Objective speech quality evaluation of real-time speech coders

NASA Astrophysics Data System (ADS)

Viswanathan, V. R.; Russell, W. H.; Huggins, A. W. F.

1984-02-01

This report describes the work performed in two areas: subjective testing of a real-time 16 kbit/s adaptive predictive coder (APC) and objective speech quality evaluation of real-time coders. The speech intelligibility of the APC coder was tested using the Diagnostic Rhyme Test (DRT), and the speech quality was tested using the Diagnostic Acceptability Measure (DAM) test, under eight operating conditions involving channel error, acoustic background noise, and tandem link with two other coders. The test results showed that the DRT and DAM scores of the APC coder equalled or exceeded the corresponding test scores fo the 32 kbit/s CVSD coder. In the area of objective speech quality evaluation, the report describes the development, testing, and validation of a procedure for automatically computing several objective speech quality measures, given only the tape-recordings of the input speech and the corresponding output speech of a real-time speech coder.

Using incentives to improve resource utilization: a quasi-experimental evaluation of an ICU quality improvement program

PubMed Central

Murphy, David J.; Lyu, Peter F.; Gregg, Sara R.; Martin, Greg S.; Hockenberry, Jason M.; Coopersmith, Craig M.; Sterling, Michael; Buchman, Timothy G.; Sevransky, Jonathan

2015-01-01

Objective Healthcare systems strive to provide quality care at lower cost. Arterial blood gas testing (ABGs), chest radiographs (CXRs), and red blood cell transfusions (RBCs) provide an important example of opportunities to reduce excess resource utilization within the ICU. We describe the effect of a multifaceted quality improvement program designed to decrease avoidable ABGs, CXRs, and RBCs utilization on utilization of these resources and patient outcomes. Design Prospective pre-post cohort study Setting Seven ICUs in an academic healthcare system Patients All adult ICU patients admitted to study ICUs during consecutive baseline (n=7,357), intervention (n=7,553), and follow up (n=7,657) years between September 2010 and August 2013. Interventions A multifaceted quality improvement program including provider education, audit and feedback, and unit-based provider financial incentives targeting ABG, CXR, and RBC utilization. Measurements and Main Results The primary outcome was the number of orders for ABGs, CXRs, and RBCs per patient. Compared to the baseline period, unadjusted ABG, CXR, and RBC utilization in the intervention period was reduced by 42%, 26%, and 17%, respectively (p<0.01). After adjusting for potentially relevant patient factors, the intervention was associated with 128 fewer ABGs, 73 fewer CXRs, and 16 fewer RBCs per 100 patients (p<0.01). This effect was durable during the follow up year. This reduction yielded an approximate net savings of $1.5 M in direct costs over the intervention and follow-up years after accounting for the direct costs of the program. Unadjusted hospital mortality decreased from 7% in the baseline period to 5.2% in the intervention period (p<0.01). This reduction remained significant after adjusting for patient factors (OR= 0.43, P<0.01). Conclusions Implementation of a multifaceted quality improvement program including financial incentives was associated with significant improvements in resource utilization. Our findings

Objective Assessment of Image Quality VI: Imaging in Radiation Therapy

PubMed Central

Barrett, Harrison H.; Kupinski, Matthew A.; Müeller, Stefan; Halpern, Howard J.; Morris, John C.; Dwyer, Roisin

2015-01-01

Earlier work on Objective Assessment of Image Quality (OAIQ) focused largely on estimation or classification tasks in which the desired outcome of imaging is accurate diagnosis. This paper develops a general framework for assessing imaging quality on the basis of therapeutic outcomes rather than diagnostic performance. By analogy to Receiver Operating Characteristic (ROC) curves and their variants as used in diagnostic OAIQ, the method proposed here utilizes the Therapy Operating Characteristic or TOC curves, which are plots of the probability of tumor control vs. the probability of normal-tissue complications as the overall dose level of a radiotherapy treatment is varied. The proposed figure of merit is the area under the TOC curve, denoted AUTOC. This paper reviews an earlier exposition of the theory of TOC and AUTOC, which was specific to the assessment of image-segmentation algorithms, and extends it to other applications of imaging in external-beam radiation treatment as well as in treatment with internal radioactive sources. For each application, a methodology for computing the TOC is presented. A key difference between ROC and TOC is that the latter can be defined for a single patient rather than a population of patients. PMID:24200954

Quality of life instruments used in mental health research: properties and utilization.

PubMed

Prigent, Amélie; Simon, Sandrine; Durand-Zaleski, Isabelle; Leboyer, Marion; Chevreul, Karine

2014-01-30

Quality of life (QoL) assessment is increasingly used in mental health. Multiple instruments exist, but the conditions for choosing one instrument over another for purposes of a specific study are not clear. We performed a systematic review to identify the QoL instruments used in mental health. The instruments were systematically described regarding their intrinsic properties (e.g., generic v. disease-specific) and their characteristics of utilization in studies (e.g., study objectives). Using cluster analyses, we investigated the existence of similar instruments with respect to each of these sets of characteristics and studied potential links between instruments' intrinsic properties and their characteristics of utilization. We included 149 studies in which 56 distinct instruments were used. Similarities were found among instruments in terms of their intrinsic properties as well as their characteristics of utilization, leading to the construction of four clusters of instruments in each case. However, no relevant links were identified between instruments' intrinsic properties and their characteristics of utilization, suggesting that the choice of QoL instruments did not depend on their properties. A consensus about common QoL instruments must be reached to facilitate the choice of instruments, the comparison of results and thus to have an impact on clinical and policy decision-making. © 2013 Published by Elsevier Ireland Ltd.

Power Quality Improvement Utilizing Photovoltaic Generation Connected to a Weak Grid

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

Muljadi, Eduard; Tumbelaka, Hanny H.; Gao, Wenzhong

Microgrid research and development in the past decades have been one of the most popular topics. Similarly, the photovoltaic generation has been surging among renewable generation in the past few years, thanks to the availability, affordability, technology maturity of the PV panels and the PV inverter in the general market. Unfortunately, quite often, the PV installations are connected to weak grids and may have been considered as the culprit of poor power quality affecting other loads in particular sensitive loads connected to the same point of common coupling (PCC). This paper is intended to demystify the renewable generation, and turnsmore » the negative perception into positive revelation of the superiority of PV generation to the power quality improvement in a microgrid system. The main objective of this work is to develop a control method for the PV inverter so that the power quality at the PCC will be improved under various disturbances. The method is to control the reactive current based on utilizing the grid current to counteract the negative impact of the disturbances. The proposed control method is verified in PSIM platform. Promising results have been obtained.« less

Top-level modeling of an als system utilizing object-oriented techniques

NASA Astrophysics Data System (ADS)

Rodriguez, L. F.; Kang, S.; Ting, K. C.

The possible configuration of an Advanced Life Support (ALS) System capable of supporting human life for long-term space missions continues to evolve as researchers investigate potential technologies and configurations. To facilitate the decision process the development of acceptable, flexible, and dynamic mathematical computer modeling tools capable of system level analysis is desirable. Object-oriented techniques have been adopted to develop a dynamic top-level model of an ALS system.This approach has several advantages; among these, object-oriented abstractions of systems are inherently modular in architecture. Thus, models can initially be somewhat simplistic, while allowing for adjustments and improvements. In addition, by coding the model in Java, the model can be implemented via the World Wide Web, greatly encouraging the utilization of the model. Systems analysis is further enabled with the utilization of a readily available backend database containing information supporting the model. The subsystem models of the ALS system model include Crew, Biomass Production, Waste Processing and Resource Recovery, Food Processing and Nutrition, and the Interconnecting Space. Each subsystem model and an overall model have been developed. Presented here is the procedure utilized to develop the modeling tool, the vision of the modeling tool, and the current focus for each of the subsystem models.

Utilizing Educational Corporate Culture To Create a Quality School.

ERIC Educational Resources Information Center

Osborne, Bill

Strategies for utilizing educational corporate culture to create a quality school are presented in this paper, which argues that the understanding of the shared belief system of organizational members is crucial to the process. Creating a quality school entails moving from a "teach the process" oriented model to one that internalizes the…

Objective vocal quality in children using cochlear implants: a multiparameter approach.

PubMed

Baudonck, Nele; D'haeseleer, Evelien; Dhooge, Ingeborg; Van Lierde, Kristiane

2011-11-01

The purpose of this study was to determine the objective vocal quality in 36 prelingually deaf children using cochlear implant (CI) with a mean age of 9 years. An additional purpose was to compare the objective vocal quality of these 36 CI users with 25 age-matched children with prelingual severe hearing loss using conventional hearing aids (HAs) and 25 normal hearing (NH) children. The design for this cross-sectional study was a multigroup posttest-only design. The objective vocal quality was measured by means of the dysphonia severity index (DSI). Moreover, perceptual voice assessment using the GRBASI scale was performed. CI children have a vocal quality by means of the DSI of +1.8, corresponding with a DSI% of 68%, indicating a borderline vocal quality situated 2% above the limit of normality. The voice was perceptually characterized by the presence of a very slight grade of hoarseness, roughness, strained phonation, and higher pitch and intensity levels. No significant objective vocal quality differences were measured between the voices of the CI children, HA users, and NH children. According to the results, one aspect of the vocal approach in children with CI and using HAs must be focused on the improvement of the strained vocal characteristic and the use of a lower pitch and intensity level. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Perceptual video quality assessment in H.264 video coding standard using objective modeling.

PubMed

Karthikeyan, Ramasamy; Sainarayanan, Gopalakrishnan; Deepa, Subramaniam Nachimuthu

2014-01-01

Since usage of digital video is wide spread nowadays, quality considerations have become essential, and industry demand for video quality measurement is rising. This proposal provides a method of perceptual quality assessment in H.264 standard encoder using objective modeling. For this purpose, quality impairments are calculated and a model is developed to compute the perceptual video quality metric based on no reference method. Because of the shuttle difference between the original video and the encoded video the quality of the encoded picture gets degraded, this quality difference is introduced by the encoding process like Intra and Inter prediction. The proposed model takes into account of the artifacts introduced by these spatial and temporal activities in the hybrid block based coding methods and an objective modeling of these artifacts into subjective quality estimation is proposed. The proposed model calculates the objective quality metric using subjective impairments; blockiness, blur and jerkiness compared to the existing bitrate only calculation defined in the ITU G 1070 model. The accuracy of the proposed perceptual video quality metrics is compared against popular full reference objective methods as defined by VQEG.

Bootstrap Signal-to-Noise Confidence Intervals: An Objective Method for Subject Exclusion and Quality Control in ERP Studies

PubMed Central

Parks, Nathan A.; Gannon, Matthew A.; Long, Stephanie M.; Young, Madeleine E.

2016-01-01

Analysis of event-related potential (ERP) data includes several steps to ensure that ERPs meet an appropriate level of signal quality. One such step, subject exclusion, rejects subject data if ERP waveforms fail to meet an appropriate level of signal quality. Subject exclusion is an important quality control step in the ERP analysis pipeline as it ensures that statistical inference is based only upon those subjects exhibiting clear evoked brain responses. This critical quality control step is most often performed simply through visual inspection of subject-level ERPs by investigators. Such an approach is qualitative, subjective, and susceptible to investigator bias, as there are no standards as to what constitutes an ERP of sufficient signal quality. Here, we describe a standardized and objective method for quantifying waveform quality in individual subjects and establishing criteria for subject exclusion. The approach uses bootstrap resampling of ERP waveforms (from a pool of all available trials) to compute a signal-to-noise ratio confidence interval (SNR-CI) for individual subject waveforms. The lower bound of this SNR-CI (SNRLB) yields an effective and objective measure of signal quality as it ensures that ERP waveforms statistically exceed a desired signal-to-noise criterion. SNRLB provides a quantifiable metric of individual subject ERP quality and eliminates the need for subjective evaluation of waveform quality by the investigator. We detail the SNR-CI methodology, establish the efficacy of employing this approach with Monte Carlo simulations, and demonstrate its utility in practice when applied to ERP datasets. PMID:26903849

Methodology for Evaluating Quality and Reusability of Learning Objects

ERIC Educational Resources Information Center

Kurilovas, Eugenijus; Bireniene, Virginija; Serikoviene, Silvija

2011-01-01

The aim of the paper is to present the scientific model and several methods for the expert evaluation of quality of learning objects (LOs) paying especial attention to LOs reusability level. The activities of eQNet Quality Network for a European Learning Resource Exchange (LRE) aimed to improve reusability of LOs of European Schoolnet's LRE…

Deriving health utilities from the MacNew Heart Disease Quality of Life Questionnaire.

PubMed

Chen, Gang; McKie, John; Khan, Munir A; Richardson, Jeff R

2015-10-01

Quality of life is included in the economic evaluation of health services by measuring the preference for health states, i.e. health state utilities. However, most intervention studies include a disease-specific, not a utility, instrument. Consequently, there has been increasing use of statistical mapping algorithms which permit utilities to be estimated from a disease-specific instrument. The present paper provides such algorithms between the MacNew Heart Disease Quality of Life Questionnaire (MacNew) instrument and six multi-attribute utility (MAU) instruments, the Euroqol (EQ-5D), the Short Form 6D (SF-6D), the Health Utilities Index (HUI) 3, the Quality of Wellbeing (QWB), the 15D (15 Dimension) and the Assessment of Quality of Life (AQoL-8D). Heart disease patients and members of the healthy public were recruited from six countries. Non-parametric rank tests were used to compare subgroup utilities and MacNew scores. Mapping algorithms were estimated using three separate statistical techniques. Mapping algorithms achieved a high degree of precision. Based on the mean absolute error and the intra class correlation the preferred mapping is MacNew into SF-6D or 15D. Using the R squared statistic the preferred mapping is MacNew into AQoL-8D. The algorithms reported in this paper enable MacNew data to be mapped into utilities predicted from any of six instruments. This permits studies which have included the MacNew to be used in cost utility analyses which, in turn, allows the comparison of services with interventions across the health system. © The European Society of Cardiology 2014.

Quality and Content of Individualized Habilitation Plan Objectives in Residential Settings.

ERIC Educational Resources Information Center

Stancliffe, Roger J.; Hayden, Mary F.; Lakin, K. Charlie

2000-01-01

The quality, number, and content of residential Individualized Habilitation Plans (IHP) objectives were evaluated for 155 adult institution and community residents. Over 90 percent of objectives were functional and age appropriate. Community residents had significantly more IHP objectives and also had objectives from a wider variety of content…

Objective quality assessment of tone-mapped images.

PubMed

Yeganeh, Hojatollah; Wang, Zhou

2013-02-01

Tone-mapping operators (TMOs) that convert high dynamic range (HDR) to low dynamic range (LDR) images provide practically useful tools for the visualization of HDR images on standard LDR displays. Different TMOs create different tone-mapped images, and a natural question is which one has the best quality. Without an appropriate quality measure, different TMOs cannot be compared, and further improvement is directionless. Subjective rating may be a reliable evaluation method, but it is expensive and time consuming, and more importantly, is difficult to be embedded into optimization frameworks. Here we propose an objective quality assessment algorithm for tone-mapped images by combining: 1) a multiscale signal fidelity measure on the basis of a modified structural similarity index and 2) a naturalness measure on the basis of intensity statistics of natural images. Validations using independent subject-rated image databases show good correlations between subjective ranking score and the proposed tone-mapped image quality index (TMQI). Furthermore, we demonstrate the extended applications of TMQI using two examples-parameter tuning for TMOs and adaptive fusion of multiple tone-mapped images.

A system to program projects to meet visual quality objectives

Treesearch

Fred L. Henley; Frank L. Hunsaker

1979-01-01

The U. S. Forest Service has established Visual Quality Objectives for National Forest lands and determined a method to ascertain the Visual Absorption Capability of those lands. Combining the two mapping inventories has allowed the Forest Service to retain the visual quality while managing natural resources.

Projector-Based Augmented Reality for Quality Inspection of Scanned Objects

NASA Astrophysics Data System (ADS)

Kern, J.; Weinmann, M.; Wursthorn, S.

2017-09-01

After scanning or reconstructing the geometry of objects, we need to inspect the result of our work. Are there any parts missing? Is every detail covered in the desired quality? We typically do this by looking at the resulting point clouds or meshes of our objects on-screen. What, if we could see the information directly visualized on the object itself? Augmented reality is the generic term for bringing virtual information into our real environment. In our paper, we show how we can project any 3D information like thematic visualizations or specific monitoring information with reference to our object onto the object's surface itself, thus augmenting it with additional information. For small objects that could for instance be scanned in a laboratory, we propose a low-cost method involving a projector-camera system to solve this task. The user only needs a calibration board with coded fiducial markers to calibrate the system and to estimate the projector's pose later on for projecting textures with information onto the object's surface. Changes within the projected 3D information or of the projector's pose will be applied in real-time. Our results clearly reveal that such a simple setup will deliver a good quality of the augmented information.

[Assessment of farmland soil quality under different utilization intensity in arid area].

PubMed

Gui, Dong-Wei; Mu, Gui-Jin; Lei, Jia-Qiang; Zeng, Fan-Jiang; Wang, Hui

2009-04-01

Based on the 2005-2007 experimental data in Cele oasis in the southern margin of Tarim Basin of Xinjiang, the soil quality of four typical types of farmland with different utilization intensity, i.e., farmland with high input, farmland with normal input, newly reclaimed farmland, and farmland in oasis' interior, was analyzed and assessed by using sustainable yield index, soil improvement index, and soil quality synthesis index. Among the farmlands, there were significant differences in the contents of soil organic matter, available nitrogen, and available phosphorus. Newly reclaimed farmland had the lowest level of soil quality, while the farmland in oasis' interior had relatively higher soil quality. This study could help the reasonable exploitation and utilization of farmlands in Cele oasis, and the protection of local farmland eco-environment.

Utilizing Objective Drought Thresholds to Improve Drought Monitoring with the SPI

NASA Astrophysics Data System (ADS)

Leasor, Z. T.; Quiring, S. M.

2017-12-01

Drought is a prominent climatic hazard in the south-central United States. Droughts are frequently monitored using the severity categories determined by the U.S. Drought Monitor (USDM). This study uses the Standardized Precipitation Index (SPI) to conduct a drought frequency analysis across Texas, Oklahoma, and Kansas using PRISM precipitation data from 1900-2015. The SPI is shown to be spatiotemporally variant across the south-central United States. In particular, utilizing the default USDM severity thresholds may underestimate drought severity in arid regions. Objective drought thresholds were implemented by fitting a CDF to each location's SPI distribution. This approach results in a more homogeneous distribution of drought frequencies across each severity category. Results also indicate that it may be beneficial to develop objective drought thresholds for each season and SPI timescale. This research serves as a proof-of-concept and demonstrates how drought thresholds should be objectively developed so that they are appropriate for each climatic region.

Objective Quality Assessment for Color-to-Gray Image Conversion.

PubMed

Ma, Kede; Zhao, Tiesong; Zeng, Kai; Wang, Zhou

2015-12-01

Color-to-gray (C2G) image conversion is the process of transforming a color image into a grayscale one. Despite its wide usage in real-world applications, little work has been dedicated to compare the performance of C2G conversion algorithms. Subjective evaluation is reliable but is also inconvenient and time consuming. Here, we make one of the first attempts to develop an objective quality model that automatically predicts the perceived quality of C2G converted images. Inspired by the philosophy of the structural similarity index, we propose a C2G structural similarity (C2G-SSIM) index, which evaluates the luminance, contrast, and structure similarities between the reference color image and the C2G converted image. The three components are then combined depending on image type to yield an overall quality measure. Experimental results show that the proposed C2G-SSIM index has close agreement with subjective rankings and significantly outperforms existing objective quality metrics for C2G conversion. To explore the potentials of C2G-SSIM, we further demonstrate its use in two applications: 1) automatic parameter tuning for C2G conversion algorithms and 2) adaptive fusion of C2G converted images.

The Utility of the OMI HCHO/NO2 in Air Quality Decision-Making Activities

NASA Technical Reports Server (NTRS)

Duncan, Bryan

2010-01-01

I will discuss a novel and practical application of the OMI HCHU and NO2 data products to the "weight of evidence" in the air quality decision-making process (e.g., State Implementation Plan (SIP)) for a city, region, or state to demonstrate that it is making progress toward attainment of the National Ambient Air Quality Standard (NAAQS) for ozone. Any trend, or lack thereof, in the observed OMI HCHO/NO2 may support that an emission control strategy implemented to reduce ozone is or is not occurring for a metropolitan area. In addition, the observed OMI HCHO/NO2 may be used to define new emission control strategies as the photochemical environments of urban areas evolve over time. I will demonstrate the utility of the OMI HCHO/NO2 over the U.S. for air quality applications with support from simulations with both a regional model and a photochemical box model. These results support mission planning of an OMI-like instrument for the proposed GEO-CAPE satellite that has as one of its objectives to study air quality from space. However, I'm attending the meeting as the Aura Deputy Project Scientist, so I don't technically need to present anything to justify the travel.

The utilization of neural nets in populating an object-oriented database

NASA Technical Reports Server (NTRS)

Campbell, William J.; Hill, Scott E.; Cromp, Robert F.

1989-01-01

Existing NASA supported scientific data bases are usually developed, managed and populated in a tedious, error prone and self-limiting way in terms of what can be described in a relational Data Base Management System (DBMS). The next generation Earth remote sensing platforms (i.e., Earth Observation System, (EOS), will be capable of generating data at a rate of over 300 Mbs per second from a suite of instruments designed for different applications. What is needed is an innovative approach that creates object-oriented databases that segment, characterize, catalog and are manageable in a domain-specific context and whose contents are available interactively and in near-real-time to the user community. Described here is work in progress that utilizes an artificial neural net approach to characterize satellite imagery of undefined objects into high-level data objects. The characterized data is then dynamically allocated to an object-oriented data base where it can be reviewed and assessed by a user. The definition, development, and evolution of the overall data system model are steps in the creation of an application-driven knowledge-based scientific information system.

Quality of Individualised Education Programme Goals and Objectives for Preschool Children with Disabilities

ERIC Educational Resources Information Center

Rakap, Salih

2015-01-01

Individualised education programmes (IEPs) are the road maps for individualising services for children with disabilities, specifically through the development of high-quality child goals/objectives. High-quality IEP goals/objectives that are developed based on a comprehensive assessment of child functioning and directly connected to intervention…

DATA QUALITY OBJECTIVES IN RESEARCH PLANNING AT MED: THREE CASE STUDIES

EPA Science Inventory

This course will give a quality assurance perspective to research planning by describing the Data Quality Objective Process....Written plans are mandatory for all EPA environmental data collection activities according to EPA Order 5360.1 CHG 1 and Federal Acquisition Regulations,...

A method of object recognition for single pixel imaging

NASA Astrophysics Data System (ADS)

Li, Boxuan; Zhang, Wenwen

2018-01-01

Computational ghost imaging(CGI), utilizing a single-pixel detector, has been extensively used in many fields. However, in order to achieve a high-quality reconstructed image, a large number of iterations are needed, which limits the flexibility of using CGI in practical situations, especially in the field of object recognition. In this paper, we purpose a method utilizing the feature matching to identify the number objects. In the given system, approximately 90% of accuracy of recognition rates can be achieved, which provides a new idea for the application of single pixel imaging in the field of object recognition

42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

Code of Federal Regulations, 2010 CFR

2010-10-01

... PRESCRIPTION DRUG BENEFIT Cost Control and Quality Improvement Requirements § 423.153 Drug utilization... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE...

Double shell tanks (DST) chemistry control data quality objectives

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

BANNING, D.L.

2001-10-09

One of the main functions of the River Protection Project is to store the Hanford Site tank waste until the Waste Treatment Plant (WTP) is ready to receive and process the waste. Waste from the older single-shell tanks is being transferred to the newer double-shell tanks (DSTs). Therefore, the integrity of the DSTs must be maintained until the waste from all tanks has been retrieved and transferred to the WTP. To help maintain the integrity of the DSTs over the life of the project, specific chemistry limits have been established to control corrosion of the DSTs. These waste chemistry limitsmore » are presented in the Technical Safety Requirements (TSR) document HNF-SD-WM-TSR-006, Sec. 5 . IS, Rev 2B (CHG 200 I). In order to control the chemistry in the DSTs, the Chemistry Control Program will require analyses of the tank waste. This document describes the Data Quality Objective (DUO) process undertaken to ensure appropriate data will be collected to control the waste chemistry in the DSTs. The DQO process was implemented in accordance with Data Quality Objectives for Sampling and Analyses, HNF-IP-0842, Rev. Ib, Vol. IV, Section 4.16, (Banning 2001) and the U.S. Environmental Protection Agency EPA QA/G4, Guidance for the Data Quality Objectives Process (EPA 1994), with some modifications to accommodate project or tank specific requirements and constraints.« less

A Systematic Review and Meta-Analysis of Utility-Based Quality of Life in Chronic Kidney Disease Treatments

PubMed Central

Wyld, Melanie; Morton, Rachael Lisa; Hayen, Andrew; Howard, Kirsten; Webster, Angela Claire

2012-01-01

Background Chronic kidney disease (CKD) is a common and costly condition to treat. Economic evaluations of health care often incorporate patient preferences for health outcomes using utilities. The objective of this study was to determine pooled utility-based quality of life (the numerical value attached to the strength of an individual's preference for a specific health outcome) by CKD treatment modality. Methods and Findings We conducted a systematic review, meta-analysis, and meta-regression of peer-reviewed published articles and of PhD dissertations published through 1 December 2010 that reported utility-based quality of life (utility) for adults with late-stage CKD. Studies reporting utilities by proxy (e.g., reported by a patient's doctor or family member) were excluded. In total, 190 studies reporting 326 utilities from over 56,000 patients were analysed. There were 25 utilities from pre-treatment CKD patients, 226 from dialysis patients (haemodialysis, n = 163; peritoneal dialysis, n = 44), 66 from kidney transplant patients, and three from patients treated with non-dialytic conservative care. Using time tradeoff as a referent instrument, kidney transplant recipients had a mean utility of 0.82 (95% CI: 0.74, 0.90). The mean utility was comparable in pre-treatment CKD patients (difference = −0.02; 95% CI: −0.09, 0.04), 0.11 lower in dialysis patients (95% CI: −0.15, −0.08), and 0.2 lower in conservative care patients (95% CI: −0.38, −0.01). Patients treated with automated peritoneal dialysis had a significantly higher mean utility (0.80) than those on continuous ambulatory peritoneal dialysis (0.72; p = 0.02). The mean utility of transplant patients increased over time, from 0.66 in the 1980s to 0.85 in the 2000s, an increase of 0.19 (95% CI: 0.11, 0.26). Utility varied by elicitation instrument, with standard gamble producing the highest estimates, and the SF-6D by Brazier et al., University of Sheffield, producing the lowest

(LMRG): Microscope Resolution, Objective Quality, Spectral Accuracy and Spectral Un-mixing

PubMed Central

Bayles, Carol J.; Cole, Richard W.; Eason, Brady; Girard, Anne-Marie; Jinadasa, Tushare; Martin, Karen; McNamara, George; Opansky, Cynthia; Schulz, Katherine; Thibault, Marc; Brown, Claire M.

2012-01-01

The second study by the LMRG focuses on measuring confocal laser scanning microscope (CLSM) resolution, objective lens quality, spectral imaging accuracy and spectral un-mixing. Affordable test samples for each aspect of the study were designed, prepared and sent to 116 labs from 23 countries across the globe. Detailed protocols were designed for the three tests and customized for most of the major confocal instruments being used by the study participants. One protocol developed for measuring resolution and objective quality was recently published in Nature Protocols (Cole, R. W., T. Jinadasa, et al. (2011). Nature Protocols 6(12): 1929–1941). The first study involved 3D imaging of sub-resolution fluorescent microspheres to determine the microscope point spread function. Results of the resolution studies as well as point spread function quality (i.e. objective lens quality) from 140 different objective lenses will be presented. The second study of spectral accuracy looked at the reflection of the laser excitation lines into the spectral detection in order to determine the accuracy of these systems to report back the accurate laser emission wavelengths. Results will be presented from 42 different spectral confocal systems. Finally, samples with double orange beads (orange core and orange coating) were imaged spectrally and the imaging software was used to un-mix fluorescence signals from the two orange dyes. Results from 26 different confocal systems will be summarized. Time will be left to discuss possibilities for the next LMRG study.

Toward objective image quality metrics: the AIC Eval Program of the JPEG

NASA Astrophysics Data System (ADS)

Richter, Thomas; Larabi, Chaker

2008-08-01

Objective quality assessment of lossy image compression codecs is an important part of the recent call of the JPEG for Advanced Image Coding. The target of the AIC ad-hoc group is twofold: First, to receive state-of-the-art still image codecs and to propose suitable technology for standardization; and second, to study objective image quality metrics to evaluate the performance of such codes. Even tthough the performance of an objective metric is defined by how well it predicts the outcome of a subjective assessment, one can also study the usefulness of a metric in a non-traditional way indirectly, namely by measuring the subjective quality improvement of a codec that has been optimized for a specific objective metric. This approach shall be demonstrated here on the recently proposed HDPhoto format14 introduced by Microsoft and a SSIM-tuned17 version of it by one of the authors. We compare these two implementations with JPEG1 in two variations and a visual and PSNR optimal JPEG200013 implementation. To this end, we use subjective and objective tests based on the multiscale SSIM and a new DCT based metric.

DATA QUALITY OBJECTIVES-FOUNDATION OF A SUCCESSFUL MONITORING PROGRAM

EPA Science Inventory

The data quality objectives (DQO) process is a fundamental site characterization tool and the foundation of a successful monitoring program. The DQO process is a systematic planning approach based on the scientific method of inquiry. The process identifies the goals of data col...

An objective method for a video quality evaluation in a 3DTV service

NASA Astrophysics Data System (ADS)

Wilczewski, Grzegorz

2015-09-01

The following article describes proposed objective method for a 3DTV video quality evaluation, a Compressed Average Image Intensity (CAII) method. Identification of the 3DTV service's content chain nodes enables to design a versatile, objective video quality metric. It is based on an advanced approach to the stereoscopic videostream analysis. Insights towards designed metric mechanisms, as well as the evaluation of performance of the designed video quality metric, in the face of the simulated environmental conditions are herein discussed. As a result, created CAII metric might be effectively used in a variety of service quality assessment applications.

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

PubMed

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

1992-11-01

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

Assessment of health utilities and quality of life in patients with non-alcoholic fatty liver disease

PubMed Central

Sayiner, Mehmet; Stepanova, Maria; Pham, Huong; Noor, Bashir; Walters, Mercedes; Younossi, Zobair M

2016-01-01

Background Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease associated with increased liver-related mortality. Additionally, NAFLD could potentially impair health-related quality of life. Although an approved treatment for NAFLD does not exist, a number of new drugs for treatment of NAFLD are being developed. As the efficacy and safety of these regimens are being established, their cost-effectiveness, which requires the use of quality of life metrics and health utility scores to quality-adjusted outcomes, must also be assessed. The aim of this study was to report quality of life and health utilities in patients with NAFLD with and without cirrhosis for future use. Methods Patients with NAFLD were seen in an outpatient clinic setting. Each patient had extensive clinical data and completed the Short Form-36 (SF-36 V.1) questionnaire. The SF-6D health utility scores were calculated. Results There were 89 patients with the spectrum of NAFLD completed the SF-36 questionnaire: 59 with non-cirrhotic NAFLD and 30 with cirrhosis. Patients with NAFLD had significantly lower quality of life and health utility scores than the general population (all p<0.0001). Furthermore, patients with cirrhosis had lower quality of life and utility scores than non-cirrhotic NAFLD patients: SF-6D 0.660±0.107 in non-cirrhotic NAFLD vs 0.551±0.138 in cirrhotic NAFLD (p=0.0003). Conclusions Health utilities and quality of life scores are impaired in patients with cirrhotic NAFLD. These values should be used in cost-effectiveness analysis of the upcoming treatment regimens for advanced NAFLD. PMID:27648297

Obesity utilization and health-related quality of life in Medicare enrollees.

PubMed

Malinoff, Rochelle L; Elliott, Marc N; Giordano, Laura A; Grace, Susan C; Burroughs, James N

2013-01-01

The obese, with disproportionate chronic disease incidence, consume a large share of health care resources and drive up per capita Medicare spending. This study examined the prevalence of obesity and its association with health status, health-related quality of life (HRQOL), function, and outpatient utilization among Medicare Advantage seniors. Results indicate that obese beneficiaries, much more than overweight beneficiaries, have poorer health, functions, and HRQOL than normal weight beneficiaries and have substantially higher outpatient utilization. While weight loss is beneficial to both the overweight and obese, the markedly worse health status and high utilization of obese beneficiaries may merit particular attention.

Objective Video Quality Assessment Based on Machine Learning for Underwater Scientific Applications

PubMed Central

Moreno-Roldán, José-Miguel; Luque-Nieto, Miguel-Ángel; Poncela, Javier; Otero, Pablo

2017-01-01

Video services are meant to be a fundamental tool in the development of oceanic research. The current technology for underwater networks (UWNs) imposes strong constraints in the transmission capacity since only a severely limited bitrate is available. However, previous studies have shown that the quality of experience (QoE) is enough for ocean scientists to consider the service useful, although the perceived quality can change significantly for small ranges of variation of video parameters. In this context, objective video quality assessment (VQA) methods become essential in network planning and real time quality adaptation fields. This paper presents two specialized models for objective VQA, designed to match the special requirements of UWNs. The models are built upon machine learning techniques and trained with actual user data gathered from subjective tests. Our performance analysis shows how both of them can successfully estimate quality as a mean opinion score (MOS) value and, for the second model, even compute a distribution function for user scores. PMID:28333123

Utilization of the Quality Assurance Handbook in Secondary School Supervision of Instruction in Enugu State, Nigeria

ERIC Educational Resources Information Center

Chidobi, R. U.; Eze Thecla, A. Y.

2016-01-01

The purpose of this study is to investigate the extent of utilization of Quality Assurance Handbook in the supervision of instruction in secondary schools. Descriptive survey design was employed. The quantitative data were collected through an 18-item questionnaire titled, "Extent of Utilization of Quality Assurance Handbook in Secondary…

Manipulation of Unknown Objects to Improve the Grasp Quality Using Tactile Information.

PubMed

Montaño, Andrés; Suárez, Raúl

2018-05-03

This work presents a novel and simple approach in the area of manipulation of unknown objects considering both geometric and mechanical constraints of the robotic hand. Starting with an initial blind grasp, our method improves the grasp quality through manipulation considering the three common goals of the manipulation process: improving the hand configuration, the grasp quality and the object positioning, and, at the same time, prevents the object from falling. Tactile feedback is used to obtain local information of the contacts between the fingertips and the object, and no additional exteroceptive feedback sources are considered in the approach. The main novelty of this work lies in the fact that the grasp optimization is performed on-line as a reactive procedure using the tactile and kinematic information obtained during the manipulation. Experimental results are shown to illustrate the efficiency of the approach.

Obsolescence, Weeding, and the Utilization of Space.

ERIC Educational Resources Information Center

Lancaster, F. W.

1988-01-01

Suggests an objective approach to weeding library materials and discusses ways of measuring obsolescence and of controlling variables to provide a true picture of aging. Weeding is shown to improve space utilization and the quality of a collection. (5 references) (MES)

Reliability and utility of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII) for auditing and quality development in services for adults with intellectual disability and challenging behaviour.

PubMed

McVilly, K; Webber, L; Paris, M; Sharp, G

2013-08-01

Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II (BSP-QEII) was developed to monitor and assess BSPs prepared by teachers to support children with disability in the school system. This study investigated the application of the BSP-QEII to the assessment of BSPs for adults with ID in community support services. The inter-rater reliability of the BSP-QEII was assessed. The utility of the BPS-QEII was then investigated with reference to a time series study of matched pairs of BSPs, developed for the same clients over a period of approximately 3 years. Differences in plan quality measured across a number of service and systemic variables were also investigated. The BSP-QEII was found to have good inter-rater reliability and good utility for audit purposes. It was able to discriminate changes in plan quality over time. Differences in plan quality were also evident across different service types, where specialist staff had or had not been involved, and in some instances where a statutory format for the plan had or had not been used. There were no differences between plans developed by government and community sector agencies, nor were there any regional differences across the jurisdiction. The BSP-QEII could usefully be adopted as an audit tool for measuring the quality of BSPs for adults with ID. In addition to being used for research and administrative auditing, the principles underpinning the BSP-QEII could also be useful to guide policy and educational activities for staff in community based services for adults with ID. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

The development of multi-objective optimization model for excess bagasse utilization: A case study for Thailand

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

Buddadee, Bancha; Wirojanagud, Wanpen; Watts, Daniel J.

In this paper, a multi-objective optimization model is proposed as a tool to assist in deciding for the proper utilization scheme of excess bagasse produced in sugarcane industry. Two major scenarios for excess bagasse utilization are considered in the optimization. The first scenario is the typical situation when excess bagasse is used for the onsite electricity production. In case of the second scenario, excess bagasse is processed for the offsite ethanol production. Then the ethanol is blended with an octane rating of 91 gasoline by a portion of 10% and 90% by volume respectively and the mixture is used asmore » alternative fuel for gasoline vehicles in Thailand. The model proposed in this paper called 'Environmental System Optimization' comprises the life cycle impact assessment of global warming potential (GWP) and the associated cost followed by the multi-objective optimization which facilitates in finding out the optimal proportion of the excess bagasse processed in each scenario. Basic mathematical expressions for indicating the GWP and cost of the entire process of excess bagasse utilization are taken into account in the model formulation and optimization. The outcome of this study is the methodology developed for decision-making concerning the excess bagasse utilization available in Thailand in view of the GWP and economic effects. A demonstration example is presented to illustrate the advantage of the methodology which may be used by the policy maker. The methodology developed is successfully performed to satisfy both environmental and economic objectives over the whole life cycle of the system. It is shown in the demonstration example that the first scenario results in positive GWP while the second scenario results in negative GWP. The combination of these two scenario results in positive or negative GWP depending on the preference of the weighting given to each objective. The results on economics of all scenarios show the satisfied outcomes.« less

Energy and water quality management systems for water utility's operations: a review.

PubMed

Cherchi, Carla; Badruzzaman, Mohammad; Oppenheimer, Joan; Bros, Christopher M; Jacangelo, Joseph G

2015-04-15

Holistic management of water and energy resources is critical for water utilities facing increasing energy prices, water supply shortage and stringent regulatory requirements. In the early 1990s, the concept of an integrated Energy and Water Quality Management System (EWQMS) was developed as an operational optimization framework for solving water quality, water supply and energy management problems simultaneously. Approximately twenty water utilities have implemented an EWQMS by interfacing commercial or in-house software optimization programs with existing control systems. For utilities with an installed EWQMS, operating cost savings of 8-15% have been reported due to higher use of cheaper tariff periods and better operating efficiencies, resulting in the reduction in energy consumption of ∼6-9%. This review provides the current state-of-knowledge on EWQMS typical structural features and operational strategies and benefits and drawbacks are analyzed. The review also highlights the challenges encountered during installation and implementation of EWQMS and identifies the knowledge gaps that should motivate new research efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

High-quality slab-based intermixing method for fusion rendering of multiple medical objects.

PubMed

Kim, Dong-Joon; Kim, Bohyoung; Lee, Jeongjin; Shin, Juneseuk; Kim, Kyoung Won; Shin, Yeong-Gil

2016-01-01

The visualization of multiple 3D objects has been increasingly required for recent applications in medical fields. Due to the heterogeneity in data representation or data configuration, it is difficult to efficiently render multiple medical objects in high quality. In this paper, we present a novel intermixing scheme for fusion rendering of multiple medical objects while preserving the real-time performance. First, we present an in-slab visibility interpolation method for the representation of subdivided slabs. Second, we introduce virtual zSlab, which extends an infinitely thin boundary (such as polygonal objects) into a slab with a finite thickness. Finally, based on virtual zSlab and in-slab visibility interpolation, we propose a slab-based visibility intermixing method with the newly proposed rendering pipeline. Experimental results demonstrate that the proposed method delivers more effective multiple-object renderings in terms of rendering quality, compared to conventional approaches. And proposed intermixing scheme provides high-quality intermixing results for the visualization of intersecting and overlapping surfaces by resolving aliasing and z-fighting problems. Moreover, two case studies are presented that apply the proposed method to the real clinical applications. These case studies manifest that the proposed method has the outstanding advantages of the rendering independency and reusability. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Effect diffraction on a viewed object has on improvement of object optical image quality in a turbulent medium

NASA Astrophysics Data System (ADS)

Banakh, Viktor A.; Sazanovich, Valentina M.; Tsvik, Ruvim S.

1997-09-01

The influence of diffraction on the object, coherently illuminated and viewed through a random medium from the same point, on the image quality betterment caused by the counter wave correlation is studied experimentally. The measurements were carried out with the use of setup modeling artificial convective turbulence. It is shown that in the case of spatially limited reflector with the Fresnel number of the reflector surface radius r ranging from 3 to 12 the contribution of the counter wave correlation into image intensity distribution is maximal as compared with the point objects (r objects of large size (r > U.

Sleep quality and health service utilization in Chinese general population: a cross-sectional study in Dongguan, China.

PubMed

Zhang, Hui-Shan; Mai, Yan-Bing; Li, Wei-Da; Xi, Wen-Tao; Wang, Jin-Ming; Lei, Yi-Xiong; Wang, Pei-Xi

The aims of this study were to explore the Pittsburgh Sleep Quality Index (PSQI) and health service utilization in Chinese general population, to investigate the association between PSQI and health service utilization and to identify the independent contributions of social demographic variables, health related factors and PSQI to health service utilization. In a cross-sectional community-based health survey using a multi-instrument questionnaire, 4067 subjects (≥15 years old) were studied. The Chinese version of the PSQI was used to assess sleep quality. Health service utilization was measured by recent two-week physician visit and annual hospitalization rates. Higher PSQI scores were associated with more frequent health service utilization. Higher scores in subjective sleep quality were associated with higher rate of recent two-week physician visit (adjusted OR = 1.24 per SD increase, P = 0.015). Higher scores in habitual sleep efficiency (adjusted OR = 1.24 per SD increase, P = 0.038) and sleep disturbances (adjusted OR = 2.09 per SD increase, P < 0.001) were associated with more frequent annual hospitalization. The independent influence of PSQI on the risk of recent two-week physician visit was 0.7%, and that of annual hospitalization 31.4%. Poorer sleep quality predicted more frequent health service utilization. The independent contribution of PSQI on health service utilization was smaller than social demographic variables. Copyright © 2016. Published by Elsevier B.V.

Quality of life and cost-utility assessment after strabismus surgery in adults.

PubMed

Fujiike, Keiko; Mizuno, Yoshinobu; Hiratsuka, Yoshimune; Yamada, Masakazu

2011-05-01

To understand the functional and psychosocial aspects of strabismus surgery, an evaluation based on the patient's perspective is essential. In this study, we assessed quality of life and utility in adult patients who had undergone strabismus surgery, and we modeled the cost of providing this intervention in order to calculate the cost-utility of strabismus surgery in adults. The study population comprised 226 patients with strabismus aged 18 years or older who were scheduled for ocular alignment surgery at 12 facilities of the Strabismus Surgery Study Group in Japan. Survey questionnaires consisting of the Japanese versions of the Visual Function Questionnaire-25 (VFQ-25) and 8-Item Short-Form Health Survey (SF-8) and utility assessment by a time trade-off method were administrated preoperatively and 3 months postoperatively. On the basis of the cost model and measured utility data, the gains in quality-adjusted life years (QALYs) and $/QALY were estimated. Postoperatively, the subscale scores of the VFQ-25 and the physical and mental component summary scores of the SF-8 showed a statistically significant improvement. A significant improvement of utility was also noted: 0.82 ± 0.28 postoperatively versus 0.76 ± 0.31 preoperatively. On the basis of the life expectancy of these patients and the cost model, the surgery resulted in a mean value gain of 0.99 QALYs and a cost-utility for strabismus surgery of 1,303 $/QALY. By using standard tools to assess vision-associated and general health status, we confirmed the psychosocial benefits of corrective surgery for adults with strabismus. Our study concurrently demonstrated that strabismus surgery in adults is very cost-effective.

Data Quality Objectives for Regulatory Requirements for Dangerous Waste Sampling and Analysis

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

MULKEY, C.H.

1999-07-02

This document describes sampling and analytical requirements needed to meet state and federal regulations for dangerous waste (DW). The River Protection Project (RPP) is assigned to the task of storage and interim treatment of hazardous waste. Any final treatment or disposal operations, as well as requirements under the land disposal restrictions (LDRs), fall in the jurisdiction of another Hanford organization and are not part of this scope. The requirements for this Data Quality Objective (DQO) Process were developed using the RPP Data Quality Objective Procedure (Banning 1996), which is based on the U.S. Environmental Protection Agency's (EPA) Guidance for themore » Data Quality Objectives Process (EPA 1994). Hereafter, this document is referred to as the DW DQO. Federal and state laws and regulations pertaining to waste contain requirements that are dependent upon the composition of the waste stream. These regulatory drivers require that pertinent information be obtained. For many requirements, documented process knowledge of a waste composition can be used instead of analytical data to characterize or designate a waste. When process knowledge alone is used to characterize a waste, it is a best management practice to validate the information with analytical measurements.« less

The influence of familiar characters and other appealing images on young children's preference for low-quality objects.

PubMed

Danovitch, Judith H; Mills, Candice M

2017-09-01

This study examines the factors underlying young children's preference for products bearing a familiar character's image. Three-year-olds (N = 92) chose between low-quality objects with images on or near the objects and high-quality objects without images. Children showed stronger preferences for damaged objects bearing images of a preferred familiar character than for objects bearing images of a preferred colour star, and they showed weak preferences for damaged objects with the character near, but not on, the object. The results suggest that children's preference for low-quality products bearing character images is driven by prior exposure to characters, and not only by the act of identifying a favourite. Statement of contribution What is already known on this subject? Children are exposed to characters in the media and on products such as clothing and school supplies. Products featuring familiar characters appeal to preschool children, even if they are of low quality. What does this study add? Three-year-olds prefer damaged objects with an image of a favourite character over plain undamaged objects. Children's preference is not solely a function of having identified a favourite image or of attentional cues. © 2017 The British Psychological Society.

Data quality objectives for the initial fuel conditioning examinations

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

Lawrence, L.A.

The Data Quality Objectives (DQOs) were established for the response of the first group of fuel samples shipped from the K West Basin to the Hanford 327 Building hot cells for examinations to the proposed Path Forward conditioning process. Controlled temperature and atmosphere furnace testing testing will establish performance parameters using the conditioning process (drying, sludge drying, hydride decomposition passivation) proposed by the Independent Technical Assessment (ITA) Team as the baseline.

Objective speech quality assessment and the RPE-LTP coding algorithm in different noise and language conditions.

PubMed

Hansen, J H; Nandkumar, S

1995-01-01

The formulation of reliable signal processing algorithms for speech coding and synthesis require the selection of a prior criterion of performance. Though coding efficiency (bits/second) or computational requirements can be used, a final performance measure must always include speech quality. In this paper, three objective speech quality measures are considered with respect to quality assessment for American English, noisy American English, and noise-free versions of seven languages. The purpose is to determine whether objective quality measures can be used to quantify changes in quality for a given voice coding method, with a known subjective performance level, as background noise or language conditions are changed. The speech coding algorithm chosen is regular-pulse excitation with long-term prediction (RPE-LTP), which has been chosen as the standard voice compression algorithm for the European Digital Mobile Radio system. Three areas are considered for objective quality assessment which include: (i) vocoder performance for American English in a noise-free environment, (ii) speech quality variation for three additive background noise sources, and (iii) noise-free performance for seven languages which include English, Japanese, Finnish, German, Hindi, Spanish, and French. It is suggested that although existing objective quality measures will never replace subjective testing, they can be a useful means of assessing changes in performance, identifying areas for improvement in algorithm design, and augmenting subjective quality tests for voice coding/compression algorithms in noise-free, noisy, and/or non-English applications.

The physician's quality of life: Relationship with ego defense mechanisms and object relations.

PubMed

Miranda, Benedito; Louzã, Mário Rodrigues

2015-11-01

To assess whether ego defense mechanisms and object relations (the way an individual subjectively experiences his/her relationships with others) are related to quality of life among physicians. In this cross-sectional mail survey, 602 physicians from Botucatu, SP, Brazil, were sent a socio-demographic questionnaire, the Bell Object Relations and Reality Testing Inventory-Form O (BORRTI-O), the Defense Style Questionnaire-40 (DSQ-40), and the World Health Organization Abbreviated Instrument for Quality of Life Assessment (WHOQOL-BREF). 198 questionnaires (33%) with valid responses were obtained. High BORRTI-O scores (indicative of pathology) on the alienation, egocentricity and insecure attachment subscales were associated with reduced WHOQOL-BREF scores for the psychological health and social relationship domains. Immature ego defense mechanisms were associated with lower WHOQOL-BREF scores for all domains. No significant associations of WHOQOL-BREF scores with working hours, workplace or monthly income were observed in the study population WHOQOL-BREF scores correlated with mature defense mechanisms and normal object relations, suggesting an association between psychological maturity and quality of life among physicians. Copyright © 2015 Elsevier Inc. All rights reserved.

32 CFR 199.15 - Quality and utilization review peer review organization program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Director, OCHAMPUS. These contractors may include contractors that have exclusive functions in the area of utilization and quality review, fiscal intermediary contractors (which perform these functions along with a... functions concerning management of the delivery and financing of health care services under CHAMPUS...

Objective Quality and Intelligibility Prediction for Users of Assistive Listening Devices

PubMed Central

Falk, Tiago H.; Parsa, Vijay; Santos, João F.; Arehart, Kathryn; Hazrati, Oldooz; Huber, Rainer; Kates, James M.; Scollie, Susan

2015-01-01

This article presents an overview of twelve existing objective speech quality and intelligibility prediction tools. Two classes of algorithms are presented, namely intrusive and non-intrusive, with the former requiring the use of a reference signal, while the latter does not. Investigated metrics include both those developed for normal hearing listeners, as well as those tailored particularly for hearing impaired (HI) listeners who are users of assistive listening devices (i.e., hearing aids, HAs, and cochlear implants, CIs). Representative examples of those optimized for HI listeners include the speech-to-reverberation modulation energy ratio, tailored to hearing aids (SRMR-HA) and to cochlear implants (SRMR-CI); the modulation spectrum area (ModA); the hearing aid speech quality (HASQI) and perception indices (HASPI); and the PErception MOdel - hearing impairment quality (PEMO-Q-HI). The objective metrics are tested on three subjectively-rated speech datasets covering reverberation-alone, noise-alone, and reverberation-plus-noise degradation conditions, as well as degradations resultant from nonlinear frequency compression and different speech enhancement strategies. The advantages and limitations of each measure are highlighted and recommendations are given for suggested uses of the different tools under specific environmental and processing conditions. PMID:26052190

Construction of the descriptive system for the Assessment of Quality of Life AQoL-6D utility instrument.

PubMed

Richardson, Jeffrey R J; Peacock, Stuart J; Hawthorne, Graeme; Iezzi, Angelo; Elsworth, Gerald; Day, Neil A

2012-04-17

Multi attribute utility (MAU) instruments are used to include the health related quality of life (HRQoL) in economic evaluations of health programs. Comparative studies suggest different MAU instruments measure related but different constructs. The objective of this paper is to describe the methods employed to achieve content validity in the descriptive system of the Assessment of Quality of Life (AQoL)-6D, MAU instrument. The AQoL program introduced the use of psychometric methods in the construction of health related MAU instruments. To develop the AQoL-6D we selected 112 items from previous research, focus groups and expert judgment and administered them to 316 members of the public and 302 hospital patients. The search for content validity across a broad spectrum of health states required both formative and reflective modelling. We employed Exploratory Factor Analysis and Structural Equation Modelling (SEM) to meet these dual requirements. The resulting instrument employs 20 items in a multi-tier descriptive system. Latent dimension variables achieve sensitive descriptions of 6 dimensions which, in turn, combine to form a single latent QoL variable. Diagnostic statistics from the SEM analysis are exceptionally good and confirm the hypothesised structure of the model. The AQoL-6D descriptive system has good psychometric properties. They imply that the instrument has achieved construct validity and provides a sensitive description of HRQoL. This means that it may be used with confidence for measuring health related quality of life and that it is a suitable basis for modelling utilities for inclusion in the economic evaluation of health programs.

Data sources for environmental assessment: determining availability, quality and utility

EPA Science Inventory

Objectives: An environmental quality index (EQI) for all counties in the United States is being developed to explore the relationship between environmental insults and human health. The EQI will be particularly useful to assess how environmental disamenities contribute to health...

Effects of Case Manager Feedback on the Quality of Individual Habilitation Plan Objectives.

ERIC Educational Resources Information Center

Horner, Robert H.; And Others

1990-01-01

The functional relation between feedback and improved writing of Individual Habilitation Plan objectives in four adult service agencies serving the retarded was assessed. The agencies improved the quality of their written objectives after receiving feedback from the case manager and maintained those gains 18 months after feedback was terminated.…

[Professional's expectations to improve quality of care and social services utilization in geriatric oncology].

PubMed

Antoine, Valéry; de Wazières, Benoît; Houédé, Nadine

2015-02-01

Coordination of a multidisciplinary and multi-professional intervention is a key issue in the management of elderly cancer patients to improve health status and quality of life. Optimizing the links between professionals is needed to improve care planning, health and social services utilization. Descriptive study in a French University Hospital. A 6-item structured questionnaire was addressed to professionals involved in global and supportive cares of elderly cancer patients (name, location, effective health care and services offered, needs to improve the quality of their intervention). After the analysis of answers, definition of propositions to improve cares and services utilization. The 37 respondents identified a total of 166 needs to improve quality of care in geriatric oncology. Major expectations were concerning improvement of global/supportive cares and health care services utilization, a better coordination between geriatric teams and oncologists. Ten propositions, including a model of in-hospital health care planning, were defined to answer to professional's needs with the aim of optimizing cancer treatment and global cares. Identification of effective services and needs can represent a first step in a continuous program to improve quality of cares, according to the French national cancer plan 2014-2019. It allows federating professionals for a coordination effort, a better organization of the clinical activity in geriatric oncology, to optimize clinical practice and global cares. Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

76 FR 37376 - Guidelines for Ensuring and Maximizing the Quality, Objectivity, Utility, and Integrity of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... the information is not compromised through corruption or falsification. 6. ``Objectivity'' is a... procedures vary depending on the type of information being disseminated and the extent to which such... proof is on the requester to show both the necessity for and type of correction sought. Procedures for...

Environmental flows and water quality objectives for the River Murray.

PubMed

Gippel, C; Jacobs, T; McLeod, T

2002-01-01

Over the past decade, there intense consideration of managing flows in the River Murray to provide environmental benefits. In 1990 the Murray-Darling Basin Ministerial Council adopted a water quality policy: To maintain and, where necessary, improve existing water quality in the rivers of the Murray-Darling Basin for all beneficial uses - agricultural, environmental, urban, industrial and recreational, and in 1994 a flow policy: To maintain and where necessary improve existing flow regimes in the waterways of the Murray-Darling Basin to protect and enhance the riverine environment. The Audit of Water Use followed in 1995, culminating in the decision of the Ministerial Council to implement an interim cap on new diversions for consumptive use (the "Cap") in a bid to halt declining river health. In March 1999 the Environmental Flows and Water Quality Objectives for the River Murray Project (the Project) was set up, primarily to establish be developed that aims to achieve a sustainable river environment and water quality, in accordance with community needs, and including an adaptive approach to management and operation of the River. It will lead to objectives for water quality and environmental flows that are feasible, appropriate, have the support of the scientific, management and stakeholder communities, and carry acceptable levels of risk. This paper describes four key aspects of the process being undertaken to determine the objectives, and design the flow options that will meet those objectives: establishment of an appropriate technical, advisory and administrative framework; establishing clear evidence for regulation impacts; undergoing assessment of environmental flow needs; and filling knowledge gaps. A review of the impacts of flow regulation on the health of the River Murray revealed evidence for decline, but the case for flow regulation as the main cause is circumstantial or uncertain. This is to be expected, because the decline of the River Murray results

Liquefaction chemistry and kinetics: Hydrogen utilization studies

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

Rothenberger, K.S.; Warzinski, R.P.; Cugini, A.V.

1995-12-31

The objectives of this project are to investigate the chemistry and kinetics that occur in the initial stages of coal liquefaction and to determine the effects of hydrogen pressure, catalyst activity, and solvent type on the quantity and quality of the products produced. The project comprises three tasks: (1) preconversion chemistry and kinetics, (2) hydrogen utilization studies, and (3) assessment of kinetic models for liquefaction. The hydrogen utilization studies work will be the main topic of this report. However, the other tasks are briefly described.

Cantera and Cantera Electrolyte Thermodynamics Objects

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

John Hewson, Harry Moffat

Cantera is a suite of object-oriented software tools for problems involving chemical kinetics, thermodynamics, and/or transport processes. It is a multi-organizational effort to create and formulate high quality 0D and 1D constitutive modeling tools for reactive transport codes.Institutions involved with the effort include Sandia, MIT, Colorado School of Mines, U. Texas, NASA, and Oak Ridge National Labs. Specific to Sandia's contributions, the Cantera Electrolyte Thermo Objects (CETO) packages is comprised of add-on routines for Cantera that handle electrolyte thermochemistry and reactions within the overall Cantera package. Cantera is a C++ Cal Tech code that handles gas phase species transport, reaction,more » and thermodynamics. With this addition, Cantera can be extended to handle problems involving liquid phase reactions and transport in electrolyte systems, and phase equilibrium problemsinvolving concentrated electrolytes and gas/solid phases. A full treatment of molten salt thermodynamics and transport has also been implemented in CETO. The routines themselves consist of .cpp and .h files containing C++ objects that are derived from parent Cantera objects representing thermodynamic functions. They are linked unto the main Cantera libraries when requested by the user. As an addendum to the main thermodynamics objects, several utility applications are provided. The first is multiphase Gibbs free energy minimizer based on the vcs algorithm, called vcs_cantera. This code allows for the calculation of thermodynamic equilibrium in multiple phases at constant temperature and pressure. Note, a similar code capability exists already in Cantera. This version follows the same algorithm, but gas a different code-base starting point, and is used as a research tool for algorithm development. The second program, cttables, prints out tables of thermodynamic and kinetic information for thermodynamic and kinetic objects within Cantera. This program serves as a "Get the

CEM data quality: Survey of the utility industry

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

Mitnick, S.A.; Wade, S.

1995-09-01

The Acid Rain Allowance Trading program of the Clean Air Act Amendments of 1990 (CAAA) represents a spectacular departure from traditional Command-and-Control regulation. The program is noteworthy both in its scale and because, defacto, it turns the pollutant Sulfur Dioxide (SO{sub 2}) into a valuable asset. The market has responded accordingly with the development of an infrastructure to support the financial aspects of the program; it includes the Electronic Emission Tracking System, the Chicago Board of Trade`s SO{sub 2} Allowance Futures Market and, more recently, Cantor Fitzgerald`s Market Price Index (MPI). While this may increase the potential for successful implementationmore » of the allowance market, one should not lose sight of the fact that these institutional supports are the trappings of an emission reduction program, not the substance. The allowance trading program will not work unless it meets its environmental goals. Continuous Emission Monitoring (CEM) requirements in the CAAA address this concern by providing the infrastructure to support the environmental aspects of the allowance trading program. CEM systems are relied upon to provide accurate, quality-assured emissions data. This information is critical to the success of the allowance trading program in the eyes of both the general public and the financial/utility community. December 31, 1994 marked the close of the fifth CEM reporting quarter since the program was initiated in November 1993. Since that time, the electric utility industry has submitted over 1,000 quarterly reports, known as electronic data reports (EDRs), to EPA. Hagler Bailly evaluated the quality of data contained in these EDRs using Superbase, software it developed to perform this task. This paper presents selected findings from that review.« less

A new approach to the identification of Landscape Quality Objectives (LQOs) as a set of indicators.

PubMed

Sowińska-Świerkosz, Barbara Natalia; Chmielewski, Tadeusz J

2016-12-15

The objective of the paper is threefold: (1) to introduce Landscape Quality Objectives (LQOs) as a set of indicators; (2) to present a method of linking social and expert opinion in the process of the formulation of landscape indicators; and (3) to present a methodological framework for the identification of LQOs. The implementation of these goals adopted a six-stage procedure based on the use of landscape units: (1) GIS analysis; (2) classification; (3) social survey; (4) expert value judgement; (5) quality assessment; and (6) guidelines formulation. The essence of the research was the presentation of features that determine landscape quality according to public opinion as a set of indicators. The results showed that 80 such indicators were identified, of both a qualitative (49) and a quantitative character (31). Among the analysed units, 60% (18 objects) featured socially expected (and confirmed by experts) levels of landscape quality, and 20% (6 objects) required overall quality improvement in terms of both public and expert opinion. The adopted procedure provides a new tool for integrating social responsibility into environmental management. The advantage of the presented method is the possibility of its application in the territories of various European countries. It is flexible enough to be based on cartographic studies, landscape research methods, and environmental quality standards existing in a given country. Copyright © 2016 Elsevier Ltd. All rights reserved.

A novel no-reference objective stereoscopic video quality assessment method based on visual saliency analysis

NASA Astrophysics Data System (ADS)

Yang, Xinyan; Zhao, Wei; Ye, Long; Zhang, Qin

2017-07-01

This paper proposes a no-reference objective stereoscopic video quality assessment method with the motivation that making the effect of objective experiments close to that of subjective way. We believe that the image regions with different visual salient degree should not have the same weights when designing an assessment metric. Therefore, we firstly use GBVS algorithm to each frame pairs and separate both the left and right viewing images into the regions with strong, general and week saliency. Besides, local feature information like blockiness, zero-crossing and depth are extracted and combined with a mathematical model to calculate a quality assessment score. Regions with different salient degree are assigned with different weights in the mathematical model. Experiment results demonstrate the superiority of our method compared with the existed state-of-the-art no-reference objective Stereoscopic video quality assessment methods.

Metrics for the Evaluation the Utility of Air Quality Forecasting

NASA Astrophysics Data System (ADS)

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

2013-12-01

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

Construction of the descriptive system for the assessment of quality of life AQoL-6D utility instrument

PubMed Central

2012-01-01

Background Multi attribute utility (MAU) instruments are used to include the health related quality of life (HRQoL) in economic evaluations of health programs. Comparative studies suggest different MAU instruments measure related but different constructs. The objective of this paper is to describe the methods employed to achieve content validity in the descriptive system of the Assessment of Quality of Life (AQoL)-6D, MAU instrument. Methods The AQoL program introduced the use of psychometric methods in the construction of health related MAU instruments. To develop the AQoL-6D we selected 112 items from previous research, focus groups and expert judgment and administered them to 316 members of the public and 302 hospital patients. The search for content validity across a broad spectrum of health states required both formative and reflective modelling. We employed Exploratory Factor Analysis and Structural Equation Modelling (SEM) to meet these dual requirements. Results and Discussion The resulting instrument employs 20 items in a multi-tier descriptive system. Latent dimension variables achieve sensitive descriptions of 6 dimensions which, in turn, combine to form a single latent QoL variable. Diagnostic statistics from the SEM analysis are exceptionally good and confirm the hypothesised structure of the model. Conclusions The AQoL-6D descriptive system has good psychometric properties. They imply that the instrument has achieved construct validity and provides a sensitive description of HRQoL. This means that it may be used with confidence for measuring health related quality of life and that it is a suitable basis for modelling utilities for inclusion in the economic evaluation of health programs. PMID:22507254

Effects of transference work in the context of therapeutic alliance and quality of object relations.

PubMed

Høglend, Per; Hersoug, Anne Grete; Bøgwald, Kjell-Petter; Amlo, Svein; Marble, Alice; Sørbye, Øystein; Røssberg, Jan Ivar; Ulberg, Randi; Gabbard, Glen O; Crits-Christoph, Paul

2011-10-01

Transference interpretation is considered as a core active ingredient in dynamic psychotherapy. In common clinical theory, it is maintained that more mature relationships, as well as a strong therapeutic alliance, may be prerequisites for successful transference work. In this study, the interaction between quality of object relations, transference interpretation, and alliance is estimated. One hundred outpatients seeking psychotherapy for depression, anxiety, and personality disorders were randomly assigned to 1 year of weekly sessions of dynamic psychotherapy with transference interpretation or to the same type and duration of treatment, but without the use of transference interpretation. Quality of Object Relations (QOR)-lifelong pattern was evaluated before treatment (P. Høglend, 1994). The Working Alliance Inventory (A. O. Horvath & L. S. Greenberg, 1989; T. J. Tracey & A. M. Kokotovic, 1989) was rated in Session 7. The primary outcome variable was the Psychodynamic Functioning Scales (P. Høglend et al., 2000), measured at pretreatment, posttreatment, and 1 year after treatment termination. A significant Treatment Group × Quality of Object Relations × Alliance interaction was present, indicating that alliance had a significantly different impact on effects of transference interpretation, depending on the level of QOR. The impact of transference interpretation on psychodynamic functioning was more positive within the context of a weak therapeutic alliance for patients with low quality of object relations. For patients with more mature object relations and high alliance, the authors observed a negative effect of transference work. The specific effects of transference work was influenced by the interaction of object relations and alliance, but in the direct opposite direction of what is generally maintained in mainstream clinical theory.

An ECG storage and retrieval system embedded in client server HIS utilizing object-oriented DB.

PubMed

Wang, C; Ohe, K; Sakurai, T; Nagase, T; Kaihara, S

1996-02-01

In the University of Tokyo Hospital, the improved client server HIS has been applied to clinical practice and physicians can order prescription, laboratory examination, ECG examination and radiographic examination, etc. directly by themselves and read results of these examinations, except medical signal waves, schema and image, on UNIX workstations. Recently, we designed and developed an ECG storage and retrieval system embedded in the client server HIS utilizing object-oriented database to take the first step in dealing with digitized signal, schema and image data and show waves, graphics, and images directly to physicians by the client server HIS. The system was developed based on object-oriented analysis and design, and implemented with object-oriented database management system (OODMS) and C++ programming language. In this paper, we describe the ECG data model, functions of the storage and retrieval system, features of user interface and the result of its implementation in the HIS.

The impact of chronic hepatitis B on quality of life: a multinational study of utilities from infected and uninfected persons.

PubMed

Levy, Adrian R; Kowdley, Kris V; Iloeje, Uchenna; Tafesse, Eskinder; Mukherjee, Jayanti; Gish, Robert; Bzowej, Natalie; Briggs, Andrew H

2008-01-01

Chronic hepatitis B (CHB) is a condition that results in substantial morbidity and mortality worldwide because of progressive liver damage. Investigators undertaking economic evaluations of new therapeutic agents require estimates of health-related quality of life (HRQOL). Recently, evidence has begun to accumulate that differences in cultural backgrounds have a quantifiable impact on perceptions of health. The objective was to elicit utilities for six health states that occur after infection with the hepatitis B virus from infected and uninfected respondents living in jurisdictions with low and with high CHB endemicity. Standard gamble utilities were elicited from hepatitis patients and uninfected respondents using an interviewer-administered survey in the United States, Canada, United Kingdom, Spain, Hong Kong, and mainland China. Generalized linear models were used to the effect on utilities of current health, age and sex, jurisdiction and, for infected respondents, current disease state. The sample included 534 CHB-infected patients and 600 uninfected respondents. CHB and compensated cirrhosis had a moderate impact on HRQOL with utilities ranging from 0.68 to 0.80. Decompensated cirrhosis and hepatocellular carcinoma had a stronger impact with utilities ranging from 0.35 to 0.41. Significant variation was observed between countries, with both types of respondents in mainland China and Hong Kong reporting systematically lower utilities. Health states related to CHB infection have substantial reductions in HRQOL and the utilities reported in this study provide valuable information for comparing new treatment options. The observed intercountry differences suggest that economic evaluations may benefit from country-specific utility estimates. The extent that systematic intercountry differences in utilities hold true for other infectious and chronic diseases remains an open question and has considerable implications for the proper conduct and interpretation of

The objective impact of clinical peer review on hospital quality and safety.

PubMed

Edwards, Marc T

2011-01-01

Despite its importance, the objective impact of clinical peer review on the quality and safety of care has not been studied. Data from 296 acute care hospitals show that peer review program and related organizational factors can explain up to 18% of the variation in standardized measures of quality and patient safety. The majority of programs rely on an outmoded and dysfunctional process model. Adoption of best practices informed by the continuing study of peer review program effectiveness has the potential to significantly improve patient outcomes.

Is quality of care a key predictor of perinatal health care utilization and patient satisfaction in Malawi?

PubMed

Creanga, Andreea A; Gullo, Sara; Kuhlmann, Anne K Sebert; Msiska, Thumbiko W; Galavotti, Christine

2017-05-22

The Malawi government encourages early antenatal care, delivery in health facilities, and timely postnatal care. Efforts to sustain or increase current levels of perinatal service utilization may not achieve desired gains if the quality of care provided is neglected. This study examined predictors of perinatal service utilization and patients' satisfaction with these services with a focus on quality of care. We used baseline, two-stage cluster sampling household survey data collected between November and December, 2012 before implementation of CARE's Community Score Card© intervention in Ntcheu district, Malawi. Women with a birth during the last year (N = 1301) were asked about seeking: 1) family planning, 2) antenatal, 3) delivery, and 4) postnatal care; the quality of care received; and their overall satisfaction with the care received. Specific quality of care items were assessed for each type of service, and up to five such items per type of service were used in analyses. Separate logistic regression models were fitted to examine predictors of family planning, antenatal, delivery, and postnatal service utilization and of complete satisfaction with each of these services; all models were adjusted for women's socio-demographic characteristics, perceptions of the closest facility to their homes, service use indicators, and quality of care items. We found higher levels of perinatal service use than previously documented in Malawi (baseline antenatal care 99.4%; skilled birth attendance 97.3%; postnatal care 77.5%; current family planning use 52.8%). Almost 73% of quality of perinatal care items assessed were favorably reported by > 90% of women. Women reported high overall satisfaction (≥85%) with all types of services examined, higher for antenatal and postnatal care than for family planning and delivery care. We found significant associations between perceived and actual quality of care and both women's use and satisfaction with the perinatal health

Vision and quality-of-life.

PubMed Central

Brown, G C

1999-01-01

OBJECTIVE: To determine the relationship of visual acuity loss to quality of life. DESIGN: Three hundred twenty-five patients with visual loss to a minimum of 20/40 or greater in at least 1 eye were interviewed in a standardized fashion using a modified VF-14, questionnaire. Utility values were also obtained using both the time trade-off and standard gamble methods of utility assessment. MAIN OUTCOME MEASURES: Best-corrected visual acuity was correlated with the visual function score on the modified VF-14 questionnaire, as well as with utility values obtained using both the time trade-off and standard gamble methods. RESULTS: Decreasing levels of vision in the eye with better acuity correlated directly with decreasing visual function scores on the modified VF-14 questionnaire, as did decreasing utility values using the time trade-off method of utility evaluation. The standard gamble method of utility evaluation was not as directly correlated with vision as the time trade-off method. Age, level of education, gender, race, length of time of visual loss, and the number of associated systemic comorbidities did not significantly affect the time trade-off utility values associated with visual loss in the better eye. The level of reduced vision in the better eye, rather than the specific disease process causing reduced vision, was related to mean utility values. The average person with 20/40 vision in the better seeing eye was willing to trade 2 of every 10 years of life in return for perfect vision (utility value of 0.8), while the average person with counting fingers vision in the better eye was willing to trade approximately 5 of every 10 remaining years of life (utility value of 0.52) in return for perfect vision. CONCLUSIONS: The time trade-off method of utility evaluation appears to be an effective method for assessing quality of life associated with visual loss. Time trade-off utility values decrease in direct conjunction with decreasing vision in the better

Protein quality and quantity and insulin control of mammary gland glucose utilization during lactation

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

Masor, M.L.

1987-01-01

Virgin Sprague-Dawley rats were bred, and fed laboratory stock (STOCK), 13% casein plus methionine, 13% wheat gluten, or 5% casein plus methionine through gestation and 4 days of lactation. Diets were switched at parturition to determine the effects of dietary protein quality and quantity fed during gestation and/or lactation on insulin stimulation of mammary glucose utilization. On day 20 of gestation (20G) and day 4 of lactation (4L) the right inguinal-abdominal mammary glands were removed, and acini and tissue slices were incubated in Krebs buffer with or without insulin containing (U-/sup 14/C)-glucose and 5mM glucose for 1 hour at 37/degrees/C.more » Glucose incorporation into CO/sub 2/, lipid and lactose was determined. Glucose incorporation into CO/sub 2/ and lipid, but not lactose was stimulated by insulin in mammary slices. Diet effects on glucose utilization in acini were confirmed in slices for basal and insulin stimulated levels. Treatment affected the absolute increase of insulin stimulation. Regression analysis significantly correlated pup weight gain with total glucose utilization. Poor dietary protein quality and quantity fed during gestation impaired both overall response of mammary glucose utilization to insulin stimulation, and mammary development during pregnancy. Improving protein value at parturition did not overcome those deficits by 4L.« less

Identifying role of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

PubMed

Karim, Rizwanul M; Abdullah, Mamun S; Rahman, Anisur M; Alam, Ashraful M

2016-06-24

Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 community clinics. Since most of the outcome indicators focus mainly on women and children, women having children less than 2 years of age were randomly assigned and interviewed for the study purpose. Data were collected through FGD, Key informants interview and a pretested semi- structured questionnaire. About 95 % of the respondents were Muslims and 5 % were Hindus. The average age of the respondents was 23.38 (SD 4.15) and almost all of them are home makers. The average monthly expenditure of their family was 95US $ (SD 32US$). At the beginning of the study, two psychometric research instruments; 24 items perceived quality of primary care services PQPCS scale (chronbach's α = .89) and 22 items community clinic service satisfaction CCSS scale (chronbach's α = .97), were constructed and validated. This study showed less educated, poor, landless mothers utilized the community clinic services more than their educated and wealthier counterpart. Women who lived in their own residence used the community clinic services more frequently than those who lived in a rental house. Perceptions concerning skill and competence of the health care provider and satisfaction indicating interpersonal communication and attitude of the care provider were important predictors for community clinic service utilization

Factors Associated with the Utilization and Quality of Prenatal Care in Western Rural Regions of China

ERIC Educational Resources Information Center

Dongxu, Wang; Yuhui, Shi; Stewart, Donald; Chun, Chang; Chaoyang, Li

2012-01-01

Purpose: The paper seeks to identify key features of prenatal care utilization and quality in western regions of China and to determine the factors affecting the quality of prenatal care. Design/methodology/approach: A descriptive, cross-sectional study was conducted. The instrument for the study was a 10-stem respondent-administered, structured…

Objective measurement of the optical image quality in the human eye

NASA Astrophysics Data System (ADS)

Navarro, Rafael M.

2001-05-01

This communication reviews some recent studies on the optical performance of the human eye. Although the retinal image cannot be recorded directly, different objective methods have been developed, which permit to determine optical quality parameters, such as the Point Spread Function (PSF), the Modulation Transfer Function (MTF), the geometrical ray aberrations or the wavefront distortions, in the living human eye. These methods have been applied in both basic and applied research. This includes the measurement of the optical performance of the eye across visual field, the optical quality of eyes with intraocular lens implants, the aberrations induced by LASIK refractive surgery, or the manufacture of customized phase plates to compensate the wavefront aberration in the eye.

Quality of care associated with common chronic diseases in a 9-state Medicaid population utilizing claims data: an evaluation of medication and health care use and costs.

PubMed

Priest, Julie L; Cantrell, C Ron; Fincham, Jack; Cook, Christopher L; Burch, Steven P

2011-02-01

The objective of this cross-sectional, retrospective study was to utilize claims data to establish a quality-of-care benchmark in a large multistate Medicaid population overall and by race. Quality of care and medication adherence (persistence and compliance) per national treatment guidelines, and health care costs/utilization were assessed across common chronic conditions in a large, 9-state Medicaid population. Overall, quality of care was suboptimal across conditions. Over 15% of asthma patients had ≥ 1 asthma-related emergency room/hospital event and 12% of chronic obstructive pulmonary disease patients had a Level II or III exacerbation. Only 36% of depression patients filled any antidepressant medication within 90 days of new episode. Only 45% of diabetes patients received ≥ 2 A1c tests. Patients who filled a prescription for any acceptable pharmacotherapy ranged from 35% (depression) to 83% (heart failure [HF]). Persistence for those filling any acceptable medication ranged from 16% (asthma) to 68% (HF). Compliance for patients filling ≥ 2 prescriptions ranged from 27% (asthma) to 75% (HF). Blacks had the lowest medication compliance and persistence for all conditions except hyperlipidemia. The results highlight the need to assess and improve quality across the spectrum of care, both overall and by race.

Teaching Quality Object-Oriented Programming

ERIC Educational Resources Information Center

Feldman, Yishai A.

2005-01-01

Computer science students need to learn how to write high-quality software. An important methodology for achieving quality is design-by-contract, in which code is developed together with its specification, which is given as class invariants and method pre- and postconditions. This paper describes practical experience in teaching design-by-contract…

Quality of life, health status, and health service utilization related to a new measure of health literacy: FLIGHT/VIDAS.

PubMed

Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J; Caballero, Joshua; Waldrop-Valverde, Drenna

2014-09-01

Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effects of Transference Work in the Context of Therapeutic Alliance and Quality of Object Relations

ERIC Educational Resources Information Center

Hoglend, Per; Hersoug, Anne Grete; Bogwald, Kjell-Petter; Amlo, Svein; Marble, Alice; Sorbye, Oystein; Rossberg, Jan Ivar; Ulberg, Randi; Gabbard, Glen O.; Crits-Christoph, Paul

2011-01-01

Objective: Transference interpretation is considered as a core active ingredient in dynamic psychotherapy. In common clinical theory, it is maintained that more mature relationships, as well as a strong therapeutic alliance, may be prerequisites for successful transference work. In this study, the interaction between quality of object relations,…

At a crossroads: modernizing utility infrastructure in a tough credit environment

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

Olson, Wayne P.

2009-08-15

Given the current state of electric utility creditworthiness, it is reasonable to question whether the industry is ''ready to roll'' from a financial perspective, and to ask what, if anything, should be done about that. Part of the answer will be to find ways to improve the credit quality of the industry over time - with the interest coverage ratio being the most objective measure of credit quality. (author)

An object detection and tracking system for unmanned surface vehicles

NASA Astrophysics Data System (ADS)

Yang, Jian; Xiao, Yang; Fang, Zhiwen; Zhang, Naiwen; Wang, Li; Li, Tao

2017-10-01

Object detection and tracking are critical parts of unmanned surface vehicles(USV) to achieve automatic obstacle avoidance. Off-the-shelf object detection methods have achieved impressive accuracy in public datasets, though they still meet bottlenecks in practice, such as high time consumption and low detection quality. In this paper, we propose a novel system for USV, which is able to locate the object more accurately while being fast and stable simultaneously. Firstly, we employ Faster R-CNN to acquire several initial raw bounding boxes. Secondly, the image is segmented to a few superpixels. For each initial box, the superpixels inside will be grouped into a whole according to a combination strategy, and a new box is thereafter generated as the circumscribed bounding box of the final superpixel. Thirdly, we utilize KCF to track these objects after several frames, Faster-RCNN is again used to re-detect objects inside tracked boxes to prevent tracking failure as well as remove empty boxes. Finally, we utilize Faster R-CNN to detect objects in the next image, and refine object boxes by repeating the second module of our system. The experimental results demonstrate that our system is fast, robust and accurate, which can be applied to USV in practice.

A fuzzy MCDM model with objective and subjective weights for evaluating service quality in hotel industries

NASA Astrophysics Data System (ADS)

Zoraghi, Nima; Amiri, Maghsoud; Talebi, Golnaz; Zowghi, Mahdi

2013-12-01

This paper presents a fuzzy multi-criteria decision-making (FMCDM) model by integrating both subjective and objective weights for ranking and evaluating the service quality in hotels. The objective method selects weights of criteria through mathematical calculation, while the subjective method uses judgments of decision makers. In this paper, we use a combination of weights obtained by both approaches in evaluating service quality in hotel industries. A real case study that considered ranking five hotels is illustrated. Examples are shown to indicate capabilities of the proposed method.

Outpatient utilization of psychopharmaceuticals in the City of Zagreb 2001-2006.

PubMed

Stimac, Danijela; Culig, Josip

2009-03-01

A comprehensive insight into drug utilization as an economic and primarily a public health issue can only be acquired in the context of overall health state of the respective population. The objectives of the study were: 1) to determine the real outpatient utilization of psychopharmaceuticals in Zagreb, 2) to determine the psychopharmaceutical prescribing quality during the study period; and 3) to propose appropriate interventions in Zagreb on the basis of the results obtained. Data on drug utilization were obtained from all Zagreb pharmacies. The number of defined daily doses (DDD) and number of DDD per 1000 inhabitants per day (DDD/1000/day) were calculated from the number of particular drug packages. The Drug Utilization 90% (DU90%) method was used as a criterion of prescribing quality. Outpatient utilization of psychopharmaceuticals showed a declining pattern from 115.40 DDD/1000/day in 2001 to 93.15 DDD/1000/day in 2006. Anxiolytics accounted for the majority of this drug group utilization in the City of Zagreb, although the anxiolytic/antidepressant ratio decreased from 7.19 in 2001 to 3.86 in 2006. The utilization of selective serotonin reuptake inhibitors showed a 2.5-fold increase and accounted for 90% of overall antidepressant utilization. A 2.5-fold decrease was recorded in the utilization of antipsychotics, while the atypical/typical antipsychotic ratio changed from 1:2 in 2001 to 1.1:1 in 2006. Despite some improvement observed in the prescribing quality, the predominance of benzodiazepines in the utilization of psychopharmaceuticals points to the need of additional rationalization in the field.

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

PubMed

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

2017-07-24

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

Laser-induced acoustic imaging of underground objects

NASA Astrophysics Data System (ADS)

Li, Wen; DiMarzio, Charles A.; McKnight, Stephen W.; Sauermann, Gerhard O.; Miller, Eric L.

1999-02-01

This paper introduces a new demining technique based on the photo-acoustic interaction, together with results from photo- acoustic experiments. We have buried different types of targets (metal, rubber and plastic) in different media (sand, soil and water) and imaged them by measuring reflection of acoustic waves generated by irradiation with a CO2 laser. Research has been focused on the signal acquisition and signal processing. A deconvolution method using Wiener filters is utilized in data processing. Using a uniform spatial distribution of laser pulses at the ground's surface, we obtained 3D images of buried objects. The images give us a clear representation of the shapes of the underground objects. The quality of the images depends on the mismatch of acoustic impedance of the buried objects, the bandwidth and center frequency of the acoustic sensors and the selection of filter functions.

A Perceptually Weighted Rank Correlation Indicator for Objective Image Quality Assessment

NASA Astrophysics Data System (ADS)

Wu, Qingbo; Li, Hongliang; Meng, Fanman; Ngan, King N.

2018-05-01

In the field of objective image quality assessment (IQA), the Spearman's $\\rho$ and Kendall's $\\tau$ are two most popular rank correlation indicators, which straightforwardly assign uniform weight to all quality levels and assume each pair of images are sortable. They are successful for measuring the average accuracy of an IQA metric in ranking multiple processed images. However, two important perceptual properties are ignored by them as well. Firstly, the sorting accuracy (SA) of high quality images are usually more important than the poor quality ones in many real world applications, where only the top-ranked images would be pushed to the users. Secondly, due to the subjective uncertainty in making judgement, two perceptually similar images are usually hardly sortable, whose ranks do not contribute to the evaluation of an IQA metric. To more accurately compare different IQA algorithms, we explore a perceptually weighted rank correlation indicator in this paper, which rewards the capability of correctly ranking high quality images, and suppresses the attention towards insensitive rank mistakes. More specifically, we focus on activating `valid' pairwise comparison towards image quality, whose difference exceeds a given sensory threshold (ST). Meanwhile, each image pair is assigned an unique weight, which is determined by both the quality level and rank deviation. By modifying the perception threshold, we can illustrate the sorting accuracy with a more sophisticated SA-ST curve, rather than a single rank correlation coefficient. The proposed indicator offers a new insight for interpreting visual perception behaviors. Furthermore, the applicability of our indicator is validated in recommending robust IQA metrics for both the degraded and enhanced image data.

Quality Assurance for Digital Learning Object Repositories: Issues for the Metadata Creation Process

ERIC Educational Resources Information Center

Currier, Sarah; Barton, Jane; O'Beirne, Ronan; Ryan, Ben

2004-01-01

Metadata enables users to find the resources they require, therefore it is an important component of any digital learning object repository. Much work has already been done within the learning technology community to assure metadata quality, focused on the development of metadata standards, specifications and vocabularies and their implementation…

Evaluation of image quality in terahertz pulsed imaging using test objects.

PubMed

Fitzgerald, A J; Berry, E; Miles, R E; Zinovev, N N; Smith, M A; Chamberlain, J M

2002-11-07

As with other imaging modalities, the performance of terahertz (THz) imaging systems is limited by factors of spatial resolution, contrast and noise. The purpose of this paper is to introduce test objects and image analysis methods to evaluate and compare THz image quality in a quantitative and objective way, so that alternative terahertz imaging system configurations and acquisition techniques can be compared, and the range of image parameters can be assessed. Two test objects were designed and manufactured, one to determine the modulation transfer functions (MTF) and the other to derive image signal to noise ratio (SNR) at a range of contrasts. As expected the higher THz frequencies had larger MTFs, and better spatial resolution as determined by the spatial frequency at which the MTF dropped below the 20% threshold. Image SNR was compared for time domain and frequency domain image parameters and time delay based images consistently demonstrated higher SNR than intensity based parameters such as relative transmittance because the latter are more strongly affected by the sources of noise in the THz system such as laser fluctuations and detector shot noise.

Chicago Residents’ Perceptions of Air Quality: Objective Pollution, the Built Environment, and Neighborhood Stigma Theory

PubMed Central

King, Katherine E.

2014-01-01

Substantial research documents higher pollution levels in minority neighborhoods, but little research evaluates how residents perceive their own communities’ pollution risks. According to “Neighborhood stigma” theory, survey respondents share a cultural bias that minorities cause social dysfunction, leading to over-reports of dysfunction in minority communities. This study investigates perceptions of residential outdoor air quality by linking objective data on built and social environments with multiple measures of pollution and a representative survey of Chicago residents. Consistent with the scholarly narrative, results show air quality is rated worse where minorities and poverty are concentrated, even after extensive adjustment for objective pollution and built environment measures. Perceptions of air pollution may thus be driven by neighborhood socioeconomic position far more than by respondents’ ability to perceive pollution. The finding that 63.5% of the sample reported excellent or good air quality helps to explain current challenging in promoting environmental action. PMID:26527847

Optimal Energy Management for a Smart Grid using Resource-Aware Utility Maximization

NASA Astrophysics Data System (ADS)

Abegaz, Brook W.; Mahajan, Satish M.; Negeri, Ebisa O.

2016-06-01

Heterogeneous energy prosumers are aggregated to form a smart grid based energy community managed by a central controller which could maximize their collective energy resource utilization. Using the central controller and distributed energy management systems, various mechanisms that harness the power profile of the energy community are developed for optimal, multi-objective energy management. The proposed mechanisms include resource-aware, multi-variable energy utility maximization objectives, namely: (1) maximizing the net green energy utilization, (2) maximizing the prosumers' level of comfortable, high quality power usage, and (3) maximizing the economic dispatch of energy storage units that minimize the net energy cost of the energy community. Moreover, an optimal energy management solution that combines the three objectives has been implemented by developing novel techniques of optimally flexible (un)certainty projection and appliance based pricing decomposition in an IBM ILOG CPLEX studio. A real-world, per-minute data from an energy community consisting of forty prosumers in Amsterdam, Netherlands is used. Results show that each of the proposed mechanisms yields significant increases in the aggregate energy resource utilization and welfare of prosumers as compared to traditional peak-power reduction methods. Furthermore, the multi-objective, resource-aware utility maximization approach leads to an optimal energy equilibrium and provides a sustainable energy management solution as verified by the Lagrangian method. The proposed resource-aware mechanisms could directly benefit emerging energy communities in the world to attain their energy resource utilization targets.

[Refractive precision and objective quality of vision after toric lens implantation in cataract surgery].

PubMed

Debois, A; Nochez, Y; Bezo, C; Bellicaud, D; Pisella, P-J

2012-10-01

To study efficacy and predictability of toric IOL implantation for correction of preoperative corneal astigmatism by analysing spherocylindrical refractive precision and objective quality of vision. Prospective study of 13 eyes undergoing micro-incisional cataract surgery through a 1.8mm corneal incision with toric IOL implantation (Lentis L313T(®), Oculentis) to treat over one D of preoperative corneal astigmatism. Preoperative evaluation included keratometry, subjective refraction, and total and corneal aberrometry (KR-1(®), Topcon). Six months postoperatively, measurements included slit lamp photography, documenting IOL rotation, tilt or decentration, uncorrected visual acuity, best-corrected visual acuity and objective quality of vision measurement (OQAS(®) Visiometrics, Spain). Postoperatively, mean uncorrected distance visual acuity was 8.33/10 ± 1.91 (0.09 ± 0.11 LogMar). Mean postoperative refractive sphere was 0.13 ± 0.73 diopters. Mean refractive astigmatism was -0.66 ± 0.56 diopters with corneal astigmatism of 2.17 ± 0.68 diopters. Mean IOL rotation was 4.4° ± 3.6° (range 0° to 10°). Mean rotation of this IOL at 6 months was less than 5°, demonstrating stability of the optic within the capsular bag. Objective quality of vision measurements were consistent with subjective uncorrected visual acuity. Implantation of the L313T(®) IOL is safe and effective for correction of corneal astigmatism in 1.8mm micro-incisional cataract surgery. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Assessing Program Learning Objectives to Improve Undergraduate Physics Education

NASA Astrophysics Data System (ADS)

Menke, Carrie

2014-03-01

Our physics undergraduate program has five program learning objectives (PLOs) focusing on (1) physical principles, (2) mathematical expertise, (3) experimental technique, (4) communication and teamwork, and (5) research proficiency. One PLO is assessed each year, with the results guiding modifications in our curriculum and future assessment practices; we have just completed our first cycle of assessing all PLOs. Our approach strives to maximize the ease and applicability of our assessment practices while maintaining faculty's flexibility in course design and delivery. Objectives are mapped onto our core curriculum with identified coursework collected as direct evidence. We've utilized mostly descriptive rubrics, applying them at the course and program levels as well as sharing them with the students. This has resulted in more efficient assessment that is also applicable to reaccreditation efforts, higher inter-rater reliability than with other rubric types, and higher quality capstone projects. We've also found that the varied quality of student writing can interfere with our assessment of other objectives. This poster outlines our processes, resources, and how we have used PLO assessment to strengthen our undergraduate program.

Measurement of utility.

PubMed

Thavorncharoensap, Montarat

2014-05-01

The Quality Adjusted Life Year (QALY) is the most widely recommended health outcome measure for use in economic evaluations. The QALY gives a value to the effect of a given health intervention in terms of both quantity and quality. QALYs are calculated by multiplying the duration of time spent in a given health state, in years, by the quality of life weighted, known as utility. Utility can range from 0 (the worst health state-the equivalent of death) to 1 (the best health state-full health). This paper provides an overview of the various methods that can be used to measure utility and outlines the recommended protocol for measuring utility, as described in the Guidelines for Health Technology Assessment in Thailand (second edition). The recommendations are as follows: Wherever possible, primary data collection using EQ-5D-3L in patients using Thai value sets generated from the general public should be used. Where the EQ-5D-3L is considered inappropriate, other methods such as Standard gamble (SG), Time-trade-off (TTO), Visual analogue scale (VAS), Health Utilities Index (HUI), SF-6D, or Quality of well being (QWB) can be used. However, justification and full details on the chosen instrument should always be provided.

Cost and time benefits for using subsurface utility engineering in Louisiana : research project capsule.

DOT National Transportation Integrated Search

2016-04-01

The objectives of this research are: to establish a record of all major projects : where DOTD has used SUE services in the past (SUE quality levels depicted : in Figure 1), including : interviews with various : DOTD personnel, : utility companies, an...

Object recognition and pose estimation of planar objects from range data

NASA Technical Reports Server (NTRS)

Pendleton, Thomas W.; Chien, Chiun Hong; Littlefield, Mark L.; Magee, Michael

1994-01-01

The Extravehicular Activity Helper/Retriever (EVAHR) is a robotic device currently under development at the NASA Johnson Space Center that is designed to fetch objects or to assist in retrieving an astronaut who may have become inadvertently de-tethered. The EVAHR will be required to exhibit a high degree of intelligent autonomous operation and will base much of its reasoning upon information obtained from one or more three-dimensional sensors that it will carry and control. At the highest level of visual cognition and reasoning, the EVAHR will be required to detect objects, recognize them, and estimate their spatial orientation and location. The recognition phase and estimation of spatial pose will depend on the ability of the vision system to reliably extract geometric features of the objects such as whether the surface topologies observed are planar or curved and the spatial relationships between the component surfaces. In order to achieve these tasks, three-dimensional sensing of the operational environment and objects in the environment will therefore be essential. One of the sensors being considered to provide image data for object recognition and pose estimation is a phase-shift laser scanner. The characteristics of the data provided by this scanner have been studied and algorithms have been developed for segmenting range images into planar surfaces, extracting basic features such as surface area, and recognizing the object based on the characteristics of extracted features. Also, an approach has been developed for estimating the spatial orientation and location of the recognized object based on orientations of extracted planes and their intersection points. This paper presents some of the algorithms that have been developed for the purpose of recognizing and estimating the pose of objects as viewed by the laser scanner, and characterizes the desirability and utility of these algorithms within the context of the scanner itself, considering data quality and

The Sensitivity of Derived Estimates to the Measurement Quality Objectives for Independent Variables

Treesearch

Francis A. Roesch

2005-01-01

The effect of varying the allowed measurement error for individual tree variables upon county estimates of gross cubic-foot volume was examined. Measurement Quality Objectives (MQOs) for three forest tree variables (biological identity, diameter, and height) used in individual tree gross cubic-foot volume equations were varied from the current USDA Forest Service...

Comparison of the performance of intraoral X-ray sensors using objective image quality assessment.

PubMed

Hellén-Halme, Kristina; Johansson, Curt; Nilsson, Mats

2016-05-01

The main aim of this study was to evaluate the performance of 10 individual sensors of the same make, using objective measures of key image quality parameters. A further aim was to compare 8 brands of sensors. Ten new sensors of 8 different models from 6 manufacturers (i.e., 80 sensors) were included in the study. All sensors were exposed in a standardized way using an X-ray tube voltage of 60 kVp and different exposure times. Sensor response, noise, low-contrast resolution, spatial resolution and uniformity were measured. Individual differences between sensors of the same brand were surprisingly large in some cases. There were clear differences in the characteristics of the different brands of sensors. The largest variations were found for individual sensor response for some of the brands studied. Also, noise level and low contrast resolution showed large variations between brands. Sensors, even of the same brand, vary significantly in their quality. It is thus valuable to establish action levels for the acceptance of newly delivered sensors and to use objective image quality control for commissioning purposes and periodic checks to ensure high performance of individual digital sensors. Copyright © 2016 Elsevier Inc. All rights reserved.

Quality of Life and Cost Effectiveness of Prostate Cancer Treatment

DTIC Science & Technology

2008-03-01

Study objective is to assess the effects of different treatments for prostate cancer on quality of life and cost of care for two ethnic groups. It...across ethnic groups; and (3) analyze resource utilization patterns, treatment modalities and quality of life of men with prostate cancer between non-VA

JPEG vs. JPEG 2000: an objective comparison of image encoding quality

NASA Astrophysics Data System (ADS)

Ebrahimi, Farzad; Chamik, Matthieu; Winkler, Stefan

2004-11-01

This paper describes an objective comparison of the image quality of different encoders. Our approach is based on estimating the visual impact of compression artifacts on perceived quality. We present a tool that measures these artifacts in an image and uses them to compute a prediction of the Mean Opinion Score (MOS) obtained in subjective experiments. We show that the MOS predictions by our proposed tool are a better indicator of perceived image quality than PSNR, especially for highly compressed images. For the encoder comparison, we compress a set of 29 test images with two JPEG encoders (Adobe Photoshop and IrfanView) and three JPEG2000 encoders (JasPer, Kakadu, and IrfanView) at various compression ratios. We compute blockiness, blur, and MOS predictions as well as PSNR of the compressed images. Our results show that the IrfanView JPEG encoder produces consistently better images than the Adobe Photoshop JPEG encoder at the same data rate. The differences between the JPEG2000 encoders in our test are less pronounced; JasPer comes out as the best codec, closely followed by IrfanView and Kakadu. Comparing the JPEG- and JPEG2000-encoding quality of IrfanView, we find that JPEG has a slight edge at low compression ratios, while JPEG2000 is the clear winner at medium and high compression ratios.

Effect of geometrical features various objects on the data quality obtained with measured by TLS

NASA Astrophysics Data System (ADS)

Pawłowicz, J. A.

2017-08-01

Collecting data on different building structures using Terrestrial Laser Scanning (TLS) has become in recent years a very popular due to minimize the time required to complete the task as compared to traditional methods. Technical parameters of 3D scanning devices (digitizers) are increasingly being improved, and the accuracy of the data collected allows you to play not only the geometry of an existing object in a digital image, but also enables the assessment of his condition. This is possible thanks to the digitalization of existing objects e.g., a 3D laser scanner, with which is obtained a digital data base is presented in the form of a cloud of points and by using reverse engineering. Measurements using laser scanners depends to a large extent, on the quality of the returning beam reflected from the target surface, towards the receiver. High impact on the strength and quality of the beam returning to the geometric features of the object. These properties may contribute to the emergence of some, sometimes even serious errors during scanning of various shapes. The study defined the effect of the laser beam distortion during the measurement objects with the same material but with different geometrical features on their three-dimensional imaging obtained from measurements made using TLS. We present the problem of data quality, dependent on the deflection of the beam intensity and shape of the object selected examples. The knowledge of these problems allows to obtain valuable data necessary for the implementation of digitization and the visualization of virtually any building structure made of any materials. The studies has been proven that the increase in the density of scanning does not affect the values of mean square error. The increase in the angle of incidence of the beam onto a flat surface, however, causes a decrease in the intensity of scattered radiation that reaches the receiver. The article presents an analysis of the laser beam reflected from broken at

DOT report for implementing OMB's information dissemination quality guidelines

DOT National Transportation Integrated Search

2002-08-01

Consistent with The Office of : Management and Budgets (OMB) Guidelines (for Ensuring and Maximizing the Quality, : Objectivity, Utility, and Integrity of Information Disseminated by Federal Agencies) : implementing Section 515 of the Treasury and...

The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS)--quality of life during the first 4 months after fracture.

PubMed

Borgström, F; Lekander, I; Ivergård, M; Ström, O; Svedbom, A; Alekna, V; Bianchi, M L; Clark, P; Curiel, M D; Dimai, H P; Jürisson, M; Kallikorm, R; Lesnyak, O; McCloskey, E; Nassonov, E; Sanders, K M; Silverman, S; Tamulaitiene, M; Thomas, T; Tosteson, A N A; Jönsson, B; Kanis, J A

2013-03-01

The quality of life during the first 4 months after fracture was estimated in 2,808 fractured patients from 11 countries. Analysis showed that there were significant differences in the quality of life (QoL) loss between countries. Other factors such as QoL prior fracture and hospitalisation also had a significant impact on the QoL loss. The International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS) was initiated in 2007 with the objective of estimating costs and quality of life related to fractures in several countries worldwide. The ICUROS is ongoing and enrols patients in 11 countries (Australia, Austria, Estonia, France, Italy, Lithuania, Mexico, Russia, Spain, UK and the USA). The objective of this paper is to outline the study design of ICUROS and present results regarding the QoL (measured using the EQ-5D) during the first 4 months after fracture based on the patients that have been thus far enrolled ICUROS. ICUROS uses a prospective study design where data (costs and quality of life) are collected in four phases over 18 months after fracture. All countries use the same core case report forms. Quality of life was collected using the EQ-5D instrument and a time trade-off questionnaire. The total sample for the analysis was 2,808 patients (1,273 hip, 987 distal forearm and 548 vertebral fracture). For all fracture types and countries, the QoL was reduced significantly after fracture compared to pre-fracture QoL. A regression analysis showed that there were significant differences in the QoL loss between countries. Also, a higher level of QoL prior to the fracture significantly increased the QoL loss and patients who were hospitalised for their fracture also had a significantly higher loss compared to those who were not. The findings in this study indicate that there appear to be important variations in the QoL decrements related to fracture between countries.

Baseline utilization of breast radiotherapy before institution of the Medicare practice quality reporting initiative.

PubMed

Smith, Benjamin D; Smith, Grace L; Roberts, Kenneth B; Buchholz, Thomas A

2009-08-01

In 2007, Medicare implemented the Physician Quality Reporting Initiative (PQRI), which provides financial incentives to physicians who report their performance on certain quality measures. PQRI measure #74 recommends radiotherapy for patients treated with conservative surgery (CS) for invasive breast cancer. As a first step in evaluating the potential impact of this measure, we assessed baseline use of radiotherapy among women diagnosed with invasive breast cancer before implementation of PQRI. Using the SEER-Medicare data set, we identified women aged 66-70 diagnosed with invasive breast cancer and treated with CS between 2000 and 2002. Treatment with radiotherapy was determined using SEER and claims data. Multivariate logistic regression tested whether receipt of radiotherapy varied significantly across clinical, pathologic, and treatment covariates. Of 3,674 patients, 94% (3,445) received radiotherapy. In adjusted analysis, the presence of comorbid illness (odds ratio [OR] 1.69; 95% confidence interval [CI], 1.19-2.42) and unmarried marital status were associated with omission of radiotherapy (OR 1.65; 95% CI, 1.22-2.20). In contrast, receipt of chemotherapy was protective against omission of radiotherapy (OR 0.25; 95% CI, 0.16-0.38). Race and geographic region did not correlate with radiotherapy utilization. Utilization of radiotherapy following CS was high for patients treated before institution of PQRI, suggesting that at most 6% of patients could benefit from measure #74. Further research is needed to determine whether institution of PQRI will affect radiotherapy utilization.

[Valuation of health-related quality of life and utilities in health economics].

PubMed

Greiner, Wolfgang; Klose, Kristina

2014-01-01

Measuring health-related quality of life is an important aspect in economic evaluation of health programmes. The development of utility-based (preference-based) measures is advanced by the discipline of health economics. Different preference measures are applied for valuing health states to produce a weighted health state index. Those preference weights should be derived from a general population sample in case of resource allocation on a collective level (as in current valuation studies of the EuroQol group). Copyright © 2014. Published by Elsevier GmbH.

Utility Analysis of Vision-related Quality of Life in Patients With Glaucoma and Different Perceptions from Ophthalmologists.

PubMed

Zhang, Shaodan; Liang, Yuanbo; Chen, Yanyun; Musch, David C; Zhang, Chun; Wang, Ningli

2015-09-01

To evaluate patient-perceived quality of life with glaucoma and to assess whether ophthalmologists fully appreciate patients' perceptions through utility analysis. Utility values were obtained from 87 glaucoma patients by linear rating scale (RS), standard gamble for blindness (SG), and time trade-off (TTO) methods. Identical questionnaires were delivered to ophthalmologists (n=26) at the same center, who were asked to assume they had mild (MD in better-seeing eye ≥-6 dB) or moderate to severe (MD in better-seeing eye <-6 dB) glaucoma. Responses from patients and ophthalmologists were compared. Patients with mild glaucoma gave a utility value of 0.70±0.14, 0.85±0.14, and 0.77±0.14 with RS, SG, and TTO method, respectively. Those with moderate to severe glaucoma generated corresponding utilities of 0.56±0.20, 0.75±0.20, and 0.78±0.11. RS and SG utilities were affected by disease severity and history of glaucoma surgery, whereas TTO utility was mainly related with education level and employment status of the patients. Ophthalmologists reported higher utility values than their patients when mild glaucoma was assumed (0.81±0.14, 0.96±0.05, and 0.95±0.05 for RS, SG, and TTO methods, respectively; P<0.05). Given the scenario of moderate to severe glaucoma, ophthalmologists gave significantly lower RS (0.35±0.21, P<0.001), but similar SG (0.74±0.27, P=0.84) and TTO (0.82±0.13, P=0.40) utility values, than the patients. Utility values are considerably decreased in Chinese patients with glaucoma. Ophthalmologists tend to substantially underestimate the impact of mild glaucoma on patients' quality of life. Better understanding patients' perceptions of glaucoma would be helpful for the establishment of shared decision making and patient-centered care.

Utilization of Expert Knowledge in a Multi-Objective Hydrologic Model Automatic Calibration Process

NASA Astrophysics Data System (ADS)

Quebbeman, J.; Park, G. H.; Carney, S.; Day, G. N.; Micheletty, P. D.

2016-12-01

Spatially distributed continuous simulation hydrologic models have a large number of parameters for potential adjustment during the calibration process. Traditional manual calibration approaches of such a modeling system is extremely laborious, which has historically motivated the use of automatic calibration procedures. With a large selection of model parameters, achieving high degrees of objective space fitness - measured with typical metrics such as Nash-Sutcliffe, Kling-Gupta, RMSE, etc. - can easily be achieved using a range of evolutionary algorithms. A concern with this approach is the high degree of compensatory calibration, with many similarly performing solutions, and yet grossly varying parameter set solutions. To help alleviate this concern, and mimic manual calibration processes, expert knowledge is proposed for inclusion within the multi-objective functions, which evaluates the parameter decision space. As a result, Pareto solutions are identified with high degrees of fitness, but also create parameter sets that maintain and utilize available expert knowledge resulting in more realistic and consistent solutions. This process was tested using the joint SNOW-17 and Sacramento Soil Moisture Accounting method (SAC-SMA) within the Animas River basin in Colorado. Three different elevation zones, each with a range of parameters, resulted in over 35 model parameters simultaneously calibrated. As a result, high degrees of fitness were achieved, in addition to the development of more realistic and consistent parameter sets such as those typically achieved during manual calibration procedures.

EVALUATION OF STREAMBANK RESTORATION ON IN-STREAM WATER QUALITY IN AN URBAN WATERSHED

EPA Science Inventory

The objectives of this on-going project are to: investigate the effectiveness of streambank restoration techniques on increasing available biological habitat and improving in-stream water quality in an impaired stream; and, demonstrate the utility of continuous water-quality moni...

AIMING FOR THE BULL'S EYE: The Cost-Utility of Screening for Hydroxychloroquine Retinopathy.

PubMed

McClellan, Andrew J; Chang, Jonathan S; Smiddy, William E

2016-10-01

Throughout medicine, the cost of various treatments has been increasingly studied with the result that certain management guidelines might be reevaluated in their context. Cost-utility is a term referring to the expense of preventing the loss of quality of life, quantified in dollars per quality-adjusted life year. In 2002, the American Academy of Ophthalmology published hydroxychloroquine screening recommendations which were revised in 2011. The purpose of this report is to estimate the cost-utility of these recommendations. A hypothetical care model of screening for hydroxychloroquine retinopathy was formulated. The costs of screening components were calculated using 2016 Medicare fee schedules from the Centers for Medicare and Medicaid Services. The cost-utility of screening for hydroxychloroquine retinopathy with the 2011 American Academy of Ophthalmology guidelines was found to vary from 33,155 to 344,172 dollars per quality-adjusted life year depending on the type and number of objective screening tests chosen, practice setting, and the duration of hydroxychloroquine use. Screening had a more favorable cost-utility when the more sensitive and specific diagnostics were used, and for patients with an increased risk of toxicity. American Academy of Ophthalmology guidelines have a wide-ranging cost-utility. Prudent clinical judgment of risk stratification and tests chosen is necessary to optimize cost-utility without compromising the efficacy of screening.

Performance evaluation of objective quality metrics for HDR image compression

NASA Astrophysics Data System (ADS)

Valenzise, Giuseppe; De Simone, Francesca; Lauga, Paul; Dufaux, Frederic

2014-09-01

Due to the much larger luminance and contrast characteristics of high dynamic range (HDR) images, well-known objective quality metrics, widely used for the assessment of low dynamic range (LDR) content, cannot be directly applied to HDR images in order to predict their perceptual fidelity. To overcome this limitation, advanced fidelity metrics, such as the HDR-VDP, have been proposed to accurately predict visually significant differences. However, their complex calibration may make them difficult to use in practice. A simpler approach consists in computing arithmetic or structural fidelity metrics, such as PSNR and SSIM, on perceptually encoded luminance values but the performance of quality prediction in this case has not been clearly studied. In this paper, we aim at providing a better comprehension of the limits and the potentialities of this approach, by means of a subjective study. We compare the performance of HDR-VDP to that of PSNR and SSIM computed on perceptually encoded luminance values, when considering compressed HDR images. Our results show that these simpler metrics can be effectively employed to assess image fidelity for applications such as HDR image compression.

Data Quality Objectives Supporting Radiological Air Emissions Monitoring for the Marine Sciences Laboratory, Sequim Site

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

Barnett, J. Matthew; Meier, Kirsten M.; Snyder, Sandra F.

2012-12-27

This document of Data Quality Objectives (DQOs) was prepared based on the U.S. Environmental Protection Agency (EPA) Guidance on Systematic Planning Using the Data Quality Objectives Process, EPA, QA/G4, 2/2006 (EPA 2006), as well as several other published DQOs. The intent of this report is to determine the necessary steps required to ensure that radioactive emissions to the air from the Marine Sciences Laboratory (MSL) headquartered at the Pacific Northwest National Laboratory’s Sequim Marine Research Operations (Sequim Site) on Washington State’s Olympic Peninsula are managed in accordance with regulatory requirements and best practices. The Sequim Site was transitioned in Octobermore » 2012 from private operation under Battelle Memorial Institute to an exclusive use contract with the U.S. Department of Energy, Office of Science, Pacific Northwest Site Office.« less

Appropriate Importation and Effective Utilization of Top Quality Foreign Higher Education Resources for Sino-Foreign Cooperation in Running Schools

ERIC Educational Resources Information Center

Jinhui, Lin; Zhiping, Liu

2009-01-01

The appropriate importation and effective utilization of superior-quality foreign higher education resources are crucial to enhance the level and quality of school administration cooperation with foreign partners because it can not only make up for the shortage in domestic education resources and push forward China's higher education reform but…

Identifying influence of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

PubMed

Karim, R M; Abdullah, M S; Rahman, A M; Alam, A M

2015-04-01

Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic (CC) services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 Community Clinics (CCs). Since most of the outcome indicators focus mainly on women and children, women having children less than two years of age were randomly assigned and interviewed for the study purpose. Data for the development of perceived service quality and satisfaction tools were collected through Focus Group Discussion (FGD), key informants interview and data for measuring the utilization status were collected by an interviewer administered pretested semi-structured questionnaire. About 95% of the respondents were Muslims and 5% were Hindus. The average age of the respondents was 23.38 (SD ± 4.15) years and almost all of them are home makers. The average monthly expenditure of their family was 7462.92 (SD ± 2545) BDT equivalent to 95 (SD ± 32) US$. To measure lay peoples' perception and satisfaction regarding primary health care service quality two scales e.g. Slim Haddad's 20-item scale for measuring perceived quality of primary health care services (PQPCS) validated in Guinea and Burkina Fuso and primary care satisfaction survey for women (PCSSW) developed by Scholle and colleagues 2004; is a 24-item survey tool validated in Turkey were chosen as a reference tools. Based on those, two psychometric research instruments; 24 items PQPCS scale (chronbach's α =0.89) and 22-items Community Clinic

Pragmatic open space box utilization: asteroid survey model using distributed objects management based articulation (DOMBA)

NASA Astrophysics Data System (ADS)

Mohammad, Atif Farid; Straub, Jeremy

2015-05-01

A multi-craft asteroid survey has significant data synchronization needs. Limited communication speeds drive exacting performance requirements. Tables have been used in Relational Databases, which are structure; however, DOMBA (Distributed Objects Management Based Articulation) deals with data in terms of collections. With this, no read/write roadblocks to the data exist. A master/slave architecture is created by utilizing the Gossip protocol. This facilitates expanding a mission that makes an important discovery via the launch of another spacecraft. The Open Space Box Framework facilitates the foregoing while also providing a virtual caching layer to make sure that continuously accessed data is available in memory and that, upon closing the data file, recharging is applied to the data.

Quality of life and health care utilization in patients with chronic respiratory diseases.

PubMed

Kurpas, D; Mroczek, B; Sitko, Z; Helicka, D; Kuchar, E

2015-01-01

High quality of life (QoL) may reduce the costs of medical care of chronically ill patients due to lower health care utilization. The purpose of this study was to establish the influence of the QoL of primary care patients with chronic respiratory diseases on the level of health care utilization and the predictors of hospitalization. The study group consisted of 594 adult patients with chronic respiratory diseases of the mean age 59.8±14.9 years. The highest QoL was observed in the social relationship domain and the lowest in the physical domain. Low QoL was associated with a low level of health care utilization among patients with chronic respiratory diseases. Most patients were hospitalized during the past 3 years. In a group of patients with chronic respiratory diseases, chances for hospitalization were: higher among patients with low QoL and health satisfaction, low QoL levels in the physical and social relationship domains, high QoL levels in the psychological domain, those with higher education, residents of rural areas, patients using frequent consultations over the phone, and those with at least an average index of services.

Improvement of image quality of coherently illuminated objects in a turbulent atmosphere

NASA Astrophysics Data System (ADS)

Banakh, Viktor A.; Chen, Ben-Nam

1994-06-01

It is shown that the phenomenon of correlation of opposing waves may lead to improvement of image quality of coherently illuminated objects in a turbulent atmosphere in the case of strong intensity fluctuations. The extent of this improvement depends on the relation between sizes of the output and receiving apertures. The betterment of visibility in a turbulent atmosphere becomes maximal in the case of their proximity and vanishes if the sizes of illuminating and receiving apertures are distinguished from each other significantly.

Objective assessment of image quality. IV. Application to adaptive optics

PubMed Central

Barrett, Harrison H.; Myers, Kyle J.; Devaney, Nicholas; Dainty, Christopher

2008-01-01

The methodology of objective assessment, which defines image quality in terms of the performance of specific observers on specific tasks of interest, is extended to temporal sequences of images with random point spread functions and applied to adaptive imaging in astronomy. The tasks considered include both detection and estimation, and the observers are the optimal linear discriminant (Hotelling observer) and the optimal linear estimator (Wiener). A general theory of first- and second-order spatiotemporal statistics in adaptive optics is developed. It is shown that the covariance matrix can be rigorously decomposed into three terms representing the effect of measurement noise, random point spread function, and random nature of the astronomical scene. Figures of merit are developed, and computational methods are discussed. PMID:17106464

Data Quality Objectives for Tank Farms Waste Compatibility Program

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

BANNING, D.L.

1999-07-02

There are 177 waste storage tanks containing over 210,000 m{sup 3} (55 million gal) of mixed waste at the Hanford Site. The River Protection Project (RPP) has adopted the data quality objective (DQO) process used by the U.S. Environmental Protection Agency (EPA) (EPA 1994a) and implemented by RPP internal procedure (Banning 1999a) to identify the information and data needed to address safety issues. This DQO document is based on several documents that provide the technical basis for inputs and decision/action levels used to develop the decision rules that evaluate the transfer of wastes. A number of these documents are presentlymore » in the process of being revised. This document will need to be revised if there are changes to the technical criteria in these supporting documents. This DQO process supports various documents, such as sampling and analysis plans and double-shell tank (DST) waste analysis plans. This document identifies the type, quality, and quantity of data needed to determine whether transfer of supernatant can be performed safely. The requirements in this document are designed to prevent the mixing of incompatible waste as defined in Washington Administrative Code (WAC) 173-303-040. Waste transfers which meet the requirements contained in this document and the Double-Shell Tank Waste Analysis Plan (Mulkey 1998) are considered to be compatible, and prevent the mixing of incompatible waste.« less

A quality assurance framework for the fully automated and objective evaluation of image quality in cone-beam computed tomography.

PubMed

Steiding, Christian; Kolditz, Daniel; Kalender, Willi A

2014-03-01

Thousands of cone-beam computed tomography (CBCT) scanners for vascular, maxillofacial, neurological, and body imaging are in clinical use today, but there is no consensus on uniform acceptance and constancy testing for image quality (IQ) and dose yet. The authors developed a quality assurance (QA) framework for fully automated and time-efficient performance evaluation of these systems. In addition, the dependence of objective Fourier-based IQ metrics on direction and position in 3D volumes was investigated for CBCT. The authors designed a dedicated QA phantom 10 cm in length consisting of five compartments, each with a diameter of 10 cm, and an optional extension ring 16 cm in diameter. A homogeneous section of water-equivalent material allows measuring CT value accuracy, image noise and uniformity, and multidimensional global and local noise power spectra (NPS). For the quantitative determination of 3D high-contrast spatial resolution, the modulation transfer function (MTF) of centrally and peripherally positioned aluminum spheres was computed from edge profiles. Additional in-plane and axial resolution patterns were used to assess resolution qualitatively. The characterization of low-contrast detectability as well as CT value linearity and artifact behavior was tested by utilizing sections with soft-tissue-equivalent and metallic inserts. For an automated QA procedure, a phantom detection algorithm was implemented. All tests used in the dedicated QA program were initially verified in simulation studies and experimentally confirmed on a clinical dental CBCT system. The automated IQ evaluation of volume data sets of the dental CBCT system was achieved with the proposed phantom requiring only one scan for the determination of all desired parameters. Typically, less than 5 min were needed for phantom set-up, scanning, and data analysis. Quantitative evaluation of system performance over time by comparison to previous examinations was also verified. The maximum

Consumer-based technology for distribution of surgical videos for objective evaluation.

PubMed

Gonzalez, Ray; Martinez, Jose M; Lo Menzo, Emanuele; Iglesias, Alberto R; Ro, Charles Y; Madan, Atul K

2012-08-01

The Global Operative Assessment of Laparoscopic Skill (GOALS) is one validated metric utilized to grade laparoscopic skills and has been utilized to score recorded operative videos. To facilitate easier viewing of these recorded videos, we are developing novel techniques to enable surgeons to view these videos. The objective of this study is to determine the feasibility of utilizing widespread current consumer-based technology to assist in distributing appropriate videos for objective evaluation. Videos from residents were recorded via a direct connection from the camera processor via an S-video output via a cable into a hub to connect to a standard laptop computer via a universal serial bus (USB) port. A standard consumer-based video editing program was utilized to capture the video and record in appropriate format. We utilized mp4 format, and depending on the size of the file, the videos were scaled down (compressed), their format changed (using a standard video editing program), or sliced into multiple videos. Standard available consumer-based programs were utilized to convert the video into a more appropriate format for handheld personal digital assistants. In addition, the videos were uploaded to a social networking website and video sharing websites. Recorded cases of laparoscopic cholecystectomy in a porcine model were utilized. Compression was required for all formats. All formats were accessed from home computers, work computers, and iPhones without difficulty. Qualitative analyses by four surgeons demonstrated appropriate quality to grade for these formats. Our preliminary results show promise that, utilizing consumer-based technology, videos can be easily distributed to surgeons to grade via GOALS via various methods. Easy accessibility may help make evaluation of resident videos less complicated and cumbersome.

Learning Objects and Gerontology

ERIC Educational Resources Information Center

Weinreich, Donna M.; Tompkins, Catherine J.

2006-01-01

Virtual AGE (vAGE) is an asynchronous educational environment that utilizes learning objects focused on gerontology and a learning anytime/anywhere philosophy. This paper discusses the benefits of asynchronous instruction and the process of creating learning objects. Learning objects are "small, reusable chunks of instructional media" Wiley…

Development of high quality pervious concrete specifications for Maryland conditions.

DOT National Transportation Integrated Search

2013-02-01

One of the main objectives of this research was to develop preliminary specifications for high quality : pervious concrete suitable for use in Maryland State Highway Administration (SHA) projects. The study : utilized aggregates that are used in SHA ...

Neural Mechanisms of the Transformation from Objective Value to Subjective Utility: Converting from Count to Worth.

PubMed

Kurnianingsih, Yoanna A; Mullette-Gillman, O'Dhaniel A

2016-01-01

When deciding, we aim to choose the "best" possible outcome. This is not just selection of the option that is the most numerous or physically largest, as options are translated from objective value (count) to subjective value (worth or utility). We localized the neural instantiation of the value-to-utility transformation to the dorsal anterior midcingulate cortex (daMCC), with independent replication. The daMCC encodes the context-specific information necessary to convert from count to worth. This encoding is not simply a representation of utility or preference, but the interaction of the two. Specifically, the relationship of brain activation to value is dependent on individual preference, with both positive and negative slopes across the population depending on whether each individual's preference results in enhancement or diminishment of the valuation. For a given value, across participants, enhanced daMCC activation corresponds to diminished subjective valuation, deactivation to enhanced subjective valuation, and non-modulated activation with non-modulated subjective valuation. Further, functional connectivity analyses identified brain regions (positive connectivity with the inferior frontal gyrus and negative connectivity with the nucleus accumbens) through which contextual information may be integrated into the daMCC and allow for outputs to modulate valuation signals. All analyses were replicated through an independent within-study replication, with initial testing in the gains domain and replication in the intermixed and mirrored losses trials. We also present and discuss an ancillary finding: we were unable to identify parametric value signals for losses through whole-brain analyses, and ROI analyses of the vmPFC presented non-modulation across loss value levels. These results identify the neural locus of the value-to-utility transformation, and provide a specific computational function for the daMCC in the production of subjective valuation through the

Neural Mechanisms of the Transformation from Objective Value to Subjective Utility: Converting from Count to Worth

PubMed Central

Kurnianingsih, Yoanna A.; Mullette-Gillman, O'Dhaniel A.

2016-01-01

When deciding, we aim to choose the “best” possible outcome. This is not just selection of the option that is the most numerous or physically largest, as options are translated from objective value (count) to subjective value (worth or utility). We localized the neural instantiation of the value-to-utility transformation to the dorsal anterior midcingulate cortex (daMCC), with independent replication. The daMCC encodes the context-specific information necessary to convert from count to worth. This encoding is not simply a representation of utility or preference, but the interaction of the two. Specifically, the relationship of brain activation to value is dependent on individual preference, with both positive and negative slopes across the population depending on whether each individual's preference results in enhancement or diminishment of the valuation. For a given value, across participants, enhanced daMCC activation corresponds to diminished subjective valuation, deactivation to enhanced subjective valuation, and non-modulated activation with non-modulated subjective valuation. Further, functional connectivity analyses identified brain regions (positive connectivity with the inferior frontal gyrus and negative connectivity with the nucleus accumbens) through which contextual information may be integrated into the daMCC and allow for outputs to modulate valuation signals. All analyses were replicated through an independent within-study replication, with initial testing in the gains domain and replication in the intermixed and mirrored losses trials. We also present and discuss an ancillary finding: we were unable to identify parametric value signals for losses through whole-brain analyses, and ROI analyses of the vmPFC presented non-modulation across loss value levels. These results identify the neural locus of the value-to-utility transformation, and provide a specific computational function for the daMCC in the production of subjective valuation through

Health state utilities among contemporary prostate cancer patients on active surveillance.

PubMed

Loeb, Stacy; Curnyn, Caitlin; Walter, Dawn; Fagerlin, Angela; Siebert, Uwe; Mühlberger, Nick; Braithwaite, R Scott; Schwartz, Mark D; Lepor, Herbert; Sedlander, Erica

2018-04-01

Active surveillance (AS) is the most rapidly expanding management option for favorable-risk prostate cancer (PCa). Early studies suggested substantial decrements in utility (quality of life weights) from disease-related anxiety. Our objective was to determine utilities for contemporary AS patients using different instruments. We performed a systematic review of PubMed, PMC and OVID for utility measurements in modern AS patients. We then examined utilities among 37 men on AS participating in focus groups between 2015-2016 using the generic EurQol five dimensions questionnaire (EQ-5D-3L) and Patient Oriented Prostate Utility Scale (PORPUS), a PCa-specific instrument. The systematic review found previous studies with utilities for PCa treatment and historical watchful waiting populations, but none specifically in contemporary AS. In our AS population, the mean EQ-5D-3L score was 0.90±0.16 (median, 1.00; range, 0.21-1.00) and PORPUS was 0.98±0.03 (median, 0.99; range, 0.84-1.00). The Spearman correlation between the EQ-5D-3L and PORPUS was 0.87 (P<0.0001), and 38% of patients had a difference >0.1 between instruments. Most contemporary AS patients had high utility scores suggesting that they perceive themselves in good health without a major decrement in quality of life from the disease. However, some patients had substantial differences in utility measured with generic versus disease-specific instruments. Further study is warranted into the optimal instrument for utility assessment in contemporary AS patients.

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.

Diabetes quality of care and outpatient utilization associated with electronic patient-provider messaging: a cross-sectional analysis.

PubMed

Harris, Lynne T; Haneuse, Sebastien J; Martin, Diane P; Ralston, James D

2009-07-01

To test the hypothesis that electronic patient-provider messaging is associated with high care quality for diabetes and lower outpatient utilization. We conducted a cross-sectional analysis of electronic patient-provider messaging over a 15-month period between 1 January 2004 and 31 March 2005. The study was set at Group Health Cooperative--a consumer-governed, nonprofit health care system that operates in Washington and Idaho. Participants included all patients aged >or=18 years with a diagnosis of diabetes. In addition to usual care, all patients had the option to use electronic messaging to communicate with their care providers. The primary outcome measures were diabetes-related quality-of-care indicators (A1C, blood pressure, and LDL cholesterol) and outpatient visits (primary care, specialty care, and emergency). Nineteen percent of patients with diabetes used electronic messaging to communicate with their care providers during the study period (n = 2,924) (overall study cohort: 15,427 subjects). In multivariate models, frequent use of electronic messaging was associated with A1C <7% (relative risk [RR] 1.36 [95% CI 1.16-1.58]). Contrary to our hypothesis, frequent use of electronic messaging was also associated with a higher rate of outpatient visits (1.39 [1.26-1.53]). Frequent use of electronic secure messaging is associated with better glycemic control and increased outpatient utilization. Electronic patient-provider communication may represent one strategy to meet the health care needs of this unique population. More research is necessary to assess the effect of electronic messaging on care quality and utilization.

Potential Re-utilization of Composted Mangrove Litters for Pond Environment Quality Improvement

NASA Astrophysics Data System (ADS)

Dwi Hastuti, Endah; Budi Hastuti, Rini; Hariyati, Riche

2018-05-01

Production of mangrove litter from pruning and thinning activities is potential source of organic materials which could be re-utilized to improve pond environment quality and fertility. This research aimed to analyze the nutrient composition compost produced from mangrove litter and to describe the effect of compost application on pond quality. This research was conducted through two phases, including composting trial and application of compost on pond trial. Composting process was conducted for 45-60 days on mangrove litter achieved from pruning activities in the silvofishery pond using composting container, while application of compost in pond was conducted by pouring 2 kg of compost in 25 m2 pond. Production of compost included solid compost and liquid compost. Nutrient concentration of solid compost was ranged from 0.47-0.52% for N; 0.36-0.44% for P; and 5.45-6.39% for organic C, while liquid compost provided 0.62-0.69%; 0.24-0.32%; and 3.98-4.45% respectively for N, P and organic C. While C/N ratio was ranged from 11.60-12.78 and 5.77-7.18 respectively for solid and liquid compost. Solid compost quality resulted that N, P and C/N ration had fulfilled the standart criteria defined by Indonesia National Standart for compost. Observed impact of compost application on pond water quality were the improvement of water clarity and increasing abundance of klekap (lab-lab). This showed that mangrove litters could be converted into a more productive materials to enhance pond environment quality and productivity, decrease management cost and increase benefit. Scheduled fertilization with compost is suggested to be conducted to provide best benefit on silvofishery management.

Quality control and quality assurance plan for bridge channel-stability assessments in Massachusetts

USGS Publications Warehouse

Parker, Gene W.; Pinson, Harlow

1993-01-01

A quality control and quality assurance plan has been implemented as part of the Massachusetts bridge scour and channel-stability assessment program. This program is being conducted by the U.S. Geological Survey, Massachusetts-Rhode Island District, in cooperation with the Massachusetts Highway Department. Project personnel training, data-integrity verification, and new data-management technologies are being utilized in the channel-stability assessment process to improve current data-collection and management techniques. An automated data-collection procedure has been implemented to standardize channel-stability assessments on a regular basis within the State. An object-oriented data structure and new image management tools are used to produce a data base enabling management of multiple data object classes. Data will be reviewed by assessors and data base managers before being merged into a master bridge-scour data base, which includes automated data-verification routines.

DATA QUALITY OBJECTIVES AND STATISTICAL DESIGN SUPPORT FOR DEVELOPMENT OF A MONITORING PROTOCOL FOR RECREATIONAL WATERS

EPA Science Inventory

The purpose of this report is to describe the outputs of the Data Quality Objectives (DQOs) Process and discussions about developing a statistical design that will be used to implement the research study of recreational beach waters.

A sound quality model for objective synthesis evaluation of vehicle interior noise based on artificial neural network

NASA Astrophysics Data System (ADS)

Wang, Y. S.; Shen, G. Q.; Xing, Y. F.

2014-03-01

Based on the artificial neural network (ANN) technique, an objective sound quality evaluation (SQE) model for synthesis annoyance of vehicle interior noises is presented in this paper. According to the standard named GB/T18697, firstly, the interior noises under different working conditions of a sample vehicle are measured and saved in a noise database. Some mathematical models for loudness, sharpness and roughness of the measured vehicle noises are established and performed by Matlab programming. Sound qualities of the vehicle interior noises are also estimated by jury tests following the anchored semantic differential (ASD) procedure. Using the objective and subjective evaluation results, furthermore, an ANN-based model for synthetical annoyance evaluation of vehicle noises, so-called ANN-SAE, is developed. Finally, the ANN-SAE model is proved by some verification tests with the leave-one-out algorithm. The results suggest that the proposed ANN-SAE model is accurate and effective and can be directly used to estimate sound quality of the vehicle interior noises, which is very helpful for vehicle acoustical designs and improvements. The ANN-SAE approach may be extended to deal with other sound-related fields for product quality evaluations in SQE engineering.

Creation of a simple natural language processing tool to support an imaging utilization quality dashboard.

PubMed

Swartz, Jordan; Koziatek, Christian; Theobald, Jason; Smith, Silas; Iturrate, Eduardo

2017-05-01

Testing for venous thromboembolism (VTE) is associated with cost and risk to patients (e.g. radiation). To assess the appropriateness of imaging utilization at the provider level, it is important to know that provider's diagnostic yield (percentage of tests positive for the diagnostic entity of interest). However, determining diagnostic yield typically requires either time-consuming, manual review of radiology reports or the use of complex and/or proprietary natural language processing software. The objectives of this study were twofold: 1) to develop and implement a simple, user-configurable, and open-source natural language processing tool to classify radiology reports with high accuracy and 2) to use the results of the tool to design a provider-specific VTE imaging dashboard, consisting of both utilization rate and diagnostic yield. Two physicians reviewed a training set of 400 lower extremity ultrasound (UTZ) and computed tomography pulmonary angiogram (CTPA) reports to understand the language used in VTE-positive and VTE-negative reports. The insights from this review informed the arguments to the five modifiable parameters of the NLP tool. A validation set of 2,000 studies was then independently classified by the reviewers and by the tool; the classifications were compared and the performance of the tool was calculated. The tool was highly accurate in classifying the presence and absence of VTE for both the UTZ (sensitivity 95.7%; 95% CI 91.5-99.8, specificity 100%; 95% CI 100-100) and CTPA reports (sensitivity 97.1%; 95% CI 94.3-99.9, specificity 98.6%; 95% CI 97.8-99.4). The diagnostic yield was then calculated at the individual provider level and the imaging dashboard was created. We have created a novel NLP tool designed for users without a background in computer programming, which has been used to classify venous thromboembolism reports with a high degree of accuracy. The tool is open-source and available for download at http

Diabetes and Hypertension Quality Measurement in Four Safety-Net Sites

PubMed Central

Benkert, R.; Dennehy, P.; White, J.; Hamilton, A.; Tanner, C.

2014-01-01

Summary Background In this new era after the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, the literature on lessons learned with electronic health record (EHR) implementation needs to be revisited. Objectives Our objective was to describe what implementation of a commercially available EHR with built-in quality query algorithms showed us about our care for diabetes and hypertension populations in four safety net clinics, specifically feasibility of data retrieval, measurements over time, quality of data, and how our teams used this data. Methods A cross-sectional study was conducted from October 2008 to October 2012 in four safety-net clinics located in the Midwest and Western United States. A data warehouse that stores data from across the U.S was utilized for data extraction from patients with diabetes or hypertension diagnoses and at least two office visits per year. Standard quality measures were collected over a period of two to four years. All sites were engaged in a partnership model with the IT staff and a shared learning process to enhance the use of the quality metrics. Results While use of the algorithms was feasible across sites, challenges occurred when attempting to use the query results for research purposes. There was wide variation of both process and outcome results by individual centers. Composite calculations balanced out the differences seen in the individual measures. Despite using consistent quality definitions, the differences across centers had an impact on numerators and denominators. All sites agreed to a partnership model of EHR implementation, and each center utilized the available resources of the partnership for Center-specific quality initiatives. Conclusions Utilizing a shared EHR, a Regional Extension Center-like partnership model, and similar quality query algorithms allowed safety-net clinics to benchmark and improve the quality of care across differing patient populations and health care

Short-term residential care for dementia patients: predictors for utilization and expected quality from a family caregiver's point of view.

PubMed

Donath, Carolin; Winkler, Angelika; Grässel, Elmar

2009-08-01

Short-term residential care (SRC) has proved to be effective in reducing the burden on family caregivers of dementia patients. Nevertheless, little is known about the factors which influence its usage or the expectations of family caregivers regarding quality. In this paper we address the following questions: (i) which variables of the care situation, the caregivers and their attitudes act as predictors for the utilization of SRC facilities? (ii) What are the views of caregivers about the quality of SRC? The cross-sectional study was carried out as an anonymous written survey of family caregivers of dementia patients in four regions of Germany. With a 20% response it was possible to analyze the quantitative and qualitative data from 404 and 254 family caregivers respectively. Predictors for utilization were evaluated using binary logistic regression analysis. The answers to questions of quality were evaluated using qualitative content analysis. Significant predictors for the utilization of SRC are the assessment of the helpfulness of SRC and the caregiver's knowledge of the accessibility of SRC facilities. Family caregivers who had already used SRC most frequently expressed the wish for "good care" in SRC facilities, followed by a program of suitable activities for dementia patients. In order to increase the rate of utilization, family caregivers must be convinced of the relevant advantages of using SRC facilities. The staff should be trained in caring for dementia patients and appropriate activities should be available.

Heart failure patients utilizing an electric home monitor: What effects does heart failure have on their quality of life?

NASA Astrophysics Data System (ADS)

Simuel, Gloria J.

Heart Failure continues to be a major public health problem associated with high mortality and morbidity. Heart Failure is the leading cause of hospitalization for persons older than 65 years, has a poor prognosis and is associated with poor quality of life. More than 5.3 million American adults are living with heart failure. Despite maximum medical therapy and frequent hospitalizations to stabilize their condition, one in five heart failure patients die within the first year of diagnosis. Several disease-management programs have been proposed and tested to improve the quality of heart failure care. Studies have shown that hospital admissions and emergency room visits decrease with increased nursing interventions in the home and community setting. An alternative strategy for promoting self-management of heart failure is the use of electronic home monitoring. The purpose of this study was to examine what effects heart failure has on patient's quality of life that had been monitoring on an electronic home monitor longer than 2 months. Twenty-one questionnaires were given to patients utilizing an electronic home monitor by their home health agency nurse. Eleven patients completed the questionnaire. The findings showed that there is some deterioration in quality of life with more association with the physical aspects of life than with the emotional aspects of life, which probably was due to the small sample size. There was no significant difference in readmission rates in patients utilizing an electronic home monitor. Further research is needed with a larger population of patients with chronic heart failure and other chronic diseases which may provide more data, and address issues such as patient compliance with self-care, impact of heart failure on patient's quality of life, functional capacity, and heart failure patient's utilization of the emergency rooms and hospital. Telemonitoring holds promise for improving the self-care abilities of persons with HF.

Health-related quality of life and utility scores of patients with breast neoplasms in China: A multicenter cross-sectional survey.

PubMed

Wang, Le; Shi, Ju-Fang; Zhu, Juan; Huang, Hui-Yao; Bai, Ya-Na; Liu, Guo-Xiang; Liao, Xian-Zhen; Mao, A-Yan; Ren, Jian-Song; Sun, Xiao-Jie; Guo, Lan-Wei; Fang, Yi; Zhou, Qi; Ma, Heng-Min; Xing, Xiao-Jing; Zhu, Lin; Song, Bing-Bing; Du, Ling-Bin; Mai, Ling; Liu, Yu-Qin; Ren, Ying; Lan, Li; Zhou, Jin-Yi; Qi, Xiao; Sun, Xiao-Hua; Lou, Pei-An; Wu, Shou-Ling; Li, Ni; Zhang, Kai; He, Jie; Dai, Min

2018-06-01

Health-related quality of life and utility scores of patients with breast cancer and precancerous lesions are sparse in China. This study aimed to derive utility scores of patients with breast cancer and precancer in China. An interviewer-administered cross-sectional survey was conducted in 12 provinces across China from 2013 to 2014. The three-level EuroQol-5-Dimension instrument was used to evaluate quality of life, and utility scores were generated using the Chinese value set. Univariate and multivariate analyses were performed to explore the determinants of utility scores. In total, 2626 breast cancer and 471 precancer patients were included. Mean age was 49.1 for breast cancer and 41.4 years for precancer (p < 0.001). Among the five dimensions, pain/discomfort was the most reported problem, 53.9% in breast cancer and 29.3% in precancer patients. Mean (95% CI) utility scores for breast cancer and precancer patients were estimated as 0.887 (0.875-0.899) and 0.781 (0.774-0.788), and the scores of breast cancer at stage-I, stage-II, stage-III and stage-IV were 0.789 (0.774-0.805), 0.793 (0.783-0.802), 0.774 (0.759-0.788) and 0.686 (0.654-0.717), respectively. Mean (95% CI) visual analogue scale scores for breast cancer and precancer were 75.6 (74.0-77.3) and 72.8 (72.3-73.3). Multiple regression showed advanced clinical stage, lower educational level, lower household income, surgery treatment, and undergoing treatment were independently associated with lower utility scores for breast cancer patients. The utility scores deteriorate with the severity of breast neoplasms. Detailed utility scores of breast cancer and precancer are fundamental for further cost-utility analysis in China. Copyright © 2018. Published by Elsevier Ltd.

Reliability and Utility of the Behaviour Support Plan Quality Evaluation Tool (BSP-QEII) for Auditing and Quality Development in Services for Adults with Intellectual Disability and Challenging Behaviour

ERIC Educational Resources Information Center

McVilly, K.; Webber, L.; Paris, M.; Sharp, G.

2013-01-01

Background: Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II…

Hualapai Tribal Utility Development Project

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

Hualapai Tribal Nation

The first phase of the Hualapai Tribal Utility Development Project (Project) studied the feasibility of establishing a tribally operated utility to provide electric service to tribal customers at Grand Canyon West (see objective 1 below). The project was successful in completing the analysis of the energy production from the solar power systems at Grand Canyon West and developing a financial model, based on rates to be charged to Grand Canyon West customers connected to the solar systems, that would provide sufficient revenue for a Tribal Utility Authority to operate and maintain those systems. The objective to establish a central powermore » grid over which the TUA would have authority and responsibility had to be modified because the construction schedule of GCW facilities, specifically the new air terminal, did not match up with the construction schedule for the solar power system. Therefore, two distributed systems were constructed instead of one central system with a high voltage distribution network. The Hualapai Tribal Council has not taken the action necessary to establish the Tribal Utility Authority that could be responsible for the electric service at GCW. The creation of a Tribal Utility Authority (TUA) was the subject of the second objective of the project. The second phase of the project examined the feasibility and strategy for establishing a tribal utility to serve the remainder of the Hualapai Reservation and the feasibility of including wind energy from a tribal wind generator in the energy resource portfolio of the tribal utility (see objective 2 below). It is currently unknown when the Tribal Council will consider the implementation of the results of the study. Objective 1 - Develop the basic organizational structure and operational strategy for a tribally controlled utility to operate at the Tribe’s tourism enterprise district, Grand Canyon West. Coordinate the development of the Tribal Utility structure with the development of the Grand

DATA QUALITY OBJECTIVE SUMMARY REPORT FOR THE 105 K EAST ION EXCHANGE COLUMN MONOLITH

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

JOCHEN, R.M.

2007-08-02

The 105-K East (KE) Basin Ion Exchange Column (IXC) cells, lead caves, and the surrounding vault are to be removed as necessary components in implementing ''Hanford Federal Facility Agreement and Consent Order'' (Ecology et al. 2003) milestone M-034-32 (Complete Removal of the K East Basin Structure). The IXCs consist of six units located in the KE Basin, three in operating positions in cells and three stored in a lead cave. Methods to remove the IXCs from the KE Basin were evaluated in KBC-28343, ''Disposal of K East Basin Ion Exchange Column Evaluation''. The method selected for removal was grouting themore » six IXCs into a single monolith for disposal at the Environmental Restoration Disposal Facility (ERDF). Grout will be added to the IXC cells, IXC lead caves containing spent IXCs, and in the spaces between the lead cave walls and metal skin, to immobilize the contaminants, provide self-shielding, minimize void space, and provide a structurally stable waste form. The waste to be offered for disposal is the encapsulated monolith defined by the exterior surfaces of the vault and the lower surface of the underlying slab. This document presents summary of the data quality objective (DQO) process establishing the decisions and data required to support decision-making activities for the disposition of the IXC monolith. The DQO process is completed in accordance with the seven-step planning process described in EPA QA/G-4, ''Guidance for the Data Quality Objectives Process'', which is used to clarify and study objectives; define the appropriate type, quantity, and quality of data; and support defensible decision-making. The DQO process involves the following steps: (1) state the problem; (2) identify the decision; (3) identify the inputs to the decision; (4) define the boundaries of the study; (5) develop a decision rule (DR); (6) specify tolerable limits on decision errors; and (7) optimize the design for obtaining data.« less

Pain, health-related quality of life and health care utilization after inpatient surgery: A pilot study

PubMed Central

VanDenKerkhof, Elizabeth G; Hopman, Wilma M; Towheed, Tanveer; Wilson, Rosemary; Murdoch, John; Rimmer, Michael; Stutzman, Sherri Schmidt; Tod, Debbie; Dagnone, Vico; Goldstein, David H

2006-01-01

BACKGROUND Little is known about pain-related outcomes in surgical inpatients after discharge from the hospital. An ongoing risk and outcomes monitoring system would provide valuable feedback to improve the quality of patient care. OBJECTIVES The purpose of the present pilot study was to describe postoperative pain, medication use, health care utilization and health-related quality of life (HRQOL) immediately and four weeks after surgery; merge clinically captured data with Web-based follow-up data; and examine patients’ willingness to complete Web-based health questionnaires. METHODS One hundred two consecutive surgical inpatients were approached for participation. Perioperative data were abstracted from the acute pain management service clinical database and linked to follow-up data captured four weeks postoperatively. RESULTS Follow-up questionnaires were completed by 88 participants. Clinical assessment data were successfully linked to Web-based follow-up data. Average pain intensity (3.7) four weeks following discharge fell just short of the acute pain management service active pain score of 3.9. At four weeks, all 88 participants reported significantly impaired HRQOL, 36 were still taking pain medications and 15 had visited an emergency room. Two-thirds of the participants had access to the Internet at home and approximately one-half were willing to complete on-line health questionnaires. DISCUSSION The study indicates that it is feasible to link clinical and research data, and shows a significant burden of pain and reduced HRQOL in the weeks following discharge. This approach to converting clinically captured data into meaningful information about surgical outcomes is valuable in the development of an ongoing risk and outcomes monitoring system. PMID:16511613

Ensuring Data Quality in Extension Research and Evaluation Studies

ERIC Educational Resources Information Center

Radhakrishna, Rama; Tobin, Daniel; Brennan, Mark; Thomson, Joan

2012-01-01

This article presents a checklist as a guide for Extension professionals to use in research and evaluation studies they carry out. A total of 40 statements grouped under eight data quality components--relevance, objectivity, validity, reliability, integrity, generalizability, completeness, and utility--are identified to ensure that research…

Lung Quality and Utilization in Controlled Donation After Circulatory Determination of Death Within the United States.

PubMed

Mooney, J J; Hedlin, H; Mohabir, P K; Vazquez, R; Nguyen, J; Ha, R; Chiu, P; Patel, K; Zamora, M R; Weill, D; Nicolls, M R; Dhillon, G S

2016-04-01

Although controlled donation after circulatory determination of death (cDCDD) could increase the supply of donor lungs within the United States, the yield of lungs from cDCDD donors remains low compared with donation after neurologic determination of death (DNDD). To explore the reason for low lung yield from cDCDD donors, Scientific Registry of Transplant Recipient data were used to assess the impact of donor lung quality on cDCDD lung utilization by fitting a logistic regression model. The relationship between center volume and cDCDD use was assessed, and the distance between center and donor hospital was calculated by cDCDD status. Recipient survival was compared using a multivariable Cox regression model. Lung utilization was 2.1% for cDCDD donors and 21.4% for DNDD donors. Being a cDCDD donor decreased lung donation (adjusted odds ratio 0.101, 95% confidence interval [CI] 0.085-0.120). A minority of centers have performed cDCDD transplant, with higher volume centers generally performing more cDCDD transplants. There was no difference in center-to-donor distance or recipient survival (adjusted hazard ratio 1.03, 95% CI 0.78-1.37) between cDCDD and DNDD transplants. cDCDD lungs are underutilized compared with DNDD lungs after adjusting for lung quality. Increasing transplant center expertise and commitment to cDCDD lung procurement is needed to improve utilization. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Experimental results supporting the determination of service quality objectives for DBS systems

NASA Technical Reports Server (NTRS)

Chouinard, G.; Whyte, W. A., Jr.; Goldberg, A. A.; Jones, B. L.

1985-01-01

A summary of the results of a joint United States and Canadian program on subjective measurements of the picture degradation caused by noise and interference on an NTSC encoded color television signal is given in this paper. The effects of system noise, cochannel and adjacent channel interference, and both single entry and aggregate as well as a combination of these types of interference were subjectively evaluated by expert and nonexpert viewers under reference conditions. These results were used to develop the rationale used at RARC '83 to establish the service quality objective for planning the DBS service for the American continents.

A quality assurance framework for the fully automated and objective evaluation of image quality in cone-beam computed tomography

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

Steiding, Christian; Kolditz, Daniel; Kalender, Willi A., E-mail: willi.kalender@imp.uni-erlangen.de

Purpose: Thousands of cone-beam computed tomography (CBCT) scanners for vascular, maxillofacial, neurological, and body imaging are in clinical use today, but there is no consensus on uniform acceptance and constancy testing for image quality (IQ) and dose yet. The authors developed a quality assurance (QA) framework for fully automated and time-efficient performance evaluation of these systems. In addition, the dependence of objective Fourier-based IQ metrics on direction and position in 3D volumes was investigated for CBCT. Methods: The authors designed a dedicated QA phantom 10 cm in length consisting of five compartments, each with a diameter of 10 cm, andmore » an optional extension ring 16 cm in diameter. A homogeneous section of water-equivalent material allows measuring CT value accuracy, image noise and uniformity, and multidimensional global and local noise power spectra (NPS). For the quantitative determination of 3D high-contrast spatial resolution, the modulation transfer function (MTF) of centrally and peripherally positioned aluminum spheres was computed from edge profiles. Additional in-plane and axial resolution patterns were used to assess resolution qualitatively. The characterization of low-contrast detectability as well as CT value linearity and artifact behavior was tested by utilizing sections with soft-tissue-equivalent and metallic inserts. For an automated QA procedure, a phantom detection algorithm was implemented. All tests used in the dedicated QA program were initially verified in simulation studies and experimentally confirmed on a clinical dental CBCT system. Results: The automated IQ evaluation of volume data sets of the dental CBCT system was achieved with the proposed phantom requiring only one scan for the determination of all desired parameters. Typically, less than 5 min were needed for phantom set-up, scanning, and data analysis. Quantitative evaluation of system performance over time by comparison to previous examinations

St. Bernard Citizens for Environmental Quality (et al.) Petition to Object to Chalmette Refinery Utilities Title V Permit

EPA Pesticide Factsheets

This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Learning to Appraise the Quality of Qualitative Research Articles: A Contextualized Learning Object for Constructing Knowledge

ERIC Educational Resources Information Center

Chenail, Ronald J.

2011-01-01

Helping beginning qualitative researchers critically appraise qualitative research articles is a common learning objective for introductory methodology courses. To aid students in achieving competency in appraising the quality of qualitative research articles, a multi-part activity incorporating the Critical Appraisal Skills Programme's (CASP)…

A method of 3D object recognition and localization in a cloud of points

NASA Astrophysics Data System (ADS)

Bielicki, Jerzy; Sitnik, Robert

2013-12-01

The proposed method given in this article is prepared for analysis of data in the form of cloud of points directly from 3D measurements. It is designed for use in the end-user applications that can directly be integrated with 3D scanning software. The method utilizes locally calculated feature vectors (FVs) in point cloud data. Recognition is based on comparison of the analyzed scene with reference object library. A global descriptor in the form of a set of spatially distributed FVs is created for each reference model. During the detection process, correlation of subsets of reference FVs with FVs calculated in the scene is computed. Features utilized in the algorithm are based on parameters, which qualitatively estimate mean and Gaussian curvatures. Replacement of differentiation with averaging in the curvatures estimation makes the algorithm more resistant to discontinuities and poor quality of the input data. Utilization of the FV subsets allows to detect partially occluded and cluttered objects in the scene, while additional spatial information maintains false positive rate at a reasonably low level.

A Quality Screening Service for Remote Sensing Data

NASA Technical Reports Server (NTRS)

Lynnes, Christopher; Olsen, Edward; Fox, Peter; Vollmer, Bruce; Wolfe, Robert; Samadi, Shahin

2010-01-01

NASA provides a wide variety of Earth-observing satellite data products to a diverse community. These data are annotated with quality information in a variety of ways, with the result that many users struggle to understand how to properly account for quality when dealing with satellite data. To address this issue, a Data Quality Screening Service (DQSS) is being implemented for a number of datasets. The DQSS will enable users to obtain data files in which low-quality pixels have been filtered out, based either on quality criteria recommended by the science team or on the user s particular quality criteria. The objective is to increase proper utilization of this critical quality data in science data analysis of satellite data products.

Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?

PubMed

Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna

2016-02-06

Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.

Assuring the Quality of Agricultural Learning Repositories: Issues for the Learning Object Metadata Creation Process of the CGIAR

NASA Astrophysics Data System (ADS)

Zschocke, Thomas; Beniest, Jan

The Consultative Group on International Agricultural Re- search (CGIAR) has established a digital repository to share its teaching and learning resources along with descriptive educational information based on the IEEE Learning Object Metadata (LOM) standard. As a critical component of any digital repository, quality metadata are critical not only to enable users to find more easily the resources they require, but also for the operation and interoperability of the repository itself. Studies show that repositories have difficulties in obtaining good quality metadata from their contributors, especially when this process involves many different stakeholders as is the case with the CGIAR as an international organization. To address this issue the CGIAR began investigating the Open ECBCheck as well as the ISO/IEC 19796-1 standard to establish quality protocols for its training. The paper highlights the implications and challenges posed by strengthening the metadata creation workflow for disseminating learning objects of the CGIAR.

A method for the evaluation of image quality according to the recognition effectiveness of objects in the optical remote sensing image using machine learning algorithm.

PubMed

Yuan, Tao; Zheng, Xinqi; Hu, Xuan; Zhou, Wei; Wang, Wei

2014-01-01

Objective and effective image quality assessment (IQA) is directly related to the application of optical remote sensing images (ORSI). In this study, a new IQA method of standardizing the target object recognition rate (ORR) is presented to reflect quality. First, several quality degradation treatments with high-resolution ORSIs are implemented to model the ORSIs obtained in different imaging conditions; then, a machine learning algorithm is adopted for recognition experiments on a chosen target object to obtain ORRs; finally, a comparison with commonly used IQA indicators was performed to reveal their applicability and limitations. The results showed that the ORR of the original ORSI was calculated to be up to 81.95%, whereas the ORR ratios of the quality-degraded images to the original images were 65.52%, 64.58%, 71.21%, and 73.11%. The results show that these data can more accurately reflect the advantages and disadvantages of different images in object identification and information extraction when compared with conventional digital image assessment indexes. By recognizing the difference in image quality from the application effect perspective, using a machine learning algorithm to extract regional gray scale features of typical objects in the image for analysis, and quantitatively assessing quality of ORSI according to the difference, this method provides a new approach for objective ORSI assessment.

Health Care of Latino Children with Autism and Other Developmental Disabilities: Quality of Provider Interaction Mediates Utilization

ERIC Educational Resources Information Center

Parish, Susan; Magana, Sandra; Rose, Roderick; Timberlake, Maria; Swaine, Jamie G.

2012-01-01

This study examines access to, utilization of, and quality of health care for Latino children with autism and other developmental disabilities. We analyze data from the National Survey of Children with Special Health Care Needs (N = 4,414 children with autism and other developmental disabilities). Compared with White children, Latino children with…

Lung Quality and Utilization in Controlled Donation after Circulatory Determination of Death Donors within the United States

PubMed Central

Mooney, Joshua J; Hedlin, Haley; Mohabir, Paul K; Vazquez, Rodrigo; Nguyen, John; Ha, Richard; Chiu, Peter; Patel, Kapilkumar; Zamora, Martin R.; Weill, David; Nicolls, Mark R; Dhillon, Gundeep S

2016-01-01

While controlled donation after circulatory determination of death (cDCDD) donors could increase the supply of donor lungs within the United States, the yield of lungs from cDCDD donors remain low compared to donation after neurologic determination of death (DNDD) donors. To explore the reason for low lung yield from cDCDD donors, Scientific Registry of Transplant Recipient data were used to assess the impact of donor lung quality on cDCDD lung utilization by fitting a logistic regression model. The relationship between center volume and cDCDD use was assessed and distance between center and donor hospital was calculated by cDCDD status. Recipient survival was compared using a multivariable Cox regression model. Lung utilization was 2.1% for cDCDD donors and 21.4% for DNDD donors. Being a cDCDD donor decreased lung donation (adjusted OR 0.101, CI 0.085–0.120). A minority of centers have performed cDCDD transplant with higher volume centers generally performing more cDCDD transplants. There was no difference in center to donor distance or recipient survival (adjusted HR 1.03, CI 0.78–1.37) between cDCDD and DNDD transplants. cDCDD lungs are underutilized compared to DNDD lungs after adjusting for lung quality. Increasing transplant center expertise and commitment to cDCDD lung procurement is needed to improve utilization. PMID:26844673

7 CFR 1778.3 - Objective.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Objective. 1778.3 Section 1778.3 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) EMERGENCY AND IMMINENT COMMUNITY WATER ASSISTANCE GRANTS § 1778.3 Objective. The objective of the...

Utility measures of health-related quality of life in patients treated for benign paroxysmal positional vertigo.

PubMed

Roberts, Richard A; Abrams, Harvey; Sembach, Melanie K; Lister, Jennifer J; Gans, Richard E; Chisolm, Theresa Hnath

2009-06-01

Comparing the effects of different disorders and interventions on health-related quality of life (HRQoL) is important for healthcare policy and accountability. There are two basic approaches to measure HRQoL: questionnaires derived from psychometrics and preference-based measures or utilities derived from econometrics. While disease-specific HRQoL questionnaires, such as the Dizziness Handicap Inventory (DHI), are important because they focus on the impact of a specific problem and its treatments (i.e., vestibular disorders), economic comparisons of the impacts of diseases/disorders and their treatments are typically based on utility assessment. The utility measures for audiology application (UMAA) were developed to measure utilities for various audiologic conditions using a standard computer. The purpose of this study was to determine if the UMAA provides stable, valid, and sensitive utility measures of the effects of benign paroxysmal positional vertigo (BPPV) and its treatment on HRQoL. It was hypothesized that utilities, as measured by the UMAA, would indicate improvement in HRQoL post-treatment for BPPV comparable to a disease-specific health status measure (DHI). The UMAA incorporates three techniques to measure utility: rating scale, standard gamble, and time tradeoff. A utility is a cardinal measure of strength of preference and is measured on a continuum basis from 0.0 (incapacitating dizziness) to 1.0 (no dizziness). Fifty-two adults with BPPV of the posterior semicircular canal completed the UMAA and DHI before treatment and again post-treatment. A subgroup of 15 participants completed the UMAA on two occasions before treatment to assess test-retest stability and to establish critical difference values. Results from this investigation demonstrate that utilities as measured through the UMAA are stable, valid, and comparable to the DHI. Post-treatment utilities were also significantly higher than pretreatment utilities, indicating that the utilities, as

Introducing the Benson Prize for Discovery Methods of Near Earth Objects by Amateurs

NASA Astrophysics Data System (ADS)

Benson, J. W.

1997-05-01

The Benson Prize Sponsored by Space Development Corporation The Benson Prize for Discovery Methods of Near Earth Objects by Amateurs is an annual competition which awards prizes to the best proposed methods by which amateur astronomers may discover such near earth objects as asteroids and comet cores. The purpose of the Benson Prize is to encourage the discovery of near earth objects by amateur astronomers. The utilization of valuable near earth resources can provide many new jobs and economic activities on earth, while also creating many new opportunities for opening up the space frontier. The utilization of near earth resources will significantly contribute to the lessening of environmental degradation on the Earth caused by mining and chemical leaching operations required to exploit the low grade ores now remaining on Earth. In addition, near earth objects pose grave dangers for life on earth. Discovering and plotting the orbits of all potentially dangerous near earth objects is the first and necessary step in protecting ourselves against the enormous potential damage possible from near earth objects. With the high quality, large size and low cost of todays consumer telescopes, the rapid development of powerful, high resolution and inexpensive CCD cameras, and the proliferation of inexpensive software for todays powerful home computers, the discovery of near earth objects by amateur astronomers is more attainable than ever. The Benson Prize is sponsored by the Space Development Corporation, a space resource exploration and utilization company. In 1997 one prize of \\500 will be awarded to the best proposed method for the amateur discovery of NEOs, and in each of the four following years, Prizes of \\500, \\250 and \\100 will be awarded. Prizes for the actual discovery of Near Earth Asteroids will be added in later years.

Near-Earth Objects: Targets for Future Human Exploration, Solar System Science, Resource Utilization, and Planetary Defense

NASA Technical Reports Server (NTRS)

Abell, Paul A.

2011-01-01

U.S. President Obama stated on April 15, 2010 that the next goal for human spaceflight will be to send human beings to a near-Earth asteroid by 2025. Given this direction from the White House, NASA has been involved in studying various strategies for near-Earth object (NEO) exploration in order to follow U.S. Space Exploration Policy. This mission would be the first human expedition to an interplanetary body beyond the Earth-Moon system and would prove useful for testing technologies required for human missions to Mars and other Solar System destinations. Missions to NEOs would undoubtedly provide a great deal of technical and engineering data on spacecraft operations for future human space exploration while conducting in-depth scientific investigations of these primitive objects. In addition, the resulting scientific investigations would refine designs for future extraterrestrial resource extraction and utilization, and assist in the development of hazard mitigation techniques for planetary defense. This presentation will discuss some of the physical characteristics of NEOs and review some of the current plans for NEO research and exploration from both a human and robotic mission perspective.

The use of UV-visible reflectance spectroscopy as an objective tool to evaluate pearl quality.

PubMed

Agatonovic-Kustrin, Snezana; Morton, David W

2012-07-01

Assessing the quality of pearls involves the use of various tools and methods, which are mainly visual and often quite subjective. Pearls are normally classified by origin and are then graded by luster, nacre thickness, surface quality, size, color and shape. The aim of this study was to investigate the capacity of Artificial Neural Networks (ANNs) to classify and estimate the quality of 27 different pearls from their UV-Visible spectra. Due to the opaque nature of pearls, spectroscopy measurements were performed using the Diffuse Reflectance UV-Visible spectroscopy technique. The spectra were acquired at two different locations on each pearl sample in order to assess surface homogeneity. The spectral data (inputs) were smoothed to reduce the noise, fed into ANNs and correlated to the pearl's quality/grading criteria (outputs). The developed ANNs were successful in predicting pearl type, mollusk growing species, possible luster and color enhancing, donor condition/type, recipient/host color, donor color, pearl luster, pearl color, origin. The results of this study shows that the developed UV-Vis spectroscopy-ANN method could be used as a more objective method of assessing pearl quality (grading) and may become a valuable tool for the pearl grading industry.

Hydro-environmental management of groundwater resources: A fuzzy-based multi-objective compromise approach

NASA Astrophysics Data System (ADS)

Alizadeh, Mohammad Reza; Nikoo, Mohammad Reza; Rakhshandehroo, Gholam Reza

2017-08-01

Sustainable management of water resources necessitates close attention to social, economic and environmental aspects such as water quality and quantity concerns and potential conflicts. This study presents a new fuzzy-based multi-objective compromise methodology to determine the socio-optimal and sustainable policies for hydro-environmental management of groundwater resources, which simultaneously considers the conflicts and negotiation of involved stakeholders, uncertainties in decision makers' preferences, existing uncertainties in the groundwater parameters and groundwater quality and quantity issues. The fuzzy multi-objective simulation-optimization model is developed based on qualitative and quantitative groundwater simulation model (MODFLOW and MT3D), multi-objective optimization model (NSGA-II), Monte Carlo analysis and Fuzzy Transformation Method (FTM). Best compromise solutions (best management policies) on trade-off curves are determined using four different Fuzzy Social Choice (FSC) methods. Finally, a unanimity fallback bargaining method is utilized to suggest the most preferred FSC method. Kavar-Maharloo aquifer system in Fars, Iran, as a typical multi-stakeholder multi-objective real-world problem is considered to verify the proposed methodology. Results showed an effective performance of the framework for determining the most sustainable allocation policy in groundwater resource management.

Characterizing Objective Quality of Life and Normative Outcomes in Adults with Autism Spectrum Disorder: An Exploratory Latent Class Analysis

ERIC Educational Resources Information Center

Bishop-Fitzpatrick, Lauren; Hong, Jinkuk; Smith, Leann E.; Makuch, Renee A.; Greenberg, Jan S.; Mailick, Marsha R.

2016-01-01

This study aims to extend the definition of quality of life (QoL) for adults with autism spectrum disorder (ASD, n = 180, ages 23-60) by: (1) characterizing the heterogeneity of normative outcomes (employment, independent living, social engagement) and objective QoL (physical health, neighborhood quality, family contact, mental health issues); and…

Mapping between 6 Multiattribute Utility Instruments.

PubMed

Chen, Gang; Khan, Munir A; Iezzi, Angelo; Ratcliffe, Julie; Richardson, Jeff

2016-02-01

Cost-utility analyses commonly employ a multiattribute utility (MAU) instrument to estimate the health state utilities, which are needed to calculate quality-adjusted life years. Different MAU instruments predict significantly different utilities, which makes comparison of results from different evaluation studies problematical. This article presents mapping functions ("crosswalks") from 6 MAU instruments (EQ-5D-5L, SF-6D, Health Utilities Index 3 [HUI 3], 15D, Quality of Well-Being [QWB], and Assessment of Quality of Life 8D [AQoL-8D]) to each of the other 5 instruments in the study: a total of 30 mapping functions. Data were obtained from a multi-instrument comparison survey of the public and patients in 7 disease areas conducted in 6 countries (Australia, Canada, Germany, Norway, United Kingdom, and United States). The 8022 respondents were administered each of the 6 study instruments. Mapping equations between each instrument pair were estimated using 4 econometric techniques: ordinary least squares, generalized linear model, censored least absolute deviations, and, for the first time, a robust MM-estimator. Goodness-of-fit indicators for each of the results are within the range of published studies. Transformations reduced discrepancies between predicted utilities. Incremental utilities, which determine the value of quality-related health benefits, are almost perfectly aligned at the sample means. Transformations presented here align the measurement scales of MAU instruments. Their use will increase confidence in the comparability of evaluation studies, which have employed different MAU instruments. © The Author(s) 2015.

Hospice Enrollment, Local Hospice Utilization Patterns, and Rehospitalization in Medicare Patients

PubMed Central

Holden, Timothy R.; Smith, Maureen A.; Bartels, Christie M.; Campbell, Toby C.; Yu, Menggang

2015-01-01

Abstract Background: Rehospitalizations are prevalent and associated with decreased quality of life. Although hospice has been advocated to reduce rehospitalizations, it is not known how area-level hospice utilization patterns affect rehospitalization risk. Objectives: The study objective was to examine the association between hospice enrollment, local hospice utilization patterns, and 30-day rehospitalization in Medicare patients. Methods: With a retrospective cohort design, 1,997,506 hospitalizations were assessed between 2005 and 2009 from a 5% national sample of Medicare beneficiaries. Local hospice utilization was defined using tertiles representing the percentage of all deaths occurring in hospice within each Hospital Service Area (HSA). Cox proportional hazard models were used to assess the relationship between 30-day rehospitalization, hospice enrollment, and local hospice utilization, adjusting for patient sociodemographics, medical history, and hospital characteristics. Results: Rates of patients dying in hospice were 27% in the lowest hospice utilization tertile, 41% in the middle tertile, and 53% in the highest tertile. Patients enrolled in hospice had lower rates of 30-day rehospitalization than those not enrolled (2.2% versus 18.8%; adjusted hazard ratio [HR], 0.12; 95% confidence interval [CI], 0.118–0.131). Patients residing in areas of low hospice utilization were at greater rehospitalization risk than those residing in areas of high utilization (19.1% versus 17.5%; HR, 1.05; 95% CI, 1.04–1.06), which persisted beyond that accounted for by individual hospice enrollment. Conclusions: Area-level hospice utilization is inversely proportional to rehospitalization rates. This relationship is not fully explained by direct hospice enrollment, and may reflect a spillover effect of the benefits of hospice extending to nonenrollees. PMID:25879990

Immunoassay for wheat processing quality: utilization of a sandwich assay incorporating an immobilized single-chain fragment.

PubMed

Hill, A S; Giersch, T M; Loh, C S; Skerritt, J H

1999-10-01

A single-chain fragment (scFv) was engineered from a monoclonal antibody to high molecular weight glutenin subunits (HMW-GS), wheat flour polypeptides that play a major role in determining the mixing- and extension strength-related properties of dough and its subsequent baking performance. The scFv was expressed in a thioredoxin mutant Escherichia coli strain that allows disulfide bond formation in the cytoplasm and incorporated into a diagnostic test for wheat quality. Although the scFv lacks the more highly conserved antibody constant regions usually involved with immobilization, it was able to be directly immobilized to a polystyrene microwell solid phase without chemical or covalent modification of the protein or solid phase and utilized as a capture antibody in a double-antibody (two-site) immunoassay. In the sandwich assay, increasing HMW-GS concentrations produced increasing assay color, and highly significant correlations were obtained between optical densities obtained in the ELISA using the scFv and the content of large glutenin polymers in flours as well as measures of dough strength as measured by resistance to dough extension in rheological testing. The assay using the scFv was able to be carried out at lower flour sample extract dilutions than that required for a similar assay utilizing a monoclonal capture antibody. This research shows that engineered antibody fragments can be utilized to provide superior assay performance in two-site ELISAs over monoclonal antibodies and is the first application of an engineered antibody to the analysis of food processing quality.

Multiple-3D-object secure information system based on phase shifting method and single interference.

PubMed

Li, Wei-Na; Shi, Chen-Xiao; Piao, Mei-Lan; Kim, Nam

2016-05-20

We propose a multiple-3D-object secure information system for encrypting multiple three-dimensional (3D) objects based on the three-step phase shifting method. During the decryption procedure, five phase functions (PFs) are decreased to three PFs, in comparison with our previous method, which implies that one cross beam splitter is utilized to implement the single decryption interference. Moreover, the advantages of the proposed scheme also include: each 3D object can be decrypted discretionarily without decrypting a series of other objects earlier; the quality of the decrypted slice image of each object is high according to the correlation coefficient values, none of which is lower than 0.95; no iterative algorithm is involved. The feasibility of the proposed scheme is demonstrated by computer simulation results.

Refocusing-range and image-quality enhanced optical reconstruction of 3-D objects from integral images using a principal periodic δ-function array

NASA Astrophysics Data System (ADS)

Ai, Lingyu; Kim, Eun-Soo

2018-03-01

We propose a method for refocusing-range and image-quality enhanced optical reconstruction of three-dimensional (3-D) objects from integral images only by using a 3 × 3 periodic δ-function array (PDFA), which is called a principal PDFA (P-PDFA). By directly convolving the elemental image array (EIA) captured from 3-D objects with the P-PDFAs whose spatial periods correspond to each object's depth, a set of spatially-filtered EIAs (SF-EIAs) are extracted, and from which 3-D objects can be reconstructed to be refocused on their real depth. convolutional operations are performed directly on each of the minimum 3 × 3 EIs of the picked-up EIA, the capturing and refocused-depth ranges of 3-D objects can be greatly enhanced, as well as 3-D objects much improved in image quality can be reconstructed without any preprocessing operations. Through ray-optical analysis and optical experiments with actual 3-D objects, the feasibility of the proposed method has been confirmed.

Estimates of utility weights in hemophilia: implications for cost-utility analysis of clotting factor prophylaxis

PubMed Central

Grosse, Scott D; Chaugule, Shraddha S; Hay, Joel W

2015-01-01

Estimates of preference-weighted health outcomes or health state utilities are needed to assess improvements in health in terms of quality-adjusted life-years. Gains in quality-adjusted life-years are used to assess the cost–effectiveness of prophylactic use of clotting factor compared with on-demand treatment among people with hemophilia, a congenital bleeding disorder. Published estimates of health utilities for people with hemophilia vary, contributing to uncertainty in the estimates of cost–effectiveness of prophylaxis. Challenges in estimating utility weights for the purpose of evaluating hemophilia treatment include selection bias in observational data, difficulty in adjusting for predictors of health-related quality of life and lack of preference-based data comparing adults with lifetime or primary prophylaxis versus no prophylaxis living within the same country and healthcare system. PMID:25585817

Development of communication networks and water quality early warning detection systems at drinking water utilities in the Ohio River Valley Basin.

PubMed

Schulte, J G; Vicory, A H

2005-01-01

Source water quality is of major concern to all drinking water utilities. The accidental introduction of contaminants to their source water is a constant threat to utilities withdrawing water from navigable or industrialized rivers. The events of 11 September, 2001 in the United States have heightened concern for drinking water utility security as their source water and finished water may be targets for terrorist acts. Efforts are underway in several parts of the United States to strengthen early warning capabilities. This paper will focus on those efforts in the Ohio River Valley Basin.

Objectivity and reliability in qualitative analysis: realist, contextualist and radical constructionist epistemologies.

PubMed

Madill, A; Jordan, A; Shirley, C

2000-02-01

The effect of the individual analyst on research findings can create a credibility problem for qualitative approaches from the perspective of evaluative criteria utilized in quantitative psychology. This paper explicates the ways in which objectivity and reliability are understood in qualitative analysis conducted from within three distinct epistemological frameworks: realism, contextual constructionism, and radical constructionism. It is argued that quality criteria utilized in quantitative psychology are appropriate to the evaluation of qualitative analysis only to the extent that it is conducted within a naive or scientific realist framework. The discussion is illustrated with reference to the comparison of two independent grounded theory analyses of identical material. An implication of this illustration is to identify the potential to develop a radical constructionist strand of grounded theory.

DATA QUALITY OBJECTIVES FOR SELECTING WASTE SAMPLES FOR THE BENCH STEAM REFORMER TEST

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

BANNING DL

2010-08-03

This document describes the data quality objectives to select archived samples located at the 222-S Laboratory for Fluid Bed Steam Reformer testing. The type, quantity and quality of the data required to select the samples for Fluid Bed Steam Reformer testing are discussed. In order to maximize the efficiency and minimize the time to treat Hanford tank waste in the Waste Treatment and Immobilization Plant, additional treatment processes may be required. One of the potential treatment processes is the fluid bed steam reformer (FBSR). A determination of the adequacy of the FBSR process to treat Hanford tank waste is required.more » The initial step in determining the adequacy of the FBSR process is to select archived waste samples from the 222-S Laboratory that will be used to test the FBSR process. Analyses of the selected samples will be required to confirm the samples meet the testing criteria.« less

Diabetes in the African-American Medicare population. Morbidity, quality of care, and resource utilization.

PubMed

Chin, M H; Zhang, J X; Merrell, K

1998-07-01

To determine whether African-American Medicare recipients with diabetes are at increased risk for morbidity, poor quality of care, and high resource utilization. We analyzed 1,376 patients with diabetes who were > or = 65 years of age and in the 1993 Medicare Current Beneficiary Survey. Morbidity measures were the Katz Index of Activities of Daily Living, Instrumental Activities of Daily Living, overall health perception, Charlson Comorbidity Index score, and diabetic complications. Quality of care standards were glycosylated hemoglobin measurements, ophthalmological visits, lipid testing, mammography, influenza vaccination, readmission within 30 days of hospital discharge, and outpatient visits within 4 weeks of hospital discharge. We stratified Medicare reimbursement by type of service and adjusted for sex, education, and age in multivariable analyses. Compared with white patients, African-American patients had worse health perception and lower quality of care. They were more likely to visit the emergency department and had fewer physician visits per year. African-Americans had higher reimbursement for home health services, but total reimbursement was similar after case-mix adjustment. Improved access to preventive care for older African-Americans with diabetes may improve health perception and use of the emergency department. The potential effect on total reimbursement is unclear. Future policy interventions to improve quality of care among Medicare patients with diabetes should especially target African-Americans.

The Use of UV-Visible Reflectance Spectroscopy as an Objective Tool to Evaluate Pearl Quality

PubMed Central

Agatonovic-Kustrin, Snezana; Morton, David W.

2012-01-01

Assessing the quality of pearls involves the use of various tools and methods, which are mainly visual and often quite subjective. Pearls are normally classified by origin and are then graded by luster, nacre thickness, surface quality, size, color and shape. The aim of this study was to investigate the capacity of Artificial Neural Networks (ANNs) to classify and estimate the quality of 27 different pearls from their UV-Visible spectra. Due to the opaque nature of pearls, spectroscopy measurements were performed using the Diffuse Reflectance UV-Visible spectroscopy technique. The spectra were acquired at two different locations on each pearl sample in order to assess surface homogeneity. The spectral data (inputs) were smoothed to reduce the noise, fed into ANNs and correlated to the pearl’s quality/grading criteria (outputs). The developed ANNs were successful in predicting pearl type, mollusk growing species, possible luster and color enhancing, donor condition/type, recipient/host color, donor color, pearl luster, pearl color, origin. The results of this study shows that the developed UV-Vis spectroscopy-ANN method could be used as a more objective method of assessing pearl quality (grading) and may become a valuable tool for the pearl grading industry. PMID:22851919

Drinking water sources, availability, quality, access and utilization for goats in the Karak Governorate, Jordan.

PubMed

Al-Khaza'leh, Ja'far Mansur; Reiber, Christoph; Al Baqain, Raid; Valle Zárate, Anne

2015-01-01

Goat production is an important agricultural activity in Jordan. The country is one of the poorest countries in the world in terms of water scarcity. Provision of sufficient quantity of good quality drinking water is important for goats to maintain feed intake and production. This study aimed to evaluate the seasonal availability and quality of goats' drinking water sources, accessibility, and utilization in different zones in the Karak Governorate in southern Jordan. Data collection methods comprised interviews with purposively selected farmers and quality assessment of water sources. The provision of drinking water was considered as one of the major constraints for goat production, particularly during the dry season (DS). Long travel distances to the water sources, waiting time at watering points, and high fuel and labor costs were the key reasons associated with the problem. All the values of water quality (WQ) parameters were within acceptable limits of the guidelines for livestock drinking WQ with exception of iron, which showed slightly elevated concentration in one borehole source in the DS. These findings show that water shortage is an important problem leading to consequences for goat keepers. To alleviate the water shortage constraint and in view of the depleted groundwater sources, alternative water sources at reasonable distance have to be tapped and monitored for water quality and more efficient use of rainwater harvesting systems in the study area is recommended.

RFC: EPA's Action Plan for Bisphenol A Pursuant to EPA's Data Quality Guidelines

EPA Pesticide Factsheets

The American Chemistry Council (ACC) submits this Request for Correction to the U.S. Environmental Protection Agency under the Guidelines for Ensuring and Maximizing the Quality, Objectivity, Utility, and Integrity of Information Disseminated by the Environmental Protection Agency

Influence of Variable Streamside Management Zone Configurations on Water Quality after Forest Harvest

Treesearch

Emma L. Witt; Christopher D. Barton; Jeffrey W. Stringer; Randy Kolka; Mac A. Cherry

2016-01-01

Streamside management zones (SMZs) are a common best management practice (BMP) used to reduce water quality impacts from logging. The objective of this research was to evaluate the impact of varying SMZ configurations on water quality. Treatments (T1, T2, and T3) that varied in SMZ width, canopy retention within the SMZ, and BMP utilization were applied at the...

NEAR-COASTAL SEDIMENT AS A HABITAT IN THE GULF OF MEXICO: CHEMICAL QUALITY, TOXICITY, AND BENTHIC COMMUNITY COMPOSITION

EPA Science Inventory

Sediment quality was determined in a multiyear study for 108 near-coastal sites located in Mississippi, Alabama and Florida. The primary objective of the study was to determine the relative impact of common stressor sources on sediment quality utilizing a weight-of-evidence appro...

Short-term scheduling of an open-pit mine with multiple objectives

NASA Astrophysics Data System (ADS)

Blom, Michelle; Pearce, Adrian R.; Stuckey, Peter J.

2017-05-01

This article presents a novel algorithm for the generation of multiple short-term production schedules for an open-pit mine, in which several objectives, of varying priority, characterize the quality of each solution. A short-term schedule selects regions of a mine site, known as 'blocks', to be extracted in each week of a planning horizon (typically spanning 13 weeks). Existing tools for constructing these schedules use greedy heuristics, with little optimization. To construct a single schedule in which infrastructure is sufficiently utilized, with production grades consistently close to a desired target, a planner must often run these heuristics many times, adjusting parameters after each iteration. A planner's intuition and experience can evaluate the relative quality and mineability of different schedules in a way that is difficult to automate. Of interest to a short-term planner is the generation of multiple schedules, extracting available ore and waste in varying sequences, which can then be manually compared. This article presents a tool in which multiple, diverse, short-term schedules are constructed, meeting a range of common objectives without the need for iterative parameter adjustment.

Reconciling Consumer and Utility Objectives in the Residential Solar PV Market

NASA Astrophysics Data System (ADS)

Arnold, Michael R.

Today's energy market is facing large-scale changes that will affect all market players. Near the top of that list is the rapid deployment of residential solar photovoltaic (PV) systems. Yet that growing trend will be influenced multiple competing interests between various stakeholders, namely the utility, consumers and technology provides. This study provides a series of analyses---utility-side, consumer-side, and combined analyses---to understand and evaluate the effect of increases in residential solar PV market penetration. Three urban regions have been selected as study locations---Chicago, Phoenix, Seattle---with simulated load data and solar insolation data at each locality. Various time-of-use pricing schedules are investigated, and the effect of net metering is evaluated to determine the optimal capacity of solar PV and battery storage in a typical residential home. The net residential load profile is scaled to assess system-wide technical and economic figures of merit for the utility with an emphasis on intraday load profiles, ramp rates and electricity sales with increasing solar PV penetration. The combined analysis evaluates the least-cost solar PV system for the consumer and models the associated system-wide effects on the electric grid. Utility revenue was found to drop by 1.2% for every percent PV penetration increase, net metering on a monthly or annual basis improved the cost-effectiveness of solar PV but not battery storage, the removal of net metering policy and usage of an improved the cost-effectiveness of battery storage and increases in solar PV penetration reduced the system load factor. As expected, Phoenix had the most favorable economic scenario for residential solar PV, primarily due to high solar insolation. The study location---solar insolation and load profile---was also found to affect the time of year at which the largest net negative system load was realized.

Line-edge quality optimization of electron beam resist for high-throughput character projection exposure utilizing atomic force microscope analysis

NASA Astrophysics Data System (ADS)

Ikeno, Rimon; Mita, Yoshio; Asada, Kunihiro

2017-04-01

High-throughput electron-beam lithography (EBL) by character projection (CP) and variable-shaped beam (VSB) methods is a promising technique for low-to-medium volume device fabrication with regularly arranged layouts, such as standard-cell logics and memory arrays. However, non-VLSI applications like MEMS and MOEMS may not fully utilize the benefits of CP method due to their wide variety of layout figures including curved and oblique edges. In addition, the stepwise shapes that appear on such irregular edges by VSB exposure often result in intolerable edge roughness, which may degrade performances of the fabricated devices. In our former study, we proposed a general EBL methodology for such applications utilizing a combination of CP and VSB methods, and demonstrated its capabilities in electron beam (EB) shot reduction and edge-quality improvement by using a leading-edge EB exposure tool, ADVANTEST F7000S-VD02, and high-resolution Hydrogen Silsesquioxane resist. Both scanning electron microscope and atomic force microscope observations were used to analyze quality of the resist edge profiles to determine the influence of the control parameters used in the exposure-data preparation process. In this study, we carried out detailed analysis of the captured edge profiles utilizing Fourier analysis, and successfully distinguish the systematic undulation by the exposed CP character profiles from random roughness components. Such capability of precise edge-roughness analysis is useful to our EBL methodology to maintain both the line-edge quality and the exposure throughput by optimizing the control parameters in the layout data conversion.

Using Actigraphy and mHealth Systems for an Objective Analysis of Sleep Quality on Systemic Lupus Erythematosus Patients.

PubMed

Balderas-Díaz, Sara; Martínez, M Pilar; Guerrero-Contreras, Gabriel; Miró, Elena; Benghazi, Kawtar; Sánchez, Ana I; Garrido, José Luis; Prados, Germán

2017-03-23

Although sleep alterations can be an important factor contributing to the clinical state of Systemic Lupus Erythematosus, there are no studies to adequately assess sleep quality in this type of disease. The aim of this work is to analyse the sleep quality of Systemic Lupus Erythematous (SLE) patients based on more objective information provided by actigraphy and mobile systems. The idea is to carry out a comprehensive study by analysing how environmental conditions and factors can affect sleep quality. In traditional methods the information for assessing sleep quality is obtained through questionnaires. In this work, a novel method is proposed by combining these questionnaires that provide valuable but subjective information with actigraphy and a mobile system to collect more objective information about the patient and their environment. The method provides mechanisms to detect how sleep hygiene could be associated directly with the sleep quality of the subjects, in order to provide a custom intervention to SLE patients. Moreover, this alternative provides ease of use, and non-intrusive ICT (Information and Communication Technology) through a wristband and a mHealth system. The mHealth system has been developed for environmental conditions sensing. This consists of a mobile device with built-in sensors providing input data about the bedroom environment during sleep, and a set of services of the Environmental Monitoring System for properly managing the configuration, registration and fusion of those input data. In previous studies, this information has never been taken into account. However, the information could be relevant in the case of SLE patients. The sample is composed of 9 women with SLE and 11 matched controls with a mean age of 35.78 and 32.18, respectively. Demographic and clinical variables between SLE patients and healthy controls are compared using the Fisher exact test and the Mann-Whitney U test. Relationships between psychological variables

[Sexual hormone and traditional Chinese patent medicine for early postmenopausal women: effect on quality of life and cost-utility analysis].

PubMed

Zhou, Ling-Ling; Xu, Liang-Zhi; Liu, Hong-Wei; Zhang, Jing; Liu, Ying; Liu, Xiao-Fang; Tang, Liu-Lin; Zhuang, Jing; Liu, Xiao-Xian; Qiao, Lin

2009-11-01

To evaluate the effect of Premarin and Kuntai capsule (a traditional Chinese patent medicine) on the quality of life (QOL) and their cost-utility in early postmenopausal women. Fifty-seven women with menopausal syndrome in the early postmenopausal stage were randomly allocated into Premarin group (0.3 mg/day and 0.6 mg/day alternately, n=29) and Kuntai group (4 g/day, n=28). The therapies lasted for one year and the patients were followed up every 3 months. The QOL of the patients was evaluated and the utility scores were obtained from rating scale to conduct a cost-utility analysis (CUA). At each follow-up examination, no significant difference was found in the QOL between the two groups (P>0.05). The QOL obviously increased after the 1-year-long therapy in both the groups, and Kuntai required longer treatment time than Premarin to take effect. The cost-utility ratio of Premarin and Kuntai were 13581.45 yuan/QALY (quality adjusted life year) and 25105.12 yuan/QALY, respectively. Both incremental cost analysis and sensitivity analysis showed that Kuntai was more costly than Premarin. The result of per-protocol analysis was consistent with that of intention-to-treat analysis. At early stage of menopause, the QOL of women with menopausal syndrome can be significantly improved by low-dose Premarin and Kuntai capsule, but the latter is more costly.

A structured review of health utility measures and elicitation in advanced/metastatic breast cancer.

PubMed

Hao, Yanni; Wolfram, Verena; Cook, Jennifer

2016-01-01

Health utilities are increasingly incorporated in health economic evaluations. Different elicitation methods, direct and indirect, have been established in the past. This study examined the evidence on health utility elicitation previously reported in advanced/metastatic breast cancer and aimed to link these results to requirements of reimbursement bodies. Searches were conducted using a detailed search strategy across several electronic databases (MEDLINE, EMBASE, Cochrane Library, and EconLit databases), online sources (Cost-effectiveness Analysis Registry and the Health Economics Research Center), and web sites of health technology assessment (HTA) bodies. Publications were selected based on the search strategy and the overall study objectives. A total of 768 publications were identified in the searches, and 26 publications, comprising 18 journal articles and eight submissions to HTA bodies, were included in the evidence review. Most journal articles derived utilities from the European Quality of Life Five-Dimensions questionnaire (EQ-5D). Other utility measures, such as the direct methods standard gamble (SG), time trade-off (TTO), and visual analog scale (VAS), were less frequently used. Several studies described mapping algorithms to generate utilities from disease-specific health-related quality of life (HRQOL) instruments such as European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Breast Cancer 23 (EORTC QLQ-BR23), Functional Assessment of Cancer Therapy - General questionnaire (FACT-G), and Utility-Based Questionnaire-Cancer (UBQ-C); most used EQ-5D as the reference. Sociodemographic factors that affect health utilities, such as age, sex, income, and education, as well as disease progression, choice of utility elicitation method, and country settings, were identified within the journal articles. Most

A structured review of health utility measures and elicitation in advanced/metastatic breast cancer

PubMed Central

Hao, Yanni; Wolfram, Verena; Cook, Jennifer

2016-01-01

Background Health utilities are increasingly incorporated in health economic evaluations. Different elicitation methods, direct and indirect, have been established in the past. This study examined the evidence on health utility elicitation previously reported in advanced/metastatic breast cancer and aimed to link these results to requirements of reimbursement bodies. Methods Searches were conducted using a detailed search strategy across several electronic databases (MEDLINE, EMBASE, Cochrane Library, and EconLit databases), online sources (Cost-effectiveness Analysis Registry and the Health Economics Research Center), and web sites of health technology assessment (HTA) bodies. Publications were selected based on the search strategy and the overall study objectives. Results A total of 768 publications were identified in the searches, and 26 publications, comprising 18 journal articles and eight submissions to HTA bodies, were included in the evidence review. Most journal articles derived utilities from the European Quality of Life Five-Dimensions questionnaire (EQ-5D). Other utility measures, such as the direct methods standard gamble (SG), time trade-off (TTO), and visual analog scale (VAS), were less frequently used. Several studies described mapping algorithms to generate utilities from disease-specific health-related quality of life (HRQOL) instruments such as European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Core 30 (EORTC QLQ-C30), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Breast Cancer 23 (EORTC QLQ-BR23), Functional Assessment of Cancer Therapy – General questionnaire (FACT-G), and Utility-Based Questionnaire-Cancer (UBQ-C); most used EQ-5D as the reference. Sociodemographic factors that affect health utilities, such as age, sex, income, and education, as well as disease progression, choice of utility elicitation method, and country settings, were identified

[Approach to quality objectives in incidents of patients in peritoneal dialysis].

PubMed

Portolés, J; Ocaña, J; López-Sánchez, P; Gómez, M; Rivera, M T; Del Peso, G; Corchete, E; Bajo, M A; Rodríguez-Palomares, J R; Fernández-Perpen, A; López-Gómez, J M

2010-01-01

In 2007 the Scientific Quality-technical and Improvement of Quality in Peritoneal Dialysis was edited. It includes several quality indicators. As far as we know, only some groups of work had evaluated these indicators, with inconclusive results. To study the evolution and impact of guidelines in Peritoneal Dialysis. Prospective cohort study of each incident of patients in Peritoneal Dialysis, in a regional public health care system (2003-2006). We prospectively collected baseline clinical and analytical data, technical efficacy, cardiovascular risk, events and deaths, hospital admissions and also prescription data was collected every 6 months. Over a period of 3 years, 490 patients (53.58 years of age; 61.6% males.) Causes of ERC: glomerular 25.5%, diabetes 16%, vascular 12.4%, and interstitial 13.3%. 26.48% were on the list for transplant. Dialysis efficacy: Of the first available results, the residual renal function was 6.37 ml/min, achieving 67.6% of all the objectives K/DOQI. 38.6% remained within the range during the entire first year. Anaemia: 79.3% received erythropoietic stimulating agents and maintained an average Hb of 12.1 g/dl. The percentage of patients in the range (Hb: 11-13 g/dl) improved after a year (58.4% vs 56.3% keeping in the range during this time of 25.6%). Evolution: it has been estimated that per patient-year the risk of: 1) mortality is 0.06 IC 95% [0.04-0.08]; 2) admissions 0.65 [0.58-0.72]; 3) peritoneal infections 0.5 [0.44-0.56]. Diabetes Mellitus patients had a higher cardiovascular risk and prevalence of events. The degrees of control during the follow-up in many topics of peritoneal dialysis improve each year; however they are far from the recommended guidelines, especially if they are evaluated throughout the whole study.

No-reference video quality measurement: added value of machine learning

NASA Astrophysics Data System (ADS)

Mocanu, Decebal Constantin; Pokhrel, Jeevan; Garella, Juan Pablo; Seppänen, Janne; Liotou, Eirini; Narwaria, Manish

2015-11-01

Video quality measurement is an important component in the end-to-end video delivery chain. Video quality is, however, subjective, and thus, there will always be interobserver differences in the subjective opinion about the visual quality of the same video. Despite this, most existing works on objective quality measurement typically focus only on predicting a single score and evaluate their prediction accuracies based on how close it is to the mean opinion scores (or similar average based ratings). Clearly, such an approach ignores the underlying diversities in the subjective scoring process and, as a result, does not allow further analysis on how reliable the objective prediction is in terms of subjective variability. Consequently, the aim of this paper is to analyze this issue and present a machine-learning based solution to address it. We demonstrate the utility of our ideas by considering the practical scenario of video broadcast transmissions with focus on digital terrestrial television (DTT) and proposing a no-reference objective video quality estimator for such application. We conducted meaningful verification studies on different video content (including video clips recorded from real DTT broadcast transmissions) in order to verify the performance of the proposed solution.

[Life quality parameters in prenosologic evaluation of health state in residents of protective measures area near objects of storage and destruction of chemical weapons].

PubMed

Filippov, V L; Nechaeva, E N

2014-01-01

The article presents results of life quality assessment and subjective evaluation data on health state, used for prenosologic evaluation of health state in residents of protective measures area near objects of storage and destruction of chemical weapons. Considering specific features of residence near potentially dangerous objects, the authors conducted qualitative evaluation of satisfaction with various life facets, with taking into account the objects specificity, established correlation between life quality and self-evaluation of health with factors influencing public health state.

Rapid toxicity detection in water quality control utilizing automated multispecies biomonitoring for permanent space stations

NASA Technical Reports Server (NTRS)

Morgan, E. L.; Young, R. C.; Smith, M. D.; Eagleson, K. W.

1986-01-01

The objective of this study was to evaluate proposed design characteristics and applications of automated biomonitoring devices for real-time toxicity detection in water quality control on-board permanent space stations. Simulated tests in downlinking transmissions of automated biomonitoring data to Earth-receiving stations were simulated using satellite data transmissions from remote Earth-based stations.

Lifetime suicide attempt history, quality of life, and objective functioning among HIV/AIDS patients with alcohol and illicit substance use disorders.

PubMed

Walter, Kimberly N; Petry, Nancy M

2016-05-01

This cross-sectional study evaluated lifetime prevalence of suicide attempts in 170 HIV/AIDS patients with substance use disorders and the impact of suicide attempt history on subjective indices of quality of life and objective indices of cognitive and physical functioning. All patients met the diagnostic criteria for past-year cocaine or opioid use disorders and 27% of patients also had co-occurring alcohol use disorders. Compared to their counterparts without a history of a suicide attempt, patients with a history of a suicide attempt (n = 60, 35.3%) had significantly poorer emotional and cognitive quality of life scores (ps < .05), but not physical, social, or functional/global quality-of-life scores. Lifetime suicide attempt status was unrelated to objective indices of cognitive functioning, but there was a non-significant trend (p = .07) toward lower viral loads in those with a lifetime suicide attempt relative to those without. The findings indicate that suicide attempt histories are prevalent among HIV/AIDS patients with substance use disorders and relate to poorer perceived emotional and cognitive quality of life, but not objective functioning. HIV/AIDS patients with substance use disorders should be screened for lifetime histories of suicide attempts and offered assistance to improve perceived emotional and cognitive functioning. © The Author(s) 2016.

Relationship of Somatic Symptoms With Depression Severity, Quality of Life, and Health Resources Utilization in Patients With Major Depressive Disorder Seeking Primary Health Care in Spain

PubMed Central

García-Campayo, Javier; Ayuso-Mateos, José Luis; Caballero, Luis; Romera, Irene; Aragonés, Enric; Rodríguez-Artalejo, Fernando; Quail, Deborah; Gilaberte, Inmaculada

2008-01-01

Objective: To investigate the relationship between the characteristics of somatic symptoms and depression severity, quality of life (QOL), and health resources utilization in patients with major depressive disorder (MDD) in primary care setting. Method: This cross-sectional, nationwide epidemiologic study, carried out in 1150 primary care patients with DSM-IV–defined MDD, evaluated the characteristics of somatic symptoms by means of the Standardized Polyvalent Psychiatric Interview. Depression severity and QOL were evaluated by means of the Zung Self-Rating Depression Scale (SDS) and the Physical and Mental Component Summaries of the Medical Outcomes Study 12-item Short-Form Health Survey. Health resources utilization was measured in terms of doctor consultations and hospitalizations. The associations were assessed by means of adjusted analyses. The study was carried out from April 2004 to July 2004. Results: Disability associated with somatic symptoms and number of somatic symptoms were strongly associated with increased depression severity (2.45 and 0.29 increase in SDS score, respectively) and health resources utilization (odds ratios of 1.42 and 1.04, respectively). Associated disability, frequency, and persistence during leisure time of somatic symptoms were strongly associated with poorer QOL. In contrast, we found a weaker relationship between duration and intensity of somatic symptoms and depression severity, QOL, and health resources utilization. Conclusions: Of the studied somatic symptom characteristics, somatic symptom–associated disability and number of somatic symptoms are strongly associated with increased depression severity and health resources utilization, as well as with decreased QOL. Our results may help physicians identify relevant characteristics of somatic symptoms to more effectively diagnose and treat depression in primary care patients. PMID:19158973

7 CFR 1775.33 - Objectives.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Objectives. 1775.33 Section 1775.33 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) TECHNICAL ASSISTANCE GRANTS Technical Assistance and Training Grants § 1775.33 Objectives. The...

Best Practices in Digital Object Development for Education: Promoting Excellence and Innovation in Instructional Quality and Assessment

ERIC Educational Resources Information Center

Reece, Amanda A.

2016-01-01

A program of development of online learning resources should provide content, resources, support and activities to promote excellence and innovation in instructional quality and assessment. This article provides details on five best practices in digital object development for teaching and learning. In addition, an evaluation of the learning object…

UTILIZING SHELLFISH RESPONSES TO SET TARGET WATER QUALITY CONDITIONS FOR THE RESTORATION OF OYSTER REEFS IN THE CALOOSAHATCHEE ESTUARY, FLORIDA.

EPA Science Inventory

Volety, Aswani K., S.G. Tolley and James T. Winstead. 2002. Utilizing Shellfish Responses to Set Target Water Quality Conditions for the Restoration of Oyster Reefs in the Caloosahatchee Estuary, Florida. Presented at the International Workshop on Restoration of Benthic Invertebr...

Quality inspection guided laser processing of irregular shape objects by stereo vision measurement: application in badminton shuttle manufacturing

NASA Astrophysics Data System (ADS)

Qi, Li; Wang, Shun; Zhang, Yixin; Sun, Yingying; Zhang, Xuping

2015-11-01

The quality inspection process is usually carried out after first processing of the raw materials such as cutting and milling. This is because the parts of the materials to be used are unidentified until they have been trimmed. If the quality of the material is assessed before the laser process, then the energy and efforts wasted on defected materials can be saved. We proposed a new production scheme that can achieve quantitative quality inspection prior to primitive laser cutting by means of three-dimensional (3-D) vision measurement. First, the 3-D model of the object is reconstructed by the stereo cameras, from which the spatial cutting path is derived. Second, collaborating with another rear camera, the 3-D cutting path is reprojected to both the frontal and rear views of the object and thus generates the regions-of-interest (ROIs) for surface defect analysis. An accurate visual guided laser process and reprojection-based ROI segmentation are enabled by a global-optimization-based trinocular calibration method. The prototype system was built and tested with the processing of raw duck feathers for high-quality badminton shuttle manufacture. Incorporating with a two-dimensional wavelet-decomposition-based defect analysis algorithm, both the geometrical and appearance features of the raw feathers are quantified before they are cut into small patches, which result in fully automatic feather cutting and sorting.

Influence of grid control and object detection on radiation exposure and image quality using mobile C-arms - first results.

PubMed

Gosch, D; Ratzmer, A; Berauer, P; Kahn, T

2007-09-01

The objective of this study was to examine the extent to which the image quality on mobile C-arms can be improved by an innovative exposure rate control system (grid control). In addition, the possible dose reduction in the pulsed fluoroscopy mode using 25 pulses/sec produced by automatic adjustment of the pulse rate through motion detection was to be determined. As opposed to conventional exposure rate control systems, which use a measuring circle in the center of the field of view, grid control is based on a fine mesh of square cells which are overlaid on the entire fluoroscopic image. The system uses only those cells for exposure control that are covered by the object to be visualized. This is intended to ensure optimally exposed images, regardless of the size, shape and position of the object to be visualized. The system also automatically detects any motion of the object. If a pulse rate of 25 pulses/sec is selected and no changes in the image are observed, the pulse rate used for pulsed fluoroscopy is gradually reduced. This may decrease the radiation exposure. The influence of grid control on image quality was examined using an anthropomorphic phantom. The dose reduction achieved with the help of object detection was determined by evaluating the examination data of 146 patients from 5 different countries. The image of the static phantom made with grid control was always optimally exposed, regardless of the position of the object to be visualized. The average dose reduction when using 25 pulses/sec resulting from object detection and automatic down-pulsing was 21 %, and the maximum dose reduction was 60 %. Grid control facilitates C-arm operation, since optimum image exposure can be obtained independently of object positioning. Object detection may lead to a reduction in radiation exposure for the patient and operating staff.

The clinical utility of health-related quality of life screening in a pediatric inflammatory bowel disease clinic.

PubMed

Ryan, Jamie L; Mellon, Michael W; Junger, Katherine W F; Hente, Elizabeth A; Denson, Lee A; Saeed, Shehzad A; Hommel, Kevin A

2013-11-01

Adjusting to symptom flares, treatment regimens, and side effects places youth with inflammatory bowel disease (IBD) at increased risk for emotional and behavioral problems and adverse disease outcomes. Implementation of psychosocial screening into clinical practice remains a challenge. This study examines the clinical utility of health-related quality of life (HRQOL) screening in predicting disease outcome and healthcare utilization. One hundred twelve youth of 7 to 18 years diagnosed with IBD and their parents. Youth completed standardized measures of HRQOL and depression. Parents completed a proxy report of HRQOL. Pediatric gastroenterologists provided the Physician Global Assessment. Families were recruited from a pediatric gastroenterology clinic. Retrospective chart reviews examined disease outcome and healthcare utilization for 12 months after baseline measurement. Linear regressions, controlling for demographic and disease parameters, revealed that baseline measurement of youth and parent proxy-reported HRQOL predicted the number of IBD-related hospital admissions, gastroenterology clinic visits, emergency department visits, psychology clinic visits, telephone contacts, and pain management referrals over the next 12 months. Disease outcome was not significant. Lower HRQOL was predictive of increased healthcare utilization among youth with IBD. Regular HRQOL screening may be the impetus to providing better case management and allocating resources based on ongoing care needs and costs. Proactive interventions focused on patients with poor HRQOL may be an efficient approach to saving on healthcare costs and resource utilization.

DATA QUALITY OBJECTIVES FOR SELECTING WASTE SAMPLES FOR BENCH-SCALE REFORMER TREATABILITY STUDIES

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

BANNING DL

2011-02-11

This document describes the data quality objectives to select archived samples located at the 222-S Laboratory for Bench-Scale Reforming testing. The type, quantity, and quality of the data required to select the samples for Fluid Bed Steam Reformer testing are discussed. In order to maximize the efficiency and minimize the time to treat Hanford tank waste in the Waste Treatment and Immobilization Plant, additional treatment processes may be required. One of the potential treatment processes is the fluidized bed steam reformer. A determination of the adequacy of the fluidized bed steam reformer process to treat Hanford tank waste is required.more » The initial step in determining the adequacy of the fluidized bed steam reformer process is to select archived waste samples from the 222-S Laboratory that will be used in a bench scale tests. Analyses of the selected samples will be required to confirm the samples meet the shipping requirements and for comparison to the bench scale reformer (BSR) test sample selection requirements.« less

Quality improvement utilizing in-situ simulation for a dual-hospital pediatric code response team.

PubMed

Yager, Phoebe; Collins, Corey; Blais, Carlene; O'Connor, Kathy; Donovan, Patricia; Martinez, Maureen; Cummings, Brian; Hartnick, Christopher; Noviski, Natan

2016-09-01

Given the rarity of in-hospital pediatric emergency events, identification of gaps and inefficiencies in the code response can be difficult. In-situ, simulation-based medical education programs can identify unrecognized systems-based challenges. We hypothesized that developing an in-situ, simulation-based pediatric emergency response program would identify latent inefficiencies in a complex, dual-hospital pediatric code response system and allow rapid intervention testing to improve performance before implementation at an institutional level. Pediatric leadership from two hospitals with a shared pediatric code response team employed the Institute for Healthcare Improvement's (IHI) Breakthrough Model for Collaborative Improvement to design a program consisting of Plan-Do-Study-Act cycles occurring in a simulated environment. The objectives of the program were to 1) identify inefficiencies in our pediatric code response; 2) correlate to current workflow; 3) employ an iterative process to test quality improvement interventions in a safe environment; and 4) measure performance before actual implementation at the institutional level. Twelve dual-hospital, in-situ, simulated, pediatric emergencies occurred over one year. The initial simulated event allowed identification of inefficiencies including delayed provider response, delayed initiation of cardiopulmonary resuscitation (CPR), and delayed vascular access. These gaps were linked to process issues including unreliable code pager activation, slow elevator response, and lack of responder familiarity with layout and contents of code cart. From first to last simulation with multiple simulated process improvements, code response time for secondary providers coming from the second hospital decreased from 29 to 7 min, time to CPR initiation decreased from 90 to 15 s, and vascular access obtainment decreased from 15 to 3 min. Some of these simulated process improvements were adopted into the institutional response while

Data Quality Objectives Process for Designation of K Basins Debris

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

WESTCOTT, J.L.

2000-05-22

The U.S. Department of Energy has developed a schedule and approach for the removal of spent fuels, sludge, and debris from the K East (KE) and K West (KW) Basins, located in the 100 Area at the Hanford Site. The project that is the subject of this data quality objective (DQO) process is focused on the removal of debris from the K Basins and onsite disposal of the debris at the Environmental Restoration Disposal Facility (ERDF). This material previously has been dispositioned at the Hanford Low-Level Burial Grounds (LLBGs) or Central Waste Complex (CWC). The goal of this DQO processmore » and the resulting Sampling and Analysis Plan (SAP) is to provide the strategy for characterizing and designating the K-Basin debris to determine if it meets the Environmental Restoration Disposal Facility Waste Acceptance Criteria (WAC), Revision 3 (BHI 1998). A critical part of the DQO process is to agree on regulatory and WAC interpretation, to support preparation of the DQO workbook and SAP.« less

Multi-object tracking of human spermatozoa

NASA Astrophysics Data System (ADS)

Sørensen, Lauge; Østergaard, Jakob; Johansen, Peter; de Bruijne, Marleen

2008-03-01

We propose a system for tracking of human spermatozoa in phase-contrast microscopy image sequences. One of the main aims of a computer-aided sperm analysis (CASA) system is to automatically assess sperm quality based on spermatozoa motility variables. In our case, the problem of assessing sperm quality is cast as a multi-object tracking problem, where the objects being tracked are the spermatozoa. The system combines a particle filter and Kalman filters for robust motion estimation of the spermatozoa tracks. Further, the combinatorial aspect of assigning observations to labels in the particle filter is formulated as a linear assignment problem solved using the Hungarian algorithm on a rectangular cost matrix, making the algorithm capable of handling missing or spurious observations. The costs are calculated using hidden Markov models that express the plausibility of an observation being the next position in the track history of the particle labels. Observations are extracted using a scale-space blob detector utilizing the fact that the spermatozoa appear as bright blobs in a phase-contrast microscope. The output of the system is the complete motion track of each of the spermatozoa. Based on these tracks, different CASA motility variables can be computed, for example curvilinear velocity or straight-line velocity. The performance of the system is tested on three different phase-contrast image sequences of varying complexity, both by visual inspection of the estimated spermatozoa tracks and by measuring the mean squared error (MSE) between the estimated spermatozoa tracks and manually annotated tracks, showing good agreement.

A mask quality control tool for the OSIRIS multi-object spectrograph

NASA Astrophysics Data System (ADS)

López-Ruiz, J. C.; Vaz Cedillo, Jacinto Javier; Ederoclite, Alessandro; Bongiovanni, Ángel; González Escalera, Víctor

2012-09-01

OSIRIS multi object spectrograph uses a set of user-customised-masks, which are manufactured on-demand. The manufacturing process consists of drilling the specified slits on the mask with the required accuracy. Ensuring that slits are on the right place when observing is of vital importance. We present a tool for checking the quality of the process of manufacturing the masks which is based on analyzing the instrument images obtained with the manufactured masks on place. The tool extracts the slit information from these images, relates specifications with the extracted slit information, and finally communicates to the operator if the manufactured mask fulfills the expectations of the mask designer. The proposed tool has been built using scripting languages and using standard libraries such as opencv, pyraf and scipy. The software architecture, advantages and limits of this tool in the lifecycle of a multiobject acquisition are presented.

The effect of phytase and fructooligosaccharide supplementation on growth performance, bone quality, and phosphorus utilization in broiler chickens.

PubMed

Shang, Y; Rogiewicz, A; Patterson, R; Slominski, B A; Kim, W K

2015-05-01

An experiment was conducted to investigate the effects of phytase and 2 levels of fructooligosaccharide (FOS) supplementation on growth performance, bone mineralization, and P utilization of broiler chickens. A total of 210 day-old male broiler chickens (Ross) were randomly placed into 7 dietary treatments consisting of 6 replicates with 5 birds per pen. The experiment was designed as an augmented 2 × 3 factorial arrangement with 0 or 500 U/kg of phytase and 0, 0.5% or 1% of FOS added to a reduced Ca (0.8%) and available P (0.25%) negative control diet (NC). A positive control diet (PC) that contained 1% Ca and 0.45% available P was also included. During the entire experimental period, phytase supplementation significantly improved (P < 0.05) the feed conversion ratio (FCR), BW gain (BWG), and feed intake. Birds fed the PC diet showed significantly higher bone mineral density (BMD) and bone mineral content (BMC) in both femur and tibia bones (P < 0.0001) than those fed the NC diet. Phytase supplementation increased femur BMD (P < 0.05), whereas FOS decreased femur BMD and BMC (P < 0.05). Phosphorus utilization was significantly higher for the NC diet (P < 0.0001). Phytase alone and in combination with 0.5% FOS increased P utilization significantly when compared with other treatments (P < 0.05). Fructooligosaccharides, especially at the level of 0.5%, increased P retention. In conclusion, phytase supplementation in low Ca and P diets improved growth performance, bone quality, and P utilization. However, supplementing NC diets with phytase and FOS did not result in bone mineralization values comparable with that of the PC diet. The application of dietary FOS alone had a negative effect on broiler bone quality. © 2015 Poultry Science Association Inc.

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

Quality competition and uncertainty in a horizontally differentiated hospital market.

PubMed

Montefiori, Marcello

2014-01-01

The chapter studies hospital competition in a spatially differentiated market in which patient demand reflects the quality/distance mix that maximizes their utility. Treatment is free at the point of use and patients freely choose the provider which best fits their expectations. Hospitals might have asymmetric objectives and costs, however they are reimbursed using a uniform prospective payment. The chapter provides different equilibrium outcomes, under perfect and asymmetric information. The results show that asymmetric costs, in the case where hospitals are profit maximizers, allow for a social welfare and quality improvement. On the other hand, the presence of a publicly managed hospital which pursues the objective of quality maximization is able to ensure a higher level of quality, patient surplus and welfare. However, the extent of this outcome might be considerably reduced when high levels of public hospital inefficiency are detectable. Finally, the negative consequences caused by the presence of asymmetric information are highlighted in the different scenarios of ownership/objectives and costs. The setting adopted in the model aims at describing the up-coming European market for secondary health care, focusing on hospital behavior and it is intended to help the policy-maker in understanding real world dynamics.

The impact of an integrated hospital-community medical information system on quality and service utilization in hospital departments.

PubMed

Nirel, Nurit; Rosen, Bruce; Sharon, Assaf; Blondheim, Orna; Sherf, Michael; Samuel, Hadar; Cohen, Arnon D

2010-09-01

In 2005, an innovative system of hospital-community on-line medical records (OFEK) was implemented at Clalit Health Services (CHS). The goals of the study were to examine the extent of OFEK's use and its impact on quality indicators and medical-service utilization in Internal Medicine and General Surgery wards of CHS hospitals. Examining the frequency of OFEK's use with its own track-log data; comparing, "before" and "after", quality indicators and service utilization data in experimental (CHS patients) versus control groups (other patients). OFEK's use increased by tens of percentages each year, Internal Medicine wards showed a significant decrease in the number of laboratory tests and 3 CT tests performed compared with the control group. Wards using OFEK extensively showed a greater decrease in CT tests, in one imaging test, and in the average number of ambulatory hospitalizations. No similar changes were found in General Surgery wards. The study helps evaluate the extent to which OFEK's targets were achieved and contributes to the development of measures to examine the impact of such systems, which can be used to assess a broad range of Health Information Technology (HIT) systems. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Propeller aircraft interior noise model utilization study and validation

NASA Technical Reports Server (NTRS)

Pope, L. D.

1984-01-01

Utilization and validation of a computer program designed for aircraft interior noise prediction is considered. The program, entitled PAIN (an acronym for Propeller Aircraft Interior Noise), permits (in theory) predictions of sound levels inside propeller driven aircraft arising from sidewall transmission. The objective of the work reported was to determine the practicality of making predictions for various airplanes and the extent of the program's capabilities. The ultimate purpose was to discern the quality of predictions for tonal levels inside an aircraft occurring at the propeller blade passage frequency and its harmonics. The effort involved three tasks: (1) program validation through comparisons of predictions with scale-model test results; (2) development of utilization schemes for large (full scale) fuselages; and (3) validation through comparisons of predictions with measurements taken in flight tests on a turboprop aircraft. Findings should enable future users of the program to efficiently undertake and correctly interpret predictions.

Reproducibility of image quality for moving objects using respiratory-gated computed tomography: a study using a phantom model

PubMed Central

Fukumitsu, Nobuyoshi; Ishida, Masaya; Terunuma, Toshiyuki; Mizumoto, Masashi; Hashimoto, Takayuki; Moritake, Takashi; Okumura, Toshiyuki; Sakae, Takeji; Tsuboi, Koji; Sakurai, Hideyuki

2012-01-01

To investigate the reproducibility of computed tomography (CT) imaging quality in respiratory-gated radiation treatment planning is essential in radiotherapy of movable tumors. Seven series of regular and six series of irregular respiratory motions were performed using a thorax dynamic phantom. For the regular respiratory motions, the respiratory cycle was changed from 2.5 to 4 s and the amplitude was changed from 4 to 10 mm. For the irregular respiratory motions, a cycle of 2.5 to 4 or an amplitude of 4 to 10 mm was added to the base data (i.e. 3.5-s cycle, 6-mm amplitude) every three cycles. Images of the object were acquired six times using respiratory-gated data acquisition. The volume of the object was calculated and the reproducibility of the volume was decided based on the variety. The registered image of the object was added and the reproducibility of the shape was decided based on the degree of overlap of objects. The variety in the volumes and shapes differed significantly as the respiratory cycle changed according to regular respiratory motions. In irregular respiratory motion, shape reproducibility was further inferior, and the percentage of overlap among the six images was 35.26% in the 2.5- and 3.5-s cycle mixed group. Amplitude changes did not produce significant differences in the variety of the volumes and shapes. Respiratory cycle changes reduced the reproducibility of the image quality in respiratory-gated CT. PMID:22966173

41 CFR 109-39.301 - Utilization guidelines.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Utilization guidelines... Management System Vehicles § 109-39.301 Utilization guidelines. DOE activities utilizing GSA IFMS motor... meeting DOE utilization guidelines or established local use objectives, as appropriate. Those vehicles not...

An efficient multi-objective optimization method for water quality sensor placement within water distribution systems considering contamination probability variations.

PubMed

He, Guilin; Zhang, Tuqiao; Zheng, Feifei; Zhang, Qingzhou

2018-06-20

Water quality security within water distribution systems (WDSs) has been an important issue due to their inherent vulnerability associated with contamination intrusion. This motivates intensive studies to identify optimal water quality sensor placement (WQSP) strategies, aimed to timely/effectively detect (un)intentional intrusion events. However, these available WQSP optimization methods have consistently presumed that each WDS node has an equal contamination probability. While being simple in implementation, this assumption may do not conform to the fact that the nodal contamination probability may be significantly regionally varied owing to variations in population density and user properties. Furthermore, the low computational efficiency is another important factor that has seriously hampered the practical applications of the currently available WQSP optimization approaches. To address these two issues, this paper proposes an efficient multi-objective WQSP optimization method to explicitly account for contamination probability variations. Four different contamination probability functions (CPFs) are proposed to represent the potential variations of nodal contamination probabilities within the WDS. Two real-world WDSs are used to demonstrate the utility of the proposed method. Results show that WQSP strategies can be significantly affected by the choice of the CPF. For example, when the proposed method is applied to the large case study with the CPF accounting for user properties, the event detection probabilities of the resultant solutions are approximately 65%, while these values are around 25% for the traditional approach, and such design solutions are achieved approximately 10,000 times faster than the traditional method. This paper provides an alternative method to identify optimal WQSP solutions for the WDS, and also builds knowledge regarding the impacts of different CPFs on sensor deployments. Copyright © 2018 Elsevier Ltd. All rights reserved.

Quality Improvement Initiatives: The Missed Opportunity for Health Plans

PubMed Central

Fernandez-Lopez, Sara; Lennert, Barbara

2009-01-01

Background The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. Objectives To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. Methods We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. Results The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Conclusion Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations. PMID:25126303

Economic Valuation on Change of Tourism Quality in Rawapening, Indonesia: An Application of Random Utility Method

NASA Astrophysics Data System (ADS)

Subanti, S.; Irawan, B. R. M. B.; Sasongko, G.; Hakim, A. R.

2017-04-01

This study aims to determine the profit (loss) earned economic actors tourism activities if the condition or quality of tourism in Rawapening be improved (deteriorated). Change condition or quality can be seen by traveling expenses, natural environment, Japanese cultural performances, and traditional markets. The method used to measure changes in the economic benefits or economic loss with a random utility approach. The study was found that travel cost, natural environment, Japanese cultural performances, and traditional markets have significant factors about respondent preferences to choose the change of tourism condition. The value of compensation received by visitors as a result of changes in conditions improved by 2,932 billion, while the change in the condition worsens by 2,628 billion. Recommendation of this study is the local government should consider environmental factors in the formulation of tourism development in Rawapening.

Do generic utility measures capture what is important to the quality of life of people with multiple sclerosis?

PubMed

Kuspinar, Ayse; Mayo, Nancy E

2013-04-25

The three most widely used utility measures are the Health Utilities Index Mark 2 and 3 (HUI2 and HUI3), the EuroQol-5D (EQ-5D) and the Short-Form-6D (SF-6D). In line with guidelines for economic evaluation from agencies such as the National Institute for Health and Clinical Excellence (NICE) and the Canadian Agency for Drugs and Technologies in Health (CADTH), these measures are currently being used to evaluate the cost-effectiveness of different interventions in MS. However, the challenge of using such measures in people with a specific health condition, such as MS, is that they may not capture all of the domains that are impacted upon by the condition. If important domains are missing from the generic measures, the value derived will be higher than the real impact creating invalid comparisons across interventions and populations. Therefore, the objective of this study is to estimate the extent to which generic utility measures capture important domains that are affected by MS. The available study population consisted of men and women who had been registered after 1994 in three participating MS clinics in Greater Montreal, Quebec, Canada. Subjects were first interviewed on an individualized measure of quality of life (QOL) called the Patient Generated Index (PGI). The domains identified with the PGI were then classified and grouped together using the World Health Organization's International Classification of Functioning, Disability and Health (ICF), and mapped onto the HUI2, HUI3, EQ-5D and SF-6D. A total of 185 persons with MS were interviewed on the PGI. The sample was relatively young (mean age 43) and predominantly female. Both men and women had mild disability with a median Expanded Disability Status Scale (EDSS) score of 2. The top 10 domains that patients identified to be the most affected by their MS were, work (62%), fatigue (48%), sports (39%), social life (28%), relationships (23%), walking/mobility (22%), cognition (21%), balance (14%), housework (12

Do generic utility measures capture what is important to the quality of life of people with multiple sclerosis?

PubMed Central

2013-01-01

Purpose The three most widely used utility measures are the Health Utilities Index Mark 2 and 3 (HUI2 and HUI3), the EuroQol-5D (EQ-5D) and the Short-Form-6D (SF-6D). In line with guidelines for economic evaluation from agencies such as the National Institute for Health and Clinical Excellence (NICE) and the Canadian Agency for Drugs and Technologies in Health (CADTH), these measures are currently being used to evaluate the cost-effectiveness of different interventions in MS. However, the challenge of using such measures in people with a specific health condition, such as MS, is that they may not capture all of the domains that are impacted upon by the condition. If important domains are missing from the generic measures, the value derived will be higher than the real impact creating invalid comparisons across interventions and populations. Therefore, the objective of this study is to estimate the extent to which generic utility measures capture important domains that are affected by MS. Methods The available study population consisted of men and women who had been registered after 1994 in three participating MS clinics in Greater Montreal, Quebec, Canada. Subjects were first interviewed on an individualized measure of quality of life (QOL) called the Patient Generated Index (PGI). The domains identified with the PGI were then classified and grouped together using the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), and mapped onto the HUI2, HUI3, EQ-5D and SF-6D. Results A total of 185 persons with MS were interviewed on the PGI. The sample was relatively young (mean age 43) and predominantly female. Both men and women had mild disability with a median Expanded Disability Status Scale (EDSS) score of 2. The top 10 domains that patients identified to be the most affected by their MS were, work (62%), fatigue (48%), sports (39%), social life (28%), relationships (23%), walking/mobility (22%), cognition (21

Evaluating the Impact of Parent-Reported Medical Home Status on Children's Health Care Utilization, Expenditures, and Quality: A Difference-in-Differences Analysis with Causal Inference Methods.

PubMed

Han, Bing; Yu, Hao; Friedberg, Mark W

2017-04-01

To evaluate the effects of the parent-reported medical home status on health care utilization, expenditures, and quality for children. Medical Expenditure Panel Survey (MEPS) during 2004-2012, including a total of 9,153 children who were followed up for 2 years in the survey. We took a causal difference-in-differences approach using inverse probability weighting and doubly robust estimators to study how changes in medical home status over a 2-year period affected children's health care outcomes. Our analysis adjusted for children's sociodemographic, health, and insurance statuses. We conducted sensitivity analyses using alternative statistical methods, different approaches to outliers and missing data, and accounting for possible common-method biases. Compared with children whose parents reported having medical homes in both years 1 and 2, those who had medical homes in year 1 but lost them in year 2 had significantly lower parent-reported ratings of health care quality and higher utilization of emergency care. Compared with children whose parents reported having no medical homes in both years, those who did not have medical homes in year 1 but gained them in year 2 had significantly higher ratings of health care quality, but no significant differences in health care expenditures and utilization. Having a medical home may help improve health care quality for children; losing a medical home may lead to higher utilization of emergency care. © Health Research and Educational Trust.

An elicitation of utility for quality of life under prospect theory.

PubMed

Attema, Arthur E; Brouwer, Werner B F; l'Haridon, Olivier; Pinto, Jose Luis

2016-07-01

This paper performs several tests of decision analysis applied to the health domain. First, we conduct a test of the normative expected utility theory. Second, we investigate the possibility to elicit the more general prospect theory. We observe risk aversion for gains and losses and violations of expected utility. These results imply that mechanisms governing decisions in the health domain are similar to those in the monetary domain. However, we also report one important deviation: utility is universally concave for the health outcomes used in this study, in contrast to the commonly found S-shaped utility for monetary outcomes, with concave utility for gains and convex utility for losses. Copyright © 2016 Elsevier B.V. All rights reserved.

Endoscopic sinus surgery reduces antibiotic utilization in rhinosinusitis

PubMed Central

Bhandarkar, Naveen D.; Mace, Jess C.; Smith, Timothy L.

2011-01-01

Background Antibiotics are a mainstay of treatment for chronic rhinosinusitis (CRS) and recurrent acute rhinosinusitis (RARS). Although quality-of-life outcomes following endoscopic sinus surgery (ESS) have been previously studied, the change in antibiotic utilization following ESS is less well known. Objective We aimed to determine the effect of ESS on antibiotic utilization in CRS and RARS. Methods A multi-institutional, prospective cohort of patients with CRS and RARS was enrolled between January, 2001 and January, 2009. Patients completed the medication subscale of the Chronic Sinusitis Survey, and the Wilcoxon signed-rank test was used to compare differences in the overall reported time of antibiotic between preoperative and postoperative time points. Results 503 patients were followed for an average 17.3 months. Overall, patients reported a 57.2% reduction in time on antibiotics following ESS. The majority of patients (60.4%) reported significantly less antibiotic utilization after ESS (p<0.001) consisting of an 83.7% reduction in the time on antibiotics. Subgroup analysis also revealed a significant reduction in antibiotic utilization for patients with and without nasal polyposis (59.0% and 58.2%; both p<0.001) as well as RARS (61.2%; p=0.001). Conclusion ESS significantly reduces antibiotic utilization for CRS and RARS. This finding demonstrates potential for lower health care expenditures related to antibiotics, as well as reduced risk of both antibiotic related morbidity and development of bacterial resistance. PMID:21666846

Decreasing unnecessary utilization in acute bronchiolitis care: results from the value in inpatient pediatrics network.

PubMed

Ralston, Shawn; Garber, Matthew; Narang, Steve; Shen, Mark; Pate, Brian; Pope, John; Lossius, Michele; Croland, Trina; Bennett, Jeff; Jewell, Jennifer; Krugman, Scott; Robbins, Elizabeth; Nazif, Joanne; Liewehr, Sheila; Miller, Ansley; Marks, Michelle; Pappas, Rita; Pardue, Jeanann; Quinonez, Ricardo; Fine, Bryan R; Ryan, Michael

2013-01-01

Acute viral bronchiolitis is the most common diagnosis resulting in hospital admission in pediatrics. Utilization of non-evidence-based therapies and testing remains common despite a large volume of evidence to guide quality improvement efforts. Our objective was to reduce utilization of unnecessary therapies in the inpatient care of bronchiolitis across a diverse network of clinical sites. We formed a voluntary quality improvement collaborative of pediatric hospitalists for the purpose of benchmarking the use of bronchodilators, steroids, chest radiography, chest physiotherapy, and viral testing in bronchiolitis using hospital administrative data. We shared resources within the network, including protocols, scores, order sets, and key bibliographies, and established group norms for decreasing utilization. Aggregate data on 11,568 hospitalizations for bronchiolitis from 17 centers was analyzed for this report. The network was organized in 2008. By 2010, we saw a 46% reduction in overall volume of bronchodilators used, a 3.4 dose per patient absolute decrease in utilization (95% confidence interval [CI] 1.4-5.8). Overall exposure to any dose of bronchodilator decreased by 12 percentage points as well (95% CI 5%-25%). There was also a statistically significant decline in chest physiotherapy usage, but not for steroids, chest radiography, or viral testing. Benchmarking within a voluntary pediatric hospitalist collaborative facilitated decreased utilization of bronchodilators and chest physiotherapy in bronchiolitis. Copyright © 2012 Society of Hospital Medicine.

A Validation of Object-Oriented Design Metrics as Quality Indicators

NASA Technical Reports Server (NTRS)

Basili, Victor R.; Briand, Lionel C.; Melo, Walcelio

1997-01-01

This paper presents the results of a study in which we empirically investigated the suits of object-oriented (00) design metrics introduced in another work. More specifically, our goal is to assess these metrics as predictors of fault-prone classes and, therefore, determine whether they can be used as early quality indicators. This study is complementary to the work described where the same suite of metrics had been used to assess frequencies of maintenance changes to classes. To perform our validation accurately, we collected data on the development of eight medium-sized information management systems based on identical requirements. All eight projects were developed using a sequential life cycle model, a well-known 00 analysis/design method and the C++ programming language. Based on empirical and quantitative analysis, the advantages and drawbacks of these 00 metrics are discussed. Several of Chidamber and Kamerer's 00 metrics appear to be useful to predict class fault-proneness during the early phases of the life-cycle. Also, on our data set, they are better predictors than 'traditional' code metrics, which can only be collected at a later phase of the software development processes.

Influence of health-related quality of life on health service utilization in Chinese rural-to-urban female migrant workers.

PubMed

Lu, Chu-Hong; Wang, Pei-Xi; Lei, Yi-Xiong; Luo, Zhong-Cheng

2014-08-15

Rural-to-urban migrant workers have been increasing rapidly in China over recent decades. Health related quality of life (HRQOL) may affect health service utilization. There is a lack of data on HRQOL in relation to health service utilization in Chinese rural-to-urban migrant workers. This study was aimed to explore the influence of HRQOL on health service utilization in Chinese rural-to-urban female migrant workers. This was a cross-sectional survey of 1,438 female rural-to-urban migrant workers in Shenzhen-Dongguan economic zone, China in 2013. HRQOL was assessed by the 36-items Health Survey Short Form (SF-36). Health service utilization was measured by any physician visit over the recent two weeks and any hospitalization over the last 1-year (annual hospitalization). Clustered logistic regression was used to analyze the influence of HRQOL on health service utilization. Lower scores in three HRQOL domains (bodily pain, general health, role physical) were associated with more frequent health service utilization in female rural-to-urban migrant workers. Bodily pain and general health were associated with an independent influence of 15.6% on the risk of recent two-week physician visit, while role physical and general health were associated with an independent influence of 21.2% on the risk of annual hospitalization. The independent influence of HRQOL on health service utilization was smaller than that of socio-demographic and health-related variables. HRQOL may have a modest influence on health service utilization in Chinese rural-to-urban female migrant workers - an underprivileged population in urban China.

A comparison of quality and utilization problems in large and small group practices.

PubMed

Gleason, S C; Richards, M J; Quinnell, J E

1995-12-01

Physicians practicing in large, multispecialty medical groups share an organizational culture that differs from that of physicians in small or independent practices. Since 1980, there has been a sharp increase in the size of multispecialty group practice organizations, in part because of increased efficiencies of large group practices. The greater number of physicians and support personnel in a large group practice also requires a relatively more sophisticated management structure. The efficiencies, conveniences, and management structure of a large group practice provide an optimal environment to practice medicine. However, a search of the literature found no data linking a large group practice environment to practice outcomes. The purpose of the study reported in this article was to determine if physicians in large practices have fewer quality and utilization problems than physicians in small or independent practices.

A Rotatable Quality Control Phantom for Evaluating the Performance of Flat Panel Detectors in Imaging Moving Objects.

PubMed

Haga, Yoshihiro; Chida, Koichi; Inaba, Yohei; Kaga, Yuji; Meguro, Taiichiro; Zuguchi, Masayuki

2016-02-01

As the use of diagnostic X-ray equipment with flat panel detectors (FPDs) has increased, so has the importance of proper management of FPD systems. To ensure quality control (QC) of FPD system, an easy method for evaluating FPD imaging performance for both stationary and moving objects is required. Until now, simple rotatable QC phantoms have not been available for the easy evaluation of the performance (spatial resolution and dynamic range) of FPD in imaging moving objects. We developed a QC phantom for this purpose. It consists of three thicknesses of copper and a rotatable test pattern of piano wires of various diameters. Initial tests confirmed its stable performance. Our moving phantom is very useful for QC of FPD images of moving objects because it enables visual evaluation of image performance (spatial resolution and dynamic range) easily.

Cross-Border Utilization of Health Care: Evidence from a Population-Based Study in South Texas

PubMed Central

Su, Dejun; Richardson, Chad; Wen, Ming; Pagán, José A

2011-01-01

Objective To assess the prevalence of health care utilization in Mexico by Texas border residents and to identify the main contributing factors to their cross-border utilization of health care services. Data and Methods This study used primary data from a population-based telephone survey that was conducted in the whole Texas border area in 2008. The survey included responses from 1,405 adults. Multivariate logistic regression models were estimated to determine predictors of utilizing a wide range of health care services in Mexico. Principal Findings Forty-nine percent of the sample reported having ever purchased medications in Mexico, followed by 41 percent for dentist visits, 37.3 percent for doctor visits, and 6.7 percent for inpatient care. The most significant predictors of health care utilization in Mexico were lack of U.S. health insurance coverage, dissatisfaction with the quality of U.S. health care, and poor self-rated health status. Conclusions The high prevalence of use of health care services in Mexico by Texas border residents is suggestive of unmet needs in health care on the U.S. side of the border. Addressing these unmet needs calls for a binational approach to improve the affordability, accessibility, and quality of health care in the U.S.–Mexico border region. PMID:21158855

Collinearity and Sample Coverage Issues in the Objective Measurement of Vocal Quality: The Case of Roughness and Breathiness

ERIC Educational Resources Information Center

Ferrer, Carlos A.; Haderlein, Tino; Maryn, Youri; de Bodt, Marc S.; Nöth, Elmar

2018-01-01

Purpose: The aim of the study was to address the reported inconsistencies in the relationship between objective acoustic measures and perceptual ratings of vocal quality. Method: This tutorial moves away from the more widely examined problems related to obtaining the perceptual ratings and the acoustic measures and centers in less scrutinized…

MODELING ASSESSMENT OF THE IMPACT OF NITROGEN OXIDES EMISSION REDUCTIONS ON OZONE AIR QUALITY IN THE EASTERN UNITED STATES: OFFSETTING INCREASES IN ENERGY USE

EPA Science Inventory

The objective of this study is to examine changes in ambient ozone concentrations estimated by a photochemical air quality model in response to the NOx emission reductions imposed on the utility sector. To accomplish this task, CMAQ air quality model simulations were performe...

Effects of Achieving Target Measures in Rheumatoid Arthritis on Functional Status, Quality of Life, and Resource Utilization: Analysis of Clinical Practice Data.

PubMed

Alemao, Evo; Joo, Seongjung; Kawabata, Hugh; Al, Maiwenn J; Allison, Paul D; Rutten-van Mölken, Maureen P M H; Frits, Michelle L; Iannaccone, Christine K; Shadick, Nancy A; Weinblatt, Michael E

2016-03-01

To evaluate associations between achieving guideline-recommended targets of disease activity, defined by the Disease Activity Score in 28 joints using C-reactive protein level (DAS28-CRP) <2.6, the Simplified Disease Activity Index (SDAI) ≤3.3, or the Clinical Disease Activity Index (CDAI) ≤2.8, and other health outcomes in a longitudinal observational study. Other defined thresholds included low disease activity (LDA), moderate (MDA), or severe disease activity (SDA). To control for intraclass correlation and estimate effects of independent variables on outcomes of the modified Health Assessment Questionnaire (M-HAQ), the EuroQol 5-domain (EQ-5D; a quality-of-life measure), hospitalization, and durable medical equipment (DME) use, we employed mixed models for continuous outcomes and generalized estimating equations for binary outcomes. Among 1,297 subjects, achievement (versus nonachievement) of recommended disease targets was associated with enhanced physical functioning and lower health resource utilization. After controlling for baseline covariates, achievement of disease targets (versus LDA) was associated with significantly enhanced physical functioning based on SDAI ≤3.3 (ΔM-HAQ -0.047; P = 0.0100) and CDAI ≤2.8 (-0.073; P = 0.0003) but not DAS28-CRP <2.6 (-0.022; P = 0.1735). Target attainment was associated with significantly improved EQ-5D (0.022-0.096; P < 0.0030 versus LDA, MDA, or SDA). Patients achieving guideline-recommended disease targets were 36-45% less likely to be hospitalized (P < 0.0500) and 23-45% less likely to utilize DME (P < 0.0100). Attaining recommended target disease-activity measures was associated with enhanced physical functioning and health-related quality of life. Some health outcomes were similar in subjects attaining guideline targets versus LDA. Achieving LDA is a worthy clinical objective in some patients. © 2016 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of the

Objective Speech Quality Assessment Based on Payload Discrimination of Lost Packets for Cellular Phones in NGN Environment

NASA Astrophysics Data System (ADS)

Uemura, Satoshi; Fukumoto, Norihiro; Yamada, Hideaki; Nakamura, Hajime

A feature of services provided in a Next Generation Network (NGN) is that the end-to-end quality is guaranteed. This is quite a challenging issue, given the considerable fluctuation in network conditions within a Fixed Mobile Convergence (FMC) network. Therefore, a novel approach, whereby a network node and a mobile terminal such as a cellular phone cooperate with each other to control service quality is essential. In order to achieve such cooperation, the mobile terminal needs to become more intelligent so it can estimate the service quality, including the user's perceptual quality, and notify the measurement result to the network node. Subsequently, the network node implements some kind of service control function, such as a resource and admission control function, based on the notification from the mobile terminal. In this paper, the role of the mobile terminal in such collaborative system is focused on. As a part of a QoS/QoE measurement system, we describe an objective speech quality assessment with payload discrimination of lost packets to measure the user's perceptual quality of VoIP. The proposed assessment is so simple that it can be implemented on a cellular phone. We therefore did this as part of the QoS/QoE measurement system. By using the implemented system, we can measure the user's perceptual quality of VoIP as well as the network QoS metrics, in terms of criteria such as packet loss rate, jitter and burstiness in real time.

Infant visual attention and object recognition.

PubMed

Reynolds, Greg D

2015-05-15

This paper explores the role visual attention plays in the recognition of objects in infancy. Research and theory on the development of infant attention and recognition memory are reviewed in three major sections. The first section reviews some of the major findings and theory emerging from a rich tradition of behavioral research utilizing preferential looking tasks to examine visual attention and recognition memory in infancy. The second section examines research utilizing neural measures of attention and object recognition in infancy as well as research on brain-behavior relations in the early development of attention and recognition memory. The third section addresses potential areas of the brain involved in infant object recognition and visual attention. An integrated synthesis of some of the existing models of the development of visual attention is presented which may account for the observed changes in behavioral and neural measures of visual attention and object recognition that occur across infancy. Copyright © 2015 Elsevier B.V. All rights reserved.

Infant Visual Attention and Object Recognition

PubMed Central

Reynolds, Greg D.

2015-01-01

This paper explores the role visual attention plays in the recognition of objects in infancy. Research and theory on the development of infant attention and recognition memory are reviewed in three major sections. The first section reviews some of the major findings and theory emerging from a rich tradition of behavioral research utilizing preferential looking tasks to examine visual attention and recognition memory in infancy. The second section examines research utilizing neural measures of attention and object recognition in infancy as well as research on brain-behavior relations in the early development of attention and recognition memory. The third section addresses potential areas of the brain involved in infant object recognition and visual attention. An integrated synthesis of some of the existing models of the development of visual attention is presented which may account for the observed changes in behavioral and neural measures of visual attention and object recognition that occur across infancy. PMID:25596333

National Utility Rate Database: Preprint

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

Ong, S.; McKeel, R.

2012-08-01

When modeling solar energy technologies and other distributed energy systems, using high-quality expansive electricity rates is essential. The National Renewable Energy Laboratory (NREL) developed a utility rate platform for entering, storing, updating, and accessing a large collection of utility rates from around the United States. This utility rate platform lives on the Open Energy Information (OpenEI) website, OpenEI.org, allowing the data to be programmatically accessed from a web browser, using an application programming interface (API). The semantic-based utility rate platform currently has record of 1,885 utility rates and covers over 85% of the electricity consumption in the United States.

Water quality, compliance, and health outcomes among utilities implementing Water Safety Plans in France and Spain.

PubMed

Setty, Karen E; Kayser, Georgia L; Bowling, Michael; Enault, Jerome; Loret, Jean-Francois; Serra, Claudia Puigdomenech; Alonso, Jordi Martin; Mateu, Arnau Pla; Bartram, Jamie

2017-05-01

Water Safety Plans (WSPs), recommended by the World Health Organization since 2004, seek to proactively identify potential risks to drinking water supplies and implement preventive barriers that improve safety. To evaluate the outcomes of WSP application in large drinking water systems in France and Spain, we undertook analysis of water quality and compliance indicators between 2003 and 2015, in conjunction with an observational retrospective cohort study of acute gastroenteritis incidence, before and after WSPs were implemented at five locations. Measured water quality indicators included bacteria (E. coli, fecal streptococci, total coliform, heterotrophic plate count), disinfectants (residual free and total chlorine), disinfection by-products (trihalomethanes, bromate), aluminum, pH, turbidity, and total organic carbon, comprising about 240K manual samples and 1.2M automated sensor readings. We used multiple, Poisson, or Tobit regression models to evaluate water quality before and after the WSP intervention. The compliance assessment analyzed exceedances of regulated, recommended, or operational water quality thresholds using chi-squared or Fisher's exact tests. Poisson regression was used to examine acute gastroenteritis incidence rates in WSP-affected drinking water service areas relative to a comparison area. Implementation of a WSP generally resulted in unchanged or improved water quality, while compliance improved at most locations. Evidence for reduced acute gastroenteritis incidence following WSP implementation was found at only one of the three locations examined. Outcomes of WSPs should be expected to vary across large water utilities in developed nations, as the intervention itself is adapted to the needs of each location. The approach may translate to diverse water quality, compliance, and health outcomes. Copyright © 2017 Elsevier GmbH. All rights reserved.

Data Quality Objectives Supporting the Environmental Soil Monitoring Program for the Idaho National Laboratory Site

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

Haney, Thomas Jay

This document describes the process used to develop data quality objectives for the Idaho National Laboratory (INL) Environmental Soil Monitoring Program in accordance with U.S. Environmental Protection Agency guidance. This document also develops and presents the logic that was used to determine the specific number of soil monitoring locations at the INL Site, at locations bordering the INL Site, and at locations in the surrounding regional area. The monitoring location logic follows the guidance from the U.S. Department of Energy for environmental surveillance of its facilities.

Post-examination interpretation of objective test data: monitoring and improving the quality of high-stakes examinations--a commentary on two AMEE Guides.

PubMed

Tavakol, Mohsen; Dennick, Reg

2012-01-01

As great emphasis is rightly placed upon the importance of assessment to judge the quality of our future healthcare professionals, it is appropriate not only to choose the most appropriate assessment method, but to continually monitor the quality of the tests themselves, in a hope that we may continually improve the process. This article stresses the importance of quality control mechanisms in the exam cycle and briefly outlines some of the key psychometric concepts including reliability measures, factor analysis, generalisability theory and item response theory. The importance of such analyses for the standard setting procedures is emphasised. This article also accompanies two new AMEE Guides in Medical Education (Tavakol M, Dennick R. Post-examination Analysis of Objective Tests: AMEE Guide No. 54 and Tavakol M, Dennick R. 2012. Post examination analysis of objective test data: Monitoring and improving the quality of high stakes examinations: AMEE Guide No. 66) which provide the reader with practical examples of analysis and interpretation, in order to help develop valid and reliable tests.

A CAD system and quality assurance protocol for bone age assessment utilizing digital hand atlas

NASA Astrophysics Data System (ADS)

Gertych, Arakadiusz; Zhang, Aifeng; Ferrara, Benjamin; Liu, Brent J.

2007-03-01

Determination of bone age assessment (BAA) in pediatric radiology is a task based on detailed analysis of patient's left hand X-ray. The current standard utilized in clinical practice relies on a subjective comparison of the hand with patterns in the book atlas. The computerized approach to BAA (CBAA) utilizes automatic analysis of the regions of interest in the hand image. This procedure is followed by extraction of quantitative features sensitive to skeletal development that are further converted to a bone age value utilizing knowledge from the digital hand atlas (DHA). This also allows providing BAA results resembling current clinical approach. All developed methodologies have been combined into one CAD module with a graphical user interface (GUI). CBAA can also improve the statistical and analytical accuracy based on a clinical work-flow analysis. For this purpose a quality assurance protocol (QAP) has been developed. Implementation of the QAP helped to make the CAD more robust and find images that cannot meet conditions required by DHA standards. Moreover, the entire CAD-DHA system may gain further benefits if clinical acquisition protocol is modified. The goal of this study is to present the performance improvement of the overall CAD-DHA system with QAP and the comparison of the CAD results with chronological age of 1390 normal subjects from the DHA. The CAD workstation can process images from local image database or from a PACS server.

Reconstruction of 3d Objects of Assets and Facilities by Using Benchmark Points

NASA Astrophysics Data System (ADS)

Baig, S. U.; Rahman, A. A.

2013-08-01

Acquiring and modeling 3D geo-data of building assets and facility objects is one of the challenges. A number of methods and technologies are being utilized for this purpose. Total station, GPS, photogrammetric and terrestrial laser scanning are few of these technologies. In this paper, points commonly shared by potential facades of assets and facilities modeled from point clouds are identified. These points are useful for modeling process to reconstruct 3D models of assets and facilities stored to be used for management purposes. These models are segmented through different planes to produce accurate 2D plans. This novel method improves the efficiency and quality of construction of models of assets and facilities with the aim utilize in 3D management projects such as maintenance of buildings or group of items that need to be replaced, or renovated for new services.

Comet/Asteroid Protection System (CAPS): A Space-Based System Concept for Revolutionizing Earth Protection and Utilization of Near-Earth Objects

NASA Technical Reports Server (NTRS)

Mazanek, Daniel D.; Roithmayr, Carlos M.; Antol, Jeffrey; Kay-Bunnell, Linda; Werner, Martin R.; Park, Sang-Young; Kumar, Renjith R.

2002-01-01

There exists an infrequent, but significant hazard to life and property due to impacting asteroids and comets. There is currently no specific search for long-period comets, smaller near-Earth asteroids, or smaller short-period comets. These objects represent a threat with potentially little or no warning time using conventional ground-based telescopes. These planetary bodies also represent a significant resource for commercial exploitation, long-term sustained space exploration, and scientific research. The Comet/Asteroid Protection System (CAPS) would expand the current detection effort to include long-period comets, as well as small asteroids and short-period comets capable of regional destruction. A space-based detection system, despite being more costly and complex than Earth-based initiatives, is the most promising way of expanding the range of detectable objects, and surveying the entire celestial sky on a regular basis. CAPS is a future spacebased system concept that provides permanent, continuous asteroid and comet monitoring, and rapid, controlled modification of the orbital trajectories of selected bodies. CAPS would provide an orbit modification system capable of diverting kilometer class objects, and modifying the orbits of smaller asteroids for impact defense and resource utilization. This paper provides a summary of CAPS and discusses several key areas and technologies that are being investigated.

Psychometric properties of health related quality of life measures in acute coronary syndrome patients: a systematic review protocol.

PubMed

Brasil, Virginia; Oliveira, Gabriela; Moraes, Katarinne Lima

2018-02-01

The objective of this systematic review is to evaluate the psychometric properties and clinical utility of patient-reported outcome measures that assess health-related quality of life in patients with a clinical diagnosis of acute coronary syndrome.

Productivity, Quality, and Patient Satisfaction

PubMed Central

Fairchild, David G; McLoughlin, Karen Sax; Gharib, Soheyla; Horsky, Jan; Portnow, Michelle; Richter, James; Gagliano, Nancy; Bates, David W

2001-01-01

CONTEXT Although few data are available, many believe that part-time primary care physicians (PCPs) are less productive and provide lower quality care than full-time PCPs. Some insurers exclude part-time PCPs from their provider networks. OBJECTIVE To compare productivity, qualtiy of preventive care, patient satisfaction, and risk-adjusted resource utilization of part-time and full-time PCPs. DESIGN Retrospective cohort study. SETTING Boston. PARTICIPANTS PCPs affiliated with 2 academic outpatient primary care networks. MEASUREMENTS PCP productivity, patient satisfaction, resource utilization, and compliance with screening guidelines. RESULTS Part-time PCP productivity was greater than that of full-time PCPs (2.1 work relative value units (RVUs)/bookable clinical hour versus 1.3 work RVUs/bookable clinical hour, P < .01). A similar proportion of part-time PCPs (80%) and full-time PCPs (75%) met targets for mammography, Pap smears, and cholesterol screening (P = .67). After adjusting for clinical case mix, practice location, gender, board certification status, and years in practice, resource utilization of part-time PCPs ($138 [95% confidence interval (CI), $108 to $167]) was similar to that of full-time PCPs ($139 [95% CI, $108 to $170], P = .92). Patient satisfation was similar for part-time and full-time PCPs. CONCLUSIONS In these academic primary care practices, rates of patient satisfaction, compliance with screenig guidelines, and resource utilization were similar for part-time PCPs compared to full-time PCPs. Productivity per clinical hour was markedly higher for part-time PCPs are atleast as efficient as full-time PCPs and that the quality of their work is similar. PMID:11679033

A cross-national study to objectively evaluate the quality of diverse simulation approaches for undergraduate nursing students.

PubMed

Kable, Ashley K; Levett-Jones, Tracy L; Arthur, Carol; Reid-Searl, Kerry; Humphreys, Melanie; Morris, Sara; Walsh, Pauline; Witton, Nicola J

2018-01-01

The aim of this paper is to report the results of a cross-national study that evaluated a range of simulation sessions using an observation schedule developed from evidence-based quality indicators. Observational data were collected from 17 simulation sessions conducted for undergraduate nursing students at three universities in Australia and the United Kingdom. The observation schedule contained 27 questions that rated simulation quality. Data were collected by direct observation and from video recordings of the simulation sessions. Results indicated that the highest quality scores were for provision of learning objectives prior to the simulation session (90%) and debriefing (72%). Student preparatiosn and orientation (67%) and perceived realism and fidelity (67%) were scored lower than other components of the simulation sessions. This observational study proved to be an effective strategy to identify areas of strength and those needing further development to improve simulation sessions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Utilizing knowledge from prior plans in the evaluation of quality assurance

NASA Astrophysics Data System (ADS)

Stanhope, Carl; Wu, Q. Jackie; Yuan, Lulin; Liu, Jianfei; Hood, Rodney; Yin, Fang-Fang; Adamson, Justus

2015-06-01

Increased interest regarding sensitivity of pre-treatment intensity modulated radiotherapy and volumetric modulated arc radiotherapy (VMAT) quality assurance (QA) to delivery errors has led to the development of dose-volume histogram (DVH) based analysis. This paradigm shift necessitates a change in the acceptance criteria and action tolerance for QA. Here we present a knowledge based technique to objectively quantify degradations in DVH for prostate radiotherapy. Using machine learning, organ-at-risk (OAR) DVHs from a population of 198 prior patients’ plans were adapted to a test patient’s anatomy to establish patient-specific DVH ranges. This technique was applied to single arc prostate VMAT plans to evaluate various simulated delivery errors: systematic single leaf offsets, systematic leaf bank offsets, random normally distributed leaf fluctuations, systematic lag in gantry angle of the mutli-leaf collimators (MLCs), fluctuations in dose rate, and delivery of each VMAT arc with a constant rather than variable dose rate. Quantitative Analyses of Normal Tissue Effects in the Clinic suggests V75Gy dose limits of 15% for the rectum and 25% for the bladder, however the knowledge based constraints were more stringent: 8.48   ±   2.65% for the rectum and 4.90   ±   1.98% for the bladder. 19   ±   10 mm single leaf and 1.9   ±   0.7 mm single bank offsets resulted in rectum DVHs worse than 97.7% (2σ) of clinically accepted plans. PTV degradations fell outside of the acceptable range for 0.6   ±   0.3 mm leaf offsets, 0.11   ±   0.06 mm bank offsets, 0.6   ±   1.3 mm of random noise, and 1.0   ±   0.7° of gantry-MLC lag. Utilizing a training set comprised of prior treatment plans, machine learning is used to predict a range of achievable DVHs for the test patient’s anatomy. Consequently, degradations leading to statistical outliers may be identified

Quality of fresh organic matter affects priming of soil organic matter and substrate utilization patterns of microbes

PubMed Central

Wang, Hui; Boutton, Thomas W.; Xu, Wenhua; Hu, Guoqing; Jiang, Ping; Bai, Edith

2015-01-01

Changes in biogeochemical cycles and the climate system due to human activities are expected to change the quantity and quality of plant litter inputs to soils. How changing quality of fresh organic matter (FOM) might influence the priming effect (PE) on soil organic matter (SOM) mineralization is still under debate. Here we determined the PE induced by two 13C-labeled FOMs with contrasting nutritional quality (leaf vs. stalk of Zea mays L.). Soils from two different forest types yielded consistent results: soils amended with leaf tissue switched faster from negative PE to positive PE due to greater microbial growth compared to soils amended with stalks. However, after 16 d of incubation, soils amended with stalks had a higher PE than those amended with leaf. Phospholipid fatty acid (PLFA) results suggested that microbial demand for carbon and other nutrients was one of the major determinants of the PE observed. Therefore, consideration of both microbial demands for nutrients and FOM supply simultaneously is essential to understand the underlying mechanisms of PE. Our study provided evidence that changes in FOM quality could affect microbial utilization of substrate and PE on SOM mineralization, which may exacerbate global warming problems under future climate change. PMID:25960162

Quality of fresh organic matter affects priming of soil organic matter and substrate utilization patterns of microbes.

PubMed

Wang, Hui; Boutton, Thomas W; Xu, Wenhua; Hu, Guoqing; Jiang, Ping; Bai, Edith

2015-05-11

Changes in biogeochemical cycles and the climate system due to human activities are expected to change the quantity and quality of plant litter inputs to soils. How changing quality of fresh organic matter (FOM) might influence the priming effect (PE) on soil organic matter (SOM) mineralization is still under debate. Here we determined the PE induced by two (13)C-labeled FOMs with contrasting nutritional quality (leaf vs. stalk of Zea mays L.). Soils from two different forest types yielded consistent results: soils amended with leaf tissue switched faster from negative PE to positive PE due to greater microbial growth compared to soils amended with stalks. However, after 16 d of incubation, soils amended with stalks had a higher PE than those amended with leaf. Phospholipid fatty acid (PLFA) results suggested that microbial demand for carbon and other nutrients was one of the major determinants of the PE observed. Therefore, consideration of both microbial demands for nutrients and FOM supply simultaneously is essential to understand the underlying mechanisms of PE. Our study provided evidence that changes in FOM quality could affect microbial utilization of substrate and PE on SOM mineralization, which may exacerbate global warming problems under future climate change.

Quality of fresh organic matter affects priming of soil organic matter and substrate utilization patterns of microbes

NASA Astrophysics Data System (ADS)

Wang, Hui; Boutton, Thomas W.; Xu, Wenhua; Hu, Guoqing; Jiang, Ping; Bai, Edith

2015-05-01

Changes in biogeochemical cycles and the climate system due to human activities are expected to change the quantity and quality of plant litter inputs to soils. How changing quality of fresh organic matter (FOM) might influence the priming effect (PE) on soil organic matter (SOM) mineralization is still under debate. Here we determined the PE induced by two 13C-labeled FOMs with contrasting nutritional quality (leaf vs. stalk of Zea mays L.). Soils from two different forest types yielded consistent results: soils amended with leaf tissue switched faster from negative PE to positive PE due to greater microbial growth compared to soils amended with stalks. However, after 16 d of incubation, soils amended with stalks had a higher PE than those amended with leaf. Phospholipid fatty acid (PLFA) results suggested that microbial demand for carbon and other nutrients was one of the major determinants of the PE observed. Therefore, consideration of both microbial demands for nutrients and FOM supply simultaneously is essential to understand the underlying mechanisms of PE. Our study provided evidence that changes in FOM quality could affect microbial utilization of substrate and PE on SOM mineralization, which may exacerbate global warming problems under future climate change.

Health-related quality of life of cataract patients: cross-cultural comparisons of utility and psychometric measures.

PubMed

Lee, Jae Eun; Fos, Peter J; Zuniga, Miguel A; Kastl, Peter R; Sung, Jung Hye

2003-07-01

This study was conducted to assess the presence and/or absence of cross-cultural differences or similarities between Korean and United States cataract patients. A systematic assessment was performed using utility and psychometric measures in the study population. A cross-sectional study design was used to examine the comparison of preoperative outcomes measures in cataract patients in Korea and the United States. Study subjects were selected using non-probabilistic methods and included 132 patients scheduled for cataract surgery in one eye. Subjects were adult cataract patients at Samsung and Kunyang General Hospital in Seoul, Korea, and Tulane University Hospital and Clinics in New Orleans, Louisiana. Preoperative utility was assessed using the verbal rating scale and standard reference gamble techniques. Current preoperative health status was assessed using the SF-36 and VF-14 surveys. Current preoperative Snellen visual acuity was used as a clinical measure of vision status. Korean patients were more likely to be younger (p = 0.001), less educated (p = 0.001), and to have worse Snellen visual acuity (p = 0.002) than United States patients. Multivariate analysis of variance (MANOVA) revealed that in contrast to Korean patients, United States patients were assessed to have higher scoring in general health, vitality, VF-14, and verbal rating for visual health. This higher scoring trend persisted after controlling for age, gender, education and Snellen visual acuity. The difference in health-related quality of life (HRQOL) between the two countries was quite clear, especially in the older age and highly educated group. Subjects in Korea and the United States were significantly different in quality of life, functional status and clinical outcomes. Subjects in the United States had more favorable health outcomes than those in Korea. These differences may be caused by multiple factors, including country-specific differences in economic status, health care system

Multi-objective optimization of laser-scribed micro grooves on AZO conductive thin film using Data Envelopment Analysis

NASA Astrophysics Data System (ADS)

Kuo, Chung-Feng Jeffrey; Quang Vu, Huy; Gunawan, Dewantoro; Lan, Wei-Luen

2012-09-01

Laser scribing process has been considered as an effective approach for surface texturization on thin film solar cell. In this study, a systematic method for optimizing multi-objective process parameters of fiber laser system was proposed to achieve excellent quality characteristics, such as the minimum scribing line width, the flattest trough bottom, and the least processing edge surface bumps for increasing incident light absorption of thin film solar cell. First, the Taguchi method (TM) obtained useful statistical information through the orthogonal array with relatively fewer experiments. However, TM is only appropriate to optimize single-objective problems and has to rely on engineering judgment for solving multi-objective problems that can cause uncertainty to some degree. The back-propagation neural network (BPNN) and data envelopment analysis (DEA) were utilized to estimate the incomplete data and derive the optimal process parameters of laser scribing system. In addition, analysis of variance (ANOVA) method was also applied to identify the significant factors which have the greatest effects on the quality of scribing process; in other words, by putting more emphasis on these controllable and profound factors, the quality characteristics of the scribed thin film could be effectively enhanced. The experiments were carried out on ZnO:Al (AZO) transparent conductive thin film with a thickness of 500 nm and the results proved that the proposed approach yields better anticipated improvements than that of the TM which is only superior in improving one quality while sacrificing the other qualities. The results of confirmation experiments have showed the reliability of the proposed method.

Considering Decision Variable Diversity in Multi-Objective Optimization: Application in Hydrologic Model Calibration

NASA Astrophysics Data System (ADS)

Sahraei, S.; Asadzadeh, M.

2017-12-01

Any modern multi-objective global optimization algorithm should be able to archive a well-distributed set of solutions. While the solution diversity in the objective space has been explored extensively in the literature, little attention has been given to the solution diversity in the decision space. Selection metrics such as the hypervolume contribution and crowding distance calculated in the objective space would guide the search toward solutions that are well-distributed across the objective space. In this study, the diversity of solutions in the decision-space is used as the main selection criteria beside the dominance check in multi-objective optimization. To this end, currently archived solutions are clustered in the decision space and the ones in less crowded clusters are given more chance to be selected for generating new solution. The proposed approach is first tested on benchmark mathematical test problems. Second, it is applied to a hydrologic model calibration problem with more than three objective functions. Results show that the chance of finding more sparse set of high-quality solutions increases, and therefore the analyst would receive a well-diverse set of options with maximum amount of information. Pareto Archived-Dynamically Dimensioned Search, which is an efficient and parsimonious multi-objective optimization algorithm for model calibration, is utilized in this study.

Research on Objectives for High-School Biology

ERIC Educational Resources Information Center

Korgan, John J., Jr.; Wilson, John T.

1973-01-01

Describes procedures to develop instructional objectives for high school biology. Two kinds of objectives are identified as pre-objectives and performance objectives. Models to classify these in branches of biology and to ensure quality control are provided. (PS)

Handling qualities of a wide-body transport airplane utilizing Pitch Active Control Systems (PACS) for relaxed static stability application

NASA Technical Reports Server (NTRS)

Grantham, William D.; Person, Lee H., Jr.; Brown, Philip W.; Becker, Lawrence E.; Hunt, George E.; Rising, J. J.; Davis, W. J.; Willey, C. S.; Weaver, W. A.; Cokeley, R.

1985-01-01

Piloted simulation studies have been conducted to evaluate the effectiveness of two pitch active control systems (PACS) on the flying qualities of a wide-body transport airplane when operating at negative static margins. These two pitch active control systems consisted of a simple 'near-term' PACS and a more complex 'advanced' PACS. Eight different flight conditions, representing the entire flight envelope, were evaluated with emphasis on the cruise flight conditions. These studies were made utilizing the Langley Visual/Motion Simulator (VMS) which has six degrees of freedom. The simulation tests indicated that (1) the flying qualities of the baseline aircraft (PACS off) for the cruise and other high-speed flight conditions were unacceptable at center-of-gravity positions aft of the neutral static stability point; (2) within the linear static stability flight envelope, the near-term PACS provided acceptable flying qualities for static stabilty margins to -3 percent; and (3) with the advanced PACS operative, the flying qualities were demonstrated to be good (satisfactory to very acceptable) for static stabilty margins to -20 percent.

Statistical approaches used to assess and redesign surface water-quality-monitoring networks.

PubMed

Khalil, B; Ouarda, T B M J

2009-11-01

An up-to-date review of the statistical approaches utilized for the assessment and redesign of surface water quality monitoring (WQM) networks is presented. The main technical aspects of network design are covered in four sections, addressing monitoring objectives, water quality variables, sampling frequency and spatial distribution of sampling locations. This paper discusses various monitoring objectives and related procedures used for the assessment and redesign of long-term surface WQM networks. The appropriateness of each approach for the design, contraction or expansion of monitoring networks is also discussed. For each statistical approach, its advantages and disadvantages are examined from a network design perspective. Possible methods to overcome disadvantages and deficiencies in the statistical approaches that are currently in use are recommended.

The Predictive Validity of the Tilburg Frailty Indicator: Disability, Health Care Utilization, and Quality of Life in a Population at Risk

ERIC Educational Resources Information Center

Gobbens, Robbert J. J.; van Assen, Marcel A. L. M.; Luijkx, Katrien G.; Schols, Jos M. G. A.

2012-01-01

Purpose: To assess the predictive validity of frailty and its domains (physical, psychological, and social), as measured by the Tilburg Frailty Indicator (TFI), for the adverse outcomes disability, health care utilization, and quality of life. Design and Methods: The predictive validity of the TFI was tested in a representative sample of 484…

Community drinking water quality monitoring data: utility for public health research and practice.

PubMed

Jones, Rachael M; Graber, Judith M; Anderson, Robert; Rockne, Karl; Turyk, Mary; Stayner, Leslie T

2014-01-01

Environmental Public Health Tracking (EPHT) tracks the occurrence and magnitude of environmental hazards and associated adverse health effects over time. The EPHT program has formally expanded its scope to include finished drinking water quality. Our objective was to describe the features, strengths, and limitations of using finished drinking water quality data from community water systems (CWSs) for EPHT applications, focusing on atrazine and nitrogen compounds in 8 Midwestern states. Water quality data were acquired after meeting with state partners and reviewed and merged for analysis. Data and the coding of variables, particularly with respect to censored results (nondetects), were not standardized between states. Monitoring frequency varied between CWSs and between atrazine and nitrates, but this was in line with regulatory requirements. Cumulative distributions of all contaminants were not the same in all states (Peto-Prentice test P < .001). Atrazine results were highly censored in all states (76.0%-99.3%); higher concentrations were associated with increased measurement frequency and surface water as the CWS source water type. Nitrate results showed substantial state-to-state variability in censoring (20.5%-100%) and in associations between concentrations and the CWS source water type. Statistical analyses of these data are challenging due to high rates of censoring and uncertainty about the appropriateness of parametric assumptions for time-series data. Although monitoring frequency was consistent with regulations, the magnitude of time gaps coupled with uncertainty about CWS service areas may limit linkage with health outcome data.

Clinical characteristics and objective living conditions in relation to quality of life among community-based individuals of schizophrenia in Hong Kong.

PubMed

Yeung, Frederick Ka Ching; Chan, Sunny Ho Wan

2006-11-01

Quality of life (QOL) has gained importance as an outcome measure for people with schizophrenia living in the community following deinstitutionalization. This study aims at exploring the effects of clinical characteristics and objective living conditions on QOL. In this study, 201 community-based individuals with schizophrenia were recruited from five different types of objective living conditions comprising long stay care home, halfway house, supported hostel/housing, living with family, and living alone. Clinical characteristics including cognitive abilities, symptom levels, and community/social functioning were assessed by the Allen Cognitive Level Screen, the Scales for the Assessment of Negative Symptoms and Positive Symptoms, and the Chinese version of the Multnomah Community Ability Scale respectively. The outcome measure of QOL was measured by the Chinese version of the WHO Quality of Life Measure. Analysis of covariance showed significant differences in community/social functioning, cognitive abilities, and negative symptoms; but not in QOL under different objective living conditions. Further simultaneous multiple regressions found out that community/social functioning was the robust significant predictor of QOL. Yet caution should be noted in making the conclusion with the objective living condition of long stay care home, as it provides a protective element for the perseverance of QOL.

Effects of crop load on distribution and utilization of 13C and 15N and fruit quality for dwarf apple trees.

PubMed

Ding, Ning; Chen, Qian; Zhu, Zhanling; Peng, Ling; Ge, Shunfeng; Jiang, Yuanmao

2017-10-26

In order to define the effects of fruit crop load on the distribution and utilization of carbon and nitrogen in dwarf apple trees, we conducted three crop load levels (High-crop load, 6 fruits per trunk cross-sectional area (cm 2 , TCA)), Medium-crop load (4 fruits cm -2 TCA), Low-crop load (2 fruits cm -2 TCA)) in 2014 and 2015. The results indicated that the 15 N derived from fertilizer (Ndff) values of fruits decreased with the reduction of crop load, but the Ndff values of annual branches, leaves and roots increased. The plant 15 N-urea utilization rates on Medium and Low-crop load were 1.12-1.35 times higher than the High-crop load. With the reduction of crop load, the distribution rate of 13 C and 15 N in fruits was gradually reduced, but in contrast, the distribution of 13 C and 15 N gradually increased in annual branches, leaves and roots. Compared with High-crop load, the Medium and Low-crop load significantly improved fruit quality p < 0.05. Hence, controlling fruit load effectively regulated the distribution of carbon and nitrogen in plants, improved the nitrogen utilization rate and fruit quality. The appropriate crop load level for mature M.26 interstocks apple orchards was deemed to be 4.0 fruits cm -2 TCA.

The impact of global budgets on pharmaceutical spending and utilization: early experience from the alternative quality contract.

PubMed

Afendulis, Christopher C; Fendrick, A Mark; Song, Zirui; Landon, Bruce E; Safran, Dana Gelb; Mechanic, Robert E; Chernew, Michael E

2014-01-01

In 2009, Blue Cross Blue Shield of Massachusetts implemented a global budget-based payment system, the Alternative Quality Contract (AQC), in which provider groups assumed accountability for spending. We investigate the impact of global budgets on the utilization of prescription drugs and related expenditures. Our analyses indicate no statistically significant evidence that the AQC reduced the use of drugs. Although the impact may change over time, early evidence suggests that it is premature to conclude that global budget systems may reduce access to medications. © The Author(s) 2014.

Caregiver negative affect is a primary determinant of caregiver report of pediatric asthma quality of life.

PubMed

Price, Marcella R; Bratton, Donna L; Klinnert, Mary D

2002-12-01

Quality of life has increased in popularity as an outcome measure in health research. However, the measurement of quality of life has been questioned on methodologic grounds, as it often shows little association with objective measures of disease status. For this report we studied the determinants of pediatric asthma caregiver report of quality of life and its relationship to disease burden. Ninety-eight children who were admitted to a Pediatric Day Program for an asthma evaluation were enrolled in an outcome study. A complete set of medical records for the 2-year period before and after the admission was collected and systematically coded for health care utilization. Using the Pediatric Asthma Caregiver's Quality of Life Questionnaire, data were collected at baseline, discharge, and year after the admission. Caregiver negative affect (anxiety and depression), measured with the Brief Symptom Inventory, was also collected at baseline and discharge. Caregiver report of quality of life was unrelated to health care utilization at baseline but instead was significantly related to baseline caregiver negative affect. A significant relationship between health care utilization and quality of life was present at followup. The Emotional Function scale from the quality of life measure can account for most of the relationship between quality of life and negative affect. Caregiver affect may have a considerable influence on report of quality of life. Understanding the individual characteristics of the respondent is important when using a quality of life instrument as an outcome measure.

Objective and Subjective Socioeconomic Gradients Exist for Sleep Quality, Sleep Latency, Sleep Duration, Weekend Oversleep, and Daytime Sleepiness in Adults

PubMed Central

Jarrin, Denise Christina; McGrath, Jennifer J.; Silverstein, Janice E.; Drake, Christopher

2017-01-01

Socioeconomic gradients exist for multiple health outcomes. Lower objective socioeconomic position (SEP), whether measured by income, education, or occupation, is associated with inadequate sleep. Less is known about whether one’s perceived ranking of their social status, or subjective SEP, affects sleep. This study examined whether a subjective socioeconomic gradient exists for sleep while controlling for objective SEP. Participants (N = 177; age, M = 45.3 years, SD = 6.3 years) completed the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, MacArthur Ladder, and other self-report measures to assess sleep and objective SEP. Subjective SEP trumped objective SEP as a better predictor of sleep duration, daytime sleepiness, and weekend oversleep. These findings highlight the need to expand our framework to better understand the mechanisms underlying socioeconomic gradients and sleep. PMID:23136841

Principles and Practices for Quality Assurance and Quality Control

USGS Publications Warehouse

Jones, Berwyn E.

1999-01-01

Quality assurance and quality control are vital parts of highway runoff water-quality monitoring projects. To be effective, project quality assurance must address all aspects of the project, including project management responsibilities and resources, data quality objectives, sampling and analysis plans, data-collection protocols, data quality-control plans, data-assessment procedures and requirements, and project outputs. Quality control ensures that the data quality objectives are achieved as planned. The historical development and current state of the art of quality assurance and quality control concepts described in this report can be applied to evaluation of data from prior projects.

Assessing utility where short measures are required: development of the short Assessment of Quality of Life-8 (AQoL-8) instrument.

PubMed

Hawthorne, Graeme

2009-09-01

As researchers seek to include clinical outcomes, the health-related quality of life (HRQoL) of participants and meet economic evaluation demands, they are confronted with collecting disparate outcome data where parsimony is imperative. This study addressed this through construction of a short HRQoL measure, the Assessment of Quality of Life (AQoL)-8 from the original AQoL. Data from the AQoL validation database (N = 996) were reanalyzed using item response theory (IRT) to identify the least fitting items, which were removed. The standard AQoL scoring algorithm and weights were applied. Validity, reliability, and sensitivity tests were carried out using the 2004 South Australian Health Omnibus Survey (N = 3015), including direct comparisons with other short utility measures, the EQ5D and SF6D. The IRT analysis showed that the AQoL was a weak scale (Loevinger H = 0.36) but reliable (Mokken rho = 0.84). Removal of the four weakest items led to an 8-item instrument with two items per subscale, the AQoL-8. The AQoL-8 Loevinger H = 0.38 and Mokken rho = 0.80 suggested similar psychometric properties to the AQoL. It correlated (intraclass correlation coefficient) 0.95 (or 90% of shared variance) with the AQoL. The AQoL-8 was as sensitive to six common health conditions as the AQoL, EQ5D, and SF6D. The utility scores fall on the same life-death scale as those of the AQoL. Where parsimony is imperative, researchers may consider use of the AQoL-8 to collect participant self-report HRQoL data that is suitable for use either as reported outcomes or for the calculation of quality-adjusted life-years for cost-utility analysis.

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…

Self-concept and quality of object relations as predictors of outcome in short- and long-term psychotherapy.

PubMed

Lindfors, Olavi; Knekt, Paul; Heinonen, Erkki; Virtala, Esa

2014-01-01

Quality of object relations and self-concept reflect clinically relevant aspects of personality functioning, but their prediction as suitability factors for psychotherapies of different lengths has not been compared. This study compared their prediction on psychiatric symptoms and work ability in short- and long-term psychotherapy. Altogether 326 patients, 20-46 years of age, with mood and/or anxiety disorder, were randomized to short-term (solution-focused or short-term psychodynamic) psychotherapy and long-term psychodynamic psychotherapy. The Quality of Object Relations Scale (QORS) and the Structural Analysis of Social Behavior (SASB) self-concept questionnaire were measured at baseline, and their prediction on outcome during the 3-year follow-up was assessed by the Symptom Check List Global Severity Index and the Anxiety Scale, the Beck Depression Inventory and by the Work Ability Index, Social Adjustment Scale work subscale and the Perceived Psychological Functioning scale. Negative self-concept strongly and self-controlling characteristics modestly predicted better 3-year outcomes in long-term therapy, after faster early gains in short-term therapy. Patients with a more positive or self-emancipating self-concept, or more mature object relations, experienced more extensive benefits after long-term psychotherapy. The importance of length vs. long-term therapy technique on the differences found is not known. Patients with mild to moderate personality pathology, indicated by poor self-concept, seem to benefit more from long-term than short-term psychotherapy, in reducing risk of depression. Long-term therapy may also be indicated for patients with relatively good psychological functioning. More research is needed on the relative importance of these characteristics in comparison with other patient-related factors. © 2013 Published by Elsevier B.V.

A system to evaluate the scientific quality of biological and restoration objectives using National Wildlife Refuge Comprehensive Conservation Plans as a case study

USGS Publications Warehouse

Schroeder, R.L.

2006-01-01

It is widely accepted that plans for restoration projects should contain specific, measurable, and science-based objectives to guide restoration efforts. The United States Fish and Wildlife Service (USFWS) is in the process of developing Comprehensive Conservation Plans (CCPs) for more than 500 units in the National Wildlife Refuge System (NWRS). These plans contain objectives for biological and ecosystem restoration efforts on the refuges. Based on USFWS policy, a system was developed to evaluate the scientific quality of such objectives based on three critical factors: (1) Is the objective specific, measurable, achievable, results-oriented, and time-fixed? (2) What is the extent of the rationale that explains the assumptions, logic, and reasoning for the objective? (3) How well was available science used in the development of the objective? The evaluation system scores each factor on a scale of 1 (poor) to 4 (excellent) according to detailed criteria. The biological and restoration objectives from CCPs published as of September 2004 (60 total) were evaluated. The overall average score for all biological and restoration objectives was 1.73. Average scores for each factor were: Factor 1-1.97; Factor 2-1.86; Factor 3-1.38. The overall scores increased from 1997 to 2004. Future restoration efforts may benefit by using this evaluation system during the process of plan development, to ensure that biological and restoration objectives are of the highest scientific quality possible prior to the implementation of restoration plans, and to allow for improved monitoring and adaptive management.

Distance from health facility and mothers' perception of quality related to skilled delivery service utilization in northern Ethiopia.

PubMed

Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

2017-01-01

Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current problem.

Distance from health facility and mothers’ perception of quality related to skilled delivery service utilization in northern Ethiopia

PubMed Central

Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen

2017-01-01

Background Poor maternal health service utilization is one of the contributing factors to a high level of maternal and newborn mortality in Ethiopia. The factors associated with utilization of services are believed to differ from one context to another. We assessed the factors associated with skilled delivery service utilization in rural northern Ethiopia. Subjects and methods A community-based survey was conducted among mothers who gave birth in the 12 months preceding the study period, from January to February 2015, in the Tigray region of Ethiopia. Multistage sampling technique was used to select mothers from the identified clusters. Households within a 10 km radius of the health facility were taken as a cluster for a community survey. Data were collected using face-to-face interview at the household level. We compared the mothers who reported giving birth to the index child in a health facility and those who reported delivering at home, in order to identify the predictors of skilled delivery utilization. Multivariable logistic regression model was used to determine the predictors of skilled delivery service utilization. The results are presented with odds ratio (OR) and 95% confidence interval (CI). Results A total of 1,796 mothers participated in the study, with a 100% response rate. Distance to health facilities (adjusted odds ratio [AOR] =0.53 [95% CI: 0.39, 0.71]), perception of mothers to the availability of adequate equipment in the delivery service in their catchment area (AOR =1.5 [95% CI: 1.11, 2.13]), experiencing any complication during childbirth, using antenatal care, lower birth order and having an educated partner were the significant predictors of skilled delivery service utilization. Conclusion Implementing community-based intervention programs that will address the physical accessibility of delivery services, such as the ambulance service, road issues and waiting rooms, and improving quality maternity service will likely reduce the current

The Utility of the Faces Pain Scale in the Assessment of Shoulder Pain in Turkish Stroke Patients: Its Relation with Quality of Life and Psychologic Status

ERIC Educational Resources Information Center

Dogan, Sebnem Koldas; Ay, Saime; Oztuna, Derya; Aytur, Yesim Kurtais; Evcik, Deniz

2010-01-01

This study was planned to investigate the utility of the vertical Faces Pain Scale (FPS) in the assessment of pain in stroke patients using the shoulder pain model and to assess its utility in the Turkish patient population. The secondary aim was to analyze the association of FPS with the quality of life and depression in the study population.…

The objective vocal quality, vocal risk factors, vocal complaints, and corporal pain in Dutch female students training to be speech-language pathologists during the 4 years of study.

PubMed

Van Lierde, Kristiane M; D'haeseleer, Evelien; Wuyts, Floris L; De Ley, Sophia; Geldof, Ruben; De Vuyst, Julie; Sofie, Claeys

2010-09-01

The purpose of the present cross-sectional study was to determine the objective vocal quality and the vocal characteristics (vocal risk factors, vocal and corporal complaints) in 197 female students in speech-language pathology during the 4 years of study. The objective vocal quality was measured by means of the Dysphonia Severity Index (DSI). Perceptual voice assessment, the Voice Handicap Index (VHI), questionnaires addressing vocal risks, and vocal and corporal complaints during and/or after voice usage were performed. Speech-language pathology (SLP) students have a borderline vocal quality corresponding to a DSI% of 68. The analysis of variance revealed no significant change of the objective vocal quality between the first bachelor year and the master year. No psychosocial handicapping effect of the voice was observed by means of the VHI total, though there was an effect at the functional VHI level in addition to some vocal complaints. Ninety-three percent of the student SLPs reported the presence of corporal pain during and/or after speaking. In particular, sore throat and headache were mentioned as the prevalent corporal pain symptoms. A longitudinal study of the objective vocal quality of the same subjects during their career as an SLP might provide new insights. 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Improving Multi-Objective Management of Water Quality Tipping Points: Revisiting the Classical Shallow Lake Problem

NASA Astrophysics Data System (ADS)

Quinn, J. D.; Reed, P. M.; Keller, K.

2015-12-01

Recent multi-objective extensions of the classical shallow lake problem are useful for exploring the conceptual and computational challenges that emerge when managing irreversible water quality tipping points. Building on this work, we explore a four objective version of the lake problem where a hypothetical town derives economic benefits from polluting a nearby lake, but at the risk of irreversibly tipping the lake into a permanently polluted state. The trophic state of the lake exhibits non-linear threshold dynamics; below some critical phosphorus (P) threshold it is healthy and oligotrophic, but above this threshold it is irreversibly eutrophic. The town must decide how much P to discharge each year, a decision complicated by uncertainty in the natural P inflow to the lake. The shallow lake problem provides a conceptually rich set of dynamics, low computational demands, and a high level of mathematical difficulty. These properties maximize its value for benchmarking the relative merits and limitations of emerging decision support frameworks, such as Direct Policy Search (DPS). Here, we explore the use of DPS as a formal means of developing robust environmental pollution control rules that effectively account for deeply uncertain system states and conflicting objectives. The DPS reformulation of the shallow lake problem shows promise in formalizing pollution control triggers and signposts, while dramatically reducing the computational complexity of the multi-objective pollution control problem. More broadly, the insights from the DPS variant of the shallow lake problem formulated in this study bridge emerging work related to socio-ecological systems management, tipping points, robust decision making, and robust control.

Improving Learning Object Quality: Moodle HEODAR Implementation

ERIC Educational Resources Information Center

Munoz, Carlos; Garcia-Penalvo, Francisco J.; Morales, Erla Mariela; Conde, Miguel Angel; Seoane, Antonio M.

2012-01-01

Automation toward efficiency is the aim of most intelligent systems in an educational context in which results calculation automation that allows experts to spend most of their time on important tasks, not on retrieving, ordering, and interpreting information. In this paper, the authors provide a tool that easily evaluates Learning Objects quality…

Survey of electric utility demand for coal. [1972-1992; by utility and state

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

Asbury, J.G.; Caruso, J.V.; Kouvalis, A.

1979-08-01

This report presents the results of a survey of electric utility demand for coal in the United States. The sources of survey information are: (1) Federal Energy Regulatory Commission Form 423 data on utility coal purchases during the period July 1972 through December 1978 and (2) direct telephone survey data on utility coal-purchase intentions for power plants to be constructed by 1992. Price and quantity data for coal used in existing plants are presented to illustrate price and market-share trends in individual coal-consuming states during recent years. Coal source, quality, quantity, and transportation data are reported for existing and plannedmore » generating plants.« less

Emergency Department Frequent Utilization for Non-Emergent Presentments: Results from a Regional Urban Trauma Center Study

PubMed Central

2016-01-01

Objectives First, to test a model of the drivers of frequent emergency department utilization conceptualized as falling within predisposing, enabling, and need dimensions. Second, to extend the model to include social networks and service quality as predictors of frequent utilization. Third, to illustrate the variation in thresholds that define frequent utilization in terms of the number of emergency department encounters by the predictors within the model. Data Source Primary data collection over an eight week period within a level-1 trauma urban hospital’s emergency department. Study Design Representative randomized sample of 1,443 adult patients triaged ESI levels 4–5. Physicians and research staff interviewed patients as they received services. Relationships with the outcome variable, utilization, were tested using logistic regression to establish odds-ratios. Principal Findings 70.6 percent of patients have two or more, 48.3 percent have three or more, 25.3 percent have four or more, and 14.9 percent have five or more emergency department visits within 12 months. Factors associated with frequent utilization include gender, race, poor mental health, mental health drugs, prescription drug abuse, social networks, employment, perceptions of service quality, seriousness of condition, persistence of condition, and previous hospital admittance. Conclusions Interventions targeting associated factors will change global emergency department encounters, although the mutability varies. Policy interventions to address predisposing factors such as substance abuse or access to mental health treatment as well as interventions that speak to enabling factors such as promoting the resiliency of social networks may result in decreased frequency of emergency department utilization. PMID:26784515

A lexicographic weighted Tchebycheff approach for multi-constrained multi-objective optimization of the surface grinding process

NASA Astrophysics Data System (ADS)

Khalilpourazari, Soheyl; Khalilpourazary, Saman

2017-05-01

In this article a multi-objective mathematical model is developed to minimize total time and cost while maximizing the production rate and surface finish quality in the grinding process. The model aims to determine optimal values of the decision variables considering process constraints. A lexicographic weighted Tchebycheff approach is developed to obtain efficient Pareto-optimal solutions of the problem in both rough and finished conditions. Utilizing a polyhedral branch-and-cut algorithm, the lexicographic weighted Tchebycheff model of the proposed multi-objective model is solved using GAMS software. The Pareto-optimal solutions provide a proper trade-off between conflicting objective functions which helps the decision maker to select the best values for the decision variables. Sensitivity analyses are performed to determine the effect of change in the grain size, grinding ratio, feed rate, labour cost per hour, length of workpiece, wheel diameter and downfeed of grinding parameters on each value of the objective function.

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.

Better utilization of low-grade woods

Treesearch

Peter Koch

1957-01-01

The objective of this paper is threefold: to outline briefly some of the avenues of approach so far employed in utilizing low-grade wood, to comment on the economic aspects of the problem, and finally, to speculate about what developments the future might bring to the field of utilization.

[Objective study of the voice quality following partial laryngectomy].

PubMed

Remacle, M; Millet, B

1991-01-01

The high resolution frequency analyzer is used for the study of the vocal quality after partial laryngectomy. The post-operative plot after speech therapy is of good quality when respecting one vocal fold. On the contrary, the heard vocal sound does not correspond to the harmonics of the fundamental frequency but to intense noise from irregular vibrations of the residual laryngeal mucosa (ventricular folds, arytenoids). High resolution frequency analysis contributes to the follow-up of the partial laryngectomy.

Work stressors, perseverative cognition and objective sleep quality: a longitudinal study among Dutch Helicopter Emergency Medical Service (HEMS) Pilots.

PubMed

Radstaak, Mirjam; Geurts, Sabine A E; Beckers, Debby G J; Brosschot, Jos F; Kompier, Michiel A J

2014-01-01

This longitudinal study examined the associations between work stressors, perseverative cognition and subjective and objective sleep quality. We hypothesized work stressors to be associated with (i) poor nocturnal sleep quality and (ii) higher levels of perseverative cognition during a free evening. We further hypothesized (iii) perseverative cognition to be associated with poor nocturnal sleep quality and (iv) the association between work stressors and sleep quality to be mediated by perseverative cognition. The participants were 24 pilots working for the Dutch Helicopter Emergency Medical Service (HEMS). They completed six questionnaires: at the end of three consecutive day shifts and each morning following the shifts. The questionnaires addressed work stressors (workload, distressing shifts and work-related conflicts), subjective sleep quality and perseverative cognition. Participants wore actigraphs to assess sleep onset latency, total sleep time and number of awakenings. Correlation analysis revealed that (i) distressing shifts were related to delayed sleep onset (r=0.50, p=0.026) and that workload was related to impaired sleep quality (e.g., subjective sleep quality: r=-0.42, p=0.044). Moreover, (ii) distressing shifts were positively related to perseverative cognition (r=0.62, p=0.002), (iii) perseverative cognition delayed sleep onset (r=0.74, p<0.001) and (iv) mediated the association between distressing shifts and sleep onset latency. Perseverative cognition may be an explanatory mechanism in the association between work stressors and poor sleep.

[Therapeutic benefit of a registered psychoeducation program on treatment adherence, objective and subjective quality of life: French pilot study for schizophrenia].

PubMed

Sauvanaud, F; Kebir, O; Vlasie, M; Doste, V; Amado, I; Krebs, M-O

2017-05-01

In schizophrenic disorders, supportive psychosocial therapies have been used as adjuncts to pharmacotherapy to help alleviate residual symptoms and to improve social functioning and quality of life. Among these therapies, psychoeducational therapies showed a significant efficacy on improving drug adherence and on reducing relapses. However, according to the French Health Agency, fewer than 10% of psychiatric structures in France offer registered psychoeducation programs. Caregiver apprehension of patients' depressive reactions to the awareness of the disease could underlie the underuse of psychoeducation therapies. Indeed, the psychoeducation programs' impact on objective and subjective quality of life is discussed among the literature. In this context, we conducted a retrospective, monocentric, open-labelled and non-controlled pilot study to measure the impact of a registered psychoeducation program on objective and subjective quality of life of patients suffering from schizophrenia. Secondary objectives included measures of the effects on drug observance and awareness of the disease. We included stabilized patients over the age of eighteen suffering from schizophrenia. Referent psychiatrics were asked to inform the patient of the diagnosis and to prescribe psychoeducation therapy. From 2011 to 2014, we offered three ambulatory programs, each program including fifteen two-hour group sessions. The groups were opened for three to six patients and managed by two caregivers. Themes discussed during the sessions included: schizophrenic disease, treatments, relationships to family, diet, social issues, toxics, relaxation. Objective and subjective quality of life were evaluated one month before and one month after the program using respectively the global assessment functioning (GAF) and the subjective quality of life (SQoL) scales. The Medical Adherence Rating Scale (MARS) and the French IQ8 scale evaluated respectively drug adherence and awareness of the disease. All

The singing power ratio as an objective measure of singing voice quality in untrained talented and nontalented singers.

PubMed

Watts, Christopher; Barnes-Burroughs, Kathryn; Estis, Julie; Blanton, Debra

2006-03-01

A growing body of contemporary research has investigated differences between trained and untrained singing voices. However, few studies have separated untrained singers into those who do and do not express abilities related to singing talent, including accurate pitch control and production of a pleasant timbre (voice quality). This investigation studied measures of the singing power ratio (SPR), which is a quantitative measure of the resonant quality of the singing voice. SPR reflects the amplification or suppression in the vocal tract of the harmonics produced by the sound source. This measure was acquired from the voices of untrained talented and nontalented singers as a means to objectively investigate voice quality differences. Measures of SPR were acquired from vocal samples with fast Fourier transform (FFT) power spectra to analyze the amplitude level of the partials in the acoustic spectrum. Long-term average spectra (LTAS) were also analyzed. Results indicated significant differences in SPR between groups, which suggest that vocal tract resonance, and its effect on perceived vocal timbre or quality, may be an important variable related to the perception of singing talent. LTAS confirmed group differences in the tuning of vocal tract harmonics.

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

Dosimetry and image quality assessment in a direct radiography system

PubMed Central

Oliveira, Bruno Beraldo; de Oliveira, Marcio Alves; Paixão, Lucas; Teixeira, Maria Helena Araújo; Nogueira, Maria do Socorro

2014-01-01

Objective To evaluate the mean glandular dose with a solid state detector and the image quality in a direct radiography system, utilizing phantoms. Materials and Methods Irradiations were performed with automatic exposure control and polymethyl methacrylate slabs with different thicknesses to calculate glandular dose values. The image quality was evaluated by means of the structures visualized on the images of the phantoms. Results Considering the uncertainty of the measurements, the mean glandular dose results are in agreement with the values provided by the equipment and with internationally adopted reference levels. Results obtained from images of the phantoms were in agreement with the reference values. Conclusion The present study contributes to verify the equipment conformity as regards dose values and image quality. PMID:25741119

Multi-energy method of digital radiography for imaging of biological objects

NASA Astrophysics Data System (ADS)

Ryzhikov, V. D.; Naydenov, S. V.; Opolonin, O. D.; Volkov, V. G.; Smith, C. F.

2016-03-01

This work has been dedicated to the search for a new possibility to use multi-energy digital radiography (MER) for medical applications. Our work has included both theoretical and experimental investigations of 2-energy (2E) and 3- energy (3D) radiography for imaging the structure of biological objects. Using special simulation methods and digital analysis based on the X-ray interaction energy dependence for each element of importance to medical applications in the X-ray range of energy up to 150 keV, we have implemented a quasi-linear approximation for the energy dependence of the X-ray linear mass absorption coefficient μm (E) that permits us to determine the intrinsic structure of the biological objects. Our measurements utilize multiple X-ray tube voltages (50, 100, and 150 kV) with Al and Cu filters of different thicknesses to achieve 3-energy X-ray examination of objects. By doing so, we are able to achieve significantly improved imaging quality of the structure of the subject biological objects. To reconstruct and visualize the final images, we use both two-dimensional (2D) and three-dimensional (3D) palettes of identification. The result is a 2E and/or 3E representation of the object with color coding of each pixel according to the data outputs. Following the experimental measurements and post-processing, we produce a 3D image of the biological object - in the case of our trials, fragments or parts of chicken and turkey.

Mapping from disease-specific measures to health-state utility values in individuals with migraine.

PubMed

Gillard, Patrick J; Devine, Beth; Varon, Sepideh F; Liu, Lei; Sullivan, Sean D

2012-05-01

The objective of this study was to develop empirical algorithms that estimate health-state utility values from disease-specific quality-of-life scores in individuals with migraine. Data from a cross-sectional, multicountry study were used. Individuals with episodic and chronic migraine were randomly assigned to training or validation samples. Spearman's correlation coefficients between paired EuroQol five-dimensional (EQ-5D) questionnaire utility values and both Headache Impact Test (HIT-6) scores and Migraine-Specific Quality-of-Life Questionnaire version 2.1 (MSQ) domain scores (role restrictive, role preventive, and emotional function) were examined. Regression models were constructed to estimate EQ-5D questionnaire utility values from the HIT-6 score or the MSQ domain scores. Preferred algorithms were confirmed in the validation samples. In episodic migraine, the preferred HIT-6 and MSQ algorithms explained 22% and 25% of the variance (R(2)) in the training samples, respectively, and had similar prediction errors (root mean square errors of 0.30). In chronic migraine, the preferred HIT-6 and MSQ algorithms explained 36% and 45% of the variance in the training samples, respectively, and had similar prediction errors (root mean square errors 0.31 and 0.29). In episodic and chronic migraine, no statistically significant differences were observed between the mean observed and the mean estimated EQ-5D questionnaire utility values for the preferred HIT-6 and MSQ algorithms in the validation samples. The relationship between the EQ-5D questionnaire and the HIT-6 or the MSQ is adequate to use regression equations to estimate EQ-5D questionnaire utility values. The preferred HIT-6 and MSQ algorithms will be useful in estimating health-state utilities in migraine trials in which no preference-based measure is present. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Beyond expected utility: rethinking behavioral decision research.

PubMed

Frisch, D; Clemen, R T

1994-07-01

Much research in psychology has evaluated the quality of people's decisions by comparisons with subjective expected utility (SEU) theory. This article suggests that typical arguments made for the status of utility theory as normative do not justify its use by psychologists as a standard by which to evaluate decision quality. It is argued that to evaluate decision quality, researchers need to identify those decision processes that tend to lead to desirable outcomes. It is contended that a good decision-making process must be concerned with how (and whether) decision makers evaluate potential consequences of decisions, the extent to which they accurately identify all relevant consequences, and the way in which they make final choices. Research that bears on these issues is reviewed.

[Assessing user satisfaction, an objective for quality of care].

PubMed

Séné-Bourgeois, Martine; Mathieu-Chakroun, Isabelle; Margat, Aurore

The assessment of user satisfaction constitutes a key indicator of the quality of care. It can be envisaged either as part of an internal strategy which favours the improvement of practices, an external strategy whose focus is more commercial and/or an exploratory strategy to develop care models. User satisfaction is expressed in particular through complaint letters and discharge questionnaires. These regulated schemes enable quality to be approached on an individual and collective level. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Multi-objective generation scheduling with hybrid energy resources

NASA Astrophysics Data System (ADS)

Trivedi, Manas

In economic dispatch (ED) of electric power generation, the committed generating units are scheduled to meet the load demand at minimum operating cost with satisfying all unit and system equality and inequality constraints. Generation of electricity from the fossil fuel releases several contaminants into the atmosphere. So the economic dispatch objective can no longer be considered alone due to the environmental concerns that arise from the emissions produced by fossil fueled electric power plants. This research is proposing the concept of environmental/economic generation scheduling with traditional and renewable energy sources. Environmental/economic dispatch (EED) is a multi-objective problem with conflicting objectives since emission minimization is conflicting with fuel cost minimization. Production and consumption of fossil fuel and nuclear energy are closely related to environmental degradation. This causes negative effects to human health and the quality of life. Depletion of the fossil fuel resources will also be challenging for the presently employed energy systems to cope with future energy requirements. On the other hand, renewable energy sources such as hydro and wind are abundant, inexhaustible and widely available. These sources use native resources and have the capacity to meet the present and the future energy demands of the world with almost nil emissions of air pollutants and greenhouse gases. The costs of fossil fuel and renewable energy are also heading in opposite directions. The economic policies needed to support the widespread and sustainable markets for renewable energy sources are rapidly evolving. The contribution of this research centers on solving the economic dispatch problem of a system with hybrid energy resources under environmental restrictions. It suggests an effective solution of renewable energy to the existing fossil fueled and nuclear electric utilities for the cheaper and cleaner production of electricity with hourly

40 CFR Appendix A to Subpart Kk of... - Data Quality Objective and Lower Confidence Limit Approaches for Alternative Capture Efficiency...

Code of Federal Regulations, 2013 CFR

2013-07-01

... approach follows: 4.3A source conducts an initial series of at least three runs. The owner or operator may... Confidence Limit Approaches for Alternative Capture Efficiency Protocols and Test Methods A Appendix A to... to Subpart KK of Part 63—Data Quality Objective and Lower Confidence Limit Approaches for Alternative...

40 CFR Appendix A to Subpart Kk of... - Data Quality Objective and Lower Confidence Limit Approaches for Alternative Capture Efficiency...

Code of Federal Regulations, 2010 CFR

2010-07-01

... approach follows: 4.3A source conducts an initial series of at least three runs. The owner or operator may... Confidence Limit Approaches for Alternative Capture Efficiency Protocols and Test Methods A Appendix A to... to Subpart KK of Part 63—Data Quality Objective and Lower Confidence Limit Approaches for Alternative...

40 CFR Appendix A to Subpart Kk of... - Data Quality Objective and Lower Confidence Limit Approaches for Alternative Capture Efficiency...

Code of Federal Regulations, 2014 CFR

2014-07-01

... of the LCL approach follows: 4.3A source conducts an initial series of at least three runs. The owner... Confidence Limit Approaches for Alternative Capture Efficiency Protocols and Test Methods A Appendix A to... to Subpart KK of Part 63—Data Quality Objective and Lower Confidence Limit Approaches for Alternative...

40 CFR Appendix A to Subpart Kk of... - Data Quality Objective and Lower Confidence Limit Approaches for Alternative Capture Efficiency...

Code of Federal Regulations, 2012 CFR

2012-07-01

... approach follows: 4.3A source conducts an initial series of at least three runs. The owner or operator may... Confidence Limit Approaches for Alternative Capture Efficiency Protocols and Test Methods A Appendix A to... to Subpart KK of Part 63—Data Quality Objective and Lower Confidence Limit Approaches for Alternative...

7 CFR 1822.262 - Objective.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Objective. 1822.262 Section 1822.262 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS...

Marital Distress and Mental Health Care Service Utilization

ERIC Educational Resources Information Center

Schonbrun, Yael Chatav; Whisman, Mark A.

2010-01-01

Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for…

Methodological quality of behavioural weight loss studies: a systematic review

PubMed Central

Lemon, S. C.; Wang, M. L.; Haughton, C. F.; Estabrook, D. P.; Frisard, C. F.; Pagoto, S. L.

2018-01-01

Summary This systematic review assessed the methodological quality of behavioural weight loss intervention studies conducted among adults and associations between quality and statistically significant weight loss outcome, strength of intervention effectiveness and sample size. Searches for trials published between January, 2009 and December, 2014 were conducted using PUBMED, MEDLINE and PSYCINFO and identified ninety studies. Methodological quality indicators included study design, anthropometric measurement approach, sample size calculations, intent-to-treat (ITT) analysis, loss to follow-up rate, missing data strategy, sampling strategy, report of treatment receipt and report of intervention fidelity (mean = 6.3). Indicators most commonly utilized included randomized design (100%), objectively measured anthropometrics (96.7%), ITT analysis (86.7%) and reporting treatment adherence (76.7%). Most studies (62.2%) had a follow-up rate >75% and reported a loss to follow-up analytic strategy or minimal missing data (69.9%). Describing intervention fidelity (34.4%) and sampling from a known population (41.1%) were least common. Methodological quality was not associated with reporting a statistically significant result, effect size or sample size. This review found the published literature of behavioural weight loss trials to be of high quality for specific indicators, including study design and measurement. Identified for improvement include utilization of more rigorous statistical approaches to loss to follow up and better fidelity reporting. PMID:27071775

Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature.

PubMed

Patouillard, Edith; Goodman, Catherine A; Hanson, Kara G; Mills, Anne J

2007-11-07

There has been a growing interest in the role of the private for-profit sector in health service provision in low- and middle-income countries. The private sector represents an important source of care for all socioeconomic groups, including the poorest and substantial concerns have been raised about the quality of care it provides. Interventions have been developed to address these technical failures and simultaneously take advantage of the potential for involving private providers to achieve public health goals. Limited information is available on the extent to which these interventions have successfully expanded access to quality health services for poor and disadvantaged populations. This paper addresses this knowledge gap by presenting the results of a systematic literature review on the effectiveness of working with private for-profit providers to reach the poor. The search topic of the systematic literature review was the effectiveness of interventions working with the private for-profit sector to improve utilization of quality health services by the poor. Interventions included social marketing, use of vouchers, pre-packaging of drugs, franchising, training, regulation, accreditation and contracting-out. The search for published literature used a series of electronic databases including PubMed, Popline, HMIC and CabHealth Global Health. The search for grey and unpublished literature used documents available on the World Wide Web. We focused on studies which evaluated the impact of interventions on utilization and/or quality of services and which provided information on the socioeconomic status of the beneficiary populations. A total of 2483 references were retrieved, of which 52 qualified as impact evaluations. Data were available on the average socioeconomic status of recipient communities for 5 interventions, and on the distribution of benefits across socioeconomic groups for 5 interventions. Few studies provided evidence on the impact of private sector

Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature

PubMed Central

Patouillard, Edith; Goodman, Catherine A; Hanson, Kara G; Mills, Anne J

2007-01-01

Background There has been a growing interest in the role of the private for-profit sector in health service provision in low- and middle-income countries. The private sector represents an important source of care for all socioeconomic groups, including the poorest and substantial concerns have been raised about the quality of care it provides. Interventions have been developed to address these technical failures and simultaneously take advantage of the potential for involving private providers to achieve public health goals. Limited information is available on the extent to which these interventions have successfully expanded access to quality health services for poor and disadvantaged populations. This paper addresses this knowledge gap by presenting the results of a systematic literature review on the effectiveness of working with private for-profit providers to reach the poor. Methods The search topic of the systematic literature review was the effectiveness of interventions working with the private for-profit sector to improve utilization of quality health services by the poor. Interventions included social marketing, use of vouchers, pre-packaging of drugs, franchising, training, regulation, accreditation and contracting-out. The search for published literature used a series of electronic databases including PubMed, Popline, HMIC and CabHealth Global Health. The search for grey and unpublished literature used documents available on the World Wide Web. We focused on studies which evaluated the impact of interventions on utilization and/or quality of services and which provided information on the socioeconomic status of the beneficiary populations. Results A total of 2483 references were retrieved, of which 52 qualified as impact evaluations. Data were available on the average socioeconomic status of recipient communities for 5 interventions, and on the distribution of benefits across socioeconomic groups for 5 interventions. Conclusion Few studies provided

A Quality Function Deployment Framework for the Service Quality of Health Information Websites

PubMed Central

Kim, Dohoon

2010-01-01

Objectives This research was conducted to identify both the users' service requirements on health information websites (HIWs) and the key functional elements for running HIWs. With the quality function deployment framework, the derived service attributes (SAs) are mapped into the suppliers' functional characteristics (FCs) to derive the most critical FCs for the users' satisfaction. Methods Using the survey data from 228 respondents, the SAs, FCs and their relationships were analyzed using various multivariate statistical methods such as principal component factor analysis, discriminant analysis, correlation analysis, etc. Simple and compound FC priorities were derived by matrix calculation. Results Nine factors of SAs and five key features of FCs were identified, and these served as the basis for the house of quality model. Based on the compound FC priorities, the functional elements pertaining to security and privacy, and usage support should receive top priority in the course of enhancing HIWs. Conclusions The quality function deployment framework can improve the FCs of the HIWs in an effective, structured manner, and it can also be utilized for critical success factors together with their strategic implications for enhancing the service quality of HIWs. Therefore, website managers could efficiently improve website operations by considering this study's results. PMID:21818418

Review of utility values for economic modeling in type 2 diabetes.

PubMed

Beaudet, Amélie; Clegg, John; Thuresson, Per-Olof; Lloyd, Adam; McEwan, Phil

2014-06-01

Economic analysis in type 2 diabetes mellitus (T2DM) requires an assessment of the effect of a wide range of complications. The objective of this article was to identify a set of utility values consistent with the National Institute for Health and Care Excellence (NICE) reference case and to critically discuss and illustrate challenges in creating such a utility set. A systematic literature review was conducted to identify studies reporting utility values for relevant complications. The methodology of each study was assessed for consistency with the NICE reference case. A suggested set of utility values applicable to modeling was derived, giving preference to studies reporting multiple complications and correcting for comorbidity. The review considered 21 relevant diabetes complications. A total of 16,574 articles were identified; after screening, 61 articles were assessed for methodological quality. Nineteen articles met NICE criteria, reporting utility values for 20 of 21 relevant complications. For renal transplant, because no articles meeting NICE criteria were identified, two articles using other methodologies were included. Index value estimates for T2DM without complication ranged from 0.711 to 0.940. Utility decrement associated with complications ranged from 0.014 (minor hypoglycemia) to 0.28 (amputation). Limitations associated with the selection of a utility value for use in economic modeling included variability in patient recruitment, heterogeneity in statistical analysis, large variability around some point estimates, and lack of recent data. A reference set of utility values for T2DM and its complications in line with NICE requirements was identified. This research illustrates the challenges associated with systematically selecting utility data for economic evaluations. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Utility values associated with vitreous floaters.

PubMed

Wagle, Ajeet M; Lim, Wei-Yen; Yap, Tiong-Peng; Neelam, Kumari; Au Eong, Kah-Guan

2011-07-01

To ascertain the health-related quality of life associated with symptomatic degenerative vitreous floaters. Cross-sectional questionnaire survey. In this institution-based study, 311 outpatients aged 21 years and older who presented with symptoms of floaters were enrolled. Data from 266 patients (85.5%) who completed the questionnaire were analyzed. Utility values were assessed using a standardized utility value questionnaire. The time trade-off (TTO) and standard gamble (SG) for death and blindness techniques were used to calculate the utility values. Descriptive, univariate, and multivariate analyses were performed using Stata Release 6.0. The mean age of the study population was 52.9 ± 12.02 years (range, 21-97). The mean utility values were 0.89, 0.89, and 0.93 for TTO, SG (death), and SG (blindness), respectively. Patients aged ≤55 years reported significantly lower SG (blindness) utility values when compared with patients above 55 years of age (age ≤55 = 0.92, age >55 = 0.94, P = .007). Utility measurements did not demonstrate significant relationship with any of the other socio-demographic variables examined in this study. The utility values did not demonstrate any significant relationship with other ocular characteristics such as duration of symptoms, presence of a posterior vitreous detachment, and presence or severity of myopia. Symptomatic degenerative vitreous floaters have a negative impact on health-related quality of life. Younger symptomatic patients are more likely to take a risk of blindness to get rid of the floaters than older patients. Copyright © 2011 Elsevier Inc. All rights reserved.

7 CFR 1778.3 - Objective.

Code of Federal Regulations, 2011 CFR

2011-01-01

... quantity or quality of water, or in which such a decline is considered imminent, to obtain or maintain adequate quantities of water that meets the standards set by the Safe Drinking Water Act (42 U.S.C. 300f et... (CONTINUED) EMERGENCY AND IMMINENT COMMUNITY WATER ASSISTANCE GRANTS § 1778.3 Objective. The objective of the...

System Transformation in Patient-Centered Medical Home (PCMH): Variable Impact on Chronically Ill Patients' Utilization.

PubMed

Carlin, Caroline S; Flottemesch, Thomas J; Solberg, Leif I; Werner, Ann M

2016-01-01

Research connecting patient-centered medical homes (PCMHs) with improved quality and reduced utilization is inconsistent, possibly because individual domains of change, and the stage of change, are not incorporated in the research design. The objective of this study was to examine the association between stage and domain of change and patterns of health care utilization. This was a cross-sectional observational study that including 87 Minnesota clinics certified as medical homes. Patients included those receiving management for diabetes or cardiovascular disease with insurance coverage by payers participating in the study. PCMH transformation stage was defined by practice systems in place, with measurements summarized in 5 domains. Health care utilization was measured by total utilization, frequency of outpatient visits and prescriptions, and occurrence of inpatient and emergency department visits. PCMH transformation was associated with few changes in utilization, but there were important differences by the underlying domains of change. We demonstrate meaningful differences in the impact of PCMH transformation by diagnosis cohort and comorbidity status of the patient. Because the association of health care utilization with PCMH transformation varied by transformation domain and patient diagnosis, practice leaders need to be supported by research incorporating detailed measures of PCMH transformation. © Copyright 2016 by the American Board of Family Medicine.

Objective measures for quality assessment of automatic skin enhancement algorithms

NASA Astrophysics Data System (ADS)

Ciuc, Mihai; Capata, Adrian; Florea, Corneliu

2010-01-01

Automatic portrait enhancement by attenuating skin flaws (pimples, blemishes, wrinkles, etc.) has received considerable attention from digital camera manufacturers thanks to its impact on the public. Subsequently, a number of algorithms have been developed to meet this need. One central aspect to developing such an algorithm is quality assessment: having a few numbers that precisely indicate the amount of beautification brought by an algorithm (as perceived by human observers) is of great help, as it works on circumvent time-costly human evaluation. In this paper, we propose a method to numerically evaluate the quality of a skin beautification algorithm. The most important aspects we take into account and quantize to numbers are the quality of the skin detector, the amount of smoothing performed by the method, the preservation of intrinsic skin texture, and the preservation of facial features. We combine these measures into two numbers that assess the quality of skin detection and beautification. The derived measures are highly correlated with human perception, therefore they constitute a helpful tool for tuning and comparing algorithms.

Management by objectives and its impact on specialist prescription quality at discharge and in external consultations.

PubMed

Olmo, M; Galvan, L; Capdevila, J; Serna, C; Mangues, I; Schoenenberger, J A

2011-01-01

To verify that implementing a policy of management by objectives, based on collaboration between hospital pharmacy, primary care and specialised medical managers, improves prescription quality indicators in specialised care and reduces unwanted "induced" prescriptions (i.e. those issued by specialists, hospital doctors or the patients themselves) in primary care. A four year quasi-experimental controlled intervention study on prescription at discharge and in outpatient hospital consultations was conducted. In hospital A, a quality cycle was applied: assessment, identifying improvement opportunities, implementing corrective actions and re-assessment. However, it was not applied in control hospital B. The indicators chosen were the percentage of generic medicines prescribed, the percentage of prescriptions for new therapies with no added value and the percentage of prescriptions for ACE inhibitors recommended. In hospital A, an increase in indicators 1 and 3 has been observed, both being statistically significant, between the last year of intervention and the year previous to intervention. Hospital A managed to reduce indicator 2 to 4.5%, while this indicator increased in hospital B to 8.8%. Furthermore, a statistically significant difference in indicators between the two hospitals has been registered. Pay-for-Performance programs in prescription practices of hospital physicians are effective actions to improve quality indicators of medication use. Copyright © 2010 SEFH. Published by Elsevier Espana. All rights reserved.

Lengthening Temporalis Myoplasty: Objective Outcomes and Site-Specific Quality-of-Life Assessment.

PubMed

Panciera, Davide Thomas; Sampieri, Claudio; Deganello, Alberto; Danesi, Giovanni

2017-12-01

Objective Evaluate outcomes of the lengthening temporalis myoplasty in facial reanimations. Study Design Case series with planned data collection. Setting Ospedali Riuniti, Bergamo, and AOUC Careggi, Florence, Italy. Subjects and Methods From 2011 to 2016, 11 patients underwent lengthening temporalis myoplasty; demographic data were collected for each. Pre- and postoperative photographs and videos were recorded and used to measure the smile angle and the excursion of the oral commissure, according to the SMILE system (Scaled Measurements of Improvement in Lip Excursion). All patients were tested with the Facial Disability Index, and they also completed a questionnaire about the adherence to physiotherapy indications. Results All patients demonstrated a significant improvement in functional parameters and in quality of life. On the reanimated side, the mean z-line and a-value, measured when smiling, significantly improved in all patients: from 22.6 mm (95% CI, 20.23-25.05) before surgery to 30.9 mm (95% CI, 27.82-33.99) after surgery ( P < .001) and from 100.5° (95% CI, 93.96°-107.13°) to 111.6° (95% CI, 105.63°-117.64°; P < .001), respectively. The mean postoperative dynamic gain, passing from rest to a full smile at the reanimated side, was 3.1 mm (95% CI, 1.30-4.88) for the z-line and 3.3° (95% CI, 1.26°-5.29°) for the a-value. The Facial Disability Index score increased from a preoperative mean of 33.4 points (95% CI, 28.25-38.66) to 49.9 points (95% CI, 47.21-52.60) postoperatively ( P < .001). Conclusions The lengthening temporalis myoplasty can be successfully used for smile reanimation, with satisfying functional and quality-of-life outcomes.

Factors affecting utilization of dental health services and satisfaction among adolescent females in Riyadh City

PubMed Central

Al-Hussyeen, Al Johara A.

2009-01-01

Objectives This study was conducted to determine factors affecting utilization of dental health services among intermediate female school students in Riyadh. In addition to assessing their satisfaction with the dental care received during the last dental visit. Subjects and methods Self-administered questionnaires were distributed among students attending eight public and four private schools. These schools were selected randomly to represent the four different administrative zones in Riyadh. Results Of 600 questionnaires distributed, 531 were complete and suitable for analysis. Nearly three quarters of the students visited the dentist more than once during the last 2 years. A bout 75% had their treatment in private dental clinics and 63% made their visits for routine treatment. The quality of dental care was found to be the most encouraging factor for utilization of dental services, whereas, far geographic location of the dental clinics was the most discouraging factor. For those who received treatment in the government clinics, the most discouraging factor was post operative complications (P < 0.0001), while the most encouraging factor was the availability of friendly staff (P < 0.0001). The high cost of dental care was the most discouraging factor for utilizing the dental services for those who visited private clinics (P < 0.0001), while the high quality of dental care was the most encouraging factor (P < 0.009). Students who made their visits because of pain highly considered modern clinics and those recommended by friends as highly encouraging factors (P < 0.002), while they considered the high cost of dental care as discouraging factor for using dental services (P < 0.038). Students who visited the dentist for routine treatment gave the quality of dental care as encouraging for the use of dental clinics (P < 0.0001). Satisfaction with dental care was found to be significantly associated with high quality of dental care, convenient appointment

Effect of protein quality on /sup 14/C glucose utilization in isolated rat mammary acini

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

Masor, M.L.; Grundleger, M.L.; Jansen, G.R.

1986-03-01

Poor protein quality has a deleterious effect on lactation in rats. Dams consuming a 13% wheat gluten (WG) diet are unable to maintain litters. Glucose utilization in isolated mammary acini taken from dams at either day 20 of gestation (G20) or day 4 of lactation (L4) was examined in dams consuming 13% WG vs 13% casein-methionine (CM) diets from day of breeding. Dams consuming WG had significantly smaller inguinal-abdominal mammary glands than CM dams at both G20 and L4, and mammary glands of CM but not WG dams were larger at L4 than G20. Both average pup weight and pupmore » daily gain were smaller in WG litters. Basal levels of /sup 14/C glucose oxidation (GO) and /sup 14/C glucose incorporation into lipid (GL) and lactose were examined. A large significant increase in GO and GL occurred in CM dams from G20 to L4 but not in WG dams. Both GO and GL were higher in CM dams on L4 but not at G20. The ratio of GO:GO+GL changed at parturition in CM but not WG dams. The normal changes in glucose utilization by mammary epithelial cells which occur at parturition were impaired by the WG diet.« less

Parallels between Objective Indicators and Subjective Perceptions of Quality of Life: A Study of Metropolitan and County Areas in Taiwan

ERIC Educational Resources Information Center

Liao, Pei-shan

2009-01-01

This study explores the consistency between objective indicators and subjective perceptions of quality of life in a ranking of survey data for cities and counties in Taiwan. Data used for analysis included the Statistical Yearbook of Hsiens and Municipalities and the Survey on Living Conditions of Citizens in Taiwan, both given for the year 2000.…

Association of Integrated Team-Based Care With Health Care Quality, Utilization, and Cost.

PubMed

Reiss-Brennan, Brenda; Brunisholz, Kimberly D; Dredge, Carter; Briot, Pascal; Grazier, Kyle; Wilcox, Adam; Savitz, Lucy; James, Brent

The value of integrated team delivery models is not firmly established. To evaluate the association of receiving primary care in integrated team-based care (TBC) practices vs traditional practice management (TPM) practices (usual care) with patient outcomes, health care utilization, and costs. A retrospective, longitudinal, cohort study to assess the association of integrating physical and mental health over time in TBC practices with patient outcomes and costs. Adult patients (aged ≥18 years) who received primary care at 113 unique Intermountain Healthcare Medical Group primary care practices from 2003 through 2005 and had yearly encounters with Intermountain Healthcare through 2013, including some patients who received care in both TBC and TPM practices. Receipt of primary care in TBC practices compared with TPM practices for patients treated in internal medicine, family practice, and geriatrics practices. Outcomes included 7 quality measures, 6 health care utilization measures, payments to the delivery system, and program investment costs. During the study period (January 2010-December 2013), 113,452 unique patients (mean age, 56.1 years; women, 58.9%) accounted for 163,226 person-years of exposure in 27 TBC practices and 171,915 person-years in 75 TPM practices. Patients treated in TBC practices compared with those treated in TPM practices had higher rates of active depression screening (46.1% for TBC vs 24.1% for TPM; odds ratio [OR], 1.91 [95% CI, 1.75 to 2.08), adherence to a diabetes care bundle (24.6% for TBC vs 19.5% for TPM; OR, 1.26 [95% CI, 1.11 to 1.42]), and documentation of self-care plans (48.4% for TBC vs 8.7% for TPM; OR, 5.59 [95% CI, 4.27 to 7.33]), lower proportion of patients with controlled hypertension (<140/90 mm Hg) (85.0% for TBC vs 97.7% for TPM; OR, 0.87 [95% CI, 0.80 to 0.95]), and no significant differences in documentation of advanced directives (9.6% for TBC vs 9.9% for TPM; OR, 0.97 [95% CI, 0.91 to 1.03]). Per 100 person

Motor Responses to Objects: Priming and Hand Shaping

DTIC Science & Technology

1988-09-20

actual manual responses to objects indicates that interactions involving different hand shapes have a common timecourse during reaching and preshaping...objects could be used with different hand shapes, given different functional contexts (e.g., picking up a stapler with a clench or stapling with the palm...research focused on the utility of these representations. We propose that when manual interactions with objects are represented cognitively, for example

Objective Versus Subjective Measures of Executive Functions: Predictors of Participation and Quality of Life in Parkinson Disease?

PubMed

Vlagsma, Thialda T; Koerts, Janneke; Tucha, Oliver; Dijkstra, Hilde T; Duits, Annelien A; van Laar, Teus; Spikman, Jacoba M

2017-11-01

To determine whether objective (neuropsychological tests) and subjective measures (questionnaires) of executive functions (EFs) are associated in patients with Parkinson disease (PD), and to determine to what extent level of participation and quality of life (QoL) of patients with PD can be predicted by these measures of EFs. Correlational research design (case-control and prediction design). Departments of neuropsychology of 3 medical centers. A sample (N=136) of patients with PD (n=42) and their relatives, and controls without PD (n=94). Not applicable. A test battery measuring EFs. In addition, patients, their relatives, and controls completed the Dysexecutive Questionnaire, Brock Adaptive Functioning Questionnaire, and Barkley Deficits in Executive Functioning Scale - time management questionnaires measuring complaints about EFs. Participation and QoL were measured with the Impact on Participation and Autonomy scale and the Parkinson's Disease Questionnaire-39, respectively. Patients with PD showed impairments in EFs on objective tests and reported significantly more complaints about EFs than did controls without PD. No associations were found between patients' performances on objective and subjective measures of EFs. However, both objective and subjective measures predicted patients' level of participation. In addition, subjective measures of EFs predicted QoL in patients with PD. These findings show that objective and subjective measures of EFs are not interchangeable and that both approaches predict level of participation and QoL in patients with PD. However, within this context, sex needs to be taken into account. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Implementation of a transfusion algorithm to reduce blood product utilization in pediatric cardiac surgery.

PubMed

Whitney, Gina; Daves, Suanne; Hughes, Alex; Watkins, Scott; Woods, Marcella; Kreger, Michael; Marincola, Paula; Chocron, Isaac; Donahue, Brian

2013-07-01

The goal of this project is to measure the impact of standardization of transfusion practice on blood product utilization and postoperative bleeding in pediatric cardiac surgery patients. Transfusion is common following cardiopulmonary bypass (CPB) in children and is associated with increased mortality, infection, and duration of mechanical ventilation. Transfusion in pediatric cardiac surgery is often based on clinical judgment rather than objective data. Although objective transfusion algorithms have demonstrated efficacy for reducing transfusion in adult cardiac surgery, such algorithms have not been applied in the pediatric setting. This quality improvement effort was designed to reduce blood product utilization in pediatric cardiac surgery using a blood product transfusion algorithm. We implemented an evidence-based transfusion protocol in January 2011 and monitored the impact of this algorithm on blood product utilization, chest tube output during the first 12 h of intensive care unit (ICU) admission, and predischarge mortality. When compared with the 12 months preceding implementation, blood utilization per case in the operating room odds ratio (OR) for the 11 months following implementation decreased by 66% for red cells (P = 0.001) and 86% for cryoprecipitate (P < 0.001). Blood utilization during the first 12 h of ICU did not increase during this time and actually decreased 56% for plasma (P = 0.006) and 41% for red cells (P = 0.031), indicating that the decrease in OR transfusion did not shift the transfusion burden to the ICU. Postoperative bleeding, as measured by chest tube output in the first 12 ICU hours, did not increase following implementation of the algorithm. Monthly surgical volume did not change significantly following implementation of the algorithm (P = 0.477). In a logistic regression model for predischarge mortality among the nontransplant patients, after accounting for surgical severity and duration of CPB, use of the transfusion

Testing the utility of three social-cognitive models for predicting objective and self-report physical activity in adults with type 2 diabetes.

PubMed

Plotnikoff, Ronald C; Lubans, David R; Penfold, Chris M; Courneya, Kerry S

2014-05-01

Theory-based interventions to promote physical activity (PA) are more effective than atheoretical approaches; however, the comparative utility of theoretical models is rarely tested in longitudinal designs with multiple time points. Further, there is limited research that has simultaneously tested social-cognitive models with self-report and objective PA measures. The primary aim of this study was to test the predictive ability of three theoretical models (social cognitive theory, theory of planned behaviour, and protection motivation theory) in explaining PA behaviour. Participants were adults with type 2 diabetes (n = 287, 53.8% males, mean age = 61.6 ± 11.8 years). Theoretical constructs across the three theories were tested to prospectively predict PA behaviour (objective and self-report) across three 6-month time intervals (baseline-6, 6-12, 12-18 months) using structural equation modelling. PA outcomes were steps/3 days (objective) and minutes of MET-weighted PA/week (self-report). The mean proportion of variance in PA explained by these models was 6.5% for objective PA and 8.8% for self-report PA. Direct pathways to PA outcomes were stronger for self-report compared with objective PA. These theories explained a small proportion of the variance in longitudinal PA studies. Theory development to guide interventions for increasing and maintaining PA in adults with type 2 diabetes requires further research with objective measures. Theory integration across social-cognitive models and the inclusion of ecological levels are recommended to further explain PA behaviour change in this population. Statement of contribution What is already known on this subject? Social-cognitive theories are able to explain partial variance for physical activity (PA) behaviour. What does this study add? The testing of three theories in a longitudinal design over 3, 6-month time intervals. The parallel use and comparison of both objective and self-report PA measures in testing these

Added value of integrated circuit detector in head CT: objective and subjective image quality in comparison to conventional detector design.

PubMed

Korn, Andreas; Bender, Benjamin; Spira, Daniel; Schabel, Christoph; Bhadelia, Rafeeque; Claussen, Claus; Ernemann, Ulrike; Brodoefel, Harald

2014-12-01

A new computed tomography (CT) detector with integrated electric components and shorter conducting pathways has recently been introduced to decrease system inherent electronic noise. The purpose of this study was to assess the potential benefit of such integrated circuit detector (ICD) in head CT by comparing objective and subjective image quality in low-dose examinations with a conventional detector design. Using a conventional detector, reduced-dose noncontrast head CT (255 mAs; effective dose, 1.7 mSv) was performed in 25 consecutive patients. Following transition to ICD, 25 consecutive patients were scanned using identical imaging parameters. Images in both groups were reconstructed with iterative reconstruction (IR) and filtered back projection (FBP) and assessed in terms of quantitative and qualitative image quality. Acquisition of head CT using ICD increased signal-to-noise ratio of gray and white matter by 14% (10.0 ± 1.6 vs. 11.4 ± 2.5; P = .02) and 17% (8.2 ± 0.8 vs. 9.6 ± 1.5; P = .000). The associated improvement in contrast-to-noise ratio was 12% (2.0 ± 0.5 vs. 2.2 ± 0.6; P = .121). In addition, there was a 51% increase in objective image sharpness (582 ± 85 vs. 884.5 ± 191; change in HU/Pixel; P < .000). Compared to standard acquisitions, subjective grading of noise and overall image quality scores were significantly improved with ICD (2.1 ± 0.3 vs. 1.6 ± 0.3; P < .000; 2.0 ± 0.5 vs. 1.6 ± 0.3; P = .001). Moreover, streak artifacts in the posterior fossa were substantially reduced (2.3 ± 0.7 vs. 1.7 ± 0.5; P = .004). At the same radiation level, acquisition of head CT with ICD achieves superior objective and subjective image quality and provides potential for significant dose reduction. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Physical security and cyber security issues and human error prevention for 3D printed objects: detecting the use of an incorrect printing material

NASA Astrophysics Data System (ADS)

Straub, Jeremy

2017-06-01

A wide variety of characteristics of 3D printed objects have been linked to impaired structural integrity and use-efficacy. The printing material can also have a significant impact on the quality, utility and safety characteristics of a 3D printed object. Material issues can be created by vendor issues, physical security issues and human error. This paper presents and evaluates a system that can be used to detect incorrect material use in a 3D printer, using visible light imaging. Specifically, it assesses the ability to ascertain the difference between materials of different color and different types of material with similar coloration.

Associations of Objectively and Subjectively Measured Sleep Quality with Subsequent Cognitive Decline in Older Community-Dwelling Men: The MrOS Sleep Study

PubMed Central

Blackwell, Terri; Yaffe, Kristine; Laffan, Alison; Ancoli-Israel, Sonia; Redline, Susan; Ensrud, Kristine E.; Song, Yeonsu; Stone, Katie L.

2014-01-01

Study Objectives: To examine associations of objectively and subjectively measured sleep with subsequent cognitive decline. Design: A population-based longitudinal study. Setting: Six centers in the United States. Participants: Participants were 2,822 cognitively intact community-dwelling older men (mean age 76.0 ± 5.3 y) followed over 3.4 ± 0.5 y. Interventions: None. Measurements and Results: Objectively measured sleep predictors from wrist actigraphy: total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of long wake episodes (LWEP). Self-reported sleep predictors: sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), TST. Clinically significant cognitive decline: five-point decline on the Modified Mini-Mental State examination (3MS), change score for the Trails B test time in the worse decile. Associations of sleep predictors and cognitive decline were examined with logistic regression and linear mixed models. After multivariable adjustment, higher levels of WASO and LWEP and lower SE were associated with an 1.4 to 1.5-fold increase in odds of clinically significant decline (odds ratio 95% confidence interval) Trails B test: SE < 70% versus SE ≥ 70%: 1.53 (1.07, 2.18); WASO ≥ 90 min versus WASO < 90 min: 1.47 (1.09, 1.98); eight or more LWEP versus fewer than eight: 1.38 (1.02, 1.86). 3MS: eight or more LWEP versus fewer than eight: 1.36 (1.09, 1.71), with modest relationships to linear change in cognition over time. PSQI was related to decline in Trails B performance (3 sec/y per standard deviation increase). Conclusions: Among older community-dwelling men, reduced sleep efficiency, greater nighttime wakefulness, greater number of long wake episodes, and poor self-reported sleep quality were associated with subsequent cognitive decline. Citation: Blackwell T; Yaffe K; Laffan A; Ancoli-Israel S; Redline S; Ensrud KE; Song Y; Stone KL. Associations of objectively and

Cost-Effectiveness and Cost-Utility of Internet-Based Computer Tailoring for Smoking Cessation

PubMed Central

Evers, Silvia MAA; de Vries, Hein; Hoving, Ciska

2013-01-01

Background Although effective smoking cessation interventions exist, information is limited about their cost-effectiveness and cost-utility. Objective To assess the cost-effectiveness and cost-utility of an Internet-based multiple computer-tailored smoking cessation program and tailored counseling by practice nurses working in Dutch general practices compared with an Internet-based multiple computer-tailored program only and care as usual. Methods The economic evaluation was embedded in a randomized controlled trial, for which 91 practice nurses recruited 414 eligible smokers. Smokers were randomized to receive multiple tailoring and counseling (n=163), multiple tailoring only (n=132), or usual care (n=119). Self-reported cost and quality of life were assessed during a 12-month follow-up period. Prolonged abstinence and 24-hour and 7-day point prevalence abstinence were assessed at 12-month follow-up. The trial-based economic evaluation was conducted from a societal perspective. Uncertainty was accounted for by bootstrapping (1000 times) and sensitivity analyses. Results No significant differences were found between the intervention arms with regard to baseline characteristics or effects on abstinence, quality of life, and addiction level. However, participants in the multiple tailoring and counseling group reported significantly more annual health care–related costs than participants in the usual care group. Cost-effectiveness analysis, using prolonged abstinence as the outcome measure, showed that the mere multiple computer-tailored program had the highest probability of being cost-effective. Compared with usual care, in this group €5100 had to be paid for each additional abstinent participant. With regard to cost-utility analyses, using quality of life as the outcome measure, usual care was probably most efficient. Conclusions To our knowledge, this was the first study to determine the cost-effectiveness and cost-utility of an Internet-based smoking

Health State Utilities for Patients with Brain Metastases.

PubMed

Lester-Coll, Nataniel H; Dosoretz, Arie P; Hayman, James A; Yu, James B

2016-07-04

 Estimating the cost-effectiveness of whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS), including Gamma Knife radiosurgery (GKRS), requires the quantitative measurement of patients' health states after treatment. We sought to quantify individuals' preferences for the relevant health states after WBRT or GKRS for brain metastases on a 0 to 1 scale, where 1 is perfect health and 0 is death.  We prospectively measured utilities in patients with brain metastases evaluated at Yale for consideration of WBRT and/or GKRS, as well as oncology nurses who had cared for patients with brain metastases before and after WBRT or GKRS, using the Standard Gamble (SG) technique. Demographic information was also collected. Nonparametric tests were used to compare potential differences in utility values and for subgroups based on demographic characteristics.  There were 24 patients and 31 nurses who completed the study between December 2013 and May 2015. Median utilities ranged from 0.85 for the status-post (S/P) GKRS state to 0.25 (for neurologic dying). The median utility of being S/P WBRT was 0.70 compared to 0.85 S/P GKRS (p < 0.001). The cognitive decline from WBRT was associated with a notably low utility score of 0.30. There were no statistically significant differences between patients' and nurses' median utility scores.  These SG utilities provide unique insights into brain metastases-related health states from the patient and provider perspective. As perceived by individuals with direct knowledge of the health states in question, WBRT has a significantly lower utility compared to GKRS. Cognitive decline following WBRT is associated with significant perceived reduction in quality of life. Differences in the relative importance of overall survival and quality of life with treatment existed between patients with different stages of disease. These utilities can be used to calculate quality-adjusted life expectancy in cost-effectiveness evaluations of

Assessing Learning, Quality and Engagement in Learning Objects: The Learning Object Evaluation Scale for Students (LOES-S)

ERIC Educational Resources Information Center

Kay, Robin H.; Knaack, Liesel

2009-01-01

Learning objects are interactive web-based tools that support the learning of specific concepts by enhancing, amplifying, and/or guiding the cognitive processes of learners. Research on the impact, effectiveness, and usefulness of learning objects is limited, partially because comprehensive, theoretically based, reliable, and valid evaluation…

Water Quality Response to Forest Biomass Utilization

Treesearch

Benjamin Rau; Augustine Muwamba; Carl Trettin; Sudhanshu Panda; Devendra Amatya; Ernest Tollner

2017-01-01

Forested watersheds provide approximately 80% of freshwater drinking resources in the United States (Fox et al. 2007). The water originating from forested watersheds is typically of high quality when compared to agricul¬tural watersheds, and concentrations of nitrogen and phosphorus are nine times higher, on average, in agricultur¬al watersheds when compared to...

Production and processing studies on calpain-system gene markers for tenderness in Brahman cattle: 2. Objective meat quality.

PubMed

Cafe, L M; McIntyre, B L; Robinson, D L; Geesink, G H; Barendse, W; Pethick, D W; Thompson, J M; Greenwood, P L

2010-09-01

Effects and interactions of calpain-system tenderness gene markers on objective meat quality traits of Brahman (Bos indicus) cattle were quantified within 2 concurrent experiments at different locations. Cattle were selected for study from commercial and research herds at weaning based on their genotype for calpastatin (CAST) and calpain 3 (CAPN3) gene markers for beef tenderness. Gene marker status for mu-calpain (CAPN1-4751 and CAPN1-316) was also determined for inclusion in statistical analyses. Eighty-two heifer and 82 castrated male cattle with 0 or 2 favorable alleles for CAST and CAPN3 were studied in New South Wales (NSW), and 143 castrated male cattle with 0, 1, or 2 favorable alleles for CAST and CAPN3 were studied in Western Australia (WA). The cattle were backgrounded for 6 to 8 mo and grain-fed for 117 d (NSW) or 80 d (WA) before slaughter. One-half the cattle in each experiment were implanted with a hormonal growth promotant during feedlotting. One side of each carcass was suspended from the Achilles tendon (AT) and the other from the pelvis (tenderstretch). The M. longissimus lumborum from both sides and the M. semitendinosus from the AT side were collected; then samples of each were aged at 1 degrees C for 1 or 7 d. Favorable alleles for one or more markers reduced shear force, with little effect on other meat quality traits. The size of effects of individual markers varied with site, muscle, method of carcass suspension, and aging period. Individual marker effects were additive as evident in cattle with 4 favorable alleles for CAST and CAPN3 markers, which had shear force reductions of 12.2 N (P < 0.001, NSW) and 9.3 N (P = 0.002, WA) in AT 7 d aged M. longissimus lumborum compared with those with no favorable alleles. There was no evidence (all P > 0.05) of interactions between the gene markers, or between the hormonal growth promotant and gene markers for any meat quality traits. This study provides further evidence that selection based on the

[Quality assessment of drug use in the elderly].

PubMed

Mosegui, G B; Rozenfeld, S; Veras, R P; Vianna, C M

1999-10-01

The objective is to evaluate the quality of medication utilization through the analysis of the pattern of usage, the degree of compliance to essential drug lists, therapeutic value and by drug interactions found among women over 60 years of age. Six hundred thirty-four women enrolled at the Open University of the Third Age were studied. Data was collected through pattern-oriented, tested questionnaires. The variables examined were related to drugs and to drug utilization. The units of analysis used were the drugs and the individual. Of 634 women that participated in the study, 9,1% did not use drugs. The number of medications taken vary from 1 to 17. The average is 4,0 drugs/woman. Among the 2.510 pharmaceutical specialties mentioned by the interviewed, 538 different substances were identified. About 26% of the medications were in agreement with the recommendations of the World Health Organization and 17% with recommendations of the "Relação Nacional de Medicamentos Essenciais". Seventeen percent of the drugs are inappropriate for use in seniors; 14,1% of the women may suffer consequences for taking drugs of the same therapeutic class, and 15, 5% are exposed to interactions. The data suggest that the pattern of the medication utilization is considerably influenced by the medical prescription and that their quality is harmed by the low selectiveness of the pharmaceutical market

Computed radiography utilizing laser-stimulated luminescence: detectability of simulated low-contrast radiographic objects.

PubMed

Higashida, Y; Moribe, N; Hirata, Y; Morita, K; Doudanuki, S; Sonoda, Y; Katsuda, N; Hiai, Y; Misumi, W; Matsumoto, M

1988-01-01

Threshold contrasts of low-contrast objects with computed radiography (CR) images were compared with those of blue and green emitting screen-film systems by employing the 18-alternative forced choice (18-AFC) procedure. The dependence of the threshold contrast on the incident X-ray exposure and also the object size was studied. The results indicated that the threshold contrasts of CR system were comparable to those of blue and green screen-film systems and decreased with increasing object size, and increased with decreasing incident X-ray exposure. The increase in threshold contrasts was small when the relative incident exposure decreased from 1 to 1/4, and was large when incident exposure was decreased further.

D Imaging for Museum Artefacts: a Portable Test Object for Heritage and Museum Documentation of Small Objects

NASA Astrophysics Data System (ADS)

Hess, M.; Robson, S.

2012-07-01

3D colour image data generated for the recording of small museum objects and archaeological finds are highly variable in quality and fitness for purpose. Whilst current technology is capable of extremely high quality outputs, there are currently no common standards or applicable guidelines in either the museum or engineering domain suited to scientific evaluation, understanding and tendering for 3D colour digital data. This paper firstly explains the rationale towards and requirements for 3D digital documentation in museums. Secondly it describes the design process, development and use of a new portable test object suited to sensor evaluation and the provision of user acceptance metrics. The test object is specifically designed for museums and heritage institutions and includes known surface and geometric properties which support quantitative and comparative imaging on different systems. The development for a supporting protocol will allow object reference data to be included in the data processing workflow with specific reference to conservation and curation.

Some thoughts on wood utilization research

Treesearch

P. Koch

1980-01-01

For over 17 years our small group of scientists has worked to improve utilization of southern wood species. From these years of experience, I have distilled some thoughts on research objectives, attributes of scientists who accomplish the objectives, administration of research, and transferring results from laboratory to industry. I would like to share these thoughts...

Review of Empirical Research That Utilized the Bell Object Relations Inventory.

ERIC Educational Resources Information Center

Hansen, Joseph Wm.

This literature review examines how the Bell Object Relations Inventory (BORI) (M. Bell and others, 1986) has been used in the literature. General domains of BORI use include interpersonal relatedness, the measurement of religious dimensions, and the diagnosis and prediction of psychopathology. Specific areas are reviewed regarding the…

[Relationship between perceived emotional intelligence and professional quality of life with the achievement of occupational objectives in the costa del sol primary health care district].

PubMed

Macías Fernández, Antonio José; Gutiérrez-Castañeda, Carlos; Carmona González, Francisco Jesús; Crespillo Vílchez, Daniel

2016-05-01

To examine the relationship between "Quality of Professional Life" and "Perceived Emotional Intelligence" and the relationship of both of these with the level of achievement of occupational objectives in the Costa del Sol Primary Health Care District. Multicentre descriptive cross-sectional observational study. The Costa del Sol Primary Health Care District in the province of Málaga. Sample of Employees of all categories in fixed and contracted employment in the Management Units of the Costa del Sol District. (N=303). Respondents 247 (81.5%) The data collected was that of the percentage of achievement of objectives in 2010 and the socio-demographic data of the participants, using ad hoc designed self-report questionnaires. The TMMS -24 questionnaire was used to measure the "Perceived Emotional Intelligence", with the following dimensions: Perception, comprehension, and emotional control, and the CVP-35 measuring: management support, work demands, and intrinsic motivation. Significant correlationas were observed between Quality of Professional Life and Emotional Intelligence in the Regulation (p<.01) and Comprehension categories (p<0.05). There were also significant correlations between the profession and the type of contract in the achievement of objectives (p<.005), and quality of professional life and type of contract (p<.05). The perceived quality of professional life is related to perception and regulation dimensions of Emotional Intelligence. Knowledge of emotion management methods should be promoted by management organisations for all employees. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Improved Objective Measurements for Speech Quality Testing

DTIC Science & Technology

1985-01-01

criterion with the possible exception of the channel vocoder, for which the spread in subjective responses was slightly less than des ired. 4 10 -a_- 14...n 5 19-.0 H ,e -- * ,- p--. -. a’ - - -:== .. LJ. . U .... :1±, .L±--± i- -.. ni m.,in h U ’ el l . ORII STCO 1RE PROIOP)LES p =.. •,,• mI.. 1 .S OI...parameter III specifies thce threshold between objectively interrupted and non-interrupted speech. In the foi- aula apecifying RATIO, mf is the index of the

Medicare program; acquisition, protection and disclosure of utilization and quality control peer review organization (PRO) information--HCFA. Proposed rule.

PubMed

1984-04-16

This proposal would govern the acquisition, protection and disclosure of information obtained or generated by Utilization and Quality Control Peer Review Organizations (PROs). The Peer Review Improvement Act of 1982 authorizes PROs to acquire information necessary to fulfill their duties and functions, places limits on the disclosure of PRO information, and establishes penalties for unauthorized disclosure. These regulations would implement the PROs' statutory right of access to necessary information and set forth their responsibilities to assure that information once acquired is adequately safeguarded, and used only for proper purposes.

International Space Station Utilization: Tracking Investigations from Objectives to Results

NASA Technical Reports Server (NTRS)

Ruttley, T. M.; Mayo, Susan; Robinson, J. A.

2011-01-01

Since the first module was assembled on the International Space Station (ISS), on-orbit investigations have been underway across all scientific disciplines. The facilities dedicated to research on ISS have supported over 1100 investigations from over 900 scientists representing over 60 countries. Relatively few of these investigations are tracked through the traditional NASA grants monitoring process and with ISS National Laboratory use growing, the ISS Program Scientist s Office has been tasked with tracking all ISS investigations from objectives to results. Detailed information regarding each investigation is now collected once, at the first point it is proposed for flight, and is kept in an online database that serves as a single source of information on the core objectives of each investigation. Different fields are used to provide the appropriate level of detail for research planning, astronaut training, and public communications. http://www.nasa.gov/iss-science/. With each successive year, publications of ISS scientific results, which are used to measure success of the research program, have shown steady increases in all scientific research areas on the ISS. Accurately identifying, collecting, and assessing the research results publications is a challenge and a priority for the ISS research program, and we will discuss the approaches that the ISS Program Science Office employs to meet this challenge. We will also address the online resources available to support outreach and communication of ISS research to the public. Keywords: International Space Station, Database, Tracking, Methods

Evaluation of overweight load routing on buried utility facilities

DOT National Transportation Integrated Search

2011-02-01

Overweight traffic movements can negatively affect pavement integrity and quality. However, it is less : known to what degree buried utility plant along and across the right of way is affected by these overweight : loads, especially if the utility fa...

42 CFR 476.160 - General quality of care review procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false General quality of care review procedures. 476.160... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

Bottom-up perspectives of extreme event and climate change threats to water quality: Drinking water utilities in California

NASA Astrophysics Data System (ADS)

Ekstrom, J.; Klasic, M.; Fencl, A.; Lubell, M.; Bedsworth, L. W.; Baker, E.

2016-12-01

Extreme events impact water quality, which pose serious challenges for drinking water systems. Such extreme events, including wildfire, storm surge, and other weather-related extremes, are projected to increase under a changing climate. It remains unclear what climate change information can support water managers in preparing for more extreme events. Exploring this topic requires understanding the larger question: What is the role of scientific information in adapting to climate change? We present two parts of a three-year study geared to understand whether, where, why and in what way climate information (or the lack of) is used or needed to support long term water quality planning for extreme events. In 2015 we surveyed California drinking water utilities and found a wide range of extreme event/water quality issues, perspectives on the severity of climate change threats, drought impacts and trusted information sources relating to water quality concerns. Approximately 70% of 259 respondents had recently experienced extreme weather-related events that worsen or trigger water quality. Survey results informed development of a case study analysis to gain a more in-depth understanding of what type of - or when - extreme events information could support climate adaptation. Projections of extreme events are often not in a form that is useable for water quality planning. Relative to supply-related projections, water quality has received much less scientific attention, leaving it an assumed scientific information gap and need for management. The question remains whether filling this gap would help adaptation, whom it would help, and in what way. Based on interviews with water systems in Summer 2016, our case study analyses reinforce that extreme events threaten water quality in many ways; largely as secondary impacts of climate change. Secondary impacts involve disinfection byproducts, increasing salinity in the Delta, and the use of lower quality sources. The most common

Report on objective ride quality evaluation

NASA Technical Reports Server (NTRS)

Wambold, J. C.; Park, W. H.

1974-01-01

The correlation of absorbed power as an objective ride measure to the subjective evaluation for the bus data was investigated. For some individual bus rides the correlations were poor, but when a sufficient number of rides was used to give reasonable sample base, an excellent correlation was obtained. The following logarithmical function was derived: S = 1.7245 1n (39.6849 AP), where S = one subjective rating of the ride; and AP = the absorbed power in watts. A six-degree-of-freedom method developed for aircraft data was completed. Preliminary correlation of absorbed power with ISO standards further enhances the bus ride and absorbed power correlation numbers since the AP's obtained are of the same order of magnitude for both correlations. While it would then appear that one could just use ISO standards, there is no way to add the effect of three degrees of freedom. The absorbed power provides a method of adding the effects due to the three major directions plus the pitch and roll.

The 3D scanner prototype utilize object profile imaging using line laser and octave software

NASA Astrophysics Data System (ADS)

Nurdini, Mugi; Manunggal, Trikarsa Tirtadwipa; Samsi, Agus

2016-11-01

Three-dimensional scanner or 3D Scanner is a device to reconstruct the real object into digital form on a computer. 3D Scanner is a technology that is being developed, especially in developed countries, where the current 3D Scanner devices is the advanced version with a very expensive prices. This study is basically a simple prototype of 3D Scanner with a very low investment costs. 3D Scanner prototype device consists of a webcam, a rotating desk system controlled by a stepper motor and Arduino UNO, and a line laser. Objects that limit the research is the object with same radius from its center point (object pivot). Scanning is performed by using object profile imaging by line laser which is then captured by the camera and processed by a computer (image processing) using Octave software. On each image acquisition, the scanned object on a rotating desk rotated by a certain degree, so for one full turn multiple images of a number of existing side are finally obtained. Then, the profile of the entire images is extracted in order to obtain digital object dimension. Digital dimension is calibrated by length standard, called gage block. Overall dimensions are then digitally reconstructed into a three-dimensional object. Validation of the scanned object reconstruction of the original object dimensions expressed as a percentage error. Based on the results of data validation, horizontal dimension error is about 5% to 23% and vertical dimension error is about +/- 3%.

Predictors of Service Utilization among Youth Diagnosed with Mood Disorders

ERIC Educational Resources Information Center

Mendenhall, Amy N.

2012-01-01

In this study, I investigated patterns and predictors of service utilization for children with mood disorders. The Behavioral Model for Health Care Utilization was used as an organizing framework for identifying predictors of the number and quality of services utilized. Hierarchical regression was used in secondary data analyses of the…

Patient Portal Utilization Among Ethnically Diverse Low Income Older Adults: Observational Study

PubMed Central

Quandt, Sara A; Sandberg, Joanne C; Miller Jr, David P; Latulipe, Celine; Leng, Xiaoyan; Talton, Jenifer W; Melius, Kathryn P; Smith, Alden; Bertoni, Alain G

2017-01-01

Background Patient portals can improve patient communication with providers, provide patients with greater health information access, and help improve patient decision making, if they are used. Because research on factors facilitating and limiting patient portal utilization has not been conceptually based, no leverage points have been indicated for improving utilization. Objective The primary objective for this analysis was to use a conceptual framework to determine potentially modifiable factors affecting patient portal utilization by older adults (aged 55 years and older) who receive care at clinics that serve low income and ethnically diverse communities. The secondary objective was to delineate how patient portal utilization is associated with perceived usefulness and usability. Methods Patients from one urban and two rural clinics serving low income patients were recruited and completed interviewer-administered questionnaires on patient portal utilization. Results A total of 200 ethnically diverse patients completed questionnaires, of which 41 (20.5%) patients reported utilizing portals. Education, social support, and frequent Internet utilization improve the odds of patient portal utilization; receiving health care at a rural clinic decreases the odds of portal utilization. Conclusions Leverage points to address disparities in patient portal utilization include providing training for older adults in patient portal utilization, involving spouses or other care partners in this training, and making information technology access available at public places in rural and urban communities. PMID:29138129

Application of cooperative and non-cooperative games in large-scale water quantity and quality management: a case study.

PubMed

Mahjouri, Najmeh; Ardestani, Mojtaba

2011-01-01

In this paper, two cooperative and non-cooperative methodologies are developed for a large-scale water allocation problem in Southern Iran. The water shares of the water users and their net benefits are determined using optimization models having economic objectives with respect to the physical and environmental constraints of the system. The results of the two methodologies are compared based on the total obtained economic benefit, and the role of cooperation in utilizing a shared water resource is demonstrated. In both cases, the water quality in rivers satisfies the standards. Comparing the results of the two mentioned approaches shows the importance of acting cooperatively to achieve maximum revenue in utilizing a surface water resource while the river water quantity and quality issues are addressed.

Trade-off decisions in distribution utility management

NASA Astrophysics Data System (ADS)

Slavickas, Rimas Anthony

As a result of the "unbundling" of traditional monopolistic electricity generation and transmission enterprises into a free-market economy, power distribution utilities are faced with very difficult decisions pertaining to electricity supply options and quality of service to the customers. The management of distribution utilities has become increasingly complex, versatile, and dynamic to the extent that conventional, non-automated management tools are almost useless and obsolete. This thesis presents a novel and unified approach to managing electricity supply options and quality of service to customers. The technique formulates the problem in terms of variables, parameters, and constraints. An advanced Mixed Integer Programming (MIP) optimization formulation is developed together with novel, logical, decision-making algorithms. These tools enable the utility management to optimize various cost components and assess their time-trend impacts, taking into account the intangible issues such as customer perception, customer expectation, social pressures, and public response to service deterioration. The above concepts are further generalized and a Logical Proportion Analysis (LPA) methodology and associated software have been developed. Solutions using numbers are replaced with solutions using words (character strings) which more closely emulate the human decision-making process and advance the art of decision-making in the power utility environment. Using practical distribution utility operation data and customer surveys, the developments outlined in this thesis are successfully applied to several important utility management problems. These involve the evaluation of alternative electricity supply options, the impact of rate structures on utility business, and the decision of whether to continue to purchase from a main grid or generate locally (partially or totally) by building Non-Utility Generation (NUG).

Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014.

PubMed

Guo, Lijun; Bao, Yong; Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

2018-01-01

Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001). In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022). The urban comprehensive score also exceeded that of the suburbs (P<0.001). In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban

Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014

PubMed Central

Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

2018-01-01

Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001). In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022). The urban comprehensive score also exceeded that of the suburbs (P<0.001). In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban

Desired Precision in Multi-Objective Optimization: Epsilon Archiving or Rounding Objectives?

NASA Astrophysics Data System (ADS)

Asadzadeh, M.; Sahraei, S.

2016-12-01

Multi-objective optimization (MO) aids in supporting the decision making process in water resources engineering and design problems. One of the main goals of solving a MO problem is to archive a set of solutions that is well-distributed across a wide range of all the design objectives. Modern MO algorithms use the epsilon dominance concept to define a mesh with pre-defined grid-cell size (often called epsilon) in the objective space and archive at most one solution at each grid-cell. Epsilon can be set to the desired precision level of each objective function to make sure that the difference between each pair of archived solutions is meaningful. This epsilon archiving process is computationally expensive in problems that have quick-to-evaluate objective functions. This research explores the applicability of a similar but computationally more efficient approach to respect the desired precision level of all objectives in the solution archiving process. In this alternative approach each objective function is rounded to the desired precision level before comparing any new solution to the set of archived solutions that already have rounded objective function values. This alternative solution archiving approach is compared to the epsilon archiving approach in terms of efficiency and quality of archived solutions for solving mathematical test problems and hydrologic model calibration problems.

Cost-Utility Analysis of Cochlear Implantation in Australian Adults.

PubMed

Foteff, Chris; Kennedy, Steven; Milton, Abul Hasnat; Deger, Melike; Payk, Florian; Sanderson, Georgina

2016-06-01

Sequential and simultaneous bilateral cochlear implants are emerging as appropriate treatment options for Australian adults with sensory deficits in both cochleae. Current funding of Australian public hospitals does not provide for simultaneous bilateral cochlear implantation (CI) as a separate surgical procedure. Previous cost-effectiveness studies of sequential and simultaneous bilateral CI assumed 100% of unilaterally treated patients' transition to a sequential bilateral CI. This assumption does not place cochlear implantation in the context of the generally treated population. When mutually exclusive treatment options exist, such as unilateral CI, sequential bilateral CI, and simultaneous bilateral CI, the mean costs of the treated populations are weighted in the calculation of incremental cost-utility ratios. The objective was to evaluate the cost-utility of bilateral hearing aids (HAs) compared with unilateral, sequential, and simultaneous bilateral CI in Australian adults with bilateral severe to profound sensorineural hearing loss. Cost-utility analysis of secondary sources input to a Markov model. Australian health care perspective, lifetime horizon with costs and outcomes discounted 5% annually. Bilateral HAs as treatment for bilateral severe to profound sensorineural hearing loss compared with unilateral, sequential, and simultaneous bilateral CI. Incremental costs per quality adjusted life year (AUD/QALY). When compared with bilateral hearing aids the incremental cost-utility ratio for the CI treatment population was AUD11,160/QALY. The incremental cost-utility ratio was weighted according to the number of patients treated unilaterally, sequentially, and simultaneously, as these were mutually exclusive treatment options. No peer-reviewed articles have reported the incremental analysis of cochlear implantation in a continuum of care for surgically treated populations with bilateral severe to profound sensorineural hearing loss. Unilateral, sequential

Multiattribute health utility scoring for the computerized adaptive measure CAT-5D-QOL was developed and validated.

PubMed

Kopec, Jacek A; Sayre, Eric C; Rogers, Pamela; Davis, Aileen M; Badley, Elizabeth M; Anis, Aslam H; Abrahamowicz, Michal; Russell, Lara; Rahman, Md Mushfiqur; Esdaile, John M

2015-10-01

The CAT-5D-QOL is a previously reported item response theory (IRT)-based computerized adaptive tool to measure five domains (attributes) of health-related quality of life. The objective of this study was to develop and validate a multiattribute health utility (MAHU) scoring method for this instrument. The MAHU scoring system was developed in two stages. In phase I, we obtained standard gamble (SG) utilities for 75 hypothetical health states in which only one domain varied (15 states per domain). In phase II, we obtained SG utilities for 256 multiattribute states. We fit a multiplicative regression model to predict SG utilities from the five IRT domain scores. The prediction model was constrained using data from phase I. We validated MAHU scores by comparing them with the Health Utilities Index Mark 3 (HUI3) and directly measured utilities and by assessing between-group discrimination. MAHU scores have a theoretical range from -0.842 to 1. In the validation study, the scores were, on average, higher than HUI3 utilities and lower than directly measured SG utilities. MAHU scores correlated strongly with the HUI3 (Spearman ρ = 0.78) and discriminated well between groups expected to differ in health status. Results reported here provide initial evidence supporting the validity of the MAHU scoring system for the CAT-5D-QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

The compressed average image intensity metric for stereoscopic video quality assessment

NASA Astrophysics Data System (ADS)

Wilczewski, Grzegorz

2016-09-01

The following article depicts insights towards design, creation and testing of a genuine metric designed for a 3DTV video quality evaluation. The Compressed Average Image Intensity (CAII) mechanism is based upon stereoscopic video content analysis, setting its core feature and functionality to serve as a versatile tool for an effective 3DTV service quality assessment. Being an objective type of quality metric it may be utilized as a reliable source of information about the actual performance of a given 3DTV system, under strict providers evaluation. Concerning testing and the overall performance analysis of the CAII metric, the following paper presents comprehensive study of results gathered across several testing routines among selected set of samples of stereoscopic video content. As a result, the designed method for stereoscopic video quality evaluation is investigated across the range of synthetic visual impairments injected into the original video stream.

Fuzzy connectedness and object definition

NASA Astrophysics Data System (ADS)

Udupa, Jayaram K.; Samarasekera, Supun

1995-04-01

Approaches to object information extraction from images should attempt to use the fact that images are fuzzy. In past image segmentation research, the notion of `hanging togetherness' of image elements specified by their fuzzy connectedness has been lacking. We present a theory of fuzzy objects for n-dimensional digital spaces based on a notion of fuzzy connectedness of image elements. Although our definitions lead to problems of enormous combinatorial complexity, the theoretical results allow us to reduce this dramatically. We demonstrate the utility of the theory and algorithms in image segmentation based on several practical examples.

Controllability of Complex Dynamic Objects

NASA Astrophysics Data System (ADS)

Kalach, G. G.; Kazachek, N. A.; Morozov, A. A.

2017-01-01

Quality requirements for mobile robots intended for both specialized and everyday use are increasing in step with the complexity of the technological tasks assigned to the robots. Whether a mobile robot is for ground, aerial, or underwater use, the relevant quality characteristics can be summarized under the common concept of agility. This term denotes the object’s (the robot)’s ability to react quickly to control actions (change speed and direction), turn in a limited area, etc. When using this approach in integrated assessment of the quality characteristics of an object with the control system, it seems more constructive to use the term “degree of control”. This paper assesses the degree of control by an example of a mobile robot with the variable-geometry drive wheel axle. We show changes in the degree of control depending on the robot’s configuration, and results illustrated by calculation data, computer and practical experiments. We describe the prospects of using intelligent technology for efficient control of objects with a high degree of controllability.

Utility of Objective Chest Tube Management After Pulmonary Resection Using a Digital Drainage System.

PubMed

Takamochi, Kazuya; Imashimizu, Kota; Fukui, Mariko; Maeyashiki, Tatsuo; Suzuki, Mikiko; Ueda, Takuya; Matsuzawa, Hironori; Hirayama, Shunki; Matsunaga, Takeshi; Oh, Shiaki; Suzuki, Kenji

2017-07-01

We sought to evaluate the clinical utility of chest tube management after pulmonary resection based on objective digital monitoring of pleural pressure and digital surveillance for air leaks. We prospectively recorded the perioperative data of 308 patients who underwent pulmonary resection between December 2013 and January 2016. We used information from a digital monitoring thoracic drainage system to measure peak air leakage during the first 24 hours after the operation, patterns of air leakage over the first 72 hours, and patterns of pleural pressure changes until the chest tubes were removed. There were 240 patients with lung cancer and 68 patients with other diseases. The operations included 49 wedge resections, 58 segmentectomies, and 201 lobectomies. A postoperative air leak was observed in 61 patients (20%). A prolonged air leak exceeding 20 mL/min lasting 5 days or more was observed in 18 patients (5.8%). Multivariate analysis of various perioperative factors showed forced expiratory volume in 1 second below 70%, patterns of air leakage, defined as exacerbating and remitting or without a trend toward improvement, and peak air leakage of 100 mL/min or more were significant positive predictors of prolonged air leak. Fluctuations in pleural pressure occurred just after the air leakage rate decreased to less than 20 mL/min. Digital monitoring of peak air leakage and patterns of air leakage were useful for predicting prolonged air leak after pulmonary resection. Information on the disappearance of air leak could be derived from the change in the rate of air leakage and from the increase in fluctuation of pleural pressure. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Investigation of stormwater quality improvements utilizing permeable friction course (PFC).

DOT National Transportation Integrated Search

2010-09-01

This report describes research into the water quality and hydraulics of the Permeable Friction Course (PFC). : Water quality monitoring of 3 locations in the Austin area indicates up to a 90 percent reduction in pollutant : discharges from PFC compar...

Longitudinal impact of IBS-type symptoms on disease activity, healthcare utilization, psychological health, and quality of life in inflammatory bowel disease.

PubMed

Gracie, David J; Hamlin, P John; Ford, Alexander C

2018-05-01

The impact of irritable bowel syndrome (IBS)-type symptoms on the natural history of inflammatory bowel disease (IBD) is uncertain. We aimed to address this in a longitudinal study of secondary care patients. Longitudinal disease activity was defined by disease flare, escalation of medical therapy, hospitalization, or intestinal resection. The number of investigations performed and clinics attended determined healthcare utilization. Psychological well-being and quality of life were assessed using validated questionnaires. These outcomes were compared over a minimum period of 2 years between patients reporting IBS-type symptoms and patients with quiescent disease, occult inflammation, and active disease at baseline. In 360 IBD patients, there were no differences in longitudinal disease activity between patients with IBS-type symptoms and patients with quiescent disease or occult inflammation. Disease flare and escalation of medical therapy was more common in patients with active disease than in patients with IBS-type symptoms (hazard ratio (HR) = 3.16; 95% confidence interval (CI) 1.93-5.19 and HR = 3.24; 95% CI 1.98-5.31, respectively). A greater number of investigations were performed in patients with IBS-type symptoms than quiescent disease (P = 0.008), but not compared with patients with occult inflammation or active disease. Anxiety, depression, and somatization scores at follow up were higher, and quality-of-life scores lower, in patients with IBS-type symptoms when compared with patients with quiescent disease, but were similar to patients with active disease. IBS-type symptoms in IBD were associated with increased healthcare utilization, psychological comorbidity, reduced quality of life, but not adverse disease activity outcomes during extended follow-up.

Evaluation on health-related quality of life in deaf children with cochlear implant in China.

PubMed

Liu, Hong; Liu, Hong-Xiang; Kang, Hou-Yong; Gu, Zheng; Hong, Su-Ling

2016-09-01

Previous studies have shown that deaf children benefit considerably from cochlear implants. These improvements are found in areas such as speech perception, speech production, and audiology-verbal performance. Despite the increasing prevalence of cochlear implants in China, few studies have reported on health-related quality of life in children with cochlear implants. The main objective of this study was to explore health-related quality of life on children with cochlear implants in South-west China. A retrospective observational study of 213 CI users in Southwest China between 2010 and 2013. Participants were 213 individuals with bilateral severe-to-profound hearing loss who wore unilateral cochlear implants. The Nijmegen Cochlear Implant Questionnaire and Health Utility Index Mark III were used pre-implantation and 1 year post-implantation. Additionally, 1-year postoperative scores for Mandarin speech perception were compared with preoperative scores. Health-related quality of life improved post-operation with scores on the Nijmegen Cochlear Implant Questionnaire improving significantly in all subdomains, and the Health Utility Index 3 showing a significant improvement in the utility score and the subdomains of ''hearing," ''speech," and "emotion". Additionally, a significant improvement in speech recognition scores was found. No significant correlation was found between increased in quality of life and speech perception scores. Health-related quality of life and speech recognition in prelingual deaf children significantly improved post-operation. The lack of correlation between quality of life and speech perception suggests that when evaluating performance post-implantation in prelingual deaf children and adolescents, measures of both speech perception and quality of life should be used. Copyright © 2016. Published by Elsevier Ireland Ltd.

Health utilities in gynecological oncology and mastology in Germany.

PubMed

Hildebrandt, Thomas; Thiel, Falk C; Fasching, Peter A; Graf, Christiane; Bani, Mayada R; Loehberg, Christian R; Schrauder, Michael G; Jud, Sebastian M; Hack, Carolin C; Beckmann, Matthias W; Lux, Michael P

2014-02-01

Cost increases in the healthcare system are leading to a need to distribute financial resources in accordance with the value of each service performed. Health-economic decision-making models can support these decisions. Due to the previous unavailability of health utilities in Germany (scored states of health as a basis for calculating quality-adjusted life-years, QALYs) for women undergoing treatment, international data are often used for such models. However, these may widely deviate from the values for a woman actually living in Germany. It is, therefore, necessary to collect and analyze health utilities in Germany. In a questionnaire survey, health utilities were collected, along with data for a healthy control group, for 580 female patients receiving treatment in the fields of mastology and gynecological oncology using a German version of the EuroQol questionnaire (EQ-5D) and a visual analogue scale (VAS). Data were also collected for the patients' medical history, tumor disease, and treatment. Significant differences with regard to quality of life were measured in relation to the individual tumor entities and in comparison to the controls. Apart from the healthy control group, patients with breast or cervical carcinoma had the best quality of life. In patients with recurrent and metastatic disease, those with breast carcinoma experienced the greatest impairment of their quality of life. According to current treatment, the most important impairment of life quality occurred in patients under radiotherapy and after surgical treatment. There are significant differences from the health utilities recorded for other countries - for example, the state of health declines much more markedly in patients with metastatic disease among American women with breast carcinoma than among German women, in whom recurrent disease and a first diagnosis of metastasis were comparable. Overall, the VAS was able to distinguish more adequately than the EQ-5D questionnaire between the

Healthcare Cost and Utilization Project (HCUP)

Cancer.gov

The Healthcare Cost and Utilization Project is a family of health care databases and related software tools and products developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality.

Integrative systems modeling and multi-objective optimization

EPA Science Inventory

This presentation presents a number of algorithms, tools, and methods for utilizing multi-objective optimization within integrated systems modeling frameworks. We first present innovative methods using a genetic algorithm to optimally calibrate the VELMA and SWAT ecohydrological ...

A Taxonomy of Object-Oriented Measures Modeling the Object-Oriented Space

NASA Technical Reports Server (NTRS)

Neal, Ralph D.; Weistroffer, H. Roland; Coppins, Richard J.

1997-01-01

In order to control the quality of software and the software development process, it is important to understand the measurement of software. A first step toward a better comprehension of software measurement is the categorization of software measures by some meaningful taxonomy. The most worthwhile taxonomy would capture the fundamental nature of the object-oriented (O-O) space. The principal characteristics of object-oriented software offer a starting point for such a categorization of measures. This paper introduces a taxonomy of measures based upon fourteen characteristics of object-oriented software gathered from the literature. This taxonomy allows us to easily see gaps or redundancies in the existing O-O measures. The taxonomy also clearly differentiates among taxa so that there is no ambiguity as to the taxon to which a measure belongs. The taxonomy has been populated with measures taken from the literature.

A Taxonomy of Object-Oriented Measures Modeling the Object Oriented Space

NASA Technical Reports Server (NTRS)

Neal, Ralph D.; Weistroffer, H. Roland; Coppins, Richard J.

1997-01-01

In order to control the quality of software and the software development process, it is important to understand the measurement of software. A first step toward a better comprehension of software measurement is the categorization of software measures by some meaningful taxonomy. The most worthwhile taxonomy would capture the fundamental nature of the object-oriented (O-O) space. The principal characteristics of object-oriented software offer a starting point for such a categorization of measures. This paper introduces a taxonomy of measures based upon fourteen characteristics of object-oriented software gathered from the literature. This taxonomy allows us to easily see gaps or redundancies in the existing O-O measures. The taxonomy also clearly differentiates among taxa so that there is no ambiguity as to the taxon to which a measure belongs. The taxonomy has been populated with measures taken from the literature.

Stochastic HKMDHE: A multi-objective contrast enhancement algorithm

NASA Astrophysics Data System (ADS)

Pratiher, Sawon; Mukhopadhyay, Sabyasachi; Maity, Srideep; Pradhan, Asima; Ghosh, Nirmalya; Panigrahi, Prasanta K.

2018-02-01

This contribution proposes a novel extension of the existing `Hyper Kurtosis based Modified Duo-Histogram Equalization' (HKMDHE) algorithm, for multi-objective contrast enhancement of biomedical images. A novel modified objective function has been formulated by joint optimization of the individual histogram equalization objectives. The optimal adequacy of the proposed methodology with respect to image quality metrics such as brightness preserving abilities, peak signal-to-noise ratio (PSNR), Structural Similarity Index (SSIM) and universal image quality metric has been experimentally validated. The performance analysis of the proposed Stochastic HKMDHE with existing histogram equalization methodologies like Global Histogram Equalization (GHE) and Contrast Limited Adaptive Histogram Equalization (CLAHE) has been given for comparative evaluation.

The construction of standard gamble utilities.

PubMed

van Osch, Sylvie M C; Stiggelbout, Anne M

2008-01-01

Health effects for cost-effectiveness analysis are best measured in life years, with quality of life in each life year expressed in terms of utilities. The standard gamble (SG) has been the gold standard for utility measurement. However, the biases of probability weighting, loss aversion, and scale compatibility have an inconclusive effect on SG utilities. We determined their effect on SG utilities using qualitative data to assess the reference point and the focus of attention. While thinking aloud, 45 healthy respondents provided SG utilities for six rheumatoid arthritis health states. Reference points, goals, and focuses of attention were coded. To assess the effect of scale compatibility, correlations were assessed between focus of attention and mean utility. The certain outcome served most frequently as reference point, the SG was perceived as a mixed gamble. Goals were mostly mentioned with respect to this outcome. Scale compatibility led to a significant upward bias in utilities; attention lay relatively more on the low outcome and this was positively correlated with mean utility. SG utilities should be corrected for loss aversion and probability weighting with the mixed correction formula proposed by prospect theory. Scale compatibility will likely still bias SG utilities, calling for research on a correction. Copyright (c) 2007 John Wiley & Sons, Ltd.

Stream Clustering of Growing Objects

NASA Astrophysics Data System (ADS)

Siddiqui, Zaigham Faraz; Spiliopoulou, Myra

We study incremental clustering of objects that grow and accumulate over time. The objects come from a multi-table stream e.g. streams of Customer and Transaction. As the Transactions stream accumulates, the Customers’ profiles grow. First, we use an incremental propositionalisation to convert the multi-table stream into a single-table stream upon which we apply clustering. For this purpose, we develop an online version of K-Means algorithm that can handle these swelling objects and any new objects that arrive. The algorithm also monitors the quality of the model and performs re-clustering when it deteriorates. We evaluate our method on the PKDD Challenge 1999 dataset.

Fast grasping of unknown objects using principal component analysis

NASA Astrophysics Data System (ADS)

Lei, Qujiang; Chen, Guangming; Wisse, Martijn

2017-09-01

Fast grasping of unknown objects has crucial impact on the efficiency of robot manipulation especially subjected to unfamiliar environments. In order to accelerate grasping speed of unknown objects, principal component analysis is utilized to direct the grasping process. In particular, a single-view partial point cloud is constructed and grasp candidates are allocated along the principal axis. Force balance optimization is employed to analyze possible graspable areas. The obtained graspable area with the minimal resultant force is the best zone for the final grasping execution. It is shown that an unknown object can be more quickly grasped provided that the component analysis principle axis is determined using single-view partial point cloud. To cope with the grasp uncertainty, robot motion is assisted to obtain a new viewpoint. Virtual exploration and experimental tests are carried out to verify this fast gasping algorithm. Both simulation and experimental tests demonstrated excellent performances based on the results of grasping a series of unknown objects. To minimize the grasping uncertainty, the merits of the robot hardware with two 3D cameras can be utilized to suffice the partial point cloud. As a result of utilizing the robot hardware, the grasping reliance is highly enhanced. Therefore, this research demonstrates practical significance for increasing grasping speed and thus increasing robot efficiency under unpredictable environments.

Association of suicidal ideation with poor sleep quality among Ethiopian adults.

PubMed

Gelaye, Bizu; Okeiga, Joseph; Ayantoye, Idris; Berhane, Hanna Y; Berhane, Yemane; Williams, Michelle A

2016-12-01

The objective of this study was to examine the extent to which poor sleep quality is associated with suicidal ideation among Ethiopian adults. A cross-sectional study was conducted among 1054 adults attending outpatient clinical facilities in Ethiopia. Standardized questionnaires were utilized to collect data on demographics, sleep quality, lifestyle, and depression status. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9), while the Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess sleep quality. Multivariate logistic regression models were fit to estimate adjusted odds ratio (AOR) and 95 % confidence intervals (95 % CI). The prevalence of suicidal ideation was 24.3 % while poor sleep quality (PSQI global score of >5 vs. ≤5) was endorsed by 60.2 % of participants. After adjustment for confounders including depression, poor sleep quality was associated with more than 3-fold increased odds of suicidal ideation (AOR = 3.59; 95 % CI 2.34-5.51). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 20 % increased odds for suicidal ideation, even after adjusting for depression (AOR = 1.20; 95 % CI 1.14-1.27). Participants with both poor sleep quality and depression had much higher odds (AOR = 23.22, 95 % CI 14.10-38.28) of suicidal ideation as compared with those who had good sleep quality and no depression although inferences from this analysis are limited due to the wide 95 % CI. Suicidal ideation and poor sleep quality are highly prevalent. Individuals with poor sleep quality have higher odds of suicidal ideation. If confirmed, mental health services need to address sleep disturbances seriously to prevent suicidal episodes.

Association of Suicidal Ideation with Poor Sleep Quality among Ethiopian Adults

PubMed Central

Gelaye, Bizu; Okeiga, Joseph; Ayantoye, Idris; Berhane, Hanna Y.; Berhane, Yemane; Williams, Michelle A.

2016-01-01

Objective To examine the extent to which poor sleep quality is associated with suicidal ideation among Ethiopian adults. Methods A cross-sectional study was conducted among 1,054 adults attending outpatient clinical facilities in Ethiopia. Standardized questionnaires were utilized to collect data on demographics, sleep quality, lifestyle, and depression status. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9), while the Pittsburgh Sleep Quality Index (PSQI) questionnaire was utilized to assess sleep quality. Multivariate logistic regression models were fit to estimate adjusted odds ratio (AOR) and 95% confidence intervals (95%CI). Results The prevalence of suicidal ideation was 24.3% while poor sleep quality (PSQI global score of > 5vs. ≤5) was endorsed by 60.2% of participants. After adjustment for confounders including depression, poor sleep quality was associated with more than 3-fold increased odds of suicidal ideation (AOR=3.46; 95%CI 2.27–5.26). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 20% increased odds for suicidal ideation, even after adjusting for depression (AOR=1.20; 95%CI 1.14–1.27). Participants with both poor sleep quality and depression had much higher odds (AOR=24.9, 95% CI 15.2–40.8) of suicidal ideation as compared with those who had good sleep quality and no depression although inferences from this analysis are limited due to the wide 95%CI. Conclusion Suicidal ideation and poor sleep quality are highly prevalent. Individuals with poor sleep quality have higher odds of suicidal ideation. If confirmed, mental health services need to address sleep disturbances seriously to prevent suicidal episodes. PMID:27771845

Determinants of elevated healthcare utilization in patients with COPD.

PubMed

Simon-Tuval, Tzahit; Scharf, Steven M; Maimon, Nimrod; Bernhard-Scharf, Barbara J; Reuveni, Haim; Tarasiuk, Ariel

2011-01-13

Chronic obstructive pulmonary disease (COPD) imparts a substantial economic burden on western health systems. Our objective was to analyze the determinants of elevated healthcare utilization among patients with COPD in a single-payer health system. Three-hundred eighty-nine adults with COPD were matched 1:3 to controls by age, gender and area of residency. Total healthcare cost 5 years prior recruitment and presence of comorbidities were obtained from a computerized database. Health related quality of life (HRQoL) indices were obtained using validated questionnaires among a subsample of 177 patients. Healthcare utilization was 3.4-fold higher among COPD patients compared with controls (p < 0.001). The "most-costly" upper 25% of COPD patients (n = 98) consumed 63% of all costs. Multivariate analysis revealed that independent determinants of being in the "most costly" group were (OR; 95% CI): age-adjusted Charlson Comorbidity Index (1.09; 1.01-1.2), history of: myocardial infarct (2.87; 1.5-5.5), congestive heart failure (3.52; 1.9-6.4), mild liver disease (3.83; 1.3-11.2) and diabetes (2.02; 1.1-3.6). Bivariate analysis revealed that cost increased as HRQoL declined and severity of airflow obstruction increased but these were not independent determinants in a multivariate analysis. Comorbidity burden determines elevated utilization for COPD patients. Decision makers should prioritize scarce health care resources to a better care management of the "most costly" patients.

IDL Object Oriented Software for Hinode/XRT Image Analysis

NASA Astrophysics Data System (ADS)

Higgins, P. A.; Gallagher, P. T.

2008-09-01

We have developed a set of object oriented IDL routines that enable users to search, download and analyse images from the X-Ray Telescope (XRT) on-board Hinode. In this paper, we give specific examples of how the object can be used and how multi-instrument data analysis can be performed. The XRT object is a highly versatile and powerful IDL object, which will prove to be a useful tool for solar researchers. This software utilizes the generic Framework object available within the GEN branch of SolarSoft.

Making Quality Health Websites a National Public Health Priority: Toward Quality Standards.

PubMed

Devine, Theresa; Broderick, Jordan; Harris, Linda M; Wu, Huijuan; Hilfiker, Sandra Williams

2016-08-02

Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out of 100 (58.0%) websites met 3 or

Analyzing compound and project progress through multi-objective-based compound quality assessment.

PubMed

Nissink, J Willem M; Degorce, Sébastien

2013-05-01

Compound-quality scoring methods designed to evaluate multiple drug properties concurrently are useful to analyze and prioritize output from drug-design efforts. However, formalized multiparameter optimization approaches are not widely used in drug design. We rank molecules synthesized in drug-discovery projects using simple and aggregated desirability functions reflecting medicinal chemistry 'rules'. Our quality score deals transparently with missing data, a key requirement in drug-hunting projects where data availability is often limited. We further estimate confidence in the interpretation of such a compound-quality measure. Scores and associated confidences provide systematic insight in the quality of emerging chemical equity. Tracking quality of synthetic output over time yields valuable insight into the progress of drug-design teams, with potential applications in risk and resource management of a drug portfolio.

Utilization of Light Detection and Ranging for Quality Control and Quality Assurance of Pavement Grades

DOT National Transportation Integrated Search

2018-02-01

Light Detection and Ranging (Lidar) technology is a useful tool that can assist transportation agencies during the design, construction, and maintenance phases of transportation projects. To demonstrate the utility of Lidar, this report discusses how...

Utility of registries for post-marketing evaluation of medicines. A survey of Swedish health care quality registries from a regulatory perspective.

PubMed

Feltelius, Nils; Gedeborg, Rolf; Holm, Lennart; Zethelius, Björn

2017-06-01

The aim of this study was to describe content and procedures in some selected Swedish health care quality registries (QRs) of relevance to regulatory decision-making. A workshop was organized with participation of seven Swedish QRs which subsequently answered a questionnaire regarding registry content on drug treatments and outcomes. Patient populations, coverage, data handling and quality control, as well as legal and ethical aspects are presented. Scientific publications from the QRs are used as a complementary measure of quality and scientific relevance. The registries under study collect clinical data of high relevance to regulatory and health technology agencies. Five out of seven registries provide information on the drug of interest. When applying external quality criteria, we found a high degree of fulfillment, although information on medication was not sufficient to answer all questions of regulatory interest. A notable strength is the option for linkage to the Prescribed Drug Registry and to information on education and socioeconomic status. Data on drugs used during hospitalization were also collected to some extent. Outcome measures collected resemble those used in relevant clinical trials. All registries collected patient-reported outcome measures. The number of publications from the registries was substantial, with studies of appropriate design, including randomized registry trials. Quality registries may provide a valuable source of post-marketing data on drug effectiveness, safety, and cost-effectiveness. Closer collaboration between registries and regulators to improve quality and usefulness of registry data could benefit both regulatory utility and value for health care providers.

The BARRIERS scale -- the barriers to research utilization scale: A systematic review

PubMed Central

2010-01-01

Background A commonly recommended strategy for increasing research use in clinical practice is to identify barriers to change and then tailor interventions to overcome the identified barriers. In nursing, the BARRIERS scale has been used extensively to identify barriers to research utilization. Aim and objectives The aim of this systematic review was to examine the state of knowledge resulting from use of the BARRIERS scale and to make recommendations about future use of the scale. The following objectives were addressed: To examine how the scale has been modified, to examine its psychometric properties, to determine the main barriers (and whether they varied over time and geographic locations), and to identify associations between nurses' reported barriers and reported research use. Methods Medline (1991 to September 2009) and CINHAL (1991 to September 2009) were searched for published research, and ProQuest® digital dissertations were searched for unpublished dissertations using the BARRIERS scale. Inclusion criteria were: studies using the BARRIERS scale in its entirety and where the sample was nurses. Two authors independently assessed the study quality and extracted the data. Descriptive and inferential statistics were used. Results Sixty-three studies were included, with most using a cross-sectional design. Not one study used the scale for tailoring interventions to overcome identified barriers. The main barriers reported were related to the setting, and the presentation of research findings. Overall, identified barriers were consistent over time and across geographic locations, despite varying sample size, response rate, study setting, and assessment of study quality. Few studies reported associations between reported research use and perceptions of barriers to research utilization. Conclusions The BARRIERS scale is a nonspecific tool for identifying general barriers to research utilization. The scale is reliable as reflected in assessments of internal

Current issues in determining dietary protein quality and metabolic utilization

USDA-ARS?s Scientific Manuscript database

In resource-limited settings, poor dietary quality has a marked negative impact on health, especially during the sensitive periods of pregnancy and first 2 years of life (the first 1000 days) when stunting, poor development and increased risk of later disease develop. Protein quality is often poor o...

Quality of life and objective outcome assessment in women with tape division after surgery for stress urinary incontinence

PubMed Central

Ulrich, Daniela; Bjelic-Radisic, Vesna; Höllein, Anna; Tamussino, Karl; Aigmüller, Thomas

2017-01-01

Background Midurethral tapes may cause long-term complications such as voiding dysfunction, groin pain, de novo urgency or mesh erosion, which necessitate a reoperation. There is a paucity of data regarding health related quality of life in patients undergoing tape removal. The aim of the study was to evaluate quality of life (QoL) and objective outcome after midurethral tape division or excision. Methods All patients who underwent a midurethral tape division for voiding difficulties, pain or therapy resistant de novo overactive bladder between 1999 and 2014 were invited for follow-up. A control group with a suburethral tape without division was established in a 1:2 ratio and matched for age, tape used and year of tape insertion. Patients completed the Kings´ Health Questionnaire (KHQ), Incontinence Outcome Questionnaire, Female Sexual Function Index Questionnaire and the Patient Global Impression of Improvement score. Results Tape division or excision was performed in 32 women. Overall, 15 (60%) of 25 women who were alive were available for clinical examination and completed the questionnaires. Tape division was performed for voiding dysfunction (n = 7), overactive bladder (n = 2), mesh extrusion (n = 3) and ongoing pain (n = 3). Median time to tape division/excision was 10 months. Three women in the tape division group had undergone reoperation for stress urinary incontinence (SUI). At a median follow-up of 11 years (IQR 9–13) subjective SUI rate was 53% (8/15 women) in the tape division group and 17% (5/30) in the control group (p = 0.016), with no significant differences in objective SUI rates between groups. With regard to quality of life, the study group had significantly worse scores in the SUI related domains role limitation, physical limitation, severity measures and social limitations (KHQ) compared to the control group. Conclusions Women needing tape division or excision have lower SUI related QoL scores compared to controls mostly because of higher

The business case for quality improvement: oral anticoagulation for atrial fibrillation.

PubMed

Rose, Adam J; Berlowitz, Dan R; Ash, Arlene S; Ozonoff, Al; Hylek, Elaine M; Goldhaber-Fiebert, Jeremy D

2011-07-01

The potential to save money within a short time frame provides a more compelling "business case" for quality improvement than merely demonstrating cost-effectiveness. Our objective was to demonstrate the potential for cost savings from improved control in patients anticoagulated for atrial fibrillation. Our population consisted of 67 077 Veterans Health Administration patients anticoagulated for atrial fibrillation between October 1, 2006, and September 30, 2008. We simulated the number of adverse events and their associated costs and utilities, both before and after various degrees of improvement in percent time in therapeutic range (TTR). The simulation had a 2-year time horizon, and costs were calculated from the perspective of the payer. In the base-case analysis, improving TTR by 5% prevented 1114 adverse events, including 662 deaths; it gained 863 quality-adjusted life-years and saved $15.9 million compared with the status quo, not accounting for the cost of the quality improvement program. Improving TTR by 10% prevented 2087 events, gained 1606 quality-adjusted life-years, and saved $29.7 million. In sensitivity analyses, costs were most sensitive to the estimated risk of stroke and the expected stroke reduction from improved TTR. Utilities were most sensitive to the estimated risk of death and the expected mortality benefit from improved TTR. A quality improvement program to improve anticoagulation control probably would be cost-saving for the payer, even if it were only modestly effective in improving control and even without considering the value of improved health. This study demonstrates how to make a business case for a quality improvement initiative.

Developing objectives with multiple stakeholders: adaptive management of horseshoe crabs and Red Knots in the Delaware Bay

USGS Publications Warehouse

McGowan, Conor P.; Lyons, James E.; Smith, David

2015-01-01

Structured decision making (SDM) is an increasingly utilized approach and set of tools for addressing complex decisions in environmental management. SDM is a value-focused thinking approach that places paramount importance on first establishing clear management objectives that reflect core values of stakeholders. To be useful for management, objectives must be transparently stated in unambiguous and measurable terms. We used these concepts to develop consensus objectives for the multiple stakeholders of horseshoe crab harvest in Delaware Bay. Participating stakeholders first agreed on a qualitative statement of fundamental objectives, and then worked to convert those objectives to specific and measurable quantities, so that management decisions could be assessed. We used a constraint-based approach where the conservation objectives for Red Knots, a species of migratory shorebird that relies on horseshoe crab eggs as a food resource during migration, constrained the utility of crab harvest. Developing utility functions to effectively reflect the management objectives allowed us to incorporate stakeholder risk aversion even though different stakeholder groups were averse to different or competing risks. While measurable objectives and quantitative utility functions seem scientific, developing these objectives was fundamentally driven by the values of the participating stakeholders.

Developing Objectives with Multiple Stakeholders: Adaptive Management of Horseshoe Crabs and Red Knots in the Delaware Bay

NASA Astrophysics Data System (ADS)

McGowan, Conor P.; Lyons, James E.; Smith, David R.

2015-04-01

Structured decision making (SDM) is an increasingly utilized approach and set of tools for addressing complex decisions in environmental management. SDM is a value-focused thinking approach that places paramount importance on first establishing clear management objectives that reflect core values of stakeholders. To be useful for management, objectives must be transparently stated in unambiguous and measurable terms. We used these concepts to develop consensus objectives for the multiple stakeholders of horseshoe crab harvest in Delaware Bay. Participating stakeholders first agreed on a qualitative statement of fundamental objectives, and then worked to convert those objectives to specific and measurable quantities, so that management decisions could be assessed. We used a constraint-based approach where the conservation objectives for Red Knots, a species of migratory shorebird that relies on horseshoe crab eggs as a food resource during migration, constrained the utility of crab harvest. Developing utility functions to effectively reflect the management objectives allowed us to incorporate stakeholder risk aversion even though different stakeholder groups were averse to different or competing risks. While measurable objectives and quantitative utility functions seem scientific, developing these objectives was fundamentally driven by the values of the participating stakeholders.

Making Quality Health Websites a National Public Health Priority: Toward Quality Standards

PubMed Central

2016-01-01

Background Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. Objective The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. Methods The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. Results This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out

UTILIZATION OF LANDSCAPE INDICATORS TO MODEL WATER QUALITY

EPA Science Inventory

Many water-bodies within the United States are contaminated by, non-point source (NFS) pollution, which is defined as those materials posing a threat to water quality arising from a number of individual sources and diffused through hydrologic processes. One such NPS pollu...

[Quality management in a clinical research facility: Evaluation of changes in quality in-house figures and the appraisal of in-house quality indicators].

PubMed

Aden, Bile; Allekotte, Silke; Mösges, Ralph

2016-12-01

For long-term maintenance and improvement of quality within a clinical research institute, the implementation and certification of a quality management system is suitable. Due to the implemented quality management system according to the still valid DIN EN ISO 9001:2008 desired quality objectives are achieved effectively. The evaluation of quality scores and the appraisal of in-house quality indicators make an important contribution in this regard. In order to achieve this and draw quality assurance conclusions, quality indicators as sensible and sensitive as possible are developed. For this, own key objectives, the retrospective evaluation of quality scores, a prospective follow-up and also discussions establish the basis. In the in-house clinical research institute the measures introduced by the quality management led to higher efficiency in work processes, improved staff skills, higher customer satisfaction and overall to more successful outcomes in relation to the self-defined key objectives. Copyright © 2016. Published by Elsevier GmbH.

Technology utilization office data base analysis and design

NASA Technical Reports Server (NTRS)

Floyd, Stephen A.

1993-01-01

NASA Headquarters is placing a high priority on the transfer of NASA and NASA contractor developed technologies and expertise to the private sector and to other federal, state and local government organizations. The ultimate objective of these efforts is positive economic impact, an improved quality of life, and a more competitive U.S. posture in international markets. The Technology Utilization Office (TUO) currently serves seven states with its technology transfer efforts. Since 1989, the TUO has handled over one-thousand formal requests for NASA related technologies assistance. The technology transfer process requires promoting public awareness of NASA related soliciting requests for assistance, matching technologies to specific needs, assuring appropriate technology transfer, and monitoring and evaluating the process. Each of these activities have one very important aspect in common: the success of each is dissemination of appropriate high quality information. The purpose of the research was to establish the requirements and develop a preliminary design for a database system to increase the effectiveness and efficiency of the TUO's technology transfer function. The research was conducted following the traditional systems development life cycle methodology and was supported through the use of modern structured analysis techniques. The next section will describe the research and findings as conducted under the life cycle approach.

An infrared modular panoramic imaging objective

NASA Astrophysics Data System (ADS)

Palmer, Troy A.; Alexay, Christopher C.

2004-08-01

We describe the optical and mechanical design of an athermal infrared objective lens with an afocal anamorphic adapter. The lens presented consists of two modules: an athermal 25mm F/2.3 mid-wave IR objective lens and an optional panoramic adapter. The adapter utilizes anamorphic lenses to create unique image control. The result of which enables an independent horizontal wide field of view, while preserving the original narrow vertical field. We have designed, fabricated and tested two such lenses. A summary of the assembly and testing process is also presented.

Utility-preserving anonymization for health data publishing.

PubMed

Lee, Hyukki; Kim, Soohyung; Kim, Jong Wook; Chung, Yon Dohn

2017-07-11

Publishing raw electronic health records (EHRs) may be considered as a breach of the privacy of individuals because they usually contain sensitive information. A common practice for the privacy-preserving data publishing is to anonymize the data before publishing, and thus satisfy privacy models such as k-anonymity. Among various anonymization techniques, generalization is the most commonly used in medical/health data processing. Generalization inevitably causes information loss, and thus, various methods have been proposed to reduce information loss. However, existing generalization-based data anonymization methods cannot avoid excessive information loss and preserve data utility. We propose a utility-preserving anonymization for privacy preserving data publishing (PPDP). To preserve data utility, the proposed method comprises three parts: (1) utility-preserving model, (2) counterfeit record insertion, (3) catalog of the counterfeit records. We also propose an anonymization algorithm using the proposed method. Our anonymization algorithm applies full-domain generalization algorithm. We evaluate our method in comparison with existence method on two aspects, information loss measured through various quality metrics and error rate of analysis result. With all different types of quality metrics, our proposed method show the lower information loss than the existing method. In the real-world EHRs analysis, analysis results show small portion of error between the anonymized data through the proposed method and original data. We propose a new utility-preserving anonymization method and an anonymization algorithm using the proposed method. Through experiments on various datasets, we show that the utility of EHRs anonymized by the proposed method is significantly better than those anonymized by previous approaches.

The effect of input data transformations on object-based image analysis

PubMed Central

LIPPITT, CHRISTOPHER D.; COULTER, LLOYD L.; FREEMAN, MARY; LAMANTIA-BISHOP, JEFFREY; PANG, WYSON; STOW, DOUGLAS A.

2011-01-01

The effect of using spectral transform images as input data on segmentation quality and its potential effect on products generated by object-based image analysis are explored in the context of land cover classification in Accra, Ghana. Five image data transformations are compared to untransformed spectral bands in terms of their effect on segmentation quality and final product accuracy. The relationship between segmentation quality and product accuracy is also briefly explored. Results suggest that input data transformations can aid in the delineation of landscape objects by image segmentation, but the effect is idiosyncratic to the transformation and object of interest. PMID:21673829

Resource utilization after introduction of a standardized clinical assessment and management plan.

PubMed

Friedman, Kevin G; Rathod, Rahul H; Farias, Michael; Graham, Dionne; Powell, Andrew J; Fulton, David R; Newburger, Jane W; Colan, Steven D; Jenkins, Kathy J; Lock, James E

2010-01-01

A Standardized Clinical Assessment and Management Plan (SCAMP) is a novel quality improvement initiative that standardizes the assessment and management of all patients who carry a predefined diagnosis. Based on periodic review of systemically collected data the SCAMP is designed to be modified to improve its own algorithm. One of the objectives of a SCAMP is to identify and reduce resource utilization and patient care costs. We retrospectively reviewed resource utilization in the first 93 arterial switch operation (ASO) SCAMP patients and 186 age-matched control ASO patients. We compared diagnostic and laboratory testing obtained at the initial SCAMP clinic visit and control patient visits. To evaluate the effect of the SCAMP over time, the number of clinic visits per patient year and echocardiograms per patient year in historical control ASO patients were compared to the projected rates for ASO SCAMP participants. Cardiac magnetic resonance imaging (MRI), stress echocardiogram, and lipid profile utilization were higher in the initial SCAMP clinic visit group than in age-matched control patients. Total echocardiogram and lung scan usage were similar. Chest X-ray and exercise stress testing were obtained less in SCAMP patients. ASO SCAMP patients are projected to have 0.5 clinic visits and 0.5 echocardiograms per year. Historical control patients had more clinic visits (1.2 vs. 0.5 visits/patient year, P<.01) and a higher echocardiogram rate (0.92 vs. 0.5 echocardiograms/patient year, P<.01) Implementation of a SCAMP may initially lead to increased resource utilization, but over time resource utilization is projected to decrease.

System for controlled acoustic rotation of objects

NASA Technical Reports Server (NTRS)

Barmatz, M. B. (Inventor)

1983-01-01

A system is described for use with acoustically levitated objects, which enables close control of rotation of the object. One system includes transducers that propagate acoustic waves along the three dimensions (X, Y, Z) of a chamber of rectangular cross section. Each transducers generates one wave which is resonant to a corresponding chamber dimension to acoustically levitate an object, and additional higher frequency resonant wavelengths for controlling rotation of the object. The three chamber dimensions and the corresponding three levitation modes (resonant wavelengths) are all different, to avoid degeneracy, or interference, of waves with one another, that could have an effect on object rotation. Only the higher frequencies, with pairs of them having the same wavelength, are utilized to control rotation, so that rotation is controlled independently of levitation and about any arbitrarily chosen axis.

Image quality assessment using deep convolutional networks

NASA Astrophysics Data System (ADS)

Li, Yezhou; Ye, Xiang; Li, Yong

2017-12-01

This paper proposes a method of accurately assessing image quality without a reference image by using a deep convolutional neural network. Existing training based methods usually utilize a compact set of linear filters for learning features of images captured by different sensors to assess their quality. These methods may not be able to learn the semantic features that are intimately related with the features used in human subject assessment. Observing this drawback, this work proposes training a deep convolutional neural network (CNN) with labelled images for image quality assessment. The ReLU in the CNN allows non-linear transformations for extracting high-level image features, providing a more reliable assessment of image quality than linear filters. To enable the neural network to take images of any arbitrary size as input, the spatial pyramid pooling (SPP) is introduced connecting the top convolutional layer and the fully-connected layer. In addition, the SPP makes the CNN robust to object deformations to a certain extent. The proposed method taking an image as input carries out an end-to-end learning process, and outputs the quality of the image. It is tested on public datasets. Experimental results show that it outperforms existing methods by a large margin and can accurately assess the image quality on images taken by different sensors of varying sizes.

A Method for a Retrospective Analysis of Course Objectives: Have Pursued Objectives in Fact Been Attained? Twente Educational Report Number 7.

ERIC Educational Resources Information Center

Plomp, Tjeerd; van der Meer, Adri

A method pertaining to the identification and analysis of course objectives is discussed. A framework is developed by which post facto objectives can be determined and students' attainment of the objectives can be assessed. The method can also be used for examining the quality of instruction. Using this method, it is possible to determine…

[Research on resources chemistry of Chinese medicinal materials and resources recycling utilization ways and goals and tasks].

PubMed

Duan, Jin-ao; Su, Shu-lan; Guo, Sheng; Jiang, Shu; Liu, Pei; Yan, Hui; Qian, Da-wei; Zhu, Hua-xu; Tang, Yu-ping; Wu, Qi-nan

2015-09-01

The objects of research on the resources chemistry of Chinese medicinal materials (RCCMM) are promotion of efficient production, rational utilization and improving quality of CMM and natural products. The development of TCM cause depends on the efficient utilization and sustainable development of CMM, hinges on the technologies and methods for using and discovering medicinal biological resources, stand or fall on the extension of industy chains, detailed utilizaion of resource chemical components by multi-way, multi-level. All of these may help to the recycling utilization and sound development of RCMM. In this article, five respects were discussed to the RCCMM researches and resources recycling utilization ways and goals and tasks. First, based on the principle of resource scarcity, discovering or replacing CMM resources, protecting the rare or endangered species or resources. Second, based on the multifunctionality of CMM, realizing the value-added and value compensation, and promoting the utilization efficiency through systermatic and detailed exploitation and utilization. Third, based on the resource conservation and environment-friendly, reducing raw material consumption, lowering cost, promoting recycling utilization and elevating utilization efficiency. Fourth, based on the stratege of turning harm into good, using the invasive alien biological resources by multi-ways and enriching the medicial resources. Fifth, based on the method of structure modification of chemical components, exploring and enhancing the utility value of resouces chemical substances. These data should provide references and attention for improving the utilization efficiency, promoting the development of recycling economy, and changing the mode of economic growth of agriculture and industry of CMM fundamentally.

Measuring the Utility of a Basic French Vocabulary.

ERIC Educational Resources Information Center

Savard, Jean-Guy; Richards, Jack C.

Using frequency, range, availability, and coverage as objectively weighted indices of utility in the development of a basic French vocabulary list, the authors describe the technical procedure used in this study and list the resultant first 153 words according to the four indices and the utility rating. Weighting factors for each index, based on…

CIFAR10-DVS: An Event-Stream Dataset for Object Classification

PubMed Central

Li, Hongmin; Liu, Hanchao; Ji, Xiangyang; Li, Guoqi; Shi, Luping

2017-01-01

Neuromorphic vision research requires high-quality and appropriately challenging event-stream datasets to support continuous improvement of algorithms and methods. However, creating event-stream datasets is a time-consuming task, which needs to be recorded using the neuromorphic cameras. Currently, there are limited event-stream datasets available. In this work, by utilizing the popular computer vision dataset CIFAR-10, we converted 10,000 frame-based images into 10,000 event streams using a dynamic vision sensor (DVS), providing an event-stream dataset of intermediate difficulty in 10 different classes, named as “CIFAR10-DVS.” The conversion of event-stream dataset was implemented by a repeated closed-loop smooth (RCLS) movement of frame-based images. Unlike the conversion of frame-based images by moving the camera, the image movement is more realistic in respect of its practical applications. The repeated closed-loop image movement generates rich local intensity changes in continuous time which are quantized by each pixel of the DVS camera to generate events. Furthermore, a performance benchmark in event-driven object classification is provided based on state-of-the-art classification algorithms. This work provides a large event-stream dataset and an initial benchmark for comparison, which may boost algorithm developments in even-driven pattern recognition and object classification. PMID:28611582

CIFAR10-DVS: An Event-Stream Dataset for Object Classification.

PubMed

Li, Hongmin; Liu, Hanchao; Ji, Xiangyang; Li, Guoqi; Shi, Luping

2017-01-01

Neuromorphic vision research requires high-quality and appropriately challenging event-stream datasets to support continuous improvement of algorithms and methods. However, creating event-stream datasets is a time-consuming task, which needs to be recorded using the neuromorphic cameras. Currently, there are limited event-stream datasets available. In this work, by utilizing the popular computer vision dataset CIFAR-10, we converted 10,000 frame-based images into 10,000 event streams using a dynamic vision sensor (DVS), providing an event-stream dataset of intermediate difficulty in 10 different classes, named as "CIFAR10-DVS." The conversion of event-stream dataset was implemented by a repeated closed-loop smooth (RCLS) movement of frame-based images. Unlike the conversion of frame-based images by moving the camera, the image movement is more realistic in respect of its practical applications. The repeated closed-loop image movement generates rich local intensity changes in continuous time which are quantized by each pixel of the DVS camera to generate events. Furthermore, a performance benchmark in event-driven object classification is provided based on state-of-the-art classification algorithms. This work provides a large event-stream dataset and an initial benchmark for comparison, which may boost algorithm developments in even-driven pattern recognition and object classification.

SEMPATH Ontology: modeling multidisciplinary treatment schemes utilizing semantics.

PubMed

Alexandrou, Dimitrios Al; Pardalis, Konstantinos V; Bouras, Thanassis D; Karakitsos, Petros; Mentzas, Gregoris N

2012-03-01

A dramatic increase of demand for provided treatment quality has occurred during last decades. The main challenge to be confronted, so as to increase treatment quality, is the personalization of treatment, since each patient constitutes a unique case. Healthcare provision encloses a complex environment since healthcare provision organizations are highly multidisciplinary. In this paper, we present the conceptualization of the domain of clinical pathways (CP). The SEMPATH (SEMantic PATHways) Oontology comprises three main parts: 1) the CP part; 2) the business and finance part; and 3) the quality assurance part. Our implementation achieves the conceptualization of the multidisciplinary domain of healthcare provision, in order to be further utilized for the implementation of a Semantic Web Rules (SWRL rules) repository. Finally, SEMPATH Ontology is utilized for the definition of a set of SWRL rules for the human papillomavirus) disease and its treatment scheme. © 2012 IEEE

Individual determinants of research utilization by nurses: a systematic review update

PubMed Central

2011-01-01

Background Interventions that have a better than random chance of increasing nurses' use of research are important to the delivery of quality patient care. However, few reports exist of successful research utilization in nursing interventions. Systematic identification and evaluation of individual characteristics associated with and predicting research utilization may inform the development of research utilization interventions. Objective To update the evidence published in a previous systematic review on individual characteristics influencing research utilization by nurses. Methods As part of a larger systematic review on research utilization instruments, 12 online bibliographic databases were searched. Hand searching of specialized journals and an ancestry search was also conducted. Randomized controlled trials, clinical trials, and observational study designs examining the association between individual characteristics and nurses' use of research were eligible for inclusion. Studies were limited to those published in the English, Danish, Swedish, and Norwegian languages. A vote counting approach to data synthesis was taken. Results A total of 42,770 titles were identified, of which 501 were retrieved. Of these 501 articles, 45 satisfied our inclusion criteria. Articles assessed research utilization in general (n = 39) or kinds of research utilization (n = 6) using self-report survey measures. Individual nurse characteristics were classified according to six categories: beliefs and attitudes, involvement in research activities, information seeking, education, professional characteristics, and socio-demographic/socio-economic characteristics. A seventh category, critical thinking, emerged in studies examining kinds of research utilization. Positive relationships, at statistically significant levels, for general research utilization were found in four categories: beliefs and attitudes, information seeking, education, and professional characteristics. The only

A Delphi study assessing the utility of quality improvement tools and resources in Australian primary care.

PubMed

Upham, Susan J; Janamian, Tina; Crossland, Lisa; Jackson, Claire L

2016-04-18

To determine the relevance and utility of online tools and resources to support organisational performance development in primary care and to complement the Primary Care Practice Improvement Tool (PC-PIT). A purposively recruited Expert Advisory Panel of 12 end users used a modified Delphi technique to evaluate 53 tools and resources identified through a previously conducted systematic review. The panel comprised six practice managers and six general practitioners who had participated in the PC-PIT pilot study in 2013-2014. Tools and resources were reviewed in three rounds using a standard pre-tested assessment form. Recommendations, scores and reasons for recommending or rejecting each tool or resource were analysed to determine the final suite of tools and resources. The evaluation was conducted from November 2014 to August 2015. Recommended tools and resources scored highly (mean score, 16/20) in Rounds 1 and 2 of review (n = 25). These tools and resources were perceived to be easily used, useful to the practice and supportive of the PC-PIT. Rejected resources scored considerably lower (mean score, 5/20) and were noted to have limitations such as having no value to the practice and poor utility (n = 6). A final review (Round 3) of 28 resources resulted in a suite of 21 to support the elements of the PC-PIT. This suite of tools and resources offers one approach to supporting the quality improvement initiatives currently in development in primary care reform.

Objective and Subjective Intra-patient Comparison of Iohexol versus Diatrizoate for Bowel Preparation Quality at CT Colonography

PubMed Central

Johnson, Brandon; Hinshaw, J. Louis; Robbins, Jessica B.; Pickhardt, Perry J.

2017-01-01

Objective To objectively and subjectively compare nonionic iohexol and ionic diatrizoate iodinated oral contrast as part of a cathartic bowel regimen within the same CT colonography (CTC) cohort, with otherwise identical preparations. Materials and Methods In our IRB-approved retrospective study, 46 asymptomatic adults (mean age, 59.4 years; 26M/20F) returning for follow-up CTC over a 9-month interval underwent the same bowel preparation with the exception of 75 ml iohexol 350 (Omnipaque) in place of 60 ml diatrizoate (Gastrografin). All other preparation components (bisacodyl, magnesium citrate, and 2% barium) remained constant. Objective volumetric analysis of residual colonic fluid volume and fluid attenuation was performed. Additionally, two radiologists experienced with CTC, blinded to the specific bowel preparation, scored each of 6 colonic segments for adherent residual solid stool using a previously validated 4-point scale (0 for no stool; 1–3 for increasing residual stool). Paired t-test was used for comparison of the cohorts. Results No clear clinically-meaningful difference was found between the two preparations on overall objective or subjective evaluation. Mean (±SD) residual fluid volume was 173±126 ml with the iohexol preparation and 130±79 ml with the diatrizoate prep (p=0.02). Mean total colonic stool score was 2.5 (0.42/segment) with iohexol and 2.3 (0.38/segment) with diatrizoate (p=0.69). Mean (±SD) fluid attenuation was higher with iohexol (849±270HU) compared with diatrizoate (732±168HU) (p=0.03). Conclusions Based on this direct intra-patient comparison, we found that oral iohexol is a suitable alternative to diatrizoate for fluid tagging as part of a cathartic bowel preparation at CTC. Because this nonionic tagging agent is more palatable, less expensive, and likely safer than ionic diatrizoate, our CTC program now utilizes iohexol as the standard recommended regimen. PMID:27010251

Spatial-temporal distortion metric for in-service quality monitoring of any digital video system

NASA Astrophysics Data System (ADS)

Wolf, Stephen; Pinson, Margaret H.

1999-11-01

Many organizations have focused on developing digital video quality metrics which produce results that accurately emulate subjective responses. However, to be widely applicable a metric must also work over a wide range of quality, and be useful for in-service quality monitoring. The Institute for Telecommunication Sciences (ITS) has developed spatial-temporal distortion metrics that meet all of these requirements. These objective metrics are described in detail and have a number of interesting properties, including utilization of (1) spatial activity filters which emphasize long edges on the order of 10 arc min while simultaneously performing large amounts of noise suppression, (2) the angular direction of the spatial gradient, (3) spatial-temporal compression factors of at least 384:1 (spatial compression of at least 64:1 and temporal compression of at least 6:1, and 4) simple perceptibility thresholds and spatial-temporal masking functions. Results are presented that compare the objective metric values with mean opinion scores from a wide range of subjective data bases spanning many different scenes, systems, bit-rates, and applications.

Robotic end gripper with a band member to engage object

DOEpatents

Pollard, R.E.; Robinson, S.C.; Thompson, W.F.; Couture, S.A.; Sutton, B.J.

1994-05-10

An end effector for use with robotic arms and like devices is described that utilizes a flexible band to draw an object against an anvil having a concave surface. One typical convex surface is created by a V-block, with an apex of the V being centrally located. If an object to be grasped is fragile, the contour of the concave surface closely matches the surface of the object. Typically the movement of the band is effected by a linear actuator, with the anvil remaining fixed relative to a support base. Several embodiments are described that utilize variations in drawing the band toward the anvil, with one of these embodiments described in detail in the form of a fabricated unit. One embodiment includes a cover element that can be moved over an object after the grasping thereof, with this cover potentially serving various functions. Movement of the cover can be effected with a second linear actuator. 8 figures.

Robotic end gripper with a band member to engage object

DOEpatents

Pollard, Roy E.; Robinson, Samuel C.; Thompson, William F.; Couture, Scott A.; Sutton, Bill J.

1994-01-01

An end effector for use with robotic arms and like devices that utilizes a flexible band to draw an object against an anvil having a concave surface. One typical convex surface is created by a V-block, with an apex of the V being centrally located. If an object to be grasped is fragile, the contour of the concave surface closely matches the surface of the object. Typically the movement of the band is effected by a linear actuator, with the anvil remaining fixed relative to a support base. Several embodiments are described that utilize variations in drawing the band toward the anvil, with one of these embodiments described in detail in the form of a fabricated unit. One embodiment includes a cover element that can be moved over an object after the grasping thereof, with this cover potentially serving various functions. Movement of the cover can be effected with a second linear actuator.

Evaluation Of Water Quality At River Bian In Merauke Papua

NASA Astrophysics Data System (ADS)

Djaja, Irba; Purwanto, P.; Sunoko, H. R.

2018-02-01

River Bian in Merauke Regency has been utilized by local people in Papua (the Marind) who live along the river for fulfilling their daily needs, such as shower, cloth and dish washing, and even defecation, waste disposal, including domestic waste, as well as for ceremonial activities related to the locally traditional culture. Change in land use for other necessities and domestic activities of the local people have mounted pressures on the status of the River Bian, thus decreasing the quality of the river. This study had objectives to find out and to analyze river water quality and water quality status of the River Bian, and its compliance with water quality standards for ideal use. The study determined sample point by a purposive sampling method, taking the water samples with a grab method. The analysis of the water quality was performed by standard and pollution index methods. The study revealed that the water quality of River Bian, concerning BOD, at the station 3 had exceeded quality threshold. COD parameter for all stations had exceeded the quality threshold for class III. At three stations, there was a decreasing value due to increasing PI, as found at the stations 1, 2, and 3. In other words, River Bian had been lightly contaminated.

Development of Hybrid Courses Utilizing Modules as an Objective in ATE Projects

ERIC Educational Resources Information Center

Payne, James E.; Murphy, Richard M.; Payne, Linda L.

2017-01-01

Orangeburg-Calhoun Technical College (OCtech) has been awarded two National Science Foundation Advanced Technological Education (NSF-ATE) grants since 2011 that have the development of module-based hybrid courses in Engineering Technology and Mechatronics as objectives. In this article, the advantages and challenges associated with module-based…

Utility of registries for post-marketing evaluation of medicines. A survey of Swedish health care quality registries from a regulatory perspective

PubMed Central

Feltelius, Nils; Gedeborg, Rolf; Holm, Lennart; Zethelius, Björn

2017-01-01

Aim The aim of this study was to describe content and procedures in some selected Swedish health care quality registries (QRs) of relevance to regulatory decision-making. Methods A workshop was organized with participation of seven Swedish QRs which subsequently answered a questionnaire regarding registry content on drug treatments and outcomes. Patient populations, coverage, data handling and quality control, as well as legal and ethical aspects are presented. Scientific publications from the QRs are used as a complementary measure of quality and scientific relevance. Results The registries under study collect clinical data of high relevance to regulatory and health technology agencies. Five out of seven registries provide information on the drug of interest. When applying external quality criteria, we found a high degree of fulfillment, although information on medication was not sufficient to answer all questions of regulatory interest. A notable strength is the option for linkage to the Prescribed Drug Registry and to information on education and socioeconomic status. Data on drugs used during hospitalization were also collected to some extent. Outcome measures collected resemble those used in relevant clinical trials. All registries collected patient-reported outcome measures. The number of publications from the registries was substantial, with studies of appropriate design, including randomized registry trials. Conclusions Quality registries may provide a valuable source of post-marketing data on drug effectiveness, safety, and cost-effectiveness. Closer collaboration between registries and regulators to improve quality and usefulness of registry data could benefit both regulatory utility and value for health care providers. PMID:28276780

Utilization of curve offsets in additive manufacturing

NASA Astrophysics Data System (ADS)

Haseltalab, Vahid; Yaman, Ulas; Dolen, Melik

2018-05-01

Curve offsets are utilized in different fields of engineering and science. Additive manufacturing, which lately becomes an explicit requirement in manufacturing industry, utilizes curve offsets widely. One of the necessities of offsetting is for scaling which is required if there is shrinkage after the fabrication or if the surface quality of the resulting part is unacceptable. Therefore, some post-processing is indispensable. But the major application of curve offsets in additive manufacturing processes is for generating head trajectories. In a point-wise AM process, a correct tool-path in each layer can reduce lots of costs and increase the surface quality of the fabricated parts. In this study, different curve offset generation algorithms are analyzed to show their capabilities and disadvantages through some test cases and improvements on their drawbacks are suggested.

Vermont's Community-Oriented All-Payer Medical Home Model Reduces Expenditures and Utilization While Delivering High-Quality Care

PubMed Central

Jones, Craig; Finison, Karl; McGraves-Lloyd, Katharine; Tremblay, Timothy; Tanzman, Beth; Hazard, Miki; Maier, Steven; Samuelson, Jenney

2016-01-01

Abstract Patient-centered medical home programs using different design and implementation strategies are being tested across the United States, and the impact of these programs on outcomes for a general population remains unclear. Vermont has pursued a statewide all-payer program wherein medical home practices are supported with additional staffing from a locally organized shared resource, the community health team. Using a 6-year, sequential, cross-sectional methodology, this study reviewed annual cost, utilization, and quality outcomes for patients attributed to 123 practices participating in the program as of December 2013 versus a comparison population from each year attributed to nonparticipating practices. Populations are grouped based on their practices' stage of participation in a calendar year (Pre-Year, Implementation Year, Scoring Year, Post-Year 1, Post-Year 2). Annual risk-adjusted total expenditures per capita at Pre-Year for the participant group and comparison group were not significantly different. The difference-in-differences change from Pre-Year to Post-Year 2 indicated that the participant group's expenditures were reduced by −$482 relative to the comparison (95% CI, −$573 to −$391; P < .001). The lower costs were driven primarily by inpatient (−$218; P < .001) and outpatient hospital expenditures (−$154; P < .001), with associated changes in inpatient and outpatient hospital utilization. Medicaid participants also had a relative increase in expenditures for dental, social, and community-based support services ($57; P < .001). Participants maintained higher rates on 9 of 11 effective and preventive care measures. These results suggest that Vermont's community-oriented medical home model is associated with improved outcomes for a general population at lower expenditures and utilization. (Population Health Management 2016;19:196–205) PMID:26348492

The Utility of the OMI HCHO and NO2 Data Products in Air Quality Decision- Making Activities

NASA Technical Reports Server (NTRS)

Duncan, Bryan N.

2010-01-01

We will present three related air quality applications of the OMI HCHO (formaldehyde) and NO2 (nitrogen dioxide) data products, which we us to support mission planning of an OMI-like instrument for the proposed GEO-CAPE satellite that has as one of its objectives to study air quality from space. First, we will discuss a novel and practical application of the data products to the "weight of evidence" in the air quality decision-making process (e.g., State Implementation Plan (SIP)) for a city, region, or state to demonstrate that it is making progress toward attainment of the National Ambient Air Quality Standard (NAAQS) for ozone. Any trend, or lack thereof, in the observed OMI HCHO/NO2, which we use as an air quality indicator, may support that an emission control strategy implemented to reduce ozone is or is not occurring for a metropolitan area. Second, we will discuss how we use variations in the OMI HCHO product as a proxy for variability in the biogenic hydrocarbon, isoprene, which is an important player for the formation of high levels of ozone and the dominant source of HCHO in the eastern U.S. Third, we will discuss the variability of NO2 in the U.S. as indicated by the OMI NO2 product. In addition, we will show the impact of the 2005 hurricanes on pollutant emissions, including those associated with the intensive oil extraction and refining activities, in the Gulf of Mexico region using the OMI NO2 product. The variability of HCHO and NO2 as indicated by OMI helps us to understand changes in the OMI HCHO/NO2 and the implications for ozone formation.

Cataract surgery cost utility revisited in 2012: a new economic paradigm.

PubMed

Brown, Gary C; Brown, Melissa M; Menezes, Alicia; Busbee, Brandon G; Lieske, Heidi B; Lieske, Philip A

2013-12-01

To assess the 2012 cost utility of cataract surgery in the United States and to compare 2012 cost-utility data with those from 2000. Value-Based Medicine (Flourtown, PA), patient preference-based, comparative effectiveness analysis and cost-utility analysis using 2012 real United States dollars. Previously published Patient Outcomes Research Team Study data and time tradeoff utilities obtained from patients with vision loss. Visual acuity measurements from patients wtih untreated cataract were used as controls. Thirteen-year, average, first-eye and second-eye cataract surgery cost-utility analysis using the societal and third-party insurer cost perspectives. Patient value gain in quality-adjusted life years (QALYs) and percent gain in quality of life as well as the cost-utility ratio using the dollars expended per QALY gained. Patient and financial value outcomes were discounted at 3% annually with net present value analysis. First-eye cataract surgery conferred 1.6212 QALYs over the 13-year model, a 20.8% quality-of-life gain. Bilateral cataract surgery conferred 2.8152 QALYs over 13 years, a 36.2% improvement in quality of life. The direct ophthalmic medical cost for unilateral cataract surgery in 2012 United States nominal dollars was $2653, an inflation-adjusted 34.2% less than in 2000 and 85% less than in 1985. The 2012 inflation-adjusted physician fee was 10.1% of that in 1985. The 13-year societal cost perspective, financial return on investment (ROI) for first-eye cataract surgery was $121,198, a 4567% gain. The third-party insurer cost perspective average cost-utility ratio was $2653/1.6212 = $1636/QALY for unilateral cataract surgery, whereas the societal cost perspective average cost-utility ratio was -$121,198/1.6212 = -$74,759/QALY. The net 13-year $123.4-billion financial ROI from a 1-year cohort of cataract surgery patients was accrued: Medicare, $36.4 billion; Medicaid, $3.3 billion; other insurers, $9.6 billion; patients, $48.6 billion; and

Young Stellar Objects observed by MOST

NASA Astrophysics Data System (ADS)

Siwak, Michal

2013-07-01

In the recent years the MOST satellite gathered dozens of high quality light curves of Young Stellar Objects (YSO). We present the most interesting results obtained from the data collected between 2009-2013.

Constructing objective tests

NASA Astrophysics Data System (ADS)

Aubrecht, Gordon J.; Aubrecht, Judith D.

1983-07-01

True-false or multiple-choice tests can be useful instruments for evaluating student progress. We examine strategies for planning objective tests which serve to test the material covered in science (physics) courses. We also examine strategies for writing questions for tests within a test blueprint. The statistical basis for judging the quality of test items are discussed. Reliability, difficulty, and discrimination indices are defined and examples presented. Our recommendation are rather easily put into practice.

The utilization of microbes as a fermentation agent to reduce saponin in Trembesi leaves (Sammanea saman)

NASA Astrophysics Data System (ADS)

Sariri, A. K.; Mulyono, A. M. W.; Tari, A. I. N.

2018-03-01

This objective of this research was to observe the utilization of microbes as a fermentation agent of trembesi leaves that can increase the quality of trembesi leaves as ruminants feed. Before fermentation, trembesi leaves were divided into three treatments. They were control = non-agentic in fermentation, D-An = the addition of Aspergillus niger as fermentation agent, and D-Lp = the addition of Lactobacillus plantarum as fermentation agent. Each treatment experienced five repetitions. The experimental design used a randomized direct pattern group design. The analysis included proximate analysis consisting of water content, crude protein content, crude fiber content, lipid content, mineral content (ash) and saponin content after fermentation. It could be concluded that the utilization of Aspergillus niger and Lactobacillus plantarum in fermentation could decrease saponin content and could increase the nutrient content of trembesi leaves by increasing crude protein content otherwise by decreasing crude fiber content of trembesi leaves.

41 CFR 101-27.203 - Program objectives.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Conduct inventory management analyses to determine if shelf-life stocks are expected to be utilized prior... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Program objectives. 101-27.203 Section 101-27.203 Public Contracts and Property Management Federal Property Management...

Barriers related to prenatal care utilization among women

PubMed Central

Roozbeh, Nasibeh; Nahidi, Fatemeh; Hajiyan, Sepideh

2016-01-01

Objectives To investigate barriers related to prenatal care utilization among women. Methods Data was collected in both English and Persian databases. English databases included: the International Medical Sciences, Medline, Web of Science, Scopus, Google Scholar. The Persian databases included: the Iranmedex, the State Inpatient Databases (SID) with the use of related keywords, and on the basis of inclusion-exclusion criteria. The keywords included are barrier, prenatal care, women, access, and preventive factors. OR and AND were Boolean operators. After the study, articles were summarized, unrelated articles were rejected, and related articles were identified. Inclusion criteria were all published articles from 1990 to 2015, written in English and Persian languages. The titles and abstracts are related, and addressed all subjects about barriers related to prenatal care utilization. At the end, all duplicated articles were excluded. There were no restrictions for exclusion or inclusion of articles. Exclusion criteria were failure in reporting in studies, case studies, and lack of access to the full text. Results After searching various databases, 112 related articles were included. After reviewing articles’ titles, 67 unrelated articles and abstracts were rejected, 45 articles were evaluated, 20 of them were duplicated. Then, the qualities of 25 articles were analyzed. Therefore, 5 articles were excluded due to not mentioning the sample size, mismatches between method and data, or results. Total of 20 articles were selected for final analysis. Prenatal care utilization barrier can be divided into various domains such as individual barriers, financial barriers, organizational barriers, social, and cultural barriers. Conclusion To increase prenatal care coverage, it is necessary to pay attention to all domains, especially individual and financial barriers.

Application of Satellite and Ozonesonde Data to the Study of Nighttime Tropospheric Ozone Impacts and Relationship to Air Quality

NASA Astrophysics Data System (ADS)

Osterman, G. B.; Eldering, A.; Neu, J. L.; Tang, Y.; McQueen, J.; Pinder, R. W.

2011-12-01

To help protect human health and ecosystems, regional-scale atmospheric chemistry models are used to forecast high ozone events and to design emission control strategies to decrease the frequency and severity of ozone events. Despite the impact that nighttime aloft ozone can have on surface ozone, regional-scale atmospheric chemistry models often do not simulate the nighttime ozone concentrations well and nor do they sufficiently capture the ozone transport patterns. Fully characterizing the importance of the nighttime ozone has been hampered by limited measurements of the vertical distribution of ozone and ozone-precursors. The main focus of this work is to begin to utilize remote sensing data sets to characterize the impact of nighttime aloft ozone to air quality events. We will describe our plans to use NASA satellite data sets, transport models and air quality models to study ozone transport, focusing primarily on nighttime ozone and provide initial results. We will use satellite and ozonesonde data to help understand how well the air quality models are simulating ozone in the lower free troposphere and attempt to characterize the impact of nighttime ozone to air quality events. Our specific objectives are: 1) Characterize nighttime aloft ozone using remote sensing data and sondes. 2) Evaluate the ability of the Community Multi-scale Air Quality (CMAQ) model and the National Air Quality Forecast Capability (NAQFC) model to capture the nighttime aloft ozone and its relationship to air quality events. 3) Analyze a set of air quality events and determine the relationship of air quality events to the nighttime aloft ozone. We will achieve our objectives by utilizing the ozone profile data from the NASA Earth Observing System (EOS) Tropospheric Emission Spectrometer (TES) and other sensors, ozonesonde data collected during the Aura mission (IONS), EPA AirNow ground station ozone data, the CMAQ continental-scale air quality model, and the National Air Quality

Financial statistics of major US investor-owned electric utilities 1994

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

NONE

1995-12-01

The Financial Statistics of Major U.S. Investor-Owned Electric Utilities publication presents summary and detailed financial accounting data on the investor-owned electric utilities. The objective of the publication is to provide Federal and State Governments, industry, and the general public with current and historical data that can be used for making policy and decisions relating to investor-owned electric utility issues.

Multi objective multi refinery optimization with environmental and catastrophic failure effects objectives

NASA Astrophysics Data System (ADS)

Khogeer, Ahmed Sirag

2005-11-01

Petroleum refining is a capital-intensive business. With stringent environmental regulations on the processing industry and declining refining margins, political instability, increased risk of war and terrorist attacks in which refineries and fuel transportation grids may be targeted, higher pressures are exerted on refiners to optimize performance and find the best combination of feed and processes to produce salable products that meet stricter product specifications, while at the same time meeting refinery supply commitments and of course making profit. This is done through multi objective optimization. For corporate refining companies and at the national level, Intea-Refinery and Inter-Refinery optimization is the second step in optimizing the operation of the whole refining chain as a single system. Most refinery-wide optimization methods do not cover multiple objectives such as minimizing environmental impact, avoiding catastrophic failures, or enhancing product spec upgrade effects. This work starts by carrying out a refinery-wide, single objective optimization, and then moves to multi objective-single refinery optimization. The last step is multi objective-multi refinery optimization, the objectives of which are analysis of the effects of economic, environmental, product spec, strategic, and catastrophic failure. Simulation runs were carried out using both MATLAB and ASPEN PIMS utilizing nonlinear techniques to solve the optimization problem. The results addressed the need to debottleneck some refineries or transportation media in order to meet the demand for essential products under partial or total failure scenarios. They also addressed how importing some high spec products can help recover some of the losses and what is needed in order to accomplish this. In addition, the results showed nonlinear relations among local and global objectives for some refineries. The results demonstrate that refineries can have a local multi objective optimum that does not

Creating Objects and Object Categories for Studying Perception and Perceptual Learning

PubMed Central

Hauffen, Karin; Bart, Eugene; Brady, Mark; Kersten, Daniel; Hegdé, Jay

2012-01-01

by these simulations can be further manipulated by various morphing methods to generate systematic variations of shape characteristics15,16. The VP and morphing methods can also be applied, in principle, to novel virtual objects other than digital embryos, or to virtual versions of real-world objects9,13. Virtual objects created in this fashion can be rendered as visual images using a conventional graphical toolkit, with desired manipulations of surface texture, illumination, size, viewpoint and background. The virtual objects can also be 'printed' as haptic objects using a conventional 3-D prototyper. We also describe some implementations of these computational algorithms to help illustrate the potential utility of the algorithms. It is important to distinguish the algorithms from their implementations. The implementations are demonstrations offered solely as a 'proof of principle' of the underlying algorithms. It is important to note that, in general, an implementation of a computational algorithm often has limitations that the algorithm itself does not have. Together, these methods represent a set of powerful and flexible tools for studying object recognition and perceptual learning by biological and computational systems alike. With appropriate extensions, these methods may also prove useful in the study of morphogenesis and phylogenesis. PMID:23149420

Creating objects and object categories for studying perception and perceptual learning.

PubMed

Hauffen, Karin; Bart, Eugene; Brady, Mark; Kersten, Daniel; Hegdé, Jay

2012-11-02

be further manipulated by various morphing methods to generate systematic variations of shape characteristics. The VP and morphing methods can also be applied, in principle, to novel virtual objects other than digital embryos, or to virtual versions of real-world objects. Virtual objects created in this fashion can be rendered as visual images using a conventional graphical toolkit, with desired manipulations of surface texture, illumination, size, viewpoint and background. The virtual objects can also be 'printed' as haptic objects using a conventional 3-D prototyper. We also describe some implementations of these computational algorithms to help illustrate the potential utility of the algorithms. It is important to distinguish the algorithms from their implementations. The implementations are demonstrations offered solely as a 'proof of principle' of the underlying algorithms. It is important to note that, in general, an implementation of a computational algorithm often has limitations that the algorithm itself does not have. Together, these methods represent a set of powerful and flexible tools for studying object recognition and perceptual learning by biological and computational systems alike. With appropriate extensions, these methods may also prove useful in the study of morphogenesis and phylogenesis.

Object-oriented structures supporting remote sensing databases

NASA Technical Reports Server (NTRS)

Wichmann, Keith; Cromp, Robert F.

1995-01-01

Object-oriented databases show promise for modeling the complex interrelationships pervasive in scientific domains. To examine the utility of this approach, we have developed an Intelligent Information Fusion System based on this technology, and applied it to the problem of managing an active repository of remotely-sensed satellite scenes. The design and implementation of the system is compared and contrasted with conventional relational database techniques, followed by a presentation of the underlying object-oriented data structures used to enable fast indexing into the data holdings.

A new approach of objective quality evaluation on JPEG2000 lossy-compressed lung cancer CT images

NASA Astrophysics Data System (ADS)

Cai, Weihua; Tan, Yongqiang; Zhang, Jianguo

2007-03-01

Image compression has been used to increase the communication efficiency and storage capacity. JPEG 2000 compression, based on the wavelet transformation, has its advantages comparing to other compression methods, such as ROI coding, error resilience, adaptive binary arithmetic coding and embedded bit-stream. However it is still difficult to find an objective method to evaluate the image quality of lossy-compressed medical images so far. In this paper, we present an approach to evaluate the image quality by using a computer aided diagnosis (CAD) system. We selected 77 cases of CT images, bearing benign and malignant lung nodules with confirmed pathology, from our clinical Picture Archiving and Communication System (PACS). We have developed a prototype of CAD system to classify these images into benign ones and malignant ones, the performance of which was evaluated by the receiver operator characteristics (ROC) curves. We first used JPEG 2000 to compress these cases of images with different compression ratio from lossless to lossy, and used the CAD system to classify the cases with different compressed ratio, then compared the ROC curves from the CAD classification results. Support vector machine (SVM) and neural networks (NN) were used to classify the malignancy of input nodules. In each approach, we found that the area under ROC (AUC) decreases with the increment of compression ratio with small fluctuations.

Mapping the Paediatric Quality of Life Inventory (PedsQL™) Generic Core Scales onto the Child Health Utility Index-9 Dimension (CHU-9D) Score for Economic Evaluation in Children.

PubMed

Lambe, Tosin; Frew, Emma; Ives, Natalie J; Woolley, Rebecca L; Cummins, Carole; Brettell, Elizabeth A; Barsoum, Emma N; Webb, Nicholas J A

2018-04-01

The Paediatric Quality of Life Inventory (PedsQL™) questionnaire is a widely used, generic instrument designed for measuring health-related quality of life (HRQoL); however, it is not preference-based and therefore not suitable for cost-utility analysis. The Child Health Utility Index-9 Dimension (CHU-9D), however, is a preference-based instrument that has been primarily developed to support cost-utility analysis. This paper presents a method for estimating CHU-9D index scores from responses to the PedsQL™ using data from a randomised controlled trial of prednisolone therapy for treatment of childhood corticosteroid-sensitive nephrotic syndrome. HRQoL data were collected from children at randomisation, week 16, and months 12, 18, 24, 36 and 48. Observations on children aged 5 years and older were pooled across all data collection timepoints and were then randomised into an estimation (n = 279) and validation (n = 284) sample. A number of models were developed using the estimation data before internal validation. The best model was chosen using multi-stage selection criteria. Most of the models developed accurately predicted the CHU-9D mean index score. The best performing model was a generalised linear model (mean absolute error = 0.0408; mean square error = 0.0035). The proportion of index scores deviating from the observed scores by <  0.03 was 53%. The mapping algorithm provides an empirical tool for estimating CHU-9D index scores and for conducting cost-utility analyses within clinical studies that have only collected PedsQL™ data. It is valid for children aged 5 years or older. Caution should be exercised when using this with children younger than 5 years, older adolescents (>  13 years) or patient groups with particularly poor quality of life. 16645249.

The utilization of coconut waste fermentated by aspergillus niger and saccharomyces cerevisiae on meat quality of weaning males rex rabbit

NASA Astrophysics Data System (ADS)

Wahyuni, T. H.; Ginting, N.; Yunilas; Hasnudi; Mirwandono, E.; Siregar, G. A.; Sinaga, I. G.; Sembiring, I.

2018-02-01

Coconut waste (CW) could be applied for animal feed while its nutrition quality were low. This study aims to investigate fermented CW effect on meat quality of Rex rabbit which feed by fermented CW either by Aspergillus niger or Tape Yeast. This research was conducted in rabbit farm Brastagi, using 24 male Rex rabbits with initial weight 1012 ± 126.67 gram in July-October 2016. The design used was complete randomized design : 6 treatment 4 replications. Treatment were T1 (unfermented 10%); T2 (unfermented 20%); T3 (a.niger fermentation 10%); T4 (a niger fermentation 20%); T5 (tape yeast fermentation 10%) and T6 (tape yeast fermentation 20%). The parameters were pH, meat texture either raw or cooked, water content, fat content, protein content of meat and cooking loss. The results showed that effect of treatment was not significantly different (P>0.05) on pH and raw meat texture, but significantly different (P< 0.05) on texture of meat cooked and meat fat content and very significantly different effect ( P> 0,01) on cooking loss, water content and protein content of meat. The conclusion of this research was the utilization of fermented CW by Aspergillius niger and Tape Yeast improved the quality of Rex rabbit meat

Federal Great Lakes fishery research objectives, priorities, and projects

USGS Publications Warehouse

Tait, Howard D.

1973-01-01

Fishery productivity of the Great Lakes has declined drastically since settlement of the area. Premium quality fishes of the Great Lakes such as whitefish, lake trout, and walleyes have been replaced by less desired species. This change is attributed to selective overfishing, pollution, and the extreme instability of fish populations. Sea lamprey predation is still a vexing problem but progress is being made in controlling this parasite. The federal fishery research program with headquarters in Ann Arbor, Michigan, has the objective of providing baseline information, needed in resource use decisions, about the fishes of the Great Lakes. Studies of the habitat requirements of fish are high priority. The program includes fish population assessments, studies of the effects of mercury and other contaminants on fish, thermal effects studies, and general investigation of the impact of engineering projects on Great Lakes fisheries. The work is closely coordinated with state and Canadian agencies through the Great Lakes Fishery Commission. Four small research vessels and four field stations are utilized with a staff of 90 and an annual budget of about $1.5 million.

The Impact of Patient Complexity on Healthcare Utilization