

PubMed

Misery, L; Finlay, A Y; Martin, N; Boussetta, S; Nguyen, C; Myon, E; Taieb, C

2007-01-01

The impact of atopic dermatitis (AD) on the patient's quality of life is relatively well known. However, the influence on the patient's spouse has never been studied. To evaluate the impact of AD on the quality of life, sleeping and sexual life of patients and their partners. In this cross-sectional study, patients and their partners completed a number of questionnaires asking about their general health and their quality of life [Short Form 12, Epworth, Dermatology Life Quality Index (DLQI)] and completed an idiosyncratic measure asking about their sexual functioning. AD severity was clinician rated using Scoring atopic dermatitis (SCORAD). A total of 266 patients were included. The mean DLQI score was 8.8. The physical and mental composite 12 scores were 50.7 and 39.5, respectively. These 3 scores were significantly related to SCORAD. A decrease in sexual desire due to AD was noted in 57.5% of patients. The quality of life of partners did not appear to be particularly impaired, but 36.5% reported that the appearance of eczema had an impact on their sex life. The influence of AD on sex life is significant both for the patients and their partners. Copyright (c) 2007 S. Karger AG, Basel.

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

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...

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

Systematic review of the impact of urinary tract infections on health-related quality of life.

PubMed

Bermingham, Sarah L; Ashe, Joanna F

2012-12-01

What's known on the subject? and What does the study add? Values for equivalent health states can vary substantially depending on the measure used and method of valuation; this has a direct impact on the results of economic analyses. To date, the majority of existing economic evaluations that include UTI as a health state refer to an analysis in which the Index of Well Being was used to estimate the quality of life experienced by young women with UTIs. Currently, there are no validated methods or filters for systematically searching for the type of generic quality of life data required for decision analytic models. This study is the only systematic review of quality of life in people with UTI in the literature. Twelve studies were identified which report quality of life using a variety of generic methods; the results of these papers were summarized in a way that is useful for a health researcher seeking to populate a decision model, design a clinical study or assess the effect of UTI on quality of life relative to other conditions. One research group provided previously unpublished data from a large cohort study; these scores were mapped to EuroQol 5-Dimension values using published algorithms and probabilistic simulations. The aim of this review was to identify studies that have evaluated the impact of symptomatic urinary tract infection (UTI) and UTI-associated bacteraemia on quality of life, and to summarize these data in a way that is useful for a health researcher seeking to populate a cost-utility model, design a clinical study or assess the effect of UTIs on quality of life relative to other conditions. We conducted a systematic search of the literature using MEDLINE, EMBASE, the NHS Economic Evaluations database, Health Technology Assessment database, Health Economics Evaluations database, Cost-Effectiveness Analysis Registry and EuroQol website. Studies that reported utility values for symptomatic UTI or UTI-associated bacteraemia derived from a generic Qo

Impact of oral conditions on the quality of life of secondary schoolchildren in Nigeria.

PubMed

Oziegbe, Elizabeth O; Esan, Temitope A; Adesina, Bola A

2012-01-01

Oral health problems have been increasingly recognized as important factors causing a negative impact on daily performance and quality of life. The purpose of this study was to assess the impact of tooth extraction with no replacement, untreated fractured anterior teeth, malocclusion, dental restorations, and orthodontic braces on the quality of life in Nigerian schoolchildren. A total of 197 9- to 17-year-old schoolchildren completed the Oral Health Impact Profile (OHIP) index/questionnaire. Students who had tooth extraction with no replacement and untreated fractured incisors had significantly higher mean OHIP scores for functional limitations, physical pain, psychological discomfort, physical, psychological, and social disabilities, and handicaps (P<.001) when compared to other groups and the control. The mean OHIP scores of students with features of malocclusion were significantly higher for functional limitations, psychological discomfort, and psychological disability compared to the control group (P<.001). Untreated dental problems had some negative impact on the quality of life on the 7 subscales of the OHIP.

Impact of periodontitis on oral health-related quality of life.

PubMed

Durham, Justin; Fraser, Hannah M; McCracken, Giles I; Stone, Kerry M; John, Mike T; Preshaw, Philip M

2013-04-01

To investigate the impact of chronic periodontitis on oral health-related quality of life (OHRQoL) using the full version of the Oral Health Impact Profile (OHIP-49) and the Oral Health Quality of Life-UK (OHQoL-UK) questionnaires. 89 patients with chronic periodontitis and 89 age- and gender-matched patients without chronic periodontitis were recruited. OHIP-49 and OHQoL-UK were self-completed by participants and mean scores were calculated for each item, domain and the overall summary score (additive method) for each instrument in each group. The mean age of participants was 47 ± 9 years, and the periodontitis patients had, on average, 33 ± 23 sites demonstrating probing depths ≥ 5 mm. OHRQoL was significantly poorer in the periodontitis patients compared to the periodontally healthy patients, when assessed by either instrument. When considering OHIP-49, fourteen of the forty-nine items indicated significantly poorer OHRQoL in the periodontitis group, and the overall OHIP-49 summary score was 48.6 ± 32.0 for periodontitis patients compared to 36.8 ± 29.8 in periodontally healthy patients (p<0.01). When considering OHQoL-UK, fifteen of the sixteen items indicated significantly poorer OHRQoL in the periodontitis group, and the overall OHQoL-UK summary score was 47.1 ± 9.7 for periodontitis patients compared to 53.1 ± 11.3 in periodontally healthy patients (p<0.01). Overall, those items with the greatest differences between periodontitis patients and the healthy group related to psychological concerns, halitosis, pain and aesthetics. Subjects with periodontitis report substantial functional, physical, psychological, and social OHRQoL impacts. This study has identified that patients with chronic periodontitis report significantly poorer oral health-related quality of life (OHRQoL) than age- and gender-matched periodontally healthy patients, with significant functional, social and psychological impacts. Clinicians should be aware of the impacts that

Rural-Urban Differences in Medicare Quality Outcomes and the Impact of Risk Adjustment.

PubMed

Henning-Smith, Carrie; Kozhimannil, Katy; Casey, Michelle; Prasad, Shailendra; Moscovice, Ira

2017-09-01

There has been considerable debate in recent years about whether, and how, to risk-adjust quality measures for sociodemographic characteristics. However, geographic location, especially rurality, has been largely absent from the discussion. To examine differences by rurality in quality outcomes, and the impact of adjustment for individual and community-level sociodemographic characteristics on quality outcomes. The 2012 Medicare Current Beneficiary Survey, Access to Care module, combined with the 2012 County Health Rankings. All data used were publicly available, secondary data. We merged the 2012 Medicare Current Beneficiary Survey data with the 2012 County Health Rankings data using county of residence. We compared 6 unadjusted quality of care measures for Medicare beneficiaries (satisfaction with care, blood pressure checked, cholesterol checked, flu shot receipt, change in health status, and all-cause annual readmission) by rurality (rural noncore, micropolitan, and metropolitan). We then ran nested multivariable logistic regression models to assess the impact of adjusting for community and individual-level sociodemographic characteristics to determine whether these mediate the rurality difference in quality of care. The relationship between rurality and change in health status was mediated by the inclusion of community-level characteristics; however, adjusting for community and individual-level characteristics caused differences by rurality to emerge in 2 of the measures: blood pressure checked and cholesterol checked. For all quality scores, model fit improved after adding community and individual characteristics. Quality is multifaceted and is impacted by individual and community-level socio-demographic characteristics, as well as by geographic location. Current debates about risk-adjustment procedures should take rurality into account.

The Impact of Child Care Subsidy Use on Child Care Quality

PubMed Central

Ryan, Rebecca M.; Johnson, Anna; Rigby, Elizabeth; Brooks-Gunn, Jeanne

2010-01-01

In 2008, the federal government allotted $7 billion in child care subsidies to low-income families through the state-administered Child Care and Development Fund (CCDF), now the government’s largest child care program (US DHHS, 2008). Although subsidies reduce costs for families and facilitate parental employment, it is unclear how they impact the quality of care families purchase. This study investigates the impact of government subsidization on parents’ selection of child care quality using multivariate regression and propensity score matching approaches to account for differential selection into subsidy receipt and care arrangements. Data were drawn from the Child Care Supplement to the Fragile Families and Child Wellbeing Study (CCS-FFCWS), conducted in 2002 and 2003 in 14 of the 20 FFCWS cities when focal children were 3 years old (N = 456). Our results indicate that families who used subsidies chose higher quality care than comparable mothers who did not use subsidies, but only because subsidy recipients were more likely to use center-based care. Subgroup analyses revealed that families using subsidies purchased higher-quality home-based care but lower-quality center-based care than comparable non-recipients. Findings suggest that child care subsidies may serve as more than a work support for low-income families by enhancing the quality of nonmaternal care children experience but that this effect is largely attributable to recipients’ using formal child care arrangements (versus kith and kin care) more often than non-recipients. PMID:21874092

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

Do Contaminants Originating from State-of-the-Art Treated Wastewater Impact the Ecological Quality of Surface Waters?

PubMed Central

Stalter, Daniel; Magdeburg, Axel; Quednow, Kristin; Botzat, Alexandra; Oehlmann, Jörg

2013-01-01

Since the 1980s, advances in wastewater treatment technology have led to considerably improved surface water quality in the urban areas of many high income countries. However, trace concentrations of organic wastewater-associated contaminants may still pose a key environmental hazard impairing the ecological quality of surface waters. To identify key impact factors, we analyzed the effects of a wide range of anthropogenic and environmental variables on the aquatic macroinvertebrate community. We assessed ecological water quality at 26 sampling sites in four urban German lowland river systems with a 0–100% load of state-of-the-art biological activated sludge treated wastewater. The chemical analysis suite comprised 12 organic contaminants (five phosphor organic flame retardants, two musk fragrances, bisphenol A, nonylphenol, octylphenol, diethyltoluamide, terbutryn), 16 polycyclic aromatic hydrocarbons, and 12 heavy metals. Non-metric multidimensional scaling identified organic contaminants that are mainly wastewater-associated (i.e., phosphor organic flame retardants, musk fragrances, and diethyltoluamide) as a major impact variable on macroinvertebrate species composition. The structural degradation of streams was also identified as a significant factor. Multiple linear regression models revealed a significant impact of organic contaminants on invertebrate populations, in particular on Ephemeroptera, Plecoptera, and Trichoptera species. Spearman rank correlation analyses confirmed wastewater-associated organic contaminants as the most significant variable negatively impacting the biodiversity of sensitive macroinvertebrate species. In addition to increased aquatic pollution with organic contaminants, a greater wastewater fraction was accompanied by a slight decrease in oxygen concentration and an increase in salinity. This study highlights the importance of reducing the wastewater-associated impact on surface waters. For aquatic ecosystems in urban areas this

Do contaminants originating from state-of-the-art treated wastewater impact the ecological quality of surface waters?

PubMed

Stalter, Daniel; Magdeburg, Axel; Quednow, Kristin; Botzat, Alexandra; Oehlmann, Jörg

2013-01-01

Since the 1980s, advances in wastewater treatment technology have led to considerably improved surface water quality in the urban areas of many high income countries. However, trace concentrations of organic wastewater-associated contaminants may still pose a key environmental hazard impairing the ecological quality of surface waters. To identify key impact factors, we analyzed the effects of a wide range of anthropogenic and environmental variables on the aquatic macroinvertebrate community. We assessed ecological water quality at 26 sampling sites in four urban German lowland river systems with a 0-100% load of state-of-the-art biological activated sludge treated wastewater. The chemical analysis suite comprised 12 organic contaminants (five phosphor organic flame retardants, two musk fragrances, bisphenol A, nonylphenol, octylphenol, diethyltoluamide, terbutryn), 16 polycyclic aromatic hydrocarbons, and 12 heavy metals. Non-metric multidimensional scaling identified organic contaminants that are mainly wastewater-associated (i.e., phosphor organic flame retardants, musk fragrances, and diethyltoluamide) as a major impact variable on macroinvertebrate species composition. The structural degradation of streams was also identified as a significant factor. Multiple linear regression models revealed a significant impact of organic contaminants on invertebrate populations, in particular on Ephemeroptera, Plecoptera, and Trichoptera species. Spearman rank correlation analyses confirmed wastewater-associated organic contaminants as the most significant variable negatively impacting the biodiversity of sensitive macroinvertebrate species. In addition to increased aquatic pollution with organic contaminants, a greater wastewater fraction was accompanied by a slight decrease in oxygen concentration and an increase in salinity. This study highlights the importance of reducing the wastewater-associated impact on surface waters. For aquatic ecosystems in urban areas this

Impact of Performance Obstacles on Intensive Care Nurses‘ Workload, Perceived Quality and Safety of Care, and Quality of Working Life

PubMed Central

Gurses, Ayse P; Carayon, Pascale; Wall, Melanie

2009-01-01

Objectives To study the impact of performance obstacles on intensive care nurses‘ workload, quality and safety of care, and quality of working life (QWL). Performance obstacles are factors that hinder nurses‘ capacity to perform their job and that are closely associated with their immediate work system. Data Sources/Study Setting Data were collected from 265 nurses in 17 intensive care units (ICUs) between February and August 2004 via a structured questionnaire, yielding a response rate of 80 percent. Study Design A cross-sectional study design was used. Data were analyzed by correlation analyses and structural equation modeling. Principal Findings Performance obstacles were found to affect perceived quality and safety of care and QWL of ICU nurses. Workload mediated the impact of performance obstacles with the exception of equipment-related issues on perceived quality and safety of care as well as QWL. Conclusions Performance obstacles in ICUs are a major determinant of nursing workload, perceived quality and safety of care, and QWL. In general, performance obstacles increase nursing workload, which in turn negatively affect perceived quality and safety of care and QWL. Redesigning the ICU work system to reduce performance obstacles may improve nurses‘ work. PMID:19207589

Air quality and energy impacts of NYSDOT highway ROW management.

DOT National Transportation Integrated Search

2010-08-01

Mowing the highway right-of-way is important for the safety of roadway users and maintaining the highway infrastructure. However, little quantitative data are available on the energy use and air quality impacts of highway mowing activities. In this r...

Massive land system changes impact water quality of the Jhelum River in Kashmir Himalaya.

PubMed

Rather, Mohmmad Irshad; Rashid, Irfan; Shahi, Nuzhat; Murtaza, Khalid Omar; Hassan, Khalida; Yousuf, Abdul Rehman; Romshoo, Shakil Ahmad; Shah, Irfan Yousuf

2016-03-01

The pristine aquatic ecosystems in the Himalayas are facing an ever increasing threat from various anthropogenic pressures which necessitate better understanding of the spatial and temporal variability of pollutants, their sources, and possible remedies. This study demonstrates the multi-disciplinary approach utilizing the multivariate statistical techniques, data from remote sensing, lab, and field-based observations for assessing the impact of massive land system changes on water quality of the river Jhelum. Land system changes over a period of 38 years have been quantified using multi-spectral satellite data to delineate the extent of different anthropogenically driven land use types that are the main non-point sources of pollution. Fifteen water quality parameters, at 12 sampling sites distributed uniformly along the length of the Jhelum, have been assessed to identify the possible sources of pollution. Our analysis indicated that 18% of the forested area has degraded into sparse forest or scrublands from 1972 to 2010, and the areas under croplands have decreased by 24% as people shifted from irrigation-intensive agriculture to orchard farming while as settlements showed a 397% increase during the observation period. One-way ANOVA revealed that all the water quality parameters had significant spatio-temporal differences (p < 0.01). Cluster analysis (CA) helped us to classify all the sampling sites into three groups. Factor analysis revealed that 91.84% of the total variance was mainly explained by five factors. Drastic changes in water quality of the Jhelum since the past three decades are manifested by increases in nitrate-nitrogen, TDS, and electric conductivity. The especially high levels of nitrogen (858 ± 405 μgL(-1)) and phosphorus (273 ± 18 μgL(-1)) in the Jhelum could be attributed to the reckless application of fertilizers, pesticides, and unplanned urbanization in the area.

Characterizing potential water quality impacts from soils treated with dust suppressants.

PubMed

Beighley, R Edward; He, Yiping; Valdes, Julio R

2009-01-01

Two separate laboratory experiment series, surface runoff and steady-state seepage, were performed to determine if dust suppressant products can be applied to soils with an expected minimal to no negative impact on water quality. The experiments were designed to mimic arid field conditions and used two soils (clayey and sandy) and six different dust suppressants. The two experiments consisted of: (i) simulated rainfall (intensities of 18, 33, or 61 mm h(-1)) and associated runoff from soil trays at a surface slope of 33%; and (ii) steady-state, constant head seepage through soil columns. Both experiment series involved two product application scenarios and three application ages (i.e., to account for degradation effects) for a total of 126 surface runoff and 80 column experiments. One composite effluent sample was collected from each experiment and analyzed for pH, electrical conductivity, total suspended solids (TSS), total dissolved solids, dissolved oxygen, total organic carbon, nitrate, nitrite, and phosphate. Paired t tests at 1 and 5% levels of significance and project specific data quality objectives are used to compare water quality parameters from treated and untreated soils. Overall, the results from this laboratory scale study suggest that the studied dust suppressants have minimal potential for adverse impacts to selected water quality parameters. The primary impacts were increased TSS for two synthetic products from the surface runoff experiments on both soils. The increase in TSS was not expected based on previous studies and may be attributed to this study's focus on simulating real-world soil agitation/movement at an active construction site subjected to rough grading.

Impact of chronic cough on quality of life.

PubMed

French, C L; Irwin, R S; Curley, F J; Krikorian, C J

Cough is the most common complaint for which adult patients seek medical care in the United States; however, the reason(s) for this is unknown. To determine whether chronic cough was associated with adverse psychosocial or physical effects on the quality of life and whether the elimination of chronic cough with specific therapy improved these adverse effects. The study design was a prospective before-and-after intervention trial with patients serving as their own controls. Study subjects were a convenience sample of 39 consecutive and unselected adult patients referred for evaluation and management of a chronic, persistently troublesome cough. Baseline data were available for 39 patients and follow-up for 28 patients (22 women and 6 men). At baseline, demographic, Adverse Cough Outcome Survey (ACOS), and Sickness Impact Profile (SIP) data were collected and patients were managed according to a validated, systematic protocol. Following specific therapy for cough, ACOS and SIP instruments were readministered. The ages, sex, duration, and spectra and frequencies of the causes of cough were similar to multiple other studies. At baseline, patients reported a mean +/- SD of 8.6 +/- 4.8 types of adverse occurrences related to cough. There were significant correlations between multiple ACOS items and total, physical, and psychosocial SIP scores. Psychosocial score correlated with total number of symptoms (P<.02). After cough disappeared with treatment, ACOS complaints decreased to a mean +/- SD of 1.9 +/- 3.2 (P<.0001) as did total (mean +/- SD, 4.8 +/- 4.5 to 1.8 +/- 2.2) (P= .004), psychosocial (mean +/- SD, 4.2 +/- 6.8 to 0.8 +/- 2.3) (P = .004), and physical (mean +/- SD, 2.2 +/- 2.9 to 0.9 +/- 1.8) (P = .05) SIP scores. Multiple linear regression analysis showed that 54% of variability of the psychosocial SIP score was explained by 4 ACOS items while none of the physical score was explained. Chronic cough was associated with deterioration in patients' quality of life

Exploratory factor analysis of the Oral Health Impact Profile.

PubMed

John, M T; Reissmann, D R; Feuerstahler, L; Waller, N; Baba, K; Larsson, P; Celebić, A; Szabo, G; Rener-Sitar, K

2014-09-01

Although oral health-related quality of life (OHRQoL) as measured by the Oral Health Impact Profile (OHIP) is thought to be multidimensional, the nature of these dimensions is not known. The aim of this report was to explore the dimensionality of the OHIP using the Dimensions of OHRQoL (DOQ) Project, an international study of general population subjects and prosthodontic patients. Using the project's Learning Sample (n = 5173), we conducted an exploratory factor analysis on the 46 OHIP items not specifically referring to dentures for 5146 subjects with sufficiently complete data. The first eigenvalue (27·0) of the polychoric correlation matrix was more than ten times larger than the second eigenvalue (2·6), suggesting the presence of a dominant, higher-order general factor. Follow-up analyses with Horn's parallel analysis revealed a viable second-order, four-factor solution. An oblique rotation of this solution revealed four highly correlated factors that we named Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact. These four dimensions and the strong general factor are two viable hypotheses for the factor structure of the OHIP. © 2014 John Wiley & Sons Ltd.

The Impact of Quality Matters Professional Development on Teaching across Delivery Formats

ERIC Educational Resources Information Center

Kearns, Lorna R.; Mancilla, Rae

2017-01-01

This study explored the impact of professional development workshops for online course design on faculty's pedagogical practices in online, face-to-face (f2f), and blended instructional modes. It specifically focused on trainings offered by the Quality Matters (QM) organization on a rubric for assessing quality in online course development. A…

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

Social support and responsiveness in online patient communities: impact on service quality perceptions.

PubMed

Nambisan, Priya; Gustafson, David H; Hawkins, Robert; Pingree, Suzanne

2016-02-01

Hospitals frequently evaluate their service quality based on the care and services provided to patients by their clinical and non-clinical staff.(1,2) However, such evaluations do not take into consideration the many interactions that patients have in online patient communities with the health-care organization (HCO) as well as with peer patients. Patients' interactions in these online communities could impact their perceptions regarding the HCO's service quality. The objective of this pilot study was to evaluate the impact of social support and responsiveness that patients experience in an HCO's online community on patients' perceptions regarding the HCO's service quality. The study data are collected from CHESS, a health-care programme (Comprehensive Health Enhancement Support System) run by the Centre for Health Enhancement System Studies at the University of Wisconsin-Madison. Findings show that the social support and the responsiveness received from peer patients in the online patient communities will impact patients' perceptions regarding the service quality of the HCO even when the organizational members themselves do not participate in the online discussions. The results indicate that interactions in such HCO-provided online patient communities should not be ignored as they could translate into patients' perceptions regarding HCOs' service quality. Ways to improve responsiveness and social support in an HCO's online patient community are discussed. © 2014 John Wiley & Sons Ltd.

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...

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...

Journal impact factor and methodological quality of surgical randomized controlled trials: an empirical study.

PubMed

Ahmed Ali, Usama; Reiber, Beata M M; Ten Hove, Joren R; van der Sluis, Pieter C; Gooszen, Hein G; Boermeester, Marja A; Besselink, Marc G

2017-11-01

The journal impact factor (IF) is often used as a surrogate marker for methodological quality. The objective of this study is to evaluate the relation between the journal IF and methodological quality of surgical randomized controlled trials (RCTs). Surgical RCTs published in PubMed in 1999 and 2009 were identified. According to IF, RCTs were divided into groups of low (<2), median (2-3) and high IF (>3), as well as into top-10 vs all other journals. Methodological quality characteristics and factors concerning funding, ethical approval and statistical significance of outcomes were extracted and compared between the IF groups. Additionally, a multivariate regression was performed. The median IF was 2.2 (IQR 2.37). The percentage of 'low-risk of bias' RCTs was 13% for top-10 journals vs 4% for other journals in 1999 (P < 0.02), and 30 vs 12% in 2009 (P < 0.02). Similar results were observed for high vs low IF groups. The presence of sample-size calculation, adequate generation of allocation and intention-to-treat analysis were independently associated with publication in higher IF journals; as were multicentre trials and multiple authors. Publication of RCTs in high IF journals is associated with moderate improvement in methodological quality compared to RCTs published in lower IF journals. RCTs with adequate sample-size calculation, generation of allocation or intention-to-treat analysis were associated with publication in a high IF journal. On the other hand, reporting a statistically significant outcome and being industry funded were not independently associated with publication in a higher IF journal.

A systematic quality assessment of Environmental Impact Statements in the oil and gas industry.

PubMed

Anifowose, B; Lawler, D M; van der Horst, D; Chapman, L

2016-12-01

The global economy relies heavily on oil and gas resources. However, hydrocarbon exploitation projects can cause significant impacts on the environment. But despite the production of numerous Environmental Impact Statements (EISs) to identify/mitigate such impacts, no study has specifically assessed the quality of EISs for both onshore and offshore oil and gas projects, with tested hypotheses. To address this research gap, our paper, for the first time, develops a modified Lee and Colley evaluation model to assess the quality of 19 sampled oil and gas project EISs produced from 1998 to 2008 in Nigeria. Our findings show that Project Description and Communication of Results are the main areas of strength. However, Environmental Impact Prediction, and Project Decommissioning, were among the key areas requiring attention. A key finding, though, is that Mann-Whitney tests suggest that there is no evidence that the quality of EISs for the latter period (2004-2008) is higher than that of the earlier period (1998-2004). We suggest that periodic systematic review of the quality of submitted/approved EISs (c. every 3-5years) should be established to monitor trends in EIS quality and identify strong and weak areas. This would help to drive continual improvement in both the EIA processes and the resultant EISs of technical engineering projects. Such reviews have the potential to illuminate some of the underlying problems of, and solutions to, oil and gas exploration, production and transportation, and their related environmental impacts. This suggested change would also be useful internationally, including for the burgeoning exploration and production of unconventional hydrocarbon resources. Copyright © 2016 Elsevier B.V. All rights reserved.

Impact of resin bonded bridgework on quality of life of patients with hypodontia.

PubMed

Anweigi, Lamyia; Finbarr Allen, P; Ziada, Hassan

2013-08-01

To determine the impact of hypodontia on the quality of life of adolescent and young adult patients, and, to assess the impact of restoring tooth spaces with resin bonded bridgework on quality of life of patients with hypodontia. In a prospective study, 82 patients with a confirmed diagnosis of hypodontia participated. The primary outcome was oral health related quality of life (OHRQoL) and this was measured using the OHIP-49 prior to treatment. The pre-treatment sample was then divided into two groups: the test group (n=40 patients) who had completed orthodontic treatment and had tooth spaces restored with resin bonded bridgework, and, a control group (n=42 patients) who were still in the process of orthodontic treatment. All patients completed a follow-up OHIP-49, and between and within group comparisons made. The pre-treatment sample included 43 females and 39 males, age ranged from 16 to 34 years (median age 19). Forty-three patients had more than 4 congenitally missing teeth and thirty-nine had ≤ 4 congenitally missing teeth. There were no differences between the groups prior to treatment. For the test group, there was a significant improvement in median OHIP summary scores (p<0.001) after treatment. OHIP scores deteriorated to a significant degree for control subjects (p=0.002). The effect sizes for the pre-post treatment change in both groups were moderate to large. Hypodontia has a significant impact on oral health related quality of life. Provision of resin bonded bridges has a positive impact on oral health related quality of life of patients with hypodontia. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

Impact of music on the quality of life of cochlear implant users: a focus group study.

PubMed

Dritsakis, Giorgos; van Besouw, Rachel M; O' Meara, Aoife

2017-07-01

To study the aspects of the quality of life (QoL) on which music has an impact in adult cochlear implant (CI) users. Thirty adult CI users aged between 18 and 81 years old with a wide range of patient characteristics and musical backgrounds participated in the study. Six focus group discussions about music in everyday life were conducted and data were analysed using template analysis based on the QoL model of the World Health Organisation Quality of Life BREF questionnaire. A theoretical framework of the impact of music on the QoL was developed. Music was reported to contribute to many aspects of physical, psychological, and social well-being in adult CI users. These positive effects of music on QoL were similar to what has been reported in the literature for normal-hearing adults. However, difficulties in music perception and enjoyment were found to have a negative impact on CI users' QoL, especially by causing unpleasant feelings and limited participation in music-related or routine daily activities. These findings suggest that an improvement in music experiences of CI users may lead to improvements in QoL and therefore support the need for music rehabilitation. However, the relative importance of music overall and of specific aspects of music for each individual should be measured for an accurate assessment of the impact of music on the QoL of CI users.

Impacts of a Rural Subdivision on Groundwater Quality: Results of Long-Term Monitoring.

PubMed

Rayne, Todd W; Bradbury, Kenneth R; Krause, Jacob J

2018-03-30

A rural subdivision in south central Wisconsin was instrumented with monitoring wells and lysimeters before, during, and after its construction to examine the impacts of the unsewered subdivision on groundwater quality and quantity. Prior to construction, the 78-acre (32 ha) site was farmland. Sixteen homes were constructed beginning in 2003. Initial monitoring from 2002 to 2005 showed that groundwater beneath the site had been impacted by previous agricultural use, with nitrate-N values as high as 30 mg/L and some detections of the herbicide atrazine. Our 12-year study shows that the transition from agricultural to residential land use has changed groundwater quality in both negative and positive ways. Although groundwater elevations showed typical seasonal fluctuations each year, there were no measurable changes in groundwater levels or general flow directions during the 12-year study period. Chloride values increased in many wells, possibly as a result of road salting or water softener discharge. Nitrate concentrations varied spatially and temporally over the study period, with some initial concentrations substantially above the drinking water standard. In some wells, nitrate and atrazine levels have declined substantially since agriculture ceased. However, atrazine was still present at trace concentrations throughout the site in 2014. Wastewater tracers show there are small but detectable impacts from septic effluent on groundwater quality. Particle traces based on a groundwater flow model are consistent with the hypothesis that septic leachate has impacted groundwater quality. © 2018, National Ground Water Association.

Factors that Impact Quality of E-Teaching/Learning Technologies in Higher Education

ERIC Educational Resources Information Center

Daukilas, Sigitas; Kaciniene, Irma; Vaisnoriene, Daiva; Vascila, Vytautas

2008-01-01

The article analyzes and assesses factors that have impact upon the quality of eTeaching/learning technologies in higher education; it is on their basis that the concept of eTeaching/learning quality is denied. Research data about the students' motives in choosing various teaching/learning technologies for the development of their competence are…

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…

Impact of nurse work environment and staffing on hospital nurse and quality of care in Thailand.

PubMed

Nantsupawat, Apiradee; Srisuphan, Wichit; Kunaviktikul, Wipada; Wichaikhum, Orn-Anong; Aungsuroch, Yupin; Aiken, Linda H

2011-12-01

To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care. Secondary data analysis of the 2007 Thai Nurse Survey. The sample consisted of 5,247 nurses who provided direct care for patients across 39 public hospitals in Thailand. Multivariate logistic regression was used to estimate the impact of nurse work environment and staffing on nurse outcomes and quality of care. Nurses cared for an average of 10 patients each. Forty-one percent of nurses had a high burnout score as measured by the Maslach Burnout Inventory; 28% of nurses were dissatisfied with their job; and 27% rated quality of nursing care as fair or poor. At the hospital level, after controlling for nurse characteristics (age, years in unit), the addition of each patient to a nurse's workload was associated with a 2% increase in the odds on nurses reporting high emotional exhaustion (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03; p < .05). Nurses who reported favorable work environments were about 30% less likely to report fair to poor care quality (OR 0.69; 95% CI 0.48-0.98; p < .05) compared with nurses who reported unfavorable work environments. The addition of each patient to a nurse's workload was associated with a 4% increase in the odds on nurses reporting quality of nursing care as fair or poor (OR 1.04; 95% CI 1.02-1.05; p < .001). Improving nurse work environments and nurse staffing in Thai hospitals holds promise for reducing nurse burnout, thus improving nurse retention at the hospital bedside as well as potentially improving the quality of care. Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world. © 2011 Sigma Theta Tau International.

DNA fragmentation of normal spermatozoa negatively impacts embryo quality and intracytoplasmic sperm injection outcome.

PubMed

Avendaño, Conrado; Franchi, Anahí; Duran, Hakan; Oehninger, Sergio

2010-07-01

To evaluate DNA fragmentation in morphologically normal sperm recovered from the same sample used for intracytoplasmic sperm injection (ICSI) and to correlate DNA damage with embryo quality and pregnancy outcome. Prospective study. Academic center. 36 infertile men participating in the ICSI program. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-fluorescein nick end labeling (TUNEL) assay and morphologic assessment by phase contrast. Simultaneous assessment of sperm morphology and DNA fragmentation by TUNEL assay was performed in the same cell, then the percentage of normal sperm with fragmented DNA (normal SFD) was correlated with embryo quality and pregnancy outcomes. A highly statistically significant negative correlation was found between the percentage of normal SFD and embryo quality. This association was confirmed for the transferred embryos and for the total embryo cohort. The receiver operating characteristics curve analysis demonstrated that the percentage of normal SFD and embryo quality were statistically significant predictors of pregnancy. When the percentage of normal SFD was impacts embryo quality and probability of pregnancy in ICSI cycles. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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 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.

Water quality simulation of sewage impacts on the west coast of Mumbai, India.

PubMed

Vijay, R; Khobragade, P J; Sohony, R A

2010-01-01

Most coastal cities use the ocean as a site of waste disposal where pollutant loading degrades the quality of coastal waters. Presently, the west coast of Mumbai receives partially treated effluent from wastewater treatment facilities through ocean outfalls and discharges into creeks as well as wastewater/sewage from various open drains and nallahs which affect the water quality of creek and coastal water. Therefore, the objective of this paper is to simulate and assess the hydrodynamic behaviour and water quality due to impact of sewage and wastewater discharges from the west coast of Mumbai. Hydrodynamics and water quality were simulated based on present conditions and validated by using measured tide, current data and observed DO, BOD and FC. Observed and simulated results indicated non compliance to standards in Malad, Mahim creeks and the impact zones of ocean outfalls. The developed model could be used for generating various conditions of hydrodynamics and water quality considering the improvement in wastewater collection systems, treatment levels and proper disposal for proper planning and management of creeks and coastal environment.

Impact of tissue type and content of neoplastic cells of samples on the quality of epidermal growth factor receptor mutation analysis among patients with lung adenocarcinoma

PubMed Central

PALIOGIANNIS, PANAGIOTIS; ATTENE, FEDERICO; COSSU, ANTONIO; DEFRAIA, EFISIO; PORCU, GIUSEPPE; CARTA, ANNAMARIA; SOTGIU, MARIA IGNAZIA; PAZZOLA, ANTONIO; CORDERO, LORENZO; CAPELLI, FRANCESCA; FADDA, GIOVANNI MARIA; ORTU, SALVATORE; SOTGIU, GIOVANNI; PALOMBA, GRAZIA; SINI, MARIA CRISTINA; PALMIERI, GIUSEPPE; COLOMBINO, MARIA

2015-01-01

Assessment of the epidermal growth factor receptor (EGFR) mutational status has become crucial in recent years in the molecular classification of patients with lung cancer. The impact of the type and quantity of malignant cells of the neoplastic specimen on the quality of mutation analysis remains to be elucidated, and only empirical and sporadic data are available. The aim of the present study was to investigate the impact of tissue type and content of neoplastic cells in the specimen on the quality of EGFR mutation analysis among patients with lung adenocarcinoma. A total of 515 patients with histologically-confirmed disease were included in the present study. Formalin-fixed paraffin embedded tissue samples were used for the mutation analysis and the content of the neoplastic cells was evaluated using light microscopy. Genomic DNA was isolated using a standard protocol. The coding sequences and splice junctions of exons 18, 19 and 21 in the EGFR gene were then screened for mutations by direct automated sequencing. The mean age of the patients examined was 64.9 years and 357 (69.3%) were male. A total of 429 tissue samples (83.3%) were obtained by biopsy and the remaining samples were obtained by surgery. A total of 456 samples (88.5%) were observed from primary lung adenocarcinomas, while 59 (11.5%) were from metastatic lesions. EGFR mutations occurred in 59 cases (11.5%); exon 18 mutations were detected in one case (1.7%), whereas exon 19 and 21 mutations were detected in 30 (51%) and 28 (47.3%) cases, respectively. EGFR mutations were more frequent in females and patients that had never smoked. The distribution of the mutations among primary and metastatic tissues exhibited no significant differences in the proportions of EGFR mutations detected. However, a statistically significant difference in the number of mutations detected was found between samples with at least 50% of neoplastic cells (450 cases-57 mutations; 12.7%) and those with <50% of neoplastic

Assessing the Organisational Impact of External Quality Assurance: Hypothesising Key Dimensions and Mechanisms

ERIC Educational Resources Information Center

Stensaker, Bjørn; Leiber, Theodor

2015-01-01

The aim of the article is to provide a framework in which the organisational impact of external quality assurance (EQA) can be assessed. Based on existing studies of the impact of EQA in universities and colleges it is suggested that greater systematisation of how impact is measured is needed for a better understanding of how EQA can be used as a…

Impact analysis of composite aircraft structures

NASA Technical Reports Server (NTRS)

Pifko, Allan B.; Kushner, Alan S.

1993-01-01

The impact analysis of composite aircraft structures is discussed. Topics discussed include: background remarks on aircraft crashworthiness; comments on modeling strategies for crashworthiness simulation; initial study of simulation of progressive failure of an aircraft component constructed of composite material; and research direction in composite characterization for impact analysis.

The Relationships Between Fatigue, Quality of Life, and Family Impact Among Children With Special Health Care Needs

PubMed Central

Anderson, Mary; Gandhi, Pranav; Tuli, Sanjeev; Krull, Kevin; Lai, Jin-Shei; Nackashi, John; Shenkman, Elizabeth

2013-01-01

Objective To examine the relationships among pediatric fatigue, health-related quality of life (HRQOL), and family impact among children with special health care needs (CSHCNs), specifically whether HRQOL mediates the influence of fatigue on family impact. Methods 266 caregivers of CSHCNs were studied. The Pediatric Quality of Life Inventory Multidimensional Fatigue Scale, Pediatric Quality of Life Inventory Generic Scale, and Impact on Family Scale were used to measure fatigue, HRQOL, and family impact, respectively. Linear regressions were used to analyze the designated relationships; path analyses were performed to quantify the mediating effects of HRQOL on fatigue–family impact relationship. Results Although greater fatigue was associated with family impact (p < .05), the association was not significant after accounting for HRQOL. Path analyses indicated the direct effect of fatigue on family impact was not significant (p > .05), whereas physical and emotional functioning significantly mediated the fatigue–family impact relationship (p < .001). Conclusion Fatigue is related to family impact among CSHCNs, acting through the impairment in HRQOL. PMID:23584707

Impact of Provider Incentives on Quality and Value of Health Care.

PubMed

Doran, Tim; Maurer, Kristin A; Ryan, Andrew M

2017-03-20

The use of financial incentives to improve quality in health care has become widespread. Yet evidence on the effectiveness of incentives suggests that they have generally had limited impact on the value of care and have not led to better patient outcomes. Lessons from social psychology and behavioral economics indicate that incentive programs in health care have not been effectively designed to achieve their intended impact. In the United States, Medicare's Hospital Readmission Reduction Program and Hospital Value-Based Purchasing Program, created under the Affordable Care Act (ACA), provide evidence on how variations in the design of incentive programs correspond with differences in effect. As financial incentives continue to be used as a tool to increase the value and quality of health care, improving the design of programs will be crucial to ensure their success.

"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.

Impact of cleft lip and/or palate in children on family quality of life before and after reconstructive surgery.

PubMed

Macho, P; Bohac, M; Fedeles, J; Fekiacova, D; Fedeles, J

2017-01-01

The aim of the study was to evaluate the impact of cleft lip/palate children together with consequent treatment on quality of family life using standardized questionnaire. Different to previous studies the evaluation of quality of family life by questionnaire was realized twice in the same group of families (before the reconstructive surgery and several months after palatoplasty). The study was conducted in 40 families divided in two groups: 20 families with children with cleft lip (CL), 20 families with children with cleft lip and palate (CLP). The questionnaire of the Impact on Family Scale was used for evaluation of the influence of orofacial clefts on parent´s quality of life. Evaluations were made at the second month of child´s life and at one year of child´s life with reciprocally comparison. The higher impact of children with CLP on quality of family life was noted at 2 months and 1 year of child's age as compared to the impact of children with CL. The reduction of impact on quality of life after surgical correction was observed in families of children with CL at one year of child's age. This decrease of influence on family quality of life was due to significantly lower impact in strain and economic dimensions in families with CL children after operation. However, in the group of families with CLP children no significant changes in the impact on family quality of life were noted when compared to the values before and shortly after the reconstructive surgery. This study showed that orofacial clefts in children influence markedly the quality of their family life. The higher impact of children with CLP on quality of family life as compared to children with CL was noted and this impact in CLP group was not influenced shortly after reconstructive surgery. It is suggested that appropriate medical care in Cleft Centre with special psychological support may lead to improvement in quality of life for families with cleft lip and palate children (Tab. 2, Fig. 2, Ref

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

Impact of climate change on water quality of an impaired New Mexico river

USDA-ARS?s Scientific Manuscript database

Climate change is predicted to advance runoff timing in snowmelt basins and decrease available water, particularly in arid and semi-arid regions. Researchers have suggested that the impacts of climate change will degrade water quality by reducing dilution. We use coupled snowmelt and water quality m...

Measuring school health center impact on access to and quality of primary care.

PubMed

Gibson, Erica J; Santelli, John S; Minguez, Mara; Lord, Alyssa; Schuyler, Ashley C

2013-12-01

School health centers (SHC) that provide comprehensive health care may improve access and quality of care for students; however, published impact data are limited. We evaluated access and quality of health services at an urban high school with a SHC compared with a school without a SHC, using a quasiexperimental research design. Data were collected at the beginning of the school year, using a paper and pencil classroom questionnaire (n = 2,076 students). We measured SHC impact in several ways including grade by school interaction terms. Students at the SHC school were more likely to report having a regular healthcare provider, awareness of confidential services, support for health services in their school, and willingness to utilize those services. Students in the SHC school reported higher quality of care as measured by: respect for their health concerns, adequate time with the healthcare provider, understandable provider communications, and greater provider discussion at their last visit on topics such as sexual activity, birth control, emotions, future plans, diet, and exercise. Users of the SHC were also more likely to report higher quality of care, compared with either nonusers or students in the comparison school. Access to comprehensive health services via a SHC led to improved access to health care and improved quality of care. Impact was measureable on a school-wide basis but was greater among SHC users. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

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 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. ...

Assessing Impacts of 20 yr Old Miscanthus on Soil Organic Carbon Quality

NASA Astrophysics Data System (ADS)

Hu, Yaxian; Schäfer, Gerhard; Kuhn, Nikolaus

2015-04-01

The use of biomass as a renewable energy source has become increasingly popular in Upper Rhine Region to meet the demand for renewable energy. Miscanthus is one of the most favorite biofuel crops, due to its long life and large yields, as well as low energy and fertilizer inputs. However, current research on Miscanthus is mostly focused on the techniques and economics to produce biofuel or the impacts of side products such as ash and sulfur emissions to human health. Research on the potential impacts of Miscanthus onto soil quality, especially carbon quality after long-term adoption, is very limited. Some positive benefits, such as sequestrating organic carbon, have been repeatedly reported in previous research. Yet the quality of newly sequestrated organic carbon and its potential impacts onto global carbon cycling remain unclear. To fully account for the risks and benefits of Miscanthus, it is required to investigate the quality as well as the potential CO2 emissions of soil organic carbon on Miscanthus fields. As a part of the Interreg Project to assess the environmental impacts of biomass production in the Upper Rhine Region, this study aims to evaluate the carbon quality and the potential CO2 emissions after long-term Miscanthus adoption. Soils were sampled at 0-10, 10-40, 40-70, and 70-100 cm depths on three Miscanthus fields with up to 20 years of cultivation in Ammerzwiller France, Münchenstein Switzerland, and Farnsburg Switzerland. Soil texture, pH, organic carbon and nitrogen content were measured for each sampled layer. Topsoils of 0-10 cm and subsoils of 10-40 cm were also incubated for 40 days to determine the mineralization potential of the soil organic matter. Our results show that: 1) only in top soils of 0-10 cm, the 20 year old Miscanthus field has significantly higher soil organic carbon concentrations, than the control site. No significant differences were observed in deeper soil layers. Similar tendencies were also observed for organic

Impact of fine particulate fluctuation and other variables on Beijing's air quality index.

PubMed

Chen, Bo; Lu, Shaowei; Li, Shaoning; Wang, Bing

2015-04-01

We analyzed fluctuation in Beijing's air quality over 328 days, based on air quality grades and air quality data from 35 atmospheric monitoring stations. Our results show the air over Beijing is subject to pollution 152 days of the year, or 46.34%. Among all pollutants, fine particulates, solid or liquid, 2.5 μm or less in size (PM2.5), appeared most frequently as the primary pollutant: 249 days, or 76% of the sample year (328 days). Nitrogen dioxide (NO2) and coarse particulates (PM10) cause the least pollution, appearing only 7 and 3 days, or 2 and 1% of the sample year, respectively. In Beijing, fine particulates like PM2.5 vary seasonally: 154.54 ± 18.60 in winter > 145.22 ± 18.61 in spring > 140.16 ± 20.76 in autumn > 122.37 ± 13.42 in summer. Air quality is best in August and worst in December, while various districts in Beijing experience different air quality. To be specific, from south to north and from west to east, air quality tends to improve. Meteorological elements have a constraining effect on air pollutants, which means there is a linear correlation between the air quality index and humidity, rainfall, wind speed, and temperature. Under a typical pollution scenario, the higher the air quality index (AQI) value, the lower the wind speed and the greater the relative humidity; the lower the AQI value, the higher the wind speed and lower the relative humidity. Analysis of influencing factors reveals that the air pollution is mainly particulate matter produced by burning coal, vehicle emissions, volatile oils and gas, fast development of food services, emissions from the surrounding region, and natural dust clouds formed in arid areas to the northwest. Topography affects the distribution of meteorological conditions, in turn varying air quality over the region from one location to another. Human activities also exercise impact on urban air quality with dual functions.

[Animal drugs quality status and reason analysis].

PubMed

Ding, Qing; Qiu, Ya-jing; Fang, Ke-hui; Hu, Hao-bin; Wu, Yue

2015-11-01

In order to reaction the quality present situation, problems on the current quality of animal sources of drugs are summed up by using test data analysis, literature search and marketing research. This paper can also help the improvement of the quality management, the revision of the relevant department policy system and the improvement of standards.

Impacts of Residential Biofuel Emissions on Air Quality and Climate

NASA Astrophysics Data System (ADS)

Huang, Y.; Unger, N.; Harper, K.; Storelvmo, T.

2016-12-01

The residential biofuel sector is defined as fuelwood, agricultural residues and dung used for household cooking and heating. Aerosol emissions from this human activity play an important role affecting local, regional and global air quality, climate and public health. However, there are only few studies available that evaluate the net impacts and large uncertainties persist. Here we use the Community Atmosphere Model version 5.3 (CAM v5.3) within the Community Earth System Model version 1.2.2, to quantify the impacts of cook-stove biofuel emissions on air quality and climate. The model incorporates a novel advanced treatment of black carbon (BC) effects on mixed-phase/ice clouds. We update the global anthropogenic emission inventory in CAM v5.3 to a state-of-the-art emission inventory from the Greenhouse Gas-Air Pollution Interactions and Synergies integrated assessment model. Global in-situ and aircraft campaign observations for BC and organic carbon are used to evaluate and validate the model performance. Sensitivity simulations are employed to assess the impacts of residential biofuel emissions on regional and global direct and indirect radiative forcings in the contemporary world. We focus the analyses on several key regions including India, China and Sub-Saharan Africa.

The Impact of Translators' Academic Experience on Their Translation Quality

ERIC Educational Resources Information Center

Varzande, Mohsen; Jadidi, Esmaeil

2015-01-01

Translators differ from each other in many ways in terms of their knowledge and professional conditions that may directly influence their translation. The present study aimed at investigating the impact of translators' academic experience on their translation quality. Following a "causal-comparative study", a sample of 100 male and…

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…

Impact of Handwriting Training on Fluency, Spelling and Text Quality among Third Graders

ERIC Educational Resources Information Center

Hurschler Lichtsteiner, Sibylle; Wicki, Werner; Falmann, Péter

2018-01-01

As recent studies and theoretical assumptions suggest that the quality of texts composed by children and adolescents is affected by their transcription skills, this experimental field trial aims at investigating the impact of combined handwriting/spelling training on fluency, spelling and text quality among normally developing 3rd graders…

Budget Impact of a Comprehensive Nutrition-Focused Quality Improvement Program for Malnourished Hospitalized Patients

PubMed Central

Sulo, Suela; Feldstein, Josh; Partridge, Jamie; Schwander, Bjoern; Sriram, Krishnan; Summerfelt, Wm. Thomas

2017-01-01

Background Nutrition interventions can alleviate the burden of malnutrition by improving patient outcomes; however, evidence on the economic impact of medical nutrition intervention remains limited. A previously published nutrition-focused quality improvement program targeting malnourished hospitalized patients showed that screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence result in significant reductions in 30-day unplanned readmissions and hospital length of stay. Objectives To assess the potential cost-savings associated with decreased 30-day readmissions and hospital length of stay in malnourished inpatients through a nutrition-focused quality improvement program using a web-based budget impact model, and to demonstrate the clinical and fiscal value of the intervention. Methods The reduction in readmission rate and length of stay for 1269 patients enrolled in the quality improvement program (between October 13, 2014, and April 2, 2015) were compared with the pre–quality improvement program baseline and validation cohorts (4611 patients vs 1319 patients, respectively) to calculate potential cost-savings as well as to inform the design of the budget impact model. Readmission rate and length-of-stay reductions were calculated by determining the change from baseline to post–quality improvement program as well as the difference between the validation cohort and the post–quality improvement program, respectively. Results As a result of improved health outcomes for the treated patients, the nutrition-focused quality improvement program led to a reduction in 30-day hospital readmissions and length of stay. The avoided hospital readmissions and reduced number of days in the hospital for the patients in the quality improvement program resulted in cost-savings of $1,902,933 versus the pre–quality improvement program baseline cohort, and $4

Budget Impact of a Comprehensive Nutrition-Focused Quality Improvement Program for Malnourished Hospitalized Patients.

PubMed

Sulo, Suela; Feldstein, Josh; Partridge, Jamie; Schwander, Bjoern; Sriram, Krishnan; Summerfelt, Wm Thomas

2017-07-01

Nutrition interventions can alleviate the burden of malnutrition by improving patient outcomes; however, evidence on the economic impact of medical nutrition intervention remains limited. A previously published nutrition-focused quality improvement program targeting malnourished hospitalized patients showed that screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence result in significant reductions in 30-day unplanned readmissions and hospital length of stay. To assess the potential cost-savings associated with decreased 30-day readmissions and hospital length of stay in malnourished inpatients through a nutrition-focused quality improvement program using a web-based budget impact model, and to demonstrate the clinical and fiscal value of the intervention. The reduction in readmission rate and length of stay for 1269 patients enrolled in the quality improvement program (between October 13, 2014, and April 2, 2015) were compared with the pre-quality improvement program baseline and validation cohorts (4611 patients vs 1319 patients, respectively) to calculate potential cost-savings as well as to inform the design of the budget impact model. Readmission rate and length-of-stay reductions were calculated by determining the change from baseline to post-quality improvement program as well as the difference between the validation cohort and the post-quality improvement program, respectively. As a result of improved health outcomes for the treated patients, the nutrition-focused quality improvement program led to a reduction in 30-day hospital readmissions and length of stay. The avoided hospital readmissions and reduced number of days in the hospital for the patients in the quality improvement program resulted in cost-savings of $1,902,933 versus the pre-quality improvement program baseline cohort, and $4,896,758 versus the pre-quality improvement program in the

Long-Term Impact of Earthquakes on Sleep Quality

PubMed Central

Tempesta, Daniela; Curcio, Giuseppe; De Gennaro, Luigi; Ferrara, Michele

2013-01-01

Purpose We investigated the impact of the 6.3 magnitude 2009 L’Aquila (Italy) earthquake on standardized self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and frequency of disruptive nocturnal behaviours (Pittsburgh Sleep Quality Index-Addendum, PSQI-A) two years after the natural disaster. Methods Self-reported sleep quality was assessed in 665 L’Aquila citizens exposed to the earthquake compared with a different sample (n = 754) of L'Aquila citizens tested 24 months before the earthquake. In addition, sleep quality and disruptive nocturnal behaviours (DNB) of people exposed to the traumatic experience were compared with people that in the same period lived in different areas ranging between 40 and 115 km from the earthquake epicenter (n = 3574). Results The comparison between L’Aquila citizens before and after the earthquake showed a significant deterioration of sleep quality after the exposure to the trauma. In addition, two years after the earthquake L'Aquila citizens showed the highest PSQI scores and the highest incidence of DNB compared to subjects living in the surroundings. Interestingly, above-the-threshold PSQI scores were found in the participants living within 70 km from the epicenter, while trauma-related DNBs were found in people living in a range of 40 km. Multiple regressions confirmed that proximity to the epicenter is predictive of sleep disturbances and DNB, also suggesting a possible mediating effect of depression on PSQI scores. Conclusions The psychological effects of an earthquake may be much more pervasive and long-lasting of its building destruction, lasting for years and involving a much larger population. A reduced sleep quality and an increased frequency of DNB after two years may be a risk factor for the development of depression and posttraumatic stress disorder. PMID:23418478

Long-term impact of earthquakes on sleep quality.

PubMed

Tempesta, Daniela; Curcio, Giuseppe; De Gennaro, Luigi; Ferrara, Michele

2013-01-01

We investigated the impact of the 6.3 magnitude 2009 L'Aquila (Italy) earthquake on standardized self-report measures of sleep quality (Pittsburgh Sleep Quality Index, PSQI) and frequency of disruptive nocturnal behaviours (Pittsburgh Sleep Quality Index-Addendum, PSQI-A) two years after the natural disaster. Self-reported sleep quality was assessed in 665 L'Aquila citizens exposed to the earthquake compared with a different sample (n = 754) of L'Aquila citizens tested 24 months before the earthquake. In addition, sleep quality and disruptive nocturnal behaviours (DNB) of people exposed to the traumatic experience were compared with people that in the same period lived in different areas ranging between 40 and 115 km from the earthquake epicenter (n = 3574). The comparison between L'Aquila citizens before and after the earthquake showed a significant deterioration of sleep quality after the exposure to the trauma. In addition, two years after the earthquake L'Aquila citizens showed the highest PSQI scores and the highest incidence of DNB compared to subjects living in the surroundings. Interestingly, above-the-threshold PSQI scores were found in the participants living within 70 km from the epicenter, while trauma-related DNBs were found in people living in a range of 40 km. Multiple regressions confirmed that proximity to the epicenter is predictive of sleep disturbances and DNB, also suggesting a possible mediating effect of depression on PSQI scores. The psychological effects of an earthquake may be much more pervasive and long-lasting of its building destruction, lasting for years and involving a much larger population. A reduced sleep quality and an increased frequency of DNB after two years may be a risk factor for the development of depression and posttraumatic stress disorder.

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.

Power quality analysis based on spatial correlation

NASA Astrophysics Data System (ADS)

Li, Jiangtao; Zhao, Gang; Liu, Haibo; Li, Fenghou; Liu, Xiaoli

2018-03-01

With the industrialization and urbanization, the status of electricity in the production and life is getting higher and higher. So the prediction of power quality is the more potential significance. Traditional power quality analysis methods include: power quality data compression, disturbance event pattern classification, disturbance parameter calculation. Under certain conditions, these methods can predict power quality. This paper analyses the temporal variation of power quality of one provincial power grid in China from time angle. The distribution of power quality was analyzed based on spatial autocorrelation. This paper tries to prove that the research idea of geography is effective for mining the potential information of power quality.

Study on regional air quality impact from a chemical plant emergency shutdown.

PubMed

Ge, Sijie; Wang, Sujing; Xu, Qiang; Ho, Thomas

2018-06-01

Emergency shutdowns of chemical plants (ESCP) inevitably generate intensive and huge amounts of VOCs and NO x emissions through flaring that can cause highly localized and transient air pollution events with elevated ozone concentrations. However, quantitative studies of regional ozone impact due to ESCP, in terms of how ESCP would affect and to what extent ESCP could impact, are still lacking. This paper reports a systematic study on regional air quality impact from an olefin plant emergency shutdown due to the sudden failure of its cracked gas compressor (CGC). It demonstrates that emergency shutdown may cause significant ozone increment subject to different factors such as the starting time of emergency shutdown, flare destruction and removal efficiency (DRE) and plant location. In our studied case, the 8-hr ozone increment ranges from 0.4 to 3.3 ppb under different starting time, from 3.3 to 24.8 ppb under different DRE, and from 1.6 to 3.3 ppb under different locations. The results enable us to understand how and to what extent emergency operating activities of the chemical process will affect local air quality, which might be beneficial for decision makings on emergency air-quality response and control in the future. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adenotonsillectomy for Obstructive Sleep Apnea and Quality of Life: Systematic Review and Meta-analysis.

PubMed

Todd, Cameron A; Bareiss, Anna K; McCoul, Edward D; Rodriguez, Kimsey H

2017-11-01

Objective To determine the impact of adenotonsillectomy on the quality of life of pediatric patients with obstructive sleep apnea (OSA) and to identify gaps in the current research. Data Sources The MEDLINE, EMBASE, and Cochrane databases were systematically searched via the Ovid portal on June 18, 2016, for English-language articles. Review Methods Full-text articles were selected that studied boys and girls <18 years of age who underwent adenotonsillectomy for OSA or sleep-disordered breathing and that recorded validated, quantitative quality-of-life outcomes. Studies that lacked such measures, performed adenotonsillectomy for indications other than OSA or sleep-disordered breathing, or grouped adenotonsillectomy with other procedures were excluded. Results Of the 328 articles initially identified, 37 were included for qualitative analysis. The level of evidence was generally low. All studies involving short-term follow-up (≤6 months) showed improvement in quality-of-life scores after adenotonsillectomy as compared with preoperative values. Studies involving long-term follow-up (>6 months) showed mixed results. Modifications to and concurrent procedures with conventional adenotonsillectomy were also identified that showed quality-of-life improvements. Three studies were identified for meta-analysis that compared pre- and postoperative Obstructive Sleep Apnea-18 scores. Short- and long-term follow-up versus preoperative scores showed significant improvement ( P < .001). Short- and long-term scores showed no significant difference. Conclusion This systematic review and meta-analysis demonstrate adenotonsillectomy's effectiveness in improving the quality of life of pediatric patients with OSA. This is well demonstrated in the short term and has strong indications in the long term.

Air quality mapping using GIS and economic evaluation of health impact for Mumbai City, India.

PubMed

Kumar, Awkash; Gupta, Indrani; Brandt, Jørgen; Kumar, Rakesh; Dikshit, Anil Kumar; Patil, Rashmi S

2016-05-01

Mumbai, a highly populated city in India, has been selected for air quality mapping and assessment of health impact using monitored air quality data. Air quality monitoring networks in Mumbai are operated by National Environment Engineering Research Institute (NEERI), Maharashtra Pollution Control Board (MPCB), and Brihanmumbai Municipal Corporation (BMC). A monitoring station represents air quality at a particular location, while we need spatial variation for air quality management. Here, air quality monitored data of NEERI and BMC were spatially interpolated using various inbuilt interpolation techniques of ArcGIS. Inverse distance weighting (IDW), Kriging (spherical and Gaussian), and spline techniques have been applied for spatial interpolation for this study. The interpolated results of air pollutants sulfur dioxide (SO2), nitrogen dioxide (NO2) and suspended particulate matter (SPM) were compared with air quality data of MPCB in the same region. Comparison of results showed good agreement for predicted values using IDW and Kriging with observed data. Subsequently, health impact assessment of a ward was carried out based on total population of the ward and air quality monitored data within the ward. Finally, health cost within a ward was estimated on the basis of exposed population. This study helps to estimate the valuation of health damage due to air pollution. Operating more air quality monitoring stations for measurement of air quality is highly resource intensive in terms of time and cost. The appropriate spatial interpolation techniques can be used to estimate concentration where air quality monitoring stations are not available. Further, health impact assessment for the population of the city and estimation of economic cost of health damage due to ambient air quality can help to make rational control strategies for environmental management. The total health cost for Mumbai city for the year 2012, with a population of 12.4 million, was estimated as USD

The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis.

PubMed

Salyers, Michelle P; Bonfils, Kelsey A; Luther, Lauren; Firmin, Ruth L; White, Dominique A; Adams, Erin L; Rollins, Angela L

2017-04-01

Healthcare provider burnout is considered a factor in quality of care, yet little is known about the consistency and magnitude of this relationship. This meta-analysis examined relationships between provider burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and the quality (perceived quality, patient satisfaction) and safety of healthcare. Publications were identified through targeted literature searches in Ovid MEDLINE, PsycINFO, Web of Science, CINAHL, and ProQuest Dissertations & Theses through March of 2015. Two coders extracted data to calculate effect sizes and potential moderators. We calculated Pearson's r for all independent relationships between burnout and quality measures, using a random effects model. Data were assessed for potential impact of study rigor, outliers, and publication bias. Eighty-two studies including 210,669 healthcare providers were included. Statistically significant negative relationships emerged between burnout and quality (r = -0.26, 95 % CI [-0.29, -0.23]) and safety (r = -0.23, 95 % CI [-0.28, -0.17]). In both cases, the negative relationship implied that greater burnout among healthcare providers was associated with poorer-quality healthcare and reduced safety for patients. Moderators for the quality relationship included dimension of burnout, unit of analysis, and quality data source. Moderators for the relationship between burnout and safety were safety indicator type, population, and country. Rigor of the study was not a significant moderator. This is the first study to systematically, quantitatively analyze the links between healthcare provider burnout and healthcare quality and safety across disciplines. Provider burnout shows consistent negative relationships with perceived quality (including patient satisfaction), quality indicators, and perceptions of safety. Though the effects are small to medium, the findings highlight the importance of effective burnout interventions for

Training and support to improve ICD coding quality: A controlled before-and-after impact evaluation.

PubMed

Dyers, Robin; Ward, Grant; Du Plooy, Shane; Fourie, Stephanus; Evans, Juliet; Mahomed, Hassan

2017-05-24

The proposed National Health Insurance policy for South Africa (SA) requires hospitals to maintain high-quality International Statistical Classification of Diseases (ICD) codes for patient records. While considerable strides had been made to improve ICD coding coverage by digitising the discharge process in the Western Cape Province, further intervention was required to improve data quality. The aim of this controlled before-and-after study was to evaluate the impact of a clinician training and support initiative to improve ICD coding quality. To compare ICD coding quality between two central hospitals in the Western Cape before and after the implementation of a training and support initiative for clinicians at one of the sites. The difference in differences in data quality between the intervention site and the control site was calculated. Multiple logistic regression was also used to determine the odds of data quality improvement after the intervention and to adjust for potential differences between the groups. The intervention had a positive impact of 38.0% on ICD coding completeness over and above changes that occurred at the control site. Relative to the baseline, patient records at the intervention site had a 6.6 (95% confidence interval 3.5 - 16.2) adjusted odds ratio of having a complete set of ICD codes for an admission episode after the introduction of the training and support package. The findings on impact on ICD coding accuracy were not significant. There is sufficient pragmatic evidence that a training and support package will have a considerable positive impact on ICD coding completeness in the SA setting.

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.

The impact of the condenser on cytogenetic image quality in digital microscope system.

PubMed

Ren, Liqiang; Li, Zheng; Li, Yuhua; Zheng, Bin; Li, Shibo; Chen, Xiaodong; Liu, Hong

2013-01-01

Optimizing operational parameters of the digital microscope system is an important technique to acquire high quality cytogenetic images and facilitate the process of karyotyping so that the efficiency and accuracy of diagnosis can be improved. This study investigated the impact of the condenser on cytogenetic image quality and system working performance using a prototype digital microscope image scanning system. Both theoretical analysis and experimental validations through objectively evaluating a resolution test chart and subjectively observing large numbers of specimen were conducted. The results show that the optimal image quality and large depth of field (DOF) are simultaneously obtained when the numerical aperture of condenser is set as 60%-70% of the corresponding objective. Under this condition, more analyzable chromosomes and diagnostic information are obtained. As a result, the system shows higher working stability and less restriction for the implementation of algorithms such as autofocusing especially when the system is designed to achieve high throughput continuous image scanning. Although the above quantitative results were obtained using a specific prototype system under the experimental conditions reported in this paper, the presented evaluation methodologies can provide valuable guidelines for optimizing operational parameters in cytogenetic imaging using the high throughput continuous scanning microscopes in clinical practice.

The Impact of the Condenser on Cytogenetic Image Quality in Digital Microscope System

PubMed Central

Ren, Liqiang; Li, Zheng; Li, Yuhua; Zheng, Bin; Li, Shibo; Chen, Xiaodong; Liu, Hong

2013-01-01

Background: Optimizing operational parameters of the digital microscope system is an important technique to acquire high quality cytogenetic images and facilitate the process of karyotyping so that the efficiency and accuracy of diagnosis can be improved. OBJECTIVE: This study investigated the impact of the condenser on cytogenetic image quality and system working performance using a prototype digital microscope image scanning system. Methods: Both theoretical analysis and experimental validations through objectively evaluating a resolution test chart and subjectively observing large numbers of specimen were conducted. Results: The results show that the optimal image quality and large depth of field (DOF) are simultaneously obtained when the numerical aperture of condenser is set as 60%–70% of the corresponding objective. Under this condition, more analyzable chromosomes and diagnostic information are obtained. As a result, the system shows higher working stability and less restriction for the implementation of algorithms such as autofocusing especially when the system is designed to achieve high throughput continuous image scanning. Conclusions: Although the above quantitative results were obtained using a specific prototype system under the experimental conditions reported in this paper, the presented evaluation methodologies can provide valuable guidelines for optimizing operational parameters in cytogenetic imaging using the high throughput continuous scanning microscopes in clinical practice. PMID:23676284

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.

Big Data and Heath Impacts of Drinking Water Quality Violation

NASA Astrophysics Data System (ADS)

Allaire, M.; Zheng, S.; Lall, U.

2017-12-01

Health impacts of drinking water quality violations are only understood at a coarse level in the United States. This limits identification of threats to water security in communities across the country. Substantial under-reporting is suspected due to requirements at U.S. public health institutes that water borne illnesses be confirmed by health providers. In the era of `big data', emerging information sources could offer insight into waterborne disease trends. In this study, we explore the use of fine-resolution sales data for over-the-counter medicine to estimate the health impacts of drinking water quality violations. We also demonstrate how unreported water quality issues can be detected by observing market behavior. We match a panel of supermarket sales data for the U.S. at the weekly level with geocoded violations data from 2006-2015. We estimate the change in anti-diarrheal medicine sale due to drinking water violations using a fixed effects model. We find that water quality violations have considerable effects on medicine sales. Sales nearly double due to Tier 1 violations, which pose an immediate health risk, and sales increase 15.1 percent due to violations related to microorganisms. Furthermore, our estimate of diarrheal illness cases associated with water quality violations indicates that the Centers for Disease Control and Prevention (CDC) reporting system may only capture about one percent of diarrheal cases due to impaired water. Incorporating medicine sales data could offer national public health institutes a game-changing way to improve monitoring of disease outbreaks. Since many disease cases are not formally diagnosed by health providers, consumption information could provide additional information to remedy under-reporting issues and improve water security in communities across the United States.

Progressing quality control in environmental impact assessment beyond legislative compliance: An evaluation of the IEMA EIA Quality Mark certification scheme

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

Bond, Alan, E-mail: alan.bond@uea.ac.uk; Research Unit for Environmental Sciences and Management, North-West University; Fischer, Thomas B, E-mail: fischer@liverpool.ac.uk

The effectiveness of Environmental Impact Assessment (EIA) systems is contingent on a number of control mechanisms: procedural; judicial; evaluative; public and government agency; professional; and development aid agency. If we assume that procedural and judicial controls are guaranteed in developed EIA systems, then progressing effectiveness towards an acceptable level depends on improving the performance of other control mechanisms over time. These other control mechanisms are either absent, or are typically centrally controlled, requiring public finances; this we argue is an unpopular model in times of greater Government austerity. Here we evaluate a market-based mechanism for improving the performance of evaluativemore » and professional control mechanisms, the UK Institute of Environmental Management and Assessments' EIA Quality Mark. We do this by defining dimensions of effectiveness for the purposes of our evaluation, and by identifying international examples of the approaches taken to delivering the other control measures to validate the approach taken in the EIA Quality Mark. We then evaluate the EIA Quality Mark, when used in combination with legal procedures and an active judiciary, against the effectiveness dimensions and use time-series analysis of registrant data to examine its ability to progress practice. We conclude that the EIA Quality Mark has merit as a model for a market-based mechanism, and may prove a more financially palatable approach for delivering effective EIA in mature systems in countries that lack centralised agency oversight. It may, therefore, be of particular interest to some Member States of the European Union for ensuring forthcoming certification requirements stemming from recent amendments to the EIA Directive. - Highlights: • Quality control mechanisms in EIA are identified. • Effectiveness of EIA is conceptualised for evaluation purposes. • The UK IEMA EIA Quality Mark is introduced as a market-based mechanism. �

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.

Nurses' Emotional Intelligence Impact on the Quality of Hospital Services

PubMed Central

Ranjbar Ezzatabadi, Mohammad; Bahrami, Mohammad Amin; Hadizadeh, Farzaneh; Arab, Masoomeh; Nasiri, Soheyla; Amiresmaili, Mohammadreza; Ahmadi Tehrani, Gholamreza

2012-01-01

Background Emotional intelligence is the potential to feel, use, communicate, recognize, remember, describe, identify, learn from, manage, understand and explain emotions. Service quality also can be defined as the post-consumption assessment of the services by consumers that are determined by many variables. Objectives This study was aimed to determine the nurses’ emotional intelligence impact on the delivered services quality. Materials and Methods This descriptive - applied study was carried out through a cross-sectional method in 2010. The research had 2 populations comprising of patients admitted to three academic hospitals of Yazd and the hospital nurses. Sample size was calculated by sample size formula for unlimited (patients) and limited (nursing staff) populations and obtained with stratified- random method. The data was collected by 4 valid questionnaires. Results The results of study indicated that nurses' emotional intelligence has a direct effect on the hospital services quality. The study also revealed that nurse's job satisfaction and communication skills have an intermediate role in the emotional intelligence and service quality relation. Conclusions This paper reports a new determinant of hospital services quality. PMID:23482866

A framework for modeling contaminant impacts on reservoir water quality

NASA Astrophysics Data System (ADS)

Jeznach, Lillian C.; Jones, Christina; Matthews, Thomas; Tobiason, John E.; Ahlfeld, David P.

2016-06-01

This study presents a framework for using hydrodynamic and water quality models to understand the fate and transport of potential contaminants in a reservoir and to develop appropriate emergency response and remedial actions. In the event of an emergency situation, prior detailed modeling efforts and scenario evaluations allow for an understanding of contaminant plume behavior, including maximum concentrations that could occur at the drinking water intake and contaminant travel time to the intake. A case study assessment of the Wachusett Reservoir, a major drinking water supply for metropolitan Boston, MA, provides an example of an application of the framework and how hydrodynamic and water quality models can be used to quantitatively and scientifically guide management in response to varieties of contaminant scenarios. The model CE-QUAL-W2 was used to investigate the water quality impacts of several hypothetical contaminant scenarios, including hypothetical fecal coliform input from a sewage overflow as well as an accidental railway spill of ammonium nitrate. Scenarios investigated the impacts of decay rates, season, and inter-reservoir transfers on contaminant arrival times and concentrations at the drinking water intake. The modeling study highlights the importance of a rapid operational response by managers to contain a contaminant spill in order to minimize the mass of contaminant that enters the water column, based on modeled reservoir hydrodynamics. The development and use of hydrodynamic and water quality models for surface drinking water sources subject to the potential for contaminant entry can provide valuable guidance for making decisions about emergency response and remediation actions.

Meteorological and air quality impacts of increased urban albedo and vegetative cover in the Greater Toronto Area, Canada

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

Taha, Haider; Hammer, Hillel; Akbari, Hashem

2002-04-30

The study described in this report is part of a project sponsored by the Toronto Atmospheric Fund, performed at the Lawrence Berkeley National Laboratory, to assess the potential role of surface property modifications on energy, meteorology, and air quality in the Greater Toronto Area (GTA), Canada. Numerical models were used to establish the possible meteorological and ozone air-quality impacts of increased urban albedo and vegetative fraction, i.e., ''cool-city'' strategies that can mitigate the urban heat island (UHI), significantly reduce urban energy consumption, and improve thermal comfort, particularly during periods of hot weather in summer. Mitigation is even more important duringmore » critical heat wave periods with possible increased heat-related hospitalization and mortality. The evidence suggests that on an annual basis cool-city strategies are beneficial, and the implementation of such measures is currently being investigated in the U.S. and Canada. We simulated possible scenari os for urban heat-island mitigation in the GTA and investigated consequent meteorological changes, and also performed limited air-quality analysis to assess related impacts. The study was based on a combination of mesoscale meteorological modeling, Lagrangian (trajectory), and photochemical trajectory modeling to assess the potential meteorological and ozone air-quality impacts of cool-city strategies. As available air-quality and emissions data are incompatible with models currently in use at LBNL, our air-quality analysis was based on photochemical trajectory modeling. Because of questions as to the accuracy and appropriateness of this approach, in our opinion this aspect of the study can be improved in the future, and the air-quality results discussed in this report should be viewed as relatively qualitative. The MM5 meteorological model predicts a UHI in the order of 2 to 3 degrees C in locations of maxima, and about 1 degree C as a typical value over most of the urban

Impact of gastroesophageal reflux disease symptoms on the quality of life in pregnant women: a prospective study.

PubMed

Fill Malfertheiner, Sara; Seelbach-Göbel, Birgit; Costa, Serban-Dan; Ernst, Wolfgang; Reuschel, Edith; Zeman, Florian; Malfertheiner, Peter; Malfertheiner, Maximilian V

2017-08-01

Pregnant women often suffer from gastroesophageal reflux disease (GERD). GERD symptoms are known to influence the quality of life; however, there is a lack of data in pregnant women. The aim of this study was to establish the impact of GERD symptoms on health-related quality of life (HRQOL) during pregnancy. A prospective longitudinal cohort study to investigate the impact of GERD symptoms on the HRQOL was carried out in 510 pregnant women and 330 nonpregnant women as controls. Two validated questionnaires, the Reflux Disease Questionnaire and the Quality of Life in Reflux and Dyspepsia Questionnaire, were used. The study showed a significant negative impact on HRQOL in pregnant women with GERD symptoms. All five areas, emotional distress, sleep disturbance, vitality, food/drink problems, and physical/social functioning, were significantly reduced, but the most significant impact was on sleep (Quality of Life in Reflux and Dyspepsia Questionnaire score -35%). Overall, quality of life in women with GERD worsened throughout pregnancy. GERD is frequently seen in pregnant women and has a negative impact on HRQOL, especially in late pregnancy. Therefore, there is a need for adequate therapy of GERD in pregnant women and HRQOL could be an adequate monitoring tool in this population.

Urinary incontinence symptoms and impact on quality of life in patients seeking outpatient physical therapy services.

PubMed

Alappattu, Meryl; Neville, Cynthia; Beneciuk, Jason; Bishop, Mark

2016-01-01

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. Retrospective cross-sectional analysis. A convenience sample of patients that positively responded to a UI screening question was included in this study. 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 (QoL) impact. Frequency of UI type, symptom severity, health-related quality of life (HRQoL) impact, and pad use were compared between treatment groups. 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 QoL compared to the pelvic pain and spine groups, but not compared to the extremity disorders, fecal dysfunction, or neurological disorder group. 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.

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…

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.

Impact of socioeconomic status and subjective social class on overall and health-related quality of life.

PubMed

Kim, Jae-Hyun; Park, Eun-Cheol

2015-08-15

Our objective was to investigate the impact of socioeconomic status and subjective social class on health-related quality of life (HRQOL) vs. overall quality of life (QOL). We performed a longitudinal analysis using data regarding 8250 individuals drawn from the Korean Longitudinal Study of Aging (KLoSA). We analyzed differences between HRQOL and QOL in individuals of various socioeconomic strata (high, middle, or low household income and education levels) and subjective social classes (high, middle, or low) at baseline (2009). Individuals with low household incomes and of low subjective social class had the highest probability of reporting discrepant HRQOL and QOL scores (B: 4.796; P < 0.0001), whereas individuals with high household incomes and high subjective social class had the lowest probability of discrepant HRQOL and QOL scores (B: -3.625; P = 0.000). Similar trends were seen when education was used as a proxy for socioeconomic status. In conclusion, both household income/subjective social class and education/subjective social class were found to have an impact on the degree of divergence between QOL and HRQOL. Therefore, in designing interventions, socioeconomic inequalities should be taken into account through the use of multi-dimensional measurement tools.

Impacts of fire smoke plumes on regional air quality, 2006-2013.

PubMed

Larsen, Alexandra E; Reich, Brian J; Ruminski, Mark; Rappold, Ana G

2017-12-29

Increases in the severity and frequency of large fires necessitate improved understanding of the influence of smoke on air quality and public health. The objective of this study is to estimate the effect of smoke from fires across the continental U.S. on regional air quality over an extended period of time. We use 2006-2013 data on ozone (O 3 ), fine particulate matter (PM 2.5 ), and PM 2.5 constituents from environmental monitoring sites to characterize regional air quality and satellite imagery data to identify plumes. Unhealthy levels of O 3 and PM 2.5 were, respectively, 3.3 and 2.5 times more likely to occur on plume days than on clear days. With a two-stage approach, we estimated the effect of plumes on pollutants, controlling for season, temperature, and within-site and between-site variability. Plumes were associated with an average increase of 2.6 p.p.b. (2.5, 2.7) in O 3 and 2.9 µg/m 3 (2.8, 3.0) in PM 2.5 nationwide, but the magnitude of effects varied by location. The largest impacts were observed across the southeast. High impacts on O 3 were also observed in densely populated urban areas at large distance from the fires throughout the southeast. Fire smoke substantially affects regional air quality and accounts for a disproportionate number of unhealthy days.

Extent and persistence of secondary water quality impacts after enhanced reductive bioremediation

USGS Publications Warehouse

Borden, Robert C.; Jason M. Tillotson,; Ng, Gene-Hua Crystal.; Bekins, Barbara A.; Kent, Douglas B.; Curtis, Gary P.

2017-01-01

Electron donor (ED) addition can be very effective in stimulating enhanced reductive bioremediation (ERB) of a wide variety of groundwater contaminants. However, ERB can result in Secondary Water Quality Impacts (SWQIs) including decreased levels of dissolved oxygen (O2), nitrate (NO3- ), and sulfate (SO42- ), and elevated levels of dissolved manganese (Mn2+), dissolved iron (Fe2+), methane (CH4), sulfide (S2- ), organic carbon, and naturally occurring hazardous compounds (e.g., arsenic). Fortunately, this ‘plume’ of impacted groundwater is usually confined within the original contaminant plume and is unlikely to adversely impact potable water supplies. This report summarizes available information on processes controlling the production and natural attenuation of SWQI parameters and can be used as a guide in understanding the magnitude, areal extent, and duration of SWQIs in ERB treatment zones and the natural attenuation of SWQI parameters as the dissolved solutes migrate downgradient with ambient groundwater flow. This information was compiled from a wide variety of sources including a survey and statistical analysis of SWQIs from 47 ERB sites, geochemical model simulations, field studies at sites where organic-rich materials have entered the subsurface (e.g., wastewater, landfill leachate, and hydrocarbon plumes), and basic information on physical, chemical, and biological processes in the subsurface. This information is then integrated to provide a general conceptual model of the major processes controlling SWQI production and attenuation.

Impact of dental caries on preschool children's quality of life: an update.

PubMed

Bönecker, Marcelo; Abanto, Jenny; Tello, Gustavo; Oliveira, Luciana Butini

2012-01-01

The literature reports that dental caries can cause functional, physical and aesthetic impairment, often with repercussions on children's general health at an early age. Moreover, recent studies have investigated how caries lesions can compromise children's quality of life. This paper aims to describe the current situation of dental caries prevalence in children and how this oral health disease can impact their quality of life.

Climate Change Impacts on US Water Quality using two Models: HAWQS and US Basins

EPA Science Inventory

Climate change and freshwater quality are well-linked. Changes in climate result in changes in streamflow and rising water temperatures, which impact biochemical reaction rates and increase stratification in lakes and reservoirs. Using two water quality modeling systems (the Hydr...

Impacts of Lowered Urban Air Temperatures on Precursor Emission and Ozone Air Quality.

PubMed

Taha, Haider; Konopacki, Steven; Akbari, Hashem

1998-09-01

Meteorological, photochemical, building-energy, and power plant simulations were performed to assess the possible precursor emission and ozone air quality impacts of decreased air temperatures that could result from implementing the "cool communities" concept in California's South Coast Air Basin (SoCAB). Two pathways are considered. In the direct pathway, a reduction in cooling energy use translates into reduced demand for generation capacity and, thus, reduced precursor emissions from electric utility power plants. In the indirect pathway, reduced air temperatures can slow the atmospheric production of ozone as well as precursor emission from anthropogenic and biogenic sources. The simulations suggest small impacts on emissions following implementation of cool communities in the SoCAB. In summer, for example, there can be reductions of up to 3% in NO x emissions from in-basin power plants. The photochemical simulations suggest that the air quality impacts of these direct emission reductions are small. However, the indirect atmospheric effects of cool communities can be significant. For example, ozone peak concentrations can decrease by up to 11% in summer and population-weighted exceedance exposure to ozone above the California and National Ambient Air Quality Standards can decrease by up to 11 and 17%, respectively. The modeling suggests that if these strategies are combined with others, such as mobile-source emission control, the improvements in ozone air quality can be substantial.

Directing Improvements in Primary Care Patient Experience through Analysis of Service Quality.

PubMed

Hudson Smith, Mel; Smith, David

2018-06-03

To examine the influence of dimensions of service quality on patient experience of primary care. Data from the national GP Patient Survey in England 2014/15, with responses from 858,351 patients registered at 7,918 practices. Expert panel and principal component analysis helped identify relevant dimensions of service quality. Regression was then used to examine the relationships between these dimensions and reported patient experience. Aggregated scores for each practice were used, comprising the proportion of positive responses to each element of the study. Of eight service quality dimensions identified, six have statistically significant impacts on patient experience but only two have large effects. Patient experience is highly influenced by practice responsiveness and the interactions with the physician. Other dimensions have small or even slightly negative influence. Service quality provided by nurses has negligible effect on patient experience. To improve patient experience in primary health care, efforts should focus on practice responsiveness and interactions with the physician. Other areas have little influence over patient experience. This suggests a gap in patients' perspectives on health care, which has policy implications for patient education. © Health Research and Educational Trust.

Multivariate analysis of water quality and environmental variables in the Great Barrier Reef catchments

NASA Astrophysics Data System (ADS)

Ryu, D.; Liu, S.; Western, A. W.; Webb, J. A.; Lintern, A.; Leahy, P.; Wilson, P.; Watson, M.; Waters, D.; Bende-Michl, U.

2016-12-01

The Great Barrier Reef (GBR) lagoon has been experiencing significant water quality deterioration due in part to agricultural intensification and urban settlement in adjacent catchments. The degradation of water quality in rivers is caused by land-derived pollutants (i.e. sediment, nutrient and pesticide). A better understanding of dynamics of water quality is essential for land management to improve the GBR ecosystem. However, water quality is also greatly influenced by natural hydrological processes. To assess influencing factors and predict the water quality accurately, selection of the most important predictors of water quality is necessary. In this work, multivariate statistical techniques - cluster analysis (CA), principal component analysis (PCA) and factor analysis (FA) - are used to reduce the complexity derived from the multidimensional water quality monitoring data. Seventeen stations are selected across the GBR catchments, and the event-based measurements of 12 variables monitored during 9 years (2006 - 2014) were analysed by means of CA and PCA/FA. The key findings are: (1) 17 stations can be grouped into two clusters according to the hierarchical CA, and the spatial dissimilarity between these sites is characterised by the different climatic and land use in the GBR catchments. (2) PCA results indicate that the first 3 PCs explain 85% of the total variance, and FA on the entire data set shows that the varifactor (VF) loadings can be used to interpret the sources of spatial variation in water quality on the GBR catchments level. The impact of soil erosion and non-point source of pollutants from agriculture contribution to VF1 and the variability in hydrological conditions and biogeochemical processes can explain the loadings in VF2. (3) FA is also performed on two groups of sites identified in CA individually, to evaluate the underlying sources that are responsible for spatial variability in water quality in the two groups. For the Cluster 1 sites

Study on the impact of air quality in agricultural and health sectors

NASA Astrophysics Data System (ADS)

Chairani, S.

2018-03-01

This study focused on the impact of air quality in agricultural and health sectors. The impact of CO2 on the agricultural crops was conducted by using literature review and the impact of air quality was conducted using secondary data to calculate the Air Quality Index (AQI), derived from some monitoring stations available in Indonesia. Numerous studies showed that the elevated CO2 decreased the agricultural productivity. Maize yields decreased by 15 % in areas which used irrigation system and 8 % in areas which used rainfed. Maize yields had already experienced severe losses without increasing CO2 concentrations. It decreased by 21 % for irrigated maize and 26 % by rainfed maize. In addition, it turned out that other elevated pollutants, such as SO2, NO2, SPM, O3, CH4, PM2.5, PM10 and TSP also occurred in the atmosphere. These pollutants’ effects might harm human being in term of health concern. The USEPA had developed a tool, called the Air Quality Index (AQI) calculator to calculate the pollutants’ concentrations in a daily basis. This tool’s function to inform how clean or polluted the air that we breathed was with the health effects based on the concentrations of each pollutant. The AQI also provided the information on sensitive groups, health effects and cautionary statements. Based on the air daily data which derived from Board of Meteorology, Climatology and Geophysics (BMKG) of Indonesia, the AQI in Indonesia varied from good, moderate to unhealthy categories; with level of health concern was respiratory diseases, such as asthma.

Impacts of drought on the quality of surface water of the basin

NASA Astrophysics Data System (ADS)

Huang, B. B.; Yan, D. H.; Wang, H.; Cheng, B. F.; Cui, X. H.

2013-11-01

Under the background of climate change and human's activities, there has been presenting an increase both in the frequency of droughts and the range of their impacts. Droughts may give rise to a series of resources, environmental and ecological effects, i.e. water shortage, water quality deterioration as well as the decrease in the diversity of aquatic organisms. This paper, above all, identifies the impact mechanism of drought on the surface water quality of the basin, and then systematically studies the laws of generation, transfer, transformation and degradation of pollutants during the drought, finding out that the alternating droughts and floods stage is the critical period during which the surface water quality is affected. Secondly, through employing indoor orthogonality experiments, serving drought degree, rainfall intensity and rainfall duration as the main elements and designing various scenario models, the study inspects the effects of various factors on the nitrogen loss in soil as well as the loss of non-point sources pollution and the leaching rate of nitrogen under the different alternating scenarios of drought and flood. It comes to the conclusion that the various factors and the loss of non-point source pollution are positively correlated, and under the alternating scenarios of drought and flood, there is an exacerbation in the loss of ammonium nitrogen and nitrate nitrogen in soil, which generates the transfer and transformation mechanisms of non-point source pollution from a micro level. Finally, by employing the data of Nenjiang river basin, the paper assesses the impacts of drought on the surface water quality from a macro level.

Periodontal disease has an impact on patients' quality of life.

PubMed

Reynolds, Ian; Duane, Brett

2018-03-23

Data sourcesMedline, Embase, OpenGrey, Journal of Clinical Periodontology, Journal of Periodontology and a hand search of the bibliographies of retrieved publications.Study selectionTwo reviewers screened the title and abstract of 1134 studies from the literature and selected 37 suitable publications for inclusion following full text analysis of 109 papers and agreement between both reviewers. The search included observational, epidemiological studies and clinical trials that fufilled the inclusion criteria. The publications assessed contained a periodontal clinical examination and a validated OHRQoL questionnaire. There were no language restrictions and the review was performed according to the MOOSE statement.Data extraction and synthesisData were extracted from each study applying the PECO format. The quality of the observational studies was evaluated by the Newcastle Ottawa Scale (NOS) and clinical trials by the (MINORS) methodological index for non-randomised studies. The Strength of Grading Taxonomy (SORT) was utilised to assess the level of evidence and strength of recommendation of the included studies. A meta-analysis was not undertaken due the heterogeneity of the included studies, therefore results were synthesised by applying a vote counting method.ResultsThirty-seven studies included in the review were evaluated by the vote counting method. According to NOS and MINORS the risk of bias was identified as moderate with most studies assessing 50% to 83% of the parameters established. A level two for quality of evidence and a level B for strength of recommendation were applicable for the relationship between clinically diagnosed periodontal disease and OHRQoL. The evidence level was consistent across the studies. Nineteen of the studies examined a distinct population group with respect to diagnosis of systemic disease, socioeconomic status, demographic background or periodontal diagnosis. Twenty-eight of the included studies reported an association between

Measuring the Impact of High Quality Instant Feedback on Learning

ERIC Educational Resources Information Center

Nutbrown, Stephen; Higgins, Colin; Beesley, Su

2016-01-01

This paper examines the impact of a novel assessment technique that has been used to improve the feedback given to second year Computer Science students at the University of Nottingham. Criteria for effective, high quality feedback are discussed. An automated marking system (The Marker's Apprentice--TMA) produces instant feedback in synergy with…

Regional air quality impacts of future fire emissions in Sumatra and Kalimantan

NASA Astrophysics Data System (ADS)

Marlier, Miriam E.; DeFries, Ruth S.; Kim, Patrick S.; Gaveau, David L. A.; Koplitz, Shannon N.; Jacob, Daniel J.; Mickley, Loretta J.; Margono, Belinda A.; Myers, Samuel S.

2015-05-01

Fire emissions associated with land cover change and land management contribute to the concentrations of atmospheric pollutants, which can affect regional air quality and climate. Mitigating these impacts requires a comprehensive understanding of the relationship between fires and different land cover change trajectories and land management strategies. We develop future fire emissions inventories from 2010-2030 for Sumatra and Kalimantan (Indonesian Borneo) to assess the impact of varying levels of forest and peatland conservation on air quality in Equatorial Asia. To compile these inventories, we combine detailed land cover information from published maps of forest extent, satellite fire radiative power observations, fire emissions from the Global Fire Emissions Database, and spatially explicit future land cover projections using a land cover change model. We apply the sensitivities of mean smoke concentrations to Indonesian fire emissions, calculated by the GEOS-Chem adjoint model, to our scenario-based future fire emissions inventories to quantify the different impacts of fires on surface air quality across Equatorial Asia. We find that public health impacts are highly sensitive to the location of fires, with emissions from Sumatra contributing more to smoke concentrations at population centers across the region than Kalimantan, which had higher emissions by more than a factor of two. Compared to business-as-usual projections, protecting peatlands from fires reduces smoke concentrations in the cities of Singapore and Palembang by 70% and 40%, and by 60% for the Equatorial Asian region, weighted by the population in each grid cell. Our results indicate the importance of focusing conservation priorities on protecting both forested (intact or logged) peatlands and non-forested peatlands from fire, even after considering potential leakage of deforestation pressure to other areas, in order to limit the impact of fire emissions on atmospheric smoke concentrations and

Land use impact on water quality: valuing forest services in terms of the water supply sector.

PubMed

Fiquepron, Julien; Garcia, Serge; Stenger, Anne

2013-09-15

The aim of this paper is to quantify the impact of the forest on raw water quality within the framework of other land uses. On the basis of measurements of quality parameters that were identified as being the most problematic (i.e., pesticides and nitrates), we modeled how water quality is influenced by land uses. In order to assess the benefits provided by the forest in terms of improved water quality, we used variations of drinking water prices that were determined by the operating costs of water supply services (WSS). Given the variability of links between forests and water quality, we chose to cover all of France using data observed in each administrative department (France is divided into 95 départements), including a description of WSS and information on land uses. We designed a model that describes the impact of land uses on water quality, as well as the operation of WSS and prices. This bioeconomic model was estimated by the generalized method of moments (GMM) to account for endogeneity and heteroscedasticity issues. We showed that the forest has a positive effect on raw water quality compared to other land uses, with an indirect impact on water prices, making them lower for consumers. Copyright © 2013 Elsevier Ltd. All rights reserved.

Modelling the impacts of agricultural management practices on river water quality in Eastern England.

PubMed

Taylor, Sam D; He, Yi; Hiscock, Kevin M

2016-09-15

Agricultural diffuse water pollution remains a notable global pressure on water quality, posing risks to aquatic ecosystems, human health and water resources and as a result legislation has been introduced in many parts of the world to protect water bodies. Due to their efficiency and cost-effectiveness, water quality models have been increasingly applied to catchments as Decision Support Tools (DSTs) to identify mitigation options that can be introduced to reduce agricultural diffuse water pollution and improve water quality. In this study, the Soil and Water Assessment Tool (SWAT) was applied to the River Wensum catchment in eastern England with the aim of quantifying the long-term impacts of potential changes to agricultural management practices on river water quality. Calibration and validation were successfully performed at a daily time-step against observations of discharge, nitrate and total phosphorus obtained from high-frequency water quality monitoring within the Blackwater sub-catchment, covering an area of 19.6 km(2). A variety of mitigation options were identified and modelled, both singly and in combination, and their long-term effects on nitrate and total phosphorus losses were quantified together with the 95% uncertainty range of model predictions. Results showed that introducing a red clover cover crop to the crop rotation scheme applied within the catchment reduced nitrate losses by 19.6%. Buffer strips of 2 m and 6 m width represented the most effective options to reduce total phosphorus losses, achieving reductions of 12.2% and 16.9%, respectively. This is one of the first studies to quantify the impacts of agricultural mitigation options on long-term water quality for nitrate and total phosphorus at a daily resolution, in addition to providing an estimate of the uncertainties of those impacts. The results highlighted the need to consider multiple pollutants, the degree of uncertainty associated with model predictions and the risk of

Impact of malocclusion on oral health related quality of life in young people

PubMed Central

2013-01-01

Background The objectives for this study were to assess Oral Health Related Quality of Life (OHRQoL) in young people aged 15–25 who sought orthodontic treatment, and to measure the association between orthodontic treatment need (using the IOTN), sex, age and education level, and oral health related quality of life (OHRQoL). Methods Survey of a consecutive series of 323 young adults aged 15 to 25 years, attending orthodontic clinics at the Faculty of Dentistry, Universiti Teknologi MARA. Participants completed the Oral Health Impact Profile-14 (OHIP-14) and had a clinical examination including the Index of Orthodontic Treatment Need- Dental Health Component (IOTN-DHC). Data analyses included descriptive statistics, One-way ANOVA and bivariate and multivariate regression models. Results The mean overall score (± SD) for OHIP-14 in young people aged 15–25 was 22.6 ± 12.5. The psychological discomfort domain was the domain where highest impact was recorded with a mean (± SD) of 4.0 ± 1.9. The regression analyses showed a significant association of IOTN-DHC with overall OHIP-14 score (p < 0.05). Although females reported a slightly higher impact than males, this was not significant in both bivariate and multivariate analyses. Age group had a significant negative association with overall OHIP-14 score (p < 0.05). The 15–18 year old group showed the highest impact on their quality of life due to malocclusion. Participants with a university education report a significantly higher impact on OHRQoL as compared to participants with only secondary education. Conclusion Malocclusion has a significant negative impact on OHRQoL and its domains. This is greatest for the psychological discomfort domain. Younger people and those with a university education report higher levels of impact. There was no reported difference in impact between male and females. PMID:23443041

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

PubMed Central

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

2017-01-01

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

Assessing concentrations and health impacts of air quality management strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST).

PubMed

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

2016-09-01

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

Water quality impacts from an ORV trail stream crossing in the Talladega National Forest, Alabama, USA

Treesearch

Renee D. Ayala; Puneet Srivastava; Christian J. Brodbeck; Emily a. Carter; Timothy P. McDonald

2005-01-01

Off-Road Vehicles (ORVs) are one of the most damaging forms of recreation utilized in our National Forests. Erosion from ORV trails can be a major source of water quality impact. In 2003, a study was initiated in the Talladega National Forest to quantifjl water quality impacts of an ORV trail crossing a local stream. Automated samplers were installed upstream and...

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.

Potential impacts of electric vehicles on air quality in Taiwan.

PubMed

Li, Nan; Chen, Jen-Ping; Tsai, I-Chun; He, Qingyang; Chi, Szu-Yu; Lin, Yi-Chiu; Fu, Tzung-May

2016-10-01

The prospective impacts of electric vehicle (EV) penetration on the air quality in Taiwan were evaluated using an air quality model with the assumption of an ambitious replacement of current light-duty vehicles under different power generation scenarios. With full EV penetration (i.e., the replacement of all light-duty vehicles), CO, VOCs, NOx and PM2.5 emissions in Taiwan from a fleet of 20.6 million vehicles would be reduced by 1500, 165, 33.9 and 7.2Ggyr(-1), respectively, while electric sector NOx and SO2 emissions would be increased by up to 20.3 and 12.9Ggyr(-1), respectively, if the electricity to power EVs were provided by thermal power plants. The net impacts of these emission changes would be to reduce the annual mean surface concentrations of CO, VOCs, NOx and PM2.5 by about 260, 11.3, 3.3ppb and 2.1μgm(-3), respectively, but to increase SO2 by 0.1ppb. Larger reductions tend to occur at time and place of higher ambient concentrations and during high pollution events. Greater benefits would clearly be attained if clean energy sources were fully encouraged. EV penetration would also reduce the mean peak-time surface O3 concentrations by up to 7ppb across Taiwan with the exception of the center of metropolitan Taipei where the concentration increased by <2ppb. Furthermore, full EV penetration would reduce annual days of O3 pollution episodes by ~40% and PM2.5 pollution episodes by 6-10%. Our findings offer important insights into the air quality impacts of EV and can provide useful information for potential mitigation actions. Copyright © 2016 Elsevier B.V. All rights reserved.

GWERD CAFO Research Program – CAFO Impacts on Ground Water Quality

EPA Science Inventory

An overview of several projects will be presented on a research program currently underway at ORD’s Ground Water and Ecosystems Restoration Division (GWERD) to evaluate CAFO impacts on ground water quality. The overall research objectives are to characterize the potential for gro...

Potential impact of a US climate policy and air quality regulations on future air quality and climate change

NASA Astrophysics Data System (ADS)

Lee, Yunha; Shindell, Drew T.; Faluvegi, Greg; Pinder, Rob W.

2016-04-01

We have investigated how future air quality and climate change are influenced by the US air quality regulations that existed or were proposed in 2013 and a hypothetical climate mitigation policy that aims to reduce 2050 CO2 emissions to be 50 % below 2005 emissions. Using the NASA GISS ModelE2 general circulation model, we look at the impacts for year 2030 and 2055. The US energy-sector emissions are from the GLIMPSE project (GEOS-Chem LIDORT Integrated with MARKAL (MARKet ALlocation) for the Purpose of Scenario Exploration), and other US emissions data sets and the rest of the world emissions data sets are based on the RCP4.5 scenario. The US air quality regulations are projected to have a strong beneficial impact on US air quality and public health in year 2030 and 2055 but result in positive radiative forcing. Under this scenario, no more emission constraints are added after 2020, and the impacts on air quality and climate change are similar between year 2030 and 2055. Surface particulate matter with a diameter smaller than 2.5 µm (PM2.5) is reduced by ˜ 2 µg m-3 on average over the USA, and surface ozone by ˜ 8 ppbv. The improved air quality prevents about 91 400 premature deaths in the USA, mainly due to the PM2.5 reduction (˜ 74 200 lives saved). The air quality regulations reduce the light-reflecting aerosols (i.e., sulfate and organic matter) more than the light-absorbing species (i.e., black carbon and ozone), leading to a strong positive radiative forcing (RF) over the USA by both aerosols' direct and indirect forcing: the total RF is ˜ 0.04 W m-2 over the globe, and ˜ 0.8 W m-2 over the USA. Under the hypothetical climate policy, a future CO2 emissions cut is achieved in part by relying less on coal, and thus SO2 emissions are noticeably reduced. This provides air quality co-benefits, but it could lead to potential climate disbenefits over the USA. In 2055, the US mean total RF is +0.22 W m-2 due to positive aerosol direct and indirect forcing

Potential Impact of a US Climate Policy and Air Quality Regulations on Future Air Quality and Climate Change

NASA Technical Reports Server (NTRS)

Lee, Y. H.; Faluvegi, Gregory S.

2016-01-01

We have investigated how future air quality and climate change are influenced by the US air quality regulations that existed or were proposed in 2013 and a hypothetical climate mitigation policy that aims to reduce 2050 CO2 emissions to be 50% below 2005 emissions. Using the NASA GISS ModelE2 general circulation model, we look at the impacts for year 2030 and 2055. The US energy-sector emissions are from the GLIMPSE project (GEOS-Chem LIDORT Integrated with MARKAL (MARKet ALlocation) for the Purpose of Scenario Exploration), and other US emissions data sets and the rest of the world emissions data sets are based on the RCP4.5 scenario. The US air quality regulations are projected to have a strong beneficial impact on US air quality and public health in year 2030 and 2055 but result in positive radiative forcing. Under this scenario, no more emission constraints are added after 2020, and the impacts on air quality and climate change are similar between year 2030 and 2055. Surface particulate matter with a diameter smaller than 2.5 micron PM(sub 2:5) is reduced by 2 approximately µg/m(sup -3) on average over the USA, and surface ozone by approximately 8 ppbv. The improved air quality prevents about 91 400 premature deaths in the USA, mainly due to the PM(sub 2:5) reduction approximately (74 200 lives saved). The air quality regulations reduce the light-reflecting aerosols (i.e., sulfate and organic matter) more than the light-absorbing species (i.e., black carbon and ozone), leading to a strong positive radiative forcing (RF) over the USA by both aerosols' direct and indirect forcing: the total RF is approximately 0.04 W m(sup -2) over the globe, and approximately 0.8 W m(sup -2) over the USA. Under the hypothetical climate policy, a future CO2 emissions cut is achieved in part by relying less on coal, and thus SO2 emissions are noticeably reduced. This provides air quality co-benefits, but it could lead to potential climate disbenefits over the USA. In 2055, the US

Incorporating Handling Qualities Analysis into Rotorcraft Conceptual Design

NASA Technical Reports Server (NTRS)

Lawrence, Ben

2014-01-01

This paper describes the initial development of a framework to incorporate handling qualities analyses into a rotorcraft conceptual design process. In particular, the paper describes how rotorcraft conceptual design level data can be used to generate flight dynamics models for handling qualities analyses. Also, methods are described that couple a basic stability augmentation system to the rotorcraft flight dynamics model to extend analysis to beyond that of the bare airframe. A methodology for calculating the handling qualities characteristics of the flight dynamics models and for comparing the results to ADS-33E criteria is described. Preliminary results from the application of the handling qualities analysis for variations in key rotorcraft design parameters of main rotor radius, blade chord, hub stiffness and flap moment of inertia are shown. Varying relationships, with counteracting trends for different handling qualities criteria and different flight speeds are exhibited, with the action of the control system playing a complex part in the outcomes. Overall, the paper demonstrates how a broad array of technical issues across flight dynamics stability and control, simulation and modeling, control law design and handling qualities testing and evaluation had to be confronted to implement even a moderately comprehensive handling qualities analysis of relatively low fidelity models. A key outstanding issue is to how to 'close the loop' with an overall design process, and options for the exploration of how to feedback handling qualities results to a conceptual design process are proposed for future work.

Breathing easier? The known impacts of biodiesel on air quality

PubMed Central

Traviss, Nora

2013-01-01

Substantial scientific evidence exists on the negative health effects of exposure to petroleum diesel exhaust. Many view biodiesel as a ‘green’, more environmentally friendly alternative fuel, especially with respect to measured reductions of particulate matter in tailpipe emissions. Tailpipe emissions data sets from heavy-duty diesel engines comparing diesel and biodiesel fuels provide important information regarding the composition and potential aggregate contribution of particulate matter and other pollutants to regional airsheds. However, exposure – defined in this instance as human contact with tailpipe emissions – is another key link in the chain between emissions and human health effects. Although numerous biodiesel emissions studies exist, biodiesel exposure studies are nearly absent from the literature. This article summarizes the known impacts of biodiesel on air quality and health effects, comparing emissions and exposure research. In light of rapidly changing engine, fuel and exhaust technologies, both emissions and exposure studies are necessary for developing a fuller understanding of the impact of biodiesel on air quality and human health. PMID:23585814

A Study on the Impact of Hyperhidrosis on the Quality of Life among College Students.

PubMed

Muthusamy, Anbarasi; Gajendran, Rajkumar; Ponnan, Sathasivam; Thangavel, Dinesh; Rangan, Venkatesan

2016-06-01

Hyperhidrosis (HH) is a condition characterized by excessive sweating or perspiration. General population, especially in developing countries like India are seldom aware of this condition and sparsely seek medical attention. The tropical climate and the environment also influence this condition to a greater extent. This can be a hindrance in their professional and social life. Though, it is a widely explored topic, studies on hyperhidrosis from India are rare. The current study was aimed at estimating the prevalence of hyperhidrosis among college students subjectively and to assess the quality of life using Dermatology Life Quality Index (DLQI). Five hundred students with age ranging from 17 to 21 years of both genders were included in this study using convenient sampling method. After explaining the study and getting written consent, the students were requested to respond to two questionnaires, one for the subjective diagnosis of hyperhidrosis using a standardized questionnaire developed by North Jersey Thoracic Surgical Associates and the other to assess the quality of life using DLQI. Based on the subjective prevalence scores, the students were divided into 3 groups as "Not bothersome" group, "Somewhat bothersome group" and "Extremely bothersome" group. The DLQI scores of these three groups were compared by ANOVA using SPSS 21.0. The study revealed that overall, 38% of the students were suffering from somewhat bothersome to extremely bothersome hyperhidrosis. Gender analysis showed that male students were affected more (58%), especially with palmar hyperhidrosis and were significantly requiring treatment when compared to female students. Analysis of DLQI scores using ANOVA revealed the fact that overall quality of life was significantly affected in almost 35% of students to the extent that they require appropriate treatment and care. This study brings into light the higher prevalence of hyperhidrosis and also its impact on the quality of life among college

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

NASA Technical Reports Server (NTRS)

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

2013-01-01

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

Grey Relational Analysis Coupled with Principal Component Analysis for Optimization of Stereolithography Process to Enhance Part Quality

NASA Astrophysics Data System (ADS)

Raju, B. S.; Sekhar, U. Chandra; Drakshayani, D. N.

2017-08-01

The paper investigates optimization of stereolithography process for SL5530 epoxy resin material to enhance part quality. The major characteristics indexed for performance selected to evaluate the processes are tensile strength, Flexural strength, Impact strength and Density analysis and corresponding process parameters are Layer thickness, Orientation and Hatch spacing. In this study, the process is intrinsically with multiple parameters tuning so that grey relational analysis which uses grey relational grade as performance index is specially adopted to determine the optimal combination of process parameters. Moreover, the principal component analysis is applied to evaluate the weighting values corresponding to various performance characteristics so that their relative importance can be properly and objectively desired. The results of confirmation experiments reveal that grey relational analysis coupled with principal component analysis can effectively acquire the optimal combination of process parameters. Hence, this confirm that the proposed approach in this study can be an useful tool to improve the process parameters in stereolithography process, which is very useful information for machine designers as well as RP machine users.

Land use impact on soil quality in eastern Himalayan region of India.

PubMed

Singh, A K; Bordoloi, L J; Kumar, Manoj; Hazarika, S; Parmar, Brajendra

2014-04-01

Quantitative assessment of soil quality is required to determine the sustainability of land uses in terms of environmental quality and plant productivity. Our objective was to identify the most appropriate soil quality indicators and to evaluate the impact of six most prevalent land use types (natural forestland, cultivated lowland, cultivated upland terrace, shifting cultivation, plantation land, and grassland) on soil quality in eastern Himalayan region of India. We collected 120 soil samples (20 cm depth) and analyzed them for 29 physical, chemical, and biological soil attributes. For selection of soil quality indicators, principal component analysis (PCA) was performed on the measured attributes, which provided four principal components (PC) with eigenvalues >1 and explaining at least 5% of the variance in dataset. The four PCs together explained 92.6% of the total variance. Based on rotated factor loadings of soil attributes, selected indicators were: soil organic carbon (SOC) from PC-1, exchangeable Al from PC-2, silt content from PC-3, and available P and Mn from PC-4. Indicators were transformed into scores (linear scoring method) and soil quality index (SQI) was determined, on a scale of 0-1, using the weighting factors obtained from PCA. SQI rating was the highest for the least-disturbed sites, i.e., natural forestland (0.93) and grassland (0.87), and the lowest for the most intensively cultivated site, i.e., cultivated upland terrace (0.44). Ratings for the other land uses were shifting cultivation (0.60) > cultivated low land (0.57) > plantation land (0.54). Overall contribution (in percent) of the indicators in determination of SQI was in the order: SOC (58%) > exch. Al (17.1%) > available P (8.9%) > available Mn (8.2%) > silt content (7.8%). Results of this study suggest SOC and exch. Al as the two most powerful indicators of soil quality in study area. Thus, organic C and soil acidity management holds the key to improve soil

Non-Destructive Thermography Analysis of Impact Damage on Large-Scale CFRP Automotive Parts

PubMed Central

Maier, Alexander; Schmidt, Roland; Oswald-Tranta, Beate; Schledjewski, Ralf

2014-01-01

Laminated composites are increasingly used in aeronautics and the wind energy industry, as well as in the automotive industry. In these applications, the construction and processing need to fulfill the highest requirements regarding weight and mechanical properties. Environmental issues, like fuel consumption and CO2-footprint, set new challenges in producing lightweight parts that meet the highly monitored standards for these branches. In the automotive industry, one main aspect of construction is the impact behavior of structural parts. To verify the quality of parts made from composite materials with little effort, cost and time, non-destructive test methods are increasingly used. A highly recommended non-destructive testing method is thermography analysis. In this work, a prototype for a car’s base plate was produced by using vacuum infusion. For research work, testing specimens were produced with the same multi-layer build up as the prototypes. These specimens were charged with defined loads in impact tests to simulate the effect of stone chips. Afterwards, the impacted specimens were investigated with thermography analysis. The research results in that work will help to understand the possible fields of application and the usage of thermography analysis as the first quick and economic failure detection method for automotive parts. PMID:28788464

Non-Destructive Thermography Analysis of Impact Damage on Large-Scale CFRP Automotive Parts.

PubMed

Maier, Alexander; Schmidt, Roland; Oswald-Tranta, Beate; Schledjewski, Ralf

2014-01-14

Laminated composites are increasingly used in aeronautics and the wind energy industry, as well as in the automotive industry. In these applications, the construction and processing need to fulfill the highest requirements regarding weight and mechanical properties. Environmental issues, like fuel consumption and CO₂-footprint, set new challenges in producing lightweight parts that meet the highly monitored standards for these branches. In the automotive industry, one main aspect of construction is the impact behavior of structural parts. To verify the quality of parts made from composite materials with little effort, cost and time, non-destructive test methods are increasingly used. A highly recommended non-destructive testing method is thermography analysis. In this work, a prototype for a car's base plate was produced by using vacuum infusion. For research work, testing specimens were produced with the same multi-layer build up as the prototypes. These specimens were charged with defined loads in impact tests to simulate the effect of stone chips. Afterwards, the impacted specimens were investigated with thermography analysis. The research results in that work will help to understand the possible fields of application and the usage of thermography analysis as the first quick and economic failure detection method for automotive parts.

The Impact of "Instant Analysis"

ERIC Educational Resources Information Center

Robinson, Michael Jay

1977-01-01

Assesses the impact of critical extemporaneous commentary following the major television presentation of "The Selling of the Pentagon" and concludes that immediate analysis tends to diminish program effectiveness and reflect negatively on the person responsible for the analysis. (MH)

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...

Impacts by point and diffuse micropollutant sources on the stream water quality at catchment scale

NASA Astrophysics Data System (ADS)

Petersen, M. F.; Eriksson, E.; Binning, P. J.; Bjerg, P. L.

2012-04-01

The water quality of surface waters is threatened by multiple anthropogenic pollutants and the large variety of pollutants challenges the monitoring and assessment of the water quality. The aim of this study was to characterize and quantify both point and diffuse sources of micropollutants impacting the water quality of a stream at catchment scale. Grindsted stream in western Jutland, Denmark was used as a study site. The stream passes both urban and agricultural areas and is impacted by severe groundwater contamination in Grindsted city. Along a 12 km reach of Grindsted stream, the potential pollution sources were identified including a pharmaceutical factory site with a contaminated old drainage ditch, two waste deposits, a wastewater treatment plant, overflow structures, fish farms, industrial discharges and diffuse agricultural and urban sources. Six water samples were collected along the stream and analyzed for general water quality parameters, inorganic constituents, pesticides, sulfonamides, chlorinated solvents, BTEXs, and paracetamol and ibuprofen. The latter two groups were not detected. The general water quality showed typical conditions for a stream in western Jutland. Minor impacts by releases of organic matter and nutrients were found after the fish farms and the waste water treatment plant. Nickel was found at concentrations 5.8 - 8.8 μg/l. Nine pesticides and metabolites of both agricultural and urban use were detected along the stream; among these were the two most frequently detected and some rarely detected pesticides in Danish water courses. The concentrations were generally consistent with other findings in Danish streams and in the range 0.01 - 0.09 μg/l; except for metribuzin-diketo that showed high concentrations up to 0.74 μg/l. The groundwater contamination at the pharmaceutical factory site, the drainage ditch and the waste deposits is similar in composition containing among others sulfonamides and chlorinated solvents (including vinyl

Reverberation negatively impacts musical sound quality for cochlear implant users.

PubMed

Roy, Alexis T; Vigeant, Michelle; Munjal, Tina; Carver, Courtney; Jiradejvong, Patpong; Limb, Charles J

2015-09-01

Satisfactory musical sound quality remains a challenge for many cochlear implant (CI) users. In particular, questionnaires completed by CI users suggest that reverberation due to room acoustics can negatively impact their music listening experience. The objective of this study was to more specifically characterize of the effect of reverberation on musical sound quality in CI users, normal hearing (NH) non-musicians, and NH musicians using a previously designed assessment method, called Cochlear Implant-MUltiple Stimulus with Hidden Reference and Anchor (CI-MUSHRA). In this method, listeners were randomly presented with an anechoic musical segment and five-versions of this segment in which increasing amounts of reverberation were artificially added. Participants listened to the six reverberation versions and provided sound quality ratings between 0 (very poor) and 100 (excellent). Results demonstrated that on average CI users and NH non-musicians preferred the sound quality of anechoic versions to more reverberant versions. In comparison, NH musicians could be delineated into those who preferred the sound quality of anechoic pieces and those who preferred pieces with some reverberation. This is the first study, to our knowledge, to objectively compare the effects of reverberation on musical sound quality ratings in CI users. These results suggest that musical sound quality for CI users can be improved by non-reverberant listening conditions and musical stimuli in which reverberation is removed.

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.

Patient movement characteristics and the impact on CBCT image quality and interpretability.

PubMed

Spin-Neto, Rubens; Costa, Cláudio; Salgado, Daniela Mra; Zambrana, Nataly Rm; Gotfredsen, Erik; Wenzel, Ann

2018-01-01

To assess the impact of patient movement characteristics and metal/radiopaque materials in the field-of-view (FOV) on CBCT image quality and interpretability. 162 CBCT examinations were performed in 134 consecutive (i.e. prospective data collection) patients (age average: 27.2 years; range: 9-73). An accelerometer-gyroscope system registered patient's head position during examination. The threshold for movement definition was set at ≥0.5-mm movement distance based on accelerometer-gyroscope recording. Movement complexity was defined as uniplanar/multiplanar. Three observers scored independently: presence of stripe (i.e. streak) artefacts (absent/"enamel stripes"/"metal stripes"/"movement stripes"), overall unsharpness (absent/present) and image interpretability (interpretable/not interpretable). Kappa statistics assessed interobserver agreement. χ 2 tests analysed whether movement distance, movement complexity and metal/radiopaque material in the FOV affected image quality and image interpretability. Relevant risk factors (p ≤ 0.20) were entered into a multivariate logistic regression analysis with "not interpretable" as the outcome. Interobserver agreement for image interpretability was good (average = 0.65). Movement distance and presence of metal/radiopaque materials significantly affected image quality and interpretability. There were 22-28 cases, in which the observers stated the image was not interpretable. Small movements (i.e. <3 mm) did not significantly affect image interpretability. For movements ≥ 3 mm, the risk that a case was scored as "not interpretable" was significantly (p ≤ 0.05) increased [OR 3.2-11.3; 95% CI (0.70-65.47)]. Metal/radiopaque material was also a significant (p ≤ 0.05) risk factor (OR 3.61-5.05). Patient movement ≥3 mm and metal/radiopaque material in the FOV significantly affected CBCT image quality and interpretability.

The impact of xerostomia on oral-health-related quality of life among younger adults

PubMed Central

Thomson, W Murray; Lawrence, Herenia P; Broadbent, Jonathan M; Poulton, Richie

2006-01-01

Background Recent research has suggested that chronic dry mouth affects the day-to-day lives of older people living in institutions. The condition has usually been considered to be a feature of old age, but recent work by our team produced the somewhat surprising finding that 10% of people in their early thirties are affected. This raises the issue of whether dry mouth is a trivial condition or a more substantial threat to quality of life among younger people. The objective of this study was to examine the association between xerostomia and oral-health-related quality of life among young adults while controlling for clinical oral health status and other potential confounding factors. Methods Cross-sectional analysis of data from a longstanding prospective observational study of a Dunedin (New Zealand) birth cohort: clinical dental examinations and questionnaires were used at age 32. The main measures were xerostomia (the subjective feeling of dry mouth, measured with a single question) and oral-health-related quality of life (OHRQoL) measured using the short-form Oral Health Impact Profile (OHIP-14). Results Of the 923 participants (48.9% female), one in ten were categorised as 'xerostomic', with no apparent gender difference. There was a strong association between xerostomia and OHRQoL (across all OHIP-14 domains) which persisted after multivariate analysis to control for clinical characteristics, gender, smoking status and personality characteristics (negative emotionality and positive emotionality). Conclusion Xerostomia is not a trivial condition; it appears to have marked and consistent effects on sufferers' day-to-day lives. PMID:17090332

SU-E-J-06: A Time Dependence Analysis of CBCT Image Quality and Mechanical Stability.

PubMed

Oves, S; Stenbeck, J; Gebreamlak, W; Alkhatib, H

2012-06-01

To quantify the change, if any, in flexmap correction factors and image quality with the XVI system over a course of several years and from these results, assess their clinical impact. Flexmap, a calibration procedure which corrects for imperfect gantry rotation for cone-beam CT reconstruction, and image quality tests were performed on three Elekta Synergy linacs equipped with XVI. Data was collected per month over three years. U and V values, corresponding to lateral and longitudinal shifts respectively, were acquired through the XVI software. Image quality parameters were obtained through CT imaging of the Catphan 500®. For each reconstruction, pixel values for low density polyethylene (LDPE) and polystyrene materials were recorded. For all three linacs, analysis of the flexmap showed a significant change in the U factor for both month-to-month comparisons and comparisons between machines. The V correction factor exhibited a small variation month to month, and showed a slight, gradual increase over time (0.2 +/-0.08 mm). Image quality analysis showed a near consistent decrease (5-10%) in LDPE and polystyrene. Despite this decrease in pixel values, the ratio of the two pixel values remained constant, thus a similar decreasing trend in contrast was not observed. Analysis of monthly flexmap calibration showed the general monthly change in correction shifts and their general trend over several years. For image quality, our research exhibited roughly 0.5% per month decrease in pixel values of the Catphan®. Our results imply that CBCT images obtained from XVI are not appropriate for treatment planning and despite the decrease in panel response over time, image quality with respect to contrast will remain within acceptable clinical standards. Future studies may be carried out to assess any correlation between image quality and XVI source strength. © 2012 American Association of Physicists in Medicine.

Impact of nocturnal heartburn on quality of life, sleep, and productivity: the SINERGE study.

PubMed

Calleja, José Luis; Bixquert, M; Maldonado, J

2007-10-01

The aim of the SINERGE study was to assess the impact of nocturnal heartburn on quality of life, sleep, and productivity. Ambulatory patients >/=18 years old and classified as defined cases of nocturnal heartburn (n=337), nonnocturnal heartburn (n=139), uncontrolled hypertension (n=198), and symptomatic depression (n=104) were included in this cross-sectional study. Information on age, gender, body mass index, and comorbidity was collected and the following validated questionnaires were applied: SF-12, Pittsburgh Sleep Quality Index, and Work Productivity and Activity Impairment questionnaire. The prevalence of primary care consultation for heartburn and nocturnal heartburn was 4.7% and 1.9%, respectively. Health-related quality of life, sleep, and productivity were significantly impaired in patients with frequent nocturnal heartburn symptoms as compared with those of the patients without nocturnal symptoms or patients with hypertension. Nocturnal heartburn poses a considerable burden for the sufferer because of the impact on quality of life, sleep, and daily activities.

Impact of Coastal Development and Marsh Width Variability on Groundwater Quality in Estuarine Tidal Creeks

NASA Astrophysics Data System (ADS)

Shanahan, M.; Wilson, A. M.; Smith, E. M.

2017-12-01

Coastal upland development has been shown to negatively impact surface water quality in tidal creeks in the southeastern US, but less is known about its impact on groundwater. We sampled groundwater in the upland and along the marsh perimeter of tidal creeks located within developed and undeveloped watersheds. Samples were analyzed for salinity, dissolved organic carbon, nitrogen and phosphorus concentrations. Groundwater samples collected from the upland in developed and undeveloped watersheds were compared to study the impact of development on groundwater entering the marsh. Groundwater samples collected along the marsh perimeter were analyzed to study the impact of marsh width variability on groundwater quality within each creek. Preliminary results suggest a positive correlation between salinity and marsh width in undeveloped watersheds, and a higher concentration of nutrients in developed versus undeveloped watersheds.

Print quality analysis for ink-saving algorithms

NASA Astrophysics Data System (ADS)

Ortiz Segovia, Maria V.; Bonnier, Nicolas; Allebach, Jan P.

2012-01-01

Ink-saving strategies for CMYK printers have evolved from their earlier stages where the 'draft' print mode was the main option available to control ink usage. The savings were achieved by printing alternate dots in an image at the expense of reducing print quality considerably. Nowadays, customers are not only unwilling to compromise quality but have higher expectations regarding both visual print quality and ink reduction solutions. Therefore, the need for more intricate ink-saving solutions with lower impact on print quality is evident. Printing-related factors such as the way the printer places the dots on the paper and the ink-substrate interaction play important and complex roles in the characterization and modeling of the printing process that make the ink reduction topic a challenging problem. In our study, we are interested in benchmarking ink-saving algorithms to find the connections between different ink reduction levels of a given ink-saving method and a set of print quality attributes. This study is mostly related to CMYK printers that use dispersed dot halftoning algorithms. The results of our efforts to develop such an evaluation scheme are presented in this paper.

Adherence to National Dietary Guidelines in Association with Oral Health Impact on Quality of Life.

PubMed

Andreeva, Valentina A; Kesse-Guyot, Emmanuelle; Galan, Pilar; Feron, Gilles; Hercberg, Serge; Hennequin, Martine; Sulmont-Rossé, Claire

2018-04-24

We aimed to assess the association between oral health, in terms of its impact on quality of life, and diet quality expressed as adherence to dietary guidelines. We analyzed cross-sectional data from the French NutriNet-Santé general population-based e-cohort (N = 18,263 adults; mean age = 56.5 ± 13.8 years). The main independent variable, oral health-related quality of life, was assessed in 2016 with the GOHAI instrument (maximum score = 60). The main dependent variable, diet’s nutritional quality, was assessed with the mPNNS-GS score (maximum score = 13.5) measuring adherence to French dietary guidelines and computed on the basis of repeated 24-h dietary records. Multivariable linear regression models were fit. Mean GOHAI score was 54.5 ± 4.3 and mean mPNNS-GS score was 7.7 ± 1.6. Among participants aged 18⁻64 years, those scoring ≤50 on GOHAI (poor oral health with a detrimental impact on quality of life) were less likely to adhere to dietary guidelines than participants scoring 57⁻60 points (good oral health) (beta = −0.18, 95% CI: −0.26, −0.09; p < 0.0001). Among participants aged 65+ years, those scoring 51⁻56 points on GOHAI (average oral health with some negative impact on quality of life) were less likely to adhere to dietary guidelines than were participants scoring in the range 57⁻60 (beta = −0.23, 95% CI: −0.33, −0.13; p < 0.0001). The findings suggested modest age-dependent associations between oral health-related quality of life and diet quality. Confirmation is needed longitudinally with representative samples and accounting for diet quality evolution.

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

The impact of bariatric surgery on pulmonary function: a meta-analysis.

PubMed

Alsumali, Adnan; Al-Hawag, Ali; Bairdain, Sigrid; Eguale, Tewodros

2018-02-01

Morbid obesity may affect several body systems and cause ill effects to the cardiovascular, hepatobiliary, endocrine, and mental health systems. However, the impact on the pulmonary system and pulmonary function has been debated in the literature. A systematic review and meta-analysis for studies that have evaluated the impact of bariatric surgery on pulmonary function were pooled for this analysis. PubMed, Cochrane, and Embase databases were evaluated through September 31, 2016. They were used as the primary search engine for studies evaluating the impact pre- and post-bariatric surgery on pulmonary function. Pooled effect estimates were calculated using random-effects model. Twenty-three studies with 1013 participants were included in the final meta-analysis. Only 8 studies had intervention and control groups with different time points, but 15 studies had matched groups with different time points. Overall, pulmonary function score was significantly improved after bariatric surgery, with a pooled standardized mean difference of .59 (95% confidence interval: .46-.73). Heterogeneity test was performed by using Cochran's Q test (I 2 = 46%; P heterogeneity = .10). Subgroup analysis and univariate meta-regression based on study quality, age, presurgery body mass index, postsurgery body mass index, study design, female patients only, study continent, asthmatic patients in the study, and the type of bariatric surgery confirmed no statistically significant difference among these groups (P value>.05 for all). A multivariate meta-regression model, which adjusted simultaneously for these same covariates, did not change the results (P value > .05 overall). Assessment of publication bias was done visually and by Begg's rank correlation test and indicated the absence of publication bias (asymmetric shape was observed and P = .34). This meta-analysis shows that bariatric surgery significantly improved overall pulmonary functions score for morbid obesity. Copyright © 2018

Analysis of non-conformity in continuous quality improvement in a Hospital Radiopharmacy Unit.

PubMed

Martinez, T; Contreras, J F

To perform an analysis of non-conformities (NC) registered between 2012 and 2015, as a part of the review process of the Quality Management System of our Radiopharmacy Unit. Non-conformities registered in the Radiopharmacy Unit in the period 2012-2015 are analyzed and sorted by their impact on the process (critical, major, and minor), cause/origin of the non-conformity, and nature of radiopharmaceutical (PET vs. SPECT). A decrease in the NC of 20% per year is observed, especially in PET radiopharmaceuticals. Non-conformities in SPECT make up about 62-84% of the total of the NC, mainly related to the high number of doses prepared and not administered, which is about 1.5-3% in the ratio of non-administered/administered per year. Analysis of the NC can be considered as a useful indicator in assessment of quality assurance, and in our particular case, the decrease in the registration of NC indicates effectiveness in the corrective and preventive actions implemented. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Resolution-Enhanced Harmonic and Interharmonic Measurement for Power Quality Analysis in Cyber-Physical Energy System.

PubMed

Liu, Yanchi; Wang, Xue; Liu, Youda; Cui, Sujin

2016-06-27

Power quality analysis issues, especially the measurement of harmonic and interharmonic in cyber-physical energy systems, are addressed in this paper. As new situations are introduced to the power system, the impact of electric vehicles, distributed generation and renewable energy has introduced extra demands to distributed sensors, waveform-level information and power quality data analytics. Harmonics and interharmonics, as the most significant disturbances, require carefully designed detection methods for an accurate measurement of electric loads whose information is crucial to subsequent analyzing and control. This paper gives a detailed description of the power quality analysis framework in networked environment and presents a fast and resolution-enhanced method for harmonic and interharmonic measurement. The proposed method first extracts harmonic and interharmonic components efficiently using the single-channel version of Robust Independent Component Analysis (RobustICA), then estimates the high-resolution frequency from three discrete Fourier transform (DFT) samples with little additional computation, and finally computes the amplitudes and phases with the adaptive linear neuron network. The experiments show that the proposed method is time-efficient and leads to a better accuracy of the simulated and experimental signals in the presence of noise and fundamental frequency deviation, thus providing a deeper insight into the (inter)harmonic sources or even the whole system.

Resolution-Enhanced Harmonic and Interharmonic Measurement for Power Quality Analysis in Cyber-Physical Energy System

PubMed Central

Liu, Yanchi; Wang, Xue; Liu, Youda; Cui, Sujin

2016-01-01

Power quality analysis issues, especially the measurement of harmonic and interharmonic in cyber-physical energy systems, are addressed in this paper. As new situations are introduced to the power system, the impact of electric vehicles, distributed generation and renewable energy has introduced extra demands to distributed sensors, waveform-level information and power quality data analytics. Harmonics and interharmonics, as the most significant disturbances, require carefully designed detection methods for an accurate measurement of electric loads whose information is crucial to subsequent analyzing and control. This paper gives a detailed description of the power quality analysis framework in networked environment and presents a fast and resolution-enhanced method for harmonic and interharmonic measurement. The proposed method first extracts harmonic and interharmonic components efficiently using the single-channel version of Robust Independent Component Analysis (RobustICA), then estimates the high-resolution frequency from three discrete Fourier transform (DFT) samples with little additional computation, and finally computes the amplitudes and phases with the adaptive linear neuron network. The experiments show that the proposed method is time-efficient and leads to a better accuracy of the simulated and experimental signals in the presence of noise and fundamental frequency deviation, thus providing a deeper insight into the (inter)harmonic sources or even the whole system. PMID:27355946

IMPACT OF STORM-WATER OUTFALLS ON SEDIMENT QUALITY IN CORPUS CHRISTI BAY, TEXAS, USA

EPA Science Inventory

To determine the quality of sediments and extent of contaminant impacts, a Sediment Quality Triad (SQT) study was conducted at 36 sites in the Corpus Christi Bay, Texas, USA, system. Fifteen of the 36 sites were located near storm-water outfalls, but 13 other sites (i.e., industr...

Why Is It Difficult to Grasp the Impacts of the Portuguese Quality Assurance System?

ERIC Educational Resources Information Center

Veiga, Amélia; Rosa, Maria João; Dias, Diana; Amaral, Alberto

2013-01-01

This article analyses the impacts of the Portuguese quality assurance system on academic cultures, using the Cultural Theory proposed by Douglas (1970, 1982) and developed by Thompson, Ellis and Wildavsky (1990) as an explanatory framework for Portuguese academics' preference formation in relation to quality assessment. The Portuguese higher…

Integrated Modelling on Flow and Water Quality Under the Impacts of Climate Change and Agricultural Activities

NASA Astrophysics Data System (ADS)

SHI, J.

2014-12-01

Climate change is expected to have a significant impact on flooding in the UK, inducing more intense and prolonged storms. Frequent flooding due to climate change already exacerbates catchment water quality. Land use is another contributing factor to poor water quality. For example, the move to intensive farming could cause an increase in faecal coliforms entering the water courses. In an effort to understand better the effects on water quality from land use and climate change, the hydrological and estuarine processes are being modelled using SWAT (Soil and Water Assessment Tool), linked to a 2-D hydrodynamic model DIVAST(Depth Integrated Velocity and Solute Transport). The coupled model is able to quantify how much of each pollutant from the catchment reaches the harbour and the impact on water quality within the harbour. The work is focused on the transportation and decay of faecal coliforms from agricultural runoff into the rivers Frome and Piddle in the UK. The impact from the agricultural land use and activities on the catchment river hydrology and water quality are evaluated. The coupled model calibration and validation showed the good model performance on flow and faecal coliform in the watershed and estuary.

Two-Year Impact of the Alternative Quality Contract on Pediatric Health Care Quality and Spending

PubMed Central

Song, Zirui; Chernew, Michael E.; Landon, Bruce E.; McNeil, Barbara J.; Safran, Dana G.; Schuster, Mark A.

2014-01-01

OBJECTIVE: To examine the 2-year effect of Blue Cross Blue Shield of Massachusetts’ global budget arrangement, the Alternative Quality Contract (AQC), on pediatric quality and spending for children with special health care needs (CSHCN) and non-CSHCN. METHODS: Using a difference-in-differences approach, we compared quality and spending trends for 126 975 unique 0- to 21-year-olds receiving care from AQC groups with 415 331 propensity-matched patients receiving care from non-AQC groups; 23% of enrollees were CSHCN. We compared quality and spending pre (2006–2008) and post (2009–2010) AQC implementation, adjusting analyses for age, gender, health risk score, and secular trends. Pediatric outcome measures included 4 preventive and 2 acute care measures tied to pay-for-performance (P4P), 3 asthma and 2 attention-deficit/hyperactivity disorder quality measures not tied to P4P, and average total annual medical spending. RESULTS: During the first 2 years of the AQC, pediatric care quality tied to P4P increased by +1.8% for CSHCN (P < .001) and +1.2% for non-CSHCN (P < .001) for AQC versus non-AQC groups; quality measures not tied to P4P showed no significant changes. Average total annual medical spending was ∼5 times greater for CSHCN than non-CSHCN; there was no significant impact of the AQC on spending trends for children. CONCLUSIONS: During the first 2 years of the contract, the AQC had a small but significant positive effect on pediatric preventive care quality tied to P4P; this effect was greater for CSHCN than non-CSHCN. However, it did not significantly influence (positively or negatively) CSHCN measures not tied to P4P or affect per capita spending for either group. PMID:24366988

Two-year impact of the alternative quality contract on pediatric health care quality and spending.

PubMed

Chien, Alyna T; Song, Zirui; Chernew, Michael E; Landon, Bruce E; McNeil, Barbara J; Safran, Dana G; Schuster, Mark A

2014-01-01

To examine the 2-year effect of Blue Cross Blue Shield of Massachusetts' global budget arrangement, the Alternative Quality Contract (AQC), on pediatric quality and spending for children with special health care needs (CSHCN) and non-CSHCN. Using a difference-in-differences approach, we compared quality and spending trends for 126,975 unique 0- to 21-year-olds receiving care from AQC groups with 415,331 propensity-matched patients receiving care from non-AQC groups; 23% of enrollees were CSHCN. We compared quality and spending pre (2006-2008) and post (2009-2010) AQC implementation, adjusting analyses for age, gender, health risk score, and secular trends. Pediatric outcome measures included 4 preventive and 2 acute care measures tied to pay-for-performance (P4P), 3 asthma and 2 attention-deficit/hyperactivity disorder quality measures not tied to P4P, and average total annual medical spending. During the first 2 years of the AQC, pediatric care quality tied to P4P increased by +1.8% for CSHCN (P < .001) and +1.2% for non-CSHCN (P < .001) for AQC versus non-AQC groups; quality measures not tied to P4P showed no significant changes. Average total annual medical spending was ~5 times greater for CSHCN than non-CSHCN; there was no significant impact of the AQC on spending trends for children. During the first 2 years of the contract, the AQC had a small but significant positive effect on pediatric preventive care quality tied to P4P; this effect was greater for CSHCN than non-CSHCN. However, it did not significantly influence (positively or negatively) CSHCN measures not tied to P4P or affect per capita spending for either group.

Quality Analysis of Open Street Map Data

NASA Astrophysics Data System (ADS)

Wang, M.; Li, Q.; Hu, Q.; Zhou, M.

2013-05-01

Crowd sourcing geographic data is an opensource geographic data which is contributed by lots of non-professionals and provided to the public. The typical crowd sourcing geographic data contains GPS track data like OpenStreetMap, collaborative map data like Wikimapia, social websites like Twitter and Facebook, POI signed by Jiepang user and so on. These data will provide canonical geographic information for pubic after treatment. As compared with conventional geographic data collection and update method, the crowd sourcing geographic data from the non-professional has characteristics or advantages of large data volume, high currency, abundance information and low cost and becomes a research hotspot of international geographic information science in the recent years. Large volume crowd sourcing geographic data with high currency provides a new solution for geospatial database updating while it need to solve the quality problem of crowd sourcing geographic data obtained from the non-professionals. In this paper, a quality analysis model for OpenStreetMap crowd sourcing geographic data is proposed. Firstly, a quality analysis framework is designed based on data characteristic analysis of OSM data. Secondly, a quality assessment model for OSM data by three different quality elements: completeness, thematic accuracy and positional accuracy is presented. Finally, take the OSM data of Wuhan for instance, the paper analyses and assesses the quality of OSM data with 2011 version of navigation map for reference. The result shows that the high-level roads and urban traffic network of OSM data has a high positional accuracy and completeness so that these OSM data can be used for updating of urban road network database.

Migrainous vertigo: prevalence and impact on quality of life.

PubMed

Neuhauser, H K; Radtke, A; von Brevern, M; Feldmann, M; Lezius, F; Ziese, T; Lempert, T

2006-09-26

To investigate the epidemiology of migrainous vertigo (MV) in the general population by assessing prevalence, clinical features, comorbid conditions, quality of life, and health care utilization. We screened a representative sample of the adult population in Germany (n = 4,869) for moderate or severe dizziness/vertigo and followed up with validated neurotologic telephone interviews (n = 1,003). Diagnostic criteria for MV were as follows: 1) recurrent vestibular vertigo; 2) migraine according to the International Headache Society; 3) migrainous symptoms during at least two vertiginous attacks (migrainous headache, photophobia, phonophobia, or aura symptoms); and 4) vertigo not attributed to another disorder. In a concurrent validation study (n = 61) the interviews had a sensitivity of 84% and a specificity of 94% for vestibular vertigo and 81% and 100% for migraine. The lifetime prevalence of MV was 0.98% (95% CI 0.70 to 1.37), the 12-month prevalence 0.89% (95% CI 0.62 to 1.27). Spontaneous rotational vertigo was reported by 67% of participants with MV while 24% had positional vertigo. Twenty-four percent always experienced headaches with their vertigo. Logistic regression analysis comparing participants with MV with dizziness-free migraineurs showed an independent association with coronary heart disease but not with sex, age, migrainous aura, education, stroke, hypertension, hyperlipidemia, body mass index, or depression. Age-adjusted health-related quality of life scores (SF-8 Health Survey) were consistently lower in participants with MV compared to dizziness-free controls. Two thirds of participants with MV had consulted a doctor but only 20% of these were diagnosed with MV. Migrainous vertigo is relatively common but underdiagnosed in the general population and has considerable personal and healthcare impact.

Assessment of the impact of traditional septic tank soakaway systems on water quality in Ireland.

PubMed

Keegan, Mary; Kilroy, Kate; Nolan, Daniel; Dubber, Donata; Johnston, Paul M; Misstear, Bruce D R; O'Flaherty, Vincent; Barrett, Maria; Gill, Laurence W

2014-01-01

One of the key threats to groundwater and surface water quality in Ireland is the impact of poorly designed, constructed or maintained on-site wastewater treatment systems. An extensive study was carried out to quantify the impact of existing sites on water quality. Six existing sites, consisting of a traditional septic tank and soakaway system, located in various ranges of subsoil permeabilities were identified and monitored to determine how well they function under varying subsoil and weather conditions. The preliminary results of the chemical and microbiological pollutant attenuation in the subsoil of the systems have been assessed and treatment performance evaluated, as well as impact on local surface water and groundwater quality. The source of any faecal contamination detected in groundwater, nearby surface water and effluent samples was confirmed by microbial source tracking. From this, it can be seen that the transport and treatment of percolate vary greatly depending on the permeability and composition of the subsoil.

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…

Elucidating hydraulic fracturing impacts on groundwater quality using a regional geospatial statistical modeling approach.

PubMed

Burton, Taylour G; Rifai, Hanadi S; Hildenbrand, Zacariah L; Carlton, Doug D; Fontenot, Brian E; Schug, Kevin A

2016-03-01

Hydraulic fracturing operations have been viewed as the cause of certain environmental issues including groundwater contamination. The potential for hydraulic fracturing to induce contaminant pathways in groundwater is not well understood since gas wells are completed while isolating the water table and the gas-bearing reservoirs lay thousands of feet below the water table. Recent studies have attributed ground water contamination to poor well construction and leaks in the wellbore annulus due to ruptured wellbore casings. In this paper, a geospatial model of the Barnett Shale region was created using ArcGIS. The model was used for spatial analysis of groundwater quality data in order to determine if regional variations in groundwater quality, as indicated by various groundwater constituent concentrations, may be associated with the presence of hydraulically fractured gas wells in the region. The Barnett Shale reservoir pressure, completions data, and fracture treatment data were evaluated as predictors of groundwater quality change. Results indicated that elevated concentrations of certain groundwater constituents are likely related to natural gas production in the study area and that beryllium, in this formation, could be used as an indicator variable for evaluating fracturing impacts on regional groundwater quality. Results also indicated that gas well density and formation pressures correlate to change in regional water quality whereas proximity to gas wells, by itself, does not. The results also provided indirect evidence supporting the possibility that micro annular fissures serve as a pathway transporting fluids and chemicals from the fractured wellbore to the overlying groundwater aquifers. Copyright © 2015 Elsevier B.V. All rights reserved.

The impact of flying qualities on helicopter operational agility

NASA Technical Reports Server (NTRS)

Padfield, Gareth D.; Lappos, Nick; Hodgkinson, John

1993-01-01

Flying qualities standards are formally set to ensure safe flight and therefore reflect minimum, rather than optimum, requirements. Agility is a flying quality but relates to operations at high, if not maximum, performance. While the quality metrics and test procedures for flying, as covered for example in ADS33C, may provide an adequate structure to encompass agility, they do not currently address flight at high performance. This is also true in the fixed-wing world and a current concern in both communities is the absence of substantiated agility criteria and possible conflicts between flying qualities and high performance. AGARD is sponsoring a working group (WG19) title 'Operational Agility' that deals with these and a range of related issues. This paper is condensed from contributions by the three authors to WG19, relating to flying qualities. Novel perspectives on the subject are presented including the agility factor, that quantifies performance margins in flying qualities terms; a new parameter, based on maneuver acceleration is introduced as a potential candidate for defining upper limits to flying qualities. Finally, a probabilistic analysis of pilot handling qualities ratings is presented that suggests a powerful relationship between inherent airframe flying qualities and operational agility.

Simultaneous Analysis and Quality Assurance for Diffusion Tensor Imaging

PubMed Central

Lauzon, Carolyn B.; Asman, Andrew J.; Esparza, Michael L.; Burns, Scott S.; Fan, Qiuyun; Gao, Yurui; Anderson, Adam W.; Davis, Nicole; Cutting, Laurie E.; Landman, Bennett A.

2013-01-01

Diffusion tensor imaging (DTI) enables non-invasive, cyto-architectural mapping of in vivo tissue microarchitecture through voxel-wise mathematical modeling of multiple magnetic resonance imaging (MRI) acquisitions, each differently sensitized to water diffusion. DTI computations are fundamentally estimation processes and are sensitive to noise and artifacts. Despite widespread adoption in the neuroimaging community, maintaining consistent DTI data quality remains challenging given the propensity for patient motion, artifacts associated with fast imaging techniques, and the possibility of hardware changes/failures. Furthermore, the quantity of data acquired per voxel, the non-linear estimation process, and numerous potential use cases complicate traditional visual data inspection approaches. Currently, quality inspection of DTI data has relied on visual inspection and individual processing in DTI analysis software programs (e.g. DTIPrep, DTI-studio). However, recent advances in applied statistical methods have yielded several different metrics to assess noise level, artifact propensity, quality of tensor fit, variance of estimated measures, and bias in estimated measures. To date, these metrics have been largely studied in isolation. Herein, we select complementary metrics for integration into an automatic DTI analysis and quality assurance pipeline. The pipeline completes in 24 hours, stores statistical outputs, and produces a graphical summary quality analysis (QA) report. We assess the utility of this streamlined approach for empirical quality assessment on 608 DTI datasets from pediatric neuroimaging studies. The efficiency and accuracy of quality analysis using the proposed pipeline is compared with quality analysis based on visual inspection. The unified pipeline is found to save a statistically significant amount of time (over 70%) while improving the consistency of QA between a DTI expert and a pool of research associates. Projection of QA metrics to a low

Simultaneous analysis and quality assurance for diffusion tensor imaging.

PubMed

Lauzon, Carolyn B; Asman, Andrew J; Esparza, Michael L; Burns, Scott S; Fan, Qiuyun; Gao, Yurui; Anderson, Adam W; Davis, Nicole; Cutting, Laurie E; Landman, Bennett A

2013-01-01

Diffusion tensor imaging (DTI) enables non-invasive, cyto-architectural mapping of in vivo tissue microarchitecture through voxel-wise mathematical modeling of multiple magnetic resonance imaging (MRI) acquisitions, each differently sensitized to water diffusion. DTI computations are fundamentally estimation processes and are sensitive to noise and artifacts. Despite widespread adoption in the neuroimaging community, maintaining consistent DTI data quality remains challenging given the propensity for patient motion, artifacts associated with fast imaging techniques, and the possibility of hardware changes/failures. Furthermore, the quantity of data acquired per voxel, the non-linear estimation process, and numerous potential use cases complicate traditional visual data inspection approaches. Currently, quality inspection of DTI data has relied on visual inspection and individual processing in DTI analysis software programs (e.g. DTIPrep, DTI-studio). However, recent advances in applied statistical methods have yielded several different metrics to assess noise level, artifact propensity, quality of tensor fit, variance of estimated measures, and bias in estimated measures. To date, these metrics have been largely studied in isolation. Herein, we select complementary metrics for integration into an automatic DTI analysis and quality assurance pipeline. The pipeline completes in 24 hours, stores statistical outputs, and produces a graphical summary quality analysis (QA) report. We assess the utility of this streamlined approach for empirical quality assessment on 608 DTI datasets from pediatric neuroimaging studies. The efficiency and accuracy of quality analysis using the proposed pipeline is compared with quality analysis based on visual inspection. The unified pipeline is found to save a statistically significant amount of time (over 70%) while improving the consistency of QA between a DTI expert and a pool of research associates. Projection of QA metrics to a low

Ambient air quality programmes for health impact assessment in the WHO European region.

PubMed

Mücke, H G

2000-06-01

An important aim of air quality assessment is to provide information about population exposure and health impact assessment. Numerous epidemiological studies have already shown that exposure to excessive levels of ambient air pollutants are associated with either acute or chronic health effects. Until recently, the adequacy of monitoring population exposure in relation to quantitative assessment of health effects of air pollution was rarely considered in ambient air monitoring strategies. This made the formulation of health-related recommendations to risk management difficult and weakens preventive and other measures to reduce adverse health effects of air pollution. To improve local and national capacities for health impact assessment, the European Centre for Environment and Health of the World Health Organization has prepared methodology guidelines concerning selected aspects of air monitoring. The WHO Collaborating Centre for Air Quality Management and Air Pollution Control support efforts in line with international programmes on quality assurance and control for Europe.

Improving Reliability of Spectrum Analysis for Software Quality Requirements Using TCM

NASA Astrophysics Data System (ADS)

Kaiya, Haruhiko; Tanigawa, Masaaki; Suzuki, Shunichi; Sato, Tomonori; Osada, Akira; Kaijiri, Kenji

Quality requirements are scattered over a requirements specification, thus it is hard to measure and trace such quality requirements to validate the specification against stakeholders' needs. We proposed a technique called “spectrum analysis for quality requirements” which enabled analysts to sort a requirements specification to measure and track quality requirements in the specification. In the same way as a spectrum in optics, a quality spectrum of a specification shows a quantitative feature of the specification with respect to quality. Therefore, we can compare a specification of a system to another one with respect to quality. As a result, we can validate such a specification because we can check whether the specification has common quality features and know its specific features against specifications of existing similar systems. However, our first spectrum analysis for quality requirements required a lot of effort and knowledge of a problem domain and it was hard to reuse such knowledge to reduce the effort. We thus introduce domain knowledge called term-characteristic map (TCM) to reuse the knowledge for our quality spectrum analysis. Through several experiments, we evaluate our spectrum analysis, and main finding are as follows. First, we confirmed specifications of similar systems have similar quality spectra. Second, results of spectrum analysis using TCM are objective, i.e., different analysts can generate almost the same spectra when they analyze the same specification.

Academics' Perceptions of the Impact of Internal Quality Assurance on Teaching and Learning

ERIC Educational Resources Information Center

Tavares, Orlanda; Sin, Cristina; Videira, Pedro; Amaral, Alberto

2017-01-01

Internal quality assurance systems are expected to improve the institutions' core mission of teaching and learning. Using data gathered through an online survey, distributed in 2014/2015, to the teaching staff of all Portuguese private and public higher education institutions, this paper examines the impact of internal quality assurance systems on…

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

7 CFR 4279.60 - Civil Rights Impact Analysis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Civil Rights Impact Analysis. 4279.60 Section 4279.60... Impact Analysis. The Agency is responsible for ensuring that all requirements of FmHA Instruction 2006-P, “Civil Rights Impact Analysis” are met and will complete the appropriate level of review in accordance...

Impacts of Biofuel-Induced Agricultural Land Use Changes on Watershed Hydrology and Water Quality

NASA Astrophysics Data System (ADS)

Lin, Z.; Zheng, H.

2015-12-01

The US Energy Independence and Security Act (EISA) of 2007 has contributed to widespread changes in agricultural land uses. The impact of these land use changes on regional water resources could also be significant. Agricultural land use changes were evaluated for the Red River of the North Basin (RRNB), an international river basin shared by the US and Canada. The influence of the land use changes on spring snowmelt flooding and downstream water quality was also assessed using watershed modeling. The planting areas for corn and soybean in the basin increased by 62% and 18%, while those for spring wheat, forest, and pasture decreased by 30%, 18%, and 50%, from 2006 to 2013. Although the magnitude of spring snowmelt peak flows in the Red River did not change from pre-EISA to post-EISA, our uncertainty analysis of the normalized hydrographs revealed that the downstream streamflows had a greater variability under the post-EISA land use scenario, which may lead to greater uncertainty in predicting spring snowmelt floods in the Red River. Hydrological simulation also showed that the sediment and nutrient loads at the basin's outlet in the US and Canada border increased under the post-EISA land use scenario, on average sediment increasing by 2.6%, TP by 14.1%, nitrate nitrogen by 5.9%, and TN by 9.1%. Potential impacts of the future biofuel crop scenarios on watershed hydrology and water quality in the RRNB were also simulated through integrated economic-hydrologic modeling.

Impact of Multimorbidity on Disability and Quality of Life in the Spanish Older Population

PubMed Central

Garin, Noe; Olaya, Beatriz; Moneta, Maria Victoria; Miret, Marta; Lobo, Antonio; Ayuso-Mateos, Jose Luis; Haro, Josep Maria

2014-01-01

Background Population aging is closely related to high prevalence of chronic conditions in developed countries. In this context, health care policies aim to increase life span cost-effectively while maintaining quality of life and functional ability. There is still, however, a need for further understanding of how chronic conditions affect these health aspects. The aim of this paper is to assess the individual and combined impact of chronic physical and mental conditions on quality of life and disability in Spain, and secondly to show gender trends. Methods Cross-sectional data were collected from the COURAGE study. A total of 3,625 participants over 50 years old from Spain were included. Crude and adjusted multiple linear regressions were conducted to detect associations between individual chronic conditions and disability, and between chronic conditions and quality of life. Separate models were used to assess the influence of the number of diseases on the same variables. Additional analogous regressions were performed for males and females. Results All chronic conditions except hypertension were statistically associated with poor results in quality of life and disability. Depression, anxiety and stroke were found to have the greatest impact on outcomes. The number of chronic conditions was associated with substantially lower quality of life [β for 4+ diseases: −18.10 (−20.95,−15.25)] and greater disability [β for 4+ diseases: 27.64 (24.99,30.29]. In general, women suffered from higher rates of multimorbidity and poorer results in quality of life and disability. Conclusions Chronic conditions impact greatly on quality of life and disability in the older Spanish population, especially when co-occurring diseases are added. Multimorbidity considerations should be a priority in the development of future health policies focused on quality of life and disability. Further studies would benefit from an expanded selection of diseases. Policies should also deal with

Pseudobulbar affect: prevalence and quality of life impact in movement disorders.

PubMed

Strowd, Roy E; Cartwright, Michael S; Okun, Michael S; Haq, Ihtsham; Siddiqui, Mustafa S

2010-08-01

Pseudobulbar affect (PBA) is an affective disinhibition syndrome characterized by sudden, involuntary outbursts of inappropriate crying or laughing. We have previously reported the prevalence of PBA in movement disorders using an interviewer-administered questionnaire that had not been validated. In the current study, a validated self-administered screening instrument, the Center for Neurologic Study-Lability Scale (CNS-LS), was used to study the prevalence of PBA, its association with mood symptoms, and the quality of life impact. Two hundred sixty-nine patients met inclusion criteria (consent, age > 18 years, formal diagnosis, and completion of the CNS-LS). The CNS-LS was used to assess PBA at a cutoff score of 17 (utilized from multiple sclerosis studies). The Beck Depression Inventory (BDI) scale and Parkinson's disease questionnaire (PDQ-39) were used to assess depressive symptoms and quality of life. Logistic regression analysis was used to predict associations with PBA. PBA was prevalent in 7.1% (n = 19) of movement disorder patients. No significant difference in prevalence was observed by patient diagnosis: 7.1% (12/168) in Parkinson's disease (PD), 11.4% (4/35) in essential tremor, 0% (0/13) in dystonia, 0% (0/16) in psychogenic movement disorders, and 10.7% (3/28) in patients with other movement disorders. Patients with PBA had higher BDI depression scores (p < 0.0001) and lower PDQ-39 emotional well-being subscores (p < 0.0001). Patients taking antidepressant medications had significantly higher rates of PBA (p = 0.0008). The prevalence of PBA symptoms was 7.1% in PD and all movement disorders patients. Patients with PBA tend to have more depressive symptoms and poorer quality of life.

Air quality impact and physicochemical aging of biomass burning aerosols during the 2007 San Diego wildfires.

PubMed

Zauscher, Melanie D; Wang, Ying; Moore, Meagan J K; Gaston, Cassandra J; Prather, Kimberly A

2013-07-16

Intense wildfires burning >360000 acres in San Diego during October, 2007 provided a unique opportunity to study the impact of wildfires on local air quality and biomass burning aerosol (BBA) aging. The size-resolved mixing state of individual particles was measured in real-time with an aerosol time-of-flight mass spectrometer (ATOFMS) for 10 days after the fires commenced. Particle concentrations were high county-wide due to the wildfires; 84% of 120-400 nm particles by number were identified as BBA, with particles <400 nm contributing to mass concentrations dangerous to public health, up to 148 μg/m(3). Evidence of potassium salts heterogeneously reacting with inorganic acids was observed with continuous high temporal resolution for the first time. Ten distinct chemical types shown as BBA factors were identified through positive matrix factorization coupled to single particle analysis, including particles comprised of potassium chloride and organic nitrogen during the beginning of the wildfires, ammonium nitrate and amines after an increase of relative humidity, and sulfate dominated when the air mass back trajectories passed through the Los Angeles port region. Understanding BBA aging processes and quantifying the size-resolved mass and number concentrations are important in determining the overall impact of wildfires on air quality, health, and climate.

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.

Psychometric qualities of questionnaires for the assessment of otitis media impact.

PubMed

Timmerman, A A; Meesters, C M G; Speyer, R; Anteunis, L J C

2007-12-01

The assessment of impact and evaluation of treatment effects in chronic otitis media (OM) calls for a much broader approach than just examining the presence of middle ear effusion or hearing loss. It is increasingly recognised that this condition may result in a comprised quality of life. Several studies have used proxy completed questionnaires to objectify the illness experience associated with chronic OM. To review questionnaires which have been developed to describe the effects of chronic OM on the daily functioning of children. Psychometric properties have been evaluated, in addition to discriminative and evaluative qualities. A systematic review of publications pertaining to developed questionnaires related with chronic OM. Systematic literature searches of PubMed (1966-January 2007) and EMBASE (1989-January 2007) were conducted, supplemented by using free text words to identify publications after January 2005. The included 15 questionnaires were developed for children with recurrent or persistent OM, describing functional health status (FHS), while two questionnaires also evaluate the effect of tympanostomy tubes insertion. The questionnaires generally cover six impact areas (physical symptoms, child development, educational performance, emotional/practical burden and general health status) with physical symptoms being the most prominant. The OM8-30, OMO-22 and OM-6 adequately reflect the multidimensional aspects of FHS in chronic OM. The OMO-22 and OM8-30 show the best psychometric properties for the discrimination of impact severity between children, while the OM-6 was found to have the best qualities for the evaluation of clinical change. Clinical applicability is crucial for the assessment of FHS in chronic OM, but requires a trade-off with necessary psychometric properties.

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

Impact of dry mouth conditions on oral health-related quality of life in older people.

PubMed

Gerdin, Elisabeth Wärnberg; Einarson, Susanne; Jonsson, Margareta; Aronsson, Kerstin; Johansson, Ingegerd

2005-12-01

The aim of the present study was to evaluate the impact of dry mouth conditions on oral health-related quality of life in frail old people, residents at community care centers. Further, reliability and validity of a visual analogue scale (VAS) for dry mouth symptoms were determined within the study cohort. In old people functional, social and psychological impacts of oral conditions are associated with an overall sense of well being and general health. Subjective dry mouth and reduced saliva flow are common disorders in old people caused by disease and medication. Thus, dry mouth conditions may be determinants for compromised oral health-related quality of life in old people. In total, 50 old people living at service homes for the old people were asked to answer questionnaires on subjective dry mouth (VAS) and Oral Health Impact Profile (OHIP14) for oral health-related quality of life. Saliva flow was estimated by absorbing saliva into a pre-weighed cotton roll. The final study cohort comprised 41 old people (aged 83-91 years). Significant associations were identified between both objective and subjective dry mouth and overall or specific aspects of oral health-related quality of life. Dry mouth (objective and subjective) is significantly associated with oral health-related quality of life strengthening the value of monitoring dry mouth conditions in the care of frail old people.

Analysis of Customer Loyalty through Total Quality Service, Customer Relationship Management and Customer Satisfaction

ERIC Educational Resources Information Center

Binsar Kristian P., Feliks Anggia; Panjaitan, Hotman

2014-01-01

This research talks about total quality service and customer relationship management effects toward customer satisfaction and its impact on customer loyalty. Fast food restaurant KFC, always strives to continue to make improvements in total quality service, so that customer satisfaction can be maintained, which in turn will have an impact on…

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.

Principal Component Clustering Approach to Teaching Quality Discriminant Analysis

ERIC Educational Resources Information Center

Xian, Sidong; Xia, Haibo; Yin, Yubo; Zhai, Zhansheng; Shang, Yan

2016-01-01

Teaching quality is the lifeline of the higher education. Many universities have made some effective achievement about evaluating the teaching quality. In this paper, we establish the Students' evaluation of teaching (SET) discriminant analysis model and algorithm based on principal component clustering analysis. Additionally, we classify the SET…

Global impacts of conversions from natural to agricultural ecosystems on water resources: Quantity versus quality

NASA Astrophysics Data System (ADS)

Scanlon, Bridget R.; Jolly, Ian; Sophocleous, Marios; Zhang, Lu

2007-03-01

Past land use changes have greatly impacted global water resources, with often opposing effects on water quantity and quality. Increases in rain-fed cropland (460%) and pastureland (560%) during the past 300 years from forest and grasslands decreased evapotranspiration and increased recharge (two orders of magnitude) and streamflow (one order of magnitude). However, increased water quantity degraded water quality by mobilization of salts, salinization caused by shallow water tables, and fertilizer leaching into underlying aquifers that discharge to streams. Since the 1950s, irrigated agriculture has expanded globally by 174%, accounting for ˜90% of global freshwater consumption. Irrigation based on surface water reduced streamflow and raised water tables resulting in waterlogging in many areas (China, India, and United States). Marked increases in groundwater-fed irrigation in the last few decades in these areas has lowered water tables (≤1 m/yr) and reduced streamflow. Degradation of water quality in irrigated areas has resulted from processes similar to those in rain-fed agriculture: salt mobilization, salinization in waterlogged areas, and fertilizer leaching. Strategies for remediating water resource problems related to agriculture often have opposing effects on water quantity and quality. Long time lags (decades to centuries) between land use changes and system response (e.g., recharge, streamflow, and water quality), particularly in semiarid regions, mean that the full impact of land use changes has not been realized in many areas and remediation to reverse impacts will also take a long time. Future land use changes should consider potential impacts on water resources, particularly trade-offs between water, salt, and nutrient balances, to develop sustainable water resources to meet human and ecosystem needs.

Global impacts of conversions from natural to agricultural ecosystems on water resources: Quantity versus quality

USGS Publications Warehouse

Scanlon, Bridget R.; Jolly, Ian; Sophocleous, Marios; Zhang, Lu

2007-01-01

Past land use changes have greatly impacted global water resources, with often opposing effects on water quantity and quality. Increases in rain‐fed cropland (460%) and pastureland (560%) during the past 300 years from forest and grasslands decreased evapotranspiration and increased recharge (two orders of magnitude) and streamflow (one order of magnitude). However, increased water quantity degraded water quality by mobilization of salts, salinization caused by shallow water tables, and fertilizer leaching into underlying aquifers that discharge to streams. Since the 1950s, irrigated agriculture has expanded globally by 174%, accounting for ∼90% of global freshwater consumption. Irrigation based on surface water reduced streamflow and raised water tables resulting in waterlogging in many areas (China, India, and United States). Marked increases in groundwater‐fed irrigation in the last few decades in these areas has lowered water tables (≤1 m/yr) and reduced streamflow. Degradation of water quality in irrigated areas has resulted from processes similar to those in rain‐fed agriculture: salt mobilization, salinization in waterlogged areas, and fertilizer leaching. Strategies for remediating water resource problems related to agriculture often have opposing effects on water quantity and quality. Long time lags (decades to centuries) between land use changes and system response (e.g., recharge, streamflow, and water quality), particularly in semiarid regions, mean that the full impact of land use changes has not been realized in many areas and remediation to reverse impacts will also take a long time. Future land use changes should consider potential impacts on water resources, particularly trade‐offs between water, salt, and nutrient balances, to develop sustainable water resources to meet human and ecosystem needs.

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.

Impact of social factors on the quality of life of patients with refractory epilepsy.

PubMed

Viteva, E

2013-06-01

To assess the impact of social factors on the quality of life of Bulgarian patients with refractory epilepsy. We have studied 70 patients with refractory epilepsy (RE) and 70 patients with pharmacosensitive epilepsy. All of them were between 18 and 65 years of age, without cognitive decline, progressive somatic or neurological disease or recent seizures. All participants were inquired about their education,employment, marital status, and driving. Only the patients with RE completed QOLIE-89. Twenty-five (35.71%) of the participants with RE were not married; 16 (22.86%) of them had an elementary education, 44 (62.86%) - a secondary education, and 10 (14.29%) - a university education.Nineteen (27.4%) participants were employed, 41 (58.57%) were recognized disabled, 10 (14.29%)were unemployed. Two (2.86%) of the patients with RE were drivers. We found out that the marital status did not change the quality of life. The university education correlated with a higher assessment of the “overall health” subscale (50%). The limited or lacking employment had a negative impact on the assessment of the following subscales: “pain”, “health discouragement”, “sexual relations”, “emotional well-being”, “memory”, “work/driving/social function”, “overall health”, “overall quality of life” and the overall score of QOLIE-89. The possibility of driving correlated with more worries about adverse events from antiepileptic drugs. The limited or lacking employment has a negative impact on most aspects of the quality of life, while education and driving influence single aspects of the quality of life.

Forest fires and smoke - impacts on air quality and human health in the USA

Treesearch

Charles K. McMahon

1999-01-01

Abstract. Scientific and regulatory interest in the air quality impacts of forest fire smoke (both prescribed and wildfires) followed the implementation of the 1970 Clean Air Act amendments. Attention on forest fires became more focused as a series of new amendments were enacted to protect the air quality and visibility of "natural" areas...

Impact of Ego-resilience and Family Function on Quality of Life in Childhood Leukemia Survivors

PubMed Central

CHO, Ok-Hee; YOO, Yang-Sook; HWANG, Kyung-Hye

2016-01-01

Background: This study aimed to examine the impact of ego-resilience and family function on quality of life in childhood leukemia survivors. Methods: This study targeted 100 pediatric leukemia survivors, who visited the Pediatric Hemato-Oncology Center in South Korea from Aug to Dec 2011. A structured questionnaire of ego-resilience, family function and quality of life used to collect data through direct interview with the pediatric patients and their parents. The correlation between the study variables analyzed using the Pearson’s correlation coefficient, and the impact on quality of life analyzed using a stepwise multiple regression. Results: Ego-resilience (r = 0.69, P<0.001) and family function (r =0.46, P< 0.001) had a positive correlation with quality of life and all the sub-categories of quality of life. Ego-resilience was a major factor affecting quality of life in childhood leukemia survivors, with an explanatory power of 48%. The explanatory power for quality of life increased to 53% when age and family function were included. Conclusion: Ego-resilience, age, and family function affect quality of life in childhood leukemia survivors. Hence, strategies are required to construct age-matched programs to improve quality of life, in order to help restore the necessary ego-resilience and to strengthen family function in childhood leukemia survivors. PMID:28032062

Decision Regulation Impact Statement for Changes to the National Quality Framework

ERIC Educational Resources Information Center

Education Council, 2017

2017-01-01

The purpose of this Decision Regulation Impact Statement (Decision RIS) is to recommend preferred options for improving the National Quality Framework for Early Childhood Education and Care. The Decision RIS follows the public release of the Consultation RIS and incorporates stakeholders' views and comments received during the ten week stakeholder…

The Impact of eHealth on the Quality and Safety of Healthcare

NASA Astrophysics Data System (ADS)

Majeed, Azeem; Black, Ashly; Car, Josip; Anandan, Chantelle; Cresswell, Kathrin; McKinstry, Brian; Pagliari, Claudia; Procter, Rob; Sheikh, Aziz

There is considerable interest in using information technology (IT) to enhance the quality and safety of healthcare. We undertook a systematic literature review to assess the impact of eHealth applications on the quality and safety of healthcare. We retrieved 46,349 potentially relevant publications, from which we selected 67 relevant systematic reviews for inclusion. The literature was found to be poorly collated and of variable quality in its methodology, reporting and utility. We categorised eHealth applications into three main areas: i). storing, managing and transmission of data; ii). supporting clinical decision-making; and iii). facilitating care from a distance. We found that relative to the potential benefits noted within the literature, little empirical evidence exists in support of these applications. Of the few studies revealing the clearest evidence of benefits, many are from academic clinical centres where developers of new applications have also been directly associated with their evaluation. It is therefore unclear how effective these applications would be if deployed outside the environment in which they were developed. Our review of the impact of eHealth applications on quality and safety of healthcare demonstrated a vast gap between the postulated and empirically demonstrated benefits. In addition, there is a lack of robust research on risks and costs. Consequently, the cost-effectiveness of these interventions has yet to be demonstrated.

Impact of peer-led quality improvement networks on quality of inpatient mental health care: study protocol for a cluster randomized controlled trial.

PubMed