Design Quality in the Context of Healthcare Environments: A Scoping Review.

PubMed

Anåker, Anna; Heylighen, Ann; Nordin, Susanna; Elf, Marie

2017-07-01

We explored the concept of design quality in relation to healthcare environments. In addition, we present a taxonomy that illustrates the wide range of terms used in connection with design quality in healthcare. High-quality physical environments can promote health and well-being. Developments in healthcare technology and methodology put high demands on the design quality of care environments, coupled with increasing expectations and demands from patients and staff that care environments be person centered, welcoming, and accessible while also supporting privacy and security. In addition, there are demands that decisions about the design of healthcare architecture be based on the best available information from credible research and the evaluation of existing building projects. The basic principles of Arksey and O'Malley's model of scoping review design were used. Data were derived from literature searches in scientific databases. A total of 18 articles and books were found that referred to design quality in a healthcare context. Design quality of physical healthcare environments involves three different themes: (i) environmental sustainability and ecological values, (ii) social and cultural interactions and values, and (iii) resilience of the engineering and building construction. Design quality was clarified herein with a definition. Awareness of what is considered design quality in relation to healthcare architecture could help to design healthcare environments based on evidence. To operationalize the concept, its definition must be clear and explicit and able to meet the complex needs of the stakeholders in a healthcare context, including patients, staff, and significant others.

Nursing practice environment, quality of care, and morale of hospital nurses in Japan.

PubMed

Anzai, Eriko; Douglas, Clint; Bonner, Ann

2014-06-01

The purpose of this study was to describe Japanese hospital nurses' perceptions of the nursing practice environment and examine its association with nurse-reported ability to provide quality nursing care, quality of patient care, and ward morale. A cross-sectional survey design was used including 223 nurses working in 12 acute inpatient wards in a large Japanese teaching hospital. Nurses rated their work environment favorably overall using the Japanese version of the Practice Environment Scale of the Nursing Work Index. Subscale scores indicated high perceptions of physician relations and quality of nursing management, but lower scores for staffing and resources. Ward nurse managers generally rated the practice environment more positively than staff nurses except for staffing and resources. Regression analyses found the practice environment was a significant predictor of quality of patient care and ward morale, whereas perceived ability to provide quality nursing care was most strongly associated with years of clinical experience. These findings support interventions to improve the nursing practice environment, particularly staffing and resource adequacy, to enhance quality of care and ward morale in Japan. © 2013 Wiley Publishing Asia Pty Ltd.

Quality management and the work environment: an empirical investigation in a public sector organization.

PubMed

Taveira, Alvaro D; James, Craig A; Karsh, Ben -Tzion; Sainfort, François

2003-07-01

The integration of quality management initiatives, particularly total quality management (TQM), and ergonomics has received increasing attention from scholars and practitioners. Above all, the question of how TQM programs relate to ergonomic aspects of organizational design and culture is at the center of this discussion. This study examines how elements of a "typical", Deming-inspired, TQM program in the public sector interact with the work environment. Elements of the TQM program were defined and measured using the Malcom Baldridge Award criteria. The specific elements examined were "Management Support of Quality", "Information and Analysis", "Human Resources", "Processes and Quality Results", and "Customer Focus and Satisfaction". The relationship between these TQM elements and the work environment were defined through five separate hypotheses. The work environment was described by the constructs "Supervisor Support", "Task Clarity", "Task Orientation", and "Innovation". Data were obtained through survey questionnaires administered to employees of four departments in a municipal government organization. Results supported three of the hypotheses, but produced some unanticipated outcomes with regard to the other two. Namely, "Management Support of Quality" was significantly related to "Supervisor Support", "Task Orientation", "Task Clarity" and "Innovation"; "Human Resources" was significantly related to "Supervisor Support"; "Processes and Quality Results" was significantly related to "Task Orientation" and "Innovation". Contrary to predicted "Information and Analysis" was negatively related to "Innovation", and "Customer Focus" was unrelated to any of the outcome variables. The relationships between these TQM elements and work environment dimensions are discussed. Implications for TQM and ergonomic practice are analyzed, and directions for future research proposed.

Links among high-performance work environment, service quality, and customer satisfaction: an extension to the healthcare sector.

PubMed

Scotti, Dennis J; Harmon, Joel; Behson, Scott J

2007-01-01

Healthcare managers must deliver high-quality patient services that generate highly satisfied and loyal customers. In this article, we examine how a high-involvement approach to the work environment of healthcare employees may lead to exceptional service quality, satisfied patients, and ultimately to loyal customers. Specifically, we investigate the chain of events through which high-performance work systems (HPWS) and customer orientation influence employee and customer perceptions of service quality and patient satisfaction in a national sample of 113 Veterans Health Administration ambulatory care centers. We present a conceptual model for linking work environment to customer satisfaction and test this model using structural equations modeling. The results suggest that (1) HPWS is linked to employee perceptions of their ability to deliver high-quality customer service, both directly and through their perceptions of customer orientation; (2) employee perceptions of customer service are linked to customer perceptions of high-quality service; and (3) perceived service quality is linked with customer satisfaction. Theoretical and practical implications of our findings, including suggestions of how healthcare managers can implement changes to their work environments, are discussed.

Water quality of hydrologic bench marks; an indicator of water quality in the natural environment

USGS Publications Warehouse

Biesecker, James E.; Leifeste, Donald K.

1974-01-01

Water-quality data, collected at 57 hydrologic bench-mark stations in 37 States, allow the definition of water quality in the 'natural' environment and the comparison of 'natural' water quality with water quality of major streams draining similar water-resources regions. Results indicate that water quality in the 'natural' environment is generally very good. Streams draining hydrologic bench-mark basins generally contain low concentrations of dissolved constituents. Water collected at the hydrologic bench-mark stations was analyzed for the following minor metals: arsenic, barium, cadmium, hexavalent chromium, cobalt, copper, lead, mercury, selenium, silver, and zinc. Of 642 analyses, about 65 percent of the observed concentrations were zero. Only three samples contained metals in excess of U.S. Public Health Service recommended drinking-water standards--two selenium concentrations and one cadmium concentration. A total of 213 samples were analyzed for 11 pesticidal compounds. Widespread but very low-level occurrence of pesticide residues in the 'natural' environment was found--about 30 percent of all samples contained low-level concentrations of pesticidal compounds. The DDT family of pesticides occurred most commonly, accounting for 75 percent of the detected occurrences. The highest observed concentration of DDT was 0.06 microgram per litre, well below the recommended maximum permissible in drinking water. Nitrate concentrations in the 'natural' environment generally varied from 0.2 to 0.5 milligram per litre. The average concentration of nitrate in many major streams is as much as 10 times greater. The relationship between dissolved-solids concentration and discharge per unit area in the 'natural' environment for the various physical divisions in the United States has been shown to be an applicable tool for approximating 'natural' water quality. The relationship between dissolved-solids concentration and discharge per unit area is applicable in all the physical

Associations between the neighbourhood food environment, neighbourhood socioeconomic status, and diet quality: An observational study.

PubMed

McInerney, Maria; Csizmadi, Ilona; Friedenreich, Christine M; Uribe, Francisco Alaniz; Nettel-Aguirre, Alberto; McLaren, Lindsay; Potestio, Melissa; Sandalack, Beverly; McCormack, Gavin R

2016-09-15

The neighbourhood environment may play an important role in diet quality. Most previous research has examined the associations between neighbourhood food environment and diet quality, and neighbourhood socioeconomic status and diet quality separately. This study investigated the independent and joint effects of neighbourhood food environment and neighbourhood socioeconomic status in relation to diet quality in Canadian adults. We undertook a cross-sectional study with n = 446 adults in Calgary, Alberta (Canada). Individual-level data on diet and socio-demographic and health-related characteristics were captured from two self-report internet-based questionnaires, the Canadian Diet History Questionnaire II (C-DHQ II) and the Past Year Physical Activity Questionnaire (PAQ). Neighbourhood environment data were derived from dissemination area level Canadian Census data, and Geographical Information Systems (GIS) databases. Neighbourhood was defined as a 400 m network-based 'walkshed' around each participant's household. Using GIS we objectively-assessed the density, diversity, and presence of specific food destination types within the participant's walkshed. A seven variable socioeconomic deprivation index was derived from Canadian Census variables and estimated for each walkshed. The Canadian adapted Healthy Eating Index (C-HEI), used to assess diet quality was estimated from food intakes reported on C-DHQ II. Multivariable linear regression was used to test for associations between walkshed food environment variables, walkshed socioeconomic status, and diet quality (C-HEI), adjusting for individual level socio-demographic and health-related covariates. Interaction effects between walkshed socioeconomic status and walkshed food environment variables on diet quality (C-HEI) were also tested. After adjustment for covariates, food destination density was positively associated with the C-HEI (β 0.06, 95 % CI 0.01-0.12, p = 0.04) though the magnitude of the

Effectiveness Comparison of TxDOT Quality Control/Quality Assurance and Method Specifications

DOT National Transportation Integrated Search

1998-12-01

Original Report date: October 1997. This is the first and final report for research project 0-1721, "Effectiveness Comparison of TxDOT Quality Control/Quality Assurance and Method Specifications." This study was established and sponsored by TxDOT to ...

Validity of three asthma-specific quality of life questionnaires: the patients' perspective

PubMed Central

Jones, Christina J; Frew, Anthony; Smith, Helen

2016-01-01

Objectives It is not known which of the many asthma-specific quality of life (QoL) questionnaires best capture the lived experience of people with asthma. The objective of this study was to explore patients' views of three commonly used asthma-specific QoL questionnaires. Design Qualitative study using semistructured interviews. Setting Primary and secondary care in Brighton and Hove, UK. Participants 30 adult people with a physician-diagnosis of asthma who were asked to complete the Juniper Asthma Quality of Life Questionnaire (AQLQ-J), the Sydney Asthma Quality of Life Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ) to elicit their views on the content validity of these. Results Thematic content analysis revealed a lack of congruence between the concerns of people with asthma and the questionnaire content in terms of missing (eg, allergies) and irrelevant (eg, smoky restaurants) content. The AQLQ-J was perceived as a ‘narrow’, ‘medical’ questionnaire focused on symptoms, the environment and functional ability. In contrast, the LWAQ and the AQLQ-S were perceived to be ‘non-medical’. The LWAQ was described as a ‘test’ and as a wide-ranging, embracing and holistic questionnaire. Its strong emotional focus was irritating to some. The AQLQ-S was described as a simple, quick and easy questionnaire, although there was a perception that it was lacking in depth. Conclusions Patient interviews highlighted strengths and shortcomings in the content validity of these three asthma-specific questionnaires. For patients, the AQLQ-S content seemed to be the most pertinent in its adequacy of coverage of medical, social and emotional aspects of health-related QoL in asthma. PMID:28007706

Capturing the complexity: Content, type, and amount of instruction and quality of the classroom learning environment synergistically predict third graders’ vocabulary and reading comprehension outcomes

PubMed Central

Connor, Carol McDonald; Spencer, Mercedes; Day, Stephanie L.; Giuliani, Sarah; Ingebrand, Sarah W.; McLean, Leigh; Morrison, Frederick J.

2014-01-01

We examined classrooms as complex systems that affect students’ literacy learning through interacting effects of content and amount of time individual students spent in literacy instruction along with the global quality of the classroom-learning environment. We observed 27 third grade classrooms serving 315 target students using two different observation systems. The first assessed instruction at a more micro-level; specifically, the amount of time individual students spent in literacy instruction defined by the type of instruction, role of the teacher, and content. The second assessed the quality of the classroom-learning environment at a more macro level focusing on classroom organization, teacher responsiveness, and support for vocabulary and language. Results revealed that both global quality of the classroom learning environment and time individual students spent in specific types of literacy instruction covering specific content interacted to predict students’ comprehension and vocabulary gains whereas neither system alone did. These findings support a dynamic systems model of how individual children learn in the context of classroom literacy instruction and the classroom-learning environment, which can help to improve observations systems, advance research, elevate teacher evaluation and professional development, and enhance student achievement. PMID:25400293

[Associations between dormitory environment/other factors and sleep quality of medical students].

PubMed

Zheng, Bang; Wang, Kailu; Pan, Ziqi; Li, Man; Pan, Yuting; Liu, Ting; Xu, Dan; Lyu, Jun

2016-03-01

To investigate the sleep quality and related factors among medical students in China, understand the association between dormitory environment and sleep quality, and provide evidence and recommendations for sleep hygiene intervention. A total of 555 undergraduate students were selected from a medical school of an university in Beijing through stratified-cluster random-sampling to conduct a questionnaire survey by using Chinese version of Pittsburgh Sleep Quality Index (PSQI) and self-designed questionnaire. Analyses were performed by using multiple logistic regression model as well as multilevel linear regression model. The prevalence of sleep disorder was 29.1%(149/512), and 39.1%(200/512) of the students reported that the sleep quality was influenced by dormitory environment. PSQI score was negatively correlated with self-reported rating of dormitory environment (γs=-0.310, P<0.001). Logistic regression analysis showed the related factors of sleep disorder included grade, sleep regularity, self-rated health status, pressures of school work and employment, as well as dormitory environment. RESULTS of multilevel regression analysis also indicated that perception on dormitory environment (individual level) was associated with sleep quality with the dormitory level random effects under control (b=-0.619, P<0.001). The prevalence of sleep disorder was high in medical students, which was associated with multiple factors. Dormitory environment should be taken into consideration when the interventions are taken to improve the sleep quality of students.

Optimizing Scoring and Sampling Methods for Assessing Built Neighborhood Environment Quality in Residential Areas

PubMed Central

Adu-Brimpong, Joel; Coffey, Nathan; Ayers, Colby; Berrigan, David; Yingling, Leah R.; Thomas, Samantha; Mitchell, Valerie; Ahuja, Chaarushi; Rivers, Joshua; Hartz, Jacob; Powell-Wiley, Tiffany M.

2017-01-01

Optimization of existing measurement tools is necessary to explore links between aspects of the neighborhood built environment and health behaviors or outcomes. We evaluate a scoring method for virtual neighborhood audits utilizing the Active Neighborhood Checklist (the Checklist), a neighborhood audit measure, and assess street segment representativeness in low-income neighborhoods. Eighty-two home neighborhoods of Washington, D.C. Cardiovascular Health/Needs Assessment (NCT01927783) participants were audited using Google Street View imagery and the Checklist (five sections with 89 total questions). Twelve street segments per home address were assessed for (1) Land-Use Type; (2) Public Transportation Availability; (3) Street Characteristics; (4) Environment Quality and (5) Sidewalks/Walking/Biking features. Checklist items were scored 0–2 points/question. A combinations algorithm was developed to assess street segments’ representativeness. Spearman correlations were calculated between built environment quality scores and Walk Score®, a validated neighborhood walkability measure. Street segment quality scores ranged 10–47 (Mean = 29.4 ± 6.9) and overall neighborhood quality scores, 172–475 (Mean = 352.3 ± 63.6). Walk scores® ranged 0–91 (Mean = 46.7 ± 26.3). Street segment combinations’ correlation coefficients ranged 0.75–1.0. Significant positive correlations were found between overall neighborhood quality scores, four of the five Checklist subsection scores, and Walk Scores® (r = 0.62, p < 0.001). This scoring method adequately captures neighborhood features in low-income, residential areas and may aid in delineating impact of specific built environment features on health behaviors and outcomes. PMID:28282878

Optimizing Scoring and Sampling Methods for Assessing Built Neighborhood Environment Quality in Residential Areas.

PubMed

Adu-Brimpong, Joel; Coffey, Nathan; Ayers, Colby; Berrigan, David; Yingling, Leah R; Thomas, Samantha; Mitchell, Valerie; Ahuja, Chaarushi; Rivers, Joshua; Hartz, Jacob; Powell-Wiley, Tiffany M

2017-03-08

Optimization of existing measurement tools is necessary to explore links between aspects of the neighborhood built environment and health behaviors or outcomes. We evaluate a scoring method for virtual neighborhood audits utilizing the Active Neighborhood Checklist (the Checklist), a neighborhood audit measure, and assess street segment representativeness in low-income neighborhoods. Eighty-two home neighborhoods of Washington, D.C. Cardiovascular Health/Needs Assessment (NCT01927783) participants were audited using Google Street View imagery and the Checklist (five sections with 89 total questions). Twelve street segments per home address were assessed for (1) Land-Use Type; (2) Public Transportation Availability; (3) Street Characteristics; (4) Environment Quality and (5) Sidewalks/Walking/Biking features. Checklist items were scored 0-2 points/question. A combinations algorithm was developed to assess street segments' representativeness. Spearman correlations were calculated between built environment quality scores and Walk Score ® , a validated neighborhood walkability measure. Street segment quality scores ranged 10-47 (Mean = 29.4 ± 6.9) and overall neighborhood quality scores, 172-475 (Mean = 352.3 ± 63.6). Walk scores ® ranged 0-91 (Mean = 46.7 ± 26.3). Street segment combinations' correlation coefficients ranged 0.75-1.0. Significant positive correlations were found between overall neighborhood quality scores, four of the five Checklist subsection scores, and Walk Scores ® ( r = 0.62, p < 0.001). This scoring method adequately captures neighborhood features in low-income, residential areas and may aid in delineating impact of specific built environment features on health behaviors and outcomes.

Quality of Vegetables Based on Total Phenolic Concentration Is Lower in More Rural Consumer Food Environments in a Rural American State

PubMed Central

2017-01-01

While daily consumption of fruits and vegetables (FVs) is widely recognized to be associated with supporting nutrition and health, disparities exist in consumer food environments regarding access to high-quality produce based on location. The purpose of this study was to evaluate FV quality using total phenolic (TP) scores (a phytochemical measure for health-promoting attributes, flavor, appearance, and shelf-life) in consumer food environments along a rural to urban continuum in the rural state of Montana, United States. Significant differences were found in the means of the FV TP scores (p < 0.0001) and vegetable TP scores (p < 0.0001) on the basis of rurality, while no significant difference was found for fruit TP scores by rurality (p < 0.2158). Specifically, FV TP scores and vegetable TP scores were highest for the least rural stores and lowest for the most rural stores. Results indicate an access gap to high-quality vegetables in more rural and more health-disparate consumer food environments of Montana compared to urban food environments. Findings highlight that food and nutrition interventions should aim to increase vegetable quality in rural consumer food environments in the state of Montana towards enhancing dietary quality and food choices. Future studies are called for that examine TP scores of a wide range of FVs in diverse food environments globally. Studies are further needed that examine linkages between FV quality, food choices, diets, and health outcomes towards enhancing food environments for public health. PMID:28817093

Quality of Vegetables Based on Total Phenolic Concentration Is Lower in More Rural Consumer Food Environments in a Rural American State.

PubMed

Ahmed, Selena; Byker Shanks, Carmen

2017-08-17

While daily consumption of fruits and vegetables (FVs) is widely recognized to be associated with supporting nutrition and health, disparities exist in consumer food environments regarding access to high-quality produce based on location. The purpose of this study was to evaluate FV quality using total phenolic (TP) scores (a phytochemical measure for health-promoting attributes, flavor, appearance, and shelf-life) in consumer food environments along a rural to urban continuum in the rural state of Montana, United States. Significant differences were found in the means of the FV TP scores ( p < 0.0001) and vegetable TP scores ( p < 0.0001) on the basis of rurality, while no significant difference was found for fruit TP scores by rurality ( p < 0.2158). Specifically, FV TP scores and vegetable TP scores were highest for the least rural stores and lowest for the most rural stores. Results indicate an access gap to high-quality vegetables in more rural and more health-disparate consumer food environments of Montana compared to urban food environments. Findings highlight that food and nutrition interventions should aim to increase vegetable quality in rural consumer food environments in the state of Montana towards enhancing dietary quality and food choices. Future studies are called for that examine TP scores of a wide range of FVs in diverse food environments globally. Studies are further needed that examine linkages between FV quality, food choices, diets, and health outcomes towards enhancing food environments for public health.

Hospital nurses' work environment, quality of care provided and career plans.

PubMed

Hinno, S; Partanen, P; Vehviläinen-Julkunen, K

2011-06-01

In several European countries, the availability of qualified nurses is insufficient to meet current healthcare requirements. Nurses are highly dissatisfied with the rising demands of the healthcare environment and increasingly considering leaving their jobs. The study aims to investigate the relationships between the characteristics of hospital nurses' work environment and the quality of care provided, and furthermore to examine Dutch nurses' career plans. A cross-sectional, questionnaire survey of registered nurses (n = 334) working in the academic and district hospitals was conducted in 2005/2006. Previously validated questionnaires translated into the participants' language were used. Factor and regression analysis were used for data analysis. Overall, nurses rated their work environment rather favourably. Five work environment characteristics were identified: support for professional development, adequate staffing, nursing competence, supportive management and teamwork. Significant relationships were found between nurses' perceptions of their work environment characteristics and quality of care provided and nurses' career plans. When work environment characteristics were evaluated to be better, nurse-assessed quality of care also increased and intentions to leave current job decreased linearly. Study findings suggest that nurses' perceptions of their work environment are important for nurse outcomes in hospital settings. Further research is needed to explore the predictive ability of the work environment for nurse, patient and organizational outcomes in hospitals. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Nursing work environment, patient safety and quality of care in pediatric hospital.

PubMed

Alves, Daniela Fernanda Dos Santos; Guirardello, Edinêis de Brito

2016-06-01

Objectives To describe the characteristics of the nursing work environment, safety attitudes, quality of care, measured by the nursing staff of the pediatric units, as well as to analyze the evolution of quality of care and hospital indicators. Methods Descriptive study with 136 nursing professionals at a paediatric hospital, conducted through personal and professional characterization form, Nursing Work Index - Revised, Safety Attitudes Questionnaire - Short Form 2006 and quality indicators. Results The professionals perceive the environment as favourable to professional practice, and consider good quality care that is also observed by reducing the incidence of adverse events and decreased length of stay. The domain job satisfaction was considered favourable to patient safety. Conclusions The work environment is favourable to nursing practice, the professionals nursing approve the quality of care and the indicators tended reducing adverse events and length of stay.

Validity of three asthma-specific quality of life questionnaires: the patients' perspective.

PubMed

Apfelbacher, Christian J; Jones, Christina J; Frew, Anthony; Smith, Helen

2016-12-22

It is not known which of the many asthma-specific quality of life (QoL) questionnaires best capture the lived experience of people with asthma. The objective of this study was to explore patients' views of three commonly used asthma-specific QoL questionnaires. Qualitative study using semistructured interviews. Primary and secondary care in Brighton and Hove, UK. 30 adult people with a physician-diagnosis of asthma who were asked to complete the Juniper Asthma Quality of Life Questionnaire (AQLQ-J), the Sydney Asthma Quality of Life Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ) to elicit their views on the content validity of these. Thematic content analysis revealed a lack of congruence between the concerns of people with asthma and the questionnaire content in terms of missing (eg, allergies) and irrelevant (eg, smoky restaurants) content. The AQLQ-J was perceived as a 'narrow', 'medical' questionnaire focused on symptoms, the environment and functional ability. In contrast, the LWAQ and the AQLQ-S were perceived to be 'non-medical'. The LWAQ was described as a 'test' and as a wide-ranging, embracing and holistic questionnaire. Its strong emotional focus was irritating to some. The AQLQ-S was described as a simple, quick and easy questionnaire, although there was a perception that it was lacking in depth. Patient interviews highlighted strengths and shortcomings in the content validity of these three asthma-specific questionnaires. For patients, the AQLQ-S content seemed to be the most pertinent in its adequacy of coverage of medical, social and emotional aspects of health-related QoL in asthma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Tropical Aquatic Archaea Show Environment-Specific Community Composition

PubMed Central

Silveira, Cynthia B.; Cardoso, Alexander M.; Coutinho, Felipe H.; Lima, Joyce L.; Pinto, Leonardo H.; Albano, Rodolpho M.; Clementino, Maysa M.; Martins, Orlando B.; Vieira, Ricardo P.

2013-01-01

The Archaea domain is ubiquitously distributed and extremely diverse, however, environmental factors that shape archaeal community structure are not well known. Aquatic environments, including the water column and sediments harbor many new uncultured archaeal species from which metabolic and ecological roles remain elusive. Some environments are especially neglected in terms of archaeal diversity, as is the case of pristine tropical areas. Here we investigate the archaeal composition in marine and freshwater systems from Ilha Grande, a South Atlantic tropical environment. All sampled habitats showed high archaeal diversity. No OTUs were shared between freshwater, marine and mangrove sediment samples, yet these environments are interconnected and geographically close, indicating environment-specific community structuring. Group II Euryarchaeota was the main clade in marine samples, while the new putative phylum Thaumarchaeota and LDS/RCV Euryarchaeota dominated freshwaters. Group III Euryarchaeota , a rare clade, was also retrieved in reasonable abundance in marine samples. The archaeal community from mangrove sediments was composed mainly by members of mesophilic Crenarchaeota and by a distinct clade forming a sister-group to Crenarchaeota and Thaumarchaeota. Our results show strong environment-specific community structuring in tropical aquatic Archaea, as previously seen for Bacteria. PMID:24086729

Using Maslow's pyramid and the national database of nursing quality indicators(R) to attain a healthier work environment.

PubMed

Groff-Paris, Lisa; Terhaar, Mary

2010-12-07

The strongest predictor of nurse job dissatisfaction and intent to leave is that of stress in the practice environment. Good communication, control over practice, decision making at the bedside, teamwork, and nurse empowerment have been found to increase nurse satisfaction and decrease turnover. In this article we share our experience of developing a rapid-design process to change the approach to performance improvement so as to increase engagement, empowerment, effectiveness, and the quality of the professional practice environment. Meal and non-meal breaks were identified as the target area for improvement. Qualitative and quantitative data support the success of this project. We begin this article with a review of literature related to work environment and retention and a presentation of the frameworks used to improve the work environment, specifically Maslow's theory of the Hierarchy of Inborn Needs and the National Database of Nursing Quality Indicators Survey. We then describe our performance improvement project and share our conclusion and recommendations.

[Changes of regional environment quality pattern in China since 1986-2008].

PubMed

Guan, Wei-Hua; Sun, Ming-Kun; Lu, Yu-Qi

2011-03-01

For further study of regional differences and the pattern of changes in environmental quality in China since 1986-2008, we perform the principal component analysis, standard deviation, Mann-Kendall and cluster analysis on 18 environmental quality indexes in 28 provinces of China in this paper. Those indexes refer to pollutant emission, pollutants treatment capacities and pollutant emission of per unit land area, etc. The paper indicates that regional environmental quality in China has been increased slightly during this period. It can be divided into four stages: 1986-2000, 2000-2001, 2001-2005 and 2005-2008. The overall patterns of regional environmental quality is the West is higher than the East in general, while the environmental quality of the eastern part have been changed somewhat. For more details, the regional environmental quality in China in 1986 is composed of two parts, the eastern part and the western part, while in 2000 and 2001 the eastern part, the middle part and the western part appears as the overall pattern. For the year of 2005, the regional environmental quality in the western is higher than that of the eastern; meanwhile, the eastern can be divided into the northern part, the middle part and the southern part, and the environmental quality in northern part is better than that of the southern part, southern part is better than that of the middle part. This pattern hardly changed in 2008, except that the area with poor environment quality region had expanded. Pollutant emission of per unit land area played as a main factor; yet both the pollutant emission and the reuse of pollutants impacted the pattern specifically. In addition, the national macro policies, the regional policies, the regional economic and the industrial structure can be primary reason for the change of regional environmental quality pattern in China as well.

Quality specifications and standard-setting for stoma care patients.

PubMed

Primer, M A

1995-12-01

Quality specifications can be used as an information resource by purchasers of health care. The nature of service provision and nursing care can be positively influenced by the formalisation of standards and quality specifications. Auditing is essential in the ongoing evaluation of a quality system.

Quality of the Literacy Environment in Inclusive Early Childhood Special Education Classrooms

ERIC Educational Resources Information Center

Guo, Ying; Sawyer, Brook E.; Justice, Laura M.; Kaderavek, Joan N.

2013-01-01

The purpose of this study was to examine the quality of the literacy environment in inclusive early childhood special education (ECSE) classrooms ("N" = 54). The first aim was to describe the quality of the literacy environment in terms of structure (i.e., book materials and print/writing materials) and instruction (i.e., instructional…

Light, Colour & Air Quality: Important Elements of the Learning Environment?

ERIC Educational Resources Information Center

Hathaway, Warren E.

1987-01-01

Reviews and evaluates studies of the effects of light, color, and air quality on the learning environment. Concludes that studies suggest a role for light in establishing and maintaining physiological functions and balances and a need for improved air quality in airtight, energy efficient buildings. (JHZ)

The Quality of Home Environment in Brazil: An Ecological Model

ERIC Educational Resources Information Center

de Oliveira, Ebenezer A.; Barros, Fernando C.; Anselmi, Luciana D. da Silva; Piccinini, Cesar A.

2006-01-01

Based on Bronfenbrenner's (1999) ecological perspective, a longitudinal, prospective model of individual differences in the quality of home environment (Home Observation for Measurement of the Environment--HOME) was tested in a sample of 179 Brazilian children and their families. Perinatal measures of family socioeconomic status (SES) and child…

Nurse-perceived quality of care in intensive care units and associations with work environment characteristics: a multicentre survey study.

PubMed

Stalpers, Dewi; Van Der Linden, Dimitri; Kaljouw, Marian J; Schuurmans, Marieke J

2017-06-01

To examine nurse-perceived quality of care, controlling for overall job satisfaction among critical care nurses and to explore associations with work environment characteristics. Nurse-perceived quality of care and job satisfaction have been positively linked to quality outcomes for nurses and patients. Much evidence exists on factors contributing to job satisfaction. Understanding specific factors that affect nurse-perceived quality potentially enables for improvements of nursing care quality. A multicentre survey study was conducted in three Dutch intensive care units. The Dutch version of the Essentials of Magnetism II questionnaire was used; including the single-item indicators: (i) nurse-perceived quality of care; (ii) overall job satisfaction; and (iii) 58 statements on work environments. Data were collected between October 2013 - June 2014. The majority of 123 responding nurses (response rate 45%) were more than satisfied with quality of care (55%) and with their job (66%). No associations were found with nurse characteristics, besides differences in job satisfaction between the units. After controlling for job satisfaction, nurse-perceived quality was positively associated with the work environment characteristics: adequacy of staffing, patient-centeredness, competent peers and support for education. Patient-centeredness and autonomy were the most important predictors for overall job satisfaction. Factors that contribute to nurse-perceived quality of care in intensive care units, independent from the effects of overall job satisfaction, were identified. Hereby, offering opportunities to maximize high quality of care to critically ill patients. Research in a larger sample is needed to confirm our findings. © 2016 John Wiley & Sons Ltd.

Estimation of contribution ratios of pollutant sources to a specific section based on an enhanced water quality model.

PubMed

Cao, Bibo; Li, Chuan; Liu, Yan; Zhao, Yue; Sha, Jian; Wang, Yuqiu

2015-05-01

Because water quality monitoring sections or sites could reflect the water quality status of rivers, surface water quality management based on water quality monitoring sections or sites would be effective. For the purpose of improving water quality of rivers, quantifying the contribution ratios of pollutant resources to a specific section is necessary. Because physical and chemical processes of nutrient pollutants are complex in water bodies, it is difficult to quantitatively compute the contribution ratios. However, water quality models have proved to be effective tools to estimate surface water quality. In this project, an enhanced QUAL2Kw model with an added module was applied to the Xin'anjiang Watershed, to obtain water quality information along the river and to assess the contribution ratios of each pollutant source to a certain section (the Jiekou state-controlled section). Model validation indicated that the results were reliable. Then, contribution ratios were analyzed through the added module. Results show that among the pollutant sources, the Lianjiang tributary contributes the largest part of total nitrogen (50.43%), total phosphorus (45.60%), ammonia nitrogen (32.90%), nitrate (nitrite + nitrate) nitrogen (47.73%), and organic nitrogen (37.87%). Furthermore, contribution ratios in different reaches varied along the river. Compared with pollutant loads ratios of different sources in the watershed, an analysis of contribution ratios of pollutant sources for each specific section, which takes the localized chemical and physical processes into consideration, was more suitable for local-regional water quality management. In summary, this method of analyzing the contribution ratios of pollutant sources to a specific section based on the QUAL2Kw model was found to support the improvement of the local environment.

Nurse work environment and quality of care by unit types: A cross-sectional study.

PubMed

Ma, Chenjuan; Olds, Danielle M; Dunton, Nancy E

2015-10-01

Nursing unit is the micro-organization in the hospital health care system in which integrated patient care is provided. Nursing units of different types serve patients with distinct care goals, clinical tasks, and social structures and norms. However, empirical evidence is sparse on unit type differences in quality of care and its relation with nurse work environment. Nurse work environment has been found as an important nursing factor predicting nurse and patient outcomes. To examine the unit type differences in nurse-reported quality of care, and to identify the association between unit work environment and quality of care by unit types. This is a cross-sectional study using nurse survey data (2012) from US hospitals nationwide. The nurse survey collected data on quality of care, nurse work environment, and other work related information from staff nurses working in units of various types. Unit types were systematically classified across hospitals. The unit of analysis was the nursing unit, and the final sample included 7677 units of 14 unit types from 577 hospitals in 49 states in the US. Multilevel regressions were used to assess the relationship between nurse work environment and quality of care across and by unit types. On average, units had 58% of the nurses reporting excellent quality of care and 40% of the nurses reporting improved quality of care over the past year. Unit quality of care varied by unit types, from 43% of the nurses in adult medical units to 73% of the nurses in interventional units rating overall quality of care on unit as excellent, and from 35% of the nurses in adult critical care units to 44% of the nurses in adult medical units and medical-surgical combined units reporting improved quality of care. Estimates from regressions indicated that better unit work environments were associated with higher quality of care when controlling various hospital and unit covariates; and this association persisted among units of different types. Unit

Urban Natural Environments, Obesity, and Health-Related Quality of Life among Hispanic Children Living in Inner-City Neighborhoods

PubMed Central

Kim, Jun-Hyun; Lee, Chanam; Sohn, Wonmin

2016-01-01

Although a substantial body of literature has provided evidence supporting the positive effects of natural environments on well-being, little has been known about the specific spatial patterns of urban nature in promoting health-related quality of life (HRQOL) among children. This study assessed the association that the urban natural environment measured by landscape spatial patterns may have with obesity and HRQOL among Hispanic children. Ninety-two 4th and 5th grade students were recruited from Houston, Texas, and the Pediatric Quality of Life Inventory (PedsQL) was used to capture the children’s HRQOL. The quality of urban natural environments was assessed by quantifying the landscape spatial patterns, using landscape indices generated by Geographic Information Systems and remote sensing. From the bivariate analyses, children’s body mass index showed a significantly negative association with their HRQOL. After controlling for socio-demographic factors, the results revealed that larger and more tree areas were positively correlated with children’s HRQOL. In addition, those children living in areas with tree patches further apart from each other showed higher HRQOL. This research adds to the current multi-disciplinary area of research on environment-health relationships by investigating the roles of urban greeneries and linking their spatial structures with children’s HRQOL. PMID:26771623

Urban Natural Environments, Obesity, and Health-Related Quality of Life among Hispanic Children Living in Inner-City Neighborhoods.

PubMed

Kim, Jun-Hyun; Lee, Chanam; Sohn, Wonmin

2016-01-12

Although a substantial body of literature has provided evidence supporting the positive effects of natural environments on well-being, little has been known about the specific spatial patterns of urban nature in promoting health-related quality of life (HRQOL) among children. This study assessed the association that the urban natural environment measured by landscape spatial patterns may have with obesity and HRQOL among Hispanic children. Ninety-two 4th and 5th grade students were recruited from Houston, Texas, and the Pediatric Quality of Life Inventory (PedsQL) was used to capture the children's HRQOL. The quality of urban natural environments was assessed by quantifying the landscape spatial patterns, using landscape indices generated by Geographic Information Systems and remote sensing. From the bivariate analyses, children's body mass index showed a significantly negative association with their HRQOL. After controlling for socio-demographic factors, the results revealed that larger and more tree areas were positively correlated with children's HRQOL. In addition, those children living in areas with tree patches further apart from each other showed higher HRQOL. This research adds to the current multi-disciplinary area of research on environment-health relationships by investigating the roles of urban greeneries and linking their spatial structures with children's HRQOL.

Degraded visual environment image/video quality metrics

NASA Astrophysics Data System (ADS)

Baumgartner, Dustin D.; Brown, Jeremy B.; Jacobs, Eddie L.; Schachter, Bruce J.

2014-06-01

A number of image quality metrics (IQMs) and video quality metrics (VQMs) have been proposed in the literature for evaluating techniques and systems for mitigating degraded visual environments. Some require both pristine and corrupted imagery. Others require patterned target boards in the scene. None of these metrics relates well to the task of landing a helicopter in conditions such as a brownout dust cloud. We have developed and used a variety of IQMs and VQMs related to the pilot's ability to detect hazards in the scene and to maintain situational awareness. Some of these metrics can be made agnostic to sensor type. Not only are the metrics suitable for evaluating algorithm and sensor variation, they are also suitable for choosing the most cost effective solution to improve operating conditions in degraded visual environments.

Image quality specification and maintenance for airborne SAR

NASA Astrophysics Data System (ADS)

Clinard, Mark S.

2004-08-01

Specification, verification, and maintenance of image quality over the lifecycle of an operational airborne SAR begin with the specification for the system itself. Verification of image quality-oriented specification compliance can be enhanced by including a specification requirement that a vendor provide appropriate imagery at the various phases of the system life cycle. The nature and content of the imagery appropriate for each stage of the process depends on the nature of the test, the economics of collection, and the availability of techniques to extract the desired information from the data. At the earliest lifecycle stages, Concept and Technology Development (CTD) and System Development and Demonstration (SDD), the test set could include simulated imagery to demonstrate the mathematical and engineering concepts being implemented thus allowing demonstration of compliance, in part, through simulation. For Initial Operational Test and Evaluation (IOT&E), imagery collected from precisely instrumented test ranges and targets of opportunity consisting of a priori or a posteriori ground-truthed cultural and natural features are of value to the analysis of product quality compliance. Regular monitoring of image quality is possible using operational imagery and automated metrics; more precise measurements can be performed with imagery of instrumented scenes, when available. A survey of image quality measurement techniques is presented along with a discussion of the challenges of managing an airborne SAR program with the scarce resources of time, money, and ground-truthed data. Recommendations are provided that should allow an improvement in the product quality specification and maintenance process with a minimal increase in resource demands on the customer, the vendor, the operational personnel, and the asset itself.

Students' Learning Environment and Education Quality in Faculty of Education of University of Tehran

ERIC Educational Resources Information Center

Keshavarz, Mohsen; Vaziri, Seyed Ali; Jafari, Ahmad; Alizadeh, Hadi

2013-01-01

The main aim of this article is to review between students' learning environment and education quality. A non-experimental, quantitative, SPSS 17.0 research design was used to explore the relationship between background demographic characteristics, transformational, and transactional leadership styles, learning environment, and education quality.…

The home environment: A mediator of nutrition knowledge and diet quality in adolescents.

PubMed

Tabbakh, Tamara; Freeland-Graves, Jean H

2016-10-01

The objective of this research was to assess adherence to the Healthy Eating Index-2010 of mothers and their adolescents (11-14 years old) and to examine the role of the home environment as a mediator of maternal nutrition knowledge and adolescent diet quality. It is hypothesized that mothers with greater knowledge impact the diet quality of their adolescents by creation of healthier home environments. A sample of 206 mother-adolescent dyads separately completed the Multidimensional Home Environment Scale, a Food Frequency Questionnaire, and a Nutrition Knowledge Scale. Body mass index-for-age percentiles were derived from weight and height measurements obtained by researcher; diet quality was estimated via the Healthy Eating Index (HEI)-2010. Percent of maximum score on nutrition knowledge for both mothers and adolescents were poor, with lowest scores on recommendations of healthy eating and physical activity (48% and 19%, respectively). A model of maternal nutrition knowledge (independent variable) and adolescent diet quality (dependent variable) indicated that greater knowledge was associated with higher scores on total fruit (p = 0.02), whole grains (p = 0.05), seafood and plant proteins (p = 0.01), and overall diet quality (p < 0.01), as well as lower scores on empty calories (p = 0.01). Inclusion of the home environment as a mediator yielded significant estimates of the indirect effect (β = 0.61, 95% CI: 0.3-1.0). Within the home environment, psychological (β = 0.46), social (β = 0.23), and environmental (β = 0.65) variables were all significant mediators of nutrition knowledge on diet quality. These results emphasize the importance of maternal nutrition knowledge and the mediating effect of the home environment on the diet quality of adolescents. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quality of institution and the FEG (forest, energy intensity, and globalization) -environment relationships in sub-Saharan Africa.

PubMed

Amuakwa-Mensah, Franklin; Adom, Philip Kofi

2017-07-01

The current share of sub-Saharan Africa in global carbon dioxide emissions is negligible compared to major contributors like Asia, Americas, and Europe. This trend is, however, likely to change given that both economic growth and rate of urbanization in the region are projected to be robust in the future. The current study contributes to the literature by examining both the direct and the indirect impacts of quality of institution on the environment. Specifically, we investigate whether the institutional setting in the region provides some sort of a complementary role in the environment-FEG relationships. We use the panel two-step system generalized method of moments (GMM) technique to deal with the simultaneity problem. Data consists of 43 sub-Saharan African countries. The result shows that energy inefficiency compromises environmental standards. However, the quality of the institutional setting helps moderate this negative consequences; countries with good institutions show greater prospects than countries with poor institutions. On the other hand, globalization of the region and increased forest size generate positive environmental outcomes in the region. Their impacts are, however, independent of the quality of institution. Afforestation programs, promotion of other clean energy types, and investment in energy efficiency, basic city infrastructure, and regulatory and institutional structures, are desirable policies to pursue to safeguard the environment.

Soft qualities in healthcare. Method and tools for soft qualities design in hospitals' built environments.

PubMed

Capolongo, S; Bellini, E; Nachiero, D; Rebecchi, A; Buffoli, M

2014-01-01

The design of hospital environments is determined by functional requirements and technical regulations, as well as numerous protocols, which define the structure and system characteristics that such environments need to achieve. In order to improve people's well-being and the quality of their experience within public hospitals, design elements (soft qualities) are added to those 'necessary' features. The aim of this research has been to experiment a new design process and also to create health care spaces with high environmental quality and capable to meet users' emotional and perceptual needs. Such needs were investigated with the help of qualitative research tools and the design criteria for one of these soft qualities - colour - were subsequently defined on the basis of the findings. The colour scheme design for the new San Paolo Hospital Emergency Department in Milan was used as case study. Focus groups were fundamental in defining the project's goals and criteria. The issues raised have led to believe that the proper procedure is not the mere consultation of the users in order to define the goals: users should rather be involved in the whole design process and become co-agents of the choices that determine the environment characteristics, so as to meet the quality requirements identified by the users themselves. The case study has shown the possibility of developing a designing methodology made by three steps (or operational tools) in which users' groups are involved in the choices, loading to plan the environments where compliance with expectations is already implied and verified by means of the process itself. Thus, the method leads to the creation of soft qualities in Healthcare.

Assessing the Quality of Early Years Learning Environments

ERIC Educational Resources Information Center

Walsh, Glenda; Gardner, John

2005-01-01

This article describes a means of evaluating early years classrooms from the perspective of the child's experience. Nine key themes, such as motivation and independence, are identified as representing significant aspects of a high-quality environment for learning. The manner in which these manifest themselves in relation to the three elements of…

Preschoolers' vocabulary acquisition in Chile: the roles of socioeconomic status and quality of home environment.

PubMed

Lohndorf, Regina T; Vermeer, Harriet J; Cárcamo, Rodrigo A; Mesman, Judi

2018-05-01

Preschoolers' vocabulary acquisition sets the stage for later reading ability and school achievement. This study examined the role of socioeconomic status (SES) and the quality of the home environment of seventy-seven Chilean majority and Mapuche minority families from low and lower-middle-class backgrounds in explaining individual differences in vocabulary acquisition of their three-and-a-half-year-old children. Additionally, we investigated whether the relation between SES and receptive and expressive vocabulary was mediated by the quality of the home environment as the Family Investment Model suggests. The quality of the home environment significantly predicted receptive and expressive vocabulary above and beyond ethnicity, SES, parental caregiver status, and quantity of daycare. Furthermore, the quality of the home environment mediated the relation between SES and expressive and receptive vocabulary acquisition.

Indoor air quality in public utility environments-a review.

PubMed

Śmiełowska, Monika; Marć, Mariusz; Zabiegała, Bożena

2017-04-01

Indoor air quality has been the object of interest for scientists and specialists from the fields of science such as chemistry, medicine and ventilation system design. This results from a considerable number of potential factors, which may influence the quality of the broadly understood indoor air in a negative way. Poor quality of indoor air in various types of public utility buildings may significantly affect an increase in the incidence of various types of civilisation diseases. This paper presents information about a broad spectrum of chemical compounds that were identified and determined in the indoor environment of various types of public utility rooms such as churches, museums, libraries, temples and hospitals. An analysis of literature data allowed for identification of the most important transport paths of chemical compounds that significantly influence the quality of the indoor environment and thus the comfort of living and the health of persons staying in it.

Perceived Neighborhood Environment and Walking for Specific Purposes Among Elderly Japanese

PubMed Central

Inoue, Shigeru; Ohya, Yumiko; Odagiri, Yuko; Takamiya, Tomoko; Kamada, Masamitsu; Okada, Shinpei; Oka, Kohichiro; Kitabatake, Yoshinori; Nakaya, Tomoki; Sallis, James F; Shimomitsu, Teruichi

2011-01-01

Background Recent research has revealed the importance of neighborhood environment as a determinant of physical activity. However, evidence among elderly adults is limited. This study examined the association between perceived neighborhood environment and walking for specific purposes among Japanese elderly adults. Methods This population-based, cross-sectional study enrolled 1921 participants (age: 65–74 years, men: 51.9%). Neighborhood environment (International Physical Activity Questionnaire Environmental Module) and walking for specific purposes (ie, transportation or recreation) were assessed by self-report. Multilevel logistic regression analyses with individuals at level 1 and neighborhoods at level 2 were conducted to examine the association between environment and walking, after adjustment for potential confounders. Results Access to exercise facilities, social environment, and aesthetics were associated with total neighborhood walking. Odds ratios (95% CI) were 1.23 (1.00–1.51), 1.39 (1.14–1.71), and 1.48 (1.21–1.81), respectively. Regarding walking for specific purposes, social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Environmental correlates differed by specific types of walking and by sex. Transportation walking significantly correlated with a greater variety of environmental attributes. Sex differences were observed, especially for transportation walking. Bicycle lanes, crime safety, traffic safety, aesthetics, and household motor vehicles were significant correlates among men, while access to shops, access to exercise facilities, and social environment were important among women. Conclusions Specific environment–walking associations differed by walking purpose and sex among elderly adults. Social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Improving these environmental features might be effective in

Assessing Quality of Program Environments for Children and Youth with Autism: Autism Program Environment Rating Scale (APERS)

ERIC Educational Resources Information Center

Odom, Samuel L.; Cox, Ann; Sideris, John; Hume, Kara A.; Hedges, Susan; Kucharczyk, Suzanne; Shaw, Evelyn; Boyd, Brian A.; Reszka, Stephanie; Neitzel, Jennifer

2018-01-01

The purpose of this study was to examine the psychometric properties of the "Autism Program Environment Rating Scale" ("APERS"), an instrument designed to assess quality of program environments for students with autism spectrum disorder. Data sets from two samples of public school programs that provided services to children and…

SLS-SPEC-159 Cross-Program Design Specification for Natural Environments (DSNE) Revision D

NASA Technical Reports Server (NTRS)

Roberts, Barry C.

2015-01-01

This document is derived from the former National Aeronautics and Space Administration (NASA) Constellation Program (CxP) document CxP 70023, titled "The Design Specification for Natural Environments (DSNE), Revision C." The original document has been modified to represent updated Design Reference Missions (DRMs) for the NASA Exploration Systems Development (ESD) Programs. The DSNE completes environment-related specifications for architecture, system-level, and lower-tier documents by specifying the ranges of environmental conditions that must be accounted for by NASA ESD Programs. To assure clarity and consistency, and to prevent requirements documents from becoming cluttered with extensive amounts of technical material, natural environment specifications have been compiled into this document. The intent is to keep a unified specification for natural environments that each Program calls out for appropriate application. This document defines the natural environments parameter limits (maximum and minimum values, energy spectra, or precise model inputs, assumptions, model options, etc.), for all ESD Programs. These environments are developed by the NASA Marshall Space Flight Center (MSFC) Natural Environments Branch (MSFC organization code: EV44). Many of the parameter limits are based on experience with previous programs, such as the Space Shuttle Program. The parameter limits contain no margin and are meant to be evaluated individually to ensure they are reasonable (i.e., do not apply unrealistic extreme-on-extreme conditions). The natural environments specifications in this document should be accounted for by robust design of the flight vehicle and support systems. However, it is understood that in some cases the Programs will find it more effective to account for portions of the environment ranges by operational mitigation or acceptance of risk in accordance with an appropriate program risk management plan and/or hazard analysis process. The DSNE is not intended

Environment quality monitoring using ARM processor

NASA Astrophysics Data System (ADS)

Vinaya, C. H.; Krishna Thanikanti, Vamsi; Ramasamy, Sudha

2017-11-01

This paper of air quality monitoring system describes a model of sensors network to continuously monitoring the environment with low cost developed model. At present time all over the world turned into a great revolution in industrial domain and on the other hand environment get polluting in a dangerous value. There are so many technologies present to reduce the polluting contents but still there is no completely reduction of that pollution. Even there are different methods to monitor the pollution content; these are much costly that not everyone can adapt those methods or devices. Now we are proposing a sensors connected network to monitor the environment continuously and displaying the pollutant gases percentage in air surroundings and can transmit the results to our mobiles by message. The advantage of this system is easy to design, establish at area to monitor, maintenance and most cost effective as well.

Prediction of passenger ride quality in a multifactor environment

NASA Technical Reports Server (NTRS)

Dempsey, T. K.; Leatherwood, J. D.

1976-01-01

A model being developed, permits the understanding and prediction of passenger discomfort in a multifactor environment with particular emphasis upon combined noise and vibration. The model has general applicability to diverse transportation systems and provides a means of developing ride quality design criteria as well as a diagnostic tool for identifying the vibration and/or noise stimuli causing discomfort. Presented are: (1) a review of the basic theoretical and mathematical computations associated with the model, (2) a discussion of methodological and criteria investigations for both the vertical and roll axes of vibration, (3) a description of within-axis masking of discomfort responses for the vertical axis, thereby allowing prediction of the total discomfort due to any random vertical vibration, (4) a discussion of initial data on between-axis masking, and (5) discussion of a study directed towards extension of the vibration model to the more general case of predicting ride quality in the combined noise and vibration environments.

Power plant fuel switching and air quality in a tropical, forested environment

DOE PAGES

Medeiros, Adan S. S.; Calderaro, Gisele; Guimarães, Patricia C.; ...

2017-07-26

How a changing energy matrix for electricity production affects air quality is considered for an urban region in a tropical, forested environment. Manaus, the largest city in the central Amazon Basin of Brazil, is in the process of changing its energy matrix for electricity production from fuel oil and diesel to natural gas over an approximately 10-year period, with a minor contribution by hydropower. Three scenarios of urban air quality, specifically afternoon ozone concentrations, were simulated using the Weather Research and Forecasting (WRF-Chem) model. The first scenario used fuel oil and diesel for electricity production, which was the reality inmore » 2008. The second scenario was based on the fuel mix from 2014, the most current year for which data were available. The third scenario considered nearly complete use of natural gas for electricity production, which is the anticipated future, possibly for 2018. For each case, inventories of anthropogenic emissions were based on electricity generation, refinery operations, and transportation. Transportation and refinery operations were held constant across the three scenarios to focus on effects of power plant fuel switching in a tropical context. The simulated NO x and CO emissions for the urban region decrease by 89 and 55 %, respectively, after the complete change in the energy matrix. The results of the simulations indicate that a change to natural gas significantly decreases maximum afternoon ozone concentrations over the population center, reducing ozone by >70 % for the most polluted days. The sensitivity of ozone concentrations to the fuel switchover is consistent with a NO x-limited regime, as expected for a tropical forest having high emissions of biogenic volatile organic compounds, high water vapor concentrations, and abundant solar radiation. There are key differences in a shifting energy matrix in a tropical, forested environment compared to other world environments. Therefore, policies favoring

Power plant fuel switching and air quality in a tropical, forested environment

NASA Astrophysics Data System (ADS)

Medeiros, Adan S. S.; Calderaro, Gisele; Guimarães, Patricia C.; Magalhaes, Mateus R.; Morais, Marcos V. B.; Rafee, Sameh A. A.; Ribeiro, Igor O.; Andreoli, Rita V.; Martins, Jorge A.; Martins, Leila D.; Martin, Scot T.; Souza, Rodrigo A. F.

2017-07-01

How a changing energy matrix for electricity production affects air quality is considered for an urban region in a tropical, forested environment. Manaus, the largest city in the central Amazon Basin of Brazil, is in the process of changing its energy matrix for electricity production from fuel oil and diesel to natural gas over an approximately 10-year period, with a minor contribution by hydropower. Three scenarios of urban air quality, specifically afternoon ozone concentrations, were simulated using the Weather Research and Forecasting (WRF-Chem) model. The first scenario used fuel oil and diesel for electricity production, which was the reality in 2008. The second scenario was based on the fuel mix from 2014, the most current year for which data were available. The third scenario considered nearly complete use of natural gas for electricity production, which is the anticipated future, possibly for 2018. For each case, inventories of anthropogenic emissions were based on electricity generation, refinery operations, and transportation. Transportation and refinery operations were held constant across the three scenarios to focus on effects of power plant fuel switching in a tropical context. The simulated NOx and CO emissions for the urban region decrease by 89 and 55 %, respectively, after the complete change in the energy matrix. The results of the simulations indicate that a change to natural gas significantly decreases maximum afternoon ozone concentrations over the population center, reducing ozone by > 70 % for the most polluted days. The sensitivity of ozone concentrations to the fuel switchover is consistent with a NOx-limited regime, as expected for a tropical forest having high emissions of biogenic volatile organic compounds, high water vapor concentrations, and abundant solar radiation. There are key differences in a shifting energy matrix in a tropical, forested environment compared to other world environments. Policies favoring the burning of

Power plant fuel switching and air quality in a tropical, forested environment

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

Medeiros, Adan S. S.; Calderaro, Gisele; Guimarães, Patricia C.

How a changing energy matrix for electricity production affects air quality is considered for an urban region in a tropical, forested environment. Manaus, the largest city in the central Amazon Basin of Brazil, is in the process of changing its energy matrix for electricity production from fuel oil and diesel to natural gas over an approximately 10-year period, with a minor contribution by hydropower. Three scenarios of urban air quality, specifically afternoon ozone concentrations, were simulated using the Weather Research and Forecasting (WRF-Chem) model. The first scenario used fuel oil and diesel for electricity production, which was the reality inmore » 2008. The second scenario was based on the fuel mix from 2014, the most current year for which data were available. The third scenario considered nearly complete use of natural gas for electricity production, which is the anticipated future, possibly for 2018. For each case, inventories of anthropogenic emissions were based on electricity generation, refinery operations, and transportation. Transportation and refinery operations were held constant across the three scenarios to focus on effects of power plant fuel switching in a tropical context. The simulated NO x and CO emissions for the urban region decrease by 89 and 55 %, respectively, after the complete change in the energy matrix. The results of the simulations indicate that a change to natural gas significantly decreases maximum afternoon ozone concentrations over the population center, reducing ozone by >70 % for the most polluted days. The sensitivity of ozone concentrations to the fuel switchover is consistent with a NO x-limited regime, as expected for a tropical forest having high emissions of biogenic volatile organic compounds, high water vapor concentrations, and abundant solar radiation. There are key differences in a shifting energy matrix in a tropical, forested environment compared to other world environments. Therefore, policies favoring

Childhood socioeconomic status and risk in early family environments: predictors of global sleep quality in college students.

PubMed

Counts, Cory J; Grubin, Fiona C; John-Henderson, Neha A

2018-06-01

Low socioeconomic status (SES) in childhood associates with poor sleep quality in adulthood. Separately, childhood family environments shape health into adulthood. Here, we investigated whether these early life factors independently or interactively inform global sleep quality in college students. Cross-sectional. College students at a state university (N = 391). As a measure of childhood SES, we asked participants to consider their families' socioeconomic standing relative to the rest of the society during their childhood. We used the Risky Family questionnaire to measure adversity and the presence of warmth and affection in the family environment during childhood, and the Pittsburgh Sleep Quality Index as a measure of current global sleep quality. We used linear regressions adjusting for age and sex to examine relationships between childhood SES, risk in childhood family environments, and global sleep quality. Lower childhood SES and greater risk in childhood family environments independently predicted poor sleep quality. Importantly, in low-risk family environments, there was no significant difference in sleep quality as a function of childhood SES. However, students who were from low childhood SES backgrounds who also reported high levels of risk in their early family environments had the worst sleep quality. Findings highlight the importance of considering socioeconomic and family environments in childhood as informants of sleep quality across the lifespan. Compromised sleep quality in college students could affect academic performance and health over time. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Quality Detection of Litchi Stored in Different Environments Using an Electronic Nose

PubMed Central

Xu, Sai; Lü, Enli; Lu, Huazhong; Zhou, Zhiyan; Wang, Yu; Yang, Jing; Wang, Yajuan

2016-01-01

The purpose of this paper was to explore the utility of an electronic nose to detect the quality of litchi fruit stored in different environments. In this study, a PEN3 electronic nose was adopted to test the storage time and hardness of litchi that were stored in three different types of environment (room temperature, refrigerator and controlled-atmosphere). After acquiring data about the hardness of the sample and from the electronic nose, linear discriminant analysis (LDA), canonical correlation analysis (CCA), BP neural network (BPNN) and BP neural network-partial least squares regression (BPNN-PLSR), were employed for data processing. The experimental results showed that the hardness of litchi fruits stored in all three environments decreased during storage. The litchi stored at room temperature had the fastest rate of decrease in hardness, followed by those stored in a refrigerator environment and under a controlled-atmosphere. LDA has a poor ability to classify the storage time of the three environments in which litchi was stored. BPNN can effectively recognize the storage time of litchi stored in a refrigerator and a controlled-atmosphere environment. However, the BPNN classification of the effect of room temperature storage on litchi was poor. CCA results show a significant correlation between electronic nose data and hardness data under the room temperature, and the correlation is more obvious for those under the refrigerator environment and controlled-atmosphere environment. The BPNN-PLSR can effectively predict the hardness of litchi under refrigerator storage conditions and a controlled-atmosphere environment. However, the BPNN-PLSR prediction of the effect of room temperature storage on litchi and global environment storage on litchi were poor. Thus, this experiment proved that an electronic nose can detect the quality of litchi under refrigeratored storage and a controlled-atmosphere environment. These results provide a useful reference for future

Optimal procedures for quality assurance specifications

DOT National Transportation Integrated Search

2003-04-01

This manual is a comprehensive guide that a highway agency can use when developing new, or modifying existing, acceptance plans and quality assurance specifications. It provides necessary instruction and illustrative examples to lead the agency throu...

Associations Among Parental Education, Home Environment Quality, Effortful Control, and Preacademic Knowledge

PubMed Central

Merz, Emily C.; Landry, Susan H.; Williams, Jeffrey M.; Barnes, Marcia A.; Eisenberg, Nancy; Spinrad, Tracy L.; Valiente, Carlos; Assel, Michael; Taylor, Heather B.; Lonigan, Christopher J.; Phillips, Beth M.; Clancy-Menchetti, Jeanine

2014-01-01

This study used a longitudinal design to examine whether effortful control mediated the associations of parental education and home environment quality with preacademic knowledge in toddlers and young preschoolers. The sample consisted of 226 children (2 to 4 years of age at T1) from socioeconomically disadvantaged backgrounds. Parents provided data on parent education and home environment quality. Children completed effortful control, early literacy, and early math assessments. T2 effortful control partially mediated the associations of T1 parental education and T1 home environment quality with T3 emergent literacy after accounting for child age, gender, race/ethnicity, T1 effortful control, and T2 early literacy. T2 effortful control partially mediated the association between T1 parental education and T3 emergent math after accounting for child age, gender, race/ethnicity, T1 effortful control, and T2 early math. Prior to entry into preschool, parental education and home environment quality may shape effortful control which in turn influences preacademic knowledge. PMID:25110382

Relationship Between State Malpractice Environment and Quality of Health Care in the United States.

PubMed

Bilimoria, Karl Y; Chung, Jeanette W; Minami, Christina A; Sohn, Min-Woong; Pavey, Emily S; Holl, Jane L; Mello, Michelle M

2017-05-01

One major intent of the medical malpractice system in the United States is to deter negligent care and to create incentives for delivering high-quality health care. A study was conducted to assess whether state-level measures of malpractice risk were associated with hospital quality and patient safety. In an observational study of short-term, acute-care general hospitals in the United States that publicly reported in the Centers for Medicaid & Medicare Services Hospital Compare in 2011, hierarchical regression models were used to estimate associations between state-specific malpractice environment measures (rates of paid claims, average Medicare Malpractice Geographic Practice Cost Index [MGPCI], absence of tort reform laws, and a composite measure) and measures of hospital quality (processes of care, imaging utilization, 30-day mortality and readmission, Agency for Healthcare Research and Quality Patient Safety Indicators, and patient experience from the Hospital Consumer Assessment of Healthcare Providers and Systems [HCAHPS]). No consistent association between malpractice environment and hospital process-of-care measures was found. Hospitals in areas with a higher MGPCI were associated with lower adjusted odds of magnetic resonance imaging overutilization for lower back pain but greater adjusted odds of overutilization of cardiac stress testing and brain/sinus computed tomography (CT) scans. The MGPCI was negatively associated with 30-day mortality measures but positively associated with 30-day readmission measures. Measures of malpractice risk were also negatively associated with HCAHPS measures of patient experience. Overall, little evidence was found that greater malpractice risk improves adherence to recommended clinical standards of care, but some evidence was found that malpractice risk may encourage defensive medicine. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

The specificity of memory enhancement during interaction with a virtual environment.

PubMed

Brooks, B M; Attree, E A; Rose, F D; Clifford, B R; Leadbetter, A G

1999-01-01

Two experiments investigated differences between active and passive participation in a computer-generated virtual environment in terms of spatial memory, object memory, and object location memory. It was found that active participants, who controlled their movements in the virtual environment using a joystick, recalled the spatial layout of the virtual environment better than passive participants, who merely watched the active participants' progress. Conversely, there were no significant differences between the active and passive participants' recall or recognition of the virtual objects, nor in their recall of the correct locations of objects in the virtual environment. These findings are discussed in terms of subject-performed task research and the specificity of memory enhancement in virtual environments.

Some lessons learned in three years with ADS-33C. [rotorcraft handling qualities specification

NASA Technical Reports Server (NTRS)

Key, David L.; Blanken, Chris L.; Hoh, Roger H.

1993-01-01

Three years of using the U.S. Army's rotorcraft handling qualities specification, Aeronautical Design Standard - 33, has shown it to be surprisingly robust. It appears to provide an excellent basis for design and for assessment, however, as the subtleties become more well understood, several areas needing refinement became apparent. Three responses to these needs have been documented in this paper: (1) The yaw-axis attitude quickness for hover target acquisition and tracking can be relaxed slightly. (2) Understanding and application of criteria for degraded visual environments needed elaboration. This and some guidelines for testing to obtain visual cue ratings have been documented. (3) The flight test maneuvers were an innovation that turned out to be very valuable. Their extensive use has made it necessary to tighten definitions and testing guidance. This was accomplished for a good visual environment and is underway for degraded visual environments.

Comprehensive evaluation and analysis of ecological environment quality ofLaoshan Natural Reservebased on Remote Sensing

NASA Astrophysics Data System (ADS)

Cui, Wenlian; Liu, Shanwei; Liu, Yan; Wang, Yanling; Zhang, Naixin

2016-11-01

We used the remote sensing images of 2001, 2005 and 2010, statistics of reservoir water quality, air quality data, precipitation data and population data to evaluate and analyze the ecological environment quality of Laoshan Natural Reserve. In this decade, the ecological environment of tourism scenic area in Laoshan Natural Reserve becomes significantly better than that of the surrounding area, and it is the urban sprawl and increase of cultivated land area that resulted in the reduction of the scenic plants; Reservoir water quality was stable, but PH value and total nitrogen content still did not meet the standards because of the use of the sewage and pesticide fertilizer in the neighborhood; Air quality decreased slightly, however, the situation of acid rain had improved; Residential population continued to grow in Laoshan district and scenic tourists have increased, so human activity has become the main impacting factor of ecological environment of Laoshan Natural Reserve.

Plasticity Regulators Modulate Specific Root Traits in Discrete Nitrogen Environments

PubMed Central

Gifford, Miriam L.; Banta, Joshua A.; Katari, Manpreet S.; Hulsmans, Jo; Chen, Lisa; Ristova, Daniela; Tranchina, Daniel; Purugganan, Michael D.; Coruzzi, Gloria M.; Birnbaum, Kenneth D.

2013-01-01

Plant development is remarkably plastic but how precisely can the plant customize its form to specific environments? When the plant adjusts its development to different environments, related traits can change in a coordinated fashion, such that two traits co-vary across many genotypes. Alternatively, traits can vary independently, such that a change in one trait has little predictive value for the change in a second trait. To characterize such “tunability” in developmental plasticity, we carried out a detailed phenotypic characterization of complex root traits among 96 accessions of the model Arabidopsis thaliana in two nitrogen environments. The results revealed a surprising level of independence in the control of traits to environment – a highly tunable form of plasticity. We mapped genetic architecture of plasticity using genome-wide association studies and further used gene expression analysis to narrow down gene candidates in mapped regions. Mutants in genes implicated by association and expression analysis showed precise defects in the predicted traits in the predicted environment, corroborating the independent control of plasticity traits. The overall results suggest that there is a pool of genetic variability in plants that controls traits in specific environments, with opportunity to tune crop plants to a given environment. PMID:24039603

Learning environment: the impact of clerkship location on instructional quality.

PubMed

Prunuske, Jacob P; Deci, David M

2013-03-01

Students provide variable feedback on instructional quality at ambulatory training sites. We hypothesized several strengths and weaknesses of placing students at resident and non-resident training sites, including differences in faculty behaviors, patient characteristics, work environment, learning opportunities, and levels of student engagement. We systematically assessed for differences in learning quality between clerkship sites with and without residents. Students completed the MedED IQ, a validated survey assessing four domains of instructional quality, after completing a required primary care rotation. We calculated descriptive and summary statistics and two sample tests of proportion analyzing student agreement with each MedEd IQ item with respect to the presence or absence of resident learners. Of 149 total, 113 (75.8%) students completed the MedEd IQ site survey. A greater percentage of students at resident training sites (25.8%) than at non-resident sites (7.3%) agreed with the statement "The opportunities were too diverse, preventing me from developing proficiency." A greater percentage of students at resident training sites (19.4%) than at non-resident sites (1.2%) agreed with the statement "The health care team was not supportive of my learning." There were no differences between sites with or without residents on 14 items measuring preceptor actions or seven items measuring student involvement. Ambulatory clerkship sites with and without residents provide comparable quality learning experiences and precepting. Students placed at resident training sites may be overwhelmed with diverse opportunities and have a less supportive learning environment than students placed at non-resident sites. Future research should evaluate the impact of health care team development programs designed to foster a more supportive training environment for medical students. Ways of aligning residency and medical student education goals within the training setting should be

Nurses' work environments, care rationing, job outcomes, and quality of care on neonatal units.

PubMed

Rochefort, Christian M; Clarke, Sean P

2010-10-01

This paper is a report of a study of the relationship between work environment characteristics and neonatal intensive care unit nurses' perceptions of care rationing, job outcomes, and quality of care. International evidence suggests that attention to work environments might improve nurse recruitment and retention, and the quality of care. However, comparatively little attention has been given to neonatal care, a specialty where patient and nurse outcomes are potentially quite sensitive to problems with staffing and work environments. Over a 6-month period in 2007-2008, a questionnaire containing measures of work environment characteristics, nursing care rationing, job satisfaction, burnout and quality of care was distributed to 553 nurses in all neonatal intensive care units in the province of Quebec (Canada). A total of 339 nurses (61.3%) completed questionnaires. Overall, 18.6% were dissatisfied with their job, 35.7% showed high emotional exhaustion, and 19.2% rated the quality of care on their unit as fair or poor. Care activities most frequently rationed because of insufficient time were discharge planning, parental support and teaching, and comfort care. In multivariate analyses, higher work environment ratings were related to lower likelihood of reporting rationing and burnout, and better ratings of quality of care and job satisfaction. Additional research on the determinants of nurse outcomes, the quality of patient care, and the impact of rationing of nursing care on patient outcomes in neonatal intensive care units is required. The Neonatal Extent of Work Rationing Instrument appears to be a useful tool for monitoring the extent of rationing of nursing care in neonatal units. © 2010 Blackwell Publishing Ltd.

Effects of Cultivar and Maternal Environment on Seed Quality in Vicia sativa

PubMed Central

Li, Rong; Chen, Lijun; Wu, Yanpei; Zhang, Rui; Baskin, Carol C.; Baskin, Jerry M.; Hu, Xiaowen

2017-01-01

Production of high quality seeds is of fundamental importance for successful crop production. However, knowledge of the effects of increased temperature resulting from global warming on seed quality of alpine species is limited. We investigated the effect of maternal environment on seed quality of three cultivars of the leguminous forage species Vicia sativa, giving particular attention to temperature. Plants of each cultivar were grown at 1700 and 3000 m a.s.l., and mass, germination, electrical conductivity (EC) of leakage and longevity were determined for mature seeds. Seeds of all three cultivars produced at the low elevation had a significantly lower mass and longevity but higher EC of leachate than those produced at the high elevation, suggesting that increased temperatures decreased seed quality. However, seed viability did not differ between elevations. The effects of maternal environment on seed germination strongly depended on cultivar and germination temperature. At 10 and 15°C, seeds of “Lanjian 3” produced at high elevation germinated to higher percentages and rates than those produced at low elevation, but the opposite trend was observed at 20°C. However, for seeds of “Lanjian 1” and “Lanjian 2,” no significant effect of elevation was observed in germination percentage. Our results indicate that the best environment for the production of high quality seeds (e.g., high seed mass, low EC, high seed longevity) of V. sativa is one in which temperatures are relatively low during seed development. PMID:28861096

Handling Qualities Specifications for U.S. Military Helicopters

NASA Technical Reports Server (NTRS)

Key, David L.

1982-01-01

Inadequacies in the military specification for helicopter handling qualities, MIL-H-8501A, have long been recognized, and the latest procurements by the U.S. Army used special Prime Item Development Specifications (PIDS). This paper assesses the efficacy of these PIDS and suggests that changes should be made. In particular, the structure developed in MIL-F-8785B (ASG) (the specification for flying qualities of piloted airplanes) should be incorporated. Improved requirements must be based on a systematic data base and concentrated on topics most important in preliminary design: static and dynamic stability, control power and sensitivity, and interaction with controllers and displays. Emphasis should be on current military helicopter missions and helicopter idiosyncrasies such as cross-coupling, nonlinearities, and higher-order dynamics.

Realization of high quality production schedules: Structuring quality factors via iteration of user specification processes

NASA Technical Reports Server (NTRS)

Hamazaki, Takashi

1992-01-01

This paper describes an architecture for realizing high quality production schedules. Although quality is one of the most important aspects of production scheduling, it is difficult, even for a user, to specify precisely. However, it is also true that the decision as to whether a scheduler is good or bad can only be made by the user. This paper proposes the following: (1) the quality of a schedule can be represented in the form of quality factors, i.e. constraints and objectives of the domain, and their structure; (2) quality factors and their structure can be used for decision making at local decision points during the scheduling process; and (3) that they can be defined via iteration of user specification processes.

Quality specification and status of internal quality control of cardiac biomarkers in China from 2011 to 2016.

PubMed

Li, Tingting; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

2017-09-07

This study aimed to investigate the status of internal quality control (IQC) for cardiac biomarkers from 2011 to 2016 so that we can have overall knowledge of the precision level of measurements in China and set appropriate precision specifications. Internal quality control data of cardiac biomarkers, including creatinine kinase MB (CK-MB) (μg/L), CK-MB(U/L), myoglobin (Mb), cardiac troponin I (cTnI), cardiac troponin T (cTnT), and homocysteines (HCY), were collected by a web-based external quality assessment (EQA) system. Percentages of laboratories meeting five precision quality specifications for current coefficient of variations (CVs) were calculated. Then, appropriate precision specifications were chosen for these six analytes. Finally, the CVs and IQC practice were further analyzed with different grouping methods. The current CVs remained nearly constant for 6 years. cTnT had the highest pass rates every year against five specifications, whereas HCY had the lowest pass rates. Overall, most analytes had a satisfactory performance (pass rates >80%), except for HCY, if one-third TEa or the minimum specification were employed. When the optimal specification was applied, the performance of most analytes was frustrating (pass rates < 60%) except for cTnT. The appropriate precision specifications of Mb, cTnI, cTnT and HCY were set as current CVs less than 9.20%, 9.90%, 7.50%, 10.54%, 7.63%, and 6.67%, respectively. The data of IQC practices indicated wide variation and substantial progress. The precision performance of cTnT was already satisfying, while the other five analytes, especially HCY, were still frustrating; thus, ongoing investigation and continuous improvement for IQC are still needed. © 2017 Wiley Periodicals, Inc.

Neighborhood Quality and Attachment: Validation of the Revised Residential Environment Assessment Tool.

PubMed

Poortinga, Wouter; Calve, Tatiana; Jones, Nikki; Lannon, Simon; Rees, Tabitha; Rodgers, Sarah E; Lyons, Ronan A; Johnson, Rhodri

2017-04-01

Various studies have shown that neighborhood quality is linked to neighborhood attachment and satisfaction. However, most have relied upon residents' own perceptions rather than independent observations of the neighborhood environment. This study examines the reliability and validity of the revised Residential Environment Assessment Tool (REAT 2.0), an audit instrument covering both public and private spaces of the neighborhood environment. The research shows that REAT 2.0 is a reliable, easy-to-use instrument and that most underlying constructs can be validated against residents' own neighborhood perceptions. The convergent validity of the instrument, which was tested against digital map data, can be improved for a number of miscellaneous urban form items. The research further found that neighborhood attachment was significantly associated with the overall REAT 2.0 score. This association can mainly be attributed to the property-level neighborhood quality and natural elements components. The research demonstrates the importance of private spaces in the outlook of the neighborhood environment.

The Specification of an Integrated Computer-Aided Ship Design Process in an Academic Environment.

DTIC Science & Technology

1984-06-01

complicated. The intuition .-nd ex:perience of a good designer are qualities that cannot yet ;e programmed into even the most capable computer. Comitters...between themselves. These application routines, while very capable in their own right, lack the qualities which would make them more usable in the...academic environment. These qualities include thorough documentation, both substantive derivations and descriptive user’s guides, user friendliness and

Ride quality criteria. [transportation system interior and passenger response to environment

NASA Technical Reports Server (NTRS)

Stephens, D. G.

1977-01-01

Ride quality refers to the interior or passenger environment of a transportation system as well as the passenger response to the environment. Ride quality factors are illustrated with the aid of a diagram presenting inputs to vehicle, the vehicle transfer function, the ride environment, the passenger response function, and the passenger ride response. The reported investigation considers the ride environment as measured on a variety of air and surface vehicles, the passenger response to the environment as determined from laboratory and field surveys, and criteria/standards for vibration, noise, and combined stimuli. Attention is given to the vertical vibration characteristics in cruise for aircraft and automobile, the aircraft vibration levels for various operating regimes, comparative noise levels during cruise, the discomfort level for a 9 Hz sinusoidal vibration, equal discomfort contours for vertical vibration, subjective response to noise in a speech situation, and noise and vibration levels for constant discomfort contours.

Head and neck cancer-specific quality of life: instrument validation.

PubMed

Terrell, J E; Nanavati, K A; Esclamado, R M; Bishop, J K; Bradford, C R; Wolf, G T

1997-10-01

The disfigurement and dysfunction associated with head and neck cancer affect emotional well-being and some of the most basic functions of life. Most cancer-specific quality-of-life assessments give a single composite score for head and neck cancer-related quality of life. To develop and evaluate an improved multidimensional instrument to assess head and neck cancer-related functional status and well-being. The item selection process included literature review, interviews with health care workers, and patient surveys. A survey with 37 disease-specific questions and the SF-12 survey were administered to 253 patients in 3 large medical centers. Factor analysis was performed to identify disease-specific domains. Domain scores were calculated as the standardized score of the component items. These domains were assessed for construct validity based on clinical hypotheses and test-retest reliability. Four relevant domains were identified: Eating (6 items), Communication (4 items), Pain (4 items), and Emotion (6 items). Each had an internal consistency (Cronbach alpha value) of greater than 0.80. Construct validity was demonstrated by moderate correlations with the SF-12 Physical and Mental component scores (r=0.43-0.60). Test-retest reliability for each domain demonstrated strong reliability between the 2 time points. Correlations were strong for each individual question, ranging from 0.53 to 0.93. Construct validity testing demonstrated that the direction of differences for each domain were as hypothesized. The Head and Neck Quality of Life questionnaire is a promising multidimensional tool with which to assess head and neck cancer-specific quality of life.

The effectiveness of an aged care specific leadership and management program on workforce, work environment, and care quality outcomes: design of a cluster randomised controlled trial

PubMed Central

2013-01-01

Background A plethora of observational evidence exists concerning the impact of management and leadership on workforce, work environment, and care quality. Yet, no randomised controlled trial has been conducted to test the effectiveness of leadership and management interventions in aged care. An innovative aged care clinical leadership program (Clinical Leadership in Aged Care − CLiAC) was developed to improve managers’ leadership capacities to support the delivery of quality care in Australia. This paper describes the study design of the cluster randomised controlled trial testing the effectiveness of the program. Methods Twenty-four residential and community aged care sites were recruited as managers at each site agreed in writing to participate in the study and ensure that leaders allocated to the control arm would not be offered the intervention program. Sites undergoing major managerial or structural changes were excluded. The 24 sites were randomly allocated to receive the CLiAC program (intervention) or usual care (control), stratified by type (residential vs. community, six each for each arm). Treatment allocation was masked to assessors and staff of all participating sites. The objective is to establish the effectiveness of the CLiAC program in improving work environment, workforce retention, as well as care safety and quality, when compared to usual care. The primary outcomes are measures of work environment, care quality and safety, and staff turnover rates. Secondary outcomes include manager leadership capacity, staff absenteeism, intention to leave, stress levels, and job satisfaction. Differences between intervention and control groups will be analysed by researchers blinded to treatment allocation using linear regression of individual results adjusted for stratification and clustering by site (primary analysis), and additionally for baseline values and potential confounders (secondary analysis). Outcomes measured at the site level will be

The effectiveness of an aged care specific leadership and management program on workforce, work environment, and care quality outcomes: design of a cluster randomised controlled trial.

PubMed

Jeon, Yun-Hee; Simpson, Judy M; Chenoweth, Lynn; Cunich, Michelle; Kendig, Hal

2013-10-25

A plethora of observational evidence exists concerning the impact of management and leadership on workforce, work environment, and care quality. Yet, no randomised controlled trial has been conducted to test the effectiveness of leadership and management interventions in aged care. An innovative aged care clinical leadership program (Clinical Leadership in Aged Care--CLiAC) was developed to improve managers' leadership capacities to support the delivery of quality care in Australia. This paper describes the study design of the cluster randomised controlled trial testing the effectiveness of the program. Twenty-four residential and community aged care sites were recruited as managers at each site agreed in writing to participate in the study and ensure that leaders allocated to the control arm would not be offered the intervention program. Sites undergoing major managerial or structural changes were excluded. The 24 sites were randomly allocated to receive the CLiAC program (intervention) or usual care (control), stratified by type (residential vs. community, six each for each arm). Treatment allocation was masked to assessors and staff of all participating sites. The objective is to establish the effectiveness of the CLiAC program in improving work environment, workforce retention, as well as care safety and quality, when compared to usual care. The primary outcomes are measures of work environment, care quality and safety, and staff turnover rates. Secondary outcomes include manager leadership capacity, staff absenteeism, intention to leave, stress levels, and job satisfaction. Differences between intervention and control groups will be analysed by researchers blinded to treatment allocation using linear regression of individual results adjusted for stratification and clustering by site (primary analysis), and additionally for baseline values and potential confounders (secondary analysis). Outcomes measured at the site level will be compared by cluster

Human voice quality measurement in noisy environments.

PubMed

Ueng, Shyh-Kuang; Luo, Cheng-Ming; Tsai, Tsung-Yu; Yeh, Hsuan-Chen

2015-01-01

Computerized acoustic voice measurement is essential for the diagnosis of vocal pathologies. Previous studies showed that ambient noises have significant influences on the accuracy of voice quality assessment. This paper presents a voice quality assessment system that can accurately measure qualities of voice signals, even though the input voice data are contaminated by low-frequency noises. The ambient noises in our living rooms and laboratories are collected and the frequencies of these noises are analyzed. Based on the analysis, a filter is designed to reduce noise level of the input voice signal. Then, improved numerical algorithms are employed to extract voice parameters from the voice signal to reveal the health of the voice signal. Compared with MDVP and Praat, the proposed method outperforms these two widely used programs in measuring fundamental frequency and harmonic-to-noise ratio, and its performance is comparable to these two famous programs in computing jitter and shimmer. The proposed voice quality assessment method is resistant to low-frequency noises and it can measure human voice quality in environments filled with noises from air-conditioners, ceiling fans and cooling fans of computers.

The human factors of quality and QA in R D environments

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

Hill, S.G.

1990-01-01

Achieving quality is a human activity. It is therefore important to consider the human in the design, development and evaluation of work processes and environments in an effort to enhance human performance and minimize error. It is also important to allow for individual differences when considering human factors issues. Human Factors is the field of study which can provide information on integrating the human into the system. Human factors and quality are related for the customer of R D work, R D personnel who perform the work, and the quality professional who overviews the process of quality in the work.more » 18 refs., 1 fig.« less

A quality by design (QbD) study on enoxaparin sodium loaded polymeric microspheres for colon-specific delivery.

PubMed

Hales, Dana; Vlase, Laurian; Porav, Sebastian Alin; Bodoki, Andreea; Barbu-Tudoran, Lucian; Achim, Marcela; Tomuță, Ioan

2017-03-30

The aim of this study was to apply quality by design (QbD) for pharmaceutical development of enoxaparin sodium microspheres for colon-specific delivery. The Process Parameters (CPPs) and Critical Quality Attributes (CQAs) were identified. A central composite experimental design was used in order to develop the design space of microspheres for colon-specific delivery that have the desired Quality Target Product Profile (QTPP). The CPPs studied were Eudragit® FS-30D/Eudragit® RS-PO ratio, poly(vinyl alcohol) (PVA) concentration and sodium chloride (NaCl) concentration. The encapsulation efficiency increased with NaCl concentration increase, the percentages of enoxaparin sodium reaching 94% for some formulations. Increasing the ratio Eudragit® FS-30D/Eudragit® RS-PO ensured a relatively complete release of enoxaparin sodium in the environment simulating the colonic pH. Based on these results, the optimum conditions were decided and the optimum formulation was prepared. The results obtained for the latter in terms of in vitro enoxaparin sodium release were good, the microparticles releasing only 9.42% enoxaparin sodium in acidic environment and 15.16% in the medium which simulated duodenal pH, but allowing the release of up to 89.24% in the medium which simulated colonic pH. The in vitro release profile of enoxaparin sodium was close to the ideal one, therefore the system was successfully designed using QbD approach. Copyright © 2017 Elsevier B.V. All rights reserved.

Mothers adjust offspring sex to match the quality of the rearing environment

PubMed Central

Pryke, Sarah R.; Rollins, Lee A.

2012-01-01

Theory predicts that mothers should adjust offspring sex ratios when the expected fitness gains or rearing costs differ between sons and daughters. Recent empirical work has linked biased offspring sex ratios to environmental quality via changes in relative maternal condition. It is unclear, however, whether females can manipulate offspring sex ratios in response to environmental quality alone (i.e. independent of maternal condition). We used a balanced within-female experimental design (i.e. females bred on both low- and high-quality diets) to show that female parrot finches (Erythrura trichroa) manipulate primary offspring sex ratios to the quality of the rearing environment, and not to their own body condition and health. Individual females produced an unbiased sex ratio on high-quality diets, but over-produced sons in poor dietary conditions, even though they maintained similar condition between diet treatments. Despite the lack of sexual size dimorphism, such sex ratio adjustment is in line with predictions from sex allocation theory because nutritionally stressed foster sons were healthier, grew faster and were more likely to survive than daughters. These findings suggest that mothers may adaptively adjust offspring sex ratios to optimally match their offspring to the expected quality of the rearing environment. PMID:22859597

Mothers adjust offspring sex to match the quality of the rearing environment.

PubMed

Pryke, Sarah R; Rollins, Lee A

2012-10-07

Theory predicts that mothers should adjust offspring sex ratios when the expected fitness gains or rearing costs differ between sons and daughters. Recent empirical work has linked biased offspring sex ratios to environmental quality via changes in relative maternal condition. It is unclear, however, whether females can manipulate offspring sex ratios in response to environmental quality alone (i.e. independent of maternal condition). We used a balanced within-female experimental design (i.e. females bred on both low- and high-quality diets) to show that female parrot finches (Erythrura trichroa) manipulate primary offspring sex ratios to the quality of the rearing environment, and not to their own body condition and health. Individual females produced an unbiased sex ratio on high-quality diets, but over-produced sons in poor dietary conditions, even though they maintained similar condition between diet treatments. Despite the lack of sexual size dimorphism, such sex ratio adjustment is in line with predictions from sex allocation theory because nutritionally stressed foster sons were healthier, grew faster and were more likely to survive than daughters. These findings suggest that mothers may adaptively adjust offspring sex ratios to optimally match their offspring to the expected quality of the rearing environment.

Quality management and work environment in Swedish oral and maxillofacial surgery.

PubMed

Pilgård, Göran

2009-01-01

This thesis attempts to describe the opinion of the work with quality, quality management, and work environment among the employees at Oral and Maxillofacial Surgery (OMFS) clinics in Sweden. Analyse if the OMFS clinics in Sweden actively work with quality development and if so which systems they use. Explore the opinion of the employees about quality work. Describe how the employees of OMFS clinics in Sweden perceive good work, i.e., their image of the dimensions that the profession should contain to be really good work. Investigate whether there is a discrepancy between ideal and reality for this group. Describe how the employees of OMFS clinics in Sweden perceive their health. Analyse how work environment influenced attitudes to and knowledge of quality among employees of OMFS clinics in Sweden. The study was based on self-report questionnaires which in 2003 were sent to all OMFS clinics in Sweden. The response rate was 86%. Only at two clinics did all the respondents agree on their system. Surgeons rated intellectually stimulating work as most important, and the hazard-free work environment as least important. The nurses rated stimulating fellowship as most important, and the opportunity for career advancement as least important. The percentage unit differences between the ideal and the reality were largest for the item the work provides opportunities to have an influence on important decisions. There were significant differences between maxillofacial. surgeons and dental nurses and assistant nurses as to muscle- and joint trouble. The differences were also significant between men and women both as to muscle- and joint troubles and somatic trouble. Only work environment was significant for attitude towards quality work. Profession, gender, clinic size, and a factor for hard demand had significant associations to quality management system used or not. More than half of the respondents stated that they worked with a quality system. The dental nurses and assistant

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

PubMed

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

2011-12-01

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

Patient-specific dosimetric endpoints based treatment plan quality control in radiotherapy.

PubMed

Song, Ting; Staub, David; Chen, Mingli; Lu, Weiguo; Tian, Zhen; Jia, Xun; Li, Yongbao; Zhou, Linghong; Jiang, Steve B; Gu, Xuejun

2015-11-07

In intensity modulated radiotherapy (IMRT), the optimal plan for each patient is specific due to unique patient anatomy. To achieve such a plan, patient-specific dosimetric goals reflecting each patient's unique anatomy should be defined and adopted in the treatment planning procedure for plan quality control. This study is to develop such a personalized treatment plan quality control tool by predicting patient-specific dosimetric endpoints (DEs). The incorporation of patient specific DEs is realized by a multi-OAR geometry-dosimetry model, capable of predicting optimal DEs based on the individual patient's geometry. The overall quality of a treatment plan is then judged with a numerical treatment plan quality indicator and characterized as optimal or suboptimal. Taking advantage of clinically available prostate volumetric modulated arc therapy (VMAT) treatment plans, we built and evaluated our proposed plan quality control tool. Using our developed tool, six of twenty evaluated plans were identified as sub-optimal plans. After plan re-optimization, these suboptimal plans achieved better OAR dose sparing without sacrificing the PTV coverage, and the dosimetric endpoints of the re-optimized plans agreed well with the model predicted values, which validate the predictability of the proposed tool. In conclusion, the developed tool is able to accurately predict optimally achievable DEs of multiple OARs, identify suboptimal plans, and guide plan optimization. It is a useful tool for achieving patient-specific treatment plan quality control.

The quality of the outdoor environment influences childrens health -- a cross-sectional study of preschools.

PubMed

Söderström, M; Boldemann, C; Sahlin, U; Mårtensson, F; Raustorp, A; Blennow, M

2013-01-01

To test how the quality of the outdoor environment of child day care centres (DCCs) influences children's health. The environment was assessed using the Outdoor Play Environmental Categories (OPEC) tool, time spent outdoors and physical activity as measured by pedometer. 172/253 (68%) of children aged 3.0-5.9 from nine DCCs participated in Southern Sweden. Health data collected were body mass index, waist circumference, saliva cortisol, length of night sleep during study, and symptoms and well-being which were scored (1-week diary - 121 parent responders). Also, parent-rated well-being and health of their child were scored (questionnaire, 132 parent responders). MANOVA, ANOVA and principal component analyses were performed to identify impacts of the outdoor environment on health. High-quality outdoor environment at DCCs is associated with several health aspects in children such as leaner body, longer night sleep, better well-being and higher mid-morning saliva cortisol levels. The quality of the outdoor environment at DCCs influenced the health and well-being of preschool children and should be given more attention among health care professionals and community planners. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.

Psychosocial work environment and prediction of quality of care indicators in one Canadian health center.

PubMed

Paquet, Maxime; Courcy, François; Lavoie-Tremblay, Mélanie; Gagnon, Serge; Maillet, Stéphanie

2013-05-01

Few studies link organizational variables and outcomes to quality indicators. This approach would expose operant mechanisms by which work environment characteristics and organizational outcomes affect clinical effectiveness, safety, and quality indicators. What are the predominant psychosocial variables in the explanation of organizational outcomes and quality indicators (in this case, medication errors and length of stay)? The primary objective of this study was to link the fields of evidence-based practice to the field of decision making, by providing an effective model of intervention to improve safety and quality. The study involved healthcare workers (n = 243) from 13 different care units of a university affiliated health center in Canada. Data regarding the psychosocial work environment (10 work climate scales, effort/reward imbalance, and social support) was linked to organizational outcomes (absenteeism, turnover, overtime), to the nurse/patient ratio and quality indicators (medication errors and length of stay) using path analyses. The models produced in this study revealed a contribution of some psychosocial factors to quality indicators, through an indirect effect of personnel- or human resources-related variables, more precisely: turnover, absenteeism, overtime, and nurse/patient ratio. Four perceptions of work environment appear to play an important part in the indirect effect on both medication errors and length of stay: apparent social support from supervisors, appreciation of the workload demands, pride in being part of one's work team, and effort/reward balance. This study reveals the importance of employee perceptions of the work environment as an indirect predictor of quality of care. Working to improve these perceptions is a good investment for loyalty and attendance. In general, better personnel conditions lead to fewer medication errors and shorter length of stay. © Sigma Theta Tau International.

Air quality inside subway metro indoor environment worldwide: A review.

PubMed

Xu, Bin; Hao, Jinliang

2017-10-01

The air quality in the subway metro indoor microenvironment has been of particular public concern. With specific reference to the growing demand of green transportation and sustainable development, subway metro systems have been rapidly developed worldwide in last decades. The number of metro commuters has continuously increased over recent years in metropolitan cities. In some cities, metro system has become the primary public transportation mode. Although commuters typically spend only 30-40min in metros, the air pollutants emitted from various interior components of metro system as well as air pollutants carried by ventilation supply air are significant sources of harmful air pollutants that could lead to unhealthy human exposure. Commuters' exposure to various air pollutants in metro carriages may cause perceivable health risk as reported by many environmental health studies. This review summarizes significant findings in the literature on air quality inside metro indoor environment, including pollutant concentration levels, chemical species, related sources and health risk assessment. More than 160 relevant studies performed across over 20 countries were carefully reviewed. These comprised more than 2000 individual measurement trips. Particulate matters, aromatic hydrocarbons, carbonyls and airborne bacteria have been identified as the primary air pollutants inside metro system. On this basis, future work could focus on investigating the chronic health risks of exposure to various air pollutants other than PM, and/or further developing advanced air purification unit to improve metro in-station air quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Associations between the Quality of the Residential Built Environment and Pregnancy Outcomes among Women in North Carolina

PubMed Central

Messer, Lynne C.; Kroeger, Gretchen L.

2011-01-01

Background: The built environment, a key component of environmental health, may be an important contributor to health disparities, particularly for reproductive health outcomes. Objective: In this study we investigated the relationship between seven indices of residential built environment quality and adverse reproductive outcomes for the City of Durham, North Carolina (USA). Methods: We surveyed approximately 17,000 residential tax parcels in central Durham, assessing > 50 individual variables on each. These data, collected using direct observation, were combined with tax assessor, public safety, and U.S. Census data to construct seven indices representing important domains of the residential built environment: housing damage, property disorder, security measures, tenure (owner or renter occupied), vacancy, crime count, and nuisance count. Fixed-slope random-intercept multilevel models estimated the association between the residential built environment and five adverse birth outcomes. Models were adjusted for maternal characteristics and clustered at the primary adjacency community unit, defined as the index block, plus all adjacent blocks that share any portion of a line segment (block boundary) or vertex. Results: Five built environment indices (housing damage, property disorder, tenure, vacancy, and nuisance count) were associated with each of the five outcomes in the unadjusted context: preterm birth, small for gestational age (SGA), low birth weight (LBW), continuous birth weight, and birth weight percentile for gestational age (BWPGA; sex-specific birth weight distributions for infants delivered at each gestational age using National Center for Health Statistics referent births for 2000–2004). However, some estimates were attenuated after adjustment. In models adjusted for individual-level covariates, housing damage remained statistically significantly associated with SGA, birth weight, and BWPGA. Conclusion: This work suggests a real and meaningful

Shared decision making in designing new healthcare environments-time to begin improving quality.

PubMed

Elf, Marie; Fröst, Peter; Lindahl, Göran; Wijk, Helle

2015-03-21

Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments. This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users' perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.

Subject-Specific Characteristics of Instructional Quality in Mathematics Education

ERIC Educational Resources Information Center

Schlesinger, Lena; Jentsch, Armin; Kaiser, Gabriele; König, Johannes; Blömeke, Sigrid

2018-01-01

Instructional research in German-speaking countries has conceptualized teaching quality recently according to three generic dimensions, namely, classroom management, student support and cognitive activation. However, as these dimensions are mainly regarded as generic, subject-specific aspects of mathematics instruction, e.g., the mathematical…

Effects of light quality on the accumulation of phytochemicals in vegetables produced in controlled environments: a review.

PubMed

Bian, Zhong Hua; Yang, Qi Chang; Liu, Wen Ke

2015-03-30

Phytochemicals in vegetables are important for human health, and their biosynthesis, metabolism and accumulation are affected by environmental factors. Light condition (light quality, light intensity and photoperiod) is one of the most important environmental variables in regulating vegetable growth, development and phytochemical accumulation, particularly for vegetables produced in controlled environments. With the development of light-emitting diode (LED) technology, the regulation of light environments has become increasingly feasible for the provision of ideal light quality, intensity and photoperiod for protected facilities. In this review, the effects of light quality regulation on phytochemical accumulation in vegetables produced in controlled environments are identified, highlighting the research progress and advantages of LED technology as a light environment regulation tool for modifying phytochemical accumulation in vegetables. © 2014 Society of Chemical Industry.

Determination of water environment standards based on water quality criteria in China: Limitations and feasibilities.

PubMed

Wang, Tieyu; Zhou, Yunqiao; Bi, Cencen; Lu, Yonglong; He, Guizhen; Giesy, John P

2017-07-01

There is a need to formulate water environment standards (WESs) from the current water quality criteria (WQC) in China. To this end, we briefly summarize typical mechanisms applied in several countries with longer histories of developing WESs, and three limitations to formulating WESs in China were identified. After analyzing the feasibility factors including economic development, scientific support capability and environmental policies, we realized that China is still not ready for a complete change from its current nation-wide unified WES system to a local-standard-based system. Thus, we proposed a framework for transformation from WQC to WESs in China. The framework consists of three parts, including responsibilities, processes and policies. The responsibilities include research authorization, development of guidelines, and collection of information, at both national and local levels; the processes include four steps and an impact factor system to establish water quality standards; and the policies include seven specific proposals. Copyright © 2016. Published by Elsevier B.V.

Low Quality of Basic Caregiving Environments in Child Care: Actual Reality or Artifact of Scoring?

ERIC Educational Resources Information Center

Norris, Deborah J.; Guss, Shannon

2016-01-01

Quality Rating Improvement Systems (QRIS) frequently include the Infant-Toddler Environment Rating Scale-Revised (ITERS-R) as part of rating and improving child care quality. However, studies utilizing the ITERS-R consistently report low quality, especially for basic caregiving items. This research examined whether the low scores reflected the…

[Characteristics of infertility-specific quality of life in Hungarian couples].

PubMed

Cserepes, Réka Eszter; Kőrösi, Tamás; Bugán, Antal

2014-05-18

Experiencing involuntary childlessness has a great impact on couples' quality of life. The aim of the authors was to examine the correlations among infertility-specific quality of life and depression on the level of individuals and couples. 126 couples in five fertility centers in Hungary filled out the FertiQoL and Beck Depression Inventory and answered some sociodemographic questions. In gender comparison, women reported about more depressive symptoms and poorer quality of life than men. Both in men and women, the higher depression level correlated with lower level of quality of life. Moreover, the presence of more depressive symptoms in women was related to men's poorer quality of life. The results show that differences may exist in affective responses to infertility between women and men and that female affective problems take effects on the level of the couple relationship. These findings may be useful in psychosocial support of the couples facing infertility, especially in couple counselling or couple therapy.

Perception of the quality of care, work environment and sleep characteristics of nurses working in the National Health System.

PubMed

Moreno-Casbas, María Teresa; Alonso-Poncelas, Emma; Gómez-García, Teresa; Martínez-Madrid, María José; Escobar-Aguilar, Gema

2018-03-19

To describe nurses' perception in relation to the quality of care and their work environment, as well as to describe their quality of sleep. To analyze the relationship between ward and work shift with nurses' perception of their work environment, sleep quality and day time drowsiness. A multicentre, observational and descriptive study carried out between 2012-2014 in seven hospitals of the Spanish National Health System. Work environment, work satisfaction, sleep quality and quality of patient care were evaluated through validated tools. 635 registered nurses participated in the study. Eighty-three point seven percent perceived the quality of cares as good/excellent, and 55.1% rated the work environment of their hospital as good/excellent. PES-NWI classified 39% of hospitals as unfavourable and 20% as favourable. Fifteen point four percent of the nurses had a high level of burnout and 58.3% had low burnout. Sleep quality was 6.38 for nurses working on day shifts, 6.78 for the rotational shifts and 7.93 for night shifts. Significant differences were found between subjective sleep quality score, sleep duration, sleep disturbances and daytime dysfunction. In the provision of quality care services, there is a multitude of related factors such as shift, ward, satisfaction, and nurses' perceptions of patient safety and sleep quality. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Quality of Child Care Using the Environment Rating Scales: A Meta-Analysis of International Studies

ERIC Educational Resources Information Center

Vermeer, Harriet J.; van IJzendoorn, Marinus H.; Cárcamo, Rodrigo A.; Harrison, Linda J.

2016-01-01

The current study provides a systematic examination of child care quality around the globe, using the Environment Rating Scales (ERS). Additional goals of this study are to examine associations between ERS process quality and structural features (group size, caregiver-child ratio) that underpin quality and between ERS and more proximal aspects of…

Indoor air quality of environments used for physical exercise and sports practice: Systematic review.

PubMed

Andrade, Alexandro; Dominski, Fábio Hech

2018-01-15

Systematic reviews have the potential to contribute substantially to environmental health and risk assessment. This study aimed to investigate indoor air quality of environments used for physical exercise and sports practice through a systematic review. The systematic review followed the PRISMA guidelines and was recorded in the PROSPERO registry (CRD42016036057). The search was performed using the SciELO, Science Direct, Scopus, LILACS, MEDLINE via PubMed, and SPORTDiscus databases, from their inception through April 2017. The search terms used in the databases were {air pollution" OR "air pollutants" OR "air quality"} AND {"physical exercise" OR "physical activity" OR "sport"}. The results of selected studies were divided into 5 categories for analysis: monitoring of air quality in the environment according to international guidelines, indoor-to-outdoor ratio (I/O), air quality during physical exercise, impact of air quality on health, and interventions to improve indoor air quality. Among 1281 studies screened, 34 satisfied the inclusion criteria. The monitoring of pollutants was conducted in 20 studies. CO and NO 2 were the most investigated pollutants, and guidelines were discussed in most studies. The I/O ratio was investigated in 12 studies, of which 9 showed a higher concentration of some pollutants in indoor rather than outdoor environments. Among the 34 studies selected, only 7 investigated the impact of indoor air pollution on human health. The population in most of these studies consisted of hockey players. Most studies conducted monitoring of pollutants in indoor environments used for physical exercise and sports practice. The earliest studies were conducted in ice skating rinks and the most recent evaluated gymnasiums, fitness centers, and sports centers. The CO, particulate matter, and NO 2 concentrations were the most investigated and have the longest history of investigation. These pollutants were within the limits established by guidelines in most

Measurement properties of asthma-specific quality-of-life measures: protocol for a systematic review.

PubMed

Apfelbacher, Christian; Paudyal, Priya; Bülbül, Alpaslan; Smith, Helen

2014-07-24

Asthma is a frequent chronic inflammatory disease of the airways, and the assessment of health-related quality of life (HrQoL) is important in both research and routine care. Various asthma-specific measures of HrQoL exist but there is uncertainty which measures are best suited for use in research and routine care. Therefore, the aim of the proposed research is a comprehensive systematic assessment of the measurement properties of the existing measures that were developed to measure asthma-specific quality of life. This study is a systematic review of the measurement properties of asthma-specific measures of health-related quality of life. PubMed and Embase will be searched using a selection of relevant search terms. Eligible studies will be primary empirical studies evaluating, describing or comparing measurement properties of asthma-specific HRQL tools. Eligibility assessment and data abstraction will be performed independently by two reviewers. Evidence tables will be generated for study characteristics, instrument characteristics, measurement properties and interpretability. The quality of the measurement properties will be assessed using predefined criteria. Methodological quality of studies will be assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. A best evidence synthesis will be undertaken if more than one study have investigated a particular measurement property. The proposed systematic review will produce a comprehensive assessment of measurement properties of existing measures of asthma-specific health-related quality of life. We also aim to derive recommendations in order to help researchers and practitioners alike in the choice of instrument. PROSPERO registration number: CRD42014010491.

Quality specification in haematology: the automated blood cell count.

PubMed

Buttarello, Mauro

2004-08-02

Quality specifications for automated blood cell counts include topics that go beyond the traditional analytic stage (imprecision, inaccuracy, quality control) and extend to pre- and post-analytic phases. In this review pre-analytic aspects concerning the choice of anticoagulants, maximum conservation times and differences between storage at room temperature or at 4 degrees C are considered. For the analytic phase, goals for imprecision and bias obtained with various approaches (ratio to biologic variation, state of the art, specific clinical situations) are evaluated. For the post-analytic phase, medical review criteria (algorithm, decision limit and delta check) and the structure of the report (general part and comments), which constitutes the formal act through which a laboratory communicates with clinicians, are considered. K2EDTA is considered the anticoagulant of choice for automated cell counts. Regarding storage, specimens should be analyzed as soon as possible. Storage at 4 degrees C may stabilize specimens from 24 to 72 h when complete blood count (CBC) and differential leucocyte count (DLC) is performed. For precision, analytical goals based on the state of the art are acceptable while for bias this is satisfactory only for some parameters. In haematology quality specifications for pre- and analytical phases are important, but the review criteria and the quality of the report play a central role in assuring a definite clinical value.

The Psychometric Properties and the Development of the Indicators of Quality Nursing Work Environments in Taiwan.

PubMed

Lin, Chiou-Fen; Lu, Meei-Shiow; Huang, Hsiu-Ying

2016-03-01

The nursing shortage in medical institutions in Taiwan averaged 9% in 2012, considerably higher than the 5% indicated in the literature. As a result, many hospitals have been forced to close wards or reduce beds. Despite the acute need, the percentage of registered nurses who are employed as nurses in Taiwan (60.4%) is considerably lower than those in Canada or the United States. This low rate may be because of the poor working environment for nurses in Taiwan. This study aimed to develop a set of nursing work environment quality indicators for Taiwan and to test the reliability and validity of the resulting survey tool. Multiple methods were used in this study. In Phase 1, we organized an expert panel, reviewed the literature, and conducted seven rounds of expert panel discussion and six focus group discussions with nursing directors. The goal was to draft indicators representing a quality nursing work environment to fit current conditions in Taiwan. In Phase 2, we conducted an expert review for content validity, held three public hearings, and conducted a survey. Four hundred twenty-seven questionnaires were sent out, with 381 returned. The goal was to test the content validity, construct validity, and internal consistency reliability. The study produced a set of indicators of a quality nursing work environment with eight dimensions and 65 items. The content validity index for importance and suitability dimensions were 1.0, whereas the internal consistency was 0.91. The eight dimensions were safe practice environment (16 items), quality and quantity of staff (four items), salary and welfare (seven items), professional specialization and teamwork (seven items), work simplification (five items), informatics (five items), career development (nine items), and support and caring (12 items). The overall load for the indicators was 77.57%. The developed indicators may be used to evaluate the quality of nursing work environments. Furthermore, the indicators may be used

7 CFR 58.735 - Quality specifications for raw materials.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 3 2011-01-01 2011-01-01 false Quality specifications for raw materials. 58.735 Section 58.735 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING... specifications for raw materials. (a) Cheddar colby, washed or soaked curd, granular or stirred curd cheese...

Television Viewing, Educational Quality of the Home Environment, and School Readiness.

ERIC Educational Resources Information Center

Clarke, Angela Teresa; Kurtz-Costes, Beth

1997-01-01

Researchers examined relationships among children's television viewing, school readiness, parental employment, and the home environment's educational quality. Thirty low-income parents completed surveys. Their preschoolers completed IQ and school readiness assessments. Television viewing adversely related to school readiness and the home…

Quality specifications for articles of botanical origin from the United States Pharmacopeia.

PubMed

Ma, Cuiying; Oketch-Rabah, Hellen; Kim, Nam-Cheol; Monagas, Maria; Bzhelyansky, Anton; Sarma, Nandakumara; Giancaspro, Gabriel

2018-06-01

In order to define appropriate quality of botanical dietary supplements, botanical drugs, and herbal medicines, the United States Pharmacopeia (USP) and the Herbal Medicines Compendium (HMC) contain science-based quality standards that include multiple interrelated tests to provide a full quality characterization for each article in terms of its identity, purity, and content. To provide a comprehensive description of the pharmacopeial tests and requirements for articles of botanical origin in the aforementioned compendia. Selective chromatographic procedures, such as high-performance liquid chromatography (HPLC) and high-performance thin-layer chromatography (HPTLC), are used as Identification tests in pharmacopeial monographs to detect species substitution or other confounders. HPLC quantitative tests are typically used to determine the content of key constituents, i.e., the total or individual amount of plant secondary metabolites that are considered bioactive constituents or analytical marker compounds. Purity specifications are typically set to limit the content of contaminants such as toxic elements, pesticides, and fungal toxins. Additional requirements highlight the importance of naming, definition, use of reference materials, and packaging/storage conditions. Technical requirements for each section of the monographs were illustrated with specific examples. Tests were performed on authentic samples using pharmacopeial reference standards. The chromatographic analytical procedures were validated to provide characteristic profiles for the identity and/or accurate determination of the content of quality markers. The multiple tests included in each monograph complement each other to provide an appropriate pharmacopeial quality characterization for the botanicals used as herbal medicines and dietary supplements. The monographs provide detailed specifications for identity, content of bioactive constituents or quality markers, and limits of contaminants

SLS-SPEC-159 Cross-Program Design Specification for Natural Environments (DSNE) Revision E

NASA Technical Reports Server (NTRS)

Roberts, Barry C.

2017-01-01

The DSNE completes environment-related specifications for architecture, system-level, and lower-tier documents by specifying the ranges of environmental conditions that must be accounted for by NASA ESD Programs. To assure clarity and consistency, and to prevent requirements documents from becoming cluttered with extensive amounts of technical material, natural environment specifications have been compiled into this document. The intent is to keep a unified specification for natural environments that each Program calls out for appropriate application. This document defines the natural environments parameter limits (maximum and minimum values, energy spectra, or precise model inputs, assumptions, model options, etc.), for all ESD Programs. These environments are developed by the NASA Marshall Space Flight Center (MSFC) Natural Environments Branch (MSFC organization code: EV44). Many of the parameter limits are based on experience with previous programs, such as the Space Shuttle Program. The parameter limits contain no margin and are meant to be evaluated individually to ensure they are reasonable (i.e., do not apply unrealistic extreme-on-extreme conditions). The natural environments specifications in this document should be accounted for by robust design of the flight vehicle and support systems. However, it is understood that in some cases the Programs will find it more effective to account for portions of the environment ranges by operational mitigation or acceptance of risk in accordance with an appropriate program risk management plan and/or hazard analysis process. The DSNE is not intended as a definition of operational models or operational constraints, nor is it adequate, alone, for ground facilities which may have additional requirements (for example, building codes and local environmental constraints). "Natural environments," as the term is used here, refers to the environments that are not the result of intended human activity or intervention. It

Sex-specific genotype-by-environment interactions for cuticular hydrocarbon expression in decorated crickets, Gryllodes sigillatus: implications for the evolution of signal reliability.

PubMed

Weddle, C B; Mitchell, C; Bay, S K; Sakaluk, S K; Hunt, J

2012-10-01

Phenotypic traits that convey information about individual identity or quality are important in animal social interactions, and the degree to which such traits are influenced by environmental variation can have profound effects on the reliability of these cues. Using inbred genetic lines of the decorated cricket, Gryllodes sigillatus, we manipulated diet quality to test how the cuticular hydrocarbon (CHC) profiles of males and females respond across two different nutritional rearing environments. There were significant differences between lines in the CHC profiles of females, but the effect of diet was not quite statistically significant. There was no significant genotype-by-environment interaction (GEI), suggesting that environmental effects on phenotypic variation in female CHCs are independent of genotype. There was, however, a significant effect of GEI for males, with changes in both signal quantity and content, suggesting that environmental effects on phenotypic expression of male CHCs are dependent on genotype. The differential response of male and female CHC expression to variation in the nutritional environment suggests that these chemical cues may be under sex-specific selection for signal reliability. Female CHCs show the characteristics of reliable cues of identity: high genetic variability, low condition dependence and a high degree of genetic determination. This supports earlier work showing that female CHCs are used in self-recognition to identify previous mates and facilitate polyandry. In contrast, male CHCs show the characteristics of reliable cues of quality: condition dependence and a relatively higher degree of environmental determination. This suggests that male CHCs are likely to function as cues of underlying quality during mate choice and/or male dominance interactions. © 2012 The Authors. Journal of Evolutionary Biology © 2012 European Society For Evolutionary Biology.

Quality of the Preschool and Home Environment as a Context of Children's Language Development

ERIC Educational Resources Information Center

Umek, Ljubica Marjanovic; Kranjc, Simona; Fekonja, Urska; Bajc, Katja

2006-01-01

Studies in the area of developmental psychology--especially those carried out in the past thirty years--show that preschool quality, both at the structural and process levels, in combination with the quality of the family environment influences various areas of children's development and learning. The goal of this study is to determine the effect…

[Correspondence analysis between traditional commercial specifications and quantitative quality indices of Notopterygii Rhizoma et Radix].

PubMed

Jiang, Shun-Yuan; Sun, Hong-Bing; Sun, Hui; Ma, Yu-Ying; Chen, Hong-Yu; Zhu, Wen-Tao; Zhou, Yi

2016-03-01

This paper aims to explore a comprehensive assessment method combined traditional Chinese medicinal material specifications with quantitative quality indicators. Seventy-six samples of Notopterygii Rhizoma et Radix were collected on market and at producing areas. Traditional commercial specifications were described and assigned, and 10 chemical components and volatile oils were determined for each sample. Cluster analysis, Fisher discriminant analysis and correspondence analysis were used to establish the relationship between the traditional qualitative commercial specifications and quantitative chemical indices for comprehensive evaluating quality of medicinal materials, and quantitative classification of commercial grade and quality grade. A herb quality index (HQI) including traditional commercial specifications and chemical components for quantitative grade classification were established, and corresponding discriminant function were figured out for precise determination of quality grade and sub-grade of Notopterygii Rhizoma et Radix. The result showed that notopterol, isoimperatorin and volatile oil were the major components for determination of chemical quality, and their dividing values were specified for every grade and sub-grade of the commercial materials of Notopterygii Rhizoma et Radix. According to the result, essential relationship between traditional medicinal indicators, qualitative commercial specifications, and quantitative chemical composition indicators can be examined by K-mean cluster, Fisher discriminant analysis and correspondence analysis, which provide a new method for comprehensive quantitative evaluation of traditional Chinese medicine quality integrated traditional commodity specifications and quantitative modern chemical index. Copyright© by the Chinese Pharmaceutical Association.

Measurement properties of rheumatoid arthritis-specific quality-of-life questionnaires: systematic review of the literature.

PubMed

Lee, Jiyeon; Kim, Soo Hyun; Moon, Seung Hei; Lee, Eun-Hyun

2014-12-01

This study conducted a systematic review of the methodological quality of the psychometric evaluation process and the quality of measurement properties of rheumatoid arthritis (RA)-specific health-related quality-of-life (HRQOL) questionnaires with the purpose of obtaining the best evidence to help in the selection of the most appropriate instrument for measuring HRQOL in RA patients. A systematic literature search was performed to identify RA-specific HRQOL questionnaires in databases. The methodological quality of the studies was assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. The quality of the measurement properties was assessed using quality criteria. The evidence regarding the measurement properties was pooled using best-evidence synthesis, with considerations of the number and methodological quality of the studies, and the consistency of their findings in terms of the quality of the measurement properties. The search identified 37 studies describing 9 instruments. Best-evidence synthesis suggested that the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire had the strongest positive evidence, especially with respect to reliability, measurement error, and content validity, and moderate positive evidence with respect to hypothesis testing and responsiveness. The current evidence suggests that the best-validated instrument among the RA-specific HRQOL measures is the RAQoL questionnaire in terms of both methodological quality in the process of psychometric evaluation and the quality of the measurement properties. However, there is limited evidence regarding internal consistency and structural validity of the RAQoL. Further efforts are warranted to establish the psychometric quality of this questionnaire.

The ontogeny of tolerance curves: habitat quality vs. acclimation in a stressful environment.

PubMed

Nougué, Odrade; Svendsen, Nils; Jabbour-Zahab, Roula; Lenormand, Thomas; Chevin, Luis-Miguel

2016-11-01

Stressful environments affect life-history components of fitness through (i) instantaneous detrimental effects, (ii) historical (carry-over) effects and (iii) history-by-environment interactions, including acclimation effects. The relative contributions of these different responses to environmental stress are likely to change along life, but such ontogenic perspective is often overlooked in studies of tolerance curves, precluding a better understanding of the causes of costs of acclimation, and more generally of fitness in temporally fine-grained environments. We performed an experiment in the brine shrimp Artemia to disentangle these different contributions to environmental tolerance, and investigate how they unfold along life. We placed individuals from three clones of A. parthenogenetica over a range of salinities during a week, before transferring them to a (possibly) different salinity for the rest of their lives. We monitored individual survival at repeated intervals throughout life, instead of measuring survival or performance at a given point in time, as commonly done in acclimation experiments. We then designed a modified survival analysis model to estimate phase-specific hazard rates, accounting for the fact that individuals may share the same treatment for only part of their lives. Our approach allowed us to distinguish effects of salinity on (i) instantaneous mortality in each phase (habitat quality effects), (ii) mortality later in life (history effects) and (iii) their interaction. We showed clear effects of early salinity on late survival and interactions between effects of past and current environments on survival. Importantly, analysis of the ontogenetic dynamics of the tolerance curve reveals that acclimation affects different parts of the curve at different ages. Adopting a dynamical view of the ontogeny of tolerance curve should prove useful for understanding niche limits in temporally changing environments, where the full sequence of

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 ...

Understanding the Role of the Professional Practice Environment on Quality of Care in Magnet® and Non-Magnet Hospitals

PubMed Central

Stimpfel, Amy Witkoski; Rosen, Jennifer E.; McHugh, Matthew D.

2017-01-01

OBJECTIVE The aim of this study was to explore the relationship between Magnet Recognition® and nurse-reported quality of care. BACKGROUND Magnet® hospitals are recognized for nursing excellence and quality patient outcomes; however, few studies have explored contributing factors for these superior outcomes. METHODS This was a secondary analysis of linked nurse survey data, hospital administrative data, and a listing of American Nurses Credentialing Center Magnet hospitals. Multivariate regressions were modeled before and after propensity score matching to assess the relationship between Magnet status and quality of care. A mediation model assessed the indirect effect of the professional practice environment on quality of care. RESULTS Nurse-reported quality of care was significantly associated with Magnet Recognition after matching. The professional practice environment mediates the relationship between Magnet status and quality of care. CONCLUSION A prominent feature of Magnet hospitals, a professional practice environment that is supportive of nursing, plays a role in explaining why Magnet hospitals have better nurse-reported quality of care. PMID:26426138

Understanding the Role of the Professional Practice Environment on Quality of Care in Magnet® and Non-Magnet Hospitals

PubMed Central

Stimpfel, Amy Witkoski; Rosen, Jennifer E.; McHugh, Matthew D.

2014-01-01

OBJECTIVE The aim of this study was to explore the relationship between Magnet Recognition® and nurse-reported quality of care. BACKGROUND Magnet® hospitals are recognized for nursing excellence and quality patient outcomes; however, few studies have explored contributing factors for these superior outcomes. METHODS This was a secondary analysis of linked nurse survey data, hospital administrative data, and a listing of American Nurses Credentialing Center Magnet hospitals. Multivariate regressions were modeled before and after propensity score matching to assess the relationship between Magnet status and quality of care. A mediation model assessed the indirect effect of the professional practice environment on quality of care. RESULTS Nurse-reported quality of care was significantly associated with Magnet Recognition after matching. The professional practice environment mediates the relationship between Magnet status and quality of care. CONCLUSION A prominent feature of Magnet hospitals, a professional practice environment that is supportive of nursing, plays a role in explaining why Magnet hospitals have better nurse-reported quality of care. PMID:24316613

Genetic correlations and sex-specific adaptation in changing environments.

PubMed

Connallon, Tim; Hall, Matthew D

2016-10-01

Females and males have conflicting evolutionary interests. Selection favors the evolution of different phenotypes within each sex, yet divergence between the sexes is constrained by the shared genetic basis of female and male traits. Current theory predicts that such "sexual antagonism" should be common: manifesting rapidly during the process of adaptation, and slow in its resolution. However, these predictions apply in temporally stable environments. Environmental change has been shown empirically to realign the direction of selection acting on shared traits and thereby alleviate signals of sexually antagonistic selection. Yet there remains no theory for how common sexual antagonism should be in changing environments. Here, we analyze models of sex-specific evolutionary divergence under directional and cyclic environmental change, and consider the impact of genetic correlations on long-run patterns of sex-specific adaptation. We find that environmental change often aligns directional selection between the sexes, even when they have divergent phenotypic optima. Nevertheless, some forms of environmental change generate persistent sexually antagonistic selection that is difficult to resolve. Our results reinforce recent empirical observations that changing environmental conditions alleviate conflict between males and females. They also generate new predictions regarding the scope for sexually antagonistic selection and its resolution in changing environments. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

Headache-specific locus of control and migraine-related quality of life: understanding the role of anxiety

PubMed Central

Grinberg, Amy S.; Seng, Elizabeth K.

2017-01-01

Purpose This study examined the relationship between headache-specific locus of control (HSLC) and migraine-related quality of life, and anxiety as a mediator of this relationship. Methods Two hundred and thirty-two people with severe migraine participated in the Treatment of Severe Migraine trial. At baseline, participants completed self-report questionnaires of headache-specific locus of control (HSLC; subscales = Internal, Chance, and Medical Professionals), anxiety, and migraine-related quality of life. Correlations examined relationships between HSLC, anxiety, and migraine-related quality of life; ordinary least squares regression evaluated anxiety as a mediator of the relationship between HSLC and migraine-related quality of life. Results Higher internal HSLC was related to higher overall migraine-related quality of life (ps < .05) and emotion function impairments (p = .012). Anxiety mediated the relationship between internal HSLC and all measures of migraine-specific quality of life (ps < .05). Higher external (medical professionals and chance) HSLC was related to higher migraine-related quality of life impairments (all ps < .001). Conclusions All HSLC beliefs are associated with higher migraine-related quality of life impairments. Anxiety mediates the relationship between internal HSLC and migraine-related quality of life. PMID:27488417

Work environment characteristics associated with quality of care in Dutch nursing homes: A cross-sectional study.

PubMed

Backhaus, Ramona; Rossum, Erik van; Verbeek, Hilde; Halfens, Ruud J G; Tan, Frans E S; Capezuti, Elizabeth; Hamers, Jan P H

2017-01-01

A lack of relationship between direct care staffing levels and quality of care, as found in prior studies, underscores the importance of considering the quality of the work environment instead of only considering staff ratios. Only a few studies, however, have combined direct care staffing with work environment characteristics when assessing the relationship with quality of care in nursing homes. To examine the relationship between direct care staffing levels, work environment characteristics and perceived quality of care in Dutch nursing homes. Cross-sectional, observational study in cooperation with the Dutch Prevalence Measurement of Care Problems. Twenty-four somatic and 31 psychogeriatric wards from 21 nursing homes in the Netherlands. Forty-one ward managers and 274 staff members (registered nurses or certified nurse assistants) from the 55 participating wards. Ward rosters were discussed with managers to obtain an insight into direct care staffing levels (i.e, total direct care staff hours per resident per day). Participating staff members completed a questionnaire on work environment characteristics (i.e., ward culture, team climate, communication and coordination, role model availability, and multidisciplinary collaboration) and they rated the quality of care in their ward. Data were analyzed using multilevel linear regression analyses (random intercept). Separate analyses were conducted for somatic and psychogeriatric wards. In general, staff members were satisfied with the quality of care in their wards. Staff members from psychogeriatric wards scored higher on the statement 'In the event that a family member had to be admitted to a nursing home now, I would recommend this ward'. A better team climate was related to better perceived quality of care in both ward types (p≤0.020). In somatic wards, there was a positive association between multidisciplinary collaboration and agreement by staff of ward recommendation for a family member (p=0.028). In

Quality assurance of the clinical learning environment in Austria: Construct validity of the Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T scale).

PubMed

Mueller, Gerhard; Mylonas, Demetrius; Schumacher, Petra

2018-07-01

Within nursing education, the clinical learning environment is of a high importance in regards to the development of competencies and abilities. The organization, atmosphere, and supervision in the clinical learning environment are only a few factors that influence this development. In Austria there is currently no valid instrument available for the evaluation of influencing factors. The aim of the study was to test the construct validity with principal component analysis as well as the internal consistency of the German Clinical Learning Environment, Supervision and Teacher Scale (CLES+T scale) in Austria. The present validation study has a descriptive-quantitative cross-sectional design. The sample consisted of 385 nursing students from thirteen training institutions in Austria. The data collection was carried out online between March and April 2016. Starting with a polychoric correlation matrix, a parallel analysis with principal component extraction and promax rotation was carried out due to the ordinal data. The exploratory ordinal factor analysis supported a four-component solution and explained 73% of the total variance. The internal consistency of all 25 items reached a Cronbach's α of 0.95 and the four components ranged between 0.83 and 0.95. The German version of the CLES+T scale seems to be a useful instrument for identifying potential areas of improvement in clinical practice in order to derive specific quality measures for the practical learning environment. Copyright © 2018 Elsevier Ltd. All rights reserved.

Long-term follow-up of disease-specific quality of life after bariatric surgery.

PubMed

Biron, Simon; Biertho, Laurent; Marceau, Simon; Lacasse, Yves

2018-05-01

Substantial improvements in health-related quality of life measured by generic questionnaires (most often the Short Form-36) have been noted over the long term in patients with morbid obesity who had undergone bariatric surgery. To obtain long-term follow-up data on disease-specific quality of life in patients who underwent bariatric surgery (biliopancreatic diversion with duodenal switch) in 2007 to 2008. Québec Heart and Lung Institute, Québec, Canada. This study is a follow-up of the validation study, the Laval Questionnaire, an obesity-specific measure of health-related quality of life developed to be used in clinical trials. Patients who contributed to the validation study in 2007 to 2008 were administered the Laval Questionnaire again at long-term follow-up. Of 112 patients who contributed to the validation study, 90 were available for this long-term follow-up study (retention rate: 80%). Median follow-up was 8.8 years. For all 6 domains of the Laval Questionnaire, the improvements in quality-of-life scores were much larger than our best estimate of the minimal clinically important difference. In others, we observed some decline in quality-of-life scores over time after initial changes that occurred 1 to 2 years after surgery, during the so-called "honeymoon period." Improvements in quality of life were clearly related to surgery. This study confirms that bariatric surgery using biliopancreatic diversion with duodenal switch improves disease-specific quality of life in the short and long term. It also demonstrates that the Laval Questionnaire is responsive to treatment-induced changes. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Can the national surgical quality improvement program provide surgeon-specific outcomes?

PubMed

Kuhnen, Angela H; Marcello, Peter W; Roberts, Patricia L; Read, Thomas E; Schoetz, David J; Rusin, Lawrence C; Hall, Jason F; Ricciardi, Rocco

2015-02-01

Efforts to improve the quality of surgical care and reduce morbidity and mortality have resulted in outcomes reporting at the service and institutional level. Surgeon-specific outcomes are not readily available. The aim of this study is to compare surgeon-specific outcomes from the National Surgical Quality Improvement Program and 100% capture institutional quality data. We conducted a cohort study evaluating institutional and surgeon-specific outcomes following colorectal surgery procedures at 1 institution over 5 years. All patients who underwent an operation by a colorectal surgeon at Lahey Hospital & Medical Center from January 1, 2008 through December 31, 2012 were identified. Thirty-day mortality, reoperation, urinary tract infection, deep vein thrombosis, pneumonia, superficial surgical site infection, and organ space infection were the primary outcomes measured. We compared annual and 5-year institutional and surgeon-specific adverse event rates between the data sets. In addition, we categorized individual surgeons as low-outlier, average, or high-outlier in relation to aggregate averages and determined the concordance between the data sets in identifying outliers. Concordance was designated if the 2 databases classified outlier status similarly for the same adverse event category. In the 100% capture institutional data, 6459 operative encounters were identified in comparison with 1786 National Surgical Quality Improvement Program encounters (28% sampled). Annual aggregate adverse event rates were similar between the institutional data and the National Surgical Quality Improvement Program. For annual surgeon-specific comparisons, concordance in identifying outliers between the 2 data sets was 51.4%, and gross discordance between outlier status was in 8.2%. Five-year surgeon-specific comparisons demonstrated 59% concordance in identifying outlier status with 8.2% gross discordance for the group. The inclusion of data from only 1 academic referral center is a

Resident-Specific Morbidity Reduced Following ACS NSQIP Data-Driven Quality Program.

PubMed

Turrentine, Florence E; Hanks, John B; Tracci, Megan C; Jones, R Scott; Schirmer, Bruce D; Smith, Philip W

2018-04-16

The Accreditation Council for Graduate Medical Education Milestone Project for general surgery provided a more robust method for developing and tracking residents' competence. This framework enhanced systematic and progressive development of residents' competencies in surgical quality improvement. A 22-month interactive, educational program based on resident-specific surgical outcomes data culminated in a quality improvement project for postgraduate year 4 surgery residents. Self- assessment, quality knowledge test, and resident-specific American College of Surgeons National Surgical Quality Improvement Program Quality In-Training Initiative morbidity were compared before and after the intervention. Quality in-training initiative morbidity decreased from 25% (82/325) to 18% (93/517), p = 0.015 despite residents performing more complex cases. All participants achieved level 4 competency (4/4) within the general surgery milestones improvement of care, practice-based learning and improvement competency. Institutional American College of Surgeons National Surgical Quality Improvement Program general surgery morbidity improved from the ninth to the sixth decile. Quality assessment and improvement self-assessment postintervention scores (M = 23.80, SD = 4.97) were not significantly higher than preintervention scores (M = 19.20, SD = 5.26), p = 0.061. Quality Improvement Knowledge Application Tool postintervention test scores (M = 17.4, SD = 4.88), were not significantly higher than pretest scores (M = 13.2, SD = 1.92), p = 0.12. Sharing validated resident-specific clinical data with participants was associated with improved surgical outcomes. Participating fourth year surgical residents achieved the highest score, a level 4, in the practice based learning and improvement competency of the improvement of care practice domain and observed significantly reduced surgical morbidity for cases in which they participated. Copyright © 2018. Published by Elsevier Inc.

Regulatory environment for allergen-specific immunotherapy.

PubMed

Kaul, S; May, S; Lüttkopf, D; Vieths, Stefan

2011-06-01

Products for specific immunotherapy (SIT) are medicinal products according to the European Regulations. To obtain a marketing authorization (MA) within the European Community, the quality, safety and efficacy have to be proven. During the development phase of a medicinal product, applicants have the opportunity to apply for scientific advice by national competent authorities or the European Medicines Agency (EMA) to compile a suitable development plan for the examination of quality and performance of nonclinical and clinical trials. Moreover, a paediatric investigation plan has to be submitted to the Paediatric Committee of the EMA and has to be approved before submission of an application for MA. Several regulatory procedures exist for obtaining a MA in the European Community. The national procedure leads only to marketability in one country whereas the Mutual Recognition, the Decentralized and Centralized Procedures (CP) are intended for MA in several or all member states of the European Union. The CP is mandatory for certain medicinal products, for example for drug substances derived by biotechnological processes such as recombinant allergens. Named Patient Products for SIT are a specialty because they are manufactured on the basis of an individual prescription and marketed without a MA. © 2011 John Wiley & Sons A/S.

The importance of lake-specific characteristics for water quality across the continental United States.

PubMed

Read, Emily K; Patil, Vijay P; Oliver, Samantha K; Hetherington, Amy L; Brentrup, Jennifer A; Zwart, Jacob A; Winters, Kirsten M; Corman, Jessica R; Nodine, Emily R; Woolway, R Iestyn; Dugan, Hilary A; Jaimes, Aline; Santoso, Arianto B; Hong, Grace S; Winslow, Luke A; Hanson, Paul C; Weathers, Kathleen C

2015-06-01

Lake water quality is affected by local and regional drivers, including lake physical characteristics, hydrology, landscape position, land cover, land use, geology, and climate. Here, we demonstrate the utility of hypothesis testing within the landscape limnology framework using a random forest algorithm on a national-scale, spatially explicit data set, the United States Environmental Protection Agency's 2007 National Lakes Assessment. For 1026 lakes, we tested the relative importance of water quality drivers across spatial scales, the importance of hydrologic connectivity in mediating water quality drivers, and how the importance of both spatial scale and connectivity differ across response variables for five important in-lake water quality metrics (total phosphorus, total nitrogen, dissolved organic carbon, turbidity, and conductivity). By modeling the effect of water quality predictors at different spatial scales, we found that lake-specific characteristics (e.g., depth, sediment area-to-volume ratio) were important for explaining water quality (54-60% variance explained), and that regionalization schemes were much less effective than lake specific metrics (28-39% variance explained). Basin-scale land use and land cover explained between 45-62% of variance, and forest cover and agricultural land uses were among the most important basin-scale predictors. Water quality drivers did not operate independently; in some cases, hydrologic connectivity (the presence of upstream surface water features) mediated the effect of regional-scale drivers. For example, for water quality in lakes with upstream lakes, regional classification schemes were much less effective predictors than lake-specific variables, in contrast to lakes with no upstream lakes or with no surface inflows. At the scale of the continental United States, conductivity was explained by drivers operating at larger spatial scales than for other water quality responses. The current regulatory practice of using

Diagnostic Air Quality Model Evaluation of Source-Specific ...

EPA Pesticide Factsheets

Ambient measurements of 78 source-specific tracers of primary and secondary carbonaceous fine particulate matter collected at four midwestern United States locations over a full year (March 2004–February 2005) provided an unprecedented opportunity to diagnostically evaluate the results of a numerical air quality model. Previous analyses of these measurements demonstrated excellent mass closure for the variety of contributing sources. In this study, a carbon-apportionment version of the Community Multiscale Air Quality (CMAQ) model was used to track primary organic and elemental carbon emissions from 15 independent sources such as mobile sources and biomass burning in addition to four precursor-specific classes of secondary organic aerosol (SOA) originating from isoprene, terpenes, aromatics, and sesquiterpenes. Conversion of the source-resolved model output into organic tracer concentrations yielded a total of 2416 data pairs for comparison with observations. While emission source contributions to the total model bias varied by season and measurement location, the largest absolute bias of −0.55 μgC/m3 was attributed to insufficient isoprene SOA in the summertime CMAQ simulation. Biomass combustion was responsible for the second largest summertime model bias (−0.46 μgC/m3 on average). Several instances of compensating errors were also evident; model underpredictions in some sectors were masked by overpredictions in others. The National Exposure Research L

Professional Quality of Life of Veterans Affairs Staff and Providers in a Patient-Centered Care Environment.

PubMed

Locatelli, Sara M; LaVela, Sherri L

2015-01-01

Changes to the work environment prompted by the movement toward patient-centered care have the potential to improve occupational stress among health care workers by improving team-based work activities, collaboration, and employee-driven quality improvement. This study was conducted to examine professional quality of life among providers at patient-centered care pilot facilities. Surveys were conducted with 76 Veterans Affairs employees/providers at facilities piloting patient-centered care interventions, to assess demographics, workplace practices and views (team-based environment, employee voice, quality of communication, and turnover intention), and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress).Professional quality-of-life subscales were not related to employee position type, age, or gender. Employee voice measures were related to lower burnout and higher compassion satisfaction. In addition, employees who were considering leaving their position showed higher burnout and lower compassion satisfaction scores. None of the work practices showed relationships with secondary traumatic stress.

Validity of using photographs to simulate visible qualities of forest recreation environments

Treesearch

Robin E. Hoffman; James F. Palmer

1995-01-01

Forest recreation managers and researchers interested in conserving and improving the visual quality and recreation opportunities available in forest environments must often resort to simulations as a means of illustrating alternatives for potential users to evaluate. This paper reviews the results of prior research evaluating the validity of using photographic...

Relationship among Medical Student Resilience, Educational Environment and Quality of Life.

PubMed

Tempski, Patricia; Santos, Itamar S; Mayer, Fernanda B; Enns, Sylvia C; Perotta, Bruno; Paro, Helena B M S; Gannam, Silmar; Peleias, Munique; Garcia, Vera Lucia; Baldassin, Sergio; Guimaraes, Katia B; Silva, Nilson R; da Cruz, Emirene M T Navarro; Tofoli, Luis F; Silveira, Paulo S P; Martins, Milton A

2015-01-01

Resilience is a capacity to face and overcome adversities, with personal transformation and growth. In medical education, it is critical to understand the determinants of a positive, developmental reaction in the face of stressful, emotionally demanding situations. We studied the association among resilience, quality of life (QoL) and educational environment perceptions in medical students. We evaluated data from a random sample of 1,350 medical students from 22 Brazilian medical schools. Information from participants included the Wagnild and Young's resilience scale (RS-14), the Dundee Ready Educational Environment Measure (DREEM), the World Health Organization Quality of Life questionnaire - short form (WHOQOL-BREF), the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI). Full multiple linear regression models were adjusted for sex, age, year of medical course, presence of a BDI score ≥ 14 and STAI state or anxiety scores ≥ 50. Compared to those with very high resilience levels, individuals with very low resilience had worse QoL, measured by overall (β=-0.89; 95% confidence interval =-1.21 to -0.56) and medical-school related (β=-0.85; 95%CI=-1.25 to -0.45) QoL scores, environment (β=-6.48; 95%CI=-10.01 to -2.95), psychological (β=-22.89; 95%CI=-25.70 to -20.07), social relationships (β=-14.28; 95%CI=-19.07 to -9.49), and physical health (β=-10.74; 95%CI=-14.07 to -7.42) WHOQOL-BREF domain scores. They also had a worse educational environment perception, measured by global DREEM score (β=-31.42; 95%CI=-37.86 to -24.98), learning (β=-7.32; 95%CI=-9.23 to -5.41), teachers (β=-5.37; 95%CI=-7.16 to -3.58), academic self-perception (β=-7.33; 95%CI=-8.53 to -6.12), atmosphere (β=-8.29; 95%CI=-10.13 to -6.44) and social self-perception (β=-3.12; 95%CI=-4.11 to -2.12) DREEM domain scores. We also observed a dose-response pattern across resilience level groups for most measurements. Medical students with higher resilience levels

Assessing the Culture and Climate for Quality Improvement in the Work Environment. AIR 1994 Annual Forum Paper.

ERIC Educational Resources Information Center

Cameron, Kim; And Others

This study attempted to develop a reliable and valid instrument for assessing work environment and continuous quality improvement efforts in the non-academic sectors of colleges and universities particularly those institutions who have adopted Total Quality Management programs. A model of a work environment for continuous quality improvement was…

Quality Assurance Specifications for Planetary Protection Assays

NASA Astrophysics Data System (ADS)

Baker, Amy

As the European Space Agency planetary protection (PP) activities move forward to support the ExoMars and other planetary missions, it will become necessary to increase staffing of labo-ratories that provide analyses for these programs. Standardization of procedures, a comprehen-sive quality assurance program, and unilateral training of personnel will be necessary to ensure that the planetary protection goals and schedules are met. The PP Quality Assurance/Quality Control (QAQC) program is designed to regulate and monitor procedures performed by labora-tory personnel to ensure that all work meets data quality objectives through the assembly and launch process. Because personnel time is at a premium and sampling schedules are often de-pendent on engineering schedules, it is necessary to have flexible staffing to support all sampling requirements. The most productive approach to having a competent and flexible work force is to establish well defined laboratory procedures and training programs that clearly address the needs of the program and the work force. The quality assurance specification for planetary protection assays has to ensure that labora-tories and associated personnel can demonstrate the competence to perform assays according to the applicable standard AD4. Detailed subjects included in the presentation are as follows: • field and laboratory control criteria • data reporting • personnel training requirements and certification • laboratory audit criteria. Based upon RD2 for primary and secondary validation and RD3 for data quality objectives, the QAQC will provide traceable quality assurance safeguards by providing structured laboratory requirements for guidelines and oversight including training and technical updates, standardized documentation, standardized QA/QC checks, data review and data archiving.

Instruments evaluating the quality of the clinical learning environment in nursing education: A systematic review of psychometric properties.

PubMed

Mansutti, Irene; Saiani, Luisa; Grassetti, Luca; Palese, Alvisa

2017-03-01

The clinical learning environment is fundamental to nursing education paths, capable of affecting learning processes and outcomes. Several instruments have been developed in nursing education, aimed at evaluating the quality of the clinical learning environments; however, no systematic review of the psychometric properties and methodological quality of these studies has been performed to date. The aims of the study were: 1) to identify validated instruments evaluating the clinical learning environments in nursing education; 2) to evaluate critically the methodological quality of the psychometric property estimation used; and 3) to compare psychometric properties across the instruments available. A systematic review of the literature (using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines) and an evaluation of the methodological quality of psychometric properties (using the COnsensus-based Standards for the selection of health Measurement INstruments guidelines). The Medline and CINAHL databases were searched. Eligible studies were those that satisfied the following criteria: a) validation studies of instruments evaluating the quality of clinical learning environments; b) in nursing education; c) published in English or Italian; d) before April 2016. The included studies were evaluated for the methodological quality of the psychometric properties measured and then compared in terms of both the psychometric properties and the methodological quality of the processes used. The search strategy yielded a total of 26 studies and eight clinical learning environment evaluation instruments. A variety of psychometric properties have been estimated for each instrument, with differing qualities in the methodology used. Concept and construct validity were poorly assessed in terms of their significance and rarely judged by the target population (nursing students). Some properties were rarely considered (e.g., reliability, measurement error

Sex-specific life history responses to nymphal diet quality and immune status in a field cricket.

PubMed

Kelly, C D; Neyer, A A; Gress, B E

2014-02-01

Individual fitness is expected to benefit from earlier maturation at a larger body size and higher body condition. However, poor nutritional quality or high prevalence of disease make this difficult because individuals either cannot acquire sufficient resources or must divert resources to other fitness-related traits such as immunity. Under such conditions, individuals are expected to mature later at a smaller body size and in poorer body condition. Moreover, the juvenile environment can also produce longer-term effects on adult fitness by causing shifts in resource allocation strategies that could alter investment in immune function and affect adult lifespan. We manipulated diet quality and immune status of juvenile Texas field crickets, Gryllus texensis, to investigate how poor developmental conditions affect sex-specific investment in fitness-related traits. As predicted, a poor juvenile diet was related to smaller mass and body size at eclosion in both sexes. However, our results also reveal sexually dimorphic responses to different facets of the rearing environment: female life history decisions are affected more by diet quality, whereas males are affected more by immune status. We suggest that females respond to decreased nutritional income because this threatens their ability to achieve a large adult body size, whereas male fitness is more dependent on reaching adulthood and so they invest in immunity and survival to eclosion. © 2013 The Authors. Journal of Evolutionary Biology © 2013 European Society For Evolutionary Biology.

The Health Effects of a Forest Environment on Subclinical Cardiovascular Disease and Heath-Related Quality of Life

PubMed Central

Tsao, Tsung-Ming; Wang, Ya-Nan; Lin, Heng-Lun; Wu, Chang-Fu; Hwang, Jing-Shiang; Hsu, Sandy-H.J.; Chao, Hsing; Chuang, Kai-Jen; Chou, Charles- CK.

2014-01-01

Background Assessment of health effects of a forest environment is an important emerging area of public health and environmental sciences. Purpose To demonstrate the long-term health effects of living in a forest environment on subclinical cardiovascular diseases (CVDs) and health-related quality of life (HRQOL) compared with that in an urban environment. Materials and Methods This study included the detailed health examination and questionnaire assessment of 107 forest staff members (FSM) and 114 urban staff members (USM) to investigate the long-term health effects of a forest environment. Air quality monitoring between the forest and urban environments was compared. In addition, work-related factors and HRQOL were evaluated. Results Levels of total cholesterol, low-density lipoprotein cholesterol, and fasting glucose in the USM group were significantly higher than those in the FSM group. Furthermore, a significantly higher intima-media thickness of the internal carotid artery was found in the USM group compared with that in the FSM group. Concentrations of air pollutants, such as NO, NO2, NOx, SO2, CO, PM2.5, and PM10 in the forest environment were significantly lower compared with those in the outdoor urban environment. Working hours were longer in the FSM group; however, the work stress evaluation as assessed by the job content questionnaire revealed no significant differences between FSM and USM. HRQOL evaluated by the World Health Organization Quality of Life-BREF questionnaire showed FSM had better HRQOL scores in the physical health domain. Conclusions This study provides evidence of the potential beneficial effects of forest environments on CVDs and HRQOL. PMID:25068265

The health effects of a forest environment on subclinical cardiovascular disease and heath-related quality of life.

PubMed

Tsao, Tsung-Ming; Tsai, Ming-Jer; Wang, Ya-Nan; Lin, Heng-Lun; Wu, Chang-Fu; Hwang, Jing-Shiang; Hsu, Sandy-H J; Chao, Hsing; Chuang, Kai-Jen; Chou, Charles-C K; Su, Ta-Chen

2014-01-01

Assessment of health effects of a forest environment is an important emerging area of public health and environmental sciences. To demonstrate the long-term health effects of living in a forest environment on subclinical cardiovascular diseases (CVDs) and health-related quality of life (HRQOL) compared with that in an urban environment. This study included the detailed health examination and questionnaire assessment of 107 forest staff members (FSM) and 114 urban staff members (USM) to investigate the long-term health effects of a forest environment. Air quality monitoring between the forest and urban environments was compared. In addition, work-related factors and HRQOL were evaluated. Levels of total cholesterol, low-density lipoprotein cholesterol, and fasting glucose in the USM group were significantly higher than those in the FSM group. Furthermore, a significantly higher intima-media thickness of the internal carotid artery was found in the USM group compared with that in the FSM group. Concentrations of air pollutants, such as NO, NO2, NOx, SO2, CO, PM2.5, and PM10 in the forest environment were significantly lower compared with those in the outdoor urban environment. Working hours were longer in the FSM group; however, the work stress evaluation as assessed by the job content questionnaire revealed no significant differences between FSM and USM. HRQOL evaluated by the World Health Organization Quality of Life-BREF questionnaire showed FSM had better HRQOL scores in the physical health domain. This study provides evidence of the potential beneficial effects of forest environments on CVDs and HRQOL.

Essential elements of professional nursing environments in Primary Care and their influence on the quality of care.

PubMed

Gea-Caballero, Vicente; Castro-Sánchez, Enrique; Júarez-Vela, Raúl; Díaz-Herrera, Miguel Ángel; de Miguel-Montoya, Isabel; Martínez-Riera, José Ramón

Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Urban environment and well-being: cross-cultural studies on Perceived Residential Environment Quality Indicators (PREQIs).

PubMed

Bonaiuto, Marino; Fornara, Ferdinando; Alves, Susana; Ferreira, Ines; Mao, Yanhui; Moffat, Eva; Piccinin, Gloria; Rahimi, Leila

2015-09-01

Architectural and environmental psychology literature has shown the importance of urban design in provoking stress feelings or enhancing well-being and quality of life. The aim of this contribution is to show the main results of a set of cross-cultural survey studies concerning the perceived quality of urban features at the neighbourhood level. A questionnaire was used including the extended or the short version of the 11 scales measuring Perceived Residential Environment Quality Indicators (PREQIs), which cover architectural, social, functional, and contextual aspects. Both versions of PREQIs showed a similar factorial structure and a good (or at least acceptable) reliability across different geographical contexts, even though some differences emerged in those countries that are more distant from the Western linguistic and cultural milieu. The development of tools like PREQIs should increase a "user-centred" vision on urban issues.

Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts

PubMed Central

Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

2016-01-01

Objective The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. Methods This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. Results 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Conclusions Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The

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.

Physical neighborhood and social environment, beliefs about sleep, sleep hygiene behaviors, and sleep quality among African Americans.

PubMed

Nam, Soohyun; Whittemore, Robin; Jung, Sunyoung; Latkin, Carl; Kershaw, Trace; Redeker, Nancy S

2018-06-01

African Americans (AAs) have a higher prevalence of sleep disorders than other racial/ethnic groups. However, little is known about the relationships among individual and neighborhood factors related to sleep quality in AAs. The purposes of this study were to (1) describe beliefs about sleep, sleep hygiene behaviors, and sleep quality among AAs; and (2) examine the relationships among sociodemographic characteristics, neighborhood environment, beliefs about sleep, sleep hygiene behaviors, and sleep quality. We conducted a cross-sectional study of 252 AA men and women in the Greater New Haven, CT, USA community. We assessed their sociodemographic characteristics, neighborhood environment, beliefs about sleep, sleep hygiene, and sleep quality with the following measures, respectively: the Neighborhood Environment Scale, the brief version of Dysfunctional Beliefs and Attitudes about Sleep, the Sleep Hygiene Practice Scale, the Pittsburgh Sleep Quality Index. We performed descriptive statistics, correlations and multiple hierarchical regression. About 72% of the participants (mean age: 53.88 ± 14.17 years, 77.8% women) reported experiencing sleep disturbance. People with poor sleep quality were more likely to report poorer neighborhood social environment (social cohesion), poorer overall neighborhood environment, more dysfunctional beliefs toward sleep, and poorer sleep hygiene than those who had good sleep quality. In the final multivariate model that controlled for a number of chronic comorbid conditions, neighborhood environment, beliefs about sleep, and sleep hygiene behaviors were significantly associated with sleep quality. Future efforts are needed to improve sleep among AAs by considering both the individual's belief about sleep, sleep hygiene behaviors and neighborhood factors. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Development of a Valid and Reliable Knee Articular Cartilage Condition-Specific Study Methodological Quality Score.

PubMed

Harris, Joshua D; Erickson, Brandon J; Cvetanovich, Gregory L; Abrams, Geoffrey D; McCormick, Frank M; Gupta, Anil K; Verma, Nikhil N; Bach, Bernard R; Cole, Brian J

2014-02-01

Condition-specific questionnaires are important components in evaluation of outcomes of surgical interventions. No condition-specific study methodological quality questionnaire exists for evaluation of outcomes of articular cartilage surgery in the knee. To develop a reliable and valid knee articular cartilage-specific study methodological quality questionnaire. Cross-sectional study. A stepwise, a priori-designed framework was created for development of a novel questionnaire. Relevant items to the topic were identified and extracted from a recent systematic review of 194 investigations of knee articular cartilage surgery. In addition, relevant items from existing generic study methodological quality questionnaires were identified. Items for a preliminary questionnaire were generated. Redundant and irrelevant items were eliminated, and acceptable items modified. The instrument was pretested and items weighed. The instrument, the MARK score (Methodological quality of ARticular cartilage studies of the Knee), was tested for validity (criterion validity) and reliability (inter- and intraobserver). A 19-item, 3-domain MARK score was developed. The 100-point scale score demonstrated face validity (focus group of 8 orthopaedic surgeons) and criterion validity (strong correlation to Cochrane Quality Assessment score and Modified Coleman Methodology Score). Interobserver reliability for the overall score was good (intraclass correlation coefficient [ICC], 0.842), and for all individual items of the MARK score, acceptable to perfect (ICC, 0.70-1.000). Intraobserver reliability ICC assessed over a 3-week interval was strong for 2 reviewers (≥0.90). The MARK score is a valid and reliable knee articular cartilage condition-specific study methodological quality instrument. This condition-specific questionnaire may be used to evaluate the quality of studies reporting outcomes of articular cartilage surgery in the knee.

Housing Quality and Access to Material and Learning Resources within the Home Environment in Developing Countries

ERIC Educational Resources Information Center

Bradley, Robert H.; Putnick, Diane L.

2012-01-01

This study examined home environment conditions (housing quality, material resources, formal and informal learning materials) and their relations with the Human Development Index (HDI) in 28 developing countries. Home environment conditions in these countries varied widely. The quality of housing and availability of material resources at home were…

The family child care home environment and children's diet quality.

PubMed

Benjamin-Neelon, Sara E; Vaughn, Amber E; Tovar, Alison; Østbye, Truls; Mazzucca, Stephanie; Ward, Dianne S

2018-07-01

Developing healthy eating behaviors and food preferences in early childhood may help establish future healthy diets. Large numbers of children spend time in child care, but little research has assessed the nutritional quality of meals and snacks in family child care homes. Therefore, it is important to assess foods and beverages provided, policies related to nutrition and feeding children, and interactions between providers and children during mealtimes. We examined associations between the nutrition environments of family child care homes and children's diet quality. We assessed the nutrition environments of 166 family child care homes using the Environment and Policy Assessment and Observation (EPAO) (scores range: 0-21). We also recorded foods and beverages consumed by 496 children in care and calculated healthy eating index (HEI) (scores range: 0-100). We used a mixed effects linear regression model to examine the association between the EPAO nutrition environment (and EPAO sub-scales) and child HEI, controlling for potential confounders. Family child care homes had a mean (standard deviation, SD) of 7.2 (3.6) children in care, 74.1% of providers were black or African American, and children had a mean (SD) age of 35.7 (11.4) months. In adjusted multivariable models, higher EPAO nutrition score was associated with increased child HEI score (1.16; 95% CI: 0.34, 1.98; p = 0.006). Higher scores on EPAO sub-scales for foods provided (8.98; 95% CI: 3.94, 14.01; p = 0.0006), nutrition education (5.37; 95% CI: 0.80, 9.94; p = 0.02), and nutrition policy (2.36; 95% CI: 0.23, 4.49; p = 0.03) were all associated with greater child HEI score. Foods and beverages served, in addition to nutrition education and nutrition policies in family child care homes, may be promising intervention targets for improving child diet quality. Copyright © 2018. Published by Elsevier Ltd.

40 CFR 52.683 - Significant deterioration of air quality.

Code of Federal Regulations, 2010 CFR

2010-07-01

... quality. 52.683 Section 52.683 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Idaho Rules for Control of Air Pollution in Idaho, specifically... the Clean Air Act for preventing significant deterioration of air quality. (b) The requirements of...

40 CFR 52.683 - Significant deterioration of air quality.

Code of Federal Regulations, 2011 CFR

2011-07-01

... quality. 52.683 Section 52.683 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Idaho Rules for Control of Air Pollution in Idaho, specifically... the Clean Air Act for preventing significant deterioration of air quality. (b) The requirements of...

40 CFR 52.683 - Significant deterioration of air quality.

Code of Federal Regulations, 2012 CFR

2012-07-01

... quality. 52.683 Section 52.683 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Idaho Rules for Control of Air Pollution in Idaho, specifically... the Clean Air Act for preventing significant deterioration of air quality. (b) The requirements of...

40 CFR 52.683 - Significant deterioration of air quality.

Code of Federal Regulations, 2013 CFR

2013-07-01

... quality. 52.683 Section 52.683 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Idaho Rules for Control of Air Pollution in Idaho, specifically... Air Act for preventing significant deterioration of air quality. (b) The requirements of sections 160...

Leading the Quality Management of Online Learning Environments in Australian Higher Education

ERIC Educational Resources Information Center

Holt, Dale; Palmer, Stuart; Munro, Judy; Solomonides, Ian; Gosper, Maree; Hicks, Margaret; Sankey, Michael; Allan, Garry; Hollenbeck, Robert

2013-01-01

The paper presents the findings of the first year of a nationally funded Australian Learning and Teaching Council (ALTC) project on the quality management of online learning environments by and through distributed leadership. The project is being undertaken by five Australian universities with major commitments to online and distance education.…

Assessing Quality of Kindergarten Classrooms in Singapore: Psychometric Properties of the Early Childhood Environment Rating Scale-Revised

ERIC Educational Resources Information Center

Bull, Rebecca; Yao, Shih-Ying; Ng, Ee Lynn

2017-01-01

The early childhood sector in Singapore has witnessed vast changes in the past two decades. One of the key policy aims is to improve classroom quality. To ensure a rigorous evaluation of the quality of early childhood environments in Singapore, it is important to determine whether commonly used assessments of quality are valid indicators across…

New Courses: Unlock the Mysteries of Productivity, Air Quality, and the Indoor Environment in Schools.

ERIC Educational Resources Information Center

Raiford, Regina

2001-01-01

Discusses the relationship between indoor air quality and productivity and a three-year research project to measure productivity within an educational setting. Also discusses research showing the impact of good indoor air quality on increasing productivity. Ten ways to manage asthma in a school environment are highlighted. (GR)

Assessment of Indoor Air Quality Problems in Office-Like Environments: Role of Occupational Health Services.

PubMed

Carrer, Paolo; Wolkoff, Peder

2018-04-12

There is an increasing concern about indoor air quality (IAQ) and its impact on health, comfort, and work-performance in office-like environments and their workers, which account for most of the labor force. The Scientific Committee on Indoor Air Quality and Health of the ICOH (Int. Comm. Occup. Health) has discussed the assessment and management of IAQ problems and proposed a stepwise approach to be conducted by a multidisciplinary team. It is recommended to integrate the building assessment, inspection by walk-through of the office workplace, questionnaire survey, and environmental measurements, in that order. The survey should cover perceived IAQ, symptoms, and psychosocial working aspects. The outcome can be used for mapping the IAQ and to prioritize the order in which problems should be dealt with. Individual health surveillance in relation to IAQ is proposed only when periodical health surveillance is already performed for other risks (e.g., video display units) or when specific clinical examination of workers is required due to the occurrence of diseases that may be linked to IAQ (e.g., Legionnaire's disease), recurrent inflammation, infections of eyes, respiratory airway effects, and sensorial disturbances. Environmental and personal risk factors should also be compiled and assessed. Workplace health promotion should include programs for smoking cessation and stress and IAQ management.

Food source quality and ant dominance hierarchy influence the outcomes of ant-plant interactions in an arid environment

NASA Astrophysics Data System (ADS)

Flores-Flores, Rocío Vianey; Aguirre, Armando; Anjos, Diego V.; Neves, Frederico S.; Campos, Ricardo I.; Dáttilo, Wesley

2018-02-01

In this study, we conducted a series of experiments in a population of Vachellia constricta (Fabaceae) in the arid Tehuacan-Cuicatláan valley, Mexico, in order to evaluate if the food source quality and ant dominance hierarchy influence the outcomes of ant-plant interactions. Using an experiment with artificial nectaries, we observed that ants foraging on food sources with higher concentration of sugar are quicker in finding and attacking potential herbivorous insects. More specifically, we found that the same ant species may increase their defence effectiveness according to the quality of food available. These findings indicate that ant effectiveness in plant protection is context-dependent and may vary according to specific individual characteristics of plants. In addition, we showed that competitively superior ant species tend to dominate plants in periods with high nectar activity, emphasizing the role of the dominance hierarchy structuring ant-plant interactions. However, when high sugar food sources were experimentally available ad libitum, the nocturnal and competitively superior ant species, Camponotus atriceps, did not dominate the artificial nectaries during the day possibly due to limitation of its thermal tolerance. Therefore, temporal niche partitioning may be allowing the coexistence of two dominant ant species (Camponotus rubritorax during the day and C. atriceps at night) on V. constricta. Our findings indicate that the quality of the food source, and temporal shifts in ant dominance are key factors which structure the biotic plant defences in an arid environment.

Geometrical specifications accuracy influence on the quality of electromechanical devices

NASA Astrophysics Data System (ADS)

Glukhov, V. I.; Lakeenko, M. N.; Dolzhikov, S. N.

2017-06-01

To improve the quality of electromechanical products is possible due to the geometrical specifications optimization of values and tolerances. Electromechanical products longevity designates the rolling-contact bearings of the armature shaft. Longevity of the rolling-contact bearings is less than designed one, since assembly and fitting alter gaps, sizes and geometric tolerances for the working parts of the basic rolling bearing details. Geometrical models of the rolling-contact bearing details for the armature shaft and the end shield are developed on the basis of an electric locomotive traction motor in the present work. The basic elements of the details conjugating with the adjacent details and materializing the generalized and auxiliary coordinate systems are determined. Function, informativeness and the number of geometrical specifications for the elements location are specified. The recommendations on amending the design documentation due to geometrical models to improve the accuracy and the quality of the products are developed: the replacement of the common axis of the shaft’s technological datums by the common axis of the basic design datums; coaxiality tolerances for these design datums with respect to their common axis; the modifiers for these auxiliary datums and these datums location tolerances according to the principles of datums uniformity, inversion and the shortest dimension chains. The investigation demonstrated that the problem of enhancing the durability, longevity, and efficiency coefficient for electromechanical products can be solved with the systematic normalizations of geometrical specifications accuracy on the basis of the coordinate systems introduced in the standards on geometrical product specifications (GPS).

40 CFR 31.45 - Quality assurance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Quality assurance. 31.45 Section 31.45... Requirements Reports, Records, Retention, and Enforcement § 31.45 Quality assurance. If the grantee's project... quality assurance practices consisting of policies, procedures, specifications, standards, and...

Stability of fruit quality traits in diverse watermelon cultivars tested in multiple environments

PubMed Central

Dia, Mahendra; Wehner, Todd C; Perkins-Veazie, Penelope; Hassell, Richard; Price, Daniel S; Boyhan, George E; Olson, Stephen M; King, Stephen R; Davis, Angela R; Tolla, Gregory E; Bernier, Jerome; Juarez, Benito

2016-01-01

Lycopene is a naturally occurring red carotenoid compound that is found in watermelon. Lycopene has antioxidant properties. Lycopene content, sugar content and hollowheart resistance are subject to significant genotype×environment interaction (G×E), which makes breeding for these fruit quality traits difficult. The objectives of this study were to (i) evaluate the influence of years and locations on lycopene content, sugar content and hollowheart resistance for a set of watermelon genotypes, and (ii) identify genotypes with high stability for lycopene, sugar, and hollowheart resistance. A diverse set of 40 genotypes was tested over 3 years and 8 locations across the southern United States in replicated, multi-harvest trials. Lycopene was tested in a subset of 10 genotypes. Data were analyzed using univariate and multivariate stability statistics (BLUP-GGE biplot) using SASGxE and RGxE programs. There were strong effects of environment as well as G×E interaction on watermelon quality traits. On the basis of stability measures, genotypes were classified as stable or unstable for each quality trait. 'Crimson Sweet' is an inbred line with high quality trait performance as well as trait stability. 'Stone Mountain', 'Tom Watson', 'Crimson Sweet' and 'Minilee' were among the best genotypes for lycopene content, sugar content and hollowheart resistance. We developed a stability chart based on marketable yield and average ranking generated from different stability measures for yield attributes and quality traits. The chart will assist in choosing parents for improvement of watermelon cultivars. See http://cuke.hort.ncsu.edu/cucurbit/wmelon/wmelonmain.html. PMID:28066557

Environment-friendly cycle time optimization and quality improvisation using Six Sigma.

PubMed

Deshpande, V S; Mungle, N P

2008-07-01

Healthy environment in any organization can make a difference in improving productivity and quality with low defect, lack of concentration, willingness to work, minimum accidental problems etc. Six Sigma is one of the more recent quality improvement initiatives to gain popularity and acceptance in many industries across the globe. It is an alternative to TQM to obtain minimum manufacturing defect, cycle time reduction, cost reduction, inventory reduction etc. Its use is increasingly widespread in many industries, in both manufacturing and service industries with many proponents of the approach claiming that it has developed beyond a quality control approach into a broader process improvement concept.

Nurses' sleep quality, work environment and quality of care in the Spanish National Health System: observational study among different shifts.

PubMed

Gómez-García, Teresa; Ruzafa-Martínez, María; Fuentelsaz-Gallego, Carmen; Madrid, Juan Antonio; Rol, Maria Angeles; Martínez-Madrid, María José; Moreno-Casbas, Teresa

2016-08-05

The main objective of this study was to determine the relationship between the characteristics of nurses' work environments in hospitals in the Spanish National Health System (SNHS) with nurse reported quality of care, and how care was provided by using different shifts schemes. The study also examined the relationship between job satisfaction, burnout, sleep quality and daytime drowsiness of nurses and shift work. This was a multicentre, observational, descriptive, cross-sectional study, centred on a self-administered questionnaire. The study was conducted in seven SNHS hospitals of different sizes. We recruited 635 registered nurses who worked on day, night and rotational shifts on surgical, medical and critical care units. Their average age was 41.1 years, their average work experience was 16.4 years and 90% worked full time. A descriptive and bivariate analysis was carried out to study the relationship between work environment, quality and safety care, and sleep quality of nurses working different shift patterns. 65.4% (410) of nurses worked on a rotating shift. The Practice Environment Scale of the Nursing Work Index classification ranked 20% (95) as favourable, showing differences in nurse manager ability, leadership and support between shifts (p=0.003). 46.6% (286) were sure that patients could manage their self-care after discharge, but there were differences between shifts (p=0.035). 33.1% (201) agreed with information being lost in the shift change, showing differences between shifts (p=0.002). The Pittsburgh Sleep Quality Index reflected an average of 6.8 (SD 3.39), with differences between shifts (p=0.017). Nursing requires shift work, and the results showed that the rotating shift was the most common. Rotating shift nurses reported worse perception in organisational and work environmental factors. Rotating and night shift nurses were less confident about patients' competence of self-care after discharge. The most common nursing care omissions

40 CFR 52.683 - Significant deterioration of air quality.

Code of Federal Regulations, 2014 CFR

2014-07-01

... quality. 52.683 Section 52.683 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... deterioration of air quality. (a) The State of Idaho Rules for Control of Air Pollution in Idaho, specifically... quality. (b) The requirements of sections 160 through 165 of the Clean Air Act are not met for Indian...

Specification and correlation of the sine vibration environment for Viking '75

NASA Technical Reports Server (NTRS)

Snyder, R. E.; Trummel, M.; Wada, B. K.; Pohlen, J. C.

1974-01-01

Two Viking spacecraft will be individually launched on a new Titan IIIE/Centaur D-1T launch vehicle in August 1975. The method for the establishment of spacecraft sine vibration test levels prior to availability of any Titan IIIE/Centaur D-1T flight data by use of both computer simulations and data from previous Titan and Atlas Centaur vehicles is described. The specification level is compared with actual flight data obtained from a proof flight launch of the Titan IIIE/Centaur D-1T and a Viking dynamic simulator in January 1974. An objective of the proof flight launch was to obtain estimates of the flight loads and environments. The criteria used to minimize the structural weight that would result from an unmodified application of a sine test environment are described.

Local body cooling to improve sleep quality and thermal comfort in a hot environment.

PubMed

Lan, L; Qian, X L; Lian, Z W; Lin, Y B

2018-01-01

The effects of local body cooling on thermal comfort and sleep quality in a hot environment were investigated in an experiment with 16 male subjects. Sleep quality was evaluated subjectively, using questionnaires completed in the morning, and objectively, by analysis of electroencephalogram (EEG) signals that were continuously monitored during the sleeping period. Compared with no cooling, the largest improvement in thermal comfort and sleep quality was observed when the back and head (neck) were both cooled at a room temperature of 32°C. Back cooling alone also improved thermal comfort and sleep quality, although the effects were less than when cooling both back and head (neck). Mean sleep efficiency was improved from 84.6% in the no cooling condition to 95.3% and 92.8%, respectively, in these conditions, indicating good sleep quality. Head (neck) cooling alone slightly improved thermal comfort and subjective sleep quality and increased Stage N3 sleep, but did not otherwise improve sleep quality. The results show that local cooling applied to large body sections (back and head) could effectively maintain good sleep and improve thermal comfort in a hot environment. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

78 FR 5810 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-28

... AHRQ Quality Indicators (QIs), their technical specifications, and associated methodological issues.... The time- limited workgroup is more restricted to specific clinical or methodological issues, while..., data enhancements, and methodological advances. The standing workgroup may potentially provide guidance...

Linking nurses' perceptions of patient care quality to job satisfaction: the role of authentic leadership and empowering professional practice environments.

PubMed

Spence Laschinger, Heather K; Fida, Roberta

2015-05-01

A model linking authentic leadership, structural empowerment, and supportive professional practice environments to nurses' perceptions of patient care quality and job satisfaction was tested. Positive work environment characteristics are important for nurses' perceptions of patient care quality and job satisfaction (significant factors for retention). Few studies have examined the mechanism by which these characteristics operate to influence perceptions of patient care quality or job satisfaction. A cross-sectional provincial survey of 723 Canadian nurses was used to test the hypothesized models using structural equation modeling. The model was an acceptable fit and all paths were significant. Authentic leadership had a positive effect on structural empowerment, which had a positive effect on perceived support for professional practice and a negative effect on nurses' perceptions that inadequate unit staffing prevented them from providing high-quality patient care. These workplace conditions predicted job satisfaction. Authentic leaders play an important role in creating empowering professional practice environments that foster high-quality care and job satisfaction.

Is the food environment surrounding schools associated with the diet quality of adolescents in Otago, New Zealand?

PubMed

Clark, Emma M; Quigg, Robin; Wong, Jyh Eiin; Richards, Rose; Black, Katherine E; Skidmore, Paula M L

2014-11-01

Using a sample of adolescents from schools in Otago, New Zealand, associations between food outlets around schools and dietary quality were investigated. Food outlet environment data were derived using GIS data. Multivariate regression analysis results showed that outlet density, in an 800m buffer around schools, of cafes and restaurants, supermarkets and takeaways was associated with higher Diet Quality Index scores in boys, and distance to nearest outlet for convenience stores, cafes and restaurants and supermarkets with lower scores for girls. Effect sizes were small, suggesting that the food environment around schools plays a minor role in adolescent diet quality. Copyright © 2014 Elsevier Ltd. All rights reserved.

Complex Visual Adaptations in Squid for Specific Tasks in Different Environments

PubMed Central

Chung, Wen-Sung; Marshall, N. Justin

2017-01-01

In common with their major competitors, the fish, squid are fast moving visual predators that live over a great range of depths in the ocean. Both squid and fish show a variety of adaptations with respect to optical properties, receptors and their underlying neural circuits, and these adaptations are often linked to the light conditions of their specific niche. In contrast to the extensive investigations of adaptive strategies in fish, vision in response to the varying quantity and quality of available light, our knowledge of visual adaptations in squid remains sparse. This study therefore undertook a comparative study of visual adaptations and capabilities in a number of squid species collected between 0 and 1,200 m. Histology, magnetic resonance imagery (MRI), and depth distributions were used to compare brains, eyes, and visual capabilities, revealing that the squid eye designs reflect the lifestyle and the versatility of neural architecture in its visual system. Tubular eyes and two types of regional retinal deformation were identified and these eye modifications are strongly associated with specific directional visual tasks. In addition, a combination of conventional and immuno-histology demonstrated a new form of a complex retina possessing two inner segment layers in two mid-water squid species which they rhythmically move across a broad range of depths (50–1,000 m). In contrast to their relatives with the regular single-layered inner segment retina live in the upper mesopelagic layer (50–400 m), the new form of retinal interneuronal layers suggests that the visual sensitivity of these two long distance vertical migrants may increase in response to dimmer environments. PMID:28286484

78 FR 22883 - AHRQ Standing Workgroup for Quality Indicator Measure Specification

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-17

... Quality Indicators (QIs), their technical specifications, and associated methodological issues. The...-limited workgroup is more restricted to specific clinical or methodological issues, while the standing... enhancements, and methodological advances. The standing workgroup may potentially provide guidance for the...

The relationship of the local food environment with obesity: A systematic review of methods, study quality, and results.

PubMed

Cobb, Laura K; Appel, Lawrence J; Franco, Manuel; Jones-Smith, Jessica C; Nur, Alana; Anderson, Cheryl A M

2015-07-01

To examine the relationship between local food environments and obesity and assess the quality of studies reviewed. Systematic keyword searches identified studies from US and Canada that assessed the relationship of obesity to local food environments. We applied a quality metric based on design, exposure and outcome measurement, and analysis. We identified 71 studies representing 65 cohorts. Overall, study quality was low; 60 studies were cross-sectional. Associations between food outlet availability and obesity were predominantly null. Among non-null associations, we saw a trend toward inverse associations between supermarket availability and obesity (22 negative, 4 positive, 67 null) and direct associations between fast food and obesity (29 positive, 6 negative, 71 null) in adults. We saw direct associations between fast food availability and obesity in lower income children (12 positive, 7 null). Indices including multiple food outlets were most consistently associated with obesity in adults (18 expected, 1 not expected, 17 null). Limiting to higher quality studies did not affect results. Despite the large number of studies, we found limited evidence for associations between local food environments and obesity. The predominantly null associations should be interpreted cautiously due to the low quality of available studies. © 2015 The Obesity Society.

The relationship of the local food environment with obesity: A systematic review of methods, study quality and results

PubMed Central

Cobb, Laura K; Appel, Lawrence J; Franco, Manuel; Jones-Smith, Jessica C; Nur, Alana; Anderson, Cheryl AM

2015-01-01

Objective To examine the relationship between local food environments and obesity and assess the quality of studies reviewed. Methods Systematic keyword searches identified studies from US and Canada that assessed the relationship of obesity to local food environments. We applied a quality metric based on design, exposure and outcome measurement, and analysis. Results We identified 71 studies representing 65 cohorts. Overall, study quality was low; 60 studies were cross-sectional. Associations between food outlet availability and obesity were predominantly null. Among non-null associations, we saw a trend toward inverse associations between supermarket availability and obesity (22 negative, 4 positive, 67 null) and direct associations between fast food and obesity (29 positive, 6 negative, 71 null) in adults. We saw direct associations between fast food availability and obesity in lower income children (12 positive, 7 null). Indices including multiple food outlets were most consistently associated with obesity in adults (18 expected, 1 not expected, 17 null). Limiting to higher quality studies did not affect results. Conclusions Despite the large number of studies, we found limited evidence for associations between local food environments and obesity. The predominantly null associations should be interpreted cautiously due to the low quality of available studies. PMID:26096983

Diet quality of urban older adults age 60 to 99 years: the Cardiovascular Health of Seniors and Built Environment Study.

PubMed

Deierlein, Andrea L; Morland, Kimberly B; Scanlin, Kathleen; Wong, Sally; Spark, Arlene

2014-02-01

There are few studies that evaluate dietary intakes and predictors of diet quality in older adults. The objectives of this study were to describe nutrient intakes and examine associations between demographic, economic, behavioral, social environment, and health status factors and diet quality. Cross-sectional data were from black, white, and Hispanic adults, age 60 to 99 years, living independently in New York City and participating in the Cardiovascular Health of Seniors and the Built Environment Study, 2009-2011 (n=1,306). Multivariable log-linear regression estimated associations between selected factors and good diet quality, defined as a Healthy Eating Index score more than 80 (based on the 2005 Dietary Guidelines for Americans [HEI-2005]). Dietary intakes were similar for men and women; intakes of energy, fiber, and the majority of micronutrients were less than recommendations, whereas intakes of fats, added sugar, and sodium were within the upper range or exceeded recommendations. Hispanic ethnicity (relative risk [RR]=1.37; 95% CI 1.07 to 1.75), energy intake <∼ 1,500 kcal/day (RR=1.93; 95% CI, 1.37 to 2.71), adherence to a special diet (RR=1.23; 95% CI: 1.02 to 1.50), purchasing food at supermarkets at least once/week (RR=1.34; 95% CI, 1.04 to 1.74), and being married/living with a partner (RR=1.37; 95% CI, 1.10 to 1.71) were positively associated with HEI-2005 score more than 80. Consuming at least one restaurant meal/day was negatively associated with HEI-2005 score more than 80 (RR=0.69; 95%CI, 0.50-0.94). These findings identify specific groups of older adults, such as blacks or those who live alone, who may benefit from dietary interventions, as well as specific modifiable behaviors among older adults, such as eating restaurant meals or shopping at supermarkets, which may be targeted through interventions. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

The function of green belt Jatibarang as quality control for the environment of Semarang city

NASA Astrophysics Data System (ADS)

Murtini, Titien Woro; Harani, Arnis Rochma; Ernadia, Loretta

2017-06-01

The quality of the healthy environment in a neighborhood city is decreasing in number. According to the government regulation, Act No. 26 of 2007, a city should have 20% of green areas from the total area of the city. Now, Semarang only has 7.5% of green areas from the total city area. One of the efforts made by the Government of Semarang is the establishment of a greenbelt in Jatibarang area. It consists of several parts, namely, the reservoirs in the green belt area and also the plant zone in other sectors. The reservoir has a function as the controller of water resources sustainability where the crops serve as the balance for the combination. Thus, it is interesting to study how the interplay of these two functions in a green belt area. The primary data used in this study was obtained from the locus of research by direct observation, interview, and physical data collection. Based on the data collection, data was then processed and analyzed in accordance with the indicators that had been compiled based on theories of reservoirs, green belts, and the quality of the urban environment. Government regulations regarding with the greenbelt and tanks were also used as references in the discussion. The research found out that the presence of the reservoir and the plants in the green belt of Jatibarang can improve the function of the green belt optimally which is a real influence for the improvement of the environment quality, especially water. The Greenbelt was divided into four zones, namely the Arboretum, Argo - Forestry, Ecotourism, Buffer - Zone also made the region became a beautiful greenbelt that brought a positive influence to environmental quality.

Quality indicators and specifications for strategic and support processes in laboratory medicine.

PubMed

Ricós, Carmen; Biosca, Carme; Ibarz, Mercè; Minchinela, Joana; Llopis, Maantonia; Perich, Carmen; Alsina, Jesus; Alvarez, Virtudes; Doménech, Vicenta; Pastor, Rosa Ma; Sansalvador, Mireia; Isern, Gloria Trujillo; Navarro, Conrad Vilanova

2008-01-01

This work is the second part of a study regarding indicators and quality specifications for the non-analytical processes in laboratory medicine. Five primary care and five hospital laboratories agreed on the indicators for two strategic processes (quality planning and project development) and various support processes (client relationships, instrument and infrastructure maintenance, safety and risk prevention, purchases and storage, personnel training). In the majority of cases, the median values recorded over 1 year is considered to be the state-of-the-art in our setting and proposed as the quality specification for the indicators stated. Values have been stratified according to primary care and hospital laboratory for referred tests and group of personnel for training. In some cases, the specifications have been set equal to zero events, such as serious incidents in the infrastructure maintenance process and number of work accidents in the safety and risk prevention process. In light of this study, an effort is needed to optimize decisions regarding corrective actions and to move from a subjective individual criterion to systematic and comparative management. This preliminary study provides a comprehensive vision of a subject that could motivate further research and advances in the quality of laboratory services.

Framing and Enhancing Distributed Leadership in the Quality Management of Online Learning Environments in Higher Education

ERIC Educational Resources Information Center

Holt, Dale; Palmer, Stuart; Gosper, Maree; Sankey, Michael; Allan, Garry

2014-01-01

This article reports on the findings of senior leadership interviews in a nationally funded project on distributed leadership in the quality management of online learning environments (OLEs) in higher education. Questions were framed around the development of an OLE quality management framework and the situation of the characteristics of…

Water Deficit and Salinity Stress Reveal Many Specific QTL for Plant Growth and Fruit Quality Traits in Tomato

PubMed Central

Diouf, Isidore A.; Derivot, Laurent; Bitton, Frédérique; Pascual, Laura; Causse, Mathilde

2018-01-01

Quality is a key trait in plant breeding, especially for fruit and vegetables. Quality involves several polygenic components, often influenced by environmental conditions with variable levels of genotype × environment interaction that must be considered in breeding strategies aiming to improve quality. In order to assess the impact of water deficit and salinity on tomato fruit quality, we evaluated a multi-parent advanced generation intercross (MAGIC) tomato population in contrasted environmental conditions over 2 years, one year in control vs. drought condition and the other in control vs. salt condition. Overall 250 individual lines from the MAGIC population—derived from eight parental lines covering a large diversity in cultivated tomato—were used to identify QTL in both experiments for fruit quality and yield component traits (fruit weight, number of fruit, Soluble Solid Content, firmness), phenology traits (time to flower and ripe) and a vegetative trait, leaf length. All the traits showed a large genotype variation (33–86% of total phenotypic variation) in both experiments and high heritability whatever the year or treatment. Significant genotype × treatment interactions were detected for five of the seven traits over the 2 years of experiments. QTL were mapped using 1,345 SNP markers. A total of 54 QTL were found among which 15 revealed genotype × environment interactions and 65% (35 QTL) were treatment specific. Confidence intervals of the QTL were projected on the genome physical map and allowed identifying regions carrying QTL co-localizations, suggesting pleiotropic regulation. We then applied a strategy for candidate gene detection based on the high resolution mapping offered by the MAGIC population, the allelic effect of each parental line at the QTL and the sequence information of the eight parental lines. PMID:29559986

7 CFR 58.735 - Quality specifications for raw materials.

Code of Federal Regulations, 2014 CFR

2014-01-01

... specifications of the finished product. (b) Swiss. Swiss cheese used in the manufacture of pasteurized process... Swiss cheese. (d) Cream cheese, Neufchatel cheese. Mixed with other foods, or used for spreads and dips... Service 1 Requirements for Processed Cheese Products Bearing Usda Official Identification § 58.735 Quality...

7 CFR 58.735 - Quality specifications for raw materials.

Code of Federal Regulations, 2013 CFR

2013-01-01

... specifications of the finished product. (b) Swiss. Swiss cheese used in the manufacture of pasteurized process... Swiss cheese. (d) Cream cheese, Neufchatel cheese. Mixed with other foods, or used for spreads and dips... Service 1 Requirements for Processed Cheese Products Bearing Usda Official Identification § 58.735 Quality...

7 CFR 58.735 - Quality specifications for raw materials.

Code of Federal Regulations, 2012 CFR

2012-01-01

... specifications of the finished product. (b) Swiss. Swiss cheese used in the manufacture of pasteurized process... Swiss cheese. (d) Cream cheese, Neufchatel cheese. Mixed with other foods, or used for spreads and dips... Service 1 Requirements for Processed Cheese Products Bearing Usda Official Identification § 58.735 Quality...

Quality of Life (QoL) Survey in Hong Kong: Understanding the Importance of Housing Environment and Needs of Residents from Different Housing Sectors.

PubMed

Gou, Zhonghua; Xie, Xiaohuan; Lu, Yi; Khoshbakht, Maryam

2018-01-27

This study presents a Quality of Life (QoL) survey to understand the influence of the housing environment and needs of residents from different housing sectors. The research focuses on Hong Kong where living conditions have become the main affect for people's QoL. Through a household survey using a standard instrument "Word Health Organisation (WHO) Quality of Life-BREF", the article found that among the four WHO QoL domains (Physical Health, Psychological Health, Social Relations And Environment), Environment, particularly its constitute aspect housing environment was the most influential factor for overall quality of life for the public rental housing sector where low-income people live. This research also found that different groups of people have differing needs of their housing environments: the low-income group needs better location and privacy while the medium and high-income groups need better architectural quality. Based on differentiating their needs and wants, this research argues for prioritizing the low-income group's needs for effectively improving their QoL.

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

Are Hip-Specific Items Useful in a Quality of Life Questionnaire for Patients with Hip Fractures?

ERIC Educational Resources Information Center

Yao, Kai-Ping Grace; Lee, Hsin-Yi; Tsauo, Jau-Yih

2009-01-01

Researchers measure the significance of hip fracture by the patient's impairment. The patient's quality of life (QOL) is usually also substantially affected. However, there is no specific quality of life (QOL) questionnaire for patients with hip fractures. This study was designed to determine whether adding a new set of specific questions about…

The Quality of Nurses' Work Environment and Workforce Outcomes From the Perspective of Swiss Allied Healthcare Assistants and Registered Nurses: A Cross-Sectional Survey.

PubMed

Lacher, Stefanie; De Geest, Sabina; Denhaerynck, Kris; Trede, Ines; Ausserhofer, Dietmar

2015-09-01

Anticipating nursing shortages, the Swiss healthcare system recently introduced the position of allied healthcare assistant (AHA). However, indicators of AHAs' integration and stability, particularly their perceptions of their work environment quality and related outcomes (i.e., burnout, job satisfaction, and intention to leave), remain unclear. (a) To describe AHAs' ratings of the quality of the nurse work environment, job satisfaction, burnout, and intention to leave their workplaces; (b) to compare AHAs' and registered nurses' (RNs') work environment quality ratings and related outcomes; and (c) to assess links between AHAs' work environment quality ratings and related workforce outcomes. A secondary analysis of RN4CAST data (October 2009 to June 2010) on 61 AHAs and 466 RNs in 13 Swiss acute care hospitals. We used descriptive statistics to summarize data of AHAs and RNs on their units and hospitals. Via binary logistic regression models, we compared AHAs and RNs and identified associations between work environment ratings and workforce outcomes. AHAs' work environment quality ratings were significantly higher than those of RNs, and were associated with lower odds of burnout and intention to leave their current job and higher odds of reported job satisfaction. This study provides primary evidence linking AHAs' work environment quality ratings to burnout, job satisfaction, and intention to leave in acute care hospitals. Given the increasing importance of AHAs for nursing care provision, hospitals should assess the quality of nurse work environment and nurse outcomes from the perspective of all nurses. © 2015 Sigma Theta Tau International.

Assessment of Indoor Air Quality Problems in Office-Like Environments: Role of Occupational Health Services

PubMed Central

2018-01-01

There is an increasing concern about indoor air quality (IAQ) and its impact on health, comfort, and work-performance in office-like environments and their workers, which account for most of the labor force. The Scientific Committee on Indoor Air Quality and Health of the ICOH (Int. Comm. Occup. Health) has discussed the assessment and management of IAQ problems and proposed a stepwise approach to be conducted by a multidisciplinary team. It is recommended to integrate the building assessment, inspection by walk-through of the office workplace, questionnaire survey, and environmental measurements, in that order. The survey should cover perceived IAQ, symptoms, and psychosocial working aspects. The outcome can be used for mapping the IAQ and to prioritize the order in which problems should be dealt with. Individual health surveillance in relation to IAQ is proposed only when periodical health surveillance is already performed for other risks (e.g., video display units) or when specific clinical examination of workers is required due to the occurrence of diseases that may be linked to IAQ (e.g., Legionnaire’s disease), recurrent inflammation, infections of eyes, respiratory airway effects, and sensorial disturbances. Environmental and personal risk factors should also be compiled and assessed. Workplace health promotion should include programs for smoking cessation and stress and IAQ management. PMID:29649167

Development of high quality pervious concrete specifications for Maryland conditions : [research summary].

DOT National Transportation Integrated Search

2013-02-01

The main objective of the study was to develop preliminary specifications for : high quality pervious concrete suitable for use in SHA projects. The study : included an extensive literature review and laboratory investigations to : determine structur...

Students' Conception of Learning Environment and Their Approach to Learning and Its Implication on Quality Education

ERIC Educational Resources Information Center

Belaineh, Matheas Shemelis

2017-01-01

Quality of education in higher institutions can be affected by different factors. It partly rests on the learning environment created by teachers and the learning approach students are employing during their learning. The main purpose of this study is to examine the learning environment at Mizan Tepi University from students' perspective and their…

Mapping the Medical Literature for High Quality Studies and Reviews for Age-specific Clinical Specialties

PubMed Central

Stevens, Adrienne L.; Wilczynski, Nancy L.; McKibbon, K. Ann; Haynes, R. Brian

2001-01-01

Objective: To identify a journal subset that publishes reports of high quality studies and reviews relating to age-specific clinical specialties, such as pediatrics and geriatrics. Design: Handsearch of 172 journals using explicit criteria to determine methodologic quality for generating evidence for clinical practice. Main outcome measure: Frequency of high quality articles and their top yielding journals. Results: Between 17% and 33% of articles published in age-specific specialties are of high quality for clinical use. Top yielding journals for the specialties ranged from 16 to 130. Conclusion: Handsearch of the clinical literature for the year 2000 reveals that high quality articles for some age-specific specialties are concentrated in a small subset of journals (eg, obstetrics), whereas articles for other specialties are widely scattered among a large number of journals (eg, adult medicine).

Nursing Practice Environment and Outcomes for Oncology Nursing

PubMed Central

Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.

2012-01-01

Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101

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

PubMed

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

2018-04-01

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

Methodology for analyzing environmental quality indicators in a dynamic operating room environment.

PubMed

Gormley, Thomas; Markel, Troy A; Jones, Howard W; Wagner, Jennifer; Greeley, Damon; Clarke, James H; Abkowitz, Mark; Ostojic, John

2017-04-01

Sufficient quantities of quality air and controlled, unidirectional flow are important elements in providing a safe building environment for operating rooms. To make dynamic assessments of an operating room environment, a validated method of testing the multiple factors influencing the air quality in health care settings needed to be constructed. These include the following: temperature, humidity, particle load, number of microbial contaminants, pressurization, air velocity, and air distribution. The team developed the name environmental quality indicators (EQIs) to describe the overall air quality based on the actual measurements of these properties taken during the mock surgical procedures. These indicators were measured at 3 different hospitals during mock surgical procedures to simulate actual operating room conditions. EQIs included microbial assessments at the operating table and the back instrument table and real-time analysis of particle counts at 9 different defined locations in the operating suites. Air velocities were measured at the face of the supply diffusers, at the sterile field, at the back table, and at a return grille. The testing protocol provided consistent and comparable measurements of air quality indicators between institutions. At 20 air changes per hour (ACH), and an average temperature of 66.3°F, the median of the microbial contaminants for the 3 operating room sites ranged from 3-22 colony forming units (CFU)/m 3 at the sterile field and 5-27 CFU/m 3 at the back table. At 20 ACH, the median levels of the 0.5-µm particles at the 3 sites were 85,079, 85,325, and 912,232 in particles per cubic meter, with a predictable increase in particle load in the non-high-efficiency particulate air-filtered operating room site. Using a comparison with cleanroom standards, the microbial and particle counts in all 3 operating rooms were equivalent to International Organization for Standardization classifications 7 and 8 during the mock surgical

A structural regression model for relationship between indoor air quality with dissatisfaction of occupants in education environment

NASA Astrophysics Data System (ADS)

Hosseini, Hamid Reza; Yunos, Mohd Yazid Mohd; Ismail, Sumarni; Yaman, Maheran

2017-12-01

This paper analysis the effects of indoor air elements on the dissatisfaction of occupants in education of environments. Tries to find the equation model for increasing the comprehension about these affects and optimizes satisfaction of occupants about indoor environment. Subsequently, increase performance of students, lecturers and staffs. As the method, a satisfaction questionnaire (SQ) and measuring environment elements (MEE) was conducted, 143 respondents at five classrooms, four staff rooms and five lectures rooms were considered. Temperature, air velocity and humidity (TVH) were used as independent variables and dissatisfaction as dependent variable. The hypothesis was tested for significant relationship between variables, and analysis was applied. Results found that indoor air quality presents direct effects on dissatisfaction of occupants and indirect effects on performance and the highest effects fallowed by temperature. These results may help to optimize the quality of efficiency and effectiveness in education environments.

Recommendations for Guidelines for Environment-Specific Magnetic-Field Measurements, Rapid Program Engineering Project #2

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

Electric Research and Management, Inc.; IIT Research Institute; Magnetic Measurements

1997-03-11

The purpose of this project was to document widely applicable methods for characterizing the magnetic fields in a given environment, recognizing the many sources co-existing within that space. The guidelines are designed to allow the reader to follow an efficient process to (1) plan the goals and requirements of a magnetic-field study, (2) develop a study structure and protocol, and (3) document and carry out the plan. These guidelines take the reader first through the process of developing a basic study strategy, then through planning and performing the data collection. Last, the critical factors of data management, analysis reporting, andmore » quality assurance are discussed. The guidelines are structured to allow the researcher to develop a protocol that responds to specific site and project needs. The Research and Public Information Dissemination Program (RAPID) is based on exposure to magnetic fields and the potential health effects. Therefore, the most important focus for these magnetic-field measurement guidelines is relevance to exposure. The assumed objective of an environment-specific measurement is to characterize the environment (given a set of occupants and magnetic-field sources) so that information about the exposure of the occupants may be inferred. Ideally, the researcher seeks to obtain complete or "perfect" information about these magnetic fields, so that personal exposure might also be modeled perfectly. However, complete data collection is not feasible. In fact, it has been made more difficult as the research field has moved to expand the list of field parameters measured, increasing the cost and complexity of performing a measurement and analyzing the data. The guidelines address this issue by guiding the user to design a measurement protocol that will gather the most exposure-relevant information based on the locations of people in relation to the sources. We suggest that the "microenvironment" become the base unit of area in a study, with

The Association between Quality Improvement Initiatives in Dementia Care and Supportive Psychosocial Work Environments in Nursing Homes.

PubMed

Nakanishi, Miharu; Tei-Tominaga, Maki

2018-05-08

Background : Quality improvement initiatives can help nursing homes strengthen psychosocial work environments. The aim of the present study was to examine the association between supportive psychosocial work environment, and professional and organizational characteristics regarding quality improvement initiatives in dementia care. Methods : A paper questionnaire survey was administered to a convenience sample of 365 professional caregivers in 12 special nursing homes in Japan. Psychosocial work environment was assessed using the Social Capital and Ethical Climate at the Workplace Scale to calculate a score of social capital in the workplace, ethical leadership, and exclusive workplace climate. Variables for quality improvement initiatives included type of home (unit-type or traditional), presence of additional benefit for dementia care, and professionalism in dementia care among caregivers evaluated using the Japanese version of the Sense of Competence in Dementia Care Staff Scale. Results : Elevated professionalism and unit-type home were significantly associated with high social capital, strong ethical leadership, and low exclusive workplace climate. The presence of dementia care benefit was not associated with any subscale of psychosocial work environment. Conclusions : Quality improvement initiatives to foster supportive psychosocial work environment should enhance professionalism in dementia care with unit-based team building of professional caregivers in special nursing homes.

Quality of Life (QoL) Survey in Hong Kong: Understanding the Importance of Housing Environment and Needs of Residents from Different Housing Sectors

PubMed Central

Xie, Xiaohuan; Khoshbakht, Maryam

2018-01-01

This study presents a Quality of Life (QoL) survey to understand the influence of the housing environment and needs of residents from different housing sectors. The research focuses on Hong Kong where living conditions have become the main affect for people’s QoL. Through a household survey using a standard instrument “Word Health Organisation (WHO) Quality of Life-BREF”, the article found that among the four WHO QoL domains (Physical Health, Psychological Health, Social Relations And Environment), Environment, particularly its constitute aspect housing environment was the most influential factor for overall quality of life for the public rental housing sector where low-income people live. This research also found that different groups of people have differing needs of their housing environments: the low-income group needs better location and privacy while the medium and high-income groups need better architectural quality. Based on differentiating their needs and wants, this research argues for prioritizing the low-income group’s needs for effectively improving their QoL. PMID:29382071

Reliability of measurement and genotype x environment 1 interaction for potato specific gravity

USDA-ARS?s Scientific Manuscript database

The dry matter content of potatoes used to make potato chips and French fries strongly influences fry oil absorption and texture of the finished product. Specific gravity (SpGr) is often used to assess the processing quality of potatoes tubers because of its strong correlation with dry matter conten...

Formal specification and verification of Ada software

NASA Technical Reports Server (NTRS)

Hird, Geoffrey R.

1991-01-01

The use of formal methods in software development achieves levels of quality assurance unobtainable by other means. The Larch approach to specification is described, and the specification of avionics software designed to implement the logic of a flight control system is given as an example. Penelope is described which is an Ada-verification environment. The Penelope user inputs mathematical definitions, Larch-style specifications and Ada code and performs machine-assisted proofs that the code obeys its specifications. As an example, the verification of a binary search function is considered. Emphasis is given to techniques assisting the reuse of a verification effort on modified code.

Specific guidelines for assessing and improving the methodological quality of economic evaluations of newborn screening

PubMed Central

2012-01-01

Background Economic evaluation of newborn screening poses specific methodological challenges. Amongst others, these challenges refer to the use of quality adjusted life years (QALYs) in newborns, and which costs and outcomes need to be considered in a full evaluation of newborn screening programmes. Because of the increasing scale and scope of such programmes, a better understanding of the methods of high-quality economic evaluations may be crucial for both producers/authors and consumers/reviewers of newborn screening-related economic evaluations. The aim of this study was therefore to develop specific guidelines designed to assess and improve the methodological quality of economic evaluations in newborn screening. Methods To develop the guidelines, existing guidelines for assessing the quality of economic evaluations were identified through a literature search, and were reviewed and consolidated using a deductive iterative approach. In a subsequent test phase, these guidelines were applied to various economic evaluations which acted as case studies. Results The guidelines for assessing and improving the methodological quality of economic evaluations in newborn screening are organized into 11 categories: “bibliographic details”, “study question and design”, “modelling”, “health outcomes”, “costs”, “discounting”, “presentation of results”, “sensitivity analyses”, “discussion”, “conclusions”, and “commentary”. Conclusions The application of the guidelines highlights important issues regarding newborn screening-related economic evaluations, and underscores the need for such issues to be afforded greater consideration in future economic evaluations. The variety in methodological quality detected by this study reveals the need for specific guidelines on the appropriate methods for conducting sound economic evaluations in newborn screening. PMID:22947299

Fertilizer Use and Water Quality.

ERIC Educational Resources Information Center

Reneau, Fred; And Others

This booklet presents informative materials on fertilizer use and water quality, specifically in regard to environmental pollution and protection in Illinois. The five chapters cover these topics: Fertilizer and Water Quality, Fertilizer Use, Fertilizers and the Environment, Safety Practices, and Fertilizer Management Practices. Key questions are…

Probability-based estimates of site-specific copper water quality criteria for the Chesapeake Bay, USA.

PubMed

Arnold, W Ray; Warren-Hicks, William J

2007-01-01

The object of this study was to estimate site- and region-specific dissolved copper criteria for a large embayment, the Chesapeake Bay, USA. The intent is to show the utility of 2 copper saltwater quality site-specific criteria estimation models and associated region-specific criteria selection methods. The criteria estimation models and selection methods are simple, efficient, and cost-effective tools for resource managers. The methods are proposed as potential substitutes for the US Environmental Protection Agency's water effect ratio methods. Dissolved organic carbon data and the copper criteria models were used to produce probability-based estimates of site-specific copper saltwater quality criteria. Site- and date-specific criteria estimations were made for 88 sites (n = 5,296) in the Chesapeake Bay. The average and range of estimated site-specific chronic dissolved copper criteria for the Chesapeake Bay were 7.5 and 5.3 to 16.9 microg Cu/L. The average and range of estimated site-specific acute dissolved copper criteria for the Chesapeake Bay were 11.7 and 8.3 to 26.4 microg Cu/L. The results suggest that applicable national and state copper criteria can increase in much of the Chesapeake Bay and remain protective. Virginia Department of Environmental Quality copper criteria near the mouth of the Chesapeake Bay, however, need to decrease to protect species of equal or greater sensitivity to that of the marine mussel, Mytilus sp.

Characterizing Spatial and Temporal Patterns of Thermal Environment and Air Quality in Taipei Metropolitan Area

NASA Astrophysics Data System (ADS)

Juang, J. Y.; Sun, C. H.; Jiang, J. A.; Wen, T. H.

2017-12-01

The urban heat island effect (UHI) caused by the regional-to-global environmental changes, dramatic urbanization, and shifting in land-use compositions has becoming an important environmental issue in recent years. In the past century, the coverage of urban area in Taipei Basin has dramatically increasing by ten folds. The strengthen of UHI effect significantly enhances the frequency of warm-night effect, and strongly influences the thermal environment of the residents in the Greater Taipei Metropolitan. In addition, the urban expansions due to dramatic increasing in urban populations and traffic loading significantly impacts the air quality and causes health issue in Taipei. In this study, the main objective is to quantify and characterize the temporal and spatial distributions of thermal environmental and air quality in the Greater Taipei Metropolitan Area by using monitoring data from Central Weather Bureau, Environmental Protection Administration. In addition, in this study, we conduct the analysis on the distribution of physiological equivalent temperature in the micro scale in the metropolitan area by using the observation data and quantitative simulation to investigate how the thermal environment is influenced under different conditions. Furthermore, we establish a real-time mobile monitoring system by using wireless sensor network to investigate the correlation between the thermal environment, air quality and other environmental factors, and propose to develop the early warning system for heat stress and air quality in the metropolitan area. The results from this study can be integrated into the management and planning system, and provide sufficient and important background information for the development of smart city in the metropolitan area in the future.

Comparison of different techniques for in microgravity-a simple mathematic estimation of cardiopulmonary resuscitation quality for space environment.

PubMed

Braunecker, S; Douglas, B; Hinkelbein, J

2015-07-01

Since astronauts are selected carefully, are usually young, and are intensively observed before and during training, relevant medical problems are rare. Nevertheless, there is a certain risk for a cardiac arrest in space requiring cardiopulmonary resuscitation (CPR). Up to now, there are 5 known techniques to perform CPR in microgravity. The aim of the present study was to analyze different techniques for CPR during microgravity about quality of CPR. To identify relevant publications on CPR quality in microgravity, a systematic analysis with defined searching criteria was performed in the PubMed database (http://www.pubmed.com). For analysis, the keywords ("reanimation" or "CPR" or "resuscitation") and ("space" or "microgravity" or "weightlessness") and the specific names of the techniques ("Standard-technique" or "Straddling-manoeuvre" or "Reverse-bear-hug-technique" or "Evetts-Russomano-technique" or "Hand-stand-technique") were used. To compare quality and effectiveness of different techniques, we used the compression product (CP), a mathematical estimation for cardiac output. Using the predefined keywords for literature search, 4 different publications were identified (parabolic flight or under simulated conditions on earth) dealing with CPR efforts in microgravity and giving specific numbers. No study was performed under real-space conditions. Regarding compression depth, the handstand (HS) technique as well as the reverse bear hug (RBH) technique met parameters of the guidelines for CPR in 1G environments best (HS ratio, 0.91 ± 0.07; RBH ratio, 0.82 ± 0.13). Concerning compression rate, 4 of 5 techniques reached the required compression rate (ratio: HS, 1.08 ± 0.11; Evetts-Russomano [ER], 1.01 ± 0.06; standard side straddle, 1.00 ± 0.03; and straddling maneuver, 1.03 ± 0.12). The RBH method did not meet the required criteria (0.89 ± 0.09). The HS method showed the highest cardiac output (69.3% above the required CP), followed by the ER technique (33

Ergonomics and quality management--humans in interaction with technology, work environment, and organization.

PubMed

Eklund, J A

1999-01-01

In many studies, ergonomics has been shown to influence human performance. The aim of this paper was to demonstrate important ergonomics influences on quality in industrial production, from the perspective of interactions between humans, technology, organization, and work environment. A second aim was to elaborate on the implications of these findings for the development of quality management strategies. This paper shows that ergonomics problems in terms of adverse work environmental conditions, inappropriate design of technology, and an unsuitable organization are important causes of quality deficiencies. Problem solving aimed at improving ergonomics, quality, and productivity simultaneously is likely to obtain support from most of the interest parties of the company, and may also enhance participation. Ergonomics has the potential of becoming a driving force for the development of new quality management strategies.

An integrative review of nurses' prosocial behaviours contributing to work environment optimization, organizational performance and quality of care.

PubMed

Feather, Janice; McGillis Hall, Linda; Trbovich, Patricia; Baker, G Ross

2018-04-22

To rigorously review the literature on the prosocial workplace behaviours of nurses. Prosocial workplace behaviours, predominantly organisational citizenship behaviours have been theoretically and empirically found to promote individual and group level performance in various industries. However, little consensus exists in the literature regarding the impact of nurses' workplace behaviours on the work environment and organisational performance. An integrative literature review was conducted on studies between 1980 and 2016. Nineteen articles were included related to nurses' prosocial behaviours and performance. A positive relationship was noted between workplace behaviours and individual level performance and unit level performance. Albeit multifactorial, leadership and the social structure of the work environment are important factors contributing to the workplace behaviour-performance relationship. Prosocial behaviours influence the social functioning of the work environment and offer insights into the delivery of quality care. Nurse managers should recognize the influence of leadership style and characteristics in the work environment that encourage employee participation in prosocial behaviours. These additional voluntary efforts by nursing staff may improve organisational effectiveness and quality of care. Inclusion of these behaviours in performance reviews and as cultural norms may help to foster a more collaborative work environment. © 2018 John Wiley & Sons Ltd.

Analytical performance specifications for external quality assessment - definitions and descriptions.

PubMed

Jones, Graham R D; Albarede, Stephanie; Kesseler, Dagmar; MacKenzie, Finlay; Mammen, Joy; Pedersen, Morten; Stavelin, Anne; Thelen, Marc; Thomas, Annette; Twomey, Patrick J; Ventura, Emma; Panteghini, Mauro

2017-06-27

External Quality Assurance (EQA) is vital to ensure acceptable analytical quality in medical laboratories. A key component of an EQA scheme is an analytical performance specification (APS) for each measurand that a laboratory can use to assess the extent of deviation of the obtained results from the target value. A consensus conference held in Milan in 2014 has proposed three models to set APS and these can be applied to setting APS for EQA. A goal arising from this conference is the harmonisation of EQA APS between different schemes to deliver consistent quality messages to laboratories irrespective of location and the choice of EQA provider. At this time there are wide differences in the APS used in different EQA schemes for the same measurands. Contributing factors to this variation are that the APS in different schemes are established using different criteria, applied to different types of data (e.g. single data points, multiple data points), used for different goals (e.g. improvement of analytical quality; licensing), and with the aim of eliciting different responses from participants. This paper provides recommendations from the European Federation of Laboratory Medicine (EFLM) Task and Finish Group on Performance Specifications for External Quality Assurance Schemes (TFG-APSEQA) and on clear terminology for EQA APS. The recommended terminology covers six elements required to understand APS: 1) a statement on the EQA material matrix and its commutability; 2) the method used to assign the target value; 3) the data set to which APS are applied; 4) the applicable analytical property being assessed (i.e. total error, bias, imprecision, uncertainty); 5) the rationale for the selection of the APS; and 6) the type of the Milan model(s) used to set the APS. The terminology is required for EQA participants and other interested parties to understand the meaning of meeting or not meeting APS.

7 CFR 1728.202 - RUS Bulletin 1728H-702, RUS Specification for Quality Control and Inspection of Timber Products.

Code of Federal Regulations, 2010 CFR

2010-01-01

... calendar year. (2) Ultimate quality control is the responsibility of the producer's management; however, a... 7 Agriculture 11 2010-01-01 2010-01-01 false RUS Bulletin 1728H-702, RUS Specification for Quality... for Quality Control and Inspection of Timber Products. (a) Scope. This specification describes in more...

The quality of nutrition and physical activity environments of child-care centers across three states in the southern U.S.

PubMed

Erinosho, Temitope; Vaughn, Amber; Hales, Derek; Mazzucca, Stephanie; Gizlice, Ziya; Treadway, Cayla; Kelly, Alexandra; Ward, Dianne

2018-04-29

This cross-sectional study assessed the quality of nutrition and physical activity environments of child-care centers in three southern states and examined differences by rural versus urban location, participation in the Child and Adult Care Food Program, and Head Start status. The sample included 354 centers that enroll children aged 2-5: 154 centers from Georgia, 103 from Kentucky, and 97 centers from Mississippi. Directors and 1-2 teachers per center completed the Environment and Policy Assessment and Observation Self-Report (EPAO-SR) tool that assesses nutrition and physical activity environments of child-care centers. The EPAO-SR items were scored to capture six nutrition domains and six physical activity domains that were averaged and then summed to create a combined nutrition and physical activity environment score (range = 0-36); higher scores indicated that centers met more best practices, which translated to higher-quality environments. Overall, the centers had an average combined nutrition and physical activity environment score of 20.2 out of 36. The scores did not differ between rural and urban centers (mean = 20.3 versus 20.2, p = 0.98). Centers in the Child and Adult Care Food Program had higher combined nutrition and physical activity environment scores than non-participating centers (mean = 20.6 versus 19.1, p < 0.01). Head Start centers also had higher combined environment scores than non-Head Start centers (mean = 22.3 versus 19.6, p < 0.01). Findings highlight the vital role of federal programs in supporting healthy child-care environments. Providing technical assistance and training to centers that are not enrolled in well-regulated, federally-funded programs might help to enhance the quality of their nutrition and physical activity environments. Copyright © 2017. Published by Elsevier Inc.

Differences in Disease-specific Quality of Life in Patients with Actinic Keratosis in Australia and Denmark.

PubMed

Miller, Iben Marie; Vinding, Gabrielle; Zarchi, Kian; Esmann, Solveig; Murrell, Dedee F; Jemec, Gregor B

2016-04-01

Actinic keratosis (AK) negatively influences patient quality of life as measured by the disease-specific Actinic Keratosis Quality of Life (AKQoL) questionnaire. The quality of life in Australian patients was significantly less affected than in Danish patients. We hypothesize that general factors such as public awareness and cultural connotations of AK, may influence the impact of AK on quality of life (QoL).

Environment-specific noise suppression for improved speech intelligibility by cochlear implant users.

PubMed

Hu, Yi; Loizou, Philipos C

2010-06-01

Attempts to develop noise-suppression algorithms that can significantly improve speech intelligibility in noise by cochlear implant (CI) users have met with limited success. This is partly because algorithms were sought that would work equally well in all listening situations. Accomplishing this has been quite challenging given the variability in the temporal/spectral characteristics of real-world maskers. A different approach is taken in the present study focused on the development of environment-specific noise suppression algorithms. The proposed algorithm selects a subset of the envelope amplitudes for stimulation based on the signal-to-noise ratio (SNR) of each channel. Binary classifiers, trained using data collected from a particular noisy environment, are first used to classify the mixture envelopes of each channel as either target-dominated (SNR>or=0 dB) or masker-dominated (SNR<0 dB). Only target-dominated channels are subsequently selected for stimulation. Results with CI listeners indicated substantial improvements (by nearly 44 percentage points at 5 dB SNR) in intelligibility with the proposed algorithm when tested with sentences embedded in three real-world maskers. The present study demonstrated that the environment-specific approach to noise reduction has the potential to restore speech intelligibility in noise to a level near to that attained in quiet.

Housing Quality and Access to Material and Learning Resources within the Home Environment in Developing Countries

PubMed Central

Bradley, Robert H.; Putnick, Diane L.

2011-01-01

This study examined home environment conditions (housing quality, material resources, formal and informal learning materials) and their relations with the Human Development Index (HDI) in 28 developing countries. Home environment conditions in these countries varied widely. The quality of housing and availability of material resources at home were consistently tied to HDI; the availability of formal and informal learning materials little less so. Gross domestic product (GDP) tended to show a stronger independent relation with housing quality and material resources than life expectancy and education. Formal learning resources were independently related to the GDP and education indices, and informal learning resources were not independently related to any constituent indices of the overall HDI. PMID:22277008

Sampling the food processing environment: taking up the cudgel for preventive quality management in food processing environments.

PubMed

Wagner, Martin; Stessl, Beatrix

2014-01-01

The Listeria monitoring program for Austrian cheese factories was established in 1988. The basic idea is to control the introduction of L. monocytogenes into the food processing environment, preventing the pathogen from contaminating the food under processing. The Austrian Listeria monitoring program comprises four levels of investigation, dealing with routine monitoring of samples and consequences of finding a positive sample. Preventive quality control concepts attempt to detect a foodborne hazard along the food processing chain, prior to food delivery, retailing, and consumption. The implementation of a preventive food safety concept provokes a deepened insight by the manufacturers into problems concerning food safety. The development of preventive quality assurance strategies contributes to the national food safety status and protects public health.

Asthma-specific health-related quality of life of people in Great Britain: A national survey.

PubMed

Upton, Jane; Lewis, Carine; Humphreys, Emily; Price, David; Walker, Samantha

2016-11-01

Although the ultimate goal of asthma treatment is to improve asthma-specific Health-Related Quality-Of-Life (HRQOL), in the UK population this is insufficiently studied. National asthma-specific HRQOL data is needed to inform strategies to address this condition. To benchmark asthma-specific HRQOL in a national survey of adults with asthma, and explore differences in this measure within subsections of the population. We analysed answers to the Marks Asthma Quality-of-Life Questionnaire (AQLQ-M) from a representative sample of 658 adults with asthma. Respondents answered asthma-specific questions to assess control, previous hospital admissions, asthma attacks and an indicator of severity. Higher scores indicate poorer HRQOL (maximum = 60). The highest quintile formed a subgroup 'Poor HRQOL'. Data were weighted to correct for any biases caused by differential non-response. Chi-square analyses were used to determine differences between good and poor quality of life and regression analyses performed to determine what factors are associated with poor HRQOL. The response rate was 49%. AQLQ-M median (IQR) scores were 5 (2-13) for the total sample (poor HRQOL = 21, good HRQOL = 3). Significant differences between good and poor HRQOL were observed in smoking status, SES, employment status and co-morbidities, but no differences were found between age groups. Those with poorly controlled asthma were significantly more likely to have poor HRQOL, ≥1 breathing related hospital admission or ≥1 asthma attack. This article provides benchmarking data on asthma-specific HRQOL. Improved strategies are needed to target interventions towards people experiencing poor HRQOL.

Implementing quality/productivity improvement initiatives in an engineering environment

NASA Technical Reports Server (NTRS)

Ruda, R. R.

1985-01-01

Quality/Productivity Improvement (QPI) initiatives in the engineering environment at McDonnell Douglas-Houston include several different, distinct activities, each having its own application, yet all targeted toward one common goal - making continuous improvement a way of life. The chief executive and the next two levels of management demonstrate their commitment to QPI with hands-on involvement in several activities. Each is a member of a QPI Council which consists of six panels - Participative Management, Communications, Training, Performance/Productivity, Human Resources Management and Strategic Management. In addition, each manager conducts Workplace Visits and Bosstalks, to enhance communications with employees and to provide a forum for the identification of problems - both real and perceived. Quality Circles and Project Teams are well established within McConnel Douglas as useful and desirable employee involvement teams. The continued growth of voluntary membership in the circles program is strong evidence of the employee interest and management support that have developed within the organization.

[Coupling coordination evaluation method between eco-environment quality and economic development level in contiguous special poverty-stricken areas of China].

PubMed

Wang, Yan-hui; Li, Jing-yi

2015-05-01

It is one of the important strategies in the new period of national poverty alleviation and development to maintain the basic balance between the ecological environment and economic development, and to promote the coordinated sustainable development of economy and ecological environment. Taking six contiguous special poverty-stricken areas as the study areas, a coupling coordination evaluation method between eco-environment quality and economic development level in contiguous special poverty-stricken areas was explored in this paper. The region' s ecological poverty index system was proposed based on the natural attribute of ecological environment, and the ecological environment quality evaluation method was built up by using AHP weighting method, followed by the design of the coupling coordination evaluation method between the ecological environment indices and the county economic poverty comprehensive indices. The coupling coordination degrees were calculated and their spatial representation differentiations were analyzed respectively at district, province, city, and county scales. Results showed that approximately half of the counties in the study areas achieved the harmoniously coordinated development. However, the ecological environmental quality and the economic development in most counties could not be synchronized, where mountains, rivers and other geographic features existed roughly as a dividing line of the coordinated development types. The phenomena of dislocation between the ecological environment and economic development in state-level poor counties were more serious than those of local poor counties.

Temporal Patterns in Seawater Quality from Dredging in Tropical Environments.

PubMed

Jones, Ross; Fisher, Rebecca; Stark, Clair; Ridd, Peter

2015-01-01

Maintenance and capital dredging represents a potential risk to tropical environments, especially in turbidity-sensitive environments such as coral reefs. There is little detailed, published observational time-series data that quantifies how dredging affects seawater quality conditions temporally and spatially. This information is needed to test realistic exposure scenarios to better understand the seawater-quality implications of dredging and ultimately to better predict and manage impacts of future projects. Using data from three recent major capital dredging programs in North Western Australia, the extent and duration of natural (baseline) and dredging-related turbidity events are described over periods ranging from hours to weeks. Very close to dredging i.e. <500 m distance, a characteristic features of these particular case studies was high temporal variability. Over several hours suspended sediment concentrations (SSCs) can range from 100-500 mg L-1. Less turbid conditions (10-80 mg L-1) can persist over several days but over longer periods (weeks to months) averages were <10 mg L-1. During turbidity events all benthic light was sometimes extinguished, even in the shallow reefal environment, however a much more common feature was very low light 'caliginous' or daytime twilight periods. Compared to pre-dredging conditions, dredging increased the intensity, duration and frequency of the turbidity events by 10-, 5- and 3-fold respectively (at sites <500 m from dredging). However, when averaged across the entire dredging period of 80-180 weeks, turbidity values only increased by 2-3 fold above pre-dredging levels. Similarly, the upper percentile values (e.g., P99, P95) of seawater quality parameters can be highly elevated over short periods, but converge to values only marginally above baseline states over longer periods. Dredging in these studies altered the overall probability density distribution, increasing the frequency of extreme values. As such, attempts

Temporal Patterns in Seawater Quality from Dredging in Tropical Environments

PubMed Central

Jones, Ross; Fisher, Rebecca; Stark, Clair; Ridd, Peter

2015-01-01

Maintenance and capital dredging represents a potential risk to tropical environments, especially in turbidity-sensitive environments such as coral reefs. There is little detailed, published observational time-series data that quantifies how dredging affects seawater quality conditions temporally and spatially. This information is needed to test realistic exposure scenarios to better understand the seawater-quality implications of dredging and ultimately to better predict and manage impacts of future projects. Using data from three recent major capital dredging programs in North Western Australia, the extent and duration of natural (baseline) and dredging-related turbidity events are described over periods ranging from hours to weeks. Very close to dredging i.e. <500 m distance, a characteristic features of these particular case studies was high temporal variability. Over several hours suspended sediment concentrations (SSCs) can range from 100–500 mg L-1. Less turbid conditions (10–80 mg L-1) can persist over several days but over longer periods (weeks to months) averages were <10 mg L-1. During turbidity events all benthic light was sometimes extinguished, even in the shallow reefal environment, however a much more common feature was very low light ‘caliginous’ or daytime twilight periods. Compared to pre-dredging conditions, dredging increased the intensity, duration and frequency of the turbidity events by 10-, 5- and 3-fold respectively (at sites <500 m from dredging). However, when averaged across the entire dredging period of 80–180 weeks, turbidity values only increased by 2–3 fold above pre-dredging levels. Similarly, the upper percentile values (e.g., P99, P95) of seawater quality parameters can be highly elevated over short periods, but converge to values only marginally above baseline states over longer periods. Dredging in these studies altered the overall probability density distribution, increasing the frequency of extreme values. As such

Nurses' Perspectives on the Geriatric Nursing Practice Environment and the Quality of Older People's Care in Ontario Acute Care Hospitals.

PubMed

Fox, Mary T; Sidani, Souraya; Butler, Jeffrey I; Tregunno, Deborah

2017-06-01

Background Cultivating hospital environments that support older people's care is a national priority. Evidence on geriatric nursing practice environments, obtained from studies of registered nurses (RNs) in American teaching hospitals, may have limited applicability to Canada, where RNs and registered practical nurses (RPNs) care for older people in predominantly nonteaching hospitals. Purpose This study describes nurses' perceptions of the overall quality of care for older people and the geriatric nursing practice environment (geriatric resources, interprofessional collaboration, and organizational value of older people's care) and examines if these perceptions differ by professional designation and hospital teaching status. Methods A cross-sectional survey, using Dillman's tailored design, that included Geriatric Institutional Assessment Profile subscales, was completed by 2005 Ontario RNs and registered practical nurses to assess their perceptions of the quality of care and geriatric nursing practice environment. Results Scores on the Geriatric Institutional Assessment Profile subscales averaged slightly above the midpoint except for geriatric resources which was slightly below. Registered practical nurses rated the quality of care and geriatric nursing practice environment higher than RNs; no significant differences were found by hospital teaching status. Conclusions Nurses' perceptions of older people's care and the geriatric nursing practice environment differ by professional designation but not hospital teaching status. Teaching and nonteaching hospitals should both be targeted for geriatric nursing practice environment improvement initiatives.

Disease-specific health-related quality of life instruments for IgE-mediated food allergy.

PubMed

Salvilla, S A; Dubois, A E J; Flokstra-de Blok, B M J; Panesar, S S; Worth, A; Patel, S; Muraro, A; Halken, S; Hoffmann-Sommergruber, K; DunnGalvin, A; Hourihane, J O'B; Regent, L; de Jong, N W; Roberts, G; Sheikh, A

2014-07-01

This is one of seven interlinked systematic reviews undertaken on behalf of the European Academy of Allergy and Clinical Immunology as part of their Guidelines for Food Allergy and Anaphylaxis, which focuses on instruments developed for IgE-mediated food allergy. Disease-specific questionnaires are significantly more sensitive than generic ones in measuring the response to interventions or future treatments, as well as estimating the general burden of food allergy. The aim of this systematic review was therefore to identify which disease-specific, validated instruments can be employed to enable assessment of the impact of, and investigations and interventions for, IgE-mediated food allergy on health-related quality of life (HRQL). Using a sensitive search strategy, we searched seven electronic bibliographic databases to identify disease-specific quality of life (QOL) tools relating to IgE-mediated food allergy. From the 17 eligible studies, we identified seven disease-specific HRQL instruments, which were then subjected to detailed quality appraisal. This revealed that these instruments have undergone formal development and validation processes, and have robust psychometric properties, and therefore provide a robust means of establishing the impact of food allergy on QOL. Suitable instruments are now available for use in children, adolescents, parents/caregivers, and adults. Further work must continue to develop a clinical minimal important difference for food allergy and for making these instruments available in a wider range of European languages. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparing Cultural Differences in Two Quality Measures in Chinese Kindergartens: The Early Childhood Environment Rating Scale-Revised and the Kindergarten Quality Rating System

ERIC Educational Resources Information Center

Hu, Bi Ying

2015-01-01

This study examined the degrees of congruence between two early childhood evaluation systems on various quality concepts: the Early Childhood Environment Rating Scale-Revised (ECERS-R) and Zhejiang's Kindergarten Quality Rating System (KQRS). Analysis of variance and post hoc least significant difference tests were employed to show the extent to…

Validity, reliability and Norwegian adaptation of the Stroke-Specific Quality of Life (SS-QOL) scale.

PubMed

Pedersen, Synne Garder; Heiberg, Guri Anita; Nielsen, Jørgen Feldbæk; Friborg, Oddgeir; Stabel, Henriette Holm; Anke, Audny; Arntzen, Cathrine

2018-01-01

There is a paucity of stroke-specific instruments to assess health-related quality of life in the Norwegian language. The objective was to examine the validity and reliability of a Norwegian version of the 12-domain Stroke-Specific Quality of Life scale. A total of 125 stroke survivors were prospectively recruited. Questionnaires were administered at 3 months; 36 test-retests were performed at 12 months post stroke. The translation was conducted according to guidelines. The internal consistency was assessed with Cronbach's alpha; convergent validity, with item-to-subscale correlations; and test-retest, with Spearman's correlations. Scaling validity was explored by calculating both floor and ceiling effects. A priori hypotheses regarding the associations between the Stroke-Specific Quality of Life domain scores and scores of established measures were tested. Standard error of measurement was assessed. The Norwegian version revealed no major changes in back translations. The internal consistency values of the domains were Cronbach's alpha = 0.79-0.93. Rates of missing items were small, and the item-to-subscale correlation coefficients supported convergent validity (0.48-0.87). The observed floor effects were generally small, whereas the ceiling effects had moderate or high values (16%-63%). Test-retest reliability indicated stability in most domains, with Spearman's rho = 0.67-0.94 (all p < 0.001), whereas the rho was 0.35 (p < 0.05) for the 'Vision' domain. Hypothesis testing supported the construct validity of the scale. Standard error of measurement values for each domain were generated to indicate the required magnitudes of detectable change. The Norwegian version of the Stroke-Specific Quality of Life scale is a reliable and valid instrument with good psychometric properties. It is suited for use in health research as well as in individual assessments of persons with stroke.

Assessment and prediction of land ecological environment quality change based on remote sensing-a case study of the Dongting lake area in China

NASA Astrophysics Data System (ADS)

Hu, Wenmin; Wang, Zhongcheng; Li, Chunhua; Zhao, Jin; Li, Yi

2018-02-01

Multi-source remote sensing data is rarely used for the comprehensive assessment of land ecologic environment quality. In this study, a digital environmental model was proposed with the inversion algorithm of land and environmental factors based on the multi-source remote sensing data, and a comprehensive index (Ecoindex) was applied to reconstruct and predict the land environment quality of the Dongting Lake Area to assess the effect of human activities on the environment. The main finding was that with the decrease of Grade I and Grade II quality had a decreasing tendency in the lake area, mostly in suburbs and wetlands. Atmospheric water vapour, land use intensity, surface temperature, vegetation coverage, and soil water content were the main driving factors. The cause of degradation was the interference of multi-factor combinations, which led to positive and negative environmental agglomeration effects. Positive agglomeration, such as increased rainfall and vegetation coverage and reduced land use intensity, could increase environmental quality, while negative agglomeration resulted in the opposite. Therefore, reasonable ecological restoration measures should be beneficial to limit the negative effects and decreasing tendency, improve the land ecological environment quality and provide references for macroscopic planning by the government.

An Evaluation of Specific Videodisc Courseware on Student Learning in a Rural School Environment.

ERIC Educational Resources Information Center

Hasselbring, Ted S.; And Others

The Tennessee Valley Authority initiated and funded a 2-year study that examined the use of interactive instructional videodiscs in a rural school environment. The purpose of this project was to evaluate the effects of several specific videodisc programs on student learning and academic achievement. Videodisc courseware in mathematics and science…

Predictors of Study Success from a Teacher's Perspective of the Quality of the Built Environment

ERIC Educational Resources Information Center

Kok, Herman; Mobach, Mark; Omta, Onno

2015-01-01

The article aims to find predictors of study success from a teacher's perspective that relate to the built environment. The research is based on a national online survey among 1752 teachers at 18 Dutch Universities of Applied Sciences. Multivariate data analyses were used to test the hypothesis that the quality of spatial and functional aspects at…

Exploring Quality Teaching in the Online Environment Using an Evidence-Based Approach

ERIC Educational Resources Information Center

Prieto-Rodriguez, Elena; Gore, Jennifer; Holmes, Kathryn

2016-01-01

Online learning is increasingly ubiquitous in higher education. However, research regarding online teaching often focuses on the affordances of the online environment rather than on the quality of pedagogy. In this paper we consider how online learning could be enhanced using rich pedagogical models that are consistent with a wealth of existing…

[A quality assessment of notified occupational diseases submitted to the National Occupational Environment Service].

PubMed

Lander, F; Bach, B; Laursen, P

1999-08-09

The aim of this study was to assess the quality of a consecutive sample of occupational disease notifications submitted to the National Working Environment Service during 1994. The sample consisted of 860 notifications describing occupational diseases among persons working in companies situated in the county of Vejle. The data information e.g. company name and address, time of employment, harmful exposure and disease, were registered. An overall data quality assessment was performed including evaluation of the etiological connection between described occupational exposure and disease and potential preventive perspectives. The study showed that the notified informations in general were adequate, but doctors need to pay more attention to dose description of the harmful exposure. About 80% of the notifications presented an adequate connection between occupational exposure and disease. Only half of the notifications described preventable and recent (less than five years) harmful exposure. In conclusion, the Danish occupational disease notification system is in general of a high standard, and the National Working Environment Service could make more use of doctors' information provided in these notifications.

A multi-method study on the quality of the nurse work environment in acute-care hospitals: positioning Switzerland in the Magnet hospital research.

PubMed

Desmedt, M; De Geest, S; Schubert, M; Schwendimann, R; Ausserhofer, D

2012-12-21

Magnet hospitals share nurse work environment characteristics associated with superior patient, nurse and financial outcomes. In Switzerland, however, it is uncertain how nurses appraise their work environments. To describe the quality of the nurse work environment in 35 Swiss acute care hospitals and to benchmark findings based on international Magnet hospital research. This study used two data sources: (1) the Swiss arm of the RN4CAST study; and (2) a structured literature review. Hospitals were categorised based on Magnet and non-Magnet data. Our outcome variable of interest was the quality of nurse work environment measured with the Practice Environment Scale of the Nurse Work Index (PES-NWI). We reviewed 13 American, Canadian, and Australian studies of acute-care hospitals. Three provided Magnet hospitals' nurse work environment data, and all included non-Magnet hospitals' data. Swiss hospitals' evaluations on nurse work environment quality varied widely, but 25% achieved scores indicating "Magnet nurse work environments". Swiss hospitals' average "Nursing manager ability" subscale scores fulfilled Magnet hospital criteria, although "Nurse participation in hospital affairs" and "Nursing staffing and resource adequacy" scores neared non-Magnet levels. On average, our results indicated high quality nurse work environments in Swiss hospitals. Implementing Magnet model organisational principles might be a valuable approach for Swiss acute-care hospitals to both improve mixed and unfavourable nurse work environments and to improve nurse and patient outcomes. National benchmarking of nurse work environments and other nurse-sensitive indicators may facilitate evaluating the impact of current developments in Swiss healthcare.

Campus Life for International Students: Exploring Students' Perceptions of Quality Learning Environment at a Private University in Malaysia

ERIC Educational Resources Information Center

Seng, Ernest Lim Kok; Khoo-Lattimore, Catheryn

2012-01-01

The number of international students enrolling at higher learning institutions in Malaysia is increasing each year. However, the quality of learning environment is not always easy to measure, particularly for private universities which are not financially aided by the government, where the learning environment is characterized by their physical…

Dementia-specific quality of life instruments and their appropriateness in shared-housing arrangements--a literature study.

PubMed

Gräske, Johannes; Fischer, Thomas; Kuhlmey, Adelheid; Wolf-Ostermann, Karin

2012-01-01

Shared-housing arrangements (SHA) in Germany are a specific type of housing arrangement that belongs to the global concept of small-scale living arrangements. This caring approach comprises characteristics of both home and institutional care for persons with dementia. To evaluate the impact of SHA on the quality of life (QoL) of residents, an appropriate setting- and dementia-specific QoL instrument is needed. This article aims to identify QoL instruments that relate to the core domains of SHA. After a comprehensive literature review, existing dementia-specific QoL instruments were evaluated to determine whether any have been specifically designed for or applied in SHA. Additionally, each domain of the instruments was matched with the core domains of SHA. None of the existing instruments was identified as having been developed for SHA. Matching of the instrument domains with the SHA core domains leads to the conclusion that Quality of Life-Alzheimer's Disease, Dementia Quality of Life, Alzheimer Disease-Related Quality of Life, and QUALIDEM are adequate instruments for measuring the dementia-specific QoL of persons living in SHA. For the first time, a basis has been created for valid QoL evaluations of residents with dementia living in SHA. The 4 identified instruments are considered applicable in SHA. Conducting a performance test and evaluating further attributes according to the Scientific Advisory Committee of the Medical Outcomes Trust (e.g., reliability and validity) will further elucidation of the appropriateness of the instruments for SHA. Copyright © 2012 Mosby, Inc. All rights reserved.

Parents' and Teachers' Perceptions of Quality in Portuguese Childcare Classrooms

ERIC Educational Resources Information Center

Barros, Sílvia; Leal, Teresa B.

2015-01-01

The main goal of this study was to examine parents' and teachers' perceptions of quality in early childhood education for toddlers in Portugal. A total of 110 parents and 110 teachers participated in the study, rating the importance of specific quality criteria and assessing childcare classrooms, based on the Infant/Toddler Environment Rating…

Construction and application of an intelligent air quality monitoring system for healthcare environment.

PubMed

Yang, Chao-Tung; Liao, Chi-Jui; Liu, Jung-Chun; Den, Walter; Chou, Ying-Chyi; Tsai, Jaw-Ji

2014-02-01

Indoor air quality monitoring in healthcare environment has become a critical part of hospital management and policy. Manual air sampling and analysis are cost-inhibitive and do not provide real-time air quality data and response measures. In this month-long study over 14 sampling locations in a public hospital in Taiwan, we observed a positive correlation between CO(2) concentration and population, total bacteria, and particulate matter concentrations, thus monitoring CO(2) concentration as a general indicator for air quality could be a viable option. Consequently, an intelligent environmental monitoring system consisting of a CO(2)/temperature/humidity sensor, a digital plug, and a ZigBee Router and Coordinator was developed and tested. The system also included a backend server that received and analyzed data, as well as activating ventilation and air purifiers when CO(2) concentration exceeded a pre-set value. Alert messages can also be delivered to offsite users through mobile devices.

Investigating the Quality of Project-Based Science and Technology Learning Environments in Elementary School: A Critical Review of Instruments

ERIC Educational Resources Information Center

Thys, Miranda; Verschaffel, Lieven; Van Dooren, Wim; Laevers, Ferre

2016-01-01

This paper provides a systematic review of instruments that have the potential to measure the quality of project-based science and technology (S&T) learning environments in elementary school. To this end, a comprehensive literature search was undertaken for the large field of S&T learning environments. We conducted a horizontal bottom-up…

The impact of resource quality on the evolution of virulence in spatially heterogeneous environments.

PubMed

Su, Min; Boots, Mike

2017-03-07

Understanding the drivers of parasite evolution and in particular disease virulence remains a major focus of evolutionary theory. Here, we examine the role of resource quality and in particular spatial environmental heterogeneity in the distribution of these resources on the evolution of virulence. There may be direct effects of resources on host susceptibility and pathogenicity alongside effects on reproduction that indirectly impact host-parasite population dynamics. Therefore, we assume that high resource quality may lead to both increased host reproduction and/or increased disease resistance. In completely mixed populations there is no effect of resource quality on the outcome of disease evolution. However, when there are local interactions higher resource quality generally selects for higher virulence/transmission for both linear and saturating transmission-virulence trade-off assumptions. The exception is that in castrators (i.e., infected hosts have no reproduction), higher virulence is selected for both low and high resource qualities at mixed local and global infection. Heterogeneity in the distribution of environment resources only has an effect on the outcome in castrators where random distributions generally select for higher virulence. Overall, our results further underline the importance of considering spatial structure in order to understand evolutionary processes. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Importance of Specific Workplace Environment Characteristics for Maximum Health and Performance: Healthcare Workers' Perspective.

PubMed

Sagha Zadeh, Rana; Shepley, Mardelle M; Owora, Arthur Hamie; Dannenbaum, Martha C; Waggener, Laurie T; Chung, Susan Sung Eun

2018-05-01

To examine the importance of specific workplace environment characteristics for maximum health and performance, assigned by healthcare employees, and how they relate to the nature of their work. A cross-sectional mixed-method study was conducted with content analysis and robust regression models to examine the relationship between workplace environment characteristics and perceived importance in promoting health and performance. Our findings suggest that perceptions of key environment characteristics that safeguard health and performance in healthcare workplaces may vary by employee sex, setting, and nature of healthcare work involved. Theme and model descriptions of the influence of these factors on participant perceptions are provided. Employee feedback on workplace characteristics that impact health and performance could be instrumental in determining the priorities of workplace design.

Does scoliosis-specific exercise treatment in adolescence alter adult quality of life?

PubMed

Płaszewski, Maciej; Cieśliński, Igor; Kowalski, Paweł; Truszczyńska, Aleksandra; Nowobilski, Roman

2014-01-01

Health-related quality of life in adults, who in adolescence participated in a scoliosis-specific exercise program, was not previously studied. Design. Cross-sectional study, with retrospective data collection. Homogenous groups of 68 persons (43 women) aged 30.10 (25-39) years, with mild or moderate scoliosis, and 76 (38 women) able-bodied persons, aged 30.11 (24-38) years, who 16.5 (12-26) years earlier had completed scoliosis-specific exercise or observation regimes, participated. Their respiratory characteristics did not differ from predicted values. The WHOQOL-BREF questionnaire, Oswestry Disability Questionnaire, and pain scale (VAS) were applied. The transformed WHOQOL-BREF scores ranged from 54.6 ± 11.19 in the physical domain in the mild scoliotic subgroup to 77.1 ± 16.05 in the social domain in the able-bodied subgroup. The ODQ values did not generally exceed 5.3 ± 7.53. Inter- and intragroup differences were nonsignificant. Age, marital status, education, and gender were significantly associated with the ODQ scores. Significant association between the ODQ and WHOQOL-BREF social relationships domain scores with the participation in exercise treatment was found. Participants with the history of exercise treatment generally did not differ significantly from their peers who were only under observation. This study cannot conclude that scoliosis-specific exercise treatment in adolescence alters quality of life in adulthood.

Housing quality and access to material and learning resources within the home environment in developing countries.

PubMed

Bradley, Robert H; Putnick, Diane L

2012-01-01

This study examined home environment conditions (housing quality, material resources, formal and informal learning materials) and their relations with the Human Development Index (HDI) in 28 developing countries. Home environment conditions in these countries varied widely. The quality of housing and availability of material resources at home were consistently tied to HDI; the availability of formal and informal learning materials a little less so. Gross domestic product (GDP) tended to show a stronger independent relation with housing quality and material resources than life expectancy and education. Formal learning resources were independently related to the GDP and education indices, and informal learning resources were not independently related to any constituent indices of the overall HDI. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.

Are Staffing, Work Environment, Work Stressors, and Rationing of Care Related to Care Workers' Perception of Quality of Care? A Cross-Sectional Study.

PubMed

Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

2015-10-01

To describe care worker-reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care. Cross-sectional study. National, randomly selected sample of Swiss nursing homes, stratified according to language region and size. A total of 4311 care workers of all educational backgrounds (registered nurses, licensed practical nurses, nurse aides) from 402 units in 155 nursing homes completed a survey between May 2012 and April 2013. Care worker-reported quality of care was measured with a single item; predictors were assessed with established instruments (eg, Practice Environment Scale-Nurse Working Index) adapted for nursing home use. A multilevel logistic regression model was applied to assess predictors for quality of care. Overall, 7% of care workers rated the quality of care provided as rather low or very low. Important factors related to better quality of care were higher teamwork and safety climate (odds ratio [OR] 6.19, 95% confidence interval [CI] 4.36-8.79); better staffing and resources adequacy (OR 2.94, 95% CI 2.08-4.15); less stress due to workload (OR 0.71, 95% CI 0.55-0.93); less implicit rationing of caring, rehabilitation, and monitoring (OR 0.34, 95% CI 0.24-0.49); and less rationing of social care (OR 0.80, 95% CI 0.69-0.92). Neither leadership nor staffing levels, staff mix, or turnover was significantly related to quality of care. Work environment factors and organizational processes are vital to provide high quality of care. The improvement of work environment, support in handling work stressors, and reduction of rationing of nursing care might be intervention points to promote high quality of care in nursing homes. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Quality Improvement, Inventory Management, Lead Time Reduction and Production Scheduling in High-Mix Manufacturing Environments

DTIC Science & Technology

2017-01-13

Quality Improvement, Inventory Management, Lead Time Reduction and Production Scheduling in High-mix Manufacturing Environments by Sean Daigle B.S...for the degree of Master of Engineering in Advanced Manufacturing and Design at the MASSACHUSETTS INSTITUTE OF TECHNOLOGY February 2017 c... Production Scheduling in High-mix Manufacturing Environments by Sean Daigle Submitted to the Department of Mechanical Engineering on January 13, 2017, in

Live births achieved via IVF are increased by improvements in air quality and laboratory environment.

PubMed

Heitmann, Ryan J; Hill, Micah J; James, Aidita N; Schimmel, Tim; Segars, James H; Csokmay, John M; Cohen, Jacques; Payson, Mark D

2015-09-01

Infertility is a common disease, which causes many couples to seek treatment with assisted reproduction techniques. Many factors contribute to successful assisted reproduction technique outcomes. One important factor is laboratory environment and air quality. Our facility had the unique opportunity to compare consecutively used, but separate assisted reproduction technique laboratories, as a result of a required move. Environmental conditions were improved by strategic engineering designs. All other aspects of the IVF laboratory, including equipment, physicians, embryologists, nursing staff and protocols, were kept constant between facilities. Air quality testing showed improved air quality at the new IVF site. Embryo implantation (32.4% versus 24.3%; P < 0.01) and live birth (39.3% versus 31.8%, P < 0.05) were significantly increased in the new facility compared with the old facility. More patients met clinical criteria and underwent mandatory single embryo transfer on day 5 leading to both a reduction in multiple gestation pregnancies and increased numbers of vitrified embryos per patient with supernumerary embryos available. Improvements in IVF laboratory conditions and air quality had profound positive effects on laboratory measures and patient outcomes. This study further strengthens the importance of the laboratory environment and air quality in the success of an IVF programme. Published by Elsevier Ltd.

Beyond greenspace: an ecological study of population general health and indicators of natural environment type and quality.

PubMed

Wheeler, Benedict W; Lovell, Rebecca; Higgins, Sahran L; White, Mathew P; Alcock, Ian; Osborne, Nicholas J; Husk, Kerryn; Sabel, Clive E; Depledge, Michael H

2015-04-30

Many studies suggest that exposure to natural environments ('greenspace') enhances human health and wellbeing. Benefits potentially arise via several mechanisms including stress reduction, opportunity and motivation for physical activity, and reduced air pollution exposure. However, the evidence is mixed and sometimes inconclusive. One explanation may be that "greenspace" is typically treated as a homogenous environment type. However, recent research has revealed that different types and qualities of natural environments may influence health and wellbeing to different extents. This ecological study explores this issue further using data on land cover type, bird species richness, water quality and protected or designated status to create small-area environmental indicators across Great Britain. Associations between these indicators and age/sex standardised prevalence of both good and bad health from the 2011 Census were assessed using linear regression models. Models were adjusted for indicators of socio-economic deprivation and rurality, and also investigated effect modification by these contextual characteristics. Positive associations were observed between good health prevalence and the density of the greenspace types, "broadleaf woodland", "arable and horticulture", "improved grassland", "saltwater" and "coastal", after adjusting for potential confounders. Inverse associations with bad health prevalence were observed for the same greenspace types, with the exception of "saltwater". Land cover diversity and density of protected/designated areas were also associated with good and bad health in the predicted manner. Bird species richness (an indicator of local biodiversity) was only associated with good health prevalence. Surface water quality, an indicator of general local environmental condition, was associated with good and bad health prevalence contrary to the manner expected, with poorer water quality associated with better population health. Effect

An Integrated Computer Modeling Environment for Regional Land Use, Air Quality, and Transportation Planning

DOT National Transportation Integrated Search

1997-04-01

The Land Use, Air Quality, and Transportation Integrated Modeling Environment (LATIME) represents an integrated approach to computer modeling and simulation of land use allocation, travel demand, and mobile source emissions for the Albuquerque, New M...

Specification of the near-Earth space environment with SHIELDS

DOE PAGES

Jordanova, Vania Koleva; Delzanno, Gian Luca; Henderson, Michael Gerard; ...

2017-11-26

Here, predicting variations in the near-Earth space environment that can lead to spacecraft damage and failure is one example of “space weather” and a big space physics challenge. A project recently funded through the Los Alamos National Laboratory (LANL) Directed Research and Development (LDRD) program aims at developing a new capability to understand, model, and predict Space Hazards Induced near Earth by Large Dynamic Storms, the SHIELDS framework. The project goals are to understand the dynamics of the surface charging environment (SCE), the hot (keV) electrons representing the source and seed populations for the radiation belts, on both macro- andmore » micro-scale. Important physics questions related to particle injection and acceleration associated with magnetospheric storms and substorms, as well as plasma waves, are investigated. These challenging problems are addressed using a team of world-class experts in the fields of space science and computational plasma physics, and state-of-the-art models and computational facilities. A full two-way coupling of physics-based models across multiple scales, including a global MHD (BATS-R-US) embedding a particle-in-cell (iPIC3D) and an inner magnetosphere (RAM-SCB) codes, is achieved. New data assimilation techniques employing in situ satellite data are developed; these provide an order of magnitude improvement in the accuracy in the simulation of the SCE. SHIELDS also includes a post-processing tool designed to calculate the surface charging for specific spacecraft geometry using the Curvilinear Particle-In-Cell (CPIC) code that can be used for reanalysis of satellite failures or for satellite design.« less

Specification of the near-Earth space environment with SHIELDS

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

Jordanova, Vania Koleva; Delzanno, Gian Luca; Henderson, Michael Gerard

Here, predicting variations in the near-Earth space environment that can lead to spacecraft damage and failure is one example of “space weather” and a big space physics challenge. A project recently funded through the Los Alamos National Laboratory (LANL) Directed Research and Development (LDRD) program aims at developing a new capability to understand, model, and predict Space Hazards Induced near Earth by Large Dynamic Storms, the SHIELDS framework. The project goals are to understand the dynamics of the surface charging environment (SCE), the hot (keV) electrons representing the source and seed populations for the radiation belts, on both macro- andmore » micro-scale. Important physics questions related to particle injection and acceleration associated with magnetospheric storms and substorms, as well as plasma waves, are investigated. These challenging problems are addressed using a team of world-class experts in the fields of space science and computational plasma physics, and state-of-the-art models and computational facilities. A full two-way coupling of physics-based models across multiple scales, including a global MHD (BATS-R-US) embedding a particle-in-cell (iPIC3D) and an inner magnetosphere (RAM-SCB) codes, is achieved. New data assimilation techniques employing in situ satellite data are developed; these provide an order of magnitude improvement in the accuracy in the simulation of the SCE. SHIELDS also includes a post-processing tool designed to calculate the surface charging for specific spacecraft geometry using the Curvilinear Particle-In-Cell (CPIC) code that can be used for reanalysis of satellite failures or for satellite design.« less

Specific deficit analyses in motor performance and quality of life of pediatric cancer patients--a cross-sectional pilot study.

PubMed

Beulertz, Julia; Bloch, Wilhelm; Prokop, Aram; Baumann, Freerk T

2013-05-01

Although survival rates in childhood cancer have distinctly improved, pediatric cancer patients often experience various disease- and treatment-related side effects with long-term consequences. Despite current studies investigating inactivity and limitations in physical functioning and quality of life in pediatric cancer patients, only little information regarding specific deficits in physical functioning and quality of life has been available until now. No study has yet analyzed these parameters from a global perspective and then identified specific deficits in a mixed childhood cancer population. Within this cross-sectional pilot study, motor performance and quality of life of 26 pediatric cancer patients were assessed after inpatient medical treatment, using standardized motor test batteries (MOT 4-6; DMT 6-18) and a quality of life questionnaire (KINDL®). Reference data have been mainly provided by the German "Children and Young People Health Survey" (KiGGS). Patients achieved lower motor performance scores (p = .000) (more than 27% below the average of healthy peers). Specific deficits were identified in motor speed and motor control (4-6 years), as well as in endurance, strength and coordination under time pressure (6-17 years). In terms of quality of life, no significant differences were examined compared to healthy children of the same age. The results of this study confirm that children with oncological diseases frequently have specific motor problems. Future research in pediatric oncology must investigate the impact of targeted, individualized exercise interventions addressing these specific deficits.

Software Quality Assurance and the Fleet Material Support Environment.

DTIC Science & Technology

1982-06-01

is one of utility; each factor identified could be applied to :t production environment. The interaction of support groups within an operational...ship-support functio2s. It is comprised of aoproxi- mately 250 people and is i furctionally oriented department. The Financial Sistems Desian and...that t h-, following specific conditions ?xist: 1. Poorly Defined Regu-rements/Speci-fica:-4ons a) FM1SO design procedures/practices tend to be appli

Improving Quality of the Child Care Environment through a Consultancy Programme for Centre Directors

ERIC Educational Resources Information Center

Helmerhorst, Katrien O. W.; Fukkink, Ruben G.; Riksen-Walraven, J. Marianne A.; Gevers Deynoot-Schaub, Mirjam J. J. M.; Tavecchio, Louis W. C.

2017-01-01

This study examined the effects of a newly developed on-site consultancy programme to improve global quality of the child care environment in non-parental child care centres for 0- to 4-year-old children as measured with the ITERS-R/ECERS-R. Using a randomised controlled trial with a pretest, posttest, and follow-up test, we compared 35…

Validity, reliability and Norwegian adaptation of the Stroke-Specific Quality of Life (SS-QOL) scale

PubMed Central

Pedersen, Synne Garder; Heiberg, Guri Anita; Nielsen, Jørgen Feldbæk; Friborg, Oddgeir; Stabel, Henriette Holm; Anke, Audny; Arntzen, Cathrine

2018-01-01

Background: There is a paucity of stroke-specific instruments to assess health-related quality of life in the Norwegian language. The objective was to examine the validity and reliability of a Norwegian version of the 12-domain Stroke-Specific Quality of Life scale. Methods: A total of 125 stroke survivors were prospectively recruited. Questionnaires were administered at 3 months; 36 test–retests were performed at 12 months post stroke. The translation was conducted according to guidelines. The internal consistency was assessed with Cronbach’s alpha; convergent validity, with item-to-subscale correlations; and test–retest, with Spearman’s correlations. Scaling validity was explored by calculating both floor and ceiling effects. A priori hypotheses regarding the associations between the Stroke-Specific Quality of Life domain scores and scores of established measures were tested. Standard error of measurement was assessed. Results: The Norwegian version revealed no major changes in back translations. The internal consistency values of the domains were Cronbach’s alpha = 0.79–0.93. Rates of missing items were small, and the item-to-subscale correlation coefficients supported convergent validity (0.48–0.87). The observed floor effects were generally small, whereas the ceiling effects had moderate or high values (16%–63%). Test–retest reliability indicated stability in most domains, with Spearman’s rho = 0.67–0.94 (all p < 0.001), whereas the rho was 0.35 (p < 0.05) for the ‘Vision’ domain. Hypothesis testing supported the construct validity of the scale. Standard error of measurement values for each domain were generated to indicate the required magnitudes of detectable change. Conclusions: The Norwegian version of the Stroke-Specific Quality of Life scale is a reliable and valid instrument with good psychometric properties. It is suited for use in health research as well as in individual assessments of persons with stroke

Inflammatory bowel disease-specific health-related quality of life instruments: a systematic review of measurement properties.

PubMed

Chen, Xin-Lin; Zhong, Liang-Huan; Wen, Yi; Liu, Tian-Wen; Li, Xiao-Ying; Hou, Zheng-Kun; Hu, Yue; Mo, Chuan-Wei; Liu, Feng-Bin

2017-09-15

This review aims to critically appraise and compare the measurement properties of inflammatory bowel disease (IBD)-specific health-related quality of life instruments. Medline, EMBASE and ISI Web of Knowledge were searched from their inception to May 2016. IBD-specific instruments for patients with Crohn's disease, ulcerative colitis or IBD were enrolled. The basic characteristics and domains of the instruments were collected. The methodological quality of measurement properties and measurement properties of the instruments were assessed. Fifteen IBD-specific instruments were included, which included twelve instruments for adult IBD patients and three for paediatric IBD patients. All of the instruments were developed in North American and European countries. The following common domains were identified: IBD-related symptoms, physical, emotional and social domain. The methodological quality was satisfactory for content validity; fair in internal consistency, reliability, structural validity, hypotheses testing and criterion validity; and poor in measurement error, cross-cultural validity and responsiveness. For adult IBD patients, the IBDQ-32 and its short version (SIBDQ) had good measurement properties and were the most widely used worldwide. For paediatric IBD patients, the IMPACT-III had good measurement properties and had more translated versions. Most methodological quality should be promoted, especially measurement error, cross-cultural validity and responsiveness. The IBDQ-32 was the most widely used instrument with good reliability and validity, followed by the SIBDQ and IMPACT-III. Further validation studies are necessary to support the use of other instruments.

Preschoolers' Vocabulary Acquisition in Chile: The Roles of Socioeconomic Status and Quality of Home Environment

ERIC Educational Resources Information Center

Lohndorf, Regina T.; Vermeer, Harriet J.; Cárcamo, Rodrigo A.; Mesman, Judi

2018-01-01

Preschoolers' vocabulary acquisition sets the stage for later reading ability and school achievement. This study examined the role of socioeconomic status (SES) and the quality of the home environment of seventy-seven Chilean majority and Mapuche minority families from low and lower-middle-class backgrounds in explaining individual differences in…

Associations Between Early Family Meal Environment Quality and Later Well-Being in School-Age Children.

PubMed

Harbec, Marie-Josée; Pagani, Linda S

Past research suggests a positive link between family meals and child and adolescent health. Although researchers have often relied on how often families eat together, this may not capture the complexity of the experience. Using a birth cohort, this study examines the prospective associations between the environmental quality of the family meal experience at age 6 years and child well-being at age 10. Participants are 1492 children of the Quebec Longitudinal Study of Child Development. When children were age 6, parents reported on their typical family meal environment quality. At age 10, parents, teachers, and children themselves provided information on lifestyle habits, academic achievement, and social adjustment, respectively. The relationship between early family meal environment quality and later child outcomes was analyzed using a series of multivariate linear regression. Family meal environment quality at age 6 predicted higher levels of general fitness and lower levels of soft drink consumption, physical aggression, oppositional behavior, nonaggressive delinquency, and reactive aggression at age 10. These relationships were adjusted for child characteristics (sex, temperament problems and cognitive abilities, and baseline body mass index [BMI]) and family characteristics (family configuration and functioning, maternal education, depression, and BMI). From a population-health perspective, our findings suggest that family meals have long-term influences on children's biopsychosocial well-being. At a time when family meal frequency is on a natural decline in the population, this environmental characteristic can become a target of home-based interventions and could be featured in information campaigns that aim to optimize child development.

[Neighborhood environment quality, individual-level social capital, and depressive symptoms among adolescents].

PubMed

Asakura, Takashi

2011-09-01

We aimed to develop measures to assess features of neighborhood quality and individual social capital, as well as their associations with depressive symptoms among early adolescents. To determine whether relations of depressive symptoms with neighborhood quality might be contingent upon the level of individual cognitive social capital, neighborhood-by-cognitive social capital interaction terms were examined. A qualitative study was conducted to elicit the perceptions of early adolescents about their neighborhood environment. Subsequently, we recruited 2,002 eighth graders and asked for responses to a self-administered questionnaire. The variables analyzed in this study were the Center for Epidemiologic Studies-Depression scale (10 items), features of neighborhood quality, cognitive and structural individual social capital, and demographics. We adopted a generalized estimating equation regression model for the multivariate analysis. The analytic sample was 1,786 with no missing variable in the models. Seven subscales were devised to assess quality features of neighborhood environments with an examination of validity and reliability: "availability of services," "good neighborhood relations," "spaces for recreation," "insecurity and danger of accidents," "dirty-looking, squalid, unclean," "civic communities," and "aesthetic look." We also developed a scale of individual cognitive social capital, which consisted of three constructs: "social trust," "reciprocity," and "social norms." Additionally, the number of social activities in which subjects participated was counted as an indicator of the structural aspect of individual social capital. On examination with the generalized estimating equation regression model, "availability of services," "insecurity and danger of accidents," "dirty-looking, squalid, unclean," and cognitive social capital were significantly associated with the CES-D scores controlling for demographics. We also found a significant interplay between

Correlates and predictors of obesity-specific quality of life of former participants of a residential intensive lifestyle intervention.

PubMed

Elbe, A-M; Elsborg, P; Dandanell, S; Helge, J W

2018-04-01

The aim of this study was to investigate the relationship between weight loss during and after a unique type of weight loss intervention, namely, a residential intensive lifestyle intervention (ILI), and participants' obesity-specific health-related quality of life (HRQOL) several years after the intervention. In the residential ILI under investigation, participants attended a 10- to 12-week long course away from their daily living environment, namely, at Ubberup Folk High School located in Denmark. A total of 79 former participants (31 male, mean age 36.6; SD = 12.7 years) who had participated in the intervention on average 5.3 (SD = 3.2) years ago were recruited for this study. They completed a questionnaire on weight-related quality of life (IWQOL-lite) and physical activity, as well as measurements of VO 2 max, blood pressure, Homeostatic Model Assessment for Insulin Resistance, waist circumference and hand grip strength. The study results showed that weight change after the end of the intervention could predict HRQOL whereas how much weight they lost during the intervention could not. Furthermore, almost all of the investigated physiological factors were related to participants' current HRQOL. Waist circumference showed relationships with four of the five aspects of HRQOL. Focusing on behavioural change, adhering to improved lifestyle and maintaining weight loss after the end of the intervention seem to be the key not only for cardio-metabolic risk factors but also for sustainable HRQOL.

Pathological motivations for exercise and eating disorder specific health-related quality of life.

PubMed

Cook, Brian; Engel, Scott; Crosby, Ross; Hausenblas, Heather; Wonderlich, Stephen; Mitchell, James

2014-04-01

To examine associations among pathological motivations for exercise with eating disorder (ED) specific health-related quality of life (HRQOL). Survey data assessing ED severity (i.e., Eating Disorder Diagnostic Survey), ED specific HRQOL (i.e., Eating Disorders Quality of Life Instrument), and pathological motivations for exercise (i.e., Exercise Dependence Scale) were collected from female students (N = 387) at seven universities throughout the United States. Regression analyses were conducted to examine the associations among exercise dependence, ED-specific HRQOL and ED severity, and the interaction of exercise dependence and ED severity on HRQOL scores. The overall model examining the impact of ED severity and exercise dependence (independent variables) on HRQOL (dependent variable) was significant and explained 16.1% of the variance in HRQOL scores. Additionally, the main effects for ED severity and exercise dependence and the interaction among ED severity and exercise dependence were significant, suggesting that the combined effects of ED severity and exercise dependence significantly impacts HRQOL. Our results suggest that pathological motivations for exercise may exacerbate ED's detrimental impact on HRQOL. Our results offer one possible insight into why exercise may be associated with deleterious effects on ED HRQOL. Future research is needed to elucidate the relationship among psychological aspects of exercise, ED, and HRQOL. Copyright © 2013 Wiley Periodicals, Inc.

A Methodology for Writing High Quality Requirements Specification and Evaluating Existing Ones

NASA Technical Reports Server (NTRS)

Rosenberg, Linda; Hammer, Theodore

1999-01-01

Requirements development and management have always been critical in the implementation of software systems; engineers are unable to build what analysts can't define. It is generally accepted that the earlier in the life cycle potential risks are identified the easier it is to eliminate or manage the conditions that introduce that risk. Problems that are not found until testing are approximately 14 times more costly to fix than if the problem was found in the requirement phase. The requirements specification, as the first tangible representation of the capability to be produced, establishes the basis for all of the project's engineering management and assurance functions. If the quality of the requirements specification is poor it can give rise to risks in all areas of the project. Recently, automated tools have become available to support requirements management. The use of these tools not only provides support in the definition and tracing of requirements, but it also opens the door to effective use of metrics in characterizing and assessing the quality of the requirement specifications.

Does Scoliosis-Specific Exercise Treatment in Adolescence Alter Adult Quality of Life?

PubMed Central

Płaszewski, Maciej; Cieśliński, Igor; Kowalski, Paweł; Truszczyńska, Aleksandra; Nowobilski, Roman

2014-01-01

Objective. Health-related quality of life in adults, who in adolescence participated in a scoliosis-specific exercise program, was not previously studied. Design. Cross-sectional study, with retrospective data collection. Material and Methods. Homogenous groups of 68 persons (43 women) aged 30.10 (25–39) years, with mild or moderate scoliosis, and 76 (38 women) able-bodied persons, aged 30.11 (24–38) years, who 16.5 (12–26) years earlier had completed scoliosis-specific exercise or observation regimes, participated. Their respiratory characteristics did not differ from predicted values. The WHOQOL-BREF questionnaire, Oswestry Disability Questionnaire, and pain scale (VAS) were applied. Results. The transformed WHOQOL-BREF scores ranged from 54.6 ± 11.19 in the physical domain in the mild scoliotic subgroup to 77.1 ± 16.05 in the social domain in the able-bodied subgroup. The ODQ values did not generally exceed 5.3 ± 7.53. Inter- and intragroup differences were nonsignificant. Age, marital status, education, and gender were significantly associated with the ODQ scores. Significant association between the ODQ and WHOQOL-BREF social relationships domain scores with the participation in exercise treatment was found. Conclusions. Participants with the history of exercise treatment generally did not differ significantly from their peers who were only under observation. This study cannot conclude that scoliosis-specific exercise treatment in adolescence alters quality of life in adulthood. PMID:25436225

Are we on the same page? Staff nurse and manager perceptions of work environment, quality of care and anticipated nurse turnover.

PubMed

Gormley, Denise K

2011-01-01

The purpose was to examine differences in perceptions of work environment and quality of care between nurse managers and staff nurses, and the relationship between nurses' perceptions of the work environment and intention to leave. It is important for managers to understand how staff nurses perceive the work environment as these perceptions may affect nurses' intention to leave the organization. Few studies have examined the perceptions of nurses compared with nurse manager/directors regarding the organizational influences on intention to leave. This study was a cross-sectional, non-experimental design. A total of 336 nurses and managers participated from two Midwestern hospitals. Participants completed the Perceived Nurse Work Environment Scale (PNWE), Anticipated Turnover Scale (ATS), and a researcher developed perception of quality scale. Data were analysed for descriptive statistics, Analysis of Variance, and Pearson's correlation. Significant differences were found between nurses and managers on perceptions of work environment. Managers rated work environment higher than staff on all subscales. Work environment was related to anticipated turnover. Managers and staff nurses are 'not on the same page' in perceptions of work environment. Nurse managers need to understand the organizational influences that may affect nurses' intention to leave. Strategies to improve the work environment are necessary to meet the needs of the staff nurse. © 2010 The Author. Journal compilation © 2010 Blackwell Publishing Ltd.

Computational Investigation of Environment-Noise Interaction in Single-Cell Organisms: The Merit of Expression Stochasticity Depends on the Quality of Environmental Fluctuations.

PubMed

Lück, Anja; Klimmasch, Lukas; Großmann, Peter; Germerodt, Sebastian; Kaleta, Christoph

2018-01-10

Organisms need to adapt to changing environments and they do so by using a broad spectrum of strategies. These strategies include finding the right balance between expressing genes before or when they are needed, and adjusting the degree of noise inherent in gene expression. We investigated the interplay between different nutritional environments and the inhabiting organisms' metabolic and genetic adaptations by applying an evolutionary algorithm to an agent-based model of a concise bacterial metabolism. Our results show that constant environments and rapidly fluctuating environments produce similar adaptations in the organisms, making the predictability of the environment a major factor in determining optimal adaptation. We show that exploitation of expression noise occurs only in some types of fluctuating environment and is strongly dependent on the quality and availability of nutrients: stochasticity is generally detrimental in fluctuating environments and beneficial only at equal periods of nutrient availability and above a threshold environmental richness. Moreover, depending on the availability and nutritional value of nutrients, nutrient-dependent and stochastic expression are both strategies used to deal with environmental changes. Overall, we comprehensively characterize the interplay between the quality and periodicity of an environment and the resulting optimal deterministic and stochastic regulation strategies of nutrient-catabolizing pathways.

A domain-specific compiler for a parallel multiresolution adaptive numerical simulation environment

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

Rajbhandari, Samyam; Kim, Jinsung; Krishnamoorthy, Sriram

This paper describes the design and implementation of a layered domain-specific compiler to support MADNESS---Multiresolution ADaptive Numerical Environment for Scientific Simulation. MADNESS is a high-level software environment for the solution of integral and differential equations in many dimensions, using adaptive and fast harmonic analysis methods with guaranteed precision. MADNESS uses k-d trees to represent spatial functions and implements operators like addition, multiplication, differentiation, and integration on the numerical representation of functions. The MADNESS runtime system provides global namespace support and a task-based execution model including futures. MADNESS is currently deployed on massively parallel supercomputers and has enabled many science advances.more » Due to the highly irregular and statically unpredictable structure of the k-d trees representing the spatial functions encountered in MADNESS applications, only purely runtime approaches to optimization have previously been implemented in the MADNESS framework. This paper describes a layered domain-specific compiler developed to address some performance bottlenecks in MADNESS. The newly developed static compile-time optimizations, in conjunction with the MADNESS runtime support, enable significant performance improvement for the MADNESS framework.« less

Material electronic quality specifications for polycrystalline silicon wafers

NASA Astrophysics Data System (ADS)

Kalejs, J. P.

1994-06-01

As the use of polycrystalline silicon wafers has expanded in the photovoltaic industry, the need grows for monitoring and qualification techniques for as-grown material that can be used to optimize crystal growth and help predict solar cell performance. Particular needs are for obtaining quantitative measures over full wafer areas of the effects of lifetime limiting defects and of the lifetime upgrading taking place during solar cell processing. We review here the approaches being pursued in programs under way to develop material quality specifications for thin Edge-defined Film-fed Growth (EFG) polycrystalline silicon as-grown wafers. These studies involve collaborations between Mobil Solar, and NREL and university-based laboratories.

How does the environment impact on the quality of life of advanced cancer patients? A qualitative study with implications for ward design.

PubMed

Rowlands, J; Noble, S

2008-09-01

It is well recognized that the ward environment has an effect on patients' quality of life and may, therefore, impact on the quality of end of life care. The body of evidence that informs ward design policy recommends single-bedded rooms on grounds of reduced infection risk, noise and versatility. Considering the majority of anticipated patient deaths occurring in hospitals, the quality of life aspects of ward design should also be considered. The aim of this study is to explore the views of patients with advanced cancer on the effect the ward environment has on their overall well-being. Semi-structured interviews exploring the experiences of 12 inpatients at a regional cancer centre were recorded and transcribed verbatim. Transcripts were analysed for emerging themes until theoretical saturation. Four major themes emerged: staff behaviours, the immediate environment, single vs. multi-bedded rooms and contact with the outside environment. The attitude, competence and helpfulness of the staff creates the atmosphere of the ward regardless of layout, furnishings, equipment and décor. The majority of the patients in this study expressed a strong preference for a multi-bedded room when they were well enough to interact and a single cubicle when they were very ill or dying, which opposes the current advice for building new hospitals with all single rooms. Although the current policy recommends the use of single-bedded rooms, this study suggests the need for a mix of multi-bedded wards and single rooms with respect to the impact of the environment on patient quality of life.

Specification of the Surface Charging Environment with SHIELDS

NASA Astrophysics Data System (ADS)

Jordanova, V.; Delzanno, G. L.; Henderson, M. G.; Godinez, H. C.; Jeffery, C. A.; Lawrence, E. C.; Meierbachtol, C.; Moulton, J. D.; Vernon, L.; Woodroffe, J. R.; Brito, T.; Toth, G.; Welling, D. T.; Yu, Y.; Albert, J.; Birn, J.; Borovsky, J.; Denton, M.; Horne, R. B.; Lemon, C.; Markidis, S.; Thomsen, M. F.; Young, S. L.

2016-12-01

Predicting variations in the near-Earth space environment that can lead to spacecraft damage and failure, i.e. "space weather", remains a big space physics challenge. A recently funded project through the Los Alamos National Laboratory (LANL) Directed Research and Development (LDRD) program aims at developing a new capability to understand, model, and predict Space Hazards Induced near Earth by Large Dynamic Storms, the SHIELDS framework. The project goals are to understand the dynamics of the surface charging environment (SCE), the hot (keV) electrons representing the source and seed populations for the radiation belts, on both macro- and microscale. Important physics questions related to rapid particle injection and acceleration associated with magnetospheric storms and substorms as well as plasma waves are investigated. These challenging problems are addressed using a team of world-class experts in the fields of space science and computational plasma physics, and state-of-the-art models and computational facilities. In addition to physics-based models (like RAM-SCB, BATS-R-US, and iPIC3D), new data assimilation techniques employing data from LANL instruments on the Van Allen Probes and geosynchronous satellites are developed. Simulations with the SHIELDS framework of the near-Earth space environment where operational satellites reside are presented. Further model development and the organization of a "Spacecraft Charging Environment Challenge" by the SHIELDS project at LANL in collaboration with the NSF Geospace Environment Modeling (GEM) Workshop and the multi-agency Community Coordinated Modeling Center (CCMC) to assess the accuracy of SCE predictions are discussed.

Childhood quality influences genetic sensitivity to environmental influences across adulthood: A life-course Gene × Environment interaction study.

PubMed

Keers, Robert; Pluess, Michael

2017-12-01

While environmental adversity has been shown to increase risk for psychopathology, individuals differ in their sensitivity to these effects. Both genes and childhood experiences are thought to influence sensitivity to the environment, and these factors may operate synergistically such that the effects of childhood experiences on later sensitivity are greater in individuals who are more genetically sensitive. In line with this hypothesis, several recent studies have reported a significant three-way interaction (Gene × Environment × Environment) between two candidate genes and childhood and adult environment on adult psychopathology. We aimed to replicate and extend these findings in a large, prospective multiwave longitudinal study using a polygenic score of environmental sensitivity and objectively measured childhood and adult material environmental quality. We found evidence for both Environment × Environment and Gene × Environment × Environment effects on psychological distress. Children with a poor-quality material environment were more sensitive to the negative effects of a poor environment as adults, reporting significantly higher psychological distress scores. These effects were further moderated by a polygenic score of environmental sensitivity. Genetically sensitive children were more vulnerable to adversity as adults, if they had experienced a poor childhood environment but were significantly less vulnerable if their childhood environment was positive. These findings are in line with the differential susceptibility hypothesis and suggest that a life course approach is necessary to elucidate the role of Gene × Environment in the development of mental illnesses.

Neighbourhood environment, physical activity, quality of life and depressive symptoms in Hong Kong older adults: a protocol for an observational study

PubMed Central

Cerin, Ester; Sit, Cindy H P; Zhang, Casper J P; Barnett, Anthony; Cheung, Martin M C; Lai, Poh-chin; Johnston, Janice M; Lee, Ruby S Y

2016-01-01

Introduction The neighbourhood environment can assist the adoption and maintenance of an active lifestyle and affect the physical and mental well-being of older adults. The psychosocial and behavioural mechanisms through which the environment may affect physical and mental well-being are currently poorly understood. Aim This observational study aims to examine associations between the physical and social neighbourhood environments, physical activity, quality of life and depressive symptoms in Chinese Hong Kong older adults. Methods and analyses An observational study of the associations of measures of the physical and social neighbourhood environment, and psychosocial factors, with physical activity, quality of life and depressive symptoms in 900 Hong Kong older adults aged 65+ years is being conducted in 2012–2016. The study involves two assessments taken 6 months apart. Neighbourhood walkability and access to destinations are objectively measured using Geographic Information Systems and environmental audits. Demographics, socioeconomic status, walking for different purposes, perceived neighbourhood and home environments, psychosocial factors, health status, social networks, depressive symptoms and quality of life are being assessed using validated interviewer-administered self-report measures and medical records. Physical functionality is being assessed using the Short Physical Performance Battery. Physical activity and sedentary behaviours are also being objectively measured in approximately 45% of participants using accelerometers over a week. Physical activity, sedentary behaviours, quality of life and depressive symptoms are being assessed twice (6 months apart) to examine seasonality effects on behaviours and their associations with quality of life and depressive symptoms. Ethics and dissemination The study received ethical approval from the University of Hong Kong Human Research Ethics Committee for Non-Clinical Faculties (EA270211) and the Department

Acculturation, quality of life and work environment of international nurses in a multi-cultural society: A cross-sectional, correlational study.

PubMed

Goh, Yong-Shian; Lopez, Violeta

2016-05-01

The aim is to examine the acculturation level of international nurses working in a multi-cultural society. The relationship between acculturation, working environment and quality of life of international nurses was also explored. A cross-sectional, correlational study using self-report questionnaire was conducted on 814 international nurses using stratified random sampling based on the nationality distribution of international nurses registered with the Singapore Nursing Board. Outcome measures included World Health Organisation Quality of Life-BREF (WHOQOL_BREF) and Practice Environment Scale of the Nursing Work Index-Revised (PES-NWI-R). Data were collected from June to December 2012. There were variations in the acculturation level among different nationality groups of international nurses. Acculturation levels were the lowest among Mainland Chinese international nurses (M=27.47, SD 5.23). A positive correlation was found between acculturation and quality of life whereas a lower perception of work environment was associated with lower acculturation level. Data obtained from this study can be utilized to develop interventions targeted at the unique needs of the international nurses as they migrate. Copyright © 2015 Elsevier Inc. All rights reserved.

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

PubMed Central

Rappazzo, Kristen; Messer, Lynne C.

2011-01-01

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

Investigations regarding the evaluation of specific intellectual property production risks within Quality Management System

NASA Astrophysics Data System (ADS)

Pakocs, R.; Lupulescu, N. B.

2016-11-01

This paper is a theoretical research concerning methods for risk assessment of specific intellectual property production risks that are identified in the product achievement stage within the Quality Management System. In order to realize this, we will start by identifying the specific intellectual property production risks and by proposing some new calculating formulas for minimalizing their negative effects. The theoretical model proposed assessment of specific intellectual property production risks, will be realized based on 3 hypothetical situations. This study intends to reduce the intellectual property risks identified in the production process of commercial societies that have an industrial profile.

Mental health issues decrease diabetes-specific quality of life independent of glycaemic control and complications: findings from Australia’s living with diabetes cohort study

PubMed Central

2013-01-01

Background While factors associated with health-related quality of life for people with chronic diseases including diabetes are well researched, far fewer studies have investigated measures of disease-specific quality of life. The purpose of this study is to assess the impact of complications and comorbidities on diabetes-specific quality of life in a large population-based cohort of type 2 diabetic patients. Methods The Living with Diabetes Study recruited participants from the National Diabetes Services Scheme in Australia. Data were collected via a mailed self-report questionnaire. Diabetes-specific quality of life was measured using the Audit of Diabetes-Dependent Quality of Life (ADDQoL) questionnaire. The analyses are for 3609 patients with type 2 diabetes. Regression models with adjustment for control variables investigated the association of complications and comorbidities with diabetes-specific quality of life. Next, the most parsimonious model for diabetes-specific quality of life after controlling for important covariates was examined. Results The expected associations with better diabetes-specific quality of life were evident, such as increased income, not on insulin, better glycaemic control and older age. However, being single and having been diagnosed with cancer were also associated with better ADDQoL. Additionally, poorer diabetes-specific quality of life was strongly sensitive to the presence of diabetes complications and mental health conditions such as depression, anxiety and schizophrenia. These relationships persisted after adjustment for gender, age, duration of diabetes, treatment regimen, sampling region and other treatment and socio-demographic variables. Conclusions A greater appreciation of the complexities of diabetes-specific quality of life can help tailor disease management and self-care messages given to patients. Attention to mental health issues may be as important as focusing on glycaemic control and complications. Therefore

Evaluation of ride quality prediction methods for helicopter interior noise and vibration environments

NASA Technical Reports Server (NTRS)

Leatherwood, J. D.; Clevenson, S. A.; Hollenbaugh, D. D.

1984-01-01

The results of a simulator study conducted to compare and validate various ride quality prediction methods for use in assessing passenger/crew ride comfort within helicopters are presented. Included are results quantifying 35 helicopter pilots discomfort responses to helicopter interior noise and vibration typical of routine flights, assessment of various ride quality metrics including the NASA ride comfort model, and examination of possible criteria approaches. Results of the study indicated that crew discomfort results from a complex interaction between vibration and interior noise. Overall measures such as weighted or unweighted root-mean-square acceleration level and A-weighted noise level were not good predictors of discomfort. Accurate prediction required a metric incorporating the interactive effects of both noise and vibration. The best metric for predicting crew comfort to the combined noise and vibration environment was the NASA discomfort index.

[Technological innovations in radiation oncology require specific quality controls].

PubMed

Lenaerts, E; Mathot, M

2014-01-01

During the last decade, the field of radiotherapy has benefited from major technological innovations and continuously improving treatment efficacy, comfort and safety of patients. This mainly concerns the imaging techniques that allow 4D CT scan recording the respiratory phases, on-board imaging on linear accelerators that ensure perfect positioning of the patient for treatment and irradiation techniques that reduce very significantly the duration of treatment sessions without compromising quality of the treatment plan, including IMRT (Intensity Modulated Radiation Therapy) and VMAT (Volumetric Modulated Arc therapy). In this context of rapid technological change, it is the responsibility of medical physicists to regularly and precisely monitor the perfect functioning of new techniques to ensure patient safety. This requires the use of specific quality control equipment best suited to these new techniques. We will briefly describe the measurement system Delta4 used to control individualized treatment plan for each patient treated with VMAT technology.

QLiS--development of a schizophrenia-specific quality-of-life scale.

PubMed

Franz, Michael; Fritz, Michael; Gallhofer, Bernd; Meyer, Thorsten

2012-06-07

The aim of the project was to develop an instrument for the assessment of subjective quality of life specific to schizophrenic persons on the basis of patients' views on their own life and on sound psychometric principles. The project applied a six-step multiphase development process with six distinct studies. (1) The elicitation of schizophrenic persons' views on their quality of life was based on open-ended interviews with interviewees from different settings (acute ward inpatients, long-term care patients, community care patients; n = 268). (2) A cross-sectional study with schizophrenic and healthy persons was conducted to quantify the relative importance of the various aspect of quality of life that emerged from the qualitative study (n = 143). (3) We conducted an empirical comparison of response formats with schizophrenic persons (n = 32). (4) A scale construction- and reliability-testing study was performed (n = 203) as well as (5) a test-retest reliability study (n = 49). (6) The final questionnaire (QLiS, quality of life in schizophrenia) was tested in an additional study on convergent and discriminant validity (n = 135). The QLiS comprises 52 items (plus 2 optional items related to work) in 12 subscales: social contacts, appreciation by others, relationship to family, appraisal of pharmacotherapy, appraisal of psychopathological symptoms, cognitive functioning, abilities to manage daily living, appraisal of accommodation/housing, financial situation, leading a 'normal' life, confidence, general life-satisfaction. An item response format with four response categories was preferred by the schizophrenic persons. The mean values of the subscales clustered around the theoretical mean of the subscales and only minimal ceiling effects were found. The reliability (test-retest-reliability and internal consistency) was with one exception > .70 for all subscales. Taking the low numbers of items per subscale into account, the QLiS can be regarded as an accurate

Game-Based Learning in an OpenSim-Supported Virtual Environment on Perceived Motivational Quality of Learning

ERIC Educational Resources Information Center

Kim, Heesung; Ke, Fengfeng; Paek, Insu

2017-01-01

This experimental study was intended to examine whether game-based learning (GBL) that encompasses four particular game characteristics (challenges, a storyline, immediate rewards and the integration of game-play with learning content) in an OpenSimulator-supported virtual reality learning environment can improve perceived motivational quality of…

Medical Students' Perception of Their Educational Environment and Quality of Life: Is There a Positive Association?

PubMed

Enns, Sylvia Claassen; Perotta, Bruno; Paro, Helena B; Gannam, Silmar; Peleias, Munique; Mayer, Fernanda Brenneisen; Santos, Itamar Souza; Menezes, Marta; Senger, Maria Helena; Barelli, Cristiane; Silveira, Paulo S P; Martins, Milton A; Zen Tempski, Patricia

2016-03-01

To assess perceptions of educational environment of students from 22 Brazilian medical schools and to study the association between these perceptions and quality of life (QoL) measures. The authors performed a multicenter study (August 2011 to August 2012), examining students' views both of (1) educational environment using the Dundee Ready Education Environment Measure (DREEM) and (2) QoL using the World Health Organization Quality of Life Assessment, abbreviated version (WHOQOL-BREF). They also examined students' self-assessment of their overall QoL and medical-school-related QoL (MSQoL). The authors classified participants' perceptions into four quartiles according to DREEM total score, overall QoL, and MSQoL. Of 1,650 randomly selected students, 1,350 (81.8%) completed the study. The mean total DREEM score was 119.4 (standard deviation = 27.1). Higher total DREEM scores were associated with higher overall QoL and MSQoL scores (P < .001 for all comparisons) and younger ages (P < .001). Mean overall QoL scores were higher than MSQoL scores (mean difference, 1.35; 95% confidence interval [CI] 1.28-1.43; P < .001). Multinomial regression models showed significant dose-response patterns: Higher DREEM quartile scores were associated with better QoL. The psychological health domain of WHOQOL-BREF was most closely associated with DREEM scores (odds ratio 4.70; 95% CI = 3.80-5.81). The authors observed a positive association between QoL measures and DREEM scores. This association had a dose-response effect, independent of age, sex, and year of medical training, showing that educational environment appears to be an important moderator of medical student QoL.