Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

PubMed

McFadden, Kathleen L; Stock, Gregory N; Gowen, Charles R

2015-01-01

Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. The results provide empirical evidence that a safety climate, which is connected to the chief executive officer's transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Quality plan for a product line.

PubMed

Lanza, M L; Binus, G K; McMillan, F J

1997-12-01

Continuous Quality improvement (CQI) has undergone radical change as health care facilities merge, expand, and modify their existing services. CQI has shifted from a centralized position in health care organizations, to unit based, to product lines. This paper describes one product line's endeavors to develop a Quality Plan to direct CQI activities. One particular strength of our innovation is that the Quality Plan was developed with attention to the important balance of interdisciplinary cooperation and maintenance of appropriate discipline boundaries.

The quality march. National survey profiles quality improvement activities.

PubMed

1993-12-05

This nationwide profile of CQI/TQM adopters and non-adopters provides important baseline information with which to chart the growing involvement of hospitals with formal quality improvement efforts. Using a stringent definition, the findings suggest rather widespread adoption of CQI/TQM, although most of it has been very recent. Further, there are systematic differences by bed size, teaching orientation, and system membership. Though the Deming method is the most popular approach to CQI/TQM, nearly as many hospitals report using a combination of approaches, and approximately 22 percent report that they have not selected any specific approach. Of particular note is the finding that those involved with CQI/TQM activities perceive fewer barriers to their quality improvement efforts than those not involved. The impact of these differences on perceived costs and outcomes will be addressed in the next issue of Hospitals & Health Networks.

Addressing Core Competencies Through Hospital Quality Improvement Activities: Attitudes and Engagement

PubMed Central

Lipstein, Ellen A; Kronman, Matthew P; Richmond, Camilla; White, Kristin Nyweide; Shugerman, Richard P; McPhillips, Heather A

2011-01-01

Background Hospital quality improvement initiatives are becoming increasingly common. Little is known about the influence of these initiatives on resident learning and attitudes. Our objective was to assess whether training in a hospital committed to involving residents in hospital-initiated, continuous quality improvement (CQI), and to participation in such activities, would influence residents' attitudes toward CQI and engagement in the hospital community. Methods We surveyed Seattle Children's Hospital pediatric residents, from residency graduation years 2002–2009. We included questions about participation in quality improvement activities during residency and measures of attitude toward CQI and of workplace engagement. We used descriptive statistics to assess trends in resident participation in hospital CQI activities, attitudes toward CQI and workplace engagement. Results The overall response rate was 84% (162 of 194). Among graduated residents, there was a significant trend toward increased participation in CQI activities (P  =  .03). We found no difference in attitude toward CQI between those who had and those who had not participated in such activities nor between residents who began training before and those who began after the hospital formally committed to CQI. Sixty-three percent of residents (25 of 40) who participated in CQI activities were engaged in the hospital community compared with 53% (57 of 107) who did not participate in CQI activities (P  =  .21). Conclusions Training in a hospital committed to involving residents in CQI was associated with a high rate of participation in CQI activities. Although such training and participation in CQI were not associated with resident attitudes toward CQI or hospital engagement, it may allow residents to learn skills for practice-based learning and improvement and systems-based practice. PMID:22942955

Quality Assurance Made Easy.

ERIC Educational Resources Information Center

Villemaire, Lorry

Designed to help adult learners realize the importance and necessity of implementing continuous quality improvement (CQI) in a rapidly changing, competitive, and modern world of work, this document presents a comprehensive explanation of CQI. The following topics are discussed in the book's introduction and seven chapters: importance of quality in…

Implementing a Continuous Quality Improvement Program in a High-Volume Clinical Echocardiography Laboratory: Improving Care for Patients With Aortic Stenosis.

PubMed

Samad, Zainab; Minter, Stephanie; Armour, Alicia; Tinnemore, Amanda; Sivak, Joseph A; Sedberry, Brenda; Strub, Karen; Horan, Seanna M; Harrison, J Kevin; Kisslo, Joseph; Douglas, Pamela S; Velazquez, Eric J

2016-03-01

The management of aortic stenosis rests on accurate echocardiographic diagnosis. Hence, it was chosen as a test case to examine the utility of continuous quality improvement (CQI) approaches to increase echocardiographic data accuracy and reliability. A novel, multistep CQI program was designed and prospectively used to investigate whether it could minimize the difference in aortic valve mean gradients reported by echocardiography when compared with cardiac catheterization. The Duke Echo Laboratory compiled a multidisciplinary CQI team including 4 senior sonographers and MD faculty to develop a mapped CQI process that incorporated Intersocietal Accreditation Commission standards. Quarterly, the CQI team reviewed all moderate- or greater-severity aortic stenosis echocardiography studies with concomitant catheterization data, and deidentified individual and group results were shared at meetings attended by cardiologists and sonographers. After review of 2011 data, the CQI team proposed specific amendments implemented over 2012: the use of nontraditional imaging and Doppler windows as well as evaluation of aortic gradients by a second sonographer. The primary outcome measure was agreement between catheterization- and echocardiography-derived mean gradients calculated by using the coverage probability index with a prespecified acceptable echocardiography-catheterization difference of <10 mm Hg in mean gradient. Between January 2011 and January 2014, 2093 echocardiograms reported moderate or greater aortic stenosis. Among cases with available catheterization data pre- and post-CQI, the coverage probability index increased from 54% to 70% (P=0.03; 98 cases, year 2011; 70 cases, year 2013). The proportion of patients referred for invasive valve hemodynamics decreased from 47% pre-CQI to 19% post-CQI (P<0.001). A laboratory practice pattern that was amenable to reform was identified, and a multistep modification was designed and implemented that produced clinically

[Quality assurance and quality improvement. Personal experiences and intentions].

PubMed

Roche, B G; Sommer, C

1995-01-01

In may 1994 we were selected by the surgical Swiss association to make a study about quality in USA. During our travel we visited 3 types of institutions: Hospitals, National Institute of standard and Technology, Industry, Johnson & Johnson. We appreciate to compare 2 types of quality programs: Quality Assurance (QA) and Continuous Quality Improvement (CQI). In traditional healthcare circles, QA is the process established to meet external regulatory requirements and to assure that patient care is consistent with established standards. In a modern quality terms, QA outside of healthcare means designing a product or service, as well as controlling its production, so well that quality is inevitable. The ideas of W. Edward Deming is that there is never improvement just by inspection. He developed a theory based on 14 principles. A productive work is accomplished through processes. Understanding the variability of processes is a key to improve quality. Quality management sees each person in an organisation as part of one or more processes. The job of every worker is to receive the work of others, add value to that work, and supply it to the next person in the process. This is called the triple role the workers as customer, processor, and supplier. The main source of quality defects is problems in the process. The old assumption is that quality fails when people do the right thing wrong; the new assumption is that, more often, quality failures arise when people do the wrong think right. Exhortation, incentives and discipline of workers are unlikely to improve quality. If quality is failing when people do their jobs as designed, then exhorting them to do better is managerial nonsense. Modern quality theory is customer focused. Customers are identified internally and externally. The modern approach to quality is thoroughly grounded in scientific and statistical thinking. Like in medicine, the symptom is a defect in quality. The therapist of process must perform diagnostic

Continuous quality improvement and medical informatics: the convergent synergy.

PubMed

Werth, G R; Connelly, D P

1992-01-01

Continuous quality improvement (CQI) and medical informatics specialists need to converge their efforts to create synergy for improving health care. Health care CQI needs medical informatics' expertise and technology to build the information systems needed to manage health care organizations according to quality improvement principles. Medical informatics needs CQI's philosophy and methods to build health care information systems that can evolve to meet the changing needs of clinicians and other stakeholders. This paper explores the philosophical basis for convergence of CQI and medical informatics efforts, and then examines a clinical computer workstation development project that is applying a combined approach.

CQI proiect Every other day nocturnal HHD - An alternative approach to reduce burden.

PubMed

2016-08-01

More frequent dialysis, typically performed five to six times per week at home, has been associated with a num- ber of clinical, cardiovascular, and health-related quality of life (HRQOL) benefits. Daily therapy often results in a burden for patients and care partners. A continuous qual- ity improvement (CQI) initiative was conducted to evaluate if an alternate day, longer duration therapy (3.5 treatments with six to 10 hour treatments per week) would provide a viable alternative for home hemodialysis (HHD). This initia- tive demonstrated that every other day (EOD) nocturnal HD is a feasible alternative option to daily HHD and should be considered to individualize home dialysis therapy.

Engaging physicians in continuous quality improvement.

PubMed

Lindenfeld, S; Vlchek, D

2001-04-01

The current ESRD environment poses significant challenges for the medical director and the admitting nephrologist of a dialysis facility. The expectations and requirements of their role have broadened and are under much greater scrutiny today than ever before. A positive response to this challenge lies in the appropriate incorporation of continuous quality improvement (CQI) methods into the provision of dialysis care. By embracing CQI the physician will find these new requirements considerably less taxing and indeed hopefully positive in their impact on the quality of care delivered to his patients. Essential components of the CQI methodology include the use of a multidisciplinary team; participative management; a consistent process, well understood by all team members; a content expert (team leader); and a trained facilitator. A familiarity with CQI tools and techniques and a willingness to play whatever is the most appropriate role in theCQI team-leader, facilitator, or contributing member-will be positive not only to those under the nephrologist's care, but also to his own professional growth and satisfaction as well. Copyright 2001 by the National Kidney Foundation, Inc.

Deming meets Braverman: toward a progressive analysis of the continuous quality improvement paradigm.

PubMed

Schiff, G D; Goldfield, N I

1994-01-01

The continuous quality improvement (CQI) model has rapidly become the dominant management paradigm in U.S. industrial and health care leadership circles. Despite its widespread corporate acceptance and its relevance to public sector policy issues, there has been a paucity of progressive analysis of CQI. The authors begin by noting remarkable similarities between CQI critiques of Taylorism (so-called scientific management of work) with those made by Braverman, a leading Marxist analyst of the work process. Each of the 14 principles of CQI pioneer W. E. Deming are explained and analyzed for their progressive content. These pluses are then contrasted with 18 problematic issues in an attempt to challenge and go beyond the constraints of CQI as it is currently being applied in health care and other sectors. These issues include (1) mismatch between rhetoric and reality, (2) public sector issues, and (3) broader contradictions. The authors emphasize the genuine need for improving health care quality and the relevance of CQI for addressing this need. They challenge progressives to grapple with the profound contradictions by the CQI paradigm inviting a broader dialogue on CQI's meaning for improving the public's health.

A New Alliance: Continuous Quality and Classroom Effectiveness. ASHE-ERIC Higher Education Report No. 6.

ERIC Educational Resources Information Center

Wolverton, Mimi

This report presents seven case studies and discusses the role of continuous quality improvement (CQI) in college classroom effectiveness efforts, particularly specific institutions where sustained CQI programs have affected college classroom practice, their common features, and lingering doubts about CQI. An introduction discusses general…

Management systems, patient quality improvement, resource availability, and substance abuse treatment quality.

PubMed

Fields, Dail; Roman, Paul M; Blum, Terry C

2012-06-01

To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007-2008. Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. © Health Research and Educational Trust.

Turning Continuous Quality Improvement into Institutional Practice: The Tools and Techniques.

ERIC Educational Resources Information Center

Cornesky, Robert A.

This manual is intended to assist managers of support units at institutions of higher education in the implementation of Continuous Quality Improvement (CQI). The purpose is to describe a cooperative model for CQI which will permit managers to evaluate the quality of their units and institution, and by using the described tools and techniques, to…

Organizational learning and continuous quality improvement: examining the impact on nursing home performance.

PubMed

Rondeau, Kent V; Wagar, Terry H

2002-01-01

Interest is growing in learning more about the ability of total quality management and continuous quality improvement (TQM/CQI) initiatives to contribute to the performance of healthcare organizations. A major factor in the successful implementation of TQM/CQI is the seminal contribution of an organization's culture. Many implementation efforts have not succeeded because of a corporate culture that failed to stress broader organizational learning. This may help to explain why some TQM/CQI programs have been unsuccessful in improving healthcare organization performance. Organizational performance variables and organizational learning orientation were assessed in a sample of 181 Canadian long-term care organizations that had implemented a formal TQM/CQI program. Categorical regression analysis shows that, in the absence of a strong corporAte culture that stresses organizational learning and employee development, few performance enhancements are reported. The results of the assessment suggest that a TQM/CQI program without the backing of a strong organizational learning culture may be insufficient to achieve augmented organizational performance.

Continuous quality improvement: a shared governance model that maximizes agent-specific knowledge.

PubMed

Burkoski, Vanessa; Yoon, Jennifer

2013-01-01

Motivate, Innovate, Celebrate: an innovative shared governance model through the establishment of continuous quality improvement (CQI) councils was implemented across the London Health Sciences Centre (LHSC). The model leverages agent-specific knowledge at the point of care and provides a structure aimed at building human resources capacity and sustaining enhancements to quality and safe care delivery. Interprofessional and cross-functional teams work through the CQI councils to identify, formulate, execute and evaluate CQI initiatives. In addition to a structure that facilitates collaboration, accountability and ownership, a corporate CQI Steering Committee provides the forum for scaling up and spreading this model. Point-of-care staff, clinical management and educators were trained in LEAN methodology and patient experience-based design to ensure sufficient knowledge and resources to support the implementation.

Continuous Quality Improvement Tools for Effective Teaching.

ERIC Educational Resources Information Center

Cornesky, Robert A.

This manual presents 15 Continuous Quality Improvement (CQI) tools and techniques necessary for effective teaching. By using the tools and techniques of CQI, teachers will be able to help themselves and their students to focus on the classroom processes. This will permit the teacher and students to plan, organize, implement, and make decisions…

Practice-based learning and improvement: a curriculum in continuous quality improvement for surgery residents.

PubMed

Canal, David F; Torbeck, Laura; Djuricich, Alexander M

2007-05-01

Surgery residents can learn continuous quality improvement (CQI) principles within a structured curriculum and propose quality improvement projects. Curriculum within a surgical residency program. A university surgical residency program with multiple hospital training sites. Fifteen surgical residents during the dedicated research year. A curriculum in CQI that focuses on devising a quality improvement project. Resident self-reported attitudes about quality improvement and implementation of resident-initiated quality improvement projects. Resident survey data demonstrated an improvement in knowledge, self-efficacy, and experiences within CQI. Fifteen individual residents, within smaller teams, created 4 quality improvement projects worthy of implementation. A structured CQI curriculum can be successfully integrated into a general surgery residency program. Residents can learn the skill of constructing CQI project ideas within the framework of the plan-do-study-act cycle. Residents are eager to make improvements in their local system of residency. By giving them the tools to critically investigate systems improvement and a much needed ear to hear their concerns and suggestions for improvement, we found ways to potentially enhance patient care and developed ideas to improve the education of future surgeons. In doing so, we provided the residents with "buy-in" into their residency program, while addressing the competency of practice-based learning and improvement required by the Accreditation Council for Graduate Medical Education for resident education.

Management Systems, Patient Quality Improvement, Resource Availability, and Substance Abuse Treatment Quality

PubMed Central

Fields, Dail; Roman, Paul M; Blum, Terry C

2012-01-01

Objective To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data Sources/Study Setting Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). Study Design The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Data Collection Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007–2008. Principal Findings Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Conclusions Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. PMID:22098342

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare.

PubMed

Price, Alex; Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

2017-02-01

Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. The objective was to adapt and apply Shortell et al.'s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework's stated facilitators and barriers. Copyright © 2017 Longwoods Publishing.

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare

PubMed Central

Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

2017-01-01

Context: Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. Objective: The objective was to adapt and apply Shortell et al.'s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. Methods: In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. Results: A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. Conclusion: The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework's stated facilitators and barriers. PMID:28277203

Researching Reciprocal Leadership: Using the Consciousness Quotient Inventory (CQ-i) as a Pilot Methodology to Explore Leadership with the Context of a School-University Partnership

ERIC Educational Resources Information Center

Poultney, Val; Fordham, Jon

2018-01-01

This article looks at the potential of using an online self-completing inventory that measures leadership consciousness awareness. The Consciousness Quotient inventory (CQ-i) has been developed to encourage leaders to be more conscious of their ability to be accountable and responsible for their leadership practice. The CQ-i as a method for…

Why Do So Few Consumers Use Health Care Quality Report Cards? A Framework for Understanding the Limited Consumer Impact of Comparative Quality Information.

PubMed

Bhandari, Neeraj; Scanlon, Dennis P; Shi, Yunfeng; Smith, Rachel A

2018-05-01

Despite growing investment in producing and releasing comparative provider quality information (CQI), consumer use of CQI has remained poor. We offer a framework to interpret and synthesize the existing literature's diverse approaches to explaining the CQI's low appeal for consumers. Our framework cautions CQI stakeholders against forming unrealistic expectations of pervasive consumer use and suggests that they focus their efforts more narrowly on consumers who may find CQI more salient for choosing providers. We review the consumer impact of stakeholder efforts to apply the burgeoning knowledge of consumers' cognitive limitations to the design and dissemination of the new generation of report cards; we conclude that while it is too limited to draw firm conclusions, early evidence suggests consumers are responding to the novel design and dissemination strategies. We find that consumers continue to have difficulty accessing reliable report cards, while the media remains underused in the dissemination of report cards.

Continuous quality improvement in substance abuse treatment facilities: How much does it cost?

PubMed

Hunt, Priscillia; Hunter, Sarah B; Levan, Deborah

2017-06-01

Continuous quality improvement (CQI) has grown in the U.S. since the 1970s, yet little is known about the costs to implement CQI in substance abuse treatment facilities. This paper is part of a larger group randomized control trial in a large urban county evaluating the impact of Plan-Study-Do-Act (PDSA)-CQI designed for community service organizations (Hunter, Ober, Paddock, Hunt, & Levan, 2014). Operated by one umbrella organization, each of the eight facilities of the study, four residential and four outpatient substance abuse treatment facilities, selected their own CQI Actions, including administrative- and clinical care-related Actions. Using an activity-based costing approach, we collected labor and supplies and equipment costs directly attributable to CQI Actions over a 12-month trial period. Our study finds implementation of CQI and meeting costs of this trial per facility were approximately $2000 to $10,500 per year ($4500 on average), or $10 to $60 per admitted client. We provide a description of the sources of variation in these costs, including differing intensity of the CQI Actions selected, which should help decision makers plan use of PDSA-CQI. Copyright © 2017. Published by Elsevier Inc.

Continuous quality improvement for continuity of care.

PubMed

Kibbe, D C; Bentz, E; McLaughlin, C P

1993-03-01

Continuous quality improvement (CQI) techniques have been used most frequently in hospital operations such as pharmaceutical ordering, patient admitting, and billing of insurers, and less often to analyze and improve processes that are close to the clinical interaction of physicians and their patients. This paper describes a project in which CQI was implemented in a family practice setting to improve continuity of care. A CQI study team was assembled in response to patients' complaints about not being able to see their regular physician providers when they wanted. Following CQI methods, the performance of the practice in terms of provider continuity was measured. Two "customer" groups were surveyed: physician faculty members were surveyed to assess their attitudes about continuity, and patients were surveyed about their preferences for provider continuity and convenience factors. Process improvements were selected in the critical pathways that influence provider continuity. One year after implementation of selected process improvements, repeat chart audit showed that provider continuity levels had improved from .45 to .74, a 64% increase from 1 year earlier. The project's main accomplishment was to establish the practicality of using CQI methods in a primary care setting to identify a quality issue of value to both providers and patients, in this case, continuity of provider care, and to identify processes that linked the performance of health care delivery procedures with patient expectations.

The quality of radiation care: the results of focus group interviews and concept mapping to explore the patient's perspective.

PubMed

Nijman, Jessica L; Sixma, Herman; van Triest, Baukelien; Keus, Ronald B; Hendriks, Michelle

2012-01-01

In this study, we explore the quality aspects of radiation care from the patient's perspective in order to develop a draft Consumer Quality Index (CQI) Radiation Care instrument. Four focus group discussions with (former) cancer patients were held to explore the aspects determining the quality of radiation care. The list of aspects generated was categorised based on similarity and importance in a concept mapping procedure. Four focus group discussions revealed seven main themes related to the quality of radiation care: information provision, a patient-centred approach, professional competence, planning and waiting times, accessibility, cooperation and communication, and follow-up care. Results of concept mapping procedures revealed which items the patients considered to be most important. A radiation oncologist who is up to date about the patient's file is of paramount importance for cancer patients receiving radiotherapy. The quality aspects found through focus group discussions provided useful insight into how patients experience radiation care. Furthermore, concept mapping made these results more solid. To evaluate the quality of radiation care from the patient's perspective, these quality aspects will be guiding in the development of a CQI Radiation Care. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

[Quality of mental health services: a self audit in the South Verona mental health service].

PubMed

Allevi, Liliana; Salvi, Giovanni; Ruggeri, Mirella

2006-01-01

To start a process of Continuous Quality Improvement (CQI) in an Italian Community Mental Health Service by using a quality assurance questionnaire in a self audit exercise. The questionnaire was administered to 14 key workers and clinical managers with different roles and seniority. One senior manager's evaluation was used as a benchmark for all the others. Changes were introduced in the service practice according to what emerged from the evaluation. Meetings were scheduled to monitor those changes and renew the CQI process. There was a wide difference in the key workers' answers. Overall, the senior manager's evaluation was on the 60th percentile of the distribution of the other evaluations. Those areas that required prompt intervention were risk management, personnel development, and CQI. The CQI process was followed up for one year: some interventions were carried out to change the practice of the service. A self audit exercise in Community Mental Health Services was both feasible and useful. The CQI process was easier to start than to carry on over the long term.

Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

ERIC Educational Resources Information Center

Pietz, Victoria Lynn

2014-01-01

Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

Continuous quality improvement for the clinical decision unit.

PubMed

Mace, Sharon E

2004-01-01

Clinical decision units (CDUs) are a relatively new and growing area of medicine in which patients undergo rapid evaluation and treatment. Continuous quality improvement (CQI) is important for the establishment and functioning of CDUs. CQI in CDUs has many advantages: better CDU functioning, fulfillment of Joint Commission on Accreditation of Healthcare Organizations mandates, greater efficiency/productivity, increased job satisfaction, better performance improvement, data availability, and benchmarking. Key elements include a database with volume indicators, operational policies, clinical practice protocols (diagnosis specific/condition specific), monitors, benchmarks, and clinical pathways. Examples of these important parameters are given. The CQI process should be individualized for each CDU and hospital.

A story of success: continuous quality improvement in cystic fibrosis care in the USA.

PubMed

Quon, Bradley S; Goss, Christopher H

2011-12-01

Continuous quality improvement (CQI) in healthcare can be described as a reiterative approach to improving processes to reduce unexpected variation in health outcomes. CQI represents one model to achieve quality improvement (QI) and has long been recognized as a key to success in the manufacturing industry with companies like Toyota leading the way. Healthcare, and specifically pulmonary, critical care and sleep medicine represent ideal settings for the application of CQI. This opinion piece will describe QI and CQI initiatives in the US Cystic fibrosis (CF) population. QI in CF care in the United States has been ongoing since inception of the US CF Foundation (CFF) in 1955. This effort has included work to improve the quality of clinical care provided at CF centers and work to improve clinical outcomes in CF. More recently, QI methods have been applied to the conduct of clinical research. The CF community has become a leader in the area of QI and has pointed out the opportunities for others to follow in the area of lung diseases.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes.

PubMed

McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10-20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.

[Audit and feedback, and continuous quality improvement strategies to improve the quality of care for type 2 diabetes: a systematic review of literature].

PubMed

Vecchi, Simona; Agabiti, Nera; Mitrova, Susanna; Cacciani, Laura; Amato, Laura; Davoli, Marina; Bargagli, Anna Maria

2016-01-01

we analysed evidence on effective interventions to improve the quality of care and management in patients with diabetes type 2. This review focuses particularly on audit and feedback intervention, targeted to healthcare providers, and continuous quality improvement (CQI) involving health professionals and health care systems, respectively. we searched The Cochrane Library, PubMed, and EMBASE (search period: January 2005-December 2015) to identify systematic reviews (SR) and randomized controlled trials (RCTs) considering patients' outcomes and process measures as quality indicators in diabetes care. Selection of studies and data extraction were carried out independently by two reviewers. Methodological quality of individual studies was assessed using the checklist «Assessment of methodological quality of systematic review» (AMSTAR) and the Cochrane's tool, respectively. We produced summaries of results for each study design. the search process resulted in 810 citations. One SR and 7 RCTs that compared any intervention in which audit and feedback and CQI was a component vs. other interventions were selected. The SR found that audit and feedback activity was associated with improvements of glycaemic (mean difference: 0.26; 95%CI 0.08;0.44) and cholesterol control (mean difference: 0.03; 95%CI -0.04;0.10). CQI interventions were not associated with an improvement of quality of diabetes care. The RCTs considered in this review compared a broad range of interventions including feedback as unique activity or as part of more complex strategies. The methodological quality was generally poor in all the included trials. the available evidence suggests that audit and feedback and CQI improve quality of care in diabetic patients, although the effect is small and heterogeneous among process and outcomes indicators.

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care

PubMed Central

Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

PubMed

Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers.

Mobile radiography CQI: an inter-national study.

PubMed

Kamat, M R; Wein, B; Cohan, R

1999-01-01

delivery of hospital based health care are well known, this study attempts to quantify and determine a dollar value for each process found as inefficient. Key inefficiencies were found to be common at large hospitals no matter whether in the United States or Europe. These impairments are responsible for a disproportionate share of overall inefficiency, and their elimination (achievable by simple solutions) would result in drastic cost reductions (ranging from 40-75% at the institutions studied). Thus this study is important in view of spiralling costs, as it is a key component of total quality management (TQM) in radiology and a continuous quality improvement (CQI) tool for mobile radiology specifically.

[Frequency of eating away-from-home and quality of dietary carbohydrate and fat intake in the SUN Project].

PubMed

Villacis, Cecilia; Zazpe, Itziar; Santiago, Susana; De la Fuente-Arrillaga, Carmen; Bes-Rastrollo, Maira; Martínez-González, Miguel Angel

2014-10-03

To investigate the association between eating- away-from-home (EAFH) and a) the quality of dietary carbohydrate intake and b) the quality of fat intake. We assessed 19,371 participants in the SUN cohort who completed a validated baseline food frequency questionnaire. Quality indices of carbohydrate (CQI) and fat (FQI) were used. Multiple regression models were fitted to determine the association between the frequency of EAFH (4 categories) and both indices. Logistic regression analysis was used to assess the association between the frequency of EAFH and low CQI or FQI ((<25th percentile). Participants showed an average CQI and FQI of 11,3 (SD 3,2) and 1,7 (SD 0,5), respectively. A higher frequency of EAFH (≥ 2 times/week) was associated with a poorer CQI and a poorer FQI. For CQI, the adjusted mean difference was -0,29, 95%CI: -0,41, -0,17 (p for trend <0,001), and for FQI it was -0,02, 95%CI: -0,03, -0,001 (p for trend 0,03). Participants with a highest frequency (≥ 2 times/week) of EAFH had higher adjusted risk of a poorer CQI, (adjusted OR 1,31, 95%CI 1,17, 1,46, p for trend <0,001), but this habit (EAFH) was unrelated to FQI (adjusted OR 0,93, 95%CI: 0,83, 1,03, p for trend 0,194). A higher frequency of EAFH was associated with a poorer quality of dietary fat, and particularly, dietary carbohohydrate. These findings highlight the importance of nutritional education addressed to consumers who frequently do out-of-home meals. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes

PubMed Central

McCalman, Janya; Bailie, Ross; Bainbridge, Roxanne; McPhail-Bell, Karen; Percival, Nikki; Askew, Deborah; Fagan, Ruth; Tsey, Komla

2018-01-01

Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally. PMID:29623271

Assessment of an intervention to train teaching hospital care providers in quality management

PubMed Central

Francois, P; Vinck, D; Labarere, J; Reverdy, T; Peyrin, J

2005-01-01

Background: Successful implementation of continuous quality improvement (CQI) programs in hospitals remains rare in all countries, making it necessary to experiment with implementation methods while considering the cultural factors of resistance to change. Objective: To assess the impact of an educational intervention on involvement of clinical department staff in the quality process. Setting: Twelve voluntary clinical departments (six experimental and six controls) in a French 2000-bed university hospital comprising 40 clinical departments. Intervention: Three day training seminar to a group of 12–20 staff members from each department. Design: Quasi-experimental post-test only design study with control group conducted 12 months after the intervention with a questionnaire completed in a face-to-face interview. Subjects: 98 trained staff and 100 untrained staff from the six experimental departments and 100 staff from the six control departments. Principal measurements: Declared knowledge of the CQI methods and participation in quality management activities. Results: 286 people (96%) were involved in the study. More of the trained staff knew the CQI methods (62.4%) than staff in the control departments (16.5%) (adjusted odds ratio (ORa) = 10.6 (95% CI 4.97 to 22.62)). More trained staff also participated in quality improvement work groups than control department staff (76.3% v 14.0%; ORa = 27.4 (95% CI 11.6 to 64.4)). In the experimental departments the untrained staff's knowledge of CQI methods and their participation in work groups did not differ from that of control department staff. Conclusions: A continuing education intervention can involve care providers in CQI. Dissemination of knowledge from trained personnel to other staff members remains limited. PMID:16076785

The Application of Continuous Quality Improvement Models and Methods to Higher Education: Can We Learn from Business?

ERIC Educational Resources Information Center

Downey, Thomas E.

Continuous quality improvement (CQI) models, which were first applied in business, are critical to making new technology-based learning paradigms and flexible learning environments a reality. The following are among the factors that have facilitated CQI's application in education: increased operating costs; increased competition from private…

Continuous quality improvement intervention for adolescent and young adult HIV testing services in Kenya improves HIV knowledge

PubMed Central

Wagner, Anjuli D.; Mugo, Cyrus; Bluemer-Miroite, Shay; Mutiti, Peter M.; Wamalwa, Dalton C.; Bukusi, David; Neary, Jillian; Njuguna, Irene N.; O’Malley, Gabrielle; John-Stewart, Grace C.; Slyker, Jennifer A.; Kohler, Pamela K.

2017-01-01

Objectives: To determine whether continuous quality improvement (CQI) improves quality of HIV testing services for adolescents and young adults (AYA). Design: CQI was introduced at two HIV testing settings: Youth Centre and Voluntary Counseling and Testing (VCT) Center, at a national referral hospital in Nairobi, Kenya. Methods: Primary outcomes were AYA satisfaction with HIV testing services, intent to return, and accurate HIV prevention and transmission knowledge. Healthcare worker (HCW) satisfaction assessed staff morale. T tests and interrupted time series analysis using Prais–Winsten regression and generalized estimating equations accounting for temporal trends and autocorrelation were conducted. Results: There were 172 AYA (Youth Centre = 109, VCT = 63) during 6 baseline weeks and 702 (Youth Centre = 454, VCT = 248) during 24 intervention weeks. CQI was associated with an immediate increase in the proportion of AYA with accurate knowledge of HIV transmission at Youth Centre: 18 vs. 63% [adjusted risk difference (aRD) 0.42,95% confidence interval (CI) 0.21 to 0.63], and a trend at VCT: 38 vs. 72% (aRD 0.30, 95% CI −0.04 to 0.63). CQI was associated with an increase in the proportion of AYA with accurate HIV prevention knowledge in VCT: 46 vs. 61% (aRD 0.39, 95% CI 0.02–0.76), but not Youth Centre (P = 0.759). In VCT, CQI showed a trend towards increased intent to retest (4.0 vs. 4.3; aRD 0.78, 95% CI −0.11 to 1.67), but not at Youth Centre (P = 0.19). CQI was not associated with changes in AYA satisfaction, which was high during baseline and intervention at both clinics (P = 0.384, P = 0.755). HCW satisfaction remained high during intervention and baseline (P = 0.746). Conclusion: CQI improved AYA knowledge and did not negatively impact HCW satisfaction. Quality improvement interventions may be useful to improve adolescent-friendly service delivery. PMID:28665882

Implementing evidence-based continuous quality improvement strategies in an urban Aboriginal Community Controlled Health Service in South East Queensland: a best practice implementation pilot.

PubMed

Hogg, Sandra; Roe, Yvette; Mills, Richard

2017-01-01

The Institute for Urban Indigenous Health believes that continuous quality improvement (CQI) contributes to the delivery of high-quality care, thereby improving health outcomes for Aboriginal and Torres Strait Islander people. The opening of a new health service in 2015 provided an opportunity to implement best practice CQI strategies and apply them to a regional influenza vaccination campaign. The aim of this project was to implement an evidence-based CQI process within one Aboriginal Community Controlled Health Service in South East Queensland and use staff engagement as a measure of success. A CQI tool was selected from the Joanna Briggs Institute Practical Application of Clinical Evidence System (PACES) to be implemented in the study site. The study site was a newly established Aboriginal and Torres Strait Islander Community Controlled Health Service located in the northern suburbs of Brisbane. This project used the evidence-based information collected in PACES to develop a set of questions related to known variables resulting in proven CQI uptake. A pre implementation clinical audit, education and self-directed learning, using the Plan Do Study Act framework, included a total of seven staff and was conducted in April 2015. A post implementation audit was conducted in July 2015. There were a total of 11 pre- and post-survey respondents which included representation from most of the clinical team and medical administration. The results of the pre implementation audit identified a number of possible areas to improve engagement with the CQI process including staff training and support, understanding CQI and its impacts on individual work areas, understanding clinical data extraction, clinical indicator benchmarking, strong internal leadership and having an external data extractor. There were improvements to all audit criteria in the post-survey, for example, knowledge regarding the importance of CQI activity, attendance at education and training sessions on CQI

Identifying Continuous Quality Improvement Priorities in Maternal, Infant, and Early Childhood Home Visiting.

PubMed

Preskitt, Julie; Fifolt, Matthew; Ginter, Peter M; Rucks, Andrew; Wingate, Martha S

2016-01-01

The purpose of this article was to describe a methodology to identify continuous quality improvement (CQI) priorities for one state's Maternal, Infant, and Early Childhood Home Visiting program from among the 40 required constructs associated with 6 program benchmarks. The authors discuss how the methodology provided consensus on system CQI quality measure priorities and describe variation among the 3 service delivery models used within the state. Q-sort methodology was used by home visiting (HV) service delivery providers (home visitors) to prioritize HV quality measures for the overall state HV system as well as their service delivery model. There was general consensus overall and among the service delivery models on CQI quality measure priorities, although some variation was observed. Measures associated with Maternal, Infant, and Early Childhood Home Visiting benchmark 1, Improved Maternal and Newborn Health, and benchmark 3, Improvement in School Readiness and Achievement, were the highest ranked. The Q-sort exercise allowed home visitors an opportunity to examine priorities within their service delivery model as well as for the overall First Teacher HV system. Participants engaged in meaningful discussions regarding how and why they selected specific quality measures and developed a greater awareness and understanding of a systems approach to HV within the state. The Q-sort methodology presented in this article can easily be replicated by other states to identify CQI priorities at the local and state levels and can be used effectively in states that use a single HV service delivery model or those that implement multiple evidence-based models for HV service delivery.

Speaking the right language: the scientific method as a framework for a continuous quality improvement program within academic medical research compliance units.

PubMed

Nolte, Kurt B; Stewart, Douglas M; O'Hair, Kevin C; Gannon, William L; Briggs, Michael S; Barron, A Marie; Pointer, Judy; Larson, Richard S

2008-10-01

The authors developed a novel continuous quality improvement (CQI) process for academic biomedical research compliance administration. A challenge in developing a quality improvement program in a nonbusiness environment is that the terminology and processes are often foreign. Rather than training staff in an existing quality improvement process, the authors opted to develop a novel process based on the scientific method--a paradigm familiar to all team members. The CQI process included our research compliance units. Unit leaders identified problems in compliance administration where a resolution would have a positive impact and which could be resolved or improved with current resources. They then generated testable hypotheses about a change to standard practice expected to improve the problem, and they developed methods and metrics to assess the impact of the change. The CQI process was managed in a "peer review" environment. The program included processes to reduce the incidence of infections in animal colonies, decrease research protocol-approval times, improve compliance and protection of animal and human research subjects, and improve research protocol quality. This novel CQI approach is well suited to the needs and the unique processes of research compliance administration. Using the scientific method as the improvement paradigm fostered acceptance of the project by unit leaders and facilitated the development of specific improvement projects. These quality initiatives will allow us to improve support for investigators while ensuring that compliance standards continue to be met. We believe that our CQI process can readily be used in other academically based offices of research.

Development of indoor environmental index: Air quality index and thermal comfort index

NASA Astrophysics Data System (ADS)

Saad, S. M.; Shakaff, A. Y. M.; Saad, A. R. M.; Yusof, A. M.; Andrew, A. M.; Zakaria, A.; Adom, A. H.

2017-03-01

In this paper, index for indoor air quality (also known as IAQI) and thermal comfort index (TCI) have been developed. The IAQI was actually modified from previous outdoor air quality index (AQI) designed by the United States Environmental Protection Agency (US EPA). In order to measure the index, a real-time monitoring system to monitor indoor air quality level was developed. The proposed system consists of three parts: sensor module cloud, base station and service-oriented client. The sensor module cloud (SMC) contains collections of sensor modules that measures the air quality data and transmit the captured data to base station through wireless. Each sensor modules includes an integrated sensor array that can measure indoor air parameters like Carbon Dioxide, Carbon Monoxide, Ozone, Nitrogen Dioxide, Oxygen, Volatile Organic Compound and Particulate Matter. Temperature and humidity were also being measured in order to determine comfort condition in indoor environment. The result from several experiments show that the system is able to measure the air quality presented in IAQI and TCI in many indoor environment settings like air-conditioner, chemical present and cigarette smoke that may impact the air quality. It also shows that the air quality are changing dramatically, thus real-time monitoring system is essential.

Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review.

PubMed

Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre

2016-02-01

Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists' perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers.

Improving prehospital trauma care in Rwanda through continuous quality improvement: an interrupted time series analysis.

PubMed

Scott, John W; Nyinawankusi, Jeanne D'Arc; Enumah, Samuel; Maine, Rebecca; Uwitonze, Eric; Hu, Yihan; Kabagema, Ignace; Byiringiro, Jean Claude; Riviello, Robert; Jayaraman, Sudha

2017-07-01

Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures. Targets of >90% were set for each metric and daily team meetings and monthly feedback sessions were implemented to address opportunities for improvement. These five pre-hospital quality metrics were assessed monthly before and after implementation of the CQIP. Met and unmet needs for O2, IVF, and c-collar were combined into a summative monthly SAMU Trauma Quality Scores (STQ score). An interrupted time series linear regression model compared the STQ score during 14 months before the CQIP implementation to the first 14 months after. During the 29-month study period 3,822 patients met study criteria. 1,028 patients needed one or more of the five studied interventions during the study period. All five endpoints had a significant increase between the pre-CQI and post-CQI periods (p<0.05 for all), and all five achieved a post-CQI average of at least 90% completion. The monthly composite STQ scores ranged from 76.5 to 97.9 pre-CQI, but tightened to 86.1-98.7 during the post-CQI period. Interrupted time series analysis of the STQ score showed that CQI programme led to both an immediate improvement of +6.1% (p=0.017) and sustained monthly improvements in care delivery-improving at a rate of 0.7% per month (p=0.028). The SAMU experience demonstrates the utility of a responsive, data-driven quality improvement

Principles of continuous quality improvement applied to intravenous therapy.

PubMed

Dunavin, M K; Lane, C; Parker, P E

1994-01-01

Documentation of the application of the principles of continuous quality improvement (CQI) to the health care setting is crucial for understanding the transition from traditional management models to CQI models. A CQI project was designed and implemented by the IV Therapy Department at Lawrence Memorial Hospital to test the application of these principles to intravenous therapy and as a learning tool for the entire organization. Through a prototype inventory project, significant savings in cost and time were demonstrated using check sheets, flow diagrams, control charts, and other statistical tools, as well as using the Plan-Do-Check-Act cycle. As a result, a primary goal, increased time for direct patient care, was achieved. Eight hours per week in nursing time was saved, relationships between two work areas were improved, and $6,000 in personnel costs, storage space, and inventory were saved.

The administrative and clinical rationale for the total organization approach to continuous quality improvement.

PubMed

Jones, D J; Ziegenfuss, J T

1993-01-01

In our view TQM and CQI represent important innovations in the continuing effort to develop higher performance organizations. Never before has the need been so great to improve quality while at the same time constraining, or reducing, costs. An increasing number of health care organizations can document their experiences that as quality goes up, costs can come down. The contribution of these new approaches is in some sense the wedding of many long established methodologies--the scientific method, statistical quality control, planning, joint problem solving, participative management, and empowerment of the work force. While this recognition could lend support to those who label this new model a fad, that perception denies the linkage of TQM/CQI to the greater stream of innovations pushing us toward ever-greater organizational excellence. Can we not take the philosophy and methods that are potentially useful and try them experimentally? Let our empirical tests tell us of their contribution. We believe the concepts and procedures of TQM/CQI will help us to be better in years to come, even though we highly respect our starting point.

Quality indexing with computer-aided lexicography

NASA Technical Reports Server (NTRS)

Buchan, Ronald L.

1992-01-01

Indexing with computers is a far cry from indexing with the first indexing tool, the manual card sorter. With the aid of computer-aided lexicography, both indexing and indexing tools can provide standardization, consistency, and accuracy, resulting in greater quality control than ever before. A brief survey of computer activity in indexing is presented with detailed illustrations from NASA activity. Applications from techniques mentioned, such as Retrospective Indexing (RI), can be made to many indexing systems. In addition to improving the quality of indexing with computers, the improved efficiency with which certain tasks can be done is demonstrated.

Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review

PubMed Central

Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre

2016-01-01

Background and aim: Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. Methods: We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. Results: We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists’ perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Conclusion: Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers. PMID:26878037

Clinical performance improvement series. Classic CQI integrated with comprehensive disease management as a model for performance improvement.

PubMed

Joshi, M S; Bernard, D B

1999-08-01

In recent years, health and disease management has emerged as an effective means of delivering, integrating, and improving care through a population-based approach. Since 1997 the University of Pennsylvania Health System (UPHS) has utilized the key principles and components of continuous quality improvement (CQI) and disease management to form a model for health care improvement that focuses on designing best practices, using best practices to influence clinical decision making, changing processes and systems to deploy and deliver best practices, and measuring outcomes to improve the process. Experience with 28 programs and more than 14,000 patients indicates significant improvement in outcomes, including high physician satisfaction, increased patient satisfaction, reduced costs, and improved clinical process and outcome measures across multiple diseases. DIABETES DISEASE MANAGEMENT: In three months a UPHS multidisciplinary diabetes disease management team developed a best practice approach for the treatment of all patients with diabetes in the UPHS. After the program was pilot tested in three primary care physician sites, it was then introduced progressively to additional practice sites throughout the health system. The establishment of the role of the diabetes nurse care managers (certified diabetes educators) was central to successful program deployment. Office-based coordinators ensure incorporation of the best practice protocols into routine flow processes. A disease management intranet disseminates programs electronically. Outcomes of the UPHS health and disease management programs so far demonstrate success across multiple dimensions of performance-service, clinical quality, access, and value. The task of health care leadership today is to remove barriers and enable effective implementation of key strategies, such as health and disease management. Substantial effort and resources must be dedicated to gain physician buy-in and achieve compliance. The

Challenges of standardized continuous quality improvement programs in community pharmacies: the case of SafetyNET-Rx.

PubMed

Boyle, Todd A; MacKinnon, Neil J; Mahaffey, Thomas; Duggan, Kellie; Dow, Natalie

2012-01-01

Research on continuous quality improvement (CQI) in community pharmacies lags in comparison to service, manufacturing, and various health care sectors. As a result, very little is known about the challenges community pharmacies face when implementing CQI programs in general, let alone the challenges of implementing a standardized and technologically sophisticated one. This research identifies the initial challenges of implementing a standardized CQI program in community pharmacies and how such challenges were addressed by pharmacy staff. Through qualitative interviews, a multisite study of the SafetyNET-Rx CQI program involving community pharmacies in Nova Scotia, Canada, was performed to identify such challenges. Interviews were conducted with the CQI facilitator (ie, staff pharmacist or technician) in 55 community pharmacies that adopted the SafetyNET-Rx program. Of these 55 pharmacies, 25 were part of large national corporate chains, 22 were part of banner chains, and 8 were independent pharmacies. A total of 10 different corporate chains and banners were represented among the 55 pharmacies. Thematic content analysis using well-established coding procedures was used to explore the interview data and elicit the key challenges faced. Six major challenges were identified, specifically finding time to report, having all pharmacy staff involved in quality-related event (QRE) reporting, reporting apprehensiveness, changing staff relationships, meeting to discuss QREs, and accepting the online technology. Challenges were addressed in a number of ways including developing a manual-online hybrid reporting system, managers paying staff to meet after hours, and pharmacy managers showing visible commitment to QRE reporting and learning. This research identifies key challenges to implementing CQI programs in community pharmacies and also provides a starting point for future research relating to how the challenges of QRE reporting and learning in community pharmacies change

Indigenous health: effective and sustainable health services through continuous quality improvement.

PubMed

Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

2007-05-21

The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

Quality-improvement analytics for intravenous infusion pumps.

PubMed

Skledar, Susan J; Niccolai, Cynthia S; Schilling, Dennis; Costello, Susan; Mininni, Nicolette; Ervin, Kelly; Urban, Alana

2013-04-15

The implementation of a smart-pump continuous quality-improvement (CQI) program across a large health system is described, with an emphasis on key metrics for outcomes analyses and program refinement. Three years ago, the University of Pittsburgh Medical Center health system launched a CQI initiative to help ensure the safe use of 6000 smart pumps in its 14 inpatient facilities. A centralized team led by pharmacists is responsible for the retrieval and interpretation of smart-pump data, which is continuously transmitted to a main server. CQI findings are regularly posted on the health system's interdisciplinary intranet. Monitored metrics include rates of compliance with preprogrammed infusion limits, the top 20 drugs involved in alerts, drugs associated with alert-override rates of ≥90%, numbers of alerts by infusion type, nurse responses to alerts, and alert rate per drug library update. Based on the collected CQI data and site-specific requests, four systemwide updates of the smart-pump drug library were performed during the first 18 months of the program, reducing "nuisance alerts" by about 10% per update cycle and enabling targeted interventions to reduce rapid-infusion errors, other adverse drug events (ADEs), and pump-programming workarounds. Over one 12-month period, bedside alerts prompted nurses to reprogram or cancel continuous infusions an average of 400 times per month, potentially averting i.v. medication ADEs. A smart-pump CQI program is an effective tool for enhancing the safety of i.v. medication administration. The ongoing refinement of the drug library through the development and implementation of key interventions promotes the growth and sustainability of the smart-pump initiative systemwide.

Application of Nemerow Index Method and Integrated Water Quality Index Method in Water Quality Assessment of Zhangze Reservoir

NASA Astrophysics Data System (ADS)

Zhang, Qian; Feng, Minquan; Hao, Xiaoyan

2018-03-01

[Objective] Based on the water quality historical data from the Zhangze Reservoir from the last five years, the water quality was assessed by the integrated water quality identification index method and the Nemerow pollution index method. The results of different evaluation methods were analyzed and compared and the characteristics of each method were identified.[Methods] The suitability of the water quality assessment methods were compared and analyzed, based on these results.[Results] the water quality tended to decrease over time with 2016 being the year with the worst water quality. The sections with the worst water quality were the southern and northern sections.[Conclusion] The results produced by the traditional Nemerow index method fluctuated greatly in each section of water quality monitoring and therefore could not effectively reveal the trend of water quality at each section. The combination of qualitative and quantitative measures of the comprehensive pollution index identification method meant it could evaluate the degree of water pollution as well as determine that the river water was black and odorous. However, the evaluation results showed that the water pollution was relatively low.The results from the improved Nemerow index evaluation were better as the single indicators and evaluation results are in strong agreement; therefore the method is able to objectively reflect the water quality of each water quality monitoring section and is more suitable for the water quality evaluation of the reservoir.

Improving physiotherapy services to Indigenous children with physical disability: Are client perspectives missed in the continuous quality improvement approach?

PubMed

Greenstein, Caroline; Lowell, Anne; Thomas, David Piers

2016-06-01

To compare the outcomes of two cycles of continuous quality improvement (CQI) at a paediatric physiotherapy service with findings from interviews with clients and their carers using the service. Case study based at one paediatric physiotherapy service Community-based paediatric allied health service in Northern Australia. Forty-nine clinical records and four staff at physiotherapy service, five Indigenous children with physical disability aged 8-21 years, and nine carers of Indigenous children aged 0-21 years (current or previous clients). The CQI process based on the Audit and Best Practice for Chronic Disease involved a clinical audit; a workshop where clinicians assessed their health care systems, identified weaknesses and strengths, and developed goals and strategies for improvement; and reassessment through a second audit and workshop. Twelve open-ended, in-depth interviews were conducted with previous or current clients selected through purposive and theoretical sampling. CQI and interview results were then compared. Comparison of findings from the two studies Both CQI and interview results highlighted service delivery flexibility and therapists' knowledge, support and advocacy as service strengths, and lack of resources and a child-friendly office environment as weaknesses. However, the CQI results reported better communication and client input into the service than the interview results. The CQI process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients and underlined the importance of including clients in the CQI process. © 2015 National Rural Health Alliance Inc.

Ozone - Current Air Quality Index

MedlinePlus

GO! Local Air Quality Conditions Zip Code: State : My Current Location Current AQI Forecast AQI Loop More Maps AQI: Good (0 - 50) ... resources for Hawaii residents and visitors more announcements Air Quality Basics Air Quality Index | Ozone | Particle Pollution | Smoke ...

Induction of labour: a continuous quality improvement and peer review program to improve the quality of care

PubMed Central

Harris, Susan; Buchinski, Bev; Gryzbowski, Stefan; Janssen, Patti; Mitchell, G.W. Erle; Farquharson, Duncan

2000-01-01

This article describes a program developed to improve the process of planned induction of labour and to reduce the rates of inappropriate induction. The setting is a tertiary-care maternity hospital in urban Vancouver, BC, in which 7000 deliveries take place annually. Approximately 65% of these can be considered primary care; the remainder are secondary- or tertiary-level cases. Continuous quality improvement (CQI) methods were used by a multidisciplinary team, which included nursing staff, physicians, health records personnel and a CQI facilitator. Interventions included the development of a new induction-booking process, clear criteria for induction, feedback to caregivers about changes and a peer review system to oversee and maintain improvement. The overall induction rate for the institution decreased, and this change has been maintained. PMID:11079064

An innovative index for evaluating water quality in streams.

PubMed

Said, Ahmend; Stevens, David K; Sehlke, Gerald

2004-09-01

A water quality index expressed as a single number is developed to describe overall water quality conditions using multiple water quality variables. The index consists of water quality variables: dissolved oxygen, specific conductivity, turbidity, total phosphorus, and fecal coliform. The objectives of this study were to describe the preexisting indices and to define a new water quality index that has advantages over these indices. The new index was applied to the Big Lost River Watershed in Idaho, and the results gave a quantitative picture for the water quality situation. If the new water quality index for the impaired water is less than a certain number, remediation-likely in the form of total maximum daily loads or changing the management practices-may be needed. The index can be used to assess water quality for general beneficial uses. Nevertheless, the index cannot be used in making regulatory decisions, indicate water quality for specific beneficial uses, or indicate contamination from trace metals, organic contaminants, and toxic substances.

A novel, fuzzy-based air quality index (FAQI) for air quality assessment

NASA Astrophysics Data System (ADS)

Sowlat, Mohammad Hossein; Gharibi, Hamed; Yunesian, Masud; Tayefeh Mahmoudi, Maryam; Lotfi, Saeedeh

2011-04-01

The ever increasing level of air pollution in most areas of the world has led to development of a variety of air quality indices for estimation of health effects of air pollution, though the indices have their own limitations such as high levels of subjectivity. Present study, therefore, aimed at developing a novel, fuzzy-based air quality index (FAQI ) to handle such limitations. The index developed by present study is based on fuzzy logic that is considered as one of the most common computational methods of artificial intelligence. In addition to criteria air pollutants (i.e. CO, SO 2, PM 10, O 3, NO 2), benzene, toluene, ethylbenzene, xylene, and 1,3-butadiene were also taken into account in the index proposed, because of their considerable health effects. Different weighting factors were then assigned to each pollutant according to its priority. Trapezoidal membership functions were employed for classifications and the final index consisted of 72 inference rules. To assess the performance of the index, a case study was carried out employing air quality data at five different sampling stations in Tehran, Iran, from January 2008 to December 2009, results of which were then compared to the results obtained from USEPA air quality index (AQI). According to the results from present study, fuzzy-based air quality index is a comprehensive tool for classification of air quality and tends to produce accurate results. Therefore, it can be considered useful, reliable, and suitable for consideration by local authorities in air quality assessment and management schemes. Fuzzy-based air quality index (FAQI).

Perspectives of primary health care staff on the implementation of a sexual health quality improvement program: a qualitative study in remote aboriginal communities in Australia.

PubMed

Hengel, Belinda; Bell, Stephen; Garton, Linda; Ward, James; Rumbold, Alice; Taylor-Thomson, Debbie; Silver, Bronwyn; McGregor, Skye; Dyda, Amalie; Knox, Janet; Guy, Rebecca; Maher, Lisa; Kaldor, John Martin

2018-04-02

Young people living in remote Australian Aboriginal communities experience high rates of sexually transmissible infections (STIs). STRIVE (STIs in Remote communities, ImproVed and Enhanced primary care) was a cluster randomised control trial of a sexual health continuous quality improvement (CQI) program. As part of the trial, qualitative research was conducted to explore staff perceptions of the CQI components, their normalisation and integration into routine practice, and the factors which influenced these processes. In-depth semi-structured interviews were conducted with 41 clinical staff at 22 remote community clinics during 2011-2013. Normalisation process theory was used to frame the analysis of interview data and to provide insights into enablers and barriers to the integration and normalisation of the CQI program and its six specific components. Of the CQI components, participants reported that the clinical data reports had the highest degree of integration and normalisation. Action plan setting, the Systems Assessment Tool, and the STRIVE coordinator role, were perceived as adding value to the program, but were less readily integrated or normalised. The remaining two components (dedicated funding for health promotion and service incentive payments) were seen as least relevant. Our analysis also highlighted factors which enabled greater integration of the CQI components. These included familiarity with CQI tools, increased accountability of health centre staff and the translation of the CQI program into guideline-driven care. The analysis also identified barriers, including high staff turnover, limited time involved in the program and competing clinical demands and programs. Across all of the CQI components, the clinical data reports had the highest degree of integration and normalisation. The action plans, systems assessment tool and the STRIVE coordinator role all complemented the data reports and allowed these components to be translated directly into

Chartbook. Quality checkup.

PubMed

Hudson, T

1999-08-01

With hospital quality programs, the reach is broad, not deep. So says the National Hospital Quality Improvement Survey, conducted by health care researcher Stephen Shortell for Arthur Andersen and the American Hospital Association. Though 93 percent of responding hospitals and health systems use CQI and TQM methods is some fashion, they've taught them to only 35 percent of employees and a scant 22 percent of doctors on their medical staffs. Those poor showings leave health care lagging behind most other industries.

Improving the provision of pregnancy care for Aboriginal and Torres Strait Islander women: a continuous quality improvement initiative.

PubMed

Gibson-Helm, Melanie E; Rumbold, Alice R; Teede, Helena J; Ranasinha, Sanjeeva; Bailie, Ross S; Boyle, Jacqueline A

2016-05-24

Australian Aboriginal and Torres Strait Islander (Indigenous) women are at greater risk of adverse pregnancy outcomes than non-Indigenous women. Pregnancy care has a key role in identifying and addressing modifiable risk factors that contribute to adverse outcomes. We investigated whether participation in a continuous quality improvement (CQI) initiative was associated with increases in provision of recommended pregnancy care by primary health care centers (PHCs) in predominantly Indigenous communities, and whether provision of care was associated with organizational systems or characteristics. Longitudinal analysis of 2220 pregnancy care records from 50 PHCs involved in up to four cycles of CQI in Australia between 2007 and 2012. Linear and logistic regression analyses investigated associations between documented provision of pregnancy care and each CQI cycle, and self-ratings of organizational systems. Main outcome measures included screening and counselling for lifestyle-related risk factors. Women attending PHCs after ≥1 CQI cycles were more likely to receive each pregnancy care measure than women attending before PHCs had completed one cycle e.g. screening for cigarette use: baseline = 73 % (reference), cycle one = 90 % [odds ratio (OR):3.0, 95 % confidence interval (CI):2.2-4.1], two = 91 % (OR:5.1, 95 % CI:3.3-7.8), three = 93 % (OR:6.3, 95 % CI:3.1-13), four = 95 % (OR:11, 95 % CI:4.3-29). Greater self-ratings of overall organizational systems were significantly associated with greater screening for alcohol use (β = 6.8, 95 % CI:0.25-13), nutrition counselling (β = 8.3, 95 % CI:3.1-13), and folate prescription (β = 7.9, 95 % CI:2.6-13). Participation in a CQI initiative by PHCs in Indigenous communities is associated with greater provision of pregnancy care regarding lifestyle-related risk factors. More broadly, these findings support incorporation of CQI activities addressing systems level issues into primary care

Vendor management: a model for collaboration and quality improvement.

PubMed

Friedman, M D; Bailit, M H; Michel, J O

1995-11-01

The Massachusetts Medicaid agency, also known as the Division of Medical Assistance, has developed a quality-driven approach for managing its managed care suppliers. Such an approach has, as its foundation, principles of continuous quality improvement (CQI). Suppliers participate in an annual process whereby CQI goals are negotiated between the division and its suppliers. The division then works with suppliers to achieve such goals. A cornerstone of the division's approach is the notion that data can highlight an unlimited number of opportunities for improvement and that pursuit of such opportunities will ultimately result in meaningful improvements in the health status of recipients who are served by the division. The agency's approach involves five key steps: 1) the development of contractual terms and purchasing specifications; 2) the identification of improvement priorities; 3) the negotiation of improvement goals; 4) efforts directed at meeting improvement goals and measurement of success; and 5) collaboration to achieve mutual objectives. Overall, suppliers report many benefits of collaborative participation in CQI activities with the division. Suppliers have enhanced their understanding of the importance of meeting the needs of the customer and have further accrued benefits resulting from discussions with managed care vendors throughout the site regarding benchmarking of efforts and CQI efforts. Conversely, suppliers are challenged by the need to balance and allocate resources to meet increasing demands, which are not always consistent, from various purchasers, including the division. The division has been challenged in the evolution of its contract management strategy by an uneven level of knowledge among managed care vendors regarding CQI; goal setting and measurement issues; the length of time and level of effort required to develop good relationships with suppliers; and the critical importance of comparable, valid, and timely submission of data. Over the

Environmental Quality Index - Overview Report

EPA Science Inventory

A better estimate of overall environmental quality is needed to improve our understanding of the relationship between environmental conditions and humanhealth. Described in this report is the effort to construct an environmental quality index representing multiple domains of the ...

Environmental Quality Index webinar

EPA Pesticide Factsheets

Environmental Quality index, data reduction approaches to help improve statistical efficiency, summarizing information on the wider environment humans are exposed to. air, water, land, built, socio-demographic, human and environmental health

Hearing the voices of women in war through continuous quality improvement.

PubMed

Farrell, M; Farrell, J D

1998-04-01

During the war in Bosnia-Herzegovina (BIH), the infrastructure of the health care system was destroyed and health officials, health care providers, and women experienced the war from their own perspectives. Using the principles of continuous quality improvement (CQI), these perspectives were honored and served as the basis for an international training program to hear the voices of women in war and the concerns of those who cared for them. With the results of a comprehensive national survey of all partners, the World Health Organization's European Regional Office held a five-day workshop that used CQI methods. The facilitators and 18 nurses, midwives, and physicians from six cantons developed interventions to address the women's needs, as detailed from the women's stories and from the professional perspectives of governmental authorities and health providers. The effort illustrates the ways in which the principles and tools of CQI can be used to capture the needs of the users of the services with those responsible for restructuring the health service and those with overall responsibility for the health of woman throughout the country.

Design and implementation of an integrated, continuous evaluation, and quality improvement system for a state-based home-visiting program.

PubMed

McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R

2012-10-01

To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management

Perceptions of Community College Presidents: Total Quality Management Performance Measures at Their Colleges

ERIC Educational Resources Information Center

Riccardi, Mark T.

2009-01-01

Continuous Quality Improvement (CQI) measures such as Total Quality Management (TQM), Strategic Planning, Six Sigma, and the Balanced Scorecard are often met with skepticism among leaders of higher education. This study attempts to fill a gap in the literature regarding the study of relationships among specific variables, or building blocks,…

Chemical analyses in the World Coal Quality Inventory

USGS Publications Warehouse

Tewalt, Susan J.; Belkin, Harvey E.; SanFilipo, John R.; Merrill, Matthew D.; Palmer, Curtis A.; Warwick, Peter D.; Karlsen, Alexander W.; Finkelman, Robert B.; Park, Andy J.

2010-01-01

The main objective of the World Coal Quality Inventory (WoCQI) was to collect and analyze a global set of samples of mined coal during a time period from about 1995 to 2006 (Finkelman and Lovern, 2001). Coal samples were collected by foreign collaborators and submitted to country specialists in the U.S. Geological Survey (USGS) Energy Program. However, samples from certain countries, such as Afghanistan, India, and Kyrgyzstan, were collected collaboratively in the field with USGS personnel. Samples were subsequently analyzed at two laboratories: the USGS Inorganic Geochemistry Laboratory located in Denver, CO and a commercial laboratory (Geochemical Testing, Inc.) located in Somerset, PA. Thus the dataset, which is in Excel (2003) format and includes 1,580 samples from 57 countries, does not have the inter-laboratory variability that is present in many compilations. Major-, minor-, and trace-element analyses from the USGS laboratory, calculated to a consistent analytical basis (dry, whole-coal) and presented with available sample identification information, are sorted alphabetically by country name. About 70 percent of the samples also have data from the commercial laboratory, which are presented on an as-received analytical basis. The USGS initiated a laboratory review of quality assurance in 2008, covering quality control and methodology used in inorganic chemical analyses of coal, coal power plant ash, water, and sediment samples. This quality control review found that data generated by the USGS Inorganic Geochemistry Laboratory from 1996 through 2006 were characterized by quality practices that did not meet USGS requirements commonly in use at the time. The most serious shortcomings were (1) the adjustment of raw sample data to standards when the instrument values for those standards exceeded acceptable limits or (2) the insufficient use of multiple standards to provide adequate quality assurance. In general, adjustment of raw data to account for instrument

Quality index tables for some eastern hardwood species

Treesearch

Joseph J. Mendel; William H. Smith; William H. Smith

1970-01-01

This paper briefly reviews the quality-index concept, presents log-quality index tables for a selected group of eastern hardwood tree species, and explains how timber operators can use Q.I. for evaluating the lumber that can be sawed from logs and trees.

Continuous quality improvement in the ambulatory endoscopy center.

PubMed

Johanson, John F

2002-04-01

What does quality assessment have to do with the practicing gastroenterologist? Why should one spend the time and effort to incorporate CQI activities into an already busy practice? First and foremost, quality improvement should directly benefit the patient by ensuring that they receive the highest quality of care possible. For example, comparing endoscopic use or outcomes, such as procedure success or complications, with national standards or other endoscopists in the same community may identify physicians who could benefit from additional training. Similar analyses may likewise identify outstanding physicians who might serve as resources for other physicians. Surveys of patient satisfaction may reveal deficiencies, which might be unknown to a physician who is otherwise technically excellent; deficiencies that would never have been uncovered by traditional measures of quality. Second, applying the techniques of CQI to study one's own practice can provide a competitive edge when vying for managed care or corporate contracts. In this regard, CQI can be used to document physician or practice performance through tracking of endoscopic use, procedure success and complication rates, and patient satisfaction. Finally, the rising concern among various patient advocacy groups has led to an increased emphasis on quality improvement, and in most cases it is a required activity as part of the accreditation process. Steps to quality improvement There is more to quality improvement than simply selecting and implementing a performance improvement plan. A number of steps have been suggested to achieve fundamental improvement in the quality of medical care [3]. The first is to use outcomes management for improvement rather than for judgment. One of the major criticisms of QA is that it will be used to judge physicians providing care. It is feared that CQI will be used to identify poor performers who will then be punished. This strategy leads to fear and inhibits an honest pursuit

CQI: using the Hoshin planning system to design an orientation process.

PubMed

Platt, D; Laird, C

1995-01-01

The Hoshin planning system, developed in Japan after World War II, includes management tools intended specifically for planning new processes. There are seven tools, which can be used individually or in any combination: affinity diagrams, interrelationship digraphs, systematic diagrams, matrix diagrams, process decision program charts, arrow diagrams and prioritization matrices. The radiology department at Carson-Tahoe Hospital formed a CQI team to improve the training of front office clerks. The team quickly discovered that a new orientation program was needed and decided to use Hoshin tools to create one. Using the tools, the team identified and prioritized all relevant factors, described specific tasks needed to complete the planning process and how long each would take, anticipated problems, and assigned areas of responsibility to members of the team. Each time the team grew weary or discouraged, the clarity and organization afforded by the tools helped them feel productive and in control of the process. The team was amazed at the creative ideas they generated through this 3-month-long process. Not only did they develop and implement a new orientation program, they also cultivated a stronger sense of pride and confidence in their work and each other.

Can there be mutual support between hospital marketing and continuous quality improvement?

PubMed

Weiland, D E

1992-01-01

Marketing the results of continuous quality improvement in hospitals builds a growing bank of loyal customers in an increasingly competitive and quality-oriented environment: If healthcare institutions want to survive and flourish, they must develop a lasting relationship with their customers. The long-term goal of CQI is to provide quality products and services. If marketing managers can sell these improved services, hospitals will build a solid client foundation.

Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best Practice for Chronic Disease project

PubMed Central

2010-01-01

Background Experimentation with continuous quality improvement (CQI) processes is well underway in Indigenous Australian primary health care. To date, little research into how health organizations take up, support, and embed these complex innovations is available on which services can draw to inform implementation. In this paper, we examine the practices and processes in the policy and organisational contexts, and aim to explore the ways in which they interact to support and/or hinder services' participation in a large scale Indigenous primary health care CQI program. Methods We took a theory-driven approach, drawing on literature on the theory and effectiveness of CQI systems and the Greenhalgh diffusion of innovation framework. Data included routinely collected regional and service profile data; uptake of tools and progress through the first CQI cycle, and data collected quarterly from hub coordinators on their perceptions of barriers and enablers. A total of 48 interviews were also conducted with key people involved in the development, dissemination, and implementation of the Audit and Best Practice for Chronic Disease (ABCD) project. We compiled the various data, conducted thematic analyses, and developed an in-depth narrative account of the processes of uptake and diffusion into services. Results Uptake of CQI was a complex and messy process that happened in fits and starts, was often characterised by conflicts and tensions, and was iterative, reactive, and transformational. Despite initial enthusiasm, the mixed successes during the first cycle were associated with the interaction of features of the environment, the service, the quality improvement process, and the stakeholders, which operated to produce a set of circumstances that either inhibited or enabled the process of change. Organisations had different levels of capacity to mobilize resources that could shift the balance toward supporting implementation. Different forms of leadership and organisational

Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best Practice for Chronic Disease project.

PubMed

Gardner, Karen L; Dowden, Michelle; Togni, Samantha; Bailie, Ross

2010-03-13

Experimentation with continuous quality improvement (CQI) processes is well underway in Indigenous Australian primary health care. To date, little research into how health organizations take up, support, and embed these complex innovations is available on which services can draw to inform implementation. In this paper, we examine the practices and processes in the policy and organisational contexts, and aim to explore the ways in which they interact to support and/or hinder services' participation in a large scale Indigenous primary health care CQI program. We took a theory-driven approach, drawing on literature on the theory and effectiveness of CQI systems and the Greenhalgh diffusion of innovation framework. Data included routinely collected regional and service profile data; uptake of tools and progress through the first CQI cycle, and data collected quarterly from hub coordinators on their perceptions of barriers and enablers. A total of 48 interviews were also conducted with key people involved in the development, dissemination, and implementation of the Audit and Best Practice for Chronic Disease (ABCD) project. We compiled the various data, conducted thematic analyses, and developed an in-depth narrative account of the processes of uptake and diffusion into services. Uptake of CQI was a complex and messy process that happened in fits and starts, was often characterised by conflicts and tensions, and was iterative, reactive, and transformational. Despite initial enthusiasm, the mixed successes during the first cycle were associated with the interaction of features of the environment, the service, the quality improvement process, and the stakeholders, which operated to produce a set of circumstances that either inhibited or enabled the process of change. Organisations had different levels of capacity to mobilize resources that could shift the balance toward supporting implementation. Different forms of leadership and organisational linkages were critical to

EPA's Environmental Quality Index Supports Public Health

EPA Pesticide Factsheets

The Environmental Quality Index (EQI) pulls data from five domains: air, water, land, built, and sociodemographic environments to provide a county-by-county snapshot of overall environmental quality across the entire U.S.

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

PubMed

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

2016-04-01

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

The development of measures of organizational citizenship behaviour and changes in job behaviours related to quality management in health care.

PubMed

Irvine, D

1995-08-01

A study was conducted at two tertiary care hospitals in Canada for the purpose of developing instruments to measure organizational citizenship behaviours (OCB) and changes in job behaviours that occur as a result of participation on hospital quality improvement (CQI) teams. Semi structured interviews were conducted among 52 hospital employees in order to elicit critical incidents of OCB and changes in job behaviours related to CQI. The results of the staff interviews were used to develop a measure of OCB in the hospital setting, and a measure of changes in job behaviours related to CQI. 39 employees, who were drawn from the major departments within the two hospitals on the basis of their membership on CQI teams, participated in a test of the psychometric properties of the two research instruments. Exploratory factor analysis, employing an orthogonal rotation, yielded two factors that accounted for 30% of the variation among the OCB items. The Cronbach alpha for items loading highly on the first factor was .88. The factor was labelled 'OCB directed towards individuals within the organization'. This factor was dominated by items reflecting the kinds of extra-role job behaviours employees engage in to assist patients, family members, visitors, and other employees within the organization. The Cronbach alpha for items loading highly on the second factor was 0.71. The second factor was labelled 'organizationally directed OCB', and consisted of behaviours that reflected an impersonal form of OCB in the hospital setting. Factor analysis, employing an orthogonal rotation, yielded four factors that accounted for 48% of the variation among the items measuring changes in job behaviours related to CQI. The four factors were labelled 'problem-solving', Cronbach alpha 0.82; 'customer awareness', Cronbach alpha 0.79; 'use of CQI knowledge', Cronbach alpha 0.77; and 'organizational interests', Cronbach alpha 0.79. The two OCB factors were moderately correlated, there were no

Measuring organizational and individual factors thought to influence the success of quality improvement in primary care: a systematic review of instruments

PubMed Central

2012-01-01

Background Continuous quality improvement (CQI) methods are widely used in healthcare; however, the effectiveness of the methods is variable, and evidence about the extent to which contextual and other factors modify effects is limited. Investigating the relationship between these factors and CQI outcomes poses challenges for those evaluating CQI, among the most complex of which relate to the measurement of modifying factors. We aimed to provide guidance to support the selection of measurement instruments by systematically collating, categorising, and reviewing quantitative self-report instruments. Methods Data sources: We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments, reference lists of systematic reviews, and citations and references of the main report of instruments. Study selection: The scope of the review was determined by a conceptual framework developed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). Papers reporting development or use of an instrument measuring a construct encompassed by the framework were included. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarising and comparing instruments. Instrument content was categorised using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. Results We identified 186 potentially relevant instruments, 152 of which were analysed to develop the taxonomy. Eighty-four instruments measured constructs relevant to primary care, with content measuring CQI implementation and use (19 instruments), organizational context (51 instruments), and individual factors (21 instruments

Total quality management in the hospital setting.

PubMed

Ernst, D F

1994-01-01

With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.

Using Formative Student Feedback: A Continuous Quality Improvement Approach for Online Course Development

ERIC Educational Resources Information Center

Bloxham, Kristy Taylor

2010-01-01

The objective of this study was to examine the use of frequent, anonymous student course surveys as a tool in supporting continuous quality improvement (CQI) principles in online instruction. The study used a qualitative, multiple-case design involving four separate online courses. Analysis methods included pattern matching/explanation building,…

Improving maternal care with a continuous quality improvement strategy: a report from the Interventions to Minimize Preterm and Low Birth Weight Infants through Continuous Improvement Techniques (IMPLICIT) Network.

PubMed

Bennett, Ian M; Coco, Andrew; Anderson, Janice; Horst, Michael; Gambler, Angela S; Barr, Wendy Brooks; Ratcliffe, Stephen

2009-01-01

Maternal medical care (prenatal and postpartum) involves a set of clinical interventions addressing risk factors associated with important maternal and infant outcomes. Programs to increase the rate of delivery of these interventions in clinical practice have not been widely implemented. A practice-based research network focused on developing continuous quality improvement (CQI) processes for maternal care among 10 family medicine residency training sites in the northeastern United States (the IMPLICIT Network) from January 2003 through September 2007. Documented delivery of 5 standard maternal care interventions was assessed before and after initiating a program to increase their frequency. Proportion chart analyses were conducted comparing the period before and after implementation of the CQI interventions. Data were available for 3936 pregnancies during the course of the study period. Results varied across the clinical interventions. Significant improvement in care processes was seen for 3 screening activities: (1) prenatal depression symptomatology (by 15 weeks' gestation); (2) screening for smoking at 30 weeks' gestation; (3) and postpartum contraception planning. Screening for smoking by 15 weeks' gestation and testing for asymptomatic bacteriuria were already conducted >90% of the time during the baseline period and did not increase significantly after initiating the CQI program. Screening for postpartum depression symptomatology was recorded in 50% to 60% of women before the CQI program and did not increase significantly. A practice-based research network of family medicine residency practices focused on CQI outcomes was successful in increasing the delivery of some maternal care interventions.

The World Coal Quality Inventory: A status report

USGS Publications Warehouse

Tewalt, S.J.; Willett, J.C.; Finkelman, R.B.

2005-01-01

National and international policy makers and industry require accurate information on coal, including coal quality data, to make informed decisions regarding international import needs and export opportunities, foreign policy, technology transfer policies, foreign investment prospects, environmental and health assessments, and byproduct use and disposal issues. Unfortunately, the information needed is generally proprietary and does not exist in the public domain. The U.S. Geological Survey (USGS), in conjunction with partners in about 60 countries, is developing a digital compilation of worldwide coal quality. The World Coal Quality Inventory (WoCQI) will contain coal quality information for samples obtained from major coal beds in countries having significant coal production, as well as from many countries producing smaller volumes of coal, with an emphasis on coals currently being burned. The information that will be incorporated includes, but is not limited to, proximate and ultimate analyses; sulfur-form data; major, minor, and trace element analysis; and semi-quantitative analyses of minerals, modes of occurrence, and petrography. The coal quality information will eventually be linked to a Geographic Information System (GIS) that shows the coal basins and sample locations along with geologic, land use, transportation, industrial, and cultural information. The WoCQI will be accessible on the USGS web page and new data added periodically. This multi-national collaboration is developing global coal quality data that contain a broad array of technologic, economic, and environmental parameters, which should help to ensure the efficient and environmentally compatible use of global coal resources in the 21st century.

Quality control analytical methods: refractive index.

PubMed

Allen, Loyd V

2015-01-01

There are numerous analytical methods that can be utilized in a compounding pharmacy for a quality-assurance program. Since the index of refraction of a liquid/solution is a physical constant, it can be used to assist in identification of a substance, establish its purity, and, in some instances, to determine the concentration of an analyte in solution. This article serves as an introduction to refractive index and some applications of its use in a compounding program.

Lean management systems: creating a culture of continuous quality improvement.

PubMed

Clark, David M; Silvester, Kate; Knowles, Simon

2013-08-01

This is the first in a series of articles describing the application of Lean management systems to Laboratory Medicine. Lean is the term used to describe a principle-based continuous quality improvement (CQI) management system based on the Toyota production system (TPS) that has been evolving for over 70 years. Its origins go back much further and are heavily influenced by the work of W Edwards Deming and the scientific method that forms the basis of most quality management systems. Lean has two fundamental elements--a systematic approach to process improvement by removing waste in order to maximise value for the end-user of the service and a commitment to respect, challenge and develop the people who work within the service to create a culture of continuous improvement. Lean principles have been applied to a growing number of Healthcare systems throughout the world to improve the quality and cost-effectiveness of services for patients and a number of laboratories from all the pathology disciplines have used Lean to shorten turnaround times, improve quality (reduce errors) and improve productivity. Increasingly, models used to plan and implement large scale change in healthcare systems, including the National Health Service (NHS) change model, have evidence-based improvement methodologies (such as Lean CQI) as a core component. Consequently, a working knowledge of improvement methodology will be a core skill for Pathologists involved in leadership and management.

Chemical analyses of coal, coal-associated rocks and coal combustion products collected for the National Coal Quality Inventory

USGS Publications Warehouse

Hatch, Joseph R.; Bullock, John H.; Finkelman, Robert B.

2006-01-01

In 1999, the USGS initiated the National Coal Quality Inventory (NaCQI) project to address a need for quality information on coals that will be mined during the next 20-30 years. At the time this project was initiated, the publicly available USGS coal quality data was based on samples primarily collected and analyzed between 1973 and 1985. The primary objective of NaCQI was to create a database containing comprehensive, accurate and accessible chemical information on the quality of mined and prepared United States coals and their combustion byproducts. This objective was to be accomplished through maintaining the existing publicly available coal quality database, expanding the database through the acquisition of new samples from priority areas, and analysis of the samples using updated coal analytical chemistry procedures. Priorities for sampling include those areas where future sources of compliance coal are federally owned. This project was a cooperative effort between the U.S. Geological Survey (USGS), State geological surveys, universities, coal burning utilities, and the coal mining industry. Funding support came from the Electric Power Research Institute (EPRI) and the U.S. Department of Energy (DOE).

Quality index of radiological devices: results of one year of use.

PubMed

Tofani, Alessandro; Imbordino, Patrizia; Lecci, Antonio; Bonannini, Claudia; Del Corona, Alberto; Pizzi, Stefano

2003-01-01

The physical quality index (QI) of radiological devices summarises in a single numerical value between 0 and 1 the results of constancy tests. The aim of this paper is to illustrate the results of the use of such an index on all public radiological devices in the Livorno province over one year. The quality index was calculated for 82 radiological devices of a wide range of types by implementing its algorithm in a spreadsheet-based software for the automatic handling of quality control data. The distribution of quality index values was computed together with the associated statistical quantities. This distribution is strongly asymmetrical, with a sharp peak near the highest QI values. The mean quality index values for the different types of device show some inhomogeneity: in particular, mammography and panoramic dental radiography devices show far lower quality than other devices. In addition, our analysis has identified the parameters that most frequently do not pass the quality tests for each type of device. Finally, we sought some correlation between quality and age of the device, but this was poorly significant. The quality index proved to be a useful tool providing an overview of the physical conditions of radiological devices. By selecting adequate QI threshold values for, it also helps to decide whether a given device should be upgraded or replaced. The identification of critical parameters for each type of device may be used to improve the definition of the QI by attributing greater weights to critical parameters, so as to better address the maintenance of radiological devices.

Continuous quality improvement using intelligent infusion pump data analysis.

PubMed

Breland, Burnis D

2010-09-01

The use of continuous quality-improvement (CQI) processes in the implementation of intelligent infusion pumps in a community teaching hospital is described. After the decision was made to implement intelligent i.v. infusion pumps in a 413-bed, community teaching hospital, drug libraries for use in the safety software had to be created. Before drug libraries could be created, it was necessary to determine the epidemiology of medication use in various clinical care areas. Standardization of medication administration was performed through the CQI process, using practical knowledge of clinicians at the bedside and evidence-based drug safety parameters in the scientific literature. Post-implementation, CQI allowed refinement of clinically important safety limits while minimizing inappropriate, meaningless soft limit alerts on a few select agents. Assigning individual clinical care areas (CCAs) to individual patient care units facilitated customization of drug libraries and identification of specific CCA compliance concerns. Between June 2007 and June 2008, there were seven library updates. These involved drug additions and deletions, customization of individual CCAs, and alterations of limits. Overall compliance with safety software use rose over time, from 33% in November 2006 to over 98% in December 2009. Many potentially clinically significant dosing errors were intercepted by the safety software, prompting edits by end users. Only 4-6% of soft limit alerts resulted in edits. Compliance rates for use of infusion pump safety software varied among CCAs over time. Education, auditing, and refinement of drug libraries led to improved compliance in most CCAs.

A new plan quality index for nasopharyngeal cancer SIB IMRT.

PubMed

Jin, X; Yi, J; Zhou, Y; Yan, H; Han, C; Xie, C

2014-02-01

A new plan quality index integrating dosimetric and radiobiological indices was proposed to facilitate the evaluation and comparison of simultaneous integrated boost (SIB) intensity modulated radiotherapy (IMRT) plans for nasopharyngeal cancer (NPC) patients. Ten NPC patients treated by SIB-IMRT were enrolled in the study. Custom software was developed to read dose-volume histogram (DVH) curves from the treatment planning system (TPS). A plan filtering matrix was introduced to filter plans that fail to satisfy treatment protocol. Target plan quality indices and organ at risk (OAR) plan quality indices were calculated for qualified plans. A unique composite plan quality index (CPQI) was proposed based on the relative weight of these indices to evaluate and compare competing plans. Plan ranking results were compared with detailed statistical analysis, radiation oncology quality system (ROQS) scoring results and physician's evaluation results to verify the accuracy of this new plan quality index. The average CPQI values for plans with OAR priority of low, normal, high, and PTV only were 0.22 ± 0.08, 0.49 ± 0.077, 0.71 ± 0.062, and -0.21 ± 0.16, respectively. There were significant differences among these plan quality indices (One-way ANOVA test, p < 0.01). This was consistent with statistical analysis, ROQS results and physician's ranking results in which 90% OAR high plans were selected. Plan filtering matrix was able to speed up the plan evaluation process. The new matrix plan quality index CPQI showed good consistence with physician ranking results. It is a promising index for NPC SIB-IMRT plan evaluation. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Evaluating the effectiveness of a multifaceted, multilevel continuous quality improvement program in primary health care: developing a realist theory of change

PubMed Central

2013-01-01

Background Variation in effectiveness of continuous quality improvement (CQI) interventions between services is commonly reported, but with little explanation of how contextual and other factors may interact to produce this variation. Therefore, there is scant information available on which policy makers can draw to inform effective implementation in different settings. In this paper, we explore how patterns of change in delivery of services may have been achieved in a diverse range of health centers participating in a wide-scale program to achieve improvements in quality of care for Indigenous Australians. Methods We elicited key informants’ interpretations of factors explaining patterns of change in delivery of guideline-scheduled services over three or more years of a wide-scale CQI project, and inductively analyzed these interpretations to propose fine-grained realist hypotheses about what works for whom and in what circumstances. Data were derived from annual clinical audits from 36 health centers operating in diverse settings, quarterly project monitoring reports, and workshops with 12 key informants who had key roles in project implementation. We abstracted potential context-mechanism-outcome configurations from the data, and based on these, identified potential program-strengthening strategies. Results Several context-specific, mechanism-based explanations for effectiveness of this CQI project were identified. These were collective valuing of clinical data for improvement purposes; collective efficacy; and organizational change towards a population health orientation. Health centers with strong central management of CQI, and those in which CQI efforts were more dependent on local health center initiative and were adapted to resonate with local priorities were both favorable contexts for collective valuing of clinical data. Where health centers had prior positive experiences of collaboration, effects appeared to be achieved at least partly through the

Creating an Overall Environmental Quality Index - Technical Report

EPA Science Inventory

A better estimate of overall environmental quality is needed to improve our understanding of the relationship between environmental conditions and humanhealth. Described in this report is the effort to construct an environmental quality index representing multiple domains of the ...

Assessing air quality index awareness and use in Mexico City.

PubMed

Borbet, Timothy C; Gladson, Laura A; Cromar, Kevin R

2018-04-23

The Mexico City Metropolitan Area has an expansive urban population and a long history of air quality management challenges. Poor air quality has been associated with adverse pulmonary and cardiac health effects, particularly among susceptible populations with underlying disease. In addition to reducing pollution concentrations, risk communication efforts that inform behavior modification have the potential to reduce public health burdens associated with air pollution. This study investigates the utilization of Mexico's IMECA risk communication index to inform air pollution avoidance behavior among the general population living in the Mexico City Metropolitan Area. Individuals were selected via probability sampling and surveyed by phone about their air quality index knowledge, pollution concerns, and individual behaviors. The results indicated reasonably high awareness of the air quality index (53% of respondents), with greater awareness in urban areas, among older and more educated individuals, and for those who received air quality information from a healthcare provider. Additionally, behavior modification was less influenced by index reports as it was by personal perceptions of air quality, and there was no difference in behavior modification among susceptible and non-susceptible groups. Taken together, these results suggest there are opportunities to improve the public health impact of risk communication through an increased focus on susceptible populations and greater encouragement of public action in response to local air quality indices.

Continuous quality improvement interventions to improve long-term outcomes of antiretroviral therapy in women who initiated therapy during pregnancy or breastfeeding in the Democratic Republic of Congo: design of an open-label, parallel, group randomized trial.

PubMed

Yotebieng, Marcel; Behets, Frieda; Kawende, Bienvenu; Ravelomanana, Noro Lantoniaina Rosa; Tabala, Martine; Okitolonda, Emile W

2017-04-26

Despite the rapid adoption of the World Health Organization's 2013 guidelines, children continue to be infected with HIV perinatally because of sub-optimal adherence to the continuum of HIV care in maternal and child health (MCH) clinics. To achieve the UNAIDS goal of eliminating mother-to-child HIV transmission, multiple, adaptive interventions need to be implemented to improve adherence to the HIV continuum. The aim of this open label, parallel, group randomized trial is to evaluate the effectiveness of Continuous Quality Improvement (CQI) interventions implemented at facility and health district levels to improve retention in care and virological suppression through 24 months postpartum among pregnant and breastfeeding women receiving ART in MCH clinics in Kinshasa, Democratic Republic of Congo. Prior to randomization, the current monitoring and evaluation system will be strengthened to enable collection of high quality individual patient-level data necessary for timely indicators production and program outcomes monitoring to inform CQI interventions. Following randomization, in health districts randomized to CQI, quality improvement (QI) teams will be established at the district level and at MCH clinics level. For 18 months, QI teams will be brought together quarterly to identify key bottlenecks in the care delivery system using data from the monitoring system, develop an action plan to address those bottlenecks, and implement the action plan at the level of their district or clinics. If proven to be effective, CQI as designed here, could be scaled up rapidly in resource-scarce settings to accelerate progress towards the goal of an AIDS free generation. The protocol was retrospectively registered on February 7, 2017. ClinicalTrials.gov Identifier: NCT03048669 .

Environmental Quality Index - Overview Report | Science ...

EPA Pesticide Factsheets

A better estimate of overall environmental quality is needed to improve our understanding of the relationship between environmental conditions and humanhealth. Described in this report is the effort to construct an environmental quality index representing multiple domains of the ambient environment, includingair, water, land, built and sociodemographic for all counties in the U.S. for the time period including the years 2000-2005. The EQI was created for two mainpurposes: a.) as an indicator of ambient conditions/exposure in environmental health modeling and b.) as a covariate to adjust for ambient conditions inenvironmental models. However, as detailed in the discussion of this report, the EQI can be adapted and used for other objectives. The EQI was developedin four parts: domain identification; data source identification and review; variable construction; and data reduction. Each of these four areas represents achapter in the report where detailed information is provided on the development of the EQI. The methods applied provide a reproducible approach thatcapitalizes almost exclusively on publically-available data sources.This report is written as an overview to the companion technical document. A better estimate of overall environmental quality is needed to improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) was developed for all counties in the U.S. using indicators from the

Total quality index of Agaricus bisporus mushrooms packed in modified atmosphere.

PubMed

Djekic, Ilija; Vunduk, Jovana; Tomašević, Igor; Kozarski, Maja; Petrovic, Predrag; Niksic, Miomir; Pudja, Predrag; Klaus, Anita

2017-07-01

The aim of this study was to develop a total quality index and examine the effects of modified atmosphere packaging (MAP) on the quality of Agaricus bisporus mushrooms stored for 22 days at 4 °C. Mushrooms were packaged under three MAPs: high nitrogen packaging (HNP), low carbon dioxide packaging (LCP) and low oxygen packaging (LOP). Passive MAP with air inside initially was used as the atmosphere treatment (AIR). This research revealed two phases in quality deterioration of A. bisporus mushrooms. During the first week, most of the quality parameters were not statistically different. Thereafter, odor intensities were stronger for all four types of packaging. Color difference and browning index values showed significantly lower color changes for AIR and LOP compared with HNP and LCP mushrooms. The best total quality index was calculated for LOP, followed by LCP and AIR. The findings of this study are useful with respect to examining two-component MAPs, separating the limiting factors (O 2 and CO 2 ) and evaluating quality deterioration effects and the total quality index of A. bisporus mushrooms. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement.

PubMed

Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne

2015-01-01

This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.

A continuous quality improvement team approach to adverse drug reaction reporting.

PubMed

Flowers, P; Dzierba, S; Baker, O

1992-07-01

Crossfunctional teams can generate more new ideas, concepts, and possible solutions than does a department-based process alone. Working collaboratively can increase knowledge of teams using CQI approaches and appropriate tools. CQI produces growth and development at multiple levels resulting from involvement in the process of incremental improvement.

CUQI: cardiac ultrasound video quality index

PubMed Central

Razaak, Manzoor; Martini, Maria G.

2016-01-01

Abstract. Medical images and videos are now increasingly part of modern telecommunication applications, including telemedicinal applications, favored by advancements in video compression and communication technologies. Medical video quality evaluation is essential for modern applications since compression and transmission processes often compromise the video quality. Several state-of-the-art video quality metrics used for quality evaluation assess the perceptual quality of the video. For a medical video, assessing quality in terms of “diagnostic” value rather than “perceptual” quality is more important. We present a diagnostic-quality–oriented video quality metric for quality evaluation of cardiac ultrasound videos. Cardiac ultrasound videos are characterized by rapid repetitive cardiac motions and distinct structural information characteristics that are explored by the proposed metric. Cardiac ultrasound video quality index, the proposed metric, is a full reference metric and uses the motion and edge information of the cardiac ultrasound video to evaluate the video quality. The metric was evaluated for its performance in approximating the quality of cardiac ultrasound videos by testing its correlation with the subjective scores of medical experts. The results of our tests showed that the metric has high correlation with medical expert opinions and in several cases outperforms the state-of-the-art video quality metrics considered in our tests. PMID:27014715

Development of innovative computer software to facilitate the setup and computation of water quality index.

PubMed

Nabizadeh, Ramin; Valadi Amin, Maryam; Alimohammadi, Mahmood; Naddafi, Kazem; Mahvi, Amir Hossein; Yousefzadeh, Samira

2013-04-26

Developing a water quality index which is used to convert the water quality dataset into a single number is the most important task of most water quality monitoring programmes. As the water quality index setup is based on different local obstacles, it is not feasible to introduce a definite water quality index to reveal the water quality level. In this study, an innovative software application, the Iranian Water Quality Index Software (IWQIS), is presented in order to facilitate calculation of a water quality index based on dynamic weight factors, which will help users to compute the water quality index in cases where some parameters are missing from the datasets. A dataset containing 735 water samples of drinking water quality in different parts of the country was used to show the performance of this software using different criteria parameters. The software proved to be an efficient tool to facilitate the setup of water quality indices based on flexible use of variables and water quality databases.

[Continuous quality improvement in anesthesia].

PubMed

Gaitini, L; Vaida, S; Madgar, S

1998-01-01

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

Continuing quality improvement procedures for a clinical PACS.

PubMed

Andriole, K P; Gould, R G; Avrin, D E; Bazzill, T M; Yin, L; Arenson, R L

1998-08-01

The University of California at San Francisco (USCF) Department of Radiology currently has a clinically operational picture archiving and communication system (PACS) that is thirty-five percent filmless, with the goal of becoming seventy-five percent filmless within the year. The design and implementation of the clinical PACS has been a collaborative effort between an academic research laboratory and a commercial vendor partner. Images are digitally acquired from three computed radiography (CR) scanners, five computed tomography (CT) scanners, five magnetic resonance (MR) imagers, three digital fluoroscopic rooms, an ultrasound mini-PACS and a nuclear medicine mini-PACS. The DICOM (Digital Imaging and Communications in Medicine) standard communications protocol and image format is adhered to throughout the PACS. Images are archived in hierarchical staged fashion, on a RAID (redundant array of inexpensive disks) and on magneto-optical disk jukeboxes. The clinical PACS uses an object-oriented Oracle SQL (systems query language) database, and interfaces to the Radiology Information System using the HL7 (Health Languages 7) standard. Components are networked using a combination of switched and fast ethernet, and ATM (asynchronous transfer mode), all over fiber optics. The wide area network links six UCSF sites in San Francisco. A combination of high and medium resolution dual-monitor display stations have been placed throughout the Department of Radiology, the Emergency Department (ED) and Intensive Care Units (ICU). A continuing quality improvement (CQI) committee has been formed to facilitate the PACS installation and training, workflow modifications, quality assurance and clinical acceptance. This committee includes radiologists at all levels (resident, fellow, attending), radiology technologists, film library personnel, ED and ICU clinician end-users, and PACS team members. The CQI committee has proved vital in the creation of new management procedures, providing a

Looking at prescription quality in Ayurveda: Developing, validating and pilot testing a prescription quality index for Ayurveda.

PubMed

Rastogi, Sanjeev

2017-11-06

Prescription quality can be a direct predictor of the net outcome of a health care delivery effort. Quality of prescription may be considered as a cumulative matrix of multiple components of a prescription on the basis of their relative importance. Prescription quality index is a recognized tool in clinical medicine for multiple purposes including the prediction of health care intervention outcome. Considering the importance of prescription quality among every system of medicine, an attempt was made to design a prescription quality index for Ayurveda. The Prescription Quality Index for Ayurveda was designed through item selection following a thorough literature search and was validated through multiple peer group discussions. Final draft of index containing 38 individual items carrying different scores as per their importance in the prescription was subjected to a pilot test upon 1576 indoor prescriptions generated in 2015 at State Ayurvedic College Hospital, Lucknow. The study revealed large information gaps in the components of the prescription where it was supposed to be noted by the prescribers. These gaps in the Ayurvedic prescriptions were most significant in the areas pertaining to Ayurvedic fundamentals of clinical examination, disease diagnosis and Ayurvedic drug intake methods. Prescription Quality Index for Ayurveda was found useful in underlining the gaps between the ideal and generated prescriptions. This can be utilized as a useful tool to evaluate the quality of Ayurvedic prescriptions by seeing their adherence to the standard prescription template. Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

Development of a Dietary Index to Assess Overall Diet Quality for Chinese School-Aged Children: The Chinese Children Dietary Index.

PubMed

Cheng, Guo; Duan, Ruonan; Kranz, Sibylle; Libuda, Lars; Zhang, Lishi

2016-04-01

A composite measure of diet quality is preferable to an index of nutrients, food groups, or health-promoting behaviors in dietary assessment. However, to date, such a tool for Chinese children is lacking. Based on the current Chinese Dietary Guidelines and Dietary Reference Intakes, a dietary index for Chinese school-aged children, the Chinese Children Dietary Index was developed to assess overall diet quality among children in South China. Dietary data were recorded using 24-hour recalls among 1,719 children aged 7 to 15 years between March and June 2013. Inactivity data and sociodemographic information were also collected. The Chinese Children Dietary Index included 16 components, which incorporated nutrients, foods/food groups, and health-promoting behaviors. The range of possible Chinese Children Dietary Index scores was 0 to 160, with a higher score indicating better diet quality. Pearson/Spearman correlation was used to assess relative validity using correlations between total Chinese Children Dietary Index score and age, body mass index (BMI; calculated as kg/m(2)), inactivity, whole-grain intake, frequency of fried-foods intake, nutrient adequacy ratios for energy intake and 12 nutrients not included in the Chinese Children Dietary Index, and the mean adequacy ratio. Finally, a stepwise multiple regression analysis was performed to indicate the factors correlated with Chinese Children Dietary Index. Mean Chinese Children Dietary Index score of this sample was 88.1 points (range=34.2 to 137.8), the Chinese Children Dietary Index score of girls was higher than that of boys and decreased with higher age. Children with higher Chinese Children Dietary Index had lower body mass index and spent less time being inactive. Positive associations were observed between Chinese Children Dietary Index and the majority of nutrient adequacy ratios and the mean adequacy ratio. Age, paternal educational level, and family size were correlated with Chinese Children Dietary

Informatics: essential infrastructure for quality assessment and improvement in nursing.

PubMed Central

Henry, S B

1995-01-01

In recent decades there have been major advances in the creation and implementation of information technologies and in the development of measures of health care quality. The premise of this article is that informatics provides essential infrastructure for quality assessment and improvement in nursing. In this context, the term quality assessment and improvement comprises both short-term processes such as continuous quality improvement (CQI) and long-term outcomes management. This premise is supported by 1) presentation of a historical perspective on quality assessment and improvement; 2) delineation of the types of data required for quality assessment and improvement; and 3) description of the current and potential uses of information technology in the acquisition, storage, transformation, and presentation of quality data, information, and knowledge. PMID:7614118

Development of innovative computer software to facilitate the setup and computation of water quality index

PubMed Central

2013-01-01

Background Developing a water quality index which is used to convert the water quality dataset into a single number is the most important task of most water quality monitoring programmes. As the water quality index setup is based on different local obstacles, it is not feasible to introduce a definite water quality index to reveal the water quality level. Findings In this study, an innovative software application, the Iranian Water Quality Index Software (IWQIS), is presented in order to facilitate calculation of a water quality index based on dynamic weight factors, which will help users to compute the water quality index in cases where some parameters are missing from the datasets. Conclusion A dataset containing 735 water samples of drinking water quality in different parts of the country was used to show the performance of this software using different criteria parameters. The software proved to be an efficient tool to facilitate the setup of water quality indices based on flexible use of variables and water quality databases. PMID:24499556

Tradeoffs between Price and Quality: How a Value Index Affects Preference Formation.

ERIC Educational Resources Information Center

Creyer, Elizabeth H.; Ross, William T., Jr.

1997-01-01

Some of a group of 143 consumers were given a choice between higher-priced, higher-quality items and items with lower price and quality but higher value index (benefit/cost tradeoff); others were given price and quality information only. Consumers were more likely to choose lower-priced, higher-value options when the index information was…

Building an Evidence-Driven Child Welfare Workforce: A University-Agency Partnership

ERIC Educational Resources Information Center

Lery, Bridgette; Wiegmann, Wendy; Berrick, Jill Duerr

2015-01-01

The federal government increasingly expects child welfare systems to be more responsive to the needs of their local populations, connect strategies to results, and use continuous quality improvement (CQI) to accomplish these goals. A method for improving decision making, CQI relies on an inflow of high-quality data, up-to-date research evidence,…

Indexing the Environmental Quality Performance Based on A Fuzzy Inference Approach

NASA Astrophysics Data System (ADS)

Iswari, Lizda

2018-03-01

Environmental performance strongly deals with the quality of human life. In Indonesia, this performance is quantified through Environmental Quality Index (EQI) which consists of three indicators, i.e. river quality index, air quality index, and coverage of land cover. The current of this instrument data processing was done by averaging and weighting each index to represent the EQI at the provincial level. However, we found EQI interpretations that may contain some uncertainties and have a range of circumstances possibly less appropriate if processed under a common statistical approach. In this research, we aim to manage the indicators of EQI with a more intuitive computation technique and make some inferences related to the environmental performance in 33 provinces in Indonesia. Research was conducted in three stages of Mamdani Fuzzy Inference System (MAFIS), i.e. fuzzification, data inference, and defuzzification. Data input consists of 10 environmental parameters and the output is an index of Environmental Quality Performance (EQP). Research was applied to the environmental condition data set in 2015 and quantified the results into the scale of 0 to 100, i.e. 10 provinces at good performance with the EQP above 80 dominated by provinces in eastern part of Indonesia, 22 provinces with the EQP between 80 to 50, and one province in Java Island with the EQP below 20. This research shows that environmental quality performance can be quantified without eliminating the natures of the data set and simultaneously is able to show the environment behavior along with its spatial pattern distribution.

Quantification of sensory and food quality: the R-index analysis.

PubMed

Lee, Hye-Seong; van Hout, Danielle

2009-08-01

The accurate quantification of sensory difference/similarity between foods, as well as consumer acceptance/preference and concepts, is greatly needed to optimize and maintain food quality. The R-Index is one class of measures of the degree of difference/similarity, and was originally developed for sensory difference tests for food quality control, product development, and so on. The index is based on signal detection theory and is free of the response bias that can invalidate difference testing protocols, including categorization and same-different and A-Not A tests. It is also a nonparametric analysis, making no assumptions about sensory distributions, and is simple to compute and understand. The R-Index is also flexible in its application. Methods based on R-Index analysis have been used as detection and sensory difference tests, as simple alternatives to hedonic scaling, and for the measurement of consumer concepts. This review indicates the various computational strategies for the R-Index and its practical applications to consumer and sensory measurements in food science.

Use of remote sensing and GIS in mapping the environmental sensitivity areas for desertification of Egyptian territory

NASA Astrophysics Data System (ADS)

Gad, A.; Lotfy, I.

2008-06-01

Desertification is defined in the first art of the convention to combat desertification as "land degradation in arid, semiarid and dry sub-humid areas resulting from climatic variations and human activities". Its consequence include a set of important processes which are active in arid and semi arid environment, where water is the main limiting factor of land use performance in such ecosystem . Desertification indicators or the groups of associated indicators should be focused on a single process. They should be based on available reliable information sources, including remotely sensed images, topographic data (maps or DEM'S), climate, soils and geological data. The current work aims to map the Environmental Sensitivity Areas (ESA's) to desertification in whole territory of Egypt at a scale of 1:1 000 000. ETM satellite images, geologic and soil maps were used as main sources for calculating the index of Environmental Sensitivity Areas (ESAI) for desertification. The algorism is adopted from MEDALLUS methodology as follows; ESAI = (SQI * CQI * VQI)1/3 Where SQI is the soil quality index, CQI is the climate quality index and VQI is the vegetation quality index. The SQI is based on rating the parent material, slope, soil texture, and soil depth. The VQI is computed on bases of rating three categories (i.e. erosion protection, drought resistance and plant cover). The CQI is based on the aridity index, derived from values of annual rainfall and potential evapotranspiration. Arc-GIS 9 software was used for the computation and sensitivity maps production. The results show that the soil of the Nile Valley are characterized by a moderate SQI, however the those in the interference zone are low soil quality indexed. The dense vegetation of the valley has raised its VQI to be good, however coastal areas are average and interference zones are low. The maps of ESA's for desertification show that 86.1% of Egyptian territory is classified as very sensitive areas, while 4.3% as

Development of Water Quality Index for the United States: A Sensitivity Analysis

EPA Science Inventory

Background: Water quality is quantified using several measures, available from various data sources, which can be combined to create a single index of overall water quality. It is necessary to identify appropriate variables to include in an index which could be used for health re...

Evaluation of Shiraz wastewater treatment plant effluent quality for agricultural irrigation by Canadian Water Quality Index (CWQI)

PubMed Central

2013-01-01

Background Using treated wastewater in agriculture irrigation could be a realistic solution for the shortage of fresh water in Iran, however, it is associated with environmental and health threats; therefore, effluent quality assessment is quite necessary before use. The present study aimed to evaluate the physicochemical and microbial quality of Shiraz wastewater treatment plant effluent for being used in agricultural irrigation. In this study, 20 physicochemical and 3 microbial parameters were measured during warm (April to September) and cold months (October to march). Using the measured parameters and the Canadian Water Quality Index, the quality of the effluent was determined in both warm and cold seasons and in all the seasons together. Results The calculated index for the physicochemical parameters in the effluent was equal (87) in warm and cold months and it was obtained as 85 for the seasons all together. When the microbial parameters were used in order to calculate the index, it declined to 67 in warm and cold seasons and 64 in all the seasons together. Also, it was found that three physicochemical parameters (TDS, EC, and NO3) and three microbial parameters (Fecal coliform, Helminthes egg, and Total coliform) had the most contribution to the reduction of the index value. Conclusions The results showed that the physicochemical quality of Shiraz Wastewater Treatment Plant Effluent was good for irrigation in the warm, cold, and total of the two kinds of seasons. However, by applying the microbial parameter, the index value declined dramatically and the quality of the effluent was marginal. PMID:23566673

Introduction of a quality improvement program in a children's hospital in Tehran: design, implementation, evaluation and lessons learned.

PubMed

Mohammadi, S Mehrdad; Mohammadi, S Farzad; Hedges, Jerris R; Zohrabi, Morteza; Ameli, Omid

2007-08-01

Reports addressing continuous quality improvement (CQI) methods in developing countries are scant and there are questions about the applicability of quality improvement methods in such settings. The structure and output of a formal quality improvement program implemented in a teaching hospital affiliated with the Tehran University of Medical Sciences is presented. OBJECTIVE METHOD: During a nine-month period, a multi-stage quality improvement program was implemented. It comprised: (i) training workshops; (ii) a steering committee; (iii) weekly consultation and facilitation of improvement projects; and (iv) a day-long demonstration and recognition meeting. Four cycles of workshops were held in which 132 employees were trained in the basics of CQI. Thirty improvement projects were initiated. Twenty-five of the projects were completed. In an evaluation survey more than 70% of respondents assessed a 'positive impact' on organizational culture, work efficiency and quality of services. More than 90% believed that the changes were sustained, and more than 60% reported that they have implemented additional improvement projects. Our quality improvement package supported rapid implementation of multiple projects. The underlying 'change structure' comprised the improvement teams, top management and the university's quality improvement office; it integrated project management, support and facilitation functions by the respective participant. Organization-wide change was more limited than anticipated. To institutionalize the program and ensure sustainability, a local structure for change should be organized, management coaching should be sustained, local facilitators should be developed, incentives should be established and physician involvement should be emphasized.

Relevance of water quality index for groundwater quality evaluation: Thoothukudi District, Tamil Nadu, India

NASA Astrophysics Data System (ADS)

Singaraja, C.

2017-09-01

The present hydrogeochemical study was confined to the Thoothukudi District in Tamilnadu, India. A total of 100 representative water samples were collected during pre-monsoon and post-monsoon and analyzed for the major cations (sodium, calcium, magnesium and potassium) and anions (chloride, sulfate, bicarbonate, fluoride and nitrate) along with various physical and chemical parameters (pH, total dissolved salts and electrical conductivity). Water quality index rating was calculated to quantify the overall water quality for human consumption. The PRM samples exhibit poor quality in greater percentage when compared with POM due to dilution of ions and agricultural impact. The overlay of WQI with chloride and EC corresponds to the same locations indicating the poor quality of groundwater in the study area. Sodium (Na %), sodium absorption ratio (SAR), residual sodium carbonate (RSC), residual sodium bicarbonate, permeability index (PI), magnesium hazards (MH), Kelly's ratio (KR), potential salinity (PS) and Puri's salt index (PSI) and domestic quality parameters such as total hardness (TH), temporary, permanent hardness and corrosivity ratio (CR) were calculated. The majority of the samples were not suitable for drinking, irrigation and domestic purposes in the study area. In this study, the analysis of salinization/freshening processes was carried out through binary diagrams such as of mole ratios of {SO}_{ 4}^{ 2- } /Cl- and Cl-/EC that clearly classify the sources of seawater intrusion and saltpan contamination. Spatial diagram BEX was used to find whether the aquifer was in the salinization region or in the freshening encroachment region.

National Wildlife's Eleventh Annual Environmental Quality Index 1980.

ERIC Educational Resources Information Center

National Wildlife, 1980

1980-01-01

Presented is the Eleventh Annual Environmental Quality Index, a subjective analysis of the state of the nation's natural resources. Resource trends are detailed for wildlife, minerals, air, water, soil living space, and forests. (BT)

The World Coal Quality Inventory: South America

USGS Publications Warehouse

Karlsen, Alex W.; Tewalt, Susan J.; Bragg, Linda J.; Finkelman, Robert B.

2006-01-01

Executive Summary-Introduction: The concepts of a global environment and economy are strongly and irrevocably linked to global energy issues. Worldwide coal production and international coal trade are projected to increase during the next several decades in an international energy mix that is still strongly dependent on fossil fuels. Therefore, worldwide coal use will play an increasingly visible role in global environmental, economic, and energy forums. Policy makers require information on coal, including coal quality data, to make informed decisions regarding domestic coal resource allocation, import needs and export opportunities, foreign policy objectives, technology transfer policies, foreign investment prospects, environmental and health assessments, and byproduct use and disposal issues. The development of a worldwide, reliable, coal quality database would help ensure the most economically and environmentally efficient global use of coal. The U.S. Geological Survey (USGS), in cooperation with many agencies and scientists from the world's coal producing countries, originally undertook a project to obtain representative samples of coal from most of the world's producing coal provinces during a limited period of time (roughly 1998-2005), which is called the World Coal Quality Inventory (WoCQI). The multitude of producing coal mines, coal occurrences, or limited accessibility to sites in some countries can preclude collecting more than a single sample from a mine. In some areas, a single sample may represent an entire coal mining region or basin. Despite these limitations in sampling and uneven distribution of sample collection, the analytical results can still provide a general overview of world coal quality. The USGS intends to present the WoCQI data in reports and, when possible, in Geographic Information System (GIS) products that cover important coal bearing and producing regions.

Total quality index of ultrasound-treated blueberry and cranberry juices and nectars.

PubMed

Režek Jambrak, Anet; Šimunek, Marina; Djekic, Ilija

2018-01-01

The influence of ultrasound in combination with elevated temperature (thermosonication) is important in inactivation effects on microorganisms. However, overall quality of these products can be deteriorated. The aim of this study was to examine the use of a single quality index in evaluating effects of ultrasound technology on quality characteristics of blueberry and cranberry juices and nectars. For the purpose of this study based on 10 quality parameters, two mathematical models for calculating a single total quality index have been introduced. Samples were treated according to the experimental design, with high power ultrasound frequency of 20 kHz under various conditions (treatment time: 3, 6 and 9 min, sample temperature: 20 ℃, for thermosonication: 40 and 60 ℃ and amplitude: 60, 90 and 120 µm). Mathematical index of total quality index in order to evaluate total quality of ultrasound-treated juices and nectars was established. For cranberry juices, treatments '11' (amplitude 120 µm) and '16' (amplitude 60 µm) both for 9 min and the temperature of 20 ℃ were best scored for both models. Treatment '6' (amplitude 120 µm, 3 min treatment time and the sample temperature of 20 ℃) for cranberry nectars was among the best for both models. Ultrasound treatments '6' of amplitude 120 µm, 3 min and the temperature of 20 ℃ and '11' same amplitude 120 µm and temperature, but 9 min were best scored blueberry juices for both models. Blueberry nectar had best total quality index for treatments '5' (amplitude 120 µm, 6 min treatment time and the sample temperature of 40 ℃) and '6' (amplitude 120 µm, 3 min treatment time and the sample temperature of 20 ℃).

Subscribing to Databases: How Important Is Depth and Quality of Indexing?

ERIC Educational Resources Information Center

Delong, Linwood

2007-01-01

This paper compares the subject indexing on articles pertaining to Immanuel Kant, agriculture, and aging that are found simultaneously in Humanities Index, Academic Search Elite (EBSCO) and Periodicals Research II (Micromedia ProQuest), in order to show that there are substantial variations in the depth and quality of indexing in these databases.…

Measuring team factors thought to influence the success of quality improvement in primary care: a systematic review of instruments

PubMed Central

2013-01-01

Background Measuring team factors in evaluations of Continuous Quality Improvement (CQI) may provide important information for enhancing CQI processes and outcomes; however, the large number of potentially relevant factors and associated measurement instruments makes inclusion of such measures challenging. This review aims to provide guidance on the selection of instruments for measuring team-level factors by systematically collating, categorizing, and reviewing quantitative self-report instruments. Methods Data sources: We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments; reference lists of systematic reviews; and citations and references of the main report of instruments. Study selection: To determine the scope of the review, we developed and used a conceptual framework designed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). We included papers reporting development or use of an instrument measuring factors relevant to teamwork. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarizing and comparing instruments. Instrument content was categorized using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. Results We identified 192 potentially relevant instruments, 170 of which were analyzed to develop the taxonomy. Eighty-one instruments measured constructs relevant to CQI teams in primary care, with content covering teamwork context (45 instruments measured enabling conditions or attitudes to teamwork), team process (57 instruments measured teamwork behaviors), and team outcomes (59 instruments measured perceptions of the team or

Temporal and spatial distribution characteristics and influencing factors of air quality index in Xuchang

NASA Astrophysics Data System (ADS)

Wang, Zhenghua; Tian, Zhihui

2018-01-01

In recent years, the problem of air pollution becomes more and more serious. Based on the geographic and seasonal climatic characteristics of Xuchang City, this paper studies the temporal and spatial distribution characteristics of air quality index. The results show that: from the time point of view, air quality index shows seasonal difference. Air quality index is highest in winter and is lowest in summer. From the space point of view, there are differences between the north and the south to a certain extent. Changge City, Yuzhou city and central Xuchang county is higher than the southeast of Xiangcheng county and Yanling county. The spatial and temporal variation characteristics of air quality index in Xuchang are influenced by natural factors and human activities, and the economic development and population are the important factors affecting the urban air quality.

Construction of an environmental quality index for public health research

EPA Science Inventory

A more comprehensive estimate of environmental quality would improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) for all counties in the U.S. was developed. The EQI was developed in four parts: doma...

Evaluation of water quality index for River Sabarmati, Gujarat, India

NASA Astrophysics Data System (ADS)

Shah, Kosha A.; Joshi, Geeta S.

2017-06-01

An attempt has been made to develop water quality index (WQI), using six water quality parameters pH, dissolved oxygen, biochemical oxygen demand, electrical conductivity, nitrate nitrogen and total coliform measured at three different stations along the Sabarmati river basin from the year 2005 to 2008. Rating scale is developed based on the tolerance limits of inland waters and health point of view. Weighted arithmetic water quality index method was used to find WQI along the stretch of the river basin. It was observed from this study that the impact of human activity and sewage disposal in the river was severe on most of the parameters. The station located in highly urban area showed the worst water quality followed by the station located in moderately urban area and lastly station located in a moderately rural area. It was observed that the main cause of deterioration in water quality was due to the high anthropogenic activities, illegal discharge of sewage and industrial effluent, lack of proper sanitation, unprotected river sites and urban runoff.

Measuring patients' experiences with rheumatic care: the consumer quality index rheumatoid arthritis.

PubMed

Zuidgeest, Marloes; Sixma, Herman; Rademakers, Jany

2009-12-01

Rheumatologists and other caregivers can learn from patients’ experiences with the quality of care that can be measured with the CQ-index Rheumatoid Arthritis (CQ-index RA) survey. Patients with RA (n = 590) received this survey were they rated their actual experiences and what they find important in rheumatic healthcare. Descriptive analyses and psychometric methods were used to test the reliability. The response rate was 69%. The items in the pilot instrument could be grouped into 10 scales (α ranged from 0.77 to 0.94). The most important quality aspects according to patients concerned the alertness when prescribing medication. Providing patients with information on a special website of the hospital about RA was the highest quality improvement aspect. The results of this study show that the CQ-index RA is a reliable instrument for quality assessment from the patients’ perspective. The instrument provides rheumatologists and other caregivers with feedback for service improvement initiatives.

Mapping Air Quality Index of Carbon Monoxide (CO) in Medan City

NASA Astrophysics Data System (ADS)

Suryati, I.; Khair, H.

2017-03-01

This study aims to map and analyze air quality index of carbon monoxide (CO) in Medan City. This research used 12 (twelve) sampling points around in Medan with an hour duration each point. CO concentration was analyzed using the NDIR CO Analyzer sampling tool. The concentration CO was obtained between 1 ppm - 23 ppm, with an average concentration was 9.5 ppm. This condition is still below the national ambient air quality standard set by Government Regulation of Indonesian Republic Number 41-1999 amounted to 29 ppm. The result of CO concentration measurements was converted into air pollutant standard index, obtained the index value of 58 - 204. Surfer 10 was used to create map of air pollutant standard index for CO. The map illustrates very unhealthy area where located in the Medan Belawan district. The main factors affecting the concentration of CO are from transportation and meteorological factors.

The Assessment of Mangrove Sediment Quality in Mengkabong Lagoon: An Index Analysis Approach

ERIC Educational Resources Information Center

Praveena, Sarva M.; Radojevic, Miroslav; Abdullah, Mohd H.

2007-01-01

The objectives of this study are to use different types of indexes to assess the current pollution status in Mengkabong lagoon and select the best index to describe the Mengkabong sediment quality. The indexes used in this study were Enrichment Factor (EF), Geo-accumulation Index (Igeo), Pollution Load Index (PLI) and Marine Sediment Pollution…

Development of a Diet Quality Index Adapted for Pregnant Women

PubMed Central

Crivellenti, Lívia Castro; Zuccolotto, Daniela Cristina Candelas; Sartorelli, Daniela Saes

2018-01-01

ABSTRACT OBJECTIVE: To develop a Diet Quality Index Adapted for Pregnant Women (IQDAG) and to evaluate its relation with the characteristics of women treated at the Brazilian Unified Health System. METHODS: The data on food intake come from a cross-sectional study carried out with 785 adult pregnant women in the city of Ribeirão Preto, state of São Paulo, Brazil, between 2011 and 2012. The index was based on the recommendations of the Brazilian Ministry of Health, previous national dietary indexes, and the new Dietary Guidelines for the Brazilian Population. We used the ANOVA, Kruskal-Wallis, and chi-square tests to describe the quality of the diet according to the characteristics of the mother. RESULTS: The IQDAG has nine components, and it is represented by three food groups (in servings/1,000 kcal), five nutrients, and a moderator component. A high proportion of pregnant women reached the maximum score for the components of legumes and vegetables. However, few women reached the maximum score for consumption of fresh fruits, fiber, omega-3, calcium, folate, iron, and ultra-processed foods. We verified a better quality of diet among older and eutrophic pregnant women who reported practicing more physical activity and taking dietary supplements. We also observed the highest index score among women with higher intake of carbohydrates, proteins, vitamins C, E, and A, and minerals calcium, folate, and iron, as well as among those with lower intake of total fats and saturated fats. CONCLUSIONS: This dietary index is unprecedented in incorporating the recommendation of the new Dietary Guidelines for the Brazilian Population regarding the moderation of the consumption of ultra-processed foods. It was useful in evaluating the quality of the diet of pregnant women and we verified a higher score among older and eutrophic women who reported a healthy lifestyle. Strategies are needed to promote a higher consumption of fresh fruits, foods high in fiber, omega-3, calcium

U.S. EPA Environmental Quality Index - Air Domain

EPA Science Inventory

This is an invited presentation by Region 5, Air Office, who asked me to provide an overview of the Air Domain and health results associated with the Air Domain of the Environmental Quality Index. Region 5 is hosting an Air Toxics meeting for its member states (Ohio, Michigan, I...

Heuristic Model Of The Composite Quality Index Of Environmental Assessment

NASA Astrophysics Data System (ADS)

Khabarov, A. N.; Knyaginin, A. A.; Bondarenko, D. V.; Shepet, I. P.; Korolkova, L. N.

2017-01-01

The goal of the paper is to present the heuristic model of the composite environmental quality index based on the integrated application of the elements of utility theory, multidimensional scaling, expert evaluation and decision-making. The composite index is synthesized in linear-quadratic form, it provides higher adequacy of the results of the assessment preferences of experts and decision-makers.

A brachytherapy photon radiation quality index Q(BT) for probe-type dosimetry.

PubMed

Quast, Ulrich; Kaulich, Theodor W; Álvarez-Romero, José T; Carlsson Tedgren, Sa; Enger, Shirin A; Medich, David C; Mourtada, Firas; Perez-Calatayud, Jose; Rivard, Mark J; Zakaria, G Abu

2016-06-01

In photon brachytherapy (BT), experimental dosimetry is needed to verify treatment plans if planning algorithms neglect varying attenuation, absorption or scattering conditions. The detector's response is energy dependent, including the detector material to water dose ratio and the intrinsic mechanisms. The local mean photon energy E¯(r) must be known or another equivalent energy quality parameter used. We propose the brachytherapy photon radiation quality indexQ(BT)(E¯), to characterize the photon radiation quality in view of measurements of distributions of the absorbed dose to water, Dw, around BT sources. While the external photon beam radiotherapy (EBRT) radiation quality index Q(EBRT)(E¯)=TPR10(20)(E¯) is not applicable to BT, the authors have applied a novel energy dependent parameter, called brachytherapy photon radiation quality index, defined as Q(BT)(E¯)=Dprim(r=2cm,θ0=90°)/Dprim(r0=1cm,θ0=90°), utilizing precise primary absorbed dose data, Dprim, from source reference databases, without additional MC-calculations. For BT photon sources used clinically, Q(BT)(E¯) enables to determine the effective mean linear attenuation coefficient μ¯(E) and thus the effective energy of the primary photons Eprim(eff)(r0,θ0) at the TG-43 reference position Pref(r0=1cm,θ0=90°), being close to the mean total photon energy E¯tot(r0,θ0). If one has calibrated detectors, published E¯tot(r) and the BT radiation quality correction factor [Formula: see text] for different BT radiation qualities Q and Q0, the detector's response can be determined and Dw(r,θ) measured in the vicinity of BT photon sources. This novel brachytherapy photon radiation quality indexQ(BT) characterizes sufficiently accurate and precise the primary photon's penetration probability and scattering potential. Copyright © 2016. Published by Elsevier Ltd.

Systematic review of the application of quality improvement methodologies from the manufacturing industry to surgical healthcare.

PubMed

Nicolay, C R; Purkayastha, S; Greenhalgh, A; Benn, J; Chaturvedi, S; Phillips, N; Darzi, A

2012-03-01

The demand for the highest-quality patient care coupled with pressure on funding has led to the increasing use of quality improvement (QI) methodologies from the manufacturing industry. The aim of this systematic review was to identify and evaluate the application and effectiveness of these QI methodologies to the field of surgery. MEDLINE, the Cochrane Database, Allied and Complementary Medicine Database, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Embase, Health Business(™) Elite, the Health Management Information Consortium and PsycINFO(®) were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Empirical studies were included that implemented a described QI methodology to surgical care and analysed a named outcome statistically. Some 34 of 1595 articles identified met the inclusion criteria after consensus from two independent investigators. Nine studies described continuous quality improvement (CQI), five Six Sigma, five total quality management (TQM), five plan-do-study-act (PDSA) or plan-do-check-act (PDCA) cycles, five statistical process control (SPC) or statistical quality control (SQC), four Lean and one Lean Six Sigma; 20 of the studies were undertaken in the USA. The most common aims were to reduce complications or improve outcomes (11), to reduce infection (7), and to reduce theatre delays (7). There was one randomized controlled trial. QI methodologies from industry can have significant effects on improving surgical care, from reducing infection rates to increasing operating room efficiency. The evidence is generally of suboptimal quality, and rigorous randomized multicentre studies are needed to bring evidence-based management into the same league as evidence-based medicine. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project.

PubMed

Bailie, Ross; Si, Damin; Connors, Christine; Weeramanthri, Tarun; Clark, Louise; Dowden, Michelle; O'Donohue, Lynette; Condon, John; Thompson, Sandra; Clelland, Nikki; Nagel, Tricia; Gardner, Karen; Brown, Alex

2008-09-17

A growing body of international literature points to the importance of a system approach to improve the quality of care in primary health care settings. Continuous Quality Improvement (CQI) concepts and techniques provide a theoretically coherent and practical way for primary care organisations to identify, address, and overcome the barriers to improvements. The Audit and Best Practice for Chronic Disease (ABCD) study, a CQI-based quality improvement project conducted in Australia's Northern Territory, has demonstrated significant improvements in primary care service systems, in the quality of clinical service delivery and in patient outcomes related to chronic illness care. The aims of the extension phase of this study are to examine factors that influence uptake and sustainability of this type of CQI activity in a variety of Indigenous primary health care organisations in Australia, and to assess the impact of collaborative CQI approaches on prevention and management of chronic illness and health outcomes in Indigenous communities. The study will be conducted in 40-50 Indigenous community health centres from 4 States/Territories (Northern Territory, Western Australia, New South Wales and Queensland) over a five year period. The project will adopt a participatory, quality improvement approach that features annual cycles of: 1) organisational system assessment and audits of clinical records; 2) feedback to and interpretation of results with participating health centre staff; 3) action planning and goal setting by health centre staff to achieve system changes; and 4) implementation of strategies for change. System assessment will be carried out using a System Assessment Tool and in-depth interviews of key informants. Clinical audit tools include two essential tools that focus on diabetes care audit and preventive service audit, and several optional tools focusing on audits of hypertension, heart disease, renal disease, primary mental health care and health promotion

Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project

PubMed Central

Bailie, Ross; Si, Damin; Connors, Christine; Weeramanthri, Tarun; Clark, Louise; Dowden, Michelle; O'Donohue, Lynette; Condon, John; Thompson, Sandra; Clelland, Nikki; Nagel, Tricia; Gardner, Karen; Brown, Alex

2008-01-01

Background A growing body of international literature points to the importance of a system approach to improve the quality of care in primary health care settings. Continuous Quality Improvement (CQI) concepts and techniques provide a theoretically coherent and practical way for primary care organisations to identify, address, and overcome the barriers to improvements. The Audit and Best Practice for Chronic Disease (ABCD) study, a CQI-based quality improvement project conducted in Australia's Northern Territory, has demonstrated significant improvements in primary care service systems, in the quality of clinical service delivery and in patient outcomes related to chronic illness care. The aims of the extension phase of this study are to examine factors that influence uptake and sustainability of this type of CQI activity in a variety of Indigenous primary health care organisations in Australia, and to assess the impact of collaborative CQI approaches on prevention and management of chronic illness and health outcomes in Indigenous communities. Methods/design The study will be conducted in 40–50 Indigenous community health centres from 4 States/Territories (Northern Territory, Western Australia, New South Wales and Queensland) over a five year period. The project will adopt a participatory, quality improvement approach that features annual cycles of: 1) organisational system assessment and audits of clinical records; 2) feedback to and interpretation of results with participating health centre staff; 3) action planning and goal setting by health centre staff to achieve system changes; and 4) implementation of strategies for change. System assessment will be carried out using a System Assessment Tool and in-depth interviews of key informants. Clinical audit tools include two essential tools that focus on diabetes care audit and preventive service audit, and several optional tools focusing on audits of hypertension, heart disease, renal disease, primary mental

An "All Teach, All Learn" Approach to Research Capacity Strengthening in Indigenous Primary Health Care Continuous Quality Improvement.

PubMed

McPhail-Bell, Karen; Matthews, Veronica; Bainbridge, Roxanne; Redman-MacLaren, Michelle Louise; Askew, Deborah; Ramanathan, Shanthi; Bailie, Jodie; Bailie, Ross

2018-01-01

In Australia, Indigenous people experience poor access to health care and the highest rates of morbidity and mortality of any population group. Despite modest improvements in recent years, concerns remains that Indigenous people have been over-researched without corresponding health improvements. Embedding Indigenous leadership, participation, and priorities in health research is an essential strategy for meaningful change for Indigenous people. To centralize Indigenous perspectives in research processes, a transformative shift away from traditional approaches that have benefited researchers and non-Indigenous agendas is required. This shift must involve concomitant strengthening of the research capacity of Indigenous and non-Indigenous researchers and research translators-all must teach and all must learn. However, there is limited evidence about how to strengthen systems and stakeholder capacity to participate in and lead continuous quality improvement (CQI) research in Indigenous primary health care, to the benefit of Indigenous people. This paper describes the collaborative development of, and principles underpinning, a research capacity strengthening (RCS) model in a national Indigenous primary health care CQI research network. The development process identified the need to address power imbalances, cultural contexts, relationships, systems requirements and existing knowledge, skills, and experience of all parties. Taking a strengths-based perspective, we harnessed existing knowledge, skills and experiences; hence our emphasis on capacity "strengthening". New insights are provided into the complex processes of RCS within the context of CQI in Indigenous primary health care.

The associations between diet quality, body mass index (BMI) and health and activity limitation index (HALEX) in the Geisinger Rural Aging Study (GRAS)

USDA-ARS?s Scientific Manuscript database

Objectives To determine the associations between diet quality, body mass index (BMI), and health-related quality of life (HRQOL) as assessed by the health and activity limitation index (HALex) in older adults. Design Multivariate linear regression models were used to analyze associations between Di...

Impact on enzyme activity as a new quality index of wastewater.

PubMed

Balestri, Francesco; Moschini, Roberta; Cappiello, Mario; Del-Corso, Antonella; Mura, Umberto

2013-03-15

The aim of this study was to define a new indicator for the quality of wastewaters that are released into the environment. A quality index is proposed for wastewater samples in terms of the inertness of wastewater samples toward enzyme activity. This involves taking advantage of the sensitivity of enzymes to pollutants that may be present in the waste samples. The effect of wastewater samples on the rate of a number of different enzyme-catalyzed reactions was measured, and the results for all the selected enzymes were analyzed in an integrated fashion (multi-enzymatic sensor). This approach enabled us to define an overall quality index, the "Impact on Enzyme Function" (IEF-index), which is composed of three indicators: i) the Synoptic parameter, related to the average effect of the waste sample on each component of the enzymatic sensor; ii) the Peak parameter, related to the maximum effect observed among all the effects exerted by the sample on the sensor components; and, iii) the Interference parameter, related to the number of sensor components that are affected less than a fixed threshold value. A number of water based samples including public potable tap water, fluids from urban sewage systems, wastewater disposal from leather, paper and dye industries were analyzed and the IEF-index was then determined. Although the IEF-index cannot discriminate between different types of wastewater samples, it could be a useful parameter in monitoring the improvement of the quality of a specific sample. However, by analyzing an adequate number of waste samples of the same type, even from different local contexts, the profile of the impact of each component of the multi-enzymatic sensor could be typical for specific types of waste. The IEF-index is proposed as a supplementary qualification score for wastewaters, in addition to the certification of the waste's conformity to legal requirements. Copyright © 2013 Elsevier Ltd. All rights reserved.

Application of water quality index to evaluate groundwater quality (temporal and spatial variation) of an intensively exploited aquifer (Puebla valley, Mexico).

PubMed

Salcedo-Sánchez, Edith R; Garrido Hoyos, Sofía E; Esteller Alberich, Ma Vicenta; Martínez Morales, Manuel

2016-10-01

The spatial and temporal variation of water quality in the urban area of the Puebla Valley aquifer was evaluated using historical and present data obtained during this investigation. The current study assessed water quality based on the Water Quality Index developed by the Canadian Council of Ministers of the Environment (CCME-WQI), which provides a mathematical framework to evaluate the quality of water in combination with a set of conditions representing quality criteria, or limits. This index is flexible regarding the type and number of variables used by the evaluation given that the variables of interest are selected according to the characteristics and objectives of development, conservation and compliance with regulations. The CCME-WQI was calculated using several variables that assess the main use of the wells in the urban area that is public supply, according to criteria for human use and consumption established by Mexican law and international standards proposed by the World Health Organization. The assessment of the index shows a gradual deterioration in the quality of the aquifer over time, as the amount of wells with excellent quality have decreased and those with lower index values (poor quality) have increased throughout the urban area of the Puebla Valley aquifer. The parameters affecting groundwater quality are: total dissolved solids, sulfate, calcium, magnesium and total hardness.

An “All Teach, All Learn” Approach to Research Capacity Strengthening in Indigenous Primary Health Care Continuous Quality Improvement

PubMed Central

McPhail-Bell, Karen; Matthews, Veronica; Bainbridge, Roxanne; Redman-MacLaren, Michelle Louise; Askew, Deborah; Ramanathan, Shanthi; Bailie, Jodie; Bailie, Ross; Matthews, Veronica

2018-01-01

In Australia, Indigenous people experience poor access to health care and the highest rates of morbidity and mortality of any population group. Despite modest improvements in recent years, concerns remains that Indigenous people have been over-researched without corresponding health improvements. Embedding Indigenous leadership, participation, and priorities in health research is an essential strategy for meaningful change for Indigenous people. To centralize Indigenous perspectives in research processes, a transformative shift away from traditional approaches that have benefited researchers and non-Indigenous agendas is required. This shift must involve concomitant strengthening of the research capacity of Indigenous and non-Indigenous researchers and research translators—all must teach and all must learn. However, there is limited evidence about how to strengthen systems and stakeholder capacity to participate in and lead continuous quality improvement (CQI) research in Indigenous primary health care, to the benefit of Indigenous people. This paper describes the collaborative development of, and principles underpinning, a research capacity strengthening (RCS) model in a national Indigenous primary health care CQI research network. The development process identified the need to address power imbalances, cultural contexts, relationships, systems requirements and existing knowledge, skills, and experience of all parties. Taking a strengths-based perspective, we harnessed existing knowledge, skills and experiences; hence our emphasis on capacity “strengthening”. New insights are provided into the complex processes of RCS within the context of CQI in Indigenous primary health care. PMID:29761095

Key Factors for a High-Quality Peritoneal Dialysis Program — The Role of the PD Team and Continuous Quality Improvement

PubMed Central

Fang, Wei; Ni, Zhaohui; Qian, Jiaqi

2014-01-01

The proportion of end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) has increased very fast in China over the last decade. Renji Hospital, affiliated with Shanghai Jiaotong University School of Medicine, is a recognized high-quality PD unit with a high PD utilization rate, excellent patient and technique survival (1-year and 5-year patient survival rate of 93% and 71%, and 1-year and 5-year technique survival of 96% and 82%, respectively), low peritonitis rate and a well-documented good quality of life of the treated patients. We believe that a dedicated and experienced PD team, a structured patient training program, continuous patient support, establishing and utilizing standardized protocols, starting PD with low dialysis dose, monitoring key performance indicators (KPIs), and continuous quality improvement (CQI) are the key factors underlying this successful PD program. PMID:24962961

A Geographically Variable Water Quality Index Used in Oregon.

ERIC Educational Resources Information Center

Dunnette, D. A.

1979-01-01

Discusses the procedure developed in Oregon to formulate a valid water quality index which accounts for the specific conditions in the water body of interest. Parameters selected include oxygen depletion, BOD, eutrophication, dissolved substances, health hazards, and physical characteristics. (CS)

Objective assessment of plaster cast quality in pediatric distal forearm fractures: Is there an optimal index?

PubMed

Labronici, Pedro José; Ferreira, Leonardo Termis; Dos Santos Filho, Fernando Claudino; Pires, Robinson Esteves Santos; Gomes, Davi Coutinho Fonseca Fernandes; da Silva, Luiz Henrique Penteado; Gameiro, Vinicius Schott

2017-02-01

Several so-called casting indices are available for objective evaluation of plaster cast quality. The present study sought to investigate four of these indices (gap index, padding index, Canterbury index, and three-point index) as compared to a reference standard (cast index) for evaluation of plaster cast quality after closed reduction of pediatric displaced distal forearm fractures. Forty-three radiographs from patients with displaced distal forearm fractures requiring manipulation were reviewed. Accuracy, sensitivity, specificity, false-positive probability, false-negative probability, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were calculated for each of the tested indices. Comparison among indices revealed diagnostic agreement in only 4.7% of cases. The strongest correlation with the cast index was found for the gap index, with a Spearman correlation coefficient of 0.94. The gap index also displayed the best agreement with the cast index, with both indices yielding the same result in 79.1% of assessments. When seeking to assess plaster cast quality, the cast index and gap index should be calculated; if both indices agree, a decision on quality can be made. If the cast and gap indices disagree, the padding index can be calculated as a tiebreaker, and the decision based on the most frequent of the three results. Calculation of the three-point index and Canterbury index appears unnecessary. Copyright © 2016 Elsevier Ltd. All rights reserved.

Data Sources for an Environmental Quality Index: Availability, Quality, and Utility

PubMed Central

Rappazzo, Kristen; Messer, Lynne C.

2011-01-01

Objectives. An environmental quality index (EQI) for all counties in the United States is under development to explore the relationship between environmental insults and human health. The EQI is potentially useful for investigators researching health disparities to account for other concurrent environmental conditions. This article focused on the identification and assessment of data sources used in developing the EQI. Data source strengths, limitations, and utility were addressed. Methods. Five domains were identified that contribute to environmental quality: air, water, land, built, and sociodemographic environments. An inventory of possible data sources was created. Data sources were evaluated for appropriate spatial and temporal coverage and data quality. Results. The overall data inventory identified multiple data sources for each domain. From the inventory (187 sources, 617 records), the air, water, land, built environment, and sociodemographic domains retained 2, 9, 7, 4, and 2 data sources for inclusion in the EQI, respectively. However, differences in data quality, geographic coverage, and data availability existed between the domains. Conclusions. The data sources identified for use in the EQI may be useful to researchers, advocates, and communities to explore specific environmental quality questions. PMID:21836111

Physician performance assessment using a composite quality index.

PubMed

Liu, Kaibo; Jain, Shabnam; Shi, Jianjun

2013-07-10

Assessing physician performance is important for the purposes of measuring and improving quality of service and reducing healthcare delivery costs. In recent years, physician performance scorecards have been used to provide feedback on individual measures; however, one key challenge is how to develop a composite quality index that combines multiple measures for overall physician performance evaluation. A controversy arises over establishing appropriate weights to combine indicators in multiple dimensions, and cannot be easily resolved. In this study, we proposed a generic unsupervised learning approach to develop a single composite index for physician performance assessment by using non-negative principal component analysis. We developed a new algorithm named iterative quadratic programming to solve the numerical issue in the non-negative principal component analysis approach. We conducted real case studies to demonstrate the performance of the proposed method. We provided interpretations from both statistical and clinical perspectives to evaluate the developed composite ranking score in practice. In addition, we implemented the root cause assessment techniques to explain physician performance for improvement purposes. Copyright © 2012 John Wiley & Sons, Ltd.

Challenges of audit of care on clinical quality indicators for hypertension and type 2 diabetes across four European countries.

PubMed

Suija, Kadri; Kivisto, Katrin; Sarria-Santamera, Antonio; Kokko, Simo; Liseckiene, Ida; Bredehorst, Maren; Jaruseviciene, Lina; Papp, Renata; Oona, Marje; Kalda, Ruth

2015-02-01

The purpose of the study was to measure clinical quality by doing an audit of clinical records and to compare the performance based on clinical quality indicators (CQI) for hypertension and type 2 diabetes across seven European countries: Estonia, Finland, Germany, Hungary, Italy, Lithuania and Spain. Two common chronic conditions in primary care (PC), hypertension and type 2 diabetes, were selected for audit. The assessment of CQI started with a literature review of different databases: Organization for Economic Co-operation and Development, World Health Organization, European Commission European Community Health Indicators, US National Library of Medicine. Data were collected from clinical records. Although it was agreed to obtain the clinical indicators in a similar way from each country, the specific data collection process in every country varied greatly, due to different traditions in collecting and keeping the patients' data, as well as differences in regulation regarding access to clinical information. Also, there was a huge variability across countries in the level of compliance with the indicators. Measurement of clinical performance in PC by audit is methodologically challenging: different databases provide different information, indicators of quality of care have insufficient scientific proof and there are country-specific regulations. There are large differences not only in quality of health care across Europe but also in how it is measured. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The consumer quality index anthroposophic healthcare: a construction and validation study.

PubMed

Koster, Evi B; Ong, Rob R S; Heybroek, Rachel; Delnoij, Diana M J; Baars, Erik W

2014-04-02

Accounting for the patients' perspective on quality of care has become increasingly important in the development of Evidence Based Medicine as well as in governmental policies. In the Netherlands the Consumer Quality (CQ) Index has been developed to measure the quality of care from the patients' perspective in different healthcare sectors in a standardized manner. Although the scientific accountability of anthroposophic healthcare as a form of integrative medicine is growing, patient experiences with anthroposophic healthcare have not been measured systematically. In addition, the specific anthroposophic aspects are not measured by means of existing CQ Indexes. To enable accountability of quality of the anthroposophic healthcare from the patients' perspective the aim of this study is the construction and validation of a CQ Index for anthroposophic healthcare. Construction in three phases: Phase 1. Determining anthroposophic quality aspects: literature study and focus groups. Phase 2. Adding new questions and validating the new questionnaire. Research population: random sample from 7910 patients of 22 anthroposophic GPs. survey, mixed mode by means of the Dillman method. Measuring instrument: experience questionnaire: CQ Index General Practice (56 items), added with 27 new anthroposophic items added and an item-importance questionnaire (anthroposophic items only). Factor analysis, scale construction, internal consistency (Chronbach's Alpha), inter-item-correlation, discriminative ability (Intra Class Correlation) and inter-factor-correlations. Phase 3. Modulation and selection of new questions based on results. Criteria of retaining items: general: a limited amount of items, statistical: part of a reliable scale and inter-item-correlation <0,7, and theoretical. Phase 1. 27 anthroposophic items. Phase 2. Two new anthroposophic scales: Scale AntroposophicTreatmentGP: seven items, Alpha=0,832, ICC=4,2 Inter-factor-correlation with existing GP-scales range from r=0

The concept of a composite perioperative quality index in kidney transplantation.

PubMed

Taber, David J; McGillicuddy, John W; Bratton, Charles F; Lin, Angello; Chavin, Kenneth D; Baliga, Prabhakar K

2014-04-01

Public reporting of patient and graft outcomes in a national registry and close Centers for Medicare and Medicaid Services oversight has resulted in transplantation being a highly regulated surgical discipline. Despite this, transplantation surgery lacks comprehensive tracking and reporting of perioperative quality measures. Therefore, the aim of this study was to determine the association between a kidney transplantation centers' perioperative quality benchmarking and graft and patient outcomes. This was an analysis of 2011 aggregate data compiled from 2 national datasets that track outcomes from member hospitals and transplantation centers. The transplantation centers included in this study were composed of accredited US kidney transplantation centers that report data through the national registry and are associate members of the University HealthSystem Consortium. A total of 16,811 kidney transplantations were performed at 236 centers in the United States in 2011, of which 10,241 (61%) from 93 centers were included in the analysis. Of the 6 perioperative quality indicators, 3 benchmarked metrics were significantly associated with a kidney transplantation center's underperformance: mean ICU length of stay (C-statistic 0.731; p = 0.002), 30-day readmissions (C-statistic 0.697; p = 0.012) and in-hospital complications (C-statistic 0.785; p = 0.001). The composite quality index strongly correlated with inadequate center performance (C-statistic 0.854; p < 0.001, R(2) = 0.349). The centers in the lowest quartile of the quality index performed 2,400 kidney transplantations in 2011, which led to 2,640 more hospital days, 4,560 more ICU days, 120 more postoperative complications, and 144 more patients with 30-day readmissions, when compared with centers in the 3 higher-quality quartiles. An objective index of a transplantation center's quality of perioperative care is significantly associated with patient and graft survival. Copyright © 2014 American College of

Quality Indexes and Feasibility Analysis of Traditional Dried Anchovy From Buru Island

NASA Astrophysics Data System (ADS)

Krisanta Enda Savitri, Imelda; Sormin, R. B. D.; Silaban, Bernita

2017-10-01

Dried anchovy is a prominent fishery product in Buru Island Maluku. It is produce traditionally in villages Batuboi and Siahoni at Kayeli bay. Drying process was done in open air under the sun directly during two days to produce dried anchovy with a prospective marketable. This preliminary research was aimed to investigated the quality indexes and business feasibility of dried anchovy produced by processor comunity. The quality index was found by laboratory analysis of sample dried anchovy referring to Indonesian National Standard. The data for feasibility analysis was found by interview and by using quesioner list. The average Quality indexes of dried anchovy as follows: Water 14.22 grams percent; Protein 55.68 grams percent; Fat 2.29 grams percent; Ash 9.02 grams percent; Total Bacteri (TPC) 3,5 × 102-; organoleptic value 7.79; E. coli, Salmonella and Mold were unidentified. Total cost of dried anchovy production is 37,050,720 Rupiahs/year with the income was 224,000,000 Rupiahs/year. Total profit is 217,824,880 Rupiahs/year and the Revenue Cost ratio was 6.05. Dried anchovy from Buru Island has a good quality and also has a good business feasibility.

Soil vital signs: A new Soil Quality Index (SQI) for assessing forest soil health

Treesearch

Michael C. Amacher; Katherine P. O' Neil; Charles H. Perry

2007-01-01

The Forest Inventory and Analysis (FIA) program measures a number of chemical and physical properties of soils to address specific questions about forest soil quality or health. We developed a new index of forest soil health, the soil quality index (SQI), that integrates 19 measured physical and chemical properties of forest soils into a single number that serves as...

A New Malaysian Quality of Life Index Based on Fuzzy Sets and Hierarchical Needs

ERIC Educational Resources Information Center

Lazim, M. Abdullah; Abu Osman, M. Tap

2009-01-01

The Malaysian Quality of Life Index (MQLI) released by the Economic Planning Unit (EPU), has led authors to search for alternative method of expressing this index. One of the limitations in MQLI computations is the failure to recognise unequal weights for each accounted component. This paper offers a new way of expressing the quality of life index…

Index admission laparoscopic cholecystectomy for acute cholecystitis restores Gastrointestinal Quality of Life Index (GIQLI) score.

PubMed

Yu, Hongyan; Chan, Esther Ern-Hwei; Lingam, Pravin; Lee, Jingwen; Woon, Winston Wei Liang; Low, Jee Keem; Shelat, Vishal G

2018-02-01

Previous studies have evaluated quality of life (QoL) in patients who underwent laparoscopic cholecystectomy (LC) for cholelithiasis. The purpose of this study was to evaluate QoL after index admission LC in patients diagnosed with acute cholecystitis (AC) using the Gastrointestinal Quality of Life Index (GIQLI) questionnaire. Patients ≥21 years admitted to Tan Tock Seng Hospital, Singapore for AC and who underwent index admission LC between February 2015 and January 2016 were evaluated using the GIQLI questionnaire preoperatively and 30 days postoperatively. A total of 51 patients (26 males, 25 females) with a mean age of 60 years (24-86 years) were included. Median duration of abdominal pain at presentation was 2 days (1-21 days). 45% of patients had existing comorbidities, with diabetes mellitus being most common (33%). 31% were classified as mild AC, 59% as moderate and 10% as severe AC according to Tokyo Guideline 2013 (TG13) criteria. Post-operative complications were observed in 8 patients, including retained common bile duct stone (n=1), wound infection (n=2), bile leakage (n=2), intra-abdominal collection (n=1) and atrial fibrillation (n=2). 86% patients were well at 30 days follow-up and were discharged. A significant improvement in GIQLI score was observed postoperatively, with mean total GIQLI score increasing from 106.0±16.9 (101.7-112.1) to 120.4±18.0 (114.8-125.9) ( p <0.001). Significant improvements were also observed in GIQLI subgroups of gastrointestinal symptoms, physical status, emotional status and social function status. Index admission LC restores QoL in patients with AC as measured by GIQLI questionnaire.

A pressure ulcer and fall rate quality composite index for acute care units: A measure development study.

PubMed

Boyle, Diane K; Jayawardhana, Ananda; Burman, Mary E; Dunton, Nancy E; Staggs, Vincent S; Bergquist-Beringer, Sandra; Gajewski, Byron J

2016-11-01

Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement. The study objective was to develop a unit-level inpatient composite nursing care quality performance index-the Pressure Ulcer and Fall Rate Quality Composite Index. Two-phase measure development study. 5144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors ® during the year 2013. The Pressure Ulcer and Fall Rate Quality Composite Index was developed in two phases. In Phase 1 the formula was generated using a utility function and generalized penalty analysis. Experts with experience in healthcare quality measurement provided the point of indicator equivalence. In Phase 2 initial validity evidence was gathered based on hypothesized relationships between the Pressure Ulcer and Fall Rate Quality Composite Index and other variables using two-level (unit, hospital) hierarchical linear mixed modeling. The Pressure Ulcer and Fall Rate Quality Composite Index=100-PUR-FR, where PUR is pressure ulcer rate and FR is total fall rate. Higher scores indicate better quality. Bland-Altman plots demonstrated agreement between pairs of experts and provided evidence for inter-rater reliability of the formula. The validation process demonstrated that higher registered nurse skill mix, higher percent of registered nurses with a baccalaureate in nursing or higher degree, higher percent of registered nurses with national specialty certification, and lower percent of hours supplied by agency staff were significantly associated with higher Pressure Ulcer and Fall Rate Quality Composite Index scores. Higher percentages of unit patients at risk for a hospital-acquired pressure ulcer and higher unit rates of physical restraint use were not associated with higher Pressure

A PRESSURE ULCER AND FALL RATE QUALITY COMPOSITE INDEX FOR ACUTE CARE UNITS: A MEASURE DEVELOPMENT STUDY

PubMed Central

Jayawardhana, Ananda; Burman, Mary E.; Dunton, Nancy E.; Staggs, Vincent S.; Bergquist-Beringer, Sandra; Gajewski, Byron J.

2016-01-01

Background Composite indices are single measures that combine the strengths of two or more individual measures and provide broader, easy-to-use measures for evaluation of provider performance and comparisons across units and hospitals to support quality improvement. Objective The study objective was to develop a unit-level inpatient composite nursing care quality performance index – the Pressure Ulcer and Fall Rate Quality Composite Index. Design Two-phase measure development study. Settings 5,144 patient care units in 857 United States hospitals participating in the National Database of Nursing Quality Indictors® during the year 2013. Methods The Pressure Ulcer and Fall Rate Quality Composite Index was developed in two phases. In Phase 1 the formula was generated using a utility function and generalized penalty analysis. Experts with experience in healthcare quality measurement provided the point of indicator equivalence. In Phase 2 initial validity evidence was gathered based on hypothesized relationships between the Pressure Ulcer and Fall Rate Quality Composite Index and other variables using two-level (unit, hospital) hierarchical linear mixed modeling. Results The Pressure Ulcer and Fall Rate Quality Composite Index = 100 − PUR − FR, where PUR is pressure ulcer rate and FR is total fall rate. Higher scores indicate better quality. Bland-Altman plots demonstrated agreement between pairs of experts and provided evidence for inter-rater reliability of the formula. The validation process demonstrated that higher registered nurse skill mix, higher percent of registered nurses with a baccalaureate in nursing or higher degree, higher percent of registered nurses with national specialty certification, and lower percent of hours supplied by agency staff were significantly associated with higher Pressure Ulcer and Fall Rate Quality Composite Index scores. Higher percentages of unit patients at risk for a hospital-acquired pressure ulcer and higher unit rates of

Water Quality Assessment for Deep-water Channel area of Guangzhou Port based on the Comprehensive Water Quality Identification Index Method

NASA Astrophysics Data System (ADS)

Chen, Yi

2018-03-01

The comprehensive water quality identification index method is able to assess the general water quality situation comprehensively and represent the water quality classification; water environment functional zone achieves pollution level and standard objectively and systematically. This paper selects 3 representative zones along deep-water channel of Guangzhou port and applies comprehensive water quality identification index method to calculate sea water quality monitoring data for different selected zones from year 2006 to 2014, in order to investigate the temporal variation of water quality along deep-water channel of Guangzhou port. The comprehensive water quality level from north to south presents an increased trend, and the water quality of the three zones in 2014 is much better than in 2006. This paper puts forward environmental protection measurements and suggestions for Pearl River Estuary, provides data support and theoretical basis for studied sea area pollution prevention and control.

Evaluating Journal Quality: Is the H-Index a Better Measure than Impact Factors?

ERIC Educational Resources Information Center

Hodge, David R.; Lacasse, Jeffrey R.

2011-01-01

Objectives: This study evaluates the utility of a new measure--the h-index--that may provide a more valid approach to evaluating journal quality in the social work profession. Method: H-index values are compared with Thomson ISI 5-year impact factors and expert opinion. Results: As hypothesized, the h-index correlates highly with ISI 5-year impact…

Collecting data along the continuum of prevention and care: a Continuous Quality Improvement approach.

PubMed

Indyk, Leonard; Indyk, Debbie

2006-01-01

For the past 14 years, a team of applied social scientists and system analysts has worked with a wide variety of Community- Based Organizations (CBO's), other grassroots agencies and networks, and Medical Center departments to support resource, program, staff and data development and evaluation for hospital- and community-based programs and agencies serving HIV at-risk and affected populations. A by-product of this work has been the development, elaboration and refinement of an approach to Continuous Quality Improvement (CQI) which is appropriate for diverse community-based providers and agencies. A key component of our CQI system involves the installation of a sophisticated relational database management and reporting system (DBMS) which is used to collect, analyze, and report data in an iterative process to provide feedback among the evaluators, agency administration and staff. The database system is designed for two purposes: (1) to support the agency's administrative internal and external reporting requirements; (2) to support the development of practice driven health services and early intervention research. The body of work has fostered a unique opportunity for the development of exploratory service-driven research which serves both administrative and research needs.

Piloting a generic cancer consumer quality index in six European countries.

PubMed

Wind, Anke; Roeling, Mark Patrick; Heerink, Jana; Sixma, Herman; Presti, Pietro; Lombardo, Claudio; van Harten, Wim

2016-09-02

Accounting for patients' perspective has become increasingly important. Based on the Consumer Quality Index method (founded on Consumer Assessment of Healthcare Providers and Systems) a questionnaire was recently developed for Dutch cancer patients. As a next step, this study aimed to adapt and pilot this questionnaire for international comparison of cancer patients experience and satisfaction with care in six European countries. The Consumer Quality Index was translated into the local language at the participating pilot sites using cross-translation. A minimum of 100 patients per site were surveyed through convenience sampling. Data from seven pilot sites in six countries was collected through an online and paper-based survey. Internal consistency was tested by calculating Cronbach's alpha and validity by means of cognitive interviews. Demographic factors were compared as possible influencing factors. A total of 698 patients from six European countries filled the questionnaire. Cronbach's alpha was good or satisfactory in 8 out of 10 categories. Patient satisfaction significantly differed between the countries. We observed no difference in patient satisfaction for age, gender, education, and tumor type, but satisfaction was significantly higher in patients with a higher level of activation. This European Cancer Consumer Quality Index(ECCQI) showed promising scores on internal consistency (reliability) and a good internal validity. The ECCQI is to our knowledge the first to measure and compare experiences and satisfaction of cancer patients on an international level, it may enable healthcare providers to improve the quality of cancer care.

Uncertainty result of biotic index in analysing the water quality of Cikapundung river catchment area, Bandung

NASA Astrophysics Data System (ADS)

Surtikanti, Hertien Koosbandiah

2017-05-01

The Biotic Index was developed in Western Countries in response to the need in water quality evaluation. This method analysis is based on the classification of aquatic macrobenthos as a bioindicator for clean and polluted water. The aim of this study is to compare the analysis of Cikapundung river using 6 different Biotic Indexes. BI Shannon-Weiner, Belgian Biological Index (BBI), Family Biotic Index (FBI), Biological Monitoring Working Party (BMWP), Biological Monitoring Working Party-Average Score Per Taxon (BMWP-ASPT), and A Scoring System for Macroinvertebrate in Australian River (A SIGNAL). Those analysis are compared with Physical Water Index (CPI) which is developed in Indonesia. The result shows that a decreasing water quality is detected upstream to downstream of Cikapundung River. However, based on the CPI analysis result, the BMWP-ASPT biotic index analysis is more comprehensive than other BI in explaining Cikapundung water quality.

The World Coal Quality Inventory (WoCQI)

USGS Publications Warehouse

Finkelman, Robert B.; Lovern, Vivian S.

2001-01-01

The Issue Policymakers around the world require accurate information on coal, particularly information on coal properties and characteristics, to make informed decisions regarding the best use of indigenous resources, international import needs and export opportunities, domestic and foreign policy objectives, technology transfer opportunities, foreign investment prospects, environmental and health assessments, and byproduct use and disposal issues.

Comparative analysis of SmartArc‐based dual arc volumetric‐modulated arc radiotherapy (VMAT) versus intensity‐modulated radiotherapy (IMRT) for nasopharyngeal carcinoma

PubMed Central

Chao, Pei‐Ju; Ting, Hui‐Min; Lo, Su‐Hua; Wang, Yu‐Wen; Tuan, Chiu‐Ching; Fang, Fu‐Min

2011-01-01

The purpose of this study was to evaluate and quantify the planning performance of SmartArc‐based volumetric‐modulated arc radiotherapy (VMAT) versus fixed‐beam intensity‐modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC) using a sequential mode treatment plan. The plan quality and performance of dual arc‐VMAT (DA‐VMAT) using the Pinnacle3 Smart‐Arc system (clinical version 9.0; Philips, Fitchburg, WI, USA) were evaluated and compared with those of seven‐field (7F)‐IMRT in 18 consecutive NPC patients. Analysis parameters included the conformity index (CI) and homogeneity index (HI) for the planning target volume (PTV), maximum and mean dose, normal tissue complication probability (NTCP) for the specified organs at risk (OARs), and comprehensive quality index (CQI) for an overall evaluation in the 11 OARs. Treatment delivery time, monitor units per fraction (MU/fr), and gamma (Γ3mm,3%) evaluations were also analyzed. DA‐VMAT achieved similar target coverage and slightly better homogeneity than conventional 7F‐IMRT with a similar CI and HI. NTCP values were only significantly lower in the left parotid gland (for xerostomia) for DA‐VMAT plans. The mean value of CQI at 0.98±0.02 indicated a 2% benefit in sparing OARs by DA‐VMAT. The MU/fr used and average delivery times appeared to show improved efficiencies in DA‐VMAT. Each technique demonstrated high accuracy in dose delivery in terms of a high‐quality assurance (QA) passing rate (>98%) of the (Γ3mm,3%) criterion. The major difference between DA‐VMAT and 7F‐IMRT using a sequential mode for treating NPC cases appears to be improved efficiency, resulting in a faster delivery time and the use of fewer MU/fr. PACS number: 87.53.Tf, 87.55.x, 87.55.D, 87.55.dk PMID:22089015

Development, application, and sensitivity analysis of a water quality index for drinking water management in small systems.

PubMed

Scheili, A; Rodriguez, Manuel J; Sadiq, R

2015-11-01

The aim of this study was to produce a drinking water assessment tool for operators of small distribution systems. A drinking water quality index (DWQI) was developed and applied to small systems based on the water quality index of the Canadian Council of Ministers of Environment. The drinking water quality index was adapted to specific needs by creating four drinking water quality scenarios. First, the temporal and spatial dimensions of drinking water quality variability were taken into account. The DWQI was designed to express global drinking water quality according to different monitoring frequencies. Daily, monthly, and seasonal assessment was also considered. With the data made available, it was possible to use the index as a spatial monitoring tool and express water quality in different points in the distribution system. Moreover, adjustments were made to prioritize the type of contaminant to monitor. For instance, monitoring contaminants with acute health effects led to a scenario based on daily measures, including easily accessible and affordable water quality parameters. On the other hand, contaminants with chronic effects, especially disinfection by-products, were considered in a seasonal monitoring scenario where disinfection by-product reference values were redefined according to their seasonal variability. A sensitivity analysis was also carried out to validate the index. Globally, the DWQI developed is adapted to the needs of small systems. In fact, expressing drinking water quality using the DWQI contributes to the identification of problematic periods and segments in the distribution system. Further work may include this index in the development of a customized decision-making tool for small-system operators and managers.

Validation of the Acoustic Voice Quality Index Version 03.01 and the Acoustic Breathiness Index in the Spanish language.

PubMed

Delgado Hernández, Jonathan; León Gómez, Nieves M; Jiménez, Alejandra; Izquierdo, Laura M; Barsties V Latoszek, Ben

2018-05-01

The aim of this study was to validate the Acoustic Voice Quality Index 03.01 (AVQIv3) and the Acoustic Breathiness Index (ABI) in the Spanish language. Concatenated voice samples of continuous speech (cs) and sustained vowel (sv) from 136 subjects with dysphonia and 47 vocally healthy subjects were perceptually judged for overall voice quality and breathiness severity. First, to reach a higher level of ecological validity, the proportions of cs and sv were equalized regarding the time length of 3 seconds sv part and voiced cs part, respectively. Second, concurrent validity and diagnostic accuracy were verified. A moderate reliability of overall voice quality and breathiness severity from 5 experts was used. It was found that 33 syllables as standardization of the cs part, which represents 3 seconds of voiced cs, allows the equalization of both speech tasks. A strong correlation was revealed between AVQIv3 and overall voice quality and ABI and perceived breathiness severity. Additionally, the best diagnostic outcome was identified at a threshold of 2.28 and 3.40 for AVQIv3 and ABI, respectively. The AVQIv3 and ABI showed in the Spanish language valid and robust results to quantify abnormal voice qualities regarding overall voice quality and breathiness severity.

SEEING THE LIGHT: A WATER CLARITY INDEX FOR INTEGRATED WATER QUALITY ASSESSMENTS

EPA Science Inventory

Smith, Lisa M. and Linda C. Harwell. In press. Seeing the Light: A Water Clarity Index for Integrated Water Quality Assessments (Abstract). To be presented at EMAP Symposium 2004: Integrated Monitoring & Assessment for Effective Water Quality Management. 1 p. (ERL,GB R970).
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A novel method to construct an air quality index based on air pollution profiles.

PubMed

Thach, Thuan-Quoc; Tsang, Hilda; Cao, Peihua; Ho, Lai-Ming

2018-01-01

Air quality indices based on the maximum of sub-indices of pollutants are easy to produce and help quantify the degree of air pollution. However, they discount the additive effects of multiple pollutants and are only sensitive to changes in highest sub-index. We propose a simple and concise method to construct an air quality index that takes into account additive effects of multiple pollutants and evaluate the extent to which this index predicts health effects. We obtained concentrations of four criteria pollutants: particulate matter with aerodynamic diameter ≤ 10μm (PM 10 ), sulphur dioxide (SO 2 ), nitrogen dioxide (NO 2 ) and ozone (O 3 ) and daily admissions to Hong Kong hospitals for cardiovascular and respiratory diseases for all ages and those 65 years or older for years 2001-2012. We derived sub-indices of the four criteria pollutants, calculated by normalizing pollutant concentrations to their respective short-term WHO Air Quality Guidelines (WHO AQG). We aggregated the sub-indices using the root-mean-power function with an optimal power to form an overall air quality index. The optimal power was determined by minimizing the sum of over- and under-estimated days. We then assessed associations between the pollution bands of the index and cardiovascular and respiratory admissions using a time-stratified case-crossover design adjusted for ambient temperature, relative humidity and influenza epidemics. Further, we conducted case-crossover analyses using the Hong Kong air quality data with the respective standards and classification of pollution bands of the China Air Quality Index (AQI), the United Kingdom Daily AQI (DAQI), and the United States Environmental Protection Agency (USEPA) AQI. The mean concentrations of PM 10 and SO 2 based on maximum 3-h mean exceeded the WHO AQG by 37% and 50%, respectively. We identified the combined condition of observed high-pollution days as either at least one pollutant > 1.5×WHO AQG or at least two pollutants > 1.0�

MS-QI: A Modulation Spectrum-Based ECG Quality Index for Telehealth Applications.

PubMed

Tobon V, Diana P; Falk, Tiago H; Maier, Martin

2016-08-01

As telehealth applications emerge, the need for accurate and reliable biosignal quality indices has increased. One typical modality used in remote patient monitoring is the electrocardiogram (ECG), which is inherently susceptible to several different noise sources, including environmental (e.g., powerline interference), experimental (e.g., movement artifacts), and physiological (e.g., muscle and breathing artifacts). Accurate measurement of ECG quality can allow for automated decision support systems to make intelligent decisions about patient conditions. This is particularly true for in-home monitoring applications, where the patient is mobile and the ECG signal can be severely corrupted by movement artifacts. In this paper, we propose an innovative ECG quality index based on the so-called modulation spectral signal representation. The representation quantifies the rate of change of ECG spectral components, which are shown to be different from the rate of change of typical ECG noise sources. The proposed modulation spectral-based quality index, MS-QI, was tested on 1) synthetic ECG signals corrupted by varying levels of noise, 2) single-lead recorded data using the Hexoskin garment during three activity levels (sitting, walking, running), 3) 12-lead recorded data using conventional ECG machines (Computing in Cardiology 2011 dataset), and 4) two-lead ambulatory ECG recorded from arrhythmia patients (MIT-BIH Arrhythmia Database). Experimental results showed the proposed index outperforming two conventional benchmark quality measures, particularly in the scenarios involving recorded data in real-world environments.

That Was a Good Story! Preliminary Construction of the Perceived Story Quality Index

ERIC Educational Resources Information Center

Baron, Jacqueline M.; Bluck, Susan

2011-01-01

The objective of this research was to develop a preliminary Perceived Story Quality Index to assess laypersons' views of story quality. Research to date has not employed a standard measure of perceived quality, nor reported whether different lay-raters judge stories similarly. The study involved systematically generating core dimensions of…

Exploring in integrated quality evaluation of Chinese herbal medicines: the integrated quality index (IQI) for aconite.

PubMed

Zhang, Ding-kun; Wang, Jia-bo; Yang, Ming; Peng, Cheng; Xiao, Xiao-he

2015-07-01

Good medicinal herbs, good drugs. Good evaluation method and indices are the prerequisite of good medicinal herbs. However, there exist numerous indices for quality evaluation and control in Chinese medicinal materials. However, most of these indices are non-interrelated each other, as well as having little relationship with efficiency and safety. The results of different evaluatior methods may not be consistent, even contradictory. Considering the complex material properties of Chinese medicinal materials, single method and index is difficult to objectively and comprehensively reflect the quality. Therefore, it is essential to explore the integrated evaluation methods. In this paper, oriented by the integrated evaluation strategies for traditional Chinese medicine quality, a new method called integrated quality index (IQI) by the integration of empirical evaluation, chemical evaluation, and biological evaluation was proposed. In addition, a study case of hypertoxic herb Aconitum carmichaelii Debx. was provided to explain this method in detail. The results suggested that in the view of specifications, the average weight of Jiangyou aconite was the greatest, followed by Weishan aconite, Butuo aconite, Hanzhong aconite, and Anxian aconite; from the point of chemical components, Jiangyou aconite had the characteristic with strong efficacy and weak toxicity, next was Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite; taking toxicity price as the index, Hanzhong aconite and Jiangyou aconite have the lower toxicity, while Butuo aconite, Weishan aconite, and Anxian aconite have the relatively higher one. After the normalization and integration of evaluation results, we calculated the IQI value of Jiangyou aconite, Hanzhong aconite, Butuo aconite, Weishan aconite, and Anxian aconite were 0.842 +/- 0.091, 0.597 +/- 0.047, 0.442 +/- 0.033, 0.454 +/- 0.038, 0.170 +/- 0.021, respectively. The quality of Jiangyou aconite is significantly better than the

Building an Evidence-Driven Child Welfare Workforce: A University–Agency Partnership

PubMed Central

Lery, Bridgette; Wiegmann, Wendy; Berrick, Jill Duerr

2016-01-01

The federal government increasingly expects child welfare systems to be more responsive to the needs of their local populations, connect strategies to results, and use continuous quality improvement (CQI) to accomplish these goals. A method for improving decision making, CQI relies on an inflow of high-quality data, up-to-date research evidence, and a robust organizational structure and climate that supports the deliberate use of evidence for decision making. This article describes an effort to build and support these essential system components through one public-private child welfare agency–university partnership. PMID:27429534

CAQI Common Air Quality Index--update with PM(2.5) and sensitivity analysis.

PubMed

van den Elshout, Sef; Léger, Karine; Heich, Hermann

2014-08-01

The CAQI or Common Air Quality Index was proposed to facilitate the comparison of air quality in European cities in real-time. There are many air quality indices in use in the world. All are somewhat different in concept and presentation and comparing air quality presentations of cities on the internet was virtually impossible. The CAQI and the accompanying website www.airqualitynow.eu and app were proposed to overcome this problem in Europe. This paper describes the logic of making an index, in particular the CAQI and its update with a grid for PM2.5. To assure a smooth transition to the new calculation scheme we studied the behaviour of the index before and after the changes. We used 2006 Airbase data from 31 urban background and 27 street stations all across Europe (that were monitoring PM2.5 in 2006). The CAQI characterises a city by a roadside and urban background situation. It also insists on a minimum number of pollutants to be included in the calculation. Both were deemed necessary to improve the basis for comparing one city to another. A sensitivity analysis demonstrates the comparative behaviour of the street and urban background stations and presents the sensitivity of the CAQI outcome to the pollutants included in its calculation. © 2013.

Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach

PubMed Central

2013-01-01

Background Rheumatic heart disease (RHD) remains a major health concern for Aboriginal Australians. A key component of RHD control is prevention of recurrent acute rheumatic fever (ARF) using long-term secondary prophylaxis with intramuscular benzathine penicillin (BPG). This is the most important and cost-effective step in RHD control. However, there are significant challenges to effective implementation of secondary prophylaxis programs. This project aimed to increase understanding and improve quality of RHD care through development and implementation of a continuous quality improvement (CQI) strategy. Methods We used a CQI strategy to promote implementation of national best-practice ARF/RHD management guidelines at primary health care level in Indigenous communities of the Northern Territory (NT), Australia, 2008–2010. Participatory action research methods were employed to identify system barriers to delivery of high quality care. This entailed facilitated discussion with primary care staff aided by a system assessment tool (SAT). Participants were encouraged to develop and implement strategies to overcome identified barriers, including better record-keeping, triage systems and strategies for patient follow-up. To assess performance, clinical records were audited at baseline, then annually for two years. Key performance indicators included proportion of people receiving adequate secondary prophylaxis (≥80% of scheduled 4-weekly penicillin injections) and quality of documentation. Results Six health centres participated, servicing approximately 154 people with ARF/RHD. Improvements occurred in indicators of service delivery including proportion of people receiving ≥40% of their scheduled BPG (increasing from 81/116 [70%] at baseline to 84/103 [82%] in year three, p = 0.04), proportion of people reviewed by a doctor within the past two years (112/154 [73%] and 134/156 [86%], p = 0.003), and proportion of people who received influenza vaccination (57

Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach.

PubMed

Ralph, Anna P; Fittock, Marea; Schultz, Rosalie; Thompson, Dale; Dowden, Michelle; Clemens, Tom; Parnaby, Matthew G; Clark, Michele; McDonald, Malcolm I; Edwards, Keith N; Carapetis, Jonathan R; Bailie, Ross S

2013-12-18

Rheumatic heart disease (RHD) remains a major health concern for Aboriginal Australians. A key component of RHD control is prevention of recurrent acute rheumatic fever (ARF) using long-term secondary prophylaxis with intramuscular benzathine penicillin (BPG). This is the most important and cost-effective step in RHD control. However, there are significant challenges to effective implementation of secondary prophylaxis programs. This project aimed to increase understanding and improve quality of RHD care through development and implementation of a continuous quality improvement (CQI) strategy. We used a CQI strategy to promote implementation of national best-practice ARF/RHD management guidelines at primary health care level in Indigenous communities of the Northern Territory (NT), Australia, 2008-2010. Participatory action research methods were employed to identify system barriers to delivery of high quality care. This entailed facilitated discussion with primary care staff aided by a system assessment tool (SAT). Participants were encouraged to develop and implement strategies to overcome identified barriers, including better record-keeping, triage systems and strategies for patient follow-up. To assess performance, clinical records were audited at baseline, then annually for two years. Key performance indicators included proportion of people receiving adequate secondary prophylaxis (≥80% of scheduled 4-weekly penicillin injections) and quality of documentation. Six health centres participated, servicing approximately 154 people with ARF/RHD. Improvements occurred in indicators of service delivery including proportion of people receiving ≥40% of their scheduled BPG (increasing from 81/116 [70%] at baseline to 84/103 [82%] in year three, p = 0.04), proportion of people reviewed by a doctor within the past two years (112/154 [73%] and 134/156 [86%], p = 0.003), and proportion of people who received influenza vaccination (57/154 [37%] to 86/156 [55%], p�

Research on the Establishment and Evaluation of End - to - End Service Quality Index System

NASA Astrophysics Data System (ADS)

Wei, Chen; Jing, Tao; Ji, Yutong

2018-01-01

From the perspective of power data networks, put forward the index system model to measure the quality of service, covering user experience, business performance, network capacity support, etc., and gives the establishment and use of each layer index in the model.

Human development index, children's health-related quality of life and movement behaviors: a compositional data analysis.

PubMed

Dumuid, Dorothea; Maher, Carol; Lewis, Lucy K; Stanford, Tyman E; Martín Fernández, Josep Antoni; Ratcliffe, Julie; Katzmarzyk, Peter T; Barreira, Tiago V; Chaput, Jean-Philippe; Fogelholm, Mikael; Hu, Gang; Maia, José; Sarmiento, Olga L; Standage, Martyn; Tremblay, Mark S; Tudor-Locke, Catrine; Olds, Timothy

2018-06-01

Health-related quality of life has been related to physical activity, sedentary behavior, and sleep among children from developed nations. These relationships have rarely been assessed in developing nations, nor have behaviors been considered in their true context, as mutually exclusive and exhaustive parts of the movement behavior composition. This study aimed to explore whether children's health-related quality of life is related to their movement behavior composition and if the relationship differs according to human development index. Children aged 9-11 years (n = 5855), from the 12-nation cross-sectional observational International Study of Childhood Obesity, Lifestyle and the Environment 2011-2013, self-reported their health-related quality of life (KIDSCREEN-10). Daily movement behaviors were from 24-h, 7-day accelerometry. Isometric log-ratio mixed-effect linear models were used to calculate estimates for difference in health-related quality of life for the reallocation of time between daily movement behaviors. Children from countries of higher human development index reported stronger positive relationships between health-related quality of life and moderate-to-vigorous physical activity, relative to the remaining behaviors (r = 0.75, p = 0.005) than those from lower human development index countries. In the very high human development index strata alone, health-related quality of life was significantly related to the movement behavior composition (p = 0.005), with moderate-to-vigorous physical activity (relative to remaining behaviors) being positively associated with health-related quality of life. The relationship between children's health-related quality of life and their movement behaviors is moderated by their country's human development index. This should be considered when 24-h movement behavior guidelines are developed for children around the world.

Reliability testing across the Environmental Quality Index and national environmental indices.

EPA Science Inventory

One challenge in environmental epidemiology is the exploration of cumulative environmental exposure across multiple domains (e.g. air, water, land). The Environmental Quality Index (EQI), created by the U.S. EPA, uses principle component analyses combining environmental domains (...

Putting the pyramid into action: the Healthy Eating Index and Food Quality Score.

PubMed

Kennedy, Eileen

2008-01-01

Consumption patterns are changing globally. As a result both researchers and policy makers require simple, easy to use measures of diet quality. The Healthy Eating Index (HEI) was developed as a single, summary measure of diet quality. The original HEI was a ten component index based on the US Dietary Guidelines and the Food Guide Pyramid. Research on the HEI indicates that the index correlates significantly with the RDA's for a range of nutrients and with an individual's self-rating of their diet. The revised HEI provides a more disaggregated version of the original index based on the 2005 Dietary Guidelines for Americans. Within each of the five major food groups, some foods are more nutrient dense than others. Nutrient Density algorithms have been developed to rate foods within food groups. The selection of the most nutrient dense foods within food groups lead to a dietary pattern with a higher HEI. The implications of using the HEI and nutrient density to develop interventions are discussed in this presentation.

Development of fuzzy air quality index using soft computing approach.

PubMed

Mandal, T; Gorai, A K; Pathak, G

2012-10-01

Proper assessment of air quality status in an atmosphere based on limited observations is an essential task for meeting the goals of environmental management. A number of classification methods are available for estimating the changing status of air quality. However, a discrepancy frequently arises from the quality criteria of air employed and vagueness or fuzziness embedded in the decision making output values. Owing to inherent imprecision, difficulties always exist in some conventional methodologies like air quality index when describing integrated air quality conditions with respect to various pollutants parameters and time of exposure. In recent years, the fuzzy logic-based methods have demonstrated to be appropriated to address uncertainty and subjectivity in environmental issues. In the present study, a methodology based on fuzzy inference systems (FIS) to assess air quality is proposed. This paper presents a comparative study to assess status of air quality using fuzzy logic technique and that of conventional technique. The findings clearly indicate that the FIS may successfully harmonize inherent discrepancies and interpret complex conditions.

Soil Quality Index Determination Models for Restinga Forest

NASA Astrophysics Data System (ADS)

Bonilha, R. M.; Casagrande, J. C.; Soares, R. M.

2012-04-01

The Restinga Forest is a set of plant communities in mosaic, determined by the characteristics of their substrates as a result of depositional processes and ages. In this complex mosaic are the physiognomies of restinga forests of high-stage regeneration (high restinga) and middle stage of regeneration (low restinga), each with its plant characteristics that differentiate them. Located on the coastal plains of the Brazilian coast, suffering internal influences both the continental slopes, as well as from the sea. Its soils come from the Quaternary and are subject to constant deposition of sediments. The climate in the coastal type is tropical (Köppen). This work was conducted in four locations: (1) Anchieta Island, Ubatuba, (2) Juréia-Itatins Ecological Station, Iguape, (3) Vila das Pedrinhas, Comprida Island; and (4) Cardoso Island, Cananeia. The soil samples were collect at a depths of 0 to 5, 0-10, 0-20, 20-40 and 40 to 60cm for the chemical and physical analysis. Were studied the additive and pondering additive models to evaluate soil quality. It was concluded: a) the comparative additive model produces quantitative results and the pondering additive model quantitative results; b) as the pondering additive model, the values of Soil Quality Index (SQI) for soils under forest of restinga are low and realistic, demonstrating the small plant biomass production potential of these soils, as well as their low resilience; c) the values of SQI similar to areas with and without restinga forest give quantitative demonstration of the restinga be considered as soil phase; d) restinga forest, probably, is maintained solely by the cycling of nutrients in a closed nutrient cycling; e) for the determination of IQS for soils under restinga vegetation the use of routine chemical analysis is adequate. Keywords: Model, restinga forest, Soil Quality Index (SQI).

Towards the Application of Fuzzy Logic for Developing a Novel Indoor Air Quality Index (FIAQI).

PubMed

Javid, Allahbakhsh; Hamedian, Amir Abbas; Gharibi, Hamed; Sowlat, Mohammad Hossein

2016-02-01

In the past few decades, Indoor Air Pollution (IAP) has become a primary concern to the point. It is increasingly believed to be of equal or greater importance to human health compared to ambient air. However, due to the lack of comprehensive indices for the integrated assessment of indoor air quality (IAQ), we aimed to develop a novel, Fuzzy-Based Indoor Air Quality Index (FIAQI) to bridge the existing gap in this area. We based our index on fuzzy logic, which enables us to overcome the limitations of traditional methods applied to develop environmental quality indices. Fifteen parameters, including the criteria air pollutants, volatile organic compounds, and bioaerosols were included in the FIAQI due mainly to their significant health effects. Weighting factors were assigned to the parameters based on the medical evidence available in the literature on their health effects. The final FIAQI consisted of 108 rules. In order to demonstrate the performance of the index, data were intentionally generated to cover a variety of quality levels. In addition, a sensitivity analysis was conducted to assess the validity of the index. The FIAQI tends to be a comprehensive tool to classify IAQ and produce accurate results. It seems useful and reliable to be considered by authorities to assess IAQ environments.

Benchmarking: A Method for Continuous Quality Improvement in Health

PubMed Central

Ettorchi-Tardy, Amina; Levif, Marie; Michel, Philippe

2012-01-01

Benchmarking, a management approach for implementing best practices at best cost, is a recent concept in the healthcare system. The objectives of this paper are to better understand the concept and its evolution in the healthcare sector, to propose an operational definition, and to describe some French and international experiences of benchmarking in the healthcare sector. To this end, we reviewed the literature on this approach's emergence in the industrial sector, its evolution, its fields of application and examples of how it has been used in the healthcare sector. Benchmarking is often thought to consist simply of comparing indicators and is not perceived in its entirety, that is, as a tool based on voluntary and active collaboration among several organizations to create a spirit of competition and to apply best practices. The key feature of benchmarking is its integration within a comprehensive and participatory policy of continuous quality improvement (CQI). Conditions for successful benchmarking focus essentially on careful preparation of the process, monitoring of the relevant indicators, staff involvement and inter-organizational visits. Compared to methods previously implemented in France (CQI and collaborative projects), benchmarking has specific features that set it apart as a healthcare innovation. This is especially true for healthcare or medical–social organizations, as the principle of inter-organizational visiting is not part of their culture. Thus, this approach will need to be assessed for feasibility and acceptability before it is more widely promoted. PMID:23634166

Benchmarking: a method for continuous quality improvement in health.

PubMed

Ettorchi-Tardy, Amina; Levif, Marie; Michel, Philippe

2012-05-01

Benchmarking, a management approach for implementing best practices at best cost, is a recent concept in the healthcare system. The objectives of this paper are to better understand the concept and its evolution in the healthcare sector, to propose an operational definition, and to describe some French and international experiences of benchmarking in the healthcare sector. To this end, we reviewed the literature on this approach's emergence in the industrial sector, its evolution, its fields of application and examples of how it has been used in the healthcare sector. Benchmarking is often thought to consist simply of comparing indicators and is not perceived in its entirety, that is, as a tool based on voluntary and active collaboration among several organizations to create a spirit of competition and to apply best practices. The key feature of benchmarking is its integration within a comprehensive and participatory policy of continuous quality improvement (CQI). Conditions for successful benchmarking focus essentially on careful preparation of the process, monitoring of the relevant indicators, staff involvement and inter-organizational visits. Compared to methods previously implemented in France (CQI and collaborative projects), benchmarking has specific features that set it apart as a healthcare innovation. This is especially true for healthcare or medical-social organizations, as the principle of inter-organizational visiting is not part of their culture. Thus, this approach will need to be assessed for feasibility and acceptability before it is more widely promoted.

USEPA Environmental Quality Index (EQI) and Associated Domain Indices by County for the United States

EPA Pesticide Factsheets

This map service displays the results data from the EPA's Environmental Quality Index. The US Environmental Protection Agency's (EPA) National Health and Environmental Effects Research Laboratory (NHEERL) in the Environmental Public Health Division (EPHD) is currently engaged in research aimed at developing a measure that estimates overall environmental quality at the county level for the United States. This work is being conducted as an effort to learn more about how various environmental factors simultaneously contribute to health disparities in low-income and minority populations, and to better estimate the total environmental and social context to which humans are exposed. This dataset contains the finalized Environmental Quality Index (EQI), and an index for each of the associated domains (air, water, land, built environment, and sociodemographic environment). Indices are at the county level for all counties in the United States.

Interdisciplinary integration for quality improvement: the Cleveland Veterans Affairs Medical Center Firm System.

PubMed

Aucott, J N; Pelecanos, E; Bailey, A J; Shupe, T C; Romeo, J H; Ravdin, J I; Aron, D C

1995-04-01

Many of the characteristics of Firm Systems lend themselves to the application of principles of continuous quality improvement (CQI). A Firm System is defined as two or more parallel practices organized on the principle of continuity of relationships between patients and an interdisciplinary group of health care professionals and trainees. Firm Systems are organized around the care of the patient or customer and emphasize access, continuity, and quality of care. The Firm System was implemented at the Cleveland Veterans Affairs Medical Center (VAMC) not as a CQI initiative per se, but as an effort to coordinate the processes involved in the delivery of patient care. The primary goals of this implementation were to improve the quality of patient care, medical education, and health care research. The main strategy to deal with problems caused by uncoordinated care were to move from a departmental approach to an integrated interdisciplinary approach. This approach represented a paradigm shift within the organization that extended to planning, documentation, and the general work environment. Most important, the institution had leaders who were committed to the Firm System and willing to authorize resources to ensure its success. VA hospitals are ideal settings for Firm Systems because they provide longitudinal, comprehensive care with a centralized, prepaid payment mechanism, and they have well-developed information systems that allow the random assignment of patients to Firms. Recommendations to others interested in implementing Firm Systems include creation of a written plan that can gain general support; identification of resources needed for successful implementation; remembering that the patient is the most important customer, as well as that complex systems have many customers; monitoring of performance; and the importance of randomizing patients and providers.

Measuring patients' experiences with palliative care: the Consumer Quality Index Palliative Care.

PubMed

Claessen, Susanne J J; Francke, Anneke L; Sixma, Herman J; de Veer, Anke J E; Deliens, Luc

2012-12-01

The Consumer Quality Index Palliative Care (CQ-index PC) is a structured questionnaire for measuring the quality of palliative care from the perspective of care users. CQ-indices assess which care aspects need quality improvement by relating answers about actual care experiences to answers about the importance of certain aspects of care. To improve the chance that the new instrument has good content validity, a literature study and individual and group discussions were performed, and a steering committee was consulted to establish the instrument's face and content validity. The questionnaire was administered to patients with a life expectancy of 6 months or less and/or who were receiving palliative treatment. Descriptive analyses were carried out on the items about actual care experiences and the importance of care aspects, and on 'need for improvement' scores. 15 care organisations participated. 133 patients met the inclusion criteria (net response n=85). Patients considered the following aspects the most important: 'offering help in good time in acute situations', 'caregivers having the necessary expertise' and 'caregivers taking the patient seriously'. The three care aspects with the highest 'need for improvement' scores were: 'support when the patient feels depressed', 'support when the patient is anxious' and 'support when the patient has shortness of breath'. The CQ-index PC provides opportunities for care organisations to assess which care aspects have the highest priority for quality improvement within their organisation. Further research is needed to assess whether the instrument has enough discriminative power to assess differences between organisations.

Method of producing optical quality glass having a selected refractive index

DOEpatents

Poco, John F.; Hrubesh, Lawrence W.

2000-01-01

Optical quality glass having a selected refractive index is produced by a two stage drying process. A gel is produced using sol-gel chemistry techniques and first dried by controlled evaporation until the gel volume reaches a pre-selected value. This pre-selected volume determines the density and refractive index of the finally dried gel. The gel is refilled with solvent in a saturated vapor environment, and then dried again by supercritical extraction of the solvent to form a glass. The glass has a refractive index less than the full density of glass, and the range of achievable refractive indices depends on the composition of the glass. Glasses having different refractive indices chosen from an uninterrupted range of values can be produced from a single precursor solution.

Quality of life in patients with vitiligo: a cross-sectional study based on Vitiligo Quality of Life index (VitiQoL).

PubMed

Hedayat, Kosar; Karbakhsh, Mojgan; Ghiasi, Maryam; Goodarzi, Azadeh; Fakour, Yousef; Akbari, Zahra; Ghayoumi, Afsaneh; Ghandi, Narges

2016-06-07

Vitiligo is a multi-factorial pigmentary skin disorder. Recently, the importance of emotional and psychological issues is proposed in incidence, progression, relapse and remission of vitiligo. There are limited studies conducted in developing countries, which assess life quality of patients with vitiligo. The aim of this study was the application and evaluation of a disease-specific quality of life index in Iranian patients, for the first time. This cross-sectional biphasic study was conducted on 25 patients as a pilot and another 173 patients as the main study group, in Razi Hospital, Tehran, Iran, 2013-2014. Persian version of Vitiligo Quality of Life index (VitiQoL) was developed with backward-forward method. Based on the pilot study, the validity and reliability were assessed. The Vitiligo Area and Score Index (VASI), VitiQoL, and their relationship, demographic and clinical characteristic of patients were measured. The Mean and standard deviation of the VitiQoL score was 30.5 ± 14.5 (range 0-60 in Persian version). There was a significant relationship between VASI score and VitiQoL (p = 0.015, r = 0.187). Confirmatory factor analysis revealed three important factors within VitiQoL: participation limitation, stigma, and behavior. In subscale analysis based on behavior factor, female patients had poorer quality of life (p = 0.02). Concomitant psychiatric problems, e.g. anxiety and depression, were not associated with QOL; however, they were near to being meaningful (p = 0.06, r = 0.14). VitiQoL is a valid index in estimating life quality of vitiligo patients and has proper relation to disease severity. Focusing on patient's life quality is an important entity in the management of vitiligo patients; relevant supportive group-based consultations and therapies are also important arms when approaching vitiligo.

Validation of no-reference image quality index for the assessment of digital mammographic images

NASA Astrophysics Data System (ADS)

de Oliveira, Helder C. R.; Barufaldi, Bruno; Borges, Lucas R.; Gabarda, Salvador; Bakic, Predrag R.; Maidment, Andrew D. A.; Schiabel, Homero; Vieira, Marcelo A. C.

2016-03-01

To ensure optimal clinical performance of digital mammography, it is necessary to obtain images with high spatial resolution and low noise, keeping radiation exposure as low as possible. These requirements directly affect the interpretation of radiologists. The quality of a digital image should be assessed using objective measurements. In general, these methods measure the similarity between a degraded image and an ideal image without degradation (ground-truth), used as a reference. These methods are called Full-Reference Image Quality Assessment (FR-IQA). However, for digital mammography, an image without degradation is not available in clinical practice; thus, an objective method to assess the quality of mammograms must be performed without reference. The purpose of this study is to present a Normalized Anisotropic Quality Index (NAQI), based on the Rényi entropy in the pseudo-Wigner domain, to assess mammography images in terms of spatial resolution and noise without any reference. The method was validated using synthetic images acquired through an anthropomorphic breast software phantom, and the clinical exposures on anthropomorphic breast physical phantoms and patient's mammograms. The results reported by this noreference index follow the same behavior as other well-established full-reference metrics, e.g., the peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM). Reductions of 50% on the radiation dose in phantom images were translated as a decrease of 4dB on the PSNR, 25% on the SSIM and 33% on the NAQI, evidencing that the proposed metric is sensitive to the noise resulted from dose reduction. The clinical results showed that images reduced to 53% and 30% of the standard radiation dose reported reductions of 15% and 25% on the NAQI, respectively. Thus, this index may be used in clinical practice as an image quality indicator to improve the quality assurance programs in mammography; hence, the proposed method reduces the subjectivity

The effects of a team-based continuous quality improvement intervention on the management of primary care: a randomised controlled trial

PubMed Central

Engels, Yvonne; van den Hombergh, Pieter; Mokkink, Henk; van den Hoogen, Henk; van den Bosch, Wil; Grol, Richard

2006-01-01

Aim To study the effects of a team-based model for continuous quality improvement (CQI) on primary care practice management. Design of study Randomised controlled trial. Setting Twenty-six intervention and 23 control primary care practices in the Netherlands. Method Practices interested in taking part in the CQI project were, after assessment of their practice organisation, randomly assigned to the intervention or control groups. During a total of five meetings, a facilitator helped the teams in the intervention group select suitable topics for quality improvement and follow a structured approach to achieve improvement objectives. Checklists completed by an outreach visitor, questionnaires for the GPs, staff and patients were used to assemble data on the number and quality of improvement activities undertaken and on practice management prior to the start of the intervention and 1 year later. Results Pre-test and post-test data were compared for the 26 intervention and 23 control practices. A significant intervention effect was found for the number of improvement objectives actually defined (93 versus 54, P<0.001) and successfully completed (80 versus 69% of the projects, P<0.001). The intervention group also improved on more aspects of practice management, as measured by our practice visit method, than the control group but none of these differences proved statistically significant. Conclusion The intervention exerted a significant effect on the number and quality of improvement projects undertaken and self-defined objectives met. Failure of the effects of the intervention on the other dimensions of practice management to achieve significance may be due to the topics selected for some of the improvement projects being only partly covered by the assessment instrument. PMID:17007709

A ranking index for quality assessment of forensic DNA profiles forensic DNA profiles

PubMed Central

2010-01-01

Background Assessment of DNA profile quality is vital in forensic DNA analysis, both in order to determine the evidentiary value of DNA results and to compare the performance of different DNA analysis protocols. Generally the quality assessment is performed through manual examination of the DNA profiles based on empirical knowledge, or by comparing the intensities (allelic peak heights) of the capillary electrophoresis electropherograms. Results We recently developed a ranking index for unbiased and quantitative quality assessment of forensic DNA profiles, the forensic DNA profile index (FI) (Hedman et al. Improved forensic DNA analysis through the use of alternative DNA polymerases and statistical modeling of DNA profiles, Biotechniques 47 (2009) 951-958). FI uses electropherogram data to combine the intensities of the allelic peaks with the balances within and between loci, using Principal Components Analysis. Here we present the construction of FI. We explain the mathematical and statistical methodologies used and present details about the applied data reduction method. Thereby we show how to adapt the ranking index for any Short Tandem Repeat-based forensic DNA typing system through validation against a manual grading scale and calibration against a specific set of DNA profiles. Conclusions The developed tool provides unbiased quality assessment of forensic DNA profiles. It can be applied for any DNA profiling system based on Short Tandem Repeat markers. Apart from crime related DNA analysis, FI can therefore be used as a quality tool in paternal or familial testing as well as in disaster victim identification. PMID:21062433

Soil quality index for evaluation of reclaimed coal mine spoil.

PubMed

Mukhopadhyay, S; Masto, R E; Yadav, A; George, J; Ram, L C; Shukla, S P

2016-01-15

Success in the remediation of mine spoil depends largely on the selection of appropriate tree species. The impacts of remediation on mine soil quality cannot be sufficiently assessed by individual soil properties. However, combination of soil properties into an integrated soil quality index provides a more holistic status of reclamation potentials of tree species. Remediation potentials of four tree species (Acacia auriculiformis, Cassia siamea, Dalbergia sissoo, and Leucaena leucocephala) were studied on reclaimed coal mine overburden dumps of Jharia coalfield, Dhanbad, India. Soil samples were collected under the canopies of the tree species. Comparative studies on the properties of soils in the reclaimed and the reference sites showed improvements in soil quality parameters of the reclaimed site: coarse fraction (-20.4%), bulk density (-12.8%), water holding capacity (+0.92%), pH (+25.4%), EC (+2.9%), cation exchange capacity (+46.6%), organic carbon (+91.5%), N (+60.6%), P (+113%), K (+19.9%), Ca (+49.6%), Mg (+12.2%), Na (+19.6%), S (+46.7%), total polycyclic aromatic hydrocarbons (-71.4%), dehydrogenase activity (+197%), and microbial biomass carbon (+115%). Principal component analysis (PCA) was used to identify key mine soil quality indicators to develop a soil quality index (SQI). Selected indicators include: coarse fraction, pH, EC, soil organic carbon, P, Ca, S, and dehydrogenase activity. The indicator values were converted into a unitless score (0-1.00) and integrated into SQI. The calculated SQI was significantly (P<0.001) correlated with tree biomass and canopy cover. Reclaimed site has 52-93% higher SQI compared to the reference site. Higher SQI values were obtained for sites reclaimed with D.sissoo (+93.1%) and C.siamea (+86.4%). Copyright © 2015 Elsevier B.V. All rights reserved.

The quality movement in higher education in the United States.

PubMed

Buchanan, H S

1995-09-01

Continuous quality improvement (CQI), often implemented as part of an integrated management system called total quality management (TQM), has been institutionalized within many manufacturing, military and service organizations in the USA as a response to declining market share, low productivity and customer complaints about poor quality. Signs and symptoms suggest that higher education has similar problems which are systematic and relate to the quality ot higher education, financing, facilities, curriculum and graduates. In the 1990S, the quality movement has begun to spread to the field of education as a means of diagnosing and treating the problems widely recognized as residing in US educational institutions, especially in colleges and universities. Many business leaders and authors believe that 'quality is the most important strategic issue facing top management in the 1990s'. This belief arises partly due to the fact that managers are beginning to understand the relationship between healthy, high quality organizations and healthy profits. This article traces the recent US quality movement from its roots in manufacturing and the military, its adoption by service institutions, and its more recent application by higher education institutions.

Application of CCME Water Quality Index to monitor water quality: a case study of the Mackenzie River Basin, Canada.

PubMed

Lumb, Ashok; Halliwell, Doug; Sharma, Tribeni

2006-02-01

All six ecosystem initiatives evolved from many years of federal, provincial, First Nation, local government and community attention to the stresses on sensitive habitats and species, air and water quality, and the consequent threats to community livability. This paper assesses water quality aspect for the ecosystem initiatives and employs newly developed Canadian Council of Ministers of the Environment Water Quality Index (CCME WQI) which provides a convenient mean of summarizing complex water quality data that can be easily understood by the public, water distributors, planners, managers and policy makers. The CCME WQI incorporates three elements: Scope - the number of water quality parameters (variables) not meeting water quality objectives (F(1)); Frequency - the number of times the objectives are not met (F(2)); and Amplitude. the extent to which the objectives are not met (F(3)). The index produces a number between 0 (worst) to 100 (best) to reflect the water quality. This study evaluates water quality of the Mackenzie - Great Bear sub-basin by employing two modes of objective functions (threshold values): one based on the CCME water quality guidelines and the other based on site-specific values that were determined by the statistical analysis of the historical data base. Results suggest that the water quality of the Mackenzie-Great Bear sub-basin is impacted by high turbidity and total (mostly particulate) trace metals due to high suspended sediment loads during the open water season. Comments are also provided on water quality and human health issues in the Mackenzie basin based on the findings and the usefulness of CCME water quality guidelines and site specific values.

Towards the Application of Fuzzy Logic for Developing a Novel Indoor Air Quality Index (FIAQI)

PubMed Central

JAVID, Allahbakhsh; HAMEDIAN, Amir Abbas; GHARIBI, Hamed; SOWLAT, Mohammad Hossein

2016-01-01

Background: In the past few decades, Indoor Air Pollution (IAP) has become a primary concern to the point. It is increasingly believed to be of equal or greater importance to human health compared to ambient air. However, due to the lack of comprehensive indices for the integrated assessment of indoor air quality (IAQ), we aimed to develop a novel, Fuzzy-Based Indoor Air Quality Index (FIAQI) to bridge the existing gap in this area. Methods: We based our index on fuzzy logic, which enables us to overcome the limitations of traditional methods applied to develop environmental quality indices. Fifteen parameters, including the criteria air pollutants, volatile organic compounds, and bioaerosols were included in the FIAQI due mainly to their significant health effects. Weighting factors were assigned to the parameters based on the medical evidence available in the literature on their health effects. The final FIAQI consisted of 108 rules. In order to demonstrate the performance of the index, data were intentionally generated to cover a variety of quality levels. In addition, a sensitivity analysis was conducted to assess the validity of the index. Results: The FIAQI tends to be a comprehensive tool to classify IAQ and produce accurate results. Conclusion: It seems useful and reliable to be considered by authorities to assess IAQ environments. PMID:27114985

A developmental evaluation to enhance stakeholder engagement in a wide-scale interactive project disseminating quality improvement data: study protocol for a mixed-methods study

PubMed Central

Laycock, Alison; Bailie, Jodie; Matthews, Veronica; Cunningham, Frances; Harvey, Gillian; Percival, Nikki; Bailie, Ross

2017-01-01

Introduction Bringing together continuous quality improvement (CQI) data from multiple health services offers opportunities to identify common improvement priorities and to develop interventions at various system levels to achieve large-scale improvement in care. An important principle of CQI is practitioner participation in interpreting data and planning evidence-based change. This study will contribute knowledge about engaging diverse stakeholders in collaborative and theoretically informed processes to identify and address priority evidence-practice gaps in care delivery. This paper describes a developmental evaluation to support and refine a novel interactive dissemination project using aggregated CQI data from Aboriginal and Torres Strait Islander primary healthcare centres in Australia. The project aims to effect multilevel system improvement in Aboriginal and Torres Strait Islander primary healthcare. Methods and analysis Data will be gathered using document analysis, online surveys, interviews with participants and iterative analytical processes with the research team. These methods will enable real-time feedback to guide refinements to the design, reports, tools and processes as the interactive dissemination project is implemented. Qualitative data from interviews and surveys will be analysed and interpreted to provide in-depth understanding of factors that influence engagement and stakeholder perspectives about use of the aggregated data and generated improvement strategies. Sources of data will be triangulated to build up a comprehensive, contextualised perspective and integrated understanding of the project's development, implementation and findings. Ethics and dissemination The Human Research Ethics Committee (HREC) of the Northern Territory Department of Health and Menzies School of Health Research (Project 2015-2329), the Central Australian HREC (Project 15-288) and the Charles Darwin University HREC (Project H15030) approved the study. Dissemination

A developmental evaluation to enhance stakeholder engagement in a wide-scale interactive project disseminating quality improvement data: study protocol for a mixed-methods study.

PubMed

Laycock, Alison; Bailie, Jodie; Matthews, Veronica; Cunningham, Frances; Harvey, Gillian; Percival, Nikki; Bailie, Ross

2017-07-13

Bringing together continuous quality improvement (CQI) data from multiple health services offers opportunities to identify common improvement priorities and to develop interventions at various system levels to achieve large-scale improvement in care. An important principle of CQI is practitioner participation in interpreting data and planning evidence-based change. This study will contribute knowledge about engaging diverse stakeholders in collaborative and theoretically informed processes to identify and address priority evidence-practice gaps in care delivery. This paper describes a developmental evaluation to support and refine a novel interactive dissemination project using aggregated CQI data from Aboriginal and Torres Strait Islander primary healthcare centres in Australia. The project aims to effect multilevel system improvement in Aboriginal and Torres Strait Islander primary healthcare. Data will be gathered using document analysis, online surveys, interviews with participants and iterative analytical processes with the research team. These methods will enable real-time feedback to guide refinements to the design, reports, tools and processes as the interactive dissemination project is implemented. Qualitative data from interviews and surveys will be analysed and interpreted to provide in-depth understanding of factors that influence engagement and stakeholder perspectives about use of the aggregated data and generated improvement strategies. Sources of data will be triangulated to build up a comprehensive, contextualised perspective and integrated understanding of the project's development, implementation and findings. The Human Research Ethics Committee (HREC) of the Northern Territory Department of Health and Menzies School of Health Research (Project 2015-2329), the Central Australian HREC (Project 15-288) and the Charles Darwin University HREC (Project H15030) approved the study. Dissemination will include articles in peer-reviewed journals, policy

The 1999 ICSI/IHI colloquium on clinical quality improvement--"quality: settling the frontier".

PubMed

Palmersheim, T M

1999-12-01

A Colloquium on Clinical Quality Improvement, "Quality: Setting the Frontier," held in May 1999, covered methods and programs in clinical quality improvement. Leadership and organizational behavior were the main themes of the breakout sessions; specific topics included implementing guidelines, applying continuous quality improvement (CQI) methods in preventive services and primary care, and using systems thinking to improve clinical outcomes. Three keynote addresses were presented. James L. Reinertsen, MD (CareGroup, Boston), characterized the financial challenges faced by many health care organizations as a "clarion call" for leadership on quality. "The leadership imperative is to establish an environment in which quality can thrive, despite unprecedented, severe economic pressures on our health systems." How do we make improvement more effective? G. Ross Baker, PhD (University of Toronto), reviewed what organizational literature says about making teams more effective, understanding the organizational context to enable improvement work, and augmenting existing methods for creating sustainable improvement. For example, he noted the increasing interest among may organizations in rapid-cycle improvement but cautioned that such efforts may work best where problems can be addressed by existing clinical teams (not cross-functional work groups) and where there are available solutions that have worked in other settings. Mark Chassin, MD (Mount Sinai School of Medicine, New York), stated that critical tasks for improving quality include increasing public awareness, engaging clinicians in improvement, increasing the investment in producing measures and improvement tools, and reinventing health care delivery, clinical education and training, and QI.

Body mass index, poor diet quality and health related quality of life are associated with mortality in rural older adults

USDA-ARS?s Scientific Manuscript database

In an aging population, potentially modifiable factors impacting mortality such as diet quality, body mass index (BMI), and health-related quality of life (HRQOL) are of interest. Surviving members of the Geisinger Rural Aging Study (GRAS) (n = 5,993; aged =74 years) were contacted in the fall of 20...

The Children's Dermatology Life Quality Index (CDLQI): linguistic and cultural validation in Serbian.

PubMed

Janković, Slavenka; Vukićević, Jelica; Djordjević, Sanja; Janković, Janko; Marinković, Jelena; Erić, Miloš

2013-01-01

The Children's Dermatology Life Quality Index (CDLQI) evaluates the impact of skin diseases on the patient's quality of life. The purpose of the study was to translate and to validate the CDLQI into Serbian. The CDLQI was translated into Serbian following international recommendations for translation and cultural adaptation. The validation study was carried out on a large cohort of secondary schoolchildren who self-reported acne. Translating the CDLQI consisted of forward translation, reconciliation, back translation, back-translation review, and cognitive debriefing. The good internal consistency of the scale was demonstrated with a Cronbach alpha coefficient of 0.87. A Spearman correlation coefficient of 0.66 between the CDLQI and the Cardiff Acne Disability Index (CADI) was deemed satisfactory to demonstrate concurrent validity. The translation, cross-cultural adaptation, and psychometric qualities of the CDLQI were satisfactory, enabling its application in clinical practice and future studies.

Droplet digital PCR-based EGFR mutation detection with an internal quality control index to determine the quality of DNA.

PubMed

Kim, Sung-Su; Choi, Hyun-Jeung; Kim, Jin Ju; Kim, M Sun; Lee, In-Seon; Byun, Bohyun; Jia, Lina; Oh, Myung Ryurl; Moon, Youngho; Park, Sarah; Choi, Joon-Seok; Chae, Seoung Wan; Nam, Byung-Ho; Kim, Jin-Soo; Kim, Jihun; Min, Byung Soh; Lee, Jae Seok; Won, Jae-Kyung; Cho, Soo Youn; Choi, Yoon-La; Shin, Young Kee

2018-01-11

In clinical translational research and molecular in vitro diagnostics, a major challenge in the detection of genetic mutations is overcoming artefactual results caused by the low-quality of formalin-fixed paraffin-embedded tissue (FFPET)-derived DNA (FFPET-DNA). Here, we propose the use of an 'internal quality control (iQC) index' as a criterion for judging the minimum quality of DNA for PCR-based analyses. In a pre-clinical study comparing the results from droplet digital PCR-based EGFR mutation test (ddEGFR test) and qPCR-based EGFR mutation test (cobas EGFR test), iQC index ≥ 0.5 (iQC copies ≥ 500, using 3.3 ng of FFPET-DNA [1,000 genome equivalents]) was established, indicating that more than half of the input DNA was amplifiable. Using this criterion, we conducted a retrospective comparative clinical study of the ddEGFR and cobas EGFR tests for the detection of EGFR mutations in non-small cell lung cancer (NSCLC) FFPET-DNA samples. Compared with the cobas EGFR test, the ddEGFR test exhibited superior analytical performance and equivalent or higher clinical performance. Furthermore, iQC index is a reliable indicator of the quality of FFPET-DNA and could be used to prevent incorrect diagnoses arising from low-quality samples.

Application of a Functional Mathematical Index to the Evaluation of the Nutritional Quality of Potatoes

USDA-ARS?s Scientific Manuscript database

This paper describes the derivation and application of a new functional mathematical index that was used to evaluate the nutritional, safety, and processing quality aspects of potatoes. The index introduces the concept of an “optimal potato”, using appropriate distance and N-dimensional parameter sp...

Wide variation in sexually transmitted infection testing and counselling at Aboriginal primary health care centres in Australia: analysis of longitudinal continuous quality improvement data.

PubMed

Nattabi, Barbara; Matthews, Veronica; Bailie, Jodie; Rumbold, Alice; Scrimgeour, David; Schierhout, Gill; Ward, James; Guy, Rebecca; Kaldor, John; Thompson, Sandra C; Bailie, Ross

2017-02-15

Chlamydia, gonorrhoea and syphilis are readily treatable sexually transmitted infections (STIs) which continue to occur at high rates in Australia, particularly among Aboriginal Australians. This study aimed to: explore the extent of variation in delivery of recommended STI screening investigations and counselling within Aboriginal primary health care (PHC) centres; identify the factors associated with variation in screening practices; and determine if provision of STI testing and counselling increased with participation in continuous quality improvement (CQI). Preventive health audits (n = 16,086) were conducted at 137 Aboriginal PHC centres participating in the Audit and Best Practice for Chronic Disease Program, 2005-2014. STI testing and counselling data were analysed to determine levels of variation in chlamydia, syphilis and gonorrhoea testing and sexual health discussions. Multilevel logistic regression was used to determine factors associated with higher levels of STI-related service delivery and to quantify variation attributable to health centre and client characteristics. Significant variation in STI testing and counselling exists among Aboriginal PHC centres with health centre factors accounting for 43% of variation between health centres and jurisdictions. Health centre factors independently associated with higher levels of STI testing and counselling included provision of an adult health check (odds ratio (OR) 3.40; 95% Confidence Interval (CI) 3.07-3.77) and having conducted 1-2 cycles of CQI (OR 1.34; 95% CI 1.16-1.55). Client factors associated with higher levels of STI testing and counselling were being female (OR 1.45; 95% CI 1.33-1.57), Aboriginal (OR 1.46; 95% CI 1.15-1.84) and aged 20-24 years (OR 3.84; 95% CI 3.07-4.80). For females, having a Pap smear test was also associated with STI testing and counselling (OR 4.39; 95% CI 3.84-5.03). There was no clear association between CQI experience beyond two CQI cycles and higher levels of

Performance of biotic indices in comparison to chemical-based Water Quality Index (WQI) in evaluating the water quality of urban river.

PubMed

Wan Abdul Ghani, Wan Mohd Hafezul; Abas Kutty, Ahmad; Mahazar, Mohd Akmal; Al-Shami, Salman Abdo; Ab Hamid, Suhaila

2018-04-19

In order to evaluate the water quality of one of the most polluted urban river in Malaysia, the Penchala River, performance of eight biotic indices, Biomonitoring Working Party (BMWP), BMWP Thai , BMWP Viet , Average Score Per Taxon (ASPT), ASPT Thai , BMWP Viet , Family Biotic Index (FBI), and Singapore Biotic Index (SingScore), was compared. The water quality categorization based on these biotic indices was then compared with the categorization of Malaysian Water Quality Index (WQI) derived from measurements of six water physicochemical parameters (pH, BOD, COD, NH 3 -N, DO, and TSS). The river was divided into four sections: upstream section (recreational area), middle stream 1 (residential area), middle stream 2 (commercial area), and downstream. Abundance and diversity of the macroinvertebrates were the highest in the upstream section (407 individual and H' = 1.56, respectively), followed by the middle stream 1 (356 individual and H' = 0.82). The least abundance was recorded in the downstream section (214 individual). Among all biotic indices, BMWP was the most reliable in evaluating the water quality of this urban river as their classifications were comparable to the WQI. BMWPs in this study have strong relationships with dissolved oxygen (DO) content. Our results demonstrated that the biotic indices were more sensitive towards organic pollution than the WQI. BMWP indices especially BMWP Viet were the most reliable and could be adopted along with the WQI for assessment of water quality in urban rivers.

A continuous quality improvement intervention to improve the effectiveness of community health workers providing care to mothers and children: a cluster randomised controlled trial in South Africa.

PubMed

Horwood, Christiane; Butler, Lisa; Barker, Pierre; Phakathi, Sifiso; Haskins, Lyn; Grant, Merridy; Mntambo, Ntokozo; Rollins, Nigel

2017-06-13

Community health workers (CHWs) play key roles in delivering health programmes in many countries worldwide. CHW programmes can improve coverage of maternal and child health services for the most disadvantaged and remote communities, leading to substantial benefits for mothers and children. However, there is limited evidence of effective mentoring and supervision approaches for CHWs. This is a cluster randomised controlled trial to investigate the effectiveness of a continuous quality improvement (CQI) intervention amongst CHWs providing home-based education and support to pregnant women and mothers. Thirty CHW supervisors were randomly allocated to intervention (n = 15) and control (n = 15) arms. Four CHWs were randomly selected from those routinely supported by each supervisor (n = 60 per arm). In the intervention arm, these four CHWs and their supervisor formed a quality improvement team. Intervention CHWs received a 2-week training in WHO Community Case Management followed by CQI mentoring for 12 months (preceded by 3 months lead-in to establish QI processes). Baseline and follow-up surveys were conducted with mothers of infants <12 months old living in households served by participating CHWs. Interviews were conducted with 736 and 606 mothers at baseline and follow-up respectively; socio-demographic characteristics were similar in both study arms and at each time point. At follow-up, compared to mothers served by control CHWs, mothers served by intervention CHWs were more likely to have received a CHW visit during pregnancy (75.7 vs 29.0%, p < 0.0001) and the postnatal period (72.6 vs 30.3%, p < 0.0001). Intervention mothers had higher maternal and child health knowledge scores (49 vs 43%, p = 0.02) and reported higher exclusive breastfeeding rates to 6 weeks (76.7 vs 65.1%, p = 0.02). HIV-positive mothers served by intervention CHWs were more likely to have disclosed their HIV status to the CHW (78.7 vs 50.0%, p = 0

Novel bibliometric scores for evaluating research quality and output: a correlation study with established indexes.

PubMed

Scotti, Valeria; De Silvestri, Annalisa; Scudeller, Luigia; Abele, Paola; Topuz, Funda; Curti, Moreno

2016-12-23

Novel bibliometric indexes (commonly known as altmetrics) are gaining interest within the scientific community and might represent an important alternative measure of research quality and output. We evaluate how these new metrics correlate with established bibliometric indexes such as the impact factor (IF), currently used as a measure of scientific production as well as a criterion for scientific research funding, and how they might be helpful in assessing the impact of research. We calculated altmetrics scores for all the articles published at our institution during a single year and examined the correlation between altmetrics scores and IFs as a measure of research quality and impact in all departments. For all articles from the various departments published in a single year, the altmetrics score and the sum of all IFs showed a strong and significant correlation (Spearman's rho 0.88). The correlation was significant also when the major components of altmetrics, including Facebook, Twitter and Mendeley, were analyzed. The implementation of altmetrics has been found to be easy and effective at both the researcher and librarian levels. The novel bibliographic index altmetrics is consistent and reliable and can complement or be considered a valid alternative to standard bibliometric indexes to benchmark output and quality of research for academic and funding purposes.

Assessment of the Impacts of Rice Cropping through a Soil Quality Index

NASA Astrophysics Data System (ADS)

Sione, S. M.; Wilson, M. G.; Paz González, A.

2012-04-01

In Entre Ríos (Argentina), rice cultivation is carried out mainly in Vertisols. Several factors, such as the use of sodium bicarbonate waters for irrigation, the excessive tillage required, and the lack of proper planning for land use, mainly regarding the crop sequence, cause serious impacts on the soil and have an effect on sustainable agriculture. Thus, the development of methodologies to detect these impacts has become a priority. The aim of this study was to standardize soil quality indicators (SQI) and integrate them into an index to evaluate the impacts of the rice production system on soil, at the farm scale. The study was conducted in farms of the traditional rice cultivation area of Entre Ríos province, Argentina. We evaluated a minimum data set consisting of six indicators: structural stability and percolation, total organic matter content (TOM), exchangeable sodium content (ESC), electrical conductivity of saturation extract (ECe) and reaction of the soil (pH). From a database from 75 production lots, we determined the reference values, i.e. limits to ensure the maintenance of long-term productivity and the allowable thresholds for each indicator. The indicators were standardized and integrated into a soil quality index. Five ranges of soil quality were established: very low, low, moderate, high and very high, depending on the values assigned to each SQI. This index allowed differentiating the impact of different crop sequences and showed that the increased participation of rice crop in the rotation resulted in a deterioration of the soil structure due to the decrease in the TOM and to the cumulative increase in ESC caused by the sodium bicarbonate water used for irrigation. Soil management strategies should aim to increase TOM values and to reduce the input of sodium to the exchange complex. A rotation with 50% to 60% of pasture and 40 to 50% of agriculture with a participation of rice lower than 20 to 25% would allow the sustainability of the

Improving iris recognition performance using segmentation, quality enhancement, match score fusion, and indexing.

PubMed

Vatsa, Mayank; Singh, Richa; Noore, Afzel

2008-08-01

This paper proposes algorithms for iris segmentation, quality enhancement, match score fusion, and indexing to improve both the accuracy and the speed of iris recognition. A curve evolution approach is proposed to effectively segment a nonideal iris image using the modified Mumford-Shah functional. Different enhancement algorithms are concurrently applied on the segmented iris image to produce multiple enhanced versions of the iris image. A support-vector-machine-based learning algorithm selects locally enhanced regions from each globally enhanced image and combines these good-quality regions to create a single high-quality iris image. Two distinct features are extracted from the high-quality iris image. The global textural feature is extracted using the 1-D log polar Gabor transform, and the local topological feature is extracted using Euler numbers. An intelligent fusion algorithm combines the textural and topological matching scores to further improve the iris recognition performance and reduce the false rejection rate, whereas an indexing algorithm enables fast and accurate iris identification. The verification and identification performance of the proposed algorithms is validated and compared with other algorithms using the CASIA Version 3, ICE 2005, and UBIRIS iris databases.

An overall index of environmental quality in coal mining areas and energy facilities.

PubMed

Vatalis, Konstantinos I; Kaliampakos, Demetrios C

2006-12-01

An approach to measuring environmental quality and trends in coal mining and industrial areas was attempted in this work. For this purpose, the establishment of a reference scale characterizing the status of environmental quality is proposed by developing an Environmental Quality Index (EQI). The methodology involves three main components: social research, the opinion of environmental experts, and the combination of new or existing indices. A survey of public opinion was carried out to identify the main environmental problems in the region of interest. Environmental experts carried out a survey, and the weights of specific environmental problems were obtained through a fuzzy Delphi method and pairwise comparison. The weight attributed to each environmental problem was computed, using new or existing indices (subindices) in the relevant literature. The EQI comprises a combination of the subindices with their own weights. The methodology was applied to a heavily industrialized coal basin in northwestern Macedonia, Greece. The results show that the new index may be used as a reliable tool for evaluating environmental quality in different areas. In addition, the study of EQI trends on an interannual basis can provide useful information on the efficiency of environmental policies already implemented by the responsible authorities.

Geospatial distribution modeling and determining suitability of groundwater quality for irrigation purpose using geospatial methods and water quality index (WQI) in Northern Ethiopia

NASA Astrophysics Data System (ADS)

Gidey, Amanuel

2018-06-01

Determining suitability and vulnerability of groundwater quality for irrigation use is a key alarm and first aid for careful management of groundwater resources to diminish the impacts on irrigation. This study was conducted to determine the overall suitability of groundwater quality for irrigation use and to generate their spatial distribution maps in Elala catchment, Northern Ethiopia. Thirty-nine groundwater samples were collected to analyze and map the water quality variables. Atomic absorption spectrophotometer, ultraviolet spectrophotometer, titration and calculation methods were used for laboratory groundwater quality analysis. Arc GIS, geospatial analysis tools, semivariogram model types and interpolation methods were used to generate geospatial distribution maps. Twelve and eight water quality variables were used to produce weighted overlay and irrigation water quality index models, respectively. Root-mean-square error, mean square error, absolute square error, mean error, root-mean-square standardized error, measured values versus predicted values were used for cross-validation. The overall weighted overlay model result showed that 146 km2 areas are highly suitable, 135 km2 moderately suitable and 60 km2 area unsuitable for irrigation use. The result of irrigation water quality index confirms 10.26% with no restriction, 23.08% with low restriction, 20.51% with moderate restriction, 15.38% with high restriction and 30.76% with the severe restriction for irrigation use. GIS and irrigation water quality index are better methods for irrigation water resources management to achieve a full yield irrigation production to improve food security and to sustain it for a long period, to avoid the possibility of increasing environmental problems for the future generation.

Self-efficacy: empowering parents of children with cystic fibrosis.

PubMed

McDonald, Catherine M; Haberman, Diane; Brown, Natalie

2013-09-01

Can parent engagement in the development and delivery of educational materials for cystic fibrosis (CF) promote increased self-efficacy and confidence in self-management skills? Standard therapies for a child with CF frequently involve pulmonary treatment, medications, and behavioral and nutritional interventions. Parents report that the prescribed CF care can be overwhelming. Previous research at this pediatric CF Center indicated the parental perception of the difficulty in managing CF-related nutrition therapy. Parents' nutrition knowledge was an initial target of this continuous quality improvement (CQI) project with a long-range aim of increasing children's median body mass index (BMI) percentiles for patients at this pediatric CF center. The local CF Parent Advisory Council, CF parents and staff collaborated on this family-centered CQI project. A CF parent website with weekly email newsletters and a facebook page were developed and evolved with input from parents. Parental feedback was gathered through electronic surveys, written questionnaires, focus groups and informal interviews. A convenience sample of parents participated in pre- and post-intervention surveys to determine change in self-confidence in effectively managing their children's CF treatment regimens. Results were also compared with responses from a larger previous survey. Parental knowledge of nutrition facts and medical nutrition therapy for CF did not increase significantly over the course of the CQI project. Surveyed parents reported increased confidence in their self-management skills. Although mean BMI percentiles have increased at this center, they remain below the national average. Parent-driven educational strategies provide an opportunity to promote reliable CF-related information in parent-preferred formats that enhance self-management skills in caring for children with CF. Parental confidence to follow CF center recommendations increased between 2004 and 2011. Although many factors

U.S. Government Open Internet Access to Sub-meter Satellite Data

NASA Technical Reports Server (NTRS)

Neigh, Christopher S. R> ; Masek, Jeffery G.; Nickeson, Jaime E.

2012-01-01

The National Geospatial-Intelligence Agency (NGA) has contracted United States commercial remote sensing companies GeoEye and Digital Globe to provide very high resolution commercial quality satellite imagery to federal/state government agencies and those projects/people who support government interests. Under NextView contract terms, those engaged in official government programs/projects can gain online access to NGA's vast global archive. Additionally, data from vendor's archives of IKONOS-2 (IK-2), OrbView-3 (OB-3), GeoEye-1 (GE-1), QuickBird-1 (QB-1), WorldView-1 (WV-1), and WorldView-2 (WV-2), sensors can also be requested under these agreements. We report here the current extent of this archive, how to gain access, and the applications of these data by Earth science investigators to improve discoverability and community use of these data. Satellite commercial quality imagery (CQI) at very high resolution (< 1 m) (here after referred to as CQI) over the past decade has become an important data source to U.S. federal, state, and local governments for many different purposes. The rapid growth of free global CQI data has been slow to disseminate to NASA Earth Science community and programs such as the Land-Cover Land-Use Change (LCLUC) program which sees potential benefit from unprecedented access. This article evolved from a workshop held on February 23rd, 2012 between representatives from NGA, NASA, and NASA LCLUC Scientists discussion on how to extend this resource to a broader license approved community. Many investigators are unaware of NGA's archive availability or find it difficult to access CQI data from NGA. Results of studies, both quality and breadth, could be improved with CQI data by combining them with other moderate to coarse resolution passive optical Earth observation remote sensing satellites, or with RADAR or LiDAR instruments to better understand Earth system dynamics at the scale of human activities. We provide the evolution of this effort, a

Spatio-temporal evaluation of Yamchi Dam basin water quality using Canadian water quality index.

PubMed

Farzadkia, Mahdi; Djahed, Babak; Shahsavani, Esmaeel; Poureshg, Yousef

2015-04-01

In recent years, the growth of population and increase of the industries around the tributaries of Yamchi Dam basin have led to deterioration of dam water quality. This study aimed to evaluate the quality of the Yamchi Dam basin water, which is used for drinking and irrigation consumptions using Canadian Water Quality Index (CWQI) model, and to determine the main water pollution sources of this basin. Initially, nine sampling stations were selected in the sensitive locations of the mentioned basin's tributaries, and 12 physico-chemical parameters and 2 biological parameters were measured. The CWQI for drinking consumptions was under 40 at all the stations indicating a poor water quality for drinking consumptions. On the other hand, the CWQI was 62-100 for irrigation at different stations; thus, the water had an excellent to fair quality for irrigation consumptions. Almost in all the stations, the quality of irrigation and drinking water in cold season was better. Besides, for drinking use, total coliform and fecal coliform had the highest frequency of failure, and total coliform had the maximum deviation from the specified objective. For irrigation use, total suspended solids had the highest frequency of failure and deviation from the objective in most of the stations. The pisciculture center, aquaculture center, and the Nir City wastewater discharge were determined as the main pollution sources of the Yamchi Dam basin. Therefore, to improve the water quality in this important surface water resource, urban and industrial wastewater treatment prior to disposal and more stringent environmental legislations are recommended.

Singapore Takes Six Steps Forward in 'The Quality of Death Index' Rankings.

PubMed

Lin Goh, Stella Seow

2018-01-01

In the latest 2015 Quality of Death Index, Singapore managed to move SIX steps forward from 18 th to the 12 th position. This advancement has been hard-won, with victories to improve the level of palliative care such as creating awareness of palliative service, improving coordinated care and growing an adequate capacity to meet the demand of care in our fast -growing ageing population. But it hasn't always been easy. Despite being a first world country, Asian societies like Singapore have inherited taboos regarding public dialogue about death and dying. Such dialogue is traditionally avoided. However, through years of continual effort in improving the standard of palliative care delivery, redesigning education module, creating public awareness and improving funding system, Singapore's palliative care providers have improved the lives of those with life-limiting illnesses. Nevertheless, the government will continue to improve and work toward achieving single digits in the next ranking of the Quality of Death Index.

Inventario mundial de la calidad del carbon mineral (WoCQI) [The world coal quality inventory (WoCQI)

USGS Publications Warehouse

Finkelman, R.B.; Lovern, V.S.

2001-01-01

Los oficiales encargados de la politica comercial de cada pais requieren informacion clara y precisa sobre el recurso del carbon mineral, particularmente sobre sus propiedades y caracteristicas, para tomar decisiones bien fundamentadas con respecto al mejor uso de los recursos naturales, necesidades de importacion y oportunidades de exportacion, objetivos de politica interna y externa, oportunidades de transferencia tecnologica, posibilidades de inversion externa, estudios ambientales y de salud, y asuntos relacionados con el uso de productos secundarios y su disposicion.

The Establishment and Application of a Labor Quality Index: The Case of Taiwan's Manufacturing Industry

ERIC Educational Resources Information Center

San,Gee; Huang, Tung-Chun; Huang, Li-Hsuan

2006-01-01

The labor quality index (LQI) not only serves as an important reference for monitoring the progress of the sustainable development of a country, but it can also serve as an important parameter for economic analysis. To compile such an index for Taiwan, we conducted two large-scale surveys of 1000 major enterprises and 844 union leaders,…

Construction of an environmental quality index for public health research

PubMed Central

2014-01-01

Background A more comprehensive estimate of environmental quality would improve our understanding of the relationship between environmental conditions and human health. An environmental quality index (EQI) for all counties in the U.S. was developed. Methods The EQI was developed in four parts: domain identification; data source acquisition; variable construction; and data reduction. Five environmental domains (air, water, land, built and sociodemographic) were recognized. Within each domain, data sources were identified; each was temporally (years 2000–2005) and geographically (county) restricted. Variables were constructed for each domain and assessed for missingness, collinearity, and normality. Domain-specific data reduction was accomplished using principal components analysis (PCA), resulting in domain-specific indices. Domain-specific indices were then combined into an overall EQI using PCA. In each PCA procedure, the first principal component was retained. Both domain-specific indices and overall EQI were stratified by four rural–urban continuum codes (RUCC). Higher values for each index were set to correspond to areas with poorer environmental quality. Results Concentrations of included variables differed across rural–urban strata, as did within-domain variable loadings, and domain index loadings for the EQI. In general, higher values of the air and sociodemographic indices were found in the more metropolitan areas and the most thinly populated areas have the lowest values of each of the domain indices. The less-urbanized counties (RUCC 3) demonstrated the greatest heterogeneity and range of EQI scores (−4.76, 3.57) while the thinly populated strata (RUCC 4) contained counties with the most positive scores (EQI score ranges from −5.86, 2.52). Conclusion The EQI holds promise for improving our characterization of the overall environment for public health. The EQI describes the non-residential ambient county-level conditions to which residents are

Development and validation of a new Prescription Quality Index

PubMed Central

Hassan, Norul Badriah; Ismail, Hasanah Che; Naing, Lin; Conroy, Ronán M; Abdul Rahman, Abdul Rashid

2010-01-01

AIMS The aims were to develop and validate a new Prescription Quality Index (PQI) for the measurement of prescription quality in chronic diseases. METHODS The PQI were developed and validated based on three separate surveys and one pilot study. Criteria were developed based on literature search, discussions and brainstorming sessions. Validity of the criteria was examined using modified Delphi method. Pre-testing was performed on 30 patients suffering from chronic diseases. The modified version was then subjected to reviews by pharmacists and clinicians in two separate surveys. The rater-based PQI with 22 criteria was then piloted in 120 patients with chronic illnesses. Results were analysed using SPSS version 12.0.1 RESULTS Exploratory principal components analysis revealed multiple factors contributing to prescription quality. Cronbach's α for the entire 22 criteria was 0.60. The average intra-rater and inter-rater reliability showed good to moderate stability (intraclass correlation coefficient 0.76 and 0.52, respectively). The PQI was significantly and negatively correlated with age (correlation coefficient −0.34, P < 0.001), number of drugs in prescriptions (correlation coefficient −0.51, P < 0.001) and number of chronic diseases/conditions (correlation coefficient −0.35, P < 0.001). CONCLUSIONS The PQI is a promising new instrument for measuring prescription quality. It has been shown that the PQI is a valid, reliable and responsive tool to measure quality of prescription in chronic diseases. PMID:20840442

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.

Measuring a hospital's ability to improve.

PubMed

Meurer, Steven J; Counte, Michael A; Rubio, Doris M; Arrington, Barbara

2004-01-01

The aim of this study was to test whether a recently developed measure of Continuous Quality Improvement (CQI) implementation can provide health care researchers and administrators with a tool to assist in understanding and with developing an appropriate structure for improvement efforts in hospitals. Two hundred respondents from 40 Missouri hospitals completed a 28-item survey addressing 8 domains of CQI. Overall, hospital scores showed low implementation of a structure that supports improvement efforts. All survey domains showed acceptable psychometric results. Leadership proved to be the most important domain of CQI because it differentiated well between all levels of the scale. Because of its ease of administration and analysis, and its reliability, validity, and level differentiation results, the researchers recommend the widespread use of this tool to understand and develop a hospital's organizational structure to support improvement activities.

Nutritional composition, glycemic index, glycemic load, and organoleptical quality of glucomannan-enriched soy milk ice cream

NASA Astrophysics Data System (ADS)

Sa'adah, S.; Candra, O. M.; Nugrahani, G.; Pramono, A.; Afifah, D. N.

2018-01-01

Over the past decades, the number of childhood obesity cases has increased significantly, which led to an increase in the number of adults suffering from degenerative diseases such as diabetes mellitus (DM). Glucomannan-Enriched Soy Milk Ice Cream (GSMIC) may prevent obesity in children. The aim of the study was to test the level of carbohydrates, protein, fat, dietary fiber, glycemic index, glycemic load, and organoleptic quality of GSMIC. This experiment used a completely randomized design to test three formulations of glucomannan flour and soy milk (0.5%, 1.5%, and 2.5%). The products were tested for nutritional composition, and evaluated on glycemic index, glycemic load, and organoleptic quality. GSMIC 2.5% had higher levels of dietary fiber and high carbohydrate, protein, and fat content compared to ice cream (3.99%, 30.7%, 1.50%, 1.33%, respectively). The glycemic index of ice cream and 2.5% GSMIC were 75.83 (75%) and 51.48 (51%), respectively, while the glycemic load of ice cream and 2.5% GSMIC were 9.04 and 11.61, respectively. Based on the organoleptic analysis, formulation preferred by the panellists was 2.5% glucomannan flour. Glucomannan flour affected the level of carbohydrates, protein, fat, dietary fiber, glycemic index, glycemic load, and organoleptic quality in soy milk ice cream.

Assessment of soil biological quality index (QBS-ar) in different crop rotation systems in paddy soils

NASA Astrophysics Data System (ADS)

Nadimi-Goki, Mandana; Bini, Claudio; haefele, Stephan

2013-04-01

New methods, based on soil microarthropods for soil quality evaluation have been proposed by some Authors. Soil microarthropods demonstrated to respond sensitively to land management practices and to be correlated with beneficial soil functions. QBS Index (QBS-ar) is calculated on the basis of microarthropod groups present in a soil sample. Each biological form found in the sample receives a score from 1 to 20 (eco-morphological index, EMI), according to its adaptation to soil environment. The objective of this study was to evaluate the effect of various rotation systems and sampling periods on soil biological quality index, in paddy soils. For the purpose of this study surface soil samples (0-15 cm depth) were collected from different rotation systems (rice-rice-rice, soya-rice-rice, fallow-rice and pea-soya-rice) with three replications, and four sampling times in April (after field preparation), June (after seedling), August (after tillering stage) and October (after rice harvesting). The study area is located in paddy soils of Verona area, Northern Italy. Soil microarthropods from a total of 48 samples were extracted and classified according to the Biological Quality of Soil Index (QBS-ar) method. In addition soil moisture, Cumulative Soil Respiration and pH were measured in each site. More diversity of microarthropod groups was found in June and August sampling times. T-test results between different rotations did not show significant differences while the mean difference between rotation and different sampling times is statistically different. The highest QBS-ar value was found in the fallow-rice rotation in the forth soil sampling time. Similar value was found in soya-rice-rice rotation. Result of linear regression analysis indicated that there is significant correlation between QBS-ar values and Cumulative Soil Respiration. Keywords: soil biological quality index (QBS-ar), Crop Rotation System, paddy soils, Italy

Development and validation of a food-based diet quality index for New Zealand adolescents

PubMed Central

2013-01-01

Background As there is no population-specific, simple food-based diet index suitable for examination of diet quality in New Zealand (NZ) adolescents, there is a need to develop such a tool. Therefore, this study aimed to develop an adolescent-specific diet quality index based on dietary information sourced from a Food Questionnaire (FQ) and examine its validity relative to a four-day estimated food record (4DFR) obtained from a group of adolescents aged 14 to 18 years. Methods A diet quality index for NZ adolescents (NZDQI-A) was developed based on ‘Adequacy’ and ‘Variety’ of five food groups reflecting the New Zealand Food and Nutrition Guidelines for Healthy Adolescents. The NZDQI-A was scored from zero to 100, with a higher score reflecting a better diet quality. Forty-one adolescents (16 males, 25 females, aged 14–18 years) each completed the FQ and a 4DFR. The test-retest reliability of the FQ-derived NZDQI-A scores over a two-week period and the relative validity of the scores compared to the 4DFR were estimated using Pearson’s correlations. Construct validity was examined by comparing NZDQI-A scores against nutrient intakes obtained from the 4DFR. Results The NZDQI-A derived from the FQ showed good reliability (r = 0.65) and reasonable agreement with 4DFR in ranking participants by scores (r = 0.39). More than half of the participants were classified into the same thirds of scores while 10% were misclassified into the opposite thirds by the two methods. Higher NZDQI-A scores were also associated with lower total fat and saturated fat intakes and higher iron intakes. Conclusions Higher NZDQI-A scores were associated with more desirable fat and iron intakes. The scores derived from either FQ or 4DFR were comparable and reproducible when repeated within two weeks. The NZDQI-A is relatively valid and reliable in ranking diet quality in adolescents at a group level even in a small sample size. Further studies are required to test the

Appraisal of long term groundwater quality of peninsular India using water quality index and fractal dimension

NASA Astrophysics Data System (ADS)

Rawat, Kishan Singh; Singh, Sudhir Kumar; Jacintha, T. German Amali; Nemčić-Jurec, Jasna; Tripathi, Vinod Kumar

2017-12-01

A review has been made to understand the hydrogeochemical behaviour of groundwater through statistical analysis of long term water quality data (year 2005-2013). Water Quality Index ( WQI), descriptive statistics, Hurst exponent, fractal dimension and predictability index were estimated for each water parameter. WQI results showed that majority of samples fall in moderate category during 2005-2013, but monitoring site four falls under severe category (water unfit for domestic use). Brownian time series behaviour (a true random walk nature) exists between calcium (Ca^{2+}) and electric conductivity (EC); magnesium (Mg^{2+}) with EC; sodium (Na+) with EC; sulphate (SO4^{2-}) with EC; total dissolved solids (TDS) with chloride (Cl-) during pre- (2005-2013) and post- (2006-2013) monsoon season. These parameters have a closer value of Hurst exponent ( H) with Brownian time series behaviour condition (H=0.5). The result of times series analysis of water quality data shows a persistent behaviour (a positive autocorrelation) that has played a role between Cl- and Mg^{2+}, Cl- and Ca^{2+}, TDS and Na+, TDS and SO4^{2-}, TDS and Ca^{2+} in pre- and post-monsoon time series because of the higher value of H (>1). Whereas an anti-persistent behaviour (or negative autocorrelation) was found between Cl- and EC, TDS and EC during pre- and post-monsoon due to low value of H. The work outline shows that the groundwater of few areas needs treatment before direct consumption, and it also needs to be protected from contamination.

National Coal Quality Inventory (NACQI)

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

Robert Finkelman

2005-09-30

The U.S. Geological Survey (USGS) conducted the National Coal Quality Inventory (NaCQI) between 1999 and 2005 to address a need for quality information on coals that will be mined during the next 20-30 years. Collaboration between the USGS, State geological surveys, universities, coal burning utilities, and the coal mining industry plus funding support from the Electric Power Research Institute (EPRI) and the U.S. Department of Energy (DOE) permitted collection and submittal of coal samples for analysis. The chemical data (proximate and ultimate analyses; major, minor and trace element concentrations) for 729 samples of raw or prepared coal, coal associated shale,more » and coal combustion products (fly ash, hopper ash, bottom ash and gypsum) from nine coal producing States are included. In addition, the project identified a new coal reference analytical standard, to be designated CWE-1 (West Elk Mine, Gunnison County, Colorado) that is a high-volatile-B or high-volatile-A bituminous coal with low contents of ash yield and sulfur, and very low, but detectable contents of chlorine, mercury and other trace elements.« less

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.

Testing the extended biotic index in Slovakia: consistency, advantages, and limitations versus the saprobic assessment method of water quality.

PubMed

Pennelli, Bruno; Nagel, Karl-Otto; Crivellaro, Giuseppe; Fabiani, Claudio; Vancova, Alexandra; Mancini, Laura

2006-04-01

The European Union Water Framework Directive requires the achievement of environmental objectives for the ecological quality of water bodies. A comparable implementation of the Directive throughout member countries of the European Union is necessary to verify equal protection of surface waters. The Directive specifies that member states determine ecological quality by means of biological indices. To improve comparability of water quality assessment, this research carried out an intercalibration trial between the Slovak Saprobic Index and the Italian protocol of the Extended Biotic Index, as part of a cooperative program between Italy and the Slovak Republic. When assessing streams with no or low pollution, statistics showed similar results for both methods. In contrast, the comparison of indices was not accurate in the case of severely affected waters. Reliable conversion formulas are feasible to transform the Italian Extended Biotic Index into the Slovak Saprobic Index, and not vice versa.

An index to measure depreciation in air quality in some coal mining areas of Korba industrial belt of Chhattisgarh, India.

PubMed

Singh, Gurdeep

2006-11-01

The comparison with National Ambient Air Quality Standards does not always depict a true picture of the Air Quality Status of a study area. As an alternative an index that measures depreciation in Air Quality on more realistic terms has been proposed and applied to the ambient air monitoring data collected from some areas of Korba Coalfields in India. Results have been discussed in detail to illustrate the application of the proposed index and utility in bringing out more realistic air quality assessment.

Next Generation Quality: Assessing the Physician in Clinical History Completeness and Diagnostic Interpretations Using Funnel Plots and Normalized Deviations Plots in 3,854 Prostate Biopsies.

PubMed

Bonert, Michael; El-Shinnawy, Ihab; Carvalho, Michael; Williams, Phillip; Salama, Samih; Tang, Damu; Kapoor, Anil

2017-01-01

Observational data and funnel plots are routinely used outside of pathology to understand trends and improve performance. Extract diagnostic rate (DR) information from free text surgical pathology reports with synoptic elements and assess whether inter-rater variation and clinical history completeness information useful for continuous quality improvement (CQI) can be obtained. All in-house prostate biopsies in a 6-year period at two large teaching hospitals were extracted and then diagnostically categorized using string matching, fuzzy string matching, and hierarchical pruning. DRs were then stratified by the submitting physicians and pathologists. Funnel plots were created to assess for diagnostic bias. 3,854 prostate biopsies were found and all could be diagnostically classified. Two audits involving the review of 700 reports and a comparison of the synoptic elements with the free text interpretations suggest a categorization error rate of <1%. Twenty-seven pathologists each read >40 cases and together assessed 3,690 biopsies. There was considerable inter-rater variability and a trend toward more World Health Organization/International Society of Urologic Pathology Grade 1 cancers in older pathologists. Normalized deviations plots, constructed using the median DR, and standard error can elucidate associated over- and under-calls for an individual pathologist in relation to their practice group. Clinical history completeness by submitting medical doctor varied significantly (100% to 22%). Free text data analyses have some limitations; however, they could be used for data-driven CQI in anatomical pathology, and could lead to the next generation in quality of care.

Daily air quality index forecasting with hybrid models: A case in China.

PubMed

Zhu, Suling; Lian, Xiuyuan; Liu, Haixia; Hu, Jianming; Wang, Yuanyuan; Che, Jinxing

2017-12-01

Air quality is closely related to quality of life. Air pollution forecasting plays a vital role in air pollution warnings and controlling. However, it is difficult to attain accurate forecasts for air pollution indexes because the original data are non-stationary and chaotic. The existing forecasting methods, such as multiple linear models, autoregressive integrated moving average (ARIMA) and support vector regression (SVR), cannot fully capture the information from series of pollution indexes. Therefore, new effective techniques need to be proposed to forecast air pollution indexes. The main purpose of this research is to develop effective forecasting models for regional air quality indexes (AQI) to address the problems above and enhance forecasting accuracy. Therefore, two hybrid models (EMD-SVR-Hybrid and EMD-IMFs-Hybrid) are proposed to forecast AQI data. The main steps of the EMD-SVR-Hybrid model are as follows: the data preprocessing technique EMD (empirical mode decomposition) is utilized to sift the original AQI data to obtain one group of smoother IMFs (intrinsic mode functions) and a noise series, where the IMFs contain the important information (level, fluctuations and others) from the original AQI series. LS-SVR is applied to forecast the sum of the IMFs, and then, S-ARIMA (seasonal ARIMA) is employed to forecast the residual sequence of LS-SVR. In addition, EMD-IMFs-Hybrid first separately forecasts the IMFs via statistical models and sums the forecasting results of the IMFs as EMD-IMFs. Then, S-ARIMA is employed to forecast the residuals of EMD-IMFs. To certify the proposed hybrid model, AQI data from June 2014 to August 2015 collected from Xingtai in China are utilized as a test case to investigate the empirical research. In terms of some of the forecasting assessment measures, the AQI forecasting results of Xingtai show that the two proposed hybrid models are superior to ARIMA, SVR, GRNN, EMD-GRNN, Wavelet-GRNN and Wavelet-SVR. Therefore, the

Dosimetric Comparison of Helical Tomotherapy and Dynamic Conformal Arc Therapy in Stereotactic Radiosurgery for Vestibular Schwannomas

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

Lee, Tsair-Fwu, E-mail: tflee@cc.kuas.edu.t; Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Chao, Pei-Ju

2011-04-01

The dosimetric results of stereotactic radiosurgery (SRS) for vestibular schwannoma (VS) performed using dynamic conformal arc therapy (DCAT) with the Novalis system and helical TomoTherapy (HT) were compared using plan quality indices. The HT plans were created for 10 consecutive patients with VS previously treated with SRS using the Novalis system. The dosimetric indices used to compare the techniques included the conformity index (CI) and homogeneity index (HI) for the planned target volume (PTV), the comprehensive quality index (CQI) for nine organs at risk (OARs), gradient score index (GSI) for the dose drop-off outside the PTV, and plan quality indexmore » (PQI), which was verified using the plan quality discerning power (PQDP) to incorporate 3 plan indices, to evaluate the rival plans. The PTV ranged from 0.27-19.99 cm{sup 3} (median 3.39 cm{sup 3}), with minimum required PTV prescribed doses of 10-16 Gy (median 12 Gy). Both systems satisfied the minimum required PTV prescription doses. HT conformed better to the PTV (CI: 1.51 {+-} 0.23 vs. 1.94 {+-} 0.34; p < 0.01), but had a worse drop-off outside the PTV (GSI: 40.3 {+-} 10.9 vs. 64.9 {+-} 13.6; p < 0.01) compared with DCAT. No significant difference in PTV homogeneity was observed (HI: 1.08 {+-} 0.03 vs. 1.09 {+-} 0.02; p = 0.20). HT had a significantly lower maximum dose in 4 OARs and significant lower mean dose in 1 OAR; by contrast, DCAT had a significantly lower maximum dose in 1 OAR and significant lower mean dose in 2 OARs, with the CQI of the 9 OARs = 0.92 {+-} 0.45. Plan analysis using PQI (HT 0.37 {+-} 0.12 vs. DCAT 0.65 {+-} 0.08; p < 0.01), and verified using the PQDP, confirmed the dosimetric advantage of HT. However, the HT system had a longer beam-on time (33.2 {+-} 7.4 vs. 4.6 {+-} 0.9 min; p < 0.01) and consumed more monitor units (16772 {+-} 3803 vs. 1776 {+-} 356.3; p < 0.01). HT had a better dose conformity and similar dose homogeneity but worse dose gradient than DCAT. Plan analysis

Development and Validation of an Index to Measure the Quality of Facility-Based Labor and Delivery Care Processes in Sub-Saharan Africa

PubMed Central

Tripathi, Vandana; Stanton, Cynthia; Strobino, Donna; Bartlett, Linda

2015-01-01

Background High quality care is crucial in ensuring that women and newborns receive interventions that may prevent and treat birth-related complications. As facility deliveries increase in developing countries, there are concerns about service quality. Observation is the gold standard for clinical quality assessment, but existing observation-based measures of obstetric quality of care are lengthy and difficult to administer. There is a lack of consensus on quality indicators for routine intrapartum and immediate postpartum care, including essential newborn care. This study identified key dimensions of the quality of the process of intrapartum and immediate postpartum care (QoPIIPC) in facility deliveries and developed a quality assessment measure representing these dimensions. Methods and Findings Global maternal and neonatal care experts identified key dimensions of QoPIIPC through a modified Delphi process. Experts also rated indicators of these dimensions from a comprehensive delivery observation checklist used in quality surveys in sub-Saharan African countries. Potential QoPIIPC indices were developed from combinations of highly-rated indicators. Face, content, and criterion validation of these indices was conducted using data from observations of 1,145 deliveries in Kenya, Madagascar, and Tanzania (including Zanzibar). A best-performing index was selected, composed of 20 indicators of intrapartum/immediate postpartum care, including essential newborn care. This index represented most dimensions of QoPIIPC and effectively discriminated between poorly and well-performed deliveries. Conclusions As facility deliveries increase and the global community pays greater attention to the role of care quality in achieving further maternal and newborn mortality reduction, the QoPIIPC index may be a valuable measure. This index complements and addresses gaps in currently used quality assessment tools. Further evaluation of index usability and reliability is needed. The

Evaluation of the psychometric properties of the main meal quality index when applied in the UK population.

PubMed

Gorgulho, B M; Pot, G K; Marchioni, D M

2017-05-01

The aim of this study was to evaluate the validity and reliability of the Main Meal Quality Index when applied on the UK population. The indicator was developed to assess meal quality in different populations, and is composed of 10 components: fruit, vegetables (excluding potatoes), ratio of animal protein to total protein, fiber, carbohydrate, total fat, saturated fat, processed meat, sugary beverages and desserts, and energy density, resulting in a score range of 0-100 points. The performance of the indicator was measured using strategies for assessing content validity, construct validity, discriminant validity and reliability, including principal component analysis, linear regression models and Cronbach's alpha. The indicator presented good reliability. The Main Meal Quality Index has been shown to be valid for use as an instrument to evaluate, monitor and compare the quality of meals consumed by adults in the United Kingdom.

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

USEPA Environmental Quality Index (EQI) and Associated Domain Indices by County for the United States

EPA Pesticide Factsheets

The US Environmental Protection Agency's (EPA) National Health and Environmental Effects Research Laboratory (NHEERL) in the Environmental Public Health Division (EPHD) is currently engaged in research aimed at developing a measure that estimates overall environmental quality at the county level for the United States. This work is being conducted as an effort to learn more about how various environmental factors simultaneously contribute to health disparities in low-income and minority populations, and to better estimate the total environmental and social context to which humans are exposed. This dataset contains the finalized Environmental Quality Index (EQI), and an index for each of the associated domains (air, water, land, built environment, and sociodemographic environment). Indices are at the county level for all counties in the United States.

Evaluation of an Air Quality Health Index for Predicting the Mutagenicity of Simulated Atmospheres

EPA Science Inventory

No study has evaluated the mutagenicity of atmospheres with a calculated air quality health index (AQHI). Thus, we generated in a UV-light-containing reaction chamber two simulated atmospheres (SAs) with similar AQHIs but different proportions of criteria pollutants and evaluated...

Developing a Water Quality Index (WQI) for an Irrigation Dam

PubMed Central

De La Mora-Orozco, Celia; Flores-Lopez, Hugo; Rubio-Arias, Hector; Chavez-Duran, Alvaro; Ochoa-Rivero, Jesus

2017-01-01

Pollution levels have been increasing in water ecosystems worldwide. A water quality index (WQI) is an available tool to approximate the quality of water and facilitate the work of decision-makers by grouping and analyzing numerous parameters with a single numerical classification system. The objective of this study was to develop a WQI for a dam used for irrigation of about 5000 ha of agricultural land. The dam, La Vega, is located in Teuchitlan, Jalisco, Mexico. Seven sites were selected for water sampling and samples were collected in March, June, July, September, and December 2014 in an initial effort to develop a WQI for the dam. The WQI methodology, which was recommended by the Mexican National Water Commission (CNA), was used. The parameters employed to calculate the WQI were pH, electrical conductivity (EC), dissolved oxygen (DO), total dissolved solids (TDS), total hardness (TH), alkalinity (Alk), total phosphorous (TP), Cl−, NO3, SO4, Ca, Mg, K, B, As, Cu, and Zn. No significant differences in WQI values were found among the seven sampling sites along the dam. However, seasonal differences in WQI were noted. In March and June, water quality was categorized as poor. By July and September, water quality was classified as medium to good. Quality then decreased, and by December water quality was classified as medium to poor. In conclusion, water treatment must be applied before waters from La Vega dam reservoir can be used for irrigation or other purposes. It is recommended that the water quality at La Vega dam is continually monitored for several years in order to confirm the findings of this short-term study. PMID:28468230

Developing a Water Quality Index (WQI) for an Irrigation Dam.

PubMed

De La Mora-Orozco, Celia; Flores-Lopez, Hugo; Rubio-Arias, Hector; Chavez-Duran, Alvaro; Ochoa-Rivero, Jesus

2017-04-29

Pollution levels have been increasing in water ecosystems worldwide. A water quality index (WQI) is an available tool to approximate the quality of water and facilitate the work of decision-makers by grouping and analyzing numerous parameters with a single numerical classification system. The objective of this study was to develop a WQI for a dam used for irrigation of about 5000 ha of agricultural land. The dam, La Vega, is located in Teuchitlan, Jalisco, Mexico. Seven sites were selected for water sampling and samples were collected in March, June, July, September, and December 2014 in an initial effort to develop a WQI for the dam. The WQI methodology, which was recommended by the Mexican National Water Commission (CNA), was used. The parameters employed to calculate the WQI were pH, electrical conductivity (EC), dissolved oxygen (DO), total dissolved solids (TDS), total hardness (TH), alkalinity (Alk), total phosphorous (TP), Cl - , NO₃, SO₄, Ca, Mg, K, B, As, Cu, and Zn. No significant differences in WQI values were found among the seven sampling sites along the dam. However, seasonal differences in WQI were noted. In March and June, water quality was categorized as poor. By July and September, water quality was classified as medium to good. Quality then decreased, and by December water quality was classified as medium to poor. In conclusion, water treatment must be applied before waters from La Vega dam reservoir can be used for irrigation or other purposes. It is recommended that the water quality at La Vega dam is continually monitored for several years in order to confirm the findings of this short-term study.

The relationship between the retinal image quality and the refractive index of defects arising in IOL: numerical analysis

NASA Astrophysics Data System (ADS)

Geniusz, Malwina

2017-09-01

The best treatment for cataract patients, which allows to restore clear vision is implanting an artificial intraocular lens (IOL). The image quality of the lens has a significant impact on the quality of patient's vision. After a long exposure the implant to aqueous environment some defects appear in the artificial lenses. The defects generated in the IOL have different refractive indices. For example, glistening phenomenon is based on light scattering on the oval microvacuoles filled with an aqueous humor which refractive index value is about 1.34. Calcium deposits are another example of lens defects and they can be characterized by the refractive index 1.63. In the presented studies it was calculated how the difference between the refractive indices of the defect and the refractive index of the lens material affects the quality of image. The OpticStudio Professional program (from Radiant Zemax, LLC) was used for the construction of the numerical model of the eye with IOL and to calculate the characteristics of the retinal image. Retinal image quality was described in such characteristics as Point Spread Function (PSF) and the Optical Transfer Function with amplitude and phase. The results show a strong correlation between the refractive indices difference and retinal image quality.

Characterizing groundwater quality ranks for drinking purposes in Sylhet district, Bangladesh, using entropy method, spatial autocorrelation index, and geostatistics.

PubMed

Islam, Abu Reza Md Towfiqul; Ahmed, Nasir; Bodrud-Doza, Md; Chu, Ronghao

2017-12-01

Drinking water is susceptible to the poor quality of contaminated water affecting the health of humans. Thus, it is an essential study to investigate factors affecting groundwater quality and its suitability for drinking uses. In this paper, the entropy theory, multivariate statistics, spatial autocorrelation index, and geostatistics are applied to characterize groundwater quality and its spatial variability in the Sylhet district of Bangladesh. A total of 91samples have been collected from wells (e.g., shallow, intermediate, and deep tube wells at 15-300-m depth) from the study area. The results show that NO 3 - , then SO 4 2- , and As are the most contributed parameters influencing the groundwater quality according to the entropy theory. The principal component analysis (PCA) and correlation coefficient also confirm the results of the entropy theory. However, Na + has the highest spatial autocorrelation and the most entropy, thus affecting the groundwater quality. Based on the entropy-weighted water quality index (EWQI) and groundwater quality index (GWQI) classifications, it is observed that 60.45 and 53.86% of water samples are classified as having an excellent to good qualities, while the remaining samples vary from medium to extremely poor quality domains for drinking purposes. Furthermore, the EWQI classification provides the more reasonable results than GWQIs due to its simplicity, accuracy, and ignoring of artificial weight. A Gaussian semivariogram model has been chosen to the best fit model, and groundwater quality indices have a weak spatial dependence, suggesting that both geogenic and anthropogenic factors play a pivotal role in spatial heterogeneity of groundwater quality oscillations.

Evaluation of maternal and neonatal hospital care: quality index of completeness

PubMed Central

da Silva, Ana Lúcia Andrade; Mendes, Antonio da Cruz Gouveia; Miranda, Gabriella Morais Duarte; de Sá, Domicio Aurélio; de Souza, Wayner Vieira; Lyra, Tereza Maciel

2014-01-01

OBJECTIVE Develop an index to evaluate the maternal and neonatal hospital care of the Brazilian Unified Health System. METHODS This descriptive cross-sectional study of national scope was based on the structure-process-outcome framework proposed by Donabedian and on comprehensive health care. Data from the Hospital Information System and the National Registry of Health Establishments were used. The maternal and neonatal network of Brazilian Unified Health System consisted of 3,400 hospitals that performed at least 12 deliveries in 2009 or whose number of deliveries represented 10.0% or more of the total admissions in 2009. Relevance and reliability were defined as criteria for the selection of variables. Simple and composite indicators and the index of completeness were constructed and evaluated, and the distribution of maternal and neonatal hospital care was assessed in different regions of the country. RESULTS A total of 40 variables were selected, from which 27 single indicators, five composite indicators, and the index of completeness of care were built. Composite indicators were constructed by grouping simple indicators and included the following variables: hospital size, level of complexity, delivery care practice, recommended hospital practice, and epidemiological practice. The index of completeness of care grouped the five variables and classified them in ascending order, thereby yielding five levels of completeness of maternal and neonatal hospital care: very low, low, intermediate, high, and very high. The hospital network was predominantly of small size and low complexity, with inadequate child delivery care and poor development of recommended and epidemiological practices. The index showed that more than 80.0% hospitals had a low index of completeness of care and that most qualified heath care services were concentrated in the more developed regions of the country. CONCLUSIONS The index of completeness proved to be of great value for monitoring the

Assessment of groundwater quality at a MSW landfill site using standard and AHP based water quality index: a case study from Ranchi, Jharkhand, India.

PubMed

Chakraborty, Shubhrasekhar; Kumar, R Naresh

2016-06-01

Landfill leachate generated from open MSW dumpsite can cause groundwater contamination. The impact of open dumping of MSW on the groundwater of adjacent area was studied. To assess the spatial and temporal variations in groundwater quality, samples were collected around an open MSW dumping site in Ranchi city, Jharkhand, India. Groundwater samples were analysed for various physicochemical and bacteriological parameters for 1 year. Results indicated that the groundwater is getting contaminated due to vertical and horizontal migration of landfill leachate. Extent of contamination was higher in areas closer to the landfill as indicated by high alkalinity, total dissolved solids and ammonia concentration. Metals such as lead, iron, and manganese were present at concentrations of 0.097, 0.97 and 0.36 mg/L, respectively exceeding the Bureau of Indian Standards (BIS) 10,500 for drinking water. Enterobacteriaceae were also detected in several groundwater samples and highest coliform count of 2.1×10(4) CFU/mL was recorded from a dug well. In order to determine the overall groundwater quality, water quality index (WQI) was calculated using weighted arithmetic index method and this index was further modified by coupling with the analytical hierarchy process (AHP) to get specific information. WQI values indicated that the overall groundwater quality of the region came under "poor" category while zone wise classification indicated the extent of impact of landfill leachate on groundwater.

USING A FISH INDEX TO ASSESS HABITAT QUALITY IN NARRAGANSETT BAY, RHODE ISLAND

EPA Science Inventory

We developed an estuarine index of biotic integrity to assess habitat quality in Narragansett Bay, Rhode Island. Fish were collected at 18 fixed stations with a 61-m x 3.05-m beach seine once per month in July and August from 1988 to 1999. Stations were designated high or low qua...

The EVIDENT diet quality index is associated with cardiovascular risk and arterial stiffness in adults.

PubMed

Rodríguez-Martin, Carmela; Alonso-Domínguez, Rosario; Patino-Alonso, María C; Gómez-Marcos, Manuel A; Maderuelo-Fernández, José A; Martin-Cantera, Carlos; García-Ortiz, Luis; Recio-Rodríguez, José I

2017-04-08

We aimed to simplify information from food frequency questionnaires (FFQs) in a single parameter that allows for rapid identification of quality of patient diet and its relationship to cardiovascular risk and pulse wave velocity (PWV). The sample from the EVIDENT study, consisting of 1553 subjects (aged 20-80 years) with no cardiovascular disease selected by random sampling among those attending primary care clinics, was used. The EVIDENT diet index (range 0-100) was calculated based on the results of a FFQ. Evaluation of dietary habits also included adherence to the Mediterranean diet (MD). Cardiovascular risk was estimated, and carotid-femoral pulse wave velocity was measured. Mean subject age was 54.9 ± 13.8 years, and 60.3% of subjects were female. The mean value of the EVIDENT diet index was 52.1 ± 3.2 points. Subjects in the third tertile (the highest score) had the greatest adherence to MD and the highest energy intake, with greater amounts of carbohydrates, protein, and fiber. The best cut-off point of the EVIDENT diet index for predicting good adherence to the MD is 52.3 (0.71 sensitivity, 0.61 specificity). In a multiple regression analysis, after a complete adjustment, it was estimated that for each one-point increase in the EVIDENT diet index, cardiovascular risk (CVR), blood-pressure, waist circumference, and PWV decreased by 0.14, 0.43, 0.24, and 0.09 respectively (p < 0.05, all). The diet quality index developed is associated to CVR and its components, and also with arterial stiffness, as measured with PWV. This index is also a good predictor of adherence to MD.

[Relationship between age, body mass index, dependency and quality of life in malnourished patients after hospital discharge].

PubMed

Casals, Cristina; Vázquez Sánchez, María Ángeles; Casals Sánchez, José Luis; Rioja Vázquez, Rosalía; Martín Salvador, Esperanza; García-Agua Soler, Nuria

2015-04-01

The quality of life assessment means investigating how patients perceive their disease. Malnutrition-specific characteristics make patients more vulnerable, so it is important to know how these factors impact on patients' daily life. To assess the quality of life in malnourished patients who have had hospital admission, and to determine the relationship of the quality of life with age, body mass index, diagnosis of malnutrition, and dependency. Multicenter transversal descriptive study in 106 malnourished patients after hospital admission. The quality of life (SF-12 questionnaire), BMI, functional independency (Barthel index), morbidity, and a dietary intake evaluation were assessed. The relationship between variables was tested by using the Spearman correlation coefficient. The patients of the present study showed a SF-12 mean of 38.32 points. The age was significantly correlated with the SF-12 (r= -0.320, p= 0.001). The BMI was correlated with the SF-12 (r= 0.251, p= 0.011) and its mental component (r= 0.289, p= 0.03). It was also reported a significant correlation between the Barthel index and the SF-12 (r= 0.370, p< 0.001). The general health perception in malnourished patients who have had a hospital admission was lower than the Spanish mean. Moreover, the quality of life in these patients is significantly correlated with age, BMI and functional independency. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Medicare Program; FY 2018 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements. Final rule.

PubMed

2017-08-04

This final rule will update the hospice wage index, payment rates, and cap amount for fiscal year (FY) 2018. Additionally, this rule includes new quality measures and provides an update on the hospice quality reporting program.

APPLICATION OF A FUNCTIONAL MATHEMATICAL QUALITY INDEX TO ASPARAGINE, FREE SUGAR AND PHENOLIC ACID CONTENT OF 20 COMMERCIAL POTATO VARIETIES

USDA-ARS?s Scientific Manuscript database

In this article, we apply a functional mathematical index (FMI), introduced in a previous publication, to 20 commercial potato varieties. The index allows evaluation of nutritional, safety and processing “quality parameters” of different potato cultivars. The main goal of the index is to link the q...

Psychometric testing of the Caregiver Quality of Life Index-Cancer scale in an Iranian sample of family caregivers to newly diagnosed breast cancer women.

PubMed

Khanjari, Sedigheh; Oskouie, Fatemeh; Langius-Eklöf, Ann

2012-02-01

To translate and test the reliability and validity of the Persian version of the Caregiver Quality of Life Index-Cancer scale. Research across many countries has determined quality of life of cancer patients, but few attempts have been made to measure the quality of life of family caregivers of patients with breast cancer. The Caregiver Quality of Life Index-Cancer scale was developed for this purpose, but until now, it has not been translated into or tested in the Persian language. Methodological research design. After standard translation, the 35-item Caregiver Quality of Life Index-Cancer scale was administered to 166 Iranian family caregivers of patients with breast cancer. A confirmatory factor analysis was carried out using LISREL to test the scale's construct validity. Further, the internal consistency and convergent validity of the instrument were tested. For convergent validity, four instruments were used in the study: sense of coherence scale, spirituality perspective scale, health index and brief religious coping scale. The confirmatory factor analysis resulted in the same four-factor structure as the original, though, with somewhat different item loadings. The Persian version of the Caregiver Quality of Life Index-Cancer scales had satisfactory internal consistency (0·72-0·90). Tests of convergent validity showed that all hypotheses were confirmed. A hierarchical multiple regression analysis additionally confirmed the convergent validity between the total Caregiver Quality of Life Index-Cancer score and sense of coherence (β = 0·34), negative religious coping (β = -0·21), education (β = 0·24) and the more severe stage of breast cancer (β = 0·23), in total explaining 41% of the variance. The Persian version of the Caregiver Quality of Life Index-Cancer scale could be a reliable and valid measure in Iranian family caregivers of patients with breast cancer. The Persian version of the Caregiver Quality of Life Index-Cancer scale is simple to

Can Western quality improvement methods transform the Russian health care system?

PubMed

Tillinghast, S J

1998-05-01

The Russian health care system largely remains the same system that was in place during the existence of the Soviet Union. It is almost entirely state owned and operated, although ownership and management have developed from the central government to the oblast (province). The ZdravReform (Health Reform) Program (ZRP) in Russia, which began in 1993, included the goal of improving the quality and cost-effectiveness of the health care system. Work on introducing continuous quality improvement (CQI), evidence-based practice guidelines, and indicators of quality was conducted in 1995-1996. INTRODUCING EVIDENCE-BASED MEDICINE: As a result of the poor quality of Russian-language medical journals and the inability to gain access to the knowledge available in Western medical literature, Russian medical practices have not kept up with the rapid evolution of evidence-based medical practice that has begun transforming Western medicine. A number of evidence-based clinical practice guidelines were translated and disseminated to Russian-speaking physicians working in facilities participating in ZRP in Russia and Central Asia. Given the limitations of existing measures of the quality of care, indicators were developed for participating ambulatory polyclinics in several oblasts in Siberia. Russian physicians responsible for quality of care for their respective oblasts formed a working group to develop the indicators. A clinical information system that would provide automated collection and analysis of the indicator data-as well as additional patient record information-was also developed. CQI activities, entailing a multidisciplinary, participatory team approach, were conducted in four oblasts in western Siberia. Projects addressed the management of community-acquired pneumonia and reduction of length of stay after myocardial infarction (MI). One of the oblasts provided an example of a home-grown evidence-based protocol for post-MI care, which was adopted in the other three oblasts

[Cross-cultural adaptation of the Quality of Life Index Spinal Cord Injury - Version III].

PubMed

Reis, Priscila Alencar Mendes; Carvalho, Zuila Maria de Figueiredo; Tirado Darder, Juan José; Oriá, Mônica Oliveira Batista; Studart, Rita Mônica Borges; Maniva, Samia Jardelle Costa de Freitas

2015-06-01

To translate and culturally adapt to Portuguese the Ferrans and Powers Quality of Life Index Spinal Cord Injury - Version III and characterize the sample in relation to sociodemographic and clinical aspects. A methodological study with view to cross-cultural adaptation, following the particular steps of this method: initial translation, translation synthesis, back-translation (translation back to the original language), review by a committee of judges and pretest of the final version. The pretest was carried out with 30 patients with spinal cord injury. An index of 74 items divided into two parts (satisfaction/importance) was obtained. The criteria of semantic equivalence were evaluated as very adequate translation, higher than 87%, and vocabulary and were grammar higher than 86%. Idiomatic equivalence was higher than 74%, experimental greater than 78% and conceptual was greater than 70%. After cross-cultural adaptation, the instrument proved semantic, idiomatic, experimental and conceptual adequacy, in addition to helping the evaluation of the quality of life of people with spinal cord injury.

Sleep Quality and Body Mass Index in College Students: The Role of Sleep Disturbances

PubMed Central

Vargas, Perla A.; Flores, Melissa; Robles, Elias

2014-01-01

Objective Obesity and its comorbidities have emerged as a leading public health concern. Our aim was to explore the relationship between BMI and sleep patterns, including duration and disturbances. Methods A convenience sample of 515 college students completed an online survey consisting of the Pittsburgh Sleep Quality Index (PSQI), and self-reported height and weight to calculate Body Mass Index (BMI). Univariate and multivariate logistic regression analyses were performed using components of the PSQI as predictors of overweight (BMI ≥ 25). Results One-third of the participants had BMI ≥ 25, and 51% were poor-quality sleepers (PSQI > 5). Controlling for age and sex, only sleep disturbances were associated to overweight (OR=1.66, 95% CI: 1.08-2.57). Conclusions Sleep disturbances, rather than sleep duration predicted overweight among young adults; this is consistent with the most recent evidence in the literature. These findings support expanding the scope of wellness programs to promote healthy sleep among students. PMID:24933244

Use of a macroinvertebrate based biotic index to estimate critical metal concentrations for good ecological water quality.

PubMed

Van Ael, Evy; De Cooman, Ward; Blust, Ronny; Bervoets, Lieven

2015-01-01

Large datasets from total and dissolved metal concentrations in Flemish (Belgium) fresh water systems and the associated macroinvertebrate-based biotic index MMIF (Multimetric Macroinvertebrate Index Flanders) were used to estimate critical metal concentrations for good ecological water quality, as imposed by the European Water Framework Directive (2000). The contribution of different stressors (metals and water characteristics) to the MMIF were studied by constructing generalized linear mixed effect models. Comparison between estimated critical concentrations and the European and Flemish EQS, shows that the EQS for As, Cd, Cu and Zn seem to be sufficient to reach a good ecological quality status as expressed by the invertebrate-based biotic index. In contrast, the EQS for Cr, Hg and Pb are higher than the estimated critical concentrations, which suggests that when environmental concentrations are at the same level as the EQS a good quality status might not be reached. The construction of mixed models that included metal concentrations in their structure did not lead to a significant outcome. However, mixed models showed the primary importance of water characteristics (oxygen level, temperature, ammonium concentration and conductivity) for the MMIF. Copyright © 2014 Elsevier Ltd. All rights reserved.

Using scientific evidence to improve information practice.

PubMed

Bradley, J; Marshall, J G

1995-09-01

The recent policy statement of the Medical Library Association (MLA) takes the position that scientific evidence is the basis for improving the quality of library and information sciences now and in the future. Research activity is seen as the foundation of an evolving knowledge base for the profession--a knowledge base that will set health sciences librarians apart from others in an increasingly competitive world of information service providers. The statement represents the culmination of many years of activity by association members, during which the role of research in health information practice has been debated. Over a similar time period, the quality movement, with its increasing demand for the collection and use of data, has been growing. Developments such as total quality management (TQM) and continuous quality improvement (CQI) reinforce the centrality of research with its increasing demand for the collection and use of data, has been growing. Developments such as total quality management (TQM) and continuous quality improvement (CQI) reinforce the centrality of research and its relationship to efficient and effective information practice as envisioned in the MLA policy statement.

Assessment of quality of prescribing in patients of hypertension at primary and secondary health care facilities using the Prescription Quality Index (PQI) tool.

PubMed

Suthar, Jalpa Vashishth; Patel, Varsha J

2014-01-01

To determine the quality of prescribing in hypertension in primary and secondary health care settings using the Prescription Quality Index (PQI) tool and to assess the reliability of this tool. An observational cross-sectional study was carried out for 6 months in order to assess quality of prescribing of antihypertensive drugs using Prescription Quality Index (PQI) at four primary (PHC) and two secondary (SHC) health care facilities. Patients attending these facilities for at least 3 months were included. Complete medical history and prescriptions received were noted. Total and criteria wise PQI scores were derived for each prescription. Prescriptions were categorized as poor (score of ≤31), medium (score 32-33) and high quality (score 34-43) based on PQI total score. Psychometric analysis using factor analysis was carried out to assess reliability and validity. Total 73 hypertensive patients were included. Mean age was 61.2 ± 11 years with 35 (48%) patients above 65 years of age. Total PQI score was 26 ± 11. There was a significant difference in PQI score between PHC and SHC (P < 0.05) Out of 73 prescriptions, 43 (59%) were of poor quality with PQI score <31. The value of Cronbach's α for the entire 22 criteria of PQI was 0.71 suggesting good reliability of PQI tool in our setting. Based on PQI scores, quality of prescribing in hypertensive patients was poor, somewhat better in primary as compared to secondary health care facility. PQI is reliable for measuring prescribing quality in hypertension in Indian set up.

Quality of pharmacy-specific Medical Subject Headings (MeSH) assignment in pharmacy journals indexed in MEDLINE.

PubMed

Minguet, Fernando; Salgado, Teresa M; van den Boogerd, Lucienne; Fernandez-Llimos, Fernando

2015-01-01

The Medical Subject Headings (MeSH) is the National Library of Medicine (NLM) controlled vocabulary for indexing articles. Inaccuracies in the MeSH thesaurus have been reported for several areas including pharmacy. To assess the quality of pharmacy-specific MeSH assignment to articles indexed in pharmacy journals. The 10 journals containing the highest number of articles published in 2012 indexed under the MeSH 'Pharmacists' were identified. All articles published over a 5-year period (2008-2012) in the 10 previously selected journals were retrieved from PubMed. MeSH terms used to index these articles were extracted and pharmacy-specific MeSH terms were identified. The frequency of use of pharmacy-specific MeSH terms was calculated across journals. A total of 6989 articles were retrieved from the 10 pharmacy journals, of which 328 (4.7%) were articles not fully indexed and therefore did not contain any MeSH terms assigned. Among the 6661 articles fully indexed, the mean number of MeSH terms was 10.1 (SD = 4.0), being 1.0 (SD = 1.3) considered as Major MeSH. Both values significantly varied across journals. The mean number of pharmacy-specific MeSH terms per article was 0.9 (SD = 1.2). A total of 3490 (52.4%) of the 6661 articles were indexed in pharmacy journals without a single pharmacy-specific MeSH. Of the total 67193 MeSH terms assigned to articles, on average 10.5% (SD = 13.9) were pharmacy-specific MeSH. A statistically significant different pattern of pharmacy-specific MeSH assignment was identified across journals (Kruskal-Wallis P < 0.001). The quality of assignment of the existing pharmacy-specific MeSH terms to articles indexed in pharmacy journals can be improved to further enhance evidence gathering in pharmacy. Over half of the articles published in the top-10 journals publishing pharmacy literature were indexed without a single pharmacy-specific MeSH. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparison of Soil Quality Index Using Three Methods

PubMed Central

Mukherjee, Atanu; Lal, Rattan

2014-01-01

Assessment of management-induced changes in soil quality is important to sustaining high crop yield. A large diversity of cultivated soils necessitate identification development of an appropriate soil quality index (SQI) based on relative soil properties and crop yield. Whereas numerous attempts have been made to estimate SQI for major soils across the World, there is no standard method established and thus, a strong need exists for developing a user-friendly and credible SQI through comparison of various available methods. Therefore, the objective of this article is to compare three widely used methods to estimate SQI using the data collected from 72 soil samples from three on-farm study sites in Ohio. Additionally, challenge lies in establishing a correlation between crop yield versus SQI calculated either depth wise or in combination of soil layers as standard methodology is not yet available and was not given much attention to date. Predominant soils of the study included one organic (Mc), and two mineral (CrB, Ko) soils. Three methods used to estimate SQI were: (i) simple additive SQI (SQI-1), (ii) weighted additive SQI (SQI-2), and (iii) statistically modeled SQI (SQI-3) based on principal component analysis (PCA). The SQI varied between treatments and soil types and ranged between 0–0.9 (1 being the maximum SQI). In general, SQIs did not significantly differ at depths under any method suggesting that soil quality did not significantly differ for different depths at the studied sites. Additionally, data indicate that SQI-3 was most strongly correlated with crop yield, the correlation coefficient ranged between 0.74–0.78. All three SQIs were significantly correlated (r = 0.92–0.97) to each other and with crop yield (r = 0.65–0.79). Separate analyses by crop variety revealed that correlation was low indicating that some key aspects of soil quality related to crop response are important requirements for estimating SQI. PMID:25148036

Critical Analysis of Forest Degradation in the Southern Eastern Ghats of India: Comparison of Satellite Imagery and Soil Quality Index

PubMed Central

Ramachandran, Andimuthu; Radhapriya, Parthasarathy; Jayakumar, Shanmuganathan; Dhanya, Praveen; Geetha, Rajadurai

2016-01-01

India has one of the largest assemblages of tropical biodiversity, with its unique floristic composition of endemic species. However, current forest cover assessment is performed via satellite-based forest surveys, which have many limitations. The present study, which was performed in the Eastern Ghats, analysed the satellite-based inventory provided by forest surveys and inferred from the results that this process no longer provides adequate information for quantifying forest degradation in an empirical manner. The study analysed 21 soil properties and generated a forest soil quality index of the Eastern Ghats, using principal component analysis. Using matrix modules and geospatial technology, we compared the forest degradation status calculated from satellite-based forest surveys with the degradation status calculated from the forest soil quality index. The Forest Survey of India classified about 1.8% of the Eastern Ghats’ total area as degraded forests and the remainder (98.2%) as open, dense, and very dense forests, whereas the soil quality index results found that about 42.4% of the total area is degraded, with the remainder (57.6%) being non-degraded. Our ground truth verification analyses indicate that the forest soil quality index along with the forest cover density data from the Forest Survey of India are ideal tools for evaluating forest degradation. PMID:26812397

Application of index number theory to the construction of a water quality index: aggregated nutrient loadings related to the areal extent of hypoxia in the northern Gulf of Mexico

USDA-ARS?s Scientific Manuscript database

The development of an index for description and monitoring of surface water quality has received significant attention in the water resources literature in recent years, primarily because of the increasing need for assessing water quality and the complex, multidimensional data collected from water q...

Medicare Program; FY 2017 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements. Final rule.

PubMed

2016-08-05

This final rule will update the hospice wage index, payment rates, and cap amount for fiscal year (FY) 2017. In addition, this rule changes the hospice quality reporting program, including adopting new quality measures. Finally, this final rule includes information regarding the Medicare Care Choices Model (MCCM).

Air quality trends and potential health effects - Development of an aggregate risk index

NASA Astrophysics Data System (ADS)

Sicard, Pierre; Lesne, Olivia; Alexandre, Nicolas; Mangin, Antoine; Collomp, Rémy

2011-02-01

The "Provence Alpes Côte d'Azur" (PACA) region, in the South East of France, is one of Europe's regions most influenced by the atmospheric pollution. During the last 15 years, the industrial emissions decrease caused an evolution of the atmospheric pollution nature. Nowadays, atmospheric pollution is more and more influenced by the road traffic, the dominating pollution source in urban zones for the PACA region. Combined with this intense road traffic, the strong hot season of the Mediterranean climate contributes to the region bad air quality; it is known to be one of the worse in Europe. The recognized air pollution effects over public health include increased risk of hospital admissions and mortality by respiratory or cardiovascular diseases. The combination of these serious pollution related health hazards with senior and children vulnerabilities leads to serious sanitary concerns. Over the 1990-2005 period, we obtained, using the non-parametric Mann-Kendall test from annual mortality dataset (CépiDC), decreasing trends for Asthma (-5.00% year -1), Cardiovascular (-0.73% year -1), Ischemic (-0.69% year -1) and cerebrovascular diseases (-3.10% year -1). However, for "Other heart diseases" (+0.10% year -1) and "Respiratory" (+0.10% year -1) an increase was observed. The development of an adequate tool to understand impacts of pollution levels is of utmost importance. Different pollutants have different health endpoints, information may be lost through the use of a single index consequently, in this study we present the modified formula of air quality index, based on Cairncross's concept the Aggregate Risk Index (ARI). ARI is based on the relative risk of the well-established increased daily mortality, or morbidity, enabling an assessment of additive effects of short-term exposure to the main air pollutants: PM 2.5, PM 10, SO 2, O 3 and NO 2 in order to account for the reality of the multiple exposures impacts of chemical agents. The ARI, developed per pathology

Use of the landfill water pollution index (LWPI) for groundwater quality assessment near the landfill sites.

PubMed

Talalaj, Izabela A; Biedka, Pawel

2016-12-01

The purpose of the paper is to assess the groundwater quality near the landfill sites using landfill water pollution index (LWPI). In order to investigate the scale of groundwater contamination, three landfills (E, H and S) in different stages of their operation were taken into analysis. Samples of groundwater in the vicinity of studied landfills were collected four times each year in the period from 2004 to 2014. A total of over 300 groundwater samples were analysed for pH, EC, PAH, TOC, Cr, Hg, Zn, Pb, Cd, Cu, as required by the UE legal acts for landfill monitoring system. The calculated values of the LWPI allowed the quantification of the overall water quality near the landfill sites. The obtained results indicated that the most negative impact on groundwater quality is observed near the old Landfill H. Improper location of piezometer at the Landfill S favoured infiltration of run-off from road pavement into the soil-water environment. Deep deposition of the groundwater level at Landfill S area reduced the landfill impact on the water quality. Conducted analyses revealed that the LWPI can be used for evaluation of water pollution near a landfill, for assessment of the variability of water pollution with time and for comparison of water quality from different piezometers, landfills or time periods. The applied WQI (Water Quality Index) can also be an important information tool for landfill policy makers and the public about the groundwater pollution threat from landfill.

Assessment of environmental injustice in Korea using synthetic air quality index and multiple indicators of socioeconomic status: A cross-sectional study.

PubMed

Choi, Giehae; Heo, Seulkee; Lee, Jong-Tae

2016-01-01

Despite the existence of the universal right to a healthy environment, the right is being violated in some populations. The objective of the current study is to verify environmental discrimination associated with socioeconomic status in Korea, using synthetic air quality index and multiple indicators of socioeconomic status. The concentrations of NO₂(nitrogen dioxide), CO (carbon monoxide), SO₂(sulfur dioxide), PM10 (particulate matter with an aerodynamic diameter <10 μm), and O₃(ozone) in ambient air were integrated into a synthetic air quality index. Socioeconomic status was measured at individual level (income, education, number of household members, occupation, and National Basic Livelihood status) and area level (neighborhood index). The neighborhood index was calculated in the finest administrative unit (municipality) by performing standardization and integration of municipality-level data of the following: number of families receiving National Basic Livelihood, proportion of people engaged in an elementary occupation, population density, and number of service industries. Each study participant was assigned a neighborhood index value of the municipality in which they reside. Six regression models were generated to analyze the relationship between socioeconomic status and overall air pollution. All models were adjusted with sex, age, and smoking status. Stratification was conducted by residency (urban/rural). Moran's I was calculated to identify spatial clusters, and adjusted regression analysis was conducted to account for spatial autocorrelation. Results showed that people with higher neighborhood index, people living with smaller number of family members, and people with no education lived in municipalities with better overall air quality. The association differed by residency in some cases, and consideration of spatial autocorrelation altered the association. This study gives strength to the idea that environmental discrimination exists in some

USING A FISH INDEX TO ASSESS HABITAT QUALITY IN NARRAGANSETT BAY, RI: THE IMPORTANCE OF THE UPPER ESTUARY

EPA Science Inventory

We developed an estuarine index of biotic integrity to assess habitat quality in Narragansett Bay, Rhode Island. Fish were collected with a 61 X 3.05 m beach seine monthly in July and August from 1988-1999 at 18 fixed stations. Stations were designated high or low quality dependi...

Assessment of patient's experiences across the interface between primary and secondary care: Consumer Quality Index Continuum of care.

PubMed

Berendsen, Annette J; Groenier, Klaas H; de Jong, G Majella; Meyboom-de Jong, Betty; van der Veen, Willem Jan; Dekker, Janny; de Waal, Margot W M; Schuling, Jan

2009-10-01

Development and validation of a questionnaire that measures patients' experiences of collaboration between general practitioners (GPs) and specialists. A questionnaire was developed using the method of the consumer quality index and validated in a cross-sectional study among a random sample of patients referred to medical specialists in the Netherlands. Validation included factor analysis, ascertain internal consistency, and the discriminative ability. The response rate was 65% (1404 patients). Exploratory factor analysis indicated that four domains could be distinguished (i.e. GP Approach; GP Referral; Specialist; Collaboration). Cronbach's alpha coefficients ranged from 0.51 to 0.93 indicating sufficient internal consistency to make comparison of groups of respondents possible. The Pearson correlation coefficients between the domains were <0.4, except between the domains GP Approach and GP Referral. All domains clearly produced discriminating scores for groups with different characteristics. The Consumer Quality Index (CQ-index) Continuum of Care can be a useful instrument to assess aspects of the collaboration between GPs and specialists from patients' perspective. It can be used to give feedback to both medical professionals and policy makers. Such feedback creates an opportunity for implementing specific improvements and evaluating quality improvement projects. 2009 Elsevier Ireland Ltd.

Building a healthy work environment: a nursing resource team perspective.

PubMed

Vaughan, Leslie; Slinger, Trisha

2013-01-01

Leadership and staff from the London Health Sciences Centre (LHSC) Nursing Resource Team (NRT), including members of their Continuous Quality Improvement (CQI) Council, attended the first Southern Ontario Nursing Resource Team Conference (SONRTC), held March 2012 in Toronto. The SONRTC highlighted healthy work environments (HWEs), noting vast differences among the province's various organizations. Conversely, CQI Council members anecdotally acknowledged similar inconsistencies in HWEs across the various inpatient departments at LHSC. In fact, the mobility of the NRT role allows these nurses to make an unbiased observation about the culture, behaviours and practices of specific units as well as cross-reference departments regarding HWEs. Studies have documented that HWEs have a direct impact on the quality of patient care. Furthermore, the literature supports a relationship between HWEs and nurse job satisfaction. Based on this heightened awareness, the NRT CQI Council aimed to investigate HWEs at LHSC. The American Association of Critical Care Nurses (AACN) Standards for Establishing and Sustaining Healthy Work Environments was adapted in developing a survey for measuring HWEs based on the perceptions of NRT staff. Each of the departments was evaluated in terms of the following indicators: skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition and authentic leadership (AACN 2005). Ultimately, the Building a Healthy Work Environment: A Nursing Resource Team Perspective survey was employed with NRT nurses at LHSC, and data was collected for use by leadership and staff for creating HWE strategies aimed at improving the quality of patient care.

Proposal for a Breakfast Quality Index (BQI) for children and adolescents.

PubMed

Monteagudo, Celia; Palacín-Arce, Alba; Bibiloni, Maria del Mar; Pons, Antoni; Tur, Josep A; Olea-Serrano, Fatima; Mariscal-Arcas, Miguel

2013-04-01

To propose and apply an instrument to assess the breakfast quality of children and adolescents in the Mediterranean area. Randomized, cross-sectional survey of breakfast consumption using a validated semi-quantitative FFQ administered at school by trained dietitians between Tuesday and Friday. A Breakfast Quality Index (BQI) score was developed, assigning a positive value to the consumption of cereals, fruit, vegetables, dairy products, MUFA, Ca and compliance with energy recommendations, and to the absence of SFA and trans-rich fats. Data were analysed by Student's t test and ANOVA. Schools in Granada and Balearic Islands (Spain). All schoolchildren (n 4332) aged 8-17 years at randomly selected and representative schools between 2006 and 2008, stratified by age and sex. Breakfast was not consumed by 6·5 % of participants. BQI score was highest for children aged 7-9 years and decreased with age (P = 0·001). Females scored higher in all age groups. The lowest score was in males aged 14-17 years and the highest in females aged 7-9 years (P = 0·006). The proposed BQI appears useful to estimate the breakfast quality of schoolchildren and to form a basis for nutrition education.

SU-E-T-60: A Plan Quality Index in IMRT QA That Is Independent of the Acceptance Criteria

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

Kim, D; Kang, S; Kim, T

2015-06-15

Purpose: In IMRT QA, plan quality evaluation is made based on pass rate under preset acceptance criteria, mostly using gamma-values. This method is convenient but, its Result highly depends on what the acceptance criteria are and suffers from the lack of sensitivity in judging how good the plan is. In this study, we introduced a simple but effective plan quality index of IMRT QA based on dose difference only to supplement such shortcomings, and investigated its validity. Methods: The proposed index is a single value which is calculated mainly based on point-by-point comparison between planned and measured dose distributions, andmore » it becomes “1” in an ideal case. A systematic evaluation was performed with one-dimensional test dose distributions. For 3 hypothetical dose profiles, various displacements (in both dose and space) were introduced, the proposed index was calculated for each case, and the behavior of obtained indices was analyzed and compared with that of gamma evaluation. In addition, the feasibility of the index was assessed with clinical IMRT/VMAT/SBRT QA cases for different sites (prostate, head & neck, liver, lung, spine, and abdomen). Results: The proposed index showed more robust correlation with the amount of induced displacement compared to the gamma evaluation method. No matter what the acceptance criteria are (e.g., whether 3%/3mm or 2%/2mm), it was possible to clearly rank every case with the proposed index while it was difficult to do with the gamma evaluation method. Conclusion: IMRT plan quality can be evaluated quantitatively by the proposed index. It is considered that the proposed index would provide useful information for better judging the level of goodness of each plan and its Result is independent of the acceptance criteria. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded

Assessment of quality guidelines implementation using a continuous quality improvement programme.

PubMed

Richards, Nick; Ayala, Juan Antonio; Cesare, Salvatore; Chazot, Charles; Di Benedetto, Attilio; Gassia, Jean-Paul; Merello, Jose-Ignacio; Rentero, Ramon; Scatizzi, Laura; Marcelli, Daniele

2007-01-01

Data from the Dialysis Outcomes and Practice Patterns Study (DOPPS) study suggest that the level of implementation of the European Best Practice Guidelines (EBPG) is at best partial. The main aim of this study is to describe the level of implementation of the EBPG in the European Fresenius Medical Care (FME) clinic network. Data presented in this investigation were gained through the FME database EuCliD (European Clinical Database). Patient data from 4 countries (Great Britain, France, Italy, Spain) were selected from the EuCliD database. The parameters chosen were haemodialysis adequacy, biocompatibility, anaemia control and serum phosphate control, which are surrogate indicators for quality of care. They were compared, by country, between the first quarter (Q1) 2002 and the fourth quarter (Q4) 2005. During Q1 2002 and Q4 2005, respectively, a total of 7,067 and 9,232 patients were treated in FME clinics located in France, Italy, Spain and the UK. This study confirms variations in haemodialysis practices between countries as already described by the DOPPS study. A large proportion of patients in each country achieved the targets recommended by the EBPG in Q4 2005 and this represented a significant improvement over the results achieved in Q1 2002. Differences in practices between countries still exist. The FME CQI programme allows some of these differences to be overcome leading to an improvement in the quality of the treatment delivered. Copyright 2007 S. Karger AG, Basel.

CENDI Indexing Workshop

NASA Technical Reports Server (NTRS)

1994-01-01

The CENDI Indexing Workshop held at NASA Headquarters, Two Independence Square, 300 E Street, Washington, DC, on September 21-22, 1994 focused on the following topics: machine aided indexing, indexing quality, an indexing pilot project, the MedIndEx Prototype, Department of Energy/Office of Scientific and Technical Information indexing activities, high-tech coding structures, category indexing schemes, and the Government Information Locator Service. This publication consists mostly of viewgraphs related to the above noted topics. In an appendix is a description of the Government Information Locator Service.

Measuring client experiences in long-term care in the Netherlands: a pilot study with the Consumer Quality Index Long-term Care.

PubMed

Triemstra, Mattanja; Winters, Sjenny; Kool, Rudolf B; Wiegers, Therese A

2010-04-12

This study aims to describe the development, testing and optimization of a new standard instrument, the Consumer Quality Index (CQ-index) Long-term Care, for measuring client experiences with long-term care in the Netherlands. Three versions of the CQ-index questionnaires and protocols for study sampling and data collection were developed, designed for interviews with residents of nursing or residential care homes and postal surveys among representatives of psychogeriatric residents and homecare clients. From July to November 2006 a pilot study was conducted among 2,697 clients of 68 nursing or residential care homes, 2,164 representatives of clients in 57 psychogeriatric care institutions, and 1,462 clients of 19 homecare organizations. We performed psychometric analyses and descriptive analyses, and evaluated the pilot study. The pilot study showed the feasibility and usability of the instruments, supported the multidimensionality of the questionnaires and showed first findings on client experiences and possibilities for quality improvement. Nine scales applied to all care settings: shared decision making, attitude and courtesy, information, body care, competence and safety of care, activities, autonomy, mental well-being, and availability of personnel. The pilot resulted in three optimized questionnaires and recommendations for nationwide implementation. The CQ-index Long-term Care provides a good basis to investigate the quality of nursing homes, residential care homes and homecare from the clients' perspective. This standardized instrument enables a nationwide comparison of the quality of long-term care for the purpose of transparency and quality assurance.

Perceptions of neighborhood park quality: associations with physical activity and body mass index.

PubMed

Bai, Hua; Wilhelm Stanis, Sonja A; Kaczynski, Andrew T; Besenyi, Gina M

2013-02-01

Parks are important resources for physical activity (PA), yet few studies have examined how perceptions of park characteristics relate to PA and health. This study investigated associations between perceptions of neighborhood park quality and overall moderate-to-vigorous PA (MVPA), park-based PA, and body mass index (BMI). Data were collected via questionnaire from 893 households in Kansas City, Missouri. The newly developed neighborhood park quality scale demonstrated good test-retest and internal reliability. Residents' perceptions of neighborhood park quality were related to PA and health outcomes. Perceiving parks as a benefit was positively related to overall MVPA and park-based PA and negatively related to BMI. Perceptions of well-used parks were positively related to BMI, while perceived cleanliness was negatively related to park-based PA. Better measuring and understanding how perceptions of local parks are associated with PA and health can improve appreciation of how parks facilitate active living.

Diet quality as measured by the Diet Quality Index-International is associated with prospective changes in body fat among Canadian children.

PubMed

Setayeshgar, Solmaz; Maximova, Katerina; Ekwaru, John Paul; Gray-Donald, Katherine; Henderson, Mélanie; Paradis, Gilles; Tremblay, Angelo; Veugelers, Paul

2017-02-01

To quantify the association of dietary quality with prospective changes in adiposity. Children participating in the QUALITY (QUebec Adipose and Lifestyle InvesTigation in Youth) study underwent examination at baseline and at 2-year follow-up. Dietary quality was assessed by the Diet Quality Index-International (DQII) using three non-consecutive 24 h diet recalls at baseline. The DQII has four main categories: dietary adequacy, variety, moderation and overall balance. Fat mass index (FMI; [fat mass (kg)]/[height (m)]2), central FMI (CFMI; [trunk fat mass (kg)]/[height (m)]2), percentage body fat (%BF; [total fat mass (kg)]/[total mass (kg)]) and percentage central BF (%CBF; [trunk fat mass (kg)]/[total mass (kg)]) were assessed through dual-energy X-ray absorptiometry. Children were selected from schools in the greater Montreal, Sherbrooke and Quebec City metropolitan areas between 2005 and 2008, Quebec, Canada. A total of 546 children aged 8-10 years, including 244 girls and 302 boys. Regression analysis adjusting for age, sex, energy intake, physical activity and Tanner stage revealed that every 10-unit improvement in overall DQII score was associated with lower gain in CFMI (β=-0·08; 95 % CI -0·17, -0·003) and %BF (β=-0·55; 95 % CI -1·08, -0·02). Each unit improvement in dietary adequacy score was associated with lower gain in FMI (β=-0·05; 95 % CI -0·08, -0·008), CFMI (β=-0·03; 95 % CI -0·05, -0·007), %BF (β=-0·15; 95 % CI -0·28, -0·03) and %CBF (β=-0·09; 95 % CI -0·15, -0·02). Promotion of dietary quality and adequacy may reduce weight gain in childhood and prevent chronic diseases later in life.

An innovative approach for determination of air quality health index.

PubMed

Gorai, Amit Kumar; Kanchan; Upadhyay, Abhishek; Tuluri, Francis; Goyal, Pramila; Tchounwou, Paul B

2015-11-15

Fuzzy-analytical hierarchical process (F-AHP) can be extended to determine fuzzy air quality health index (FAQHI) for deducing health risk associated with local air pollution levels, and subjective parameters. The present work aims at determining FAQHI by considering five air pollutant parameters (SO2, NO2, O3, CO, and PM10) and three subjective parameters (population sensitivity, population density and location sensitivity). Each of the individual pollutants has varying impacts. Hence the combined health effects associated with the pollutants were estimated by aggregating the pollutants with different weights. Global weights for each evaluation alternatives were determined using fuzzy-AHP method. The developed model was applied to determine FAQHI in Howrah City, India from daily-observed concentrations of air pollutants over the three-year period between 2009 and 2011. The FAQHI values obtained through this method in Howrah City range from 1 to 3. Since the permissible value of FAQHI (as calculated for NAAQS) for residential areas is 1.78, higher index values are of public health concern to the exposed individuals. During the period of study, the observed FAQHI values were found to be higher than 1.78 in most of the day in the months of January to March, and October to December. However, the index values were below the recommended limit during rest of the months. In conclusion, FAQHI in Howrah city was above permissible limit in winter months and within acceptable values in summer and rainy months. Diurnal variations of FAQHI showed a similar trend during the three-year period of assessment. Copyright © 2015 Elsevier B.V. All rights reserved.

Diet quality and body mass index are associated with healthcare resource use in older adults

USDA-ARS?s Scientific Manuscript database

Health care resource consumption is a growing concern. The aim of this study was to examine the associations between diet quality and body mass index with health care resource use (HRU) in a cohort of advanced age. Participants in the Geisinger Rural Aging Study (n=5,993) were mailed demographic and...

Development of invertebrate community indexes of stream quality for the islands of Maui and Oahu, Hawaii

USGS Publications Warehouse

Wolff, Reuben H.

2012-01-01

In 2009-10 the U.S. Geological Survey (USGS) collected physical habitat information and benthic macroinvertebrates at 40 wadeable sites on 25 perennial streams on the Island of Maui, Hawaiʻi, to evaluate the relations between the macroinvertebrate assemblages and environmental characteristics and to develop a multimetric invertebrate community index (ICI) that could be used as an indicator of stream quality. The macroinvertebrate community data were used to identify metrics that could best differentiate among sites according to disturbance gradients such as embeddedness, percent fines (silt and sand areal coverage), or percent agricultural land in the contributing basin area. Environmental assessments were conducted using land-use/land-cover data and reach-level physical habitat data. The Maui data were first evaluated using the previously developed Preliminary-Hawaiian Benthic Index of Biotic Integrity (P-HBIBI) to determine if existing metrics would successfully differentiate stream quality among the sites. Secondly, a number of candidate invertebrate metrics were screened and tested and the individual metrics that proved the best at discerning among the sites along one or more disturbance gradients were combined into a multimetric invertebrate community index (ICI) of stream quality. These metrics were: total invertebrate abundance, Class Insecta relative abundance, the ratio of Trichoptera abundance to nonnative Diptera abundance, native snail (hihiwai) presence or absence, native mountain shrimp (′δpae) presence or absence, native torrent midge (Telmatogeton spp.) presence or absence, and native Megalagrion damselfly presence or absence. The Maui ICI classified 15 of the 40 sites (37.5 percent) as having "good" quality communities, 17 of the sites (42.5 percent) as having "fair" quality communities, and 8 sites (20 percent) as having "poor" quality communities, a classification that may be used to initiate further investigation into the causes of the poor

The role of CQI in the strategic planning process.

PubMed

Sahney, V K; Warden, G L

1993-01-01

This article describes the strategic planning process used to define the health care needs of a region and to prepare Henry Ford Health System (HFHS) to meet the needs of the 21st century. It presents key applications of continuous quality improvement in the development and implementation of the strategic plans for HFHS; explains how HFHS adapted the Deming/Shewhart cycle of continuous improvement for the purpose of improving its planning process; and delineates how the strategic planning, financial planning, and quality planning processes have been integrated.

Improving the quality of urban public space through the identification of space utilization index at Imam Bonjol Park, Padang city

NASA Astrophysics Data System (ADS)

Eriawan, Tomi; Setiawati, Lestari

2017-06-01

Padang City as a big city with a population approaching one million people has to address the issue of increased activities of the population and increased need for land and space for those activities. One of the effects of population growth and the development of activities in Padang is the decreasing number of open spaces for the outdoor public activities, both the natural and artificial public. However, Padang City has several open spaces that are built and managed by the government including 40 units of open spaces in the form of plansum parks, playgrounds, and sports parks, with a total area of 10.88 hectares. Despite their status as public open spaces, not all of them can be used and enjoyed by the public since most of them are passive parks, in which they are made only as a garden without any indulgences. This study was performed to assess the quality of public spaces in the central business of Padang City, namely Imam Bonjol Park (Taman Imam Bonjol). The methods of this study were done through several stages, which were to identify the typology of function space based on [1] Carmona (2008) and to assess the space utilization index based on the approach of Public Space Index according to Mehta [2] (2007). The purpose of this study was to assess the quality of space which is a public space in Padang City. The space quality was measured based on the variables in Good Public Space Index, the intensity of use, the intensity of social activity, the duration of activity, the variations in usage, and the diversity of use. The rate of the index of public space quality at Taman Imam Bonjol was determined by assessing 5 (five) variables of space quality. Based on the results of the analysis, public space utilization index was equal to 0.696. This result could be used to determine the quality of public space, in this case was Imam Bonjol Park was in Medium category. The parameters indicated several results including the lack of diversity in users' activity time, less

Using a composite morbidity score and cultural survey to explore characteristics of high proficiency neonatal intensive care units.

PubMed

Kaempf, Joseph W; Wang, Lian; Dunn, Michael

2018-01-03

Continuous quality improvement (CQI) collaboration has not eliminated the morbidity variability seen among neonatal intensive care units (NICUs). Factors other than inconstant application of potentially better practices (PBPs) might explain divergent proficiency. Measure a composite morbidity score and determine whether cultural, environmental and cognitive factors distinguish high proficiency from lower proficiency NICUs. Retrospective analysis using a risk-adjusted composite morbidity score (Benefit Metric) and cultural survey focusing on very low birth weight (VLBW) infants from 39 NICUs, years 2000-2014. The Benefit Metric and yearly variance from the group mean was rank-ordered by NICU. A comprehensive survey was completed by each NICU exploring whether morbidity variance correlated with CQI methodology, cultural, environmental and/or cognitive characteristics. 58 272 VLBW infants were included, mean (SD) age 28.2 (3.0) weeks, birth weight 1031 (301) g. The 39 NICU groups' Benefit Metric improved 40%, from 80 in 2000 to 112 in 2014 (P<0.001). 14 NICUs had composite morbidity scores significantly better than the group, 16 did not differ and 9 scored below the group mean. The 14 highest performing NICUs were characterised by more effective team work, superior morale, greater problem-solving expectations of providers, enhanced learning opportunities, knowledge of CQI fundamentals and more generous staffing. Cultural, environmental and cognitive characteristics vary among NICUs perhaps more than traditional CQI methodology and PBPs, possibly explaining the inconstancy of VLBW infant morbidity reduction efforts. High proficiency NICUs foster spirited team work and camaraderie, sustained learning opportunities and support of favourable staffing that allows problem solving and widespread involvement in CQI activities. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is

Discussion of Policies for Achieving Continuous Improvement in Community Colleges. Commission on Innovation Policy Discussion Paper Number 1.

ERIC Educational Resources Information Center

BW Associates, Berkeley, CA.

Intended to provide background information and preliminary options for the California Community Colleges' Commission on Innovation, this document describes the principles of Continuous Quality Improvement (CQI) and describes policy options for implementation in the state's community colleges. Following introductory materials, the paper recommends…

Validation of the Acoustic Voice Quality Index in the Japanese Language.

PubMed

Hosokawa, Kiyohito; Barsties, Ben; Iwahashi, Toshihiko; Iwahashi, Mio; Kato, Chieri; Iwaki, Shinobu; Sasai, Hisanori; Miyauchi, Akira; Matsushiro, Naoki; Inohara, Hidenori; Ogawa, Makoto; Maryn, Youri

2017-03-01

The Acoustic Voice Quality Index (AVQI) is a multivariate construct for quantification of overall voice quality based on the analysis of continuous speech and sustained vowel. The stability and validity of the AVQI is well established in several language families. However, the Japanese language has distinct characteristics with respect to several parameters of articulatory and phonatory physiology. The aim of the study was to confirm the criterion-related concurrent validity of AVQI, as well as its responsiveness to change and diagnostic accuracy for voice assessment in the Japanese-speaking population. This is a retrospective study. A total of 336 voice recordings, which included 69 pairs of voice recordings (before and after therapeutic interventions), were eligible for the study. The auditory-perceptual judgment of overall voice quality was evaluated by five experienced raters. The concurrent validity, responsiveness to change, and diagnostic accuracy of the AVQI were estimated. The concurrent validity and responsiveness to change based on the overall voice quality was indicated by high correlation coefficients 0.828 and 0.767, respectively. Receiver operating characteristic analysis revealed an excellent diagnostic accuracy for discrimination between dysphonic and normophonic voices (area under the curve: 0.905). The best threshold level for the AVQI of 3.15 corresponded with a sensitivity of 72.5% and specificity of 95.2%, with the positive and negative likelihood ratios of 15.1 and 0.29, respectively. We demonstrated the validity of the AVQI as a tool for assessment of overall voice quality and that of voice therapy outcomes in the Japanese-speaking population. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Applying a water quality index model to assess the water quality of the major rivers in the Kathmandu Valley, Nepal.

PubMed

Regmi, Ram Krishna; Mishra, Binaya Kumar; Masago, Yoshifumi; Luo, Pingping; Toyozumi-Kojima, Asako; Jalilov, Shokhrukh-Mirzo

2017-08-01

Human activities during recent decades have led to increased degradation of the river water environment in South Asia. This degradation has led to concerns for the populations of the major cities of Nepal, including those of the Kathmandu Valley. The deterioration of the rivers in the valley is directly linked to the prevalence of poor sanitary conditions, as well as the presence of industries that discharge their effluents into the river. This study aims to investigate the water quality aspect for the aquatic ecosystems and recreation of the major rivers in the Kathmandu Valley using the Canadian Council of Ministers of the Environment water quality index (CCME WQI). Ten physicochemical parameters were used to determine the CCME WQI at 20 different sampling locations. Analysis of the data indicated that the water quality in rural areas ranges from excellent to good, whereas in denser settlements and core urban areas, the water quality is poor. The study results are expected to provide policy-makers with valuable information related to the use of river water by local people in the study area.

The Environmental Quality Index: associations of the land and socioeconomic domains with preterm birth in New Jersey.

EPA Science Inventory

Human health is affected by simultaneous exposure to positive and negative area-level features, but research often focuses on single exposures. To address this discontinuity, a county-level environmental quality index (EQI) is being constructed, including variables representin...

Water Quality Index for measuring drinking water quality in rural Bangladesh: a cross-sectional study.

PubMed

Akter, Tahera; Jhohura, Fatema Tuz; Akter, Fahmida; Chowdhury, Tridib Roy; Mistry, Sabuj Kanti; Dey, Digbijoy; Barua, Milan Kanti; Islam, Md Akramul; Rahman, Mahfuzar

2016-02-09

Public health is at risk due to chemical contaminants in drinking water which may have immediate health consequences. Drinking water sources are susceptible to pollutants depending on geological conditions and agricultural, industrial, and other man-made activities. Ensuring the safety of drinking water is, therefore, a growing problem. To assess drinking water quality, we measured multiple chemical parameters in drinking water samples from across Bangladesh with the aim of improving public health interventions. In this cross-sectional study conducted in 24 randomly selected upazilas, arsenic was measured in drinking water in the field using an arsenic testing kit and a sub-sample was validated in the laboratory. Water samples were collected to test water pH in the laboratory as well as a sub-sample of collected drinking water was tested for water pH using a portable pH meter. For laboratory testing of other chemical parameters, iron, manganese, and salinity, drinking water samples were collected from 12 out of 24 upazilas. Drinking water at sample sites was slightly alkaline (pH 7.4 ± 0.4) but within acceptable limits. Manganese concentrations varied from 0.1 to 5.5 mg/L with a median value of 0.2 mg/L. The median iron concentrations in water exceeded WHO standards (0.3 mg/L) at most of the sample sites and exceeded Bangladesh standards (1.0 mg/L) at a few sample sites. Salinity was relatively higher in coastal districts. After laboratory confirmation, arsenic concentrations were found higher in Shibchar (Madaripur) and Alfadanga (Faridpur) compared to other sample sites exceeding WHO standard (0.01 mg/L). Of the total sampling sites, 33 % had good-quality water for drinking based on the Water Quality Index (WQI). However, the majority of the households (67 %) used poor-quality drinking water. Higher values of iron, manganese, and arsenic reduced drinking water quality. Awareness raising on chemical contents in drinking water at household level is required to

Dietary Quality of Preschoolers’ Sack Lunches as Measured by the Healthy Eating Index

PubMed Central

Romo-Palafox, Maria Jose; Ranjit, Nalini; Sweitzer, Sara J.; Roberts-Gray, Cindy; Hoelscher, Deanna M.; Byrd-Williams, Courtney E.; Briley, Margaret E.

2015-01-01

Background Eating habits are developed during the preschool years and track into adulthood, but few studies have quantified dietary quality of meals packed by parents for preschool children enrolled in early care and education centers. Objective Our aim was to evaluate the dietary quality of preschoolers’ sack lunches using the Healthy Eating Index (HEI) 2010 to provide parents of preschool children with guidance to increase the healthfulness of their child’s lunch. Design This study is a cross-sectional analysis of baseline dietary data from the Lunch Is in the Bag trial. Participants A total of 607 parent–child dyads from 30 early care and education centers in Central and South Texas were included. Main outcome measures Total and component scores of the HEI were computed using data obtained from direct observations of packed lunches and of children’s consumption. Statistical analysis Three-level regression models with random intercepts at the early care and education center and child level were used; all models were adjusted for child sex, age, and body mass index (calculated as kg/m2). Results Mean HEI-2010 total scores were 58 for lunches packed and 52 for lunches consumed, out of 100 possible points. Mean HEI component scores for packed and consumed lunches were lowest for greens and beans (6% and 8% of possible points), total vegetables (33% and 28%), seafood and plant proteins (33% and 29%), and whole grains (38% and 34%); and highest for empty calories (85% and 68% of possible points), total fruit (80% and 70%), whole fruit (79% and 64%), and total protein foods (76% and 69%). Conclusions Parents of preschool children pack lunches with low dietary quality that lack vegetables, plant proteins, and whole grains, as measured by the HEI. Education of parents and care providers in early care and education centers is vital to ensure that preschoolers receive high dietary-quality meals that promote their preference for and knowledge of a healthy diet. PMID

Dietary Quality of Preschoolers' Sack Lunches as Measured by the Healthy Eating Index.

PubMed

Romo-Palafox, Maria Jose; Ranjit, Nalini; Sweitzer, Sara J; Roberts-Gray, Cindy; Hoelscher, Deanna M; Byrd-Williams, Courtney E; Briley, Margaret E

2015-11-01

Eating habits are developed during the preschool years and track into adulthood, but few studies have quantified dietary quality of meals packed by parents for preschool children enrolled in early care and education centers. Our aim was to evaluate the dietary quality of preschoolers' sack lunches using the Healthy Eating Index (HEI) 2010 to provide parents of preschool children with guidance to increase the healthfulness of their child's lunch. This study is a cross-sectional analysis of baseline dietary data from the Lunch Is in the Bag trial. A total of 607 parent-child dyads from 30 early care and education centers in Central and South Texas were included. Total and component scores of the HEI were computed using data obtained from direct observations of packed lunches and of children's consumption. Three-level regression models with random intercepts at the early care and education center and child level were used; all models were adjusted for child sex, age, and body mass index (calculated as kg/m(2)). Mean HEI-2010 total scores were 58 for lunches packed and 52 for lunches consumed, out of 100 possible points. Mean HEI component scores for packed and consumed lunches were lowest for greens and beans (6% and 8% of possible points), total vegetables (33% and 28%), seafood and plant proteins (33% and 29%), and whole grains (38% and 34%); and highest for empty calories (85% and 68% of possible points), total fruit (80% and 70%), whole fruit (79% and 64%), and total protein foods (76% and 69%). Parents of preschool children pack lunches with low dietary quality that lack vegetables, plant proteins, and whole grains, as measured by the HEI. Education of parents and care providers in early care and education centers is vital to ensure that preschoolers receive high dietary-quality meals that promote their preference for and knowledge of a healthy diet. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A neurite quality index and machine vision software for improved quantification of neurodegeneration.

PubMed

Romero, Peggy; Miller, Ted; Garakani, Arman

2009-12-01

Current methods to assess neurodegradation in dorsal root ganglion cultures as a model for neurodegenerative diseases are imprecise and time-consuming. Here we describe two new methods to quantify neuroprotection in these cultures. The neurite quality index (NQI) builds upon earlier manual methods, incorporating additional morphological events to increase detection sensitivity for the detection of early degeneration events. Neurosight is a machine vision-based method that recapitulates many of the strengths of NQI while enabling high-throughput screening applications with decreased costs.

Stakeholder involvement in establishing a milk quality sub-index in dairy cow breeding goals: a Delphi approach.

PubMed

Henchion, M; McCarthy, M; Resconi, V C; Berry, D P; McParland, S

2016-05-01

The relative weighting on traits within breeding goals are generally determined by bio-economic models or profit functions. While such methods have generally delivered profitability gains to producers, and are being expanded to consider non-market values, current approaches generally do not consider the numerous and diverse stakeholders that affect, or are affected, by such tools. Based on principles of respondent anonymity, iteration, controlled feedback and statistical aggregation of feedback, a Delphi study was undertaken to gauge stakeholder opinion of the importance of detailed milk quality traits within an overall dairy breeding goal for profit, with the aim of assessing its suitability as a complementary, participatory approach to defining breeding goals. The questionnaires used over two survey rounds asked stakeholders: (a) their opinion on incorporating an explicit sub-index for milk quality into a national breeding goal; (b) the importance they would assign to a pre-determined list of milk quality traits and (c) the (relative) weighting they would give such a milk quality sub-index. Results from the survey highlighted a good degree of consensus among stakeholders on the issues raised. Similarly, revelation of the underlying assumptions and knowledge used by stakeholders to make their judgements illustrated their ability to consider a range of perspectives when evaluating traits, and to reconsider their answers based on the responses and rationales given by others, which demonstrated social learning. Finally, while the relative importance assigned by stakeholders in the Delphi survey (4% to 10%) and the results of calculations based on selection index theory of the relative emphasis that should be placed on milk quality to halt any deterioration (16%) are broadly in line, the difference indicates the benefit of considering more than one approach to determining breeding goals. This study thus illustrates the role of the Delphi technique, as a complementary

Artificial neural network modeling of the water quality index using land use areas as predictors.

PubMed

Gazzaz, Nabeel M; Yusoff, Mohd Kamil; Ramli, Mohammad Firuz; Juahir, Hafizan; Aris, Ahmad Zaharin

2015-02-01

This paper describes the design of an artificial neural network (ANN) model to predict the water quality index (WQI) using land use areas as predictors. Ten-year records of land use statistics and water quality data for Kinta River (Malaysia) were employed in the modeling process. The most accurate WQI predictions were obtained with the network architecture 7-23-1; the back propagation training algorithm; and a learning rate of 0.02. The WQI forecasts of this model had significant (p < 0.01), positive, very high correlation (ρs = 0.882) with the measured WQI values. Sensitivity analysis revealed that the relative importance of the land use classes to WQI predictions followed the order: mining > rubber > forest > logging > urban areas > agriculture > oil palm. These findings show that the ANNs are highly reliable means of relating water quality to land use, thus integrating land use development with river water quality management.

Floristic Quality Index for woodland ground flora restoration: Utility and effectiveness in a fire-managed landscape

Treesearch

Calvin J. Maginel; Benjamin O. Knapp; John M. Kabrick; Rose-Marie Muzika

2016-01-01

Monitoring is a critical component of ecological restoration and requires the use of metrics that are meaningful and interpretable. We analyzed the effectiveness of the Floristic Quality Index (FQI), a vegetative community metric based on species richness and the level of sensitivity to anthropogenic disturbance of individual species present (Coefficient of...

An association between diet quality index for Koreans (DQI-K) and total mortality in Health Examinees Gem (HEXA-G) study.

PubMed

Lim, Jiyeon; Lee, Yunhee; Shin, Sangah; Lee, Hwi-Won; Kim, Claire E; Lee, Jong-Koo; Lee, Sang-Ah; Kang, Daehee

2018-06-01

Diet quality scores or indices, based on dietary guidelines, are used to summarize dietary intake into a single numeric variable. The aim of this study was to examine the association between the modified diet quality index for Koreans (DQI-K) and mortality among Health Examinees-Gem (HEXA-G) study participants. The DQI-K was modified from the original diet quality index. A total of 134,547 participants (45,207 men and 89,340 women) from the HEXA-G study (2004 and 2013) were included. The DQI-K is based on eight components: 1) daily protein intake, 2) percent of energy from fat, 3) percent of energy from saturated fat, 4) daily cholesterol intake, 5) daily whole-grain intake, 6) daily fruit intake, 7) daily vegetable intake, and 8) daily sodium intake. The association between all-cause mortality and the DQI-K was examined using Cox proportional hazard regression models. Hazard ratios and confidence intervals were estimated after adjusting for age, gender, income, smoking status, alcohol drinking, body mass index, and total energy intake. The total DQI-K score was calculated by summing the scores of the eight components (range 0-9). In the multivariable adjusted models, with good diet quality (score 0-4) as a reference, poor diet quality (score 5-9) was associated with an increased risk of all-cause mortality (hazard ratios = 1.23, 95% confidence intervals = 1.06-1.43). Moreover, a one-unit increase in DQI-K score resulted in a 6% higher mortality risk. A poor diet quality DQI-K score was associated with an increased risk of mortality. The DQI-K in the present study may be used to assess the diet quality of Korean adults.

Multi-pollutant surface objective analyses and mapping of air quality health index over North America.

PubMed

Robichaud, Alain; Ménard, Richard; Zaïtseva, Yulia; Anselmo, David

2016-01-01

Air quality, like weather, can affect everyone, but responses differ depending on the sensitivity and health condition of a given individual. To help protect exposed populations, many countries have put in place real-time air quality nowcasting and forecasting capabilities. We present in this paper an optimal combination of air quality measurements and model outputs and show that it leads to significant improvements in the spatial representativeness of air quality. The product is referred to as multi-pollutant surface objective analyses (MPSOAs). Moreover, based on MPSOA, a geographical mapping of the Canadian Air Quality Health Index (AQHI) is also presented which provides users (policy makers, public, air quality forecasters, and epidemiologists) with a more accurate picture of the health risk anytime and anywhere in Canada and the USA. Since pollutants can also behave as passive atmospheric tracers, they provide information about transport and dispersion and, hence, reveal synoptic and regional meteorological phenomena. MPSOA could also be used to build air pollution climatology, compute local and national trends in air quality, and detect systematic biases in numerical air quality (AQ) models. Finally, initializing AQ models at regular time intervals with MPSOA can produce more accurate air quality forecasts. It is for these reasons that the Canadian Meteorological Centre (CMC) in collaboration with the Air Quality Research Division (AQRD) of Environment Canada has recently implemented MPSOA in their daily operations.

Improve EPA's AIRNow Air Quality Index Maps with NASA/NOAA Satellite Data

NASA Astrophysics Data System (ADS)

Pasch, A.; Zahn, P. H.; DeWinter, J. L.; Haderman, M. D.; White, J. E.; Dickerson, P.; Dye, T. S.; Martin, R. V.

2011-12-01

The U.S. Environmental Protection Agency's (EPA) AIRNow program provides maps of real-time hourly Air Quality Index (AQI) conditions and daily AQI forecasts nationwide (http://www.airnow.gov). The public uses these maps to make decisions concerning their respiratory health. The usefulness of the AIRNow air quality maps depends on the accuracy and spatial coverage of air quality measurements. Currently, the maps use only ground-based measurements, which have significant gaps in coverage in some parts of the United States. As a result, contoured AQI levels have high uncertainty in regions far from monitors. To improve the usefulness of air quality maps, scientists at EPA and Sonoma Technology, Inc. are working in collaboration with the National Aeronautics and Space Administration (NASA), the National Oceanic and Atmospheric Administration (NOAA), and university researchers on a project to incorporate additional measurements into the maps via the AIRNow Satellite Data Processor (ASDP). These measurements include estimated surface PMQuality model. Once operational, the ASDP will be able to fuse multiple PM2.5 concentration data sets to generate AQI maps with improved spatial coverage. The goal of ASDP is to provide better AQI information in monitor-sparse locations and augment monitor-dense locations with more information. The methodology and evaluation of the data fusion will be presented, along with several case studies from fall 2009 through summer 2010.

Application of a functional mathematical index (FMI) for predicting effects of the composition of jujube fruit on nutritional quality and health

USDA-ARS?s Scientific Manuscript database

In the present study, we extend the concept of a Functional Mathematical Index (FMI) for the assessment and prediction of food quality and safety of jujube fruit, a medicinal food widely consumed in Asian countries. In this study the index has been applied to one field-grown jujube fruit harvested a...

Assessing Restoration Effects on River Hydromorphology Using the Process-based Morphological Quality Index in Eight European River Reaches

NASA Astrophysics Data System (ADS)

Belletti, B.; Nardi, L.; Rinaldi, M.; Poppe, M.; Brabec, K.; Bussettini, M.; Comiti, F.; Gielczewski, M.; Golfieri, B.; Hellsten, S.; Kail, J.; Marchese, E.; Marcinkowski, P.; Okruszko, T.; Paillex, A.; Schirmer, M.; Stelmaszczyk, M.; Surian, N.

2018-01-01

The Morphological Quality Index (MQI) and the Morphological Quality Index for monitoring (MQIm) have been applied to eight case studies across Europe with the objective of analyzing the hydromorphological response to various restoration measures and of comparing the results of the MQI and MQIm as a morphological assessment applied at the reach scale, with a conventional site scale physical-habitat assessment method. For each restored reach, the two indices were applied to the pre-restoration and post-restoration conditions. The restored reach was also compared to an adjacent, degraded reach. Results show that in all cases the restoration measures improved the morphological quality of the reach, but that the degree of improvement depends on many factors, including the initial morphological conditions, the length of the restored portion in relation to the reach length, and on the type of intervention. The comparison with a conventional site scale physical-habitat assessment method shows that the MQI and MQIm are best suited for the evaluation of restoration effects on river hydromorphology at the geomorphologically-relevant scale of the river reach.

Assessing Restoration Effects on River Hydromorphology Using the Process-based Morphological Quality Index in Eight European River Reaches.

PubMed

Belletti, B; Nardi, L; Rinaldi, M; Poppe, M; Brabec, K; Bussettini, M; Comiti, F; Gielczewski, M; Golfieri, B; Hellsten, S; Kail, J; Marchese, E; Marcinkowski, P; Okruszko, T; Paillex, A; Schirmer, M; Stelmaszczyk, M; Surian, N

2018-01-01

The Morphological Quality Index (MQI) and the Morphological Quality Index for monitoring (MQIm) have been applied to eight case studies across Europe with the objective of analyzing the hydromorphological response to various restoration measures and of comparing the results of the MQI and MQIm as a morphological assessment applied at the reach scale, with a conventional site scale physical-habitat assessment method. For each restored reach, the two indices were applied to the pre-restoration and post-restoration conditions. The restored reach was also compared to an adjacent, degraded reach. Results show that in all cases the restoration measures improved the morphological quality of the reach, but that the degree of improvement depends on many factors, including the initial morphological conditions, the length of the restored portion in relation to the reach length, and on the type of intervention. The comparison with a conventional site scale physical-habitat assessment method shows that the MQI and MQIm are best suited for the evaluation of restoration effects on river hydromorphology at the geomorphologically-relevant scale of the river reach.

Water quality assessment of Australian ports using water quality evaluation indices

PubMed Central

Jahan, Sayka

2017-01-01

Australian ports serve diverse and extensive activities, such as shipping, tourism and fisheries, which may all impact the quality of port water. In this work water quality monitoring at different ports using a range of water quality evaluation indices was applied to assess the port water quality. Seawater samples at 30 stations in the year 2016–2017 from six ports in NSW, Australia, namely Port Jackson, Botany, Kembla, Newcastle, Yamba and Eden, were investigated to determine the physicochemical and biological variables that affect the port water quality. The large datasets obtained were designed to determine the Water Quality Index, Heavy metal Evaluation Index, Contamination Index and newly developed Environmental Water Quality Index. The study revealed medium water quality index and high and medium heavy metal evaluation index at three of the study ports and high contamination index in almost all study ports. Low level dissolved oxygen and higher level of total dissolved solids, turbidity, fecal coliforms, copper, iron, lead, zinc, manganese, cadmium and cobalt are mainly responsible for the poor water qualities of the port areas. Good water quality at the background samples indicated that various port activities are the likely cause for poor water quality inside the port area. PMID:29244876

[Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy].

PubMed

Machado, Flávia Mori Sarti; Simões, Arlete Naresse

2008-02-01

To test the use of cost-effectiveness analysis as a decision making tool in the production of meals for the inclusion of the recommendations published in the World Health Organization's Global Strategy. Five alternative options for breakfast menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost). Health benefits were estimated based on adaptation of the Diet Quality Index (DQI). Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost. The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58) as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72) compared to the others (DQI2=48 / DQI4=58). The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.

Qualities of Sore Throat Index (QuaSTI): measuring descriptors of sore throat in a randomized, placebo-controlled trial.

PubMed

Schachtel, Bernard; Shephard, Adrian; Schachtel, Emily; Lorton, Mary Beth; Shea, Tim; Aspley, Sue

2018-03-01

Patients with pharyngitis often describe various sensory, affective and evaluative pain qualities. Using an 11-word/phrase index, the Qualities of Sore Throat Index (QuaSTI), we characterized throat symptoms and evaluated changes in a randomized controlled trial (NCT01986361). Patients received a single flurbiprofen 8.75 mg (n = 101) or placebo (n = 21) lozenge and rated throat soreness at baseline and regular intervals over 3 h, and the QuaSTI at baseline, 1, 2 and 3 h post-treatment. The QuaSTI distinguished active drug from placebo and detected clinically important (≥2-point) changes over 3 h. Mean change from baseline over 3 h was significantly greater for flurbiprofen (154%) than placebo (p < 0.05). The QuaSTI is a sensitive instrument for measuring therapeutic effects in patients with pharyngitis.

Quality of counselling for knee and shoulder arthroscopy patients during day surgery.

PubMed

Kaakinen, Pirjo; Ervasti, Helka; Kääriäinen, Maria

2017-02-01

Counselling for day surgery patients is one of the core components for a knee or shoulder arthroscopy patient to succeed in self-care. This cross-sectional study examined the quality of counselling given to patients (n = 86) during their day surgery, using the Counselling Quality Instrument (CQI). The data were analysed using basic and multivariate statistical methods. Most respondents were male and aged over 50 years. Almost all knee and shoulder arthroscopy patients were satisfied with the counselling given on follow-up and rehabilitation as well as the counselling given relating to wound and pain treatment. There was a lack of patient-centred and goal-oriented counselling, although interaction during counselling was good. Counselling was perceived as providing benefit in regard to a patient's self-care, emotions and knowledge. Respondents aged below 40 years were more dissatisfied with counselling for day surgery than those aged 40 years and over. This study identified a need to train healthcare staff in patient-centred and goal-oriented counselling. Counselling with people who are aged below 40 years should take account of patients' specific concerns. Copyright © 2016 Elsevier Ltd. All rights reserved.

A quality approach for conducting training needs assessments in the Ministry of Health, State of Bahrain.

PubMed

Benjamin, S; al-Darazi, F

2000-01-01

In health care organizations around the world, Training Needs Assessments (TNAs) have generally followed a professions-based approach. For example, the training needs of doctors, nurses, each allied health profession, and distinct support staff have been analyzed separately--individualized TNAs conducted for each speciality and functional area. Although a professions-based TNA model can provide useful information to human resource development (HRD) professionals, there are two major drawbacks: (1) it is possible that important training needs might be overlooked because of lack of information sharing among professions and (2) such an approach does not encourage an interdisciplinary, team orientation to service provision. This paper proposes an improved method of conceptualizing TNAs, using an approach that builds on the quality management literature (TQM, CQI, etc.) which stresses the importance of customer- and service-orientations to organizing and measuring organizational and individual performance.

Humor adds the creative touch to CQI teams.

PubMed

Balzer, J W

1994-07-01

The health care industry is looking to continuous quality improvement as a process to both improve patient care and promote cost effectiveness. Interdisciplinary teams are learning to work together and to use data-driven problem solving. Humor adds a creative and welcome touch to the process that makes it easier and more fun to work in teams. The team leader or facilitator who uses humor along the journey sanctions the risk-taking behavior that accompanies creative solutions to tough problems.

Healthy eating index measures diet quality of Brazilian children of low socioeconomic status.

PubMed

Rauber, Fernanda; da Costa Louzada, Maria Laura; Vitolo, Márcia Regina

2014-01-01

This study aimed to assess the adaptation of the Healthy Eating Index (HEI) to Brazilian dietary recommendations for children aged 3 to 4 years (n = 345) and 7 to 8 years (n = 307). Dietary data were collected using two 24-hour recalls and diet quality was evaluated according to the adapted HEI. The mean HEI score was 65.7 ± 11.2 at 3 to 4 years and 65.0 ± 8.8 at 7 to 8 years. The HEI correlated positively with dietary variety and food groups (grains, vegetables, fruits, and meat/beans), except for milk at 3 to 4 years, and negatively with sodium, total fat, and saturated fat intake. HEI score was moderately to strongly associated with dietary fiber and several micronutrients. The HEI as adapted to Brazilian dietary guidelines can be used to determine diet quality in preschool- and school-aged children in Brazil.

Using knowledge for indexing health web resources in a quality-controlled gateway.

PubMed

Joubert, Michel; Darmoni, Stefan J; Avillach, Paul; Dahamna, Badisse; Fieschi, Marius

2008-01-01

The aim of this study is to provide to indexers MeSH terms to be considered as major ones in a list of terms automatically extracted from a document. We propose a method combining symbolic knowledge - the UMLS Metathesaurus and Semantic Network - and statistical knowledge drawn from co-occurrences of terms in the CISMeF database (a French-language quality-controlled health gateway) using data mining measures. The method was tested on CISMeF corpus of 293 resources. There was a proportion of 0.37+/-0.26 major terms in the processed records. The method produced lists of terms with a proportion of terms initially pointed out as major of 0.54+/-0.31. The method we propose reduces the number of terms, which seem not useful for content description of resources, such as "check tags", but retains the most descriptive ones. Discarding these terms is accounted for by: 1) the removal by using semantic knowledge of associations of concepts bearing no real medical significance, 2) the removal by using statistical knowledge of nonstatistically significant associations of terms. This method can assist effectively indexers in their daily work and will be soon applied in the CISMeF system.

Experimental Optimization of Exposure Index and Quality of Service in Wlan Networks.

PubMed

Plets, David; Vermeeren, Günter; Poorter, Eli De; Moerman, Ingrid; Goudos, Sotirios K; Luc, Martens; Wout, Joseph

2017-07-01

This paper presents the first real-life optimization of the Exposure Index (EI). A genetic optimization algorithm is developed and applied to three real-life Wireless Local Area Network scenarios in an experimental testbed. The optimization accounts for downlink, uplink and uplink of other users, for realistic duty cycles, and ensures a sufficient Quality of Service to all users. EI reductions up to 97.5% compared to a reference configuration can be achieved in a downlink-only scenario, in combination with an improved Quality of Service. Due to the dominance of uplink exposure and the lack of WiFi power control, no optimizations are possible in scenarios that also consider uplink traffic. However, future deployments that do implement WiFi power control can be successfully optimized, with EI reductions up to 86% compared to a reference configuration and an EI that is 278 times lower than optimized configurations under the absence of power control. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Kaizen: a method of process improvement in the emergency department.

PubMed

Jacobson, Gregory H; McCoin, Nicole Streiff; Lescallette, Richard; Russ, Stephan; Slovis, Corey M

2009-12-01

Recent position statements from health care organizations have placed a strong emphasis on continuous quality improvement (CQI). CQI finds many of its roots in kaizen, which emphasizes small, low-cost, low-risk improvements. Based on the successful Kaizen Programs at organizations such as Toyota, the authors thought the emergency department (ED) would be an ideal environment to benefit from such a program. The authors sought to create a CQI program using a suggestion-based model that did not require a large time commitment, was easy to implement, and had the potential to empower all physicians in the department. It would not take the place of other improvement efforts, but instead augment them. The hypothesis was that such a program would foster sustainable engagement of emergency physicians in system improvement efforts and lead to a continuous stream of low-cost implementable system improvement interventions. A CQI program was created for the physician staff of the Department of Emergency Medicine at Vanderbilt University Medical Center, focusing on a suggestion-based model using kaizen philosophy. Lectures teaching kaizen philosophy were presented. Over the past 4 years, a methodology was developed utilizing a Web-based application, the Kaizen Tracker, which aids in the submission and implementation of suggestions that are called kaizen initiatives (KIs). The characteristics of the KIs submitted, details regarding resident and faculty participation, and the effectiveness of the Kaizen Tracker were retrospectively reviewed. There were 169, 105, and 101 KIs placed in the postimplementation calendar years 2006, 2007, and 2008, respectively. Seventy-six percent of KIs submitted thus far have identified a "process problem." Fifty-three percent of KIs submitted have led to operational changes within the ED. Ninety-three percent of the resident physicians entered at least one KI, and 73% of these residents submitted more than one KI. Sixty-nine percent of the

Quality Index Tables for Some Eastern Hardwood Species Based on Lumber Prices from 1970 to 1974

Treesearch

Joseph J. Mendel; Margaret K. Peirsol

1977-01-01

Revised quality index (QI) tables for white ash, beech, black cherry, birch, hard maple, soft maple, red oak, white oak, and yellow-poplar are based on 1970-74 lumber prices for the Appalachian and northeastern marketing areas. Changes in QI since 1964-68 were greatest for white oak; there also were significant changes in QI for red oak, white ash, and yellow-poplar....

High-Quality Diets Associate With Reduced Risk of Colorectal Cancer: Analyses of Diet Quality Indexes in the Multiethnic Cohort.

PubMed

Park, Song-Yi; Boushey, Carol J; Wilkens, Lynne R; Haiman, Christopher A; Le Marchand, Loïc

2017-08-01

Healthy eating patterns assessed by diet quality indexes (DQIs) have been related to lower risk of colorectal cancer-mostly among whites. We investigated the associations between 4 DQI scores (the Healthy Eating Index 2010 [HEI-2010], the Alternative Healthy Eating Index 2010 [AHEI-2010], the alternate Mediterranean diet score [aMED], and the Dietary Approaches to Stop Hypertension score) and colorectal cancer risk in the Multiethnic Cohort. We analyzed data from 190,949 African American, Native Hawaiian, Japanese American, Latino, and white individuals, 45 to 75 years old, who entered the Multiethnic Cohort study from 1993 through 1996. During an average 16 years of follow-up, 4770 invasive colorectal cancer cases were identified. Scores from all 4 DQIs associated inversely with colorectal cancer risk; higher scores associated with decreasing colorectal cancer risk (all P's for trend ≤ .003). Associations were not significant for AHEI-2010 and aMED scores in women after adjustment for covariates: for the highest vs lowest quintiles, the hazard ratio for the HEI-2010 score in men was 0.69 (95% confidence interval [CI], 0.59-0.80) and in women was 0.82 (95% CI, 0.70-0.96); for the AHEI-2010 score the hazard ratio in men was 0.75 (95% CI, 0.65-0.85) and in women was 0.90 (95% CI, 0.78-1.04); for the aMED score the hazard ratio in men was 0.84 (95% CI, 0.73-0.97) and in women was 0.96 (95% CI, 0.82-1.13); for the Dietary Approaches to Stop Hypertension score the hazard ratio in men was 0.75 (95% CI, 0.66-0.86) and in women was 0.86 (95% CI, 0.75-1.00). Associations were limited to the left colon and rectum for all indexes. The inverse associations were less strong in African American individuals than in the other 4 racial/ethnic groups. Based on an analysis of data from the Multiethnic Cohort Study, high-quality diets are associated with a lower risk of colorectal cancer in most racial/ethnic subgroups. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All

The Pittsburgh Sleep Quality Index: validation of the Urdu translation.

PubMed

Hashmi, Ali Madeeh; Khawaja, Imran Shuja; Butt, Zeeshan; Umair, Muhammad; Naqvi, Suhaib Haider; Jawad-Ul-Haq

2014-02-01

To translate and validate the Pittsburgh Sleep Quality Index (PSQI), a standardized self-administered questionnaire for the assessment of subjective sleep quality into the Urdu language. Validation study. Mayo Hospital, Lahore, from March to April 2012. The PSQI was translated into Urdu following standard guidelines. The final Urdu version (PSQI-U) was administered to 200 healthy volunteers comprising medical students, nursing staff and doctors. Inter-item correlation was assessed by calculating Cronbach alpha. Correlation of component scores with global score was assessed by calculating Spearman correlation coefficient. Correlation between global PSQI-U scores at baseline with global scores for each PSQI-U and PSQI-E at 4-week interval was evaluated by calculating Spearman correlation coefficient. Moreover, scores on individual items of the scale at baseline were compared with respective scores after 4-week by t-test. One hundred and eighty five (185) participants completed the PSQI-U at baseline. The Cronbach alpha for PSQI-U was 0.56. Scores on individual components of the PSQI-U and composite scores were all highly correlated with each other (all p-values < 0.01). Composite scores for PSQI-U at baseline and PSQI-E at 4-week interval were also highly correlated with each other (Spearman correlation coefficient 0.74, p-value < 0.01) indicating good linguistic interchangeability. Composite scores for PSQI-U at baseline and at 4-week interval were positively correlated with each other (Spearman correlation coefficient 0.70, p < 0.01) indicating good test-retest reliability. The PSQI-U is a valid and reliable instrument for the assessment of sleep quality. It shows good linguistic interchangeability and test-retest reliability in comparison to the original English version when applied to individuals who speak the Urdu language. The PSQI-U can be a tool either for clinical management or research.

The reliability of manual reporting of clinical events in an anesthesia information management system (AIMS).

PubMed

Simpao, Allan F; Pruitt, Eric Y; Cook-Sather, Scott D; Gurnaney, Harshad G; Rehman, Mohamed A

2012-12-01

Manual incident reports significantly under-report adverse clinical events when compared with automated recordings of intraoperative data. Our goal was to determine the reliability of AIMS and CQI reports of adverse clinical events that had been witnessed and recorded by research assistants. The AIMS and CQI records of 995 patients aged 2-12 years were analyzed to determine if anesthesia providers had properly documented the emesis events that were observed and recorded by research assistants who were present in the operating room at the time of induction. Research assistants recorded eight cases of emesis during induction that were confirmed with the attending anesthesiologist at the time of induction. AIMS yielded a sensitivity of 38 % (95 % confidence interval [CI] 8.5-75.5 %), while the sensitivity of CQI reporting was 13 % (95 % CI 0.3-52.7 %). The low sensitivities of the AIMS and CQI reports suggest that user-reported AIMS and CQI data do not reliably include significant clinical events.

Spanish adaptation of the Quality of Life Index-Spinal Cord Injury version.

PubMed

Kovacs, F M; Barriga, A; Royuela, A; Seco, J; Zamora, J

2016-10-01

A cross-sectional, validation study. To (a) develop the Spanish version of the Quality of Life Index-Spinal Cord Injury version (SV-QLI/SCI) and (b) assess its psychometric characteristics among permanent wheelchair users and specifically among those with SCI. Associations of wheelchair users in Mallorca (Spain). Two forward and backward translations of the QLI/SCI into Spanish were carried out separately. Seventy-seven subjects were randomly selected among the members of the associations. They completed the SV-QLI/SCI and validated instruments to measure depression and spinal pain upon recruitment and 14 days later. Assessments included comprehensibility, reproducibility, floor and ceiling effects and correlations between quality of life, pain and depression (Spearman's correlation coefficient). Analyses were repeated excluding data from subjects without SCI. Three items of the SV-QLI/SCI required rephrasing. Reproducibility was 'almost perfect' for the entire questionnaire and its 'Health and functioning' subscale, 'substantial' for the 'Social and economic' and 'Family' subscales and 'moderate' for the 'Psychological/spiritual' subscale. Floor effect was not observed, and only for the 'Family' subscale >3% of the subjects reached the maximum possible score. The correlation between quality of life and depression was the strongest (r=-0.628). Results were virtually identical in the subsample with SCI. These results support the use of the SV-QLI/SCI among Spanish-speaking wheelchair users.

Water quality assessment in terms of water quality index (WQI): case study of the Kolong River, Assam, India

NASA Astrophysics Data System (ADS)

Bora, Minakshi; Goswami, Dulal C.

2017-10-01

The Kolong River of Nagaon district, Assam has been facing serious degradation leading to its current moribund condition due to a drastic human intervention in the form of an embankment put across it near its take-off point from the Brahmaputra River in the year 1964. The blockage of the river flow was adopted as a flood control measure to protect its riparian areas, especially the Nagaon town, from flood hazard. The river, once a blooming distributary of the mighty Brahmaputra, had high navigability and rich riparian biodiversity with a well established agriculturally productive watershed. However, the present status of Kolong River is highly wretched as a consequence of the post-dam effects thus leaving it as stagnant pools of polluted water with negligible socio-economic and ecological value. The Central Pollution Control Board, in one of its report has placed the Kolong River among 275 most polluted rivers of India. Thus, this study is conducted to analyze the seasonal water quality status of the Kolong River in terms of water quality index (WQI). The WQI scores shows very poor to unsuitable quality of water samples in almost all the seven sampling sites along the Kolong River. The water quality is found to be most deteriorated during monsoon season with an average WQI value of 122.47 as compared to pre-monsoon and post-monsoon season having average WQI value of 85.73 and 80.75, respectively. Out of the seven sampling sites, Hatimura site (S1) and Nagaon Town site (S4) are observed to be the most polluted sites.

National Coal Quality Inventory (NaCQI) and U.S. Geological Survey Coal Quality Databases

USGS Publications Warehouse

,

1999-01-01

Coal will remain a very significant part of U.S. energy needs (fig.l), even though there will continue to be concern about environmental impacts associated with its use. Currently, about 88 percent of U.S. coal production is used by electric utilities. The remaining 12 percent is either exported or used domestically for other industrial applications, such as coke for steel production.

Application of the acoustic voice quality index for objective measurement of dysphonia severity.

PubMed

Núñez-Batalla, Faustino; Díaz-Fresno, Estefanía; Álvarez-Fernández, Andrea; Muñoz Cordero, Gabriela; Llorente Pendás, José Luis

Over the past several decades, many acoustic parameters have been studied as sensitive to and to measure dysphonia. However, current acoustic measures might not be sensitive measures of perceived voice quality. A meta-analysis which evaluated the relationship between perceived overall voice quality and several acoustic-phonetic correlates, identified measures that do not rely on the extraction of the fundamental period, such the measures derived from the cepstrum, and that can be used in sustained vowel as well as continuous speech samples. A specific and recently developed method to quantify the severity of overall dysphonia is the acoustic voice quality index (AVQI) that is a multivariate construct that combines multiple acoustic markers to yield a single number that correlates reasonably with overall vocal quality. This research is based on one pool of voice recordings collected in two sets of subjects: 60 vocally normal and 58 voice disordered participants. A sustained vowel and a sample of connected speech were recorded and analyzed to obtain the six parameters included in the AVQI using the program Praat. Statistical analysis was completed using SPSS for Windows, version 12.0. Correlation between perception of overall voice quality and AVQI: A significant difference exists (t(95) = 9.5; p<.000) between normal and dysphonic voices. The findings of this study demonstrate the clinical feasibility of the AVQI as a measure of dysphonia severity. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

The dermatology life quality index as a means to assess life quality in patients with different scar types.

PubMed

Reinholz, M; Poetschke, J; Schwaiger, H; Epple, A; Ruzicka, T; Gauglitz, G G

2015-11-01

Measuring quality of life through questionnaires is a common method to evaluate the impact of different afflictions on the patient's well-being, especially in the field of dermatology where appearance changing afflictions are common. A variety of questionnaires has been used to distinguish different skin conditions like psoriasis, atopic dermatitis and scars. Using the Dermatology Life Quality Index (DLQI), we investigated different scar types regarding their impact on quality of life. We assessed the quality of life in 130 patients presenting to our outpatient scar clinic for the first time using the DLQI. Scars were analysed according to their clinical appearance (physiological scars, keloids, hypertrophic scars, atrophic scars, self-harm scars). Physiological scars were established as a baseline for further comparison between groups. Patients in the physiological scar group scored a mean DLQI score of 2.07 ± 3.56, patients in the keloid-, hypertrophic scar-, atrophic scar- and self-harm scar group scored values of 6.06 ± 4.00, 2.53 ± 2.48, 7.26 ± 6.72 and 12.00 ± 3.85 respectively. When compared to the baseline group the difference in the overall score for keloids was +3.99 (P < 0.001), hypertrophic scars scored +0.45 (ns), atrophic scars +5.19 (P < 0.01) and self-harm scars +9.93 (P < 0.001). Using the DLQI, we could demonstrate that different subsets of pathological scars do affect patients in a different magnitude. The DLQI provides a promising adjunct for quantifying the quality of life in patients suffering from keloids, atrophic- and self-harm scars and may constitute an interesting additional tool for monitoring the progress of scar treatments. © 2015 European Academy of Dermatology and Venereology.

SEER*Educate: Use of Abstracting Quality Index Scores to Monitor Improvement of All Employees.

PubMed

Potts, Mary S; Scott, Tim; Hafterson, Jennifer L

2016-01-01

Integral parts of the Seattle-Puget Sound's Cancer Surveillance System registry's continuous improvement model include the incorporation of SEER*Educate into its training program for all staff and analyzing assessment results using the Abstracting Quality Index (AQI). The AQI offers a comprehensive measure of overall performance in SEER*Educate, which is a Web-based application used to personalize learning and diagnostically pinpoint each staff member's place on the AQI continuum. The assessment results are tallied from 6 abstracting standards within 2 domains: incidence reporting and coding accuracy. More than 100 data items are aligned to 1 or more of the 6 standards to build an aggregated score that is placed on a continuum for continuous improvement. The AQI score accurately identifies those individuals who have a good understanding of how to apply the 6 abstracting standards to reliably generate high quality abstracts.

Best Practices in Health Promotion: The Joy of Chasing the Uncatchable.

PubMed

Terry, Paul E

2017-09-01

Continuous quality improvement (CQI) systems enable organizations to get better and better at what they do, thereby increasing the value of the products they make or the services they provide. This editorial argues that CQI principles are closely related to the goal of this journal to advance best practices in health promotion. To this end, contributors of articles are called on to write a discussion section that offers soaring insights alongside practical takeaways for our readers. Unlike other sections of an article, the discussion section is where scientists should feel emboldened to speculate, admit surprises, and muse about possible cause and effect relationships they found gratifying or troubling. The discussion section is our window into how today's best practices are informing next practices or are about to be supplanted by a better idea.

Prediction of ground water quality index to assess suitability for drinking purposes using fuzzy rule-based approach

NASA Astrophysics Data System (ADS)

Gorai, A. K.; Hasni, S. A.; Iqbal, Jawed

2016-11-01

Groundwater is the most important natural resource for drinking water to many people around the world, especially in rural areas where the supply of treated water is not available. Drinking water resources cannot be optimally used and sustained unless the quality of water is properly assessed. To this end, an attempt has been made to develop a suitable methodology for the assessment of drinking water quality on the basis of 11 physico-chemical parameters. The present study aims to select the fuzzy aggregation approach for estimation of the water quality index of a sample to check the suitability for drinking purposes. Based on expert's opinion and author's judgement, 11 water quality (pollutant) variables (Alkalinity, Dissolved Solids (DS), Hardness, pH, Ca, Mg, Fe, Fluoride, As, Sulphate, Nitrates) are selected for the quality assessment. The output results of proposed methodology are compared with the output obtained from widely used deterministic method (weighted arithmetic mean aggregation) for the suitability of the developed methodology.

Using Social Media to Detect Outdoor Air Pollution and Monitor Air Quality Index (AQI): A Geo-Targeted Spatiotemporal Analysis Framework with Sina Weibo (Chinese Twitter).

PubMed

Jiang, Wei; Wang, Yandong; Tsou, Ming-Hsiang; Fu, Xiaokang

2015-01-01

Outdoor air pollution is a serious problem in many developing countries today. This study focuses on monitoring the dynamic changes of air quality effectively in large cities by analyzing the spatiotemporal trends in geo-targeted social media messages with comprehensive big data filtering procedures. We introduce a new social media analytic framework to (1) investigate the relationship between air pollution topics posted in Sina Weibo (Chinese Twitter) and the daily Air Quality Index (AQI) published by China's Ministry of Environmental Protection; and (2) monitor the dynamics of air quality index by using social media messages. Correlation analysis was used to compare the connections between discussion trends in social media messages and the temporal changes in the AQI during 2012. We categorized relevant messages into three types, retweets, mobile app messages, and original individual messages finding that original individual messages had the highest correlation to the Air Quality Index. Based on this correlation analysis, individual messages were used to monitor the AQI in 2013. Our study indicates that the filtered social media messages are strongly correlated to the AQI and can be used to monitor the air quality dynamics to some extent.

Using Social Media to Detect Outdoor Air Pollution and Monitor Air Quality Index (AQI): A Geo-Targeted Spatiotemporal Analysis Framework with Sina Weibo (Chinese Twitter)

PubMed Central

Tsou, Ming-Hsiang; Fu, Xiaokang

2015-01-01

Outdoor air pollution is a serious problem in many developing countries today. This study focuses on monitoring the dynamic changes of air quality effectively in large cities by analyzing the spatiotemporal trends in geo-targeted social media messages with comprehensive big data filtering procedures. We introduce a new social media analytic framework to (1) investigate the relationship between air pollution topics posted in Sina Weibo (Chinese Twitter) and the daily Air Quality Index (AQI) published by China’s Ministry of Environmental Protection; and (2) monitor the dynamics of air quality index by using social media messages. Correlation analysis was used to compare the connections between discussion trends in social media messages and the temporal changes in the AQI during 2012. We categorized relevant messages into three types, retweets, mobile app messages, and original individual messages finding that original individual messages had the highest correlation to the Air Quality Index. Based on this correlation analysis, individual messages were used to monitor the AQI in 2013. Our study indicates that the filtered social media messages are strongly correlated to the AQI and can be used to monitor the air quality dynamics to some extent. PMID:26505756

External Validation of the Acoustic Voice Quality Index Version 03.01 With Extended Representativity.

PubMed

Barsties, Ben; Maryn, Youri

2016-07-01

The Acoustic Voice Quality Index (AVQI) is an objective method to quantify the severity of overall voice quality in concatenated continuous speech and sustained phonation segments. Recently, AVQI was successfully modified to be more representative and ecologically valid because the internal consistency of AVQI was balanced out through equal proportion of the 2 speech types. The present investigation aims to explore its external validation in a large data set. An expert panel of 12 speech-language therapists rated the voice quality of 1058 concatenated voice samples varying from normophonia to severe dysphonia. The Spearman rank-order correlation coefficients (r) were used to measure concurrent validity. The AVQI's diagnostic accuracy was evaluated with several estimates of its receiver operating characteristics (ROC). Finally, 8 of the 12 experts were chosen because of reliability criteria. A strong correlation was identified between AVQI and auditoryperceptual rating (r = 0.815, P = .000). It indicated that 66.4% of the auditory-perceptual rating's variation was explained by AVQI. Additionally, the ROC results showed again the best diagnostic outcome at a threshold of AVQI = 2.43. This study highlights external validation and diagnostic precision of the AVQI version 03.01 as a robust and ecologically valid measurement to objectify voice quality. © The Author(s) 2016.

Assessment of automatic exposure control performance in digital mammography using a no-reference anisotropic quality index

NASA Astrophysics Data System (ADS)

Barufaldi, Bruno; Borges, Lucas R.; Bakic, Predrag R.; Vieira, Marcelo A. C.; Schiabel, Homero; Maidment, Andrew D. A.

2017-03-01

Automatic exposure control (AEC) is used in mammography to obtain acceptable radiation dose and adequate image quality regardless of breast thickness and composition. Although there are physics methods for assessing the AEC, it is not clear whether mammography systems operate with optimal dose and image quality in clinical practice. In this work, we propose the use of a normalized anisotropic quality index (NAQI), validated in previous studies, to evaluate the quality of mammograms acquired using AEC. The authors used a clinical dataset that consists of 561 patients and 1,046 mammograms (craniocaudal breast views). The results show that image quality is often maintained, even at various radiation levels (mean NAQI = 0.14 +/- 0.02). However, a more careful analysis of NAQI reveals that the average image quality decreases as breast thickness increases. The NAQI is reduced by 32% on average, when the breast thickness increases from 31 to 71 mm. NAQI also decreases with lower breast density. The variation in breast parenchyma alone cannot fully account for the decrease of NAQI with thickness. Examination of images shows that images of large, fatty breasts are often inadequately processed. This work shows that NAQI can be applied in clinical mammograms to assess mammographic image quality, and highlights the limitations of the automatic exposure control for some images.

Body Mass Index Category Moderates the Relationship Between Depressive Symptoms and Diet Quality in Overweight and Obese Rural-Dwelling Adults.

PubMed

Abshire, Demetrius A; Lennie, Terry A; Chung, Misook L; Biddle, Martha J; Barbosa-Leiker, Celestina; Moser, Debra K

2017-07-07

This study was conducted to (1) compare diet quality among depressed and nondepressed overweight and obese rural-dwelling adults and (2) determine whether body mass index (BMI) category moderates the relationship between depressive symptoms and overall diet quality. Rural adults in Kentucky (n = 907) completed the 9-item Patient Health Questionnaire (PHQ-9) that assessed depressive symptoms and a food frequency questionnaire that generated 2005 Healthy Eating Index (HEI) scores. Participants were grouped into overweight (BMI 25-29.9 kg/m 2 ) and obese (≥30 kg/m 2 ), and nondepressed (PHQ-9 < 10) and depressed (PHQ-9 ≥ 10) groups. Bootstrapped ANCOVAs were used to compare diet quality among the 4 groups. Ordinary least-squares regression using PROCESS was used to determine whether BMI category (overweight vs obese) moderated the association between depressive symptoms and overall diet quality. Overall diet quality was poorer in the obese depressed group than in the obese nondepressed group. Intake of fruit and dark green/orange vegetables and legumes was lower in the obese depressed group than in the overweight nondepressed group. Depressive symptoms predicted poor overall diet quality (B = -0.287, P < .001) and the relationship was moderated by BMI category (coefficient of BMI category * depressive symptom interaction term = 0.355, P < .049). A significant inverse relationship between depressive symptoms and overall diet quality was observed in the overweight group but not in the obese group. Components of diet quality vary according to BMI category and depressive symptom status. The relationship between depressive symptoms and diet quality is influenced by BMI category. © 2017 National Rural Health Association.

Parameter-based estimation of CT dose index and image quality using an in-house android™-based software

NASA Astrophysics Data System (ADS)

Mubarok, S.; Lubis, L. E.; Pawiro, S. A.

2016-03-01

Compromise between radiation dose and image quality is essential in the use of CT imaging. CT dose index (CTDI) is currently the primary dosimetric formalisms in CT scan, while the low and high contrast resolutions are aspects indicating the image quality. This study was aimed to estimate CTDIvol and image quality measures through a range of exposure parameters variation. CTDI measurements were performed using PMMA (polymethyl methacrylate) phantom of 16 cm diameter, while the image quality test was conducted by using catphan ® 600. CTDI measurements were carried out according to IAEA TRS 457 protocol using axial scan mode, under varied parameters of tube voltage, collimation or slice thickness, and tube current. Image quality test was conducted accordingly under the same exposure parameters with CTDI measurements. An Android™ based software was also result of this study. The software was designed to estimate the value of CTDIvol with maximum difference compared to actual CTDIvol measurement of 8.97%. Image quality can also be estimated through CNR parameter with maximum difference to actual CNR measurement of 21.65%.

Groundwater quality assessment for irrigation purposes based on irrigation water quality index and its zoning with GIS in the villages of Chabahar, Sistan and Baluchistan, Iran.

PubMed

Abbasnia, Abbas; Radfard, Majid; Mahvi, Amir Hossein; Nabizadeh, Ramin; Yousefi, Mahmood; Soleimani, Hamed; Alimohammadi, Mahmood

2018-08-01

The present study was conducted to evaluate the groundwater quality and its suitability for irrigation purpose through GIS in villages of Chabahr city, Sistan and Baluchistan province in Iran. This cross-sectional study was carried out from 2010 to 2011 the 1-year-monitoring period. The water samples were collected from 40 open dug wells in order to investigate the water quality. Chemical parameters including EC, SAR, Na + , Cl - , pH, TDS, H C O 3 - and IWQI were analyzed. In order to calculate the irrigation water quality index subsequent five water quality parameters (EC, SAR, Na + , Cl - , and H C O 3 - ) were utilized. Among the total of 40 samples were analyzed for IWQI, 40% of the samples classified as excellent water, 60% of the samples in good water category.

Diet quality, inflammation, and the ankle brachial index in adults with or without cardiometabolic conditions.

PubMed

Mattei, Josiemer; Sotres-Alvarez, Daniela; Gellman, Marc; Castañeda, Sheila F; Hu, Frank B; Tucker, Katherine L; Siega-Riz, Anna Maria; Kaplan, Robert C

2018-08-01

Diet quality may influence non-traditional cardiovascular disease (CVD) risk factors - namely, C-reactive protein (CRP) and the ankle-brachial index (ABI). Pre-existing traditional cardiometabolic conditions may confound this association. We aimed to determine whether diet quality was associated with high-risk CRP or ABI, independently from traditional cardiometabolic risk factors. Baseline data were analyzed from US-Hispanics/Latinos aged 18-74 y without previously-diagnosed CVD participating in the population-based Hispanic Community Health Study/Study of Latinos cohort. Included were 14,623 participants with CRP data, and 7892 participants (≥45 y) with ABI data. Diet quality was measured with the Alternate Healthy Eating Index (AHEI). Nearly 35% of Hispanics/Latinos had high-risk CRP concentration and 6.3% had high-risk ABI (peripheral artery disease (PAD): 4.2%; arterial stiffness: 2.1%). After adjusting for sociodemographic and lifestyle factors, diabetes, hypertension, hypercholesterolemia, and obesity, the odds (95% confidence interval) of having high-risk ABI were 37% (5, 44%) lower per 10-unit increase in AHEI (p = 0.018). The association was marginally significant for PAD (0.77 (0.58, 1.00); p = 0.05), and non-significant for arterial stiffness (p = 0.16). Each 10-unit increase in AHEI was associated with 21% (10, 30%) lower odds of high-risk CRP (p = 0.0002) after similar adjustments. There were no significant interactions between AHEI and age, sex, ethnicity, smoking, or pre-existing cardiometabolic conditions for associations with ABI. The association between AHEI and high-risk CRP was stronger for those with diabetes (p-interaction < 0.0001), obesity (p-interaction = 0.005), or ages 45-74 y (p-interaction = 0.011). Higher diet quality is associated with lower inflammation and less adverse ABI among Hispanics/Latinos, independently from traditional cardiometabolic risk factors. Copyright © 2017 Elsevier Ltd and European Society for

Application of the Benthic Ecosystem Quality Index 2 to benthos in Dutch transitional and coastal waters

NASA Astrophysics Data System (ADS)

van Loon, W. M. G. M.; Boon, A. R.; Gittenberger, A.; Walvoort, D. J. J.; Lavaleye, M.; Duineveld, G. C. A.; Verschoor, A. J.

2015-09-01

The Benthic Ecosystem Quality Index 2 (BEQI2) is the Dutch multi-metric index (MMI) for assessing the status and trend of benthic invertebrates in transitional and coastal waters for the Water Framework Directive (WFD). It contains the same indicators, i.e. species richness, Shannon index and AMBI, as in the multivariate m-AMBI. The latter MMI has been adopted by several European countries in the context of WFD implementation. In contrast to m-AMBI, the BEQI2 calculation procedure has been strongly simplified and consists of two steps, i.e. the separate indicator values are normalized using their long-term reference values resulting in three Ecological Quality Ratios (EQRs), which are subsequently averaged to give one BEQI2 value. Using this method only small numbers of samples need to be analysed by Dutch benthos laboratories annually, without the necessity to co-analyse a larger historical dataset. BEQI2 EQR values appeared to correlate quantitatively very well with m-AMBI EQR values. In addition, a data pooling procedure has been added to the BEQI2 tool which enables the pooling of small core samples (0.01-0.025 m2) into larger standardized data pools of 0.1 m2 in order to meet the data requirements of the AMBI indicator and to obtain comparable reference values. Furthermore, the BEQI2 tool automatically and efficiently converts species synonym names into standardized species names. The BEQI2 tool has been applied to all Dutch benthos data monitored by Rijkswaterstaat in the period of 1991-2010 in the transitional and coastal waters and salt lakes and these results are reported here for the first time. Reference values for species richness and Shannon index (99 percentile values) and AMBI reference values (1 percentile values) were estimated for all water body-ecotopes and are discussed. BEQI2 results for all these water bodies are discussed in view of natural and human pressures. The pressure sensitivity of the BEQI2 for sewage and dredging/dumping, via the

Citation analysis of faculty publication: beyond Science Citation Index and Social Science Citation Index.

PubMed

Reed, K L

1995-10-01

When evaluated for promotion or tenure, faculty members are increasingly judged more on the quality than on the quantity of their scholarly publications. As a result, they want help from librarians in locating all citations to their published works for documentation in their curriculum vitae. Citation analysis using Science Citation Index and Social Science Citation Index provides a logical starting point in measuring quality, but the limitations of these sources leave a void in coverage of citations to an author's work. This article discusses alternative and additional methods of locating citations to published works.

Gender disparities in high-quality research revealed by Nature Index journals

PubMed Central

Müller, Ruth; Brueggmann, Doerthe; Groneberg, David A.

2018-01-01

Background The present study aims to elucidate the state of gender equality in high-quality research by analyzing the representation of female authorships in the last decade (from 2008 to 2016). Methods Based on the Gendermetrics platform, 293,557 research articles from 54 journals listed in the Nature Index were considered covering the categories Life Science, Multidisciplinary, Earth & Environmental and Chemistry. The core method was the combined analysis of the proportion of female authorships and the female-to-male odds ratio for first, co- and last authorships. The distribution of prestigious authorships was measured by the Prestige Index. Results 29.8% of all authorships and 33.1% of the first, 31.8% of the co- and 18.1% of the last authorships were held by women. The corresponding female-to-male odds ratio is 1.19 (CI: 1.18–1.20) for first, 1.35 (CI: 1.34–1.36) for co- and 0.47 (CI: 0.46–0.48) for last authorships. Women are underrepresented at prestigious authorships compared to men (Prestige Index = -0.42). The underrepresentation accentuates in highly competitive articles attracting the highest citation rates, namely, articles with many authors and articles that were published in highest-impact journals. More specifically, a large negative correlation between the 5-Year-Impact-Factor of a journal and the female representation at prestigious authorships was revealed (r(52) = -.63, P < .001). Women publish fewer articles compared to men (39.0% female authors are responsible for 29.8% of all authorships) and are underrepresented at productivity levels of more than 2 articles per author. Articles with female key authors are less frequently cited than articles with male key authors. The gender-specific differences in citation rates increase the more authors contribute to an article. Distinct differences at the journal, journal category, continent and country level were revealed. The prognosis for the next decades forecast a very slow harmonization of

Gender disparities in high-quality research revealed by Nature Index journals.

PubMed

Bendels, Michael H K; Müller, Ruth; Brueggmann, Doerthe; Groneberg, David A

2018-01-01

The present study aims to elucidate the state of gender equality in high-quality research by analyzing the representation of female authorships in the last decade (from 2008 to 2016). Based on the Gendermetrics platform, 293,557 research articles from 54 journals listed in the Nature Index were considered covering the categories Life Science, Multidisciplinary, Earth & Environmental and Chemistry. The core method was the combined analysis of the proportion of female authorships and the female-to-male odds ratio for first, co- and last authorships. The distribution of prestigious authorships was measured by the Prestige Index. 29.8% of all authorships and 33.1% of the first, 31.8% of the co- and 18.1% of the last authorships were held by women. The corresponding female-to-male odds ratio is 1.19 (CI: 1.18-1.20) for first, 1.35 (CI: 1.34-1.36) for co- and 0.47 (CI: 0.46-0.48) for last authorships. Women are underrepresented at prestigious authorships compared to men (Prestige Index = -0.42). The underrepresentation accentuates in highly competitive articles attracting the highest citation rates, namely, articles with many authors and articles that were published in highest-impact journals. More specifically, a large negative correlation between the 5-Year-Impact-Factor of a journal and the female representation at prestigious authorships was revealed (r(52) = -.63, P < .001). Women publish fewer articles compared to men (39.0% female authors are responsible for 29.8% of all authorships) and are underrepresented at productivity levels of more than 2 articles per author. Articles with female key authors are less frequently cited than articles with male key authors. The gender-specific differences in citation rates increase the more authors contribute to an article. Distinct differences at the journal, journal category, continent and country level were revealed. The prognosis for the next decades forecast a very slow harmonization of authorships odds between the two

Do body mass index and fat volume influence vocal quality, phonatory range, and aerodynamics in females?

PubMed

Barsties, Ben; Verfaillie, Rudi; Roy, Nelson; Maryn, Youri

2013-01-01

To analyze the impact of body weight and body fat volume on selected parameters of vocal quality, phonatory range, and aerodynamics in females. Based on measurements of body mass index in combination with body fat volume, 29 normophonic female subjects were classified as normal weight, underweight, and obese. Voice quality was investigated via auditory-perceptual ratings of breathiness, roughness, and overall dysphonia severity, via various acoustic measures and a multiparametric index. Phonatory range performance was examined using selected measures of the voice range profile and speech range profile. Measures of vocally relevant aerodynamics included vital capacity (i.e., VC), expected VC, phonation quotient, and maximum phonation time (i.e., MPT). Significant differences between the three weight groups were found across several measures of intensity, VC, MPT, and shimmer. As compared to the other groups, significantly higher values of maximum and minimum intensity levels, as well as sound pressure level during habitual running speech were observed for the obese group (all p-values<0.05); whereas, the underweight group had significantly lower values for VC and ratio of expected to measured VC (p-values<0.01). Furthermore, underweight subjects differed significantly as compared to normal weight subjects with lower MPT (p=0.025) and higher lowest-F0 (p=0.035). Finally the obese group showed significantly lower shimmer values than the normal weight subjects (p<0.05). Body weight and body fat volume appear to influence select objective measures of voice quality, vocal aerodynamics, and phonatory range performance.

An evaluation of a bed instability index as an indicator of habitat quality in mountain streams of the northwestern United States

USGS Publications Warehouse

Kusnierz, Paul C.; Holbrook, Christopher; Feldman, David L.

2015-01-01

Managers of aquatic resources benefit from indices of habitat quality that are reproducible and easy to measure, demonstrate a link between habitat quality and biota health, and differ between human-impacted (i.e., managed) and reference (i.e., nonimpacted or minimally impacted) conditions. The instability index (ISI) is an easily measured index that describes the instability of a streambed by relating the tractive force of a stream at bankfull discharge to the median substrate size. Previous studies have linked ISI to biological condition but have been limited to comparisons of sites within a single stream or among a small number of streams. We tested ISI as an indicator of human impact to habitat and biota in mountain streams of the northwestern USA. Among 1428 sites in six northwestern states, ISI was correlated with other habitat measures (e.g., residual pool depth, percent fine sediment) and indices of biotic health (e.g., number of intolerant macroinvertebrate taxa, fine sediment biotic index) and differed between managed and reference sites across a range of stream types and ecoregions. While ISI could be useful in mountain streams throughout the world, this index may be of particular interest to aquatic resource managers in the northwestern USA where a large dataset, from which ISI can be calculated, exists.

Quality index of the surface water of Amazonian rivers in industrial areas in Pará, Brazil.

PubMed

Medeiros, Adaelson Campelo; Faial, Kleber Raimundo Freitas; do Carmo Freitas Faial, Kelson; da Silva Lopes, Iris Danielly; de Oliveira Lima, Marcelo; Guimarães, Raphael Mendonça; Mendonça, Neyson Martins

2017-10-15

In this study was to evaluate the waters quality of the Murucupi River, located in urban agglomerate area and intense industrial activity in Barcarena City, Pará State. The Arapiranga River in Abaetetuba City was used as control area (Background), next to Barcarena. Was used the Water Quality Index (WQI) based on nine variables analized. Waters quality of the Arapiranga and Murucupi rivers were regular to good and bad to good, respectively. Anthropogenic influence on the Murucupi River was higher, mainly by the disposal of domestic effluents from the urban agglomerate and of the industrial waste tailing basins upstream of this river. Due to its less inhabited environment and further away from the area urban and industrial, the Arapiranga River was more preserved. Waters pollution of around these area is increasingly intense, and restricted its uses for various purposes. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Validation of the French version of the Pittsburgh Sleep Quality Index Addendum for posttraumatic stress disorder

PubMed Central

Ait-Aoudia, Malik; Levy, Pierre P.; Bui, Eric; Insana, Salvatore; de Fouchier, Capucine; Germain, Anne; Jehel, Louis

2013-01-01

Background Sleep disturbances are one of the main complaints of patients with trauma-related disorders. The original Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A) is self-report instrument developed to evaluate posttraumatic stress disorder (PTSD)-specific sleep disturbances in trauma-exposed individuals. However, to date, the PSQI-A has not yet been translated nor validated in French. Objective The present study aims to: a) translate the PSQI-A into French, and b) examine its psychometric properties. Method Seventy-three adult patients (mean age=40.3 [SD=15.0], 75% females) evaluated in a specialized psychotraumatology unit completed the French versions of the PSQI-A, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), and Impact Event Scale-Revised (IES-R). Results The French version of the PSQI-A showed satisfactory internal consistency, inter-item correlations, item correlations with the total score, convergent validity with PTSD and anxiety measures, and divergent validity with a depression measure. Conclusion Our findings support the use of the French version of the PSQI-A for both clinical care and research. The French version of the PSQI-A is an important addition to the currently available instruments that can be used to examine trauma-related sleep disturbances among French-speaking individuals. PMID:24044071

Multi-criteria indexes to evaluate the effects of repeated organic amendment applications on soil quality

NASA Astrophysics Data System (ADS)

Obriot, Fiona; Stauffer, Marie; Goubard, Yolaine; Vieuble-Gonod, Laure; Revallier, Agathe; Houot, Sabine

2015-04-01

Objectives The soil application of organic waste products (OWP) favours the recycling of nutrients, the crop production, the increase of soil biological activity and biodiversity. It may also lead to soil contamination. All these effects occurred simultaneously and must be considered in the evaluation of the practice. This study aims at deciphering the long-term impact of repeated applications and the short-term effect of an additional application on soil quality using 5 different Soil Quality Indices (SQI)[a]: fertility, microbial activity, biodiversity, physical properties and productivity and one pollution index by heavy metals. Methodology A long term field experiment was used (QualiAgro, Ile de France) where repeated applications of 4 amendments (a municipal solid waste compost, MSW; a biowaste compost, BIO; a co-compost of sewage sludge and green waste, GWS and a farmyard manure, FYM) have differentiated soil characteristics and crop production compared to a control treatments without organic residue and receiving mineral fertilizer or not (CONT+N and CONT). The OWP are applied every 2 years, in September, at doses equivalent to 4 t C/ha (4 replicates) on a maize-wheat succession. We used 2 sampling dates: 3 weeks before application (cumulative residual effect of 7 applications) and 3 weeks just after the 8th application (short-term additional effect of a recent application), in 2011. More than 30 different variables were used: chemical (pH, Polsen…), physical (bulk density, plasticity…) and biological (microbial biomass, enzymatic activity…) soil indicators. All of these were classified in 6 classes: fertility, microbial activity, biodiversity, physical properties, productivity and pollution. Five SQI and one pollution index by heavy metals were estimated using a weighted additive index calculation method described by Velasquez et al. (2007)[a]. Only parameters with statistically significant differences (p<0.05) were taken into account, the maximum

A saprobic index for biological assessment of river water quality in Brazil (Minas Gerais and Rio de Janeiro states).

PubMed

Junqueira, Marilia Vilela; Friedrich, Günther; Pereira de Araujo, Paulo Roberto

2010-04-01

Based upon several years of experience in investigations with macrozoobenthos in rivers in the states of Minas Gerais and Rio de Janeiro, a biological assessment system has been developed to indicate pollution levels caused by easily degradable organic substances from sewers. The biotic index presented here is aimed at determining water's saprobic levels and was, therefore, named the "Saprobic Index for Brazilian Rivers in Minas Gerais and Rio de Janeiro states" (ISMR). For this purpose, saprobic valences and weights have been established for 122 taxa of tropical macrozoobenthos. Investigations were carried out in little, medium sized and big rivers in mountains and plains. Through ISMR, a classification of water quality and the respective cartographic representation can be obtained. Data collection and treatment methods, as well as the limitations of the biotic index, are thoroughly described. ISMR can also be used as an element to establish complex multimetric indexes intended for an ecological integrity assessment, where it is essential to indicate organic pollution.

Can a Simple Dietary Index Derived from a Sub-Set of Questionnaire Items Assess Diet Quality in a Sample of Australian Adults?

PubMed Central

Trapp, Georgina S. A.; Knuiman, Matthew; Hooper, Paula; Ambrosini, Gina L.

2018-01-01

Large, longitudinal surveys often lack consistent dietary data, limiting the use of existing tools and methods that are available to measure diet quality. This study describes a method that was used to develop a simple index for ranking individuals according to their diet quality in a longitudinal study. The RESIDential Environments (RESIDE) project (2004–2011) collected dietary data in varying detail, across four time points. The most detailed dietary data were collected using a 24-item questionnaire at the final time point (n = 555; age ≥ 25 years). At preceding time points, sub-sets of the 24 items were collected. A RESIDE dietary guideline index (RDGI) that was based on the 24-items was developed to assess diet quality in relation to the Australian Dietary Guidelines. The RDGI scores were regressed on the longitudinal sub-sets of six and nine questionnaire items at T4, from which two simple index scores (S-RDGI1 and S-RDGI2) were predicted. The S-RDGI1 and S-RDGI2 showed reasonable agreement with the RDGI (Spearman’s rho = 0.78 and 0.84; gross misclassification = 1.8%; correct classification = 64.9% and 69.7%; and, Cohen’s weighted kappa = 0.58 and 0.64, respectively). For all of the indices, higher diet quality was associated with being female, undertaking moderate to high amounts of physical activity, not smoking, and self-reported health. The S-RDGI1 and S-RDGI2 explained 62% and 73% of the variation in RDGI scores, demonstrating that a large proportion of the variability in diet quality scores can be captured using a relatively small sub-set of questionnaire items. The methods described in this study can be applied elsewhere, in situations where limited dietary data are available, to generate a sample-specific score for ranking individuals according to diet quality. PMID:29652828

Can a Simple Dietary Index Derived from a Sub-Set of Questionnaire Items Assess Diet Quality in a Sample of Australian Adults?

PubMed

Bivoltsis, Alexia; Trapp, Georgina S A; Knuiman, Matthew; Hooper, Paula; Ambrosini, Gina L

2018-04-13

Large, longitudinal surveys often lack consistent dietary data, limiting the use of existing tools and methods that are available to measure diet quality. This study describes a method that was used to develop a simple index for ranking individuals according to their diet quality in a longitudinal study. The RESIDential Environments (RESIDE) project (2004-2011) collected dietary data in varying detail, across four time points. The most detailed dietary data were collected using a 24-item questionnaire at the final time point ( n = 555; age ≥ 25 years). At preceding time points, sub-sets of the 24 items were collected. A RESIDE dietary guideline index (RDGI) that was based on the 24-items was developed to assess diet quality in relation to the Australian Dietary Guidelines. The RDGI scores were regressed on the longitudinal sub-sets of six and nine questionnaire items at T4, from which two simple index scores (S-RDGI1 and S-RDGI2) were predicted. The S-RDGI1 and S-RDGI2 showed reasonable agreement with the RDGI (Spearman's rho = 0.78 and 0.84; gross misclassification = 1.8%; correct classification = 64.9% and 69.7%; and, Cohen's weighted kappa = 0.58 and 0.64, respectively). For all of the indices, higher diet quality was associated with being female, undertaking moderate to high amounts of physical activity, not smoking, and self-reported health. The S-RDGI1 and S-RDGI2 explained 62% and 73% of the variation in RDGI scores, demonstrating that a large proportion of the variability in diet quality scores can be captured using a relatively small sub-set of questionnaire items. The methods described in this study can be applied elsewhere, in situations where limited dietary data are available, to generate a sample-specific score for ranking individuals according to diet quality.

A comparison of indexing methods to evaluate quality of soils subjected to different erosion: the role of soil microbiological properties.

NASA Astrophysics Data System (ADS)

Romaniuk, Romina; Lidia, Giuffre; Alejandro, Costantini; Norberto, Bartoloni; Paolo, Nannipieri

2010-05-01

Soil quality assessment is needed to evaluate the soil conditions and sustainability of soil and crop management properties, and thus requires a systematic approach to select and interpret soil properties to be used as indicators. The aim of this work was to evaluate and compare different indexing methods to assess quality of an undisturbed grassland soil (UN), a degraded pasture soil (GL) and a no tilled soil (NT) with four different A horizon depths (25, 23, 19 and 14 cm) reflecting a diverse erosion. Twenty four soil properties were measured from 0 to10 (1) and 10 to 20 cm. (2) and a minimum data set was chosen by multivariate principal component analysis (PCA) considering all measured soil properties together (A), or according to their classification in physical, chemical or microbiological (B) properties. The measured soil properties involved either inexpensive or not laborious standard protocols, to be used in routine laboratory analysis (simple soil quality index - SSQI), or a more laborious, time consuming and expensive protocols to determine microbial diversity and microbial functionality by methyl ester fatty acids (PLFA) and catabolic response profiles (CRP), respectively (complex soil quality index - CSQI). The selected properties were linearly normalized and integrated by the weight additive method to calculate SSQI A, SSQI B, CSQI A and CSQI B indices. Two microbiological soil quality indices (MSQI) were also calculated: the MSQI 1 only considered microbiological properties according to the procedure used for calculating SQI; the MSQI 2 was calculated by considering microbial carbon biomass (MCB), microbial activity (Resp) and functional diversity determined by CPR (E). The soil quality indices were SSQI A = MCB 1 + Particulate Organic Carbon (POC)1 + Mean Weight Diameter (MWD)1; SSQI B = Saturated hydraulic conductivity (K) 1 + Total Organic Carbon (TOC) 1 + MCB 1; CSQI A = MCB 1 + POC 1 + MWD 1; CSQI B = K 1+ TOC 1+ 0.3 * (MCB 1+ i/a +POC 1) + 0

Preliminary analysis on the water quality index (WQI) of irradiated basic filter elements

NASA Astrophysics Data System (ADS)

Arif Abu Bakar, Asyraf; Muhamad Pauzi, Anas; Aziz Mohamed, Abdul; Syima Sharifuddin, Syazrin; Mohamad Idris, Faridah

2018-01-01

Simple water filtration system is needed in times of extreme floods. Clean water for sanitation at evacuation centres is essential and its production is possible by using the famous simple filtration system consisting of empty bottle and filter elements (sands, gravels, cotton/coffee filter). This research intends to study the effects of irradiated filter elements on the filtration effectiveness through experiments. The filter elements will be irradiated with gamma and neutron radiation using the facilities available at Malaysia Nuclear Agency. The filtration effectiveness is measured using the water quality index (WQI) that is developed in this study to reflect the quality of filtered water. The WQI of the filtered water using the system with irradiated filter elements is then compared with that of the system with non-irradiated filter elements. This preliminary analysis only focus on filtration element of silica sand. Results shows very nominal variation in in WQI after filtered by non-irradiated, gamma and neutron filter element (silica sand), where the hypothesis could not be affirmed.

The association between dietary glycemic index, glycemic load and diet quality indices in Iranian adults: results from Isfahan Healthy Heart Program.

PubMed

Azadbakht, Leila; Mohammadifard, Noushin; Akhavanzanjani, Mohsen; Taheri, Marzieh; Golshahi, Jafar; Haghighatdoost, Fahimeh

2016-01-01

To assess the association between dietary glycemic index (GI), glycemic load (GL) and dietary quality indices in Iranian adults. This cross section was conducted among 1571 Iranian adults aged  ≥19 years. GI, GL and diet quality indices were estimated by 24-h recall and DDS was calculated using a validated 48-item food frequency questionnaire. Participants who were in the top tertile of GI had lower healthy eating index (HEI) (57.2 ± 7.8 versus 55.6 ± 8.7; p < 0.001), dietary diversity score (DDS) (3.6 ± 0.9 versus 3.3 ± 1.1; p < 0.001) and nutrient adequacy ratios (NARs) for Zn, Ca, vitamin C and B2. Individuals in the lowest tertile of GL had lower HEI, MAR and NARs for Zn, vitamin B2, B3, B6, B12, vitamin D. Both GI and GL were positively related to dietary diversity score (DED) (p < 0.001). The inverse associations for GI and GL with diet quality indices may suggest the relevance of carbohydrate source in determining the diet quality indices.

Voice quality after endoscopic laser surgery and radiotherapy for early glottic cancer: objective measurements emphasizing the Voice Handicap Index

PubMed Central

Caminero Cueva, Maria Jesús; Señaris González, Blanca; Llorente Pendás, José Luis; Gorriz Gil, Carmen; López Llames, Aurora; Alonso Pantiga, Ramón; Suárez Nieto, Carlos

2007-01-01

We analyzed the functional outcome and self-evaluation of the voice of patients with T1 glottic carcinoma treated with endoscopic laser surgery and radiotherapy. We performed an objective voice evaluation, as well as a physical, emotional and functional well being assessment of 19 patients treated with laser surgery and 18 patients treated with radiotherapy. Voice quality is affected both by surgery and radiotherapy. Voice parameters only show differences in the maximum phonation time between both treatments. Results in the Voice Handicap Index show that radiotherapy has less effect on patient voice quality perception. There is a reduced impact on the patient’s perception of voice quality after radiotherapy, despite there being no significant differences in vocal quality between radiotherapy and laser cordectomy. PMID:17999074

Reproductive effects on fecal nitrogen as an index of diet quality: an experimental assessment

USGS Publications Warehouse

Monteith, Kyle B.; Monteith, Kevin L.; Bowyer, R. Terry; Leslie,, David M.; Jenks, Jonathan A.

2014-01-01

Concentration of fecal nitrogen has been used widely as an indicator of dietary quality for free-ranging ruminants. Differences in digestive function between species of dimorphic ungulates render interspecific comparisons of fecal nitrogen unreliable; however, whether intraspecific sexual differences in digestive function also bias this nutritional index is unknown. Our objective was to compare sex-specific variation in concentration of fecal nitrogen using male, nonlactating female, and lactating female white-tailed deer (Odocoileus virginianus) on high- and low-quality diets. During weekly trials over spring and summer (2008-2009), we monitored intake rates, collected feces twice daily, and used micro-Kjeldahl procedures to determine percent fecal nitrogen. We also determined nitrogen content of feces following a neutral detergent fiber (NDF) rinse during pre-, peak, and postlactation. Fecal nitrogen reflected general differences in dietary quality between diets; however, fecal nitrogen of lactating females in both dietary groups was lower than for males or nonlactating females throughout lactation. Nitrogen concentration following an NDF rinse also was lower for lactating females during peak lactation. We hypothesize that the remodeling of the digestive tract and increased rumination by lactating females may enhance their ability to extract nitrogen from their forage. These adjustments may expand the foraging options of lactating females by increasing their ability to process low-quality foods, but also affects the interpretation of fecal nitrogen during the season of lactation.

Quality of life in patients with vitiligo: an analysis of the dermatology life quality index outcome over the past two decades.

PubMed

Amer, Abdulrahman A A; Gao, Xing-Hua

2016-06-01

Vitiligo is one of the most important skin disorders that does not cause much physical impairment, but due to its disfiguring appearance, patients have disturbances in mental health and quality of life (QoL). The dermatology life quality index (DLQI), as one of the most specific QoL instruments, is now used widely for patients with vitiligo. The main objective of this review is to collect and present detailed information about issues and disturbances related to the QoL of patients with vitiligo by reviewing the DLQI studies worldwide in the past 20 years. The impact of vitiligo assessed by the DLQI varies according to the clinical and demographic characteristics of patients. In the majority of our reviewed studies, women showed more QoL impairment than men did, as did young patients compared to elderly ones, married women with vitiligo than singles, and patients with involvement on exposed sites than those on unexposed sites. Dark-skinned people showed more life quality effects than white people did. Dermatologists should pay particular attention to such patients who experience insufficient QoL, as they require more effort to cure their disease. © 2016 The International Society of Dermatology.

To what extent is quality of life impaired in vitiligo? A multicenter study on Italian patients using the dermatology life quality index.

PubMed

Ingordo, Vito; Cazzaniga, Simone; Medri, Matelda; Raone, Beatrice; Digiuseppe, Maria Donata; Musumeci, Maria Letizia; Romano, Ivana; Fai, Dario; Pellegrino, Michele; Pezzarossa, Enrico; Di Lernia, Vito; Peccerillo, Francesca; Battarra, Vincenzo Claudio; Sirna, Riccardo; Patrizi, Annalisa; Naldi, Luigi

2014-01-01

It is believed that vitiligo has an impact on the overall patient quality of life (QoL). To estimate QoL in a fairly large sample of Italian vitiligo patients by using the Dermatology Life Quality Index (DLQI) questionnaire. One hundred and sixty-one vitiligo patients referred to 9 dermatological centers were offered to participate by filling in the Italian version of the DLQI questionnaire. The mean total DLQI score was 4.3 (SD ±4.9; range: 0-22). In multivariate analysis, DLQI >5 was associated with female gender, stability of the disease over time and involvement of the face at disease onset. The impairment of QoL is overall limited in Italian vitiligo patients, especially if it is compared with results from other available studies. This could be due to cultural and ethnic characteristics of the sample.

Citation analysis of faculty publication: beyond Science Citation Index and Social Science Citation Index.

PubMed Central

Reed, K L

1995-01-01

When evaluated for promotion or tenure, faculty members are increasingly judged more on the quality than on the quantity of their scholarly publications. As a result, they want help from librarians in locating all citations to their published works for documentation in their curriculum vitae. Citation analysis using Science Citation Index and Social Science Citation Index provides a logical starting point in measuring quality, but the limitations of these sources leave a void in coverage of citations to an author's work. This article discusses alternative and additional methods of locating citations to published works. PMID:8547915

Floristic Quality Index: An assessment tool for restoration projects and monitoring sites in coastal Louisiana

USGS Publications Warehouse

Cretini, K.F.; Steyer, G.D.

2011-01-01

The Coastwide Reference Monitoring System (CRMS) program was established to assess the effectiveness of individual coastal restoration projects and the cumulative effects of multiple projects at regional and coastwide scales. In order to make these assessments, analytical teams have been assembled for each of the primary data types sampled under the CRMS program, including vegetation, hydrology, landscape, and soils. These teams consist of scientists and support staff from the U.S. Geological Survey and other Federal agencies, the Louisiana Office of Coastal Protection and Restoration, and university academics. Each team is responsible for developing or identifying parameters, indices, or tools that can be used to assess coastal wetlands at various scales. The CRMS Vegetation Analytical Team has developed a Floristic Quality Index for coastal Louisiana to determine the quality of a wetland based on its plant species composition and abundance.

The influence of body mass index, age, implants, and dental restorations on image quality of cone beam computed tomography.

PubMed

Ritter, Lutz; Mischkowski, Robert A; Neugebauer, Jörg; Dreiseidler, Timo; Scheer, Martin; Keeve, Erwin; Zöller, Joachim E

2009-09-01

The aim was to determine the influence of patient age, gender, body mass index (BMI), amount of dental restorations, and implants on image quality of cone-beam computerized tomography (CBCT). Fifty CBCT scans of a preretail version of Galileos (Sirona, Germany) were investigated retrospectively by 4 observers regarding image quality of 6 anatomic structures, pathologic findings detection, subjective exposure quality, and artifacts. Patient age, BMI, gender, amount of dental restorations, and implants were recorded and statistically tested for correlations to image quality. A negative effect on image quality was found statistically significantly correlated with age and the amount of dental restorations. None of the investigated image features were garbled by any of the investigated influence factors. Age and the amount of dental restorations appear to have a negative impact on CBCT image quality, whereas gender and BMI do not. Image quality of mental foramen, mandibular canal, and nasal floor are affected negatively by age but not by the amount of dental restorations. Further studies are required to elucidate influence factors on CBCT image quality.

Massage therapy in cortisol circadian rhythm, pain intensity, perceived stress index and quality of life of fibromyalgia syndrome patients.

PubMed

de Oliveira, Felipe Rodrigues; Visnardi Gonçalves, Laura Cristina; Borghi, Filipy; da Silva, Larissa Gabriela Rocha Ventura; Gomes, Anne Elise; Trevisan, Gustavo; Luiz de Souza, Aglécio; Grassi-Kassisse, Dora Maria; de Oliveira Crege, Danilo Roberto Xavier

2018-02-01

We investigate the effects of a massage therapy program (MTP) in cortisol concentration (CC), intensity of pain, quality of life and perceived stress index of fibromyalgia patients. Volunteers (n = 24, aged 26-55 years) were treated with MT, twice a week for three months. They answered the Fibromyalgia Impact Questionnaire (FIQ), Perceived Stress Questionnaire (PSQ) and McGill Pain Questionnaire (MPQ-Br), and collected saliva to evaluate CC before and after the end of each month. The MT had improvement in quality of life, according to the FIQ results, and promoted reduction in PSQ values after the second (PSQ2-0.62 ± 0.04vsPSQ0-0.71 ± 0.04) and third month (PSQ3-0.64 ± 0.04vsPSQ0-0.71 ± 0.04). The MTP also promoted reduction in pain after the third month (MQP-Br1-44.50 ± 2.15vsMQP-Br4-35.38 ± 3.71). Despite PSQ reduction, the CC were not affected by the program. This pilot suggests that this treatment improved quality of life, reduced perceived stress index and pain in these volunteers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Machine-Aided Indexing at NASA.

ERIC Educational Resources Information Center

Silvester, June P.; And Others

1994-01-01

Describes the National Aeronautics and Space Administration (NASA) Lexical Dictionary (NLD), a machine-aided indexing system used online at the NASA Center for AeroSpace Information (CASI). The functions of NLD system components are described in detail, and production and quality benefits resulting from machine-aided indexing at CASI are…

Measurement Characteristics of the Quality of Life Index When Used with Adults Who Have Severe Mental Retardation. Brief Report.

ERIC Educational Resources Information Center

Campo, Stephanie F.; And Others

1996-01-01

The Quality of Life Index was completed by 120 residential staff for 60 adults with severe to profound mental retardation residing in group homes. Measurement integrity was analyzed through use of principal components analysis, confirmatory rotation of components, and Cronbach alphas. Results are compared with results obtained from a more…

The Michigan Spine Surgery Improvement Collaborative: a statewide Collaborative Quality Initiative.

PubMed

Chang, Victor; Schwalb, Jason M; Nerenz, David R; Pietrantoni, Lisa; Jones, Sharon; Jankowski, Michelle; Oja-Tebbe, Nancy; Bartol, Stephen; Abdulhak, Muwaffak

2015-12-01

OBJECT Given the scrutiny of spine surgery by policy makers, spine surgeons are motivated to demonstrate and improve outcomes, by determining which patients will and will not benefit from surgery, and to reduce costs, often by reducing complications. Insurers are similarly motivated. In 2013, Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) established the Michigan Spine Surgery Improvement Collaborative (MSSIC) as a Collaborative Quality Initiative (CQI). MSSIC is one of the newest of 21 other CQIs that have significantly improved-and continue to improve-the quality of patient care throughout the state of Michigan. METHODS MSSIC focuses on lumbar and cervical spine surgery, specifically indications such as stenosis, disk herniation, and degenerative disease. Surgery for tumors, traumatic fractures, deformity, scoliosis, and acute spinal cord injury are currently not within the scope of MSSIC. Starting in 2014, MSSIC consisted of 7 hospitals and in 2015 included another 15 hospitals, for a total of 22 hospitals statewide. A standardized data set is obtained by data abstractors, who are funded by BCBSM/BCN. Variables of interest include indications for surgery, baseline patient-reported outcome measures, and medical history. These are obtained within 30 days of surgery. Outcome instruments used include the EQ-5D general health state score (0 being worst and 100 being the best health one can imagine) and EQ-5D-3 L. For patients undergoing lumbar surgery, a 0 to 10 numeric rating scale for leg and back pain and the Oswestry Disability Index for back pain are collected. For patients undergoing cervical surgery, a 0 to 10 numeric rating scale for arm and neck pain, Neck Disability Index, and the modified Japanese Orthopaedic Association score are collected. Surgical details, postoperative hospital course, and patient-reported outcome measures are collected at 90-day, 1-year, and 2-year intervals. RESULTS As of July 1, 2015, a total of 6397 cases

Vision and Quality of Life Index: validation of the Indian version using Rasch analysis.

PubMed

Gothwal, Vijaya K; Bagga, Deepak K

2013-07-18

A multi-attribute utility instrument (MAUI) consists of a descriptive system in which the items and responses seek information about a concept of the universe of health-related quality of life (QoL), and responses to these items then are weighted and combined to produce the index. To our knowledge, the 6-item Vision and Quality of Life Index (VisQoL) is the only available vision-related MAUI, developed and validated in Australia, specifically for visually impaired (VI) populations. To our knowledge, the psychometric properties of the VisQoL have not yet been investigated in an Indian VI sample; this was the aim of our study. The Indian VisQoL was administered to 349 VI adults face-to-face by a trained interviewer at the Vision Rehabilitation Centres of a tertiary eye care facility, South India. Rasch analysis was used to assess the psychometric properties. Rescoring was necessary for all except one item before ordered thresholds were obtained. All items fit the Rasch model and unidimensionality was confirmed. Person separation was acceptable (2.01), indicating that the instrument can discriminate among three strata of participants" vision-related QoL (VRQoL). The VisQoL items were targeted substantially to the participants" VRQoL (-0.69 logits). One item ("ability to have friendships") demonstrated large differential item functioning by work status; working participants reported the item to be more difficult (-1.13 logits) relative to other items when compared to the nonworking participants. The 6-item Indian VisQoL satisfies unidimensional Rasch model expectations in VI patients. Disordering of response categories was evident; replication is required before a common rescoring option should be considered.

Associations of key diet-quality indexes with mortality in the Multiethnic Cohort: the Dietary Patterns Methods Project.

PubMed

Harmon, Brook E; Boushey, Carol J; Shvetsov, Yurii B; Ettienne, Reynolette; Reedy, Jill; Wilkens, Lynne R; Le Marchand, Loic; Henderson, Brian E; Kolonel, Laurence N

2015-03-01

Healthy dietary patterns have been linked positively with health and longevity. However, prospective studies in diverse populations in the United States addressing dietary patterns and mortality are limited. We assessed the ability of the following 4 diet-quality indexes [the Healthy Eating Index-2010 (HEI-2010), the Alternative HEI-2010 (AHEI-2010), the alternate Mediterranean diet score (aMED), and the Dietary Approaches to Stop Hypertension (DASH)] to predict the reduction in risk of mortality from all causes, cardiovascular disease (CVD), and cancer. White, African American, Native Hawaiian, Japanese American, and Latino adults (n = 215,782) from the Multiethnic Cohort completed a quantitative food-frequency questionnaire. Scores for each dietary index were computed and divided into quintiles for men and women. Mortality was documented over 13-18 y of follow-up. HRs and 95% CIs were computed by using adjusted Cox models. High HEI-2010, AHEI-2010, aMED, and DASH scores were all inversely associated with risk of mortality from all causes, CVD, and cancer in both men and women (P-trend < 0.0001 for all models). For men, the HEI-2010 was consistently associated with a reduction in risk of mortality for all causes (HR: 0.75; 95% CI: 0.71, 0.79), CVD (HR: 0.74; 95% CI: 0.69, 0.81), and cancer (HR: 0.76; 95% CI: 0.70, 0.83) when lowest and highest quintiles were compared. In women, the AHEI and aMED showed large reductions for all-cause mortality (HR: 0.78; 95% CI: 0.74, 0.82), the AHEI showed large reductions for CVD (HR: 0.76; 95% CI: 0.69, 0.83), and the aMED showed large reductions for cancer (HR: 0.84; 95% CI: 0.76, 0. 92). These results, in a US multiethnic population, suggest that consuming a dietary pattern that achieves a high diet-quality index score is associated with lower risk of mortality from all causes, CVD, and cancer in adult men and women. © 2015 American Society for Nutrition.

Development and validation of the Consumer Quality index instrument to measure the experience and priority of chronic dialysis patients.

PubMed

van der Veer, Sabine N; Jager, Kitty J; Visserman, Ella; Beekman, Robert J; Boeschoten, Els W; de Keizer, Nicolette F; Heuveling, Lara; Stronks, Karien; Arah, Onyebuchi A

2012-08-01

Patient experience is an established indicator of quality of care. Validated tools that measure both experiences and priorities are lacking for chronic dialysis care, hampering identification of negative experiences that patients actually rate important. We developed two Consumer Quality (CQ) index questionnaires, one for in-centre haemodialysis (CHD) and the other for peritoneal dialysis and home haemodialysis (PHHD) care. The instruments were validated using exploratory factor analyses, reliability analysis of identified scales and assessing the association between reliable scales and global ratings. We investigated opportunities for improvement by combining suboptimal experience with patient priority. Sixteen dialysis centres participated in our study. The pilot CQ index for CHD care consisted of 71 questions. Based on data of 592 respondents, we identified 42 core experience items in 10 scales with Cronbach's α ranging from 0.38 to 0.88; five were reliable (α ≥ 0.70). The instrument identified information on centres' fire procedures as the aspect of care exhibiting the biggest opportunity for improvement. The pilot CQ index PHHD comprised 56 questions. The response of 248 patients yielded 31 core experience items in nine scales with Cronbach's α ranging between 0.53 and 0.85; six were reliable. Information on kidney transplantation during pre-dialysis showed most room for improvement. However, for both types of care, opportunities for improvement were mostly limited. The CQ index reliably and validly captures dialysis patient experience. Overall, most care aspects showed limited room for improvement, mainly because patients participating in our study rated their experience to be optimal. To evaluate items with high priority, but with which relatively few patients have experience, more qualitative instruments should be considered.

Diet quality of individuals with rheumatoid arthritis using the Healthy Eating Index (HEI)-2010.

PubMed

Berube, Lauren Thomas; Kiely, Mary; Yazici, Yusuf; Woolf, Kathleen

2017-03-01

Rheumatoid arthritis (RA) afflicts approximately 1.5 million American adults and is a major cause of disability. As disease severity worsens, individuals with RA may experience functional decline that can impact dietary intake. The objective of this study is to assess the diet quality of individuals with RA using the Healthy Eating Index (HEI)-2010 and examine associations between diet quality and disease activity and functional status. This cross-sectional study assessed diet quality and disease activity and functional status in adults with RA. Participants completed seven-day weighed food records, which were scored using the HEI-2010. Participants had a fasting blood draw and completed the Multidimensional Health Assessment Questionnaire to determine disease activity and functional status. The mean age of individuals with RA ( N = 84) was 53 ± 14 years, and 86.9% were female. The mean HEI-2010 total score was 58.7 ± 15.9, with 7.1% of participants scoring "good", 58.3% "fair", and 34.5% "poor". Most participants did not adhere to recommended intakes of total fruit, total vegetables, whole grains, fatty acids, refined grains, sodium, and empty calories. An unadjusted multiple linear regression model found duration of morning stiffness and C-reactive protein concentration to be significant variables to inversely predict HEI-2010 total score. The diet quality of many individuals with RA needs improvement and may be related to functional disability associated with RA. Healthcare providers should encourage individuals with RA to meet dietary guidelines and maintain a healthy diet. Moreover, healthcare providers should be aware of the potential impacts of functional disability on diet quality in individuals with RA.

Improvement in delivery of type 2 diabetes services differs by mode of care: a retrospective longitudinal analysis in the Aboriginal and Torres Strait Islander Primary Health Care setting.

PubMed

Schierhout, Gill; Matthews, Veronica; Connors, Christine; Thompson, Sandra; Kwedza, Ru; Kennedy, Catherine; Bailie, Ross

2016-10-07

Addressing evidence-practice gaps in primary care remains a significant public health challenge and is likely to require action at different levels of the health system. Whilst Continuous Quality Improvement (CQI) is associated with improvements in overall delivery, little is known about delivery of different types of care processes, and their relative improvement during CQI. We used data from over 15,000 clinical audit records of clients with Type 2 diabetes collected as part of a wide-scale CQI program implemented between 2005 and 2014 in 162 Aboriginal and Torres Strait Islander health centres. We abstracted data from clinical records on 15 service items recommended in clinical guidelines and categorised these items into five modes of care on the basis of the mechanism through which care is delivered: laboratory tests; generalist-delivered physical checks; specialist-delivered checks; education/counselling for nutrition and physical activity and education/counselling for high risk substance use. We calculated delivery for each patient for each of mode of care by determining the proportion of recommended services delivered for that mode. We used multilevel regression models to quantify variation attributable to health centre or client level factors and to identify factors associated with greater adherence to clinical guidelines for each mode of care. Clients on average received 43 to 60 % of recommended care in 2005/6. Different modes of care showed different patterns of improvement. Generalist-delivered physical checks (delivered by a non-specialist) showed a steady year on year increase, delivery of laboratory tests showed improvement only in the later years of the study, and delivery of counselling/education interventions showed early improvement which then plateaued. Health centres participating in CQI had increased odds of top quartile service delivery for all modes compared to baseline, but effects differed by mode. Health centre factors explained 20-52�

Index to Estimate the Efficiency of an Ophthalmic Practice.

PubMed

Chen, Andrew; Kim, Eun Ah; Aigner, Dennis J; Afifi, Abdelmonem; Caprioli, Joseph

2015-08-01

A metric of efficiency, a function of the ratio of quality to cost per patient, will allow the health care system to better measure the impact of specific reforms and compare the effectiveness of each. To develop and evaluate an efficiency index that estimates the performance of an ophthalmologist's practice as a function of cost, number of patients receiving care, and quality of care. Retrospective review of 36 ophthalmology subspecialty practices from October 2011 to September 2012 at a university-based eye institute. The efficiency index (E) was defined as a function of adjusted number of patients (N(a)), total practice adjusted costs (C(a)), and a preliminary measure of quality (Q). Constant b limits E between 0 and 1. Constant y modifies the influence of Q on E. Relative value units and geographic cost indices determined by the Centers for Medicare and Medicaid for 2012 were used to calculate adjusted costs. The efficiency index is expressed as the following: E = b(N(a)/C(a))Q(y). Independent, masked auditors reviewed 20 random patient medical records for each practice and filled out 3 questionnaires to obtain a process-based quality measure. The adjusted number of patients, adjusted costs, quality, and efficiency index were calculated for 36 ophthalmology subspecialties. The median adjusted number of patients was 5516 (interquartile range, 3450-11,863), the median adjusted cost was 1.34 (interquartile range, 0.99-1.96), the median quality was 0.89 (interquartile range, 0.79-0.91), and the median value of the efficiency index was 0.26 (interquartile range, 0.08-0.42). The described efficiency index is a metric that provides a broad overview of performance for a variety of ophthalmology specialties as estimated by resources used and a preliminary measure of quality of care provided. The results of the efficiency index could be used in future investigations to determine its sensitivity to detect the impact of interventions on a practice such as training

The Air Quality Health Index and Asthma Morbidity: A Population-Based Study

PubMed Central

Shen, Shixin; Atenafu, Eshetu G.; Guan, Jun; McLimont, Susan; Stocks, Brian; Licskai, Christopher

2012-01-01

Background: Exposure to air pollution has been linked to the exacerbation of respiratory diseases. The Air Quality Health Index (AQHI), developed in Canada, is a new health risk scale for reporting air quality and advising risk reduction actions. Objective: We used the AQHI to estimate the impact of air quality on asthma morbidity, adjusting for potential confounders. Methods: Daily air pollutant measures were obtained from 14 regional monitoring stations in Ontario. Daily counts of asthma-attributed hospitalizations, emergency department (ED) visits, and outpatient visits were obtained from a provincial registry of 1.5 million patients with asthma. Poisson regression was used to estimate health services rate ratios (RRs) as a measure of association between the AQHI or individual pollutants and health services use. We adjusted for age, sex, season, year, and region of residence. Results: The AQHI values were significantly associated with increased use of asthma health services on the same day and on the 2 following days, depending on the specific outcome assessed. A 1-unit increase in the AQHI was associated with a 5.6% increase in asthma outpatient visits (RR = 1.056; 95% CI: 1.053, 1.058) and a 2.1% increase in the rate of hospitalization (RR = 1.021; 95% CI: 1.014, 1.028) on the same day and with a 1.3% increase in the rate of ED visits (RR = 1.013; 95% CI: 1.010, 1.017) after a 2-day lag. Conclusions: The AQHI values were significantly associated with the use of asthma-related health services. Timely AQHI health risk advisories with integrated risk reduction messages may reduce morbidity associated with air pollution in patients with asthma. PMID:23060364

The quality of the reported sample size calculations in randomized controlled trials indexed in PubMed.

PubMed

Lee, Paul H; Tse, Andy C Y

2017-05-01

There are limited data on the quality of reporting of information essential for replication of the calculation as well as the accuracy of the sample size calculation. We examine the current quality of reporting of the sample size calculation in randomized controlled trials (RCTs) published in PubMed and to examine the variation in reporting across study design, study characteristics, and journal impact factor. We also reviewed the targeted sample size reported in trial registries. We reviewed and analyzed all RCTs published in December 2014 with journals indexed in PubMed. The 2014 Impact Factors for the journals were used as proxies for their quality. Of the 451 analyzed papers, 58.1% reported an a priori sample size calculation. Nearly all papers provided the level of significance (97.7%) and desired power (96.6%), and most of the papers reported the minimum clinically important effect size (73.3%). The median (inter-quartile range) of the percentage difference of the reported and calculated sample size calculation was 0.0% (IQR -4.6%;3.0%). The accuracy of the reported sample size was better for studies published in journals that endorsed the CONSORT statement and journals with an impact factor. A total of 98 papers had provided targeted sample size on trial registries and about two-third of these papers (n=62) reported sample size calculation, but only 25 (40.3%) had no discrepancy with the reported number in the trial registries. The reporting of the sample size calculation in RCTs published in PubMed-indexed journals and trial registries were poor. The CONSORT statement should be more widely endorsed. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Development and application of a soil organic matter-based soil quality index in mineralized terrane of the Western US

Treesearch

S. W. Blecker; L. L. Stillings; M. C. Amacher; J. A. Ippolito; N. M. DeCrappeo

2012-01-01

Soil quality indices provide a means of distilling large amounts of data into a single metric that evaluates the soil's ability to carry out key ecosystem functions. Primarily developed in agroecosytems, then forested ecosystems, an index using the relation between soil organic matter and other key soil properties in more semi-arid systems of the Western US...

Low index contrast heterostructure photonic crystal cavities with high quality factors and vertical radiation coupling

NASA Astrophysics Data System (ADS)

Ge, Xiaochen; Minkov, Momchil; Fan, Shanhui; Li, Xiuling; Zhou, Weidong

2018-04-01

We report here design and experimental demonstration of heterostructure photonic crystal cavities resonating near the Γ point with simultaneous strong lateral confinement and highly directional vertical radiation patterns. The lateral confinement is provided by a mode gap originating from a gradual modulation of the hole radii. High quality factor resonance is realized with a low index contrast between silicon nitride and quartz. The near surface-normal directional emission is preserved when the size of the core region is scaled down. The influence of the cavity size parameters on the resonant modes is also investigated theoretically and experimentally.

Higher Mediterranean Diet Quality Scores and Lower Body Mass Index Are Associated with a Less-Oxidized Plasma Glutathione and Cysteine Redox Status in Adults.

PubMed

Bettermann, Erika L; Hartman, Terryl J; Easley, Kirk A; Ferranti, Erin P; Jones, Dean P; Quyyumi, Arshed A; Vaccarino, Viola; Ziegler, Thomas R; Alvarez, Jessica A

2018-02-01

Both systemic redox status and diet quality are associated with risk outcomes in chronic disease. It is not known, however, the extent to which diet quality influences plasma thiol/disulfide redox status. The purpose of this study was to investigate the influence of diet, as measured by diet quality scores and other dietary factors, on systemic thiol/disulfide redox status. We performed a cross-sectional study of 685 working men and women (ages ≥18 y) in Atlanta, GA. Diet was assessed by 3 diet quality scores: the Alternative Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean Diet Score (MDS). We measured concentrations of plasma glutathione (GSH), cysteine, their associated oxidized forms [glutathione disulfide (GSSG) and cystine (CySS), respectively], and their redox potentials (EhGSSG and EhCySS) to determine thiol/disulfide redox status. Linear regression modeling was performed to assess relations between diet and plasma redox after adjustment for age, body mass index (BMI), sex, race, and history of chronic disease. MDS was positively associated with plasma GSH (β = 0.02; 95% CI: 0.003, 0.03) and total GSH (GSH + GSSG) (β = 0.02; 95% CI: 0.003, 0.03), and inversely associated with the CySS:GSH ratio (β = -0.02; 95% CI: -0.04, -0.004). There were significant independent associations between individual MDS components (dairy, vegetables, fish, and monounsaturated fat intake) and varying plasma redox indexes (P < 0.05). AHEI and DASH diet quality indexes and other diet factors of interest were not significantly correlated with plasma thiol and disulfide redox measures. Adherence to the Mediterranean diet was significantly associated with a favorable plasma thiol/disulfide redox profile, independent of BMI, in a generally healthy working adult population. Although longitudinal studies are warranted, these findings contribute to the feasibility of targeting a Mediterranean diet to improve plasma redox

Construction and Application of Enhanced Remote Sensing Ecological Index

NASA Astrophysics Data System (ADS)

Wang, X.; Liu, C.; Fu, Q.; Yin, B.

2018-04-01

In order to monitor the change of regional ecological environment quality, this paper use MODIS and DMSP / OLS remote sensing data, from the production capacity, external disturbance changes and human socio-economic development of the three main factors affecting the quality of ecosystems, select the net primary productivity, vegetation index and light index, using the principal component analysis method to automatically determine the weight coefficient, construction of the formation of enhanced remote sensing ecological index, and the ecological environment quality of Hainan Island from 2001 to 2013 was monitored and analyzed. The enhanced remote sensing ecological index combines the effects of the natural environment and human activities on ecosystems, and according to the contribution of each principal component automatically determine the weight coefficient, avoid the design of the weight of the parameters caused by the calculation of the human error, which provides a new method for the operational operation of regional macro ecological environment quality monitoring. During the period from 2001 to 2013, the ecological environment quality of Hainan Island showed the characteristics of decend first and then rise, the ecological environment in 2005 was affected by severe natural disasters, and the quality of ecological environment dropped sharply. Compared with 2001, in 2013 about 20000 square kilometers regional ecological environmental quality has improved, about 8760 square kilometers regional ecological environment quality is relatively stable, about 5272 square kilometers regional ecological environment quality has decreased. On the whole, the quality of ecological environment in the study area is good, the frequent occurrence of natural disasters, on the quality of the ecological environment to a certain extent.

Overview of Automotive Core Tools: Applications and Benefits

NASA Astrophysics Data System (ADS)

Doshi, Jigar A.; Desai, Darshak

2017-08-01

Continuous improvement of product and process quality is always challenging and creative task in today's era of globalization. Various quality tools are available and used for the same. Some of them are successful and few of them are not. Considering the complexity in the continuous quality improvement (CQI) process various new techniques are being introduced by the industries, as well as proposed by researchers and academia. Lean Manufacturing, Six Sigma, Lean Six Sigma is some of the techniques. In recent years, there are new tools being opted by the industry, especially automotive, called as Automotive Core Tools (ACT). The intention of this paper is to review the applications and benefits along with existing research on Automotive Core Tools with special emphasis on continuous quality improvement. The methodology uses an extensive review of literature through reputed publications—journals, conference proceedings, research thesis, etc. This paper provides an overview of ACT, its enablers, and exertions, how it evolved into sophisticated methodologies and benefits used in organisations. It should be of value to practitioners of Automotive Core Tools and to academics who are interested in how CQI can be achieved using ACT. It needs to be stressed here that this paper is not intended to scorn Automotive Core Tools, rather, its purpose is limited only to provide a balance on the prevailing positive views toward ACT.

Measuring site index in the central hardwood region

Treesearch

Robert A. McQuilkin

1989-01-01

Site index is the average height of dominant and codominant trees growing in well-stocked, even-aged stands at a given age called ?index age.? Fifty years is the most commonly used index age in upland hardwoods. Sometimes 25 or 30 years are used for short-rotation bottomland hardwoods. Site index is widely used to indicate site quality because it correlates well with...

The individual and combined influence of the "quality" and "quantity" of family meals on adult body mass index.

PubMed

Berge, Jerica M; Wickel, Katharine; Doherty, William J

2012-12-01

Although there is a well-established literature showing a positive association between the frequency of family meals and child and adolescent healthful dietary intake and lower body mass index (BMI), little is known about the association between family meal frequency (quantity) and adult health outcomes and whether quality (distractions) of family meals influences adult BMI. This study investigates the association between the quantity and quality of family meals and adult BMI. Data were from a nationally representative sample of 4,885 adults ages 25 to 64 years (56% female), from which an analytic sample of 1,779 parents was drawn for the current study. Multiple linear regression was used to test the relationship between family meal frequency and quality of family meals and adult BMI, controlling for sociodemographics. Interactions between family meal quantity and quality were also examined. The quantity of family meals and the quality of family meals were both independently related to adult BMI. Specifically, the frequency of family meals was associated with lower adult BMI and lower quality of family meals was associated with higher adult BMI. The interaction between quantity and quality was not statistically significant. Results suggest that both the quantity and quality of family meals matter for adult BMI, but one is not dependent on the other. Health care providers who work with families may want to consider promoting the importance of the quality and quantity of family meals to benefit the entire family.

Korean association of medical journal editors at the forefront of improving the quality and indexing chances of its member journals.

PubMed

Suh, Chang-Ok; Oh, Se Jeong; Hong, Sung-Tae

2013-05-01

The article overviews some achievements and problems of Korean medical journals published in the highly competitive journal environment. Activities of Korean Association of Medical Journal Editors (KAMJE) are viewed as instrumental for improving the quality of Korean articles, indexing large number of local journals in prestigious bibliographic databases and launching new abstract and citation tracking databases or platforms (eg KoreaMed, KoreaMed Synapse, the Western Pacific Regional Index Medicus [WPRIM]). KAMJE encourages its member journals to upgrade science editing standards and to legitimately increase citation rates, primarily by publishing more great articles with global influence. Experience gained by KAMJE and problems faced by Korean editors may have global implications.

A simulation-based suitability index of the quality and quantity of agricultural drainage water for reuse in irrigation.

PubMed

Allam, Ayman; Fleifle, Amr; Tawfik, Ahmed; Yoshimura, Chihiro; El-Saadi, Aiman

2015-12-01

The suitability of agricultural drainage water (ADW) for reuse in irrigation was indexed based on a simulation of quality and quantity. The ADW reuse index (DWRI) has two components; the first one indicates the suitability of water quality (QLT) for reuse in irrigation based on the mixing ratio of ADW to canal irrigation water without violating the standards of using mixed water in irrigation, while the second indicates the available water quantity (QNT) based on the ratio of the available ADW to the required reuse discharge to meet the irrigation requirements alongside the drain. The QLT and QNT values ranged from 0 to ≥3 and from 0 to ≥0.40, respectively. Correspondingly, five classes from excellent to poor and from high scarcity to no scarcity were proposed to classify the QLT and QNT values, respectively. This approach was then applied to the Gharbia drain in the Nile Delta, Egypt, combined with QUAL2Kw simulations in the summer and winter of 2012. The QLT values along the drain ranged from 1.11 to 2.91 and 0.68 to 1.73 for summer and winter, respectively. Correspondingly, the QLT classes ranged from good to very good and from fair to good, respectively. In regard to QNT, values ranged from 0.10 to 0.62 and from 0.10 to 0.88 for summer and winter, respectively. Correspondingly, the QNT classes ranged from medium scarcity to no scarcity for both seasons. The demonstration of DWRI in the Gharbia drain suggests that the proposed index presents a simple tool for spatially evaluating the suitability of ADW for reuse in irrigation. Copyright © 2015 Elsevier B.V. All rights reserved.

Spatial variation of air quality index and urban driving factors linkages: evidence from Chinese cities.

PubMed

Pu, Haixia; Luo, Kunli; Wang, Pin; Wang, Shaobin; Kang, Shun

2017-02-01

Daily air quality index (AQI) of 161 Chinese cities obtained from the Ministry of Environmental Protection of China in 2015 is conducted. In this study, to better explore spatial distribution and regional characteristic of AQI, global and local spatial autocorrelation is utilized. Pearson's correlation is introduced to determine the influence of single urban indicator on AQI value. Meanwhile, multiple linear stepwise regression is chosen to estimate quantitatively the most influential urban indicators on AQI. The spatial autocorrelation analysis indicates that the AQI value of Chinese 161 cities shows a spatial dependency. Higher AQI is mainly located in north and northwest regions, whereas low AQI is concentrated in the south and the Qinghai-Tibet regions. The low AQI and high AQI values in China both exhibit relative immobility through seasonal variation. The influence degree of three adverse urban driving factors on AQI value is ranked from high to low: coal consumption of manufacturing > building area > coal consumption of the power industry. It is worth noting that the risk of exposed population to poor quality is greater in the northern region than in other regions. The results of the study provide a reference for the formulation of urban policy and improvement of air quality in China.

High-quality Mach-Zehnder interferometer based on a microcavity in single-multi-single mode fiber structure for refractive index sensing.

PubMed

Liu, Yi; Wu, Guoqiang; Gao, Renxi; Qu, Shiliang

2017-02-01

A fiber inline Mach-Zehnder interferometer (MZI) based on a microcavity with two symmetric openings in single-multi-single mode fiber (SMSF) structure is proposed. By using the finite difference beam propagation method (FD-BPM), the interference spectrum simulation result shows that the MZI can still have high-quality interference even if the microcavity deviates along the radial direction for 3 μm. Therefore, it allows a larger fabrication tolerance and tremendously decreases the fabrication difficulty. Then a microcavity with two symmetric openings in SMSF was fabricated by using femtosecond laser-induced water breakdown. The insertion loss of the microcavity immerged in water is only -8  dB, and the MZ interference peak contrast in the transmission spectrum reaches more than 30 dB. The MZI based on the microcavity in SMSF can be used as a practical liquid refractive index sensor as its high-quality interference spectrum, ultrahigh sensitivity (9756.75 nm/RIU), high refractive index resolution (2×10^-5  RIU), good linearity (99.93%), and low-temperature crosstalk (0.04 nm/°C).

Co-morbidity, body mass index and quality of life in COPD using the Clinical COPD Questionnaire.

PubMed

Sundh, Josefin; Ställberg, Björn; Lisspers, Karin; Montgomery, Scott M; Janson, Christer

2011-06-01

Quality of life is an important patient-oriented measure in COPD. The Clinical COPD Questionnaire (CCQ) is a validated instrument for estimating quality of life. The impact of different factors on the CCQ-score remains an understudied area. The aim of this study was to investigate the association of co-morbidity and body mass index with quality of life measured by CCQ. A patient questionnaire including the CCQ and a review of records were used. A total of 1548 COPD patients in central Sweden were randomly selected. Complete data were collected for 919 patients, 639 from primary health care and 280 from hospital clinics. Multiple linear regression with adjustment for sex, age, level of education, smoking habits and level of care was performed. Subanalyses included additional adjustment for lung function in the subgroup (n = 475) where spirometry data were available. Higher mean CCQ score indicating lower quality of life was statistically significant and independently associated with heart disease (adjusted regression coefficient (95%CI) 0.26; 0.06 to 0.47), depression (0.50; 0.23 to 0.76) and underweight (0.58; 0.29 to 0.87). Depression and underweight were associated with higher scores in all CCQ subdomains. Further adjustment for lung function in the subgroup with this measure resulted in statistically significant and independent associations with CCQ for heart disease, depression, obesity and underweight. The CCQ identified that heart disease, depression and underweight are independently associated with lower health-related quality of life in COPD.

SME Worker Affective (SWA) index based on environmental ergonomics

NASA Astrophysics Data System (ADS)

Ushada, M.; Kusuma Aji, G.; Okayama, T.; Khidir, M.

2018-04-01

Small-Medium sized (SME) is a focal type of Indonesian industry which contributes to national emerging economies. Indonesian goverment has developed employee social security system (BPJS Ketenagakerjaan) to support worker quality of life. However, there were limited research which could assist BPJS Ketenagakerjaan in evaluating worker quality of life. Worker quality of life could be categorized as the highest worker needs or affective states. SME Worker Affective (SWA) index is being concerned as a basic tool to make balance between worker performance and quality of life in workstation of SMEs. The research objectives are: 1) To optimize the environmental ergonomics in SMEs; 2) To quantify SME Worker Affective (SWA) index based on optimized environmental ergonomics. The research advantage is to support Indonesian goverment in monitoring SMEs good practices to its worker quality of life. Simulated annealing optimized the heart rate and environmental ergonomics parameters. SWA index was determined based on comparison between optimized heart rate and environmental ergonomics parameters. SWA index were quantified for 380 data of worker. The evaluation indicated 51.3% worker in affective and 48.7% in non-affective condition. Research results indicated that stakeholders of SMEs should put more attention on environmental ergonomics and worker affective.

Measurement of Health Care Quality in Atopic Dermatitis - Development and Application of a Set of Quality Indicators.

PubMed

Steinke, S; Beikert, F C; Langenbruch, A; Fölster-Holst, R; Ring, J; Schmitt, J; Werfel, T; Hintzen, S; Franzke, N; Augustin, M

2018-05-15

Quality indicators are essential tools for the assessment of health care, in particular for guideline-based procedures. 1) Development of a set of indicators for the evaluation of process and outcomes quality in atopic dermatitis (AD) care. 2) Application of the indicators to a cross-sectional study and creation of a global process quality index. An expert committee consisting of 10 members of the German guideline group on atopic dermatitis condensed potential quality indicators to a final set of 5 outcomes quality and 12 process quality indicators using a Delphi panel. The outcomes quality and 7 resp. 8 process quality indicators were retrospectively applied to a nationwide study on 1,678 patients with atopic dermatitis (AtopicHealth). Each individual process quality indicator score was then summed up to a global index (ranges from 0 (no quality achieved) to 100 (full quality achieved)) displaying the quality of health care. In total, the global process quality index revealed a median value of 62.5 and did not or only slightly correlate to outcome indicators as the median SCORAD (SCORing Atopic Dermatitis; rp =0.08), Dermatology Life Quality Index (DLQI; rp = 0.256), and Patient Benefit Index (PBI; rp = -0.151). Process quality of AD care is moderate to good. The health care process quality index does not substantially correlate to the health status of AD patients measured by 5 different outcomes quality indicators. Further research should include the investigation of reliability, responsiveness, and feasibility of the proposed quality indicators for AD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Medicare program; FY 2014 hospice wage index and payment rate update; hospice quality reporting requirements; and updates on payment reform. final rule.

PubMed

2013-08-07

This final rule updates the hospice payment rates and the wage index for fiscal year (FY) 2014, and continues the phase out of the wage index budget neutrality adjustment factor (BNAF). Including the FY 2014 15 percent BNAF reduction, the total 5 year cumulative BNAF reduction in FY 2014 will be 70 percent. The BNAF phase-out will continue with successive 15 percent reductions in FY 2015 and FY 2016. This final rule also clarifies how hospices are to report diagnoses on hospice claims, and provides updates to the public on hospice payment reform. Additionally, this final rule changes the requirements for the hospice quality reporting program by discontinuing currently reported measures and implementing a Hospice Item Set with seven National Quality Forum (NFQ) endorsed measures beginning July 1, 2014, as proposed. Finally, this final rule will implement the hospice Experience of Care Survey on January 1, 2015, as proposed.

Assessment of Life Quality Index Among Patients with Acne Vulgaris in a Suburban Population

PubMed Central

Hazarika, Neirita; Rajaprabha, Radha K

2016-01-01

Background and Aims: Acne vulgaris affects about 85% of adolescents, often extending into adulthood. Psychosocial impact of acne on health-related quality of life (QoL) has been identified, but it remains under-evaluated, especially in Indian patients. This study was aimed to assess the impact of acne and its sequelae on the QoL. Materials and Methods: This was a hospital-based, prospective, cross-sectional study done between June and November 2014 on 114 consenting patients above 15 years of age with acne vulgaris. Acne vulgaris and its sequelae were graded, and QoL was assessed by using Dermatology Life Quality Index (DLQI) questionnaire. Results: Most cases (64%) were between 15 and 20 years. Females (57%) outnumbered males. Facial lesions (61.4%) and grade II acne were most common. Mean DLQI score was 7.22. DLQI scores were statistically influenced by the age of the patient, duration and grade of acne, acne scar, and postacne hyperpigmentation. Conclusion: This study showed significant impairment of QoL in acne patients. Assurance and counseling along with early treatment of acne vulgaris are important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment. PMID:27057015

The impact of eating frequency and time of intake on nutrient quality and body mass index: The INTERMAP Study, a population based study

PubMed Central

Aljuraiban, Ghadeer S.; Chan, Queenie; Griep, Linda M. Oude; Brown, Ian J.; Daviglus, Martha L.; Stamler, Jeremiah; Van Horn, Linda; Elliott, Paul; Frost, Gary S.

2014-01-01

Background Epidemiologic evidence is sparse on the effect of dietary behaviors and diet quality on body mass index (BMI) that may be important drivers of the obesity epidemic. Objective This study investigated the relationships of frequency of eating and time of intake to energy density, nutrient quality and BMI using data from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) including 2,696 men and women aged 40-59 from the United States and the United Kingdom. Design INTERMAP is a cross-sectional investigation with four 24-hour dietary recalls and BMI measurements conducted between 1996 and 1999. Consumption of solid foods was aggregated into eating occasion. Nutrient density is expressed using the Nutrient Rich Food (NRF 9.3) index. The ratio of evening/morning energy intake was calculated; mean values of four visits were used. Statistical analyses performed Characteristics across eating occasion categories are presented as adjusted mean with corresponding 95% confidence interval. Multiple linear regression models were used to examine associations of eating occasions, ratio of evening/morning energy intake, dietary energy density, and NRF 9.3 index with BMI. Results Compared to participants with < 4 eating occasions/24-hours, those with ≥ 6 eating occasions/24-hours had lower mean: BMI: 27.3 vs. 29.0 kg/m2; total energy intake: 2,129 vs. 2,472 kcal/24-hours; dietary energy density: 1.5 vs. 2.1 kcal/g; and higher NRF 9.3 index: 34.3 vs. 28.1. In multiple regression analyses, higher evening intake relative to morning intake was directly associated with BMI; however this did not influence the relationship between eating frequency and BMI. Conclusions Our results suggest that a larger number of small meals may be associated with improved diet quality and lower BMI. This may have implications for behavioral approaches to controlling the obesity epidemic. PMID:25620753

Assessment of water quality index of bore well water samples from some selected locations of South Gujarat, India.

PubMed

Tripathi, S; Patel, H M; Srivastava, P K; Bafna, A M

2013-10-01

The present study calculates the water quality index (WQI) of some selected sites from South Gujarat (India) and assesses the impact of industries, agriculture and human activities. Chemical parameters were monitored for the calculation of WQI of some selected bore well samples. The results revealed that the WQI of the some bore well samples exceeded acceptable levels due to the dumping of wastes from municipal, industrial and domestic sources and agricultural runoff as well. Inverse Distance Weighting (IDW) was implemented for interpolation of each water quality parameter (pH, EC, alkalinity, total hardness, chloride, nitrate and sulphate) for the entire sampled area. The bore water is unsuitable for drinking and if the present state of affairs continues for long, it may soon become an ecologically dead bore.

Transmission of laser pulses with high output beam quality using step-index fibers having large cladding

DOEpatents

Yalin, Azer P; Joshi, Sachin

2014-06-03

An apparatus and method for transmission of laser pulses with high output beam quality using large core step-index silica optical fibers having thick cladding, are described. The thick cladding suppresses diffusion of modal power to higher order modes at the core-cladding interface, thereby enabling higher beam quality, M.sup.2, than are observed for large core, thin cladding optical fibers. For a given NA and core size, the thicker the cladding, the better the output beam quality. Mode coupling coefficients, D, has been found to scale approximately as the inverse square of the cladding dimension and the inverse square root of the wavelength. Output from a 2 m long silica optical fiber having a 100 .mu.m core and a 660 .mu.m cladding was found to be close to single mode, with an M.sup.2=1.6. Another thick cladding fiber (400 .mu.m core and 720 .mu.m clad) was used to transmit 1064 nm pulses of nanosecond duration with high beam quality to form gas sparks at the focused output (focused intensity of >100 GW/cm.sup.2), wherein the energy in the core was <6 mJ, and the duration of the laser pulses was about 6 ns. Extending the pulse duration provided the ability to increase the delivered pulse energy (>20 mJ delivered for 50 ns pulses) without damaging the silica fiber.

Physicochemical quality evaluation of groundwater and development of drinking water quality index for Araniar River Basin, Tamil Nadu, India.

PubMed

Jasmin, I; Mallikarjuna, P

2014-02-01

Groundwater is the most important natural resource which cannot be optimally used and sustained unless its quality is properly assessed. In the present study, the spatial and temporal variations in physicochemical quality parameters of groundwater of Araniar River Basin, India were analyzed to determine its suitability for drinking purpose through development of drinking water quality index (DWQI) maps of the post- and pre-monsoon periods. The suitability for drinking purpose was evaluated by comparing the physicochemical parameters of groundwater in the study area with drinking water standards prescribed by the World Health Organization (WHO) and Bureau of Indian Standards (BIS). Interpretation of physicochemical data revealed that groundwater in the basin was slightly alkaline. The cations such as sodium (Na(+)) and potassium (K(+)) and anions such as bicarbonate (HCO3 (-)) and chloride (Cl(-)) exceeded the permissible limits of drinking water standards (WHO and BIS) in certain pockets in the northeastern part of the basin during the pre-monsoon period. The higher total dissolved solids (TDS) concentration was observed in the northeastern part of the basin, and the parameters such as calcium (Ca(2+)), magnesium (Mg(2+)), sulfate (SO4 (2-)), nitrate (NO3 (-)), and fluoride (F(-)) were within the limits in both the seasons. The hydrogeochemical evaluation of groundwater of the basin demonstrated with the Piper trilinear diagram indicated that the groundwater samples of the area were of Ca(2+)-Mg(2+)-Cl(-)-SO4 (2-), Ca(2+)-Mg(2+)-HCO3 (-) and Na(+)-K(+)-Cl(-)-SO4 (2-) types during the post-monsoon period and Ca(2+)-Mg(2+)-Cl(-)-SO4 (2-), Na(+)-K(+)-Cl(-)-SO4 (2-) and Ca(2+)-Mg(2+)-HCO3 (-) types during the pre-monsoon period. The DWQI maps for the basin revealed that 90.24 and 73.46% of the basin area possess good quality drinking water during the post- and pre-monsoon seasons, respectively.

The Impact of Changes in Psoriasis Area and Severity Index by Body Region on Quality of Life in Patients with Psoriasis.

PubMed

Sojević Timotijević, Zorica; Majcan, Predrag; Trajković, Goran; Relić, Milijana; Novaković, Tatjana; Mirković, Momčilo; Djurić, Sladjana; Nikolić, Simon; Lazić, Bratislav; Janković, Slavenka

2017-10-01

Psoriasis severity varies by body region, with each affected region having a different impact on patient quality of life (QoL). The aim of this study was to assess the impact of changes in the Psoriasis Area and Severity Index (PASI) scores by body region on QoL in patients with psoriasis after treatment. A total of 100 patients with psoriasis were recruited to the study. All patients completed the generic EuroQol-5D instrument and two specific QoL measures, Dermatology Life Quality Index (DLQI) and Psoriasis Disability Index (PDI) at the beginning of the study, and 50 patients successfully completed the same questionnaires four weeks after the end of the treatment. Clinical severity was assessed using PASI total score and PASI body region (head, trunk, arms, and legs) scores. QoL improved after treatment, and PASI improvements on visible body regions (head, legs, and arms) showed significant correlation with the most sub-areas of the Visual Analog Scale (EQ VAS), DLQI, and PDI. Multiple linear regression analysis revealed that PASI improvement (particularly on the head), sex, age, and disease duration were predictors of QoL score changes for most domains of the three instruments. Improvement of psoriasis in visible body regions has an appreciable influence on QoL improvement, and may positively affect treatment success in patients with psoriasis.

[Evaluating quality and effectiveness in the promotion of health: approaches and methods of public health and social sciences].

PubMed

Deccache, A

1997-06-01

Health promotion and health education have often been limited to evaluation of the effectiveness of actions and programmes. However, since 1996 with the Third European Conference on Health Promotion and Education Effectiveness, many researchers have become interested in "quality assessment" and new ways of thinking have emerged. Quality assurance is a concept and activity developed in industry with the objective of increasing production efficiency. There are two distinct approaches: External Standard Inspection (ESI) and Continuous Quality Improvement (CQI). ESI involves establishing criteria of quality, evaluating them and improving whatever needs improvement. CQI views the activity or service as a process and includes the quality assessment as part of the process. This article attempts to answer the questions of whether these methods are sufficient and suitable for operationalising the concepts of evaluation, effectiveness and quality in health promotion and education, whether it is necessary to complement them with other methods, and whether the ESI approach is appropriate. The first section of the article explains that health promotion is based on various paradigms from epidemiology to psychology and anthropology. Many authors warn against the exclusive use of public health disciplines for understanding, implementing and evaluating health promotion. The author argues that in practice, health promotion: -integrates preventive actions with those aiming to maintain and improve health, a characteristic which widens the actions of health promotion from those of classic public health which include essentially an epidemiological or "risk" focus; -aims to replace vertical approaches to prevention with a global approach based on educational sciences; -involves a community approach which includes the individual in a "central position of power" as much in the definition of needs as in the evaluation of services; -includes the participation and socio-political actions

Evaluation of the Missoula-VITAS Quality of Life Index--revised: research tool or clinical tool?

PubMed

Schwartz, Carolyn E; Merriman, Melanie P; Reed, George; Byock, Ira

2005-02-01

Quality of life (QOL) is a central outcome measure in caring for seriously ill patients. The Missoula-VITAS Quality of Life Index (MVQOLI) is a 25-item patient-centered index that weights each of five QOL dimensions (symptoms, function, interpersonal, wellbeing, transcendence) by its importance to the respondent. The measure has been used to assess QOL for hospice patients, and has been found to be somewhat complex to use and analyze. This study aimed to simplify the measure, and evaluate the reliability and validity of a revised version as either a research or clinical tool (i.e., "psychometric" versus "clinimetric"). Two data collection efforts are described. The psychometric study collected QOL data from 175 patients at baseline, 3-5 days, and 21 days later. The implementation study evaluated the feasibility and utility of the MVQOLI-R during over six weeks of use. End-stage renal patients on dialysis, hospice, or long-term care patients participated in the psychometric study. The implementation study was done in hospice, home health, and palliative care settings. The MVQOLI-R and the Memorial Symptom Assessment Scale. The psychometric and implementation studies suggest that the MVQOLI-R performs well as a clinical tool but is not powerful as an outcome research instrument. The MVQOLI-R has the heterogeneous structure of clinimetric tools, and demonstrated both relevance and responsiveness. Additionally, in a clinical setting the MVQOLI-R was useful therapeutically for stimulating communication about the psychosocial and spiritual issues important to the tasks of life completion and life closure. The MVQOLI-R has clinical utility as a patient QOL assessment tool and may have therapeutic utility as a tool for fostering discussion among patients and their clinicians, as well as for helping patients identify sources of suffering and opportunities during this time in their lives.

DSSTOX MASTER STRUCTURE-INDEX FILE: SDF FILE AND ...

EPA Pesticide Factsheets

The DSSTox Master Structure-Index File serves to consolidate, manage, and ensure quality and uniformity of the chemical and substance information spanning all DSSTox Structure Data Files, including those in development but not yet published separately on this website. The DSSTox Master Structure-Index File serves to consolidate, manage, and ensure quality and uniformity of the chemical and substance information spanning all DSSTox Structure Data Files, including those in development but not yet published separately on this website.

Prevalence of poor sleep quality and its relationship with body mass index among teenagers: evidence from Taiwan.

PubMed

Chen, Duan-Rung; Truong, Khoa D; Tsai, Meng-Ju

2013-08-01

The linkage between sleep quality and weight status among teenagers has gained more attention in the recent literature and health policy but no consensus has been reached. Using both a propensity score method and multivariate linear regression for a cross-sectional sample of 2,113 teenagers, we analyzed their body mass index (BMI) in relation to sleep quality while controlling for family characteristics (household income, parent/guardian level of education, disability status, work night shift, and smoking) and individual factors (age, sex, regular exercise, smoking, employment, and feeling secure in the neighborhood). Sleep quality was assessed using 3 scales: difficulty in initiating sleep, difficulty in maintaining sleep, and non-restorative sleep, based on Diagnostic and Statistical Manual of Mental Disorders-IV-defined insomnia. Considering all 3 types of poor sleep quality, 20.9% of teenagers in Taiwan experienced some form of sleep problems. After adjusting for the other variables, 2 factors independently and statistically predicted sleep problems: current smoking and working night shifts by the head of the household. Teens experiencing difficulty in initiating sleep had higher BMIs ranging from 0.86 to 1.41 units. Efforts to address childhood obesity need to take into consideration sleep problems that are highly prevalent among teenagers. © 2013, American School Health Association.

Adaptation of the QBR index for use in riparian forests of central Ohio

Treesearch

Stephanie R. Colwell; David M. Hix

2008-01-01

Although high quality riparian forests are an endangered ecosystem type throughout the world, there has been no ecological index to measure the habitat quality of riparian forests in Ohio. The QBR (qualitat del bosc de ribera, or riparian forest quality) index was developed to assess the quality of habitat in Mediterranean forested riparian areas, and we have modified...

Estimating occupant satisfaction of HVAC system noise using quality assessment index.

PubMed

Forouharmajd, Farhad; Nassiri, Parvin; Monazzam, Mohammad R; Yazdchi, Mohammadreza

2012-01-01

Noise may be defined as any unwanted sound. Sound becomes noise when it is too loud, unexpected, uncontrolled, happens at the wrong time, contains unwanted pure tones or unpleasant. In addition to being annoying, loud noise can cause hearing loss, and, depending on other factors, can affect stress level, sleep patterns and heart rate. The primary object for determining subjective estimations of loudness is to present sounds to a sample of listeners under controlled conditions. In heating, ventilation and air conditioning (HVAC) systems only the ventilation fan industry (e.g., bathroom exhaust and sidewall propeller fans) uses loudness ratings. In order to find satisfaction, percent of exposure to noise is the valuable issue for the personnel who are working in these areas. The room criterion (RC) method has been defined by ANSI standard S12.2, which is based on measured levels of in HVAC systems noise in spaces and is used primarily as a diagnostic tool. The RC method consists of a family of criteria curves and a rating procedure. RC measures background noise in the building over the frequency range of 16-4000 Hz. This rating system requires determination of the mid-frequency average level and determining the perceived balance between high-frequency (HF) sound and low-frequency (LF) sound. The arithmetic average of the sound levels in the 500, 1000 and 2000 Hz octave bands is 44.6 dB; therefore, the RC 45 curve is selected as the reference for spectrum quality evaluation. The spectral deviation factors in the LF, medium-frequency sound and HF regions are 2.9, 7.5 and -2.3, respectively, giving a Quality Assessment Index (QAI) of 9.8. This concludes the QAI is useful in estimating an occupant's probable reaction when the system design does not produce optimum sound quality. Thus, a QAI between 5 and 10 dB represents a marginal situation in which acceptance by an occupant is questionable. However, when sound pressure levels in the 16 or 31.5 Hz octave bands exceed 65

Multi-Index Attribution of Beijing's 2013 "Airpocalypse"

NASA Astrophysics Data System (ADS)

Callahan, C.; Diffenbaugh, N. S.; Horton, D. E.

2017-12-01

Poor air quality causes 2 to 4 million premature deaths per year globally. Individual high-impact events, like Beijing's January 2013 "airpocalypse," have drawn significant attention, as they have demonstrated that short-lived air quality events can have outsized effects on public health and economic vitality. Poor air quality events are the result of emission of pollutants and the meteorological conditions favorable to their accumulation in the near-surface environment. Accumulation occurs when pollutants are not dispersed or scavenged from the atmosphere. The most important meteorological precursors of these conditions include lack of precipitation, low wind speeds, and vertical temperature inversions. Recent reports of extreme air quality, in conjunction with projected future changes in some meteorological air quality indices, raise the question: have the meteorological conditions that shape air quality changed in frequency, intensity, or duration over the observational era? Here we assess whether anthropogenic climate change has altered meteorological conditions conducive to poor air quality. To gain a more complete picture of the effect of anthropogenic change on air quality, we use three indices that quantify poor air quality: the Pollution Potential Index (Zou et al, 2017), which measures temperature inversions and surface wind speeds, the Haze Weather Index (Cai et al, 2017), which measures temperature inversions and mid-level wind speeds, and the Air Stagnation Index (Horton et al, 2014), which measures precipitation, surface wind speeds, and mid-level wind speeds. Drawing on the attribution methods of Diffenbaugh et al (2017), we assess the contribution of observed meteorological trends to the magnitude of air quality events, the return interval of events in the observational record, historical simulated climate, and pre-industrial simulated climate, and the probability of the observed trend in historical and pre-industrial simulated climates. Particular

Three success factors for continual improvement in healthcare: an analysis of the reports of improvement team members.

PubMed

Brandrud, Aleidis Skard; Schreiner, Ada; Hjortdahl, Per; Helljesen, Gro Sævil; Nyen, Bjørnar; Nelson, Eugene C

2011-03-01

The objectives of the Breakthrough Series Collaborative are to close the gap between what we know and what we do, and to contribute to continuous quality improvement (CQI) of healthcare through collaborative learning. The improvement efforts are guided by a systematic approach, combining professional and improvement knowledge. To explore what the improvement teams have learnt from participating in the collaborative and from dealing with promoting and inhibiting factors encountered. Qualitative interviews with 19 team members were conducted in four focus groups, using the Critical Incident Technique. A critical incident is one that makes significant contributions, either positively or negatively, to an activity. The elements of a culture of improvement are revealed by the critical incidents, and reflect the eight domains of knowledge, as a product of collaborative learning. The improvement knowledge and skills of individuals are important elements, but not enough to achieve sustainable changes. 90% of the material reflects the need for a system of CQI to solve the problems that organisations experience in trying to make lasting improvements. A pattern of three success factors for CQI emerges: (1) continuous and reliable information, including measurement, about best and current practice; (2) engagement of everybody in all phases of the improvement work: the patient and family, the leadership, the professional environment and the staff; and (3) an infrastructure based on improvement knowledge, with multidisciplinary teams, available coaching, learning systems and sustainability systems.

Perceived barriers to guidelines in peritoneal dialysis.

PubMed

Allen, Nathan; Schwartz, Daniel; Sood, Amy R; Mendelssohn, David; Verrelli, Mauro; Tanna, Gemini; Schiff, Jeff; Komenda, Paul; Rigatto, Claudio; Sood, Manish M

2011-05-01

Little is known regarding barriers to guideline adherence in the nephrology community. We set out to identify perceived barriers to evidence-based medicine (EBM) and measurement of continuous quality indicators (CQI) in an international cohort of peritoneal dialysis (PD) practitioners. Subscribers to an online nephrology education site (Nephrology Now) were invited to participate in an online survey. Nephrology Now is a non-profit, monthly mailing list that highlights clinically relevant articles in nephrology. Four hundred and seventy-five physicians supplying PD care participated in an online survey assessing their use of EBM and CQI in their PD practice. Ordinal logistic regression was utilized to determine relationships between baseline characteristics and EBM and CQI practices. The majority of physicians were nephrologists (89.7%), and 50.4% worked in an academic centre. Respondents were from the following geographic regions: 13.5% Canadian, 24% American, 23.8% European, 4.4% Australian, 5.3% South American, 10.7% African and 12.2% Asian. Adherence to PD clinical practice guidelines were generally strong; however, lower adherence was associated with countries with lower healthcare expenditure, not using personal digital assistant (PDA), the longer the physician had been practising and smaller (< 20 patients per centre) PD practice. International variation in guideline adherence may be influenced by a country's healthcare expenditure, physician's PDA use and experience, and size of PD practice which may impact future guideline development and implementation.

[ROM and the position of the health insurance companies].

PubMed

Laane, R; Luijk, R

2012-01-01

Up till 2008 the Dutch mental health services came under the Dutch General Law on Special Medical Costs (AWBZ). Health insurers regarded the mental health services as 'black box'. In 2008 the mental health services were transferred to the basic health insurance system and the health insurers became responsible for the healthcare purchasing services. In the same year the mental health services began to use ROM to measure the effects of treatment and thereby improve the quality of treatment. To clarify the use that the insurers make of ROM. The developments in this field are described. The feedback supplied by ROM enables therapists to improve treatment. An additional benefit is that the mental health services are then in a position to improve quality at aggregate level and compare their own results with those of others. Nationally, ROM can provide health insurers with information about treatment quality in combination with the Consumer Quality Index (CQI), and national 'benchmarks' can be implemented. To facilitate the interpretation of these rom data the health insurers set up the independent foundation, Stichting Benchmark GGZ (mental health care), in which GGZ Nederland has participated since 2010. ROM provides therapists with a means for improving treatment and provides insurers with a means by which they can express their views about the quality of the mental health services at aggregate level.

Preliminary reliability and validity of Persian version of the Family Dermatology Life Quality Index (FDLQI).

PubMed

Safizadeh, H; Nakhaee, N; Shamsi-Meymandi, S; Pourdamghan, N; Basra, M K A

2014-04-01

Family Dermatology Life Quality Index (FDLQI) is an instrument for assessing the quality of life of family members of dermatologic patients. The aim of this study was to describe the cultural adaptation of this questionnaire and to assess psychometric properties of the Persian version. At first, the questionnaire was translated into Persian, and then back-translation was performed. The whole cycle was repeated until a consensus was reached about the optimal translation. In the next step, cognitive debriefing was performed, and after approval of the Persian version by FDLQI developers, it was distributed among 100 family members of dermatological patients in order to evaluate its validity and reliability. Mean age of participants was 37.1 years (±12.3). Mean score of FDLQI was 15.4 (±5.5) with maximum and minimum scores of 30 and 6, respectively. The quality of life of studied participants showed no significant difference based on age-group, sex, educational level and the family relationship. Cronbach's alpha was calculated as 0.87. Exploratory factor analysis revealed a one-factor solution that accounted for 40.7 % of the variance. The unidimensional model was supported by confirmatory factor analysis. The results of the present study showed that the Persian version of FDLQI has acceptable factorial validity and internal consistency reliability.

DICOM index tracker enterprise: advanced system for enterprise-wide quality assurance and patient safety monitoring

NASA Astrophysics Data System (ADS)

Zhang, Min; Pavlicek, William; Panda, Anshuman; Langer, Steve G.; Morin, Richard; Fetterly, Kenneth A.; Paden, Robert; Hanson, James; Wu, Lin-Wei; Wu, Teresa

2015-03-01

DICOM Index Tracker (DIT) is an integrated platform to harvest rich information available from Digital Imaging and Communications in Medicine (DICOM) to improve quality assurance in radiology practices. It is designed to capture and maintain longitudinal patient-specific exam indices of interests for all diagnostic and procedural uses of imaging modalities. Thus, it effectively serves as a quality assurance and patient safety monitoring tool. The foundation of DIT is an intelligent database system which stores the information accepted and parsed via a DICOM receiver and parser. The database system enables the basic dosimetry analysis. The success of DIT implementation at Mayo Clinic Arizona calls for the DIT deployment at the enterprise level which requires significant improvements. First, for geographically distributed multi-site implementation, the first bottleneck is the communication (network) delay; the second is the scalability of the DICOM parser to handle the large volume of exams from different sites. To address this issue, DICOM receiver and parser are separated and decentralized by site. To facilitate the enterprise wide Quality Assurance (QA), a notable challenge is the great diversities of manufacturers, modalities and software versions, as the solution DIT Enterprise provides the standardization tool for device naming, protocol naming, physician naming across sites. Thirdly, advanced analytic engines are implemented online which support the proactive QA in DIT Enterprise.

A fuzzy-logic based decision-making approach for identification of groundwater quality based on groundwater quality indices.

PubMed

Vadiati, M; Asghari-Moghaddam, A; Nakhaei, M; Adamowski, J; Akbarzadeh, A H

2016-12-15

Due to inherent uncertainties in measurement and analysis, groundwater quality assessment is a difficult task. Artificial intelligence techniques, specifically fuzzy inference systems, have proven useful in evaluating groundwater quality in uncertain and complex hydrogeological systems. In the present study, a Mamdani fuzzy-logic-based decision-making approach was developed to assess groundwater quality based on relevant indices. In an effort to develop a set of new hybrid fuzzy indices for groundwater quality assessment, a Mamdani fuzzy inference model was developed with widely-accepted groundwater quality indices: the Groundwater Quality Index (GQI), the Water Quality Index (WQI), and the Ground Water Quality Index (GWQI). In an effort to present generalized hybrid fuzzy indices a significant effort was made to employ well-known groundwater quality index acceptability ranges as fuzzy model output ranges rather than employing expert knowledge in the fuzzification of output parameters. The proposed approach was evaluated for its ability to assess the drinking water quality of 49 samples collected seasonally from groundwater resources in Iran's Sarab Plain during 2013-2014. Input membership functions were defined as "desirable", "acceptable" and "unacceptable" based on expert knowledge and the standard and permissible limits prescribed by the World Health Organization. Output data were categorized into multiple categories based on the GQI (5 categories), WQI (5 categories), and GWQI (3 categories). Given the potential of fuzzy models to minimize uncertainties, hybrid fuzzy-based indices produce significantly more accurate assessments of groundwater quality than traditional indices. The developed models' accuracy was assessed and a comparison of the performance indices demonstrated the Fuzzy Groundwater Quality Index model to be more accurate than both the Fuzzy Water Quality Index and Fuzzy Ground Water Quality Index models. This suggests that the new hybrid fuzzy

The preliminary effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life among older people with sarcopenia.

PubMed

Chang, Shu-Fang; Lin, Pei-Chen; Yang, Rong-Sen; Yang, Rea-Jeng

2018-01-17

Studies have shown that sarcopenia easily leads to difficulty moving, disability, and poor quality of life. However, researches on the use of whole-body vibration for older adults with sarcopenia living in institutions have been lacking. Therefore, the main objective of the present study was to investigate the effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life of older adults with sarcopenia living in institutions. This study adopted a quasi-experimental, single-group, pretest-posttest design. The whole-body vibration intervention was performed over a 3-month period, in which the older adults trained 3 times per week; each training lasted 60 s with a break of 30 s for 10 repetitions. The older adults' skeletal muscle mass index, physical fitness and quality of life before and after the intervention of the whole-body vibration was collected. Concerning the statistical methods adopted, nonparametric method-based tests were employed. According to the results of analysis, after the intervention of the 12-week whole-body vibration, the skeletal muscle mass index (z = - 3.621, p = 0.000), physical fitness on standing on one foot (z = - 2.447, p = 0.014), shoulder-arm flexibility (z = - 3.159, p = 0.002), 8-ft up and go test (z = - 2.692, p = 0.009), hand grip strength (z = - 3.388, p = 0.009), and five repeated sit-to-stand tests (z = - 2.936, p = 0.003), all improved significantly. Furthermore, concerning the quality of life of the older adults in the pretest and posttest, the improvements were statistically significant (z = - 2.533, p = 0.011). The study results showed the effect of whole-body vibration intervention on improving the skeletal muscle mass index, physical fitness, and quality of life of sarcopenic older people living in institutions and could serve as a crucial reference to health care professionals.

Determination of the water quality index ratings of water in the Mpumalanga and North West provinces, South Africa

NASA Astrophysics Data System (ADS)

Wanda, Elijah M. M.; Mamba, Bhekie B.; Msagati, Titus A. M.

2016-04-01

This study reports on the water quality index (WQI) of wastewater and drinking water in the Mpumalanga and North West provinces of South Africa. The WQI is one of the most effective tools available to water sustainability researchers, because it provides an easily intelligible ranking of water quality on a rating scale from 0 to 100, based on the ascription of different weightings to several different parameters. In this study the WQI index ratings of wastewater and drinking water samples were computed according to the levels of pH, electrical conductivity (EC), biochemical oxygen demand (BOD), E. coli, temperature, turbidity and nutrients (nitrogen and phosphates) found in water samples collected from the two provinces between June and December, 2014. This study isolated three groups of WQ-rated waters, namely: fair (with a WQI range = 32.87-38.54%), medium (with a WQI range = 56.54-69.77%) and good (with a WQI range = 71.69-81.63%). More specifically, 23%, 23% and 54% of the sampled sites registered waters with fair, medium and good WQ ratings respectively. None of the sites sampled during the entire period of the project registered excellent or very good water quality ratings, which would ordinarily indicate that no treatment is required to make it fit for human consumption. Nevertheless, the results obtained by the Eerstehoek and Schoemansville water treatment plants in Mpumalanga and North West provinces, respectively, suggest that substantial improvement in the quality of water samples is possible, since the WQI values for all of the treated samples were higher than those for raw water. Presence of high levels of BOD, low levels of dissolved oxygen (DO), E. coli, nitrates and phosphates especially in raw water samples greatly affected their overall WQ ratings. It is recommended that a point-of-use system should be introduced to treat water intended for domestic purposes in the clean-water-deprived areas.

PLAM - a meteorological pollution index for air quality and its applications in fog-haze forecasts in north China

NASA Astrophysics Data System (ADS)

Yang, Y.; Wang, J.; Gong, S.; Zhang, X.; Wang, H.; Wang, Y.; Wang, J.; Li, D.; Guo, J.

2015-03-01

Using surface meteorological observation and high resolution emission data, this paper discusses the application of PLAM/h Index (Parameter Linking Air-quality to Meteorological conditions/haze) in the prediction of large-scale low visibility and fog-haze events. Based on the two-dimensional probability density function diagnosis model for emissions, the study extends the diagnosis and prediction of the meteorological pollution index PLAM to the regional visibility fog-haze intensity. The results show that combining the influence of regular meteorological conditions and emission factors together in the PLAM/h parameterization scheme is very effective in improving the diagnostic identification ability of the fog-haze weather in North China. The correlation coefficients for four seasons (spring, summer, autumn and winter) between PLAM/h and visibility observation are 0.76, 0.80, 0.96 and 0.86 respectively and all their significance levels exceed 0.001, showing the ability of PLAM/h to predict the seasonal changes and differences of fog-haze weather in the North China region. The high-value correlation zones are respectively located in Jing-Jin-Ji (Beijing, Tianjin, Hebei), Bohai Bay rim and the southern Hebei-northern Henan, indicating that the PLAM/h index has relations with the distribution of frequent heavy fog-haze weather in North China and the distribution of emission high-value zone. Comparatively analyzing the heavy fog-haze events and large-scale fine weather processes in winter and summer, it is found that PLAM/h index 24 h forecast is highly correlated to the visibility observation. Therefore, PLAM/h index has better capability of doing identification, analysis and forecasting.

PLAM - a meteorological pollution index for air quality and its applications in fog-haze forecasts in North China

NASA Astrophysics Data System (ADS)

Yang, Y. Q.; Wang, J. Z.; Gong, S. L.; Zhang, X. Y.; Wang, H.; Wang, Y. Q.; Wang, J.; Li, D.; Guo, J. P.

2016-02-01

Using surface meteorological observation and high-resolution emission data, this paper discusses the application of the PLAM/h index (Parameter Linking Air-quality to Meteorological conditions/haze) in the prediction of large-scale low visibility and fog-haze events. Based on the two-dimensional probability density function diagnosis model for emissions, the study extends the diagnosis and prediction of the meteorological pollution index PLAM to the regional visibility fog-haze intensity. The results show that combining the influence of regular meteorological conditions and emission factors together in the PLAM/h parameterization scheme is very effective in improving the diagnostic identification ability of the fog-haze weather in North China. The determination coefficients for four seasons (spring, summer, autumn, and winter) between PLAM/h and visibility observation are 0.76, 0.80, 0.96, and 0.86, respectively, and all of their significance levels exceed 0.001, showing the ability of PLAM/h to predict the seasonal changes and differences of fog-haze weather in the North China region. The high-value correlation zones are located in Jing-Jin-Ji (Beijing, Tianjin, Hebei), Bohai Bay rim, and southern Hebei-northern Henan, indicating that the PLAM/h index is related to the distribution of frequent heavy fog-haze weather in North China and the distribution of emission high-value zone. Through comparative analysis of the heavy fog-haze events and large-scale clear-weather processes in winter and summer, it is found that PLAM/h index 24 h forecast is highly correlated with the visibility observation. Therefore, the PLAM/h index has good capability in identification, analysis, and forecasting.